强直性脊柱炎髋关节病变的危险因素

目的：探讨强直性脊柱炎（ＡＳ）患者发生髋关节病变的可能危险因素，方法：对６６例有髋关节破坏的ＡＳ患者（Ａ组）和４８例有髋痛但Ｘ线正常患者（Ｂ组）进行回顾性分析，并与３４例无髋关节病变的ＡＳ患者（Ｃ组）做对照，结果：Ａ组及Ｂ组的发病年龄均早于Ｃ组（Ｐ〈０．０５）。以外周关节起病者，在三组分别为６９．７％，５９．３％和２０．６％（Ｐ〈０．０１）；发病至出现髋痛的间隔对间在Ａ组短于Ｂ组（Ｐ〈０．０１），     

SLE病人PBMC分泌IL—6活性水平的研究

为了研究了ＳＬＥ病人ＰＢＭＣ分泌ＩＬ－６的能力，我们采用ＭＴＴ比色法，用ＩＬ－６依赖细胞株（７ＴＤ１）分别测定了１５例活动期，１５例非活动期ＳＬＥ病人和１５例正常对照者ＰＢＭＣ培养上清ＩＬ－６的活性水平。结果表明ＳＬＥ患者ＰＢＭＣ自发分泌ＩＬ－６的水平显著高于正常人（Ｐ〈０．０２或Ｐ〈０．００１），活动期患者高于非活动期患者（Ｐ〈０．００１）。ｐＨＡ－Ｍ刺激培养体系后，ＳＬＥ患者及正常人ＰＢＭＣ培     

结核性胸膜炎病变局部B淋巴细胞CD23,CD40表达及其影响因素的探讨

采用细胞－酶联标记法测定了结核性胸膜炎病人胸水中Ｂ淋巴细胞ＣＤ２３、ＣＤ４０的表达，并进一步观察了Ｂ淋巴细胞在Ｔ淋巴细胞、ＰＰＤ等参与培养后ＣＤ２３、ＣＤ４０的表达受影响情况。结果显示：结核性胸膜炎病人胸水中Ｂ淋巴细胞与Ｔ淋巴混合培养后与单独Ｂ淋巴细胞培养组相比较，ＣＤ２３的表达明显降低（Ｐ〈０．０５），二者存在密切相关（ｒ＝０．８０），而Ｂ＋ＰＰＤ、Ｂ＋ＰＰＤ＋Ｔ培养组与Ｂ淋巴细胞培养组相比较，     

结核性胸膜炎病变局部B淋巴细胞CD23、CD40表达及其影响因素的探讨

采用细胞─酶联标记法测定了结核性胸膜炎病人胸水中Ｂ淋巴细胞ＣＤ２３、ＣＤ４０的表达，并进一步观察了Ｂ淋巴细胞在Ｔ淋巴细胞、ＰＰＤ等参与培养后ＣＤ２３、ＣＮ４０的表达受影响情况。结果显示：结核性胸膜炎病人胸水中Ｂ琳巴细胞与Ｔ淋巴细胞混合培养后与单独Ｂ淋巴细胞培养组相比较，ＣＤ２３的表达明显降低（Ｐ＜０．０５），二者存在密切相关（ｒ＝０．８０），而Ｂ＋ＰＰＤ、Ｂ＋ＰＰＤ＋Ｔ培养组与Ｂ淋巴细胞培养组相比较，ＣＤ２３表达无明显差异（Ｐ＞０．０５）；各组之间ＣＤ４０的表达无差异。健康人外周血Ｂ淋巴细胞培养过程中ＣＤ２３、ＣＤ４０的表达不受Ｔ细胞及ＰＰＤ的影响。提示：结核病人Ｔ细胞对Ｂ细胞ＣＤ２３的表达具有明显抑制作用。     

喉癌癌变过程中P21^WAFI／CIPI表达及临床病理学意义

采用免疫组化检测２０例喉正常粘膜，４０例不典型增生病变和６０例喉癌患者组织中Ｐ２１＾ＷＡＦＩ／ＣＩＰＩ的表达。结果显示：（１）Ｐ２１＾ＷＡＦＩ／ＣＩＰＩ的生表达定位于细胞核。（２）在喉癌癌变过程中，喉正常粘膜，不典型增生病变和喉癌中Ｐ２１＾ＷＡＰＩ／ＣＩＰＩ阳性表达率分别为９５．０％（１９／２０）、７５．０％（３０／４０）和６３．３％（３８／６０），Ｐ〈０．０１。（３）Ｐ１２１＾ＷＡＦＩ／ＣＩＰＩ     

比较不同剂量氟伐代和普伐他汀治疗原发性高胆固醇…

采用随机、双盲、平行对照方式，比较氟伐他汀４０－８０ｍｇ／ｄ，（Ａ组３３例）和普伐他汀２０－４０ｍｇ／ｄ（Ｂ组３５例）治疗原发性高胆固醇血症１２周后的疗效和安全性。结果：Ａ组服药１２周后，血清ＴＣ、ＬＤＬ－Ｃ、ＴＣ／ＨＤＬ－Ｃ水平与Ｏ周时比较分别降低１８．４％，２４．７％和１１．７％；Ｂ组分别降低２１．０％、３１．５％和２７．５％。Ａ组和Ｂ组服药１２周时降低ＴＣ的总有效率分别为７７．４％和８２％。     

活化PBL作用肝癌细胞的表型分析与TCR Vβ基因亚家族的优势取用

目的采用抗ＣＤ２８，ＣＤ８０，ＣＤ２及ＣＤ５８分别刺激健康人ＰＢＬ后作用肝癌细胞，对作用前后ＰＢＬ的表型变化及ＴＣＲＶβ基因亚家族的表达水平进行探讨．方法用ＦＡＣＳ分析作用肝癌细胞前后ＰＢＬ表型变化，并用ＲＴＰＣＲＳｏｕｔｈｅｒｎ印迹分析其ＴＣＲＶβ１２０的表达水平及特征．结果健康人ＰＢＬ作用肝癌细胞后ＣＤ３和ＣＤ８分子表达比作用前明显增高，而ＣＤ４分子无显著变化．健康人ＰＢＬ分别加ＩＬ２，ＰＨＡ，抗ＣＤ３和ＣＤ３＋ＣＤ２８，ＣＤ２８＋ＣＤ８０，ＣＤ２＋ＣＤ５８作用肝癌细胞（ＢＥＬ７４０２）前表达水平平均约５％，作用ＢＥＬ７４０２后表达水平约１３％～２５％，其特征为Ｖβ７增高．结论在癌抗原的参与下，ｍＡｂ共刺激的Ｔ细胞活化，ＴＣＲ接受ＡＰＣ呈递的相应抗原的刺激，具有该ＴＣＲ的淋巴细胞迅速增殖而成为针对抗原的Ｔ细胞克隆，发挥其识别和杀伤癌细胞的作用     

毛细胞白血病外周血淋巴细胞亚群和NK细胞活性的初步观察

用一组抗Ｔ、Ｂ细胞分化抗原的单克隆抗体检测５例毛细胞白血病病人外周血单个核细胞的表面标记。其中３例Ｂ淋巴细胞占优势（ＣＤ２０：５８％、５０％、６７％；ＣＤ２２：４８％、４３％、５０％，ＳｍＩｇ：８０％、４７％、６０％），包括１例伴有ＩｇＭ单珠峰的病人；２例Ｂ细胞表面标记阳性率很低（ＣＤ２０：２０％，１７％；ＣＤ２２；１５％；１０％；ＳｍＩｇ：１７％、１８％）。５例病人外周血ＷＴ３＋、ＷＴ４＋细胞及ＷＴ４／ＷＴ８比值明显低于正常对照组（Ｐ＜０．００１），ＷＴ８＋细胞增高与正常组比较差异无显著意义（Ｐ＞０．０５）。４例病人ＮＫ细胞活性降低，脾切除后的ＮＫ细胞活性明显升高。     

CD28/CD80和CD2/CD58活化PBLs作用肝癌细胞的表型分析与TCR Vβ基因亚家族的优势取用

目的　采用抗ＣＤ２８ ,ＣＤ８０ ,ＣＤ２ 及ＣＤ５８ 分别刺激健康人ＰＢＬｓ 后作用肝癌细胞,对作用前后ＰＢＬｓ 的表型变化及ＴＣＲＶβ基因亚家族的表达水平进行探讨．方法　用ＦＡＣＳ 分析作用肝癌细胞前后ＰＢＬｓ 表型变化,并用ＲＴＰＣＲＳｏｕｔｈｅｒｎ 印迹分析其ＴＣＲ Ｖβ１ ～２０ 的表达水平及特征．结果　健康人ＰＢＬｓ 作用肝癌细胞后ＣＤ３ 和ＣＤ８ 分子表达比作用前明显增高,而ＣＤ４ 分子无显著变化． 健康人ＰＢＬｓ 分别加ＩＬ２ , ＰＨＡ, 抗 ＣＤ３ 和 ＣＤ３ ＋ ＣＤ２８ , ＣＤ２８ ＋ ＣＤ８０ ,ＣＤ２ ＋ ＣＤ５８ 作用肝癌细胞（ＢＥＬ７４０２） 前表达水平平均约５ ％ ,作用ＢＥＬ７４０２ 后表达水平约１３ ％ ～２５ ％ ,其特征为Ｖβ７增高．结论　在癌抗原的参与下,ＭｃＡｂ 共刺激的Ｔ 细胞活化,ＴＣＲ接受ＡＰＣ 提呈的相应抗原的刺激,具有该ＴＣＲ 的淋巴细胞迅速增殖而成为针对抗原的Ｔ 细胞克隆,发挥其识别和杀伤癌细胞的作用．     

HBV感染与肝癌患者血清可溶性IL—2受体及T淋巴细胞亚群的变化及意义

用ＥＬＩＳＡ及ＡＰＡＡＰ法分别检测了３９例乙型肝炎病毒（ＨＢＶ）感染者、１５例者ＨＢＶ感染的肝癌患者及２０例正常人的血清可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）和外周血Ｔ淋巴细胞亚群结果显示,肝癌及ＨＢＶ感染者（Ｐ〈０．０１）。吕患者及ＨＢＶ感染者ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ４／ＣＤ８与对照相比均有显著差异（Ｐ〈０．０５）,而肝癌与ＨＢＶ感染者相比无显著差异（Ｐ〉０．０５）。提示ＨＢＶ感染者及肝癌     

Systemic and mucosal antibodies to Klebsiella in patients with ankylosing spondylitis and Crohn''s disease.

Whole gut lavage fluid is a useful source of material for the study of intestinal immunity and inflammation in humans. Systemic and mucosal antibodies to Klebsiella pneumoniae were measured by enzyme linked immunosorbent assay (ELISA) in serum samples and whole gut lavage fluid from 14 patients with ankylosing spondylitis, 14 with Crohn's disease, and 16 immunologically normal controls. As the concentration of IgG in whole gut lavage fluid reflects disease activity in Crohn's disease, this approach was used to detect intestinal inflammation in patients with ankylosing spondylitis who also had disease activity and use of non-steroidal anti-inflammatory drugs (NSAIDs) recorded. Small intestinal permeability to cellobiose and mannitol was also studied. In serum samples, levels of IgA antibody to klebsiella were high in patients with Crohn's disease and in patients with active ankylosing spondylitis, and were significantly correlated with the erythrocyte sedimentation rate in patients with ankylosing spondylitis. Levels of IgG antibody to klebsiella were also high in patients with Crohn's disease. Studies of whole gut lavage fluid showed similar levels of IgA antibody to klebsiella in the three study groups, but levels of whole gut lavage fluid IgM and IgG antibodies to klebsiella were high in patients with Crohn's disease. Levels of IgG in whole gut lavage fluid were high in patients with Crohn's disease but in only one patient with ankylosing spondylitis, though the cellobiose/mannitol permeability ratio was abnormal in eight of 13 patients with ankylosing spondylitis. It is concluded that high levels of serum IgA antibody to klebsiella are not specific to ankylosing spondylitis, and that there is no evidence of an abnormal intestinal IgA antibody response to klebsiella in patients with ankylosing spondylitis.     

系统性红斑狼疮患者外周血单个核细胞CD28 mRNA的表达

目的　探讨CD28在系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中的表达水平及其意义。方法　应用反转录-聚合酶链反应(RT-PCR)检测了34例活动期SLE患者和30名正常人PBMC中CD28mRNA的表达水平。结果　活动期SLE患者CD28的阳性表达率为20.6%,明显低于正常人对照组(70.0%),差异非常显著(P＜0.001);活动期SLE组CD28的平均表达水平(0.19±0.21)亦明显低于正常对照组(0.43±0.11),差异显著(P＜0.05)。结论　CD28的异常表达可能在SLE发病机制中起作用,CD28mRNA的低水平表达可能与外周血CD28＋T细胞凋亡增加或迁移到炎症部位有关。     

Antibodies to and elevations of beta 2 microglobulin in the serum of ankylosing spondylitis patients

Antibodies to beta 2 microglobulin are found in systemic lupus erythematosus patients and are important in the lymphocytotoxic reactions of sera from such patients. In this study, beta 2 microglobulin antibodies were measured with the use of an enzyme-linked immunosorbent assay with purified beta 2 microglobulin antigen and peroxidase-labeled anti-human IgG or IgM. IgG antibodies to beta 2 microglobulin were found in 68% of 22 patients with ankylosing spondylitis. This incidence was higher than the 5% in 80 controls (P less than 0.01) and similar to the 71% incidence found in 35 patients with systemic lupus erythematosus. Eleven (27%) of 41 patients with rheumatoid arthritis had elevated levels of antibodies to beta 2 microglobulin (P less than 0.01). The mean antibody levels expressed in enzyme units were 0.125 for patients with ankylosing spondylitis, 0.157 for those with systemic lupus erythematosus, 0.101 for those with rheumatoid arthritis, and 0.067 for controls. IgM anti-beta 2 microglobulin was not significantly different from controls. A competitive binding assay with enzyme-labeled beta 2 microglobulin was used to determine serum beta 2 microglobulin. These values were also found to be elevated in 48% of patients in all 3 disease categories (P less than 0.01). Beta 2 microglobulin antibodies and serum beta 2 microglobulin did not correlate with each other, renal diseases or antinuclear antibodies in patients with systemic lupus erythematosus, with rheumatoid factor or severity of articular disease in patients with rheumatoid arthritis, or with peripheral arthritis or iritis in those with ankylosing spondylitis. Although antibodies to beta 2 microglobulin might reflect a general disturbance of immune regulation in patients with systemic lupus erythematosus, their presence in those with ankylosing spondylitis, a disease closely associated with a specific HLA allotype and not usually associated with formation of autoantibody, suggests that they might play a role in the pathogenesis of the latter disease.     

The HLA system and the arthropathies associated with psoriasis.

Histocompatibility typing was carried out in 74 patients with psoriasis and an inflammatory arthropathy. In 40 patients with peripheral arthropathy characterized by distal interphalangeal joint involvement, 13 (32-5%) were HLA-B27 positive, significantly higher than the control frequency (P = 5-8 X 10 (-6). 26 of the 40 patients did not have ankylosing spondylitis or radiological sacroiliitis and 7 were HLA-B27 positive, also significantly higher than in controls (P = 0-0049). All 7 patients with psoriasis and ankylosing spondylitis without peripheral arthropathy were HLA-B27 positive. The 10 patients with ankylosing spindylitis or radiological sacroliitis who were HLA-B27 negative all had peripheral arthropathy. It is suggested that being HLA-B27 positive increases the risk of a psoriatic patient developing both peripheral arthropathy and ankylosing spondylitis. In addition, some of the genes involved in susceptibility to psoriasis also have a role in the pathogenesis of both types of arthropathy. A hypothesis is put forward that some of the genes for psoriasis may be aetiologically important in some HLA-B27 negative patients with ankylosing spondylitis.     

强直性脊柱炎患者外周血CD4+CD25+调节性T细胞的研究

目的 观察强直性脊柱炎(AS)患者外周血CD4+CD25调节性T细胞(Treg)的数量、功能及肿瘤坏死因子(TNF)-a 抑制剂治疗的影响.方法 活动性AS患者25例,10例给予etanercept治疗12周,健康对照21名,分离外周血单个核细胞(PBMC),流式细胞术检测CD4+CD25high T细胞比例;实时定量聚合酶链反应检测FOXP3 mRNA表达;免疫磁珠法去除CD25+细胞,可溶性噻唑盐(WST-1)法检测T细胞增殖.结果 活动性AS组CD4+CD25high T细胞比例与对照组差异尤统计学意义,但FOXP3 mRNA表达明显低于对照组(P＜0.01),并与C反应蛋白(CRP)呈负相关(P＜0.01).两组的CD4+CD25+细胞体外均能抑制T细胞增殖(P均＜0.01). Etanercept治疗明显增加CD4+CD25highT细胞比例和FOXP3 mRNA表达(P均＜0.01),与CRP降低呈负相关(P＜0.05;P＜0.01).结论 AS患者外周血表达FOXP3的CD4+CD25+Treg细胞异常,可能参与AS发生和发展;Etanercept治疗上调Treg细胞,可能是抗TNF-α治疗的一个机制.     

雷公藤内酯醇对系统性红斑狼疮病人B细胞表达CD86分子的影响

目的 了解系统性红斑狼疮(SLE)患者外周血B细胞表达CD86的情况，以及雷公藤内酯醇(Tripto1ide，TL)对其的影响。方法 用流式细胞仪检测外周血单个核细胞(PBMC)新鲜分离时以及与不同浓度TL在体外培养后的CB86阳性率。结果 SLE B细胞的CD86阳性率在新鲜分离时(P＜0．002)和培养48h后(P＜0．001)均较正常人B细胞高。25ng／m1的TL可明显降低SLE和正常人B细胞的CD86阳性率(P＜0．001)，2．5ng／ml则只对SLE B细胞起作用(P＜0．001)。结论 SLE病人B细胞CD86阳性率高于正常人；TL对SLE或正常人的CD86^ B细胞均有显著的下调作用，在某一浓度下仅抑制SLEB细胞的CD86表达。     

Determination of endotoxin in inflammatory rheumatic diseases--the effect of nonsteroidal anti-inflammatory agents on intestinal permeability

We measured the amount of plasma endotoxin in 95 patients with inflammatory rheumatic diseases (42 with ankylosing spondylitis; 12 with possible ankylosing spondylitis; 41 with rheumatoid arthritis) and in 16 patients with Crohn's disease with a quantitative Limulus assay. Significantly increased mean values were found in inflammatory rheumatic diseases and in Crohn's disease. Between 31% and 50% of the patients had endotoxin values higher than 10 pg/ml--none of the controls had such values. Patients on regular treatment with NSAIDS had higher amounts of endotoxin again. From our results we discuss an intestinal involvement in inflammatory rheumatic diseases. An inflammation of the gut with an increased permeability seems to be responsible for the raised plasma endotoxin levels compared to healthy controls. NSAIDs probably contribute to the increased permeability of the gut.     

溃疡性结肠炎肠黏膜组织CD8、Fas/FasL和Bcl-2/Bax的表达及关系

目的:研究溃疡性结肠炎(UC)肠黏膜CD8 T细胞Fas／FasL、Bcl-2／Bax蛋白表达以及相互关系,探讨细胞凋亡机制在UC发病中的作用．方法:采用免疫组化SP法检测60例UC肠黏膜组织以及60例正常肠黏膜组织CD8,Fas／FasL, Bcl-2／Bax蛋白表达．结果:CD8阳性细胞在上皮间的浸润在UC 组为52％,正常组为78％,两组相比差异显著 (P<0．01);急性期较缓解期也显著减少(20％ vs 74％,P<0．01)．CD8在UC患者急性期黏膜固有层的表达为80％,高于缓解期的34％(P= 0．0006)．Fas在UC上皮中表达62％,正常组织 30％,两组相比差异显著(P<0．01);急性期高于缓解期(84％ vs 45％,P<0．01)．FasL在固有膜炎性细胞中的表达UC组为62％,正常组7％, 两组相比差异显著(P<0．00;急性期(88％)高于缓解期(43％),而且CD8与FasL在黏膜固有层炎性细胞的表达呈正相关(X2=7．3,P<0．01)． Bcl-2／Bax在UC肠黏膜上皮的表达率与正常组相近,差异无显著性．结论:UC肠黏膜组织Fas／FasL表达增强, Bcl-2／Bax表达无明显变化,CD8细胞与UC急性期Fas／FasL表达相关．     

Adipose tissue, serum adipokines, and ghrelin in patients with ankylosing spondylitis

Adipokines such as leptin and adiponectin are involved in the regulation of inflammation. Ghrelin, a gastric peptide playing a role in the appetite regulation, possesses anti-inflammatory properties. In this study, we evaluated the circulating levels of adipokines (leptin as potential proinflammatory and adiponectin as anti-inflammatory marker) and ghrelin and the fat mass in patients with ankylosing spondylitis (AS). Serum leptin, adiponectin, and ghrelin were evaluated in 53 AS patients with active disease (mean Bath Ankylosing Spondylitis Disease Activity Index >40) and 35 controls. Fat and lean masses were determined using dual-energy x-ray absorptiometry. Fat and lean masses did not differ between patients and controls. Ankylosing spondylitis patients had lower leptin levels compared with controls, even after adjustment for fat mass (AS vs controls: leptin, 7.6 +/- 1.3 ng/mL vs 10.3 +/- 1.5 ng/mL; leptin [in nanograms per milliliter]/fat mass [in kilograms], 0.28 +/- 0.04 vs 0.44 +/- 0.04; P = .006 and P = .0003, respectively). Serum adiponectin did not differ between patients and controls, whereas circulating ghrelin was higher in AS patients (1354.6 +/- 70.5 pg/mL vs 1008.0 +/- 82.5 pg/mL; P = .001). However, all these results were significant only for male patients. No correlation was found between leptin and adiponectin, and erythrocyte sedimentation rate, C-reactive protein levels, tumor necrosis factor alpha, or Bath Ankylosing Spondylitis Disease Activity Index. Ankylosing spondylitis patients had no changes in fat mass. Leptin production was reduced in contrast with normal levels of adiponectin. These adipokine results, together with high serum ghrelin levels, may influence the inflammatory response in AS.     

慢性淋巴细胞白血病血清可溶性CD23及血小板生成素研究

目的 探讨慢性淋巴细胞白血病(CLL)患者血清可溶性CD23(sCD23)及血小板生成素(TPO)水平及与其他预后指标的相关性.方法 采用酶联免疫吸附试验检测25例CLL患者外周血标本中sCD23及TPO的水平;流式细胞术检测ZAP-70蛋白及CD28的表达.结果 CLL患者TPO水平为67.22～1881.77 ng/L,明显高于正常对照组70.29～147.98 ng/L(P=0.003);CLL患者血清sCD23水平为129.80～405.31 U/ml,也明显高于正常对照组0.65～32.99 U/ml(P=0.000).血清TPO水平与Binet分期、CD28具有显著相关性.Binet A期患者TPO水平为121.92～163.83 ng/L,低于BinetB和C期患者140.57～457.48 ng/L(P=0.014);CD38高表达组TPO水平113.23～199.10 ng/L,高于CD38低表达组141.34～454.92 ng/L(P=0,033).而TPO与ZAP-70表达及sCD23与CD28、ZAP-70表达无明显相关性.另外,血清sCD23及TPO与患者性别、年龄、外周血淋巴细胞计数和乳酸脱氢酶均无相关性.结论 血清TPO水平对CLL预后判断可能具有一定的价值.