人IL_2活性测定及其影响因素的探讨

作者建立了小鼠胸腺细胞MTT比色分析法并检测了33份正常人的IL_2活性。探讨了影响人IL_2活性测定的因素并与~3H-TdR掺入法进行比较。结果表明,该法简便,稳定,可行,与~3H-TdR掺入法比较二者有较好的一致性,认为本法可用于临床IL_2样本的检测。     

白细胞介素-10诱导的大鼠树突状细胞体外免疫功能的研究

目的　研究白细胞介素 10 (IL 10 )诱导的大鼠未成熟树突状细胞 (imDCs)体外诱导免疫耐受的可行性。方法　在经典诱导方案的基础上 ,应用IL 10 ( 10 μg/L)抑制大鼠骨髓来源DCs的成熟 (IL 10组 ,10例 ) ,并设对照组 (IL 4组 ,10例 )。培养期间观察DCs形态 ,检测DCs表型、摄取抗原能力、体外免疫功能及培养上清细胞因子水平。结果　与IL 4组比较 ,IL 10组DCs细胞表面CD80 、CD86及OX6低度表达 ( 2 5 .3 %、42 .4%、3 2 .3 % ) ,吞噬能力较强 ( 81.9) ,刺激同种异体淋巴细胞增殖能力下降 ,该淋巴细胞具有抗原特异性低反应性 ;培养上清中IL 12水平 ( 4 0 6.5pg/L)及初次MLR培养上清IL 2水平 ( 2 45 .4ng/L)均较低 ,差异有非常显著性 (P <0 .0 1)。 结论　IL 10作用的大鼠imDCs具有诱导免疫耐受的应用价值。     

硬膜外腔阻滞对胸部手术应激反应的影响

目的 观察硬膜外腔阻滞对胸部手术应激激素和细胞因子的影响。方法20例食管癌手术病人,随机分为两组,每组10例,即全麻复令硬膜外腔阻滞(GEA)组和全麻(GA)组,分别测定麻醉诱导前、手术2h、手术4h、术毕、术后1d及术后3d的血浆去甲肾上腺素、肾上腺素、血清促肾上腺皮质激素(ACTH)、皮质醇、C-反应蛋白、IL-6及IL-10的水平。结果 血浆去甲肾上腺素和血清皮质醇GEA组术中术后无显著改变,但GA组术毕和术后1d显著升高(P<0.05),术后3d恢复至术前水平,组间比较前者有显著差异(P<0.05)。两组血浆肾上腺素、IL-10术中术后均无显著变化。两组血清ACTH、IL-6及CRP术中术后均显著升高(P<0.05),组间比较无显著差异。结论 硬膜外腔阻滞可以减轻胸部手术的应激反应。IL-6是较CRP更灵敏的反映组织损伤的炎性指标。     

白细胞介素-13功能研究进展

白细胞介素－13主要由活化的Th2(CD4^ )细胞分泌，诱导单核巨噬细胞分化及延长寿命；促进MHC－Ⅱ，CD23表达；抑制炎性和趋化因子产生；诱导B细胞增殖，活化，刺激IgM,IgG的产生和重链的转换；使血管细胞粘附分子－1表达；抑制人类免疫缺陷病毒（HIV）复制；间接诱导巨噬细胞和NK细胞参与抗肿瘤作用。在变态反应性疾病和哮喘中引起呼吸道高反应性，嗜酸粒细胞性炎症，粘液分泌过多，基膜纤维化等，其受体是与IL－4Rα形成功能复合体而发挥作用。IL－13信号转导途径除了JAK／STAT6以外，尚有IRS－1,Fes，磷酸激酶，BCL－6／SOCS等途径。     

失血性大鼠休克后肠、肝、肺组织中细胞因子表达、释放时相及其伴随的病理变化

目的：探讨休克后促炎细胞因子的表达、释放时相及伴随的肠、肝、肺组织病理变化。方法：80只SD大鼠随机均分为失血性休克组和对照组。采用RT-PCR、ELISA方法检测失血性休克后30、60、90min及复苏后30、90min肠、肝、肺组织内TNF-α、IL-6 mRNA表达及血清中TNF-α、IL-6含量；HE和IHC染色检测伴随的组织病理变化。结果：①休克30min时，肠、肝、肺内的促炎细胞因子表达未见升高；60min时肠道先出现TNF-αmRNA表达升高（P〈0．05）：而肝脏在90min开始表达升高（P〈0．05），肺脏则在复苏后30min开始表达升高（P〈0．05）。复苏后90min肠、肝、肺的细胞因子表达都继续显著升高（P〈0．01）。②TNF-α 在肠、肝、肺的表达升高最早，其后为IL-6 mRNA。③30min时门静脉和外周血中TNF-α、IM的含量与对照组相比无显著差异，而60min时门静脉血中含量显著升高（P〈0．01）。④休克后肠黏膜坏死脱落；肝组织结构紊乱、肝窦增宽、肝细胞变性坏死；肺脏间质水肿、炎症细胞浸润。结论：失血性休克时细胞因子的释放顺序是肠道、肝脏和肺脏，推测存在“肠-肝-肺”细胞因子释放轴的可能，有待进一步确定。     

Neutrophil superoxide release and interleukin 8 in acute myocardial infarction: distinction between complicated and uncomplicated states

Superoxide release in neutrophils and sera levels of interleukin 8 (IL-8) were determined in 15 patients with complicated acute myocardial infarction (MI) and 15 patients with uncomplicated MI. All patients showed increased superoxide release in unstimulated and stimulated neutrophils compared with healthy control subjects, indicating priming of these cells. Superoxide release of unstimulated or stimulated neutrophils was found to be significantly higher in patients with complicated MI than in patients with uncomplicated MI. Thrombolytic therapy did not affect the rates of superoxide release. The neutrophil chemoattractant/activator IL-8 was detected in the sera of all patients, with significantly higher levels in those with complicated MI. The highest levels of IL-8 were detected at admission to the Coronary Care Unit and significantly decreased thereafter, suggesting its contribution to neutrophil-mediated tissue injury. The high levels of IL-8 may be one of the major contributors to the priming of neutrophils in these patients.     

人重组C3片段通过IL-2自分泌效应对CTLL-2细胞产生促增殖作用

目的研究补体Ｃ３片段的体外生物学活性及其作用机理，进一步探讨Ｃ３片段与免疫细胞的关联。方法利用重组ＤＮＡ技术表达纯化Ｃ３活性片段（命名为Ｃ３３），观察其对ＩＬ－２依赖性的小鼠杀伤性Ｔ细胞株ＣＴＬＬ－２细胞的促增殖效应，并通过抗体封闭途径和分子杂交技术研究Ｃ３３作用的机理。结果发现Ｃ３３蛋白对ＣＴＬＬ－２细胞具有明显的促增殖作用，并呈剂量依赖关系；这一作用能够部分地被抗小鼠ＣＤ１１ｂ抗体所封闭，能够完全被抗小鼠ＩＬ－２抗体所封闭；分子杂交显示Ｃ３３蛋白能够明显刺激ＣＴＬＬ－２细胞的ＩＬ－２ｍＲＮＡ表达。结论人重组Ｃ３片段Ｃ３３可通过ＩＬ－２的自分泌效应对ＣＴＬＬ细胞产生促增殖作用，补体受体ＣＲ３参与这一作用。     

Cerebrospinal fluid-filtration reduces TNF alpha in bacterial meningitis-CSF

A 37 year old male was admitted with the diagnosis of bacterial meningitis. Pneumococci were seen in the Gram stain of the cerebrospinal fluid. The clinical condition did not suggest severely raised intracranial pressure, there were no localizing signs and symptoms. CSF was turpid, with 20.100/3/mm³, mainly polymorphonuclear cells. Tumor necrosis factor alpha in CSp was greatly increased with 813 pg/ml. Parallel to the application of intravenous Penicillin G a CSF filtration was carried out. Within 214 h 225 ml CSF were filtrated through a Pall-filter, using a bidirectional pump. Cell count dropped to 720/3 cells/mm³, TNF-alpha to 39 pg/ml. The clinical course was uneventful, on day 12 the patient could be discharged without sequelae. CSF filtration may be a highly effective method to reduce from the CSF pathogenetically important cytokines, such as TNF-alpha, being responsible for intrathecal/meningeal inflammatory processes and triggered by cell-wall components of bacteria, e.g. pneumococci.     

Abdominal Stab Wounds in Children: an 18-Year Experience

Objective: Evaluation of the diagnosis, management, and the role of selective treatment in children with abdominal stab wounds. Patients and Methods: 59 children (56 male and three female) were included in the study. The patients' median age was 11.8 years (range, 5–14 years). Time between injury and admission was about 3 h. Laparotomy was performed in 44 patients (74%). Solid organ injury was detected in 32 of these patients (73%) and could not be observed in twelve (27%). 15 patients (26%) were treated conservatively, and only one (6.6%) underwent laparotomy during the follow-up. The stomach was the most frequently injured organ (ten patients), followed by the intestines (nine patients). Types of surgical treatment were as follows: primary suture in 28 patients, resection-anastomosis in three, and osteotomy in two. Results: Some prognostic factors such as presence of abdominal organ evisceration and pneumoperitoneum were not significantly correlated with intraabdominal organ injury, whereas some other risk factors such as acute abdomen on admission (p < 0.002) or abdominal clinical and hemodynamic findings (p < 0.001) showed significant correlation with intraabdominal organ injury. The relative risk (odds ratio) of developing an intraabdominal organ injury was > 2 for patients with signs of an acute abdomen on admission. Postoperative complications were observed in five patients with organ injuries. None of our patients died. Conclusions: Conservative treatment can be safely performed in most children with abdominal stab injuries. Signs of major internal hemorrhage or generalized peritonitis are an absolute indication for emergency operation for abdominal stab wounds. Peritoneal penetrations, free air on the abdominal X-ray, and omental or intestinal evisceration are poor indicators of significant organ injuries, and patients presenting these signs shold be closely followed up for developing acute abdominal symptoms. Received: November 2, 2001; revision accepted: February 15, 2002