不稳定型心绞痛患者外周血辅助性T淋巴细胞功能失衡的意义

目的:探讨不稳定型心绞痛患者(UAP)外周血辅助性T淋巴(Th)细胞亚群功能失衡及意义。方法:采用流式细胞分析法,对22例UA患者、20例稳定型心绞痛患者(SAP)和21例胸痛综合征(CPS)患者外周血CD4+细胞内细胞因子干扰素γ(IFN-γ)和白细胞介素4(IL-4)进行动态监测。结果:UAP患者发病24 h内Th1型细胞因子IFN-γ的表达增高(20.6%),明显高于SAP组(11.3%)和CPS组(10.7%),而SAP组和CPS组间差异无统计学意义;各组间Th2型细胞因子IL-4水平差异无统计学意义。UAP患者IFN-γ高表达持续时间较短,发病1周后恢复(11.7%)。结论:UAP患者存在T细胞亚群功能失衡,主要表现为Th1细胞功能亢进,可能是其发病机制之一。     

寡聚脱氧核苷酸对BALB/c小鼠Th细胞的调节

目的观察在体外实验中，包含有重复序列TTAGGG的寡核苷酸（ODNA151）对小鼠脾淋巴细胞分泌Th1、Th2型细胞因子的影响。方法分离小鼠脾淋巴细胞，根据分组加入伴刀豆蛋白A（ConA）以及不同浓度的ODNA151或对照的ODN1612，培养72h后采用夹心法ELISA测定上清中的IFNγ／和IL-4浓度。结果ODNA151，抑制淋巴细胞培养上清的IFNγ／浓度，并升高IL-4的浓度，降低IFNγ／与IL-4的比值，并且ODNA151的作用呈剂量依赖关系；而对照的ODN1612对细胞因子水平无影响。结论在非抗原特异性、多克隆刺激剂（ConA）作用下，ODNA151对小鼠脾淋巴细胞的Th1／Th2平衡有调节作用，既抑制Th1分化又促进Th2分化。     

不稳定性心绞痛患者体内辅助性T细胞细胞因子变化及意义

目的通过检测不稳定性心绞痛(UAP)患者血清中1型辅助性T细胞(Th1)和2型辅助性T细胞(Th2)细胞因子的变化,探讨其在UAP发病过程中的作用及对近期预后的判断价值。方法选取UAP患者42例(UAP组),稳定性心绞痛(SAP)患者34例(SAP组),同时选取健康体检者22例(对照组)。测定各组血清中的γ-干扰素(IFN-γ)、白细胞介素(IL)-2、IL-4和IL-10水平,并观察UAP患者3个月内不良心脏事件发生率。Th1细胞因子包括IFN-γ、IL-2,Th2细胞因子包括IL-4、IL-10。结果 UAP组血清中IFN-γ、IL-2水平明显高于对照组和SAP组,而IL-4、IL-10水平明显低于对照组和SAP组(P0.05)。UAP患者中,有心脏事件患者血清IFN-γ、IL-2水平明显高于无心脏事件患者,IL-10、IL-4水平明显低于无心脏事件患者(P0.05)。结论外周血中Th1和Th2细胞因子水平变化可能与冠状动脉病变不稳定性斑块的存在有关,可反应冠心病患者临床病情,对判断UAP患者近期预后有较好的预测价值。     

老年急性冠状动脉综合征患者辅助性T淋巴细胞的研究

目的 通过分析老年急性冠状动脉综合征(ACS)患者外周血中辅助性T淋巴细胞亚群1(Th1)和亚群2(Th2)频率的变化,探讨辅助性T淋巴细胞在ACS进程中的作用.方法 通过细胞内细胞染色对32例ACS患者(ACS组)、35例稳定性心绞痛(SAP)患者(SAP组)及20例健康体检者(对照组)的外周血单个核细胞进行Th1、Th2分型,ELISA法检测血浆Th1、Th2相关细胞因子水平:干扰素-γ(IFN-γ)、白细胞介素2(IL-2)、白细胞介素4(IL-4)和白细胞介素10(IL-10).结果 ACS组患者Th1细胞较SAP组及对照组明显升高(P＜0.05);3组间Th2细胞变化无统计学差异(P＞0.05).ACS组患者Th1相关细胞因子IFN-γ和IL-2较SAP组和对照组明显升高(P＜0.05);ACS组患者Th2相关细胞因子IL-10较SAP组和对照组明显降低(P＜0.05),IL-4低于检测水平;IFN-γ和IL-2水平与Th1的升高密切相关(P＜0.05).结论 Th1和Th2的失衡与ACS的发生密切相关,其相关细胞因子IFN-γ和IL-2水平的升高,使系统炎性反应进一步恶化.     

阿托伐他汀对不稳定型心绞痛患者Th细胞亚群的影响

目的:探讨阿托伐他汀对不稳定型心绞痛(UA)患者外周血辅助性T淋巴(T help,Th)细胞亚群的影响及意义.方法:采用流式细胞分析法检测38例UA患者,28例稳定型心绞痛(SA)患者及20例胸痛综合征(CPS)患者外周血CD4+细胞内细胞因子干扰素γ(IFN-γ)和白细胞介素4(IL-4)的表达;分离患者外周血单个核...     

急性冠状动脉综合征患者外周血辅助性T细胞和调节性T细胞的检测意义

目的探讨外周血辅助性T细胞(Th17)和调节性T细胞(Treg)平衡在急性冠状动脉综合征(ACS)患者中的变化和意义。方法选择79例冠心病患者分为急性心肌梗死(AMI)组22例、不稳定性心绞痛(UAP)组19例、稳定性心绞痛(SAP)组18例及胸痛综合征(CPS)组20例,用流式细胞术检测外周血中Th17(其占CD3T淋巴细胞比例)及Treg(其占CD4T淋巴细胞比例)的表达,ELISA检测血清Th17及Treg的相关细胞因子白细胞介素(IL)-17和IL-10水平。结果与CPS组和SAP组比较,UAP组及AMI组Th17表达[(2.97±0.62)%和(3.58±1.02)%vs(0.59±0.27)%和(1.37±0.44)%]及血清中IL-17水平显著升高[(41.92±8.89)ng/L和(52.27±9.49)ng/L vs(10.32±2.05)ng/L和(14.73±4.74)ng/L,P0.01],Treg表达及血清中IL-10水平显著降低(P0.01)。SAP组Th17表达及IL-17水平也显著高于CPS组,Treg表达及IL-10水平显著低于CPS组(P0.05,P0.01)。与CPS组和SAP组比较,UAP组和AMI组Th17/Treg比值显著升高(P0.01),SAP组Th17/Treg比值显著高于CPS组(P0.01)。结论 ACS患者外周血中Th17/Treg失衡可能促进了冠状动脉粥样硬化斑块不稳定的进展并进一步诱导ACS的发病。     

非小细胞肺癌患者外周血Th1、Th2、Th17淋巴细胞及其相关细胞因子表达及临床意义

目的:观察非小细胞肺癌(NSCLC)患者外周血中Th1、Th2、Th17淋巴细胞及其细胞因子IFN-γ、IL-4、IL-17的表达及临床意义。方法:收集山西省肿瘤医院胸外科,原发未治疗的NSCLC60例患者作为实验组和60例健康志愿者作为对照组,以IFN-γ、IL-4、IL-17为代表分别测定Th1、Th2、Th17淋巴细胞因子。首先采用流式细胞技术(FCM)分别检测两组外周血Th1、Th2、Th17淋巴细胞含量,采用酶联免疫吸附法(ELISA)分别检测两组血清中细胞因子IFN-γ、IL-4、IL-17水平含量。同时分析比较两组外周血Th1、Th2、Th17淋巴细胞及细胞因子IFN-γ、IL-4、IL-17水平含量与临床病理特征关系。结果:实验组外周血Th1、Th2、Th17淋巴细胞的水平分别为(44.57±20.32)%、(3.08±1.28)%和(1.74±1.18)%;对照组外周血中Th1、Th2、Th17淋巴细胞的水平分别为(49.04±12.30)%、(2.67±1.36)%和(0.89±0.56)%,两组比较差异有统计学意义(P<0.05)。Ⅲ、Ⅳ期肺癌患者Th1淋巴细胞的水平(41.1±23.6)%、(44.6±20.3)%低于Ⅰ—Ⅱ期肺癌患者(46.2±19.1)%(P<0.05),Ⅲ、Ⅳ期肺癌患者的Th2、Th17淋巴细胞水平高于Ⅰ—Ⅱ期肺癌患者(P<0.05)。鳞癌患者外周血Th2、Th17淋巴细胞水平高于腺癌患者。结论:检测NSCLC患者外周血Th1、Th2、Th17及其细胞因子IFN-γ、IL-4、IL-17水平含量对判断病情、了解机体的免疫功能具有重要的临床意义。     

不稳定型心绞痛患者血清Th17型细胞因子含量变化的临床意义研究

目的探讨不稳定型心绞痛(UA)患者外周血Th17型细胞因子的水平及临床意义。方法选择UA组30例、稳定型心绞痛(SA)组16例和胸痛综合征(CPS)组20例,应用酶联免疫吸附方法(ELISA)检测患者外周血Th17相关细胞因子白细胞介素(IL)-17、IL-6和肿瘤坏死因子-α(TNF-α)的表达。结果 UA组患者IL-17、IL-6和TNF-α水平均明显高于SA组和CPS组,差异均有统计学意义(P0.05);而SA组和CPS组间差异无统计学意义(P0.05)。结论 UA患者外周血Th17型细胞因子水平增加,Th17细胞可能参与动脉粥样斑块不稳定和不稳定的发生。     

急性冠状动脉综合征患者外周血中辅助性T细胞亚群失衡促进血管内皮细胞的损伤作用

目的 分析急性冠状动脉综合征(ACS)和稳定性心绞痛(SAP)患者外周血中1型辅助性T细胞2型辅助性T细胞(Th1/Th2)的变化,探讨Th细胞在ACS中的变化及对血管内皮细胞损伤的作用.方法 收集40例ACS患者和18例SAP患者的外周血,检测外周血中Th1/Th2相关细胞因子的浓度,及不同细胞哑群对人脐静脉内皮细胞(HUVEC)的杀伤作用.结果 ACS组外周血中干扰素-γ(IFN-γ)和白细胞介素-2(IL-2)的浓度,均高于SAP组[IFN-γ:(131.2±42.2)ng/L比(47.6±20.2)ng/L,P<0.05;IL-2:(83.7±21.3)ns/L比(46.2 ±16.7)ng/L,P<0.05],ACS组外周血中IL-10浓度低于SAP组[(16.7±4.3)ng/L比(27.5±5.5)ns/L,P<0.05];ACS组患者的外周血单个核细胞(PBMC)对HUVEC的杀伤作用较SAP组明显增强(PBMC:28.84%±4.20%比20.28%±2.71%,P<0.05),而ACS组患者清除CD4+T细胞的PBMC[(CD4-)-PBMC]对HUVEC的杀伤作用与SAP组比较,差异无统计学意义[(CD4-)-PBMC:20.70%±3.26%比20.28%±2.71%,P>0.05].结论 ACS患者Th1亚群相关细胞凶子水平明显高于SAP患者,Th2亚群相父细胞因子水平显著低于SAP患者,Th1/Th2亚群失衡在PBMC对血管内皮的损伤中起促进作用,提示Th1/Th2亚群失衡可能参与了ACS的发生.     

急性冠状动脉综合征患者外周血Th1/Th2细胞因子水平的变化

目的通过检测急性冠状动脉综合征(ACS)患者血清中1型辅助性T细胞/2型辅助性T细胞(Th1/Th2)细胞因子的变化,探讨细胞因子变化在斑块活化和进展评估中的作用。方法 ACS患者64例,其中急性心肌梗死22例,不稳定型心绞痛42例,同时选取稳定型心绞痛患者34例及正常对照22例。测定血清中的γ干扰素(IFN-γ)、白细胞介素-2(IL-2)I、L-4和IL-10水平,所有患者均行冠脉造影检查。结果 ACS患者外周血Th1细胞因子水平明显高于、而Th2细胞因子水平则明显低于正常对照组和稳定型心绞痛组。依据冠脉斑块形态分为两型,Ⅱ型斑块患者血清中的Th1细胞因子水平显著高于Ⅰ型斑块患者;Ⅱ型斑块患者Th2细胞因子显著低于Ⅰ型斑块患者。结论外周血中Th1/Th2细胞因子水平的失衡与ACS的发生密切相关,对斑块的活化和进展有一定的量化评估作用。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.