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 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.

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.

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

The peri-operative changes of T-lymphocyte subsets in the elder esophageal carcinoma patients

Objective:The aim of the study was to observe and compare the trend of T-lymphocyte subsets in the elder and adult esophageal carcinoma patients postoperatively. Methods: Forty-four esophageal carcinoma patients, classified as ASA physical status I-II, were divided into two groups. Twenty-two patients aged than 65 years were grouped as elder patient group, and the rest twenty-two patients, served as adult patient group, were younger than 60 years old. The jugular venous blood samples were collected before induction of anesthesia (T1) as baseline, after completion of surgery (T2), on the first, second and fifth postoperative days (T3, T4 and T5), respectively. The blood counts of CD3+, CD4+ and CD8+T-lymphocyte were measured by flow cytometer. Results: Compared with the baseline level, the blood CD3+, CD4+ and CD4/CD8 levels were significantly decreased immediately after surgery, on the first and second postoperative days in the two groups (P<0.01), which returned to baseline values on the fifth postoperative day (P>0.05). On the fifth postoperative day, CD3+, CD4+ and CD4/CD8 levels in adult group were significantly higher than those in elder group (P<0.05). Conclusion: The postoperative immune function in elder patients recovered more slowly than that in adult.

Does East Meet West?—The Association between Oriental Tongue Inspection and Western Clinical Assays of White Blood Cell Subsets

The autonomic nervous system (ANS) controls white blood cell (WBC) subsets;therefore, the status of ANS can be assessed by assaying WBCs. However, this requires invasive blood sampling, time, cost, and training. Therefore, this study focused on a traditional technique, tongue inspection, which is a simpler method. The purpose of this study was to investigate whether there is an association between the traditional method of tongue inspection and clinical assay of WBC subsets. Twenty-one female alopecia areata patients were divided into two age-matched groups: 1) alopecia areata totalis (AT);and 2) alopecia areata multiplex (AM). Images of patient tongues were captured by a digital camera and categorized before blood sampling. Finally, patients were divided into five groups (normal, Yin+, Yang–, Yin– and Yang+) based on the Eight Principles of traditional Chinese medicine (TCM). Concurrently, venous blood was obtained for WBC subsets. The absolute numbers of WBCs and granulocytes of the AT group were higher than those of the AM group. The AT group was Yin+ but not Yang+, whereas the AM group was Yang+ but not Yin+. Thus, the AT group showed more elements of “cold” (Yin > Yang) compared with the AM group with elements of “hot” (Yin < Yang). Tongue inspection suggested a possibility of consistence with those of WBCs although statistical significance was not obtained. Moreover, some Yin+ and Yang+ subjects showed some trend in similarities between tongue inspection and WBC subsets although this was not statistically significant. Therefore, traditional techniques (such as tongue inspection) acupuncture must be studied further to detect whether subtle effects are induced by acupuncture treatment. As this study is underpowered, a larger scale study including males is required in the future.

T-CELL SUBSETS OF PERIPHERAL BLOOD AND SPLEEN IN HEPATOCARCINOMA-BEARING RATS

T-cell subsets from peripheral blood and spleen were investigated prospectively by flow cytometry in a murine intrahepatic implanted tumor model. Peripheral blood OX-19+ cells (pan T-cells) and W3/25+ cells (Th cells) decreased with tumor development in tumor-bearing rats, giving significant differences when compared with healthy rats. No significant changes were found in OX-8+ cells (Ts cells). Hence, Th Ts ratio in tumor-bearing rats was lower than that in control group. Meanwhile, on day 17 following tumor implantation, in tumor-bearing rats with intrahepatic or peritoneal metastasis, there were less W3/25+ cells and more OX-8+ cells than those of hepatoma-bearing rats without metastasis (p<0.01). In the spleen, the phenotypes of lymphocyte markers showed less OX-8+ cells and more OX-12+ cells (B cells) tumor-bearing rats. It was suggested that, in tumor-bearing host, not only was T-cell immune function inhibited, but also there was abnormal distribution of T-cell subsets. It seems that there is a close relationship between tumor growth and its spread and a lower Th/Ts ratio.

Effects of Radiofrequency Ablation on Lymphocyte Subsets and Type 1/Type 2 T Cell Subpopulations in Patients with Hepatocellular Carcinoma

Objective： To evaluate whether radiofrequency ablation （RFA） might have an influence on immune status in hepatocellular carcinoma （HCC） patients. Methods： We measured the T lymphocytes, B lymphocyte and NK cells, and determined the population of Thl, Th2, Tcl and Tc2 of peripheral blood samples taken from 26 HCC patients before and after RFA. Results： The proportion of Typel cells （Thl and Tcl） and NK cells were significantly increased after RFA, especially in patients of the following subgroups： male, age〉55 years, pathological grade Ⅰ-Ⅱ tumor, clinical stage Ⅰ-Ⅱ or Child-Pugh A and B. Conclusion： TypeⅠ cells and NK cells in HCC patients were increased in a short period after RFA.

mIL-2R,T cell subsets & hepatitis C

AIM: To study the levels of membrane interleukin-2 receptor (mIL-2R) and T cell subsets in peripheral blood mononuclear cells (PBMC) from patients with hepatitis C and their role in the pathogenesis of hepatitis C. METHODS: The levels of mIL-2R and T cells subsets in PBMC were detected by biotin- streptatividin (BSA) technique before and after stimulation with PHA in 203 patients with hepatitis C with HCV-RNA(+), anti-HCV(+), anti-HCV(-). RESULTS: The total expressive levels of mIL-2R before and after stimulation with PHA(0.03+/-0.01, 0.03+/-0.02, 0.04+/-0.02, 0.36+/-0.03), and T cell subsets in PBMC (0.62+/-0.06, 0.37+/-0.05, 0.35+/-0.07) were all lower in patients with hepatitis C than those in normal controls (0.66+/-0.07, 0.41+/-0.06, 0.31+/-0.05, P【0.01). Among the patients, the levels of mIL-2R were lower in silence than those in situation of PHA inducting (P【0.01). However, the levels of mIL-2R were similar in acute hepatitis C to that in chronic hepatitis C (P】0.05). The levels of CD(3)(+), CD(4)(+), CD(4)(+)/CD(8)(+) were lower and CD(8)(+) was higher in patients with acute and chronic hepatitis C with anti-HCV(+) than those in normal controls (0.62+/-0.06, 0.37+/-0.05, 0.35+/-0.07, 1.18+/-0.30, 0.61+/-0.07, 0.37+/-0.05, 1.39+/-0.33, 0.31+/-0.05, P【0.05-P【0.01). CONCLUSION: The cellular immunity is obviously changed in patients with hepatitis C. The levels of mIL-2R and activation of T cells are closely associated with chronicity of hepatitis C.

Changes in T lymphocyte subsets after severe traumatic brain injury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.

STUDY OF T－LYMPHOCYTE SUBSETS AND INTERLEUKIN－2 AND INTERLEUKIN－2 RECEPTOR OF RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA

T-Lymphocyte subsets and humoral immune and the activity of IL-2 and IL-2R in respiratory syncytial virus (RSV) pneumonia in 26 cases were tested. The result showed in the patients with RSV pneumonia the averages of T3 and T4 were 37.56±1.46% and 27. 15±8. 02% respectively,They were significantly lower than 53.4 ±9.2% and 35.5±7.7% of averages of T3 and T4 in healthy controlled group (both. P< 0. 001 ), the average of T3 was 22. 73±7.06%, it was lower an 26. 7±6. 3 % of T8 in controlled group (P<0. 02 );the ratio of T4/T8 was 1. 245±0. 399 ,there was no significant difference from 1. 35 ±0. 17 of the ratio in controlled group (P > 0. 1). The mean value of IgG was 1. 177± 0. 3685g/L, it was significantly lower than 1. 427± 0. 498g/L of that in controlled group(P < 0. 005). The mean values of IgA and IgM were 0. 1136±0.0393g/L and 0. 768±0. 353g/L respectively, they were significantly lower than 0. 2706 ±0. 876g/L and 0. 122±0. 061g/L of IgA and IgM in controlled group. The activity of IL-2 and IL-2R were 17. 46 ±5. 79%, and 28. 32 ±5. 924% respectively, they were significantly lower than 30. 22 ±14. 55% and 39. 53±8. 61 % of those in healthy group (both P < 0. 001). The severe the pneuumonia, the greater the lowering of IL-2 and IL-2R. These about results suggested that RSV could greatly suppress the immune function of the patients, inducing secondary immunodeficiency, leading to repeated breather and asthma.

活动性肺结核合并糖尿病患者血糖水平与树突状细胞亚群及T细胞亚群的相关性研究

目的研究活动性肺结核合并糖尿病患者血糖水平与树突状细胞(DCs)亚群及T细胞亚群的相关性。方法选取2020年1月至2022年1月惠州市中心人民医院接受诊治的200例患者为研究对象,按照病情分为单纯活动性肺结核患者(对照组)和活动性肺结核合并糖尿病患者(研究组),每组各100例。按照患者糖化血红蛋白(HbA1c)水平将研究组患者分为轻度高血糖组(10 mmol/L≤HbA1c<13.9 mmol/L)45例、中度高血糖组(13.9 mmol/L≤HbA1c<22 mmol/L)33例、重度高血糖组(HbA1c≥22 mmol/L)22例。比较每组患者血糖指标、DCs亚群、T细胞亚群、细胞因子水平,并分析不同血糖程度与DCs、T细胞亚群的相关性。结果四组患者各血糖指标比较为对照组<轻度高血糖组<中度高血糖组<重度高血糖组(P<0.05);DCs亚群(cDC1、cDC2、pDC)及T细胞亚群(CD4^(+)、CD8^(+)、CD3^(+))分布值比较为对照组>轻度高血糖组>中度高血糖组>重度高血糖组(P<0.05);四组患者各炎性细胞因子水平比较为对照组<轻度高血糖组<中度高血糖组<重度高血糖组(P<0.05);外周血DCs亚群、T细胞亚群分布情况与血糖水平呈负相关(P<0.05)。结论针对活动性肺结核合并糖尿病患者,不同血糖程度患者炎性细胞因子水平、DCs亚群及T细胞亚群分布情况不同,且DCs亚群及T细胞亚群分布情况与患者血糖水平呈负相关。

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。

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。

辐照红细胞与普通悬浮红细胞输注对肝癌患者CD4+T细胞亚群水平的影响

目的分析辐照红细胞与普通悬浮红细胞输注对肝癌患者CD4+T细胞亚群水平的影响。方法回顾性分析100例肝癌患者,根据输血红细胞类型,将以辐照红细胞输注治疗的65例患者纳入辐照组,以普通悬浮红细胞输注治疗的35例患者纳入普通组。比较输血前和输血后14 d时,2组患者外周血CD4+T细胞亚群水平(Th1、Th2、Th17、Treg)、细胞因子水平[白介素-2(IL-2)、白介素-10(IL-10)、白介素-17(IL-17)、干扰素(IFN-γ)]。比较输血后3个月内2组患者感染发生率。输血后随访3年,比较2组患者无进展生存期(PFS)。结果输血后14 d时,辐照组患者Th1、IL-2、IFN-γ水平显著高于普通组,Th2、Treg、IL-10、IL-17水平显著低于普通组(P<0.05),2组Th17水平比较差异无统计学意义(P>0.05)。输血后3个月内辐照组患者感染发生率低于普通组,比较差异无统计学意义(P>0.05)。输血后随访3年,2组患者PFS比较无统计学意义(P>0.05)。结论异体普通悬浮红细胞输注将抑制肝癌患者细胞免疫功能,而辐照红细胞输注可减轻异体输血引起的细胞免疫抑制反应,后者在肝癌手术中具有较高推广应用价值。

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。

联合辛麻颗粒对慢性阻塞性肺疾病急性加重期外寒内饮证患者临床疗效和免疫功能的影响

目的观察慢性阻塞性肺疾病急性加重期外寒内饮证患者联合辛麻颗粒治疗的临床疗效。方法选择2023年8月至2024年4月收治的60例慢性阻塞性肺疾病急性加重期外寒内饮证患者,根据治疗方法分为对照组(n=30)和观察组(n=30)。对照组采用常规西药治疗,观察组采用常规西药联合辛麻颗粒治疗。比较2组临床疗效、血气分析[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))]、免疫指标及不良反应。结果2组总有效率观察组96.67%(29/30)高于对照组73.33%(22/30)(P<0.05)。治疗后,观察组PaO_(2)、SaO_(2)、IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+高于对照组,PaCO_(2)、CD8+低于对照组(P<0.05)。2组不良反应发生率比较无统计学差异(P>0.05)。结论慢性阻塞性肺疾病急性加重期外寒内饮证患者采用常规西药联合辛麻颗粒治疗,对免疫功能、血气分析指标有明显的改善作用,临床疗效较好、安全性较高。

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。