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

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.

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.

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.

Endothelial function and T-lymphocyte subsets in patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea

Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases.This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications,and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.Methods:Totally 25 patients with stable COPD (COPD group),25 patients with OSA (OSA group),25 patients with OS (OS group),and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital.The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1),tumor necrosis factor-α(TNF-α),and T-lymphocyte subsets were detected.One-way analysis of variance,x^2 test and Pearson correlation were used to manage the data.Results:The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control,OSA,and COPD groups (x^2 =20.69,P < 0.05 and x^2 =11.03,P < 0.05,respectively).The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F =127.40,P < 0.05 and F =846.77,P < 0.05,respectively).The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F =25.40,P < 0.05 and F =75.08,P < 0.05,respectively).There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4^+/CD8^+ lymphocytes (r =-0.77,P < 0.05 and r =-0.83,P < 0.05,respectively).Conclusions:The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone.Patients with OS exhibited more severe vascular endothelial injury,stronger inflammatory response,and lower cellular immune function.

Regulatory Effect of Langchuang Serial Recipes on T-Lymphocyte Subsets Th and Tc in Patients with Systemic Lupus Erythematosus

Objective： To study the principle of clearing Fei （肺）, cooling blood, and detoxification as well as nourishing yin and moisening Fei （abbr. as CCD-NM） in regulating the levels of peripheral T-lymphocyte subsets Th and Tc cells to explore its mechanism for lowering the incidence of infection in patients with systemic lupus erythematosus iSLE）. Methods： Sixty SLE patients without complicated infection were assigned to the treatment group and the control group, 30 in each group. The control group was treated with Western medicine alone, while the treatment group was treated with the same program of Western medicine, but additionally administered with either Langchuang No.1 （狼疮 Ⅰ号） or 2 （狼疮 Ⅱ 号）, serial concerted Chinese recipes, applied respectively in patients in the active stage or in the resting stage. The total time of treatment for both groups was 1 year. Further, a healthy control group was set up with 20 healthy subjects. The expressions of Thl, Th2, and Tcl and Tc2 cells in peripheral blood were detected and compared with those in the healthy control group. Results： （1） As compared with the healthy control group, ratios of Thl/Th2 and Tcl/Tc2 in SLE patients, whether complicated with infection or not, were significantly lower （P〈0.05 or P〈0.01）. （2） Comparison between patients with complications and those uncomplicated with infection showed that the two ratios and Thl expression were lower and Tc2 was higher in the former than those in the latter （all P〈0.05）. （3） Ratios of Thl/Th2 and Tcl/Tc2 increased after treatment in patients of both the treatment group and the control group （P〈0.05 and P〈0.01）, but the changes in the treatment group were more significant （P〈0.05）. Conclusion： The principle of CCD-NM could regulate the Th and Tc subsets toward equilibrium in SLE patients, which might be one of the mechanisms of action for alleviating complicated infection.

Clinical characteristics and T-lymphocyte subsets in 48 acquired immune deficiency syndrome patients with cytomegalovirus infections

Objective To investigate the clinical features and Tlymphocytes subsets in patients with acquired immunedeficiency syndrome ( AIDS ) and cytomegalovirus(CMV) infection. Methods A total of 48 hospitalizedpatients with human immunodeficiency virus (HIV)-1 /AIDS and CMV infections were recruited at Peking UnionMedical College Hospital from Jan 2010 to Aug 2017.Their clinical features and immune function were retrospectivelyanalyzed. Patients with only HIV/AIDS inprevious study were recruited as controls. Results All 48patients were at C3 stage, including 36 men and12 women. Five of them were younger than 30 years old,33 cases within 31 - 50 years old,and 10 cases olderthan 50 years old.

腺样体肥大患儿机体免疫功能变化研究

<正>腺样体也称咽扁桃体或增殖体,属于淋巴组织,表面呈桔瓣样。正常生理情况下,儿童6~7岁时腺样体发育至最大,青春期后逐渐萎缩,成人后基本消失~[1]。腺样体位于鼻咽顶后壁处,病理性肥大易引起鼻堵、张口呼吸、耳闷、听力下降等症状,最终造成慢性鼻-鼻窦炎、阻塞性睡眠呼吸暂停低通气综合征及分泌性中耳炎等疾病,给儿童的颌面骨发育、智力发育造成严重影响。

PCT及T淋巴细胞亚群在老年卫生保健相关性肺炎并发呼吸衰竭中的诊断价值

目的:探讨PCT及T淋巴细胞亚群在老年卫生保健相关性肺炎并发呼吸衰竭中的诊断价值。方法:对40例老年卫生保健相关性肺炎并发呼吸衰竭患者的血清PCT和T淋巴细胞亚群水平进行检测,并以40例健康体检者作为对照组,分析对比各组血清PCT及T淋巴细胞亚群水平。结果:老年卫生保健相关性肺炎并发呼吸衰竭降钙素元(PCT)水平显著升高(P<0.05),在T淋巴细胞亚群中,老年卫生保健相关性肺炎并发呼吸衰竭组CD4+细胞显著高于对照组(P<0.05),CD4+/CD8+细胞比值明显高于对照组(P<0.05),而CD8+细胞无显著差异(P>0.05)。结论:老年卫生保健相关性肺炎并发呼吸衰竭患者PCT水平显著增高,而T淋巴细胞亚群检测结果呈现免疫抑制,临床医生可根据这些指标准确评估病情以便制定合理的治疗方案。

和解分消法对慢性肾脏病3～4期患者T细胞亚群、骨代谢及肾功能的影响

目的观察和解分消法联合西医常规治疗对慢性肾脏病3~4期患者T细胞亚群、骨代谢及肾功能的影响。方法将128例慢性肾脏病3~4期患者随机分为2组,对照组64例予西医常规治疗,治疗组64例在对照组治疗基础上加用中医和解分消法治疗,2组均以3个月为1个疗程。观察2组治疗前后T细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)、骨代谢指标[血清钙(Ca)、磷(P)、骨钙素(BGP)]、肾功能指标[血肌酐(SCr)、内生肌酐清除率(Ccr)、尿素氮(BUN)、肾小球滤过率(GFR)]、炎症指标[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及中医证候评分变化情况,统计2组治疗1个疗程后的临床疗效。结果治疗组治疗后CD4^+、CD4^+/CD8^+均明显高于治疗前及对照组(P均<0.05),CD8^+明显低于治疗前及对照组(P均<0.05);2组治疗后血清Ca、BGP、Ccr、GFR均明显升高(P均<0.05),且治疗组各指标水平均明显高于对照组(P均<0.05);2组治疗后血清P、SCr、BUN水平和中医证候评分均明显降低(P均<0.05),且治疗组各指标水平和中医证候评分均明显低于对照组(P均<0.05)。2组治疗后hs-CRP水平均明显降低(P均<0.05),治疗组治疗后IL-6、TNF-α水平均明显低于治疗前及对照组(P均<0.05)。治疗1个疗程后,治疗组总有效率明显高于对照组(P<0.05)。结论和解分消法联合西医常规治疗慢性肾脏病3~4期患者疗效优于单纯西医治疗,可显著改善肾功能和骨代谢指标,减轻炎症反应。

实热证、虚热证患者T淋巴细胞亚群的对比性研究

目的:观察中医实热证、虚热证两种不同证型之间与外周血 T 淋巴细胞亚群的变化差异。方法:采用间接免疫荧光法检测正常对照组30例、实热证患者27例、虚热证患者35例 T 细胞亚群的变化。结果:实热证、虚热证组患者与正常对照组相比,T 细胞亚群 CD_3、CD_4、CD_4/CD_8水平显著下降(P<0.05或 P<0.01),其中虚热证组 CD_4下降明显(P<0.05);而 CD_8水平升高只在实热证组患者有显著差异(P<0.01)。结论:虚热证、实热证两组患者都存在 T 细胞免疫功能紊乱。虚热证细胞免疫功能低下,而实热证虽然 T 淋巴细胞亚群亦低于正常人,但高于虚热证组。T 淋巴细胞亚群变化可为实热证、虚热证的客观化研究提供依据。

人CD_(137)单抗对急性白血病T淋巴细胞亚群的影响及意义

目的:探讨人CD137单抗对急性白血 病(acuteleukemia,AL)T淋巴细胞亚群的影 响,及其在AL免疫治疗中的作用和意义。方 法:采用免疫荧光标记、流式细胞术(FACS) 及体外细胞培养技术,分析人CD137单抗刺激 前后22例初治AL患者外周血T淋巴细胞亚 群的变化特点。结果:人CD137单抗可诱导初 治患者外周血T细胞CD3、CD4和CD4/CD8 比值显著升高,P<0.05;从而使其T细胞亚 群接近正常,而对于对照组T细胞亚群几无 影响。结论:人CD137单抗可逆转初治AL患者 T细胞缺陷或失衡,使T细胞亚群恢复或接近 正常,这对改善患者基础免疫状态,配合联合 化疗,具有重要意义;CD137单抗可促使CD4、 CD8T细胞增多,从而参与抗肿瘤免疫反应,可 能是AL免疫治疗的重要方法之一,具有一定 的临床应用价值。

老年骨质疏松症合并髋部骨折患者外周T淋巴细胞亚群炎性细胞因子水平与骨代谢生化指标的关系

目的探讨老年骨质疏松症(OP)合并髋部骨折患者外周T淋巴细胞亚群、炎性细胞因子水平与骨代谢生化指标的相关性。方法在骨伤科收治的老年患者中(年龄≥60岁),根据骨质疏松症的诊断标准及有无发生髋部骨折,选取OP合并骨折组(A组)30例OP无骨折组(B组)30例,并选择同一时期年龄、性别相匹配的体检者30例作为健康对照组(C组)。测定3组研究对象的T淋巴细胞亚群、炎性细胞因子与骨代谢生化指标,并分析各指标间的相关性。结果A组和B组患者血清中外周T淋巴细胞亚群CD4^(+)与CD8^(+)含量低于C组(F=8.545、9.201,P<0.05);A组和B组患者血清中炎性细胞因子IL-6、TNF-α与骨代谢生化指标Ⅰ型胶原羧基末端肽(typeⅠcollagen carboxy-terminal peptide,CTX)、Ⅰ型前胶原氨基端前肽(typeⅠprollagen amino-terminal peptide,P1NP)含量高于C组(F=18.291、4.906、7.077、14.411,P<0.05);3组患者血清中CD4^(+)/CD8^(+)、IFN-γ、Ca、P含量无明显差异(P>0.05);老年骨质疏松症合并髋部骨折患者血清中CD4^(+)与CD8^(+)含量与CTX、P1NP含量呈负相关(CD4^(+):r=-0.714、-0.667,P=0.003、0.007;CD8^(+):r=-0.647、-0.746,P=0.007、0.001),IL-6、TNF-α含量与CTX、P1NP含量呈正相关(IL-6:r=0.777、0.864,P=0.0010.000;TNF-α:r=0.611、0.554,P=0.016、0.032)。结论老年骨质疏松症合并髋.部骨折患者血清中T淋巴细胞亚群CD4^(+)、CD8^(+)和炎性细胞因子IL-6、TNF-α的含量变化影响了骨代谢的过程,下降的CD4^(+)、CD8^(+)与上升的IL-6、TNF-α指标存在加大老年骨质疏松症合并髋部骨折风险的可能性,其指标对预测该类骨折发生有较大意义。

Epidemiological survey of cryptosporidiosis in Anhui Province China

AIM: To provide scientific evidence for prevention and controlling of cryptosporidiosis, the infection of Cryptosporidium parvum and its epidemiological characteristics were studied in some areas of Anhui Province. METHODS: The oocyst of Cryptosporidium parvum in 5421 fresh stool samples from eleven areas of Anhui Province was tested by auramine-phenol stain and improved anti-acid stain respectively. The specific antibody of IgG, IgM and T subsets of 41 patients with positive Cryptosporidium parvum in stools were detected by ELISA and biotin-streptavidin (BSA) respectively. RESULTS: The total infective rate of Cryptosporidium parvum was 1.33% (74/5421). Among them, the positive rates of oocyst in the areas of Huaibei (1.82%) and Fuyang (1.80%) were higher. The positive rates of oocyst in stools of infants, pupils, middle school students, college students, adults, patients with diarrhea, and those with immunodeficiency were 3.15%(28/889), 0.82% (9/1098), 0.82%(9/1092), 0.83%(8/969), 0.85% (9/1095), 2.88%(8/278) and 8.33%(3/36)% respectively. The positive rates of oocyst in infants and the patients with diarrhea and immunodeficiency were significantly higher than those in controls (P【0.01). The positive rate of oocyst in males was similar to that in females (P】0.05). The positive rate of oocyst in urban areas (1.13%) was significantly lower than those in rural areas (1.72%, P【0.01). The positive rates of specific IgG, IgM and IgG+IgM in sera of the patients with positive oocyst in stool were 63.4% (26/41), 17.1% (7/41), 19.5% (8/41) respectively. The number fractions of T subsets of CD(3)(+), CD(4)(+), CD(8)(+) and CD(4)(+)/CD(8)(+) of the patients were 0.66+/-0.07, 0.44+/-0.06, 0.28+/-0.04 and 1.58+/-0.32 respectively. The difference between the patients and the controls was significant (P【0.05). The main manifestations of the patients were subclinical infection, in forms of slight abdominal pain, mild diarrhea, and loose stool. CONCLUSION: There are two infection peaks in infection of Cryptosporidium parvum and its infection can be found more often in infants, patients with diarrhea or immunodeficiency, and in rural areas. Subclinical infection is the main manifestation and might be easily misdiagnosed. When the therapeutic effectiveness is low for diarrhea, the infection of Cryptosporidium parvum should be considered, concerning their age and immune function.

代谢综合征对脓毒性休克患者T淋巴细胞亚群及预后的影响

目的探讨代谢综合征（MS）对脓毒性休克患者外周血T淋巴细胞亚群及预后的影响。方法选取2014年1月至2017年6月海南医学院第二附属医院东湖分院急诊科收治的脓毒性休克患者93例作为研究对象，根据是否合并MS，将脓毒性休克患者分为非MS组（48例）和MS组（45例）。所有患者入院后均给予积极规范治疗。比较2组患者T淋巴细胞亚群相关指标和临床终点指标，采用Pearson相关性方法分析MS对脓毒性休克患者外周血T淋巴细胞亚群及预后的影响。结果MS组患者急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分明显高于非MS组[（23±5）分比（21±6）分]，差异有统计学意义（P〈0．05）。MS组患者co；T淋巴细胞、CD4T淋巴细胞及CD8T淋巴细胞水平明显低于非MS组[（50±6）％比（55±7）％、（36±6）％比（39±6）％、（18±5）％比（21±6）％]，差异均有统计学意义（均P〈0．05），而MS组患者CD4／CD8＋T淋巴细胞比值与非MS组比较，差异无统计学意义（P〉0．05）。MS组机械通气时间、血管活性药物使用时间及连续肾替代疗法时间长于日}MS组，28d病死率高于非MS组{（4．4±3．6）d比（2．94±2．8）d、（6．9±2．1）d比（5．9±1．7）d、（4．1±3．0）d比（2．8±2．7）d、37．8％（17／45）比16．7％（8／48）]，差异均有统计学意义（均P〈0．05）。MS组重症监护病房停留时间与非MS组比较，差异无统计学意义（P〉0．05）。Pearson相关性分析结果显示，脓毒性休克患者APACHE11评分与外周血CD4＋T淋巴细胞水平呈负相关（r=-0．256，P=0．013），而与其他T淋巴细胞亚群相关指标及临床终点无明显相关性（均P〉0．05）。结论MS可加重脓毒性休克患者T淋巴细胞亚群异常表达及病情，CD4T淋巴细胞与脓毒性休克患者病情严重程度密切相关。

Randomized Double-blinded and Controlled Clinical Trial on Treatment of HIV/AIDS by Zhongyan-4 (中研-4号)

Objective： To assess the efficacy and safety of Zhongyan-4 （中研-4号, ZY-4, a Chinese herbal preparation worked out according to the therapeutic principle of supplementing qi, nourishing Yin, clearing heat and detoxication） in treating HIV/AIDS patients in the early or middle stage. Methods： Adopted was randomized double-blinded and placebo-parallel-controlled method, with 72 HIV/AIDS patients randomly divided into the ZY-4 group （36 patients） treated with ZY-4 and the control group （36 patients） treated with placebo. The treatment course was six months. The index of OD4^＋, OD8^＋ counts, body weight, clinical symptom scoring were estimated at 4 time points （0, 1, 3 and 6 month in the course）, and also the viral load before and after treatment. The whole course of observation was completed in 63 patients, 30 in the ZY-4 group and 33 in the control group. Results： OD4^＋ count in the ZY-4 group got elevated by 7.70 4±150.96/mm^3 on average, while that in the control group lowered by 27.33 4±85.28 /mm^3 . Fifteen out of the 30 patients in the ZY-4 group had their OD4^＋ count increased, which was evidently much higher than that in the control group （8/33, P〈0. 05）, suggesting that the efficacy of ZY-4 is superior to that of placebo in elevating OD4^＋ count. Moreover, ZY-4 showed actions in elevating OD45RA^＋ and OD8^＋ count, reducing HIV virus load, improving clinical symptom/sign and increasing body weight of patients. No obvious adverse reaction was found in the clinical trial. Conclusion： ZY-4 has an immunity-protective and/or rebuilding function in HIV/AIDS patients in the early and middle stage, and also shows effects in lowering viral load, increasing body weight and improving symptoms and signs to a certain degree.