利用流式细胞仪检测人外周血NK细胞毒性方法的建立

目的利用流式细胞仪（FAcs）技术检测人外周血NK细胞的毒性。方法首先将pEGFP-N1质粒转染人NK细胞的天然靶细胞K562，经过G418筛选后进一步单克隆化，得到稳定、均一表达绿色荧光蛋白的K562细胞。取对数期的K562-EGFP细胞与人外周血单个核细胞分别按5：1、10：1、20：1、40：1的比例混合，分别孵育0．5、1、2、4h后用碘化丙啶（PI）标记，用流式细胞仪分析呈红、绿色荧光的细胞数，最后计算NK细胞的杀伤效率。结果0．5、1、2、4h均能得到明显的杀伤效果，而且以2h的杀伤率最高。此时杀伤率与传统乳酸脱氢酶法（LDH）具有显著相关性（7=0．997，P=0．003），而且显示出更强的敏感性。结论利用流式细胞仪检测NK细胞毒活性的方法可作为传统^51Cr释放法、LDH法的一个补充，而且具有经济、快速和敏感的特点。     

流式细胞术检测NK细胞活性在获得性噬血细胞性淋巴组织细胞增多症诊断中的应用

本研究目的旨在建立一种准确、稳定的NK细胞杀伤活性检测方法,应用于获得性噬血细胞性淋巴组织细胞增多症诊断。21例疑似患者及20例健康对照者纳入本研究。根据HLH-2004标准将疑似患者分为确诊组和排除组,将pEGFP—N1质粒转染人NK细胞的天然靶细胞K562,经过G418筛选后进一步单克隆,得到稳定、均一表达绿色荧光蛋白的EGFP—K562细胞,将EGFP—K562细胞与人外周血单个核细胞按10：1的比例混合孵育2小时后,用碘化丙啶（PI）标记,用流式细胞仪分析呈红、绿色荧光的细胞数,最后计算NK细胞的杀伤效率;同时采用LDH释放法测定外周血NK细胞对单纯K562细胞的杀伤活性,并进行比较。结果表明：获得了稳定表达绿色荧光蛋白的EGFP—K562细胞;流式细胞仪检测表明健康人NK细胞杀伤率与病人组之间存在明显差异,流式细胞仪技术检测NK细胞杀伤活性与传统LDH释放法检测NK细胞杀伤活性具有显著相关性。结论：EGFP—K562细胞株作为靶细胞用于流式细胞术检测NK细胞杀伤活性,无需预先染色和标记靶细胞,操作简便、省时、稳定、重复性高,可应广泛应用于获得性噬血细胞性淋巴组织细胞增多症诊断。     

荧光染色技术检测细胞杀伤能力

目的:用羧基荧光素二醋酸盐琥珀酰亚胺酶(CFSE)及碘化丙锭(propidium iodide,PI)两种荧光染料标记方法检测小鼠脾细胞杀伤能力,并探讨其应用价值。方法:采用CFSE标记靶细胞,PI标记被杀伤细胞,并通过直接杀伤实验和双向杀伤实验验证方法可行性。分离各组C57BL/6小鼠脾细胞作为攻击细胞,Balb/c小鼠脾细胞经5μmol/LCFSE染色后作为靶细胞。将攻击细胞与靶细胞按20∶1的比例混合,培养6h后用PI染色10min,经流式细胞术分析。比较Balb/c小鼠脾细胞致敏C57BL/6小鼠组(免疫组)和地塞米松处理组的脾细胞杀伤能力。结果:CFSE及PI两种荧光染色细胞可以在流式细胞仪上明显区分。CFSE和PI双阳性细胞是被杀伤的靶细胞。免疫组与地塞米松处理组的杀伤能力差异存在显著性(P<0.05)。结论:CFSE与PI两种荧光染料染色的杀伤实验方法操作简单、方便,有良好的应用价值。     

利用流式细胞仪检测人外周血NK细胞毒性方法的建立

目的利用流式细胞仪(FACS)技术检测人外周血NK细胞的毒性。方法首先将pEGFP-N1质粒转染人NK细胞的天然靶细胞K562,经过G418筛选后进一步单克隆化,得到稳定、均一表达绿色荧光蛋白的K562细胞。取对数期的K562-EGFP细胞与人外周血单个核细胞分别按5∶1、10∶1、20∶1、40∶1的比例混合,分别孵育0.5、1、2、4 h后用碘化丙啶(PI)标记,用流式细胞仪分析呈红、绿色荧光的细胞数,最后计算NK细胞的杀伤效率。结果0.5、1、2、4 h均能得到明显的杀伤效果,而且以2h的杀伤率最高。此时杀伤率与传统乳酸脱氢酶法(LDH)具有显著相关性(γ=0.997,P=0.003),而且显示出更强的敏感性。结论利用流式细胞仪检测NK细胞毒活性的方法可作为传统51Cr释放法、LDH法的一个补充,而且具有经济、快速和敏感的特点。     

LDH释放法检测肿瘤患者PBMC和CIK细胞的细胞毒活性

目的建立检测细胞毒活性的乳酸脱氢酶（LDH）测定法，了解肿瘤患者外周血单个核细胞（PBMC）和细胞因子诱导的杀伤细胞（CIK）的抗肿瘤活性，为肿瘤的免疫细胞治疗提供参考。方法采集肿瘤患者和健康成人外周血，常规分离PBMC，体外进行CIK的培养，用LDH释放法分别检测PBMC和CIK对肿瘤细胞K562的细胞毒活性。结果肿瘤患者PBMC对K562的杀伤活力比正常人显著降低（P〈0．05）。经多种细胞因子诱导培养7～10d后，健康人和肿瘤患者的CIK对K562的杀伤活力都有显著提高（P〈0．01），肿瘤患者CIK杀伤活力接近于健康人。结论肿瘤患者PBMC细胞毒活性显著降低，但经诱导培养成CIK后则显著提高。用LDH释放法检测肿瘤病人CIK细胞毒活力，有助于CIK疗法适应病人的选择及个体疗效观察。     

聚焦超声激活血卟啉对H-22肿瘤细胞的杀伤作用

目的 研究声动力学疗法（SDT）杀伤肿瘤细胞的最佳声照处理时间点，探讨不同强度的聚焦超声激活血卟啉对H-22肝癌腹水瘤细胞的杀伤作用。方法采用荧光分光光度法测定血卟啉衍生物（HpD）在H-22肿瘤细胞内的富集时间，选择最佳声照处理时间点。采用频率为1．43MHz，强度分别为1W／cm^2、2W／cm^2和3W／cm^2的聚焦超声结合血卟啉作用于H-22肿瘤细胞，于不同时间段取材，通过扫描电镜观察细胞表面的超微结构变化，并与单纯血卟啉或单纯超声处理后的细胞进行比较。结果加入HpD后45min，肿瘤细胞内药物含量最高，作为最佳声照处理时间点。形态学观察显示：单纯血卟啉处理对H-22肿瘤细胞仅有轻微影响；单纯超声处理对细胞有一定的损伤作用，并且细胞受损程度随着超声强度的增大和取材时间的延迟而逐渐加重；超声结合血卟啉对细胞的协同杀伤效应在同等条件下显著高于单纯超声处理的细胞。结论SDT对H-22肿瘤细胞的损伤效应依赖于超声强度以及声敏剂在细胞内的含量，并且表现出一定的时间相关性变化。     

表阿霉素对K562细胞的杀伤作用的研究

【目的】探讨肿瘤化疗药物表阿霉素(E-ADM)对K562细胞杀伤作用的某些规律。【方法】采用流式细胞术-PI染色检测法对经不同浓度、不同时间E-ADM作用的K562细胞的磺化丙啶阳性(PI )细胞百分率和PI 细胞平均荧光强度(MFI)进行了检测和分析。【结果】K562细胞在不同浓度E-AEM作用后,无论是24h还是72h组,PI 细胞百分率和PI 细胞MFI,除0.01μg/mL组与对照组无明显差异外,其余各组均与对照组有显著性差异(P<0.01);并随E-ADM浓度增加而逐步升高。其中24h组,随E-ADM浓度增加PI 细胞百分率增高曲线呈‘S’型分布。PI 细胞百分率在E-ADM浓度为0.1、1.0和10.0μg/mL时,24h组均大于72h组(P<0.01);而PI 细胞MFI,24h各组均大于72h各组(P<0.01)。【结论】①E-AEM对K562细胞有明显的杀伤作用,杀伤细胞的浓度效应呈"S"形曲线分布;②E-ADM对K562细胞的杀伤效果,24h优于72h;③E-ADM杀伤K562细胞的最佳浓度为0.10μg/mL。该结果为E-ADM的临床应用提供了有价值的参考信息。     

高能X线照射对肿瘤细胞表达MICA及NK细胞功能的影响

目的探讨肿瘤细胞接受不同剂量高能X线照射后，细胞表面MICA抗原表达及对NK细胞功能的影响。方法分别取T淋巴细胞株他、结肠腺癌细胞株LS-174-T及食管鳞癌细胞株ECA-109，经0、4、8、16、32Gy的剂量照射，16h过夜培养，给细胞标记MICA的单克隆抗体，分析肿瘤细胞平均荧光密度（MFI的变化。并将外周血单个核细胞与经优化剂量照射的肿瘤细胞按10：1比例孵育，4h后利用流式细胞术胞内染色法分析NK细胞释放穿孔素的情况以评价NK细胞的杀伤毒性。结果不同肿瘤细胞株上调MICA表达的最佳放疗剂量不同，而肿瘤细胞上调MICA表达后可增强NK细胞的杀伤毒性。结论适宜的放射剂量促进肿瘤细胞表达MICA抗原而增强机体免疫功能。     

靶向siRNA沉默mdr1基因表达及对白血病耐药细胞系K562/ADM的耐药逆转作用

目的 研究小干扰RNA（siRNA）对白血病多药耐药细胞系K562／ADM细胞mdr1基因表达的沉默作用和凋亡抑制的逆转效应。方法 K562／ADM为靶细胞，设计、筛选和合成2对针对mdr1基因mRNA的siRNA（mdr1 siRNA-1和mdr1siRNA-2），用脂质体介导转染K562／ADM细胞；实时荧光定量PCR（real—time PCR）法检测mdr1 mRNA的表达；流式细胞术测定P-糖蛋白（P—gP）水平和caspase-3活性；细胞形态学和FITC标记的膜联蛋白V／碘化丙锭（Annexin V—FITC／PI）双染色法检测细胞的凋亡。结果 筛选出的mdr1 siRNA-1和mdr1 siRNA-2显著抑制K562／ADM细胞mdr1的表达，mdr1 mRNA的表达分别降低91．2％和82．0％，P-gp水平下降74．1％和84．4％；增强caspase-3活性，活化caspase-3增加约40％；K562／ADM耐药细胞对阿霉素诱导凋亡的敏感性增强，Annexin V—FITC／PI染色检测细胞凋亡率提高约60％。结论 siRNA通过沉默mdr1 ／P—gp表达而逆转K562／ADM多药耐药细胞的凋亡抑制现象。     

流式细胞术快速检测念珠菌的药物敏感性

目的建立流式细胞术（FCM）快速检测念珠菌药物敏感性的方法。方法选定了3种代表性染料：碘化丙啶（PI）、FUN-1和DiOC5（3）,采用FCM测定60株临床分离的念珠菌对氟康唑（FLC）和两性霉素B（AMB）的敏感性,并与美国临床实验室标准化委员会（NCCLS）推荐的M27-A法的结果进行比较。结果PI、FUN—1和DiOC5（3）3种荧光染料均可用于FCM检测念珠菌的药物敏感性,其中PI、FUN-1均可用于FLC和AMB2种药物的敏感性试验;与另外2种染料相比,利用PI染料进行检测的结果与M27-A法有更好的-致性,并且价廉易得,但其要求药物与细菌的孵育时间较另外2种染料长;DiOC5（3）仅可用于对AMB的最低抑菌浓度（MIC）测定,但其要求药物与细菌的孵育时间最短,只需0．5h。结论利用FCM进行抗真菌药物敏感性试验,可大大缩短检测时间,但为获得与M27-A法较为-致的结果,应针对不同的药物选用不同的染料,设定各自的最佳检测条件。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.