COPD急性发作期患者外周血IL-35、hs-CRP检测及临床意义

目的 观察慢性阻塞性肺疾病急性发作期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)患者外周血IL-35、hs-CRP水平,并探讨其临床意义。 方法 80例COPD患者分为急性发作期组(A组,n=49)和稳定期组(B组,n=31),同期健康体检者25名为对照者(C组,n=25)。ELISA法检测3组外周血清IL-35表达;检测3组外周血清hs-CRP。 结果COPD患者B组、A组外周血清IL-35表达水平分别为(4.171±1.339)ng/ml、(3.480±1.790)ng/ml,与对照组[(5.194±1.595)ng/ml]相比,差异有统计学意义(P<0.05);B组与A组相比,差异无统计学意义(P>0.05)。A组患者血清hs-CRP水平[(61.143±30.024)mg/L]明显高于B组和C组[(12.161±4.495mg/L、(1.075±0.855)mg/L],差异有统计学意义(P<0.05)。A组外周血清IL-35与hs-CRP呈负相关性(r=-0.349,P=0.014),B组无负相关(r=-0.237,P=0.199)。 结论 AECOPD患者外周血清IL-35低表达及hs-CRP高表达,两者联合检测可作为临床诊断AECOPD的辅助指标。     

紫杉醇对人树突状细胞的生物活性的影响

目的 探讨常用化疗药物紫杉醇（TAX）对人树突状细胞（DC）生物活性的影响及作用机制,为化疗联合生物免疫治疗抗肿瘤提供理论基础.方法 体外实验：分别在紫杉醇5 ng/mL（b组）、10 ng/mL（c组）、20 ng/mL（d组）、40 ng/mL（e组）的浓度下及不加紫杉醇的条件下（a组）培养DC细胞,检测各组DC细胞的存活率、细胞成熟标志物及细胞因子分泌量,探究紫杉醇对人树突状细胞生物活性的影响,同时通过乳酸脱氢酶释放法（LDH）测定与紫杉醇处理的树突细胞共培养的细胞因子诱导的杀伤细胞（CIK）对肺癌A549细胞株的杀伤作用,测定紫杉醇对树突细胞抗原呈递作用的影响.体内实验：采用人肺癌细胞株A549的肿瘤组织块,皮下接种于裸鼠腋下,建立裸鼠肺癌模型.2d后将30只裸鼠随机分成5组,分别为A组（对照组）：细胞株A549＋盐水（NS）;B组：细胞株A549＋DC＋CIK;C组：细胞株A549＋CIK＋TAX;D组：细胞株A549＋TAX;E组：细胞株A549＋TAX＋DC＋CIK.每3天检测1次肿瘤大小、裸鼠存活时间.结果 体外实验：在共培养6d的前提下,b、c组第6天存活率与第0天存活率比较,差异无统计学意义（P＞0.05）,d、e组第6天存活率与第0天存活率比较,差异有高度统计学意义（P＜0.01）,e组存活率仅为17.5％.c组和e组CD86、CD40、MHCⅡ的表达以及IL-12的分泌与正常组相比有显著增加（P＜0.05）,d组除了CD86,其他检测指标较正常组差异均有统计学意义,b组中只有MHCⅡ较正常组差异有统计学意义,经10 ng/mL紫杉醇处理的细胞在效靶比5∶1和10∶1的情况下,杀伤效果明显高于未经紫杉醇处理的细胞.其中紫杉醇处理组的细胞在效靶比为10∶1的情况下,杀伤活性已经到达（91.37±5.24）％.体内实验：B、C、D、E组的平均存活时间分别为33.0、34.0、31.8、41.8 d,明显高于对照A组（23.8 d）（P＜ 0.05）.E组平均存活时间大于41.8 d,明显高于B、C、D组（P＜ 0.01）,其中E组中,45 d仍有3只存活,D组在前25 d体现出较好的治疗效果,但是25 d后瘤体增长速度增加,与B组差异无统计学意义.结论 低中浓度的紫杉醇可促进树突状细胞的成熟并提高其抗原呈递能力.高浓度紫杉醇可杀死树突状细胞,抑制其免疫活性.中浓度紫杉醇能促进树突状细胞分泌白介素12.紫杉醇、DC、CIK联合应用可提高荷瘤裸鼠生存时间.     

Maxillary sinus floor elevation using a tissue engineered bone complex with BMP-2 gene modified bMSCs and a novel porous ceramic scaffold in rabbits

Objectives

To study the effects of maxillary sinus floor elevation by a tissue engineered bone complex with bone morphogenetic protein-2 (BMP-2) gene modified bone marrow stromal cells (bMSCs) and a novel porous ceramic scaffold (OsteoBone™) in rabbits.

Materials and methods

bMSCs derived from New Zealand rabbit bone marrow were cultured and transduced with adenovirus AdBMP-2 and with AdEGFP gene (without BMP-2 gene sequence) as a control, respectively, in vitro. These bMSCs were then combined with OsteoBone™ scaffold at a concentration of 2 × 10⁷ cells/ml and used to elevate the maxillary sinus floor in rabbits. Eight rabbits were randomly allocated into groups and sacrificed at weeks 2 and 4. For each time point, 8 maxillary sinus floor elevation surgeries were made bilaterally in 4 rabbits for the two groups (n = 4 per group): group A (AdBMP-2-bMSCs/material) and group B (AdEGFP-bMSCs/material). All samples were evaluated by histologic and histomorphometric analysis.

Results

The augmented maxillary sinus height was maintained for both groups over the entire experimental period, while new bone area increased over time for group A. At week 4 after operation, bone area in group A was significantly more than that in group B (P < 0.05), and was more obviously detected in the center of the elevated space. Under a confocal microscope, green fluorescence in newly formed bone was observed in the EGFP group, which suggests that those implanted bMSCs had contributed to the new bone formation.

Conclusion

bMSCs modified with AdBMP-2 gene can promote new bone formation in elevating the rabbit maxillary sinus. OsteoBone™ scaffold could be an ideal carrier for gene enhanced bone tissue engineering.     

经阴道超声进行妇科普查的临床价值

目的分析经阴道超声检查在妇科普查中的临床价值。方法回顾性分析2008年至2010年期间10230例的年龄在28岁至65岁的妇女进行阴道超声妇科普查的情况。结果 10230例妇女中检出妇科疾病的共有2530例,5例早孕。结论在妇科普查中应用阴道超声检出妇科疾病是有效可行的。     

斑点免疫金渗滤法定量测定血清淀粉样蛋白A方法的建立及性能评估

目的建立斑点免疫金渗滤法（DIGFA）定量测定血清淀粉样蛋白A（SAA）并评估其分析性能。方法选用2株商品化抗SAA单克隆抗体，分别结合于硝酸纤维素膜和胶体金，制备免疫金渗滤试剂板条（SAA—DOT）以定量检测SAA。按照EP文件，评估SAA—DOT的分析性能（检测限、精密度、准确性、线性范围等）。结果SAA—DOT最低检测限为5mg／L；10和100mg／L的批内变异系数（CV）分别为9．07％和10．21％，天间CV分别为11．33％和11．53％；线性范围为5—230mg／L；SAA—DOT的测定结果与商品化乳胶增强速率散射比浊法（LERN）试剂具有良好的相关性（r=0．995，P〈0．05）。表观健康者血清SAA浓度中位数为5．7mg／L，95％可信区间为0—9．6mg／L。结论基于DIGFA的SAA-DOT简便、快速，能在5min内完成检测，各项分析性能指标达到国家食品药品监督管理局（SFDA）对体外诊断试剂的要求，可用于临床患者血清标本的检测。     

吲哚查尔酮衍生物FC58的抗白血病多药耐药活性研究

目的 合成吲哚查尔酮衍生物FC58,考察其对白血病细胞的抑制活性。方法 以3,4,5-三甲氧基苯乙酮和吲哚-3-甲醛为原料,经羟醛缩合得到目标化合物。采用CellTiter-Blue法测试体外抗肿瘤活性,并通过细胞周期实验分析其作用特点。结果 FC58对多种白血病细胞均有较强活性,活性抗耐药指数远高于传统微管蛋白抑制剂紫杉醇、长春碱和多柔比星,并使细胞周期停滞在G2/M期。结论 FC58是一个极具潜力的抗耐药白血病的先导化合物。     

Visible-light-induced aerobic C3–H fluoroalkoxylation of quinoxalin-2(1H)-ones with fluoroalkyl alcohols

A novel and efficient method of visible-light-induced C3–H fluoroalkoxylation of quinoxalin-2(1H)-ones with fluoroalkyl alcohols is developed. This approach uses readily available fluoroalkyl alcohols as fluoroalkoxylation reagents and displays a wide substrate scope, providing the fluoroalkoxylated products in moderate to good yields. Compared with the previous method, such a transformation uses oxygen as an oxidant, which avoids the utilization of plenty of PhI(TFA)₂. In addition, this strategy also gives a practical tool for the rapid synthesis of histamine-4 receptor antagonist and new N-containing bidentate ligands. A radical mechanism was suggested according to the results of control experiments.

A visible-light-induced aerobic C3–H fluoroalkoxylation of quinoxalin-2(1H)-ones with fluoroalkyl alcohols was reported, providing a green access to fluoroalkoxylated quinoxalin-2(1H)-ones.     

胸膜侵犯程度对肺癌手术治疗患者预后的影响

目的研究胸膜侵犯(VPI)程度对肺癌手术治疗患者预后的影响。方法回顾性分析2012年1月至2014年12月上海交通大学附属瑞金医院收治的接受根治性手术切除的100例肺癌患者的临床病例资料,根据VPI程度分为PL0组(n=40)、PL1组(n=38)、PL2组(n=22) 3级。比较不同程度的VPI组患者的临床病理特点,采用COX比例风险模型分析预后的危险因素,采用Kaplan-Meier法进行生存分析,组间比较采用Log-rank检验。结果肺癌手术治疗患者TNM分期、T分期及肿瘤直径、淋巴结转移与VPI程度显著相关(P <0. 05);单因素分析显示,年龄、TNM分期、T分期、肿瘤直径、淋巴结转移、VPI程度与肺癌手术治疗患者的预后相关(P <0. 05);多因素分析显示,年龄、TNM分期、肿瘤直径、VPI程度是肺癌手术治疗患者预后的独立危险因素(P <0. 05)。Kaplan-Meier法进行生存分析显示,患者的平均总生存时间(OS)、无病生存时间(DFS)分别为31. 8个月(95%CI:29. 7~33. 9)、23. 3个月(95%CI:21. 3~25. 4),随着VPI程度的增加,患者OS、DFS均显著缩短(χ~2=52. 61,64. 46,P <0. 05)。结论 VPI程度与肺癌肿瘤TNM分期具有良好的相关性,是导致肺癌手术治疗患者不良预后的重要因素。     

Clinical diagnostic performance of the simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis complex for smear-negative or sputum-scarce pulmonary tuberculosis in China

Background Early detection of pulmonary tuberculosis （PTB） is a big challenge in smear negative and sputum scarce patients in China.Simultaneous amplification and testing methods for detection of the Mycobactedum tuberculosis （MTB） complex （SAT-TB assay） is a novel molecular technique established in our hospital.This method has a high sensitivity and specificity in the lab.In this study,the clinical diagnostic performance of this method in smear-negative or sputum-scarce PTB suspects was investigated and evaluated.Methods Two hundred smear negative and 80 sputum-scarce patients were recruited in this study.Samples that included sputum or bronchial washing fluid were collected and sent for both bacteria culture and SAT-TB assay.Diagnosis for these patients was based on the comprehensive evaluation of chestX-ray/CT study,histology examination,lab results,and treatment response.Sensitivity,specificity,positive predictive value （PPV） and negative predictive value （NPV） for each diagnostic test were investigated and calculated using confirmed tuberculosis （TB） and non-TB cases.The time required for detection of MTB was also measured for each method.Results Ninety-two patients （33％） were diagnosed as definitive TB,112 patients （40％） were probable PTB,and 76 （27％） were non-TB.The sensitivity,specificity,PPV,and NPV of SAT-TB in smear-negative PTB suspects were 93％ （95％ CI,84％-98％）,98％ （95％ CI,90％-100％）,98％ （95％ Cl,91％-100％）,and 93％ （95％ CI,83％-98％）.In sputum scarce PTB suspects,the sensitivity,specificity,PPV,and NPV of the SAT-TB assay on bronchial washing fiuids were 90％ （95％Cl,74％-98％）,100％ （95％ Cl,85％-100％）,100％ （95％ Cl,88％-100％）,and 88％ （95％ CI,69％-97％）.The accuracy of the SAT-TB assay is consistent with the bacteria culture assay.The median time required for detecting MTB in the SAT-TB assay was 0.5 day,which was much faster than bacteria culture （28 days）.Conclusions The SAT-TB assay is a fast and accurate method for the detection of MTB.It can be widely applied in the clinic and be an asset in early detection and management of PTB suspects,especially in those patients who are smear negative or sputum scarce.