活化性杀伤细胞免疫球蛋白样受体阳性的NK细胞对靶细胞的杀伤作用

Objective To study the killing effects of the killer cell immunoglobutin-like receptors (KIR) KIR2DS1-positive natural killer (NK) cells against acute, myeloid leukemia (AML) target cells, and to explore the KIR, human leucocyte antigen-Cw, and Cw loci (HLA-Cw) of NK cells, and, HLA-Cw of target cells mismatches destruction mechanism. Methods High-purified NK cells separated by DNYAL bead negative selection from healthy donor peripheral blood were taken as effector cells, and the freshly isolated bone marrow mononuclear cells from newly diagnosed AML patients as target cells. The anti-CD158a, CD158b monoclonal antibody was used to block inhibitory KLR receptors of NK cells (such as: KIR2DL1, KIR2DL2, KIR2DL3). The NK cells cytotoxicities against target cells before and after KIR blockades were detected by MTT reduction assay in vitro. Polymerase chain reaction and sequence specific primers (PCR-SSP) genotyping techniques were used to detect HLA-Cw, KIR gene of the healthy donors and patients. NK cells and target cells were divided into group C1 (expressing HLA-Cw 01, 03, 07, 08, 12, 14, 16 alleles), C2 group (expressing HLA-Cw 02, 04, 05, 06, 15, 17, 18 alleles) and the C1/C2 group (co-expressing the alleles in C1 group and C2 group) based on HLA-Cw. Results The purity of NK cells analyzed by flow cytometry was (90.8±6.08)%, and the killing effects of NK cells were significantly enhanced after inhibitory KIR blockades (t=-3.00, P=0.005). The cell lysis in C1 group, KIR2DS1+ NK cells against C2 group target cells (57.37±1.40)% was significantly higher than that against C1 group (44.19±4.67) % and C1/C2 group (36.77±6.56)% target cells (F= 11.87, P = 0.021), furthermore the differences in cell lysis among the above three groups become more evident after the inhibitory KIR blockades (F = 18. 72, P=0. 009). Conclusions The activity of NK cells was increased after the inhibitory KIR blockades, and the killing activities of KIR2DS1+ NK cells were higher than KIR2DS1 NK cells. The incompatibility between KIR, HLA-Cw of NK cells and HLA-Cw of target cells mediated NK alloactivation, realizing "missing self" recognition, and enabling NK cells cytotoxieity against targets.     

脾切除对特发性血小板减少性紫癜患者可溶性选择素表达的影响

目的:研究特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)患者可溶性选择素的表达水平,及其与脾切除治疗疗效的关系.方法:利用19例激素治疗疗效不良者的ITP,在全麻下行脾切除术,于术前术后分别抽全血用ELISA法检测可溶性选择素E、P、L(sE-selectin、sP-selectin、sL-selectin);同时检测血小板计数.15名健康献血者为正常对照.结果:①ITP术前sE-selectin 水平为58.2 ng/ml,明显高于正常(28.3 ng/ml,P<0.05),术后逐步下降,在术后一个月接近正常水平;sP-selectin/Plt术前A组远高于正常水平(7.69 vs 0.6 fg/platelet,P<0.05),术后一个月下降至正常水平; sL-selectin与正常无明显差异.②A组18例特发性血小板减少性紫癜术后获随访,17例属反应极好,1例属反应良好;术后一个月平均血小板数为188.3×109/L,术后六个月为198.6×109/L,术后一年为136.6×109/L,术后二年为234.1×109/L,术后三年为176.5×109/L.结论:选择素参与了特发性血小板减少性紫癜血小板破坏的病理过程,ITP术前表达的sE-selectin、sP-selectin/Plt较高,脾切除后sE-selectin、sP-selectin/Plt明显下降.     

陈发性睡眠性血红细胞尿患者测定CD55,CD59的意义

本文采用流式细胞技术测定６例陈发性睡眠性血红蛋白尿（ＰＮＨ）,１１例再障－ＰＮＨ综合征,１０例再生障碍性贫血（ＡＡ）患者外周血淋巴细胞膜ＣＤ５５和ＣＤ５９标记率。６例ＰＮＨ患者均表现出ＣＤ５５和ＣＤ５９下降（Ｐ〈０．０１）,１１例再障－ＰＮＨ综合征患者也表现出ＣＤ５５和ＣＤ５９下降（Ｐ〈０．０５）;１０例再生障碍性贫血患者中８例ＣＤ５５和ＣＤ５９标记率在９５％以上,２例标记率在８５％以上,与对照组     

伴有Y染色体缺失的恶性血液病患者临床及实验室研究8例分析

目的 探讨恶性血液病伴有Y染色体缺失患者临床及实验室特点.方法 对8例恶性血液病患者进行常规遗传学分析,用骨髓细胞24小时短期培养后,制备染色体标本,R技术显带后进行核型分析;利用荧光原位杂交方法,采用着丝粒探针CSP X/CSP Y(绿/红)检测Y染色体缺失;流式细胞仪间接免疫荧光法检测白细胞表面抗原,综合分析患者临床表现和实验室资料.结果 8例伴有Y染色体缺失患者中位年龄53岁(29～76岁),其中急性髓细胞性白血病(AML)5例,均有贫血表现,出血较轻.伴有附加染色体异常4例,其中伴有t(8;21)2例.患者完全缓解率低,生存期短.结论 Y染色体缺失常见于AML,尤其是伴有t(8;21)的AML,可以发生于任何年龄,具有独特的临床特征,预后不良.     

双丹颗粒辅助治疗冠心病效果观察及对颈动脉粥样硬化的影响

目的 观察双丹颗粒治疗冠心病的效果及对颈动脉粥样硬化的影响。方法 2020年8月至2022年7月该院收治的冠心病患者106例，随机分为观察组与对照组各53例。两组均予西医常规治疗，口服阿司匹林肠溶片、美托洛尔片、阿托伐他汀钙片。观察组加用双丹颗粒治疗，每日3次，每次1袋。连续治疗5周比较两组疗效、心绞痛症状改善情况，治疗前后颈动脉粥样硬化程度指标[颈动脉中膜厚度(IMT)、颈内总动脉(ICA)内径、双侧颈总动脉(CCA)内径]、心功能指标[左室射血分数(LVEF)、每搏输出量(SV)]水平变化。结果 观察组治疗总有效率92.45%(49/53)高于对照组的77.36%(41/53),LVEF、SV水平高于对照组，心绞痛频率、持续时间、硝酸甘油用量、IMT、ICA内径、CCA内径均低于对照组，差异均有统计学意义(χ²=4.71,t=3.95、4.59、5.63、5.53、6.51、3.26、6.51、4.04;P <0.05)。结论 双丹颗粒辅助治疗冠心病，能减轻患者心绞痛症状，改善颈动脉粥样硬化及心功能。     

胃康灵颗粒辅助治疗急性胃炎效果观察

目的 观察胃康灵颗粒辅助治疗急性胃炎的效果。方法 中国人民解放军联勤保障部队第九〇三医院2018年7月至2022年6月就诊的急性胃炎患者80例，随机分为观察组与对照组各40例。两组均予阿托品注射液联合注射用奥美拉唑钠静脉滴注，观察组加用胃康灵颗粒口服，两组连续治疗7天后比较疗效，腹痛、腹泻、恶心呕吐、反酸症状消失时间，治疗前后血清白介素-17(IL-17)、IL-6、CRP水平变化。结果 观察组治疗总有效率为92.6%(37/40)，高于对照组的75.0%(30/40)；腹痛、腹泻、恶心呕吐、反酸消失时间均短于对照组，治疗后IL-17、IL-6、CRP水平均低于对照组，差异均有统计学意义(χ²=4.50,t=2.53、3.56、4.44、3.60、4.26、4.04、4.26;P <0.05)。结论 在常规阿托品联合奥美拉唑治疗急性胃炎基础上，加用胃康灵颗粒，较常规治疗能有效改善患者临床症状，降低炎症反应。