加味补中益气汤对慢性阻塞性肺疾病稳定期生存质量的影响研究

目的:研究加味补中益气汤对慢性阻塞性肺疾病(COPD)稳定期生存质量的改善作用。方法:60例病情程度为Ⅱ级(中度)～Ⅲ级(重度)COPD稳定期患者随机分为中医组和西医对照组各30例。中医组予加味补中益气汤(组成:黄芪、甘草、红参、当归、川芎、橘皮、半夏、升麻、柴胡、茯苓、白术、桔梗、枳壳、杏仁、桃仁)口服,西医对照组予沙美特罗替卡松粉吸入剂吸入治疗,疗程2个月。测评治疗前后生存质量评分。结果:与本组治疗前比较,中医组生存质量总均分(TMS)、日常工作能力因子分(F1S)、社会活动状况因子分(F2S)、抑郁心理症状因子分(F3S)、焦虑心理症状因子分(F4S)均有显著下降(P<0.05,P<0.001),西医对照组TMS、F1S、F4S有显著下降(P<0.001),但F2S、F3S无显著下降(P>0.05);治疗前后评分差值比较,中医组TMS、F1S、F3S、F4S明显高于西医组(P<0.05,P<0.01,P<0.001),F2S差值无显著性差异(P>0.05)。结论:加味补中益气汤能有效改善COPD稳定期患者生存质量。     

砭石治疗慢性阻塞性肺疾病急性加重期临床研究

目的观察砭石治疗慢性阻塞性肺疾病急性加重期的疗效。方法采用随机对照方法，将145例慢性阻塞性肺疾病急性加重期患者分为综合组、中药组和对照组，综合组49例采用砭石热熨背部、中药汤剂以及西医常规治疗，中药组48例采用中药汤剂配合西医常规治疗，对照组48例采用西医常规治疗。结果临床总有效率综合组89．80％，中药组85.42％，对照组72．92％；综合组及中药组血气分析指标、肺通气功能指标的改善与对照组比较，差异有统计学意义（P〈0．05）。结论纳入砭石疗法的中西医结合治疗慢性阻塞性肺疾病急性加重期临床疗效令人满意。     

白术内酯Ⅰ对慢性萎缩性胃炎大鼠胃黏膜保护作用

目的:探讨白术内酯Ⅰ对慢性萎缩性胃炎(CAG)大鼠胃黏膜保护机制。方法:实验动物随机分为空白对照组、模型组、白术内酯Ⅰ组(10、20、40 mg/kg),采用脱氧胆酸钠和热盐水交替灌胃、结合饥饱失常方法制备CAG大鼠模型,治疗8周后,采用ELISA法检测白细胞介素-8(IL-8)含量、Western blot法检测热休克蛋白70(HSP 70)、核转录因子-kB(NF-kB)和环氧合酶-2(COX-2)蛋白表达。结果:与空白对照组对比,模型组HSP70蛋白表达降低(P0.01),IL-8含量(P0.01)增加、NF-κB和COX-2蛋白表达升高(P0.01);与模型组对比,白术内酯Ⅰ高、中、低3个剂量组提高HSP70蛋白表达,降低IL-8含量、NF-κB和COX-2蛋白表达(P0.05),以白术内酯Ⅰ组(40 mg/kg)作用显著。结论:白术内酯Ⅰ对CAG大鼠的保护作用是通过抗炎作用。     

抵当丸治疗慢性肾功能衰竭疗效分析

目的:观察祛淤排浊法对延缓慢性肾衰2、3期进展的影响。方法:102例慢性肾衰2、3期患者随机分为两组,两组在常规治疗基础上,对照组47例加用包醛氧化淀粉酶胶囊,治疗组55例加用抵当丸治疗,两组均治疗2个月。结果:治疗组总有效率74.55%,对照组总有效率44.68%,两组比较有非常显著性差异(P<0.01),治疗组血清肌酐、血清尿素氮、内生肌酐清除率及临床症状明显改善,两组比较有非常显著性差异(P<0.01)。结论:祛淤排浊法对延缓慢性肾衰进展有明显作用。     

益元生血方对慢性再生障碍性贫血患者外周血γ-干扰素与肿瘤坏死因子-α的影响

目的 :探讨益元生血方对慢性再生障碍性贫血 (CAA)患者外周血γ 干扰素 (γ IFN)、肿瘤坏死因子 α(TNF α)的影响。方法 :36例CAA患者分为肾阴虚组 ( 2 1例 )和肾阳虚组 ( 15例 ) ,采用微量细胞病变抑制法及L595细胞毒法 ,检测使用益元生血方前后外周血γ IFN、TNF α水平 ,并与正常组 ( 15名 )比较。结果 :外周血γ IFN、TNF α水平 ,治疗总组与正常组比较 ,治疗前有明显差异 (P <0 0 5 ,P <0 0 1) ,治疗后无明显差异 (P >0 0 5 ) ,肾阴虚组与肾阳虚组比较 ,治疗前后均有明显差异 (P <0 0 5 ,P <0 0 1) ,且有效率肾阳虚组高于肾阴虚组。结论 :益元生血方是通过降低CAA患者体内γ IFN、TNF α水平 ,调节紊乱的免疫状态而发挥治疗作用。     

Reduction of Foxp3+ T cell subsets involved in incidence of chronic graft‐versus‐host disease after allogeneic hematopoietic stem cell transplantation

Foxp3+ T cells (CD4+ Tregs and CD8+ Treg) have been demonstrated to play roles in the maintenance of tolerance after allogeneic hematopoietic stem cell transplantation (Allo‐HSCT). We have found that Foxp3+ γδTCR+ Treg cells (γδTregs) exerted regulatory functions. In the current study, patients were recruited and divided as non‐cGVHD, limited cGVHD and extensive cGVHD groups. Healthy volunteers were recruited as healthy group. Treg cells were evaluated by flow cytometry. Serum cytokine levels of IL‐2, tumour necrosis factor‐α, interferon‐γ and transforming growth factor‐β1 (TGF‐β1) were evaluated by ELISA. The results showed that percentages of CD4+ Tregs, CD8+ Tregs and γδTregs were all significantly increased in non‐cGVHD group compared with those in healthy group, limited cGVHD group and extensive cGVHD group. Moreover, compared with extensive cGVHD group, percentages of these three types of Tregs were significantly increased in limited cGVHD group. The levels of TGF‐β1 increased dramatically in non‐cGVHD group compared with other groups. Spearman's correlation analysis revealed that the increased levels of TGF‐β1 and IL‐2 were positively associated with increased Treg subsets, indicating that TGF‐β1 and IL‐2 participated in the expansion process of Foxp3+ Tregs in vivo. Our findings support that increasing the number of Tregs following allo‐HSCT would be a preferential strategy for controlling cGVHD. Copyright © 2015 John Wiley & Sons, Ltd.     

Spectrum and immunophenotyping of 653 patients with B‐cell chronic lymphoproliferative disorders in China: A single‐centre analysis

The incidence of B‐cell chronic lymphoproliferative disorders (B‐CLPDs) is significantly lower in China than that in western countries. There have been studies involving small cohorts with conflicting results regarding the spectrum of B‐CLPDs in China, and the types and immunophenotyping of B‐CLPDs in China remain largely unexplored. We conducted a retrospective analysis of 653 cases of B‐CLPDs seen in our centre from 2011 to 2015. Four‐colour flow cytometry was used to determine the expression of each immunological marker, and the diagnostic values of the immunological markers were also investigated. Chronic lymphocytic leukaemia (CLL) was the most common type of B‐CLPD, which was consistent with that in west countries. However, the proportions of CLL (55.9%), follicular lymphoma (2.6%), and hairy cell leukaemia (0.2%) were lower, while the proportion of lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia (5.4%) was higher in China, as compared with western countries. With respect to immunophenotypic characteristics, CD23 (31.7%) was more frequently expressed in mantle cell lymphoma (MCL) in our cohort than that in western countries. Immunophenotyping was useful in differentiating MCL from CLL or B‐cell prolymphocytic leukaemia and lymphoplasmacytic lymphoma/WaldenstrÖm macroglobulinaemia from splenic marginal zone lymphoma. CD200 was of better diagnostic performance (accuracy: 94.6%) in differentiating CLL from MCL compared with CD23 (accuracy: 93.3%). Some cases of B‐CPLDs, however, had no definite diagnoses, which were diagnosed as CD5⁺B‐CPLDs unclassified (7.7%) and CD5^?B‐CPLDs unclassified (15.8%). This is the largest study that systematically explores the spectrum and immunophenotyping of B‐CLPDs in Asia, confirming that spectrum of B‐CLPDs in China was different from that in western countries. The immunophenotypic features of B‐CLPDs were similar between China and western countries, although a few disparities exist. Cases with no definite diagnoses warrant further studies in the future.     

慢性粒细胞白血病端粒酶的相关研究

目的：对慢性粒细胞白血病端粒酶进行研究,采用 PCR －ELISA 半定量法测定端粒酶活性,同时观察端粒酶活性变化的相关性。方法：选取15例慢性粒细胞白血病患者骨髓标本和15例正常骨髓（取自非肿瘤病人需行骨髓检查者）样本分为慢性粒细胞白血病组（CML 组）和正常对照组,采用 PCR －ELISA 法来测定CML 组和正常对照组的端粒酶活性。结果：正常对照组端粒酶具有微弱的活性,而 CML 组则具有较强的活性,且端粒酶活性 CML 组高于正常对照组,两者差异性非常显著。其中,CML 组男性与女性组间端粒酶活性差异无统计学意义。结论：正常组端粒酶具有微弱的活性,而 CML 组则具有较强的活性。端粒酶活性可能反映了一个高度增生的状态,是一种新的肿瘤标记物,与肿瘤发生密切相关。     

中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征

目的:探讨与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征.方法:报告3例不同类型与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病并结合文献进行讨论.结果:3例均为老年男性,表现为以中性粒细胞为主的白细胞异常增多、BCR/ABL融合基因阴性.例1诊断为慢性中性粒细胞白血病(CNL),脾大,外周血以成熟中性粒细胞增高为特征,胞浆内中毒颗粒易见,无明显病态造血,中性粒细胞碱性磷酸酶(NAP)染色强阳性,骨髓粒系增生明显活跃.例2诊断为不典型慢性髓细胞白血病(aCML),血涂片示不成熟粒细胞比例增高伴粒系病态造血,尤其核染色质异常浓聚更为明显,骨髓象表现为髓系增生和病态造血,原始细胞轻度增多.例3诊断为慢性粒单核细胞白血病(CMML),外周血成熟单核细胞数量和比例异常偏高,粒系病态如核分叶过多、环状核和假性Pelger-Huet畸形等易见,骨髓髓系增生明显活跃伴病态造血,无原始细胞增多.结论:中性粒细胞异常增殖相关的BCR/ABL-慢性白血病较为少见,易于误诊,细胞形态学特征是诊断BCR/ABL-慢性白血病的基础.临床表现、多种实验室检查结果尤其是分子生物学等有助于正确诊断这类疾病.     

慢性牙周炎与口腔鳞状细胞癌关系的研究进展

口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)的发病率和死亡率呈年轻化趋势上升,已成为世界范围内的主要公共卫生问题.近年来,慢性牙周炎(chronic periodontitis,CP)与口腔鳞癌之间的关系越来越受到重视,一些研究发现,以慢性炎症和微生物失调为特征的牙周病是口腔肿瘤...