健康老年人及老年糖尿病患者外周血T淋巴细胞亚群的观察

本文采用萤光免疫法,应用抗人T淋巴细胞单克隆抗体OKT系列检测了7例老年Ⅱ型糖尿病患者周围血T淋巴细胞亚群的变化。OKT_3^+的百分率为32.97±5.77,OKT_4^+和OKT_8^+。分别为24.43±4.93、17±3.37。结果显示:老年Ⅱ型糖尿病患者OKT_3^+、OKT_4^+较健康老年人,中青年明显降低(p<0.01),OKT_8也显著降低(p<0.01),显示本病的发生似与T细胞调节功能不全有关,作者对其原因进行了初步探讨。

Hypertonic saline resuscitation maintains a more balanced profile of T-lymphocyte subpopulations in a rat model of hemorrhagic shock

Objective: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte sub- populations in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4+ and CD8+ subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. Results: In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4+ lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8+ lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4+/CD8+ ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. Conclusion: In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopula- tions regulating network.

Effects of Glutamine Supplementation on Patients Undergoing Abdominal Surgery

Objective To evaluate the effects of supplementation of glutamine （GLN） on maintaining glu- tathione （GSH） level, immune system function, liver function, and clinical outcome of patients receiving abdominal operation. Methods Forty patients undergoing elective abdominal surgical treatment were randomly divided into 2 groups： study group （n=20） and control group （n=20）. All patients received total parenteral nutrition （TPN） for up to 7 days during perioperative period. The study group received TPN supplemented with GLN dipeptide while the control group received TPN without GLN dipeptide. Patients in both groups received equivalent nitrogen and caloric intake. Blood sample was taken on preoperative day, and the 1st, 3rd, 6th postoperative day to measure GSH level, immune indexes, and liver function indexes. Results The decrease of GSH level in plasma and red blood cell （RBC） in study group was less than that in control group during postoperative period. Ratio of GSH/glutathione disulfide （GSSG） in plasma in study grouP was higher than that in control group on the 3rd postoperative day （52.53±11.46 vs. 31.43±7.27, P = 0.001）. Albumin level in study group was higher than that in control group on the 3rd postoperative day （37.7±3.8 g/L vs. 33.8±4.2 g/L, P = 0.02）. There was no significant difference in the levels of immunoglobin （IgG, IgM, IgA） or T lymphocyte subgroup （CD4, CD8, CD4/CD8） in both groups during postoperative period. There was one case with infectious complication in control group, while none in study group. A trend of shortened hospital stay was observed in study group compared with control group （22.3±2.1 d vs. 24.9±1.7 d,P= 0.32）. Conclusions Supplementation of GLN-enriched TPN has beneficial effects on maintaining GSH levels in plasma and RBC, sustaining GSH/GSSG ratio and albumin level, and keeping antioxidant abilities during postoperative period in patients with abdominal operation, with the trends of decreasing incidence of infectious complication and shortening hospital stay.

Study on the blood-borne virus co-infection and T lymphocyte subset among intravenous drug users

AIM： To investigate the features of various blood- borne virus infections and co-infection in intravenous drug users （IDUs）, and to examine the correlation of T lymphocyte subsets with virus co-infection. METHODS： Four hundred and six IDUs without any clinical manifestation of hepatitis and 102 healthy persons were enrolled in this study. HBV-DNA and HCV-RNA were detected by fluorescence quantitative PCR. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag, anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay （ELISA） and immunochromatographic tests. The levels of Th1 and Th2 cytokines were measured by ELISA and radioactive immune assay （RIA）. The T lymphocyte subpopulation was detected by using fluorescence immunoassay. The similar indices taken from the healthy persons served as controls. RESULTS： The viral infection rate among IDUs was 36.45% for HBV, 69.7% for HCV, 47.3% for HIV, 2.22% for HDV, 1.97% for HGV, and 3.45% for HCMV. The co- infection rate of blood-borne virus was detected in 255 of 406 （62.81%） IDUs. More than 80% （161/192） of subjects infected with HIV were co-infected with the other viruses, such as HBV, HCV. In contrast, among the controls, the infection rate was 17.65% for HBV and 0% for the other viruses. Our investigation showed that there was a profound decrease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but not in the percentage of CD8. The levels of PHA-induced cytokines （IFN-γ and IL-4） and serum IL-2 were obviously decreased in IDUs. On the other hand, the level of serum IL-4 was increased. The level of IFN-γ and the percentage of CD4 were continuously decreased when the IDUs were infected with HIV or HIV co-infection. IDUs with HIV and HBV co-infection was 15.1% （29/192）. Of those 29 IDU with HIV and HBV co-infection, 51.72% （15/29） and 37.93% （11/29） were HBV-DNA-positive and HBeAg-positive, respectively. But, among IDUs without HIV infection, only 1.68% （2/119） of cases were HBV- DNA-positive.CONCLUSION： HCV, HBV and HIV infections are common in this population of IDU, leading to a high incidence of impaired Thl cytokine levels and CD4 lymphocyte. IDUs with HIV and HBV/HCV co-infection have lower expression of Th1 cytokine with enhancement of the Th2 response. HIV may be causing HBV replication by decreasing Thl function.

Autologous cytokine-induced killer cells combined with chemotherapy in the treatment of advanced colorectal cancer: a randomized control study

Objective：To evaluate the ef icacy of autologous cytokine-induced kil er （CIK） cells transfusion combined with chemotherapy in patients suf ered from advanced colorectal cancer. Methods： Sixty untreated patients with advanced colorectal cancer were randomly divided into two groups. The 30 patients in the control group received chemotherapy with the regimen of xeloda plus oxiplatin （XELOX）. The 30 patients in the trial group were treated with chemotherapy （XELOX） in combination with autologous CIK celltransfusion. T-lymphocyte subgroups were separated and measured by flow cytometry quality of life （QOL） was determined by EORTC QLQ-C30. The short-term curative ef ect was evaluated via imaging examina-tions. The patients’ median progression free survival time was estimated by Kaplan-Meier. Results：The T-lymphocyte im-mune activity was improved in patients received autologous CIK celltransfusion than those treated with chemotherapy alone. The subgroup of CD3＋CD56＋T lymphocyte was significantly increased （4.28 ± 0.45 vs 10.14 ± 1.02, P=0.01）. Short-term ef icacy evaluation revealed that there was no significant dif erence in terms of objective response rate （ORR） between the two groups, but the disease control rate （DCR） was markedly increased （86.7%vs 56.7%, P=0.020） in the group treated by chemotherapy plus CIK cells compared to the group treated with chemotherapy alone. The progression free survival time was 8.64 months （ 95%CI 6.25-9.75 months） in control group and 10.15 months （ 95%CI 7.48-12.52 months） in trial group. Compared to patients in control group, the patients in trial group had significantly longer progression-free survival （P=0.046）. The QOL assessment suggested the QOL in trial group was obviously improved than that in the control group. Compared with the control group, patients treated with autologous CIK celltransfusion scored more in the area of physical function and general health status, while the symptomatic scores in terms of pain, fatigue, nausea and vomiting and diarrhea were significantly reduced. Conclusion：Autologous CIK celltransfusion combined with chemotherapy can ef ectively enhance the immune activity of T-lymphocytes, prevent disease progression and improve the progression-free survival and QOL in patients with advanced colorectal cancer.

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.

Application of three dimensional conformal radiation therapy combined with high-intensity focused ultrasound for prostate cancer

Objective:Prostate cancer is a form of cancer that develops in the prostate,a gland in the male reproductive system.Prostate cancer tends to develop in men over the age of fifty;it is one of the most prevalent types of cancer in men.This article introduced a new method of prostate cancer treatment with the combination of three dimensional conformal radiation therapy (3D-CRT) and high-intensity focused ultrasound (HIFU),its efficacy was evaluated.Methods:From January 2004 to December 2009,95 patients were diagnosed with prostate cancer,among them,48 patients were received combined therapy with total irradiation of TD 60 Gy/30 Fx and 5 fractions of HIFU treatment,while 47 patients were received with pure 3D-CRT with total irradiation of TD (66-72) Gy/(33-36) Fx.Various indicators were evaluated,such as the local control rate and distant metastasis rate,the changes in blood PSA and fPSA,changes in T-lymphocyte subsets and NK cells,as well as acute adverse reaction of normal tissue.Results:The local response rate difference between the two groups had statistical significance (P < 0.05);the changes in blood PSA and fPSA were significant (P < 0.05);CD3+,CD4+,CD8+,CD4+/CD8+ and NK cells of the combined group increased obviously (P < 0.01),while the latter group had no increase (P > 0.05);the combined group had lower blood cells reduction and II-level acute adverse reaction of rectum,bladder and caput humeri than the pure group,but the II-level acute adverse reaction of urogenital canal in the combined group was higher (P < 0.05).Conclusion:The combined therapy with 3D-CRT and HIFU is a good way for the treatment of aged-related prostate cancer.It can ease the symptoms,control the disease and lengthen the survival time.

T Lymphocytes and Th1/Th2 Cytokines in Peripheral Blood of Patients with Recurrent Genital Herpes

Objective: This study analyzed the T lymphocytes and Th1/Th2 type cytokine profile shift in the peripheral blood ofpatients with recurrent genital herpes (RGH). Methods: Immunofluorescent staining or cell surface antigenand intracellular cytokines(IL-2、IL-4、IL-12、IFN-r)inperipheral blood from 20 RGH patients and 10 controls wereanalyzed using flow cytometric techniques. Results: RGH patients had signiflcantly lower levels ofCD3^+T cells, CD4^+T cells and CD4^+ T/ CD8^+ T cells ratiocompared to control levels (P<0.001), and IL-2-producing,IFN-r-producing and IL-12-producing T cells were increasedin RGH patients (CD4^+T: P<0.001, CD8^+T: P<0.05respectively), whereas IL-4-producing T cells were increased inRGH patients compared to controls (CD4^+T: P<0.05; CD8^+T:P<0.001 respectively). Conclusions: RGH patients have T lymphocyte subsetvariations and Th1/Th2 cytokine changes. The increase in Th2cells Th1/Th2 imbalance may have important implications forRGH pathogenesis.

Effect of different anesthesia methods on immune function in patients of laparoscopic cholecystectomy in peri-operative period

Objective To compare effects of combined acupuncture and general anesthesia （CAGA） and general anesthesia （GA） on immune function in patients of laparoscopic cholecystectomy （LC） in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu （合谷- LI 4）, Neiguan （内关PC 6）, Zusanli （足三里ST 36） and Yanglingquan （阳陵泉 GB 34） for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction （all P〈0.05）, and the percentage of CD4 in the GA group decreased significantly （P〈0.05）, while the percentage of CD： did not significantly change and CD4/CD8 increased significantly in the CAGA group （P〈0.05）. At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction （P〈0.05）. The cases with nausea after operation in the CAGA group were significantly less than those in the GA group （P〈0.05）. Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.

Clinical observation of the effects of moxibustion with seed-sized moxa cone plus opioid drugs on cancer pain and immune function

Objective:To observe the clinical efficacy of moxibustion with seed-sized moxa cone plus opioid drugs for moderate-to・severe cancer pain,and the effect on immune function in patients with cancer pain.Methods:A total of 80 patients with moderate-to-severe cancer pain were randomized into an observation group and a control group by the random number table method,with 40 cases in each group.Both groups were treated with opioid drugs for an algesia accordi ng to the stan dardized man agement prin ciples for cancer pain.In addition,the observati on group was given moxibustion with seed-sized moxa cone.The treatment was performed once a day,continuous 5-day treatment with a 2-day interval constituted a treatment course,and a total of 2 courses were performed.The score of numerical rating scale(NRS)and 24 h eq ui vale nt morphi ne consumpti on was compared betwee n the two groups before treatment,after 1 treatment course and after 2 courses of treatment.The immune functions were compared between the two groups before and after 2 courses of treatment.Results:During the treatment,there were 3 dropouts in the control group,and 2 dropouts in the observation group.Before the treatme nt,there were no sign ificant differe nces in the NRS score and 24 h equivale nt morphine consumpti on betwee n the two groups(both P>0.05).The NRS scores of both two groups were quite stable during the whole treatment period,and there was no significant differenee in the intra-group comparison after treatment(both P>0.05),and there was no significant difference between the two groups at the same time point(both P>0.05).In the control group,the 24 h equivale nt morphine con sumpti on showed an in creasi ng trend.The dosage after 1 treatme nt course and 2 courses of treatment was statistically different from that before treatment in the control group(both P<0.01).There was no significant cha nge in the mea n 24 h equivale nt morphi ne con sumpti on in the observati on group compared with that before treatme nt(both P>0.05).After 2 courses of treatme nt,the 24 h equivale nt morphine con sumpti on in the observati on group was significantly lower than that in the control group at the same time point(P<0.05).Before treatment,there was no significant difference in the levels of T lymphocyte subsets(CD3:CD4+and CD4+/CD8+)between the two groups(all P>0.05).After treatment the levels of T lymphocyte subsets(CD3+Z CD4+and CD4+/CD8+)in the control group were lower than those before treatment(all P<0.05),while the levels in the observation group were higher than those before treatment,and the levels of CD3+and CD4+were significantly different from those before treatment(both P<0.05).After treatment,the levels of T lymphocyte subsets(CD3+,CD4+and CD4+/CD8+)of the observation group were significantly higher than those of the control group at the same time point(all P<0.05).Conclusion:Moxibustion with seed-sized moxa cone can reduce the dosage of opioid drugs used in patients with moderate-to-severe cancer pain and improve their immune functions.

Effect of Xuebijing injection on peripheral T-lymphocyte subpopulations in patients with severe trauma

Objective： To investigate the effect and clinical significance of Xuebijing injection on peripheral T-lymphocyte subpopulations in patients with severe trauma. Methods： Thirty-three patients with severe trauma were randomly divided into a control group （n=16） and a treatment group （n=17）. The patients of two groups were all treated conventionally, and the only difference was that Xuebijing injection was given to patients of the treatment group. The CD4^＋ and CD8^＋ subpopulations of T-lymphocyte in the peripheral blood were detected respectively on admission, 3rd and 5th days after trauma by double antibody labeling and flow cytometry. Results： The CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of peripheral blood in patients with severe trauma decreased markedly on the 3rd and 5th days after trauma. Furthermore, compared with control group, the peripheral CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of treatment group renewed obviously on the 5th day after trauma, and showed statistical differences （P〈0.05）. Conelusion： In the treatment of patients with severe trauma, the early use of Xuebijing injection is effective in correcting disorder or suppression of T-lymphocyte subpopulations regulating network, and promoting a more balanced profile of immunologic function.

Clinical Study on the Effect of Electroacupuncture on Cellular Immune Function in Patients with Gastrointestinal Tumor

Objective： To investigate the effect of electroacupuncture （EA） on the T-lymphocyte subsets and lymphocyte transformation in patients with gastrointestinal tumor during peri-operative and peri-chemotherapy periods. Methods： A total of 44 cases with gastrointestinal tumor were allocated into 4 groups of surgical removal （SR）, SR ＋ electroacupuncture （EA）, SR ＋ chemotherapy, and SR ＋ chemotherapy ＋ EA. Then changes of T-lymphocyte subsets in varying stages of gastrointestinal tumor were determined using a flow cytometer. Results： On the 3rd day after operation, the patients＇ CD3＋ cell percentage and lymphocyte transformation were significantly lower than that before operation （P〈0.05, P〈0.01）; the CD3＋ cell percentage and lymphocyte transformation of patients who received EA were not significantly reduced, showing a statistic difference when compared with the SR group （P〈0.05）. On the 10th day after operation, the patients＇ lymphocyte transformation was almost restored to the level before operation, the CD8＋ cells in patients who received EA were significantly reduced （P〈0.05） and their CD4＋/CD8＋ ratios were markedly elevated （P〈0.05）. On the 3rd day after operation coupled with chemotherapy, the CD3＋ cell percentage and CD4＋/CD8＋ ratios were somewhat reduced, but not showing a statistic difference. Upon EA intervention, the CD3＋ cell percentage and CD4＋/CD8＋ ratios on the third day after operation coupled with chemotherapy were significantly increased （P〈0.05）. The intra-group comparison before and after treatment has shown that EA can improve the lymphocyte transformation of patients after operation and chemotherapy （P〈0.01）. Conclusion： EA can substantially improve the cellular immune function in patients with gastrointestinal tumor during peri-operative and peri-chemotherapy periods.

A clinical study of Weining Granules in the treatment of gastric precancerous lesions

OBJECTIVE:To investigate the clinical effects of Weining Granules on gastric precancerous lesions(GPLs).METHODS:120 patients with GPLs were randomly assigned in a 1:1 ratio to receive Weining Granules(trial group) or the comparator Weifuchun tablets(control group) for 6 months.Outcomes were compared between the two groups including:overall response;gastroscopically-determined response;pathologically-confirmed response;eradication of Helicobacter pylori(HP);microvessel density(MVD) in the gastric mucosa;expression of vascular endothelial growth factor(VEGF);interleukin 2(IL-2);interleukin 6(IL-6);T lymphocyte subsets;immunoglobulins;symptom scores;quality of life(QOL);and adverse reactions.RESULTS:Patients in the trial group had a significantly higher(P<0.05) overall response rate(81.7%) as compared with those in the control group(63.3%).Relative to treatment with Weifuchun tablets treatment with Weining Granules resulted in a significant improvement(P<0.05) in the scores for gastric pain,distension and stuffiness in the hypochondrium,and anorexia.As compared with the tablets the Granules were associated with a significantly higher overall gastroscopically-determined response rate(78.3%;P<0.05).Pathological examination of tissue samples indicated that 61.7% of patients receiving the granules were cured with an overall response rate of 75.5%;these rates were significantly higher than in the control group(P<0.05).In comparison with patients receiving the tablets,those given the granules were significantly more likely to have their HP eradicated(75.0% vs.51.4%;P<0.05).Improvements in MVD,VEGF,CD4+,CD4+/CD8+,IL-2,IL-6 and IgG were significantly greater with the Weining Granules than with the Weifuchun tablets(P<0.05 or P<0.01).After follow-up of 1 year,17.5% of patients in the trial group relapsed as compared with 39.5% in the control group(P<0.05).Relative to the control group,the trial group showed significantly greater improvements in physical,psychological and social relationships,and in environmental domains(P<0.05 or P<0.01).No significant adverse reactions were observed during treatment.CONCLUSION:The Weining Granules appear to be effective in improving the gastric precancerous state and the main symptoms,in inhibiting angiogenesis,enhancing immune function and QOL,and in reducing 1-year relapses.In addition,this preparation seems to be associated with a low risk of adverse events,making it a safe and efficacious option for the treatment of GPLs.

Biological indicators of sub-optimal health status

OBJECTIVE:To investigate biological indicators of sub-optimal health status and provide means of objective assessment of sub-optimal health status.METHODS:We set the unified standards for diagnosing a SHS.We tested various laboratory indicators in 407 cases that we selected randomly from2807 subjects and collected 15 mL of fasting venous blood from each case.We measured serum immunoglobulin A(IgA)and immunoglobulin G(IgG)concentrations,serum beta endorphins(β-EP),cortisol(C),testosterone(T),plasma adrenocorticotropic hormone(ACTH)and serum T lymphocyte subsets CD3+and CD4+.RESULTS:Mean serum testosterone concentrations and their ratio to cortisol(C)concentrations weresignificantly higher in the healthy group than in those with sub-optimal health status(P<0.01).Mean serum CD3+concentrations were significantly higher in those with sub-optimal health status than in the healthy group(P<0.05).CONCLUSION:Decreased serum testosterone/cortisol ratio may be an objective indication of sub-optimal health status.Changes in neuroendocrine and immunological indicators may explain some of the symptoms,including malaise and poor work performance,attributable to persistent or relapsing fatigue in subjects with sub-optimal health status.