慢性乙型肝炎患者树突状细胞功能与单个核细胞乙型肝炎病毒共价闭合环状DNA的关系

目的 探讨慢性乙型肝炎(CHB)患者外周血单个核细胞(PBMC)及树突状细胞(DC)内HBV共价闭合环状DNA(HBV cccDNA)的存在状况,DC成熟度及功能状态与DC或PBMC中HBV cccDNA载量的关系.方法 分离29例CHB患者和10例健康对照者的PBMC,用重组人粒细胞-巨噬细胞集落刺激因子(GM-CS...     

慢性乙型肝炎患者树突状细胞功能与单个核细胞乙型肝炎病毒共价闭合环状DNA的关系

Objective To investigate the relationship between the maturity and function of dendritic cells (DC) and hepatitis B virus covalently closed circular DNA (HBV cccDNA) load in the peripheral blood mononuclear cells (PBMC)/monocyte-derived DC in patients with chronic hepatitis B (CHB). Methods The peripheral blood samples were collected from 29 patients with CHB and 10healthy controls. PBMC were isolated freshly and induced with granulocyte/macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). A large amount of DC were harvested after seven days of culture. The expressions of CD209, CD80, CD86, human leucocyte antigen (HLA)-DR and CD1a of DC were analyzed by flow cytometry. The HBV cccDNA load in PBMC and DC were measured by real-time polymerase chain reaction (PCR). The interleukin-12 (IL-12) level in the culture supernatant of DC was determined by enzyme linked immunosorbent assay (ELISA). The effects on T lymphocyte proliferation induced by DC were tested by mixed lymphocyte reaction (MLR). The data was compared by t test and analysis of variance. Results HBV cccDNA could be detected in PBMC from 16 patients, but not in DC from all 29 patients. HBV cccDNA load was all negatively correlated with the expressions of CD209 (r= -0. 793, P＜0.01), CD80 (r= -0. 581,P＜0.05), CD86 (r=-0. 698, P＜0.01), HLA-DR (r=-0. 817, P＜0.01), CD1a (r=-0. 734, P＜0.01), IL-12 level (r=-0. 632, P＜0.05) and allogenic T lymphocyte proliferation induced by DC (r=-0. 617, P＜0.05). The expressions of CD209, CD80, CD86, CD1a and HLA-DR on DC,IL-12 level in culture supernatant of DC and the allogenic T lymphocyte proliferation induced by DC in patients with positive PBMC HBV cccDNA were all significantly lower compared to those in healthy controls, and the changes of the parameters mentioned above were greater in PBMC HBV cccDNA positive patients than those in PBMC HBV cccDNA negative patients (P ＜ 0. 05 or P ＜ 0. 01).Conclusions The function and maturity of DC are impaired in CHB patients. HBV cccDNA can be detected in PBMC from CHB patients. Moreover, the higher PBMC HBV cccDNA is, the worse DC function and maturity are, which could be one of the important mechanisms of HBV persistent infection.     

慢性乙型肝炎患者树突状细胞功能与单个核细胞乙型肝炎病毒共价闭合环状DNA的关系

Objective To investigate the relationship between the maturity and function of dendritic cells (DC) and hepatitis B virus covalently closed circular DNA (HBV cccDNA) load in the peripheral blood mononuclear cells (PBMC)/monocyte-derived DC in patients with chronic hepatitis B (CHB). Methods The peripheral blood samples were collected from 29 patients with CHB and 10healthy controls. PBMC were isolated freshly and induced with granulocyte/macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). A large amount of DC were harvested after seven days of culture. The expressions of CD209, CD80, CD86, human leucocyte antigen (HLA)-DR and CD1a of DC were analyzed by flow cytometry. The HBV cccDNA load in PBMC and DC were measured by real-time polymerase chain reaction (PCR). The interleukin-12 (IL-12) level in the culture supernatant of DC was determined by enzyme linked immunosorbent assay (ELISA). The effects on T lymphocyte proliferation induced by DC were tested by mixed lymphocyte reaction (MLR). The data was compared by t test and analysis of variance. Results HBV cccDNA could be detected in PBMC from 16 patients, but not in DC from all 29 patients. HBV cccDNA load was all negatively correlated with the expressions of CD209 (r= -0. 793, P＜0.01), CD80 (r= -0. 581,P＜0.05), CD86 (r=-0. 698, P＜0.01), HLA-DR (r=-0. 817, P＜0.01), CD1a (r=-0. 734, P＜0.01), IL-12 level (r=-0. 632, P＜0.05) and allogenic T lymphocyte proliferation induced by DC (r=-0. 617, P＜0.05). The expressions of CD209, CD80, CD86, CD1a and HLA-DR on DC,IL-12 level in culture supernatant of DC and the allogenic T lymphocyte proliferation induced by DC in patients with positive PBMC HBV cccDNA were all significantly lower compared to those in healthy controls, and the changes of the parameters mentioned above were greater in PBMC HBV cccDNA positive patients than those in PBMC HBV cccDNA negative patients (P ＜ 0. 05 or P ＜ 0. 01).Conclusions The function and maturity of DC are impaired in CHB patients. HBV cccDNA can be detected in PBMC from CHB patients. Moreover, the higher PBMC HBV cccDNA is, the worse DC function and maturity are, which could be one of the important mechanisms of HBV persistent infection.     

磁共振液体衰减反转恢复序列血管高信号征与弥散加权成像不匹配在动脉取栓术前评估中的作用

目的以灌注成像为参照, 探讨MRI液体衰减反转恢复序列血管高信号征(FVH)与弥散加权成像(DWI)不匹配征象在急性前循环大血管闭塞性缺血性卒中血管内取栓术(EVT)前评估中的作用。方法回顾性分析2020年5月至2021年10月就诊于天津市环湖医院神经外科、发病时间为6～24 h的急性前循环大血管闭塞性缺血性卒中患者的临床资料, 共91例。患者均同时接受MRI平扫和灌注成像(CT灌注成像或MRI灌注加权成像)检查, 分别应用两种影像筛选模式判断EVT指征。其中MRI平扫判断有EVT指征的标准为存在FVH-DWI不匹配;灌注成像判断EVT指征的标准为梗死核心体积与缺血半暗带不匹配。评价两种影像筛选模式判断EVT指征的一致性, 以及经两种方法筛选后行EVT患者术后90 d预后良好[改良Rankin量表评分(mRS)≤2分]率的差异。结果 91例患者中, 应用FVH-DWI不匹配筛选73例(80.2%)存在EVT指征, 其中49例行EVT, 术后90 d 28例(57.1%)预后良好。应用灌注成像不匹配筛选75例(82.4%)存在EVT指征, 其中55例行EVT, 术后90 d 28例(50...     

基于大鼠大脑中动脉阻塞模型的DTI研究进展

大鼠脑卒中模型具有诸多优点,其中大脑中动脉阻塞(MCAO)模型以其手术简单、成功率高、不影响脑缺血后脑水肿和颅内压等病生理变化,已广泛应用于局灶性脑缺血的研究。一些基于MCAO模型的神经放射学技术,如扩散张量成像(DTI),能够在活体状态下,评价脑缺血后大脑功能和结构的时间与空间上的改变,这有助于揭示脑卒中后的病生理过程。传统DTI能够评价组织结构完整性和白质连接,而一些DTI新技术,如扩散波谱成像(DSI)、Q-ball成像和扩散峰度成像(DKI)更是提高了这项技术的应用能力。这些基于MCAO模型的MRI研究,可提供良好的手段去发现脑卒中后组织结构与功能长时间的改变,并以此为基础,研究脑缺血的转归和一些药物的疗效。就基于MCAO模型的DTI研究最新进展予以综述。     

基于局部一致性的脑静息功能模式偏侧化研究

目的 应用局部一致性方法揭示静息状态下大脑左右半球在局部区域内功能模式的偏侧化差异.方法 采集21名健康的在校大学生睁眼条件下6分钟的静息状态功能磁共振扫描数据.结果 在前额下回、中央前回区域右脑局部一致性均高于左脑区域,而在颞上回、楔叶区右脑局部一致性小于左脑区域.结论 静息状态下大脑功能模式不是单一的左侧或右偏侧化...     

大脑中动脉闭塞模型大鼠高分辨力扩散张量纤维束示踪成像研究

目的探讨缺血性卒中大鼠梗死灶中心和周围白质纤维束损伤情况。方法共25只Sprague-Dawley大鼠随机分为对照组(10只)和大脑中动脉闭塞组(MCAO组,15只),其中MCAO组以线拴法制备大脑中动脉闭塞模型。两组大鼠分别于模型制备后3 h、6 h、1 d、2 d、3 d、4 d和7 d,采用高场强(7.0T)扩散张量成像(DTI)和扩散张量纤维束示踪成像(DTT),于梗死侧皮质、皮质下和胼胝体选择兴趣区并计算部分各向异性(FA)值、平均扩散率(MD)值、轴向扩散系数(λ║)值和径向扩散系数(λ┴)值,以及于内囊区选择兴趣区并计数纤维数目(NT)值。结果两组大鼠不同时间点梗死侧皮质、皮质下和胼胝体FA值(均P=0.000)、MD值(均P=0.000)、λ║值(均P=0.000)和λ┴值(均P=0.000)差异均有统计学意义,MCAO组梗死侧皮质、皮质下和胼胝体FA值于超急性期(≤6 h)缓慢升高(均P=0.000)、急性期(6小时至3天)明显下降(均P=0.000)、亚急性期(3天至8周)趋于稳定,MD值、λ║值和λ┴值均于急性期明显升高(均P=0.000),亚急性期趋于稳定;对照组与MCAO组大鼠梗死侧皮质、皮质下和胼胝体FA值(P=0.003,0.000,0.000),皮质下MD值(P=0.013),皮质下和胼胝体λ║值(P=0.012,0.001)和λ┴值(P=0.001,0.036)差异有统计学意义。两组大鼠不同时间点梗死侧NT值差异有统计学意义(P=0.000),MCAO组梗死侧NT值于超急性期缓慢下降(P=0.032)、急性期明显下降(均P=0.000)、亚急性期趋于稳定;MCAO组大鼠各时间点梗死侧NT值低于对照组(P=0.000)。DTT显示,MCAO组大鼠梗死侧白质纤维束走行迂曲,部分离断,尤其模型制备1 d后即可见梗死侧受损纤维趋于围绕病灶边缘。结论缺血性卒中超急性期至急性期,神经损伤持续存在,至亚急性期出现神经纤维重塑。DTT显示梗死侧受损纤维趋于围绕病灶边缘,提示受损纤维包绕病灶的保护作用。     

鼻窦颅底肿瘤相关型低磷骨软化症1例

<正>1临床资料患者,男,41岁,因“全身骨痛半年余”于2020-03-05收入我科,既往有肋骨骨折和骶尾骨骨折病史。患者半年前无明显诱因出现全身骨痛,以双侧肋部、腰骶部、双侧膝部疼痛感为主,行走时尤甚。就诊外院行骨密度检查示全身骨密度降低,双侧肋骨骨折,考虑肿瘤性病变可能。为进一步诊治,患者遂就诊我院,于核医学门诊查生化示血磷0.7 mmol/L（正常参考范围为0.97～1.62 mmol/L,下同）,骨碱性磷酸酶（BALP）30.29μg/L（正常参考范围为3.87～20.73μg/L,下同）。全身PET-CT示左侧筛窦结节紧贴颅底筛板,     

药物性鼻炎阶梯治疗的临床分析

目的 分析药物性鼻炎采用3个阶段阶梯治疗的临床效果,为临床治疗提供参考.方法 78例药物性鼻炎患者根据致病原因分为口服药物组12例和减充血剂组66例.采用鼻用激素+抗组胺药(第一阶段)、鼻用激素+抗组胺药物+高渗海水(第二阶段)和手术治疗(第三阶段)阶梯治疗方法,对两组患者在治疗的不同阶段采用视觉模拟评分(VAS)量表...     

扁桃体部分切除术对OSAHS患儿的临床效果观察

目的　探讨扁桃体部分切除术对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apner hypopnea syndrome,OSAHS）患儿的临床效果。 方法　对中山大学附属第一医院耳鼻咽喉医院2016年8月~2019年1月收治的138例扁桃体肥大合并腺样体肥大的儿童,行扁桃体部分切除术（TT组,69例）和扁桃体全切除术（TE组,69例）,比较患儿术后疼痛指数、术中出血量、手术时间、术后出血、术后发热、术后再发上呼吸道炎症、住院时间、术后呼吸暂停低通气指数、术后进食等方面的差异。 结果　TE组患儿相比TT组,术中出血量明显较多,手术时间较长,术后疼痛指数较高,但术后发热更少见。TT组患儿住院时间短于TE组,术后更快恢复进普食。两组患儿术后呼吸暂停低通气指数均较术前明显下降。术后再发上呼吸道炎症两组大致相同。 结论　对于OSAHS患儿,扁桃体部分切除术手术时间短、术中出血更少、术后出血机会更低,且同样达到缓解患儿上呼吸道阻塞的目的,值得临床应用推广。