系统性红斑狼疮患者淋巴细胞亚群早期凋亡的初步研究

目的：检测系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中不同细胞亚群发生凋亡的情况，并初步分析其在SLE发病机制中的意义。方法：取28例SLE患者和性别年龄与之相匹配的20个正常对照者。采用淋巴细胞亚群标志、Annexin-V及碘化丙啶三色荧光标记、流式细胞术检测细胞的早期凋亡。结果：SLE患者体内CD3^ T细胞、CD4^ T细胞和CD8^ T细胞的凋亡百分率均显著高于正常对照组(P＜0．05)。同时，SLE患者T淋巴细胞的死亡百分率也高于正常人。经激素治疗一定时间后，这些细胞亚群的凋亡率会进一步升高(P＜0．01)，但CD4／CD8比值恢复至接近正常人。SLE患考体内CDl9^ B淋巴细胞的凋亡或死亡百分率和正常对照组相比均无明显差别，激素治疗对B细胞凋亡和死亡的影响亦不显著。结论：在SLE患者体内主要是T淋巴细胞凋亡增加，但SLE患者淋巴细胞数目减少不仅仅是因为细胞凋亡所致，死亡细胞数目明显升高也是其中一个重要原因。激素治疗可诱导SLE患者T淋巴细胞进一步发生凋亡，并使T细胞亚群比例有所改善。     

小鼠胸腺细胞发育过程中CD4+CD25+T细胞变化的体内外比较

目的比较研究小鼠体内外胸腺细胞CD4^＋CD25^＋双阳性T细胞发育的动态变化，为天然调节性T细胞的研究提供基础数据。方法采用14．5天龄胚鼠胸腺进行体外培养，以FACS检测不同时间点胸腺细胞的表型变化，同时计数每个胸腺小叶的细胞数变化。结果胸腺在体内发育的第14．5、15、16、17、18、19天CD4^＋CD25^＋双阳性T细胞的比例、细胞的数量与在体外胸腺培养的第1～6天在胸腺细胞中的比例、细胞数发育趋势相似；CD4^＋CD25^＋双阳性T细胞占CD4^＋T细胞的比例分别为8．19％、16．41％、24．06％、13．62％、8．10％、2．35％，占CD25^＋细胞的比例分别为0．34％、1．08％、2．40％、10．59％、32．51％、34．04％。与体内结果相似，胸腺细胞体外培养的结果显示：在培养的第1～6天，CD4^＋CD25^＋T细胞占CD4^＋T细胞的比例分别为58．29％、12．14％、6．08％、17．78％、9．06％、4．04％，占CD25^＋T细胞的比例分别为3．75％、10．81％、17．20％、51．93％、61．64％、80．06％。结论体外培养的CD4^＋CD25^＋双阳性胸腺细胞数量和比例变化与体内发育变化趋势一致，在体外培养第4天（约等于18．5天胚鼠）和体内发育的第17天该群细胞比例最大．这将为天然调节性T细胞的发生、发育学研究提供有效的参考。     

进展期胃癌患者手术前后细胞免疫状态的变化和临床意义

目的 检测进展期胃癌患者手术前后细胞免疫指标．即T细胞亚群及NK细胞变化的情况。方法 采用流式细胞仪(FACS)对22例进展期胃癌患者手术前后不同时期的T细胞亚群．即所有表达于T细胞表面的分子(CD3^ )．辅助T性细胞表面分子(CD4^ )，抑制性T细胞表面分子(CD8^ )，以及NK细胞表面分子(CD16 56)进行检测。结果 (1)进展期胃癌组CD3、CD4、CD16 56阳性细胞数．CD4^ ／CD8^ 比值明显低于正常对照组．CD8阳性细胞数明显高于正常对照组．机体的细胞免疫机能受到抑制。(2)术后第3天组的CD8阳性细胞数明显高于术前组，CD16 56阳性细胞数、CD4／CD8比值明显低于术前组，机体的细胞免疫机能进一步受到抑制。(3)术后第7天组的T细胞亚群及NK细胞阳性数基本恢复至术前水平．但同正常对照组相比．仍有显著差异。(4)术后第7天组CD4^ ／CD8^ 比值明显高于术后第3天组，提示机体TH／TS比值逐渐好转．细胞免疫功能逐步改善。结论 开展围手术期T细胞亚群及NK细胞群的动态检测．对了解进展期胃癌细胞免疫状态．肿瘤的转移和预后有一定的临床意义．并对进展期胃癌患者术后早期的免疫治疗或免疫化疗提供理论依据。     

大鼠肾移植亚临床急性排斥反应中T淋巴细胞亚群的变化及其意义

目的建立大鼠异体肾移植模型，研究肾移植中T细胞亚群的变化及其与亚临床急性排斥反应的关系。方法实验分为5组，第1～4组为异品系移植组(SD to Wistar)；第5组为同品系移植组(Wistar to Wistar)作为对照组，观察第1、2、3、5组移植术后排斥反应；用免疫荧光染色流式细胞仪检测第4、5组手术前后T细胞亚群。结果异品系移植组(SD→Wistar)大鼠肾移植亚临床急性排斥反应于术后3、4d出现；CD4／CD8比值于术后第2天显著增高，同品系移植组(Wistar to Wistar)术后，CD4／CD8较术前无明显变化，未出现排斥反应。结论肾移植术后T细胞亚群中CD4／CD8比值的变化比病理改变提前出现1、2d，可作为监测异体肾移植亚临床急性排斥反应的免疫学指标。     

卡介菌多糖核酸对尖锐湿疣患者外周血T细胞亚群及其细胞因子表达的影响

目的 研究卡介菌多糖核酸（BCG-PSN）对尖锐湿疣（CA）患者外周血T淋巴细胞亚群及胞内细胞因子表达的影响，探讨BCG-PSN对尖锐湿疣可能的免疫调节机制。方法 采用三色和双色荧光抗体染色技术经流式细胞仪检测18例CA患者在BCG-PSN治疗前后外周血T淋巴细胞亚群及CD4^＋T细胞、CD8^＋T细胞内IL-2、IL-4、IL-12、IFN-γ染色阳性细胞百分率。结果 在BCG-PSN治疗前，CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显低于对照组（均P〈O．01），CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较对照组明显下降（均P〈0．01），IL-4阳性细胞百分率与对照组比较差异无显著性意义（P〉0．05）；而治疗后CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显高于治疗前（均P〈O．01）；CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较治疗前升高（均P〈0．01）。结论 BCG-PSN可通过调节尖锐湿疣患者T细胞亚群，纠正患者Th1／Th2模式及Tc1／Tc2模式失衡现象，起到治疗尖锐湿疣的作用。     

T淋巴细胞亚群异常与特发性血小板减少性紫癜的关系

目的 通过检测T淋巴细胞亚群及其凋亡，初步探讨T淋巴细胞亚群异常在特发性减少性紫癜（ITP）发病机制中的作用。方法 采用流式细胞术对ITP患者及正常对照组的外周血淋巴细胞亚群进行检测；DNA琼脂糖凝胶电泳检测T淋巴细胞的凋亡。结栗ITP患者CD3^＋、CD4^＋和CD4^＋CD25^＋T细胞比例均显著低于正常对照组（P〈0．05或P〈0．01），而CD8^＋T细胞和CD4^＋T细胞表面Fas表达均较正常组增加（P〈0．01）；T淋巴细胞凋亡敏感性增加。结论 ITP患者外周血T淋巴细胞亚群异常，T细胞免疫调控亚群（CD4^＋CD25^＋）凋亡增多，对自身反应性T细胞亚群免疫下调作用降低，破坏自身免疫耐受，在ITP的发病中起重要作用。     

原发性肝癌患者CD8^＋CD28^—和CD8^＋CD28^＋细胞亚群的分析

目的 研究原发性肝癌（HCC）病人外周血CD8^ 细胞亚群及CD8^ T细胞上CD28分子的表达。方法 用流式细胞仪对20例原发性肝癌病人的CD8^ 细胞亚群及CD8^ T细胞上CD28分子（即CD8^ CD28^ 和CD8^ CD28^-)的表达进行检测。结果 HCC病人CD8 细胞百分率升高，CD8^ CD28^ 细胞百分率降低，CD8^ CD28^-细胞百分率升高，与对照组相比具有显著性差异。CD8^ CD28^ ,CD8^ CD28^-细胞百分率与CD8^ T细胞百分率的相关性研究表明，CD8^ CD28^- 细胞数与CD8^ T细胞数之间呈正相关。结论 HCC病人CD8^ 细胞升高，CD8^ 细胞上CD28分子的表达是异常的，即CD8^ CD28^-细胞数升高。CD8^ CD28^ 细胞细胞数降低；CD8^ T细胞的升高是CD8^ CD28^-细胞亚群升高的结果。     

霉酚酸对21例系统性红斑狼疮患者细胞因子释放及Th细胞亚群的作用研究

目的：研究霉酚酸(MPA)对系统性红斑狼疮(SLE)患者外周血Th细胞亚群平衡的作用。方法：分离2l例SLE患者及14例健康对照的外周血单个核细胞(PBMCs)，分别加或不加MPA培养48h，用ELISA法测培养上清中IL-10、IL-12和IFN-γ的水平，用三色流式细胞术检测培养细胞中CD4^ IFN-γ^ IL-10-T细胞、CD4^ IFN-γ-IL-10^ T细胞及CD4^ IFN-γ-IL-10^ T细胞百分率。结果：SLE患者PBMCs培养上清中IL-10、IL-12、IFN-γ等细胞因子水平显著升高，MPA可使SLE患者PBMCs自发产生或PHA刺激产生的IL-10、IL-12和IFN-γ的水平显著降低；SLE患者培养的PBMCs中CD4^ IFN-γ^ IL-10^ T细胞亚群和CD4^ IFN-γ^ IL-10^ T细胞亚群百分率显著增高，而MPA可导致用或未用PHA刺激培养的PBMCs中CD4^ IFN-γ^ IL-10-T细胞、CD4’IFN-γ-IL-10^ T细胞及CD4^ IFN-γ^ IL-10^ T细胞阳性率下降，尤其是可使SLE异常升高的CD4^ IFN-γ-IL-10^ T细胞亚群和CD4^ IFN-γ^ IL-10^ T细胞亚群百分率显著降低。结论：MPA治疗SLE的疗效作用可能与抑制IL-10、IL-12和IFN-γ等细胞因子的异常释放及抑制CD4^ IFN-γ^ IL-10-T细胞、CD4^ IFN-γ-IL-10 T细胞及CD4^ IFN-γ^ IL-10^ T细胞亚群的活化增殖有关。     

外科危重病人手术后TPN支持对患者血清蛋白质和细胞免疫的影响

目的：探讨TPN支持疗法对外科危重病人手术后血清蛋白质和细胞免疫的影响。方法：70例外科危重病人随机分成TPN组(40例)和常规组(30例)，分别在术前和术后第10天采血测其白蛋白(AL)、前蛋白(PA)、转铁蛋白(TF)；T细胞亚群(CD3^ 、CD4^ 、CD8^ 、CD4^ ／CD8^ )；血清白介素—2(IL—2)的浓度。结果：与常规组相比，TPN组血清蛋白含量术后未见明显下降；细胞免疫指标CD3^ 、CD4、CD8^ 、CD4^ ／CD8^ 、IL—2升高明显。结论：TPN改善了重病患者手术后的营养状况，提高了免疫力。     

BSA系统检测慢性乙肝患者T淋巴细胞亚群

应用生物素-链霉亲合素（Biotin-streptavidia,BSA）系统对乙肝患者外周血单个核T淋巴细胞（PBMC）亚群变化进行检测分析．结果各型慢性乙肝患者CD4+细胞的百分率均较正常对照组明显降低，而CD8+细胞的百分率较正常对照组显著增高，CD4+／CD8+值明显下降；但各型慢性乙肝患者淋巴细胞亚群间相比，差别无显著性。表明慢性乙肝患者存在明显细胞免疫功能紊乱,但与病情轻重无直接关系．     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.