人外周血树突状细胞的分离与鉴定

目的:体外分离培养并鉴定人外周血树突状细胞,并观察其抗原呈递功能。方法:实验于2005-05/2006-11在南方医科大学南方医院肿瘤中心生物治疗实验室完成。从人类白细胞抗原A2表达阳性的健康人外周血中分离获得单个核细胞。培养5h后洗涤贴壁细胞,加入含有10%人AB血清的RPMI1640培养基,及重组人粒细胞-巨噬细胞集落刺激因子和重组人白细胞介素4,于培养的第1,3,6天对树突状细胞的形态、表型进行分析,并定期检测树突状细胞的纯度与得率。抽取与以上树突状细胞不同来源的其他健康人外周血。经淋巴细胞分离液分离后,获取非贴壁细胞,用含10%人AB血清的1640培养基重悬,加入白细胞介素2继续孵育6d,作为同种异体T淋巴细胞。将树突状细胞分为两组,一组按常规方法培养6d,另一组在培养至第5天时加入黑色素瘤抗原基因A3编码的多肽继续培养24h。在经紫外线处理后的96孔板中,分别加入树突状细胞悬液1×104,5×103,2×103,1×103细胞/每孔,以自身T淋巴细胞作为对照,每孔设3个复孔,分别加入1×105淋巴细胞/每孔。评价树突状细胞刺激T淋巴细胞增殖的能力。结果:①单个核细胞体外培养至第6天,可获得大量、90.81%高纯度的树突状细胞,能够较高地表达21.8?1a、99.0%HLA-DR、63.4?80、18.9?83和80.6?86。②将诱导培养6d获得的两组树突状细胞作为刺激细胞,以不同的浓度与同种异体淋巴细胞混合,均可产生增殖反应;经过黑色素瘤抗原基因A3编码的多肽处理的各种比例的树突状细胞,较相应未经黑色素瘤抗原基因A3编码的多肽处理的树突状细胞激发淋巴细胞增殖的能力明显增强,浓度相对较高的树突状细胞刺激效果最明显,能够强烈地激发同种混合淋巴细胞增殖。结论:得到了一群较高程度表达CD83、CD86和HLA-DR分子、体外可强烈激发同种异体T淋巴细胞增殖的树突状细胞群。     

The prevalence of immunization to Duffy antigens in a population of known racial distribution

A retrospective study at our hospital determined the race or ethnicity of patients seen in an 8-year period who had formed antibodies to Duffy antigens. During that time, 9876 serologic investigations had been performed as a result of a positive direct or indirect antiglobulin test. Among these samples, sera from 45 previously transfused or pregnant patients contained anti-Fya and two contained anti-Fy3. Twenty-nine of the sera that contained anti-Fya (62%) were from blacks, 12 (25%) were from whites, and 6 (13%) were from Hispanics. Both examples of anti-Fy3 were made by black patients. Red cells (RBCs) from 21 of the black patients were Fy(a-b-), those from 7 were Fy(a-b+), and those from 1 could not be phenotyped. RBCs from 17 of the non-black patients were Fy(a-b+) and those from 1 could not be phenotyped. The population of transfused patients evaluated in this study was 47 percent black, 29 percent white, and 24 percent Hispanic. Calculations based on an expected Fy(a-) frequency of 88 percent in blacks, 33 percent in whites, and 20 percent in Hispanics predict that the racial makeup of the Fy(a-) population at our hospital would be 73 percent black, 18 percent white, and 9 percent Hispanic, which is not significantly different (p = 0.25) from the racial makeup of the patients forming anti-Fya and -Fy3. These data indicate that blacks make antibodies to Duffy antigens as frequently as non-blacks.     

From GHRH to IGF-1 and downstream: clinical phenotypes and biological mechanisms

Genetic defects have been observed at almost all levels of the GHRH-IGF-1 axis. The first observations of GH-1 gene deletions date some 30 years ago. Whereas mutations in the GH-1 and GHRHR genes account for the majority of mutations detectable in patients with Isolated Growth Hormone Deficiency (IGHD) resulting in postnatal growth failure, the overall detection of genetic defects in these patients remains low with app. 10-15%. Similarly, at the lower end of the GHRH-IGF-1 axis the frequency of defects within the IGF-1 and IGF-1 receptor (IGF1R) genes might hardly approach 10% of all cases with intrauterine and postnatal growth retardation. In this article we examine the pathomechanisms involved in the genetic defects at both ends of the GHRH-IGF-1 axis and describe the clinical and biochemical phenotypes involved. Although it seems tempting to increase the detection rate by limiting genetic investigations to patients with phenotypic characteristics described, at present it seems more appropriate to follow a permissive approach for such investigations as we are probably have not envisioned the full spectrum of phenotypic variability.     

Prognostic factors in mucoepidermoid carcinoma of the salivary glands

BACKGROUND:

Mucoepidermoid carcinoma (MEC) is the most common malignancy of the major salivary glands. Prior reports noted histological grade and tumor stage as consistently important prognostic factors. This study reviewed the experience of patients with MEC at the University of Texas MD Anderson Cancer Center to determine the impact of clinical and pathologic findings on disease outcomes.

METHODS:

A retrospective clinical review was performed of patients with salivary gland MEC treated at a tertiary cancer center from 1990 to 2007.

RESULTS:

A total of 125 patients were included. The 5‐year overall survival and disease‐free survival of all patients were 79.3% and 76.5%, respectively. Patients with low‐ and intermediate‐grade disease had significantly better overall survival and disease‐free survival than patients with high‐grade disease, but no difference in survival rates was found between low‐ and intermediate‐grade disease. Pathologic results of positive lymph nodes, extracapsular lymph node spread, and perineural invasion were all found to be poor prognostic indicators. On multivariate analysis, advanced disease stage and perineural invasion were found to be the most significant prognostic factors.

CONCLUSIONS:

Patients with either low‐ or intermediate‐grade tumors uniformly have favorable local control and survival. High histological grade, advanced stage, perineural invasion, positive surgical margins, and submandibular location all portend for poor outcomes in MEC. Further advances in therapy are needed to improve outcomes for high‐grade and advanced‐stage disease. Cancer 2012. © 2011 American Cancer Society.     

Maternal Temperature Elevation and Occiput Posterior Position at Birth Among Low‐Risk Women Receiving Epidural Analgesia

Introduction: To evaluate the relationship between maternal temperature elevation and occiput posterior position at birth as well as the association of fetal head position and temperature elevation on method of birth among women receiving epidural analgesia. Methods: We conducted a secondary analysis of data from the Fetal Orientation during Childbirth by Ultrasound Study (FOCUS), which used serial ultrasounds to evaluate the effect of epidural anesthesia on fetal position at birth in low‐risk women. The current analysis was limited to the 1428 study participants who received epidural analgesia. Results: In our population, 47% (n = 669) of women had a maximum intrapartum temperature greater than or equal to 99.6°F (37.6°C). The prevalence of fetal occiput posterior position at admission did not differ between women who later developed temperature elevations (24.4%) and those who did not (23.6%, P= .70). Women who developed an elevated temperature greater than or equal to 99.6°F (37.6°C) had an increased risk of occiput posterior fetal head position at birth regardless of the amount of temperature elevation (odds ratio [OR]= 2.0; 95% confidence interval [CI], 1.5‐2.8); the association persisted after control for potentially confounding factors (adjusted OR = 1.5; 95% CI, 1.1‐2.1). The cesarean birth rate among women with both temperature elevation and occiput posterior position at birth was more than 12 times the rate of women with neither risk factor (adjusted OR = 12.6; 95% CI, 7.5‐21.2). Discussion: Intrapartum temperature elevation among women receiving epidural analgesia, even if only to 99.6°F (37.6°C), is associated with approximately a 2‐fold increase in the occurrence of occiput posterior fetal head position at birth. Additionally, although this observational study cannot establish causal links, our findings suggest that the relationship between epidural‐related intrapartum temperature elevation and occiput posterior position at birth could contribute to an increased cesarean birth rate among women receiving epidural analgesia for pain relief in labor.