沙利度胺对骨髓瘤患者免疫学的影响

目的从免疫学角度了解沙利度胺治疗难治性复发性多发性骨髓瘤的机制.方法用双抗夹心法ELISA动态检测经沙利度胺治疗后多发性骨髓瘤(MM)患者的IL-6,IL-10,IL-4,TNF-α水平,用RT-PCR半定量法检测瘤细胞以上4种细胞因子mRNA的表达.结果口服沙利度胺200mg*d-114d时,IL-6,IL-10和TNF-α水平无明显变化,而IL-4水平开始升高,并随时间和沙利度胺剂量增加而增加,口服沙利度胺400mg·d     

白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α与 冠心病关系的初步研究

【摘要】 目的 研究炎症细胞因子白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、IL-10 等与冠心病（CHD）发病的关系。 方法 选取冠心病患者 628 例, 同期经冠脉造影证实冠脉无狭窄的非冠心病患者 540 例为对照组, 记录患者的资料, 包括年龄、体质指数（BMI）、血糖（Glu）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等指标, 同时用酶联免疫吸附试验法检测血清 IL-6、IL-10、TNF-α等炎症因子水平。 结果 CHD 组 BMI、LDL-C、TG 水平均高于对照组, 而 HDL-C 水平低于对照组（均 P<0.05）。 CHD 组血清 IL-6、TNF-α水平均高于对照组, 而 IL-10 低于对照组（均 P<0.05）。 结论 血清 IL-6、TNF-α参与了 CHD 的发生。血清 IL-10有抑制炎症作用, 可能对血管有保护作用。     

支气管哮喘患者血清细胞因子水平变化的研究

目的 探讨支气管哮喘患者血清细胞因子水平的变化.方法 采用酶联免疫吸附法（ELISA）检测支气管哮喘患者在急性发作期、缓解期与正常对照组患者的血清TNF-α、IL-6、IL-8水平及FEV1/FVC值.结果 支气管哮喘患者在急性发作期血清TNF-α、IL-6、IL-8水平明显高于缓解期和对照组（P＜0.05）;缓解期患者的血清TNF-α、IL-6、IL-8显著高于对照组（P＜0.05）.支气管哮喘患者在急性发作期、缓解期血清TNF-α、IL-6、IL-8与FEV1/FVC呈负相关（P＜0.05）.结论 血清TNF-α、IL-6、IL-8水平参与了支气管哮喘的炎症反应,可作为判断支气管哮喘患者病情严重程度的指标.     

危重症患者血清肿瘤坏死因子-α、白细胞介素-6及白细胞介素-10变化的研究

目的探讨危重症患者的血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）的变化，为判断危重症患者病情的严重程度提供新的客观指标。方法41例危重症患者中好转或治愈30例为存活组，死亡11例为死亡组，健康体检者20例为对照组。患者入住ICU后第1、7天清晨空腹抽取静脉血3ml，对照组抽空腹静脉血3ml，应用双抗体夹心酶联免疫吸附法检测血清中TNF-α、IL-6和IL-10的浓度。同时按急性生理和慢性健康评分系统（APACHEⅢ评分）方法进行危重症评分。结果危重症患者早期血清中促炎因子TNF-α、IL-6及抗炎因子IL-10的浓度均较对照组明显升高，存活组和死亡组与对照组比较均有统计学意义；TNF-α、IL-6、IL-10及APACHEⅢ评分四项指标两两之间呈显著性相关（P〈0．05）。结论促炎因子TNF-α、IL-6和抗炎因子IL-10在危重症患者中起重要作用，决定患者的预后。TNF-α、IL-6和IL-10浓度同APACHEⅢ评分一样可作为危重症预警的价值参数。     

手足口病患儿血清中白细胞介素-6、肿瘤坏死因子-α与白细胞介素-10水平变化的意义

目的：探讨手足口病（HFMD）患儿治疗前后外周血白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）水平变化的意义。方法采用酶联免疫吸附试验双抗体夹心法,测定39例HFMD患儿治疗前后血清IL-6、TNF-α、IL-10的含量。结果治疗3d 后,HFMD患儿血清IL-6、TNF-α、IL-10水平均较治疗前明显下降,差异有统计学意义。结论观察HFMD患儿的血清IL-6、TNF-α、IL-10水平有助于判定病情和治疗效果。     

免疫球蛋白静脉滴注对重症手足口病患儿血清炎性因子水平的影响

目的 研究静脉滴注免疫球蛋白对重症手足口病患儿血清炎性因子水平的影响.方法 将2009年4至6月收治的手足口病患儿40例,根据病情分为普通病例组(20例)和重症病例组(20例),单纯隐睾或斜疝儿童20例为对照组.20例手足口病重症病例组出现神经系统受累,但无心肺功能损害.重症病例组入院第1天及第2天分别予静脉滴注免疫球蛋白1g/(kg·d),用酶联免疫吸附试验分别检测血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和IL-10含量.结果 普通病例组、重症病例组治疗前,重症病例组治疗后及对照组TNF-α含量分别为(71.70±12.35)、(152.20±59.99)、(150.95±61.77)、(36.65±10.46)ng/L,IL-6含量分别为(14.50±3.83)、(59.35±13.27)、(25.30±7.58)、(16.40±6.63) ng/L,IL-10 含量分别为(9.82±2.20)、(38.19±8.54)、(23.30±5.21)、(9.32±2.08)ng/L.重症病例组血清TNF-α、IL-6和IL-10含量均高于普通病例组和对照组(P＜0.01),静脉滴注免疫球蛋白治疗后重症病例组血清IL-6和IL-10明显降低(P＜0.01),但血清TNF-α水平治疗前后差异无统计学意义(P＞0.05).普通病例组血清TNF-α含量高于对照组(P＜0.01),普通病例组血清IL-6和IL-10含量与对照组比较,差异无统计学意义(P＞0.05).结论 静脉滴注免疫球蛋白可明显降低重症手足口病患儿血清IL-6和IL-10水平.     

炎性细胞因子与心力衰竭的相关性研究

目的探讨肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）与慢性心力衰竭（CHF）的关系。方法采用放射免疫分析法（RIA）和酶联免疫吸附法（ELISA）测定血清TNF-α、IL-6、IL一10的含量。结果心功能Ⅳ级组患者血清TNF-α、IL-6、IL-10含量显著高于对照组和心功能Ⅱ、III级组（P〈0．05）,心功能Ⅲ级患者的TNF-α、IL-6、IL．10水平显著高于心功能Ⅱ级患者和对照组（P〈0．05）。CHF组血清TNF-α和IL-6水平与LVEF呈负相关（r=-0．755,-0．751）。CHF组血清IL-10水平与LVEF呈正相关（r=0．476）。结论TNF-α、IL-6、IL-10水平与CHF发生发展密切相关。     

柴胡皂苷A对大鼠肛肠术后血清白细胞介素-6和肿瘤坏死因子-α的影响

目的 研究柴胡皂苷A(Saikosaponin A)对大鼠肛肠术后血清细胞介素-6(IL-6)、白细胞介素10(IL-10)和肿瘤坏死因子-α(TNF-α)的影响.方法 将30只大鼠随机分为正常组、对照组(进行肛肠术不给药)和实验组(进行肛肠术并服用柴胡皂苷A),每组各10只.用酶联免疫吸附(ELISA)法在术后第3天...     

骨髓增生异常综合征骨髓细胞凋亡与TNF-α关系的探讨

目的：研究并分析骨髓增生异常综合征（MDS）各型骨髓细胞凋亡与肿瘤坏死因子-α（TNF-α）二者之间的关系。方法观察组选取21例确诊为MDS的患者,对照组选取5例其他科室非血液系统疾病患者的骨髓,分别测定两组细胞凋亡指数和TNF-α的含量。结果在骨髓细胞凋亡指数方面,与对照组相比,观察组MDS各型均有所提高（P〈0.05）。随着疾病发展,凋亡指数有下降趋势;在TNF-α含量方面,与对照组相比,观察组MDS各型均有所提高（P〈0.05）。随着疾病发展, TNF-α含量亦有下降趋势。结论MDS呈现骨髓细胞过度凋亡状态,且早期更加明显,与TNF-α有正相关联系。     

抗淋巴细胞血清联合脾细胞促进异基因骨髓细胞形成嵌合体诱导免疫耐受

目的:探讨抗淋巴细胞血清(ALS)联合异基因脾细胞(SC)在促进异基因骨髓细胞移植诱导小鼠皮肤移植免疫耐受中的作用。方法:第-5～-3天,C57BL/6(H-2b)受体小鼠每天腹腔注入0.5 ml抗淋巴细胞血清(ALS),共3天。第0天,C57BL/6受体小鼠通过尾静脉输注均源自BALB/c(H-2d)的1×108脾细胞(SC)及2×107骨髓细胞(BMC)。第二天,受体鼠腹腔注入200 mg/kg的环磷酰胺(CP)。第六天进行从BALB/c到C57BL/6的尾-尾皮肤移植。每天观察移植皮片存活情况,共观察100天。并于骨髓细胞移植后30天、50天及70天对受体小鼠外周血进行嵌合体检查。结果:抗淋巴细胞血清和(或)异基因脾细胞的输注能促进异基因BMC的植入,并能延长移植皮片的存活时间。在30、50天及70天,SC BMC CP、ALS BMC CP及ALS SC BMC CP移植组受体小鼠体内能检测到供体骨髓源性细胞,ALS SC BMC CP移植组的嵌合率较高,随着时间推移,嵌合率下降,而且移植皮片存活时间与嵌合率具一定相关性。结论:抗淋巴细胞血清(ALS)联合异基因脾细胞能协助异基因BMC植入,形成嵌合体,促进免疫耐受的诱导,使移植皮片存活时间延长。     

原发性肝癌合并门静脉癌栓肝移植术后27例随访报告

目的 探讨肝移植治疗原发性肝癌合并门静脉癌栓的价值。方法 收集我院2000年9月至2005年1月进行的27例原发性肝癌合并门静脉癌栓肝移植病例的临床资料并进行分析。结果 本组6个月、1年、2年生存率分别为79．2％、57．1％、51．4％，存活时间最长达46个月，6个月、1年和2年的无瘤生存率为58.3％、37．1％及37．1％。结论 如果没有肝外远处转移，肝移植治疗原发性肝癌合并门静脉癌栓是一种有效的姑息治疗方式。     

Regulation of the spontaneous contractile activity of the portal vein by the sarcoplasmic reticulum: evidence from the phospholamban gene-ablated mouse

The rapid contraction/relaxation cycles of phasic smooth muscles necessitates intracellular calcium cycling at a more rapid rate than that of tonic smooth muscles. Recent studies suggest that sarcoplasmic reticulum calcium handling is an important determinant of portal vein phasic contractions. We evaluated the importance and role of phospholamban, a protein which inhibits the sarcoplasmic reticulum (SR) calcium ATPase (SERCA), in regulating the contractility of the phasic mouse portal vein. PLB gene ablation significantly reduced the basal frequency of spontaneous mechanical activity and increased force development of the portal vein. Cyclopiazonic acid (CPA), an inhibitor of SERCA, did not significantly affect the spontaneous activity of the wild-type (WT) portal vein. CPA (1 microM) eliminated the differences in frequency and force between the PLB-KO and WT, localizing the effects to the SR. The PLB-KO portal vein had a lower resting membrane potential than WT controls. There were no significant differences between WT and KO responses to charybdotoxin (250 nM), indicating that calcium-activated potassium channels do not contribute to altered KO portal vein contractility. While contractile sensitivity to acetylcholine was not different between WT and PLB-KO portal veins, force generated in response to a given concentration of acetylcholine was significantly greater in the PLB-KO portal vein, both in the absence and presence of CPA. Our results confirm that SR activity can play a major role in modulating the frequency of the spontaneous mechanical activity of portal veins and removal of PLB inhibition of the SR calcium ATPase has significant effects on the spontaneous activity of the portal vein.     

门静脉插管滴注5-氟尿嘧啶化疗在预防大肠癌术后肝转移中的作用

目的:探讨门静脉插管滴注5-氟尿嘧啶化疗在大肠癌术后肝转移中的预防效果。方法:对32例大肠癌患者在根治切除肿瘤后(术前、术中均未发现临床肝转移),实施门静脉插管滴注5-氟尿嘧啶预防性化疗1周;观察其术后5年内肝转移的发生率。结果:预防性化疗组5年内肝转移的发生率为12.5%,对照组25.0%,两组相比较P<0.01,差异有极显著性。结论:大肠癌术后门静脉插管滴注5-氟尿嘧啶预防性化疗可预防肝转移,中西医结合治疗更有助于术后机体的恢复。     

Effects of sodium vanadate on the smooth muscle of the rat portal vein

Summary The effects of vanadate on the mechanical and electrical activity of the rat portal vein were examined. Vanadate increased the height of the spontaneous contractions of the portal vein without affecting basal tension. This effect was not blocked by -blockers or atropine. Vanadate did not exert any effect when the spontaneous contractions were abolished by high concentrations of verapamil or in the absence of Ca. Vanadate did not change the resting membrane potential of the smooth muscle cells of the vein, but it increased the rate of rise and the amplitude of the action potentials and the number of action potentials per burst. The intracellular Na content was increased slightly by vanadate. However, the effects of Na,K-pump inhibition by ouabain or K-removal were quite different from those of vanadate, and these procedures did not block the effect of vanadate, although they attenuated it. Vanadate also potentiated the K-contracture of the portal vein. These results indicate that vanadate increases the amplitude of the spontaneous contractions through an increase in the number of action potentials per burst which underly the contraction. These effects are not mediated by intrinsic nerve excitation or inhibition of Na,K pump activity. The facilitation of Ca entry through the voltage dependent Ca channel may be the main cause of the effect of vanadate on mechanical activity.Send offprint requests to K. Shimamura     

Effects of 4-aminopyridine on mechanical activity and noradrenaline release in the rat portal vein in vitro.

4-Aminopyridine (4-AP) increased the spontaneous mechanical activity of the isolated rat portal vein. Since denervation and adrenergic receptor blockade failed to prevent this effect of 4-AP it is suggested that the drug enhances the electrical excitability of the muscle membrane. 4-AP significantly increased the response of the muscle to electrical nerve stimulation in most experiments but had little effect on the response to applied noradrenaline (NA). Both spontaneous and evoked release of 3H-activity, following preincubation in 3H-noradrenaline, were increased in the presence of 4-AP (10(-3) M). The present results with 4-AP can be explained by its known ability to block the transient potassium conductance which accompanies the action potential in excitable tissues.     

Effects of Bay K 8644 on the spontaneous electrical and mechanical activities of the rat portal vein

Summary Effects of Bay K 8644 on the spontaneous electrical and mechanical activities of the rat portal vein were studied. Bay K 8644 enhanced contractions in amplitude and duration. Bay K 8644 prolonged the duration of the spontaneous spike potential bursts and increased the number of spike potentials in a burst. These results indicate that the increase in the amplitude and duration of spontaneous contractions of the rat portal vein induced by Bay K 8644 are mediated mainly by the facilitation of the membrane electrical activity.Send offprint requests to: K. Shimamura at the above address     

CTA对肝门静脉显示能力的实验研究

目的评价螺旋田门静脉成像对门静脉的显示能力。方法对6只新西兰大白兔分别进行门静脉CT血管成像（CTA）和数字减影血管造影（DSA）成像,比较2种成像方法对门静脉系统主要血管显示率、门静脉分支显示级数、图像质量及门静脉主干／其左右支和肠系膜上静脉的测量差异。结果本组CTA图像可清晰显示门静脉主干、门静脉左右支和肠系膜上静脉,5只可显示脾静脉,并能显示4～5级门静脉分支;DSA能够显示门静脉主干、门静脉左右支和肠系膜上静脉,但对其远端分支显示能力较差,仅能显示2—3级门静脉分支,3只可显示脾静脉。6只中图像质量为“好”者CTA5只、DSA1只。CTA对血管的分辨率和图像质量方面优于DSA图像。门静脉主干／其左右支和肠系膜上静脉测量值差异无统计学意义（P〉0．C15）。结论CTA可清晰显示门静脉主干及主要分支／属支,并用于测量,相对DSA有一定优势,可作为门静脉DSA的替代方法。     

The contribution of calcium and potassium to the alpha-action of adrenaline on smooth muscle cells of the portal vein, pulmonary artery and taenia caeci of the guinea-pig

The role of calcium and potassium in the alpha-action of adrenaline in pulmonary artery and portal vein was compared with that in taenia caeci by measuring changes in membrane potential, muscle contraction and ion fluxes in quiescent preparations from guinea-pigs (23 degrees C). The depolarization evoked by adrenaline (5 x 10(-8)-3 x 10(-5) M) was sustained in portal vein; in pulmonary artery it declined to a constant level after reaching an initial maximum. In calcium-free medium (20 min) containing EGTA (0.4 mM) and high magnesium (6.2 mM) adrenaline did not affect the membrane potential or the contractile state of the portal vein. Under these conditions the sustained phase of the response was abolished in the pulmonary artery; the remaining transient depolarization and contraction could be evoked only once. Adrenaline (3 x 10(-5) M) caused an increased 45Ca loss and 86Rb loss from the pulmonary artery and taenia caeci in calcium-free solution; a second addition of adrenaline to the calcium-free solution did not enhance the 45Ca loss from these tissues. The portal vein responded with an enhanced 86Rb loss on addition of the alpha-agonist. The bee toxin apamin (3 x 10(7) M) did not modify the depolarization, the contraction or the 45Ca and 86Rb fluxes evoked by adrenaline in the blood vessels. Enhancement of the 86Rb loss from taenia in the presence of adrenaline was prevented by apamin, but the excess loss of 45Ca was not abolished. It is concluded that adrenaline enhances cytoplasmic calcium by promoting calcium entry from the extracellular space in portal vein. In pulmonary artery and taenia caeci this is accompanied by mobilization of calcium from a cellular structure. Calcium entry facilitates triggering of the contractile proteins in vascular smooth muscle and is associated with membrane depolarization; in taenia caeci the mobilization of calcium caused by alpha-receptor activation is associated with the opening of potassium channels producing hyperpolarization and accordingly relaxation of the smooth muscle cells.     

移植途径对骨髓间充质干细胞调节小鼠心脏移植排斥反应的影响

目的 探讨不同途径注射骨髓间充质干细胞（BMSCs）对调节小鼠心脏移植排斥反应的影响。方法 BALB/c和C57小鼠分别作为供体和受体,建立颈部心脏移植模型,随机分为4组,每组12只,A组在移植成功后立即经移植心脏升主动脉注射C57来源绿色荧光BMSCs悬液30 μL（含1×106细胞）,B组同样时间点经移植心脏右心室腔内注射相同数量细胞,C组同样时间点移植心脏心肌内注射相同数量细胞,D组为空白对照组。移植后第7天各组处死4只小鼠,切取移植心脏,荧光显微镜下观察绿色荧光细胞的存活情况,HE染色观察移植心脏的病理学改变,流式细胞学检测移植物浸润白细胞中巨噬细胞的比例,其余8只小鼠用来观察移植心脏的存活时间。结果 术后第7天,仅A组移植心脏内可见绿色荧光细胞,病理学检测发现A组排斥反应受到明显抑制,心肌间质内细胞浸润明显减少,局灶性的心肌细胞损害,B组和C组移植心脏间质内可见多灶性淋巴细胞浸润并伴有心肌细胞变性坏死,而D组小鼠心脏见满视野大量白细胞浸润,心肌结构消失,心肌坏死。流式细胞学检测发现A组移植心脏内巨噬细胞的比例明显高于其他3组,A组的心脏存活时间明显长于其他3组。结论 BMSCs能减轻心脏移植排斥反应,动脉途径注射优于静脉和心肌局部注射途径,其机制可能与骨髓间充质干细胞在移植心脏内存活时间以及巨噬细胞比例增加有关。