STUDY ON THE DIAGNOSIS OF MULTIPLE MYELOMA 2547 CASES

ＳＴＵＤＹＯＮＴＨＥＤＩＡＧＮＯＳＩＳＯＦＭＵＬＴＩＰＬＥＭＹＥＬＯＭＡ２５４７ＣＡＳＥＳＬｉＳｈｏｕｊｉｎｇ李守静；ＬｉＨｏｎｇｒａｎ李宏然；ＺｈａｏＸｉａｎｇｙｉｎ赵相印；（ＤｅｐａｒｔｍｅｎｔｏｆＩｎｔｅｒｎａｌＭｅｄｉｃｉｎｅ，Ｔｏｎｇｒｅｎ...     

早期肠内营养对胃癌患者术后营养状况和免疫功能的影响

目的研究术后早期肠内营养对胃癌患者术后营养状况和免疫功能的影响。方法将60例胃癌患者随机分为肠内营养(EN)组和肠外营养(PN)组各30例。PN组术后行TPN支持;EN组术后第1天起经鼻饲管输注能全力。分别于术前及术后8 d测体重、血清蛋白质、Hb、免疫球蛋白及外周血T淋巴细胞亚群(CD+3、CD+4、CD+8、CD+4/CD+8)等。临床观察生命体征、胃肠道功能恢复情况及各种不良反应。结果EN组术后8 d体重(60.5±5)kg,高于PN组的(58.8±3)kg(P<0.05);肛门排气时间EN组(62±10)h,较PN组(74±15)h显著缩短(P<0.05)。PN组术后CD+3、CD+4、CD+4/CD+8稍下降,而EN组术后CD+3、CD+4、CD+4/CD+8与术前相比无显著变化。术后CD+4/CD+8EN组(1.4±0.3),高于PN组(1.2±0.2),两组比较有统计学意义(P<0.05)。结论早期肠内营养可改善胃癌患者术后营养状态及免疫功能。     

免不1号对雌性小鼠免疫性不孕症的实验研究

目的 :为了研究中药免不 1号治疗免疫性不孕症作用机理。方法 :用精子抗原免疫昆明种雌小鼠 ,建立免疫不孕症动物模型 ,饲喂中药复方免不 1号 ,观察抗精子抗体指标、组织学指标、免疫细胞化学指标和妊娠指标。结果 :免不 1号能降低卵巢免疫复合物沉积 ;免不 1号能明显降低小白鼠血清抗精子抗体 ,且停药后抗体反跳幅度小 ;免不 1号明显提高动物的妊娠 ,每胎仔数明显高于模型组 (P <0 0 5 )及西药组 (P <0 0 5或P <0 0 1)。结论 :免不 1号可能通过清除卵巢免疫复合物沉积 ,降低免疫复合物对组织的损伤 ,并降低血清 ,宫颈黏液AsAb ,有利于提高小鼠的妊娠。     

益寿饮颗粒对衰老动物模型免疫功能的影响

目的探讨益寿饮颗粒剂对衰老动物模型免疫功能的影响。方法模型大、小鼠各60只，按20只分组，分为生理盐水对照组、益寿饮小剂量组和益寿饮大剂量组。各组连续灌胃30d，停药后小鼠摘取眼球取肝素抗凝静脉血，大鼠自尾静脉取血，测IL-1α，IL-2，IL-6，RBC—C3bRR，RBC-ICR以及外周血T淋巴细胞亚群。结果大、小剂量组与对照组比较，IL-1α，IL-2，IL-6水平明显升高，RBC—C3bRR结合率明显升高，RBC—ICR结合率明显下降，CD3^＋，CD4^＋淋巴细胞的比值明显升高，CD8^＋淋巴细胞的比值明显降低，各项指标均具有统计学意义。结论益寿饮颗粒提高衰老动物模型T淋巴细胞增殖和产生白介素-1（IL—1）、白介素-2（IL-2）、白介素-6（IL-6）的能力，增强红细胞膜RBC—C3bRR活性及粘附IC的能力，影响外周血T淋巴细胞亚群分类的水平，影响外周血T淋巴细胞亚群的数量、活性及亚群细胞之间的比例，调节T细胞的免疫功能，改善机体免疫调节功能。     

高州市卫生人力资源现状调查与对策思考

目的 通过对高州市卫生人力资源现状的调查与分析,为政府职能部门制定人力资源发展政策以及医院进行人力资源管理提供依据. 方法 采用统一设计的<卫生人力基本信息调查表>进行全面调查,应用Excel软件的排序、分类汇总、筛选等功能,对人力资源基本资料的总量、性别、年龄、学历、职称构成以及区域分布进行挖掘、提取、重新整合统计,利用SPSS软件进行统计分析,获得高州市卫生人力资源的总体现状. 结果 高州市卫生人力资源存在总量上不足,总体素质不高,专业及区域分布不均衡等问题. 结论 制定卫生人力发展规划和激励政策, 吸纳稳定发展卫生人员总体数量,提高整体素质,调整专业、区域分布,更加合理有效地利用卫生人力资源.     

社会心理咨询机构的现状调查

目的了解目前社会上的心理咨询机构发展现状及咨询人员对心理咨询市场的看法。方法采用半结构化访谈,逐一走访15家社会心理咨询机构,以频数统计和类属分析的方式分析访谈资料。结果目前专职的心理咨询人员仅占21.4%,门诊咨询是主要的咨询方式,咨费多集中在80~150元/小时,咨询人员50%以上采用兼容取向的心理咨询技术,平均每个咨询机构月咨询量约53人次,咨询机构经营状况处于"非盈利"状态的占到60%以上,学生和30~45岁的成年人是咨询机构的主要客源。结论目前心理咨询市场存在缺乏市场规范、咨询人员良莠不齐等问题。咨询师们强烈呼吁国家成立管理机构、出台相应政策法规规范心理咨询行业。     

The association between immunodeficiency and congenital heart disease

Summary The predilection of children with congenital heart disease (CHD) to infection may be explained in part by an underlying immunodeficiency disorder. Some 13 syndromes in which immunodeficiency and CHD may coexist have been reported in the medical literature. In addition, immunoglobulin and T-cell deficiencies have been found in nonsyndromal patients with CHD. The diagnosis of immunodeficiency should be entertained in such children, as early recognition of an immunodeficiency disorder can result in improved antimicrobial and immunological management.     

HTLV III antibodies and immunological alterations in hemophilia patients

Summary The clinical, immunological, and serological status of 28 patients with hemophilia A and of 13 patients with hemophilia B was investigated. Thirty-four patients were treated regularly by clotting factor concentrates and 7 patients had been substituted only 1 to 4 times. Almost all patients with severe hemophilia suffered from hepatopathy. No patient had clinical evidence of the acquired immunodeficiency syndrom (AIDS).Asymptomatic hemophiliacs showed a decreased number of T-helper (OKT 4) cells and an increased number of T-suppressor (OKT 8) cells, which resulted in an inversed OKT 4/OKT 8 cell ratio. Natural killer cell activity of all patients was decreased compared to controls. After culture there was no significant difference of NK cell activity between hemophiliacs and controls. This phenomen was interpreted as a possible maturation defect of NK-cells in vivo.No relationship between immunological alterations and hepatopathy, hepatitis markers, CMV antibodies, amount and source of required factor concentrates, and the kind of hemophilia was observed. IgG immunoglobulins were higher and the OKT 4/OKT 8 ratio lower in the eight patients with lymphadenopathy than in patients without lymphadenopathy. The prevalence of antibodies to human T-lymphotropic virus (HTLV III) was measured in 35 hemophiliacs and in 25 polytransfused patients, most of whom were suffering from acute leukemia. In 8 of 35 hemophiliacs antibodies to HTLV III virus were detected by an enzyme linked immunosorbent assay (ELISA) and confirmatory tests. All seropositive patients were treated by blood products from the United States. Eight hemophiliacs treated by factor concentrates from German donors only were seronegative. In comparison 2 of 25 examined non-hemophilia patients receiving multiple blood products from local donors were seropositive for HTLV III. The results show that hemophilia patients treated by imported clotting factor concentrates have a high risk of HTLV III positivity. Hemophiliacs substituted by blood products obtained by local donor pools have only a small risk of infection. Because non-hemophiliac polytransfused patients had HTLV III antibodies, there must be asymptomatic virus carriers in the local donor pool. The HTLV III antibody screening of all donors and the heat treating of factor concentrates will give better therapeutic safety.Abbreviations AIDS Acquired immunodeficiency syndrome - ALT Alanin-Aminotransferase - Anti-HBc Antibody to hepatitis B core antigen - Anti-HBs Antibody to hepatitis B surface antigen - AST Aspartat-Aminotransferase - CMV Cytomegaly virus - EBV Epstein-Barr-virus - EDTA Ethylendiamintetraacetate - ELISA Enzyme linked immunosorbent assay - -GT Gamma-Glutamyl-Transferase - HBsAg Hepatitis B surface antigen - HLA Human Leukocyte Antigen - HTLV III Human T-lymphotropic virus - IL-2 Interleukin 2 - IPS Immune peroxidase staining - LDH Lactat-Dehydrogenase - LGL Large granular lymphocyte - LU₃₀ Lytic units - MNC Mononuclear cells - NK Natural Killer cells - OKT 3 Total T-cells - OKT 4 T-helper cells - OKT 8 T-suppressor cells     

Filaggrin repeat number polymorphism is associated with a dry skin phenotype

Profilaggrin is a key epidermal protein, critical for the generation and maintenance of the stratum corneum barrier. It is encoded by a gene located in the epidermal differentiation complex of Chromosome 1q21 and is composed of multiple filaggrin repeats connected by highly conserved linker peptides. Within the human population the number of filaggrin repeats encoded by this gene varies between 10, 11 or 12 repeats. Using a PCR-based approach we have determined individual profilaggrin allelotypes in a group of 113 subjects and identified preliminary evidence of an inverse association between the 12 repeat allele and self-perceived frequent dry skin (P=0.0293). This is the first demonstration of a potential association between a genetic marker and cosmetic skin condition and suggests that cosmetic skin dryness may in part be genetically determined and associated with specific profilaggrin allelotypes.     

Early cytoskeletal rearrangement during dendritic cell maturation enhances synapse formation and Ca(2+) signaling in CD8(+) T cells

The interplay between dendritic cells (DC) and T cells is a dynamic process critically depending on DC maturation. Ca(2+) influx is one of the initial events occurring during DC/T cell contacts. To determine how DC maturation influences DC/T cell contacts, time-lapse video microscopy was established using TCR-transgenic CD8(+) T cells from P14 mice. DC maturation shifted DC/T cell contacts from short-lived interactions with transient Ca(2+) influx in T cells to long-lasting interactions and sustained Ca(2+) influx of 30 min and more. Follow-up of DC/T cell interactions after 2 h using confocal microscopy revealed that long-lasting Ca(2+) responses in T cells were preferentially associated with the formation of an immunological synapse involving CD54 and H2-K(b) at the DC/T cell interface. Such synapse formation preceded MHC or B7 up-regulation, since DC developed into potent Ca(2+) stimulators 7 h after initiation of maturation. Instead, the enhanced capacity of 7 h-matured DC to induce sustained Ca(2+) responses in CD8(+) T cells is critically dependent on the polarization and rearrangement of the cytoskeleton, as shown by Clostridium difficile toxin B inhibitor experiments. These data indicate that already very early after receiving a maturation stimulus, DC display enhanced cytoskeletal activity resulting in the rapid formation of immunological synapses and effective CD8(+) T cell stimulation.