支气管哮喘患者红细胞免疫指标及外周血相关细胞因子水平的观察

近年来的研究证实 ,呼吸道炎症发生过程中有红细胞免疫参与 ,且与外周血细胞因子水平关系密切[1,2 ] 。为探讨红细胞免疫指标及相关细胞因子水平与支气管哮喘发作与缓解的关系 ,我们测定了 35例哮喘患者的红细胞Ｃ3 受体花环率 (ＲＢＣＣ3 ｂＲＲ)、外周血白细胞介素 10 (ＩＬ - 10 )及白细胞介素5 (ＩＬ - 5 )的水平。对象和方法一、对象 :哮喘发作期组 35例 (男 2 2 ,女 13) ,年龄 14～ 6 4岁。哮喘缓解期组 30例 (男 2 0 ,女 10 ) ,年龄 12～ 6 9岁 ,为哮喘发作后病情缓解 2周以上者。病情程度判定按 1993年中华医学会呼吸病学会哮喘学组…     

系统性红斑狼疮患者骨髓造血微环境的初步研究

目的： 研究系统性红斑狼疮（SLE）患者骨髓造血微环境，探讨SLE的发病机制。 方法： 采用体外集落培养、免疫组化、流式细胞仪、ELISA及RT-PCR方法观察SLE患者骨髓基质细胞形态、数量、细胞基质、粘附分子及多种细胞因子的变化。 结果： SLE患者骨髓基质细胞集落形成单位数、形态及纤维粘连蛋白、层粘连蛋白、Ⅳ型胶原等细胞基质与对照组无明显差别（P＞0.05）；骨髓基质细胞ICAM-1、VCAM-1表达明显高于对照组（P＜0.01），两者均与SLEDAI评分相关；SLE患者骨髓基质细胞培养上清液中IL-6高于对照组（P＜0.01），SCF、SDF-1与对照组无异（P＞0.05）,MIP-1、IFN-γ明显高于对照组（P<0.01），TGF-β则低于对照组（P<0.01），3种细胞因子与SLEDAI评分相关。 结论： SLE患者骨髓造血微环境存在缺陷，主要表现为粘附分子以及部分负调控因子异常表达，与SLE的发病、发展有一定关系。     

复发性生殖器疱疹患者外周血趋化性细胞因子及其受体的研究

目的 :在单细胞水平上研究复发性生殖器疱疹 (RGH)外周血T淋巴细胞上CCR2、CCR5、CXCR1、CXCR3的表达 ,并通过观察血清趋化性细胞因子的改变 ,探讨趋化性细胞因子及其受体在RGH发病机理中的作用。方法 :采用ELISA法检测 2 0例RGH患者及 30例正常人血清中白细胞介素 8(IL 8)、γ干扰素诱导的蛋白 10 (IP 10 )、单核细胞趋化蛋白 1(MCP 1)、巨噬细胞炎性蛋白 12 (MIP 12 )活化后可调节的正常T细胞表达和分泌的因子 (RANTES) ,巨噬细胞来源的趋化性细胞因子(MDC)等水平变化 ;同时用双色荧光标记的流式细胞术分析 2 0例RGH患者外周血淋巴细胞表面趋化因子受体CCR2、CCR5、CXCR1、CXCR3的表达情况。结果 :RGH患者血清RANTES水平低于正常对照组 (P <0 0 5 ) ;外周血CXCR1+ T淋巴细胞百分率高于正常对照组 (P <0 0 5 )。结论 :病毒反复感染机体后 ,抑制机体的免疫细胞产生RANTES并通过T淋巴细胞CXCR1+ 的高表达可能在RGH抗病毒感染的免疫机理中起重要作用。     

子宫内膜异位症患者外周血和腹腔液细胞因子水平的检测及临床意义

子宫内膜异位症（简称内异症）是子宫内膜组织出现在子宫腔面以外身体的其它部位,在育龄期妇女发生率为10％-15％,其病因复杂,难以根治,容易复发,且发生率有上升趋势,因此对于内异症的发病原因越来越得到医学界的重视。近年来,许多研究表明内异症的形成和发展与免疫因素有密切关系。本文通过行腹腔镜手术并联合用药治疗的36例内异症患者术前腹腔液及术前术后外周血中的IL-6、IL-8、TNF-α水平的检测,进一步探讨其与内异症的关系,现报道如下。     

骨髓微环境对骨髓瘤细胞生物行为的影响

目的：观察骨髓瘤患者基质细胞(BMSC)及其对瘤细胞几种细胞因子及瘤细胞膜上粘附分子表达的影响。方法：用细胞培养、RT-PCR、流式细胞仪分别测定BMSC及与BMSC共同培养前后瘤细胞IL-6 mRNA、IL-1βmRNA、TNF-α mRNA及瘤细胞膜上ICAM-1、VCAM-1的表达。结果：初治多发性骨髓瘤(multiple myeloma，MM)患者BMSC与瘤细胞共同培养后，初治和复发、难治性MM患者瘤细胞ICAM-1、VCAM-1表达增加；复发、难治MM患者BMSC与瘤细胞共同培养后，初治和复发、难治胁患者瘤细胞的IL-6 mRNA、IL-1β mRNA、TNF-α mRNA及ICAM-1、VCAM-1表达均增加；初治MM患者BMSC膜上ICAM—1、VCAM-1表达高于正常对照组；复发、难治MM患者BMSC IL-6 mRNA、IL-1βmRNA、TNF-α mRNA及ICAM-1、VCAM-1的表达均高于正常对照组和初治MM患者。结论：初治MM患者BMSC表达粘附分子增加，复发、难治MM患者BMSC除粘附分子表达异常外，其IL-6 mRNA、IL-1β mRNA、TNF-α mRNA亦表达异常；MM细胞与BMSC共同培养后，粘附分子和(或)IL-6 mRNA、IL-1β mRNA、TNF-α mRNA表达增加，可能与MM细胞的存活、生长、耐药及疾病复发密切相关。     

重症肌无力患者骨髓、胸腺及外周血中IFN-γ、IL-4分泌细胞的检测

<正>重症肌无力（MG）是神经肌肉传递障碍的自身免疫性疾病,它是以抗乙酰胆碱受体（AchR）抗体为其主要的致病性抗体。目前认为该抗体的产生依赖于T淋巴细胞,T细胞所分泌的细胞因子参与了实验性自身免疫性重症肌无力（EAMG）的诱导和发病过程。干扰素-γ（IFN-γ）和白细胞介素-4（IL-4）分别由Th1和 Th2亚型细胞所分泌,在机体免疫调节中起重要作用。本实验检测了早期发病的MG手术病人的骨髓、胸腺及外周血中IFN-γ和IL-4分泌细胞数,以期了解是否Th1及Th2均参与了MG的发病过程。     

熊果酸对正常人外周血淋巴细胞Th1型细胞因子的影响

本实验旨在研究熊果酸对正常人外周血淋巴细胞Th1型细胞因子的影响,并对机制作初步探讨。采用半定量RT-PCR和夹心法ELISA分别检测不同浓度熊果酸对PHA和PMA活化的外周血淋巴细胞的Th1型细胞因子(IFN-γ和IL-2)mRNA的表达及分泌的影响。结果显示Th1型细胞因子mRNA和蛋白的表达水平均随熊果酸浓度的增加而下降(P<0.05),表明熊果酸可能对IFN-γ和IL-2在转录和(或)转录后水平发挥抑制作用,有可能用于自身免疫性疾病和超敏反应性疾病的防治。而熊果酸和地塞米松分子结构相似,可能通过类似机制下调糖皮质激素受体发挥作用。     

外周血单个核细胞中乙型肝炎病毒核酸与细胞因子含量变化

目的：探讨慢性乙型肝炎患者外周血单个核细胞中乙型肝炎病毒核酸与血清细胞因子变化关系。方法：采用荧光实时PCR技术定量检测76例慢性乙型肝炎患者和15例健康者外周血单个核细胞中HBVDNA含量，用ELISA法定量检测血浆细胞因子(IFN-γ、TNF—α、IL-4、IL-6、TGF-β1、sIL-2R)水平。结果：①慢性乙型病毒性肝炎中细胞因子(IFN-γ、TNF-α、IL-4、IL-6、TGF-β1、sIL-2R)水平明显高于健康对照组；②单个核细胞HBVDNA阳性组IFN-γ、TNF-α含量明显低于阴性组，而sIL-2R含量则高于阴性组但无统计学差异，IL-4、IL-6、TGF-β1含量无差异；③随着PBMCs中HBVDNA含量升高，TNF—α含量逐渐降低，IL-4和sIL-2R含量逐渐升高，而IFN-γ，IL-6、TGF-β1含量无显著性变化。结论：外周血单个核细胞HBVDNA持续存在及含量变化与细胞因子相对异常有关，进而导致肝细胞损伤。     

风险产妇部分细胞因子血清水平分析

目的:分析临产风险孕妇细胞因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)血清水平变化。方法:选择正常足月产妇40例(正常足月产妇组),风险产妇(包括早产、产后大出血和多胎妊娠)60例(风险产妇组),入院后于产前空腹采集静脉血;选择非孕健康妇女40例作为对照组。采用化学发光法检测各组血清IL-1β、IL-6、IL-8、IL-10和TNF-α水平,并统计分析各组各指标水平差异。结果:各组血清IL-1β和IL-8水平差异无统计学意义(P0.05)。风险产妇组IL-6水平显著高于正常足月产妇组和对照组(P0.01)。风险产妇组IL-10水平高于对照组(P0.01),但低于正常足月产妇组(P0.05)。风险产妇组与正常足月产妇组TNF-α水平差异无统计学意义(P0.05),但均高于对照组(P0.05)。结论:临产前检测细胞因子水平,对产妇风险评估有一定辅助参考价值。     

Comparable Outcomes of Allogeneic Peripheral Blood versus Bone Marrow Hematopoietic Stem Cell Transplantation in Major Thalassemia: A Multivariate Long-Term Cohort Analysis

Allogeneic hematopoietic stem cell transplantation (HSCT) currently is the only available curative option for transfusion-dependent thalassemia. Peripheral blood is a more convenient source for HSCT in comparison with bone marrow. Information about the relative success of transplantation with these 2 graft sources would help physicians and patients choose between them. The aim of this study was to evaluate the pros and cons of using peripheral blood instead of bone marrow as the graft source in thalassemia transplantation. We analyzed the transplant results of 567 transfusion-dependent thalassemia patients who received a transplant between 1998 and 2015 considering their stem cell source as a comparative variable. In multivariate Cox analysis the survival advantage for bone marrow compared with peripheral blood was not significant after adjusting for sex, age, and hepatic fibrosis presence. Rejection incidence was significantly lower in patients who used peripheral blood as their graft source. Acute and chronic graft-versus-host disease were more frequent in peripheral blood transplants, but the difference was not statistically significant. This study shows that peripheral blood could be an alternative stem cell source in patients undergoing allogeneic HSCT for thalassemia.     

Comparable Long-Term Outcome of Unrelated Cord Blood Transplantation with Related Bone Marrow or Peripheral Blood Stem Cell Transplantation in Patients Aged 45 Years or Older with Hematologic Malignancies after Myeloablative Conditioning

We investigated whether bone marrow or peripheral blood stem cells from older sibling donors or cord blood from unrelated donors provided a better outcome in allogeneic hematopoietic stem cell transplantation for relatively older patients who were candidates for myeloablative conditioning. Clinical outcomes of 97 patients aged 45 years or older with hematologic malignancies who received unrelated cord blood transplantation (CBT) (n = 66) or bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) from related donors (n = 31) were compared. The cumulative incidences of grades III to IV acute and extensive chronic graft-versus-host diseases were similar between both groups. Although transplant-related mortality was significantly lower after CBT compared with BMT/PBSCT from related donors (hazard ratio [HR], .29, P = .04), overall mortality (HR, .72, P = .47) and relapse (HR, 2.02, P = .23) were not significantly different after CBT and BMT/PBSCT from related donors. These data suggest that CBT could be as safe and effective as BMT/PBSCT from older related donors for relatively older patients when it is used as a primary unrelated stem cell source.     

骨髓涂片和骨髓活检在骨髓增生异常综合征诊断中的意义

对33例初诊骨髓增生异常综合征病人的骨髓涂片及骨髓活检进行分析,表明涂片在初诊筛选中能对MDS作出诊断,而骨髓活检对判断增生度,显示各系病态造血,提供预后信息及确诊MDS合并骨髓纤维化中意义重大,后者对前者起补充、修正的作用.     

Comparison of Cytokine Expression in Mesenchymal Stem Cells from Human Placenta, Cord Blood, and Bone Marrow

Mesenchymal stem cells (MSCs) are capable of self-renewal and differentiation into lineages of mesenchymal tissues that are currently under investigation for a variety of therapeutic applications. The purpose of this study was to compare cytokine gene expression in MSCs from human placenta, cord blood (CB) and bone marrow (BM). The cytokine expression profiles of MSCs from BM, CB and placenta (amnion, decidua) were compared by proteome profiler array analysis. The cytokines that were expressed differently, in each type of MSC, were analyzed by real-time PCR. We evaluated 36 cytokines. Most types of MSCs had a common expression pattern including MIF (GIF, DER6), IL-8 (CXCL8), Serpin E1 (PAI-1), GROα(CXCL1), and IL-6. MCP-1, however, was expressed in both the MSCs from the BM and the amnion. sICAM-1 was expressed in both the amnion and decidua MSCs. SDF-1 was expressed only in the BM MSCs. Real-time PCR demonstrated the expression of the cytokines in each of the MSCs. The MSCs from bone marrow, placenta (amnion and decidua) and cord blood expressed the cytokines differently. These results suggest that cytokine induction and signal transduction are different in MSCs from different tissues.     

冠状动脉粥样硬化患者外周血Th17细胞与 IL-17的水平及意义

目的 探究冠状动脉粥样硬化患者外周血Th17细胞与IL-17水平变化的意义。方法 收集青岛阜外心血管病医院冠状动脉粥样硬化患者200例,根据疾病类型分为心肌梗死（AMI）组（52例）、不稳定型心绞痛（UA）组（68例）、稳定型心绞痛（SA）组（80例）,另外选取同期200例体检者作为对照组。采用流式细胞术检测患者Th17细胞频率,ELISA法检测各组血清中IL-17、CRP表达水平。结果 流式细胞检测结果显示,与对照组比较,各组Th17细胞的频率表达均升高,差异具有统计学意义（P＜0.05）,且AMI组升高水平高于SA组和UA组,差异具有统计学意义（P＜0.05）; ELISA检测结果显示,与对照组比较,各组IL-17及CRP表达水平均升高,差异具有统计学意义（P＜0.05）,且AMI组升高水平高于SA组和UA组,差异具有统计学意义（P＜0.05）。结论 冠状动脉粥样硬化患者血中Th17及IL-17水平的升高,可能是导致冠状动脉粥样硬化患者板块不稳定的原因。     

医学数字化可视技术在周围血管疾病 临床诊断中的应用

目的 分析医学数字化可视技术在周围血管疾病临床诊断中的应用价值。方法 选择2014年5月~2018年5月我院手足外科收治的63例周围血管疾病患者为研究对象,对患者行数字减影血管造影（DSA）,后再行数字化可视技术检查,对其病情进行诊断评估,并对两种检查的结果进行对比。结果 周围血管疾病患者采用数字化可视技术检查,出现血管狭窄22例,闭塞11例,血管扩张12例,血管破裂8例,静脉瓣关闭不全10例;DSA检查中,出现血管狭窄20例,闭塞10例,血管扩张10例,血管破裂8例,静脉瓣关闭不全8例。数字化可视技术对周围血管疾病的诊断率高于DSA（100.00% vs 88.89%）,差异具有统计学意义（P＜0.05）。结论 在周围血管疾病临床诊断当中使用数字化可视技术,可对病灶予以明确诊断,为临床治疗提供参考依据,应用前景广阔。但目前数字化可视技术在我国医学领域的应用尚未普及,在未来的研究中仍需更多的理论和数据支持。     

Peripheral Blood versus Bone Marrow from Unrelated Donors: Bone Marrow Allografts Have Improved Long-Term Overall and Graft-versus-Host Disease-Free,Relapse-Free Survival

Peripheral blood (PB) and bone marrow (BM) from unrelated donors can serve as a graft source for hematopoietic cell transplantation (HCT). Currently, PB is most commonly used in roughly 80% of adult recipients. Determining the long-term impact of graft source on outcomes would inform this decision. Data collected by the Center for International Blood and Marrow Transplant Research from 5200 adult recipients of a first HCT from an 8/8 or 7/8 HLA antigen-matched unrelated donor for treatment of acute leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome between 2001 and 2011 were analyzed to determine the impact of graft source on graft-versus-host disease (GVHD) relapse-free survival (GRFS), defined as freedom from grade III/IV acute GVHD, chronic GVHD requiring immunosuppressive therapy, relapse, and death, and overall survival. GRFS at 2 years was superior in BM recipients compared with PB recipients (16%; 95% confidence interval [CI], 14% to 18% versus 10%; 95% CI, 8% to 11%; P <.0001) in the 8/8 HLA-matched cohort and 7/8 HLA-matched cohort (11%; 95% CI, 8% to 14% versus 5%; 95% CI, 4% to 7%; P?=?.001). With 8/8 HLA-matched unrelated donors, overall survival at 5 years was superior in recipients of BM (43%; 95% CI, 40% to 46% versus 38%; 95% CI, 36% to 40%; P?=?.014). The inferior 5-year survival in the PB cohort was attributable to a higher frequency of deaths while in remission compared with the BM cohort. For recipients of 7/8 HLA-matched grafts, survival at 5 years was similar in BM recipients and PB recipients (32% versus 29%; P?=?.329). BM grafts are associated with improved long-term GRFS and overall survival in recipients of matched unrelated donor HCT and should be considered the unrelated allograft of choice, when available, for adults with acute leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome.     

便携式血糖仪与生化分析仪实际方法检测血糖结果比对分析

目的 通过京都GT-1640便携式血糖仪与日立7600全自动生化分析仪测定血糖结果的比对,评价京都GT-1640便携式血糖仪的准确性。方法 选择献县中医医院门诊及住院糖尿病患者100例,同一患者同时采集末梢血和静脉血,分别利用京都GT-1640便携式血糖仪和日立7600全自动生化分析仪检测血糖。结果 京都GT-1640便携式血糖仪与日立7600全自动生化分析仪检测血糖结果,无统计学差异（P＞0.05）,准确系数＞0.981,准确性较好。结论 京都GT-1640便携式血糖仪性能较稳定、重复性较好、准确性较高。     

Donor Experiences of Second Marrow or Peripheral Blood Stem Cell Collection Mirror the First,but CD34+ Yields Are Less

Little is known about the experiences of individuals donating peripheral blood stem cells (PBSCs) or marrow for a second time. To study this, unrelated donors making a second donation through the National Marrow Donor Program between 2004 and 2013 were evaluated. Experiences of second-time donors giving marrow (n?=?118: first donation was PBSC in 76 and marrow in 42) were compared with those making only 1 marrow donation (n?=?5829). Experiences of second-time donors giving PBSCs (n?=?602) (first donation was PBSCs in 362; marrow in 240) were compared to first-time PBSC donors (n?=?16,095). For donors giving a second PBSC or marrow donation there were no significant differences in maximum skeletal pain, maximum symptoms measured by an established modified toxicity criteria, and recovery time compared with those who donated only once. Notably, the yield of marrow nucleated cells and PBSC CD34⁺ cells with second donations was less. As previously noted with single first-time donations, female (PBSCs and marrow) and obese donors (PBSCs) had higher skeletal pain and/or toxicity with a second donation. PBSC donors who experienced high levels of pain or toxicity with the first donation also experienced high levels of these symptoms with their second donation and slower recovery times. In conclusion, for most donors second donation experiences were similar to first donation experiences, but CD34⁺ yields were less. Knowledge of the donor's first experience and stem cell yields may help centers decide whether second donations are appropriate and institute measures to improve donor experiences.     

红景天多糖对骨髓抑制贫血小鼠外周血及骨髓细胞周期的影响

目的观察红景天多糖对骨髓抑制贫血小鼠外周血及骨髓细胞周期的影响,并探讨其造血调控作用机制。方法用全自动血细胞分析仪、白细胞计数法、流式细胞术（FCM）分别检测红景天多糖对骨髓抑制贫血小鼠外周血、骨髓有核细胞、骨髓细胞周期的影响。结果中剂量和高剂量红景天多糖能明显升高外周血白细胞（WBC）、红细胞（RBC）、血红蛋白（Hb）及骨髓有核细胞（BMCs）数,但对血小板的作用不明显。高剂量组可促进骨髓G0／G1期细胞向S期细胞以及S期细胞向G2／M期细胞的转化,增殖指数（PI）也明显升高。结论红景天多糖可能通过促使骨髓抑制贫血小鼠骨髓细胞通过G1期的限制点,进入细胞增殖周期,加速骨髓G0／G1期细胞向S期细胞、S期细胞向G2／M期细胞的转化,促进骨髓造血细胞增殖,提高外周血象,促进骨髓造血功能的恢复。