辅助性T细胞17及调节性T细胞比例失衡与子宫内膜异位症研究现状

子宫内膜异位症(EMs)是目前严重困扰育龄期女性的常见疾病，因其发病机制复杂，病因尚未阐明，以及其易种植、复发等类似肿瘤的特性，迄今尚无确切诊治手段。最新研究发现，EMs属于一种自身免疫性疾病，与T细胞免疫密切相关。CD4^＋T细胞的2个重要亚型，辅助性T细胞(Th)17与调节性T细胞(Treg)比例(Th17/Treg)失衡及其所致的腹腔内环境稳态失衡，均与EMs发生、病变程度及其导致不孕等临床特征有关。笔者拟就Th17/Treg与免疫内环境失衡在EMs中的最新研究现状进行阐述。     

多囊卵巢综合征患者阴道微生态状况分析

目的 比较多囊卵巢综合征（Polycystic ovary syndrome,PCOS）患者和健康育龄妇女的各项阴道微生态评价指标,初步评估PCOS 患者阴道微生态状况。方法 选择杭州市妇产科医院2018 年8 月～2020 年3 月确诊的35例PCOS 患者作为研究组,选择同期在我院进行体检的41 例育龄期女性为对照组。采集其阴道分泌物,检测菌群密集度和多样性、pH 值、清洁度、念珠菌、滴虫、革兰阳性球菌、革兰阴性杆菌、线索细胞及乳酸杆菌等情况,通过对比研究组和对照组的阴道微生态指标,分析研究组阴道微生态状况。结果 两组年龄比较,差异无统计学意义（P＞0.05）。研究组清洁度在Ⅲ～Ⅳ度的有37.14%,较对照组（17.07%）高;研究组Nugent 评分及AV 评分均高于对照组;两组的清洁度、Nugent 评分及AV 评分比较,差异有统计学意义（P＜0.05）。研究组乳酸杆菌比例≥70%有31.43%,对照组有65.86%,差异有统计学意义（P＜0.01）;研究组pH 值3.8～4.5 占比48.57%,较对照组（73.17%）低,差异有统计学意义（P＜0.05）;研究组微生态失衡率（80.00%）与对照组（39.02%）比较,差异有统计学意义（P＜0.01）。结论 与正常育龄妇女比较,PCOS 患者存在较高比例的阴道微生态失衡现象,可能由于PCOS 患者内分泌紊乱引起激素水平改变,从而导致阴道微生态发生变化,提示临床对PCOS 患者进行诊治时应综合考虑评估阴道微生态。     

原发性肾病综合征患者外周血T淋巴细胞亚群变化及临床意义

目的：研究原发性肾病综合征患者外周血T淋巴细胞亚群的变化及临床意义,探讨其发病机制。方法：选择2010年8月至2013年3月我院收治的原发性肾病综合征患者115例,测定外周血T淋巴细胞亚群指标,给予标准剂量激素治疗,8周后复查。结果：发病前,激素敏感（ SSNS ）组及激素抵抗（ SRNS）组CD3＋CD4＋T淋巴细胞与对照组比较均降低, CD3＋CD8＋T淋巴细胞对照组比较均升高,CD4/CD8与对照组比较均降低。治疗后,激素敏感（ SSNS）组及激素抵抗（ SRNS）组CD3＋CD4＋T 淋巴细胞与对照组比较均降低,激素敏感（ SSNS）组CD3＋CD8＋T 淋巴细胞较对照组下降,激素抵抗（ SRNS）组CD4/CD8与对照组相比偏低。结论：T淋巴细胞亚群平衡失调可能参与了成人原发性肾病综合征的发生发展过程。     

β-淀粉样肽诱发的细胞内钙离子、内质网钙通道蛋白表达变化及二苯乙烯苷干预效果

目的 探讨β-淀粉样肽(Aβ)诱发的细胞内钙失衡机制中位于内质网上的鱼尼丁受体(RyRs)的作用及二苯乙烯苷(TSG)的干预效果.方法 Wistar大鼠80只采用完全随机数字表法分为对照组、假手术组、模型组及TSG组,每组20只.后3组在立体定向仪下注射Aβ1-42至大鼠海马部位,建立AD模型:对照组不做任何处理.激光扫描共聚焦显微镜观察细胞内钙离子浓度.RT-PCR法检测RyR3 mRNA的表达.结果 各组大鼠海马细胞内钙离子浓度差异有统计学意义,其中模型组明显高于对照组及假手术组,TSG组明显低于模型组,差异有统计学意义(P<0.05).RT-PCR半定量分析结果显示,模型组RyR3/β-actin值明显降低,与对照组及假手术组比较差异有统计学意义(P<0.05);TSG组RyR3/β-actin值略微升高,与对照组及假手术组比较差异没有统计学意义(P>0.05).结论 Aβ神经毒性作用引起的细胞内钙稳态失衡并非通过RyR3介导的钙释放途径,而是通过细胞膜通透性改变所致.TSG可通过纠正细胞内钙超载来抵抗Aβ神经毒性损伤.

Abstract：

Objective To study the effects of stilbene glucoside(TSG)on calcium homeostasis and expression of RyR3 in pyramidal neurons of the rat hippocampus induced by β-amyloid(Aβ).Methods Eighty Wistar rats were equally randomized into 4 groups(n=20): control group,sham-operated group,model group and TSG inducement group.AD models in the later 3 groups were induced by stereotactic injection of Aβ1-42 to the rat hippocampus;and rats of the control group did not give any treatment.The mRNA expression of RyR3 was detected by real time PCR(RT-PCR) and monitored under laser scanning confocal microscope. Results The concentration of intracellular calcium between each 2 groups was significantly different(P<0.05);that in the model group was obviously higher than that in the control and sham-operated groups,and that in the TSG inducement group was obviously lower than that in the model group(P<0.05).Semi-quantitative RT-PCR indicated that the value of RyR3/β-actin in the model group was obviously decreased as compared with that in the control and sham-operated groups(P<0.05);the value of RyR3/β-actin in the TSG inducement group was slightly increased, but no significant difference was noted as compared with that in the control and sham-operated groups (P>0.05). Conclusion Aβ neurotoxicity causes disorder of intracellular calcium homeostasis,which is not through the pathway of Ca2+-induced Ca2+ release induced by RyR3,but through the changes of permeability of cytomembrane.TSG plays a protection role from Aβ neurotoxicity by calcium homeostasis.     

亚健康与脾肾阴阳气血失调的关系初探

阐述亚健康的中医学概念,并从脾肾阴阳气血的生理与病因、病理机制着手,阐明亚健康状态脾肾阴阳气血失调的病机特点、准证候及其干预对策。     

Imbalance between vascular endothelial growth factor and endostatin correlates with the prognosis of operable non-small cell lung cancer

Background

Angiogenesis is regulated by a balance of pro-angiogenic and anti-angiogenic factors. Vascular endothelial growth factor (VEGF) and endostatin respectively represents a frequent component of inducers and inhibitors in the process of angiogenesis. The ratio of VEGF/endostatin may reflect the balance of angiogenic switch. This study aimed to determine whether an imbalance between VEGF/endostatin exists in operable non-small cell lung cancer (NSCLC) patients and to assess the correlation, if any, between the imbalance and the prognosis.

Methods

Preoperative serum levels of VEGF and endostatin were simultaneously determined by quantitiative enzyme-linked immunosorbent assay (ELISA) and the ratio of them was calculated among 98 NSCLC patients and 51 healthy controls. The relationship between these factors and clinicopathological features, including prognosis, was examined.

Results

The ratio of VEGF/endostatin levels was significantly higher in operable NSCLC patients [median, 10.4; interquartile range (IQR), 5.9–19.8] than in normal controls [median, 5.1; IQR, 3.3–9.7] (P = 0.002). While the ratio in patients who were still alive for more than 60 months was 8.3 (IQR, 4.3–17.9), the ratio in those who died was 12.9 (IQR, 8.0–22.1) (p = 0.017). In subgroup analysis of patients with pathological stage N0, there was a statistically significant increase of the survival time in the group with a lower ratio than in the group with a higher ratio (p = 0.032). Multivariate analysis confirmed that the VEGF/endostatin ratio was an independent prognostic factor (p = 0.018).

Conclusion

There was an imbalance between VEGF and endostatin in serum of operable NSCLC patients. The imbalance correlated with the prognosis of operable NSCLC.     

5·12汶川大地震挤压综合征伤员电解质紊乱特点分析

目的探讨汶川地震挤压综合征伤员电解质紊乱的特点。方法对149例地震挤压综合征伤员的临床特点,尤其是电解质紊乱的特点进行分析。结果与非挤压综合征伤员比较,149例（8.2%）挤压综合征伤员有更严重的肾功能损害,血钾及血磷水平更高,血钙水平更低（P〈0.05）;同时表现出血清天冬氨酸氨基转移酶（AST）、乳酸脱氢酶（LDH）和肌酸激酶（CK）水平显著升高（P〈0.05）;电解质紊乱表现多种多样,包括高钾血症、低钾血症、低钠血症、低钙血症、高磷血症、低磷血症以及代谢性酸中毒,尤其是高钾血症,不但严重而且顽固,需要尽早积极治疗。结论地震后挤压综合征伤员表现出严重而且复杂的电解质紊乱,高钾血症是最严重的表现,需要密切监测和积极治疗。     

苦参碱对急性髓系白血病SCID模型鼠细胞生物学特性的影响

目的:观察苦参碱对急性髓系白血病SCID小鼠模型细胞生物学特性的影响。方法:将40只数字随机法分为空白组(n=10)、模型组(n=30),其中模型组小鼠腹腔注射对数生长期HL-60细胞株制备急性髓系白血病模型,4周后将27只成模的模型组小鼠随机分为造模组、苦参碱A组及苦参碱B组,每组9只。其中苦参碱A组及B组分别用10 mL/kg及5 mL/kg灌胃,空白组及造模组大鼠接受等体积生理盐水灌胃,各组均连续干预4周。比较各组生存期、体质量、外周血血常规变化、同源性磷酸酶-张力蛋白(PTEN)水平变化、白血病细胞HL-60各周期生长情况以及Th1/Th2细胞的相关指标水平变化。结果:苦参碱可明显延长SCID小鼠生存期,减少外周血白细胞、淋巴细胞、HL-60细胞数量、IL-4、IL-10水平,上调PTEN、IFN-γ、IL-2水平、G0/G1期的细胞含量,与造模组比较差异有统计学意义(P<0.05)。结论:苦参碱对急性髓系白血病HL-60细胞株具有明显的抑制效应,疗效具有一定的剂量依赖性,其作用机制可能与增强PTEN蛋白及调整Th1/Th2细胞平衡有关。