乳腺癌能量多普勒超声成像及微血管密度检测与腋窝淋巴结转移的关系

目的研究乳腺癌能量多普勒超声成像（power Doppler imaging,PDI）及微血管密度（microvessel densi-ty,MVD）检测与腋窝淋巴结转移的关系。方法利用PDI检测乳腺癌肿块内血流信号,并采用免疫组化法检测30例乳腺癌肿块内MVD,比较乳腺癌肿块内血流信号及MVD与腋窝淋巴结转移的关系。结果有腋窝淋巴结转移即LN＋组13例,无腋窝淋巴结转移即LN-组17例。LN＋组肿块内血流信号较LN-组明显丰富（P〈0.05）。LN＋组CD34标记的血管计数较LN-组明显增高（P〈0.01）。结论通过PDI技术与MVD检测结合,能很好地评估乳腺癌血管生成,且与腋窝淋巴结转移密切相关。     

基于多模态DCE-MRI特征在乳腺癌腋窝淋巴结转移风险评估中的价值

目的探究多模态动态增强磁共振成像（dynamic contrast enhanced magnetic resonance imaging,DCE-MRI）在预测乳腺癌病人腋窝淋巴结转移风险中的价值。方法回顾性分析54例经手术病理证实的乳腺癌病人的术前临床及影像学资料,入组病人均在术前进行多模态DCE-MRI扫描。根据病人有无腋窝淋巴结（axillary lymph node metastasis,ALNM）分为腋窝淋巴结转移组（ALNM阳性组）19例和无腋窝淋巴结转移组（ALNM阴性组）35例,重点分析2组临床一般资料及DCE-MRI特征与腋窝淋巴结转移间的相关性。结果54例乳腺癌病人的临床一般资料（包括年龄、绝经史、生育史、肿块质地、肿块活动性）与ALNM无关（P>0.05）;在多模态DCE-MRI特征方面,ALNM阳性组肿块边缘模糊者比例明显高于ALNM阴性组（P < 0.01）;ALNM阳性组病人的肿块ADC明显低于ALNM阴性组（P < 0.01）;ALNM阳性组中ALN≥0.5 cm比例明显高于ALNM阴性组（P < 0.05）;多因素分析结果显示,肿块ADC值和肿块边缘方面是乳腺癌ALNM的独立危险因素（P < 0.01）;此外,肿块ADC值的AUC、敏感性、特异性和cut-off值分别为0.743、78.9%、71.4%和0.912×10-3mm2/s;肿块边缘的AUC、敏感性和特异性分别为0.750、84.2%和65.6%。结论多模态DCE-MRI中的边缘特征及ADC值与乳腺癌腋窝淋巴结转移的风险因素有助于乳腺癌病人治疗方案的制定及预后评估。     

microRNA-34a与乳腺癌的临床病理相关性研究

目的 检测microRNA-34a（miR-34a）在乳腺癌与相应正常组织中的表达情况,研究miR-34a与乳腺癌的临床病理相关性。 方法 应用qRT-PCR技术检测67例乳腺癌标本中miR-34a的表达,同时分析其和临床病理因素之间的相关性。 结果 乳腺癌组织中miR-34a的表达量明显低于配对的癌旁组织（P < 0.01）;年龄、性别、月经状况、孕激素受体水平、Ki67表达与人类表皮生长因子受体水平对病人癌组织miR-34a的表达影响均无统计学意义（P>0.05）;肿块直径、淋巴结转移、病理类型、临床分期、雌激素受体水平、是否三阴性对对病人癌组织miR-34a的表达影响均有统计学意义（P < 0.05~P < 0.01）,肿块直径≤2 cm组的表达高于直径>2 cm组（P < 0.05）,淋巴结无转移组的表达高于有转移组（P < 0.05）,非浸润性组的表达高于浸润性（P < 0.05）,Ⅰ期组和Ⅱ期组的表达均高于Ⅲ+Ⅳ期组（P < 0.01）,雌激素受体阳性组的表达高于阴性（P < 0.01）,三阴性组的表达低于非三阴性组（P < 0.01）。 结论 乳腺癌中miR-34a呈现低表达,与各临床病理因素分析后表明其可能在乳腺癌的发生发展及预后中起重要作用。     

Logistic回归和 ROC工作曲线评价五种肿瘤标志物在乳腺癌诊断中的价值

目的 综合应用Logistic回归和 ROC工作曲线评价癌胚抗原(carcinoembryo antigen,CEA)、血清糖类抗原125(serum carbohydrate antigen 125, CA125)、血清糖类抗原153(carbohydrate antigen153,CA153)、降钙素原 (procalcitonin,PCT)、人附睾蛋白4( human epididymis protein 4,HE4)五种肿瘤标志物在乳腺癌诊断中的价值。 方法 采用罗氏全自动电化学发光仪检测42例乳腺癌患者（乳腺癌组）和42例健康者（对照组）的血清CEA、CA125、CA153、PCT、HE4水平,分析比较乳腺癌组与对照组血清CEA、CA125、CA153、PCT、HE4水平差异;运用Logistic回归分析筛选出诊断乳腺癌有效指标,并用ROC曲线综合评价各种指标在乳腺癌诊断中的价值。 结果 乳腺癌组血清CEA、CA125、CA153、PCT、HE4水平高于对照组,差异有统计学意义（P<0.05）;把CA125、PCT从自变量中筛除（P>0.05）,设自变量X₁=CEA、X₂=CA153、X₃=HE4,建立Logistic回归方程：Logit(P)=-17.806+0.715X₁+0.157X₂+0.078X₃;通过ROC曲线分析,HE4、CEA、CA153曲线下面积分别为0.843、0.775、0.716,在单独检测中HE4的曲线下面积最大,三项联合检测曲线下面积（0.906）大于其他三项。 结论 HE4、CEA、CA153可作为诊断乳腺癌的有效指标,三项肿瘤标志物联合检测可以在一定程度上弥补单项指标的不足。     

中西医结合疗法对乳腺癌患者术后免疫功能的影响

目的 观察中西医结合疗法对应用了新辅助化疗后的乳腺癌根治术患者术后体液及细胞免疫功能及炎症因子的影响。 方法 普外科90例乳腺癌患者,术前均行新辅助化疗,术后分为对照组与观察组(n=45),其中观察组在常规治疗同时给予中医药治疗。于术前(T₁)、术后24 h(T₂)、术后1周(T₃)、术后4周(T₄)、术后9周(T₅)采血用全自动生化分析仪检测T淋巴亚群CD4+、CD8+和NK细胞水平,免疫球蛋白IgA、IgG、IgM含量及采用酶联免疫吸附法(ELISA)检测炎症因子IL-6、IL-10、TNF-α水平。采用统计学软件SPSS 16.0处理数据。 结果 与T₁比较,2组T_2~3时点CD8+,T_3~5时点IgG及IgM水平升高;对照组T_2~3时点CD4+,NK细胞以及T_2~5的CD4+/CD8+下降;观察组T₂时点CD4+,NK细胞以及T_2~3的CD4+/CD8+下降;对照组T_3~5时点和观察组T_2~3时点IL-6及TNF-α水平升高,IL-10水平下降(P＜0.05)。与对照组比较,观察组T_3~5时点CD4+、CD4+/CD8+、NK细胞、IgG及IgM上升,CD8+下降;T_4~5时点IL-6及TNF-α水平下降,IL-10水平升高(P＜0.05)。 结论 中西医结合疗法可提高新辅助化疗后的乳腺癌根治术患者术后免疫力,减少炎症反应,促进康复。      

乳腺癌组织HIF-1α和Sema 4D表达及其与淋巴管密度和各临床病理指标的关系

目的通过检测HIF-1α和Sema 4D在乳腺癌组织表达,探讨其与淋巴管密度（LVD）和临床病理指标的关系。方法采用免疫组化SP法检测110例乳腺癌组织标本HIF-1α和Sema 4D表达,检测微淋巴管密度（LVD）,依据不同临床病理特征分组并进行组间比较,并与乳腺纤维腺瘤组织标本对照。结果乳腺癌组织HIF-1α和Sema 4D阳性表达率分别为72.72%（80/110）和77.27%（85/110）;HIF-1α与Sema 4D表达呈正相关性（r=0.691,P〈0.01）。乳腺癌组织LVD显著高于纤维腺瘤组（P〈0.01）,淋巴结转移组LVD显著高于无淋巴结转移组（P〈0.01）;p TNMⅠ~Ⅱ期组、淋巴结无转移组癌组织HIF-1α和Sema 4D表达阳性率明显低于p TNMⅢ期组、有淋巴结转移组（P〈0.05,P〈0.01）,不同年龄、组织学分级、肿块大小组之间差异无统计学意义（P〉0.05）。结论乳腺癌组织HIF-1α、Sema 4D高表达,可能与淋巴管的增生、转移侵袭有密切关系。     

尿液中转化生长因子β1和层粘连蛋白含量与乳腺癌的相关性研究

目的探讨尿液中转化生长因子β1（TGF-β1）和层粘连蛋白（LN）与乳腺浸润性导管癌的相关性。方法采用夹心法酶联免疫吸附技术（ELISA）分别检测60例乳腺癌患者、32例乳腺良性疾病患者及32例健康对照者尿液TGF-β1及LN的含量。结果乳腺癌组尿液LN含量高于良性病变组和对照组,差异均有显著性（P〈005）,乳腺癌组尿液TGF-β1含量与良性病变组和对照组相比,差异无显著性（P〉0.05）。但在乳腺癌进展期患者尿液TGF-β1含量均明显升高,差异有统计学意义（P＜0.05）。等级相关分析：尿液TGF-β1和LN含量与临床分期和淋巴结转移状况呈显著性正相关（r＝0.598/0.560,P=0.001;r＝0.647/0.602,P＝0.000/0.000）;与雌激素受体、C-erbB-2呈负相关（r＝-0.263/-0.311,P＝0.042/0.016;r＝-0.288/-0.330,P＝0.026/0.010）。结论乳腺癌患者尿液中TGF-β1及LN含量与临床分期和淋巴结转移状况呈正相关,提示TGF-β1和LN与乳腺癌的病理机制及浸润、转移等生物学行为有密切关系。     

术前能量多普勒超声检测血流信号联合CD34检测微血管密度诊断乳腺癌腋窝淋巴结转移的临床意义

目的探讨术前联合能量多普勒超声(power Doppler imaging,PDI)检测血流信号及CD34检测微血管密度对乳腺癌腋窝淋巴结转移诊断的临床意义。方法以30名乳腺癌患者为研究对象,用PDI检测乳腺癌肿块内血流信号,用免疫组化法检测30例乳腺癌组织内微血管密度(microvessel density,MVD),研究乳腺癌肿瘤内血流信号及微血管密度与腋窝淋巴结转移的关系。结果研究结果显示,30名患者中有腋窝淋巴结转移患者即LN+组13例,无腋窝淋巴结转移即LN-组17例。LN+组肿块内血流信号较LN-组明显丰富(P<0.05);LN+组CD34标记的血管计数较LN-组明显增高(P<0.01)。结论术前对乳腺癌患者行PDI与MVD的联合检测,能很好评估乳腺癌血管生成,且可预测腋窝淋巴结转移的风险,对临床治疗方案的选择具有重要的参考意义。     

Hsa_circ_0001946/miR-7/KLF4轴调控乳腺癌进展的研究

目的探讨环状RNAhsa_circ_0001946在乳腺癌组织中的表达情况及hsa_circ_0001946/miR-7/Kruppel样因子4（KLF4）轴调控乳腺癌细胞发生侵袭和转移的机制。方法收集2018年6月至2019年8月在温州医科大学附属第三医院切除的乳腺癌组织标本及其癌旁正常乳腺组织标本91例。采用实时荧光定量PCR法检测乳腺癌及其癌旁正常组织中hsa_circ_0001946、miR-7、KLF4mRNA表达情况及乳腺癌细胞株MCF-7中hsa_circ_0001946、miR-7、KLF4、E-钙黏蛋白（E-cadherin）、N-钙黏蛋白（N-cadherin）mRNA表达情况;采用细胞侵袭实验分析乳腺癌MCF-7细胞株的侵袭能力;采用Westernblot法检测乳腺癌细胞株MCF-7中E-cadherin及N-cadherin蛋白表达情况。结果与癌旁正常乳腺组织比较,乳腺癌组织中hsa_circ_0001946和KLF4mRNA表达水平均升高,miR-7表达水平下降（均P＜0.05）。与正常乳腺组织、乳腺导管原位癌组织比较,乳腺浸润性导管癌组织中hsa_circ_0001946mRNA表达水平升高（均P＜0.05）。分析82例乳腺浸润性导管癌患者发现,有淋巴结转移者hsa_circ_0001946mRNA表达水平高于无淋巴结转移者（P＜0.05）。Pearson相关显示,乳腺癌组织中hsa_circ_0001946mRNA的表达与miR-7的表达呈负相关（r=-0.418,P＜0.05）,miR-7的表达与KLF4mRNAmRNA的表达呈负相关（r=-0.340,P＜0.05）。与阴性对照组相比,转染sh-hsa_circ_0001946组MCF-7细胞中miR-7表达升高,KLF4mRNA表达下降（均P＜0.05）;与阴性对照组相比,转染miR-7mimics组MCF-7细胞中KLF4mRNA表达下降（P＜0.05）;与阴性对照组相比,转染sh-hsa_circ_0001946组侵袭细胞数减少（P＜0.05）;与阴性对照组相比,转染KLF4siRNA组MCF-7细胞中E-cadherinmRNA及蛋白表达水平均升高,N-cadherinmRNA及蛋白表达水平均下降（均P＜0.05）。结论Hsa_circ_0001946在乳腺癌细胞中表达升高,可通过miR-7/KLF4调控轴使癌细胞发生上皮-间质转化,促进癌细胞的侵袭和转移。     

IL-4协同雌二醇对小鼠乳腺癌细胞生长的促进作用及其机制

目的：探讨白细胞介素4（IL-4）协同雌二醇对小鼠乳腺癌4T1细胞对其生物学行为的影响,并阐明其作用机制。方法：体外培养4T1细胞,加入不同浓度（0、12.5、25.0、50.0和100.0 μg·L^-1） IL-4或雌二醇（0、6.25、12.50、25.00、50.00 nmol·L^-1）,作用72 h后MTT法检测乳腺癌4T1细胞增殖率。将乳腺癌4T1细胞分为对照组（不进行任何处理）、IL-4组（加入50.0 μg·L^-1 IL-4）、雌二醇组（加入12.50 nmol·L^-1雌二醇）和联合组（加入50.0 μg·L^-1 IL-4+12.50 nmol·L^-1雌二醇）,MTT法检测各组乳腺癌4T1细胞增殖率,流式细胞术检测各组不同细胞周期乳腺癌4T1细胞百分比,Western blotting法检测各组乳腺癌4T1细胞中STAT6、p-STAT6、ERα、Erk、p-Erk、P70S6K、p-P70S6K、S6和p-S6蛋白表达水平。结果：与0 μg·L^-1 IL-4组比较,25.0、50.0和100.0 μg·L^-1IL-4组乳腺癌4T1细胞增殖率升高（P<0.05）。与0 nmol·L^-1雌二醇组比较,12.50、25.00、50.00 nmol·L^-1雌二醇组乳腺癌4T1细胞增殖率升高（P<0.05）。与对照组比较,IL-4组乳腺癌4T1细胞增殖率升高（P<0.05）;与对照组比较,雌二醇组乳腺癌4T1细胞增殖率升高（P<0.05）;与IL-4组或雌二醇组比较,联合组乳腺癌4T1细胞增殖率升高（P<0.05）。与对照组比较,IL-4组乳腺癌4T1细胞中S期和G₂/M期细胞百分比升高（P<0.05）,G₀及G₁期细胞百分比降低（P<0.05）;雌二醇组乳腺癌4T1细胞中S期细胞百分比明显升高（P<0.05）,G₀及G₁期细胞百分比降低（P<0.05）。与IL-4组或雌二醇组比较,联合组乳腺癌4T1细胞中S期和G₂/M期细胞百分比升高（P<0.05）,G₀及G₁期细胞百分比降低（P<0.05）。与对照组比较,IL-4组乳腺癌4T1细胞中ERα、p-Erk、p-P70S6K和p-S6蛋白表达水平升高,雌二醇组乳腺癌4T1细胞中p-STAT6、ERα、p-Erk、p-P70S6K、S6和p-S6蛋白表达水平升高（P<0.05）;联合组乳腺癌4T1细胞中STAT6、p-STAT6、ERα、p-Erk、p-P70S6K和p-S6蛋白表达水平升高（P<0.05）。结论：IL-4协同雌二醇可促进小鼠4T1乳腺癌细胞膜IL-4受体（IL-4R）和雌激素受体（ER）表达,增强乳腺癌4T1细胞中Erk1和p70S6K激酶的激活及下游分子S6蛋白的磷酸化。     

Changes in T cell subsets and T suppressor cell function and their relationship in human schistosomiasis japonica

Summary The function of spontaneous T suppressor cell (STs) of peripheral blood was examined in 56 patients with schistosomiasis japonica at various stages. The subsets of T cell were simultaneously phenotyped in 46 cases. The percentages of CD₃ ⁺(pan T cell), CD₄ ⁺ (helper/inducer T cell) and CD₈ ⁺ (suppressor/cytotoxic T cell) in patients with acute schistosomiasis japonica were significantly higher than those in the normal controls. In patients with chronic and advanced schistosomiasis japonica, the percentage of CD₈ ⁺ T cell and the function of STs were greatly increased, but the percentage of CD₃ ⁺ T cell and the ratio of CD₄ ⁺/CD₈ ⁺ were obviously reduced. All of these markers changed more significantly in patients with advanced schistosomiasis japonica. The percentage of CD₈ ⁺ T cell in patients with acute schistosomiasis japonica was negatively correlated with the function of STs. In patients with chronic and advanced schistosomiasis japonica the percentage of CD₈ ⁺ T cell was correlated positively and the ratio of CD₄ ⁺/CD₈ ⁺ negatively with the function of STs. The results indicated that the cellular immunity was significantly increased in cases of acute schistosomiasis japonica and decreased in those with chronic or advanced schistosomiasis japonica. The increased CD₈ ⁺ T cell may be principally cytotoxic T cells in patients with acute schistosomiasis japonica, but suppressor T cells in patients with chronic and advanced schistosomiasis japonica. The subsets of T cells and the function of T suppressor cells may play an important role in the immunoregulation of schistosomiasis japonica.     

Effect of Tiotropium Bromide on Expression of CD_8~＋CD_（25）~＋FoxP_3~＋ Regulatory T Cells in Patients with Stable Chronic Obstructive Pulmonary Disease

The expression of CD8+CD25+FoxP3+ regulatory T cells(CD8+Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD),and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8+Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide(18 μg daily) for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoclonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8+T cells,CD8+CD25+T cells,CD8+Tregs,CD4+T cells,CD4+CD25+T cells and CD4+CD25+FoxP3+ regulatory T cells(CD4+Tregs) respectively.The percentage of CD4+T cells was increased from(27.82±2.18)% to(35.53±1.3)%(t=3.20,P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4+CD25+T cells was decreased from(10.03 ±1.42)% to(4.21 ±0.65)%(t=3.78,P=0.001),and that of CD8+Tregs was increased from(8.41 ±1.68)% to(21.34 ±4.20)%(t=2.72,P=0.013).At baseline,CD8+T cells,CD8+CD25+T cells and CD4+Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4+T cells and CD4+CD25+T cells was negatively correlated with the ratio of change in CD8+Tregs before and after treatment(r=-0.61,P=0.013;r=-0.72,P=0.001 respectively).In the peripheral blood of patients with stable COPD,there was the expression of CD8+Tregs and CD4+Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4+T cells,inhibit the expression of CD25+T cells,and enhance the expression of CD8+Tregs.CD8+Tregs and CD4+Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.     

Study on abnormality and regulation of T-Lymphocyte subsets in peripheral blood of rheumatoid arthritis patients

Objective:ToinvestigatethechangeofT lymphocytesubsetsinperipheralbloodofrheumatoidarthritis (RA) patientsandanalyzetheeffectsofFuzhengQubiDecoction (FZQBD)onT cellsubsets.Methods:ThirtyRApatientswererandomlydividedintotwo groups,andtreatedwithFZQBDorweste…     

Determination of CD30 expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome by FCM

Summary To determine the CD₃₀ expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome (HFRS) and its clinical implications, double immunofluorescence technique and flow cytometry were used. There was no significant difference among the severe group, mild-moderate group and normal control group in the CD+CD₃₀ T lymphocyte subset. While the CD₄ ⁺CD₃₀ ⁻ T cells of HFRS patients were increased and the difference between severe group and mild-moderate group or normal control group were very significant (P<0.01) and the difference between the mild-moderate group and normal control group was also significant (P<0.05). The CD₈ ⁺CD₃₀ ⁻ T cells were increased while the CD₈ ⁺CD₃₀ ^- T cells decreased obviously in HFRS patients, and the differences among three groups in both subsets were very significant (P<0.01). The results showed that the humoral immunity and cellular immunity are overactive in HFRS patients during acute phase. The loss of balance between T lymphocyte subsets may play an important role in the pathophysiology of HFRS and is closely correlated with the severity of the HFRS. This project is supported by the grant of the Ministry of Health (Serial No. 96-2-116).     

中西医结合治疗对Graves病患者外周血T、B淋巴细胞亚群的影响

目的：研究中西医结合治疗对Graves病患者外周血T、B淋巴细胞亚群及部分协同刺激分子表达的影响。方法：运用流式细胞术测定20例Graves病初发患者、11例他巴唑治疗患者（西药组）、16例他巴唑合用中药五岳抗甲丸治疗患者（中西医结合组）及16例正常对照外周血淋巴细胞CD19、CD40、CD80、CD3、CD4、CD8、CD28等分子的表达水平。结果：Graves病初发患者CD19⁺、CD40⁺、CD19⁺ CD40⁺、CD80⁺细胞比率高于正常对照组(P＜0.01或P＜0.05),CD3⁺CD8⁺细胞比率降低(P＜0.05),CD3⁺CD4⁺/CD3⁺CD8⁺比值高于正常对照(P＜0.05);西药组患者CD80+细胞恢复正常,CD3⁺CD4⁺细胞比率及CD3⁺CD4⁺/CD3⁺CD8⁺比值高于正常对照(P＜0.05,P＜0.01),而CD3⁺CD8⁺及CD8⁺CD28⁺细胞比率低于正常对照(P＜0.01,P＜0.05);除CD80+细胞比率高于正常对照外,中西医结合组所测各种分子的表达同正常对照组比较,差异无统计学意义;同西药组比较,中西医结合组CD3⁺CD4⁺细胞降低(P＜0.01),CD3⁺CD8⁺及CD8⁺CD28⁺细胞比率升高(P＜0.01,P＜0.05), CD3⁺CD4⁺/CD3⁺CD8⁺比值降至正常水平(P＜0.01)。结论：Graves病患者体液免疫处于较高水平,存在细胞免疫调节失衡,中西医结合治疗较单纯西药治疗更有利于患者免疫状态的恢复。     

Clinical Observation on the Effect of Zengse Pill （增色丸） in Treating Patients with Vitiligo of Qi-stagnancy and Blood-stasis Syndrome Type

Objective： To observe the clinical efficacy of Zengse Pill （增色丸, ZSP） on patients with vitiligo of qi-stagnancy and blood-stasis syndrome type （V-QB）, and to preliminarily explore its mechanism of action. Methods： Sixty-five V-QB patients, with their diagnosis confirmed by clinical examination, were randomized by digital table method into two groups, with 31 patients in the control group and 34 in the treatment group. Cobamamide （2 tablets） was administered orally to all patients, and Psoralea tincture （a self-formulated preparation） was applied externally thrice a day. In addition, for patients in the treatment group, ZSP was given orally, at 5 pills per dose, 3 times every day. The therapeutic course for both groups was 3 months. Patients were re-examined every half-month, and changes in the skin lesions were observed and recorded. The levels of lymphocyte subsets, serum immune globulin, and complement C3 and C4 in patients were determined before and after the therapeutic course and compared with the corresponding indexes determined in 21 healthy subjects, Results： The total effective rate in the treatment group was 82.4%, which was markedly higher than that in the control group （54.8%）, showing a significant difference （P〈O.05）. After treatment, CD4^＋ percentage, CD4^＋/CD8^＋ratio, and blood levels of C3 and C4 increased, while CD8^＋ percentage decreased in the treatment group （P〈0.05 or P〈0.01）. All these indexes remained unchanged in the control group, and the respective comparisons between groups showed significant differences （P〈0.01）. Conclusion： ZSP has a definite clinical effect on the treatment of V-QB but with no evident adverse reactions, and it can increase the CD4^＋ percentage, CD4^＋/CD8^＋ ratio, and the levels of serum C3 and C4, thus regulating the immunity of the organism, which might be one of its mechanisms of action.     

非小细胞肺癌免疫指标、癌胚抗原及铁蛋白的相关性分析

目的：研究非小细胞肺癌患者免疫指标、癌胚抗原（CEA）与铁蛋白（SF）之间的关系。方法：回顾性分析92例非小细胞肺癌患者的临床资料，分析患者的CD3＋T、CD4＋T、CD8＋T及CD4＋/CD8＋、NK细胞、B细胞、CEA和SF变化的关系。结果：①CEA（＋）组中，CD4＋T、CD4＋/CD8＋及NK细胞明显降低（P〈0.01），CD8＋T及SF明显增高（P〈0.01）。CEA与CD4＋T、CD8＋T、CD4＋/CD8＋及NK细胞水平密切相关（P〈0.01）。②SF（＋）组中，CD4＋T、CD4＋／CD8＋及NK细胞明显降低（P〈0.01），CD8＋T明显增高（P〈0.01），CD3＋T明显增高（P〈0．05）。SF与CD4＋T、CD8＋T、CD4＋／CD8＋及NI（细胞水平密切相关（P〈0.01），与CD3＋T水平密切相关（P〈0.05）。结论：非小细胞肺癌患者存在不同程度的细胞免疫状态紊乱，且与CEA、SF变化密切相关。     

Effect of Compound Glycyrrhizin Injection on liver function and cellular immunity of children with infectious mononucleosis complicated liver impairment

Objective： To investigate the effects of Compound Glycyrrhizin Injection （CGI） on liver function and cellular immunity of children with infectious mononucleosis complicated liver impairment （IM-LI） and to explore its clinical therapeutic effect. Methods： Forty-two patients with IM-LI were randomly assigned, according to the randomizing number table, to two groups, 20 in the control group and 22 in the treated group. All the patients were treated with conventional treatment, but to those in the treated group, CGI was given additionally once a day, at the dosage of 10 ml for children aged below 2 years, 20 ml for 2-4 years old, 30 ml for 5-7 years old and 40 ml for 8- 12 years old, in 100-200 ml of 5% glucose solution by intravenous dripping. The treatment lasted for 2 weeks. T lymphocyte subsets and serum levels of alanine transaminase （ALT）, aspartate aminotransferase （AST） and total bilirubin （TBil） were detected before and after treatment. Besides, a normal control group consisting of 20 healthy children was also set up. Results： Baseline of the percentage of CD3^＋ , CD8^＋ lymphocyte and serum levels of ALT, AST, TBiL in the children with IM-LI were markedly higher, while the percentage of CD 4^＋ lymphocyte and the CD4^＋/CD8^＋ ratio was markedly lower in IM-LI children as compared with the corresponding indices in the healthy children （ P〈0.01 ）. These indices were improved after treatment in both groups of patients, but the improvement in the treated group was better than that in the control group （P〈0.01）. Conclusion： Cellular immunity dysfunction often occurs in patients with IM-LI, and CGI treatment can not only obviously promote the recovery of liver function, but also regulate the immune function in organism.     

Clinical Observation on Shuanghuanglian powder in treating viral myocarditis of childrenin treating viral myocarditis of children

Objective: To study immune function of children viral myocarditis and to evaluate the clinical effect of Shuanghuanglian Powder (SHLP) by injection.Methods: The 62 patients of viral myocarditis were divided into two groups randomly, the SHLP group (n = 32) treated with conventional therapy plus SHLP and the conventional treatment group (n = 30) with conventional therapy alone. Their serum antibody of Coxsackie virus group B (COXB-IgM), T-lymphocyte subsets including CD₃ ⁺, CD₄ ⁺, CD₈ ⁺ and CD₄ ⁺/CD₈ ⁺ were determined with ELISA and indirect immunofluorescent assay.Results: COXB-IgM was positive in 39 of the 62 patients, which was significantly different with those of normal controls (P< 0.001). Patients’ serum level of CD₄ ⁺ cells and CD₄ ⁺/CD₈ ⁺ ratio decreased while CD₈ ⁺ increased. After treatment, the recovery of symptoms, signs and immune function in patients of the SHLP group were significantly better than those in patients treated with conventional treatment alone (P<0.01).Conclusion: Immunoregulatory disturbance is involved in children with viral myocarditis and SHLP is an effective drug in the treatment of children viral myocarditis.     

IGF-1在妊娠期糖尿病胎盘组织中的表达及其对新生儿T淋巴细胞亚群的影响

目的 分析胰岛素样生长因子-1(IGF-1)在妊娠期糖尿病(GDM)胎盘组织中的表达及其对新生儿T淋巴细胞亚群的影响。方法选取本院GDM患者(研究组)和同期健康孕妇(对照组)各40例。两组孕妇均于胎儿、胎盘分娩后于胎盘中央带取材,行常规HE染色和IGF-1抗免疫组织化学染色,比较两组孕妇胎盘组织中IGF-1表达强度和分娩的新生儿T淋巴细胞亚群指标的差异,并进行相关性分析。结果研究组IGF-1表达强于对照组。IGF-1主要存在于滋养层上皮细胞胞浆和少数血管内皮细胞中。与对照组孕妇新生儿比较,研究组孕妇新生儿CD⁺₃、CD⁺₄、CD⁺₄/CD⁺₈显著较低,CD⁺₈显著较高。相关性分析结果显示孕妇胎盘组织中IGF-1表达强度与CD⁺₃、CD⁺₄、CD⁺₄/CD⁺₈呈正相关,与CD⁺₈呈负相关。结论GDM胎盘组织中的IGF-1表达水平较健康孕妇高,GDM胎盘组织中的高IGF-1表达可显著影响新生儿T淋巴细胞亚群,导致新生儿免疫功能低下。