Study on the relationship between the expression of NFκB1 and LncRNA-PACER in peripheral blood mononuclear cells of patients with pulmonary tuberculosis

Objective: To investigate the expression relationship between nuclear transcription factor kappa B1 (NFκB1) and long non-coding RNA PACER (LncRNA-PACER) in peripheral blood mononuclear cells (PBMCs) of patients with pulmonary tuberculosis. Methods: From February 2018 to March 2019, 40 patients with pulmonary tuberculosis (tuberculosis group) and 40 healthy persons (control group) were collected, the levels of TNF-α, IL-6 and IL-8 in serum were detected by enzyme-linked immunosorbent assay (ELISA);the expressions of LncRNA-PACER and NFκB1 mRNAs in PBMCs were detected by real-time fluorescence quantitative PCR;Western blot was used to detect the expressions of NFκB1 and COX 2 in PBMCs;Pearson method was used to analyze the expressions of LncRNA-PACER and NFκB1 in PBMCs of patients with pulmonary tuberculosis, and the expressions of LncRNA-PACER and NFκB1 in PBMCs of patients with pulmonary tuberculosis were analyzed. Results: Compared with the control group, the expressions of TNF-α, IL-6 and IL-8 in the serum of patients with pulmonary tuberculosis was significantly increased (P<0.05), and the expressions of LncRNA-PACER, NFκB1 mRNAs, proteins and COX-2 protein in PBMCs were significantly increased (P<0.05). The expressions of LncRNA-PACER and NFκB1 proteins in PBMCs were related to the number of pulmonary lesions and pulmonary cavity (P<0.05), and there was a positive correlation between the expression of LncRNA-PACER and the expression of NFκB1 mRNA in PBMCs of patients with pulmonary tuberculosis (r = 0.873, P<0.05). Conclusions: The expressions of NFκB1 and LncRNA-PACER in PBMCs of patients with pulmonary tuberculosis are significantly increased, they are positively correlated and both of them are related to the occurrence and development of pulmonary tuberculosis.

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.

Culturing adequate CAR-T cells from less peripheral blood to treat B-cell malignancies

Objective:Chimeric antigen receptor-modified T(CAR-T)cells have shown impressive results against relapsed/refractory B cell malignancies.However,the traditional manufacture of CAR-T cells requires leukapheresis to isolate large amounts of peripheral blood T cells,thus making some patients ineligible for the procedure.Methods:We developed a simple method for CAR-T cell preparation requiring small volumes of peripheral blood.First,CD3+T cells isolated from 50 mL peripheral blood from patients(B-cell malignancies)were stimulated with immobilized anti-CD3/RetroNectin in 6-well plates and then transduced with CAR-expressing lentiviral vector.After 4 d,the T cells were transferred to culture bags for large-scale CAR-T cell expansion.In vitro and animal experiments were performed to evaluate the activity of the manufactured CAR-T cells.Finally,29 patients with B-cell acute lymphoblastic leukemia(B-ALL)and 9 patients with B-cell lymphoma were treated with the CAR-T cells.Results:The CAR-T cells were expanded to 1–3×10^(8) cells in 8–10 d and successfully killed B cell-derived malignant tumor cells in vitro and in vivo.For patients with B-ALL,the complete remission rate was 93%1 month after CAR-T cell infusion;after 12 months,the overall survival(OS)and leukemia-free survival rates were 69%and 31%,respectively.For patients with lymphoma,the objective response rate(including complete and partial remission)was 78%2 months after CAR-T cell infusion,and after 12 months,the OS and progression-free survival rates were 71%and 43%,respectively.Cytokine-release syndrome(CRS)occurred in 65.51%and 55.56%of patients with B-ALL and B-cell lymphoma,respectively;severe CRS developed in 20.69%of patients with B-ALL and in no patients with lymphoma.Conclusions:Our novel method can generate sufficient numbers of CAR-T cells for clinical use from 50–100 mL peripheral blood,thus providing an alternative means of CAR-T cell generation for patients ineligible for leukapheresis.

Day 100 Absolute Monocyte/Lymphocyte Prognostic Score and Survival Post Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Diffuse Large B-Cell Lymphoma

Day 100 prognostic factors post-autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT) to predict clinical outcomes in diffuse large B-cell lymphoma (DLBCL) patients have not been studied. Thus, we retrospectively examined if day 100 absolute monocyte/lymphocyte prognostic score (AMLPS-100) affects clinical outcomes by landmark analysis from day 100 post-APBHSCT in DLBCL. Only DLBCL patients in complete remission at day 100 post-APBHSCT were evaluated. From 2000 to 2007, 134 consecutive DLBCL patients are qualified for the study. Patients with a day 100 absolute monocyte count (AMC-100) ≥ 630 cells/μL and day 100 absolute lymphocyte count (ALC-100) ≤ 1000 cells/μL experienced inferior overall survival (OS) and progression free survival (PFS). On multivariate analysis, the AMC-100 and ALC-100 remained independent predictors of OS and PFS. Combining both values into the AMLPS-100, the 5-year OS rates for low, intermediate, and high AMLPS-100 risk groups were 94% (95% CI, 83.0% - 98.1%), 70% (95% CI, 58.6% - 80.1%), and 13% (95% CI, 3.4% - 40.5%), respectively;and the 5-year PFS rates were 87% (95% CI, 74.0% - 94.1%), 68% (95% CI, 56.0% - 77.8%), and 13% (95% CI, 3.4% - 40.5%), respectively. The AMLPS-100 is a simple biomarker score that can stratify clinical outcomes from day 100 post-APBHSCT in DLBCL patients.

A Review: Interactions of Equine Herpesvirus-1 with Immune System and Equine Lymphocyte

Equine herpesvirus-1 (EHV-1) remains one of the most common viral pathogens affecting horses worldwide presenting as a persistent infection which can establish latency in nerve ganglia (trigeminal ganglion), lymphoid tissues of the respiratory tract and peripheral blood lymphocytes. EHV-1 infection induces both humoral and cellular immune responses in horses. Virus neutralising antibody, particularly in the nasopharynx, is to kill free virus shed from infected epithelial cells. Hence this antibody has important functions in reducing virus shedding and spreading infection to cohorts. Cellular immune responses, particularly those carried out by cytotoxic T lymphocyte (CTL), have been shown to be effective in killing virus-infected cells in vitro. This review underlines the state of knowledge regarding immunity to EHV-1 and also its interaction with equine lymphocyte. Finally, the review also includes the importance of the viral immediate early (IE) protein in the pathogenesis of EHV-1. This information can be used as the basis for future research.

Double potentialities of tumoricide and hematopoiesis of human bone marrow cells activated by IL-2 and IL-3

The biomodulative and hematopoietic potentialities of IL-2 and IL-3 activatedbone marrow(ABM)cells from patients with lung adenocarcinoma were studied in vitro.Human bone marrow(BM)cells could be activated by IL-2 in culture for 7d.TheseIL-2 ABM cells had higher cytolytic activities against cells of H 7402 cell line and freshautologous adenocarcinoma cells and maintained the cytotoxicities longer than IL-2 acti-vated peripheral blood lymphocytes(APBLs),a point of possible importance in adoptiveimmunotherapy for cancer patients.The IL-2 ABM cells also had similar number ofBFU-E and CFU-GM to that had fresh BM cells if 1L-3 was added 48h alter IL-2 inculture.The IL-2 and IL-3 ABM cells might be used to eliminate tumor cells and tosupply reconstitutive elements of BM for autologous bone marrow transplantation.

外周血细胞计数比值及淋巴细胞亚群在类风湿关节炎病情评估中的价值

目的探讨外周血细胞计数比值及淋巴细胞亚群在类风湿关节炎(RA)及合并间质性肺病(ILD)病情评估中的价值。方法回顾性分析2020年6—12月50例住院RA患者的一般资料、外周血细胞计数比值及淋巴细胞亚群检测结果。按28个关节疾病活动度评分(DAS 28)分为高疾病活动度组(DAS 28>5.1分)及中低疾病活动度组(DAS 28≤5.1分)。另根据是否合并ILD,分为未合并ILD(RA-non-ILD)与合并ILD(RA-ILD)组。对比不同分组外周血细胞计数比值及淋巴细胞亚群的差异,并使用受试者工作特征(ROC)曲线评估外周血细胞计数比值及淋巴细胞亚群对RA的诊断评估价值。结果与中低疾病活动度组相比,RA高疾病活动度组的血小板-淋巴细胞比值(PLR)较高,淋巴细胞-单核细胞比值、总T淋巴细胞比率、总T淋巴细胞绝对计数、CD8^(+)T细胞及CD4^(+)T细胞绝对计数低于中低疾病活动度组(P<0.05)。PLR评估RA病情活动度的ROC曲线下面积(AUC)为0.722,95%CI为0.579~0.865。RA-non-ILD组与RA-ILD组外周血细胞计数比值及淋巴细胞亚群差异无统计学意义(P>0.05),各指标ROC曲线的AUC也均低于0.7。结论PLR对于RA疾病活动度的区分可能具有一定价值,其他各指标无论对于区分RA疾病活动度还是区分是否合并ILD都没有表现出明显潜力。

T淋巴细胞亚群、IL-6在胃癌患者中的表达及其与预后的相关性

目的分析外周血T淋巴细胞亚群及白细胞介素-6(interleukin-6,IL-6)在胃癌患者中的表达,探究其与预后的相关性。方法选取2021年6月至2023年6月连云港市第二人民医院收治的106例胃癌患者为试验组,入院次日检测其外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))及IL-6水平。选取同时段于连云港市第二人民医院进行体检的健康者80例为对照组,体检当日检测其外周血T淋巴细胞亚群及IL-6水平。比较两组T淋巴细胞亚群及IL-6水平。胃癌患者院外随访6个月,根据患者死亡、存活情况将其分为预后不良组(17例)、预后良好组(89例)。预后不良组男10例(58.82%),女7例(41.18%),年龄(60.47±5.89)岁;文化程度:中学及以上9例(52.94%),中学以下8例(47.06%)。预后良好组男55例(61.80%),女34例(38.20%),年龄(60.08±5.71)岁;文化程度:中学及以上32例(35.96%),中学以下57例(64.04%)。logistic回归分析影响胃癌患者预后的因素。采用受试者操作特征曲线(ROC)评估外周血T淋巴细胞亚群及IL-6预测胃癌患者预后的价值。采用t检验和χ^(2)检验。结果试验组CD3^(+)、CD4^(+)水平低于对照组[(55.27±8.72)%比(68.97±6.45)%、(26.42±10.21)%比(38.12±5.07)%],CD8^(+)、IL-6水平高于对照组[(33.36±6.02)%比(24.66±3.75)%、(6.97±3.29)ng/L比(3.62±1.01)ng/L],差异均有统计学意义(t=-11.821、-9.413、11.360、8.803,均P<0.05)。预后不良组CD3^(+)、CD4^(+)水平低于预后良好组[(45.12±10.06)%比(57.21±6.97)%、(20.01±10.12)%比(27.64±9.81)%],CD8^(+)、IL-6水平、肿瘤分期Ⅳ期患者占比高于预后良好组[(40.12±6.01)%比(32.07±5.12)%、(9.75±3.16)ng/L比(6.44±3.05)ng/L、70.59%(12/17)比32.58%(29/89)],差异有统计学意义(t=-6.068、-2.924、5.774、4.077,χ^(2)=8.692,均P<0.05)。logistic回归分析显示,肿瘤分期、CD3^(+)、CD8^(+)、IL-6水平是影响胃癌患者预后的因素(均P<0.05)。CD3^(+)、CD8^(+)、IL-6预测患者预后不良的ROC下面积分别为0.847、0.853、0.768。结论胃癌患者CD3^(+)、CD4^(+)低表达,CD8^(+)及IL-6高表达。CD3^(+)、CD8^(+)、IL-6水平是影响胃癌患者预后的因素。

PD⁃1抑制剂联合全身化疗治疗复发转移性宫颈癌的临床效果观察

目的探讨程序性细胞死亡受体-1(PD-1)抑制剂(卡瑞利珠单抗)免疫治疗联合全身化疗治疗复发转移性宫颈癌的临床效果。方法选择2019年2月—2021年6月定州市人民医院收治的复发转移性宫颈癌64例,依据随机数字表法分为研究组和对照组各32例。对照组给予紫杉醇联合顺铂全身化疗方案,研究组给予全身化疗方案+PD-1卡瑞利珠单抗免疫治疗。比较2组临床疗效,分析治疗前及治疗3个周期后鳞状细胞癌抗原(SCC)、外周血淋巴细胞/单核细胞(LMR)及血小板/淋巴细胞(PLR)指标水平及Kamofsky评分变化,并观察治疗期间毒性作用发生情况及随访期间患者总生存期。结果研究组总有效率、疾病控制率分别为93.75%(30/32)、96.88%(31/32),高于对照组的68.75%(22/32)、75.00%(24/32),差异有统计学意义(P<0.05)。治疗3个周期后,2组血清SCC、PLR水平较治疗前降低,LMR较治疗前升高,且研究组改善程度优于对照组(P<0.05)。治疗后,2组Kamofsky评分均较治疗前升高,且研究组高于对照组(P<0.05)。治疗后研究组1、2年生存率及总生存期高于或长于对照组(P<0.05)。2组毒性作用多数为1~2级。研究组血小板下降和转氨酶升高比例分别为37.50%(12/32)和28.12%(9/32),高于对照组的18.75%(6/32)和9.38%(3/32),差异有统计学意义(P<0.05);2组贫血、白细胞下降、恶心、腹泻、乏力等毒性作用发生率比较差异无统计学意义(P>0.05);研究组中发生反应性毛细血管增生症、甲状腺功能减退、皮疹、带状疱疹、过敏等经对症处理后症状消失。结论PD-1抑制剂联合全身化疗治疗复发转移性宫颈癌提高了临床效果、生存质量及生存率,延长生存期,改善了机体的炎症免疫反应状态,毒性作用较少,患者耐受性好。

儿童脐血移植后巨细胞病毒活化的危险因素及其与T细胞重建的相关性

目的 探讨儿童白血病接受脐带血移植后巨细胞病毒(CMV)活化的危险因素及其与T淋巴细胞重建的相关性。方法 回顾性分析2016年1月—2021年12月在苏州大学附属儿童医院血液科行脐带血造血干细胞移植的白血病患儿的临床资料及CMV活化的发生率,并分析单次及多次CMV活化对T淋巴细胞重建的影响,最后随访时间是2022年12月。结果 共纳入75例患儿,移植100d内53例发生CMV活化,18例表现为难治性。单因素分析示:预处理使用ATG是CMV活化的危险因素(P=0.043);移植时HLA配型不合、发生Ⅱ-Ⅳ度aGVHD是难治性CMV活化的危险因素(P<0.01);多因素分析示:发生Ⅱ-Ⅳ度aGVHD是难治性CMV活化的独立危险因素(P=0.021);发生多次CMV活化者移植后1年内CD4^(+)细胞重建延迟。移植后1个月内CMV活化对总体生存率无明显影响,CMV活化的AML患儿累积复发率下降。结论 预处理使用ATG是白血病儿童脐血移植后CMV活化的危险因素,供-受体HLA配型不合、发生Ⅱ-Ⅳ度aGVHD是发生难治性CMV感染的危险因素;多次CMV活化影响CD4^(+)细胞重建。

SGLT2抑制剂联合新活素治疗高血压伴心力衰竭的疗效及对患者TLR4/NF-κB信号通路指标的影响

目的研究钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂(达格列净)联合新活素治疗高血压伴心力衰竭(心衰)的临床效果及对患者外周血单核细胞Toll样受体4/核转录因子-κB(TLR4/NF-κB)信号通路指标的影响。方法前瞻性选取2021年5月至2023年6月郑州大学第一附属医院收治的138例高血压伴心衰患者作为研究对象,采用随机数表法分为对照组、单一组和联合组各46例。对照组接受常规基础治疗,单一组在此基础上接受新活素治疗,联合组在此基础上接受达格列净联合新活素治疗。治疗7 d后比较三组患者的临床疗效,以及治疗前后的心功能[左室收缩末期内径(LVESD)、左室射血分数(LVEF)、心率(HR)]、运动耐力[6 min步行试验距离(6 MWT)]、血压[收缩压(SBP)、舒张压(DBP)]、氧化应激指标[丙二醛(MDA)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)]和TLR4/NF-κB信号通路相关指标[TLR4、NF-κB、白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)],同时比较三组患者的不良反应发生情况。结果联合组患者的治疗总有效率为95.65%,明显高于单一组的86.96%和对照组的73.91%,差异均有统计学意义(P<0.05);治疗后,联合组患者的LVEF、6 MWT分别为(43.28±3.16)%、(336.48±32.49)m,明显高于单一组的(40.54±2.68)%、(306.45±40.26)m和对照组的(38.07±2.89)%、(280.69±36.98)m,LVESD、HR分别为(35.29±4.26)mm、(71.34±3.62)次/min,明显低于单一组的(38.75±3.64)mm、(74.25±3.59)次/min和对照组的(42.36±4.05)mm、(76.46±3.98)次/min,且单一组变化幅度大于对照组,差异均有统计学意义(P<0.05);治疗后,联合组患者的SBP、DBP分别为(110.36±5.02)mmHg、(81.42±2.56)mmHg,明显低于单一组的(114.83±4.76)mmHg、(84.39±2.88)mmHg和对照组的(117.25±5.18)mmHg、(86.05±2.62)mmHg,且单一组低于对照组,差异均有统计学意义(P<0.05);治疗后,联合组患者的GSH-Px、CAT分别为(105.24±20.29)U/g·Hb、(148.35±32.46)U/mL,明显高于单一组的(90.35±19.45)U/g·Hb、(125.64±26.49)U/mL和对照组的(84.49±17.32)U/g·Hb、(103.29±25.38)U/mL,MDA为(7.39±2.56)mmol/L,明显低于单一组的(11.35±2.95)mmol/L和对照组的(13.08±2.72)mmol/L,且单一组变化幅度大于对照组,差异均有统计学意义(P<0.05);治疗后,联合组患者的TLR4 mRNA、NF-κB mRNA、IL-1βmRNA、IL-6 mRNA、TNF-αmRNA明显低于单一组和对照组,且单一组低于对照组,差异均有统计学意义(P<0.05);三组患者的不良反应总发生率比较差异无统计学意义(P>0.05)。结论SGLT2抑制剂联合新活素治疗高血压伴心衰能有效改善患者的氧化应激水平,调节TLR4/NF-κB信号通路,恢复患者血压与心功能,临床应用效果显著,且安全性较高。

PBL亚型联合CTC对儿童肝母细胞瘤预后的预测价值

目的:探究外周血淋巴细胞(PBL)亚型与循环肿瘤细胞(CTC)联合对儿童肝母细胞瘤(HB)术后生存的预测价值。方法:选取2018年6月至2022年6月于郑州大学第一附属医院接受肿瘤切除术的HB患儿116例,随访并记录患儿术后12个月的生存状态。采集患者术前静脉血,检测PBL亚型及CTC。采用Logistic回归构建PBL亚型联合CTC的预后预测模型。绘制ROC曲线,评价联合预测模型与单一指标对HB患儿预后的预测效能。结果:联合预测模型为Logit(P)=-20.297+0.192×CD3^(+)+1.511×CD4^(+)/CD8^(+)+0.383×CTC。CD3^(+)、CD4^(+)/CD8^(+)、CTC及联合预测模型预测HB患儿术后生存的AUC(95%CI)分别为0.634(0.488~0.780)、0.606(0.487~0.725)、0.822(0.735~0.909)、0.865(0.786~0.944),联合预测模型与单一指标相比具有更好的预测效能。结论:CTC、CD3^(+)、CD4^(+)/CD8^(+)联合预测模型可用于HB患儿术后的生存预测。

危重病患者外周血单个核细胞核因子-κB的活性与SOFA评分的关系

目的 观察危重病患者外周血单个核细胞核因子 -κB(NF -κB)的活性和序贯器官衰竭估计 (SOFA)评分的变化 ,探讨NF -κB对危重病患者病情和预后的预测作用。方法 将入住ICU的 4 0例危重病患者分成多器官功能障碍综合征(MODS)组和非MODS组 ,存活组和死亡组 ;选择健康体检者 2 0例作为对照组。检测他们外周血单个核细胞NF -κB的活性 ,并进行SOFA评分。结果 危重病患者的NF -κB活性明显高于对照组 (P <0 0 1) ;NF -κB的活性和SOFA评分在MODS组和死亡组分别明显高于非MODS组和存活组 (P <0 0 1) ;NF -κB的活性和SOFA评分呈明显正相关 (r =0 90 2 ,P <0 0 1)。结论 外周血单个核细胞NF -κB的活性是判断危重病患者病情和预后的敏感指标。

结核T细胞斑点试验联合外周血T淋巴细胞亚群检测在临床诊断中的价值

目的探讨结核T细胞斑点试验(T-SPOT.TB)联合外周血T淋巴细胞亚群检测在结核患者中的诊断价值。方法回顾性分析本院就诊的279例患者的临床资料。依据诊断标准分为结核组147例、非结核组132例,评估T-SPOT.TB与外周血T淋巴细胞亚群检测对结核病的诊断价值。结果结核组T-SPOT.TB阳性率高于非结核组(P<0.01);肺结核组患者CD3^(+)、CD4^(+)及CD8^(+)较非结核组相比有下降(P<0.05),CD4^(+)/CD8^(+)较非结核组变化不明显(P>0.05);两者联合检测受试者工作特征曲线下面积(AUC)为0.354(P<0.01),灵敏度90.48%,特异性38.64%,约登指数为0.291。结论T-SPOT.TB和外周血T淋巴细胞亚群检测诊断肺结核具有较高灵敏度,但在对结核和非结核的鉴别诊断中特异性降低,在临床中对结核的诊断价值有一定的意义,是对肺结核诊断的有效补充。

基于关键免疫细胞亚群的胆管癌患者外周血早期诊断标志物的研究

目的基于关键免疫细胞亚群探究胆管癌患者外周血早期诊断标志物。方法于2021年5月至2023年5月选取在本院确诊为CCA的患者75例即为CCA组,同期在本院收治的75例胆管炎患者即为对照组。同期在本院体检健康的志愿者75例为健康组。采用流式细胞仪检测CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平;采用酶联免疫吸附试验(ELISA)法检测肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、γ干扰素(IFN-γ)水平。采用Pearson法分析CCA患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平与TNF-α、IL-2、IFN-γ水平的相关性;ROC曲线分析外周血免疫细胞亚群对CCA发生的诊断价值。多因素Logistic回归分析CCA发生的影响因素。结果与健康组相比,对照组、CCA组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著升高;与对照组相比,CCA组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著升高(P<0.05)。与健康组相比,对照组、CCA组患者IL-2、IFN-γ水平显著降低,TNF-α水平显著升高;与对照组相比,CCA组患者IL-2、IFN-γ水平显著降低,TNF-α水平显著升高(P<0.05)。相关性分析显示,CCA患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平与IL-2、IFN-γ呈负相关关系,与TNF-α呈正相关关系(P<0.05)。外周血免疫细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、TNF-α、IL-2、IFN-γ)联合检测对CCA发生诊断的AUC显著高于单一指标诊断的AUC的值(Z_(CD3^(+)vs联合)=4.424,P<0.001;Z_(CD4^(+)vs联合)=3.425,P=0.001;Z_(CD4^(+)/CD8^(+)vs联合)=4.502,P<0.001;Z_(TNF-αvs联合)=3.322,P<0.001;Z_(IL-2^(+)vs联合)=7.473,P=0.001;Z_(IFN-γ^(+)vs联合)=3.166,P=0.001)。多因素Logistic回归分析显示,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IL-2、IFN-γ水平是影响CCA发生的影响因素(P<0.05)。结论CCA患者外周血免疫细胞亚群水平显著升高,联合检测能够提高对CCA发生的诊断效能。

食管癌患者术前PLT、白细胞数、NLR及PLR水平对预后的预测价值

目的探究术前血小板(PLT)、白细胞数、中性粒细胞与淋巴细胞比值(NLR)及外周血细胞与淋巴细胞比值(PLR)水平预测食管癌预后的价值。方法选取100例食管癌患者,于食管癌根治术前检测患者PLT、白细胞数、NLR及PLR水平。对患者进行为期2年的随访,根据患者预后分为复发组(36例)和未复发组(64例)。比较不同预后患者上述指标水平。多因素COX回归分析影响食管癌预后的因素。绘制ROC曲线评估PLT、白细胞数、NLR及PLR对食管癌患者预后的预测价值。结果复发组PLT水平明显低于未复发组(P<0.05),白细胞数、PLR、NLR明显高于未复发组(P<0.05)。多因素COX分析显示,NLR、PLT、PLR及白细胞数均为影响食管癌预后的因素(P<0.05)。绘制ROC曲线评估PLT、白细胞数、PLR、NLR预测食管癌患者预后的价值显示,单独检测时,NLR敏感度最高,PLT特异度最高,联合检测时敏感度、特异度最高。结论术前白细胞数、PLR、NLR、PLT水平与食管癌患者预后有关,四者联合检测预测食管癌预后的价值更高。

不同病原体呼吸道感染患儿外周血淋巴细胞亚群差异对比

目的对比分析不同病原体呼吸道感染患儿外周血淋巴细胞亚群指标的差异。方法选取2022年6月—2023年6月宜兴市人民医院接诊收治的120例呼吸道感染患儿纳入观察组,其中包含甲流患儿60例,支原体肺炎患儿60例,选择同期进行体检的健康儿童60例纳入对照组。对比观察组与对照组外周血淋巴细胞亚群指标的检测结果,进一步比较不同病原体患儿各项淋巴细胞亚群指标差异。结果观察组呼吸道感染患儿CD3^(+)(907.48±11.15)%、CD3^(+)CD8^(+)(254.94±10.13)%、CD3-CD19^(+)(89.51±5.22)%与CD3-CD56/16^(+)(98.85±10.20)%均明显低于对照组,CD3-CD4^(+)(2307.48±12.29)%高于对照组,差异有统计学意义(t=123.749、177.729、51.590、43.580、765.587,P均<0.05)。结合观察组患儿不同病原体类型检测结果分析显示,甲流(病毒感染)患儿CD3^(+)、CD3^(+)CD8^(+)、CD3-CD19^(+)与CD3-CD56/16^(+)均低于支原体肺炎(细菌感染)患儿,CD3-CD4^(+)高于支原体肺炎患儿,差异有统计学意义(P均<0.05)。结论呼吸道感染患儿不同病原体感染所引起外周血淋巴细胞亚群测定结果存在明显差异,临床可通过检测该指标用于掌握儿童免疫状态,判断感染类型,为进一步治疗提供依据。

获得性免疫缺陷综合征合并脓毒症患者外周血中T淋巴细胞亚群研究

目的 探讨获得性免疫缺陷综合征(AIDS)合并脓毒症患者外周血中T淋巴细胞亚群。方法 回顾性选取2021年10月至2023年9月海南医学院第二人民医院内AIDS合并脓毒症患者60例作为试验组,AIDS无脓毒症患者60例作为对照1组,健康献血员20名作为对照2组。应用免疫荧光和单克隆抗体标记技术检测试验组、对照1组和对照2组外周血T淋巴细胞亚群(CD3细胞数量、CD4细胞数量、CD8细胞数量、CD4/CD8比值),比较试验组、对照1组和对照2组T淋巴细胞亚群计数和比例,并统计分析试验组不同年龄、确诊时间患者的T淋巴细胞亚群计数和比例。结果 试验组患者的CD3细胞数量、CD4细胞数量分别为(864.72±184.22)、(145.37±25.37)个/μL,均明显少于对照1组[(971.80±135.14)、(218.11±36.24)个/μL]、对照2组[(1 098.12±156.23)、(296.23±41.25)个/μL],CD4/CD8比值为0.258±0.024,明显低于对照1组(0.344±0.034)、对照2组(0.458±0.045),差异均有统计学意义(P<0.05);对照1组患者的CD3细胞数量、CD4细胞数量均明显少于对照2组,CD4/CD8比值明显低于对照2组,差异均有统计学意义(P<0.05);但3组研究对象的CD8细胞数量比较,差异均无统计学意义(P>0.05)。不同年龄患者的CD3细胞数量、CD4细胞数量、CD8细胞数量、CD4/CD8比值比较,差异均无统计学意义(P>0.05)。不同确诊时间患者的CD4细胞数量比较,差异有统计学意义(P<0.05),其中,确诊时间0~1年、1~2年患者的CD4细胞数量均多于2~3年、3~4年、4~5年、≥5年患者(P<0.05);但不同确诊时间患者的CD3细胞数量、CD8细胞数量、CD4/CD8比值比较,差异均无统计学意义(P>0.05)。结论 AIDS合并脓毒症患者外周血中T淋巴细胞亚群降低,CD4细胞数量与确诊时间密切相关,不仅能拓宽临床对于AIDS机会性感染认识,更能为其诊治提供新的思路及方向。

维生素D辅助布地奈德福莫特罗治疗在支气管哮喘患儿中的临床应用效果

目的:探究将维生素D、布地奈德福莫特罗联合运用于支气管哮喘患儿治疗中对外周血T淋巴细胞亚群及肺功能的影响。方法:选取2021年6月—2023年6月宿迁市第一人民医院收治的89例支气管哮喘患儿,并按照治疗方式进行分组,设接受常规单一布地奈德福莫特罗治疗为对照组(n=44),而研究组(n=45)在对照组的基础上予以维生素D辅助治疗。对比两组的临床治疗效果。结果:研究组的哮鸣音消失时间、喘息消失时间、呼吸困难时间均短于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)及CD8^(+)细胞对比,差异均无统计学意义(P>0.05);治疗后,研究组的CD3^(+)、CD4^(+)均高于对照组,而CD8^(+)低于对照组(P<0.05)。治疗后,研究组的第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、最大呼气流量(PEF)均高于对照组(P<0.05)。治疗后,研究组治疗总有效率为95.56%,高于对照组的81.82%(χ^(2)=4.210,P=0.040)。结论:在小儿支气管哮喘疾病中采用维生素D辅助布地奈德福莫特罗治疗能够缩短哮鸣音、喘息、呼吸困难等症状的消失时间,从而对提升机体的免疫功能和肺功能水平具有显著的成效,在临床疾病治疗过程中具有积极的意义。

外周血淋巴细胞亚群在非小细胞肺癌患者中的表达情况

目的:分析外周血淋巴细胞亚群在非小细胞肺癌(non-small cell lung cancer,NSCLC)患者中的表达情况。方法:选择2023年3—10月南京市高淳人民医院肿瘤科收治的88例NSCLC住院患者作为研究组,按照病理分型将研究组患者分为腺癌组(n=41)和鳞癌组(n=47),按照临床分期将研究组患者分为Ⅰ~Ⅱ期组(n=46)、Ⅲ~Ⅳ期组(n=42)。另外将同期于本院体检中心进行健康体检的88例对象作为对照组。检测并比较研究组与对照组、腺癌组与鳞癌组及Ⅰ~Ⅱ期组与Ⅲ~Ⅳ期组外周血淋巴细胞亚群水平。结果:相较于对照组,研究组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平明显低,而CD8^(+)水平明显高,差异有统计学意义(P<0.05);腺癌组与鳞癌组、Ⅰ~Ⅱ期组与Ⅲ~Ⅳ期组CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05)。结论:相较于健康人群,NSCLC患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均更低,而CD8^(+)更高;腺癌和鳞癌患者、Ⅰ~Ⅱ期和Ⅲ~Ⅳ期患者CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平差异不显著。