脐血DC与CIK共培养对白血病K562细胞杀伤活性的影响

目的观察细胞因子诱导的杀伤细胞（CIK）与同源树突状细胞（DC）共培养后DC—CIK细胞的增殖活性、表型的变化及其对白血病K562细胞杀伤活性的影响。方法采集健康产妇分娩正常足月胎儿脐血50ml,密度梯度离心法分离出脐血单个核细胞培养。收集非贴壁细胞用于诱导培养CIK,贴壁细胞诱导分化出成熟DC;将成熟DC和CIK按1：5的比例混合培养3d,用MTT法检测Dc—CIK共培养细胞对白血病K562细胞杀伤活性。结果DC与CIK共培养后,DC—CIK细胞群的增殖活性和杀伤活性明显高于单纯CIK。结论DC—CIK共培养可明显提高CIK增殖活性和细胞毒作用。     

体外培养的树突状细胞与细胞因子诱导的杀伤细胞相互作用的研究

目的 观察同源的树突状细胞（DC）与细胞因子诱导的杀伤（CIK）细胞于体外同一培养体系共同培养时的相互影响,为临床联合应用DC和CIK细胞进行肿瘤生物治疗提供依据.方法 用无血清培养基进行DC和CIK细胞的体外培养制作,共同培养1 w后,检测CIK细胞免疫表型、杀瘤活性的变化以及DC分泌IL-12的变化.结果 DC与CIK细胞的共培养会增加CIK细胞的CD3CD56双阳性细胞的比例和非特异性增强对K562细胞的杀伤活性;同时增强DC分泌IL-12的能力.结论 体外共培养DC与CIK细胞可相互增强抗肿瘤免疫活性.     

树突状细胞与细胞因子诱导的杀伤细胞共培养对白血病耐药细胞杀伤作用的实验研究

目的探讨负载P-糖蛋白(P-gp)高表达的多药耐药(MDR)白血病K562/A02细胞冻融抗原的树突状细胞(DC)与同源细胞因子诱导的杀伤细胞(CIK)共培养对MDRK562/A02杀伤作用的影响。方法提取健康人骨髓单个核细胞,常规诱导出DC及CIK,将K562/A02细胞冻融物作为抗原冲击的DC,与CIK共培养作为实验组,抗原不冲击的DC与CIK共培养作为对照组,以CIK及DC单独培养分别作为空白对照组1和空白对照组2。光镜下观察细胞形态,流式细胞术分析细胞表型,MTT法检测杀伤活性。结果实验组、对照组细胞增殖活性均大于CIK组(P<0.05)。实验组对K562/A02、K562的杀伤活性在效靶比5∶1、10∶1、20∶1时分别为(42.90±0.67)%、(49.85±0.28)%、(63.36±0.46)%和(23.56±0.43)%、(26.11±0.34)%、(34.46±0.35)%,均高于对照组及空白对照组1(P<0.05);实验组对K562/A02的杀伤活性高于K562和MCF7(P<0.05)。结论DC与CIK共培养物是一种增殖活性和细胞毒活性高于CIK的免疫活性细胞,而经冻融抗原冲击的DC与CIK共培养能明显提高对MDRK562/A02的杀伤活性。     

脐血DC-CIK共培养体外抗肿瘤效应及趋化性的实验研究

目的探讨细胞因子诱导的杀伤细胞（CIK）与同源树突状细胞（DC）共培养后对人白血病K562细胞、人淋巴瘤raji细胞、人乳腺癌MCF-7细胞的杀伤作用及CIK细胞的趋化性。方法采集健康产妇分娩的正常足月胎儿脐血,分离单个核细胞,诱导培养CIK、DC细胞。将成熟DC和CIK混合培养3d,用MTT法检测CIK、DC-CIK对K562、raji、MCF-7细胞的杀伤活性;趋化试验检测CIK细胞的趋化性。结果 CIK、DC-CIK细胞对K562、raji、MCF-7细胞均具有较强的杀伤作用,DC-CIK杀伤活性明显高于CIK。趋化试验显示,IL-8、MCP-1作用后穿过微孔滤膜的细胞数明显高于阴性对照。结论 DC-CIK共培养可明显提高CIK对K562、raji、MCF-7细胞的杀伤作用,IL-8、MCP-1对CIK细胞存在趋化性。     

骨髓瘤独特型抗原负载树突细胞介导的抗肿瘤效应研究

目的:研究骨髓瘤独特型抗原(Idiotype,Id)负载树突细胞(DC)对同源细胞因子诱导的杀伤细胞(CIK)体外抗瘤活性的影响。方法:采集健康供者外周血单个核细胞(PBMNC)用常规方法诱导DC和CIK细胞,将骨髓瘤OPM-2细胞培养上清提取的Id冲击或未冲击的DC与CIK细胞共培养(CIK、DC加CIK、Id-DC加CIK),用流式细胞术分析细胞表型,MTT法检测体外效应细胞杀伤活性。结果:在(5～20):1效靶比范围内, CIK细胞对OPM-2和K562细胞的杀伤率分别为(24．47±3．00)％～(40．64±1．62)％和(23．36±1．51)％～(42．52±2．06)％。DC加CIK及Id—DC加CIK对OPM-2和K562细胞的杀伤活性均高于CIK组,差异有统计学意义(P<0．05);而在相同效靶比之下,Id-DC加CIK对OPM-2细胞的杀伤活性最强,差异有统计学意义(P <0．05)。结论:CIK细胞对骨髓瘤细胞有强的杀伤活性,经Id负载的DC与CIK细胞共培养能进一步增强其特异性杀伤活性,对骨髓瘤可能有免疫治疗作用。     

K562细胞可溶性抗原负载树突状细胞体外诱导CTL作用的研究

目的探讨经K562细胞裂解物冲击致敏的外周血单个核细胞衍生的树突状细胞（DC）的生物特性及体外诱导抗原特异性CTL应答的能力。方法采集健康人抗凝外周血分离单个核细胞，贴壁细胞用含rhGM—CSF、rhIL-4、TNF—α的RPM1640＋10％FBS培养基体外诱导培养产生DC，5天收获细胞并将细胞分组：A组：未负载抗原DC；B组：加入K562细胞裂解液脉冲DC。7天后用流式细胞仪检测成熟DC免疫表型，并将非贴壁细胞（淋巴细胞）作为效应细胞与各组DE共育，以产生细胞毒性T淋巴细胞（CTL）。12天用LDH释放试验测定对K562细胞的杀伤活性。并用ELISA方法测定细胞上清液中IL-12的含量。结果（1）经细胞因子联合体外诱导的各组DC较培养前在数量，形态及免疫表型上差异有统计学意义，CD86、CD83、CD40、CD1a表达增加，其中经K562细胞裂解液冲击的DC的CD83CD86表达率明显升高。（2）效应细胞与K562细胞混合培养时，负载K562细胞裂解液的DC刺激后的T细胞比单独DC刺激后的T细胞对K562细胞的杀伤作用更明显。（3）负载K562细胞裂解液的DC细胞培养上清液中产生IL-12含量较未负载抗原的DC明显增加。结论用GM—CSF、IL-4以及TNF—α诱导培养健康人外周血单个核细胞可以得到成熟的DC，且经K562细胞裂解液致敏可以进一步促进DC的成熟并体外诱导特异性杀伤靶细胞的CTL。     

脐血浆在CIK细胞培养中的应用

目的观察脐血浆体外培养脐血细胞因子诱导的杀伤细胞（CIK细胞）的增殖情况,探讨其替代AB血浆的可行性。方法无菌采集脐血并分离血浆,密度梯度离心法分离脐血单个核细胞,用脐血浆培养脐血CIK细胞,并与人AB血浆进行对照。计数培养不同时间CIK细胞数,流式细胞仪进行表型分析,以K562细胞为靶细胞,CCK-8法计算杀伤活性。结果脐血浆体外培养脐血CIK21d后,CD3^＋CD56^＋细胞扩增倍数、表达率、对白血病K562细胞的杀伤率与人AB血浆相比无显著性差异（P〉0．05）。结论脐血浆可以代替AB血浆进行脐血CIK培养。     

不同细胞因子联合诱导K562细胞向杀伤细胞转化的研究

目的 探讨肿瘤细胞系K562向杀伤细胞转化的可能性。方法 通过rhIL-2、rhIL-15和A23187的不同组合诱导K562细胞,动态监测细胞形态学、免疫表型及杀伤功能变化。结果 经过40d的诱导,K562细胞在各细胞因子组合下均可以被诱导成具有杀伤功能的CD3^-CD36^＋NK细胞和CD3^＋CD56^＋NKT细胞,以IL-2＋IL-15组的诱导率最高,杀伤功能最强;IL-2＋A23187组的免疫标记出现最早。结论 IL-2可将K562细胞诱导成杀伤细胞dL-15可提高K562细胞向杀伤细胞转化的诱导率;A23187可能加速K562细胞向杀伤细胞的转化。     

脐血CIK细胞对耐药白血病细胞体外杀伤效应及其机制的研究

目的:探索干预或克服白血病细胞耐药的新策略.方法:采用抗CD3McAb联合多种细胞因子诱导的脐血杀伤细胞(CB-CIK)体外作用于K562耐药细胞株(K562/A02),用MTT比色法检测其杀伤效应;用免疫组化染色法检测杀伤前后K562/A02细胞表面多药耐药基因mdr1表达产物P170水平;采用DNA凝胶电泳进行CB-CIK细胞诱导白血病细胞凋亡的检测.结果:①CB-CIK细胞杀伤K562/A02细胞活性(73.647±5.72)与杀伤K562细胞活性(75.124±4.36)相比差异无统计学意义,P＞0.05;其杀瘤活性显著高于CB-LAK细胞、CB-CD3AK细胞,P<0.05,与成人CB-CIK细胞相比差异无统计学意义,P＞0.05.②经CIK细胞杀伤后,K562/A02细胞表面mdr1表达产物P170含量明显减少.③K562/A02细胞在CIK细胞作用20 h后,其DNA结构断裂,在DNA凝胶电泳上呈现凋亡特有的梯形图谱(DNA Ladder).结论:CB-CIK细胞对K562细胞及其耐药株K562/A02细胞均有较强的杀伤作用,其杀伤机制可能与CIK细胞能下调白血病细胞表面多药耐药基因mdr1表达产物P170水平,以及诱导白血病细胞凋亡有关.提示脐血CIK细胞在抗白血病多药耐药性方面具有独特的优势,若与化疗联合使用,有可能成为克服白血病细胞多药耐药性的一种可供选择的新策略,因脐血的来源较广,采制相对简便,该研究方法可能具有广泛的应用前景.     

三种来源CIK细胞体外增殖及杀伤活性比较

目的为白血病的治疗提供理论依据。方法用Fieoll两步分离法分别从正常人、非霍奇金淋巴瘤患者外周血和脐血中分离获得单个核细胞;细胞因子诱导培养成细胞因子诱导的杀伤细胞（CIK）。流式细胞仪检测CIK的免疫表型,MTT法测定其对白血病K562细胞的杀伤活性。结果三种不同来源的单个核细胞均可诱导成CIK,脐血来源的CIK其扩增效率和杀伤活性均优于其他两种来源,差异有显著性（P〈0．01）。结论脐血来源的CIK细胞体外增殖快,杀伤活性强;脐血具有来源方便、免疫原性弱、含有大量造血干细胞、单个核细胞提取率高、输注时移植物抗宿主病（GVHD）发生率低等优点,白血病治疗时可优先考虑。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.