支气管哮喘是由多种细胞和和细胞因子参与的气道慢性炎症性疾病,白细胞介素、干扰素、集落刺激因子、肿瘤坏死因子、趋化因子等细胞因子在哮喘发生发展过程中发挥着重要作用。

目的 对比紫杉醇脂质体(LEP)与紫杉醇(PTX)联合顺铂(DDP)治疗晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法 晚期NSCLC患者48例,随机分为对照组和试验组,对照组采用紫杉醇175 mg/m²,试验组采用紫杉醇脂质体175 mg/m²,均联合顺铂75 mg/m²化疗,21天为1个周期,治疗2个周期后评价疗效,记录近期疗效与治疗期间不良反应。结果 近期疗效:对照组有效率37.50%,疾病控制率为79.17%,试验组有效率为41.67%,疾病控制率为83.33%,两组差异均无统计学意义(P>0.05)。不良反应:白细胞减少、贫血及血小板减少的发生率两组差异无统计学意义(P>0.05),脱发和恶心、呕吐的发生率两组差异亦无统计学意义(P>0.05),但试验组皮疹、呼吸困难、肌肉痛及周围神经炎的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 紫杉醇脂质体治疗晚期NSCLC与紫杉醇疗效相当,但周围神经炎及过敏反应较紫杉醇为轻。

Objective To compare the efficacy and safety of paclitaxel liposome combined with cisplatin and paclitaxel combined with cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods 48 patients with advanced NSCLC were randomized into two groups, experimental group were given paclitaxel liposome at 175 mg/m²,and control group were given paclitaxel at 175 mg/m². Both groups combined with DDP at 75 mg/m² per cycle every 21 days.The efficacy and safety were evaluated after two cycles. Results The overall response rate was 37.50% in experimental group and 41.67% in control group, and the disease control rate was 79.17% in experimental group and 83.33% in control group. There was no significant difference between two groups(P>0.05). Though there was no significant difference in incidence of neutropenia,anemia, thrombocytopenia and alopecia, nausea and vomiting, but the occurred rates of rash、muscle pain and peripheral neuritis were significantly lower in experimental group than those in control group. Conclusion In the treatment of advanced NSCLC, both paclitaxel liposome combined with cisplatin and paclitaxel combined with cisplatin have similar efficacy, but paclitaxel liposome can significantly reduce the incidence of peripheral neuritis and serious hypersensitive reactions.

目的 探讨糖尿病胃轻瘫大鼠不同血糖水平对Cajal间质细胞(ICC)的影响及其机制。方法 选择雌性Wista大鼠60只进行随机分组,实验组40只,对照组20只。实验组糖尿病Wista大鼠模型以单次腹腔注射链脲佐菌素法诱导。免疫组织化学荧光染色检测不同血糖浓度大鼠胃ICC数量及网络结构。结果 实验组大鼠血糖浓度高于对照组,ICC数量,低于对照组,且比较差异有统计学意义(P<0.05)。实验组大鼠中血糖浓度越高,ICC数量越低,说明血糖浓度升高可能与平滑肌及神经末梢之间缝隙连接的减少及其ICC网络的超微结构损伤及异常有关。结论 DM小鼠胃组织中血糖水平的升高,可能是DM胃中ICC数量减少的原因;外源性降低血糖能改善DM相关的胃肠道ICC病变。

Objective To observe the effects of glucose fluctuations on Cajal interstitial cells (ICC) of rats with diabetic gastroparesis(DGP) and its mechanistic. Methods 60 Wistar rats were selected and randomly divided into two groups. 20 rats in experimental group and 40 rats in control group. Used immunofluorescence staining to detect the amount of gastric ICC and network structure in DGP rats with different glucose levels. Results The blood glucose concentration in the experimental group was significantly higher than that in the control group, the amount of ICC in the experimental group was significantly lower than that in the control group(P<0.05). The amount of ICC decreased with the increase of glucose levels. In the experimental group, The gap junctions between smooth muscle and nerve endings, ultrastructural damage and abnormalities of the ICC network were probably related to glucose level. Conclusion The increase of glucose level was probably the cause of the decrease of the amount in ICC. Exogenousy decrease glucose levels probably can help to improve the lesion of ICC with DGP.

目的 探讨儿童肾病综合征(NS)的红细胞分布宽度(RDW)与肾功能损害的关系。方法 收集168例NS患者作为观察组,根据eGFR分期分为三组,按照起病时长4月为界限分为两组;选健康儿童100例为对照组。检测各组血常规、肝肾功能等,采用SPSS 21.0软件进行统计分析。结果 ①与对照组相比,NS患儿的RBC[(4.86±0.69)vs(4.32±0.48)],RDW[(13.39±1.69)vs(12.99±1.04)]升高,差异有统计学意义(P<0.05);②RDW在肾功能3期(14.60±1.36)较2期(12.84±0.79)升高,在起病时长≤4月患儿(13.66±1.78)较健康儿童(12.99±1.04)上升,差异有统计学意义(P<0.05);红细胞平均容积(MCV)在起病时长≤4月较对照组下降,起病时间>4月组较起病时长≤4月上升,差异有统计学意义(P<0.05)。结论 儿童NS患者的RBC、RDW较健康儿童升高,RDW在肾功能3期较2期升高。

Objective To investigate the relationship between red cell distribution width(RDW) and renal function damage in children with nephrotic syndrome(NS). Methods 168 NS patients were chosen as the observation group, divided into three groups by eGFR level, while also divided into two groups by onset duration of 4 months. 100 healthy children were included as the control group. The blood routine, biomedical function of liver and kidney were detected. Data were analyzed by SPSS 21.0. Results ① Compared to control group, NS patients have higher levels of RBC[(4.86±0.69) vs (4.32±0.48)] and RDW[(13.39±1.69) vs (12.99±1.04)], P<0.05; ② RDW is higher in the third phase of renal function than the second [(14.60±1.36) vs(12.84±0.79)], and also higher in the onset duration of less than 4 months group than the control group [(13.66±1.78) vs (12.99±1.04)], P<0.05; Mean corpuscular volume is lower in the onset duration group of less than 4 months than the control group, and higher in the onset duration group more than 4 months than the onset duration group of less than 4 months, P<0.05. Conclusion The RBC, RDW are higher in children NS patients than in the healthy children; RDW is higher in the third renal function than the second renal function.

目的 探讨白癜风初诊患者外周血细胞因子水平与临床分型、皮损面积的相关性。方法 收集我院2009年7月—2013年7月4年间收治的初诊白癜风患者78例及健康志愿者37例,用ELISA检测外周血血清IL-6、IL-2, IFN-γ、TNF-α浓度并判断其与白癜风分型、皮损程度的相关性。结果 与对照组相比,白癜风各分型组的IL-6、IL-2水平均升高,其中,散在性的升高幅度最为明显。IL-6及IL-2与皮损面积呈正相关,其相关系数分别为0.664及0.483,P值分别为0.021及0.014。结论 IL-2及IL-6在白癜风的发病过程中起重要作用,且在不同的分型中的表达存在差异,并与皮损面积呈正相关。

Objective To evaluate the correlation of cytokine level of peripheral blood cells, clinical classification and skin lesion in preliminary diagnosis of vitiligo. Methods A total of 78 patients with vitiligo of preliminary diagnosis and 37 health volunteers were collected from July 2009 to July 2013. The peripheral blood were collected for ELISA measurement of IL-6, IL-2, IFN-γand TNF-α, and evaluated whether the cytokines concentration was correlated to clinical classification and skin lesion. Results Compared to control group, IL-6 and IL-2 in all of classification of vitiligo was higher, and the most increase was observed in scattered group. Both IL-6 and IL-2 showed the positive correlation with skin lesion (CI: 0.664 and 0.483, P=0.021 and 0.014). Conclusion IL-2 and IL-6 maybe play a key role in vitiligo etiology, and showed different level in different classification of vitiligo. Besides, they showed a positive correlation with skin lesion.

目的 探讨单倍体亲缘异基因造血干细胞移植治疗重型再生障碍性贫血(SAA)的可行性。方法 对1例诊断SAA 4年余,先后经CsA治疗、脐血移植治疗均无效并反复输注红细胞、血小板的12岁男性患者进行单倍体亲缘异基因造血干细胞移植,供者为其胞兄,高分辨HLA基因型5/10相合,预处理方案为BU+CTX+ATG:BU 3.2 mg/kg×2 d,CTX 50 mg/kg×4 d,ATG 2.5 mg/kg×4 d。干细胞来源为G-CSF动员的骨髓+外周造血干细胞,共计输注单个核细胞(MNC)4.055×10⁸/kg(受者体重),CD 34 2.331×10⁶/kg。GVHD预防:-1 d采用与受者HLA部分相合的第三方脐带血细胞,术后联合应用环孢素A、短程氨甲碟呤、霉酚酸酯。结果 造血缓慢重建,术后22天(+22 d)ANC>0.5×10⁹/L,术后3月血小板脱离输注。+26天DNA指纹图全部表现为供者基因型。+40天血型转为供者型“O”型。+29 d出现急性移植物抗宿主病aGVHD(胃肠型,Ⅲ度),+31 d、+34 d及+42 d予巴利昔单抗20 mg静滴,+40 d、+44 d、+63 d输注间充质干细胞,患者急性GVHD逐渐控制。期间曾出现肺部感染、口腔黏膜炎及巨细胞病毒血症,经抗感染后可控制。现随访3年,血象正常稳定,Kamofsky评分100分。结论 单倍体亲缘异基因造血干细胞移植治疗SAA,对无相合供者(包括亲缘或非亲缘)且强效免疫抑制治疗失败的患者,可考虑进行,GVHD和感染为主要并发症,需根据患者病情采用相应措施。

Objective To investigate the feasibility of haploid genetic allogeneic hematopoietic stem cell transplantation in the treatment of severe aplastic anemia(SAA) in our hospital. Methods A 12-year-old patient with acquired SAA for 4 years showed no response to CsA and cord blood transplant treatment and was transfusion-dependent. Lacking an HLA-identical sibling donor, the patient was treated with HSCT from his brother 5/10 matched at the generic level. Theconditioning regimen was BU+CTX+ATG:BU 3.2 mg/kg×2 d,CTX 50 mg/kg×4 d,ATG 2.5 mg/kg×4 d. Stem cells were the source of G-CSF mobilization of bone marrow and peripheral blood stem cells, dose of stem cells infused: mononuclear cells (MNC) 4.055×10⁸/kg (body weight of subject), CD34 2.331×10⁶/kg. Prevention of GVHD: -1 d Third-party umbilical cord blood cells which were HLA partially matched were used. Postoperative joint use included cyclosporine A, short-course methotrexate, mycophenolate mofetil. Results Hematopoiesis was slowly rebuilding, 22 d after surgery (+22 d) ANC> 0.5×10⁹/L, after three months departing from transfusion of platelets. +26 d suggesting that the DNA fingerprints showed donor genotypes. +40 d into donor blood type “O” type. + 29 d occurred acute GVHD (GI type, Ⅲ degrees), + 31 d, + 34 d + 42 d infusion of basiliximab 20mg, + 40 d, + 44 d, + 63 d infusion of mesenchymal stem cells. Gradually acute GVHD was controlled in the patient, who had lung infections, oral mucositis and cytomegalovirus viremia, could be controlled with anti-infective. Now followed up for 3 years, hemogram change has been normal and stable. Kamofsky score was 100 points. Conclusion It may be considered to have haploid genetic allogeneic hematopoietic stem cell transplantation for treatment of SAA, for those patients who have non-matched donor (including relatives and non-relatives) and potent immunosuppressive therapy failure. GVHD and infection are major complications. Need to adopt appropriate measures in accordance with the patient's condition.

目的 探讨同步放化疗治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法 选取我院2014年收治的晚期NSCLC患者102例,随机分为观察组和对照组,对照组以紫杉醇联合顺铂化疗方案(TP)化疗治疗,观察组加用三维适形放疗同步放化疗治疗,观察两组的临床疗效和不良反应。结果 观察组和对照组患者的总有效率分别为43.14%和21.57% (P<0.05),两组患者的总控制率分别为84.31%和66.67% (P<0.05)。两组患者Ⅲ～Ⅳ级胃肠道反应、白细胞减少、骨髓抑制的发生率差异无统计学意义(P>0.05),观察组比对照组增加了放射性肺炎和放射性食管炎的发生 (P<0.05)。两组患者生活质量比较,差异具有统计学意义(P＜0.05)。结论 同步放化疗治疗晚期NSCLC可以显著提高治疗的总有效率、肿瘤的控制率及生活质量,但也使不良反应增加,选择治疗方案时应根据个体情况综合考虑。

Objective To study the clinical efficacy of concurrent chemoradiotherapy in the treatment of advanced non small cell lung cancer (NSCLC). Methods 102 cases of advanced NSCLC treated in our hospital in 2014 were selected and randomly divided into the observation group and the control group. Patients in control group were treated by chemotherapy with Paclitaxel combined Cisplatin (TP), while those in observation group were treated by concurrent chemoradiotherapy with three- dimensional conformal radiotherapy and TP. The clinical efficacy and adverse reactions of the two groups were observed. Results The total effective rate of the observation group and the control group were 43.14% and 21.57% (P<0.05), respectively. The total control rate of the two groups were 84.31% and 66.67%(P<0.05). In two groups III ~ IV gastrointestinal tract reaction, leukopenia, bone marrow suppression occurrence had no statistical significance(P>0.05). Incidence of radiation pneumonitis and radiation esophagitis increased in observation group(P<0.05). The difference of quality of life between the two groups was statistically significant(P<0.05). Conclusion Concurrent radiotherapy and chemotherapy in the treatment ofadvanced non-small cell lung cancer(NSCLC)can not only significantly improve the treatment, tumor control rate and quality of life, but also make adverse reaction increased. Treatment options should be chosen based on individual circumstances into account

目的 探讨自噬激活剂和自噬抑制剂分别对鼻咽癌细胞CNE2放疗敏感性的影响。方法 利用RNA干扰技术使atg5基因沉默,构建自噬抑制细胞模型后,与雷帕霉素、氯喹分别处理的两组细胞一起,每天以X射线5Gy照射细胞,连续8天观察各组细胞的生长状况,并设置对照组。以MTT法及克隆集落形成法检测其细胞活力,用流式细胞仪分析其细胞周期。结果 与对照组相比,其他三组细胞存活率、克隆形成率、照射后存活率均显著降低(P<0.05);细胞周期检测除对照组外其他三组细胞集中在G0/G1期,其他两个时期比G0/G1期相对较少。结论 自噬抑制剂与激活剂和atg5沉默均能为CNE2放疗增敏,然而自噬激活剂的增敏效果好于其他,为增敏放疗提供实验依据,开辟新的放疗增敏途径。

Objective This study aimed to investigate the autophagy activators and inhibitors effects in nasopharyngeal CNE2 cells radiotherapy sensitization. Methods Atg5 gene silencing by RNA interference technology, two groups of cell autophagy inhibition were built by rapamycin and chloroquine respectively. Then 5Gy x-ray irradiation of cells was taken every day, after 8 days in a row in each group of cell growth and setting a control group. The cell viability was clonaled colony formation by MTT method assay and cell cycle by flow cytometry analysis. Results The three cell group survival rate, colony-forming rate and survival after irradiation were significantly lower (P<0.05) than the control group. Detection of cell cycle in addition to control three other groups concentrated in the G0/G1 period.That of two other periods was relatively fewer than that of the G0/G1 period. Conclusion Autophagy inhibitors, activators and atg5 silence improved the radio-sensitization to CNE2. The autophagy activator group improving the sensitivity was better than the others.This study provided evidence to sensitive radiotherapy, explored a new promising radiosensitization ways.

目的 探讨初诊的弥漫大B细胞淋巴瘤(DLBCL)患者外周血Th17细胞的表达与国际预后指标(IPI)之间关系。方法 初诊DLBCL组(n=45)按照国际预后指数(IPI)积分分为4组,采用ELISA和流式细胞术检测各个DLBCL组与正常对照组(n=43)的外周血中IL-17的浓度以及Th17阳性细胞比例,比较各组数值间的差异,并分析IPI的5个指标与IL-17的浓度以及Th17阳性细胞比例的相关性。结果 DLBCL中高危组与高危组的IL-17的浓度以及Th17阳性细胞比例较正常对照组及其他IPI组降低,有显著性差异;DLBCL四组的IL-17的浓度以及Th17阳性细胞比例均低于正常对照组;且可见随着IPI分组的增高,IL-17的浓度以及Th17阳性细胞比例呈降低的趋势;IPI指标中年龄、临床分期、全身状态与Th17细胞的表达有相关性。结论 初诊DLBCL患者外周血Th17细胞的表达与国际预后指标有关系;随着IPI积分的增加,DLBCL患者Th17细胞表达下降;临床上对于年龄60岁以上、临床分期Ⅲ期以上、长期卧床及需别人照顾的患者更要注意监测其外周血Th17细胞的表达情况。

Objective To explore the relationship between the international prognosis indexes(IPI) and the Th17 cells expression in DLBCL patients. Methods DLBCL patients (n=45) were divided into 4 groups according to IPI score, peripheral blood were taken from each person in DLBCL groups and normal group. We used ELISA to test IL-17 and flow cytometry (FCM) to examine the Th17 positive cells. We compared the value of each group, and analyzed the relativity of IPI and Th17 cells' expression. Results Th17 cells' expression level in middle-high risk group and high risk group were higher than that in normal group and other IPI groups; Th17 cells' expression level in DLBCL groups were all lower than that in normal group; Th17 cells decreased while IPI score increased; Age, clinical stage and general body state have the relativity with DLBCL patients' Th17 cells expression level. Conclusion Th17 cells in DLBCL patients has the relativity with prognosis index. In our clinical diagnosis and treatment, we need to pay more attention to those patients who are over 60 years old, or whose clinical stage is above Ⅲ phase, or who need to stay on bed for a long time and need other peoples' help .

目的 构建重组pEGFP-C3-HCVc真核表达载体,并建立稳定表达HCVc基因的肝内胆管癌细胞株RBE-core。方法 采用PCR钓取目的基因HCVc,并克隆入pEGFP-C3的多克隆位点,构建pEGFP-C3-HCVc重组质粒。经过双酶切及测序验证后,采用脂质体将pEGFP-C3-HCVc质粒转染到RBE细胞中,经2周G418 (200 μg/mL) 筛选后进行单克隆挑选及扩大培养,建立稳定表达HCVc的胆管癌细胞株RBE-core。采用RT-PCR和Western blot验证HCVc在RBE-core中的表达情况。结果 PCR成功钓取HCVc基因,大小约573 bp,并插入pEGFP-C3载体HindⅢ和BamHⅠ多克隆位点;双酶切及测序证实目的基因HCVc正确连接到pEGFP-C3的多克隆位点。RT-PCR和Western blot分别在573 bp处和34 KD左右检测到相应的阳性条带。结论 成功构建重组质粒pEGFP-C3-HCVc,并在胆管癌细胞RBE中获得稳定表达。

Objective To construct a recombinant plasmid of pEGFP-C3-HCVc containing hepatitis C virus core protein, and establish the HCVc-expressing cell line RBE-core. Methods The HCVc gene was amplified by PCR and cloned into HindⅢ and BamHⅠsite of pEGFP-C3 plasmid. The recombinant plasmid of pEGFP-C3-HCVc was confirmed by sequencing. RBE cells were transfected with the recombinant plasmid by using Lipofectamine 2000, and then performed G418 (200 μg/mL) selection after 2 weeks. The expressing of HCVc gene in RBE cells was confirmed by RT-RCR and western blot. Results The recombinant plasmid of pEGFP-C3-HCVc was successfully constructed. RT-PCR and western blot detected a 573bp and 34KD bland, indicating the stably expressing of HCVc in RBE cells. Conclusion The recombinant plasmid of pEGFP-C3-HCVc is stabled expressing in RBE cells,which provides support for the further study.