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.     

药物涂层球囊与药物洗脱支架治疗冠状动脉再狭窄的疗效比较

目的比较药物涂层球囊（DCB）与药物洗脱支架(DES)治疗冠状动脉再狭窄(ISR)的疗效,给临床诊疗提供策略指导。方法回顾分析27例ISR再次经皮冠状动脉介入治疗（PCI）者的临床资料,再次PCI时采用：DCB18例,DES9例。比较两组患者的一般基线资料,包括年龄、性别、吸烟史、高血压病史、糖尿病史、高脂血症史;定量分析冠状动脉造影的影像资料,比较两组靶病变的最小管腔直径与最小管腔面积。结果两组术前靶病变最小管腔直径及最小管腔面积比较,均无统计学差异（均P＞0.05）;两组术前与术后即刻靶病变管腔直径与面积的变化均有统计学差异（均P＜0.01）。术后即刻靶病变管腔直径与面积的改善,DES组优于DCB组,均有统计学差异（P＜0.01）。两组6~12个月、12~24个月、24~36个月靶病变管腔直径与面积,均无统计学差异（均P＞0.05）,两组患者治疗相关费用（住院总费用、日均费用、耗材费用）和术时所接受X线辐射剂量对比,均无统计学差异（均P＞0.05）。结论DCB与DES对ISR处理均有效,且DCB治疗ISR不劣于DES。DCB是ISR再次PCI的良选。     

腹腔镜粘连松解术治疗粘连性肠梗阻27例临床分析

目的探讨腹腔镜粘连松解术治疗粘连性肠梗阻的应用价值。方法对我院2005年7月至2011年9月期间采用腹腔镜进行肠粘连松解术的27例患者的临床资料进行回顾性分析。结果 27例患者中除2例因术中探查发现小肠坏死而中转开腹行肠切除外,其余25例均手术成功,手术时间(65±15)min(40～115 min)。27例均获随访,随访时间(14±6)个月(8个月～2年),1例患者于术后1个月时有阵发性腹痛,经保守治疗缓解,其余病例均无腹胀、腹痛等症状发生。结论腹腔镜粘连松解术治疗粘连性肠梗阻具有创伤小、恢复快的优点,是较理想的治疗术后肠粘连的手段。     

L-T4预防结节性甲状腺肿术后复发的观察

手术是治疗结节性甲状腺肿的主要手段,但术后复发率较高,我院采用术后口服L-T4(左旋甲状腺素片)预防复发,疗效较好,现报告如下.     

自血疗法在肺系疾病中的应用研究进展

目的 对自血疗法在肺系疾病中的应用进行分析和综述.方法 检索中国知网、万方、维普数据库中关于自血疗法在肺系疾病中的应用的研究文献,对文献进行全文阅读及整理,探讨其临床效果及存在问题,并进行总结和展望.结果 自血疗法的运用可以改善肺系疾病(支气管哮喘、慢性阻塞性肺疾病、变应性鼻炎、支气管扩张等)患者症状,减少发病次数,从...     

浅谈《傅青主男女科》的男科学术特点

《傅青主男女科》为清代著名医家傅山所著，包括《傅青主女科》、《傅青主男科》、《傅青主产后编》。傅山，原字青竹，后改字青主，山西阳曲(太原)人。傅氏博通经史百家，工诗文书画，精于医药。“世传先生字不如诗，诗不如画，画不如医，医不如人。”明亡后，隐居不仕，其医学著作不见流传，直至道光年间，才有《傅青主女科》刊行，后又有《傅青主男科》等问世。以《傅青主女科》流传最广，影响最大。《傅青主男科》流传较少，本文主要谈及傅氏男科的学术思想和用药特点，现叙述如下。     

参附三七汤救治心衰、大咯血

彭某某,女,28岁。农民。因心慌、气促5年,加重伴下肢浮肿1月,咯血1天,于1990年2月13日入院。入院诊断为“风心病、二尖瓣狭窄、心衰Ⅲ级、心房纤颤”。体查:体温37℃,脉搏84次/分,呼吸34次/次,血压12/8 Kpa。慢性危重病容,极度疲乏,端坐呼吸,颈静脉怒张,心尖搏动瀰散,可触及舒张期震颤,心界向两侧扩大,心率94次/分,节律不齐,二尖辩区可闻及Ⅲ级舒张期隆隆性杂音,肝在右肋缘下     

肺俞穴注射鹿茸精对支气管哮喘缓解期患者血浆皮质醇、醛固酮及IgE水平的影响

目的：观察鹿茸精注射液肺俞穴注射对支气管哮喘缓解期患者血浆皮质醇、醛固酮及IgE含量的影响，从而证实鹿茸精注射液的补肾益肺功能。方法：对35位支气管哮喘患者取双侧肺俞穴注射鹿茸精注射液，治疗前后分别测定患者血浆皮质醇、酮固酮及IgE的含量并进行统计学处理。结果：肺俞穴注射鹿茸精注射液，可以显著降低支气管哮喘缓解期患者IgE水平，显著升高血浆皮质醇、醛固酮水平。     

红细胞变形的动力学行为

应用北京医科大学医学物理教研室和北京地质仪器厂研制的激光衍射仪测量了兔血红细胞在应力松弛过程中变形指数DI随时间的变化。用15％PVP,η=21cP,和η=0.89cP的PBS两种缓冲液,在三种切变率:66秒(-1),400秒~(-1)和800秒~(-1)下进行应力松弛实验。