HLA-DR expression on regulatory T cells is closely associated with the global immune activation in HIV-1 infected subjects naïve to antiretroviral therapy

Background  The frequencies of regulatory T cells (Tregs) increased over the HIV infection but its counts actually decreased. We proposed that the decrease of Treg counts may cause the reduction of inhibitory effect and thereby account for the over-activation of Tregs during HIV infection. However, it remains unknown whether Tregs are also over-activated and thereafter the activation induced death may lead to the decrease of Tregs.

Methods  Tregs were defined as CD4⁺CD25⁺CD127^lo/- T cells. Eighty-one HIV-1 infected patients were enrolled in our study, and twenty-two HIV-1 seronegative donors were recruited as the control. The levels of HLA-DR on Tregs were determined by FACSAria flow cytometer.

Results  Compared to HIV-1 seronegative donors, the levels of HLA-DR on CD4⁺CD25⁺CD127^lo/- Tregs were significantly increased in HIV-1 infected patients, and its increase was positively associated with viral loads (r=0.3163, P=0.004) and negatively with CD4 T-cell counts (r=−0.4153, P <0.0001). In addition, significant associations between HLA-DR expression on CD4⁺CD25⁺CD127^lo/- Tregs and the percentages of HLA-DR, CD38, Ki67 expressing CD4⁺ and CD8⁺ T cells were also identified.

Conclusion  HLA-DR on Tregs is a good marker for viral replication and disease progression. The over-activation of Tregs might result in the decrease of Tregs.

     

Correlation of Thl7 cells and CD4＋CD25＋ regulatory T cells with clinical parameters in patients with systemic sclerosis

Background Systemic sclerosis （SSc） is an autoimmune disease that has three major components： inflammation, fibrosis, and vasculopathy. T-helper 17 cell （Th17） and regulatory T cell （Treg） are considered to be critical for autoimmune disease pathogenesis. The role of Th17 and Treg in SSc is still unclear. The aim of this study was to detect the presence of Th17s and CD4＊CD25~ Tregs in peripheral blood samples from SSc patients and to investigate the possible roles of these two T cell subsets in SSc pathogenesis. Methods Th17s （CD4 and IL-17 positive） and CD4＊CD25~ Tregs （CD4, CD25 and Foxp3 positive） in the peripheral blood mononuclear cells of 53 SSc patients and 27 healthy controls were counted by flow cytometry. The differences between SSc and control patients were analyzed. Clinical parameters, including disease duration, duration of the second symptoms, Modified Rodnan Skin Score （MRSS）, anti-topoisomerase I antibody, anti-U1 ribonucleoprotein （RNP） antibody, systemic involvements, pulmonary function test （PFT） and high resolution computed tomography （HRCT） score were prospectively collected following EUSTAR （EULAR scleroderma trial and research group） protocols. The correlations between the experimental and clinical data were investigated. Results The ratio of Th17 in SSc patients was significantly elevated compared to healthy controls （8.74% vs. 4.41%, P 〈0.001）. The amount of Th17 was positively correlated with disease duration （R=-0.531, P=-0.013） and duration of the second symptoms （R=-0.505, P=0.023）. The ratio of CD4＊CD25＊ Treg in SSc patients also significantly differed from the healthy controls （3.04% vs. 2.24%, P=0.018）. Elevated Tregs were more frequently observed in patients with a high interstitial lung disease （ILD） score on computed tomography （24/36） compared with patients with normal ILD scores （4/12, ,P=-0.043）. Elevated Tregs were also more often observed in patients with low carbon monoxide diffusing capacity     

肺癌患者外周血CD4~+T淋巴细胞Th1/Th2分化情况检测与分析

目的观察肺癌患者外周血CD4+T淋巴细胞中Th1/Th2分化情况与反应状态,为肺癌的诊断和免疫治疗研究提供依据。方法以干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)代表Th1和Th2细胞功能,应用细胞因子诱生技术和流式细胞仪,检测25例肺癌患者及25例健康志愿者外周血CD4+T淋巴细胞诱生的IFN-γ和IL-4水平。结果肺癌患者外周血CD4+T淋巴细胞诱生的IFN-γ水平与健康对照组比较明显降低,差异有统计学意义(P<0.05),IL-4水平在2组间差异无统计学意义(P>0.05)。结论肺癌患者外周血CD4+T淋巴细胞向Th1细胞的分化明显减少,向Th2细胞的分化无明显变化,Th1向Th2方向的漂移可能是肺癌细胞生长和免疫逃避的机制之一。     

AIHA患者外周血Th1/Th2、Tc1/Tc2亚群的研究及意义

目的:研究自身免疫性溶血性贫血(autoimmunehaemolyticanaemia,AIHA)患者外周血Th1/Th2、Tc1/Tc2亚群极化状态,分析AIHA的免疫学发病机制,为AIHA的临床治疗提供新的理论依据。方法:收集AIHA患者及健康对照组外周抗凝静脉血,分离纯化T细胞。以Cy5标记的抗CD4、CD8单抗和PE标记的CD30单抗作双色流式细胞术,分析AIHA患者Th/Tc、Th1/Th2、Tc1/Tc2亚群的比例变化。结果:与正常对照组相比,AIHA患者外周血CD4+细胞百分率显著降低(P<0.05),CD8+细胞百分率无明显变化(P>0.05),CD4+/CD8+比例明显降低(P<0.05),CD4+CD30-T、CD4+CD30+T细胞百分率明显下降,CD4+CD30-T/CD4+CD30+T和CD8+CD30-T/CD8+CD30+T比例均明显升高(P<0.05),而CD8+CD30-T及CD8+CD30+T细胞百分率无明显变化(P>0.05)。结论:AIHA患者外周血存在细胞免疫功能失调,T细胞亚群极化状态发生改变,呈明显Th1/Tc1型细胞优势;Th1/Tc1型细胞介导的细胞免疫可能与AIHA的免疫学发病机制有关。     

Pre-clinical evaluation of a new indirectly labeled 99mTc-6-hydrazinopyridine-3-carboxylic acid (HYNIC)-depreotide with HYNIC as bifunctional chelator

Background  Technetium-99m or ^99mTc is widely used for labeling peptide in nuclear medicine. Somatostatin and its analog can inhibit tumor cell growth after binding with its receptor. This research was to study the preclinical effect of a new ^99mTc-6-hydrazinopyridine-3-carboxylic acid (HYNIC)-depreotide, indirect ^99mTc labeling of depreotide using HYNIC as a bifunctional chelator.

Methods  The cyclopeptide, cyclo-[(N-Me) Phe-Tyr-D-Trp-Lys-Val-Hcy], the linear peptide, and [ClCH₂-CO×b-Dap-Lys- Cys-Lys×amide] were synthesized by Fmoc solid-phase synthesis. The cyclopeptide and the linear peptide were linked by liquid-phase synthesis. The product depreotide was isolated and purified by high performance liquid chromatography and was confirmed by mass spectrography. Depreotide was labeled with ^99mTc through a direct labeling method, using HYNIC as a bifunctional chelator. Paper chromatography method was used to calculate the labeling rate, and through the comparative analysis selected the best mark conditions. The new ^99mTc-HYNIC-depreotide was tested by high-performance liquid chromatography (HPLC). The internalization and externalization rates of the new ^99mTc-HYNIC-depreotide were studied in A549 cells. Furthermore, biodistribution of the radiopeptide was studied in nude mice, bearing tumors from human lung carcinoma cells SPC-A1.

Results  The molecular of synthesize depreotide was 1358, and the purity of it was 95.29%. The labeling efficiency of ^99mTc-HYNIC-depreotide was highest at pH 6.0 and 15°C, about (70.95±0.84)%. The labeling rate of the new ^99mTc-HYNIC-depreotide rose to a peak of (20.75±0.48)% at 60 minutes in A549 cells at 37°C and decreased slightly later, while it elevated gradually during the time course at 4°C and 25°C. The internalization rate of the new ^99mTc-HYNIC-depreotide at 37°C increased gradually and reached the peak of 84.4% in 120 minutes, while the externalization rate of the new ^99mTc-HYNIC-depreotide was always less than 20%. In mice bearing the experimental SPC-A1 tumor, the new ^99mTc-HYNIC-depreotide demonstrated a high tumor uptake of (4.05±0.04)% ID/g at 1.5 hpi and remained high ((2.51±0.06)% ID/g) at 4 hpi. The tumor-to-lung activity concentration ratio (T/Lu) was very high for the new ^99mTc-HYNIC-depreotide at all time points. So did the tumor-to-muscle activity (T/Mu) and tumor-to-blood activity concentration ratios (T/Bl).

Conclusion  The findings suggested that the new ^99mTc-HYNIC-depreotide might be a promising candidate radiopharmaceutical for imaging somatostatin receptor positive lung cancer.     

Immature CD4+ dendritic cells conditioned with donor kidney antigen prolong renal allograft survival in rats

Background  Allogeneic transplant rejection is currently a major problem encountered during organ transplantation. The dendritic cell (DC) is the most effective powerful known professional antigen-presenting cell, and recent studies have found that DCs can also induce immune tolerance, and avoid or reduce the degree of transplant rejection. The aim of this study was to evaluate the effect of transfused immature CD4⁺ DCs on renal allografts in the rat model.

Methods  In this study, we induced CD4⁺ immature DCs from rat bone marrow cells by a cytokine cocktail. The immature CD4⁺ DCs were identified by morphological analysis and then the suppressive activity of these cells conditioned with donor kidney antigen was evaluated in vitro and in vivo.

Results  Immature CD4⁺ DCs conditioned with donor kidney antigen possessed immunosuppressive activity in vitro and they were able to prolong renal transplant survival in an allograft rat model in vivo.

Conclusions  Our study provides new information on efficacious renal transplantation, which might be useful for understanding the function of immature CD4⁺ DCs in modulating renal transplant rejection and improving clinical outcome in future studies.

     

Expression of chemokine receptors CCR3, CCR5 and CXCR3 on CD4^＋ T cells in CBA/J×DBA/2 mouse model,selectively induced by IL-4 and IL-10, regulates the embryo resorption rate

Background Chemokines and their receptors have been a research focus in transplantation immunology. Chemokines and their receptors play a role in lymphocyte recruitment and differentiation process. This study aimed to observe whether IL-4 and IL-10 may regulate the expression of chemokine receptors CCR3, CCR5 and CXCR3 on CD4^＋ T cells in CBA/J×DBA/2 mouse model and to explore the role of CCR3, CCR5, CXCR3 in immune tolerance in pregnancy. Methods The mouse model of spontaneous abortion （CBA/J×DBA/2） and the normal pregnant mouse model （CBA/J×BALB/c） were used. CBA/J×DBA/2 mice were injected with IL-4 （CBA/J×DBA/2-IL-4）, IL-4 and IL-10 （CBA/J×DBA/2-IL-4＋IL-10）, or normal saline （CBA/J×DBA/2-NS） as a control. The expression of CCR3, CCR5 and CXCR3 on CD4^＋ T cells from mouse peripheral blood was measured by the double-labelled FCM method, and the embryo resorption rate was also examined. Results The embryo resorption rate in the CBA/J×DBA/2 group without any treatment was significantly higher than that in the CBA/J×BALB/c group （17.9% vs 3.7%, P 〈0.01）. The embryo resorption rate in the CBA/J×DBA/2 group immunized with IL-4 or IL-4 together with IL-10 was significantly decreased, compared with that in the control and NS groups respectively. CCR3 expression on CD4^＋ T cells in the CBA/J×DBA/2 group without any treatment was significantly lower than that in the CBA/J×BALB/c group （0.3738±0.3575 vs 1.2190±0.2772, P 〈0.01）; both CCR5 （3.0900±1.5603 vs 1.2390±0.6361, P〈0.01） and CXCR3 （2.4715±0.9074 vs 0.9200±0.5585, P 〈0.01） expressions on CD4^＋ T cells of the CBA/J×DBA/2 group without any treatment were significantly higher than those of the CBA/J×BALB/c group. Significant up-regulation of CCR3 and down-regulation of CXCR3 were found in the CBA/J×DBA/2 group treated with IL-4 （CCR3： 2.0360±0.6944, CXCR3： 1.3510±0.5263, P〈0.01） or IL-4 and IL-10 （CCR3： 1.8160±1.0947, CXCR3：1.0940±0.7168, P〈0.01）. Because of the CCR5, IL-4 and IL-10 （1.9400±0.8504 vs 3.0900±1.5603, P 〈0.05）, but IL-4 alone （2.5310±1.3595 vs 3.0900±1.5603, P 〉0.05） treatment significantly decreased the expression of CCR5 in CBA/J×DBA/2. Conclusions The abnormal expression of CCR3, CCR5 and CXCR3 on CD4^＋ T cells may play an important role in the pathogenesis of spontaneous abortion. The pregnancy immune tolerance may be induced through selective induction of CCR3, CCR5 and CXCR3 expressions by IL-4 together with IL-10.     

调节性CD4~+T细胞及非调节性CD4~+T细胞与HIV/AIDS患者疾病进展关系的研究

目的分析比较中国HIV感染者CD4+CD25+Foxp3+调节性T细胞(CD4+regulatory T cells,Treg)及非Treg细胞与疾病进展的关系,探讨Treg细胞在HIV感染过程中的作用。方法选取76例HIV/AIDS患者,根据其CD4+T细胞计数水平不同分为3组,A组CD4<200个/μL,B组CD4200～400个/μL,C组CD4>400个/μL。采用流式细胞仪胞内染色技术检测CD4+CD25+Foxp3+调节性T细胞的水平,并分析其与CD4计数及病毒载量的相关性。结果随着疾病的进展,Treg细胞百分比逐渐升高,各组间差异有统计学意义;Treg细胞及非Treg细胞的绝对计数均明显下降,且以非Treg细胞下降为主;Treg绝对计数与病毒载量呈负相关(P<0.05)。结论中国HIV感染者随着疾病进展,辅助性T细胞等非Treg细胞的数量下降,对机体免疫保护能力降低,而Treg细胞数量及功能的下降使其对机体的过度免疫活化的抑制作用减弱,病毒复制,加剧病情进展。     

缺血再灌注小鼠心肌细胞Na~+/Ca~(2+)交换电流的改变

目的观察缺血再灌注损伤对小鼠心肌细胞Na+/Ca2+交换蛋白电流的直接影响,探讨缺血再灌注损伤中Ca2+超载的机制。方法采用全细胞打孔膜片钳技术,观察缺血再灌注损伤对急性分离的小鼠心室肌细胞Na+/Ca2+交换蛋白电流(INa/Ca)的影响。细胞外灌流代谢抑制剂(5 mmol/L氰化钠和10 mmol/L脱氧葡萄糖)模拟化学性心肌细胞缺血状态。结果缺血8m in明显抑制了小鼠心室肌细胞钠钙交换蛋白内向和外向电流〔在-100 mV,电流从(-0.04±0.01)nA减小到0 nA;在+50mV,电流从(0.25±0.08)nA减小到(0.11±0.03)nA〕。而随后的再灌注则导致钠钙交换蛋白电流迅速而明显的增大,尤以外向电流增大更加显著〔在+50 mV,电流从(0.25±0.08)nA增大到(0.49±0.12)nA〕。结论缺血再灌注直接影响小鼠心室肌细胞Na+/Ca2+交换蛋白的功能及状态,使Na+/Ca2+交换蛋白的反向转运功能明显增强,这种改变可能是导致缺血再灌注损伤中Ca2+超载的关键因素。     

Application of T2* measurement on gradient echo T2*-weighted imaging in differential diagnosis of intracranial hemorrhage and calcification

Background  Differential diagnosis of intracranial hemorrhage and calcification is a common problem encountered in clinical imaging diagnosis. The purpose of this study was to investigate the feasibility of T2^* measurement on gradient echo (GRE) T2^*-weighted imaging (T2^*WI) in differential diagnosis of intracranial hemorrhage and calcification.

Methods  Thirty-eight hemorrhagic foci in 18 patients and 11 calcification foci in seven patients were included in this study. The diagnosis of hemorrhage and calcification was confirmed in all cases with enhanced T2^* weighted angiography (ESWAN) magnetic resonance imaging (MRI) and CT respectively. The significance for the difference of T2^* value between the central and peripheral areas of hemorrhage and calcification lesions was tested with univariate analysis of variance.

Results  The detection rate of GRE T2^*WI on intracranial hemorrhage was 1.9-fold higher than that of CT, especially for the hemorrhage in the brainstem and cerebellum. However, GRE T2^*WI was far less sensitive to calcification than CT. There was a significant difference in the T2^* value between the central area of hemorrhage and calcification (P <0.001), though no difference in the T2^* value was obtained between the peripheral area of hemorrhage and calcification (P >0.05).

Conclusions  Quantitative measurement of T2^* value on GRE T2^*WI with a single MRI examination provides a fast, convenient, and effective means in differential diagnosis between intracranial hemorrhage and calcification, which may thus reduce the medical cost and save precious time for clinical management.

     

A novel and feasible way to cultivate and purify endothelial progenitor cells from bone marrow of children with congenital heart diseases

Background  Endothelial progenitor cells (EPCs) are used in vascular tissue engineering and clinic therapy. Some investigators get EPCs from the peripheral blood for clinic treatment, but the number of EPCs is seldom enough. We have developed the cultivation and purification of EPCs from the bone marrow of children with congenital heart disease, to provide enough seed cells for a small calibre vascular tissue engineering study.

Methods  The 0.5-ml of bone marrow was separated from the sternum bone, and 5-ml of peripheral blood was collected from children with congenital heart diseases who had undergone open thoracic surgery. CD34+ and CD34+/VEGFR+ cells in the bone marrow and peripheral blood were quantified by flow cytometry. CD34+/VEGFR+ cells were defined as EPCs. Mononuclear cells in the bone marrow were isolated by Ficoll^® density gradient centrifugation and cultured by the EndoCult Liquid Medium Kit™. Colony forming endothelial cells was detected. Immunohistochemistry staining for Dil-ac-LDL and FITC-UEA-1 confirmed the endothelial lineage of these cells.

Results  CD34+ and CD34+/VEGFR+ cells in peripheral blood were (0.07±0.05)% and (0.05±0.02)%, respectively. The number of CD34+ and CD34+/VEGFR+ cells in bone marrow were significantly higher than in blood, (4.41±1.47)% and (0.98±0.65)%, respectively (P <0.0001). Many colony forming units formed in the culture. These cells also expressed high levels of Dil-ac-LDL and FITC-UEA-1.

Conclusion  This is a novel and feasible approach that can cultivate and purify EPCs from the bone marrow of children with congenital heart disease, and provide seed cells for small calibre vascular tissue engineering.

     

Correlation of eosinophil counts in induced sputum and fractional concentration of exhaled nitric oxide and lung functions in patients with mild to moderate asthma

Background  The airway inflammation could be assessed by some noninvasive approaches. To investigate the value of eosinophil counts in induced sputum and fractional concentration of exhaled nitric oxide (FENO) for the regimen adjustment in patients with asthma, the correlation was analyzed between the two parameters and lung function parameter (forced expiratory volume in one second (FEV₁)).

Methods  Sixty-five outpatients with mild to moderate non-exacerbation asthma from Beijing Chao-Yang Hospital were enrolled as treatment group. Combined medications of inhaled corticosteroids plus long-acting beta-2 agonist were administered for one year. Lung function parameters, eosinophil counts in induced sputum, concentration of exhaled nitric oxide and the Asthma Control Test scores were recorded, at regular intervals in the follow-up period. Twenty-one healthy volunteers were enrolled as control group and underwent examination of eosinophil counts in induced sputum, lung function and concentration of exhaled nitric oxide.

Results  Sixty-three subjects from treatment group completed follow-up period for one year or longer. Mean FEV₁ value of the 63 subjects was (2.75±0.54) L at baseline, (2.97±0.56) L and (3.07±0.52) L at month 3 and month 6, respectively, and maintained as (3.14±0.51) L in the following six months. Mean FENO decreased from (61±25) parts per billion (ppb) at baseline to (32±19) ppb at month 3 (P <0.05), and continued to decrease to (22±12) ppb at month 6, the difference being significant when compared to both baseline and control group ((13±8) ppb). Mean eosinophil counts decreased to (0.032±0.011) ×10⁶/ml at month 3, which was significantly different from baseline ((0.093±0.023) ×10⁶/ml) and the control group ((0.005±0.003) ×10⁶/ml (both P <0.05). The eosinophil counts in induced sputum correlated positively with concentration of FENO in the first six months (all P <0.05). The concentration of FENO had a significant negative correlation with FEV₁ value (all P <0.05) in any time point in the follow-up period. The Asthma Control Test scores were 18±5, 19±7, 23±2, 24±1 and 24±1 at months 1, 3, 6, 9 and 12, respectively, which were significantly different from the score at baseline (14±3) (P <0.05 ). The most rapid clinical effect was observed at the second month after treatment.

Conclusion  Eosinophil counts in induced sputum and FENO are sensitive parameters to detect airway inflammation and may be useful in evaluating the efficacy of treatment and adjusting medication regimens.

     

HIV-1 Nef重组重叠肽诱导小鼠免疫保护作用研究

目的探讨HIV-1 Nef重组重叠肽诱导小鼠细胞免疫应答的效果。方法以HIV-1 LAI Nef重组重叠肽和相应蛋白免疫接种BALB/c和C57BL/10小鼠,每组5例,分离小鼠脾单个核细胞(spleen mononuclear cell,SMC),以ELISPOT和流式细胞术检测特异性细胞应答,以大剂量Nef重组痘苗病毒攻击试验检测重组重叠肽对免疫小鼠的保护作用。结果在C57BL/10小鼠中,佐剂组ELISPOT为阴性,重叠肽组和相应蛋白组LAI Nef特异性细胞免疫应答分别为(145.7±36.2)SFU/106SMC和(24.2±10.2)SFU/106SMC(P=0.001),在BALB/c小鼠中分别为(148.8±50.4)SFU/106SMC和(19.8±9.0)SFU/106SMC(P=0.004),而NL4-3 Nef特异性细胞免疫应答分别为(104.0±33.8)SFU/106SMC和(20.7±9.5)SFU/106SMC。重组重叠肽疫苗诱导的Nef特异性CD4+和CD8+细胞的百分比分别为1.53和0.80。在攻毒试验中,重叠肽组、蛋白组、佐剂组和空白对照组的生存率分别为80%、40%、20%和0%。结论重组重叠肽免疫小鼠可产生具有保护作用的较强的广谱特异性细胞免疫应答,对于不同株系的Nef具有交叉反应,重组重叠肽的免疫接种效果强于相应蛋白。     

Protective effect of low potassium dextran solution on acute kidney injury following acute lung injury induced by oleic acid in piglets

Background  Low potassium dextran (LPD) solution can attenuate acute lung injury (ALI). However, LPD solution for treating acute kidney injury secondary to ALI has not been reported. The present study was performed to examine the renoprotective effect of LPD solution in ALI induced by oleic acid (OA) in piglets.

Methods  Twelve animals that suffered an ALI induced by administration of OA into the right atrium were divided into two groups: the placebo group (n=6) pretreated with normal saline and the LPD group (n=6), pretreated with LPD solution. LPD solution was injected intravenously at a dose of 12.5 ml/kg via the auricular vein 1 hour before OA injection.

Results  All animals survived the experiments with mild histopathological injury to the kidney. There were no significant differences in mean arterial pressure (MAP), creatinin and renal damage scores between the two groups. Compared with the placebo group, the LPD group had better gas exchange parameters at most of the observation points ((347.0±12.6) mmHg vs. (284.3±11.3) mmHg at 6 hours after ALI, P <0.01). After 6 hours of treatment with OA, the plasma concentrations of NGAL and interleukin (IL)-6 in both groups increased dramatically compared to baseline ((6.0±0.6) and (2.50±0.08) folds in placebo group; and (2.5±0.5) and (1.40±0.05) folds in LPD group), but the change of both parameters in the LPD group was significantly lower (P <0.01) than in the placebo group. And 6 hours after ALI the kidney tissue concentration of IL-6 in the LPD group ((165.7 ± 22.5) pg∙ml^-1∙g^-1 protein) was significantly lower (P <0.01) than that in placebo group ((67.2± 25.3) pg∙ml^-1∙g^-1 protein).

Conclusion  These findings suggest that pretreatment with LPD solution via systemic administration might attenuate acute kidney injury and the cytokine response of IL-6 in the ALI piglet model induced by OA injection.

     

Blockade of the OX40/OX40L pathway and induction of PD-L1 synergistically protects mouse islet allografts from rejection

Background OX40/OX40 ligand （OX40/OX40L） and programmed death-1/programmed death ligand-1 （PD-1/PD-L1） co- stimulator/signals play important roles in T cell-induced immune responses. The aim of this study was to investigate the roles of OX40/OX40L and PD-1/PD-L1 costimulatory pathways in mouse islet allograft rejection. Methods Lentiviral vectors containing OX40L siRNA sequences and an adenovirus vector containing the PD-L1 gene were constructed. The streptozotocin-induced model of diabetes was established in C57BL/6 （H-2b） mice. Diabetic C57BL/6 mice were randomly allocated into five groups： group 1, untreated control; group 2, Ad-EGFP treatment; group 3, Ad-PD-L1 treatment; group 4, OX40L-RNAi-LV treatment; group 5, OX40L-RNAi-LV combined with Ad-PD-L1 treatment. Lentiviral vector and the adenovirus vector were injected, singly or combined, into the caudal vein one day before islet transplantation. The islets of DBA/2 （H-2d） mice were transplanted into the renal subcapsular space of the diabetic recipients. Recipient blood glucose and the survival time of the allografts were monitored. Antigen-specific mixed lymphocyte reaction was also evaluated.     

HAART早期AIDS患者CD4~+CD25~+Foxp3~+调节性T细胞的变化及其与免疫活化关系的研究

目的了解高效抗反转录病毒联合疗法(highly active antiretroviral the rapy,HAART)早期AIDS患者CD4+CD25+Foxp3+调节性T细胞(regulatory Tcell,Treg)的变化规律,探讨抗病毒治疗过程中Treg细胞的作用。方法前瞻性分析21例接受HAART规律治疗的AIDS患者,收集患者服药前及服药第2、4、8、12周时的静脉血,采用流式细胞仪胞内染色技术检测CD4+CD25+Foxp3+调节性T细胞的水平,分析Treg细胞在治疗过程中的变化规律,以及Treg细胞的变化与免疫活化间的相关性。结果 HAART治疗开始,Treg细胞计数呈逐渐上升的趋势,前4周呈现快速上升,而后上升速度减慢,Treg百分比变化也有相似的规律;CD8+CD38+表达水平随治疗时间延长而下降,未治疗时Treg细胞计数与免疫活化水平呈负相关,治疗后Treg细胞计数4周内的变化与12周CD8+CD38+水平呈负相关,即治疗开始后,前4周内Treg细胞增加越明显,治疗3个月时免疫活化水平下降越明显。结论抗病毒治疗过程中,活化CD8+淋巴细胞比例的下降与外周血中Treg细胞数的增加相关。Treg细胞数量恢复越早,活化CD8+淋巴细胞比例下降越明显。     

Transesophageal echocardiography guided cannulation for peripheral cardiopulmonary bypass during robotic cardiac surgery

Background  Minimally invasive cardiac surgery and closed chest cardiopulmonary bypass (CPB) techniques continue to evolve. Previous reports have demonstrated the benefits of fluoroscopy guided cannulation for endovascular CPB during port access cardiac surgery. However, few data are available on the role of transesophageal echocardiography (TEE) guided cannulation for peripheral CPB during robotic cardiac surgery. The purpose of this study was to evaluate TEE guided cannulation for peripheral CPB during robotic cardiac surgery.

Methods  We performed a retrospective analysis of intraoperative data of 129 consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB from September 2007 to August 2011, which was established using femoral arterial inflow and kinetic venous drainage by way of the femoral vein and right internal jugular vein and a transthoracic aortic cross clamp. TEE was used to guide cannulation of the inferior vena cava (IVC), superior vena cava (SVC), and ascending aorta (AAO). The success rate and the complication rate of TEE guided cannulation for peripheral CPB were evaluated and compared with the results of fluoroscopy guided cannulation in a historical control group.

Results  One hundred and twenty-nine consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB. There were 67 female (51.9%) and 62 male (48.1%) patients, ranging in age from 13 to 70 years (mean (43.94 ± 13.82) years) and body surface area 1.32 to 2.39 m² (mean (1.71 ± 0.20) m²). Some 61 (47.3%) patients underwent mitral valve repair, 27 (20.9%) mitral valve replacement, 27 (20.9%) left atrial myxoma removal, and 14 (10.9%) ventricular septal defect repair. Of the 129 patients, TEE guided cannulation of the IVC or SVC was successful in all patients (100%), and no puncture related complications occurred in all patients. Of the 129 patients, successful cannulation of the AAO was achieved in all patients (100%), and aortic perforation occurred in 1 patient (0.78%) under TEE guidance. Of the 42 patients in the historical control group, successful cannulation occured in 39 patients (92.86%), and major complications occurred in 3 patients (7.14%) under fluoroscopy guidance. TEE guided cannulation of the AAO significantly improved success rate (100% vs. 92.86%, P=0.014) and decreased complication rate (0.78% vs. 7.14%, P=0.046).

Conclusion  TEE may be useful in guiding successful placement of the cannulae in the IVC, SVC, and AAO in the establishment of peripheral CPB during robotic cardiac surgery.

     

Outcome of in vitro fertilization in endometriosis-associated infertility: a 5-year database cohort study

Background  Endometriosis affects natural fertility through various approaches, and in vitro fertilization (IVF) is a good treatment. But the IVF result of endometriosis patients is still under debate. We investigated the effect of endometriosis on IVF by analyzing the data from a single reproductive center.

Methods  A retrospective, database-searched cohort study was performed. Relevant information was collected from the electronic records of women who underwent IVF/intracytoplasmic sperm injection between January 2006 and December 2010 in the Assisted Reproductive Unit of Sir Run Run Shaw Hospital. Patients with endometriosis were enrolled the study group. The rest of the women formed the control group. The main outcome was the clinical pregnancy rate. Secondary outcomes were oocytes retrieved number, fertilization rate, high-quality embryo rate, number of high-quality embryo for embryo transplantation, and implantation embryo/high-quality embryo ratio (IE/HQE ratio). Comparisons were performed by the  c²-test and independent t-test.

Results  The endometriosis group (n=177) had a markedly lower oocytes retrieved number, fertilization rate, implantation rate, and clinical pregnancy rate (7.6±5.1, 63.6%, 27.7%, and 45.2%, respectively) compared with the non-endometriosis group (n=4267; 11.8±7.3, 68.4%, 36.2%, and 55.2%, respectively).  Stratified analysis showed that this difference was found in the subgroup younger than 35-years old, while only fertilization rate and implantation rate were different in the elder subgroup. The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs. 71.8%, P <0.05), but there is no difference in IE/HQE ratio between two groups. There is no significant difference in fertilization rate, implantation rate, and clinical pregnancy rate between mild and severe endometriosis patients.

Conclusions  Endometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate, regardless of the severity of the disease. Appropriate intracytoplasmic sperm injection manipulation might improve the outcomes of IVF.

     

Overexpression of interleukin-l7 in tumor-associated macrophages is correlated with the differentiation and angiogenesis of laryngeal squamous cell carcinoma

Background  Interleukin-l7 (IL-17), which exerts strong pro-inflammatory effects, has emerged as an important mediator in inflammation-associated cancer. The aim of this study was to clarify the relationship between IL-17 and tumor associated macrophages (TAMs), and the correlation of the microvessel density in the development of laryngeal squamous cell carcinoma (LSCC).

Methods  Histopathological observations and immunohistochemistry staining for IL-17, CD68, and CD34 were performed on 72 specimens (32 cases of LSCC, 20 cases of adjacent tissues of carcinoma as controls, and 20 cases of chronic hypertrophic laryngitis). Double immunohistochemical staining was done to determine which cells expressed IL-17. Real-time quantitative PCR determined the mRNA expression of IL-17. ELISA was used to detect the expression of the serum level of IL-17 in the three groups.

Results  The inflammation response had increased in LSCC. Overexpression of IL-17 and CD68 protein were seen in LSCC (P <0.01). The expression of IL-17 was different between well and poorly differentiated LSCC (P <0.01). The IL-17 expressing cells were mainly located in macrophages (CD68⁺/IL17⁺) as demonstrated by double immunohistochemical staining. IL-17 expression significantly correlated with high microvessel density (CD34⁺) in LSCC (P <0.05). Relatively higher mRNA expression levels of IL-17 were seen in LSCC compared to the controls (P <0.05). The serum expression of IL-17 was similar among the three groups (P >0.05).

Conclusion  IL-17 was expressed by TAMs, and IL-17 may significantly correlate to the differentiation and angiogenesis in the development of LSCC.