应用流式细胞术分析CIK细胞胞内Th1/Th2细胞因子

目的：建立细胞因子诱导的杀伤细胞(cytokine-induced killer,CIK)体外扩增的方法,并从单细胞水平分析CIK细胞的胞内Th1／Th2类因子产生的情况,进一步明确CIK细胞的免疫学特性及其参与的免疫效应机制。方法：取健康人外周血单个核细胞(PBMC),按一定的时间顺序分别加入IFN-γ、IL-2和CD3单抗,体外扩增CIK细胞,再应用流式细胞术,经刺激、阻断、固定、穿透和标记等过程测定CIK细胞内细胞因子IFN-γ和IL-4水平。结果：外周血单个核细胞加细胞因子培养两周后CD3^ CD56^ 增加,培养至第21天、28天未见明显下降;诱导后CD3^ CD8^ 细胞量与CD3^ CD4^ 量相比明显增多;单细胞胞内细胞因子测定显示扩增后的CIK细胞Th1／Th2因子状态明显向Th1偏移。结论：采用多种因子组合刺激外周血单个核细胞,可大量诱导出CD3^ CD56^ 双阳性细胞,具高度增殖性,是一类新型的免疫过继疗法细胞;其偏移的Th1／Th2因子状态可作为解释其极强的细胞毒作用的理论依据。     

不同培养条件对CIK细胞体外扩增和抗肿瘤特性的影响

目的观察不同类型、不同浓度的抗CD3单抗对细胞因子诱导的杀伤细胞（CIK细胞）体外增殖能力及其抗肿瘤特性的影响,优化扩增方案。方法取多名健康供血者血液用淋巴细胞分离液分离外周血单个核细胞,加入不同类型（OKT3、UCHT1、HIT3a）、不同浓度、不同组合的抗CD3单抗及细胞因子（γ-IFN、rhIL-22）,诱导生成CIK细胞,体外培养12 d。观察CIK细胞的扩增情况,采用MTT法测定其杀瘤活性。结果 （1）等量混合3种不同类型的抗CD3单抗,CIK细胞增殖反应优于添加单一类型抗CD3单抗（P〈0.05）。（2）抗CD3单抗浓度增加,CIK细胞的增殖效应及细胞毒活性反而下降。（3）不同rhIL-2浓度对CIK细胞的增殖效应及细胞毒活性均无明显影响。结论培养CIK细胞时混合不同类型的抗CD3单抗有利于CIK细胞的体外扩增。     

人骨髓基质干细胞克隆对脐血造血干细胞体外扩增作用的研究

目的：探讨人骨髓基质干细胞的克隆化培养及其对体外造血干细胞扩增的影响。方法：取正常肋骨分离骨髓，制备单个核细胞贴壁培养，约5d后取集落样生长的梭形细胞扩增培养，传代、将分选的脐血造血干／祖细胞接种到克隆培养的人骨髓基质干细胞及其他培养条件液上，比较不同培养条件及不同代次骨髓基质干细胞对造血干／祖细胞扩增能力及集落形成能力的影响。结果：人骨髓基质干细胞能扩增达20代以上，经流式细胞仪检测证实基质干细胞，单纯细胞因子组和细胞因子加基质干细胞组能有效扩增造血细胞，而后者有维持长期造血的作用。结论：该克隆培养方法能有效扩增骨髓基质干细胞，培养的细胞有体外支持长期造血的作用。     

细胞因子参与下的脐血造血干细胞体外扩增

目的观察细胞因子参与下脐血干细胞体外扩增效果。方法用含15%胎牛血清改良细胞培养液,加入不同的细胞因子,设置1个对照组和3个实验组,分别于培养第0d、3d、7d、14d取培养液,台盼蓝染色计数单个核细胞的总数、流式细胞仪分析CD34＋细胞含量。结果与对照组相比,实验组单个核细胞的数量和CD34＋细胞的百分比均有显著增加,尤其以Ⅲ组（IL-3,6,2,4）第7d的扩增为最高：单个核细胞总数达（17.11±6.12）×109个/L,CD34＋细胞比率达（9.92±2.56）%。结论细胞因子可以提高脐血单个核细胞和CD34＋细胞的扩增效率,SCF＋IL-3＋6＋2＋4的组合在第7d时达到了最佳的扩增。     

人脐血CD56+细胞毒性淋巴细胞的扩增研究

目的:从人脐血单个核细胞(CBMC)中高效扩增CD56+细胞毒性淋巴细胞.方法:以干细胞生长培养基(SCGM)为基础培养基,设计不同浓度抗CD3单抗、IL-2的培养条件,从CBMC中诱导扩增CD56+细胞毒性淋巴细胞,用四甲基氮唑蓝(MTI)法检测其对肿瘤细胞株K562和Raji的杀伤活性,并与抗CD3单抗激活的杀伤细胞(CD3AK)、细胞因子诱导的杀伤细胞(CIK)进行比较.结果:在以SCGM为基础培养基时,CBMC经500ng/ml抗CD3单抗、500U/ml IL-2作用获得大量增殖,在12天时扩增(14.7±4.0)倍,(56.4±2.8)％为CD56+细胞,其中CD3-CD56+NK细胞和CD3+CD56+T细胞分别占细胞总数的(24.9±5.3)％和(30.0±4.7)％:在效/靶比10:1时,对K562和Raii的杀伤率分别为80.5％和55.3％,均显著高于CD3AK和CIK细胞.结论:在抗CD3单抗和IL-2作用下可使用SCGM,获得以CD56+淋巴细胞为主的强细胞毒性免疫效应细胞,为进行肿瘤过继免疫治疗提供了一种简单的扩增脐血CD56+细胞毒性淋巴细胞的方法.     

人脐血CD56^＋胞毒性淋巴细胞的扩增研究

目的从人脐血单个核细胞(CBMC)中高效扩增CD56+细胞毒性淋巴细胞.方法以干细胞生长培养基(SCGM)为基础培养基,设计不同浓度抗CD3单抗、IL-2的培养条件,从CBMC中诱导扩增CD56+细胞毒性淋巴细胞,用四甲基氮唑蓝(MTI)法检测其对肿瘤细胞株K562和Raji的杀伤活性,并与抗CD3单抗激活的杀伤细胞(CD3AK)、细胞因子诱导的杀伤细胞(CIK)进行比较.结果在以SCGM为基础培养基时,CBMC经500ng/ml抗CD3单抗、500U/ml IL-2作用获得大量增殖,在12天时扩增(14.7±4.0)倍,(56.4±2.8)%为CD56+细胞,其中CD3-CD56+NK细胞和CD3+CD56+T细胞分别占细胞总数的(24.9±5.3)%和(30.0±4.7)%在效/靶比101时,对K562和Raii的杀伤率分别为80.5%和55.3%,均显著高于CD3AK和CIK细胞.结论在抗CD3单抗和IL-2作用下可使用SCGM,获得以CD56+淋巴细胞为主的强细胞毒性免疫效应细胞,为进行肿瘤过继免疫治疗提供了一种简单的扩增脐血CD56+细胞毒性淋巴细胞的方法.     

血液肿瘤患者AHSCT后DC/CIK免疫治疗的疗效观察

目的应用树突状细胞(dendritic cell,DC)/细胞因子诱导的杀伤细胞(cytokine induced killer cell,CIK)细胞免疫治疗自体造血干细胞移植后完全缓解血液肿瘤患者,观察疗效。方法采集12例血液肿瘤自体造血干细胞移植后完全缓解患者的外周血单个核细胞,在体外经GM-CSF、IL-4、TNF-α等诱导产生DC,经IFN-γ、抗CD3单抗、IL-2等诱导产生CIK,观察其临床应用的不良反应及疗效。结果在DC/CIK细胞免疫治疗过程中,3例患者DC注射部位出现轻微疼痛,可自行缓解。2例患者输注完CIK后出现低热,持续时间2～6 h,可自行消退;4例患者输注完CIK后出现乏力,约2 h可自行缓解。7例仍完全缓解(CR),中位CR期18(5～32)个月,2例为非常好的部分缓解(VGPR)或疾病稳定(SD),3例复发或疾病进展(PD),其中1例复发死亡。结论 DC/CIK细胞免疫治疗自体造血干细胞移植(AutologousHematopoietic Stem Cell Transplantation,AHSCT)后完全缓解的血液肿瘤患者,安全性好,不良反应少,有较好的临床应用前景。     

CIK细胞对急性髓细胞白血病微小残留病作用的研究

目的:制备和观察CIK细胞对自体、异体原代急性髓细胞白血病(AML)细胞的杀伤作用和对G0期CD3+4白血病细胞的细胞毒作用,以及对正常骨髓造血干细胞的影响。方法:取AML化疗后及正常人外周血单个核细胞加入一系列细胞因子诱导培养CIK细胞,流式细胞仪检测CIK细胞表型,G带法分析CIK细胞核型。冻存、复苏后作为靶细胞,MTT法测定CIK细胞对自体、异体原代白血病细胞杀伤作用。AO染色法测定复苏后G0期AMLCD3+4细胞比例。流式细胞仪检测CIK细胞杀伤前后G0期CD3+4细胞比例变化。半固体培养法检测CIK细胞对正常骨髓CFU-GM、BFU-E集落形成的影响。结果:CIK细胞可从白血病患者外周血中获得,来源于正常淋巴细胞,对自体原代白血病细胞有明显杀伤作用,对G0期白血病细胞有明显抑制作用,对正常造血干细胞无杀伤作用。结论:CIK细胞可作为清除残留急性髓细胞白血病细胞的有效工具     

负载自体肿瘤抗原的树突状细胞联合细胞因子诱导的杀伤细胞在乳腺癌的临床研究

目的：探讨负载自身肿瘤裂解物的树突状细胞（DC）与细胞因子诱导的杀伤细胞（CIK）共培养后，对CIK体外肿瘤细胞杀伤活性的影响，进一步观察负载自身肿瘤裂解物的DC联合CIK治疗乳腺癌患者的临床免疫学疗效、毒副反应。方法：选择20例乳腺癌患者，分离外周血单个核细胞，其中贴壁细胞经GM—CSF和IL-4诱导产生DC，并负载自体肿瘤细胞裂解物；悬浮细胞经IFN-γ、IL-2、抗CD3单抗、IL-1α体外诱导产生CIK细胞。将负载抗原的DC与CIK共培养，观察CIK在体外对自身肿瘤细胞和乳腺癌细胞株SKBR-3的杀伤活性。此外，20例患者在切除原发病灶后，接受Ag—DC＋CIK细胞的过继免疫治疗，观察临床免疫疗效。结果：①CIK细胞培养后可见CD3^＋、CD8^＋和CD3^＋CD56^＋细胞较培养前显著增加；②将负载自身肿瘤抗原的DC与CIK共培养后，CIK的体外特异性和非特异性杀瘤活性明显提高；③细胞治疗后患者外周淋巴细胞Ag—NORs的IS值明显增高；CD3^＋、CD8^＋、CD56^＋升高；PBMC对自身肿瘤细胞的杀伤活性增强（P〈0．05）；④除一过性发热、畏寒外未见其它不良反应。结论：负载自体肿瘤细胞裂解物的DC疫苗联合CIK细胞在体外能明显增强对乳腺癌细胞的杀伤作用，亦能增强乳腺癌患者的细胞免疫功能，取得较理想的临床免疫疗效。     

人脐带间充质干细胞对再生障碍性贫血患者T细胞相关因子调节的体外研究

目的体外观察人脐带间充质干细胞对再生障碍性贫血患者和正常对照T细胞相关细胞因子IL-2、IFN-γ、IL-17、IL-6的调节作用.方法采用组织块培养法从脐带分离、培养间充质干细胞.用流式细胞术鉴定脐带间充质干细胞的表型.分离再生障碍性贫血患者和正常对照外周血单个核细胞与脐带间充质干细胞共培养.用ELISA法测定外周血单个核细胞组和共培养组培养上清中细胞因子IL-2、IFN-γ、IL-17和IL-6的水平.结果脐带来源间充质干细胞高表达CD29、CD44、CD105、HLA-I.人脐带间充质干细胞与再生障碍性贫血患者外周血单个核细胞共培养后上清中IL-2水平无明显变化（P〉0.05）而IFN-γ水平有所下降（P〉0.05）,IL-17水平和IL-6水平明显上升（P〈0.01）.人脐带间充质干细胞与正常对照外周血单个核细胞共培养后上清中IL-2和IFN-γ水平明显下降（P〈0.05）而IL-17水平无明显变化（P〉0.05）,IL-6水平明显上升（P〈0.01）.结论人脐带间充质干细胞明显可抑制正常外周血单个核细胞分泌IL-2、IFN-γ,其与外周血单个核细胞共培养后可升高IL-6水平.     

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.