免疫性血小板减少症细胞免疫及大剂量地塞米松对其的影响

目的检测以及分析免疫性血小板减少症(ITP)患者细胞免疫状态即T淋巴细胞亚群的分布,评估ITP患者免疫功能状态及大剂量地塞米松冲击治疗对T淋巴细胞亚群的影响。方法采用流式细胞仪分别检测初治ITP患者和正常对照组外周血T淋巴细胞亚群,观察大剂量地塞米松冲击治疗对ITP患者T淋巴细胞亚群的影响。结果 ITP组的Th细胞(CD3+、CD4+),Th/Ts比值均低于正常对照组,差异有统计学意义(P<0.01);Ts细胞(CD3+、CD8+)的表达高于正常对照组,差异有统计学意义(P<0.01)。治疗前后Th细胞(CD3+、CD4+)、Th/Ts比值、Ts细胞比较差异均有统计学意义(P<0.01)。结论ITP患者T淋巴细胞亚群失衡导致细胞免疫功能紊乱,大剂量地塞米松冲击治疗可改善患者的T淋巴细胞亚群失衡。     

支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值

目的探讨支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值。方法选取50例在我院就诊的肺癌患者为观察组,并选取同期在我院就诊的肺部良性病变患者30例为对照组。两组患者均予以行支气管肺泡灌洗,收集支气管肺泡灌洗液检测血清T淋巴细胞亚群、肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)及鳞状细胞癌相关抗原(SCC)。观察并比较两组肺泡灌洗液T淋巴细胞亚群及肿瘤标志物水平的差异。结果观察组患者支气管肺泡灌洗液T淋巴细胞CD3~+、CD4~+水平明显低于对照组,CD8~+水平明显高于对照组,CD4~+/CD8~+水平明显低于对照组,差异有统计学意义(P0.05或P0.01);观察组患者支气管肺泡灌洗液肿瘤标志物CEA、CYFRA21-1、SCC水平均明显高于对照组,差异有统计学意义(P0.01)。结论肺癌患者免疫功能低下,辅助性T淋巴细胞减少,细胞毒性T淋巴细胞增加,检测支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物能为临床诊断肺癌提供依据。     

支气管肺泡灌洗液腺苷脱氨酶及T细胞亚群在肺结核诊断中的应用价值

目的探讨支气管肺泡灌洗液腺苷脱氨酶(ADA)及T细胞亚群在肺结核诊断中的应用价值。方法选取2015年1月~2017年1月我院30例肺结核患者为观察组,另选取同期就诊的肺部良性病变患者30例为对照组。两组患者均行支气管肺泡灌洗,收集支气管肺泡灌洗液检测ADA及T淋巴细胞亚群。观察并比较两组患者的肺泡灌洗液ADA及T淋巴细胞亚群的差异。结果观察组患者支气管肺泡灌洗液ADA含量明显高于对照组,差异有统计学意义(P0.05);观察组患者支气管肺泡灌洗液T淋巴细胞CD3+、CD4+、CD4+/CD8+水平明显低于对照组,CD8+水平明显高于对照组,差异均有统计学意义(P0.05或P0.01)。结论肺结核患者免疫功能低下,检测支气管肺泡灌洗液ADA及T淋巴细胞亚群能为临床诊断肺癌提供依据,具有较高的临床应用价值。     

鼻咽癌患者外周血T淋巴细胞及T细胞亚群的研究

用抗T淋巴细胞及亚群的单克隆抗体(CD系列)检测了50例不同病期的鼻咽癌患者外周血T淋巴细胞及T细胞亚群的变化,结果表明,鼻咽癌T细胞和辅助性T细胞(Th)数减少;抑制性T细胞(Ts)数增加;Th/Ts细胞比值下降,患癌组测定值与正常对照组比较有极显著性差异(p<0.01)。实验结果表明,放射治疗使T细胞总数、辅助性T细胞和抑制性T细胞亦下降,尤以T细胞总数明显下降,表明放射线使细胞免疫功能下降,但通过对鼻咽癌取得局部控制的同时Th/Ts细胞比例失调又有一定程度纠正。结果表明,T细胞及其亚群,尤其Th/Ts比值能较准确地反映机体的免疫状态,对肿瘤临床有一定指导意义。     

34例婴幼儿呼吸道合胞病毒肺炎T辅助淋巴细胞亚群的改变

目的探索呼吸道合胞病毒(RSV)肺炎患儿细胞免疫状况的变化。方法采用流式细胞仪检测RSV肺炎急性期患儿及正常对照组外周血T辅助淋巴细胞1(Th1)和T辅助淋巴细胞2(Th2)的百分率、CD4 细胞百分率、CD3、CD8、NK细胞、B细胞百分率及CD4/CD8比值。结果RSV肺炎急性期患儿的外周血Th1、Th2的细胞百分率〔(11.96±6.26)%、(3.45±2.03)%〕均显著高于对照组〔(9.16±9.90)%、(2.14±1.12)%〕,(P<0.05);但RSV肺炎组Th1/Th2之比值、CD3、CD8、NK细胞、B细胞百分率及CD4/CD8比值,均与正常对照组之间无统计学差异(P>0.05)。结论RSV感染可活化T辅助淋巴细胞亚群,表现为Th1和Th2细胞百分率均增加,Th1和Th2细胞免疫反应增强。     

子宫肌瘤患者细胞免疫状态的研究及临床价值

机体的免疫状态,特别是细胞免疫与人类肿瘤的发生、发展及预后有着密切的关系。细胞免疫中T淋巴细胞亚群分布的变化起着重要的作用,其中辅助性T细胞(Th)与抑制性T细胞(Ts)的比值(Th/Ts)是决定机体免疫反应水平的中心环节,细胞免疫的损害常与Th/Ts比率下降有关。国内外对于各种     

特发性血小板减少性紫癜患儿T细胞免疫功能的变化

目的探讨T淋巴细胞亚群以及Th1/Th2相关细胞因子在特发性血小板减少性紫癜(ITP)中的变化.方法用PMA、 ionomycin作刺激剂,刺激全血中淋巴细胞表达细胞因子,以monensin阻断细胞因子分泌至胞外,应用两种免疫荧光抗体同时标记淋巴细胞的膜表面特异的分子和表达被阻滞在细胞内的细胞因子,流式细胞仪进行检测和分析.结果 ITP患儿外周血CD4+降低,CD8+升高,CD4+/CD8+降低.ITP患儿IFN-γ血清表达升高,Th1细胞占20.66%±2.82%,IL-4表达降低,Th2细胞占4.55%±2.33%,Th1/Th2的比值为4.78±0.66,明显高于健康儿童的1.43±0.19(P<0.05).结论 ITP患儿T淋巴细胞亚群表达的比例失调,IFN-γ产生增多,IL-4减少,提示辅助性T淋巴细胞亚型(Th1/Th2)失调.     

急性白血病患者外周血T淋巴细胞亚群的检测

目的:探讨急性白血病 (AL )患者外周血 T淋巴细胞亚群的表达及其意义。 方法:采用间接免疫荧光法对 2 4例 AL患者和 2 2例正常对照者外周血 T淋巴细胞亚群 ,包括 T细胞 (CD3 )、T辅助细胞 (CD4 )、T抑制细胞 (CD8 )及 CD4 /CD8 的比值进行检测。按外周血白血病细胞多少将 AL 分为白血病细胞 <30 %组和 >30 %组 ,并对 2组 T细胞亚群检测结果进行了比较。结果 :AL 患者 CD3 、CD4 、CD8 、CD4 /CD8 比值较正常对照组明显下降 (P均 <0 .0 1)。急性淋巴细胞白血病 (AL L )患者外周血 CD4 (18.6 0± 7.91) % ,CD8 为 (18.91± 6 .0 0 ) % ,CD4 /CD8 呈现比值倒置。白血病细胞 <30 %组 CD3 为 (4 3.10± 7.2 6 ) % ,白血病细胞 >30 %组 CD3 为(30 .78± 9.30 ) % ,两者相比差异有统计学意义 (P<0 .0 5 )。 结论:细胞免疫功能紊乱与 AL 的发病有关。     

再生障碍性贫血患者外周血T细胞亚群及Th1/Th2细胞分析

目的通过分析再生障碍性贫血(再障)患者外周血T细胞亚群及Th1和Th2细胞,进一步探讨再障的免疫发病机制。方法①流式细胞术检测再障患者外周血T细胞亚群和T细胞HLADR抗原的表达;②用流式细胞术检测经体外刺激后再障患者外周血单个核细胞(PBMNC)中Th1、Th2细胞。结果①再障患者CD3 CD4 细胞、CD3 CD8 细胞、CD8 HLADR 细胞百分率及CD4 /CD8 比值分别为(35.05±9.47)%,(36.29±6.81)%,(18.36±2.07)%,1.0±0.33;对照组为(52.84±4.03)%,(24.69±3.90)%,(11.13±1.14)%,2.14±0.24;再障患者CD3 CD4 细胞和CD4 /CD8 比值显著低于对照组(P<0.01);CD3 CD8 细胞、CD8 HLADR 细胞显著高于对照组(P<0.01);而CD3 细胞与对照组相比差异无显著性(P>0.05)。②再障患者外周血中Th1细胞百分率和Th1/Th2比值分别为(20.62±2.98)%和14.63±4.81,均显著高于对照组(11.13±1.48)%和9.33±2.82(P<0.01);而Th2细胞百分率与对照组相比差异无显著性(P>0.05)。③Th1细胞与CD3 CD8 细胞呈正相关(r为0.678,P<0.01),与网织红细胞相对值、中性粒细胞绝对值(ANC)呈负相关(r分别为-0.590和-0.503,P值均<0.05)。结论再障患者的T淋巴细胞亚群失衡,Th1细胞增多可能是导致再障造血衰竭的重要环节。     

江苏省未接受治疗的HIV感染者和患者免疫功能状况研究

目的:了解江苏省HIV感染者T淋巴细胞的变化及合并结核杆菌感染的情况,为抗病毒治疗提供参考依据.方法:应用流式细胞仪、X线拍片机及痰检的方法分析140例正常人、116例HIV感染者的T淋巴细胞亚群及其合并结核的情况.结果:HIV感染者CD4 细胞数低于正常人群(P＜0.001),CD4 /CD8 的比值明显降低(P＜0.001);CD4 细胞＜200个/μl者占37.07%,＞200个/μl者占62.93%,两组人群的CD8 T淋巴细胞、Th/Ts有显著性差异;其中77.59%无临床症状,有临床相关症状的占22.41%,两组人群的CD4 细胞数及Th/T8有显著性差异;共11例合并结核感染.结论:HIV感染机体后,CD4 、CD8 细胞水平的变化与病情发展关系密切,联合检测的判断能力优于单项检测.     

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.