白细胞粘附分子在慢性阻塞性肺疾病及肺心病发病中作用的探讨

目的：探讨白细胞粘附分子在慢性阻塞性肺疾病（COPD），慢性肺原性心脏病（肺心病）发病机制中的作用，及抗白细胞粘附疗法在肺心病治疗中的疗效。方法：采用流式细胞术，用单克隆抗一量测定42例COPD患（稳定期），41例肺心病患（稳定期）周围血中白细胞粘附分子CD11a,CD11b,CD18,CD54的阳性表达率，并以24名健康人作正常对照，41例肺心病患分为2组，治疗组20例，服用火把花根片（1次3片，1日3次），对照组21例，测定20例服火把花根片后的肺心病患周围血中白细胞粘附分子CD11a,CD11b,CSD18,CD54，淋巴细胞表面CD11a的阳性表达率明显高于正常对照组（P＜0．05），肺心病患组血液中性粒细胞表达CD11a,CD11b,CD18,CD54，单核细胞表面CD11a,CD18,CD54，淋巴细胞表面CD18较正常对照组明显增强（P＜0．05）；服火把花根片后，肺心病治疗组中性粒细胞表达CD11a,CD11b,CD18,CD54，单核细胞表面CD11a,CD18,CD54,淋巴细胞表达CD18较服药前肺心病组有显下降（P＜0．05），余各型均无显差异。结论：COPD患通过单核细胞粘附分子CD11a/CD18,CD11b/CD18,CD54的表达上调，肺心病患通过中性粒细胞表面粘附分子CD11a/CD18,CD11b/CD18,CD54及单核细胞表达CD11/CD18,CD54的表达上调，使白细胞与内皮细胞粘附明显增强，参与各自疾病的病理发展过程，火把花根通过肺心病中性粒细胞表面粘附分子CD11a/CD18,CD11b/CD18,CD54及单核细胞表达CD11a/CD18,CD54的表达下调，使白细胞与内皮细胞的粘附下降，阻止肺心病的发展。     

冠心病患者外周血白细胞表面粘附分子的表达

目的　目前认为炎症可能在冠心病发病及恶化过程中起重要的作用。本研究通过测定冠心病患者外周血中性粒细胞和单核细胞表面CD11b、CD18的表达 ,探讨炎症与冠心病的关系。方法　选择 5 4例冠心病患者 ,其中急性心肌梗死 2 5例 ,不稳定心绞痛患者 2 9例。根据不稳定心绞痛患者病情的严重程度将其按Braunwald分级分为三组 :第一组 (9例 ,BraunwaldⅠ级 ) ;第二组 (8例BraunwaldⅡ级 ) ;第三组 (12例BraunwaldⅢ级 )。选择 12例健康人为正常对照组。采用流式细胞术分析外周血中性粒细胞和单核细胞表面粘附分子CD11b、CD18的表达。结果　冠心病患者外周血中性粒细胞和单核细胞表面CD11b、CD18的表达较正常对照组显著升高 (P <0 0 0 1) ;不稳定心绞痛患者由第一组到第三组外周血中性粒细胞和单核细胞表面CD11b、CD18的表达是逐渐升高的 ,且第一组与第三组有统计学意义 (P <0 0 5 )。结论　冠心病患者外周血白细胞是激活的 ;随着不稳定心绞痛病情的加重 ,外周血白细胞活性也是增加的 ,白细胞活性状态与冠脉缺血的严重程度正相关     

卡维地络对心绞痛患者外周血白细胞粘附分子表达的影响

目的　研究卡维地络对心绞痛患者外周血白细胞粘附分子表达的影响。方法　我科住院冠心病共 4 8(男37)例 ,其中稳定型心绞痛 (SAP) 2 2例 ,不稳定型心绞痛(UAP) 2 6例 ,随机将SAP、UAP二组病人各分为治疗组 (给予卡维地络 10mg口服 2 /d术前 7d起使用 )及对照组 (给予美托洛尔 12 5mg口服 2 /d术前 7d起使用 ) ,分别于服药前及手术前采集股动脉血样 ,用FCM直接免疫荧光法检测股动脉血中性粒细胞、单核细胞表面粘附分子CD11b表达水平。结果　SAP患者服药前卡维地络组与美托洛尔组中性粒细胞与单核细胞CD11b表达无显著差异 (P >0 0 5 ) ,UAP患者卡维地络组与美托洛尔组中性粒细胞与单核细胞CD11b均高于SAP患者 (P <0 0 5 ) ,服药 7d后UAP组中性粒细胞CD11b卡维地络组明显低于美托洛尔组。结论　不稳定心绞痛单核细胞及中性粒细胞CD11b表达均显著高于稳定心绞痛。卡维地络降低中性粒细胞表面CD11b表达的主要机理可能是减少了中性粒细胞活化 ,而对单核细胞的影响尚有待评估     

化疗后中性粒细胞表面粘附分子CD11b/CD18的表达变化

可导致患者感染,与化疗后外周血中性粒细胞减少有关.而中性粒细胞抗感染能力与其表面粘附分子表达有关.我们应用流式细胞术检测34例急性髓性白血病患者巩固化疗前后外周血中性粒细胞表面粘附分子CD11b/CD18表达及其体外对趋化三肽(fMLP)的反应,观察其与感染的关系.     

冠心病血瘀证病人血白细胞CD11b/CD18表达的研究

目的 :探讨不同类型冠心病病人中性粒细胞和单核细胞CD11b/CD18表达的变化规律及其与冠心病中医证型之间的关系。方法 :采用流式细胞仪检测不同类型和不同中医证型冠心病中性粒细胞和单核细胞CD11b/CD18表达。结果 :UAP和AMI组中性粒细胞和单核细胞显著高于SAP组 (P <0 .0 0 1)。SAP、UAP、AMI组之间中性粒细胞和单核细胞CD11b、CD18表达随着病情严重程度增加而明显增加(P <0 .0 0 1)。AMI组中性粒细胞和单核细胞CD11b、CD18的表达 ,血瘀证组明显高于非血瘀证组 (P <0 .0 0 1)。结论 :冠心病病人中性粒细胞和单核细胞CD11b/CD18表达明显上调 ,其增加程度与心肌缺血的类型及冠心病中医血瘀证有关。     

冠心病患者PTCA手术前、后CD11b/CD18的表达及临床意义

探讨不同类型 CHD患者白细胞粘附分子的变化和 PTCA对白细胞粘附分子表达的影响。选择行冠状动脉造影 （CA）和 PTCA术的患者 2 7例 ,将其分为 SAP组、UAP组及正常对照组。分别检测 CA或 PTCA术前、术后 6h,2 4h,48h的白细胞计数及 CD11b/ CD18在单核细胞和中性粒细胞 （PMN）膜上的表达。结果 :1CHD患者血液中单核细胞、PMN的 CD11b/ CD18表达较健康对照组均显著增加 （P<0 .0 1） ,其中 U AP组最为明显。 2 PTCA术后白细胞计数和单核细胞 CD11b/ CD18表达与术前无明显差异 ,而 PMN膜 CD11b/ CD18表达在 6 h开始升高 （P<0 .0 1） ,48h升高尤为显著。而 CA术前后各项检测指标均无差异。结论 :CHD患者 PMN、单核细胞膜上 CD11b/CD18的表达明显增加 ,粘附性增强 ,其增加程度与心肌缺血状态有关 ;PTCA术后 PMN膜 CD11/ CD18表达的上调 ,可能是冠脉再狭窄的原因之一。     

冠心病患者中性粒细胞和单核细胞CD11b/CD18表达的研究

目的 :探讨不同类型冠心病患者中性粒细胞和单核细胞膜 CD11b/CD18表达的变化。方法 :选择经冠状动脉造影确诊的 49例心绞痛患者 ,30例急性心肌梗死患者和 2 0例正常人 ,用流式细胞仪直接免疫荧光法检测中性粒细胞和单核细胞膜 CD11b/CD18表达。结果 :冠心病患者中性粒细胞和单核细胞膜 CD11b/CD18表达较正常对照组均显著增加 （P<0 .0 1） ;不稳定性心绞痛和急性心肌梗死患者中性粒细胞和单核细胞膜 CD11b/CD18表达显著高于稳定性心绞痛患者 （P<0 .0 1）。与正常对照组比较 ,心绞痛患者组中性粒细胞和单核细胞计数无变化 （P>0 .0 5 ） ,而急性心肌梗死组明显增加 （P<0 .0 1）。急性心肌梗死患者中性粒细胞和单核细胞膜 CD11b/CD18表达与梗死范围无关。结论 :冠心病患者中性粒细胞和单核细胞膜 CD11b/CD18表达明显增加 ,其增加程度与心肌缺血的类型有关。     

冠心病患者PTCA前后外周血CD11b、CD62P表达变化及意义

采用流式细胞仪检测23例健康体检者（对照组）及41例冠心病患者（观察组）,经皮冠状动脉腔内成形术（PTCA）术前72、2h、术后30min及24、72h外周血中性粒细胞和单核细胞表面CD11b、CD62P的表达。结果观察组患者外周血中性粒细胞和单核细胞CD11b平均荧光强度（MFI）和CD62P阳性细胞百分比较对照组明显升高。PTCA术后24hCD11b荧光强度和CD62P阳性细胞百分比较术前72、2h明显升高。血小板CD62P与中性粒细胞CD11b呈正相关（r=0．253）。认为PTCA术后中性粒细胞和单核细胞CD11b及血小板CD62P表达上调,且可作为反映PTCA后炎症反应和血栓形成状况的指标。     

急性冠脉综合征患者血清E-选择素和白细胞CD11b/CD18表达的研究

目的观察血清E-选择素水平、中性粒细胞及单核细胞CD11b/CD18表达在急性冠脉综合征(ACS)患者中的变化,探讨其与斑块稳定性的关系.方法 30例ACS患者(ACS组)、24例稳定型心绞痛患者(SA组),30例冠状动脉造影阴性者作为对照组.酶联免疫吸附法检测E-选择素,流式细胞仪检测CD11b/CD18的表达.结果血清E-选择素水平、中性粒细胞和单核细胞膜CD11b/CD18的表达ACS组显著高于SA组(P<0.01)和对照组(P<0.01).结论 ACS患者血清E-选择素水平、中性粒细胞和单核细胞膜CD11b/CD18的表达增加与斑块不稳定性有关.     

急性动脉血栓患者中性粒细胞黏附分子表达的变化及意义

目的探讨急性动脉血栓形成患者中性粒细胞(PMN)表面黏附分子CD62L和CD11b/CD18的表达及其意义。方法选择急性心、脑动脉血栓患者各20例,健康志愿者30例作为对照组。运用流式细胞仪检测外周血中PMN表面黏附分子CD62L和CD11b/CD18表达。结果相对于正常组黏,动脉血栓组黏附分子CD62L平均抗体阳性表达率显著降低(P<0.001);CD11b/CD18平均阳性表达率显著升高(P<0.001)。动脉血栓组内部CD62L、CD11b/CD18相关分析,二者呈明显负相关(r=-0.259,P<0.001)。结论在动脉血栓的急性期,以细胞黏附为表现的PMN活化加快了血栓的进程,可能是血栓形成的重要发病原因之一。     

A novel digital method to assess air space loss associated with acute lung injury in experimental acute pancreatitis

Background/Objectives

Respiratory dysfunction and/or failure from acute lung injury (ALI) are common in acute pancreatitis (AP), but assessment of ALI in experimental AP has lacked standardisation.

超声心动图在与急性心肌梗死混淆的急性肺栓塞患者诊断中的价值

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58例急性粒-单核细胞和急性单核细胞白血病的临床及治疗疗效的比较

本文总结了24例 M_4和34例 M_5患者的临床和治疗疗效观察。研究结果表明,M_4好发于女性而 M_5多见于男性,在>60岁老人中 M_5较 M_4多见.M_4患者出血和贫血较明显,M_5以高热、肝脾浸润多见,在治疗反应上,无论 HOAP 或其它化疗方案组,M_5的 CR 率低于 M_4患者。     

急性粒单和急性单核细胞性白血病的临床和细胞表面标记分析

目的：分析ＡＭＬ－Ｍ４、Ｍ５患者的临床和免疫学特征。方法：总结了７５例患者的血液学和临床特征，并用活细胞间接免疫荧光法检测了其中３９例患者的细胞免疫表型，着重分析了ＣＤ７＾＋ＡＭＬ在这二类ＡＭＬ中的发生率、临床特征及预后。结果：这两类白血病的ＨＬＡ－ＤＲ、ＣＤ３８、ＣＤ３４阳性率很高，分别为９１．４３％，８５．１９％和６５．６３％；结论：Ｍ４、Ｍ５这二种亚型有不同于其它ＡＭＬ亚型的临床，血液学和生     

Protective effects of erythropoietin against acute lung injury in a rat model of acute necrotizing pancreatitis

AIM： TO investigate the effect of exogenous erythro- poietin （EPO） administration on acute lung injury （ALI） in an experimental model of sodium taurodeoxycholate- induced acute necrotizing pancreatitis （ANP）. METHODS： Forty-seven male Wistar albino rats were randomly divided into 7 groups： sham group （n = 5）, 3 ANP groups （n = 7 each） and 3 EPO groups （n = 7 each）. ANP was induced by retrograde infusion of 5% sodium taurodeoxycholate into the common bile duct. Rats in EPO groups received 1000 U/kg intramuscular EPO immediately after induction of ANP. Rats in ANP groups were given 1 mL normal saline instead. All animals were sacrificed at postoperative 24 h, 48 h and 72 h. Serum arnilase, IL-2, IL-6 and lung tissue malondialdehyde （MDA） were measured. Pleural effusion volume and lung/body weight （LW/BW） ratios were calculated. Tissue levels of TNF-a, IL-2 and IL-6 were screened immunohistochemically. Additionally, ox-LDL accumulation was assessed with immune-fluorescent staining. Histopathological alterations in the lungs were also scored.RESULTS： The mean pleural effusion volume, calculated LW/BW ratio, serum IL-6 and lung tissue MDA levels were significantly lower in EPO groups than in ANP groups. No statistically significant difference was observed in either serum or tissue values of IL-2 among the groups. The level of tumor necrosis factor-（~ （TNF-（~） and IL-6 and accumulation of ox-LDL were evident in the lung tissues of ANP groups when compared to EPO groups, particularly at 72 h. Histopathological evaluation confirmed the improvement in lung injury parameters a~er exogenous EPO administration, particularly at 48 h and 72 h. CONCLUSION： EPO administration leads to a significant decrease in ALI parameters by inhibiting polymorphonuclear leukocyte （PMNL） accumulation, decreasing the levels of proinflammatory cytokines in circulation, preserving microvascular endothelial cell integrity and reducing oxidative stress-associated lipid peroxidation and therefore     

Acute lung injury and ARDS in acute pancreatitis: Mechanisms and potential intervention

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in acute pancreatitis still represents a substantial problem,with a mortality rate in the range of 30%-40%.The present review evaluates underlying pathophysiological mechanisms in both ALI and ARDS and potential clinical implications.Several mediators and pathophysiological pathways are involved during the different phases of ALI and ARDS.The initial exudative phase is characterized by diffuse alveolar damage,microvascular injury and inf...     

Acute pancreatitis complicated by acute myocardial infarction – A rare association

Acute pancreatitis complicated by acute myocardial infarction has been reported very rarely. The exact mechanism of the cause of myocardial injury is not known. We report a case of 36 year old male presenting with acute pancreatitis complicated by ST elevation acute myocardial infarction (AMI). The administration of thrombolytic therapy in such patients can have deleterious effects. We report successful performance of primary angioplasty in this complicated patient.     

Original single-incision laparoscopic cholecystectomy for acute inflammation of the gallbladder

AIM: To investigate the safety and feasibility of our original single-incision laparoscopic cholecystectomy (SILC) for acute inflamed gallbladder (AIG).METHODS: One hundred and ten consecutive patients underwent original SILC for gallbladder disease without any selection criteria and 15 and 11 of these were diagnosed with acute cholecystitis and acute gallstone cholangitis, respectively. A retrospective review was performed not only between SILC for AIG and non-AIG, but also between SILC for AIG and traditional laparoscopic cholecystectomy (TLC) for AIG in the same period.RESULTS: Comparison between SILC for AIG and non-AIG revealed that the operative time was longer in SILC for AIG (97.5 min vs 85.0 min, P = 0.03). The open conversion rate (2/26 vs 2/84, P = 0.24) and complication rate (1/26 vs 3/84, P = 1.00) showed no differences, but a need for additional trocars was more frequent in SILC for AIG (5/24 vs 3/82, P = 0.01). Comparison between SILC for AIG and TLC for AIG revealed no differences based on statistical analysis.CONCLUSION: Our original SILC technique was adequately safe and feasible for the treatment of acute cholecystitis and acute gallstone cholangitis.     

Use of the FAB Crriteria for the Diagnosis of Acute Erythroleukaemia (AEL)

Abstract: Use of the FA6 criteria for the diagnosis of acute erythroleukaemia (AEL). R. K. Woodruff, I. H. Bunce, S. Johnson, A. in. Paxton and J. S. malpas, Aust. N.Z. J. med ., 1981, 11, pp. 1–7.
The criteria proposed by the French-American-British (FAB) Group for the diagnosis of acute erythroleukaemia (AEL), including the requirement for ≥ 30% marrow myeloblasts, were used in a review of patients with erythroleukaemia. Ten patients with AEL were identified, and a further twelve patients with marrows suggestive of AEL but having <30% myeloblasts were classified as having refractory anemia with excess of blasts (RAEB). The AEL patients had a poor prognosis, poor response to chemotherapy, and none showed evolution to myeloblastic or monoblastic leukaemia. In contrast, the patients with RAEB appeared to survive longer, respond better to chemotherapy, and several evolved into typical myelogenous leukaemia
The FAB criteria subdivides patients with erythroleukaemia into groups with apparent clinic pathological and prognostic differences. Further studies using these or equally strict criteria are required