乌苯美司对尖锐湿疣患者外周血T淋巴细胞亚群的影响

目的 研究乌苯美司对尖锐湿疣患者外周血T淋巴细胞亚群的影响,探讨乌苯美司对尖锐湿疣可能的免疫调节机制.方法 应用玫瑰花结法检测68例尖锐湿疣患者在乌苯美司治疗前后外周血T淋巴细胞亚群.结果 乌苯美司治疗前,尖锐湿疣患者外周血CD3+T细胞、CD4+T细胞及CD4+/CD8+比值明显低于正常对照组(均P＜0.01),而CD8+T细胞明显高于正常对照组(P＜0.01);治疗后尖锐湿疣患者外周血CD3+T细胞、CD4+T细胞及CD4+/CD8+比值明显高于治疗前(均P＜0.01),而CD8+T细胞明显低于治疗前(P＜0.05).结论 乌苯美司可通过调节尖锐湿疣患者T细胞亚群,起到治疗尖锐湿疣的作用.     

再生障碍性贫血患者外周血淋巴细胞亚群和调节性T细胞的检测及临床意义

目的 研究再生障碍性贫血(AA)患者外周血淋巴细胞亚群和调节性T细胞水平的变化及临床意义.方法 采用流式细胞仪对40例AA患者(AA组)及40例正常人(正常对照组)外周血淋巴细胞亚群及调节性T细胞水平进行检测.结果 与正常对照组相比,AA组CD4+T淋巴细胞百分比、CD4+/CD8+比值及CD16+/56+自然杀伤(NK)细胞百分比明显降低(P＜0.05),CD8+T淋巴细胞百分比明显升高(P＜0.01),CD3+T淋巴细胞与CD19+B细胞百分比与正常对照组比较,无统计学差异(P＞0.05).AA患者外周血中CD4+CD25+T细胞和CD4+CD25high调节性T细胞比例均明显低于正常对照组(P＜0.01).结论 AA患者细胞免疫功能明显异常,调节性T细胞减少可能与AA免疫发病机制有关.淋巴细胞亚群及调节性T细胞水平检测在评价AA疗效及判断预后方面具有一定的临床价值.     

胸腺肽对原发性干燥综合征患者T淋巴细胞亚群的影响

目的 胸腺肽属于细胞免疫增强剂,临床用于治疗原发性干燥综合征有一定效果,但其作用机制尚不明确.文中探讨胸腺肽对原发性干燥综合征(primary Sjongren syndrome, pSS)的疗效及对T淋巴细胞亚群的影响. 方法 62例pSS患者随机分为治疗组与对照组,对照组采用口服硫酸羟氯喹片治疗,治疗组采用口服硫酸羟氯喹片加胸腺肽肠溶胶囊治疗.同时设35名健康体检者为对照组. 结果 治疗组临床疗效为87.5%,优于对照组70.0% (P＜0.05),与健康对照组比较,pSS患者CD3+CD4+ T淋巴细胞和CD4+/CD8+比值明显降低(P＜0.05),CD8+T淋巴细胞高于高于健康对照组(P＜0.05).治疗12周后治疗组CD3+CD4+ T淋巴细胞及CD4+/CD8+均升高,而CD8+T淋巴细胞明显下降,与治疗前及对照组相比,差异均具有统计学意义(P＜0.05). 结论 CD4+、CD8+ T淋巴细胞亚群失衡与pSS发病相关.胸腺肽具有免疫调节作用,对pSS具有一定疗效.     

益肾安宫方对复发性自然流产外周血β-HCG及T淋巴细胞亚群影响

目的 探讨益肾安宫方对复发性自然流产外周血β-HCG及T淋巴细胞亚群影响。方法 选择2017年5月～2018年5月我科复发性自然流产患者26例，其中西医组12和中医组14例；对照组15例为同期在我科正常妊娠的孕妇。西医组采用孕前服用阿司匹林，妊娠后加用肝素；中医组采用益肾安宫方治疗，疗程均为12周。比较3组外周血β-HCG和 CD4+/CD8+Ｔ淋巴细胞亚群水平。 结果 3组不同时间血清β-HCG水平比较均有显著差异(F=26.89~351.76，P <0.01)，第4周至第12周血清β-HCG水平比较，中药组显著高于西药组 (t=2.93~18.12，P<0.01)；3组治疗后CD8+T淋巴细胞亚群和CD4+/CD8+比较，有显著差异(F=7.22；4.56，P <0.01)；治疗后CD4+/CD8+比较，西药组与对照组无显著差异(t=1.55，P>0.05)，而中药组显著小于西药组(t=2.53，P<0.05)。结论 益肾安宫方可显著提高外周血β-hCG水平，可使复发性自然流产患者CD4 + /CD8 + 比值由CD4 +向CD8 + 优势转化。     

慢性乙型肝炎患者抗病毒治疗对T淋巴细胞亚群及补体C3、C4变化

目的 分析慢性乙型肝炎患者在抗病毒治疗前后T淋巴细胞亚群及补体C3、C4水平变化。 方法 选取我院2017年1～12月感染科收治的慢性乙型肝炎患者52例作为观察组,同时选取同期健康体检人群30例作为对照组。分别于治疗前和治疗1、2个疗程后检测肝功能、T淋巴细胞亚群、补体C3及C4水平。 结果 治疗前,观察组患者肝功能各指标较对照组明显升高（P＜0.01）,CD3+、CD4+细胞及CD4+/CD8+值、补体C3、C4水平较对照组明显降低（P＜0.01）,而 CD8+淋巴细胞明显升高（P＜0.01）。 治疗 1个疗程后,与治疗前相比,肝功能各指标明显下降（P＜0.01）,CD4+细胞、CD4+/CD8+值及补体 C3、C4 水平均明显升高（P＜0.01）,CD8+细胞明显下降（P＜0.01）;治疗 2 个疗程后,肝功能各指标、T淋巴细胞亚群、补体C3及C4水平均进一步改善（P＜0.01）,趋向于正常。同时,研究期间观察组患者并未出现与治疗药物相关的不良反应。 结论 慢性乙型肝炎患者处于免疫抑制状态,给予抗病毒治疗后,T淋巴细胞亚群及补体C3、C4水平得到改善,免疫功能恢复,有益于病毒清除和病情控制。     

胃癌根治术中不同麻醉方法对患者血清sIL-2R及T细胞亚群的影响

目的探讨不同麻醉方法是对胃癌根治术患者围手术期外周血可溶性白细胞介素-2受体(sIL-2R)和T淋巴细胞亚群的影响.方法 36例择期行胃癌根治术患者随机分为硬膜外阻滞组(A组)、静吸复合全麻醉组(B组)、硬膜外阻滞加全麻组(C组);于麻醉前、切皮前、切皮后2h及术后第1,3,5天分别检测外周血sIL-2R和T淋巴细胞亚群.结果切皮前三组sIL-2R和T淋巴细胞亚群较麻醉前没有明显变化;切皮后2h、术后1d和3d,A、B组sIL-2R明显升高(P＜0.01),且在施术2h、术后1d血清sIL-2R高于C组,C组术后1d增高(P＜0.01).三组病人血T淋巴细胞亚群在施术2h、术后第1,3天CD3+、CD4+及CD4+/CD8+均较麻醉前明显下降(P＜0.05),但C组的CD4+/CD8+在第3天已恢复(P＞0.05)并高于A,B组(P＜0.05);术后第5天,C组CD3+、CD4+及CD4+/CD8+接近麻醉前水平(P＞0.05),且高于A,N组(P＜0.05).结论硬膜外复合全麻能减轻围术期应激反应及麻醉药物对sIL-2R和T淋巴细胞亚群的影响,有利于肿瘤病人功能的恢复.     

宁肺合剂联合三伏贴对慢性阻塞性肺疾病患者血IL-8和T淋巴细胞亚群的影响

目的:探讨宁肺合剂联合三伏贴对稳定期慢性阻塞性肺疾病患者血IL-8和T淋巴细胞亚群的影响及作用机制。方法:将于我院体检的60名健康人员作为健康组,将同期诊治的60例COPD稳定期患者作为疾病组,并将疾病组随机分为治疗组和对照组各30例,2组均予西医常规治疗,治疗组在西医常规治疗基础上予宁肺合剂联合三伏贴治疗,连续治疗2个疗程。结果:健康组血IL-8和CD8+低于疾病组,T淋巴细胞亚群中CD4+和CD4+/CD8+高于疾病组(P0.05);治疗组治疗后与治疗前相比,血IL-8和CD8+下降,T淋巴细胞亚群中CD4+和CD4+/CD8+升高(P0.05);对照组治疗后与治疗前相比,血IL-8下降(P0.05),但T淋巴细胞亚群中CD4+,CD8+及CD4+/CD8+变化无统计学差异(P0.05)。结论:宁肺合剂联合三伏贴治疗慢性阻塞性肺疾病的可能机制在于减轻气道炎症反应,增强机体免疫功能。     

晚期恶性肿瘤患者化疗前后CD8^＋、CD8^＋CD28^＋、CD8^＋CD28^-T细胞的变化观察

目的分析64例晚期恶性肿瘤患者化疗前后CD8+、CD8+CD28+、CD8+CD28-的变化,并探讨其与病情的关系.方法采用流式细胞术检测64例晚期恶性肿瘤患者治疗前后T淋巴细胞亚群,并与健康体检者作比较.结果实验组晚期恶性肿瘤患者化疗前CD4+低于对照组(P＜0.05),而化疗前后CD4+/CD8+明显低于对照组(P＜0.01),CD8+、CD8+CD28-明显高于对照组(P＜0.01).治疗后,化疗有效者CD4+、CD4+/CD8+、CD8+CD28+升高(P＜0.05、P＜0.01),而CD8+CD28-降低(P＜0.05);化疗无效者CD4+/CD8+、CD8+CD28+降低(P＜0.05、P＜0.01),CD8+CD28-升高(P＜0.01).结论晚期恶性肿瘤患者T淋巴细胞免疫功能低下,有效的治疗能提高患者的T淋巴细胞免疫功能,临床上检测CD8+、CD8+CD28+、CD8+CD28-对恶性肿瘤的治疗和预后有一定的监测作用.     

足三里注射黄芪液对精神分裂症T淋巴细胞亚群及免疫球蛋白的影响

目的探讨足三里穴位注射黄芪液对慢性住院精神分裂症患者T淋巴细胞亚群及免疫球蛋白的影响.方法于穴位注射前、注射4周末、注射8周末对上述各免疫指标进行检测,并与健康组比较;注射前、后行PANSS 量表评定及行相关因素分析.结果SP组CD3+、CD4+、CD8+及CD4+/CD8+比值均明显低于对照组(P＜0.05～0.01).注射前后自身比较差异显著(P＜0.05～0.01).组间比较发现Ⅰ型组和氯氮平组的CD8+、氯丙嗪组CD4+/CD8+比值上升明显(P均＜0.05).IgA注射前低于对照组;注射前后差异显著(P＜0.05).IgG、IgM注射前高于对照组,注射后未见改善.注射前后精神症状无改善.结论T淋巴细胞亚群检测对了解SP免疫状态有价值;足三里注射黄芪液对改善慢性精神分裂症免疫低下作用明显.     

外周血T淋巴细胞亚群与乙型肝炎患者病情程度的关联性探究

目的研究外周血T淋巴细胞亚群与乙型肝炎患者病情程度的关联性。方法选取该院2018年5月至2019年5月接收的乙型肝炎患者72例为肝炎组,其中轻度18例,中度30例,重度24例,选取同期健康体检者52例为对照组,检测比较两组外周血T淋巴细胞亚群(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)水平,并分析其与乙型肝炎患者病情程度关联性。结果肝炎组T淋巴细胞亚群CD3~+、CD4~+、CD8~+水平低于对照组(P0.05),肝炎组中度、重度CD4~+/CD8~+比值低于对照组(P0.05),肝炎组T淋巴细胞亚群CD3~+、CD4~+、CD8~+水平随病情程度加重而逐渐递减(P0.05),肝炎组重度CD4~+/CD8~+比值低于轻度者(P0.05);经Spearman相关性分析,T淋巴细胞亚群CD3~+、CD4~+、CD8~+与乙型肝炎病情程度呈负相关(P0.05)。结论外周血T淋巴细胞亚群CD3~+、CD4~+、CD8~+水平与乙型肝炎病情程度呈负相关,故检测乙型肝炎细胞免疫指标,可为临床判断病情严重程度、及时对症治疗、疗效评估提供科学合理理论依据。     

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.