双歧四联活菌片联合复方谷氨酰胺颗粒对早产儿肠黏膜屏障功能的影响

目的 探讨复方谷氨酰胺颗粒联合双歧四联活菌片对早产儿肠道黏膜屏障免疫功能的影响。方法 选取2014年6月至2015年6月东营市人民医院儿科的148例早产儿为研究对象,将其随机分为A、B、C、D组,A组为复方谷氨酰胺颗粒联合双歧四联活菌片治疗,B组单独应用复方谷氨酰胺颗粒治疗,C组为单独双歧四联活菌片治疗,D组采用标准的肠内营养喂养,4组早产儿均给予新生儿监护室（NICU）常规治疗;监测治疗前、治疗1周和2周时检测4组早产儿的血清免疫球蛋白SIgA含量、T淋巴细胞亚群CD₃⁺含量、CD₄⁺含量及CD₄⁺/CD₈⁺比值,同时检测4组早产儿大便中的益生菌数量,并比较各组发生院内感染及并发症情况。结果 治疗1周时,4组早产儿的SIgA、CD₃⁺、CD₄⁺含量、CD₄⁺/CD₈⁺比值,及肠道益生菌数量5项指标较治疗前均有不同程度的升高,与治疗前比较,差异均有统计学意义（P<0.05）;A组上述5项指标均高于B、C、D组,差异有统计学意义（P<0.05）;治疗2周时,A组T淋巴细胞亚群（CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺比值）、SIgA、肠道菌群数量均高于B、C、D组,差异有统计学意义（P<0.05）;2周时,A组（8.1%）早产儿院内感染发生率低于其他3组（13.5%、13.5%、18.9%）,差异有统计学意义（P<0.05）。结论 谷氨酰胺与双歧四联活菌片联合应用,能够明显提高患儿T淋巴细胞亚群数量,增加肠道益生菌数量,降低院内感染的发病率,改善患儿预后。     

白附子混悬液对H22荷瘤小鼠抗肿瘤作用的免疫调节机制研究

[目的]研究白附子混悬液对荷瘤小鼠免疫功能的调节作用,探讨其抗肿瘤作用的免疫学机制。[方法]采用H₂₂荷瘤小鼠模型为研究对象,用酶联免疫吸附实验(ELISA)法检测小鼠血清中白介素-2(IL-2)和白介素-4(IL-4)水平;用流式细胞术(FACS)法分析对CD₄⁺,CD₈⁺T细胞的调节作用。[结果]白附子混悬液能够上调荷瘤小鼠血清IL-2细胞因子的表达,降低IL-4水平,可以使CD₄⁺T细胞表达升高,CD₈⁺T细胞表达降低。[结论]白附子混悬液能够通过调节荷瘤机体异常免疫功能状态而发挥抗肿瘤作用。     

负压吸引对糖尿病患者皮肤非结核分枝杆菌感染病灶切除术后创面愈合的疗效观察

【】 目的 观察负压吸引对糖尿病患者皮肤非结核分枝杆菌感染病灶切除术后创面愈合的疗效。方法 将21例糖尿病伴皮肤非结核分枝杆菌感染的患者随机分为两组,其中观察组11例和对照组10例。对照组予常规抗痨、外科病灶切除及支持营养等治疗;观察组在对照组治疗的基础上行负压吸引。观察两组患者创面愈合情况和并发症,及外周血T淋巴细胞亚群水平变化。结果 ①观察组总有效率(100%)高于对照组(70%),差异有统计学意义(P3₊、CD₄₊水平均有上升(P<0.05),观察组CD₈₊水平下降(P<0.05)。与对照组比较,观察组CD₃₊、CD₄₊水平明显上升、CD₈₊水平明显下降,差异有统计学意义(P<0.05)。结论 间断负压吸引可能通过影响外周血T细胞变化发挥对糖尿病患者皮肤非结核分枝杆菌感染创面愈合的治疗作用。     

自体CIK细胞对晚期不同阶段肿瘤患者免疫状态和生活质量的影响

目的 探讨自体细胞因子诱导的杀伤细胞（CIK）治疗晚期恶性肿瘤患者,对其免疫状态和生活质量的影响。方法 选取2013年2月至2016年3月合肥市第一人民医院血液肿瘤科收治的42例晚期肿瘤患者,按照预计生存期分为A组（预计生存期<3个月）20例、B组（预计生存期≥3个月）22例,检测治疗前后A、B组患者外周血T细胞亚群的变化。观察治疗前后A、B组患者免疫功能的变化,生活质量改善情况及治疗相关不良反应。结果 CIK细胞治疗后,A组患者CD₃⁺T细胞水平较治疗前降低（P<0.05）;B组治疗后CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺水平较治疗前明显升高（P<0.05）,CD₈⁺T淋巴细胞亚群水平较治疗前降低（P<0.05）。A、B两组患者治疗后KPS评分分别较治疗前均有提高,其中A组差异无统计学意义（P>0.05）,而B组差异有统计学意义（P<0.05）。42例患者在输注CIK过程中未出现明显不良反应。结论 CIK细胞回输安全、副作用小,自体CIK细胞治疗可提高晚期恶性肿瘤患者的免疫功能,改善其生活质量,但应尽早进行。     

妊娠期糖尿病孕妇IGF-1表达与新生儿免疫球蛋白和T细胞亚群的相关性分析

本研究通过比较妊娠期糖尿病孕妇(观察组)和正常妊娠孕妇(对照组,)胎盘组织中胰岛素样生长因子-1 (IGF-1)表达强度,以及新生儿外周血免疫球蛋白(IgG、IgA、IgM)和T细胞亚群(CD3、CD4、CD8、CD4/CD8)水平,以探讨IGF-1对新生儿免疫球蛋白和T细胞亚群的影响。结果显示:观察组孕妇胎盘组织IGF-1表达强度大于对照组,观察组新生儿外周血IgG、CD3、CD4和CD4/CD8低于对照组,而CD8高于对照组,Spearman分析显示IGF-1表达强度与IgG、CD3、CD4、CD4/CD8呈负相关(Rs=－0.539,－0.421,－0.389,－0.503,P＜0.05),而与CD8呈正相关(Rs=0.412,P＜0.05)。本研究结果说明:妊娠期糖尿病孕妇胎盘组织IGF-1表达强度明显增加,并影响新生儿外周血免疫球蛋白和T细胞亚群,引起新生儿免疫功能低下。     

他克莫司联合中药热敷及激光照射改善白癜风患者的疗效及机制

观察在他克莫司软膏治疗的基础上配合中药热敷与308nm准分子激光照射对白癜风的治疗效果的影响,并探讨其机制。结果显示中药热敷与308nm准分子激光照射能改善他克莫司对白癜风的治疗效果,并且可提高患者血清CD₄⁺,CD₂₅⁺,Treg,CD₄⁺CD₂₅⁺FOXP₃⁺Treg浓度。表明他克莫司联合中药热敷、308nm准分子激光照射治疗白癜风可显著提高临床疗效,其机制可能通过调控调节性T细胞CD₄⁺CD₂₅⁺FOXP₃⁺改善机体免疫机能。     

MDT模式的营养干预对妊娠期糖尿病糖脂代谢、妊娠结局及新生儿免疫功能的影响

目的探讨基于多学科团队协作(MDT)模式的营养干预对妊娠期糖尿病(GDM)孕妇糖脂代谢、妊娠结局及新生儿免疫功能的影响。方法选取规范产检并分娩的GDM孕妇150例,采用随机数字表法将其分为对照组及观察组,每组各75例。对照组给予常规营养干预,观察组给予基于MDT模式的营养干预。对比两组GDM孕妇糖脂代谢指标、妊娠结局及新生儿免疫功能。结果观察组孕妇干预后空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、稳态模型-胰岛素抵抗指数(HOMA-IR)及甘油三酯(TG)低于对照组(P＜0.05);观察组孕妇顺产率高于对照组(P＜0.05);观察组孕妇剖宫产率、妊娠期高血压、新生儿低血糖、巨大儿发生率低于对照组(P＜0.05);观察组新生儿外周血免疫球蛋白G(IgG)水平高于对照组(P＜0.05);观察组新生儿CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺低于对照组(P＜0.05)。结论基于MDT模式的营养干预可有效调控GDM孕妇糖脂代谢,提升新生儿免疫功能,改善妊娠结局。     

神经干细胞脑出血大鼠脑内移植对T淋巴细胞亚群的影响

目的 探讨神经干细胞（neural stem cells,NSCs）移植入脑出血大鼠模型脑内后,观察脑组织内和血液中T淋巴细胞亚群的变化。方法 选择成年雄性SD大鼠作为模型动物,采用Ⅳ型胶原酶诱导法建立脑出血模型,脑出血后3h移植神经干细胞,3天进行各项指标检测。应用流式细胞仪分析脑组织与血液中的T淋巴细胞亚群变化。应用酶联免疫吸附试验检测脑组织与血液中细胞因子的变化。通过组织免疫荧光了解T淋巴细胞与NSCs在脑出血大鼠脑内的分布情况。结果 在血液中,与对照组相比较,NSCs移植组能够增加调节性T细胞（regulatory T cells,Treg）与CD4⁺T细胞表达,减少γδT与CD8⁺T细胞表达。在脑组织中,NSCs移植组能够增加Treg细胞表达,减少γδT、CD4⁺T和CD8⁺T细胞表达。与对照组比较,NSCs移植组增加血液与脑组织中IL-4（interleukin-4）、IL-10（interleukin-10）和TGF-β（transforming growth factor-β）的表达,并且减少IL-6（interleukin-6）与IFN-γ（interferon-γ）的表达。结论 脑出血早期NSCs脑内移植促进保护性的T细胞亚群和抑制破坏性的T细胞亚群表达,提示移植的NSCs可能通过发挥免疫调节作用起到神经保护作用。     

GDM孕妇胎盘组织IGF-1及受体表达与新生儿胰岛β细胞功能和胰岛素抵抗的相关性

通过比较妊娠期糖尿病(GDM)孕妇和正常妊娠孕妇胎盘组织中胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子-1受体(IGF-1R)表达,以及新生儿胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR),从而探讨胎盘组织IGF-1和IGF-1R表达与新生儿HOMA-β和HOMA-IR的相关性。结果显示:GDM组孕妇胎盘组织IGF-1和IGF-1R的mRNA和蛋白表达均显著高于对照组(P＜0.05);GDM组孕妇分娩新生儿HOMA-IR显著高于对照组(P＜0.05),而HOMA-β明显低于对照组(P＜0.05);Spearman分析显示孕妇胎盘组织IGF-1和IGF-1R表达与新生儿HOMA-β呈负相关,而与HOMA-IR呈正相关。说明妊娠期糖尿病孕妇胎盘组织IGF-1和IGF-1R表达增加,导致新生儿胰岛β细胞功能受损和胰岛素抵抗。     

退变腰椎间盘髓核组织HMGB2、LEF-1、Col Ⅱ的表达及相关性

目的探讨肠道病毒分型和T淋巴细胞亚群与手足口病(HFMD)病情程度的关系。 方法分析HFMD患儿92例(HFMD组)及健康儿童40例(对照组)的临床资料,HFMD组按照病情程度分为重症组和轻症组。探讨HFMD患儿肠道病毒分型和T淋巴细胞亚群与HFMD病情程度的关系。 结果HFMD患儿肠道病毒感染以单一感染为主,其中柯萨奇病毒A16(CA16)和CA6构成比较高;重症组与轻症组病毒分型情况比较差异无显著性(P＞0.05)。CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺水平HFMD组低于对照组,重症组低于轻症组(P＜0.05)。 结论HFMD患儿T淋巴细胞亚群检测分析有助于其临床诊断和病情判断。     

Determination of CD30 expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome by FCM

Summary To determine the CD₃₀ expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome (HFRS) and its clinical implications, double immunofluorescence technique and flow cytometry were used. There was no significant difference among the severe group, mild-moderate group and normal control group in the CD+CD₃₀ T lymphocyte subset. While the CD₄ ⁺CD₃₀ ⁻ T cells of HFRS patients were increased and the difference between severe group and mild-moderate group or normal control group were very significant (P<0.01) and the difference between the mild-moderate group and normal control group was also significant (P<0.05). The CD₈ ⁺CD₃₀ ⁻ T cells were increased while the CD₈ ⁺CD₃₀ ^- T cells decreased obviously in HFRS patients, and the differences among three groups in both subsets were very significant (P<0.01). The results showed that the humoral immunity and cellular immunity are overactive in HFRS patients during acute phase. The loss of balance between T lymphocyte subsets may play an important role in the pathophysiology of HFRS and is closely correlated with the severity of the HFRS. This project is supported by the grant of the Ministry of Health (Serial No. 96-2-116).     

Changes in T cell subsets and T suppressor cell function and their relationship in human schistosomiasis japonica

Summary The function of spontaneous T suppressor cell (STs) of peripheral blood was examined in 56 patients with schistosomiasis japonica at various stages. The subsets of T cell were simultaneously phenotyped in 46 cases. The percentages of CD₃ ⁺(pan T cell), CD₄ ⁺ (helper/inducer T cell) and CD₈ ⁺ (suppressor/cytotoxic T cell) in patients with acute schistosomiasis japonica were significantly higher than those in the normal controls. In patients with chronic and advanced schistosomiasis japonica, the percentage of CD₈ ⁺ T cell and the function of STs were greatly increased, but the percentage of CD₃ ⁺ T cell and the ratio of CD₄ ⁺/CD₈ ⁺ were obviously reduced. All of these markers changed more significantly in patients with advanced schistosomiasis japonica. The percentage of CD₈ ⁺ T cell in patients with acute schistosomiasis japonica was negatively correlated with the function of STs. In patients with chronic and advanced schistosomiasis japonica the percentage of CD₈ ⁺ T cell was correlated positively and the ratio of CD₄ ⁺/CD₈ ⁺ negatively with the function of STs. The results indicated that the cellular immunity was significantly increased in cases of acute schistosomiasis japonica and decreased in those with chronic or advanced schistosomiasis japonica. The increased CD₈ ⁺ T cell may be principally cytotoxic T cells in patients with acute schistosomiasis japonica, but suppressor T cells in patients with chronic and advanced schistosomiasis japonica. The subsets of T cells and the function of T suppressor cells may play an important role in the immunoregulation of schistosomiasis japonica.     

Effect of Compound Glycyrrhizin Injection on liver function and cellular immunity of children with infectious mononucleosis complicated liver impairment

Objective： To investigate the effects of Compound Glycyrrhizin Injection （CGI） on liver function and cellular immunity of children with infectious mononucleosis complicated liver impairment （IM-LI） and to explore its clinical therapeutic effect. Methods： Forty-two patients with IM-LI were randomly assigned, according to the randomizing number table, to two groups, 20 in the control group and 22 in the treated group. All the patients were treated with conventional treatment, but to those in the treated group, CGI was given additionally once a day, at the dosage of 10 ml for children aged below 2 years, 20 ml for 2-4 years old, 30 ml for 5-7 years old and 40 ml for 8- 12 years old, in 100-200 ml of 5% glucose solution by intravenous dripping. The treatment lasted for 2 weeks. T lymphocyte subsets and serum levels of alanine transaminase （ALT）, aspartate aminotransferase （AST） and total bilirubin （TBil） were detected before and after treatment. Besides, a normal control group consisting of 20 healthy children was also set up. Results： Baseline of the percentage of CD3^＋ , CD8^＋ lymphocyte and serum levels of ALT, AST, TBiL in the children with IM-LI were markedly higher, while the percentage of CD 4^＋ lymphocyte and the CD4^＋/CD8^＋ ratio was markedly lower in IM-LI children as compared with the corresponding indices in the healthy children （ P〈0.01 ）. These indices were improved after treatment in both groups of patients, but the improvement in the treated group was better than that in the control group （P〈0.01）. Conclusion： Cellular immunity dysfunction often occurs in patients with IM-LI, and CGI treatment can not only obviously promote the recovery of liver function, but also regulate the immune function in organism.     

孟鲁司特治疗重度慢性阻塞性肺疾病急性加重对免疫功能影响的分析

目的探讨孟鲁司特联合舒利迭治疗重度慢性阻塞性肺疾病（COPD）急性加重对免疫功能的影响。方法将113例重度COPD急性加重期患者,随机分为孟鲁司特联合舒利迭治疗组57例,单纯舒利迭治疗组56例,治疗14 d后,评价所有患者治疗前、后T细胞亚群CD₃⁺、CD₄⁺及CD₄⁺/CD₈⁺的变化。结果治疗组CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺指标差异有统计学意义（P<0.05）,而对照组无明显变化,药物冶疗安全性好。结论孟鲁司特钠联合舒利迭治疗中重度COPD急性加重期,能有效改善患者免疫功能,提高患者免疫力。     

Effect of Tiotropium Bromide on Expression of CD_8~＋CD_（25）~＋FoxP_3~＋ Regulatory T Cells in Patients with Stable Chronic Obstructive Pulmonary Disease

The expression of CD8+CD25+FoxP3+ regulatory T cells(CD8+Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD),and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8+Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide(18 μg daily) for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoclonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8+T cells,CD8+CD25+T cells,CD8+Tregs,CD4+T cells,CD4+CD25+T cells and CD4+CD25+FoxP3+ regulatory T cells(CD4+Tregs) respectively.The percentage of CD4+T cells was increased from(27.82±2.18)% to(35.53±1.3)%(t=3.20,P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4+CD25+T cells was decreased from(10.03 ±1.42)% to(4.21 ±0.65)%(t=3.78,P=0.001),and that of CD8+Tregs was increased from(8.41 ±1.68)% to(21.34 ±4.20)%(t=2.72,P=0.013).At baseline,CD8+T cells,CD8+CD25+T cells and CD4+Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4+T cells and CD4+CD25+T cells was negatively correlated with the ratio of change in CD8+Tregs before and after treatment(r=-0.61,P=0.013;r=-0.72,P=0.001 respectively).In the peripheral blood of patients with stable COPD,there was the expression of CD8+Tregs and CD4+Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4+T cells,inhibit the expression of CD25+T cells,and enhance the expression of CD8+Tregs.CD8+Tregs and CD4+Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.     

巨大儿胎盘组织中HO-1、IGF-1的变化及其意义

目的：探讨血红素氧合酶-1（HO-1）、胰岛素样生长因子-1（IGF-1）在健康母亲和妊娠糖尿病（GDM）母亲分娩的巨大儿胎盘组织中的变化及其意义。方法：选择足月新生儿60例,其中GDM母亲分娩的巨大儿（巨大儿A组）12例,健康母亲分娩的巨大儿组（巨大儿B组）18例,正常出生体重新生儿（对照组）30例。分别用免疫组织化学法观察胎盘HO-1、IGF-1的表达,用酶联免疫吸附法测定胎盘HO-1、IGF-1水平。结果：巨大儿A组、B组胎盘HO-1、IGF-1表达强度均高于对照组（ P＜0．05）,巨大儿A组、B组与对照组比较,胎盘HO-1、IGF-1水平均增高（ P＜0．05）,而巨大儿A组与B组之间HO-1、IGF-1的表达强度及水平比较,差异无统计学意义（P＞0．05）。巨大儿A组及B组HO-1与IGF-1的水平均呈正相关（P＜0．05）。结论：胎盘HO-1、IGF-1的表达水平可能与巨大儿的发生有关。     

Study on abnormality and regulation of T-Lymphocyte subsets in peripheral blood of rheumatoid arthritis patients

Objective:ToinvestigatethechangeofT lymphocytesubsetsinperipheralbloodofrheumatoidarthritis (RA) patientsandanalyzetheeffectsofFuzhengQubiDecoction (FZQBD)onT cellsubsets.Methods:ThirtyRApatientswererandomlydividedintotwo groups,andtreatedwithFZQBDorweste…     

乳腺癌患者细胞免疫水平与预后危险因素的关系及临床意义

目的：探讨乳腺癌患者细胞免疫状态与预后危险因素之间的关系。方法：回顾性分析1997年至2002年收治的110例女性乳腺癌患者的临床资料,分析其一般情况及CD⁺₃T、CD⁺₄T、CD⁺₈T、CD⁺₄/CD⁺₈、淋巴细胞转化率（LTR）的变化及其与乳腺癌肿块大小、淋巴结转移情况及癌胚抗原（CEA）的关系。结果：①乳腺癌不同肿块大小患者中CD⁺₄T、CD⁺₈T、CD⁺₄/CD⁺₈水平差异有统计学意义（P＜0.01或P＜0.05）,在肿块较小时即有CD4+T水平的降低和CD⁺₈T水平的升高,而CD⁺₄/CD⁺₈水平随着肿瘤负荷的增大而降低;②淋巴结转移组［LN(+)］与未转移组［LN(-)］比较,CD⁺₄/CD⁺₈在LN(+)组中显著降低(P＜0.05);CD⁺₃T、CD⁺₄T、CD⁺₈T在LN(+)组中表达增高,CD⁺₃T、CD⁺₈T的升高有统计学意义(P＜0.05或P＜0.01)。 ③CEA在LN(+)组中明显升高(P＜0.05), 在不同肿瘤负荷组间比较差异无统计学意义（P＞0.05）。CEA（+）组和CEA（-）组之间比较,CD⁺₄T升高及CD⁺₄/CD⁺₈水平降低差异均有统计学意义（P＜0.01）, 且CEA与CD⁺₄T及CD⁺₄/CD⁺₈水平密切相关（P＜0.01）。结论：乳腺癌患者存在不同程度的细胞免疫状态紊乱,且与乳腺癌CEA水平及肿块大小、淋巴结转移情况密切相关。     

Clinical Observation on Shuanghuanglian powder in treating viral myocarditis of childrenin treating viral myocarditis of children

Objective: To study immune function of children viral myocarditis and to evaluate the clinical effect of Shuanghuanglian Powder (SHLP) by injection.Methods: The 62 patients of viral myocarditis were divided into two groups randomly, the SHLP group (n = 32) treated with conventional therapy plus SHLP and the conventional treatment group (n = 30) with conventional therapy alone. Their serum antibody of Coxsackie virus group B (COXB-IgM), T-lymphocyte subsets including CD₃ ⁺, CD₄ ⁺, CD₈ ⁺ and CD₄ ⁺/CD₈ ⁺ were determined with ELISA and indirect immunofluorescent assay.Results: COXB-IgM was positive in 39 of the 62 patients, which was significantly different with those of normal controls (P< 0.001). Patients’ serum level of CD₄ ⁺ cells and CD₄ ⁺/CD₈ ⁺ ratio decreased while CD₈ ⁺ increased. After treatment, the recovery of symptoms, signs and immune function in patients of the SHLP group were significantly better than those in patients treated with conventional treatment alone (P<0.01).Conclusion: Immunoregulatory disturbance is involved in children with viral myocarditis and SHLP is an effective drug in the treatment of children viral myocarditis.