CHC患者外周血T细胞免疫功能与丙型肝炎病毒表达的关系

目的 探讨慢性丙型肝炎(CHC)患者外周血T细胞免疫功能与丙型肝炎病毒(HCV)复制及核心抗原(HCV-cAg)表达的关系.方法 采用流式细胞术、荧光定量PCR和ELISA对63例健康体检者(对照组)和85例CHC患者(CHC组)的外周血T淋巴细胞亚群、血清HCV-RNA和HCV-cAg进行测定.结果 CHC组总T细胞、T4细胞、T8细胞、双阴性细胞(DNT )、双阳性细胞(DPT )水平依次为(67 .37 ± 10 .43)% 、(37 .11 ± 10 .28)% 、(21 .63 ± 8 .87)% 、(7 .80 ± 4 .57)% 、(0 .20 ± 0 .29)% ,T4/T8比值为(2 .18 ± 1 .26 )% ,绝对水平依次为(0 .70 ± 0 .44 ) × 109/L、(0 .37 ± 0 .22 ) × 109/L、(0 .22 ± 0 .17 ) × 109/L、(0 .08 ± 0 .06 ) × 109/L和(0 .19 ± 0 .68)× 107/L ;CHC患者T8细胞水平显著减少(P＜0 .01) ,致使T4/T8比值升高(P＜0 .05);CHC患者总T细胞、T4细胞、T8细胞和DNT的绝对值均显著减少(P＜0 .05);HCV-RNA和 HCV-cAg阳性时 ,T4细胞和DNT 水平显著升高(P＜0 .05).结论 CHC患者 HCV复制表达时 ,患者 T细胞亚群存在明显异常 ,T细胞免疫功能低下或免疫耐受是CHC迁延难愈的重要原因.     

Multilocus typing and population structure of Cryptosporidium from children in Zaragoza,Spain

A multilocus typing approach with eight variable-number tandem-repeat (VNTR) loci and the GP60 gene was used to analyze the inter- and intra-species variation of 44 Cryptosporidium isolates from pediatric patients in Zaragoza city (NE, Spain). Restriction and sequence analyses of the SSU rRNA gene revealed that Cryptosporidium transmission is mostly anthroponotic in this area, with the predominance of Cryptosporidium hominis (n: 41) over Cryptosporidium parvum (n: 3). GP60 subtyping showed limited genetic diversity and four subtypes were identified, including IbA10G2 (n: 35), IaA24R3 (n: 6), IIaA15G1R1 (n: 1) and IIaA15G2R1 (n: 2). Five out of eight VNTR loci showed a discriminatory power higher than the GP60 gene, although each locus had a predominant allele exhibited by more than 50% of isolates. All but four alleles were associated to either C. hominis or C. parvum and linked alleles at different loci were found. Multilocus typing substantially increased the discriminatory power (Hunter–Gaston index: 0.807, 95% CI, 0.683–0.926) and revealed that genetic diversity is much higher than that reported by GP60 sequencing, since 17 multilocus subtypes (MLTs) were identified. Nearly half of the specimens were allocated to a single major MLT. However, no more than three specimens were allocated to each of the remaining MLTs. Both phylogenetic and population analyses revealed a population clustering of C. hominis according to the GP60 subtype, which indicates the robustness of this marker to differentiate genetic subpopulations. Subpopulations had an overall clonal genetic structure, although traces of genetic flow between them were also observed.     

3种类型布-加综合征的临床特点分析

[目的]探讨3种类型布-加综合征的临床特征。[方法]回顾性分析3种类型共57例布-加综合征患者的临床资料,对其临床表现、实验室生化检查结果及影像学结果等进行比较。[结果]57例中男38例,女19例,发病率男女之比为2∶1。3种类型中以下腔静脉型最多26例(45.6%)、肝静脉型14例(24.6%)、混合型17例(29.8%);肝静脉型平均起病年龄小于其他2种类型(均P<0.01)。临床表现以腹胀、腹水、乏力最为常见,肝静脉型出现上述症状较其他2型更为常见(P<0.05~P<0.01)。肝静脉型肝功能损伤较其他类型严重(P<0.05~P<0.01),下腔静脉型与混合型肝功能指标比较无明显差异(P>0.05)。CT影像学结果显示,肝静脉型的增强CT影像学更易出现肝脏形态学改变,如肝脏肿大、肝脏密度不均等。混合型的CT增强影像学表现介于肝静脉型和下腔静脉型之间。[结论]当布-加综合征累及不同血管时,其临床表现也有一定差异,通过统计分析,总结布-加综合征不同类型的临床特点,有利于提高人们对该病的认识和诊断水平。     

冠状动脉粥样硬化性心脏病患者T淋巴细胞亚群的变化及意义

目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者外周血T淋巴细胞亚群数量和比例变化特征及意义。方法入选2016年1月至2018年12月南京医科大学附属南京医院254例冠心病患者,其中急性心肌梗死80例、不稳定型心绞痛84例和稳定型心绞痛90例,另外选择同期79例胸痛综合征患者设为对照组。流式细胞分析法检测各组患者总T淋巴细胞(CD3⁺淋巴细胞)和T淋巴细胞亚群(CD4⁺和CD8⁺淋巴细胞)数量。结果与对照组患者比较,急性心肌梗死组患者的CD3⁺(P<0.05)和CD8⁺(P<0.01)淋巴细胞数量明显升高,CD4⁺淋巴细胞数量显著减少(P<0.05),CD4⁺与CD8⁺淋巴细胞比值(CD4⁺/CD8⁺)明显下降(P<0.01),差异均有统计学意义;不稳定型心绞痛组患者的CD3⁺和CD4⁺淋巴细胞数量显著增加(P<0.05),CD4⁺/CD8⁺明显升高(P<0.05),差异有统计学意义;稳定型心绞痛组T淋巴细胞数量及比例未见明显差异(P>0.05)。结论在冠心病的发生和发展过程中伴随着T淋巴细胞亚群水平变化,这些T淋巴细胞亚群水平变化可能与不稳定的冠状动脉粥样斑块形成有关。     

Optimisation of HLA-B27 Testing by Association of Flow Cytometry and DNA Typing

HLA-B27 typing contributes to the diagnosis of ankylosing spondylitis. The classical technique of microlymphocytotoxicity is costly and can give false-negative results. We have compared 304 samples using two relatively new methods – flow cytometry and PCR-SSP – and evaluated their respective uses in routine analysis. Flow cytometric HLA-B27 testing was performed using three monoclonal anti-B27 antibodies (HLA-ABC-m³, GS145.2 and FD705 clones). Cut-off values were established to differentiate HLA-B27-positive from HLA-B27-negative samples with ROC curves. Although flow cytometric analysis with a reliable monoclonal antibody (mAb) is valuable for HLA screening, none of the HLA-B27 flow cytometry protocols was sufficient on its own to ascertain the HLA phenotype in 100% of samples. Two false negatives were observed with the FD705 mAb and the use of two different monoclonal antibodies did not increase the accuracy of HLA-B27 typing. HLA-B27 typing using molecular biology is a reliable but costly technique. Therefore we suggest that DNA typing could be used as a complementary technique and applied to samples whose HLA-B27 phenotype cannot be determined by flow cytometry. The association of flow cytometry and DNA typing is, in our experience, an economical and reliable approach. Received: 12 February 1998 / Accepted: 13 July 1998     

老年脑梗塞患者外周血T细胞亚群的变化

本文运用单克隆抗体直接免疫荧光染色法测定３１例老年急性脑梗塞患者急性期外周血Ｔ细胞亚群ＯＫＴ系列，包括ＯＫＴ３、ＯＫＴ４、ＯＫＴ８及ＯＫＴ４／ＯＫＴ８比值，并与正常老年人进行了对照，结果发现老年急性脑梗塞患者ＯＫＴ３、ＯＫＴ４降低，ＯＫＴ８增高，ＯＫＴ４／ＯＫＴ８比值降低，与正常老年人相比，有非常显著差异。表明老年急性脑梗塞患者存在明显的Ｔ细胞免疫功能的异常。     

湖北省血吸虫病不同亚型流行区抽样调查病情对比分析

目的 掌握全省血吸虫病不同亚型流行区病情动态，评价防治效果，为制定防治规划提供科学依据。方法 以行政村为单位．采用分层整群随机抽样法，于1989、1995、2001三个年度分别对人、畜进行血吸虫粪检查病，用EXCELL建立数据库，SAS统计分析。结果 3次抽样调查中，不同亚型流行区人群和耕牛感染率总体呈下降趋势，但病人和人群感染度(EPG)均呈上升趋势。洲滩、垸内地区居民感染率和EPG男性高于女性，但丘陵地区女性高于男性；各亚型流行区30-岁以上的年龄组人群感染率和EPG较高。2001年洲滩、丘陵地区人群感染率和EPG最高的职业是农民，垸内地区是渔民。结论 3次抽样调查结果显示，虽然全省人群和耕牛感染率总体呈下降趋势，但不同亚型流行区的病人和人群EPG均呈上升趋势。因此，防治工作需针对不同亚型地区的流行特点，因地制宜，加大力度。巩固血防成果。     

高效抗逆转录病毒治疗15例人类免疫缺陷病毒感染者一年总结

目的 首次报道我国于1999年5月开始对人类免疫缺陷病毒（HIV）－1感染者的规范化高效抗逆转录病毒治疗。方法 用齐多夫定＋拉米夫定（AZT＋3TC,商品名：双汰芝）联合硫酸茚地那韦（indinavir,商品名：佳息患）对15例HIV感染或艾滋病患者进行为期1年的治疗。随访指标为病毒载量和T淋巴细胞亚群分析。结果 15例随访1年,用药3个月后HIV－1 RNA平均值至198拷贝／ml,比治疗前的90743RNA拷贝／ml下降2.7log。用药后12个月CD4细胞计数平均增加67个／μl,CD8细胞计数平均减少192个／μl,CD4／CD8比例从0．35增加到0．56,15例中2例未作T淋巴细胞亚群分类,13例治疗后3、6、9、12个月CD4^ 童贞细胞（CD45RA＋CD62L＋）数呈现平稳上升趋势,在治疗1年时平均升高42个／μl。而CD8^ 童贞细胞（CD45RA＋CD62L＋）数平均升高19个/μl。所有患者用药后出现消化道反应,3例出现一过性黄疸,2例出现泌尿系结石。结论 与国外临床报道的治疗效果相一致,15例HIV－1不同阶段感染者经治疗后病毒载量水平明显降低,CD4平均细胞数有所增加,在具有不同病毒基因亚型的病例显示同样的治疗效果。