树突状细胞在肿瘤免疫治疗中的应用

肿瘤的主动免疫治疗近年来一直是肿瘤治疗研究的热点。随着人们对免疫应答、T细胞活化机制认识的逐渐深入,抗原递呈细胞对肿瘤相关抗原(tumorassociatedantigenTAA)俘获、加工以及激活T细胞,从而启动抗肿瘤免疫反应越来越受到重视。树突状细胞(dendriticcellsDCs)起源于骨髓CD34 造血干细胞,是目前已知体内抗原递呈能力最强的抗原递呈细胞。它们特征性地高水平表达与抗原递呈有关的主要组织相容性复合体(MHC)Ⅰ类和Ⅱ类分子,并高水平表达刺激分子CD80(B7 -1)、CD86(B7-2)、CD40、CD50等以及某些粘附分子,其本身也可以产生多种细胞因子如干扰素α(IFN -α)、白介素12(IL -12)、肿瘤坏死因子(TNF)等。DCs介导免疫反应的途径主要有:1.DC摄取、加工抗原,再转运至细胞内主要组织相容性复合体(MHC)Ⅰ类和Ⅱ类分子富含区,形成MHC -肽复合体,在细胞表面表达并激活T细胞,CD8 细胞毒T细胞被MHC -Ⅰ类复合物分子激活,CD4 辅助T细胞被MHC -Ⅱ类复合物激活。2.DC可以自身分泌或诱导其他细胞分泌IL -12、白介素15(IL -15)等...     

胃癌Hsp70-肽复合物致敏树突状细胞抗肿瘤作用的研究

目的探讨胃癌Hsp70-肽复合物致敏树突状细胞(DC)抗肿瘤作用。方法采用GM-CSF,IL-4刺激,培养胃癌患者外周血单个核细胞,增殖产生大量DC,用离子交换层析法从临床胃癌组织中提取Hsp70肽复合物,并行westernbolt鉴定,Hsp70-肽复合物修饰DC,通过细胞因子检测试剂盒对修饰DC上清液进行检测,用DC激活混合T淋巴细胞,观察其对胃癌细胞的杀伤作用。用未被Hsp70-肽复合物修饰DC作对照。结果Hsp70-肽复合物DC分泌IL-12、TNF-α、IL-1β含量分别为(305.02±20.70)pg/ml、(480.61±32.52)pg/ml和(519.60±39.12)pg/ml,而未被Hsp70修饰DC分泌IL-12、TNF-α、IL-1β的含量分别为(3.81±0.84)pg/ml、(3.50±0.21)pg/ml、(50.11±2.86)pg/ml,两者比较,有显著性差异(P<0.01)。Hsp70修饰DC激活的T淋巴细胞后对胃癌细胞的杀伤率为(93.54±8.26)%明显高于对照组的(6.20±0.38)%(P<0.01)。结论胃癌Hsp70-肽复合物致敏DC并激活T淋巴细胞后对胃癌细胞具有很强的杀伤作用。     

局部湿热联合微波消融对小鼠乳腺癌动物模型中树突状细胞的比例和功能的影响

目的:研究局部湿热联合微波消融对乳腺癌荷瘤小鼠脾细胞中树突状细胞的比例和功能的影响,并探讨其意义.方法:建立小鼠乳腺癌实验动物模型;用FACS检测局部湿热联合微波消融处理后荷瘤小鼠脾细胞中DC细胞比例变化及其MHC-Ⅱ类分子和协同刺激分子CD80,CD86的表达水平;MTT法检测DC细胞对T淋巴细胞增殖的刺激作用;FACS检测DC细胞对T细胞的细胞因子IFN-γ,IL-4分泌的影响.结果:局部湿热联合微波消融处理组荷瘤小鼠脾细胞中DC细胞的比例明显增高,DC细胞的MHC-II类分子和协同刺激分子CD86的表达明显上调,并且DCs刺激T淋巴细胞增殖和IFN-γ分泌的能力明显增强.结论:局部湿热联合微波消融术可以较单一热疗方法更有效的增加DC细胞的比例和增强其功能.     

雷公藤多甙和白细胞介素-1 0对人树突状细胞表面人类白细胞抗原-DR和CD80表达及白细胞介素-12 p40转录和分泌的影响

目的：研究雷公藤多甙和IL－10对人树突状细胞（DC）表面人类白细胞抗原－DR（HLA－DR）和CD80表达及IL－12p40转发洋和分泌的影响。方法：通过粒细胞－巨噬细胞型集落刺激因子（GM－CSF）、IL－4和肿瘤坏死因子α（TNF-α）体外培养体系,从人外周血单个核细胞中获得DC,细胞表面HLA－DR和CD80表达采用流式细胞仪分析,IL－12p40转录和分泌分别采用逆转录多聚酶链反应（RT－PCR）技术和ELISA法。结果：雷公藤多甙（5－20ug/ml）、IL－10（50－200ng/ml）能下调DC表面HLA－DR和CD80的表达,同时雷公藤多甙、IL－10能抑制DC内IL－2p40mRNA的转录和分泌。结论：雷公藤多甙、IL－10能通过抑制表面分子的表达和细胞因子的合成而干扰DC的成熟和功能。     

转染肿瘤细胞总RNA的树突状细胞联合CIK细胞抗小鼠肝癌作用的实验研究

目的探讨转染小鼠肝癌H22细胞总RNA的树突状细胞(DC)疫苗体外抗小鼠肝癌的免疫作用。方法提取小鼠四肢长骨骨髓,在rmGM-CSF和rmIL-4体外刺激下增殖分化为DC。制备小鼠脾淋巴细胞,在体外经rmIFN-γ、anti-CD3、rmIL-2和rmIL-1b诱导成为细胞因子诱导的杀伤性细胞(CIK细胞)。制备肝癌H22细胞总RNA,体外转染DC,流式细胞仪检测转染前后的DC表面分子的表达情况。将转染H22细胞总RNA的DC和CIK细胞混合培养制备成为效应细胞,LDH释放法测定效应细胞对小鼠H22细胞、S180细胞的杀伤活性。结果经H22细胞总RNA转染后的DC,其MHCⅠ类分子、MHCⅡ类分子及CD83、CD86表达率明显增高,CD14表达率降低(P<0.05)。转染H22细胞总RNA的DC激活的CIK细胞对H22细胞的杀伤率高于其对S180细胞的杀伤率(P<0.05)。转染H22细胞总RNA的DC激活的CIK细胞对H22细胞的杀伤率高于其他各组效应细胞对H22细胞的杀伤率(P<0.05)。结论转染H22细胞总RNA的DC激活的CIK细胞对H22细胞具有高效而特异性的体外抗小鼠肝癌免疫作用。     

重组人热休克蛋白70D的免疫佐剂样效应研究

目的：研究重组人热休克蛋白70D(rhHSP70D)蛋白的免疫佐剂样效应。方法：用rhHSP70D诱导体外培养的树突状细胞（DC），观察DC分泌前炎性细胞因子的水平、DC成熟及刺激同种异体淋巴细胞增殖的能力；用rhHSP70D与OVA257-264体外交联的蛋白免疫C57BL/6小鼠，观察能否诱导产生抗原特异性免疫保护作用。结果：rhHSP70D可以明显刺激DC分泌IL-1β、IL-12p70、TNF-α等细胞因子，可以促进DC表达HLA-DR、CD86、CD40等膜分子，增强DC诱导同种异体T淋巴细胞增殖的能力；rhHSP70D-OVA257-264交联蛋白可诱导小鼠产生具有明显抗原特异性的免疫保护作用，而rhHSP70D或OVA257-264单独免疫小鼠均不能产生这种保护作用。结论：rhHSP70D能通过促进DC成熟、刺激前炎性细胞因子的分泌增强DC的免疫激发功能，rhHSP70D-抗原肽复合物免疫能够诱导产生抗原特异性的免疫保护作用，提示rhHSP70D有望作为一种新的佐剂应用于抗肿瘤及抗感染免疫治疗。     

Study on Anti-mouse Hepatocellular Carcinoma Effect of Cytokine-induced Kill Cells Activated by Dendritic Cells Transfected With Mouse Hepatocellular Carcinoma Total RNA in vitro

目的 探讨转染小鼠肝癌H22细胞总RNA的树突状细胞(DC)疫苗体外抗小鼠肝癌的免疫作用.方法 提取小鼠四肢长骨骨髓,在rmGM-CSF和rmIL-4体外刺激下增殖分化为DC.制备小鼠脾淋巴细胞,在体外经rmIFN-γ、anti-CD3、rmIL-2和rmIL-1b诱导成为细胞因子诱导的杀伤性细胞(CIK细胞).制备肝癌H22细胞总RNA,体外转染DC,流式细胞仪检测转染前后的DC表面分子的表达情况.将转染H22细胞总RNA的DC和CIK细胞混合培养制备成为效应细胞,LDH释放法测定效应细胞对小鼠H22细胞、S180细胞的杀伤活性.结果 经H22细胞总RNA转染后的DC,其MHC Ⅰ类分子、MHC Ⅱ类分子及CD83、CD86表达率明显增高,CD14表达率降低(P＜0.05).转染H22细胞总RNA的DC激活的CIK细胞对H22细胞的杀伤率高于其对S180细胞的杀伤率(P＜0.05).转染H22细胞总RNA的DC激活的CIK细胞对H22细胞的杀伤率高于其他各组效应细胞对H22细胞的杀伤率(P＜0.05).结论 转染H22细胞总RNA的DC激活的CIK细胞对H22细胞具有高效而特异性的体外抗小鼠肝癌免疫作用.     

胰岛素B9-23多肽对树突状细胞表型及功能的影响

目的:观察小鼠骨髓来源的树突状细胞(DCs)负载胰岛素B9-23多肽后其表型和功能的变化,探讨其对免疫状态的影响?方法:①应用10 ng/ml的粒细胞巨噬细胞集落刺激因子(GM-CSF)及10 ng/ml的白细胞介素(IL)-4诱导小鼠骨髓细胞分化为DCs,将其分为空白对照组?胰岛素B9-23多肽刺激组?脂多糖(LPS)刺激组;②流式细胞术检测DCs表面CD11c?CD80?CD86?CD40?MHC-Ⅱ类分子的表达;③CCK-8检测DCs刺激同种异体淋巴细胞增殖的能力;④ELISA检测DCs培养上清中IL-12及干扰素-γ(IFN-γ)的水平?结果:流式细胞术检测各组DCs,其CD11c的表达均在60%以上,与空白对照组相比,胰岛素B9-23多肽刺激组表达低水平的CD40以及中等水平的CD80?CD86?MHC-Ⅱ类分子,LPS刺激组表达较高水平的CD80?CD86?CD40?MHC-Ⅱ类分子,同时,胰岛素B9-23多肽组DCs刺激同种异体淋巴细胞增殖的能力显著增强(P < 0.05),分泌较高水平的IL-12,但分泌较低水平的IFN-γ?结论:胰岛素B9-23多肽能够刺激产生半成熟的DCs,对进一步探讨应用胰岛素B9-23多肽负载DCs免疫NOD鼠诱导免疫耐受预防自身免疫性糖尿病的发生具有重要的意义?     

白细胞介素-10对人树突状细胞表型及致炎细胞因子分泌的影响

目的 观察白细胞介素(IL)-10对体外培养人树突状细胞(DC)表型和致炎细胞因子IL-12分泌的影响，探讨IL-10对DC炎性成熟过程中的负调节作用。方法 通过SCF、GM-CSF、TGF-β、Flt-3和TNF-α体外培养体系，从脐血CD34造血干细胞中诱导扩增获得DC，并于细胞成熟中用重组人IL-10进行干预。流式细胞仪分析细胞表型CD1a、CD11c、CD83、CD80、CD86和HLA-DR；RT-PCR检测IL-12 p35、p40mRNA表达；ELISA法测定IL-12 p70分泌的含量。结果 IL-10可下调成熟中DC表面CD11c、CD83、CD80和CD86的表达，同时可抑制DC内IL．12p35、p40mRNA的转录和IL-12p70的分泌。结论 IL-10可抑制DC黏附共刺激分子表达和致炎细胞因子的合成，提示其不仅可调抑DC的递呈抗原功能，且参与了炎症局部微环境的调节。     

可溶性虫卵抗原对小鼠骨髓源性树突状细胞表型及Th17细胞分化的影响

目的:探讨日本血吸虫可溶性虫卵抗原(soluble egg antigen,SEA)致敏小鼠骨髓源性树突状细胞(dendritic cells,DCs)后对其细胞表型及Th17细胞分化的影响?方法:收集BALB/c小鼠骨髓细胞,应用粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony stimulating factor,GM-CSF)?白介素(interleukin,IL)-4定向诱导小鼠骨髓细胞向DCs分化;流式细胞仪检测SEA刺激培养后DCs表面分子的表达情况;流式细胞术检测DCs 分泌IL-6?IL-23的水平,ELISA法检测DCs分泌转化生长因子-β(transforming growth factor-β,TGF-β)的水平;SEA刺激DCs与CD4+T细胞共培养后检测培养上清中IL-6?TGF-β?IL-23和IL-17细胞因子水平?结果:诱导培养出可供实验用的高纯度DCs;SEA刺激DCs能表达较高水平的CD80?CD86?CD40?组织相容性复合体(major histocompatibility complex,MHC)-Ⅱ类分子;SEA刺激DCs产生IL-6和TGF-β明显增多;SEA刺激的共培养细胞上清中IL-17水平增高?结论:SEA能够促进DCs成熟,并诱导CD4+T细胞向Th17细胞分化?     

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.