靶向树突状细胞的脓毒症免疫调理新策略

树突状细胞是介导机体天然免疫和获得性免疫应答的主要抗原提呈细胞。脓毒症状态下, 树突状细胞数目减少, 抗原提呈能力减弱, 分泌细胞因子异常, 造成T淋巴细胞活化障碍。既往研究提示, 树突状细胞数目和功能变化是导致免疫功能抑制的主要原因之一。笔者针对脓毒症时树突状细胞的变化特点, 结合其目前的研究进展, 简要分析并提出了靶向树突状细胞凋亡、分化和功能等方面的免疫调理新策略, 以期为严重烧创伤并发脓毒症的有效防治提供新思路。     

抗原负载的树突状细胞体外诱导抗肿瘤免疫的研究

目的 观察抗原负载的树突状细胞(DCs)体外诱导抗肿瘤免疫效应,探讨树突状细胞肿瘤疫苗的制备方法 .方法 以细胞因子粒细胞-巨噬细胞集落刺激因子(GM-CSF)和白细胞介素(IL)-4体外诱导人单核细胞来源的树突状细胞,第6天加入肝癌细胞BeL-7402的冻融抗原并以联合细胞因子鸡尾酒法[肿瘤坏死因子(TNF-α)+IL-6+IL-1β+前列腺素E2(PGE2)]诱导成熟,对照组仅以鸡尾酒法诱导成熟.24 h后收获DCs以流式细胞仪检测其成熟表型CD80、CD83、CD86和LHA-DR,酶联免疫吸附试验(ELISA)法检测其IL-12的分泌,噻唑蓝(MTT)比色法检测其刺激淋巴细胞增殖活性,乳酸脱氢酶释放实验检测其诱导的免疫效应细胞对肝癌细胞的特异性细胞毒作用.结果 联合细胞因子可诱导的DCs成熟和IL-12的分泌(P＜0.05),成熟的DCs有较强的刺激淋巴细胞增殖能力;抗原负载组DCs可诱导效应细胞对肝癌细胞BeL-7402的特异性杀伤作用(P＜0.05).结论 抗原负载的DCs可体外诱导特异性抗肿瘤免疫效应,提示以抗原负载的树突状细胞作为肿瘤免疫治疗的方法 是可行的.     

树突状细胞、调节性T细胞在肾小球肾炎中的研究进展

肾小球肾炎(GN)是以肾小球损害为主的变态反应性炎症,是一种较为常见的疾病.树突状细胞(DCs)作为专职抗原递呈细胞(APC)具有强大的抗原递呈及及免疫调节能力,在机体免疫反应中起重要作用.最近的研究揭示DCs是T细胞在肾淋巴结中的活化剂,并且它们在肾脏中相互作用.这种相互作用通过细胞因子和趋化因子来调控,维持肾小管间...     

脑胶质瘤细胞通过上调树突状细胞TSP-1水平抑制其成熟

目的探究脑胶质瘤细胞对树突状细胞(DCs)活化成熟的影响及其相关机制。方法诱导培养DCs过程中加入胶质瘤细胞培养上清(TCM),RNA测序分析筛选出差异基因,通过Western blot实验和流式细胞分析检测不同处理下的DCs中TSP-1的表达水平和成熟度,通过ELISA法检测DCs所分泌的不同细胞因子的浓度。结果 RNA测序分析发现凝血酶敏感蛋白1(TSP-1)基因的表达在TCM处理组DCs中较其在阴性对照组DCs中升高。Western blot结果表明,加入TCM或转染过表达质粒,DCs表达TSP-1增加,同时流式细胞分析和ELISA结果证明,其成熟度降低,分泌的细胞因子由Th1型(IL-12p70和TNF-α)向Th2型(IL-10)方向漂移;而利用siRNA进行敲低后,DCs表达TSP-1减少,成熟度升高,分泌的细胞因子也向Th1型方向漂移。结论脑胶质瘤细胞通过上调DCs中TSP-1的表达,抑制DCs的成熟,使其分泌的细胞因子向免疫抑制型因子的方向漂移。     

耐受性树突状细胞和调节性T细胞相互作用研究进展

树突状细胞(DCs)是体内最重要的抗原递呈细胞(APC),其最重要的特点就是能够刺激初始型T细胞增殖,是机体免疫系统反应的启动者,在免疫应答过程中起着重要的作用,同时DCs在诱导免疫耐受中起重要作用,是诱导外周免疫耐受的调控点[1].而近年来在免疫学领域的另一研究热点则是对调节性T细胞(Tr)的研究.Tr细胞是外周免疫耐受新的重要作用机制,它可通过细胞接触或者抑制性细胞因子作用于APCs或效应性T细胞,从而发挥调节效应.越来越多的研究结果证实DCs与Tr细胞在人类免疫调节过程中存在着紧密联系.现介绍DCs与Tr在免疫调节中的相互作用的进展.     

负载抗原的树突状细胞诱导特异性抗膀胱癌细胞的效应

树突状细胞(DCs)是体内“专职的”抗原提呈细胞，与机体抗瘤免疫关系密切。本研究旨在用DCs负载膀胱癌细胞冻融抗原，探讨其在体外对膀胱癌细胞的杀伤效应。     

趋化因子在树突状细胞肿瘤疫苗研究中的进展

趋化因子是一类调节免疫细胞定向迁移的细胞因子,其与表达于细胞表面的趋化因子受体结合而发挥生物学功能.树突状细胞(DC)是重要的专职抗原递呈细胞,其主要的应用是制备成各种肿瘤疫苗,树突状细胞功能的行使与趋化因子及其受体介导的细胞迁移密切相关,趋化因子在树突状细胞游走与迁徙过程中始终发挥着调节、促进或抑制的作用,从而促使树突状细胞递呈抗原、激活初始T细胞,引起机体免疫反应,杀伤、消灭肿瘤细胞和炎性分子.     

负载膀胱癌酸洗抗原肽对树突状细胞分泌IL-12的影响及意义

目的：研究负载膀胱癌酸洗抗原肽对树突状细胞（DCs）分泌IL-12的影响和意义.方法：用弱酸洗脱法获得膀胱癌细胞株BIU-87肿瘤抗原肽;联合应用重组人GM-CSF、IL-4和TNF-α体外诱导健康志愿者DCs并负载膀胱癌肿瘤抗原肽;DC诱导膀胱癌抗原特异性CTLs;用MTT法检测其对BIU-87体外杀伤效应;用ELISA法检测第3、6、9天培养细胞的上清液,评价DCs分泌IL-12 p70的能力.结果：联合应用重组人GMCSF、IL-4和TNF-α可在体外诱导出DCs;负载膀胱癌抗原肽的DC诱导的特异性CTLs可杀伤高达（78.5±7.0）%的BIU-87细胞,显著高于各对照组（P〈0.01）;经ELISA方法检测不同时期的DCs分泌IL-12的量不同,而且负载抗原肽DCs较未负载抗原DCs有更强的分泌能力（P〈0.05）.结论：IL-12 p70在DCs刺激特异性CTLs的过程中发挥重要作用,其分泌量受DCs的成熟状态及某些刺激信号的影响,膀胱癌酸洗抗原肽是其刺激信号之一.     

以树突状细胞为靶点的免疫抑制药物研究进展

树突状细胞(dendritic cell,DC)是功能最强的专职抗原提呈细胞,能有效刺激初始型T细胞的增殖,是机体免疫反应的始动者,在机体细胞免疫和体液免疫调控中均起重要作用,笔者主要对以树突状细胞为作用靶点的一些免疫抑制药物做一简要综述.     

树突状细胞与肾细胞癌免疫治疗进展

树突状细胞(DCs)是机体内最有效、功能最强的抗原提呈细胞,其在激发免疫反应中起核心作用,在抗肿瘤免疫中发挥重要作用。近年来采用DCs瘤苗进行肿瘤免疫治疗获得一些突破性进展。本文就DCs与RCC的关系,DCs在RCC免疫治疗中的应用的最新进展作一综述。     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

下颌全牙弓后移量及最后界的测量

目的：研究下颌牙弓的有效后移量及找寻下颌牙弓移动的后界。方法：选取涉及拔除下颌第三磨牙或下颌第三磨牙缺失的病例18例（男6例,女12例）。采用种植支抗牵引下牙弓向远中,治疗完成时所有病例均明确到达下颌牙弓后界,即下颌第二磨牙远中到达下颌升支前缘软组织交界处。应用治疗前后的曲断片测量下颌第二磨牙远中到升支前缘的距离。结果：下颌第二磨牙后移量为（3.49±1.21）mm;治疗后磨牙后间隙的长度为（4.43±0.97）mm。结论：下颌牙弓可确定性地实现整体后移;最大后移量由磨牙后间隙的长度决定;其最后界止于下颌第二磨牙远中与下颌升支前缘软组织交界处。     

Preservation of the pylorus in resection of the head of the pancreas

Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.