肾移植患者外周血中的CD4+ CD25+ CD127low/-调节性T细胞

背景：越来越多的实验在分析免疫耐受标志,以期能够更好地辅助患者进行移植后免疫抑制治疗。 目的：分析肾移植后患者外周血中CD4+ CD25+ CD127low/-调节性T细胞在肾移植免疫耐受中的作用。 方法：采集62例肾移植后患者(急性排斥反应组22例,移植稳定组40例)及20例健康对照者的外周抗凝血,经免疫染色,应用流式细胞仪分析CD4+ CD25+ CD127low/-调节性T细胞所占CD4+ T细胞百分含量,同时采用ELISA方法检测患者血清中白细胞介素2和白细胞介素10的质量浓度。 结果与结论：移植稳定组中CD4+ CD25+ CD127low/-调节性T细胞所占CD4+ T细胞百分含量显著高于健康对照组和急性反应排斥组(P < 0.01);CD4+ CD25+ CD127low/-调节性T细胞百分含量与白细胞介素2呈显著负相关(P < 0.05),与白细胞介素10呈显著正相关(P < 0.01)。提示CD4+ CD25+ CD127low/-调节性T细胞在肾移植后免疫耐受的机制中发挥了一定作用。     

血红素加氧酶1在间充质干细胞上调哮喘患者外周血调节性T细胞中的作用

背景：上调CD4+CD25+CD127low/-调节性T细胞是目前治疗哮喘的新靶点。骨髓间充质干细胞在体外可上调正常人外周血的调节性T细胞,但机制尚未明确。 目的：观察血红素加氧酶1对间充质干细胞上调哮喘患者外周血CD4+CD25+CD127low/-调节性T细胞的影响。 方法：分别加入0,15,30,45,60 μmol/L氯化高铁血红素和0,5,10,15,20 μmol/L锌-原卟啉对骨髓间充质干细胞进行预处理,荧光定量PCR检测各组间充质干细胞中血红素加氧酶1 mRNA的表达量。密度梯度离心法分离哮喘急性发作期患者和健康对照者的外周血单个核细胞,分别与经氯化高铁血红素预处理、经锌-原卟啉预处理、不经预处理的间充质干细胞共孵育,加入植物血凝素反应72 h,流式细胞仪检测各组CD4+CD25+CD127low/-调节性T细胞占CD4+T细胞的比例。 结果与结论：人骨髓间充质干细胞中有血红素加氧酶1表达,其表达在体外可被诱导和抑制。间充质干细胞中血红素加氧酶1 mRNA的表达量随氯化高铁血红素浓度增加而增加(P < 0.05),随锌-原卟啉浓度增加而减少(P < 0.05),具有剂量依赖性。间充质干细胞在体外可提高哮喘患者和健康对照者CD4+CD25+CD127low/-调节性T细胞的水平(P < 0.01),诱导间充质干细胞中血红素加氧酶1的表达可使共孵育后CD4+CD25+CD127low/-调节性T细胞水平提高(P < 0.01),抑制间充质干细胞中血红素加氧酶1的表达可使共孵育后CD4+CD25+CD127low/-调节性T细胞的水平降低(P < 0.01),但仍高于对照组(P < 0.01)。提示骨髓间充质干细胞部分通过血红素加氧酶1上调哮喘患者外周血CD4+CD25+CD127low/-调节性T细胞。     

外周血CD4+CD25highTreg细胞的比例变化在肾移植受者术后免疫监测中的临床应用研究

目的 研究外周血CD4+CD25highTreg细胞(regulatory T cell,Treg)比例对肾移植受者免疫力的影响,为CD4+CD25highTreg细胞的比例变化作为评估移植受者免疫状态及作为预测排斥反应和感染的特异性指标提供实验依据。方法 肾移植受者52例按肾移植术后恢复情况分为免疫力正常组26例,发生排斥反应组17例,发生感染组9例,用流式细胞仪检测外周血CD4+CD25highTreg细胞的比例,所得结果进行相关分析。结果 发生急性排斥反应组CD4+CD25highTreg细胞比例较免疫力正常组显著降低（p〈0.05）,发生感染组外周血CD4+CD25highTreg细胞的比例较正常组显著升高（p〈0.01）,均有统计学意义。FK-506和CsA分别对CD4+CD25highTreg细胞比例的影响没有显著性差异。结论 肾移植术后受者外周血CD4+CD25highTreg细胞比例与受者免疫状态密切相关。CD4+CD25highTreg细胞比例的变化可以反应机体的免疫状态的变化,其升高或降低可以作为预测肾移植受者术后发生感染或排斥反应的指标之一。     

CD4~+、CD25~+、CD127 low调节T细胞及CD16~+、CD56NK细胞在脑梗死急性期患者外周血中的表达及其关系

目的探讨脑梗死(CI)患者外周血中CD4+、CD25+、CD127 low调节T细胞及CD16+、CD56NK细胞的百分比变化及两者在CI患者免疫反应中的相互作用机制。方法采用流式细胞术检测50例急性CI患者(发病2d)外周血中CD4+、CD25+、CD127 low调节T细胞及CD16+、CD56NK细胞的表达水平,并与健康对照组进行比较。结果急性CI患者(发病2d)外周血中的CD4+、CD25+、CD127 low调节T细胞的表达水平低于健康对照组,而CD16+、CD56NK细胞的数量则明显高于健康对照组(p<0.05)。结论急性CI患者发病2d,CD16+、CD56NK细胞表达水平上升,而CD4+、CD25+、CD127 low调节性T细胞表达明显低于健康对照组,说明CD4+、CD25+、CD127 low调节性T细胞和CD16+、CD56NK细胞是促进CI发生的原因之一。     

重症肌无力患者外周血调节性T细胞及B细胞激活因子受体的分析

目的 研究重症肌无力(MG)患者外周血多群调节性T细胞的水平及其B细胞表达B细胞激活因子受体(B cell-activating factor receptor,BAFF-R)的情况.方法 应用四色流式细胞仪检测61例MG患者与23名健康对照外周血调节性T细胞(CD4+ CD25 high Foxp3+、CD8+ CD28-、CD8+ CD122+)以及CD19+ BAFF-R+细胞的百分率.结果 MG组与健康对照组外周血CD4+ CD25 high Foxp3+ T细胞的百分率分别为32.12%±16.12%与65.15%±14.72%,MG组该群调节性T细胞的水平明显低于健康对照组(P＜0.01);两组CD8+ CD28-及CD8+ CD122+ T细胞的水平差异无统计学意义.此外,MG组外周血CD19+ BAFF-R+细胞的水平(10.57%±5.59%)显著高于健康对照组(5.38%±3.87%,P＜0.01).大剂量激素或大剂量激素加丙种球蛋白治疗后短期内可使MG组外周血CD4+ CD25 high Foxp3+调节性T细胞的百分率增加(P＜0.05).结论 MG患者Foxp3+的CD4+ CD25 high调节性T细胞的减少提示MG患者存在免疫和耐受的失衡,显示了T细胞的自身免疫性.在B细胞方面,MG患者外周血CD19+ B细胞上BAFF-R表达增高,提示其体内B细胞已处于易激活状态.     

肾移植术后受者外周血淋巴细胞的早反应基因表达谱变化

背景：同种异体免疫应答过程中有许多基因参与淋巴细胞的活化及其调控。 目的：研究肾移植后受者外周血淋巴细胞差异表达基因,尤其是早反应基因。 设计、时间及地点：基因水平的对照观察实验,于2003-09/2004-02在解放军第二军医大学长征医院泌尿外科及器官移植中心以及上海博星基因芯片公司完成。 对象：选取无明显急性排斥反应的同种异体肾移植受者16例。 方法：应用包含4 096个人cDNA克隆的微矩阵芯片,分析肾移植受者移植后24 h外周血淋巴细胞的基因表达谱。每位受者于移植前当日和术后24 h分别抽取外周血10 mL,分离外周血淋巴细胞。16例受试者同一时间点的淋巴细胞混合。按一步法抽提两个时间点细胞总RNA并纯化mRNA,分别反转录合成、标记cDNA探针,与包含4 096个人cDNA克隆的微矩阵芯片杂交,结果通过生物信息学方法分析。 主要观察指标：差异表达的基因。 结果：肾移植后24 h与移植前相比,肾移植受者外周血淋巴细胞差异表达的基因共有216个,其中下调基因103个,上调基因113个。这些基因主要涉及细胞信号转导、细胞凋亡等多个种类。 结论：肾移植后24 h,基因芯片技术可有效地筛选出受者外周血淋巴细胞早反应基因的差异表达。     

肝移植后他克莫司血药浓度对外周血单个核细胞内HBV DNA的影响

背景：肝移植后他克莫司等免疫抑制剂的长期应用导致机体细胞免疫功能降低,并有可能影响机体对乙肝病毒的清除。 目的：分析乙肝相关肝移植患者后不同浓度他克莫司对外周血单个核细胞中的HBV DNA含量的影响。 方法：纳入乙肝相关终末期肝病肝移植受者23例,根据移植后12周清晨空腹他克莫司血药浓度,分为高浓度组(≥ 10 μg/L) 9例和低浓度组(< 10 μg/L)14例,同时用荧光标记单克隆抗体结合流式细胞技术检测外周血T细胞亚群的百分比,用实时荧光定量PCR检测外周血单个核细胞内的HBV DNA。 结果与结论：用多元线性回归分析外周血单个核细胞内的HBV DNA含量与CD8+CD152+呈正相关,与CD8+CD28+呈负相关。高血药浓度他克莫司的患者外周血单个核细胞内的HBV DNA高于低浓度组,其改变与反映细胞免疫功能的指标CD8+CD152+和CD8+CD28+的变化有关。     

胚胎骨髓来源间充质干细胞对人Th17细胞的免疫调节*☆◆

背景：众多研究表明间充质干细胞能发挥免疫调节功能,抑制T细胞增殖。 目的：观察胚胎骨髓来源间充质干细胞对人Th17细胞的调节作用。 方法：将人胚胎骨髓间充质干细胞与正常人外周血单个核细胞或CD4+ T细胞以1∶10比例共培养4 d,以单个核细胞或CD4+T细胞单独培养为对照。应用实时定量PCR检测细胞白细胞介素17 mRNA表达,酶联免疫吸附试验检测细胞上清中白细胞介素17蛋白水平,流式细胞术检测Th17细胞数量。 结果与结论：胚胎骨髓来源间充质干细胞与单个核细胞共培养组白细胞介素17 mRNA表达水平明显高于单个核细胞组(P < 0.01)。与此一致的是,胚胎骨髓来源间充质干细胞与单个核细胞或CD4+T细胞共培养组细胞上清中白细胞介素17蛋白水平明显高于单个核细胞组、CD4+ T细胞组(P < 0.05,P < 0.01)。胚胎骨髓来源间充质干细胞与CD4+ T细胞共培养组Th17细胞数量明显高于CD4+ T细胞组(P < 0.01),但胚胎骨髓来源间充质干细胞本身并不表达白细胞介素17。表明胚胎骨髓来源间充质干细胞可促进人Th17细胞增殖。     

急性髓细胞性白血病患者外周血单个核细胞CD28 mRNA的表达

背景：大量研究显示,肿瘤患者外周血T细胞表面共刺激分子CD28蛋白表达存在差异,提示共刺激通路异常可能与恶性肿瘤的发生进展有关。 目的：观察急性髓细胞性白血病外周血单个核细胞共刺激信号分子CD28 mRNA在中的表达。 方法：急性髓细胞性白血病患者80例,其中M0型7例,M1型6例,M2型18例,M3型15例,M4型17例,M5型9例,M6型8例。并根据急性白血病疗效标准将80例患者分为完全治愈组、缓解组、未缓解组。采用Taqman探针实时荧光定量PCR检测80例患者及76名健康人群外周血单个核细胞CD28 mRNA的表达。 结果与结论：急性髓细胞性白血病外周血单个核细胞M1,M3和M4亚型中的CD28 mRNA表达量低于健康人群 (P < 0.05);急性髓细胞性白血病未缓解组中CD28 mRNA低于健康人群 (P < 0.05),完全治愈组和缓解组中CD28 mRNA表达与健康人群差异无显著性意义。说明急性髓细胞白血病患者外周血单个核细胞存在CD28 mRNA表达缺陷,并与临床分期、病情进展及预后有关。     

大鼠脑局灶缺血／再灌注对外周血单个核CD34^＋细胞的影响

目的本研究探讨大鼠脑局灶缺血/再灌注是否影响外周血单个核CD34+细胞的数量.方法采用大鼠大脑中动脉(MCA)缺血/再灌注线栓法模型,将大鼠随机分为3组对照组,假手术组,动物模型组.取再灌注后1、3、6、12 h和1、2、3、4、7、14 d,10个观察点,测外周血单个核CD34+表达情况.结果大鼠脑缺血/再灌注模型中外周血单个核CD34+细胞在再灌注后1 h～2 d无明显变化,在脑缺血/再灌注后3～7 d明显减少,14 d后恢复.结论大鼠脑缺血/再灌注模型再灌注后1 h～2 d再灌注后外周血单个核CD34+细胞没有变化,在脑缺血/再灌注后3～7 d明显减少.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。