CpG ODN增强人外周血单个核细胞对淋巴瘤细胞系Jurket杀伤活性的实验研究

目的 探讨合成含CpG基序的寡核苷酸(CpG ODN)体外刺激人外周血单个核细胞(PBMC)的活性,以及活化后的PBMC对肿瘤细胞的杀伤作用.方法 采用MTT法,ELISA法检测CpG ODN对人外周血单个核细胞(PBMC)的增殖活性以及活化后的PBMC对Jurkat细胞的杀伤活性.结果 CpG ODN组,植物血球凝集素(PHA)组及CpG ODN+PHA组较空白对照组能明显促进PBMC的增殖和干扰素-γ(IFN-γ)、白细胞介素-12(IL-12)的分泌,杀伤活性明显增高(P<0.05);CpG ODN组比PHA组明显促进PBMC的增殖和IFN - γ、IL-12的分泌,且杀伤活性明显增高(P<0.05) ;CpG ODN+PHA组在促进PBMC的增殖和IFN - γ、IL-12的分泌和对Jurkat细胞杀伤活性上明显高于其他组(P<0.05).结论 CpG ODN 具有免疫增强作用,能提高PBMC对肿瘤细胞Jurkat的杀伤作用.     

细胞因子诱导的杀伤细胞对人胃癌高侵袭腹膜转移细胞株体内外杀瘤过程中多种细胞因子的影响

目的:观察细胞因子诱导的杀伤细胞(CIK细胞)自分泌细胞因子及其体内外杀瘤过程中多种细胞因子含量的变化,探讨CIK细胞对抗肿瘤的作用机制.方法:取正常人的外周肝素抗凝血分离外周血单个核细胞(PBMC),体外诱导成CIK细胞;同时建立人胃癌高侵袭转移瘤(OCUM-2MD3)细胞裸鼠腹膜移植模型.检测CIK细胞中白介素-2(IL-2)、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)等细胞因子的分泌及其对OCUM-2MD3细胞株体内外杀瘤时上述细胞因子的变化.结果:①CIK细胞培养过程中其上清液IL-2、TNF-α、INF-γ、GM-CSF含量随时间增长而升高,至2周左右达最高峰,随后下降;②体外培养CIK细胞以E:T=25:1对OCUM-2MD3肿瘤细胞作用后,IL-2含量减低明显(P<0.05),TNF-α、GM-CSF含量均降低,INF-γ含量升高;③体内抗瘤实验结果表明,CIK治疗组血清中IL-2、TNF-α、IFN-γ、GM-CSF的含量均较生理盐水对照组显著增高(P<0.05).结论:CIK细胞分泌的细胞因子在2周左右具有最大生物学活性;CIK细胞可能通过其自身分泌IL-2、TNF-α、IFN-γ、GM-CSF等细胞因子参与抗肿瘤作用.     

The Effect of Vitamin A on Secretion of IFN-γ and IL-4 in A549 Cells Induced by Mycoplasma Pneumoniae

In order to investigate the effect of vitamin A (VA) on the secretion of IFN-γ and IL-4 in Mycoplasma Pneumoniae (MP)-induced A549 cells, A549 cells were co-cultured with MP for different time lengths and then the levels of IFN-γ and IL-4 in the cell culture supernatants were detected before and after treatment with different concentrations of VA by using the enzyme-linked immu-nosorbent assay ( ELISA). The results showed that the level of IFN-γ and IL-4 in the supernatants of MP-induced A549 cells was much higher than that in non-induced cells (P<0.01). After application of VA, IL-4 level was not increased until the concentration of VA was up to 0.5×10-5 mol/L (P<0.01). However, with concentration of VA increased up to 1×10-4 mol/L, IL-4 was significantly suppressed (P<0.01). It was concluded that MP could induce the secretion of IFN-γ and IL-4 in A549 cells. VA could inhibit the secretion of IFN-γ and increase the IL-4 level in MP-induced A549 cells. However, high concentration of VA had an inhibitory effect on the secretion of IL-4 as well as on the IFN-γ. These data provided a theoretical basis for the application of VA in MP pneumonia in the clinical practice.     

Enhancement of Immunological Activity of CpG ODN by Chitosan Gene Carrier

To investigate the enhancement of immunological activity of CpG ODN by chitosan gene carrier in mice, the effect of lymphocyte proliferation was detected in mice by using MTT, the levels of IgG and cytokines (IL-2 and IL-12) in serum were measured by ELISA and peripheral blood T lymphocyte subsets CD4 , CD8 were analyzed by flow cytometry. Our results showed that spleen lymphocytes isolated from the CS-CpG ODN group of mice showed the strongest proliferation (SI =1.551), and the levels of IgG, IL-2 and IL-12 in serum were higher than those of other groups. Com- pared with the immunization with CpG ODN, the immunization with CS-CpG ODN gene carrier was more efficient in up-regulating the percentage of CD4 T cells and the ratio of CD4 /CD8 of mice. It was concluded that CS gene carrier of CpG ODN was much more effective in improving immunity of CpG ODN in mice.     

The effect of vitamin a on secretion of IFN-γ and IL-4 in A549 cells induced by <Emphasis Type="Italic">Mycoplasma Pneumoniae</Emphasis>

In order to investigate the effect of vitamin A （VA） on the secretion of IFN-γ and IL-4 in Mycoplasma Pneumoniae （MP）-induced A549 cells, A549 cells were co-cultured with MP for different time lengths and then the levels of IFN-γ and IL-4 in the cell culture supernatants were detected before and after treatment with different concentrations of VA by using the enzyme-linked immu-nosorbent assay （ ELISA）. The results showed that the level of IFN-γ and IL-4 in the supernatants of MP-induced A549 cells was much higher than that in non-induced cells （P〈0.01）. After application of VA, IL-4 level was not increased until the concentration of VA was up to 0.5×10-5 mol/L （P〈0.01）. However, with concentration of VA increased up to 1×10-4 mol/L, IL-4 was significantly suppressed （P〈0.01）. It was concluded that MP could induce the secretion of IFN-γ and IL-4 in A549 cells. VA could inhibit the secretion of IFN-γ and increase the IL-4 level in MP-induced A549 cells. However, high concentration of VA had an inhibitory effect on the secretion of IL-4 as well as on the IFN-γ. These data provided a theoretical basis for the application of VA in MP pneumonia in the clinical practice.     

CIK细胞与DC-CIK细胞抗肿瘤效应的对照研究

目的比较细胞因子诱导的杀伤细胞（cytokine-induced killer cells,CIK）与树突状细胞（dendritic cells,DC）结合CIK细胞抗肿瘤效应。方法外周血单个核细胞诱导DC和CIK细胞,将DC与CIK共培养,以CIK细胞单独培养为对照。用MTT法测定杀伤活性,流式细胞术分析免疫表型,ELISA法测定干扰素-γ（IFN-γ）、白介素-12（IL-12）、肿瘤坏死因子-α（TNF-α）的水平。结果 DC-CIK细胞增殖能力明显高于CIK细胞（P〈0.05）,DC-CIK细胞共培养后,CD3＋CD8＋、CD3＋CD56＋细胞比率较相同条件下CIK细胞组显著增多（P〈0.05）,共培养3 d,DC-CIK细胞上清液中IL-12、IFN-γ、TNF-α水平均比CIK细胞单独培养的水平高（P〈0.01）,DC-CIK细胞对白血病细胞与淋巴瘤细胞的杀伤率显著高于CIK细胞（P〈0.01）。结论 DC-CIK细胞比CIK细胞有更强的抗肿瘤效应。     

K型和D型CpG寡脱氧核苷酸对猪外周血单个核细胞免疫刺激活性的比较研究

目的：比较K、D两型CpG寡脱氧核苷酸(CpG ODN)对猪外周血单个核细胞(PBMC)免疫刺激活性的差异。方法：用人工合成的-K型和D型两类CpG ODN和不含CpG基元的对照ODN D48分别刺激已分离的猪PBMC,^3H—TdR掺入法测定每分闪烁次数(cpm)值,计算刺激指数(SI)。双抗体夹心ELISA法测定活化细胞上清中IFN—γ和IL—2表达水平。结果：D和K型CpG ODN对猪PBMC增殖均具有较强刺激作用,K型的增殖效应高于D型。含“GTCGTT”基元的2006作用尤为显著,但不能有效刺激猪：PBMC分泌IFN—γ和IL—2。D型刺激增殖效应低于K型,但能有效地促进猪PBMC分泌IFN—γ和IL—2。结论：K型和D型CpG ODN在刺激猪PBMC增殖及其分泌IFN—γ、IL—2的水平有所不同。     

Construction,Expression and in vitro Biological Effects of Idiotype Ig Fab Fragment of B-Chronic Lymphocytic Leukemia

The purpose of this study was to construct expression vectors of idiotype （Id） SmIg in patients with B-chronic lymphocytic leukemia and to express them in E.coli to obtain recombinant Id, and to investigate the effect of the protein on the proliferation and secretion of IL-2 and IFN-γ of stimulated peripheral blood mononuclear cells （PBMC） in vitro. Light chain gene and Fd fragment of heavy chain gene were inserted into fd-tet-DOG2 vector to construct fd-tet-DOG2-Fab. Fab gene was further cloned into expression vector pHEN2 to construct the soluble expression vector pHEN2-Fab. After induction by IPTG, Fab protein was purified by Ni-NTA-chromatography. MTT was used to determine the effects of purified protein on the proliferation of stimulated PBMC in vitro and the concentrations of IL-2 and IFN-γ in the culture supernatants were detected by ELISA. The results showed that recombinant pHEN2-Fab expression vector was constructed successfully. Fab protein was expressed in positive clone after induced by IPTG and two specific bands at 24-25 kD position were observed by SDS-PAGE electrophoresis. Proliferation of PBMC could be induced by purified Fab and the concentrations of IL-2 and IFN-γ in culture supernatants were increased significantly af- ter induction. It was suggested that the expression vector of SmIg Fab fragment was constructed suc- cessfully, and expressed and secreted from E. coli. The Fab protein could induce proliferation of PBMC and promote secretion of IL-2 and IFN-γ.     

TLR9在非小细胞肺癌患者外周血单个核细胞抗肿瘤免疫中的调控作用

目的 研究TLR9激动剂--含非甲基化胞嘧啶-鸟嘌呤二核苷酸序列的寡脱氧核苷酸(CpG ODN)对非小细胞肺癌(NSCLC)患者外周血单个核细胞(PBMC)抗肿瘤免疫的影响.方法 分离36例NSCLC患者PBMC和肺癌细胞,RT-PCR检测TLR9 mRNA表达.PBMC分别经空白培养、不含非甲基化胞嘧啶-鸟嘌呤二核苷酸序列的寡脱氧核苷酸(non-CpG ODN)和CpG ODN共培养72 h.3H-TdR掺入法测定PBMC增殖变化.流式细胞仪检测T细胞表面CD69分子变化、T细胞亚群比例以及CD8+T胞内IFN-γ和IL-4的表达.ELISA法测定PBMC上清液IFN-α的浓度,并评价抑制性ODN和氯喹对IFN-α产生的影响.分别以自体肿瘤细胞和K562细胞为靶细胞(T),以PBMC为效应细胞(E)流式细胞仪检测不同E/T时PBMC的细胞毒活性.结果 NSCLC患者PBMC表达TLR9 mRNA,其表达强度(0.76±0.09)与健康者(0.77±0.09)差异无统计学意义(t=0.00,P=1.00).CpG ODN诱导肺癌患者PBMC增殖(P<0.01),上调CD3+T细胞表面CD69分子表达(P<0.01),增加CD4+T/CD8+T比值(P<0.01),增强CD8+T产生IFN-γ的能力(P<0.01).CpG ODN促进PBMC分泌IFN-α(P<0.01),抑制性ODN和氯喹抑制CpG ODN诱导产生的IFN-α.CpG ODN增强PBMC对K562和自体肿瘤细胞的细胞毒活性(均P<0.01).结论 TLR9参与调控NSCLC患者的抗肿瘤免疫,TLR9的激活效应主要包括促进PBMC活化、增殖并诱导产生IFN-α,增加PBMC中CD4+T的比例并促进CD8+T分泌IFN-γ,增强PBMC对肿瘤细胞的细胞毒活性.     

CpG ODN对非小细胞肺癌患者化疗后免疫功能的影响

 目的 测定非小细胞肺癌（non-small cell lung cancer,NSCLC）患者化疗前后外周血单个核细胞（peripheral blood mononuclear cell,PBMC）经胞嘧啶-磷酸-鸟嘌呤寡脱氧核苷酸（cytosine-phosphorothioate guanine oligodeoxynucleotides,CpG ODN）刺激后,CD4+CD25^high Treg细胞及IFN-γ、IL-12的变化,评价不同时间点CpG ODN的干预效果。方法 选取NSCLC患者20例,分别抽取患者化疗前（d0）、化疗后第3天（d3）及第7天（d7）外周血3 mL,分离PBMC。每份PBMC均分为实验组及对照组,实验组给予CpG ODN 2006刺激,对照组不做干预。经培养48 h后收集细胞以流式细胞仪检测CD4⁺CD25^high Treg细胞百分比,并取上清液检测INF-γ和IL-12（pg/mL）。结果 实验组CD4⁺CD25^high Treg细胞百分比在d0、d3、d7分别为（2.22±0.66）%,（2.09±0.44）%和（2.08±0.48）%,较对照组均有明显下降（P<0.05）。实验组IFN-γ在d0、d3、d7分别为（40.64±5.90）、（40.57±5.80）和（45.30±4.78）pg/mL,d0和d7时较对照组显著增加（P<0.05）,d3时变化不明显（P>0.05）。实验组IL-12在d0、d3、d7分别为（41.02±6.65）、（39.41±7.41）和（45.75±12.46）pg/mL,d0和d3时较对照组明显增加（P<0.05）,而d7时变化不明显（P>0.05）。动态观察对照组,d3时CD4⁺CD25^high Treg细胞比例下降至最低点,而后逐渐回升;实验组在d7时CD4⁺CD25^high Treg细胞比例仍持续下降;实验组的IFN-γ值呈现升高趋势,d7和d0、d3相比明显升高（P<0.05）;而实验组IL-12值在化疗前后无明显变化,即化疗前d0与化疗后d3、d7比较,以及d3与d7比较,差异均不明显（P值均>0.05）。肺癌患者化疗次数及外周血淋巴细胞的数目与CpG ODN对CD4⁺CD25^high Treg细胞比例及IFN-γ、IL-12的分泌作用无显著相关性（P>0.05）。结论 CpG ODN能有效下调CD4⁺CD25^high Treg细胞,刺激INF-γ的分泌,优化肺癌患者抗肿瘤的免疫微环境,有利于机体的抗肿瘤免疫;肺癌患者即使化疗后外周血淋巴细胞的数目明显减少,CpG ODN仍能下调CD4⁺CD25^high Treg细胞和刺激INF-γ的分泌,发挥抗肿瘤作用。     

半月板桶柄状撕裂的MRI诊断与关节镜下分类的相关研究

目的 探讨MRI对半月板桶柄状撕裂的诊断与关节镜下分类的比较研究.方法 分析63例患者65个经关节镜检查证实为半月板桶柄状撕裂的术前MRI的特征性表现,并将5种MRI征象(双后交叉韧带征、半月板翻转征、空领结征、碎块内移征和外周残半月板征)与关节镜下Dandy分型进行比较.结果 MRI桶柄状撕裂诊断符合率89.2%.碎块内移征和空领结征阳性率最高,分别为84.6%和81.5%;双后交叉韧带征(双PCL征)、半月板翻转征(双前角征)、外周残半月板征不如上二者普遍(阳性率分别为43%、21.5%、29.3%).未发现外侧半月板双PCL征;内侧半月板交锁Ⅰ型和Ⅱ型及外侧半月板半长全宽型、全长半宽型与MRI碎块内移征和空领结征有相关性;2例为半月板撕裂Ⅲ级信号,5例为假阴性.结论 5种MRI征象中最少2种(碎块内移征和空领结征阳性率最高)以上出现应高度怀疑为桶柄状撕裂. Abstract： Objective To evaluate the arthroscopic findings of meniscal bucket handle tears and to correlate them with the proposed MR imaging signs of meniscal bucket handle tears suggested in the literature. Methods Sixty-three patients who had a diagnosis of bucket handle tear in arthroscopy were included in our study.Meniscal tears were evaluated in arthroscopy according to Dandy's classification.The MRIs were retrospectively analyzed regarding the following findings:absence of bow tie sign,presence of double posterior cruciate ligament(PCL), fragment within the intercondylar region,flipped meniscus sign, abnormal circumferential meniscus sign. Sensitivity were evaluated for the presence of each individual sign. Results Locked types Ⅰand Ⅱfragment of medial meniscus and half-length,whole-width and whole length-half-width fragement of lateral meniscus in arthroscopy were correlated with fragement within the intercondylar notch and absent bow tie signs in MRI.We didn't find the double PCL sign in any of the patients with a lateral meniscal bucket handle tear.The most common signs in MR imagings of meniscal bucket handle tears were the fragement in the notch sign and the absent bow tie sign.They were observed with frequency of 84.6% and 81.5% respectively.The presence of double posterior cruciate ligament, flipped meniscus sign, abnormal circumferential meniscus sign were less common(43%,21.5% and 29.2%,respectively). Conclusions The presence of at least two of the five MRI signs should be regarded as highly suggestive for bucket handle tears of menisci.     

不同药物配方在分娩镇痛中的临床观察

目的 探讨产妇在分娩时镇痛时麻醉药物的选择.方法 选择我院2007年5月至2009年4月期间单胎初产妇150例随机分为三组,分别使用0.75%罗哌卡因20 ml+芬太尼0.2 mg+生理盐水至100 ml;0.75%罗哌卡因20 ml+曲马多200 mg+生理盐水至100 ml;0.75%罗哌卡因20 ml+曲马多200 mg+氟哌利多50 mg+生理盐水至100 ml,观察各组的疼痛评分、镇静评分及副作用.结果 使用芬太尼的患者镇痛、镇静效果明显优于其他的药物配伍,并且不良反应轻.结论 芬太尼在分娩镇痛中具有镇痛、镇静效果好,不良反应少,用药少的优势. Abstract： Objective To explore the choice of narcotic drugs required for analgesia in childbirth in maternal. Methods Random selection in our hospital from May 2007 to April 2009 during the period 150 cases of singleton pregnancies were divided into three groups of primipara.The use of 0.75% ropivacaine 20 ml+fentanyl 0.2 mg+saline to the 100 ml; 0.75% ropivacaine 20 ml+tramadol 200 mg+saline to the 100 ml; 0.75% ropivacaine 20 ml+tramadol 200 mg+droperidol 50 mg+physical salt to 100 ml. Observed in each group the pain score, sedation score and side effects. Results Patients using the fentanyl analgesic, sedative effect is superior to other drug compatibility, and side effects of light. Conclusions Fentanyl labor analgesia with analgesic, sedative effect is good, fewer adverse reactions, medication less advantage.     

雌激素对缺氧/复氧神经元高迁移率族蛋白B1及核因子-κB表达的影响

目的 探讨雌激素对缺氧/复氧诱导新生大鼠皮质神经元损伤的保护作用及其机制.方法 将培养7 d的大鼠皮质神经元随机分为三组,A组为正常对照组,B组采用缺氧/复氧(H/R),C组采用雌激素(17βE2)预处理加H/R处理,各组在H/R后0、1、3、6、12、24 h各时间点,以TUNEL法比较各组凋亡细胞,免疫组化方法比较各组高迁移率族蛋白B1(HMGB1)、核因子-κB(NF-κB)表达.结果 ①B组凋亡神经元明显多于正常对照组(H/R后3～24 h),C组凋亡细胞数目显著少于B组,三组比较差异有统计学意义.②B组HMGB1、NF-κB的表达较正常对照组明显增加,C组HMGB1、NF-κB表达较B组明显减少.结论 雌激素可使H/R后神经元HMGB1、NF-κB表达降低,抑制神经元凋亡,提高其存活率,这可能是其脑保护作用的机制之一. Abstract： Objective To explore the protective effects of estrogen on injured neurons induced by H/R and the mechanisms of that. Methods The cortical neurons cultured for 7 days were randomly divided into group A (normal control group), group B (H/R alone), group C (pretreatment with Estrogen -17βE2 and H/R). Then the apoptotic neurons were count by TUNEL, and the expression of HMGB1,NF- κB was observed by immunocytochemical technique, on each time point after reoxygenation 0,1,3,6,12,24 h of each group. Results ①The number of apoptotic neurons in group B was more than that in control group after H/R 3-24 h, and was less in group C than in group B. ②Compared with group A, the expression of HMGB1 and NF-κB was higher in group B,and was lower in group C than in group B. Conclusions Estrogen could decrease the expression of HMGB1 and NF-κB to inhibit neuronal apoptosis after H/R, which may be one of the mechanisms in which estrogen exerts its neuro-protective effect.     

四种抗体联合检测在SLE患者中的诊断价值

目的 探讨抗双链DNA(dsDNA)抗体、抗Smith(Sm)抗体、抗核小体抗体(AnuA)、抗组蛋白抗体联合检测在系统性红斑狼疮(SLE)患者中的诊断价值.方法 抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体均采用欧蒙斑点法测定98例SLE患者(分为活动期和稳定期)、90例其他结缔组织病患者及40例健康人血清中的四种自身抗体.结果 98例SLE患者中抗dsDNA抗体、抗Sm抗体、AnuA、抗组蛋白抗体阳性率分别为45.9%、 29.6%、 57.1%、33.6%,特异性分别为100%、99.2%、98.5%、89.2%;抗dsDNA抗体和AnuA在活动期SLE中的敏感性与稳定期相比差异有统计学意义(P<0.05);抗dsDNA抗体和AnuA以及四种抗体联合检测时阳性率分别为70.4%和79.6%,明显高于其中任何单项检测的阳性率,且明显高于疾病对照组,差异有统计学意义(P<0.05).结论 所检测的四种抗体在SLE中都具有很高的特异性和敏感性,其中抗dsDNA抗体和AnuA对活动期SLE具有很好的诊断价值,抗体的联合检测可较大程度提高SLE检测阳性率,四种抗体有明显的互补作用,尤其抗dsDNA抗体和AnuA的联合检测具有很好的组合价值. Abstract： Objective To investigate the diagnostic significance of combined detection of anti-double stranded DNA antibody(anti-dsDNA),anti-Smith antibody(anti-Sm)and antinuclesome antibody(AnuA) and anti-histone antibody in systemic lupus erythematosus(SLE),and evaluate the significance of combined detection of these autoantibodies in the diagnosis of SLE. Methods Ninety-eight cases of SLE patients who were divided into active and stable stage group and 90 disease controls and 40 healthy people were detected with Euro immunoblot assay.Results In the assays mentioned above. The serum positive rates of anti-dsDNA,anti-Sm, AnuA and anti-histone antibody were 45.9%,29.6%,57.1% and 33.1% in SLE, and the specificities were 100%,99.2%,98.5% and 89.2% respectively in patients with SLE.The positive rates of anti-dsDNA and AnuA in active SLE group were 57.5%,65.1%,which was apparently higher than that in the stable stage group;The sensibility of combined detection of anti-dsDNA and AnuA was 70.4%, four autoantibodies combined detection in SLE was 79.6%, which was apparently higher than any single autoantibodies, the difference had statistical significance. Conclusions These four autoantibodies have very high sensibility and specificity respectively, combined detection of four autoantibodies can markedly raise the relevance ratio in SLE, while their specificity didn't have a visual reduction. Especially, the sensibility of combined detection of anti-dsDNA and AnuA can markedly increased in active SLE patients. This compose can raise effectively the diagnosis of active SLE.So the detections of the four antibodies are complementary for the diagnosis of SLE.     

低浓度5-氟尿嘧啶与糖皮质激素联合激光治疗瘢痕疙瘩的疗效

目的 观察低浓度5-氟尿嘧啶(5-Fu)与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效及安全性.方法 瘢痕疙瘩70例,102处病灶,平均病史8.6年,平均治疗时间为10.29个月.70例瘢痕疙瘩患者108处病灶进行单纯瘢痕内注射,0.6 ml 5-Fu与5 ml曲安奈德、1 ml 2%利多卡因混合后局部注射于瘢痕全层注射,每2～4周1次,瘢痕完全萎缩后逐渐降低药物浓度并延长注射间歇期.另一组70例瘢痕疙瘩患者102处病灶将三联药物局部注射半个月后Nd:YAG激光照射,每2～4周1次.结果 在治疗6个月以上的患者中,5-氟尿嘧啶与糖皮质激素联合激光治疗瘢痕疙瘩的总有效率为97.06%,其中完全缓解者占45.10%,极大缓解者占49.02%,部分缓解者占2.94%,未缓解者为2.94%.结论 低浓度5-氟尿嘧啶与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效显著. Abstract： Objective To monitor the therapeutic action and security of 5-Fu and steroid injected associate with laser to keloid. Methods One hundred and two keloid focuses of 70 patients have the average 8.6 years history and the average therapy period of 10.29 months. Among them,70 patients with total 108 keloid were treated merely with intralesional injection of a mixture of 0.6 ml 5-Fu,5 ml corticosteroid and 1 ml 2% lidocaine once per 2-4 weeks. The other 70 patients with total 102 keloid around sternal area were treated with the mixture once per 2-4 weeks. And they were irradiated with apulsed Nd:YAG laser(wavelength 1064 nm)at 35-140 energy density levels after 15 days. After keloid became flattened,drug concentration was decreased with prolonged intermission of drug injection. Results The total therapy efficacy of 5-Fu associate with steroid to keloid was 97.06%. Of them, the complete remission percentage was 45.10%,the large remission percentage was 49.02%,part remission percentage was 2.94%,and the inefficacy percentage was 2.94%. Conclusions It is more effective that the combination therapy to keloid of low concentration 5-Fu,steroid and Nd:YAG laser.     

压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期35例疗效观察

目的 探讨压缩雾化吸入可必特对慢性阻塞性肺疾病急性加重期的疗效和不良反应.方法 将75例患者随机分为两组,对照组30例采用常规治疗,治疗组35例在常规治疗基础上加用雾化治疗,观察两组治疗效果和解除主要症状、体征的时间和住院时间.结果 治疗组住院时间和喘憋、肺部喘鸣音的持续时间均明显短于对照组(P＜0.05).结论 压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期疗效确切,方法简便,不良反应小,值得推广. Abstract： Objective To explore the effect of compressed nebulized inhalation combivent on chronic obstructive pulmonary disease with acute exacerbation. Mehods Seventy-five patients were randomly divided into two groups,the control group(30 cases) with conventional treatment, the treatment group (35 cases) on the basis of conventional therapy plus treatment with the spray were observed lifting of the main symptoms and signs of the time and hospital stay.Results The treatment group hospitalization time and asthmatic lungs duration of wheezing were significantly shorter than the control group (P<0.01). Conclusions Compression combivent aerosol inhalation treatment of chronic obstructive pulmonary disease with acute exacerbation is simple, side effects are little and are worth promoting.     

高血压病患者颈动脉粥样硬化与血尿酸及载脂蛋白水平的相关性

目的 通过对高血压病患者颈动脉超声多普勒检查和血尿酸及载脂蛋白水平的测定,探讨血尿酸及载脂蛋白与颈动脉硬化程度的关系.方法 测定100例高血压病患者血尿酸及载脂蛋白水平,用超声多普勒检测颈动脉粥样硬化程度.结果 颈动脉粥样硬化程度与血尿酸及载脂蛋白水平有关.结论 血尿酸及载脂蛋白水平与颈动脉粥样硬化的程度具有相关性,血尿酸及载脂蛋白B水平升高、载脂蛋白A水平降低是动脉粥样硬化的危险因素. Abstract： Objective To evaluate the correlation among the level of serum uric acid, apolipoproteins and the degree of carotid artery atherosclerosis in patients with hypertension. Methods The serum uric acid, apolipoproteins in 100 patients with hypertension were detected, and the degree of carotid artery atherosclerosis was determined by ultrasonic Doppler examination. Results The serum uric acid,apolipoproteins had the positive correlation to the degree of carotid artery atherosclemsis. Conclusions The concentrations of serum uric acid, apolipoproteins have positive relationship to the degree of carotid artery atherosclerosis. Increase of level of serum uric acid and ApoB, reduce of level of ApoA are risk factors for carotid artery atherosclerosis.     

410例膝关节外伤MRI诊断分析

目的 探讨MRI对膝关节外伤的诊断价值.方法 回顾性分析410例膝关节外伤的MRI表现,其中72例行CT检查,380例同时拍摄X线平片,比较3种方法对膝关节外伤的诊断价值.结果 MRI、CT及X线对膝关节外伤的阳性检出率分别为99.02%(406/410)、70.83%(51/72)、30.00%(114/380).MRI表现分别为骨挫伤伴或不伴骨折、关节腔积液、半月板损伤、韧带损伤、关节周围软组织损伤.MRI阳性检出率明显高于CT组及X线组,组间比较差异有统计学意义(P<0.05).结论 MRI对膝关节外伤具有独特而重要的诊断价值,而且无创伤、无辐射,能够最大限度弥补X线及CT检查的不足,可作为膝关节外伤的常规检查手段. Abstract： Objective To investigate the diagnostic value of MRI imaging on detecting knee joint injury. Methods MRI manifestations of knee joint injury in 410 cases were analyzed retrospectively. Of all patients, 72 cases underwent CT scan,380 cases underwent X-ray examinations and to compare the diagnostic value of the three methods in detecting knee joint injury. Results The positive rates of MRI, CT, X-ray in detecting knee joint injury were 99.02%(406/410), 71.83%(51/71), 30.00%(114/380) respectively. Knee joint injury manifested as bone contusion or bone contusion accompanied with bone fracture, joint effusion, meniscus injury, ligament injury, para-articular soft tissue injuries with MRI. The positive rate was significantly higher than that of CT and X-ray, the difference was statistical significance. Conclusions MRI not only play a peculiar and important role in the diagnosis of the knee joint injury with non-invasion or radiation, but also can largely make up for the disadvantage of CT and X-ray,and could be used routinely.     

叶酸联合塞来昔布对食管癌的化学预防作用

目的 探讨选择性环氧合酶-2(COX-2)抑制剂塞来昔布联合叶酸预防食管癌的有效性.方法 将84例食管上皮轻、中重度不典型增生患者随机分为叶酸组(28例)、塞来昔布联合叶酸组(28例)以及安慰剂组(28例),连续服用12个月后,再行胃镜及病理复查.终点指标定义为食管上皮不典型增生的组织学分级有严重程度的改变,记录其逆转、稳定、进展变化,比较各治疗组疗效.结果 塞来昔布联合叶酸组的不典型增生的好转率为60.7%(17/28),显著高于对照组(P＜0.05).叶酸组对食管上皮各级不典型增生并未有显著影响.结论 塞来昔布和叶酸联合应用可能降低食管癌发病的危险,尚需进一步扩大样本量的研究. Abstract： Objective To determine the validity of celecoxib combined with folate for the prevention of esophageal carcinoma.Methods Eighty four subjects completed the trial. Subjects had histologically confirmed mild or moderate esophageal dysplasia at baseline. And they were randomly divided into three groups: folate group,celecoxib plus folate group and control group.Esophagogastroduodenoscopy was performed before and after a 12-month intervention. Per-subject change (regression, stable or progression) in the worst dysplasia grade was defined as the primary end point. Results were compared by agent group.Results The relative reverse rate of celecoxib plus folate group was 60.7%(17/28), significantly higher than that in placebo group (P＜0.05). Folate alone did not influence changes in dysplasia grade by baseline histology subgroup(P＞0.05).Conclusions Celecoxib and folate have better effects than celecoxib alone in the chemoprevention of esophageal carcinoma for high risk subjects. Further trials with larger numbers are needed to confirm these results.     

Ki-67和p16表达与宫颈上皮内瘤变发生发展相关性的探讨

目的 观察Ki-67和p16在宫颈上皮内瘤变(CIN)中的分布特点及其与HPV16感染的关系,并探讨两者表达的意义.方法 采用免疫组织化学方法(EnVison两步法)检测Ki-67和p16在CINⅠ48例、CINⅡ52例、CINⅢ 40例和浸润性子宫颈鳞状细胞癌(SCC)36例中的表达情况.另选取正常子宫颈鳞状上皮20例作为对照组.结果 ①p16在正常子宫颈鳞状上皮表达均阴性(0/20),在CINⅠ、CINⅡ、CINⅢ和浸润性SCC中的阳性率分别为47.9%(23/48)、82.7%(43/52)、95.0%(38/40)、97.2%(35/36),与正常对照组相比差异均有统计学意义(χ2＝28.3812, P<0.01).p16阳性强度在各级CIN病变中不同,差异有统计学意义(χ2＝30.0869,P<0.01).②Ki-67在正常对照组有5例表达,在CINⅠ中的阳性率为66.7%(32/48),而100%的CINⅡ和CINⅢ均为Ki-67阳性(χ2＝28.3812, P<0.01).Ki-67阳性强度在各级CIN病变中不同(χ2＝30.0869,P<0.01).③HPV16在正常组均为阴性,在33.3%(16/48)CINⅠ级、48.1%(25/52)CINⅡ级、87.5%(35/40)CINⅢ级、91.7%(33/36)子宫颈浸润性鳞状细胞癌中为阳性.HPV16感染与p16表达呈正相关(r=0.33,P<0.05),而与Ki-67表达无相关性(P>0.05).结论 p16在各级CIN中呈现不同的分布特点并与HPV16感染有关,是子宫颈CIN病变中细胞异型程度高的标记物.p16和Ki-67的高表达与CIN发生发展及最终癌变有密切关系. Abstract： Objective To investigate the expression of p16 and Ki-67 in cervical intraepithelial neoplasia and cervical squamous cell carcinoma and the relationship with HPV16 infection.Methods Immunohistochemical study for p16 and Ki-67 and HPV16 were performed on paraffin-embedded tissue of diagnostic biopsies and surgical materials, including 20 normal cervix, 48 CINⅠ, 52 CINⅡ,40 CINⅢ and 36 invasive cervical SCC.Results ①There was no p16 positive cell in normal control samples. Overexpression of p16 was detectedin samples of CINⅠ,CINⅡ,CINⅢ and SCC at frequencies of 47.9%(23/48),82.7%(43/52),38/40(95.0%) and 97.2%(35/36). There was significant statistic difference in these groups(χ2＝28.3812, P<0.01). ②Overexpression of Ki-67 were also detectedin samples of CIN at frequencies of 66.7%(32/48) in CINⅠand 100% in CINⅡ/Ⅲ(χ2=30.0869,P<0.01). ③HPV16 was showed negative in normal control group. However, 33.3%(16/48)CINⅠ,48.1%(25/52)CINⅡ,87.5%(35/40)CINⅢand 91.7%(33/36) cervical SCC were HPV16 positive. Overexpression of p16 was correlated with HPV16 infection(r=0.33,P<0.05). However not was Ki-67 (P>0.05). Conclusions Overexpression of the protein p16 is atypical marker for dysplastic and neoplastic epithelium of cervixuteri, which is associated with HPV16 infection.