Correlation of Inflammatory Cells in Induced Sputum and Peripheral Blood of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory disease worldwide. Inflammatory cells reflect the inflammatory situation both in peripheral blood and induced sputum. Their correlation has not been reported. The correlation between neutrophils (Neu), eosinophils (Eos), and lymphocyte (Lym) in induced sputum and that in peripheral blood of COPD patients was evaluated to explore the consistency of inflammatory cells in peripheral blood and induced sputum. Peripheral blood and induced sputum were collected from 437 patients with acute exacerbation of COPD (AECOPD) who were hospitalized in the Department of respiratory and critical care medicine, Inner Mongolia People’s Hospital. The correlation analysis was performed by Spearman correlation analysis. The ratios of Neu, Eos, and Lym in induced sputum were (79.15 ± 22.60)%, (5.23 ± 12.74)%, and (1.69 ± 2.66)%. The ratios of Neu, Eos, and Lym in peripheral blood were (63.29 ± 11.44)%, (2.99 ± 3.60)%, and (25.16 ± 10.19)%. The results showed that the ratios of Neu and Eos in induced sputum were significantly correlated with the proportion of corresponding cells in peripheral blood (P < 0.05). There was no correlation between the ratio of Lym and Leu in induced sputum and corresponding cells in peripheral blood (P > 0.05). In patients with AECOPD, the tendency of Neu and Eos in induced sputum was consistent with the corresponding cells in peripheral blood. Neu and Eos in induced sputum and peripheral blood reflected the degree of inflammation to guide the individualized medication of patients.

Expression and significance of toll-like receptor 2,4 in peripheral blood mononuclear cells in patients with systemic inflammatory response syndrome

To explore changes of toll-like receptor (TLR) 2,4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome (SIRS) and their significance.Methods A clinical study was done on 103 patients of which 65 were with SIRS.The mRNA expression of TLR2,4 were detected by RT-PCR;the expression of TNF-α and IL-6 were observed by ELISA;the correlation between TLR2,4 mRNA,the level of TNF-α and IL-6,and the clinical course was evaluated.Results TLR2 mRNA ,TNF-α and IL-6 were upregulated markedly on the first day of hospitalization,then decreased gradually;TLR2 mRNA maintained on high level till the 5th day.The expression of TLR2,4 mRNA was positive correlated with the level of TNF-α and IL-6,and the length of stay.TLR2,4 mRNA expression increased in patients with multiple organ failure.Conclusion In actue abdomen patients with SIRS,the expression of TLR2,4 of PBMC increased markedly,indicating its improtant role in the pathogenesis of SIRS.4 refs,2 figs,2 tabs.

Effect of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer

Objective:To investigate the effects of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer.Methods: Eighty patients with gastric cancer admitted to our hospital from May 2016 to October 2017 were selected as the research object and randomly divided into observation group and control group, 40 cases in each group. Control group was treated by DCF chemotherapy, while the observation group by Shenqi Fuzheng Injection based on the DCF chemotherapy. The levels of peripheral blood cells, tumor markers and immune function indexes in both groups were detected and compared before and after treatment.Results: There were no significant differences in serum RBC, WBC, PLT, Hb, NSE, CYFRA21-1, CA199, CEA, CD3+, CD4+, CD8+ and CD4+/CD8+ levels before treatment in both groups. Compared with the pretreatment group, the levels of RBC, WBC, PLT and Hb in both groups decreased to some extent after treatment, and the levels in the observation group were significantly higher than those in the control group;Compared with the same group before treatment, the levels of NSE, CYFRA21-1, CA199 and CEA in the two groups were significantly decreased, and the observation group was significantly lower than the control group;CD3+, CD4+, CD4+/CD8+ levels in control group and observation group increased to some extent after treatment, and the levels in observation group were significantly higher than those in control group. The levels of CD8+ in both groups after treatment were significantly lower than those before treatment, and the observation group was significantly lower than the control group after treatment. The above data for statistical analysis had significant differences.Conclusions: Shenqi Fuzheng injection combined with chemotherapy helps to clear and kill cancer cells, enhance immunity and reduce hematological toxicity after chemotherapy, which can be used as an adjuvant chemotherapy for gastric cancer.

Relationship between Maternal PBMC HBV cccDNA and HBV Serological Markers and its Effect on HBV Intrauterine Transmission

Objective To investigate the relationship between maternal peripheral blood mononuclear cells (PBMC) hepatitis B virus(HBV) covalenty closed circular deoxyribonucleic acid(cccDNA) and other HBV serological markers and its effects on HBV intrauterine transmission. Methods We enrolled 290 newborns and their hepatitis B surface antigen(HBsAg) positive mothers. HBV cccDNA in PBMC and HBV DNA in serum were detected by a real‐time PCR‐TaqM an probe while HBV serological markers were detected with an electrochemiluminescence immunoassay. Results There was a positive correlation between the levels of PBMC HBV cccD NA and serum HBV DNA and HBeA g(r = 0.436 and 0.403, P < 0.001). The detection rate of pattern A [‘HBsA g(+), HBeA g(+), and anti‐HBc(+)’] was significantly higher in the PBMC HBV cccD NA positive group than in the control group(χ^2 = 48.48, P < 0.001). There was a significant association between HBV intrauterine transmission and PBMC HBV cccD NA(χ^2 = 9.28, P = 0.002). In the presence of serum HBV DNA, HBeA g, and PBMC HBV cccD NA, the risk of HBV intrauterine transmission was three times higher(OR = 3.69, 95% CI: 1.30‐10.42) than that observed in their absence. The risk of HBV intrauterine transmission was the greatest(OR = 5.89, 95% CI: 2.35‐14.72) when both PBMC HBV cccD NA and pattern A were present. A Bayesian network model showed that maternal PBMC HBV cccD NA was directly related to HBV intrauterine transmission. Conclusion PBMC HBV cccDNA may be a direct risk factor for HBV intrauterine transmission. Our study suggests that serological markers could be combined with PBMC‐related markers in prenatal testing.

Correlation between in vitro and in vivo immunomodulatory properties of lactic acid bacteria

AIM： To investigate the correlation between in vitro and in vivo immunomodulation potential of the probiotic strain and its ability to prevent experimental colitis in mice. METHODS： In vitro immunomodulation was assessed by measuring interleukJn （IL）-12p70, IL-10, tumor necrosis factor alpha （TNFα） and interferon 7 （IFNγ） release by human peripheral blood mononuclear cells （PBMCs） after 24 h stimulation with 13 live bacterial strains. A murine model of acute TNBS-colitis was next used to evaluate the prophylactic protective capacity of the same set of strains. RESULTS： A strain-specific in vivo protection was observed. The strains displaying an in vitro potential to induce higher levels of the anti-inflammatory cytokine IL-10 and lower levels of the inflammatory cytokine IL-12, offered the best protection in the in vivo colitis model. In contrast, strains leading to a low IL-10/IU12 cytokine ratio could not significantly attenuate colitis symptoms, CONCLUSION：These results show that we could predict the in vivo protective capacity of the studied lactic acid bacteria （LAB） based on the cytokine profile we established in vitro. The PBHC-based assay we used may thus serve as a useful primary indicator to narrow down the number of candidate strains to be tested in murine models for their anti-inflammatory potential.

不同炎症表型慢性阻塞性肺疾病急性加重患者的临床特征及预后分析

目的分析不同炎症表型慢性阻塞性肺疾病急性加重(AECOPD)患者的临床特征及预后。方法回顾性分析2021年1月至2022年4月苏北人民医院呼吸内科收治的255例AECOPD患者的临床资料。根据患者入院首次外周血细胞计数结果,将其分为嗜酸粒细胞(EOS)组(87例)、中性粒细胞组(92例)、混合粒细胞组(30例)和粒细胞缺乏组(46例)。比较四组患者的临床特征及出院后1年内急性加重再入院率。结果四组患者白细胞计数(WBC)、EOS百分比(EOS%)、EOS、中性粒细胞百分比(NE%)、中性粒细胞(NE)、淋巴细胞百分比(LY%)、淋巴细胞(LY)、中性粒细胞计数/淋巴细胞计数比值(NLR)、C反应蛋白(CRP)、降钙素原(PCT)、白蛋白(ALB)水平比较,差异有统计学意义(P<0.05)。中性粒细胞组WBC、NE%、NE、NLR、CRP、PCT水平高于EOS组,EOS%、EOS、LY%、LY、ALB水平低于EOS组;混合粒细胞组WBC、NE%、NE、NLR水平高于EOS组,LY%、LY、ALB水平低于EOS组,EOS%、EOS水平高于中性粒细胞组;粒细胞缺乏组WBC、NE%、NE、NLR、PCT水平低于中性粒细胞组与混合粒细胞组,LY%、LY水平高于中性粒细胞组与混合粒细胞组,EOS%、EOS水平低于EOS组与混合粒细胞组,CRP水平低于中性粒细胞组,差异有统计学意义(P<0.05)。四组患者肺功能指标比较差异有统计学意义(P<0.05)。中性粒细胞组第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)水平低于EOS组;粒细胞缺乏组FEV_(1)%pred、FEV_(1)/FVC水平高于中性粒细胞组,FEV_(1)/FVC水平高于混合粒细胞组,差异有统计学意义(P<0.05)。四组患者住院天数、静脉激素及抗生素使用率比较差异有统计学意义(P<0.05)。中性粒细胞组住院天数大于EOS组,静脉激素使用率高于EOS组,抗生素使用率高于EOS组和粒细胞缺乏组,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示,急性加重再入院率由高到低依次为中性粒细胞组(61.06%)、混合粒细胞组(54.78%)、粒细胞缺乏组(45.23%)和EOS组(42.89%),log-rank检验显示四组差异有统计学意义(χ^(2)=10.816,P=0.013)。结论基于外周血细胞计数的四种不同炎症表型的AECOPD患者在炎症指标水平、营养状况、肺功能、住院天数、治疗效果及预后等方面存在明显差异。中性粒细胞型AECOPD相比于EOS型AECOPD表现出更严重的临床特征,且出院后1年内急性加重再入院率更高。

外周血炎症指数与乳腺癌腋窝淋巴结转移的相关性分析

目的 探讨外周血炎症相关指数与乳腺癌腋窝淋巴结转移的相关性。方法 回顾性收集2018年1月—2023年8月就诊于兰州大学第二医院浸润性乳腺癌患者的首次就诊临床资料,计算外周血相关炎症指数,分析各项指数与腋窝淋巴结转移的相关性。结果 共收集了328例患者的临床资料,单因素分析显示,体重指数、肿瘤直径、癌胚抗原、癌胚抗原125、系统炎症反应指数和泛免疫炎症值在腋窝淋巴结转移组和非腋窝淋巴结转移组之间差异有统计学意义(P<0.05)。多因素分析发现肿瘤直径、泛免疫炎症值、系统炎症反应指数、体重指数、组织学分级Ⅲ级和癌胚抗原125是腋窝淋巴结转移的独立危险因素。受试者操作特征曲线中泛免疫炎症值的曲线下面积为0.634,最佳临界值为110.37。系统炎症反应指数的曲线下面积为0.639,最佳临界值为0.554。结论 泛免疫炎症值和系统炎症反应指数与浸润性乳腺癌腋窝淋巴结转移相关,可以作为乳腺癌腋窝淋巴结转移的潜在预测指标。

肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期非小细胞肺癌的临床疗效

目的探讨肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期非小细胞肺癌(NSCLC)的临床疗效及对血清肿瘤标志物和炎性因子水平的影响。方法选取2019年2月—2021年2月于我院就诊的痰瘀互结型晚期NSCLC患者100例,根据随机数字表法分为对照组和治疗组(n=50)。对照组患者口服吉非替尼片,治疗组患者在对照组的基础上加用肺瘤消积方,以21 d为1个治疗周期,两组患者均治疗4周期。对比分析两组血清肿瘤标志物和炎性因子水平、生活质量评分、无进展生存期(PFS)、中医症状分级、临床疗效、不良反应。结果治疗后,两组细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)水平以及癌症患者生命质量测定量表(QLQ-C30)评分均低于治疗前,且治疗组低于对照组(P<0.05);治疗组PFS显著长于对照组(P<0.05);两组中医症状分级均显著改善,且治疗组优于对照组(P<0.05);治疗组客观缓解率(ORR)、疾病控制率(DCR)(68.00%、84.00%)均显著高于对照组(42.00%、62.00%)(P<0.05);治疗组皮肤反应、腹泻总发生率(22.00%、50.00%)均显著低于对照组(42.00%、74.00%)(P<0.05)。结论肺瘤消积方联合吉非替尼治疗痰瘀互结型晚期NSCLC患者疗效显著,可有效降低患者血清CYFRA21-1、CA19-9、CEA、IL-1、IL-6、TNF-α水平,改善患者病情,且安全性较高。

CRP水平及其基因多态性与2型糖尿病的相关性

目的探讨C反应蛋白(CRP)水平及其基因多态性、外周血炎症标志物与2型糖尿病(T2DM)的相关性。方法2021年10月1日至2022年9月30日南方医科大学第十附属医院内分泌科100例T2DM患者为T2DM组,100例同期健康人群为对照组,收集两组抗凝血标本,采用PCR反应和测序技术确定CRP基因rs2794521(CRP-717A/G)位点基因型分布,通过收集患者临床资料,分析CRP及其基因多态性与中性粒细胞/淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)、衍生中性粒细胞/淋巴细胞比值(dNLR)、系统免疫炎症指数(SII)与T2DM的相关性。结果T2DM组AA基因频率显著高于对照组(P<0.05)。与A/G+G/G基因型比较,A/A基因型携带者CRP值增高(P<0.05)。不同基因型间其他临床指标比较,差异无统计学意义(P>0.05)。Pearson相关性分析发现,CRP水平与体质指数(BMI)、PLR、MLR和SII呈正相关(P<0.05)。两组受试对象性别、总胆固醇(TCH)、MLR等基本资料比较,差异无统计学意义(P>0.05),两组年龄、BMI、TG、NLR、PLR、dNLR、SII和CRP比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示TG(OR=1.945)、NLR(OR=2.022)、SII(OR=7.312)、PLR(OR=1.512)、dNLR(OR=2.121)、CRP(OR=10.126)、CRP-A/A(OR=2.132)是T2DM的危险因素(P<0.05)。结论CRP基因A/A多态性可能是T2DM的遗传危险因素;此基因型携带者具有较高的CRP水平;TG、NLR、SII、PLR、dNLR、CRP升高是T2DM的危险因素;CRP水平与BMI、NLR、SII、PLR、dNLR呈正相关。

术前外周血炎症指标评价OSCC患者预后的研究进展

口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)是口腔颌面部最常见的恶性肿瘤之一,5年生存率在综合治疗模式的发展完善下仍不理想。口腔部位组织因血液及淋巴丰富,有着易淋巴结转移及复发等特点,大量研究表明炎症和肿瘤息息相关,癌症相关炎症在肿瘤微环境及肿瘤的发生、发展阶段发挥重大作用,已有相关研究表明外周血炎症指标是多种恶性肿瘤的重要预后因子,本文通过检阅国内外相关文献分析术前外周血中性粒细胞/淋巴细胞比率(neutrophil-lymphocyteratio,NLR)、血小板/淋巴细胞比率(platelet to lymphocyteratio,PLR)、淋巴细胞/单核细胞比率(lymphocyte-to-monocyte ratio,LMR)、全身免疫炎症指数(systemic immune-inflammation index,SII)和全身炎症反应指数(systemic inflammation response index,SIRI)及C反应蛋白(C-reactive protein,CRP)预测OSCC预后的研究进展,以期为临床上选择综合治疗策略提供参考。

外周血标志物检测识别免疫检查点抑制剂治疗NSCLC免疫相关毒性风险的临床观察

目的探讨外周血标志物识别免疫检查点抑制剂(ICIs)治疗晚期非小细胞肺癌(NSCLC)免疫相关毒性(irAE)风险的临床意义。方法回顾性分析2018年8月至2023年4月在右江民族医学院附属医院接受ICIs的195例晚期NSCLC患者,随访并记录irAE。比较irAE与患者临床病理特征的关系。采用Kaplan-Meier法绘制无进展生存时间(PFS)曲线,生存差异行Log-rank检验。采用Logistic多因素回归模型分析影响irAE的因素。采用受试者工作特征(ROC)曲线评价外周血标志物对irAE的诊断效能。采用R软件构建列线图。结果全组患者中位随访时间为7.91个月(1.0~45.63个月),ICIs的中位给药周期为4(1~49)个周期。57例患者发生irAE,主要包括肺炎、腹泻、脂肪酶/淀粉酶升高和皮肤反应等。irAE组患者基线NLR、PLR、MLR和LDH水平高于无irAE患者(P<0.001)。与无irAE组患者比较,发生irAE患者的ORR更高(47.37%vs.25.36%;P=0.003)。无irAE组患者的中位PFS(313天,95%CI:242~383天)略长于irAE组(235天,95%CI:199~270天),差异无统计学意义(P=0.144)。Logistic多因素回归分析显示,NLR、PLR和ICIs治疗情况是影响irAE的独立因素(P<0.05)。训练队列和验证队列的C指数接近,分别为0.71和0.75。校准曲线的拟合度较高,证实了该列线图具有较高的预测值。结论基线NLR和PLR及多线治疗ICIs可能是影响晚期NSCLC患者irAE的因素。

肿瘤外周血炎症标志物与^(18)F-FDG PET/CT代谢参数的相关性

外周血炎症标志物如中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)等能够在一定程度上反映肿瘤内部炎性细胞反应性增生,同时,^(18)F-FDG PET/CT代谢参数与肿瘤内部炎性细胞反应性增生之间也存在相关性,但是目前肿瘤代谢参数和外周血炎症标志物之间关系的报道较少,因此本文将从肿瘤外周血炎症标志物、肿瘤内部炎性细胞反应性增生、^(18)F-FDG PET/CT代谢参数等三方面之间的关系出发,对^(18)F-FDG PET/CT代谢参数和外周血炎症标志物之间的相关性作文献综述。

延期妊娠引产失败的相关因素分析

目的探讨延期妊娠引产失败的相关因素。方法收集2017年1月至2021年1月在西北妇女儿童医院产科住院的延期妊娠产妇病历资料171例;依据引产结果将其分为引产成功组84例,引产失败组87例;按产后胎盘病检结果分为亚临床期绒毛膜羊膜炎组59例,非绒毛膜羊膜炎组112例;对各组产妇的基本指标、外周血炎性指标、胎盘病检结果进行比较,并进行统计学分析。结果引产成功组与引产失败组产妇的年龄、人工流产次数、孕前体重、分娩前体重、孕前体质量指数(BMI)、分娩前BMI、新生儿出生体重比较差异均有统计学意义(t值分别为-3.414、-1.220、-2.373、-2.461、-3.470、-3.764、-5.616,P<0.05);引产成功组与引产失败组产妇的身高比较差异有统计学意义(Z=2.158,P<0.05)。引产成功组与引产失败组的产前外周血白细胞计数(WBC)、中性粒细胞百分比(NEUT)、C反应蛋白(CRP)、降钙素原(PCT)水平比较差异均有统计学意义(t值分别为-2.348、-2.158、-2.614、-2.176,P<0.05)。亚临床期绒毛膜羊膜炎组与非绒毛膜羊膜炎组外周血WBC、NEUT、CRP和PCT水平比较差异均有统计学意义(t值分别为2.589、2.603、2.615、2.144,P<0.05)。引产成功组与引产失败组产妇产后胎盘出现亚临床期绒毛膜羊膜炎的发生率比较差异有统计学意义(χ2=75.385,P<0.001);引产成功组与引产失败组产妇产后发热的发生率比较差异也有统计学意义(Fisher确切概率法,P=0.001)。多因素Logistic回归分析结果显示,产妇的年龄(OR=1.203,95%CI:1.019~1.419)、身高(OR=1.151,95%CI:1.021~2.060)、人工流产次数(OR=2.021,95%CI:1.571~4.216)、分娩前BMI(OR=3.403,95%CI:2.581~5.348)、WBC(OR=1.021,95%CI:1.001~1.046),以及新生儿出生体重(OR=1.003,95%CI:1.001~1.004)均是引产失败的危险因素(P<0.05)。ROC曲线分析显示,WBC、NEUT、CRP、PCT诊断亚临床期绒毛膜羊膜炎的截断值分别为7.85×109/L、76.00%、14.00μg/mL、0.04ng/mL。WBC+NEUT+CRP+PCT联合诊断亚临床期绒毛膜羊膜炎的AUC为0.683,灵敏度为85.40%,特异度为77.90%,四项指标联合诊断亚临床期绒毛膜羊膜炎有较高的AUC、灵敏度、特异度,优于单项指标的诊断。结论产妇的年龄、身高、人工流产次数、分娩前BMI、WBC,以及新生儿出生体重均是引产失败的危险因素,亚临床期绒毛膜羊膜炎是导致引产失败高危因素之一。

SD大鼠外周血单个核细胞成分及干/祖细胞含量的年龄变化

目的:研究SD大鼠外周血单个核细胞(PBMNCs)的组成成分及其随年龄的变化,为大鼠PBMNCs相关研究提供参考。方法:使用淋巴细胞分离液、不连续密度梯度离心法制备3、6、12月龄雄性SD大鼠PBMNCs,检测PBMNCs中细胞种类和含量、淋巴细胞和单核细胞含量随年龄的变化趋势;流式细胞术、免疫荧光技术检测PBMNCs干/祖细胞含量及随年龄变化趋势。结果:使用淋巴细胞分离液,不连续梯度离心法制备PBMNCs,不同细胞成分分层清晰,红细胞、粒细胞去除较完全,PBMNCs中淋巴细胞、单核细胞含量随年龄的增长下降趋势明显;PBMNCs中Nanog、OCT4、SOX2、SSEA4四种干性标志物均有表达,Nanog阳性表达量最低,SSEA4表达量最高,可达23.1%;总体趋势均为6月龄大鼠PBMNCs中干/祖细胞含量最高。结论:SD大鼠PBMNCs中干/祖细胞含量较高,动物实验治疗疾病的作用可能较人体应用的疗效好。进行SD大鼠PBMNCs移植治疗疾病的实验研究,建议选用6月龄以下大鼠为宜。

放疗联合安多霖胶囊对老年鼻咽癌患者外周血单核细胞凋亡及炎症因子表达的影响

目的探究放疗联合安多霖胶囊对老年鼻咽癌患者外周血单核细胞凋亡及炎症因子表达的影响。方法选取2020年6月至2022年6月麻城市中医医院收治的116例老年鼻咽癌患者作为研究对象,按照随机数字表法分为对照组与实验组,每组58例。对照组仅采用放疗治疗,实验组在对照组基础上联合安多霖胶囊治疗,比较两组不良反应发生率、外周血单核细胞情况、疼痛程度[视觉模拟评分法(VAS)评分]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]和生存质量核心问卷(QLQ-C30)评分。结果实验组不良反应发生率为8.62%,低于对照组的32.76%,差异有统计学意义(P<0.05)。实验组细胞坏死率、细胞凋亡率、细胞早期凋亡率均低于对照组,细胞存活率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组VAS评分均低于治疗前,且实验组低于对照组,差异有差异意义(P<0.05)。治疗后,两组血清IL-6、TNF-α水平均高于治疗前,但实验组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SAS、SDS评分均低于治疗前,且实验组低于对照组,差异有统计学差异(P<0.05)。治疗后1、4、10周,两组QLQ-C30评分均高于前一时间点,且实验组高于对照组,差异有统计学差异(P<0.05)。结论放疗联合安多霖胶囊治疗老年鼻咽癌效果较好,不仅能降低不良反应发生率,有效控制外周血单核细胞凋亡率,还可缓解患者疼痛及不良心理状态,改善炎症因子水平,提高患者生存质量,值得临床推广应用。

脐血来源CIK细胞高表达激活型表面标志物及耐药基因ABCG2

目的:比较脐血来源的细胞因子诱导杀伤(cytokine-induced killer,CIK)细胞和肿瘤患者外周血来源CIK(peripheral blood-derived CIK,PB-CIK)细胞的增殖、激活型和抑制型表面标志物、耐药基因ABCG2以及干细胞转录因子表达的差异,探讨脐血来源CIK(umbilical cord blood-derived CIK,CB-CIK)细胞应用于肿瘤过继细胞免疫治疗的优越性。方法:采用Ficoll-plaque淋巴细胞分离液分离脐血及肿瘤患者外周血单个核细胞,加入细胞因子诱导培养CIK细胞。流式细胞术检测CIK细胞的增殖、免疫表型、激活型表面标志物CD28、CD27和抑制型表面标志物PD-1的表达,RT-PCR检测耐药基因ABCG2和干细胞转录因子c-Myc、Nanog、Oct-4、Sox2的表达。结果:CB-CIK细胞与PB-CIK细胞体外培养第4天时均开始增殖,第10天时CB-CIK细胞的增殖指数明显高于PB-CIK细胞[(251.52±16.76)%vs(158.00±43.19)%,P<0.05]。体外诱导培养13 d后CB-CIK细胞中CD3+CD56+细胞比例较PB-CIK细胞高[(21.20±4.82)%vs(10.06±3.46)%,P<0.05];激活型CD4+CD28+、CD4+CD27+和CD8+CD27+细胞比例在CB-CIK细胞中也明显升高[(32.40±16.81)%vs(18.65±9.23)%,(27.48±13.53)%vs(0.98±0.55)%,(41.76±13.98)%vs(2.58±2.10)%;P<0.05或P<0.01];而抑制型CD8+PD-1+细胞比例明显降低[(3.25±2.13)%vs(8.05±9.23)%,P<0.01]。此外,CB-CIK细胞与PB-CIK细胞均表达干细胞转录因子c-Myc、Nanog、Oct-4、Sox2,但两者之间无显著差异(P>0.05);而仅CB-CIK细胞表达高水平的耐药基因ABCG2。结论:CB-CIK细胞较PB-CIK细胞增殖速度快、激活型表面标志物表达水平高、抑制型表面标志物表达水平低、高表达耐药基因ABCG2,应用于肿瘤过继细胞免疫治疗有一定的优势。

降钙素原等炎症标志物检测在儿童手足口病中的意义

目的探讨降钙素原(PCT)、C反应蛋白(CRP)、白细胞(WBC)等炎症标志物检测在手足口病患儿临床诊断中的意义。方法分析138例手足口患儿(观察组)和50例健康儿童(对照组)的PCT、WBC计数、中性粒细胞计数(NC)、淋巴细胞(Ly)、CRP、免疫球蛋白等常见实验室指标,并进行比较。结果观察组患儿PCT、CRP、WBC、NC、Ly%、IgM等水平均高于对照组,差异有统计学意义(P<0.05);IgG、IgA水平均低于对照组,差异有统计学意义(P<0.05)。结论 PCT、WBC、NC、Ly、CRP等炎症标志物和免疫球蛋白的检测可为小儿手足口病的诊断提供依据。

Cytokeratin和CD133在肺腺癌患者外周血中的联合检测及临床病理分析

目的联合检测肺腺癌患者外周血中细胞角蛋白(cytokeratin,CK,肺腺癌循环肿瘤细胞阳性)和CD133基因(肺癌干细胞标志物)的表达,探讨二者在评估肺腺癌预后的临床价值。方法选取2014年6月至2016年6月昆明总医院心胸外科和宣威市第一人民医院心胸外科的178例未化疗的肺腺癌手术患者,中位年龄59岁,其中男性78例,女性100例。收集患者术前外周血标本10 m L,细胞块法和CK(免疫细胞化学法)用于检测CTC,PCR法用于检测CD133表达。免疫组化法检测肺腺癌组织中CK、Vimentin(Vim)、TTF-1、Ki-67、CD133的表达,并分析与外周血CK和CD133表达的关系。根据外周血CK和CD133的检测结果,将病例分为CK/CD133双阳性组和非双阳性组,统计学分析两组间临床病理因素的差异。结果 178例肺腺癌患者外周血CTC(CK阳性)的检出率为48.3%(86/178),与癌组织中Ki-67、Vim表达显著正相关(P<0.05);外周血的CD133阳性表达率为66.9%(119/178),与癌组织Vim、CD133表达显著正相关(P<0.05);外周血CK/CD133双阳组53例(29.8%),双阳组淋巴结转移率显著增高,肺腺癌组织学分化级别显著降低,临床分期显著提高,转移率显著增高(P<0.05)。结论肺腺癌患者外周血中CK与CD133双阳性表达提示外周血存在干性特征的循环肿瘤细胞,表明预后不良,联合检测CK与CD133可用于肺腺癌患者预后监测和指导治疗。

葡萄糖钾盐体外协同增强胰岛素抗炎作用

目的探讨葡萄糖钾盐体外协同增强胰岛素抗炎作用。方法密度梯度离心分离健康人外周血单个核细胞群(PBMCs),随机分为胰岛素葡萄糖钾盐组(GIK组),胰岛素组(INS组),葡萄糖钾盐组(GK)和基础对照组(C组),检测4组内毒素刺激后的PBMCs培养上清液葡萄糖、乳酸、TNF-α、IL-6和IL-4、IL-10含量。结果GIK组和INS组TNF-α、IL-6含量均明显低于C组(P<0.01),IL-4和IL-10含量却均明显高于C组(P<0.01);GIK组IL-4和IL-10含量明显高于INS组(P<0.01);GIK组上清液葡萄糖和乳酸均明显低于GK组(P<0.01)。结论胰岛素葡萄糖钾盐和胰岛素均能直接抑制PBMCs分泌促炎细胞因子,同时促进PBMCs分泌抗炎细胞因子。葡萄糖钾盐对胰岛素促进PBMCs分泌抗炎细胞因子有协同增强作用。葡萄糖钾盐和胰岛素联合抗炎效果优于单独胰岛素,可能与葡萄糖胰岛素钾盐为PBMCs提供能量有关。

外周血常见炎性反应指标与非小细胞肺癌预后相关性的研究进展

肺癌是一种发病率高、预后差的恶性肿瘤,其中非小细胞肺癌占多数。瘤体除发生解剖学变化之外,可在体内出现其他的进展指征,通过监测这些指征可及早了解病情。炎性反应与非小细胞肺癌的发生发展密切相关,以常见的外周血细胞及C反应蛋白为基础的炎性反应指标具有较好的预后价值。本文通过针对临床外周血常见炎性反应指标在非小细胞肺癌患者中的预后价值进行文献梳理,科学、全面、客观地了解其研究现状,为临床决策提供一定的证据支持。