过敏性哮喘发作期患者T淋巴细胞亚群及IgE变化

应用免疫组化技术检测 2 8例过敏性哮喘发作期病人外周血T细胞亚群 ,采用ELISA双抗体夹心法测定血清IgE和白细胞介素 -4 (IL -4 )水平。结果过敏性哮喘患者发作期血清IgE、IL -4水平明显升高 ,CD+ 8下降 ,CD+ 4/CD+ 8比值升高 ,与缓解期和对照组差异有高度显著性 (P <0 .0 1) ,且血清IgE与IL -4水平有明显的正相关 (r =0 .796)。说明T淋巴细胞激活及其释放的IL -4在哮喘发病中起重要作用 ,IgE合成增加是过敏性哮喘发作的关键。     

医学生外周血T细胞mIL-2R的表达

目的:测定正常医学生外周血T细胞数量及其亚群比例和活化后mIL-2R的表达水平,为正常机体细胞免疫功能状态提供参考数据.方法:用生物素-链霉亲和素法对49名在校医学生外周血T淋巴细胞亚群及mIL-2R进行检测.结果:男生外周血淋巴细胞中总T细胞亚群(CD3+)占(64.90±4.11)%,其中CD4+和CD8+ T细胞亚群分别为(42.84±4.08)%和(30.23±2.03)%,CD4+/CD8 +比例为1.42±0.10;植物血凝素(PHA)诱导前后淋巴细胞的mIL-2R表达水平分别为(3.08± 1.22)%和(3 1.76±3.52)%;女生T细胞亚群阳性百分率分别为CD3+(66.61±3.36)%、CD4+(43.83± 3.85)%、CD8+(29.06±2.53)%、CD4+/CD8+1.52±0.16,PHA诱导前后的mI L- 2R表达水平分别为(3.48±1.41)%和(34.58±3.05)%.虽然女生CD3+、CD4+和mIL- 2R表达水平偏高,CD8+偏低,但差异均无显著性(P＞0.05);女生CD4+/CD8+ 比值及诱导期mIL-2R表达水平较男生增高(P＜0.05和P＜0.01). 结论:医学生外周血T淋巴细胞亚群的百分率均在正常范围,男生和女生之间无明显差异,但女生CD4+/CD8+比值较高;PHA刺激诱导mIL-2R正常表达,但在女生较高.     

小儿支气管哮喘发作期细胞免疫及体液免疫的改变

目的 :对 84例支气管哮喘发作期患儿进行了外周血T淋巴细胞亚群及总IgE测定 ,并与健康儿童对照组进行比较。方法 :采用单克隆抗体检测T淋巴细胞亚群试剂盒检测病儿外周血T淋巴细胞亚群阳性细胞百分率 ;应用微粒子化学发光法测定外周血总IgE水平。结果 :哮喘组中CD4+ 平均值为 47.2 8± 8.6 4,对照组平均值为 31.10± 6 .86 ,CD4+ 值高于对照组 (P <0 0 5 ) ;哮喘组CD8+ 平均值 32 .19± 5 .2 1,对照组平均值为 37.14± 5 .6 1,CD8+ 值低于对照组 (P <0 .0 5 )。哮喘组总IgE平均值为 80 4± 14 4 ,对照组平均值为 2 76± 12 5 ,总IgE值高于对照组 (P <0 .0 5 )。结果提示 :小儿支气管哮喘发作期CD4+ 细胞升高 ,CD8+ 细胞下降和血清总IgE升高。     

哮喘患儿外周血淋巴细胞亚群和CD4+ T细胞亚群的变化情况

目的 小儿哮喘的发生发展受免疫系统的影响,本文探讨哮喘患儿外周血淋巴细胞亚群和CD4+T细胞亚群的变化情况,探讨其临床意义。 方法 选择2013年1月-2015年12月哮喘患儿80例作为哮喘组,健康体检儿童80例作为对照组。测定外周血淋巴细胞亚群和CD4+T细胞亚群含量。 结果 哮喘组CD3+、CD4+、CD19+、CD4+/CD8+[(62.13±11.24)%、(32.97±6.57)%、(24.35±11.21)%、(1.66±0.31)%]高于对照组[(71.16±12.64)%、(37.68±7.12)%、(13.87±8.46)%、(1.43±0.28)%,P<0.05],哮喘组CD8+[(19.87±4.21)%]低于对照组[(26.37±4.65)%。P<0.05]。哮喘组Th2、Th17、Treg、Th17/Treg[(4.42±2.14)%、(1.71±0.97)%、(7.65±1.35)%、(0.22±0.05)%]均高于对照组[(1.96±1.25)%、(0.89±0.42)%、(5.91±1.28)%、(0.15±0.03)%,P<0.05],哮喘组Th1/Th2[(1.31±1.32)]低于对照组[(2.70±1.47),P<0.05],2组Th1比较差异无统计学意义(P>0.05)。哮喘组淋巴细胞[(36.57±13.24)%]低于对照组[(59.64±15.47)%,P<0.05],哮喘组单核细胞[(12.17±4.21)%]高于对照组[(3.68±1.74)%,P<0.05],2组白细胞和中性粒细胞比较差异无统计学意义(P>0.05)。淋巴细胞与Th1、Th2、Th17呈负相关(P<0.05),单核细胞与CD3+、CD4+、CD19+呈负相关(P<0.05),与CD8+呈正相关(P<0.05)。 结论 哮喘患儿存在淋巴细胞亚群和CD4+T细胞亚群异常,外周血淋巴细胞亚群和CD4+T细胞亚群含量可用于哮喘患儿免疫功能判断。      

淋巴细胞检查在慢性阻塞性肺疾病(COPD)中的临床应用

目的:探讨慢性阻塞性肺疾病慢(COPD)患者T淋巴细胞亚群的变化及其临床意义。方法:将100例COPD患者及30例门诊体检健康者进行T细胞亚群检测。T淋巴细胞亚群(CD3+、CD4+、CD8+细胞)比例采用直接免疫荧光标记的流式细胞分析测定。结果:100例COPD患者组外周血中,CD3+细胞比例(68.23±7.32),与30例对照组CD3+细胞比例(67.57±4.85)差异无统计学意义(P>0.05)。CD4+细胞比例(35.77±4.71)及CD4+/CD8+比值(1.25±0.36)都有降低,与30例对照组比较CD4+细胞比例(40.85±3.58),CD4+/CD8+比值(2.09±0.45)差异有统计学意义(P<0.001)。而CD8+细胞比例(25.32±6.15)提高,和对照组(20.28±3.20)比较,差异有统计学意义(P<0.001)。结论:COPD患者存在细胞免疫功能异常,CD4+T淋巴细胞比及CD4+/CD8+比值下降,而CD8+T淋巴细胞免疫反应加强,是COPD发病机制之一。     

肺炎支原体感染后患儿血清免疫球蛋白及T淋巴细胞亚群的动态变化分析

目的 探究肺炎支原体感染后患儿血清免疫球蛋白及T淋巴细胞亚群的动态变化分析情况.方法 便利选取该院2014年4月-2016年4月期间确诊的肺部支原体感染患儿70例为观察组,选取同时期于该院体检的健康小儿45名为对照组,抽取两组研究对象外周血以免疫散射比浊法和流式细胞术进行检测.比较两组在IgG﹑IgM﹑IgA血清免疫球蛋白与CD3+﹑CD4+﹑CD4+/CD8+T淋巴细胞亚群的变化情况.结果 观察组患儿血清免疫球蛋白检测中IgG﹑IgM及IgA水平均低于对照组健康小儿.观察组急性期患儿血清免疫蛋白中IgG(9.12±1.48)g/L﹑IgM(0.76±0.41)g/L﹑IgA(1.03±0.19)g/L与对照组相比差异有统计学意义(P<0.05),且观察组急性期IgG﹑IgM﹑IgA水平略低于恢复期(P<0.05).②观察组患者各时期T淋巴细胞亚群中CD3+﹑CD4+﹑CD4+/CD8+均分别低于对照组,差异有统计学意义(P<0.05).观察组各时期CD8+(34.27±3.48)%均高于对照组,且观察组急性期CD3+(59.56±7.34)%﹑CD4+(40.38±7.23)%﹑CD4+/CD8+(1.14±0.53)%与恢复期比较差异有统计学意义(P<0.05).结论 小儿肺炎支原体感染后,在急性期与恢复期的血清免疫球蛋白及T淋巴细胞亚群均出现不同幅度的变化,MP与机体免疫反应存在相关,可据此做出相对应的MP诊治方案.     

儿童哮喘血免疫球蛋白和T细胞亚群的动态观察及临床意义

目的　探讨儿童哮喘发作期与缓解期血免疫球蛋白和T细胞亚群的动态变化及临床意义 ;方法　应用免疫荧光技术对 38例哮喘患儿的哮喘发作期与缓解期和 2 0例健康对照儿童的外周血免疫球蛋白和T细胞亚群进行测定 ;结果　 (1 )哮喘发作期lgG ;1 1 .83± 7.54与对照组 1 0 .1 6± 2 .65比较有显著差异 (P <0 .0 5) ;(2 )哮喘发作期及缓解期CD3 +、CD4+、CD4+/CD8+值与正常对照组比较有显著差异 (P <0 .0 5) ;发作期及缓解期CD8+与对照组比较无明显差异 (P >0 .0 5) ;结论　儿童哮喘存在着lgG的改变 ,CD4+T细胞增加 ,CD8+T细胞数量或和功能不足导致免疫功能紊乱是哮喘的主要发病机制。     

T淋巴细胞亚群、血清TNF-α、IgE水平在肺炎支原体合并哮喘患儿表达意义

目的:研究T淋巴细胞亚群、血清TNF-α、IgE水平在肺炎支原体合并哮喘患儿表达意义.方法:选取2018年5月—2019年10月在巩义市人民医院住院治疗的70例哮喘患儿作为研究组,根据是否存在肺炎支原体感染又将研究组分为感染组(哮喘合并肺炎支原体感染)和非感染组(单纯哮喘),其中感染组患儿37例(肺炎支原体感染轻症25例,重症12例),非感染组33例;同期选择与研究组性别、年龄相匹配的健康体检儿童35例作为对照组.检测各组患儿外周血T淋巴细胞亚群水平、血清TNF-α和IgE水平.结果:与对照组相比,研究组CD3+、CD4+、CD4+/CD8+较低,CD8+及血清TNF-α、IgE水平较高,差异具有统计学意义(P<0.05).感染组CD3+、CD4+、CD4+/CD8+低于非感染组,CD8+及血清TNF-α、IgE水平高于非感染组,差异具有统计学意义(P<0.05).肺炎支原体感染轻症CD3+、CD4+、CD4+/CD8+高于肺炎支原体感染重症,CD8+及血清TNF-α、IgE水平低于重症,差异具有统计学意义(P<0.05).结论:哮喘患儿在感染肺炎支原体时CD3+、CD4+、CD4+/CD8+比值会降低,CD8+比值及血清TNF-α、IgE水平会增高,其异常程度与肺炎支原体感染程度有关.     

SARS患者T淋巴细胞亚群变化的初步研究

目的探讨严重急性呼吸综合征(SARS)患者T淋巴细胞亚群的变化.方法采用流式细胞术对30例SARS患者进行外周血T淋巴细胞亚群进行测定.结果SARS患者在病程早期外周血白细胞(4153.25±515.61)μl和淋巴细胞(1 535.14±147.91)μl,CD3+(941.45±101.64)μl,CD4+(378.35±42.51)μl,CD8+(436.39±52.41)μl及CD4+/CD8+比值(0.95±0.54),较正常人外周血白细胞(6958.52±789.45)μl和淋巴细胞(2589.63±351.81)μl,CD3+(1 465.28±139.23)μl,CD4+(798.65±69.35)μl,CD8+(563.89±71.81)μl及CD4+/CD8+比值(1.49±0.64)均明显降低(P均＜0.05).结论SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制及指导临床合理用药有一定意义.     

传染性单核细胞增多症患儿淋巴细胞亚群的变化

目的 :探讨传染性单核细胞增多症 (IM)患儿急性期和恢复期淋巴细胞亚群的变化规律。方法 :采用流式细胞仪 (FCM)检测IM患儿急性组和恢复组淋巴细胞亚群 ,并和正常对照组比较。结果 :IM患儿急性组CD3+ 、CD8+ T淋巴细胞明显上升 ,CD4 + T淋巴细胞、CD4/CD8、CD19+ 淋巴细胞下降 ,与恢复组、正常对照组比较差异具有显著性 (P <0 .0 5)。恢复组与对照组比较CD8+ T淋巴细胞上升、CD4/CD8下降差异有显著性(P <0 .0 0 1)。恢复组CD3 + 、CD8+ T淋巴细胞下降 ,CD4 + T淋巴细胞、CD4/CD8,CD19+ 淋巴细胞上升与急性组比较差异具有显著性 (P <0 .0 5)。结论 :IM患儿存在细胞与体液免疫功能紊乱 ,在整个疾病过程中T淋巴细胞起着主要作用 ,对IM患儿应进行长期随访以防治恶性疾患     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.