T细胞亚群及共刺激分子表达与系统性红斑狼疮免疫病理的关系

目的：探讨T细胞亚群及共刺激分子表达与系统性红斑狼疮免疫病理的关系。方法；采用免疫荧光标记技术和流式细胞仪检测技术对系统性红斑狼疮（SLE）患者和正常人外周血T细胞亚群及外周血单个核细胞膜表面共刺激分子的表达进行分析。结果：（1）与正常人相比，SLE患者CD3^ ,CD4^ T细胞亚群显著减少，CD4／CD8比例失调，双标记CDr^ CD28^ ,CD8^ CD28^ T细胞亦显著减少；（2）患者共刺激分子CD28表达显著降低，4－1BB分子表达显著增高；（3）患者T细胞CD4／CD8与抗核抗体呈负相关，共刺激分子4－1BB与抗核抗体，尿蛋白呈正相关，而与CD4^ CD28^ T细胞亚群呈负相关。结论：T细胞亚群及共刺激分子表达异常在系统性斑狼疮发病机制中可能具有重要作用。     

CD3AK细胞联合BCG对膀胱癌细胞的体外杀伤活性研究

目的探讨CD3AK细胞对膀胱癌细胞的体外杀伤活性,以及CD3AK细胞与BCG联合作用于膀胱癌细胞的效应.方法采用抗CD3单抗和IL-2共同刺激健康人外周血单个核细胞诱导出CD,AK细胞;以流式细胞仪测定细胞表型;用MTT法测定CD,AK以及CDaAK联合BCG对膀胱癌细胞系(T24)的杀伤活性.结果CD3AK细胞为异质细质细胞群,其细胞类型主要是CD8 细胞;在效靶比为10:1及20:1时,培养4 d的CD:,AK细胞BCG联合作用于T24细胞的杀伤率高于二者分别对T24细胞的杀伤率.结论CD3AK细胞是一种高效的抗肿瘤效应细胞,对膀胱癌细胞具有较强的杀伤作用;CD3AK细胞与BCG对膀胱细胞呈协同杀伤作用.CD3AK细胞在膀胱癌过继免疫治疗中具有重要的临床应用前景.     

病原体抗原刺激的正常人外周血CD4^＋T细胞对γδT细胞的影响

CD4 T辅助（Th）细胞和γδT细胞在抗微生物感染中发挥着重要作用，两者相互作用有待阐明。本文报道以胞内感染体结核杆菌、人类VI型疱疹病毒及胞外寄生虫阴道毛滴虫刺激活化从正常人外周血经洗淘法分离纯化的CD4 T细胞，结果各组活化的细胞均表现明显增殖和产生以白介素-2（IL－2）、γ干扰素（IFN－γ）显著升高为主的Th1型细胞因子分泌谱。利用细胞隔离渗透性共培养体系，将抗原活化的CD4 T细胞和γδT细胞共培养，结果显示γδT细胞的增殖和细胞毒作用均可为CD4 T细胞产生的可溶性因子所显著增强。这提示在抗感染免疫中，CD4 Th1细胞可通过Th1型细胞因子促进γδT细胞功能。     

膀胱癌患者膀胱腔内过继免疫治疗后外周血T细胞亚群的变化

1目的　观察膀胱腔内过继免疫治疗后患者外周血中 T淋巴细胞亚群分布的变化。 2方法　由膀胱肿瘤可溶性抗原与卡介苗 (BCG)共同活化人外周血单个核细胞成为抗膀胱肿瘤特异性杀伤细胞 -BT-BAK细胞。临床随机选择 3 7例膀胱癌术后患者进行膀胱腔内 BT-BAK细胞灌注治疗 ,采用 SAP免疫组化法于治疗前后分别测定患者外周血 T细胞亚群分布的变化。 3结果　治疗 2个疗程后患者外周血 CD3+ 、CD4+ T细胞亚群分别较治疗前增加约 (2 8.5 8± 7.16) %及 (12 .92± 5 .2 2 ) % ,CD8+ T亚群变化不显著。随诊平均 18.16个月 ,仅 1例发现膀胱粘膜轻度异型性增生 ,复发率为 2 .7%。 4结论　 BT-BAK细胞膀胱腔内过继免疫治疗可显著提高膀胱癌患者全身免疫反应能力 ,有效降低患者术后膀胱肿瘤的复发率。     

HIV-1感染者治疗后的T淋巴细胞异常激活研究

  目的   探讨外周全血中异常激活的T淋巴细胞亚群与人类免疫缺陷病毒1型（HIV-1）感染者免疫功能恢复的关系,探讨HIV-1 DNA病毒库的大小与T淋巴细胞亚群的关系。  方法   以2019年7月–2020年5月进行常规检测的HIV-1感染者为目标人群,入组时根据抗逆转录病毒疗法（antiretroviral therapy, ART）治疗后CD4+ T细胞是否达到500 cells/ μL,将HIV-1感染者分为两组,其中缺陷组76例,无缺陷组61例。同时选择22例未暴露且HIV-1抗体检测阴性者作为对照组。对以上3组人群的T细胞亚群进行检测,并对缺陷组44例和无缺陷组33例共计77例进行HIV-1 DNA病毒库检测。6个月后随访缺陷组和无缺陷组,收集缺陷组（74例）和无缺陷组（59例）共133例血液样本中的CD4+ T细胞检测结果。  结果   入组时,缺陷组的活化CD4+、CD8+ T细胞含量均高于无缺陷组和对照组。缺陷组衰老CD4+ T、CD8+ T细胞含量与无缺陷组相当,均高于对照组,但仅在衰老CD8+ T细胞上差异有统计学意义。缺陷组比对照组检出更高的效应记忆CD4+ T和CD8+ T细胞,无缺陷组只检出更高的效应记忆CD8+ T细胞。缺陷组和无缺陷组均表现出比对照组更低水平的中心记忆CD4+ T和CD8+ T细胞,无缺陷组中心记忆CD4+ T细胞比缺陷组还低。对于幼稚细胞而言,无缺陷组表现出更高水平的幼稚CD4+ T细胞,缺陷组和无缺陷组的幼稚CD8+ T细胞较对照组下降。HIV-1 DNA病毒库大小与CD4+ T细胞数量和各T细胞亚群均无相关。活化CD4+ T细胞、活化CD8+ T细胞、中心记忆CD4+ T细胞与6个月以后的后续CD4+ T细胞数量呈负相关,r分别为－0.378、－0.334、－0.322（P<0.05）;幼稚CD4+ T细胞、幼稚CD8+ T细胞与后续CD4+ T细胞数量呈正相关,r分别为0.350、0.267（P<0.05）。  结论   HIV-1感染者存在不同程度的T细胞亚群异常激活,部分T细胞亚群的异常激活与后续免疫功能的恢复有关,病毒库的大小与T细胞亚群无相关关系。     

异种抗原免疫续贯瘤内注射对肿瘤浸泣淋巴细胞的影响

目的 研究异种抗原免疫续贯瘤内注射对瘤荷小鼠的治疗作用,以及该方法对肿瘤浸润淋巴细胞的影响。方法 使用异种抗原免疫续贯瘤内注射的方法处理小鼠,观察肿瘤的大小,分离肿瘤浸润淋巴细胞,并利用流式细胞术检测肿瘤细胞的凋亡及各细胞亚群的比例。结果 各组小鼠肿瘤浸润淋巴细胞的CD3+T细胞数量没有统计学差异。免疫后治疗组中的CD3+CD4+T细胞、CD3+CD8+T细胞以及CD3+CD4+CD25+T细胞所占比例分别为54%、22%和2.91%,其中CD4+与CD8+的比值为2.49,这与对照组之间存在显著性差异（P < 0.01）。结论 异种抗原续贯瘤内注射方法可以增加肿瘤微环境中效应细胞的数量,减少CD3+CD4+CD25+T调节细胞的表达,具有显著的抗肿瘤效应。 【关键词】异种抗原 免疫治疗 肿瘤浸润淋巴细胞     

异种黑色素细胞疫苗诱导小鼠抗恶性黑色素瘤免疫反应的机理研究

目的　研究异种黑色素细胞疫苗诱导小鼠抗恶性黑色素瘤免疫反应的机理。方法　制备异种黑色素细胞疫苗 ,免疫小鼠。采用间接 EL ISA法检测小鼠抗肿瘤抗体滴度及抗体亚型 ,纯化免疫球蛋白及进行体外抗肿瘤增殖 ,采用 Western blot法分析交叉抗原蛋白质。接种恶性黑色素瘤 ,观察肿瘤生长 ,采用免疫细胞去除法分析NK细胞及 T细胞亚群对疫苗抑瘤效应的影响。结果　异种疫苗免疫后 2周小鼠体内出现抗自身肿瘤抗体 ,产生的抗体以 Ig G为主 ,抗体认别的猪眼黑色素细胞及恶性黑色素瘤细胞交叉抗原为相对分子质量达 180× 10 3的蛋白质 ,纯化的免疫球蛋白在体外能抑制恶性黑色素瘤细胞增殖。异种疫苗诱导特异性保护性免疫反应使 90 %小鼠恶性黑色素瘤生长受到抑制 ,去除 NK细胞不影响疫苗抑瘤效应 ,去除 CD4 + T细胞使疫苗抑瘤效应消失 ,去除CD8+ T细胞 70 %小鼠恶性黑色素瘤生长仍受到抑制。结论　异种黑色素细胞疫苗诱导特异性体液免疫及细胞免疫反应 ,抑制恶性黑色素瘤的生长 ,CD4 + T细胞在这一过程中发挥了关键性作用。     

树突状细胞与免疫激活和免疫耐受

树突状细胞（DC）在诱导T细胞活化或耐受的过程发挥了十分重要的作用,其摄取的外源性抗原多通过MHC-II类途径呈递给CD4^ T细胞,也能通过MHC-I类途径呈递内化的外源性抗原。DC能打破机体对多种抗原的免疫耐受,也在机体对某些抗原免疫耐受的建立过程中发挥了重要作用。此外,DC的作用还与DC的亚群、DC的成熟程度有关。在DC对T细胞功能调控的过程中,T细胞对DC的作用也具有重要影响。     

溶酶体相关膜蛋白作为嵌合体可显著增强基于SARS冠状病毒核蛋白优势T细胞表位簇DNA疫苗的免疫应答

由于常规DNA疫苗进入体内,表达的目的蛋白属内源性抗原,抗原提呈细胞（antigen presenting cell,APC）将启动MHCI类抗原加工途径,提呈MHCI/抗原肽复合物给CD8^＋T细胞,因此,CD4^＋T细胞不能被有效活化。     

CD1d分子研究进展

传统观点认为, 肽类抗原是引起T淋巴细胞免疫反应的唯一物质.然而近年来研究发现,脂类、糖脂类抗原也可通过CD1d介导特异性激活自然杀伤T细胞(NKT细胞).CD1d是CD1家族中的一员,在胸腺细胞、B细胞亚群、表皮朗罕细胞、树突状细胞亚群、肠道上皮细胞中表达,是一类功能类似于MHCⅠ类分子又独立于MHCⅠ分子之外的具有抗原提呈作用的非多肽性跨膜糖蛋白分子.CD1d分子激活NKT细胞后具有抗肿瘤、抗病毒、抗病菌作用.因此,成为国内外学者研究热点.本文拟对CD1d分子的最新研究进展作一综述.     

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.     

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.     

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.