自身免疫性溶血性贫血患者输血的临床问题

输血是治疗自身免疫性溶血性贫血（ＡＩＨＡ），特别是严重ＡＩＨＡ的手段之一，然而由于患者血液中自身抗体的存在使ＡＩＨＡ的输血问题变得复杂，一般教科书上在叙述ＡＩＨＡ的治疗时，对输血问题均强调“谨慎”或“尽量避免”，不少临床医生对ＡＩＨＡ的输血望而却步，...     

钙离子载体促进K562细胞诱导分化成DC样细胞的研究

目的 观察钙离子载体(CI)诱导慢性髓系白血病细胞株K562分化成DC样细胞的作用.方法 将细胞分三组培养:第1组加入GM-CSF 1 000 U/ml和IL-4 500 U/ml;第2组加入GM-CSF 1 000 U/ml、IL-4 500 U/ml 和CI 375 ng/ml;第3组为对照,不加细胞因子,也不加CI.流式细胞仪检测各组细胞表面免疫表型的表达,MTT 比色法检测其刺激同种异体T 细胞增殖的作用.结果 细胞因子加CI 组培养48 h后即可见细胞形态呈多形性,有些细胞可见突起;96 h后CD80、CD86、CD83的表达率较对照组、单用细胞因子明显提高,明显刺激同种异体T 淋巴细胞增殖.单用细胞因子组培养96 h后细胞形态无明显变化,CD80、CD86的阳性率明显高于对照组,CD83与对照组之间差异无统计学意义,不能明显刺激同种异体T 淋巴细胞增殖.结论 CI与GM -CSF和IL-4联合可迅速将K562细胞诱导成DC样细胞;CI与细胞因子可能有协同作用.     

白介素6与多发性骨髓瘤

新近研究表明，白介素是多发性骨髓瘤细胞的主要生长因子，ＭＭ病人体内过多的ＩＬ－６主要由骨髓基质细胞的旁分泌产生。ＩＬ－６与瘤细胞膜ＩＬ－６受体结合，活化伟导链ｇｐ１３０，促进瘤细胞增生。ＭＭ细胞ｇｐ１３０传导链及其后信号传导的蛋白质突变可能是导致恶性细胞分化用阻滞的重要环节。     

树突状细胞与肿瘤的免疫治疗

尽管化学治疗和放射治疗的进步明显提高了肿瘤治疗的缓解率 ,延长了患者的生存期 ,但许多肿瘤尚无法治愈 ,因此有必要发展其它治疗方法 ,尤其是抗肿瘤的免疫疗法。树突状细胞 (DCs)在激发 T细胞免疫方面起重要作用 ,可能成为抗肿瘤免疫疗法理想的佐剂 ,值得研究和开发。1　肿瘤抗原和抗肿瘤免疫肿瘤细胞表面存在可被 T细胞识别的抗原 ,这是抗肿瘤细胞免疫的基础 ,也是开展抗肿瘤特异性免疫治疗的前提。这些被认为具肿瘤特异性的抗原 (TSA)包括 [1 ] :(1)变异的蛋白 ,如 K- ras,p5 3,erb B2 等 ;(2 )染色体易位产生的融合基因产物 ,如在…     

哺乳动物耳蜗Kölliker器的形态学及退化机制研究

目的　探索哺乳动物耳蜗Kölliker器退化过程中是否存在自噬现象。方法　以P1~P14的SD大鼠耳蜗为研究对象,运用HE染色和透射电镜观察Kölliker器在耳蜗早期发育过 程中的显微和亚显微形态学改变,并利用免疫组化、Western blot分子生物学实验观察自噬标记物LC3、Beclin1、P62在早期发育过程中的动态变化。结果　利用HE染色及透射电镜大鼠耳蜗Kölliker器支持细胞的形态从底回向顶回逐渐由假复层柱状上皮转变为单层立方上皮,细胞层数和数量逐渐减少,最终形成成熟的内沟区域,并观察到自噬小体。免疫组化耳蜗Kölliker器支持细胞LC3-II、Beclin1、P62呈阳性。Western blot观察到P3~P10自噬相关蛋白呈逐渐下降的趋势。结论　哺乳动物耳蜗Kölliker器退化过程中存在时间依赖性的自噬现象。     

白介素6与多发性骨髓瘤

新近研究表明,白介素6(IL-6)是多发性骨髓瘤(MM)细胞的主要生长因子。MM病人体内过多的IL-6主要由骨髓基质细胞的旁分泌产生。IL-6与瘤细胞膜IL-6受体结合,活化传导链gp130,促进瘤细胞增生。MM细胞gP130传导链及其后信号传导的蛋白质突变可能是导致恶性浆细胞分化阻滞的重要环节。抑制IL-6作用可能成为MM新的重要治疗方法。     

强直性脊柱炎外周血破骨细胞前体细胞活性的研究

Objective To investigate the number of osteoclast (OC) precursor in the peripheral blood of patients with ankylosing spondylitis (AS) and its relationship with serum receptor activator of nuclear factor KB-ligand (RANKL) and Osteoprotegerin (OPG) concentration as well as the disease activity. Methods The peripheral blood mononuclear cells from 8 cases of AS patients and 5 healthy controls were cultured in the medium containing macrophage colony-stimulating factor (M-CSF) (25 ng/ml) and RANKL (40 ng/ml). After being cultured for 14 days, cytochemistry was applied to detect tartrate-resistant acid phosphatase (TRAP) expression and the cells with TRAP expression and ≥3 nuclei were counted and defined as OC. Bone resorption assay was used to demonstrate OC function. ELISA was used to measure serum RANKL and OPG concentration in 23 cases of AS and 17 healthy controls. The relationship was analyzed in AS patients between the number of OC precursors and serum RANKL and OPG concentration as well as the disease activity. The indicators of disease activity were Bath ankylosing spondylitis disease activity index (BASDAI), Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). T test, t' test and Spearman correlation were selec-ted. Results ① Significantly higher OC production was observed in the peripheral blood of AS patients than that of healthy control group. The OC number per ten fields was 10.9±3.4 and 6.2±1.3 respectively (P<0.05); ② There was significant difference between AS patients and healthy controls in serum concentration of OPG and RANKL and the ratio of RANKL/OPG. OPG was significantly higher in AS patients [(157±49) pg/ml] than in healthy controls [(105±20) pg/ml] (P<0.05). RANKL was significantly higher in AS patients [(5.4± 3.8) pg/ml] than in healthy controls [(1.6±0.8) pg/ml] (P<0.05). The ratio of RANKL/OPG was significantly higher in AS patients (0.037±0.026) than in healthy controls (0.016±0.008) (P<0.01 );③Significantly positive correlation was observed between the OC number and the serum concentration of RANKL (r=0.692, P=0.009), the ratio of RANKL/OPG (r=0.813, P=0.001);④ In AS patients, serum concentration of OPG was found to have significantly negative correlation with BASDAI (r=-0.444, P=0.044). Serum RANKL concentration was found to have significantly positive correlation with BASDAI (r=0.543, P=0.011). The ratio of RANKL/OPG was found to have significantly positive correlation with BASDAI (r=0.672, P=0.001). Conclusion ① More OC precursors exist in the peripheral blood of AS patients. These cells may differentiate into osteoclasts, which might play a role in joints destructions in AS;② The mechanism of high OC production is likely to be due to high RANKL concentration which is caused by inflammatory reaction.     

骨髓坏死2例报告

骨髓坏死２例报告福建医科大学附属第一医院陈红新，关家瑞，陈君敏骨髓坏死（ＢＭＮ）是一种血液系统疾病和恶性肿瘤的罕见并发症，预后不良。我院自１９８５年以来共发现２例，报告如下。一、病例报告例１，男性，３８岁。以全身骨痛进行性加剧，伴脸色苍白、低热、多汗...     

体外诱导树突状细胞向破骨细胞分化的研究进展

破骨细胞（OC）来源于骨髓来源的单核细胞,在骨代谢平衡中起重要作用.近年研究发现,免疫系统和骨系统关系密切,参与免疫调节的树突状细胞（DC）在多发性骨髓瘤（MM）环境下可以细胞融合方式转化为参与骨重建的bOC,且是比单核细胞更具分化效率的、更接近OC的前体细胞.这对于理解MM无疑有重要作用.该文就DC转化为OC的生物学过程及其临床意义予以综述.     

自体骨髓移植治疗晚期转移性乳腺癌

1例晚期转移性乳腺癌患者采用大剂量联合化疗与自体骨髓移植(ABMT)。患者58岁,肝、肺、骨骼、肾与淋巴结均有转移,且有不同程度的功能损害,用一般剂量的联合化疗无效,ABMT后肝脏和肺部转移灶明显缩小,全身情况明显改善。