弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导的肠IEL持续性免疫应答

目的采用可溶性速殖子抗原(solubletachyzoiteantigen,STAg)和霍乱毒素(choleratoxin,CT)佐剂制备弓形虫复合黏膜疫苗,观察经滴鼻免疫BALB/c小鼠后诱导的肠上皮内淋巴细胞(intraepitheliallymphocytes,IEL)免疫应答及持续时间,探讨其抗弓形虫感染的作用机制。方法BALB/c小鼠96只随机分为实验组和对照组,实验组以免疫原性好的STAg(20μg/只)为抗原和CT(1μg/只)为佐剂滴鼻免疫,对照组以PBS滴鼻。滴鼻2次(间隔2周)后分别于第1、2、3、4、6、8、10、12周处死小鼠。制备肠IEL细胞悬液,计数并涂片;免疫细胞化学法(immunocytochemistry,ICC)检测CD4 T、CD8 T细胞亚群水平。结果免疫后肠IEL显著增生,第2周达高峰,第1周至第4周(P<0.01)高于对照组。其中以CD8 T细胞增生为主,CD8 T细胞水平第2周达高峰,第1周至第6周增高显著(P<0.01),CD4 T细胞也略有增生,第2、3周(P<0.05)有显著性,CD4 /CD8 比值倒置,第1、2周明显低于对照组(P<0.05)。结论弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠可有效诱导肠IEL免疫应答,且可持续较长时间,在预防弓形虫感染中起重要作用。     

弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导的脾淋巴细胞持续性免疫应答

目的观察弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠后诱导的脾淋巴细胞的免疫应答及持续时间。方法96只BALB/c小鼠随机分为免疫组和对照组,免疫组以弓形虫复合黏膜疫苗20μl/只(20μg可溶性速殖子抗原 1μg霍乱毒素)滴鼻免疫2次(间隔2周),对照组以PBS滴鼻。分别于末次滴鼻后第1,2,3,4,6,8,10,12周处死小鼠,脾淋巴细胞计数,免疫细胞化学法检测CD4 、CD8 T细胞亚群水平。结果免疫组小鼠于第1,2周脾淋巴细胞明显高于对照组(P<0.01),其中以CD4 T细胞增生为主,第1,2,3,4,6周增生显著(P<0.01),CD8 T细胞水平在第2,3周也有增生(P<0.05),CD4 /CD8 比值第6周高于对照组(P<0.01)。结论弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠可有效诱导脾淋巴细胞增殖性免疫应答,且可持续较长时间。     

几种化学合成免疫调节剂免疫小鼠诱导的抗弓形虫感染研究

目的观察不同剂量的几种化学免疫调节剂免疫小鼠诱导抗弓形虫感染作用。方法不同剂量匹多莫德、沙利度胺、匹多莫德加沙利度胺分别灌胃小鼠,共免疫14次,对照组用PBS灌胃,检测其免疫效果,并观察其受到弓形虫攻击感染后的生存情况。结果匹多莫德、匹多莫德加沙利度胺使小鼠IFN—r、CD4^＋细胞数量升高（P〈0．01）,CD4^＋与CD8^＋比值增加,各组均未检测到IL-4;沙利度胺使小鼠CD8^＋细胞数量明显增加（P〈0．01）,CD4^＋与CD8^＋比值减少,各组T细胞增殖活性与PBS对照组比较明显增强（P〈0．05）,且匹多莫德20mg加沙利度胺1．0mg组T细胞增殖活性最明显。小鼠攻击试验表明,20mg匹多莫德加1．0mg沙利度胺组小鼠存活时间明显长于匹多莫德、沙利度胺以及PBS对照组。结论匹多莫德20mg加沙利度胺1．0mg可诱导更有效的抗弓形虫感染保护作用。     

能全素对梗阻性黄疸大鼠肠黏膜免疫功能的研究

目的研究梗阻性黄疸（obstructive jaundice,OJ）幼鼠肠黏膜细胞免疫功能的变化和能全素（Nutrison）喂养对实验鼠肠黏膜免疫功能的保护作用。方法将普通级雄性Wistar大鼠40只,随机分为对照组、假手术组、OJ组、OJ＋能全素（OJ＋N）组,每组10只。流式细胞术检测大鼠肠黏膜CD4^＋、CD8^＋淋巴细胞,并计算CD4^＋／CD8^＋的比值。结果OJ组大鼠肠黏膜CD4^＋淋巴细胞百分数与对照组、假手术组和OJ＋N组比较差异有统计学意义（P〈0．05）,OJ＋N组CD4^＋／CD8^＋比值较OJ组显著升高,OJ组CD4^＋／CD8^＋比值明显低于对照组和假手术组（P均〈0．05）。结论OJ显著降低大鼠肠黏膜CD4^＋淋巴细胞百分数,OJ＋N组与OJ组比较,CD4^＋淋巴细胞百分比显著增加。OJ组肠黏膜CD4^＋／CD8^＋比值较对照组和假手术组及OJ＋N组显著降低,肠内营养对肠黏膜免疫功能有保护作用,为临床上应用肠内营养改善梗阻性黄疸患者的肠黏膜局部免疫功能提供了初步的佐证。     

创伤后应激障碍对机体免疫和心肌酶类的影响

目的对汶川地震灾区执行救灾任务患有应激障碍的某师官兵的免疫和心肌酶类指标进行分析,并对其身心健康进行评估与干预。方法对上述人员T、B、NK淋巴细胞亚群等6项免疫指标和心肌酶类等4项指标进行测定,将其分为急性应激反应阳性组（A）和急性应激反应阴性组（B）组,并与正常健康组（C）比较。结果各组各项免疫指标均在正常范围。A组CD3^＋T淋巴细胞、CD3^＋CD4^＋T淋巴细胞高于B组（P〈0．01,P〈0．05）;B组CD3^＋和CD3^＋CD4^＋T淋巴细胞计数低于C组fP〈0．01）,A、B组CD4／CD8均低于C组（P〈0．01）。与B组比较,A组CD19^＋B淋巴细胞明显降低（P〈0．05）;与C组比较,B组CD19^＋B淋巴细胞和A组CD3^-CD56^＋NK淋巴细胞显著增加（P〈0．05）。提示应激组官兵免疫功能异常。另与c组比较,A组和B组AST、CK、CKMB、LDH均显著增加（P〈0．01）,尤其是CK,其结果已显示异常;提示对于参加一线救助的PTSD阳性和PTSD阴性部队官兵,与正常对照组比较,其心肌功能有遭受不同程度损伤趋势。结论应激障碍可致免疫功能异常及心肌酶类指标代谢紊乱。     

脓毒症患者T淋巴细胞亚群水平与APACEⅡ评分的关系

目的探讨脓毒症患者T淋巴细胞亚群水平与APACHEⅡ评分的相关性。方法采用流式细胞仪测定60例脓毒症患者（脓毒症组）和柏例同期住院的非脓毒症患者（对照组）的外周血CD4^＋T、CD8^＋T细胞水平,并计算CD4^＋T／CD8^＋T细胞比值和APACHEⅡ评分。按疾病转归将60例脓毒症患者分成死亡组（n=22）和存活组（n=38）,比较上述检测指标水平。结果脓毒症组的CD4^＋T、CD4^＋T／CD8^＋T细胞水平明显低于对照组,差异有统计学意义（P〈0．01）;死亡组患者CD4^＋T、CD4^＋T／CD8^＋T细胞水平明显低于存活组,差异有统计学意义（P〈0．01）。结论脓毒症患者APACHEⅡ评分与外周血CD4^＋T（r=-0．474,P〈0．01）和CD4^＋T／CD8^＋T细胞比值（r=-0．425,P〈0．01）呈显著负相关。     

胸腺肽对老年呼吸道感染免疫功能的影响

目的探讨胸腺肽治疗老年呼吸道感染的效果。方法将108例老年呼吸道感染患者按随机数字表法分成两组,对照组52例用常规治疗,治疗组56例在对照组的基础上静滴胸腺肽60mg,1次／d,2周为1疗程治疗。治疗前、后检测免疫球蛋白（IgG、IgM、IgA）及外周血T淋巴细胞亚群（CD3^＋、CD4^＋、CD8^＋）,并观察治疗组治疗前后补体C3、C4含量的变化。结果治疗组疗效优于对照组（P〈0．01）;治疗组血清免疫球蛋白IgG、IgM、IgA水平显著升高,CD3^＋、CD4^＋、CD4^＋／CD8^＋细胞数高于治疗前并高于对照组（P〈0．05）;治疗组补体C3明显升高（P〈0．05）。结论胸腺肽辅助治疗能提高老年呼吸道感染患者的免疫功能,临床疗效明显。     

重度脓毒血症患者外周血T淋巴细胞亚群变化的分析

目的：探讨重度脓毒血症患者T淋巴细胞亚群的变化及其临床意义。方法：将63例重度脓毒血症患者及55例健康体检者进行T细胞亚群检测。T淋巴细胞亚群（CD3^＋,CD4^＋,CD8^＋,CD4^＋／CD8^＋细胞）活性采用直接免疫荧光法的流式细胞分析术法测定。结果：重度脓毒血症患者组外周血中,CD3^＋,CD4^＋细胞比例及CD4^＋／CD8^＋比值降低,与对照组比较差异有显著性（P〈0．01）,而CD8^＋细胞的比例增高,与对照组比较差异有显著性（P〈0．01）。同时重度脓毒血症患者死亡组外周血CD4^＋、CD4^＋／CD8^＋比值、CD3^＋明显低于好转组（P〈0．01）,CD8^＋明显高于好转组（P〈0．01）。结论：重度脓毒血症患者存在细胞免疫功能异常,CD3^＋,CD4^＋,T淋巴细胞比例及CD4^＋／CD8^＋比值降低,重度脓毒血症患者细胞免疫功能异常影响患者的预后。     

流式细胞术检测特发性血小板减少性紫癜患者血小板相关免疫球蛋白及T淋巴细胞亚群

目的：应用流式细胞术检测特发性血小板减少性紫癜（ITP）患者外周血中的血小板相关免疫球蛋白（PAIg）水平和T淋巴细胞亚群分布情况。方法：应用三色免疫荧光多参数流式细胞术检测ITP患者（n=30）和对照者（n=30）外周血PAIg水平和T淋巴细胞免疫表型（CD3^＋、CD3^＋CD4^＋及CD3^＋CD8^＋）。结果：ITP患者外周血PAIgG、PAIgM及PAIgA的平均荧光强度均显著高于正常对照组（P〈0．01）；与对照组比较，ITP患者外周血CI）3^＋、CD3^＋CD4^＋亚群明显减低（P〈0．05），CD3^CD8^＋亚群明显升高（P〈0．05），而CD3^＋CD4^＋／CD3^＋CD8^＋比值显著减低（P〈0．01）。结论：ITP患者PAIg水平显著增高，且存在T淋巴细胞亚群分布漂移。此方法简便易行，有助于ITP的诊断．     

卡介菌多糖核酸对尖锐湿疣患者外周血T细胞亚群及其细胞因子表达的影响

目的 研究卡介菌多糖核酸（BCG-PSN）对尖锐湿疣（CA）患者外周血T淋巴细胞亚群及胞内细胞因子表达的影响，探讨BCG-PSN对尖锐湿疣可能的免疫调节机制。方法 采用三色和双色荧光抗体染色技术经流式细胞仪检测18例CA患者在BCG-PSN治疗前后外周血T淋巴细胞亚群及CD4^＋T细胞、CD8^＋T细胞内IL-2、IL-4、IL-12、IFN-γ染色阳性细胞百分率。结果 在BCG-PSN治疗前，CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显低于对照组（均P〈O．01），CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较对照组明显下降（均P〈0．01），IL-4阳性细胞百分率与对照组比较差异无显著性意义（P〉0．05）；而治疗后CA患者CD3^＋T细胞、CD4^＋T细胞、CD4^＋／CD8^＋比值明显高于治疗前（均P〈O．01）；CD4^＋T细胞和CD8^＋T细胞内IL-2、IL-12、IFN-γ阳性细胞百分率较治疗前升高（均P〈0．01）。结论 BCG-PSN可通过调节尖锐湿疣患者T细胞亚群，纠正患者Th1／Th2模式及Tc1／Tc2模式失衡现象，起到治疗尖锐湿疣的作用。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.