IL-10在约氏疟原虫感染过程中免疫调节作用的实验观察

目的探讨IL-10在疟原虫感染过程中的免疫调节效应。方法用约氏疟原虫感染DBA／2和BALB／c小鼠，取血，制薄血膜，染色后镜检疟原虫，计算红细胞感染率；用ELISA试剂盒检测小鼠血清IFN-γ和IL-10水平。结果DBA／2小鼠于感染后第21d自愈，血清IFN-γ在感染后第3d显著升高（6542pg／ml），之后逐渐下降，至感染后第12d仍高于未感染鼠；血清IL-10于感染后第6d显著升高（248pg／ml），并于感染后第15d达到峰值（980pg／ml）后下降。BALB／c小鼠感染后第6d红细胞感染率达57．5％，并于当日和次日全部死亡；血清IFN-γ仅于感染后第3d出现一过性升高，峰值为2225pg／ml而IL-10一直处于高水平状态，峰值为432pg／ml。结论小鼠感染约氏疟原虫后过早分泌的高水平IL-10对Th1反应具有明显的抑制效应，而IL-10适时的分泌可能与Th1向Th2反应的转换密切相关。     

香菇多糖对约氏疟原虫感染BALB/c小鼠Th1型应答的调节作用

目的探讨香菇多糖(Lentinan,Lent)对致死型约氏疟原虫(Plasmodium yoelii 17XL,Py17XL)感染BALB/c小鼠Th1型细胞免疫应答的调节效应。方法对Py17XL感染的BALB/c小鼠进行不同时间点的Lent预处理,动态观察用药后各组感染小鼠原虫血症水平和生存率;于感染后第0d、1d、3d和5d分别提取小鼠脾细胞,ELISA法检测脾细胞培养上清中IL-12、IFN-γ的分泌水平,Griess反应检测脾细胞培养上清中一氧化氮(NO)含量。结果与药物未处理组相比,感染前15d 1mg/kg Lent用药组显著降低感染小鼠的原虫血症水平,提高生存率;明显增强Th1型免疫应答中关键细胞因子IL-12、IFN-γ的分泌水平,并提高NO含量。结论Lent预处理能够有效激发Py17XL感染的BALB/c小鼠Th1型细胞免疫应答的建立,提示调控免疫应答对于致死型约氏疟原虫感染早期免疫防御的重要性。     

自然调节性T细胞对脑型疟疾易感鼠和抵抗鼠感染结局的影响

目的探讨自然调节性T细胞(nTregs)在伯氏疟原虫感染过程中的活化特点及其与疾病进展的相关性。方法用伯氏疟原虫ANKA分别感染C57BL/6、BALB/c和DBA/2小鼠,计数红细胞感染率;感染前和感染后3、5、8d制备脾细胞悬液,流式细胞术检测脾细胞悬液中nTregs百分含量;ELISA和Griess方法检测脾细胞培养上清IFN-γ、IL-10和NO水平。结果C57BL/6小鼠感染后8～11d死于脑疟,BALB/c和DBA/2小鼠感染后3～4w死于贫血和过度虫体血症。3种小鼠于感染后3d,nTregs百分数达到峰值后逐渐下降,于感染后8d,C57BL/6小鼠nTregs百分数下降最为显著并明显低于正常水平,整个感染过程中,C57BL/6小鼠的nTregs百分含量显著低于BALB/c和DBA/2小鼠。3种小鼠脾细胞培养上清IFN-γ、NO和IL-10水平于感染后开始升高,感染后5d达到峰值,感染后8d与感染后5d相比,C57BL/6小鼠IFN-γ、NO水平轻微下降,IL-10水平显著下降;BALB/c和DBA/2小鼠IFN-γ、NO水平显著下降,IL-10水平轻微下降。并且C57BL/6小鼠IFN-γ、NO水平高于BALB/c和DBA/2小鼠,而IL-10水平低于BALB/c和DBA/2小鼠。3种小鼠感染后脾脏nTregs数量与IFN-γ和NO水平呈负相关,IL-10水平与感染率呈正相关。结论伯氏疟原虫感染过程中,nTregs数量的动态变化与宿主感染结局密切相关。     

约氏疟原虫感染早期CD4^＋ CD25^＋ Foxp^3＋调节性T细胞的作用

目的探讨调节性T细胞（Tregs）在致死型约氏疟原虫（Plasmodiumyoelii17XL,P.y17XL）感染早期的作用。方法用P.y17XL感染DBA/2、BALB/c及BALB/c Treg消除小鼠,计数红细胞感染率;感染后第0、3和5 d制备脾细胞悬液,ELISA检测脾细胞培养上清中IFN-γ和IL-10水平。结果P.y17XL感染DBA/2和BALB/c小鼠后,其感染结局分别为自愈和死亡。易感BALB/c小鼠于感染前1 d和感染后1 d经CD25单抗处理后,与正常感染小鼠相比原虫血症水平明显降低,生存率提高;脾细胞培养上清中IL-10水平于感染后第3～5 d显著降低,IFN-γ水平于感染后第3d显著增高。结论P.y17XL感染早期,BALB/c小鼠Tregs数量的过早升高影响宿主的易感性。Tregs可能通过分泌细胞因子IL-10抑制Th1型细胞免疫应答的有效建立。     

抗鼠疟免疫核糖核酸治疗约氏疟原虫感染的疗效观察

目的观察抗鼠疟免疫核糖核酸的疗效。方法以约氏疟原虫腹腔感染DBA／2和BALB／c小鼠，并用抗鼠疟免疫核糖核酸对其进行治疗。薄血膜染色，计数红细胞感染率；用ELISA试剂盒和Griess实验分别检测DBA／2小鼠牌细胞培养上清中IFN-γ和NO含量。结果注射正常核酸的BALB／c小鼠于感染后6～7d全部死亡，与其相比，注射免疫核糖核酸BALB／C小鼠虫体血症蜂值出现的时间被推迟2d，并且有20％的小鼠被治愈；注射免疫核糖核酸DBA／2小鼠牌细胞分泌的IFN-γ水平比对照组略有升高，但NO水平升高显著，其红内期原虫的清除时间也比对照组提前了4天。结论抗鼠疟免疫核糖核酸可使抵抗宿主的巨噬细胞活化状态得以进一步强化，其对约氏疟原虫感染所致的鼠疟具有一定疗效。     

调节性T细胞抑制约氏疟原虫感染小鼠早期Th1应答的建立

目的探讨调节性T细胞(Tregs)参与约氏疟原虫感染早期调控Th1型免疫应答的相关机制。方法用约氏疟原虫(致死型)感染对照组和anti-CD25 mAb注射组BALB/c小鼠,计数红细胞感染率;感染后第0、3和5d制备脾细胞悬液,磁珠分选、纯化树突状细胞(DCs)并体外培养;ELISA方法检测脾细胞培养上清中IFN-γ和DCs培养上清中IL-12的水平,Griess方法检测脾细胞培养上清中NO含量。结果两组小鼠脾细胞培养上清中IFN-γ和NO水平在感染后第3～5d均明显升高,但对照组小鼠IFN-γ和NO水平明显低于anti-CD25 mAb注射组小鼠。anti-CD25 mAb注射组小鼠DCs培养上清中IL-12的水平于感染后第3d达峰值,并于感染后第5d仍维持较高水平。相比,对照组小鼠DCs培养上清中IL-12的水平仅于感染后第3d出现有意义的升高。结论Tregs在致死型约氏疟原虫感染BALB/c小鼠早期可能通过抑制DCs分泌细胞因子IL-12来抑制Th1型免疫应答的有效建立。     

致死型约氏疟原虫感染DBA/2小鼠保护性免疫机制的研究

目的 观察约氏疟原虫(P.yoelii) 17XL感染DBA/2小鼠的免疫应答机制及免疫效应的动态变化。方法 1×10⁶ P.yoelii 17XL感染的红细胞经腹腔接种DBA/2小鼠, ELISA测定血清白细胞介素-12 (IL-12)、干扰素-γ( IFN-γ)、IL-4和IL-10的水平以及特异性抗体IgG水平。Griess反应检测脾细胞培养上清中一氧化氮(NO)含量。检测小鼠原虫血症、单核细胞百分率,观测其吞噬疟原虫现象。结果 感染小鼠第9天原虫血症高达46.9%,多数小鼠于感染后第20天左右自愈。感染后第6至16天,外周血查见有吞噬作用的单核细胞。感染后第1天起, IL-12水平开始升高; IFN-γ于第6天达最高水平, IL-4和IL-10分别于第9天和第15天达最高水平。脾细胞培养上清NO含量,分别于第6天和第20天显著升高。血清中特异性抗体IgG水平呈增高趋势,至第70天达最高水平。结论 Th1细胞的有效活化对遏制原虫血症和最终清除疟原虫具有重要意义。约氏疟原虫感染早期,单核-巨噬细胞对原虫血症的遏制起到关键作用。     

夏氏疟原虫感染早期易感和抵抗小鼠树突状细胞细胞因子的分泌特点

目的探讨在夏氏疟原虫(Plasmodiumchabaudi chabaudi AS,P.c.chabaudi AS)感染早期,树突状细胞(Den-dritic cells,DCs)调控Th1细胞免疫应答的相关机制。方法用P.c.chabaudi AS感染易感型DBA/2和抵抗型BALB/c小鼠,计数红细胞感染率;感染前和感染后3、5、8d制备脾细胞悬液,磁珠分选、纯化DCs并体外培养;ELISA方法检测DCs培养上清中IL-12p40、IL-10和TGF-β1的水平。结果 DBA/2小鼠DCs培养上清中IL-12p40的水平在感染后3-8天明显升高,BALB/c小鼠DCs培养上清中IL-12p40的水平在感染后5-8d出现有意义的升高,但其水平均明显低于DBA/2小鼠;两种小鼠DCs培养上清中IL-10与TGF-β1的分泌水平在感染后5-8d明显升高,但DBA/2小鼠DCs培养上清中IL-10与TGF-β1的分泌水平明显低于BALB/c小鼠。结论 P.c.chabaudi AS感染早期,DBA/2和BALB/c小鼠在DCs细胞因子的分泌模式上存在显著差异。     

不同毒力疟原虫感染早期根治性治疗对再感染细胞免疫应答的影响

目的 探讨不同毒力疟原虫感染早期根治性治疗对再感染细胞免疫应答的影响。方法 用两种毒力不同约氏疟原虫感染DBA/2小鼠,感染后3d进行根治性治疗,并于感染后90d进行再感染。吉姆萨薄血膜染色法计数红细胞感染率,流式细胞术检测再感染前后不同时间点脾T细胞中活化性T细胞百分率,ELISA检测脾细胞培养上清中细胞因子水平。结果 两组根治性治疗小鼠再感染后均出现了短暂的低水平虫体血症;活化性T细胞百分率、IFN-γ、TNF-α、IL-10和IL-4分别于再感染后第1d、3d和5d出现有意义的升高;但在每一相同检测时间点,两组小鼠的虫体血症、活化性T细胞百分率、Th1和Th2型细胞因子水平均没有显著差异。结论 不同毒力疟原虫感染早期根治性治疗后,宿主在同种疟原虫再感染时可产生模式和强度相似的细胞免疫应答。     

CD+4T细胞在约氏疟原虫抵抗型小鼠模型中的作用与地位

目的探讨抵抗型小鼠CD4^＋T细胞在疟原虫感染过程中的作用与地位。方法以约氏疟原虫感染DBA／2小鼠，于自愈后30d、60d和90d，分别用同种疟原虫进行再次感染。以吉姆萨薄血膜染色法观察小鼠虫体血症水平，采用ELISA法和Griess反应分别检测初次及再感染后第3d和第10d脾细胞培养上清中IFN-γ、NO水平和血清中特异性IgG水平，并以流式细胞仪检测小鼠脾细胞中CD4^＋T细胞百分率。结果初次感染后第3d，疟原虫感染的红细胞出现于小鼠的外周血中，且其脾细胞可产生高水平的IFN-γ和N0；感染后10d，IFN-γ和NO回落至感染前水平，CD4^＋T细胞百分率有所下降，但特异性IgG出现了有意义的升高。与初次感染相比，再感染过程中仅出现一过性低水平的虫体血症，再感染后第3d和第10d的CD4^＋T细胞百分率和IFN-γ及NO水平均未出现有意义的变化，而高水平IgG一直持续存在。结论与再次感染相比，约氏疟原虫感染的抵抗型小鼠在初次感染早期可建立更为显著的CD4^＋Th1型细胞反应。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.