Preclinical evaluation of herpes simplex virus armed with granulocyte-macrophage colony-stimulating factor in pancreatic carcinoma

AIM: To investigate the therapeutic efficacy and mechanisms of action of oncolytic-herpes-simplex-virus encoding granulocyte-macrophage colony-stimulating factor(HSVGM-CSF) in pancreatic carcinoma.METHODS: Tumor blocks were homogenized in a sterile grinder in saline.The homogenate was injected into the right armpit of each mouse.After vaccination,the mice were randomly assigned into four groups: a control group,a high dose HSVGM-CSFgroup [1 × 107plaque forming units(pfu)/tumor],a medium dose HSVGM-CSF group(5 × 106pfu/tumor) and a low dose HSVGM-CSF group(5 × 105pfu/tumor).After initiation of drug administration,body weights and tumor diameters were measured every 3 d.Fifteen days later,after decapitation of the animal by cervical dislocation,each tumor was isolated,weighed and stored in 10% formaldehyde solution.The drug effectiveness was evaluated according to the weight,volume and relative volume change of each tumor.Furthermore,GM-CSF protein levels in serum were assayed by enzyme-linked immunosorbent assays at 1,2,3 and 4 d after injection of HSVGM-CSF.RESULTS: Injection of the recombinant mouse HSV encoding GM-CSF resulted in a significant reduction in tumor growth compared to the control group,and dosedependent effects were observed: the relative tumor proliferation rates of the low dose,medium dose and high dose groups on 15 d after injection were 45.5%,55.2% and 65.5%,respectively.The inhibition rates of the tumor weights of the low,middle,and high dose groups were 41.4%,46.7% and 50.5%,respectively.Furthermore,the production of GM-CSF was significantly increased in the mice infected with HSVGM-CSF.The increase in the GM-CSF level was more pronounced in the high dose group compared to the other two dose groups.CONCLUSION: Our study provides the first evidence that HSVGM-CSFcould inhibit the growth of pancreatic cancer.The enhanced GM-CSF expression might be responsible for the phenomenon.

CONSTRUCTION OF EUKARYOTIC EXPRESSION VECTOR WITH GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR GENE

Objective: To construct the eukaryotic expression vector that express human granulocyte-macrophage colony-stimulating factor (hGM-CSF) gene for making highly express in mammalian cells. Methods: Extract totally RNA from the induced human fetal lung (HFL) cell line. HGM-CSF cDNA was obtained by reverse transcription-polymerase chain reaction (RT-PCR), and then directionally subcloned into the HindIII and EcoRI site on the pcDNA3.1 plasmid, which was controlled by the CMV promoter, to form the recombinant expressing vector pcDNA3.1-GM-CSF. Results: The PCR amplification was identified and the sequence was analyzed, the results showed that hGM-CSF was properly inserted into the vector and the sequence was correct.

Granulocyte-macrophage colony-stimulating factor-transfected bone marrow stromal cells for the treatment of ischemic stroke

Adult, male, Sprague-Dawley rats were injected with granulocyte-macrophage colony-stimulating factor-transfected bone marrow stromal cells （GM-CSF-BMSCs） into the ischemic boundary zone at 24 hours after onset of middle cerebral artery occlusion. Results showed reduced infarct volume, decreased number of apoptotic cells, improved neurological functions, increased angiogenic factor expression, and increased vascular density in the ischemic boundary zone in rats that underwent GM-CSF-BMSCs transplantation compared with the BMSCs group. Experimental findings suggested that GM-CSF-BMSCs could serve as a potential therapeutic strategy for ischemic stroke and are superior to BMSCs alone.

EFFECTS OF GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR GENE ENCODED VACCINIA VIRUS VECTOR ON MURINE PULMONARY METASTATIC MELANOMA

A recombinant vaccinia virus expressing murine granulocyte-macrophage colony-stimulating factor (VVGM-CSF) was tested for its antitumor activity.Murine pulmonary metastasis was established by injecting 20×10~5 B16F10 melanoma cells into the tail vein of C57BL/6 mice. Three days after B16F10 inoculation,WGM-CSF or VVTK, a thymidine kinase gene deficient control vaccinia virus, were injected intraperitoneally twice weekly for 2 weeks. Two weeks later, the mice were sacrificed and pulmonary metastasis fool counted.The results demonstrated that VVGM-CSF treatment significantly decreased the number of pulmonary metastasis and prolonged the survival time of tumorbearing mice. Cytotoxic and phagocytic activities of the peritoncal macrophages were found to be markedly elevated in mice treated with WGM-CSF. Nitric oxide released from the macrophages was also found to be increased. These data, together with our other results,strongly demonstrated that continuous secretion of GMCSF and activation of macrophages might pal-tially explain the therapeutic effects of VVGM-CSF on murine pulmonary metastasis.

Pharmacokinetics of recombinant human granulocyte macrophage colony-stimulating factor in Macaca mulata

目的：研究重组人粒细胞巨噬细胞集落刺激因子（ｒｈＧＭＣＳＦ）在恒河猴体内的药物动力学．方法：用酶连接免疫吸附测定法检测血浆中ｒｈＧＭＣＳＦ的含量．结果：ｉｖｒｈＧＭＣＳＦ后血药浓度时间曲线符合三房室模型．第１，２和３相的Ｔ１２分别为００５－００７ｈ，０１４－０５８ｈ和１４－４１ｈ．ＡＵＣ随剂量成比例增加．ｉｖ高剂量和低剂量的Ｃｌ和Ｋ１０都相似．ｓｃｒｈＧＭＣＳＦ后血药浓度的峰值为０９３±０１６μｇ·Ｌ－１，达峰时间为２６５±０１４ｈ，生物利用度为０６１．结论：恒河猴ｒｈＧＭＣＳＦ药物动力学数据为临床试验提供有用参考．

A pilot study on the combined therapy of granulocyte-macrophage colony-stimulating factor and hepatitis B vaccine on chronic hepatitis B virus carrier children

Objective To observe the efficacy of treating intrauterine infected chronic hepatitis B virus (HBV) carrier children with a combination of granulocyte macrophage colony stimulating factor (GM CSF) or hepatitis B immunoglobulin (HBIG) plus recombinant hepatitis B vaccine (rHBvac) Methods A total of 27 chronic HBV infected children, who were born to HBV carrier mothers and received hepatitis B immunoprophylaxis at birth, were randomized into 2 groups: one receiving a combined therapy of 50 μg of GM CSF plus 10 μg of rHBvac injected intramuscularly at the same location (GM CSF group, 14 children) or 200 IU HBIG and 10 μg rHBvac in different muscles (HBIG group, 13 children) on a monthly four dose schedule HBV DNA quantification and other HBV serological markers were tested before and after the four dose therapy Results Twelve children in each group completed the study Of them, 3 children in the GM CSF group and 4 in the HBIG group had elevated serum alanine transaminase (ALT) before the trial, and then 2 in each group became ALT normal after the treatment Before the therapy, hepatitis B e antigen (HBeAg) positivity was found in nine children in the GM CSF group and 10 in the HBIG group One from each group had an HBeAg/anti HBe seroconversion after the treatment The quantity of HBV DNA was significantly lower after the treatment ( P =0 023) in GM CSF group, but was not significantly reduced in HBIG group No subjects were found to be negative for hepatitis B surface antigen (HBsAg) after the treatment, and no serious adverse events occurred in either group Conclusion Combined GM CSF and rHBvac therapy inhibit HBV replication in carrier children who were not protected after treatment with immunoprophylaxis

Granulocyte-macrophage colony-stimulating factor and interleukin 4 induce the malignant transformation of the bone marrow- derived human adult mesenchymal stem cells

Background The purpose of the study was to examine the effects of granulocyte-macrophage colony-stimulating factor （GM-CSF） and interleukin 4 （IL-4） on the bone-marrow-derived human adult mesenchymal stem cells （hMSCs）. Methods The hMSCs were isolated and cultured with GM-CSF and IL-4 for a period of one month. A single colony of transformed cells was then isoloated and their phenotype was characterized by morphology, surface marker expression, and in vivo tumorigenesis.Results After one month culture, the transformed mesenchymal cells exhibited the morphology and phenotype similar to those of tumor cells, and also caused multiple fast growing lung deposits when it was injected into immunodeficient mice.Conclusion Cytokines-driven malignant transformation of hMSCs may be a useful model for studying signaling pathways initiating malignant transformation of hMSC.

Effects of granulocyte-macrophage colony stimulating factor on the repair of vessel intima damaged by balloon

The dysfunction of vascular endothelial cells plays a key role in startingand facilitating restenosis. The acceleration of intima repair and the recovery of endothelialfunction would reduce the restenosis rate. This study was undertaken to assess the effect ofgranulocyte-macrophage colony stimulating factor ( GM-CSF) on the repair of damaged iliac arteries.Twenty-four male New Zealand white rabbits undergoing primary iliac artery deendothelialization wererandomly divided into two groups ( GM-CSF group and control group) . The GM-CSF group received asubcutaneous injection of GM-CSF (10 μg ? kg^(-1) ? d^(-1) ) , and the control groupwas given a subcutaneous injection of equivalent saline. The iliac arteries of all animals weredamaged by balloon after 7 days. The levels of nitric oxide ( NO) were detected before, 1 week, 2weeks and 4 weeks after angioplasty. The repair and hyperplasia of the intima were observedmicroscopically and the indices of stenosis were evaluated by computerized planimetry after 4 weeksof angioplasty. The NO levels of the GM-CSF group were higher than those of the control group 2weeks and 4 weeks after angioplasty [91.92 +-11.57) μmol/L vs. (81. 67 +- 12. 18) μmol/L; (97. 67+- 10. 13 ) ( μmol/L vs. (83. 16 +-12. 64) μmol/L]. Four weeks after balloon damage,histological examination showed that neointima formation, vascular smooth muscle cells and fibroustissue of the GM-CSF group were less than those of the control group. The endothelium of the GM-CSFgroup was more integrated, and stenosis of lumen was slighter than that of the control group.Morphometry showed the lumen area of the GM-CSF group was larger than that of the control group[(1.27 +-0. 31) mm^2 vs. (0. 92 +- 0. 24) mm^2 ] , the neointimal area and percent of intimahyperplasia were significantly smaller than those of the control group [ (0. 85 +-0. 34) mm vs. (1.18 +-0. 38) mm^2; (40 +- 7)% vs. (55 +- 6)%]. GM-CSF could facilitate the repair of the intima,reduce neointima formation, better the function of the endothelium, and decrease the rate ofrestenosis.

Regulatory effects of lipopolysaccharide in murine macrophage proliferation

AIMS To study the regulatory effects of bacterial lipopolysaccharide (LPS) in murine macrophage proliferation . METHODS Using murine peritoneal exudate macrophage (PEM) and macrophage cell line J 774 A.1 as targets, LPS effects on M CSF and granulocyte macrophage colony stimulating factor (GM CSF) stimulated macrophage colony forming cells (CFU M) were detected. 125 I GM CSF receptor binding assay was used to examine LPS regulation on GM CSF receptor expression. RT PCR was employed to test TGF β 1 inhibition on IFN γ mRNA expression on macrophage induced by LPS. RESULTS Without direct effect on macrophage proliferation, LPS could inhibit the macrophage proliferation stimulated by GM CSF. However, with the concomitant existence of GM CSF and TGF β 1, the LPS inhibitory effect was eliminated. RT PCR analysis indicated that the strongest macrophage growth inhibitory factor IFN γ mRNA expression in macrophage induced by LPS was remarkably suppressed by TGF β 1, 125 I GM CSF receptor binding assay showed that LPS could enhance GM CSF receptor expression likewise as TGF β 1 . CONCLUSIONS LPS is involved in the network of macrophage proliferative regulation by multiple cytokines, displaying inhibitory and stimulatory effects based on the coexisting cytokines.

Circulating myeloid-derived suppressor cells in patients with pancreatic cancer

BACKGROUND： Myeloid-derived suppressor cells （MDSCs） are heterogeneous cell types that suppress T-cell responses in cancer patients and animal models, some MDSC subpopulations are increased in patients with pancreatic cancer. The present study was to investigate a specific subset of MDSCs in patients with pancreatic cancer and the mechanism of MDSCs increase in these patients. METHODS： Myeloid cells from whole blood were collected from 37 patients with pancreatic cancer, 17 with cholangiocarcinoma, and 47 healthy controls. Four pancreatic cancer cell lines were co- cultured with normal peripheral blood mononudear cells （PBMCs） to test the effect of tumor cells on the conversion of PBMCs to MDSCs. Levels of granulocyte-macrophage colony-stimulating factor （GM-CSF） and arginase activity in the plasma of cancer patients were analyzed by enzyme-linked immunosorbent assay. RESULTS： CD14＋/CD11b＋/HLA-DR MDSCs were increased in patients with pancreatic or bile duct cancer compared with those in healthy controls, and this increase was correlated with clinical cancer stage. Pancreatic cancer cell lines induced PBMCs to MDSCs in a dose-dependent manner. GM-CSF and arginase activity levels were significantly increased in the se rum of patients with pancreatic cancer. CONCLUSIONS： MDSCs were tumor related： tumor cells induced PBMCs to MDSCs in a dose-dependent manner and circulating CD14＋/CD11b＋/HLA-DR- MDSCs in pancreatic cancer patients were positively correlated with tumor burden. MDSCs might be useful markers for pancreatic cancer detection and progression.

人类疱疹病毒-2对HaCaT细胞表达GCSF和GMCSF的影响

目的探讨HaCaT细胞在人类疱疹病毒-2(HSV-2)刺激前后粒细胞集落刺激因子(GCSF)和粒/巨噬细胞集落刺激因子(GMCSF)的表达变化及意义。方法以VERO细胞进行HSV-2扩增,采用RT-PCR和荧光实时定量PCR检测HSV-2感染HaCaT细胞前及感染后24h、48h、72h时GCSF和GMCSF的表达量。结果HaCaT细胞可自分泌GCSF和GMCSF;HSV-2感染后24h,HaCaT细胞表达GCSF及GMCSF的水平增高,72h时又明显上升,且实验组与对照组相比两种细胞因子的表达有显著性差异。结论HaCaT细胞可以自发表达GCSF和GMCSF;HSV-2刺激对HaCaT细胞表达GCSF和GMCSF有促进作用。

小剂量环孢素A治疗溃疡性结肠炎对肠黏膜中NFAT活性及GM-CSF表达的影响

目的:研究小剂量环孢素A(CsA)治疗的溃疡性结肠炎(UC)患者肠黏膜中核转录因子(NFAT)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)的变化,及其对黏膜炎症的影响.方法:UC患者14例经CsA治疗,采用凝胶电泳迁移率改变分析法(EMSA)检测肠黏膜NFAT治疗前后活性的变化,半定量RT-PCR法检测肠黏膜中GM-CSFmRNA的改变,治疗前后对肠黏膜炎症程度进行评估.结果:UC患者治疗后肠黏膜NFAT活性下降(0.80±0.31vs0.50±0.20,P<0.05),GM-CSFmRNA表达也有降低(1.09±0.07vs0.49±0.03,P<0.01),肠黏膜炎症程度也下降(P<0.05).结论:小剂量CsA治疗UC有效,其机制与调控NFAT的转录活性有关,并进一步降低激活因子GM-CSF的表达.

rhG-CSF在治疗儿童化疗性口腔黏膜炎中的应用研究

目的探究重组人粒细胞集落刺激因子(recombinant human granulocyte-colony stimulating factor,rhG-CSF)在治疗儿童化疗性口腔黏膜炎中的应用效果。方法选取2020年1月至2022年6月于笔者医院肿瘤外科化疗的60例化疗性口腔黏膜炎患儿,按随机数字表法分为两组,每组30例。对照组采取生理盐水口腔护理,实验组采取rhG-CSF口腔护理。比较两组患儿干预效果、口腔黏膜炎分度、生存质量[健康状况调查简表(36-item short—form,SF-36)]、患儿家长护理满意度。结果实验组总有效率较对照组高,差异有统计学意义(P<0.05)。干预5d,实验组患儿口腔黏膜炎分度结果优于对照组,差异有统计学意义(P<0.05)。干预5d,两组患儿SF-36评分较干预前高,实验组较对照组高,差异有统计学意义(P<0.05)。实验组患儿家长满意度较对照组高,差异有统计学意义(P<0.05)。结论rhG-CSF口腔护理可有效提高儿童化疗性口腔黏膜炎的干预效果,减轻口腔黏膜炎分度,改善患儿生存质量,提高患儿家长护理满意度。

ATRA对兔颈动脉内膜增生和GMCSF及L-选择素影响

目的 观察全反式维甲酸（ARTA）对兔颈动脉内膜损伤灶增生和粒细胞-巨噬细胞集落刺激因子（GMCSF）、L-选择素血清浓度的影响。方法 将54只健康新西兰雄性大白兔随机分为正常饮食组、手术组和治疗组,每组18只。正常饮食组给予普通饮食并分离、暴露颈动脉;手术组给予高脂饮食并行动脉内膜空气干燥术以损伤颈动脉内膜;治疗组给予ARTA灌胃,其余操作同手术组。各组分别于术后1、2、4周取静脉血5 mL,用ELISA法检测血清GMCSF及L-选择素水平;处死动物,取病变处血管行苏木精-伊红染色,光镜下观察各组动物内膜增生情况。结果 正常饮食组第1、2、4周损伤灶内膜增生均不明显,GMCSF和L-选择素血清浓度在正常范围内。手术组血管内膜增生程度和血管管腔狭窄程度随时间增加加重,差异有显著性（F=6.04~1 084.74,P〈0.001）;GMCSF及L-选择素血清浓度术后第2周较第1周明显增加,第4周又略有下降,差异有显著性（F=145.11、503.88,P〈0.001）。治疗组第1、2、4周血管内膜增生和管腔狭窄程度较手术组均显著减轻（F=3.98~123.15,P〈0.05）,GMCSF和L-选择素含量显著低于手术组（F=387.298~1 605.83,P〈0.001）。结论 ARTA可以减轻内膜增生和管腔狭窄,并且与血清内GMCSF和L-选择素浓度相关。

Immune Responses of Dendritic Cells Loaded with Antigens from Apoptotic Cholangiocarcinoma Cells Caused by Y-Irradation

Objective To investigate the induction cytotoxic T cells (CTLs) with antitumor activity and therapeutic efficacy after dendritic cells(DCs) acquired antigen from apoptotic cholangiocarcinoma cells caused by y-irradiation.Methods DCs from peripheral blood mononuclear cells (PBMC) that maintain the antigen capturing and processing capacity charateristicof immature cells have been established in vitro, using granulocyte macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). Then, in cholangiocarcinoma cells apoptosis was induced by J-irradiation. The experimental groups were as follows: (1) coculture ofDCs and apoptotic cancer cells and T cells; (2) coculture of DCs and necrotic cancer cells and T cells; (3) coculture of DCs, culturedcancer cell and T cells. They are cocultured for 7 days. DCs and T cells were riched, isolated and their antitumor response was tested.Results The cells had typical dendritic morphology, expressed high levels of GDI a and B7, acquired antigen from apoptotic cells causedby y-irradiation and induced an increased T cell stimulatory capacity in mixed lymphocyte reactions (MLR) .Conclusion DCs obtained from PBMCs using GM-CSF and IL-4 can efficiently present antigen derived from apoptotic cells caused by y-irradiation and efficiently induce T cells. This strategy, therefore, may present an effective approach to transduce DCs with antigen.

可视化分析GM-CSF在免疫炎症中的研究现状

目的通过文献计量学方法对粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony stimulating factor,GM-CSF)在免疫炎症方面相关研究现状、热点及发展趋势进行分析。方法在Web of Science核心数据库中检索1990年1月1日至2024年1月1日的相关文献,并应用CiteSpace软件对数据进行可视化分析。结果共纳入1219篇GM-CSF在免疫炎症方面相关文献,发文量整体呈上升趋势,美国以445篇居全球第一。发文量最高的机构是墨尔本大学25篇;发文量并列第一的作者是Jordana M和Becher B,每人10篇,被引次数最高的作者是Hamilton JA 128次;被引次数最多的期刊是Journal of Immunology 986次,GM-CSF在免疫炎症中相关热点主要包括inflammation、dendritic cell、T cell等,近几年的研究热点集中在immunity和microglia。结论随着GM-CSF在免疫炎症领域研究不断深入,其学术影响力也逐渐广泛,未来研究方向在于探索GM-CSF在免疫炎症领域中的作用机制和靶向治疗。

CONSTRUCTION AND EXPRESSION OF THE REPLICATION-DEFI-CIENT ADENONIRUS VECTOR OF HUMAN GM-CSF

The full-length cDNA encoding human Granulocyte macrophage colony stimulating factor (GM CSF) was cloned by RT PCR, placed under the control of CMV promoter, and inserted into adenovirus vector of E1 substitution type, pAx1cw. Subsequently, the cassette cosmid was cotransfected into 293 cells together with EcoT22I digested Ad5 TPC, and the replication deficient recombinant adenoviruses(Ad) of human GM CSF were generated efficiently by homologous recombination, with the titers of 1.51×10 9pfu/ml. 48 hours after infection with prepared human GM CSF recombinant adenoviruses in vitro, HeLa cells and primary human skin fibroblasts expressed high levels of human GM CSF (80～400ng/ 10 6cells/24hr). These suggest that the recombinant Ad of human GM CSF prepared by COS/TPC method is effective in mediating GM CSF gene transfer and might be used in cancer gene therapy.

血管瘤患儿血清粒细胞-巨噬细胞集落刺激因子及转录激活因子3水平与瘤体增生的相关性

目的探索血管瘤患儿血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)及转录激活因子3(STAT3)的表达水平并分析其与瘤体增生的相关性。方法选取2020年1月—2023年1月收治的152例血管瘤增生患儿作为研究对象,分为增生期组(87例)与退化期组(65例),另选择同期确诊为血管畸形的53例患儿作为血管畸形组。对血清GM-CSF、STAT3及碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、血管生成素-1(Ang-1)的表达水平进行检测;Pearson法相关性分析血清GM-CSF、STAT3与bFGF、VEGF、HIF-1α、Ang-1的相关性;受试者工作特征(ROC)曲线分析血清GM-CSF、STAT3对血管瘤瘤体增生的预测价值;多因素Logistic回归分析血管瘤瘤体增生的影响因素。结果增生期组患儿血清bFGF、VEGF、HIF-1α、GM-CSF、STAT3表达水平高于血管畸形组及退化期组患儿(P<0.05),但血清Ang-1表达水平低于血管畸形组及退化期组患儿(P<0.05);Pearson法相关性分析显示,增生期组患儿血清GM-CSF及STAT3水平均与bFGF、VEGF、HIF-1α水平正相关,与Ang-1水平负相关;ROC曲线下面积显示,GM-CSF和STAT3单独预测血管瘤瘤体增生风险的AUC分别为0.847,0.822,联合预测的AUC为0.918,联合预测的效能显著大于GM-CSF单独诊断的AUC(Z=2.459,P=0.014),STAT3单独诊断的AUC(Z=3.371,P=0.001)。多因素Logistic回归分析显示GM-CSF、STAT3是血管瘤瘤体增生的影响因素(P<0.05)。结论血管瘤瘤体增生患儿血清GM-CSF及STAT3表达水平升高,是瘤体增生的影响因素,联合检测能较好的预测血管瘤瘤体增生风险。

金刚藤胶囊联合桂枝茯苓胶囊治疗慢性盆腔炎的疗效及对血清GM-CSF、MMP-2水平的影响

【目的】分析金刚藤胶囊联合桂枝茯苓胶囊治疗湿热瘀结型慢性盆腔炎的疗效及对血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、基质金属蛋白酶2(MMP-2)水平的影响。【方法】将90例湿热瘀结型慢性盆腔炎患者随机分为联合组和单药组,每组各45例。单药组患者给予桂枝茯苓胶囊治疗,联合组患者在单药组的基础上联合金刚藤胶囊治疗,疗程为2周并随访1个月。观察2组患者治疗前后中医证候积分和血清GM-CSF、MMP-2水平的变化情况,比较2组患者的临床疗效、症状缓解时间、疾病复发和不良反应发生情况。【结果】(1)疗效方面,治疗2周后,联合组的总有效率为93.33%(42/45),单药组为66.67%(30/45),组间比较,联合组的疗效明显优于单药组(P<0.01)。(2)中医证候积分方面,治疗后,2组患者的下腹疼痛、腰骶疼痛、带下量多、月经量多、经行腹痛、神疲乏力等各项中医证候积分均较治疗前明显降低(P<0.05),且联合组对各项中医证候积分的降低幅度均明显优于单药组(P<0.05)。(3)症状缓解时间方面,联合组患者治疗后的白带恢复正常时间、下腹坠胀和腹痛缓解时间均较单药组明显缩短(P<0.01)。(4)血清学指标方面,治疗后,2组患者的血清GM-CSF、MMP-2水平均较治疗前明显降低(P<0.05),且联合组对血清GM-CSF、MMP-2水平的降低幅度均明显优于单药组(P<0.05或P<0.01)。(5)疾病复发和不良反应方面,联合组的复发率和不良反应发生率分别为11.11%(5/45)、13.33%(6/45),均明显低于单药组的35.56%(16/45),差异均有统计学意义(P<0.05或P<0.01)。【结论】金刚藤胶囊联合桂枝茯苓胶囊治疗,可以显著提高湿热瘀结型慢性盆腔炎的临床疗效,有效缩短症状缓解时间,降低血清GM-CSF、MMP-2水平。

干扰素调节因子5、粒细胞-巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值

目的探讨干扰素调节因子5(interferon regulatory factor 5,IRF5)、粒细胞-巨噬细胞集落刺激因子(granulocyte-macro-phage colony-stimulating factor,GM-CSF)在细菌性肺炎病儿血清中的表达变化及疾病预后价值。方法选取2019年4月至2021年5月中国人民解放军联勤保障部队第九二八医院收治的细菌感染性肺炎病儿96例作为细菌组,同期非细菌感染性肺炎病儿88例作为非细菌组,另外选取健康体检儿童96例为对照组,收集检测三组病儿基本临床资料。检测血清中IRF5、GM-CSF及其组间差异;采用Pearson法分析细菌性肺炎病儿血清IRF5、GM-CSF水平与病情指标的相关性;应用受试者操作特征曲线(ROC曲线)分析IRF5、GM-CSF及二者联合预测细菌性肺炎预后的价值。结果细菌组血清IRF5水平[(38.85±13.86)ng/L]显著高于非细菌组[(11.15±4.37)ng/L]和对照组[(10.76±1.55)ng/L],且重症组高于轻症组(P<0.05);细菌组血清GM-CSF水平[(54.73±16.56)ng/L]显著低于非细菌组[(246.73±28.94)ng/L]和对照组[(250.64±55.67)ng/L],且重症组低于轻症组(P<0.05)。重症组气促、吐沫、三凹征、肺部明显湿啰音比例、C反应蛋白(C-reactive protein,CRP)、白细胞水平显著高于轻症组、非细菌组(P<0.05),轻症组、非细菌组CRP水平显著高于对照组(P<0.05),非细菌组CRP水平显著高于对照组(P<0.05)。血清IRF5水平与CRP、白细胞、临床肺部感染评分(clinical pulmonary infection score,CPIS)均呈正相关(r=0.34、0.36、0.41,P<0.05),血清GM-CSF水平与CRP、白细胞、CPIS均呈负相关(r=-0.40、-0.32、-0.45,P<0.05)。预后不良组血清IRF5水平高于预后良好组,血清GM-CSF水平低于预后良好组(P<0.05)。ROC曲线显示,IRF5、GM-CSF对预后预测的AUC分别为0.90、0.87,二者联合对预后预测的AUC为0.96,明显高于二者单独诊断,(Z联合vs.IRF5=2.86,P=0.004;Z联合vs.GM-CSF=2.24,P=0.025),其灵敏度、特异度分别为90.32%、90.77%。结论细菌性肺炎病儿血清IRF5水平升高,GM-CSF水平降低,二者在评估病情进展及疾病预后预测方面具有较高的价值。