哮喘患者支气管肺泡灌洗液和外周血CD_4~＋T细胞活化与白细胞介素-5释放水平的观察

为探讨Ｔ淋巴细胞功能异常与哮喘发病的关系，对１２例过敏性哮喘患者、１０例非过敏性哮喘患者、９例非哮喘过敏患者和１０例正常人的支气管肺泡灌洗（ＢＡＬ）液细胞和外周血单个核细胞（ＰＢＭＣ），分别在有无过敏原刺激条件下在体外进行培养，观察辅助（ＣＤ＋４）Ｔ细胞活化状态和白细胞介素（ＩＬ）－５释放水平。结果表明，过敏性与非过敏性哮喘组ＢＡＬ液细胞和ＰＢＭＣ在无刺激培养条件下，ＣＤ＋４Ｔ细胞活化数量及释放ＩＬ－５水平均显著增高；过敏性哮喘组患者Ｔ细胞对过敏原的反应性明显高于非过敏性哮喘组（Ｐ值均＜０．０１）；非哮喘过敏症组患者ＰＢＭＣ在过敏原刺激下，ＣＤ＋４Ｔ细胞活化数量和上清液ＩＬ┐５含量显著增加，但其ＢＡＬ液细胞在过敏原刺激下培养，释放ＩＬ┐５水平仍然显著低于两哮喘组（Ｐ值均＜０．０１）。研究表明，支气管┐肺局部ＣＤ＋４Ｔ细胞活化程度和ＩＬ┐５释放能力在哮喘发病中起重要作用。     

地塞米松对哮喘患者IL—4,IL—5及IgE合成的抑制作用观察

观察了地塞米松（Ｄｅｘ）对哮喘患考外周血单个核细胞（ＰＢＭＣ）合成白介素－４（ＩＬ－４）、白介素－５（ＩＬ－５）和免疫球蛋白Ｅ（ＩｇＥ）的抑制作用。结果证明，哮喘１组（仅用植物血凝素，简称ＰＨＡ）ＰＢＭＣ合成ＩＬ－４、ＩＬ－５、ＩｇＥ较对照组（仅用ＰＨＡ）明显增高（Ｐ＜０．０１），哮喘２组（ＰＨＡ＋Ｄｅｘ）ＰＢＭＣ合成ＩＬ－４、ＩＬ－５、ＩｇＥ较哮喘１组显著下降（Ｐ＜０．０５）。认为Ｄｅｘ治疗哮喘的机理，部分是通过减少ＩＬ－４ＩＬ－５、ＩｇＥ的合成而达到抗炎的目的。     

C—erbB—2P185蛋白在多形性腺瘤中的表达及意义

应用免疫组织化学ＳＡＢＣ法对５２ 例良性多形性腺瘤（ＢＰＡ）、１３ 例恶性多形性腺瘤（ＭＰＡ）患者及６ 例正常涎腺（对照组）者涎腺组织中的Ｃ－ｅｒｂＢ－２Ｐ１８５ 蛋白进行检测,结果：Ｃ－ｅｒｂＢ－２Ｐ１８５ 蛋白阳性表达率在对照组为０,ＢＰＡ组为６９．２３％ ,ＭＰＡ组为９２．３１％ ;ＢＰＡ组、ＭＰＡ组与对照组比较有极显著差异（Ｐ＜ ０．００１）,ＢＰＡ组与ＭＰＡ组之间亦有显著差异（Ｐ＜ ０．０１）。提示Ｃ－ｅｒｂＢ－２Ｐ１８５ 蛋白在涎腺多形性腺瘤的发生、发展过程中起重要作用。     

多发性骨髓瘤克隆起源的研究

为了解外周血中肿瘤克隆细胞的分化阶段，进一步研究ＭＭ（多发性骨髓瘤）发病机理，采用针对Ｂ细胞不同分化阶段抗原ＣＤ１０、ＣＤ１９、ＣＤ２０、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ、ＣＤ３８的单克隆抗体，用ＡＰＡＡＰ法（碱性磷酸酶抗碱性磷酸酶法）同时检测１７例外周血中不含浆细胞的ＭＭ患者骨髓及外周血的免疫表型，其中１０例外周血表达浆细胞抗原增高（Ｐ＜０．００１）且与骨髓一致。９例外周血表达ＣＤ３８和ＣＤ４５ＲＯ，３例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ，１例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＡ和ＣＤ１０。此结果显示ＭＭ患者外周血的Ｂ系抗原表达既与骨髓具有一致性，又具多样性，提示ＭＭ的外周血中存在多分化阶段的肿瘤前体细胞，呈现自早期Ｂ细胞，经活化Ｂ细胞及晚期Ｂ细胞向前浆细胞的持续分化过程，并验证了文献关于ＭＭ发病途径的推测。     

糖皮质激素对哮喘患者白细胞介素-5mRNA表达与嗜酸性粒细胞激活作用的影响

为了观察糖皮质激素对哮喘患者白细胞介素（ＩＬ）－５ｍＲＮＡ表达与嗜酸性粒细胞激活作用的影响，本研究用逆转录（ＲＴ）－聚合酶链反应（ＰＣＲ）法半定量分析了哮喘患者用糖皮质激素治疗前后外周血单个核细胞（ＰＢＭＣ）中ＩＬ－５ｍＲＮＡ表达水平的变化，检测了血清嗜酸细胞阳离子蛋白（ＥＣＰ）浓度、一秒钟用力呼气容积（ＦＥＶ１）下降２０％时的乙酰甲胆碱（ＭＣＨ）激发浓度（ＭＣＨ－ＰＣ２０值）和基础ＦＥＶ１占用力肺活量比值（ＦＥＶ１％）等指标。结果发现，糖皮质激素不仅能改善哮喘患者的气道高反应性和通气功能，而且还可抑制ＰＢＭＣ中ＩＬ－５ｍＲＮＡ的表达和降低血清ＥＣＰ浓度（Ｐ＜０．０５）；血清ＥＣＰ浓度下降幅度或ＭＣＨ－ＰＣ２０值改善幅度与ＩＬ－５ｍＲＮＡ表达水平下降幅度之间均呈显著正相关（ｒ分别为０．５４２６和０．４８５７，Ｐ值＜０．０５）。提示糖皮质激素可能是通过抑制ＩＬ－５基因的转录，从而抑制后者对嗜酸性粒细胞的活化，而发挥其抗气道炎症反应和降低气道高反应性的作用。     

低亲和力IgE受体与外源性支气管哮喘

本文对３０例外源性哮喘患者及３０例正常人的外周血单个核细胞（ＭＮＣ）低亲和力ＩｇＥ受体（即ＣＤ２３）表达、白细胞介素－４（ＩＬ－４）及血清ＩｇＥ水平进行测定。结果显示：发作组哮喘患者ＩｇＥ、ＩＬ－４、ＣＤ２３与缓解组及正常对照组之间有显著性差异（Ｐ＜０．０１）。且ＩｇＥ升高与ＣＤ２３呈正相关（ｒ＝０．８２７；Ｐ＜０．０１）。缓解组ＩｇＥ抗体、ＩＬ－４与正常对照组之间无显著性差异（Ｐ＞０．０５）；ＣＤ２３与正常对照组之间有显著性差异（Ｐ＜０．０ｌ）。以上结果表明了这一细胞因子的失衡与外源性哮喘的关系。     

CD^＋4淋巴细胞ICAM—1表达水平与类风湿性关节炎发病的相关性研究

利用流式细胞技术对２０例类风湿性关节炎患者和１０例正常志愿者检测外周血ＣＤ＋４淋巴细胞ＩＣＡＭ－１（ＣＤ＋４／ＣＤ５４）表达水平。患者组ＣＤ＋４／ＣＤ５４表达水平为（１７．８８±１２．４６）％,正常对照组为（０．４８±０．８８）％;８例患者治疗前后ＣＤ＋４／ＣＤ５４表达水平有显著性差别（Ｐ＜０．０１）,ＣＤ＋４／ＣＤ５４表达水平与类风湿性关节炎患者临床各参数（除关节肿胀数外）呈明显正相关（Ｐ＜０．０５）。ＣＤ＋４淋巴细胞及其膜表面ＩＣＡＭ－１表达在本病的发生发展中可能有关键性作用     

汉族类风湿关节炎患者HLA—DR和—DQ基因分型研究

为探讨ＨＬＡ－ＤＲ和－ＤＱ等位基因与我国汉族类风湿关节炎（ＲＡ）的相关性，采用聚合酶链反应－限制性内切酶片段长度多态性分析（ＰＣＲ－ＲＦＬＰ）方法对汉族人群中３５例ＲＡ患者和１００名健康人的ＤＲ和ＤＱ位点进行ＤＮＡ定型分析。结果发现，ＤＲ４频率在正常人为２４．０％，在ＲＡ患者为５１．４％（Ｐ＜０．０１，ＲＲ＝３．３０）；ＤＲ４亚型位点分析发现２组均以ＤＲＢ１＊０４０５占多数，但ＤＲＢ１＊０４０５频率在ＲＡ组为３１．４％，高于正常人的１０．０％（Ｐ＜０．０１）。ＤＱ４频率在全部ＲＡ患者为３７．１％，在ＤＲ＋４ＲＡ患者为７２．２％，均高于全部正常人的１０．０％（Ｐ＜０．０１）和ＤＲ＋４正常人的４１．６％（Ｐ＝０．０３７６）；ＤＲ＋４－ＤＱ＋４ＲＡ患者的病情重于ＤＲ－４患者。结果提示，ＤＲ４、主要是ＤＲＢ１＊０４０５与ＲＡ相关，ＤＱ４可增加ＤＲ４对ＲＡ的易感性，ＤＲ＋４－ＤＱ＋４单倍型是ＲＡ病情严重程度的标志。     

慢性阻塞性肺疾病气道上皮细胞间粘附分子1及人类白细胞？…

目的 探讨慢性阻塞性肺疾病（ＣＯＰＤ）气道上皮细胞间粘附分子１（１ＣＡＭ－１）和人类白细胞ＤＲ抗原（ＨＬＡ－ＤＲ）表达。方法 对１０例ＣＯＰＤ患，７例支气管哮喘患，９例慢性支气管炎患和１０名健康自愿气道上皮细胞进行了ＩＣＡＭ－１和ＨＬＡ－ＤＲ的免疫组化检查，对上皮细胞作染色进行分类检查。结果 在气道刷检所获细胞分类中ＣＯＰＤ组中性粒细胞占０．０４，与哮喘组（０．０１）和健康组（０．０１）比     

哮喘患者外周血单个核细胞白细胞介素—4和介素—5的基因表达

为进一步了解激素抵抗型哮喘的发病与细胞免疫功能紊乱的关系，应用地高辛标记ｃＤＮＡ探针、抗地高辛抗体－碱性磷酸酶检测系统行细胞涂片原位杂交，测定了１５例激素抵抗（ＳＲ）型和１５例激素敏感（ＳＳ）型哮喘患者外周血单个核细胞（ＰＢＭＣｓ）中白细胞介素（ＩＬ）－４和ＩＬ－５基因的ｍＲＮＡ表达。结果显示：（１）单独培养的ＳＲ型和ＳＳ型哮喘患者的外周血单个核细胞中ＩＬ－４ｍＲＮＡ和ＩＬ－５ｍＲＮＡ阳性细胞率差异无显著性（Ｐ＞０．０５）。（２）与氟美松（１０－７ｍｏｌ／Ｌ）共同培养４８小时后，ＳＳ型哮喘患者的外周血单个核细胞中ＩＬ－４ｍＲＮＡ和ＩＬ－５ｍＲＮＡ阳性细胞率较单独培养时明显减少（Ｐ＜０．０１）；而在ＳＲ型患者中则无明显改变（Ｐ＞０．０５）。提示氟美松不能有效地抑制ＳＲ型哮喘患者的外周血单个核细胞中ＩＬ－４和ＩＬ－５基因的ｍＲＮＡ表达，这可能是发生激素抵抗的机制之一。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.