Distribution of natural killer cells and T-lymphocyte subsets in peripheral blood,gallbladder cancer and surrounding tissue

BACKGROUND: The patient with malignant tumor always show immunologic function drawback and ingravescent with tumor development, especially in the aspect of cell-mediated immunity. This study was undertaken to define the relationship between the immune function of local cells and cancer development by investigating the distribution of natural killer (NK) cells and T-lymphocyte subsets in peripheral blood, the cancer tissue and the tissue surrounding gallbladder carcinoma. METHODS: The numbers of CD4(+) and CD8(+) T-lymphocytes and NK cells were measured by flow cytometry in samples taken from gallbladder cancer tissue, the surrounding tissues and peripheral blood of 38 patients, and compared with the numbers in the peripheral blood and gallbladder tissue of 30 patients with cholecystitis as controls. RESULTS: The numbers of CD4(+) and CD8(+) T-cells and NK cells in gallbladder cancer tissues were significantly higher than those in the surrounding tissue and gallbladder with gallstone. However, the ratio of CD4(+)/CD8(+) was lower in the cancer tissue than that in the surrounding tissue and tissue from gallbladders with gallstones. The distribution of CD4(+) and CD8(+) T-cells and NK cells in mucous membrane of cholecystitis gallbladder and that in the tissue surrounding gallbladder cancer were significantly different. CONCLUSIONS: Disproportionate and imbalanced distribution of NK cells and subsets of T-lymphocytes occurs in the mucous membrane proper of gallbladder cancer and surrounding tissue. Although gallbladder cancer tissue has higher expressions of CD4(+), CD8(+) and NK cells, the immune function is low or in an inhibited state. In gallbladder cancer immunization therapy, local cellular immunological function should be enhanced and the protective barrier improved.

Effects of Intraoperative Administration of Dexmedetomidine on the Percentage of T-Lymphocyte Subsets and Natural Killer Cells in Patients with Colorectal Cancer

Study Objective: To observe the effect of dexmedetomidine (DEX) on T-lymphocyte subsets and natural killer (NK) cells in the peripheral blood of perioperative patients with colorectal cancer. Design: A random double-blind control clinical study. Setting: A university hospital. Patients: Forty patients with colorectal cancer, ASA I-П. Interventions: All patients were randomly divided into a DEX group (n = 20) and a control group (n = 20). Before induction of anesthesia, epidural catheters were placed in the L1-L2 or T12-L1 intervertebral spaces. The DEX group received 1 μg/kg of DEX (200 μg/50 ml) intravenously for 15 min prior to the surgery, which was then infused at a rate of 0.5 μg/kg/h until 30 min before the end of the surgery. The control group received an intravenous infusion of saline (50 ml) instead of DEX during the same periods as the DEX group. All patients received routine anesthesia and postoperative analgesia. Measurements: Blood samples from all patients were collected at the following time points: before anesthesia (T0), 24 h after surgery (T1), 48 h after surgery (T2) and 72 h after surgery (T3). Changes in T-lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and NK cells were determined by flow cytometry. Main Results: Compared with the control group, the percentages of CD3+ and CD4+ cells and the CD4+/CD8+ ratio in the DEX group increased significantly from T1 to T3

A Comparative Study on the Effect of BCG-PSN and Thymopeptides on T-lymphocyte Subsets of Normal and Immunosuppressed Mice

To compare the effects of polysaccharide nucleic acid fraction of bacillus calmette guerin (BCG PSN) and thymopeptides on T lymphocytes of normal and immunosuppressed mice, CD4 + and CD8 + T lymphocyte subsets of single nucleic cell in thymus, spleen and peripheral blood were detected successively by flow cytometry after application of BCG PSN and thymopeptides. Meanwhile, CD4 +/CD8 + ratio was also calculated. The results showed that both BCG PSN and thymopeptides could decrease the proportion of CD4 + CD8 + T lymphocyte subsets in the thymus, at the same time increase CD4 + T lymphocyte, CD8 +T lymphocyte proportion in the three tissues. The fluctuation in amplitude was greater in thymopeptides group than that in BCG PSN group. It is concluded that acting location of thymopeptides is in thymus, its stimulating action is stronger than that of BCG PSN, while BCG PSN not only accelerates the differentiation in thymus, but also has some direct stimulation to peripheral CD4 +T lymphocytes, and can maintain CD4 +/CD8 + ratio within normal range. So, BCG PSN is safer.

Effects of Heat Clearing and Stasis Resolving Method on PTS,Inflammatory Factors and T-lymphocyte Subsets in Peripheral Blood of URM Patients with Suppressed Internal Heat

[Objectives]To explore the effects of heat clearing and stasis resolving method on prethrombotic state,inflammatory factors and T-lymphocyte subsets in peripheral blood of unexplained recurrent miscarriage(URM)patients with suppressed internal heat.[Methods]Thirty cases of URM patients with suppressed internal heat and 30 normal women were collected,and characteristics of changes in peripheral serum D-dimer(D-D),fibrin degradation product(FDP),fibrinogen(FIB),IL-6,IL-10 and TNF-α,CD,CD,CD,CD,CDlevels were detected.URM patients were treated with traditional Chinese medicine for clearing heat and resolving blood stasis for 3 menstrual cycles,and the changes of indicators before and after treatment were observed.[Results]Compared with normal women,the peripheral serum levels of D-D,IL-6,TNF-αand CDin URM patients with suppressed internal heat were increased(P<0.05),while the IL-10 lymphocyte level was significantly decreased(P<0.05);compared with that before treatment,the contents of D-D,IL-6,TNF-αand CDdecreased after 3 menstrual cycles(P<0.05),while the contents of IL-10 and CDT lymphocytes increased significantly(P<0.05).[Conclusions]The heat clearing heat and stasis resolving method can effectively improve the prethrombotic state of URM,and the action mechanism may be related to the regulation of immune and peripheral blood inflammatory factors.

Machine learning-enhanced Monte Carlo and subset simulations for advanced risk assessment in transportation infrastructure

The maintenance of safety and dependability in rail and road embankments is of utmost importance in order to facilitate the smooth operation of transportation networks.This study introduces a comprehensive methodology for soil slope stability evaluation,employing Monte Carlo Simulation(MCS)and Subset Simulation(SS)with the"UPSS 3.0 Add-in"in MS-Excel.Focused on an 11.693-meter embankment with a soil slope(inclination ratio of 2H:1V),the investigation considers earthquake coefficients(kh)and pore water pressure ratios(ru)following Indian zoning requirements.The chance of slope failure showed a considerable increase as the Coefficient of Variation(COV),seismic coefficients(kh),and pore water pressure ratios(ru)experienced an escalation.The SS approach showed exceptional efficacy in calculating odds of failure that are notably low.Within computational modeling,the study optimized the worst-case scenario using ANFIS-GA,ANFIS-GWO,ANFIS-PSO,and ANFIS-BBO models.The ANFIS-PSO model exhibits exceptional accuracy(training R2=0.9011,RMSE=0.0549;testing R2=0.8968,RMSE=0.0615),emerging as the most promising.This study highlights the significance of conducting thorough risk assessments and offers practical insights into evaluating and improving the stability of soil slopes in transportation infrastructure.These findings contribute to the enhancement of safety and reliability in real-world situations.

Comparison of Block Design Nonparametric Subset Selection Rules Based on Alternative Scoring Rules

This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.

Correlation Study Between T Lymphocyte Subsets and Rheumatoid Arthritis

Objective:To study the effect of Helicobacter pylori infection on rheumatoid arthritis and T-lymphocyte subpopulations in patients with rheumatoid arthritis and to provide a new method for the treatment of rheumatoid arthritis by removing Helicobacter pylori from patients.Methods:60 patients with rheumatoid arthritis admitted to the hospital from May 2022 to May 2023 were selected for the study,and all patients underwent a 13-carbon urea breath test to detect gastric H.pylori and the test results showed that 20 cases were negative and 40 cases were positive.The 40 positive patients were divided into the treatment group(n=20)and non-treatment group(n=20)by random number table method and the treatment group was given anti-Helicobacter pylori treatment,and the non-treatment group was given maintenance rheumatoid basic treatment,comparing the anti-cyclic citrulline peptide(CCP),DS28 score,peripheral blood T-lymphocyte subsets(CD4^(+)T-lymphocytes,CD8^(+)T-lymphocytes,CD4^(+)/CD8^(+)ratio)before and after the treatment of patients by 13-carbon urea respiration test(pylori-negative group,20 patients)and those who were positive for the treatment of H pylori(pylori-positive group,40 patients).Besides,the correlation of peripheral blood T-lymphocyte subsets and disease activity between treatment and non-treatment groups in the pylori-positive group was identified together with the correlation of DS28 scores,TNF-αlevels,sedimentation and immunoglobulin,lymphocyte subsets in the pylori-positive treatment group and positive non-treatment group as well as the level of globulin,lymphocyte subsets,and peripheral blood lymphocytes before and after treatment.Results:Before treatment,CCP,DS28 score,CD8^(+)T lymphocyte level of the pylori-negative group were lower than that of the positive group,and CD4^(+)T lymphocyte and CD4^(+)/CD8^(+)ratio were higher than that of the positive group(P<0.05);after treatment,the indexes of the pylori-positive group improved,and there was no significant difference in the comparison of the indexes with those of the pylori-negative group(P>0.05);the positive treatment group had a DS28(3.19±1.02)points,positive non-treatment group DS28(5.36±1.85)points,non-treatment group DS28 score and CD4^(+)T lymphocytes,CD4^(+)/CD8^(+)negative correlation with CD8^(+)T lymphocytes showed a positive correlation(P<0.05);before the treatment,pylori-positive treatment group and non-treatment group DS28 scores,TNF-αlevels,peripheral blood T lymphocyte subpopulation levels were not significantly different(P>0.05);after treatment,DS28 score,TNF-αlevel,CD8^(+)T of the treatment group were lower than those of the non-treatment group,and CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)ratio were higher than those of the non-treatment group(P<0.05).Conclusion:H.pylori affects the level of T lymphocyte subsets in patients with rheumatoid arthritis,and there is a certain correlation between the two.Removal of H.pylori can improve the level of T lymphocyte subsets,which is important for the treatment of patients with rheumatoid arthritis.

Effect of cytotoxic T-lymphocyte antigen-4,TNF-alpha polymorphisms on osteosarcoma: evidences from a meta-analysis

Objective： Previous studies have investigated the role of cytotoxic T-lymphocyte antigen-4 （CTLA-4） and tumor necrosis factor-alpha （TNF-a） in carcinogenesis of osteosarcoma, but their results were inconsistent. We aimed to clarify the associations between CTLA-4, TNF-a polymorphism and osteosarcoma risk by using meta-analysis. Methods： We searched relevant studies without language restriction in PubMed, EMbase, Cochrane Library, Google Scholar databases, Chinese National Knowledge Infrastructure （CNKI） and conference literature in humans published prior to March 2013. The strengths of the associations between genetic variants and osteosarcoma risk were estimated by odds ratio （OR） with 95% confidence interval （95% CI）. Results： A total of seven studies with 1,198 osteosarcoma patients and 1,493 controls were selected. Four studies were eligible for CTLA-4 （1,003 osteosarcoma and 1,162 controls）, and three studies for TNF-a （195 osteosarcoma and 331 controls）. Pooled results showed that rs231775 polymorphism of CTLA-4 was associated with osteosarcoma risk （GG vs. AA： OR=1.63, 95% CI=1.24-2.13; GG ＋ GA vs. AA： OR=1.56, 95% CI=1.21-2.01; AA ＋ GA vs. GG： OR=0.83, 95% CI=0.71-0.97; G vs. A： OR=1.21, 95% CI=1.08-1.36）. No significant heterogeneity was observed across the studies. No significant associations were found between rs5742909 polymorphism of CTLA-4 or rs1800629 polymorphism of TNF-a and osteosarcoma risk. Conclusions： These results suggest that the rs231775 polymorphism of CTLA-4 may play an important role in carcinogenesis of osteosarcoma.

Analysis of T-lymphocyte subtypes of the peripheral blood and skindelayed-type hypersensitivity in patients with hyper-IgE syndrome

Objective: To study the function of ce ll ular immunity in patients with hyper-IgE syndrome (HIE). Methods: T-lymphocyte subtypes of the peripheral blood and cutaneous delayed-typ e hypersensitivity (DTH) response to two recall antigens, tetanus toxoid (TT) an d purified protein derivative(PPD), were measured in five patients with HIE and 15 healthy controls, respectively. Results: The CD4+ cell cou nts in HIE group were significantly lower than those in control group (P<0. 01). In contrast, CD8+ cells were significantly higher than those in the contro l (P<0.01). The induration sizes of DTH response to two recall antigens wer e smaller in HIE group than those in the control group (P<0.01). Co nclusion: There was an immunologic dysfunction of T lymphocytes in the p atients with HIE.

SFSDA:Secure and Flexible Subset Data Aggregation with Fault Tolerance for Smart Grid

Smart grid(SG)brings convenience to users while facing great chal-lenges in protecting personal private data.Data aggregation plays a key role in protecting personal privacy by aggregating all personal data into a single value,preventing the leakage of personal data while ensuring its availability.Recently,a flexible subset data aggregation(FSDA)scheme based on the Pail-lier homomorphic encryption was first proposed by Zhang et al.Their scheme can dynamically adjust the size of each subset and obtain the aggregated data in the corresponding subset.In this paper,firstly,an efficient attack with both theorems proving and experimentative verification is launched.We find that in a specific scenario where the encrypted data constructed by a smart meter(SM)exceeds the size of one Paillier ciphertext,the malicious fog node(FN)may use the received ciphertext to obtain the reading of the SM.Secondly,to avoid the possibility of privacy disclosure under certain circumstances,additional hash functions are added to the individual encryption process.In addition,fault tolerance is very important to aggregation schemes in practical scenarios.In most of the current schemes,once some SMs failed,then they will not work.As far as we know,there is no multi-subset aggregation scheme both supports flexible subset data aggregation and fault tolerance.Finally,we construct the first secure flexible subset data aggregation(SFSDA)scheme with fault tolerance by combining the fault tolerance method with the flexible multi-subset aggregation,where FN enables the control server(CS)to finally decrypt the aggregated ciphertext by recovering equivalent ciphertexts when some SMs fail to submit their ciphertexts.Experiments show that our SFSDA scheme keeps the efficiency in implementing a flexible multi-subset aggregation function,and only has a small delay in implementing fault-tolerant data aggregation.

Association of T lymphocyte subset counts with the clinical features of colorectal cancer

Background:Colorectal cancer(CRC)is a common gastrointestinal malignancy.The T lymphocyte subsets are important in the develop-ment,invasion and metastasis of tumors,including CRC.Nevertheless,limited research has explored the relationship between T cell subpopu-lations and the clinical characteristics of CRC.This study compared the T lymphocyte subsets in patients with CRC and healthy individuals,and assessed the relationship between these values and clinical characteristics.Methods:Peripheral blood was collected from 100 patients with CRC and 54 healthy individuals.The numbers of CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocytes,NK cells,and the CD4^(+)T/CD8^(+)T ratio in peripheral blood were measured using flow cytometry,and were compared between CRC patients and healthy individuals.Spearman's correlation analysis was performed to investigate the relationship between the T lymphocyte subsets in patients diagnosed with CRC and the levels of carcinoembryonic antigen(CEA)and thymidine kinase 1(TK1).Receiver operating characteristic(ROC)curves were utilized to evaluate the potential utility of the T lymphocyte counts in predicting lymph node metastasis,vas-cular infiltration,and high Ki-67 expression.Results:The CRC patients had lower counts of CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocytes compared to the healthy population(P<0.05).However,no significant differences were observed in the CD4^(+)/CD8^(+)ratio or NK cells(P>0.05).Notably,the CD3^(+)T,CD4^(+)T,and CD8^(+)T lym-phocyte counts were higher in patients with stageⅠ-Ⅱdisease,no lymph node metastasis,no vascular invasion,and low Ki-67 expression than in those with stageⅢ,lymph node metastasis,vascular invasion,and high Ki-67 expression(P<0.05).There was a negative association be-tween the CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts and CEA and TK1 levels in patients with CRC.The ROC curves demonstrated that CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts had significant predictive value for lymph node metastasis,vascular infiltration,and high Ki-67 expression.Conclusions:The peripheral blood CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts are related to the clinical traits of patients with CRC and can predict the prognosis of the disease.

基于XGBoost的中国上市公司违约风险预测模型

准确预测上市公司的违约风险,是企业信用风险评价的关键,也是金融机构信贷决策的重要依据。通过线性回归模型的信息量AIC遴选违约判别能力最大的指标组合,采用粒子群优化算法构建基于XGBoost的违约预测模型。选取中国A股3425家上市公司不同时间窗口的数据为样本进行违约预测,将所构建的PSO-XGBoost模型与逻辑回归、支持向量机等13种预测模型对比,验证所建模型的有效性。通过UCI数据库中的3个公开信用数据集,利用Friedman检验,验证所建模型的稳健性。研究表明:使用上市公司数据与13种模型对比,PSO-XGBoost模型提高了预测精度G-mean;使用3个公开信用数据集,在多个评价指标上,PSO-XGBoost模型的平均预测性能显著优于对比模型;通过指标对预测结果的贡献获得指标重要性得分,增强了预测模型的可解释性。研究发现:“资产负债率”“流动比率”“长期资本负债率”等财务指标对违约预测的影响最大,“行业景气指数”“社会消费品零售总额增长率”“流通中现金(M0)供应量同比增长率”等指标是影响违约预测的重要指标。本研究可以为提高违约风险预测的准确性提供有效的方法和实证证据,有助于加强上市公司违约风险的预警和防范,降低违约风险监管成本,为企业管理者、债权人及投资者提供良好的决策支持。

老年初治肺结核中医证型与细胞因子及免疫表达的相关性分析

目的 观察老年初治肺结核患者血清中细胞因子及TB淋巴细胞亚群的表达水平,探究中医证型与细胞因子、TB淋巴细胞表达之间的关系。方法 纳入2016年5月至2021年12月解放军总医院第八医学中心结核医学部收治的初治老年肺结核病患者322例作为研究对象,根据辨证分型分为肺阴亏虚组78例、阴虚火旺组83例、气阴两虚组79例、阴阳两虚组82例。采用酶联免疫吸附试验检测血清中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-5、IL-2、IL-6、IL-8、IL-17、IL-4、IL-10等细胞因子的表达水平,流式细胞仪测定TB淋巴细胞亚群中CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞的绝对数及CD4^(+)/CD8^(+)T细胞比值,并将测定结果进行统计学分析。结果 四组肺结核患者IL-β、IL-5、IL-2、IL-17、IL-4、IL-10水平差异无统计学意义(P>0.05)。气阴两虚组IFN-γ水平显著高于其他三组(P<0.05);阴阳两虚组TNF-α水平显著高于其他三组(P<0.05);阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组的IL-6水平依次降低(P<0.05);阴阳两虚组IL-8水平显著高于其他三组,气阴两虚组高于肺阴亏虚组、阴虚火旺组(P<0.05)。CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞绝对数在阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组依次降低,差异均有统计学意义(P<0.05)。阴阳两虚组CD4^(+)/CD8^(+)T细胞比值显著高于其他三组,肺阴亏虚组、阴虚火旺组、气阴两虚组组间比较差异无统计学意义(P>0.05)。结论 不同证型的老年肺结核病患者细胞因子及免疫细胞表达存在差异性,可作为中医辨证论治的客观参考标准之一,为临床辨证治疗提供一定参考。

经导管动脉化疗栓塞术联合微波消融治疗原发性肝细胞癌患者疗效观察

目的观察经导管动脉化疗栓塞术(TACE)联合微波消融治疗原发性肝细胞癌(HCC)对患者血清肿瘤标志物、T淋巴细胞亚群的影响。方法收集2018年10月—2021年12月哈尔滨医科大学附属肿瘤医院介入科收治的原发性HCC患者104例临床资料,随机分为TACE组52例(TACE治疗)、联合组52例(TACE+微波消融治疗),评估术后1个月疗效,比较治疗前后2组患者肝功能指标、血清肿瘤标志物、T淋巴细胞亚群,统计患者并发症发生率。结果联合组总有效率为86.5%,高于TACE组的69.2%(χ^(2)/P=4.522/0.033);治疗后1个月联合组AST、ALT水平低于TACE组(t=10.473、8.602,P均<0.001);AFP水平低于TACE组(t=11.724,P<0.001);CD4^(+)、CD4^(+)/CD8^(+)高于TACE组,CD8^(+)低于TACE组(t=3.913、5.460、5.586,P均<0.001);2组并发症发生率比较差异无统计学意义(P>0.05)。结论原发性HCC患者接受TACE联合微波消融治疗可显著下调其血清肿瘤标志物水平,改善肝功能及免疫功能,提升整体疗效。

超声结合检验指标评价不同放疗方式对肺癌患者淋巴细胞亚群的影响

目的探索不同调强放疗方式H-alfentanil区差异对原发性肺癌患者围放疗期外周血淋巴细胞亚群的影响。方法选取2021年8月至2023年1月于河北北方学院附属第一医院放疗科行放疗的原发性肺癌患者58例,根据放疗方式不同分为IMRT组(n=28)、VMAT组(n=30);记录2组患者放疗计划参数;选定放疗前1周内(T0)、放疗剂量至40Gy时(T1)、放疗结束后4周(T2)3个时间点进行外周血淋巴细胞和亚群化验及超声检查锁骨上淋巴结及颈部淋巴结。结果治疗前VMAT组双肺V5、V10、V15、V20、V25、V30高于IMRT组,MLD低于IMRT组,差异均有统计学意义(P<0.05),治疗前PTV、2组淋巴细胞亚群各指标比较差异均无统计学意义(P>0.05);治疗后2组的淋巴细胞总数、CD3^(+)T总数、CD3^(+)CD4^(+)T亚群、CD4^(+)/CD8^(+)均降低(P<0.01);CD3^(+)CD8^(+)T亚群、CD16^(+)CD56^(+)NK亚群均升高(P<0.01);其中VMAT组CD3^(+)CD4^(+)T亚群指标、CD4^(+)/CD8^(+)指标低于IMRT组(P<0.05);Logistic分析,2组患者淋巴细胞总数的下降与双肺V5、V10、V15、V35、V40、V45、V50、V60呈正相关(P<0.05);超声检查锁骨上淋巴结及颈部淋巴结大小、形态及淋巴门的位置比较,差异无统计学意义(P>0.05)。结论原发性肺癌行IMRT、VMAT放疗均引起外周血淋巴细胞减少及淋巴细胞亚群再分布,VMAT放疗双肺H-alfentanil区较IMRT范围更大,外周血淋巴细胞减低越明显,超声的形态学检查在评价不同放疗方式对肺癌患者淋巴细胞亚群的影响的作用有限。

黄芪对甲状腺功能正常的桥本甲状腺炎患者外周血T淋巴细胞亚群表达的影响

目的·探讨黄芪对甲状腺功能正常的桥本甲状腺炎患者T淋巴细胞亚群及细胞因子表达的影响。方法·选择2020年1月—12月在上海市第六人民医院金山分院接受治疗且资料完整的甲状腺功能正常的桥本甲状腺炎患者120例,采用随机数字表将患者为干预组及对照组,每组各60例。对照组治疗方案为碘适宜状态饮食,干预组在对照组治疗方案基础上联合黄芪药液口服(150 mL/次,2次/d)治疗。连续治疗6个月,比较2组治疗前后外周血清T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),细胞因子[包括白细胞介素2(interleukin-2,IL-2)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、IL-6、IL-10],超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP),红细胞沉降率(erythrocyte sedimentation rate,ESR),以及甲状腺功能及自身抗体、肝肾功能等指标的变化。观察黄芪治疗期间不良反应。应用多因素线性回归分析甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)变化幅度的影响因素。结果·最终纳入118例患者,每组各59例。治疗6个月后,干预组CD4^(+)T细胞比例,CD4^(+)/CD8^(+)比值,IL-2、TNF-α、IL-6、IL-10、hs-CRP、ESR、TPOAb和甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)水平均较治疗前及其同期对照组显著改善,差异均有统计学意义(均P<0.05)。对照组治疗后上述指标与治疗前比较,差异均无统计学意义(P>0.05)。治疗后干预组未见严重不良反应。多因素线性回归分析结果显示,应用黄芪、CD4^(+)T细胞、CD4^(+)/CD8^(+)比值升高幅度及hs-CRP下降幅度均是TPOAb下降幅度的独立影响因素(β=−0.393,P=0.029;β=−0.513,P=0.010;β=−0.351,P=0.035;β=0.434,P=0.023)。结论·黄芪可改善甲状腺功能正常的桥本甲状腺炎患者CD4^(+)T细胞、IL-2、TNF-α、IL-6、IL-10水平及CD4^(+)/CD8^(+)比值,且安全性佳。

PD-1检测联合T淋巴细胞亚群分析对脓毒症患者预后评估的临床研究

目的 检测PD-1表达量联合T淋巴细胞亚群和部分细胞因子分析,评估脓毒症患者的免疫状态及预后。方法 选取符合2016年美国重症医学会/欧洲重症医学会(SCCM/ESICM)脓毒症及脓毒症休克定义Sepsis-3诊断标准,并且符合入组条件的68例患者,根据病情分为脓毒症组和脓毒症休克组,其中脓毒症组30例,脓毒症休克组38例,记录患者一般临床资料,通过ELISA法检测PD-1,抽取外周血送检,检查项目包括血常规、淋巴细胞亚群测定(T辅助淋巴细胞CD4^(+)与T抑制淋巴细胞CD8^(+))、降钙素原、白介素-6、超敏C反应蛋白。结果 2组患者一般资料比较差异无统计学意义(P>0.05),但2组患者急性生理与慢性健康评分和序贯器官衰竭的评分比较差异有统计学意义(P<0.05);脓毒症休克组的PD-1较脓毒症组表达水平高,差异有统计学意义(P<0.05),但淋巴细胞计数、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)较脓毒症组低(P<0.05);2组患者的感染指标降钙素原及炎症指标白介素-6和超敏C反应蛋白比较差异有统计学意义(P<0.05),脓毒症休克组较脓毒症组检测值更高(P<0.05);总T淋巴细胞相比,2组患者差异无统计学意义(P>0.05);脓毒症休克组患者的住ICU时间、14天病死率、28天病死率均较脓毒症组明显升高(P<0.05);PD-1表达水平、CD4^(+)T细胞是影响脓毒症患者死亡的独立危险因素。结论 脓毒症和脓毒症休克患者早期即出现免疫抑制,脓毒症休克组患者免疫抑制更严重,预后更差。

不同剂量异烟肼治疗肺结核的临床效果及对患者肺功能和T淋巴细胞亚群的影响

目的 探讨不同剂量异烟肼治疗肺结核的临床效果及对患者肺功能、T淋巴细胞亚群的影响。方法 选取2020年6月至2022年6月河北省胸科医院收治的肺结核患者90例为研究对象,按照随机数字表法分为对照组和观察组,各45例。对照组在常规抗结核药物基础上予0.3 g/d异烟肼治疗,观察组在常规抗结核药物基础上予0.5 g/d异烟肼治疗,2组疗程均为6个月。比较2组临床疗效,评估患者肺功能及T淋巴细胞亚群变化情况。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组最大呼气流量、第1秒用力呼气容积均高于治疗前,且观察组均高于对照组[(7.8±1.4)L/s比(6.3±1.2)L/s、(1.48±0.28)L比(1.15±0.23)L](均P<0.05)。治疗后,2组血清CD+3、CD+4、CD+4/CD+8比值均高于治疗前,且观察组均高于对照组,CD+8均低于治疗前,且观察组低于对照组(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 不同剂量异烟肼治疗肺结核的临床效果不同,增加异烟肼剂量至0.5 g/d能够提升疗效,促进肺结核患者肺功能改善,提高免疫功能,且安全性较好。

雷帕霉素在移植物抗宿主病防治中作用的研究进展

移植物抗宿主病(GVHD)降低异基因造血干细胞移植后患者的疗效和生活质量,特别是激素耐药的GVHD,探索新的防治策略至关重要。雷帕霉素通过抑制mTOR信号通路,在急、慢性GVHD的预防和治疗中均显示出一定的临床优势。另外,雷帕霉素可以调节T细胞、B细胞、树突细胞、骨髓来源的抑制细胞等细胞亚群,阐明了其有效防控GVHD的机制。本文就mTOR抑制剂雷帕霉素防治GVHD的最新研究进展作一综述,同时就如何优化使用雷帕霉素提出新的思考。