Sequential changes in NK and ADCC effector cell function after organ transplantation in man

Antibody-dependent cellular (K cell) cytotoxicity (ADCC) and cellular cytotoxicity against natural killer (NK) targets exerted by the same cells were both measured sequentially in ten patients after renal transplantation using conventional immunosuppression. Cytotoxicity against NK targets appeared to correlate more closely with rejection episodes than did assays of ADCC activity during the same period. An apparent rise in NK activity was frequently accompanied by a fall in ADCC activity. Collectively these data suggest that the previously reported increase in NK activity during rejection episodes may represent a manifestation of the appearance of non-clonally activated T-cells in peripheral blood during rejection.     

周围神经损伤后远端效应器的变化

INTRODUCTION The peripheral nerve injury can result in loss of neural function and the rehabilitation after injuries is the problem remained to be solved in medicine. The studies of nerve injury should begin with the study of the local depressed site. Then the neuron, axon and effective apparatus should be studied[1, 2]. The function of the nerve mainly depend on the distal effective apparatus, so it is more important to study it. Recently the scholars home and abroad pay more attention to form and dynamics of the cell proliferation of the distal effective apparatus such as motor endplate, sensory corpuscle and muscle. The review about this research is as follows.     

Kupffer cell function in chronic liver injury and after partial hepatectomy

The reticuloendothelial system (RES) plays an important role in the biological defense system. In the liver, Kupffer cells are the main constituent of the RES, and when their function is impaired postoperative complications may more often occur. By using^99mTc-labeled human serum albumin millimicrospheres (^99mTc-HSA-MM) combined with assessment of single photon emission computed tomography (SPECT), we have attempted to determine the function of Kupffer cells independently of the hepatic blood flow. First, Kupffer cell function in rats with chronic liver injury caused by CCl₄ was studied. The hepatic uptake rate in chronic liver injury was decreased, and a reduced phagocytic activity of the Kupffer cells was noted. The parameter concerning Kupffer cell degradation, the excretion rate (k), was markedly decreased in the early period of chronic liver injury. Changes in Kupffer cell function after 30% and 70% hepatectomy were also studied. After 30% hepatectomy, the excretion rate was decreased on the first postoperative day (POD), and it was increased beyond that found after sham operation on the 3rd POD. In contrast, slower recovery of uptake rate was demonstrated. After 70% hepatectomy, both uptake and excretion rates were markedly reduced, and recovery was prolonged beyond the 5th POD. The hepatic uptake was not parallel with the excretion rate in either experiment. These results suggest that the method that measures the hepatic excretion rate may provide a better assessment of Kupffer cell function than the current uptake measurement with radiolabeled colloid.     

聚甲基丙烯酸甲酯骨水泥充填治疗骨损伤后的肺功能变化

背景：目前聚甲基丙烯酸甲酯骨水泥充填在治疗骨折以及人工关节置换骨损伤中的应用已很普遍,对于其引起的肺功能变化,尤其是老年骨损伤患者,应积极防治。目的：观察骨损伤应用聚甲基丙烯酸甲酯骨水泥充填治疗后患者的肺功能变化。方法：选取2010年5月至2011年6月大庆油田总医院骨科收治的骨折以及人工关节置换骨损伤患者24例,应用聚甲基丙烯酸甲酯骨水泥充填治疗,比较治疗后1d以及1周的肺活量、用力肺活量、最大通气量变化。结果与结论：所有应用聚甲基丙烯酸甲酯骨水泥治疗骨折以及人工关节置换的骨损伤患者,在治疗后1d的肺活量（2．45±0．56）L、用力肺活量（2．20±0．39）L、最大通气量（50．9±23．9）L,均明显低于治疗后1周。说明应用聚甲基丙烯酸甲酯骨水泥可以在一定程度上影响患者的肺功能,这种改变可能与骨水泥的使用导致肺组织的微血管栓塞有关,需要加强监测以及通过在治疗前后应用药物来预防和治疗肺栓塞。     

Antigen-specific inhibition of effector T cell function in humans after injection of immature dendritic cells

Immunostimulatory properties of dendritic cells (DCs) are linked to their maturation state. Injection of mature DCs rapidly enhances antigen-specific CD4+ and CD8+ T cell immunity in humans. Here we describe the immune response to a single injection of immature DCs pulsed with influenza matrix peptide (MP) and keyhole limpet hemocyanin (KLH) in two healthy subjects. In contrast to prior findings using mature DCs, injection of immature DCs in both subjects led to the specific inhibition of MP-specific CD8+ T cell effector function in freshly isolated T cells and the appearance of MP-specific interleukin 10-producing cells. When pre- and postimmunization T cells were boosted in culture, there were greater numbers of MP-specific major histocompatibility complex tetramer-binding cells after immunization, but these had reduced interferon production and lacked killer activity. These data demonstrate the feasibility of antigen-specific inhibition of effector T cell function in vivo in humans and urge caution with the use of immature DCs when trying to enhance tumor or microbial immunity.     

造血干细胞移植后侵袭性肺曲霉病患者12例的肺功能改变

目的观察12例造血干细胞移植(HSCT)后并发侵袭性肺曲霉病(IPA)对患者肺功能参数及动脉血气的影响。方法 2007年2月~2009年10月本院接受HSCT后并发IPA患者12例,男8例,女4例,中位年龄34岁(26~67岁)。移植前后均行肺功能测试、动脉血气分析以及影像学检查。结果中位随访时间为132 d(97~432 d),无1例发生Ⅲ、Ⅳ度急性移植物抗宿主病(GVHD)。2例在移植1年后发生慢性GVHD。12例均为病理确诊或临床诊断IPA者,移植前肺功能测定仅有弥散功能轻度减退。抗真菌治疗8周后肺功能测试发现所有患者均存在不同程度的阻塞性通气障碍,其中8例患者呈小气道病变[FEF50和FEF75分别为(55.9±3.4)%和(41.9±4.1)%],4例患者则出现混合性通气障碍,总弥散量(DLCO)也显著降低[(47.4±2.9)%预计值],动脉血氧分压(PaO2)仅为(68.7±4.1)mmHg,但弥散常数(DLCO/VA)尚正常,与移植前无显著差异(P0.05)。结论 HSCT后并发IPA可对患者的肺功能造成不同程度的损害,肺内多部位感染或反复发生IPA的患者可出现较严重的混合性通气障碍,弥散也显著减退。     

Biochemical evidence for pulmonary endothelial cell injury after carbon tetrachloride administration in mice

Angiotensin converting enzyme (ACE) is concentrated in pulmonary endothelial cells. Its release into the general circulation after lung damage may provide an index of pulmonary microvascular injury. In the present study, we have examined the effect of the volatile solvent carbon tetrachloride on serum levels of ACE. In mice, a dose-response relationship was obtained in serum ACE 24 hr after acute oral doses of carbon tetrachloride ranging from 0.1 to 2.8 ml/kg. Serum levels of ACE returned to normal by 48 hr after treatment. The increase in serum ACE after carbon tetrachloride treatment correlates with a significant reduction in lung ACE, whereas liver and kidney levels are unaffected. The elevation in serum ACE which occurs after carbon tetrachloride would appear to be, therefore, the result of release from the lungs. Because tissue injury is associated with inflammation, we investigated what effect an anti-inflammatory drug has on the elevation of serum ACE by carbon tetrachloride. Pretreatment of mice with 100 mg/kg of aspirin, orally, produced a 53% reduction in the elevation of serum ACE produced by carbon tetrachloride. These studies strongly suggest that carbon tetrachloride can produce damage to pulmonary endothelial cells. A model to explain the transient nature of elevated serum ACE based on current knowledge of glycoprotein structure and metabolism is proposed.     

Systemic inflammatory response syndrome (SIRS) and endothelial cell injury

During recent years, evidences have been accumulated demonstrating bidirectional crosstalk between coagulation and inflammation. This review outlines the influences that coagulation and inflammation exert on each other to the endothelium and how these systems induce systemic inflammatory response syndrome (SIRS). Then we discussed the implications of leucocyte-endothelial activation to endothelial cell injury followed by multiple organ dysfunction syndrome (MODS) in patients with sustained SIRS. Last we demonstrated an important role of inflammatory circulation disturbance induced by endothelial cell injury for the pathogenesis of MODS in SIRS and sepsis.     

Effects of heparin and lisofylline on pulmonary function after smoke inhalation injury in an ovine model

OBJECTIVE: This study evaluates the effects of heparin alone and in combination with lisofylline, 1-(5-R-hydroxyhexyl)3,7-dimethylxanthine, on severe smoke injury. DESIGN: Prospective animal study with concurrent controls. SETTING: An animal laboratory. SUBJECTS: Eighteen 1-yr-old female sheep, weighing 24-32 kg. INTERVENTIONS: After smoke exposure and tracheostomy, animals were divided into three groups. Group S (n = 6) received nebulized saline through an endotracheal tube every 4 hrs for 48 hrs. Group H (n = 6) received 10,000 units of nebulized heparin every 4 hrs. Group LH (n = 6) was treated with nebulized heparin and intravenous infusion of lisofylline (10 mg x kg(-1) x hr(-1)) for 48 hrs after a bolus injection (20 mg/kg). Animals initially breathed room air spontaneously. If PaO2 was <50 torr and PaCO2 >60 torr, animals were mechanically ventilated. Sheep were killed 48 hrs postinjury. MEASUREMENTS AND MAIN RESULTS: Blood gases were measured serially. At 48 hrs, ventilation perfusion distribution mismatching was analyzed by using the multiple inert gas elimination technique. Lung malondialdehyde was determined. The postinjury increase in alveolar-arterial oxygen tension gradient (LH, 36.7 +/- 3.5 vs. S, 89.0 +/- 24.6 torr at 48 hrs) was significantly attenuated in those animals receiving LH. The percentage of pulmonary shunt, Qs/Qt (LH, 20.8 +/- 4.9 vs. S, 36.6 +/- 4.6%), and the percentage of animals that required ventilation (LH, 0 vs. S, 67%) were significantly reduced in LH. Multiple inert gas elimination technique study showed that the true shunt fraction was decreased in LH. Lung malondialdehyde was significantly less in LH (LH, 0.33 +/- 0.06 vs. S, 0.56 +/- 0.09 nmol/mg protein). There was no significant difference in any of these variables between H and S. CONCLUSION: Treatment with heparin alone did not attenuate pulmonary dysfunction after severe smoke injury. Combined treatment with nebulized heparin and systemic lisofylline had beneficial effects on pulmonary function in association with a decrease in blood flow to poorly ventilated areas and less lipid peroxidation.     

Temporal pulmonary function changes in cervical cord injury

Temporal changes in pulmonary function (PF) in subjects with complete cervical cord transection occur in two stages. The first, extending from the acute to post-acute periods, is characterized by relatively rapid increases in the following: vital, inspiratory, and total lung capacities (VC, IC, and TLC, respectively), and inspiratory and expiratory airflows coupled with decreases in functional residual capacity (FRC). Second stage changes--from the post-acute period on--are more gradual, with both VC increase and FRC decrease continuing while TLC and ventilatory indices remain unchanged. The initial stage appears to be caused in part by functional respiratory muscle return coincident with resolution of inflammation and edema above the injury level. Altered respiratory mechanics also contribute to these early changes and the continuing later changes. Mechanical changes in the lung are probably both decreased compliance (which decreases FRC) and increased airway resistance (which diminishes airflow). Chest wall changes, resulting from returning spinal cord reflexes, affect PF via: (1) increased rib cage stability, leading to a more effective transduction of diaphragmatic displacement into lung volume, and (2) abdominal and expiratory intercostal spasticity, which could limit maximum inspiration. The net effect of these changes, however, may eventually lead to chronic hypoventilation.     

手外伤后指关节僵硬的系统康复治疗

目的 观察系统康复治疗对手外伤后指关节僵硬的临床疗效。方法 配合物理因子治疗。对213例外伤后指关节僵硬的手指先行牵引与手法治疗，后行ROM训练并结合矫形夹板与中药水浴治疗。结果 治疗后AROM优良率82.2%。有效率97.7%；PROM优良率94.8%。有效率100%；手指综合功能从治疗前的17%增至56%。结论 运动治疗的同时结合物理因子治疗与作业疗法能较好地改善手外伤后僵硬指关节的活动范围，促进手功能的恢复。     

跑台运动训练对脊髓损伤大鼠肺功能及HMGB-1表达的影响

目的:探讨跑台运动训练对脊髓损伤(SCI)后大鼠肺功能及高迁移率族蛋白B1 (HMGB1)表达的影响.方法:选取96只SD雌鼠,随机分成4组,即正常组、假手术组、脊髓损伤非训练组、脊髓损伤训练组.脊髓损伤训练组大鼠于术后第3天开始进行跑台运动训练.分别在术后第3天、术后第14天检测4组大鼠动脉血气分析,肺组织湿/干重比...     

Ventilation efficiency and pulmonary function after a wheelchair interval-training program in subjects with recent spinal cord injury

OBJECTIVE: To study the effect of a wheelchair interval-training program on the ventilatory function of subjects with recent spinal cord injury (SCI). DESIGN: Evaluation trial before and after a training program. SETTING: Center of reeducation and university hospital. PARTICIPANTS: Six subjects (5 men, 1 woman) hospitalized after a recent SCI. INTERVENTION: On a wheelchair ergometer, subjects with SCI performed 30 minutes of interval training 3 times a week for 6 weeks. The training program was part of their reeducation program. MAIN OUTCOME MEASURES: Spirometric values at rest and dynamic ventilatory responses were studied before and after this training program with a spirometric test, a maximal exercise test that increased by 5W every 2 minutes, and a submaximal test. RESULTS: Spirometric values at rest did not change after training. At maximal exercise, peak ventilation (Vepeak, 7.5%), peak breathing frequency (f peak) (-13.4%), peak tidal volume (Vtpeak +28.9%), and the ventilatory reserve (12.9%) improved after training. The oxygen cost of Ve decreased significantly (-20%) after training. We observed for the wheelchair tests that, at the same workload after training, Ve and f decreased and Vt increased. CONCLUSIONS: After 6 weeks of our interval-training program in subjects with recent SCI, the increase of Vt and the decrease of oxygen cost of Ve indicated better ventilatory efficiency.     

Interleukin-1 and T cell function following injury

Sepsis is responsible for 75% of late deaths after major thermal or traumatic injury. In the clinical setting, efforts to prevent or control sepsis, or both, should include an understanding of normal host resistance, proper resuscitation techniques, and nutritional support. Previous studies have identified T suppressor cell abnormalities following thermal injury and have suggested macrophage defects after traumatic injury. Although major thermal injury is easier to quantify than mechanical trauma, both insults can stress patients' host resistance to a maximal degree, leading to profound and often fatal immunosuppression. Recent studies summarized in this paper have suggested that the macrophage and the interleukin system may play a major role in initiating some of these immune abnormalities following injury.     

pSVPoMCAT微基因修饰雪旺氏细胞移植治疗实验性脊髓损伤的酶及免疫组化评价

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