卡介苗的免疫保护机制及其改造策略进展

结核病是目前全球死亡率最高的单一感染性疾病。卡介苗(bacille Calmette-Guérin,BCG)作为唯一的预防性疫苗,在包括中国在内的结核病高危地区的新生儿出生时即被接种,在结核病防控中发挥了重要作用。然而,近年来的研究结果显示,BCG的保护力具有一定的时效性,尤其在成年人中保护力明显减弱。因此,如何改造BCG以增强其抗结核免疫保护作用将成为结核病疫苗研发和结核病防控的重点研究方向之一。作者复习相关文献,从BCG的改造和接种两方面论述BCG的研究现状和未来应用策略。     

Iris metastasis from prostate carcinoma: A case report and review of the literature

Despite the high incidence of prostate carcinoma, metastases of the uvea are very rare and the iris localization is even more. Only a few cases worldwide have been described so far. We report here the case of a 66-year-old man diagnosed with a metastatic prostate carcinoma. Nine months later, he developed brain and skin metastases. A couple of weeks later, the metastatic lesion appeared on his left iris. He has received whole brain radiation therapy including the iris lesion in the radiation fields. Through this case report and a literature review, we discuss the incidence, the different clinical presentations and the impact on the survival prognosis of this uncommon metastatic site.     

Li-Fraumeni syndrome: Multiple distinct brain tumours in two brothers

Li-Fraumeni syndrome is a rare autosomal dominant cancer-prone condition characterized by the occurrence of a large set of different types of cancer in a patient and their family. A germline disease-causing mutation of the gene encoding the p53 protein is associated with the syndrome. We report on a family in which segregation of a TP53 mutation in two generations was associated with two brain tumours, a leiomyosarcoma and a thyroid carcinoma in four male patients. The main patient presented with seizures revealing several primary brain tumours. We review recent views on its molecular basis and discuss management of the condition as well as a review of the literature.     

骨盆三联截骨联合股骨近端截骨术治疗Legg-Calvé-Perthes 病的疗效

目的：评价骨盆三联截骨联合股骨近端截骨术治疗Legg‐Calvé‐Perthes病的短期疗效。方法回顾性分析2010年5月至2012年12月采用包容治疗的40例（40髋）Legg‐Calvé‐Perthes病患者资料,其中男29例,女11例;年龄6岁～10岁4个月,平均8．3岁。根据包容治疗方法将患者分为2组：A组,20例,采用骨盆三联截骨联合股骨近端截骨术;B组：20例,采用其他包容治疗（股骨近端截骨术、Salter骨盆截骨联合股骨近端截骨术）。比较两组手术前后影像学数据变化和 Harris髋关节评分。结果所有患者均获得术后18～48个月（平均32个月）的随访。术后 A、B组C E角分别增加18．45°±4．25°和13．18°±3．07°,股骨头外移比值分别降低0．53±0．25和0．35±0．19,Sharp角分别降低14．64°±3．25°和10．87°±6．42°,股骨头覆盖率分别增加22．42％±2．19％和18．57％±6．42％,差异均有统计学意义（P＜0．05）。A组术后Harris髋关节评分4分及以上19例,B组18例,差异无统计学意义（P＞0．05）。结论骨盆三联截骨联合股骨近端截骨术治疗Legg‐Calvé‐Perthes病髋关节局部解剖结构改变较小,能达到很好的包容效果,可有效防止单一术式局部矫正过大引发的并发症,适用于严重Legg‐Calvé‐Perthes病。     

卡介苗HSP70基因转染对小鼠淋巴细胞白血病细胞免疫原性的影响

目的探讨卡介苗热休克蛋白70(BCG HSP70)基因转染对小鼠淋巴细胞白血病细胞(L1210)致瘤性及免疫原性的影响。方法利用脂质体2000将BCG HSP70基因转入小鼠淋巴细胞白血病细胞系L1210表面,获得高表达HSP70分子的L1210-HSP70细胞,作为肿瘤疫苗分别对裸鼠及同系小鼠致瘤性、瘤苗对荷瘤小鼠的免疫治疗作用以及瘤苗对L1210细胞攻击的免疫保护作用进行研究。结果 BCG HSP70成功表达在转染后的L1210细胞表面,并具有与野生型细胞同样的致瘤性。同系小鼠DBA/2皮下接种L1210-HSP70细胞后肿瘤生长缓慢或不成瘤;相对于L1210组和L1210-neo组,生存期明显延长,小鼠脾淋巴细胞中针对L1210细胞的特异性T细胞数量明显增加,差异有统计学意义(P0.05);瘤体病理切片示彻底凝固性坏死,周边可见淋巴样细胞,免疫组化检测示大量CD8+T淋巴细胞浸润。L1210-HSP70细胞瘤苗具有对荷瘤小鼠的免疫治疗作用,以及抗肿瘤攻击的免疫保护作用,均表现为肿瘤出瘤时间明显延长,生长受到显著抑制,瘤体平均直径明显减小;荷瘤小鼠生存时间明显长于L1210组、L1210-neo组和PBS组,差异有统计学意义(P0.05)。结论BCG HSP70基因转染能有效增强肿瘤细胞的免疫原性,激活特异性T细胞,降低肿瘤细胞的致瘤性;并具有提高宿主抗瘤免疫作用。