共刺激分子B7在移植免疫中的研究现状及展望

B7家族成员是最重要的共刺激分子,其中对B7-1、B7-2分子的研究最为深入,近年来,该家族中B7-H1、B7-H2、B7-H3、B7-DC、B7-H4等新成员也被陆续发现,其作用机制主要是为T细胞活化提供所需的正性和负性共刺激信号,通过复杂的网络平衡作用决定最终的免疫效应。随着器官移植的迅速发展,诱导对移植物的特异性耐受成为解决移植排斥的重要途径,正性共刺激通路B7CD28通路、B7-H2ICOS通路、B7-H3通路的过度活化,以及负性共刺激通路B7CT-LA-4通路、B7-H1、B7-DCPD-1通路、B7-H4BTLA通路的发现,在移植免疫中意义尤为突出。     

细胞因子紊乱与支气管哮喘

细胞因子主要是由免疫细胞所产生、具有广泛生物活性的小分子蛋白质.近年研究发现多种细胞因子参与支气管哮喘(哮喘)炎症调控,如细胞白细胞介素、生长因子、趋化因子等在诱发、维持和加重哮喘的变应性炎症反应中起着重要作用.该文就白细胞介素、生长因子、趋化因子与哮喘的关系及其在哮喘治疗中的前景作一综述.     

双次造血干细胞移植治疗多发性骨髓瘤一例临床分析

多发性骨髓瘤(multiple myeloma,MM)是浆细胞异常增生的恶性肿瘤,可分为IgG型、IgA型、轻链型、IgD型等多种类型。其中轻链型占15%~20%,该型瘤细胞分化差,恶性程度高,治疗效果不佳。近十余年内,国内外有关双次自体造血干细胞移植治疗多发性骨髓瘤的研究日趋增多,而关于采用序贯     

人白血病细胞裸鼠异种移植模型的建立

我们成功地将人T淋巴细胞白血病细胞（MOLT－4）、人早幼粒细胞白血病细胞（HL-60）移植到裸鼠体内。裸鼠经环磷酰胺（2.5mg／只）预处理后分别将（5～10）×10~6MOLT-4细胞及（2～4）×10~7HL－60细胞移植到动物皮下能形成实体瘤，该肿瘤呈进行性生长。MOLT－肿瘤在裸鼠间连续传代4次，移植成功率为69.2％，HL-60肿瘤连续传代3次，成功率为100％。肿瘤染色体分析属于人体细胞核型，细胞学研究显示裸鼠体内MOLT-4、HL-60细胞与体外培养的细胞具有良好的一致性，故裸鼠体内MOLT-4、HL-60肿瘤模型的建立对于研究人白血病提供了有用工具。     

以培养岗位胜任力为导向的全科医师自主学习模式的研究与实践

目的 以全科医师培训基地的视角探讨建立全科医师自主学习培养模式.方法 调查了全科医师培训学员学习能力的研究现状,进行了临床教学中自主学习教学模式的探讨,通过统一基础培训、导师个性化带教引导、在评估与考核中建立评价机制,构建了以培养岗位胜任力为导向的全新教学理念.结果 学员强化了学习方法 ,保证了教学质量.结论 在全科医师培训过程中,进行自主学习教学模式的改革是促进其提升学习能力和培养临床实践的有利手段.     

抗人胸腺细胞球蛋白与柔红霉素交联方法及其偶联物体外抗肿瘤作用

分别用12.5％、25.0％、50.0％、75.0％和100.0％氧化的Dex T_(10)作为交联剂交联抗人胸腺细胞球蛋白(AHTG)和柔红霉素(DNR)形成免疫偶联物(AHTG-Dex-DNR),其中以25.0％氧化的DexT10作为交联剂最佳。它既提高了偶联物的交联度,又降低了硼氢化钠对AH-TG和DNR活性的损伤。偶联物对靶细胞CEM 24h细胞毒试验LD_(50)为10.68μg/ml。对非靶细胞K562仅有轻微杀伤作用,10min细胞毒试验为特异的杀灭肿瘤细胞试验,对CEM的LD_(50)为14.79μg/ml,对K562几乎无细胞毒作用,表明免疫偶联物有特异性细胞毒作用。     

慢性乙型肝炎恩替卡韦治疗过程中病毒动力学特点分析

Objective To analyze the viral dynamics and clinical significance during the antiviral treatment by a mathematical model.Methods Six chronic hepatitis B patients were evaluated with a kinetic model(Neumann model)during dose of 0.5 mg/d oral entecavir.Blood samples were drawn for HBV DNA measurement at week 0,2,4,12,24.Non-linear modeling was used to fit individual patient data.Results The median effectiveness in blocking viral production was 99.970%(n=6).The median half-life of viral turn-over was 1.6 d(n=6).The median half-life of infected hepatocytes was 21.3 d(n=5).Compared with the other patients,the c(virions are cleared at a rate)、ε(effectiveness)、δ(infected cell are lost at a rate)value of one patient(eg.6)were all lower and the half-life of virus and infected cells were higher,and eg.6 developed viral break-through after 38 weeks of follow-up.Conclusions Viral load decay showed a biphasic pattern during entecavir therapy which can be described with a mathematical model.The model relates processes of viral infection and replication as well as drug efficacy to model parameters.It indicates the prediction of bio-mathematical model during antiviral treatment.     

慢性乙型肝炎恩替卡韦治疗过程中病毒动力学特点分析

Objective To analyze the viral dynamics and clinical significance during the antiviral treatment by a mathematical model.Methods Six chronic hepatitis B patients were evaluated with a kinetic model(Neumann model)during dose of 0.5 mg/d oral entecavir.Blood samples were drawn for HBV DNA measurement at week 0,2,4,12,24.Non-linear modeling was used to fit individual patient data.Results The median effectiveness in blocking viral production was 99.970%(n=6).The median half-life of viral turn-over was 1.6 d(n=6).The median half-life of infected hepatocytes was 21.3 d(n=5).Compared with the other patients,the c(virions are cleared at a rate)、ε(effectiveness)、δ(infected cell are lost at a rate)value of one patient(eg.6)were all lower and the half-life of virus and infected cells were higher,and eg.6 developed viral break-through after 38 weeks of follow-up.Conclusions Viral load decay showed a biphasic pattern during entecavir therapy which can be described with a mathematical model.The model relates processes of viral infection and replication as well as drug efficacy to model parameters.It indicates the prediction of bio-mathematical model during antiviral treatment.     

177例慢性粒细胞白血病患者血糖测定值分析

目的 探讨可能影响慢性粒细胞白血病（CML）患者血糖测定值的因素，加深对白血病假性低血糖现象的认识。方法 应用自动生化分析仪对177例CML患者血糖和外周血白细胞进行测定，并结合临床进行分析。结果 在177例CML患者中，共发现32例（18.1%)白血病假性低血糖现象。血糖测定值与白细胞计数呈负相关（P＜0.05)，环境温度对假性低血糖现象的发生也有一定的影响。32例白血病假性低血糖现象中，24例未得到临床医师的充分认识。此外，5例（2.8%)CML急变合并高血糖患者，其原因可能是应激导致了血糖增高。结论 外周血白细胞计数和环境温度对白血病假性低血糖现象的产生有一定作用，对CML血糖值的分析应与临床症状相结合。