急性白血病及肾炎患者外周血淋巴细胞电泳观察

细胞电泳是一项从分子水平和细胞水平研究细胞表面结构和功能的生物物理学方法[1 ]我们应用上海医科大学细胞电泳仪对 12例急性白血病病人及 7例肾炎病人进行了淋巴细胞电泳观察 ,现报导如下 :1　材料与方法1 1　仪器　上海医科大学细胞电泳仪1 2　方法　 30～ 40ＩＵ ｍｌ肝素抗凝血 3ｍｌ,稀释一倍后缓慢加入比重为 1.0 77± 0 .0 0 2的淋巴细胞分层液中 ,2 5 0 0～ 30 0 0ｒ ｍｉｎ离心 15ｍｉｎ ,吸出白细胞层 ,以无钙、镁的Ｈａｎｋ’ｓ液洗涤三次 ,配成 1～ 1.5× 10 7 ｍｌ细胞悬液。1 3　将淋巴细胞注入方形管 ,找到静止层 ,显微镜…     

初发急性白血病患者外周血T淋巴细胞亚群的表达

目的：探讨不同类型初发急性白血病患者外周血 T 淋巴细胞亚群及其绝对数量,了解在不同类型急性白血病患者中的意义。方法采用流式细胞仪对66例急性白血病（AL）患者（急性髓细胞性白血病49例、急性B 淋巴细胞性白血病11例、急性 T 淋巴细胞性白血病6例）及30例健康人外周血 T 淋巴细胞亚群的百分率及其绝对值进行检测。结果初诊 AL 与健康对照组比较,急性髓细胞白血病（AML）及 B-ALLCD3＋ T 淋巴细胞百分比明显高于健康对照组（P ＜0．05）,而 T-ALLCD3＋ T 细胞明显低于健康对照组（P ＜0．05）,CD4＋ T 淋巴细胞百分比与健康对照组相比差异无统计学意义（P ＞0．05）;B-ALLCD4＋ T 淋巴细胞明显高于健康对照组（P ＜0．05）,T-ALLD4＋ T 淋巴细胞则明显减低（P ＜0．05）;AMLCD8＋ T 淋巴细胞明显增高（P ＜0．05）,B-ALL 及 T-ALL 增高但差异无统计学意义（P ＞0．05）;T-ALL 及 AMLCD4＋/CD8＋的比值均明显低于健康对照组（P ＜0．05）,B-ALL 增高但无统计学意义（P ＞0．05）;AML、B-ALL 及 T-ALLCD3＋ T 淋巴细胞和 CD4＋ T 淋巴细胞绝对值明显低于健康对照组（P ＜0．05）;CD8＋ T 淋巴细胞差异无统计学意义（P ＞0．05）。结论不同类型急性白血病 T 淋巴细胞亚群百分率的表达有所差异,不能全面反映急性白血病患者的免疫状态;急性白血病者存在细胞免疫功能混乱,主要表现在 T 淋巴细胞亚群绝对数量的减少,检测外周血 T 淋巴细胞亚群百分率的同时应检测 T 淋巴细胞亚群绝对值,才更有助于急性白血病患者免疫状态的评估。     

急性白血病患者血清IL—2及T淋巴细胞亚群水平测定及临床意义

目的 探讨急性白血病（AL）患血清白细胞介素－2（IL－2）及血液T细胞亚群水平。方法 采用酶联免疫吸附试验（ELISA）及荧光免疫法测定30例急性白血病患白细胞介素－2及血液T细胞亚群水平，并与对照组比较。结果 AL患IL－2含量显低于对照组（P＜0．01），T细胞亚群中CD3^ 、CD4^ 均低于对照组水平（P＜0．01），CD8^ 高于对照组水平（P＞0．05），经治疗缓解患IL－2、CD3^ 、CD4^ 、CD8^＋达正常水平。结论 IL－2和T细胞亚群可作为AL辅助诊断指标，为治疗提供实验依据。     

T淋巴细胞亚群结合遗传学检测在初发急性白血病中的相关研究

目的 通过检测急性白血病(Acute Leukemia,AL)患者外周血中T细胞亚群来了解初发患者的免疫功能,同时结合细胞遗传学的变化进一步探讨白血病发生、发展及转归与细胞免疲的关系.方法 采用多参数流式细胞术分析172例初发急性白血病患者T细胞亚群,以CD4/CD8＜1为比例倒置;常规染色体核型结合荧光原位杂交(fluorescence in situ hybridization,FISH)检测分析有元核型异常.结果 所有患者中共有118例(68.6%)出现CD4/CD8比例倒置,CD4/CD8平均表达率在患者组为0.99±0.6,在对照组为1.9±0.5,两者差异有明显统计学意义(P=0.005);根据遗传学特征将急非淋(ANLL)和急淋(ALL)分成3组:预后良好组、预后中等组、预后较差组,CD4/CD8在预后良好组和预后中等组差异无明显统计学意义(P=0.629),预后良好组和预后较差组,以及预后中等组和预后较差组差异均有明显统计学意义(P=0.000,P=0.005);CD4/cD8比值在不同年龄组差异无明显统计学意义(P=0.591).结论 CD4/cD8比例倒置直接导致免疫功能的紊乱,影响机体的肿瘤免疫效应.细胞遗传学检查被认为是AL重要的预后相关指标,伴染色体核型高度异质性的患者免疫监视功能更为低下,该类患者肿瘤细胞更易适脱免疫监视而加速肿瘤的发生与发展,如能充分了解患者淋巴细胞亚群和功能,以进一步了解患者免疫状态,对临床个体化治疗有积极地指导作用.     

多发性硬化患者淋巴细胞亚群的研究

用碱性磷酸抗磷酸酶法检测了４６例多发性硬化活动期患者外周血和脑脊液配对标本的淋巴细胞亚群。结果显示：活动期ＭＳ患者外周血ＣＤ４＾＋，ＣＤ＾＋细胞较对照组减少，ＣＤ２５＾＋，ＣＤ＾４＋／ＣＤ８＾＋比值较对照组明显升高。ＣＳＦ中ＣＤ４＾＋，ＣＤ２５＋细胞，ＣＤ４＋／ＣＤ８＋比值较对照组升高，ＣＤ８＋细胞降低。     

白血病T淋巴细胞亚群和NK细胞功能分析

目的研究白血病患者不同疾病阶段的Ｔ淋巴细胞亚群及ＮＫ细胞功能，旨在探讨白血病患者的免疫功能状态。方法采用间接免疫荧光法检测白血病患者Ｔ淋巴细胞亚群、ＮＫ细胞百分数，ＭＴＴ法检测ＮＫ细胞杀伤活性。结果白血病患者ＣＤ＋３、ＣＤ＋４细胞减少，ＣＤ４／ＣＤ８比例下降甚至倒置，ＮＫ（ＣＤ＋５６）细胞减少，活性降低，且以上改变与肿瘤负荷有关。结论初治及复发白血病患者免疫功能严重低下，完全缓解期次之，而长生存患者与正常人无差异。     

急性白血病患儿T淋巴细胞亚群及血清白三烯B4含量变化的临床意义

目的 探讨急性白血病(AL)患儿外周血T淋巴细胞亚群和血清白三烯B4含量的变化及临床意义.方法 用免疫荧光流式细胞技术检测40例AL患儿(观察组)及40名正常儿童(对照组)外周血T淋巴细胞亚群CD3+T细胞、CD4+T细胞和CD8+T细胞水平及自然杀伤(NK)细胞活性;同时采用酶联免疫吸附试验(ELSA)方法检测上述AL患儿与正常儿童血清白三烯B4含量的变化情况.结果 AL患儿CD3+T细胞[(49.51±6.53)%]、CD4+T细胞[(22.15±4.87)%]及CD8+T细胞[(23.41±3.96)%]均低于对照组[分别为(67.63±5.23)%、(34.43±5.07)%(28.17±4.61)%],差异有统计学意义(t=13.698、t=11.047、t=4.953,P＜0.01);AL患儿自然杀伤细胞活性[(5.41±4.25)%]明显低于对照组[(13.10±4.91)%],差异有统计学意义(t=7.498,P＜0.01);而AL患儿血清白三烯B4含量[(25.23±6.24)ng/L]明显高于对照组[(8.28±2.53)ng/L],差异有统计学意义(t=15.921,P＜0.01).结论 AL患儿T淋巴细胞亚群及白三烯B4发生明显改变,对揭示AL发病机制提供重要的理论依据.

Abstract：

Objective To study the changes of T lymphocyte subtype levels and serum levels of leukotriene B4 ( LTB4 )in children with acute leukemia (AL). Methods The activity of T lymphocyte subsets:CD3+ T cells,CD4+ T cells,CD8 + T cell levels and NK cell were detected in 40 cases of AL and 40 control by Flow Cytometry(FCM). The serum level of LTB4 was measured by ELISA in all subjects. Results Compared with normal control , the percentages of CD3 + T cells ( [ 49.51 ± 6.53 ] ％ vs [ 67.63 ± 5.23 ] ％ ), CD4 + T cells ([22.15±4.87]％ vs [34.43 ±5.07]％),CD8+ T cell ([23.41 ±3.96]％ vs [28. 17 ±4.61]％),NK cell ( [5.41 ± 4.25 ] ％ vs [ 13.10 ± 4.91 ] ％ ) were significantly lower in children AL patients, ( Ps ＜0.01 ). However,the serum levels of LTB4 increased significantly in AL patients compared with normal control ( [ 25.23 ± 6.24 ] ng/L vs [ 8.28 ± 2.53 ] ng/L, P ＜ 0.01 ). Conclusion T lymphocyte subtype and serum level of LTB4 showed significant changes in children AL patients compared with normal control, which revealed an important theoretical basis to AL pathogenesis.     

慢性B淋巴细胞白血病患者免疫表型及其淋巴细胞亚群和NK细胞的分析

本研究评价慢性B淋巴细胞白血病（B—CLL）患者骨髓（BM）或外周血（PB）白血病细胞的免疫表型及外周血T淋巴细胞亚群和NK细胞在B-CLL诊断、治疗和预后中的应用价值。收集67例B—CLL患者外周血或骨髓标本,应用多参数流式细胞术进行测定。结果表明：67例B—CLL患者外周血淋巴细胞比例明显增加,CD3、CD4、cD8和NK细胞各项指标均极度减低,与正常人相比有显著差异（P〈0．01）,而CD4／CD8比值与正常人相比无显著差异（P〉0．05）。在这些患者中CD19阳性率最高（91．04％）,其他抗原表达阳性率依次为CD5（80．60％）,CD20（76．12）．cyCD79a（74．63％）,CD38（43．28％）,CD11c（42．86％）,CD7（41．94％）,ZAP-70（39．29％）,CD25（0．00％）,CD5和CD19双阳性者占72．73％,CD38与ZAP-70表达有相关性（P〈0．05）。结论：测定B-CLL患者外周血或骨髓白血病细胞的免疫表型、外周血淋巴细胞亚群及NK细胞对于B—CLL的诊断有重要意义。     

急性脑卒中患者T淋巴细胞亚群的变化

目的:探讨急性脑卒中患者T淋巴细胞亚群的变化.方法:连续收集发病24 h内入院的急性脑卒中患者161例为卒中组,入院时对其进行NIHSS评分;并以同时期门诊体检中心42例健康中老年人作为对照组.采用流式细胞仪测受试者入院第1天 T淋巴细胞亚群变化,并进行相关性分析.结果:卒中组早期T淋巴细胞亚群CD3+、CD4+、CD...     

肺癌患者辅助性T淋巴细胞亚群的变化

为探讨人类辅助性Ｔ淋巴细胞 (Ｔｈ)亚群在肺癌患者中的变化规律 ,我们应用抗干扰素 (ＩＦＮ) γ单抗及抗ＩＬ 4单抗通过免疫细胞化学方法[1] ,对肺癌患者大剂量ｒｈＩＬ 2治疗前后的Ｔｈ亚群及外周血单个核细胞 (ＰＢＭＣ)上清液中ＩＦＮ γ及ＩＬ 4含量进行了测定。一、材料及方法1.试剂 :ＩＦＮ γ和ＩＬ 4单抗、依诺霉素 (ｉｏｎｏｍｙｃｉｎ)、十四烷酰佛醇乙酯 (ＰＭＡ)、莫能菌素 (ｍｏｎｅｎｓｉｎ)、皂素 (ｓａｐｏｎｉｎ)均由北京中日友好医院临床医学研究所提供。免疫组化检测试剂盒 (抗小鼠一碱性磷酸酶 ＦＡＳＴＲＥＤ)购自…     

微芯片电泳及毛细管电泳在筛查急性髓系白血病 FLT3-ITD 基因突变中的应用研究简

本研究旨在比较微芯片电泳及毛细管电泳在急性髓系白血病（AML）FLT3-ITD基因突变检测中的可靠性.应用PCR-微芯片电泳和PCR-毛细管电泳法同时检测214例初治AML患者DNA样本FLT3-ITD基因突变,并通过直接测序法进行序列分析.PCR-微芯片电泳结果显示,FLT3-ITD突变阴性151例,阳性58例（58/214,27.1％）,可疑阳性5例（5/214,2.3％）;PCR-毛细管电泳结果显示,FLT3-ITD突变阴性147例,阳性67例（67/214,31.3％）.在毛细管电泳结果为阳性的67例样本中,其中4例微芯片电泳结果为阴性,5例为可疑阳性,用直接测序法进行检测,结果均为突变阳性.这一结果揭示,PCR-毛细管电泳法用于检测FLT3-ITD突变更为准确,虽然微芯片电泳组与毛细管电泳组FLT3-ITD突变检测阳性率并无显著差异（卡方检验,P＞0.05）.结论：PCR-微芯片电泳与PCR-毛细管电泳均可作为简便的FLT3-ITD基因突变筛查方法,但作为新的检测手段,PCR-毛细管电泳法准确度与测序法一致、可用,而PCR-微芯片电泳法作为诊断检测的方法,其准确度有待于改进.     

肺结核患者血清蛋白电泳图谱的调查分析

目的：调查肺结核患者血清蛋白水平，分析电泳图谱六条区带的改变，并与正常人进行比较，探讨临床应用价值。方法：应用法国SEBIA公司全自动毛细管电泳仪对标本进行电泳分析，在日立7600全自动生化分析仪上对血清蛋白水平进行检测。结果：肺结核患者血清总蛋白（TP）水平有所下降（P〈0.05），白蛋白（ALB）水平显著下降（P〈0.05）。患者血清蛋白电泳的6条区带中有4条区带的比率与正常人相比差异存在显著性，ALB区带所占比例有所下降α1、γ区带有所升高（三者均P〈0.05），α2区带明显升高（P〈0．01）。虽然β2比例有轻度增高，β1区带轻度下降（均P〉0.05），但其与正常人相比无统计学意义。结论：肺结核患者血清蛋白电泳图谱可有明显改变，联合检测血清TP、ALB水平进行血清蛋白电泳分析有利于全面了解肺结核患者的血清蛋白成分变化情况，具有一定的临床意义和价值     

Humoral and cellular immune responses to Salmonella typhi in patients with typhoid fever

Humoral and cellular immune responses to Salmonella typhi have been studied in nine children with typhoid fever. By using dot immunobinding assay, anti-O-polysaccharide chain and antilipid A antibody titers have been evaluated during the course of the disease. Anti-O-polysaccharide chain antibody titers are lower at the first week and increase up to the third week of the infection. On the other hand, antilipid A antibody levels, which are already higher at the beginning of the disease, progressively augment during the following weeks. Concerning cellular immunity to S. typhi, antibacterial activity mediated by typhoid peripheral mononuclear cells has been determined. Results show this function to be depressed in the initial phase of typhoid, increasing with the time. Together, these data bring new insight on immunity in typhoid patients.     

肾病患者血清蛋白电泳图谱分析

目的应用血清蛋白电泳分析肾病患者血清蛋白成分的变化,为临床肾病的诊断提供可靠的依据。方法利用琼脂糖凝胶电泳分析仪检测65例肾病患者和75例健康人的血清蛋白成分,并对两组人群的血清蛋白成分进行分析。结果肾病患者组蛋白电泳区带中的白蛋白、α1、α2、β四个区带百分比与健康组比较差异有高度统计学意义（P〈0.001）。实验组γ球蛋白百分比与对照组比较差异无统计学意义（P〉0.05）。结论血清蛋白电泳的测定对肾病患者的诊断、治疗及预后有十分重要的意义。     

Acute leukemia in patients with breast cancer

Symptoms related to pancytopenia were the earliest signs of acute myelogenous leukemia (AML) in two patients with breast cancer. Although some patients with breast cancer may be predisposed to AML, prolonged treatment with alkylating agents may be leukemogenic.     

Acute renal failure in patients with acute leukemia

Acute renal failure may be a contributory cause of death in patients with acute leukemia. The purpose of this study was to define the causes and course of acute renal failure in group of patients with acute leukemia in order to identify preventive measures and reversible aspects of the renal insufficiency. Among 88 patients with acute leukemia whose courses were followed to the time of death, ten developed acute renal failure. Etiologic factors of the renal failure were uric acid nephropathy, sepsis with complicating hypotension and hypovolemia, and the administration of nephrotoxic antibiotics. In one patient ureteral obstruction from clots was responsible for renal failure, while in another patient disseminated aspergillosis led to renal failure. Other causes of acute renal failure in persons with acute leukemia, but not observed in this patient group, are hypercalcemia and leukemic infiltration of the kidneys.     

反复自然流产患者封闭抗体检测及淋巴细胞免疫治疗的临床效果

[目的]了解反复自然流产(RSA)患者封闭抗体(BA)的水平,并观察淋巴细胞免疫治疗的临床效果.[方法]用酶联免疫吸附试验测定218例RSA患者BA水平,并对其中198例BA阴性患者进行淋巴细胞免疫治疗,疗程结束后复查BA,追踪BA转阳后妊娠情况,评估免疫治疗的临床效果.[结果]218例RSA患者中BA阴性率为90.8％ (198/218),198例BA阴性患者经淋巴细胞免疫治疗1个疗程后,BA阳性率为61.1％,2个疗程后阳性率为78.3％,3个疗程后阳性率为86.4％,BA阳性率与治疗前比较差异均有显著性(P＜0.05);198例免疫治疗的患者中,有164例再次妊娠,其中138例获妊娠成功,26例再次发生早期自然流产,妊娠成功率为84.2％,与治疗前比较差异具有显著性(P＜0.05).[结论]RSA患者BA阴性率高,用淋巴细胞免疫治疗可提高RSA患者的BA阳性率,淋巴细胞免疫治疗是一种治疗BA不足引起RSA的安全、有效的方法.     

Immunological characteristics and effect of cyclosporin in patients with immune thrombocytopenia

ObjectiveImmune thrombocytopenia (ITP) is well‐known as an antibody‐mediated autoimmune disease, and it is easy to get response but often turns to relapse or refractory. Cyclosporin is a traditional immunosuppressant and had a good effect on ITP patients. In this paper, we retrospectively analyze the immunological characteristics and therapeutic effect of cyclosporin in 220 patients with ITP.MethodsAll newly diagnosed ITP patients in the Department of Hematology, Tianjin Medical University General Hospital from June 2018 to December 2020 were enrolled and divided into four groups according to the expression of autoantibodies and the occurrence of prodromal infection. The basic data and immune indexes of ITP patients in each group were collected. The clinical immunological characteristics of patients in each group and the therapeutic effect of cyclosporin in each group were analyzed.ResultsMulti‐autoantibody ITP patients were more likely to have low serum albumin and high gamma globulin, and the ratio of albumin to globulin decreased. In addition, the level of IgA and IgG increased and the level of complement C3 and C4 decreased more frequently than those in other groups. The number of CD3+T lymphocytes, especially CD3+CD4+T lymphocytes, decreased in ANA+ITP patients. The number of CD16+CD56+NK cells, pDC/DC ratio, and pDC/mDC ratio were higher than those in other groups. The expression of IL‐6 and the proportion of CD19+B lymphocytes increased in two groups of ITP patients with abnormal autoantibodies. The patients of pro‐infected group were more likely to suffer from coagulation disorder. After treatment with cyclosporin, the response rate increased and the 3‐month relapse rate decreased in all ITP patients, and the therapeutic effect of patients with high megakaryocyte number was significantly higher than that of patients with low megakaryocyte number. The impact factors that influence the effect of glucocorticoid and(or) IVIG were the number of CD3+CD8+T lymphocytes, CD4/CD8 cell ratio, and the number of CD19+B lymphocytes. The independent impact factor of cyclosporin therapeutic response rate was the number of CD3+T lymphocytes.ConclusionsITP is a heterogeneous disease, recurrence may occur during or rapidly after treatment. Cyclosporine included treatment can improve the effective rate of ITP and reduce the relapse rate within 3 months. The number of CD3+T lymphocytes was the only impact factor that influence the therapeutic effect of cyclosporin in ITP patients.     

Multiple distinct sets of stereotyped antigen receptors indicate a role for antigen in promoting chronic lymphocytic leukemia

Previous studies suggest that the diversity of the expressed variable (V) region repertoire of the immunoglobulin (Ig)H chain of B-CLL cells is restricted. Although limited examples of marked constraint in the primary structure of the H and L chain V regions exist, the possibility that this level of restriction is a general principle in this disease has not been accepted. This report describes five sets of patients, mostly with unmutated or minimally mutated IgV genes, with strikingly similar B cell antigen receptors (BCRs) arising from the use of common H and L chain V region gene segments that share CDR3 structural features such as length, amino acid composition, and unique amino acid residues at recombination junctions. Thus, a much more striking degree of structural restriction of the entire BCR and a much higher frequency of receptor sharing exists among patients than appreciated previously. The data imply that either a significant fraction of B-CLL cells was selected by a limited set of antigenic epitopes at some point in their development and/or that they derive from a distinct B cell subpopulation with limited Ig V region diversity. These shared, stereotyped Ig molecules may be valuable probes for antigen identification and important targets for cross-reactive idiotypic therapy.