ACE基因多态性及循环中酶活性与EHT的关系及赖诺普利对其疗效的观察

对１１０例原发性高血压（ＥＨＴ）患者和１６３例正常对照者取血测定其血管紧张素转换酶（ＡＣＥ）基因Ｉ与 Ｄ多态性及循环中酶活性。高血压组Ｄ等位基因频率高于对照组,分别为 ０．５１８　２和０．４３２ ５（Ｐ＜０．０５）。两组中ＡＣＥ活性均存在ＤＤ＞ＩＤ＞Ⅱ。高血压组及对照组ＩＤ型ＡＣＥ活性分别为３１４．１±６７．９４和２５８．３５±６４．１１（Ｐ＜０．０１）,Ⅱ型分别为２５９．６８±６９．６８和２２０．８８±６２．８５（Ｐ＜０．０５）。高血压组应用赖诺普利后各基因型患者血压均有明显下降,降压幅度ＤＤ＞ＩＤ＞Ⅱ。结果显示ＡＣＥ基因多态性与原发性高血压有密切关系,ＤＤ型有高易患性。ＡＣＥ活性受基因型控制,ＤＤ型活性最高。应用赖诺普利后各基因型血压均有下降,降压幅度 ＤＤ＞ ＩＤ＞ Ⅱ。 ＤＤ型可作为ＡＣＥ抑制剂应用的最佳指征。     

多巴胺对大鼠移植肾热缺血再灌注损伤的预处理

目的　观察在大鼠的热缺血再灌注损伤的动物模型中多巴胺的前处理是否可以降低肾脏的免疫活性。方法　♂Lewis大鼠缺血前给予不同浓度多巴胺 (2、5、10 μg·kg-1·min-1)持续灌注 4 8h ,对照组用生理盐水。灌注后夹住左肾动脉 1h ,取右肾检测血氧化酶 (HO 1) ,5d后取左肾用于免疫组化分析。结果　多巴胺的前处理可以降低肾脏单核吞噬细胞的浸润和MHC Ⅱ的表达 ,提高肾脏HO 1的含量。结论　多巴胺的前处理可以降低缺血再灌注损伤肾脏的免疫活性。     

鲨肝活性肽的免疫调节和抗细胞凋亡作用

目的　为了选择鲨肝活性肽 (SHAP)临床应用的适应症并了解其作用机制。方法　分离培养人外周血单核细胞 (PBMC) ,检测SHAP对其分泌IFN α和IFN γ的影响 ;用环磷酰胺 (Cy)建立免疫低下模型 ,检测SHAP对免疫低下小鼠血清溶血素的生成及血清IL 2水平的影响 ;用流式细胞仪分析SHAP对对乙酰氨基酚 (AAP)诱导小鼠肝损伤模型中细胞凋亡的影响 :用Fas单克隆抗体诱导小鼠暴发性肝炎和抑制肝癌细胞株SMMC772 1的增殖 ,用SHAP处理后 ,分析小鼠血清谷丙转氨酶 (GPT)的水平及SMMC772 1增殖的变化情况。结果　SHAP能够有效诱导PBMC分泌IFN α和IFN γ ,促进免疫低下小鼠血清溶血素的生成和提高血清IL 2的水平 ,显著降低AAP诱导的肝细胞凋亡。 5 0mg·L- 1的SHAP可消除 5mg·L- 1Fas单克隆抗体对SMMC772 1增殖的抑制作用。 3mg·kg- 1的SHAP能显著降低Fas单克隆抗体诱导的暴发性肝炎小鼠的血清GPT水平。结论　SHAP具有免疫调节作用和抗细胞凋亡的作用 ,可能是SHAP防治肝炎的作用机制之一。     

Effects of super-extended paraaortic lymphadenectomy (PAL) on biological responses in totally gastrectomized patients with T3 or T4 gastric cancer

Background. In Japan, much attention has recently been paid to super-extended paraaortic lymphadenectomy (PAL) for the treatment of advanced gastric cancer. However, it has been reported that PAL is associated with increased morbidity and mortality, as compared to conventional extended lymphadenectomy (D2 or D3). Therefore, an analysis of the effects of PAL on perioperative changes in the biological responses of patients essential for determining the potential utility of this procedure. Methods. The current non-randomized prospective study included evaluations of perioperative changes in parameters of surgical stress (series I; serum levels of antidiuretic hormone, interleukin-6, trypsin, and phospholipase A ₂ ) and immunocompetence (series II; phytohemagglutinin- and concanavalin A-induced blastogenesis, activity of natural killer cells and the ratio of CD4 cells to CD8 cells) in patients with advanced gastric cancer (T3 or T4), comparing groups treated with D3 plus PAL ( n = 12) and D3 ( n = 13), and a control group with early gastric cancer ( n = 16) treated with D1 lymphadenectomy (perigastric N1 nodes) between April 1995 and April 1997. Results. The duration of surgery and the amount of blood lost were longer and greater in the D3 plus PAL group than in the D3 and D1 groups. D3 plus PAL and D3 were associated with significant postoperative increases in parameters of surgical stress, as well as with significant postoperative immunosuppression, compared to results with D1. However, there were no significant differences in the respective parameters between the D3 plus PAL and D3 groups. Conclusions. Our results indicate that there are no essential differences in patients' biological responses between D3 plus PAL and D3 lymphadenectomy. It appears that PAL-associated morbidity can be minimized by very careful manipulation during the dissection of paraaortic lymph nodes. Received for publication on Feb. 10, 1998; accepted on Jun. 3, 1998     

Fulminant Cytomegalovirus Myocarditis in an Immunocompetent Host: Resolution with Oral Valganciclovir

We report a case of fulminant myocarditis after a primary cytomegalovirus infection, in a previously healthy 72-year-old woman. The infection underwent clinical and immunologic resolution consequent to treatment with oral valganciclovir. In an immunocompetent host, the primary cytomegalovirus infection is usually asymptomatic or manifests itself as a heterophile-negative mononucleosis-like syndrome. Cytomegalovirus myocarditis is uncommon in immunocompetent patients. After presenting our case, we review the literature on cytomegalovirus myocarditis in immunocompetent individuals.     

Immunocompetence to assess nutritional status in eating disorders

Despite the seriously undernourished state of patients with anorexia nervosa and bulimia nervosa, controversial findings have been published regarding some aspects of the immune system that are otherwise impaired in more typical types of malnutrition, such as protein-energy malnutrition. However, cell-mediated immunity is usually altered and the study of immunocompetence has provided useful markers to assess the nutritional status of these patients. In addition, a relative protection against infection has been observed in these patients. Changes in the interactions between the endocrine, central nervous and immune systems are considered relevant to understanding the adaptive mechanisms triggered in these syndromes. The role of cytokines and several hormones are reviewed for their implication in immune homeostasis.     

人参单体皂甙Rh2对非小细胞肺癌患者肺泡巨噬细胞免疫活性的影响

目的:探讨人参单体皂甙Rh2(G-Rh2)对非小细胞肺癌患者肺泡巨噬细胞(AM)分泌细胞毒效应分子的影响.方法:采用ELISA法和酶法分别检测35例非小细胞肺癌患者支气管肺泡灌洗液及其AM培养上清液中肿瘤坏死因子(TNF-α)和NO浓度,并分别用干扰素-α(IFN-α)、G-Rh2以及两药联合干预AM培养,检测其上清液中TNF-α和NO变化情况.结果:所有非小细胞肺癌患者其AM均可产生一定量的TNF-α和NO;非小细胞肺癌患者荷瘤侧肺NO和TNF-α活性在肺泡灌洗液及AM培养上清液中均明显低于非荷瘤侧肺.G-Rh2干预下AM培养上清液中TNF-α和NO的浓度较对照组明显升高(P＜0.05);与TNF-α干预AM培养上清液中TNF-α和NO的浓度比较差异无统计学意义(P＞0.05).G-Rh2和TNF-α联合干预时AM培养上清液中TNF-α和NO的浓度明显大于TNF-α或G-Rh2单独干预(P＜0.01).结论:G-Rh2能促进非小细胞肺癌患者肺泡巨噬细胞分泌细胞毒效应分子,联合干扰素时其作用更显著,两者具有协同性.     

异种细胞外基质的研究进展

细胞外基质因为其组织结构、成分及生物力学环境最适合种子细胞的生长发育及新陈代谢,材料可降解,因而成为国内外组织工程领域的研究热点,目前异体ECM临床应用较多,而异种ECM由于潜在的免疫风险及伦理因素等原因尚未广泛应用于临床。就异种ECM的制备、组织结构、免疫特点及其在医学各领域的临床应用等方面结合国内外研究进展进行综述。     

绵毛黄芪总甙的抗炎及免疫活性作用

从新疆绵毛黄芪中分得的绵毛黄芪总甙(Astrasieversianin,AS)50mg/kg能抑制大鼠角叉菜性肿胀和对抗佐剂性关节炎的初级症状。AS 50、75mg/kg能提高网状内皮系统的吞噬功能,使小鼠抗SRBC溶血素生成增加,增强SRBC诱导的迟发型超敏反应和DNCB引起的接触性皮炎。1、7.5mg/L的AS对体外ConA诱导~3[H]-TdR参入的淋巴细胞转化有增强作用。用化学发光法测定发现AS对O_2具有清除作用。提示绵毛黄芪总甙有一定的抗炎和免疫活性作用。     

九头狮子草对小鼠免疫功能的影响

目的：研究九头狮子草对小鼠免疫功能的影响。方法：采用小鼠碳廓清实验和血清溶血素测定法，观察九头狮子草对小鼠单核巨噬细胞吞噬功能、溶血素抗体生成的影响。结果：九头狮子草可激活小鼠网状内皮系统，增加小鼠血清溶血素含量。结论：九头狮子草具有一定增强机体免疫力的作用。