树突状细胞体外激活的CTL杀伤效应

目的 :研究树突状细胞 (dendriticcell,DC)激活的肿瘤特异性细胞毒性T淋巴细胞 (CTL)的特异性杀伤效应。方法 :从人外周血中分离出外周血单个核细胞 (peripheralbloodmononuclearcell,PBMC) ,在GM -CSF和IL - 4的作用下培养 7天诱导出DC ,然后PBMC或DC为刺激细胞在体外诱导出HBsAg特异性CTL ;在调节好一定浓度靶细胞 (人肝癌细胞系HepG2及人肺腺癌细胞系A5 4 9)中加入效应细胞 (DC或PBMC) ,4 8h后瑞氏染色计数残存细胞数 ,计算杀伤率。结果 :DC激活的CTL对HepG2 杀伤率为 71.6 % ,而PBMC(APC ,非T细胞 )激活的CTL杀伤率为 4 3.8% ,两者有显著性差异 ,P <0 .0 1。此外 ,DC诱导的肝癌细胞抗原特异性CTL对肺癌细胞的杀伤率仅为 2 3%。结论 :DC诱导的CTL比PBMC高效 ,而且具有较高的特异性。     

鼻咽癌可溶性抗原负载DC诱导CTL杀伤鼻咽癌细胞的体外研究

目的：用负载鼻咽癌细胞(CNE)可溶性抗原的树突状细胞(dendritic cells，DC)诱导自身淋巴细胞，使之活化为鼻咽癌(nasopharyngeal carcinoma，NPC)特异性细胞毒性T细胞(cvtotoxic T lymphocyte，CTL)，观察其对鼻咽癌细胞的体外特异性杀伤作用。方法：用GM-CSF、IL-4和TNF-α体外诱导健康成人外周血单核细胞，使其分化为高纯度DC。用鼻咽癌细胞(CNE)可溶性抗原负载成熟DC，流式细胞仪检测负载前后DC的表型特征，MLR检测负载前后DC对同种异体T淋巴细胞增殖的能力。在白细胞介素-2(IL-2)的作用下，用负载鼻咽癌细胞可溶性抗原的DC诱导自身淋巴细胞成NPC特异性CTL，通过杀伤活性实验观察它对鼻咽癌细胞(CNE)的特异性杀伤效应。结果：人外周血单核细胞体外在GM-CSF、IL-4、TNF-α诱导下获得具典型表型特征的成熟DC。负载CNE可溶性抗原对成熟DC表面共刺激分子及特异性表面标志无影响，仍有较强的刺激同种异体淋巴细胞增殖能力，所诱导的CTL对鼻咽癌细胞(CNE)有明显的特异性杀伤作用。结论：负载鼻咽癌细胞(CNE)可溶性抗原的DC所诱导的CTL在体外对鼻咽癌细胞有特异性杀伤作用，对NPC的临床治疗有潜在的应用价值。     

抗原致敏树突状细胞诱导CTL对MCF-7细胞的体外杀伤效应

目的:采用MCF-7乳腺癌细胞裂解物致敏树突状细胞(DC),观察其体外诱导人T淋巴细胞产生特异性抗乳腺癌免疫的效能。方法:联合应用细胞因子从外周血单个核细胞(PBMC)中诱导出DC,体外负载MCF-7细胞冻融抗原,活化自身T淋巴细胞,采用ELISA法测定γ-干扰素(IFN-γ)、白介素-12(IL-12)水平,乳酸脱氢酶释放法检测细胞毒性T淋巴细胞(CTL)对MCF-7细胞的杀伤效应。结果:负载抗原DC与T淋巴细胞共培养产生IFN-γI、L-12的水平,显著高于未负载抗原DC组(P<0.05)、单纯抗原组(P<0.01)和对照组(P<0.01);负载抗原DC诱导CTL对MCF-7的杀伤效应,显著高于其他3组(P<0.01)。结论:MCF-7细胞裂解物致敏DC诱导的人CTL,对MCF-7细胞具有明显的特异性杀伤效应。     

K-ras(12-Val)树突状细胞疫苗诱导抗胰腺癌免疫反应

目的探讨构建K-ras（12-Val）树突状细胞（DC）疫苗体外诱导抗胰腺癌特异性免疫反应的可行性。方法采用健康人外周人单核细胞（PBMC）体外刺激分化的DC,负载K-ras（12-Val）多肽后诱导成熟,流式细胞仪测定其细胞表型;与PBMC混合培养扩增特异性细胞毒性T淋巴细胞（CTL）,MTT法测定CTL对胰腺癌细胞和正常细胞的免疫杀伤活性。结果负载K-ras（12-Val）多肽的DC成熟后能较好表达突变位点并能有效地刺激T淋巴细胞活化,其诱导产生的CTL对表达该突变的胰腺癌细胞有较好的免疫杀伤作用,对正常组织无损伤作用。结论利用K-ras（12-Val）DC疫苗能成功诱导出较强的抗胰腺癌免疫反应,且具有高度特异性。     

树突状细胞对肿瘤特异性CTL体外激发、扩增及功能的作用研究

目的:研究凋亡肿瘤细胞负载的DCs联合细胞因子对T细胞体外激发、扩增及功能的诱导作用。方法:人B淋巴瘤细胞株Raji经顺铂(DDP)诱导凋亡，体外共育法负载DCS，DCs和T细胞体外共培养观察DC5对T细胞的效应，采用免疫荧光标记和流式细胞仪分析T细胞表型：ELISA法检测细胞培养上清中细胞因子IFN-γ、IL-10的含量；溶血实验检测细胞毒性T细胞(CTL)产生穿孔素的能力；体外肿瘤杀伤实验分析CTL的特异性肿瘤杀伤作用。结果：凋亡肿瘤细胞负载联合CD40激发的DCs能有效地激发自体T细胞的体外扩增并诱导具有较特异杀伤肿瘤细胞作用的CTL。结论：凋亡肿瘤细胞负载的DCS在CD40信号的作用下对自体T细胞具有较强的激发和扩增效应．所获得的CTL对肿瘤细胞具有较特异的杀伤作用。     

MAGE-A3抗原肽负载树突状细胞诱导乳腺癌患者免疫应答的研究

目的研究MAGE-A3抗原肽负载对乳腺癌患者树突状细胞(DC)的功能的影响,探讨其是否可以在体外诱导特异性细胞毒性T淋巴细胞(CTL)应答.方法体外培养HLA-A2乳腺癌患者外周血来源的DC,并经孵育携带MAGE-A3抗原肽,用以刺激CTL,用3H-TdR渗入法检测抗原肽负载前后DC刺激同种淋巴细胞增殖能力(MLR),并用乳酸脱氢酶(LDH)释放法检测CTL对靶细胞的杀伤效应.结果DC:T为1:10时,单纯DC组刺激能力显著高于抗原肽负载组DC(DC-P)(P＜0.05),但当DC:T低于1:20时后DC-P组刺激能力显著强于单纯DC组(P＜0.05).DC-P组和单纯DC组所激发的CTL对细胞株MCF-7,Sk-Br-3,MDA-MB-435s的杀伤活性有显著性差异,而对细胞株Raji无显著性差异,DC-P组对细胞株MCF-7,Sk-Br-3,MDA-MB-435s的杀伤活性明显高于对细胞株Raji的杀伤活性.结论负载MAGE-A3抗原肽的DC在体外可以诱导乳腺癌患者特异性的CTL免疫应答,为临床以DC为基础的过继免疫治疗的应用提供理论基础.     

WT1多肽特异性T细胞受体基因转导正常T细胞的抗肺癌效应

目的 通过基因转导技术获得WT1多肽特异性TCR基因转导的正常外周CD8+T细胞,检测其对肺癌细胞的杀伤活性,探讨TCR基因转导用于过继性细胞治疗肺癌的可行性及安全性.方法 通过克隆HLA-A*2402限制性WT1特异性细胞毒性T细胞(CTL)之TCR基因,经构建逆转录病毒载体后转导WT1-TCR基因至正常外周CD8+T细胞;所获得的CD8+T细胞对靶细胞的杀伤效应经标准51Cr释放试验测定.结果 WT1-TCR基因转导后的正常外周CD8+T细胞显示出对WT1多肽负载的HLA-A*2402+LCL细胞的特异性杀伤作用,同时TCR基因改造后的CD8+T细胞可特异性杀伤HLA-A*2402及WT1表达阳性的肺癌细胞株而不对HLA-A*2402表达阳性的正常细胞产生杀伤作用.结论 这些数据论证了WT1-TCR基因转导正常外周T细胞具有与亲代CTL一致的特异性杀伤特性,提示该方法用于过继性细胞免疫疗法治疗肺癌具有可行性.     

脐静脉内皮细胞诱导脐血单个核细胞向树突状细胞的分化

目的探讨人脐静脉内皮细胞对人脐血单个核细胞(UBMCs)向树突状细胞(DC)分化的影响,建立更便捷、更经济体外培养DC的方法。方法胶原酶消化分离出脐静脉内皮细胞(HUVEC),经鉴定和体外培养扩增后,使其平铺生长于Tran-swell板上室底部,将UBMCs接种到Transwell小室内,同时加入EC9706细胞冻融形成的蛋白质抗原,与HUVEC共培养,使UBMCs与HUVEC紧密接触并从Transwell板上室迁移到下室,收集Transwell板下室细胞,流式细胞术检测下室细胞DC相关表面标志CD80、CD40、CD83、CD1a和MHC分子;通过MTT法检测肿瘤负载的UBDC诱导CTL对靶细胞的特异性杀伤作用。结果经HUVEC诱导并负载了肿瘤细胞抗原的DC CD80、CD40、CD83、CD1a和MHC-Ⅱ类分子表达增加,产生的细胞毒性T细胞(CTL)可特异性杀伤食管癌细胞EC9706;与细胞因子诱导DC活化的CTL对EC9706的杀伤率比较差异无统计学意义(P>0.05)。结论利用Transwell小室以人原代脐静脉内皮细胞诱导脐血单个核细胞分化的DC是可行的一种实验方法。     

肺癌可溶性抗原致敏的DC诱导CTL特异性杀伤肺癌细胞的实验研究

目的 通过对负载人肺癌GLC-82细胞可溶性抗原的树突状细胞（DC）体外诱导特异性细胞毒T淋巴细胞（CTL）对肺癌细胞的杀伤研究，为以DC为基础的肺癌免疫瘤苗的临床应用提供一定的实验依据。方法 通过用3MKCl提取法和弱酸洗脱法获得人肺腺癌细胞GLC-82的可溶性抗原多肽，用GLC-82细胞抗原多肽冲击致敏从人外周血单核细胞（PBMC）中用GM-CSF、IL-4和TNF—α体外诱导扩增并经鉴定的DC；利用负载GLC～82细胞抗原多肽的DC，刺激同种异体外周血T淋巴细胞活化增殖，诱导产生具有识别肺癌细胞抗原的特异性CTL；进一步探讨该CTL对GLC-82，肺癌CALU-6和人红白血病K562细胞的体外杀伤效应。结果 人PBMC体外经7d诱导出的DC，经光镜、电镜、免疫组化证实具有典型的树突状细胞特性；经GLC-82抗原致敏的DC诱导同种异体T淋巴细胞活化增殖产生CTL，诱导激活的CTL与靶细胞共育时镜下发现CTL靠近并聚集在肿瘤细胞周围，致使肿瘤细胞发生凋亡和坏死。结论肺癌可溶性蛋白抗原能活化致敏DC，无需明确肿瘤特异抗原，获取方法简便可行；联合应用GM—CSF、IL-4和TNF—α诱导人PBMC中的单核细胞，能诱导出功能较强的DC；致敏DC能强烈刺激初始型同种异体T淋巴细胞增殖产生CD8^＋表达增加的CTL;激活的CTL对肺癌靶细胞发挥高效而特异的细胞毒效应，对非肺组织瘤靶细胞也具有非特异性杀伤效应。     

肿瘤抗原致敏的树突状细胞诱导特异性抗膀胱癌作用的研究

目的 研究不同肿瘤抗原提取物致敏的树突状细胞(DC)诱导特异性体外杀伤膀胱癌细胞的作用.方法 反复冻融法和弱酸洗脱法分别获取膀胱癌细胞株BIU-87肿瘤抗原;联合应用重组人的GM-CSF、IL-4和TNF-α体外诱导健康志愿者DC并分别负载膀胱癌肿瘤抗原,进而激活T淋巴细胞;用MTT法检测其对BIU-87体外杀伤效应.结果 用枸橼酸一磷酸盐缓冲液洗脱或反复冻融BIU-87(1×107)后获得的肿瘤抗原蛋白含量分别为(426.0±4.3)μg和(681.0±5.6)μg;外周血单个核细胞可培养出DC;负载两种膀胱癌细胞抗原的DC致敏的CTL对BIU-87有明显的杀伤作用,而且负载酸洗脱肿瘤抗原肽的树突状细胞致敏的特异性CTL有更明显的杀伤作用(P＜0.05).结论 弱酸洗脱和反复冻融都可以有效获取膀胱肿瘤抗原;以上法致敏的DC均可以高效活化CTL.后者对膀胱癌细胞株发挥特异性杀伤作用,而且弱酸洗脱组可以更为有效杀伤膀胱癌细胞,为以DC为基础的膀胱癌免疫瘤苗的临床应用提供一定的实验依据.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…