自体外周血干细胞移植治疗老年人慢性下肢缺血临床研究

目的:评价外周血干细胞移植治疗老年人慢性下肢缺血的临床疗效。方法:应用自体外周血干细胞移植治疗慢性下肢缺血10例,其中下肢动脉硬化闭塞症4例,糖尿病足3例,血管闭塞性脉管炎3例。患肢12条中左5条,右7条。均予G-CSF 300μg/d皮下注射,连用4～6天行外周血干细胞动员,当外周血白细胞计数>30×109/L时,用血细胞分离机单采干细胞,配成干细胞悬液。部分干细胞悬液直接注射至患肢肌肉内,其余干细胞悬液经球囊导管技术灌注至患肢末梢动脉内。结果:患肢疼痛和冷感觉改善率为100%。间歇性跛行3例行走距离明显增加。移植后1个月,5例7条下肢数字减影血管造影结果示均有新生侧支血管形成。结论:外周血干细胞移植治疗慢性下肢缺血安全、简单、有效。     

晚期肝癌患者TNF水平的检测

肿瘤坏死因子(Tumor Necrosis Factor，TNF)是一种多活性因子，可由周围血单核巨噬细胞，淋巴细胞等产生。在体内具有较强的抗肿瘤作用，并参与体内免疫功能的调节，影响机体的代谢，在许多重要的生理和病理活动中都起着积极的调节作用。为探讨TNF在晚期肝癌患者血清中量的变化及对疾病过程的影响。     

Enhancement of contraction of rat mesenteric artery by acteoside: role of endothelial nitric oxide

The present study describes the role of endothelium in the vascular response to purified acteoside from Ligustrum purpurascens in rat mesenteric arteries. In endothelium-intact rings, acteoside (3-50 micromol/L) enhanced phenylephrine-induced contraction without affecting the maximum response. This enhancement was absent in endothelium-denuded rings. Pretreatment with nitric oxide synthase (NOS) inhibitors, N(G)-nitro-L-arginine (L-NNA, 100 micromol/L) and N(G)-nitro-L-arginine methyl ester (L-NAME, 100 micromol/L), or a selective guanylyl cyclase inhibitor, 1H-[1,2,4]oxadiazolo[4,2-alpha]quinoxalin-1-one (ODQ, 10 micromol/L), increased both the sensitivity of vasoconstriction to phenylephrine and the maximal response. The enhancing effect of acteoside (30 micromol/L) was abolished in the presence of L-NAME, L-NNA, or ODQ. Tetraethylammonium (TEA(+), 3 mmol/L), a putative K(+) channel blocker, also abolished the effect of acteoside. CaCl2 (0.01-10 mmol/L) induced contractions in 50 mmol/L K(+)-containing Krebs solution. Neither acteoside nor TEA(+) affected CaCl2-induced contraction in elevated K(+) solution. Acteoside (30 micromol/L) attenuated acetylcholine-induced endothelium-dependent relaxation. Acteoside did not influence relaxation induced by exogenous NO donors, hydroxylamine or sodium nitroprusside, in endothelium-denuded rings. Acteoside did not alter endothelium-independent relaxation induced by forskolin or NS 1619. The present results indicate that acteoside enhanced the evoked vasoconstriction, mainly through inhibition of endothelial NO production/release and inhibition of NO-mediated TEA(+)-sensitive activation of K(+) channels.     

左髂静脉压迫综合征的外科治疗

目的 探讨对左髂静脉压迫综合征患者外科处理的适应证、手术方法和围手术期的处理经验。方法 左下肢静脉曲张或慢性肿胀46例,行介入治疗32例,进腹行髂静脉松解、右髂动脉后置吻合8例,髂静脉病变段切除、人工血管原位移植6例,同时或二期手术处理大隐静脉及股静脉瓣膜41例。急性左下肢深静脉血栓形成36例,取栓后行左髂静脉病变段切除、人工血管原位移植25例,髂一下腔静脉搭桥11例。随访6～66个月。结果 无手术死亡和急性肺动脉栓塞发生。效果良好。结论 左髂静脉病变是左下肢静脉曲张或肿胀和急性左下肢深静脉血栓形成的重要原因,应尽早处理。介入治疗或外科手术治疗能取得良好的效果。     

Expression of a "self-"antigen by human tumor cells enhances tumor antigen-specific CD4(+) T-cell function

CD4(+) T cells can recognize "self" tumor antigens, but the impact of tumor cell expression of self-antigens on CD4(+) T-cell function in humans is unknown. Here, we identify a new epitope (ISPNSVFSQWRVVCDSLEDYD) derived from tyrosinase-related protein-1 (TRP-1) using a predictive algorithm and mice transgenic for a chimeric HLA-DRB1*0401 molecule. We then compared the functions of TRP-1-epitope-specific, CD4(+) T-cell responses in normal healthy individuals to those found in patients with metastatic malignant melanoma. Surprisingly, we found that tumor-bearing patients had significantly higher levels of TRP-1-specific, CD4(+) T-cell function than healthy volunteers as measured ex vivo. Thus, the net effect of "self" antigen expression by tumor cells was the enhancement of tumor antigen-specific CD4(+) T-cell function, rather than immunosuppression. These findings indicate that antigens expressed by malignant melanoma cells can partially activate CD4(+) T lymphocytes.     

梗阻性黄疸时胃α_1肾上腺素能受体的密度变化

目的：研究大鼠α1肾上腺素能受体在胃粘膜和粘膜下层的分布和梗阻性黄疸时密度的变化。方法：16只Wistar大鼠分成正常组与黄阻性黄疸组，每组8只。并采用光学显微镜放射自显影术。结果：大鼠胃粘膜无α1肾上腺素能受体。α1肾上腺素能受体分布在胃粘膜下层动脉平滑肌细胞表面。正常大鼠α1肾上腺素能受体密度在胃体大干胃窦，梗阻性黄疸时α1肾上腺素能受体密度明显减少。结论：由于α1肾上腺素能受体密度在胃体大于胃窦，所以交感-肾上腺素系统对胃体血流的影响大于胃窦。梗阻性黄疸α1肾上腺素能受体明显减少，可能是胃粘膜下血管对去甲肾上腺素敏感性降低的原因之     

Nickel inhibits urocortin-induced relaxation in the rat pulmonary artery

Urocortin relaxes rat pulmonary arteries partly through a cyclic AMP-dependent but Ca(2+) channel-independent mechanism. However, other participating mechanisms are relatively unknown. The present study was designed to examine whether the forward mode of Na(+)-Ca(2+) exchangers play a role in the relaxant responses to urocortin in isolated rat small pulmonary arteries. Endothelium-denuded rings were mounted on small vessel myographs for measurement of changes in isometric tension. Urocortin inhibited 9,11-dideoxy-11alpha,9alpha-epoxy-methanoprostaglandin F(2alpha) (U46619)-induced contraction in a concentration-dependent manner and this inhibition was reversed by astressin, a corticotropin-releasing factor receptor antagonist. Micromolar concentrations of nickel (Ni(2+)) chloride, a putative inhibitor of the Na(+)-Ca(2+) exchanger, reduced the relaxant responses to urocortin. Urocortin-induced relaxation was abolished in a Na(+)-free solution, a condition that eliminates influence of the forward mode of Na(+)-Ca(2+) exchanger. In contrast, the relaxant responses to atrial natriuretic peptide or forskolin were unaffected by Ni(2+) or with removal of extracellular Na(+). The present results provide indirect evidence suggesting that stimulation of Na(+)-Ca(2+) exchangers may contribute to urocortin-induced endothelium-independent pulmonary artery relaxation.     

细胞介素融合蛋白质粒促进乙肝病毒DNA疫苗诱导的抗体产生

目的初步评价人白细胞介素融合蛋白质粒(pFP)以不同方式和剂量,联合乙肝DNA疫苗(pS2.S)1次性接种诱导健康小鼠体液免疫应答的效果,并探讨其作用机制.方法第1批分为pS2.S(10μg.只-1)与pFP(10μg.只-1)同时混合,于pFP后或前3日及分左、右侧胫前肌注射4种方式.第2批为不同剂量的pFP与一定剂量(10μg.只-1)的pS2.S混合共注射.第3批为不同剂量pS2.S与pFP按11混合共注射免疫实验.结果pFP与pS2.S混合共注射免疫效果最佳,以此方式改变pFP剂量联合pS2.S免疫2、4周时,血清抗-HBs阳性例数及水平以2者剂量按11配伍为最高,按此配伍免疫4周时,高(H)、中(M)、低(L)剂量组血清抗-HBs阳性率均为100%,而L组血清抗-HBs水平(51.1±23.8)mIu@ml-1均较M组(217.4±64.1)mIu@ml-1及L组(212.1±124.6)mIu·ml-1低,差异具有显著性(t=7.168,P＜0.01;t=2.838,P＜0.05).联合免疫接种2天后,分离采集各组10只小鼠局部引流淋巴结(LN),淋巴细胞及树突状细胞(DCs)计数结果,pS2.S+pFP组DCs密度及其占LN细胞的百分比均较pS2.S+pcDNA3.1组高.结论pFP与pS2.S剂量按11配伍混合共注射免疫效果最佳,pFP可能通过促进局部组织抗原呈递功能较强的DCs的增殖及活性而达到其佐剂效应.     

胰岛素昏迷治疗精神分裂症致精神衰退100例

目的：研究影响精神衰退的相关因素。方法：对曾用正规胰岛素昏迷疗法治疗的１００例精神分裂症患者的临床疗效进行评估,并设对照组进行对比分析研究。结果：精神病的精神衰退与胰岛素昏迷疗法相关。临床资料,胰岛素昏迷治疗衰退比例８６．０％,服用抗精神病药物治疗的衰退比例为１２．０％,经ｔ检验差异极显著（Ｐ〈０．０１）。结论：胰岛素昏迷治疗加速加重精神分裂症的精神衰退,对照组中单纯型、青春型患者由于未能长期服药