异基因外周血干细胞移植患者外周血淋巴细胞IFN-γ和IL-4水平的检测及其临床意义

目的:探讨异基因外周血干细胞移植(allo-PBSCT)患者外周血淋巴细胞内细胞因子干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)水平的变化及其临床意义。方法:用流式细胞仪动态检测19例行allo-PBSCT患者外周血淋巴细胞内IFN-γ和IL-4的水平。结果:所有患者均获得造血重建,其中5例发生急性移植物抗宿主病(aGVHD),8例发生慢性移植物抗宿主病(cGVHD),IFN-γ的水平在aGVHD 组显著高于aGVHD-组(P<0.05),而IL-4的水平在2组间差异无统计学意义。IFN-γ和IL-4的水平在cGVHD 组和cGVHD-组之间差异均无统计学意义。结论:IFN-γ在人类aGVHD的发病中起重要的正向调节作用,可干扰免疫耐受的形成。     

化疗前后肺癌患者血清IFN-γI、L-6、TNF-α水平变化及意义

目的观察化疗前后肺癌患者血清干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平变化,并探讨其临床意义。方法对60例肺癌患者(观察组)化疗前后及30例健康查体者(对照组)血清中的IFN-γI、L-6和TNF-α采用双抗体夹心ELISA法测定。结果化疗后观察组血清IL-6、TNF-α水平均明显低于、血清IFN-γ水平明显高于化疗前及对照组(P均<0.05);观察组化疗后肺癌复发患者血清IFN-γI、L-6、TNF-α与化疗前比较,P均>0.05。结论化疗后,肺癌患者血清IL-6、TNF-α水平降低I、FN-γ水平升高;动态观这些指标有助于指导治疗、评价疗效和判断预后。     

胃肠道肿瘤癌性贫血患者血清Hepcidin和IL-6、IFN-γ、TNF-α表达及意义

目的:探讨胃肠道肿瘤癌性贫血患者外周血铁调素(Hepcidin)水平变化的意义及其与白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)浓度变化的相关性。方法:采用双抗夹心生物素-亲和素-酶联免疫吸附试验(ABC-ELISA)法检测94例胃肠道恶性肿瘤患者的血清Hepcidin、IL-6、IFN-γ和TNF-α浓度,其中29例伴有癌性贫血,分析Hepcidin与贫血、IL-6、IFN-γ、TNF-α之间的相关性。结果:①胃肠道肿瘤癌性贫血患者血清Hepcidin和IL-6水平均显著高于无贫血患者[(50.89±32.78)μg/L∶(30.06±30.40)μg/L、(30.77±34.44)ng/L∶(11.61±28.13)ng/L,均P0.05],而IFN-γ和TNF-α无明显差异[(138.96±70.23)ng/L∶(135.00±59.06)ng/L、(7.20±3.81)ng/L∶(9.20±8.19)ng/L,均P0.05];②胃肠道肿瘤癌性贫血患者的Hepcidin与IL-6呈正相关(r=0.375,P0.05),而与IFN-γ和TNF-α无相关性(r=-0.167和0.01,均P0.05);③胃肠道肿瘤癌性贫血患者的Hepcidin和IL-6、IFN-γ、TNF-α均与血红蛋白无相关性(均P0.05)。结论:胃肠道肿瘤癌性贫血患者外周血清Hepcidin和IL-6显著升高,且Hepcidin浓度与IL-6水平呈正相关,Hepcidin和IL-6在胃肠道肿瘤癌性贫血的发生发展过程中起重要的作用。     

溃疡性结肠炎患者Th1类细胞因子的表达

目的:检测Th1类细胞因子IL-12,IFN-γ在溃疡性结肠炎(UC)中的表达,从分子水平上探讨UC的发病机制.方法:选取通过结肠镜诊断并经病理证实的患者UC 30例,正常对照者20例.用RT-PCR方法检测Th1类细胞因子IFN-γ和IL-12 mRNA表达,用双抗体夹心ELISA法检测血清IL-12,IFN-γ的水平.结果:UC组(轻、中、重度)IL-12 mRNA表达较正常对照组显著增加(0.51±0.09,0.59±0.07,0.66±0.06 vs 0.25±0.03,P<0.05),而IFN-γ与正常对照组相比,表达无显著差异(P>0.05).UC组和正常对照组IL-12的血清浓度差异没有显著性(P>0.05),IFN-γ未达到可检测浓度.结论:IL-12在UC的发病中可能起重要作用.     

慢阻肺合并肺结核患者血清细胞因子水平变化与意义研究

目的分析慢阻肺合并肺结核患者血清细胞因子水平变化情况。方法选择四川省眉山市仁寿县人民医院2011年1月—2016年12月中的50例慢阻肺合并肺结核患者视作观察组,另外选取50例单纯慢阻肺患者视作对照1组,50例健康受检者视作对照2组,均进行白介素(IL-6)、干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)各项血清细胞因子水平测定,分析结果。结果观察组患者血清细胞因子TNF-α、IFN-γ、IL-6指标水平分别为(89.58±32.46)ng/L、(37.48±15.69)ng/L、(70.15±32.46)ng/L,均高于单纯慢阻肺的对照1组、健康者对照2组,单纯慢阻肺的对照1组各项指标水平也明显高于健康者的对照2组(P0.05);观察组痰菌阳性患者的细胞因子TNF-α、IFN-γ、IL-6水平均明显高于痰菌阴性患者,P0.05;观察组治疗后血清细胞因子TNF-α、IFN-γ、IL-6指标水平分别为(60.38±15.48)ng/L、(22.35±10.46)ng/L、(48.42±16.92)ng/L,明显低于治疗前(P0.05)。结论慢阻肺合并肺结核患者血清细胞因子水平会有明显升高,通过测定血清细胞因子水平有助于帮助临床辅助诊断慢阻肺合并肺结核,有重要应用价值。     

阿德福韦酯对慢性乙型肝炎患者Th1/Th2型细胞因子的影响

目的分析细胞因子IFN-γ、TNF-α、IL-10、IL-6、IL-4、IL-2在慢性乙型肝炎患者治疗后血清中的浓度改变及其临床意义。方法应用微阵列流式细胞术(CBA)体外检测慢性乙型肝炎患者治疗前、治疗12周、24周、48周的血清细胞因子IFN-γ、TNF-α、IL-10、IL-6、IL-4、IL-2的浓度。结果慢性乙型肝炎患者阿德福韦酯治疗后外周血清的TH1/TH2细胞因子浓度度,比较治疗前,均是显著升高的(P0.05),除IL-6外,各细胞因子在治疗过程中均未有显著变化(P0.05);治疗12周时的血清IL-6的浓度与HBVDNA成负相关,治疗24周,IL-6、IL-10、TNF-α与HBVDNA成负相关(P0.05)。结论阿德福韦酯除直接抑制病毒作用外,还可能通过免疫调节作用抑制病毒复制。     

异基因造血干细胞移植后CD4+和CD8+T细胞ATP水平的临床意义

目的:探讨荧光素酶法检测CD4⁺和CD8⁺T淋巴细胞三磷酸腺苷(ATP)水平在异基因造血干细胞移植(allo-HSCT)后感染、急性移植物抗宿主病(aGVHD)及疾病复发的变化和临床意义。方法:纳入2019年1月—2020年5月接受allo-HSCT的血液系统肿瘤患者为研究对象,荧光素酶法检测allo-HSCT后不同时间点患者的CD4⁺和CD8⁺T细胞ATP水平,分析其与aGVHD、感染和肿瘤复发的关系。结果:纳入本研究患者26例,中位年龄31(17～64)岁。allo-HSCT后ATP^CD4和ATP^CD8分别为(217.50±117.59)ng/mL和(196.23±117.32)ng/mL,均比健康人群低(P<0.05)。发生aGVHD的中位时间为+48(+25～+184) d,发生Ⅲ～Ⅳ度aGVHD患者基础ATP^CD4比轻度和未发生GVHD的患者明显下降(P=0.018),而且,aGVHD时的ATP^CD4     

长效干扰素对克罗恩病患者肠黏膜白细胞介素-12、白细胞介素-17、肿瘤坏死因子-α和γ干扰素的影响

目的探讨长效干扰素治疗克罗恩病(Crohn’s disease, CD)的免疫学机制,为其治疗CD提供一定的实验基础及理论依据。方法选取中南大学湘雅医院2015年6月至2016年6月门诊和病房确诊的16例CD患者的内镜活检标本,实验设CD治疗前、CD治疗后(长效干扰素10μg,肌注,2次/周,治疗4周)及正常对照组。正常对照组选取16例为结肠息肉患者,用免疫组织化学方法检测局部肠黏膜细胞因子白细胞介素(interleukin, IL)-12、IL-17、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和γ干扰素(interferon-γ,IFN-γ)的表达。结果治疗前CD患者结肠组织中IL-12、IL-17、TNF-α和IFN-γ表达显著增多,结肠组织中IL-12、IL-17呈弥散性分布,在黏膜上皮均有表达,主要分布于黏膜腺体内及间质炎性细胞胞质;TNF-α仅在黏膜层间质表达,围绕炎性细胞核呈团块状的胞质表达;IFN-γ分布于肠黏膜固有层,腺体周围淋巴细胞膜表面。长效干扰素可降低CD患者结肠黏膜中IL-12、IL-17、TNF-α、IFN-γ。结论 IL-12、IL-17、TNF-α和IFN-γ等促炎性细胞因子在CD黏膜免疫发生过程中发挥重要作用;长效干扰素能下调CD患者肠黏膜中IL-12、IL-17、TNF-α、IFN-γ的表达,具有治疗作用。     

异基因造血干细胞移植治疗白血病20例临床观察

目的探讨不同类型异基因造血干细胞移植(allo-HSCT)治疗白血病的疗效、造血重建及存活情况。方法哈尔滨血液病肿瘤研究所2003年3月至2006年7月进行异基因造血干细胞移植的白血病患者20例,其中同胞间人类白细胞抗原(HLA)相合的异基因外周血造血干细胞移植(allo-PBSCT)12例,无亲缘关系HLA不全相合脐血移植(UCBT)4例,无关供者的异基因外周血干细胞移植(其中1例HLA-CW位点亚型不合)3例,无关供者骨髓移植1例(经过去除红细胞处理)。结果19/20受者获造血重建,UCBT患者造血重建速度较HLA相合的同胞allo-PBSCT慢,异基因造血干细胞移植后20例患者中发生急性移植物抗宿主病(aGVHD)7例,其中4例Ⅰ~Ⅱ度,3例Ⅲ~Ⅳ度。3例患者死于复发,3例死于移植物抗宿主病(GVHD),另15例至今仍无病存活,中位存活时间30(1~41)个月。结论allo-HSCT是目前治愈白血病的有效方法,对于无同胞HLA相合的供者,选择较高细胞数量,HLA1~2个位点不合的UCBT仍然有效、可行。     

探索Th17细胞在急性髓细胞白血病中的作用

目的:探索急性髓细胞白血病(AML)骨髓中Th17细胞及其相关因子在AML发生与发展中的作用。方法:选取初诊AML患者23例,另取25名健康志愿者为对照。采用流式细胞仪分别测初诊AML组、初诊AML组诱导缓解后、对照组骨髓中CD3~+ CD161~+ IL-17~+ IFN-γ~+ T细胞的比例。采用ELISA法检测初诊AML组、初诊AML组诱导缓解后、对照组骨髓液中血管内皮生长因子(VEGF)、IL-17浓度;对VEGF与IL-17进行相关性分析。结果:初诊AML组骨髓中CD3~+ CD161~+ IL-17~+ IFN-γ~+ T细胞的比例为(1.52±0.10)%,初诊AML组诱导缓解后CD3~+ CD161~+ IL-17~+ IFN-γ~+ T细胞的比例为(1.36±0.06)%,对照组骨髓中CD3~+ CD161~+ IL-17~+ IFN-γ~+ T细胞的比例为(0.22±0.04)%。初诊AML组VEGF浓度(254.08±24.34)pg/ml,IL-17浓度(20.24±3.82)pg/ml;初诊AML组诱导缓解后VEGF浓度(137.37±22.51)pg/ml,IL-17浓度(10.42±2.96)pg/ml;对照组骨髓液中VEGF浓度(125.98±14.96)pg/ml,IL-17浓度(10.59±2.87)pg/ml;VEGF与IL-17呈正相关。结论:Th17细胞具有促进AML发生与发展的作用。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.