调节性B细胞及其在移植中的研究进展

B细胞在体液免疫中起核心作用,还可促进细胞免疫。同时,B细胞还具有调节功能,不同的炎症环境刺激诱导产生不同的B细胞群体,这是一种全新的调节性B细胞(Breg),它可通过分泌白细胞介素(IL)10、IL-35及转化生长因子β等抑制性细胞因子介导发生免疫耐受,从而在移植中抑制过度炎症反应。目前对于Breg细胞的功能、表型及调节机制没有深入的认识,尤其在移植免疫中Breg细胞发挥的作用至今尚未明确。     

调节性B细胞在皮肤病中的作用

B细胞不仅在体液免疫中发挥免疫效应功能,同时也具有重要的负向免疫调节功能,这些具有负向免疫调节功能的B细胞被称为调节性B细胞(Breg),Breg细胞在多种炎症性疾病、自身免疫性疾病及恶性肿瘤的发生、发展过程中发挥重要的调节作用,其在皮肤病中的作用尤其引起研究者的关注,深入分析Breg细胞在相关皮肤病中的作用,将有助于进一步理解疾病的病因及发病机制,并为皮肤病的免疫治疗提供新的靶点。     

白介素-35与心血管疾病关系研究进展

白介素-35（ IL-35）是最近发现的一种细胞因子，主要由调节性T细胞（ Treg）或调节性B细胞（ Breg）分泌，具有负性免疫功能，在自身免疫性疾病、感染性疾病及肿瘤等多种疾病的发展中起重要的调节作用，是一种具有潜在治疗前景的新型调节因子。心血管疾病大多存在免疫异常的表现，表现为Treg、Breg等起负性免疫作用的细胞生成减少，IL-35的表达下降。本文对IL-35的最新研究及其与心血管疾病的关系作一综述，为心血管疾病的病情评估和免疫治疗提供新的思路。     

B细胞与肿瘤免疫逃逸

B淋巴细胞是人免疫系统中的重要组成细胞,在机体发挥特异性免疫的过程中占有一席之地。近年来关于B细胞与肿瘤免疫逃逸的研究进展迅速。研究表明不同类型的B细胞在肿瘤微环境中通过多样化的机制发挥差异性作用。三级淋巴结构中的B细胞促进肿瘤的免疫杀伤作用,而调节性B细胞促进肿瘤的免疫逃逸。靶向B细胞的抗体药物是肿瘤免疫治疗潜在的新方向。     

逆转录病毒载体介导大鼠乳腺癌细胞共表达mMIP-1α和mB7-1

肿瘤免疫基因治疗为肿瘤治疗提供了新的途径,趋化因子和共刺激分子B7在肿瘤免疫基因治疗研究中发挥着重要的作用。B7通过为T细胞激活提供第二信号,趋化因子MIP—1α能趋化T细胞、单核细胞、树突状细胞、NK细胞等在抗肿瘤免疫中有相应作用的细胞。从而产生抗肿瘤效应。研究表明共转染B7因子和趋化因子。可能通过“招引一活化”的机制而产生更强的抗肿瘤效应。本研究利用两种含不同选择标记的重组逆转录病毒载体,     

新型免疫检查点BTLA在免疫调控及肿瘤免疫治疗中的作用

随着肿瘤发病率和死亡率的逐年升高,寻找新型的肿瘤治疗方法已迫在眉睫。近年来,免疫检查点阻断治疗在肿瘤治疗领域表现突出,B和T淋巴细胞衰减子(BTLA)作为一种免疫检查点分子,不仅在T细胞表面表达,同时也在B细胞、NKT细胞和树突状细胞中表达,通过与其配体结合传递抑制信号,在机体的免疫调控中发挥负调控作用。调控BTLA的表达能够激活T细胞的功能和活性,抑制肿瘤生长,因此BTLA有望成为肿瘤免疫治疗的潜在靶点。     

NKT细胞抗肿瘤作用及其机制

自然杀伤T细胞(NKT)是一类特殊类型的T淋巴细胞,可识别由CD1d分子提呈的抗原,活化后既可直接作为抗肿瘤效应细胞发挥杀伤作用,又能通过激活其他免疫效应细胞,如NK细胞,间接实现抗肿瘤作用.NKT细胞在机体的自身免疫性疾病、感染性疾病、肿瘤以及移植排斥等方面也发挥着重要的作用.     

调节性B细胞的研究概述

B细胞主要通过分泌各种抗体发挥免疫学作用,新近研究发现在B细胞中存在一种新的细胞亚群——调节性B细胞,它们可通过分泌IL-10和TGF-β1抑制获得性免疫介导的炎症反应发展和(或)加快炎症的恢复,相关研究表明此种细胞可在炎症性肠病、系统性红斑狼疮、肿瘤等疾病中发挥重要作用。本文综述了调节性B细胞的来源、功能、作用机制及相关研究进展。     

中药双向调控肿瘤免疫治疗癌症的机制研究

中医药在改善肿瘤常见症状、缓解放化疗不适、提高患者生存质量等方面具有显著优势。中药及其活性成分具有广泛的药理作用,不仅能够增强机体免疫反应,发挥抗肿瘤作用,还能通过上调Treg等免疫抑制细胞及相关因子改善免疫系统的过度激活,进而发挥肿瘤免疫的双向调节作用,治疗肿瘤。但目前研究仍有下列不足：中药调控肿瘤免疫的具体作用机制及免疫治疗靶点尚未明确;中医基础理论与现代药理作用结合不足;中药调节B淋巴细胞治疗肿瘤的相关研究有待深入探究;中药双向调控肿瘤免疫的研究多基于单个靶点或单个方向,缺乏机制串联研究,需加强多靶点、多通路研究。今后可进一步探索中药调节免疫治疗肿瘤相关机制,基于免疫学技术深化中医药免疫基础研究,同时协同化疗药物治疗恶性肿瘤,发挥中药减毒增效的作用,为中西医结合防治肿瘤提供新思路。     

逆转录病毒载体介导大鼠乳腺癌细胞共表达mMIP-1α和mB7—1

肿瘤免疫基因治疗为肿瘤治疗提供了新的途径。趋化因子和共刺激分子B7在肿瘤免疫基因治疗研究中发挥着重要的作用。B7通过为T细胞激活提供第二信号，趋化因子MIP-1α能趋化T细胞、单核细胞、树突状细胞、NK细胞等在抗肿瘤免疫中有相应作用的细胞。从而产生抗肿瘤效应。研究表明共转染B7因子和趋化因子．可能通过“招引-活化”的机制而产生更强的抗肿瘤效应。本研究利用两种含不同选择标记的重组逆转录病毒载体，采用重复感染法，将小鼠MIP-1a和B7—1基因共转染到大鼠乳腺癌细胞（SHZ-88）中，实现共表达，并检测到招弓『单个核细胞，并将其激活的体外生物学活性。[第一段]     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.