IL—2／LAK与放,化疗联合治疗晚期恶性肿瘤

目的：探讨ＩＬ－／ＬＡＫ细胞与放疗和／或化疗联合治疗晚期恶性肿瘤的价值。方法：本组共３０例,其中单纯ＩＬ－２／ＬＡＫ细胞治疗５例（包括２例ＴＩＬ细胞胸腹腔灌注）,ＩＬ－２／ＬＡＫ细胞联合放疗１８例（包括１例动脉灌注）,ＩＬ－２／ＬＡＫ细胞联合化疗４例）包括１例动态灌注）,ＩＫ－２／ＬＡＫ细胞联合放疗和化疗３例。结果：完全缓解率２０．０％（６／３０）,总有效率５０．０％（１５／３９）,其中单纯ＩＬ－     

4种细胞因子对K562／S及其耐药细胞株K562／A02积蓄柔红？…

目的 通过检测４种用细胞因子对白血病细胞株Ｋ５６２／Ｓ及其药耐药细胞株Ｋ５６２／Ａ０２积蓄柔红霉素（ＤＮＲ）能力的影响。评价细胞因子在 病细胞多药耐药必贩应用前景方法 用流式细胞仪及荧光法检测重组人α－干扰素（ＩＦＮ－α）、白细胞介素２（ＩＬ－２）、肿瘤坏死因子（ＩＮＦ）重组人粒－单集落刺因子（ＧＭ－ＣＳＦ）对Ｋ５６２＝Ｓ及Ｋ５６２／Ａ０２积蓄柔红霉素能力的影响。结果 ＩＬ－１ ＩＮＦ、ＧＭ－ＣＳ     

IL－2／LAK细胞过继免疫治疗后“毛细血管渗漏综合征”临床分析

ＩＬ－２／ＬＡＫ细胞过继免疫治疗后“毛细血管渗漏综合征”临床分析王峻，徐桂兰（杭州市红会医院邮编３１０００４）我们自１９９２年１月至１９９３年５月应用白细胞介素－２／淋巴因子激活杀伤细胞疗法（以下简称ＩＬ－２／ＬＡＫ细胞疗法）治疗晚期恶性肿瘤３０例，...     

LAK细胞治疗慢性活动型乙型肝炎的疗效与机理研究

目的观察淋巴因子激活杀伤细胞（ＬＡＫ细胞）治疗慢性活动型乙型肝炎（ＣＡＨ）的疗效，探讨治疗机理。方法ＬＡＫ细胞治疗４０例患者，治疗前、疗程结束时，分别检测ＨＢＶＭ，ＡＬＴ，Ｔ细胞亚群，Ｂ细胞，ＩＬ－２，ｍＩＬ－２Ｒ，ＮＫ及ＬＡＫ细胞活性。疗程结束１ａ复查ＨＢＶＭ。对照组４０例。结果ＬＡＫ治疗组疗程结束时，ＨＢｅＡｇ和ＨＢＶＤＮＡ转阴率分别为２２．５％和４０．０％，与对照组相比差异显著（Ｐ均＜０．００１）。疗程结束１ａ复查ＨＢｅＡｇ、ＨＢＶＤＮＡ转阴率分别达４０．０％和６８．６％。治疗后患者ＣＤ＋４细胞数及ＣＤ＋４／ＣＤ＋８比值，ＩＬ－２水平及ｍＩＬ－２Ｒ表达，ＮＫ细胞及ＬＡＫ细胞活性均较治疗前明显升高（Ｐ均＜０．０１）。尤以ＨＢｅＡｇ转阴者，ＩＬ－２升高更显著（Ｐ均＜０．００５）。结论ＬＡＫ细胞疗法有增强免疫功能、调节免疫紊乱和清除乙肝病毒的效用，但主要不是ＬＡＫ细胞的溶细胞作用。     

应用LAK细胞／IL—2治疗肿瘤患者的副反应观察及处理

应用ＬＡＫ细胞／ＩＬ－２治疗肿瘤患者的副反应观察及处理广西医科大学一附院高干外科黄妹宾近年来，以ＬＡＫ细胞（用淋巴因子激活的肿瘤杀伤细胞）／ＩＬ－２（白细胞介素－２）为代表的肿瘤过继免疫疗法已较广泛应用于临床（１）。我科从１９９４年４月至１９９５年１...     

支气管动脉灌注LAK／rIL－2及化疗药物联合治疗原发性肺癌疗效及病理

本组５４例原发性肺癌均在支气管动脉灌注（ＢＡＩ）化疗１次后，经３～４周开始用ＬＡＫ／ＩＬ－２（ＢＡＩ）治疗。我们采用肿瘤缩小、疗后免疫指标、疗后病人的生活质量、肿瘤经ＬＡＫ／ＩＬ－２治疗后病理变化四项指标。ＬＡＫ细胞围绕在癌灶周围，与癌细胞密切接触，癌细胞有变性、坏死，证实经ＢＡＩ给予ＬＡＫ／ＩＬ－２治疗肺癌方法可行、疗效确实。经ＢＡＩ联合化疗治疗总有效率可达８７％，明显高于单纯ＢＡＩ化疗组的７０％（Ｐ＜０．０５），同时也讨论了影响ＬＡＫ／ＩＬ－２疗效的因素及ＬＡＫ／ＩＬ－２的副作用和防治。     

白血病细胞对白细胞介素-2的反应研究

为研究重组人ＩＬ－２（ｒｈＩＬ－２）对白血病治疗的可用性和安全性，用３Ｈ胸腺嘧核苷（３ＨＴｄＲ）掺入法检测有白介素－２受体（ＩＬ－２Ｒ）基因表达的７个白血病细胞株，６例急性淋巴细胞白血病（ＡＬＬ）患者和８例急性髓细胞白血病（ＡＭＬ）患者白血病细胞体外对ｒｈＩＬ－２的反应性。结果显示：ＩＬ－２Ｒ基因表达阳性细胞体外对ｒｈＩＬ－２的反应呈不均一性。ＩＬ－２ＲαｍＲＮＡ和ＩＬ－２ＲβｍＲＮＡ均为阳性的Ｎｕｌ细胞株ＮＫＬ－１，２例ＡＬＬ和１例Ｍ５型ＡＭＬ患者细胞呈增殖反应；３个白血病细胞株，２例ＡＬＬ和２例ＡＭＬ患者细胞呈抑制反应，其余３个白血病细胞株及７例患者白血病细胞对ｒｈＩＬ－２无反应。本研究表明：白血病细胞对ｒｈＩＬ－２的反应不均一，可出现增殖、受抑或不反应。给白血病细胞体外对ｒｈＩＬ２呈受抑和无反应的患者使用ｒｈＩＬ－２作免疫治疗是合适的，而白血病细胞呈增殖反应者不宜使用ｒｈＩＬ－２。     

4种细胞因子对K562/S及其耐药细胞株K562/A02积蓄柔红霉素的影响

目的通过检测４种常用细胞因子对白血病细胞株Ｋ５６２／Ｓ及其多药耐药细胞株Ｋ５６２／Ａ０２积蓄柔红霉素（ＤＮＲ）能力的影响,评价细胞因子在抗白血病细胞多药耐药性方面的应用前景。方法用流式细胞仪及荧光法检测重组人α－干扰素（ＩＦＮ－α）、白细胞介素２（ＩＬ－２）、肿瘤坏死因子（ＴＮＦ）、重组人粒－单集落刺激因子（ＧＭ－ＣＳＦ）对Ｋ５６２／Ｓ及Ｋ５６２／Ａ０２积蓄柔红霉素能力的影响。结果ＩＬ－２、ＴＮＦ、ＧＭ－ＣＳＦ作用后Ｋ５６２／Ｓ及Ｋ５６２／Ａ０２细胞株对柔红霉素的积蓄无改变,而ＩＦＮ－α可显著提高耐药细胞系Ｋ５６２／Ａ０２细胞内ＤＮＲ浓度,在１５０ｍｉｎ时升高了４.０１倍（Ｐ＜０.０５）。结论小剂量（５００Ｕ／ｍｌ） α－干扰素作用后,多药耐药细胞株 Ｋ５６２／Ａ０２对抗肿瘤药物ＤＮＲ的积蓄作用大大提高,提示ＩＦＮ－α具有提高耐药细胞株细胞内药物浓度、恢复其药物敏感性、逆转多药耐药性的作用。     

用IL－2／LAK细胞对中晚期癌症病人细胞免疫的影响

为了探讨ＩＬ－２／ＬＡＫ细胞对中晚期癌症病人细胞免疫的影响，用３Ｈ－ＴｄＲ掺入ＤＮＡ法测定了１７例中晚期癌症病人在ＩＬ－２／ＬＡＫ细胞治疗前后外周血加ＰＨＡ或不加ＰＨＡ淋巴细胞体外增殖试验，结果显示无论空白对照（１１／１６）还是ＰＨＡ诱导的Ｔ淋巴细胞增殖试验（１２／１６），ｃｐｍ值较治疗前均有明显的提高（Ｐ＜０．０５，Ｐ＜０．０１）；在Ｔ细胞亚群的测定中，ＩＬ－２／ＬＡＫ细胞治疗前后比较，ＣＤ３＋和Ｃ８＋细胞都未发现明显的差异，只有Ｃ４＋细胞较治疗前（１３／１７）有了显著提高（Ｐ＜０．０１）；ＮＫ细胞虽未达到正常水平，但也显示较治疗前有显著增高的倾向；结果表明，ＩＬ－２／ＬＡＫ细胞疗法既对肿瘤细胞有直接杀伤作用，也对细胞免疫起了明显的促进作用。     

环孢菌素A与细胞因子联合逆转白血病多药耐药性的体外研究

目的 探讨环孢菌素Ａ（ＣｓＡ）联合细胞因子对耐药细胞系Ｋ５６２／Ａ０２的逆转作用,方法 以甲基四唑蓝法测定柔红霉素（ＤＮＲ）的细胞毒性,用流式细胞仪技术测定细胞内罗丹明（Ｒｈ１２３）浓度,用ＲＴ－ＰＣＲ及ＪＳＢ－１抗体分别检测多药耐药（ＭＤＲ１）ｍＲＮＡ及其Ｐ糖蛋白的表达。结果 １μｍｏｌ／ＬＣｓＡ,５００Ｕ／ｍｌ干扰素２００Ｕ／ｍｌ白介素２（ＩＬ－２）均能增加ＤＮＲ对耐药细胞系Ｋ５６２／Ａ０２的     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.