清肺承气颗粒对重症急性胰腺炎患者感染期免疫反应的影响

目的 观察清肺承气颗粒对重症急性胰腺炎（SAP）患者感染期免疫反应的影响.方法 将72例确诊为SAP感染期的患者随机分为对照组33例和观察组39例;对照组给予西医常规治疗＋安慰剂,观察组给予西医常规治疗＋清肺承气颗粒,疗程为7d.分别于第1、3、7天,检测患者外周血CD14＋单核细胞人类白细胞抗原DR位点（HLA-DR）、T辅助淋巴细胞1/2（Th1/Th2）、自然调节性T细胞（Treg）.结果 28 d内观察组死亡2例（5.13％）,对照组死亡7例（21.21％）,P ≤0.05.两组第1、3天外周血HLA-DR、Th1/Th2、Treg比较,P均＞0.05.第7天,观察组外周血HLA-DR、Th1/Th2、Treg分别为87.02％±15.94％、5.96 ±6.12、4.58％±3.67％,对照分别为51.01％±33.90％、2.53 ±1.74、8.87％±6.19％;两组比较,P≤0.01、0.05、0.05.结论 清肺承气颗粒可减轻SAP感染期患者免疫抑制、促进免疫恢复,从而降低患者的病死率.     

Validity and reproducibility of an interviewer-administered food frequency questionnaire in Austrian adults at risk of or with overt diabetes mellitus

Food frequency questionnaires (FFQs) provide an inexpensive tool for dietary assessment. Given the scarcity of data on their validity for nutritional analysis in persons with overt diabetes mellitus or with increased risk of diabetes (relatives of patients with diabetes), this study tests the hypothesis that an FFQ, adapted to local dietary habits, yields a reliable estimate of nutrient intake when compared with 7-day food record (7DR) in healthy, prediabetes, and diabetes cohorts. One hundred three volunteers (50 persons with overt diabetes mellitus, 24 relatives of patients with diabetes, and 29 nondiabetic individuals without a family history of diabetes) completed both FFQ and 7DR. A second FFQ was completed by 100 of these volunteers after 3 months to evaluate its reproducibility. Data were compared by correlation and Bland-Altman analyses. Across the entire group, estimates for gram intakes of nutrients and total energy were associated with wide limits of agreement between FFQ and 7DR (correlation coefficients, 0.23-0.72; P < .02). Compared with 7DR, the FFQ overestimated intakes of saturated fat in the entire group (+6.6 ± 14 g; P < .001) and in persons with overt diabetes mellitus (+7.6 ± 15 g; P < .001) but underestimated protein intake in relatives of patients with diabetes (−16.36 ± 31 g; P = .01). The repeated FFQ revealed variable agreement (correlation coefficients, 0.34-0.72; P < .001) and underestimated (P < .01) macronutrient and total energy intakes, with slightly better performance in persons with overt diabetes mellitus and relatives of patients with diabetes than in nondiabetic individuals without a family history of diabetes. Hence, the FFQ allows measuring intakes of total energy and macronutrients in prediabetes and diabetes cohorts but reveals limitations when assessing dietary composition.     

Increased frequency of HLA DR13 in hepatitis C virus carriers with persistently normal ALT levels

The aim of this study was to clarify the relationship between human leukocyte antigen DR allele distribution and the degree of liver cell injury of hepatitis C virus (HCV) carriers in Japan. The subjects, 68 HCV carriers, were divided into two groups according to the laboratory data and liver histology. Those in the asymptomatic carrier group (n = 19) had normal ALT levels persistently for 8–153 months (mean 25.7 months) and were diagnosed histologically as normal liver, nonspecific reactive hepatitis or chronic persistent hepatitis. Those in the chronic active hepatitis group (n = 49) had elevated ALT levels and were diagnosed histologically with chronic active hepatitis. The human leukocyte antigen DR alleles of all subjects were defined using the polymerase chain reaction restriction fragment length polymorphism method. The expression of human leukocyte antigen class I antigen and intercellular adhesion molecule 1 on the hepatocyte membrane were also examined in 14 patients from each group using an indirect immunohistochemical method. The frequency of DR13 (42.1%) in the asymptomatic carrier group was significantly higher (Pc < 0.003) than that of the chronic active hepatitis group (4.1%). There were no significant differences for the other DR alleles. The frequencies of expression of human leukocyte antigen class I antigen and intercellular adhesion molecule 1 on the hepatocyte membrane of the asymptomatic carrier group were significantly less than those of the chronic hepatitis group (64% vs. 100% P < 0.05, 29%; vs. 71% P < 0.05, respectively), although there was no significant difference in the serum HCV-RNA titer between the two groups (10^6.4±1.1 vs. 10^6.5±0.7 copies/mL). These results demonstrate that the cellular immune response of the asymptomatic carrier group is less activated than the response of the chronic active hepatitis group and that HLA DR13 may be closely associated with this low activity of hepatitis among HCV carriers. © 1996 Wiley-Liss, Inc.     

肿瘤坏死因子相关凋亡诱导配体受体DR4在大肠癌的表达及意义

目的:探讨肿瘤坏死因子相关凋亡诱导配体受体DR4在大肠癌组织中的表达情况及其与临床病理的关系．方法:采用免疫组化SP法和流式细胞分析方法对41例大肠癌组织和9例正常组织DR4的表达情况进行检测并比较．结果:DR4蛋白免疫组化染色定位于细胞膜和细胞浆,癌组织中阳性表达率为65．85％,明显高于正常组织的22．20％(P<0．05)．流式细胞分析该蛋白表达量,癌组织平均荧光指数为1．17±0．13,亦明显高于正常组织的1．00± 0．13(P<0．05)．不同分化程度的癌组织中DR4 蛋白表达无统计学差异,临床有淋巴结转移的癌组织与无淋巴结转移的癌组织DR4表达无统计学差异．结论:大肠癌组织中DR4表达上调,与组织分化程度无关．     

TRAIL/死亡受体5途径在缺氧再给氧诱导人肝细胞凋亡中的作用及相关机制

目的:研究肿瘤坏死因子相关凋亡诱导配体(TNF-related apoptosis-inducing ligand,TRAIL)/死亡受体5(Death receptor 5,DR5)途径在人肝细胞缺氧/再给氧(Hypoxia/reoxygenation,H/R)损伤中的作用,并探讨其作用机制。方法:在体外建立肝细胞H/R模型,模拟肝脏的缺血再灌注。H/R处理后,培养基中加入不同浓度外源性TRAIL蛋白,噻唑盐比色法(MTT)和流式细胞术检测细胞活力和凋亡率。半定量RT-PCR检测DR5mRNA的表达。结果:以正常人肝细胞为对照,H/R使人肝细胞的DR5 mRNA的表达上调,再给氧2小时达峰值,此后直至再给氧20小时维持在相对高的水平。单纯缺氧6小时不能引起肝细胞的大量凋亡。TRAIL诱导H/R处理后的肝细胞发生凋亡,并呈浓度依赖性。H/R大大增强TRAIL的肝毒性。结论:H/R使DR5在人肝细胞的表达上调,增加TRAIL的肝毒性。TRAIL/DR5途径可能在IRI诱导人肝细胞凋亡过程中发挥重要作用。     

Sjögren-Lupus erythematodesÜberlappungssyndrom

Zusammenfassung Patienten mit ph?notypischer Sj?gren-Syndrom (SS)-Lupus erythematodes(LE)-überlappung stellen eine immungenetisch, serologisch und klinisch einheitliche Krankheitsgruppe dar mit polyzyklisch-anul?ren, erythematosquam?sen Hautl?sionen, zirkulierenden SSA(Ro)-Antik?rpern und hoher Pr?valenz des immungenetischen Ph?notyps HLA-DR3. Die Sicca-Symptomatologie des SS kann der LE-Symptomatik zeitlich folgen oder vorangehen. Neben Hautver?nderungen wie beim subakuten kutanen LE (SCLE) kommt es zu vaskulitischen, purpuriformen und Sweet-Syndrom-artigen Hautl?sionen. Die ?lteren, vornehmlich weiblichen Patienten zeigen ein erh?htes Risiko pulmonaler und neurologischer Komplikationen. Demgegenüber kommt es selten zu einer Nierenbeteiligung. Eine 81j?hrige, anti-SSA(Ro)-, HLA-DR3-positive Frau mit 30j?hriger Anamnese eines kutanen LE wird vorgestellt, bei der erst Jahre sp?ter neben den Hautver?nderungen eines SCLE eine Sicca-Symptomatik, vaskulitische und Sweet-Syndrom-artige Hautver?nderungen auftraten. Wenngleich diskutiert werden kann, ob es sich bei der ph?notypischen SS-LE-überlappung um ein eigenst?ndiges Krankheitsbild oder um einen LE mit sekund?rem SS bzw. ein prim?res SS mit Hautmanifestationen handelt, scheint das SS-LE-überlappungssyndrom hinreichend gut charakterisiert, um es als eine Krankheitsentit?t mit eigenen Implikationen für die Therapie und Prognose anzuerkennen. Die Stellung des SS/LE-überlappungssyndroms im Spektrum der anti-SSA(Ro)-, HLA-DR3-positiven Erkrankungen, und die enge immunologische Verwandtschaft zum SS und zum anti-SSA(Ro)-positiven LE werden diskutiert. Eingegangen am 5. April 1994 Angenommen am 24. August 1994     

绒毛中TRAIL及其受体的表达与不明原因反复自然流产的相关性的探讨

目的探讨肿瘤坏死因子相关凋亡诱导配体TRAIL及其受体在不明原因早期反复自然流产患者(URSA)绒毛中的表达及二者的相关性。方法选择实验组妊娠45～60 d的URSA患者15例,对照组健康人工流产15例。两组分别取绒毛组织采用免疫组化法检测TRAIL及其受体的表达,进行方差分析和t检验比较两组绒毛组织中TRAIL及其受体蛋白表达水平的差异。结果实验组绒毛组织中TRAIL及其受体DR4、DR5蛋白表达较强,而诱骗受体DcR1及DcR2蛋白与正常对照相比表达较少,P值均小于0.05。结论TRAIL及其受体可能是造成自然流产的机制之一。     

基于Random-Walk算法的DR图像分割方法

本文算法对原图像进行快速Mallat小波分解得到骨干图后,利用其高频子带梯度信息优化边的权重,并在概率阈值的准则下对争议区域做进一步划分,最后把最大到达概率所在类的标签赋予未标定顶点,并扩展到原图像,得到分割边界。用微软GrabCut分割数据库图像和实际DR图像对该算法进行了验证,该算法能快速而有效地分割出特定的图像,适用于DR图像的分割,为进行组织增强和进一步提高DR图像质量打下基础。     

抗hDR5单抗对食管癌细胞的凋亡及CDC作用观察

目的：观察抗hDR5单抗对食管癌细胞的凋亡作用及CDC作用。方法：采用杂交瘤技术制备单克隆抗体,采用MTT法及显微摄影观察McAb及补体作用后EC109的增殖及形态变化,流式细胞仪观察细胞凋亡。结果：获得了单克隆抗体,其对EC109的凋亡诱导作用呈剂量依赖性;与对照组比较,补体可显著提高单抗对EC109的细胞毒作用,二者联用其细胞生长抑制率可达83.04%,形态学观察可见凋亡小体及细胞溶解;结论：DR5单抗具有诱导EC109细胞凋亡的作用,与补体联合应用具有较强的CDC效应。     

2例异体手移植术后受者T细胞亚群与CD3~+HLA-DR~+细胞水平的动态观察

目的　研究异体复合组织移植 手移植术后病人外周血T淋巴细胞亚群及CD3+ HLA DR +T细水平的动态变化。方法　用流式细胞术测定了 2例异体手移植术后不同时间外周血CD3+ 、CD3+ CD4+ 、CD3+ CD8+ 、CD3+ HLA DR+ (活化T细胞 )细胞百分率 ,及CD4/CD8比值 ,以病人术前一周结果作对照。结果　使用免疫抑制剂后 ,于术后第 1日CD3+ 、CD3+ CD4+ 、CD3+CD8+ 、CD3+ HLA DR+ 细胞水平 ,CD4/CD8比值都开始降低 ,以 3～ 5日为最低水平。术后 8日 ,上述指标逐渐回升 ,至 15日后基本趋于平稳 ,但CD3+ 、CD3+ CD4+ 细胞及CD4/CD8比值仍明显低于术前 ,而CD3+ CD8+ 、CD3+ HLA DR+ 细胞水平则高于术前。结论　异体复合组织 手移植术后病人外周血T淋巴细胞亚群及CD3+ HLA DR+ 细胞水平的变化与单一组织器官移植 (肾移植 )术后稳定期的变化一致 ,也与病人术后的稳定病情相吻合。