针刺复合小剂量硬膜外麻醉对胆囊摘除术患者外周血T淋巴细胞免疫功能的影响

目的:研究胆囊摘除术患者围手术期外周血T淋巴细胞亚群的变化.采用针刺复合小剂量硬膜外麻醉进行胆囊切除术以探讨针刺镇痛对免疫功能的效应.方法:选择胆囊炎胆石症患者20例,针刺复合小剂量硬膜外麻醉组(简称Ⅰ组)和小剂量硬膜外麻醉组(简称Ⅱ组)各10例.针刺取左右内关、足三里穴,连接韩氏刺激仪,频率2/15 Hz,疏密波,刺激量以病人耐受为宜.硬膜外麻醉剂为1.5%利多卡因5 mL,并按4 mL/次酌情追加.两组均于手术前、手术中和手术后第五天采外周血2 mL,分离淋巴细胞,用免疫细胞化学染色法染色,检测淋巴细胞亚群,并测定健康成年人10例外周血T淋巴细胞亚群作对照组.结果:①麻醉前,Ⅰ、Ⅱ组患者T淋巴细胞亚群与对照组相比CD3+、CD4+、CD8+细胞数和CD4+/CD8+比值均无统计学差异.②术中Ⅰ、Ⅱ组相比,前者T细胞亚群高于后者,有显著差异(P＜0.05).③术后第五天,Ⅰ组T细胞亚群高于Ⅱ组,有显著差异(P＜0.05).④Ⅰ组组内比较:手术前与手术中、手术后第五天比较,CD3+、CD4+、CD8+细胞数及CD4+/CD8+比值无明显差异.⑤Ⅱ组组内比较:手术前与手术中、手术后第五天比较,各细胞数均有所降低但无统计学意义,唯独CD4+下降比较明显(P＜0.05).结论:小剂量硬膜外麻醉,可能由于手术创伤和麻醉使CD4+细胞数下降,免疫功能受抑制,提示易发术后感染.针刺复合小剂量硬膜外麻醉,在围手术期,T细胞亚群的细胞数与比值均无明显改变.说明针刺除有加强镇痛作用减少麻醉用量外,可能还能加强细胞免疫功能,对于术后有抵御微生物感染作用.

Objective: To observe the clinical effect of Shengxue Mixture (SXM) in treating aplastic anemia and study the possible mechanism. Methods: Eighty-four patients in the treated group with Spleen-Kidney Yang deficiency syndrome and Spleen-Kidney Yin deficiency syndrome were treated with SXM-Ⅰ and SXM-Ⅱ respectively, and 30 patients in the control group were treated with Stanozolol. The clinical effect and several experimental parameters were also observed. Results: The basic cure was gained in 18 cases, remission in 23, markedly improved in 32, ineffective 11, total effective rate and cure remission rate of the treated group were 86.90% and 48.81% respectively, which were obviously better than those of the control group (P<0.05) with no obvious side-effect. While the patient's symptoms were alleviated, the peripheral blood cells increased, the ratio of T lymphocyte subsets tended to balance, the level of natural killer cell activity increased, interleukin-2 reduced, and reproduction of the bone marrow were markedly improved in most of the patients treated by SXM. Conclusions: SXM is an effective and safe drug for aplastic anemia. Its mechanism might be likely due to its regulating the immune function, which facilitates the recovery of the bone marrow hematopoiesis function.

Objective: To explore the clinical efficacy of Chinese and western integrative medicine (TCM-WM) in treating repeatedly recurrent chronic pyelonephritis (CPN) and its therapeutic mechanism. Methods: Ninety-one repeatedly recurrent CPN patients were randomly divided into 2 groups, the control group (45 cases) treated with sufficient amount of sensitive antibiotics and other WM, the treated group (46 cases) treated with above-mentioned WM complemented with TCM syndrome differentiation (SD). Results: In the treated group completely cured was 14 cases (30.4%), markedly effective 14 cases (30.4%), the total effective rate was 91.3%; while that of the control group was 4 (8.9%), 5 (11.1%), and 48.9% respectively, (P<0.05) and (P<0.01); the mean days of urinary bacteria and urinary routine negative conversion were in the treated group 19.6±12.6 days and 24.3±11.5 days, obviously shorter than those of the control group (35.6±14.6 days and 53.6±16.4 days), P<0.01; the various symptoms of the treated group improved or disappeared in a short time, while in the control group a few patients improved in a longer period (P<0.01); the various immune parameters improved in the treated group, while in the control group only IgA was elevated to some extent (P<0.05), in comparing these data, the difference was significant (P<0.01). Conclusion: The TCM-WM integrative treatment could obviously raise the clinical efficacy, accelerate the symptom improvement, and enhance the immune function.

Objective:To find out the effective treatment for infantile autumn diarrhea(IAD).Methods:Retention enema with Qilian Liquid(QLL) was applied to 106 patients of IAD with positive antigen of rotavirus in stool,and the result in the treated group was compared with that in the control group(82 patients) in aspects of clinical effect, negative conversion rate of rotavirus in stool and change of serum immunoglobulin. Animal experimental study was also conducted.Results:The disappearance time of principal symptoms, negative conversion rate of rotavirus in stool and serum levels of IgA and IgG in the treated group were significantly better than those in the control group (P<0.01, P< 0.05). Experimental study showed that QLL not only has the anti-viral effects to stop diarrhea, but also has effects in enhancing immune function and protecting intestinal mucous membrane. Conclusion:Retention enema with QLL is an effective therapy for the treatment of IAD.

To observe the effects of Fuzheng Kangbai Granule (FZKBG) on immune function and survival time in minimal residual leukemia (MRL) model mice and explore its mechanism. Methods: MRL model mice were established by hypodermic inoculation with L7212 cells 1×106 following intraperitoneal injection of cytoxan (CTX) 250 mg/kg 3 days later, and divided into the control group and FZKBG treated group. The changes of T-lymphocyte subsets, including CD3+, CD4+ and CD8+, and the survival time in model mice were observed. Results: Compared with the control, FZKBG could obviously increase both the percentage and absolute value of CD3+ and CD4+ lymphocytes and prolong the survival time of model mice, the prolongation rate being 29.6% - 60.4%. Conclusion: FZKBG could markedly prolong the survival time of MRL mice, and its mechanism might be through elevating the immunologic function and inhibiting the leukemia cells in model mice.

康莱特注射液结合中医辨证对晚期肺癌生存质量及免疫功能的影响

康莱特注射液是浙江康莱特药业有限公司生产的抗肿瘤中药制剂,临床主要用于肺癌及消化道肿瘤的治疗.我科近年来应用康莱特注射液治疗晚期肺癌取得了一定的疗效,现将观察结果报告如下.

Purpose: To observe the effects of electroacupuncture therapy on T cells and activity of NK cell in the patient of Chemotherapy. Method: Electro-acupuncture therapy was simultaneously applied during chemotherapy, T cells and activity of NK cell of patients were determined before electroacupuncture treatment (before chemotherapy) and after 4-course electro-acupuncture treatments. Results: Before chemotherapy, CD3 was low within the normal range, CD4 was much lower than the normal range, and CD8, CD4/CD8 and activity of NK cell were within the normal range. After one month of chemotherapy combined with electro-acupuncture, no decline of all the indices was found (P>0.05). Conclusion: Electro-acupuncture can really increase the immune function of patients of chemotherapy.The suppression of both immunity and hematopoiesis caused by chemotherapy is mainly characterized by declines of T cells subpopulations (CD3, CD4, CD8), activity of NK cell, WBC count and humoral immunity. Since 1996, the authors have applied electro-acupuncture therapy for 28 cases of malignant tumor in the process of chemotherapy with good results as reported in the following.

睡眠剥夺对大鼠免疫功能的影响

已有实验证明,睡眠剥夺或缺失可降低机体的防御能力.Brown[1]曾发现睡眠剥夺能使小鼠对流感病毒的抵抗力减弱,IL-1或胞壁肽可对抗这一改变.相继的研究显示白细胞介素与肿瘤坏死因子等细胞因子可不同程度地促进睡眠[2].睡眠是否与免疫有关,本文拟通过对睡眠剥夺大鼠T细胞和B细胞增殖反应的变化,来探讨睡眠对免疫功能的影响.

多次储存式自体血回输对肝癌患者围手术期免疫功能的影响

肝癌是常见的消化系统肿瘤，能否实施根治性切除手术很大程度上决定了其预后结果。据统计，接受根治性切除的肝癌患者5年生存率可达到70％以上［1］。然而，肝脏本身血供丰富、解剖复杂，肿瘤生长的部位各异，且常常侵犯肝内大血管，要实施规范标准的肝脏切除手术经常会遇到术中大量失血的问题。目前，常用的输血方式包括异体输血及自体血回输，但均各有弊端。异体血回输常常存在血源紧张的问题，且容易产生免疫抑制。自体血回输包括储存式自体血回输，稀释式自体血回输，以及回收式自体血回输三种，然而术中回收式自体血回输可能造成脱落的肿瘤细胞回输入血液循环，是肿瘤患者的禁忌。储存式自体血回输，通过术前储血、术中输血的方式，理论上可以降低术中丢失血液的红细胞浓度，控制实际失血量，能避免大量的异体血输入，减少相应的并发症。本文旨在研究该输血方式在临床中实际应用的可行性及对患者术后免疫功能的影响。

急性重症胰腺炎经鼻空肠置管早期肠内营养的疗效观察

目的探讨及评价区域性动脉灌注(RAI)治疗急性重症胰腺炎(SAP)过程中,经鼻空肠置管早期肠内营养的方法及疗效.方法SAP行RAI治疗中,对经鼻空肠置管早期肠内营养和完全胃肠外营养(TPN)两组共62例患者进行疗效观察,对其营养状况、脏器功能、并发症发生率等作对比分析.结果经鼻空肠置管早期肠内营养,与TPN使患者营养状况改善情况相同,但患者消化道、肝脏功能恢复快,并发症发生率低.结论只要方法正确,经鼻空肠置管早期肠内营养无创伤、痛苦小、安全有效,对于改善机体免疫力、营养状况,降低并发症发生率作用显著.

外源质粒DNA经胃肠道途径对小鼠免疫功能的影响

目的:研究外源质粒DNA经胃肠道吸收后对小鼠免疫功能的影响.方法:观察外源质粒pcDNA3对小鼠胸腺、脾脏指数,脾脏淋巴细胞转化率,脾脏抗体细胞生成含量,血清溶血素水平,巨噬细胞吞噬指数及吞噬率的影响,并考察了外源质粒pcDNA3对免疫低下小鼠血清IgA、IgG及IgM的影响.结果:外源质粒pcDNA3经胃肠道摄入后能够提高胸腺指数(3.53±0.80 vs 5.10±0.47 mg/g,P＜0.05)、脾脏指数(5.69±0.92vs7.49±1.18mg/g,P＜0.05)、脾脏淋巴细胞转化率(1.047±0.012 vs 1.154±0.016,P＜0.05)、脾脏抗体细胞生成含量(0.403±0.008 vs 0.471±0.007,P＜0.05)、血清溶血素水平(6.46±0.12 vs 8.18±0.29,P＜0.05)、巨噬细胞吞噬指数(0.53±0.017 vs 0.72±0.029,P＜0.01)及吞噬率(32.30±1.098 vs 60.53±2.022,P＜0.01),并且能够恢复免疫低下小鼠血清IgA、IgG及IgM的水平.结论:外源质粒DNA经胃肠道途径摄入后能够诱导小鼠广泛的体液免疫和细胞免疫应答.

IMMUNITY IN ATHLETES:CURRENT ISSUES

KEY POINTS1.The immune systems of athletes and nonathletes when measured in the resting state are more similar than disparate.Even when significant reductions in resting immune function have been observed in athletes,investigators have had little success in linking these to a higher incidence of infection and illness.

高迁移率族蛋白B1在创伤免疫功能紊乱中的作用及其调节机制

Objective To investigate the potential effect of high mobility group box 1 protein (HMGB1) on host immune response and its molecular regulation mechanism as well as its interventional pathway following major burns/trauma. Methods With both animal experiments and clinical investigation, serial studies were conducted to observe the effects of HMGB1 on changes in immune function of T lymphoeytes, dendritic cells, and macrophages both in vivo and in vitro. Results It was found that thermal injury or trauma induced a delayed and persistent increase in HMGB1 expression as well as its release in various tissues.HMGB1 formation could markedly influence the cell-mediated immunity, including the changes in T lymphocytes, dendritic cells, and macrophages following major trauma or burns. These effects were closely related with dysfunction of various organs in the course of sepsis. Conclusion These data proved that HMGB1 not only acts as a novel "late" inflammatory mediator but is also closely associated with immunosuppression after acute insults. HMGB1 might play an important role in inducing systemic inflammatory response together with host immunological dissonance, resulting in the development of septic complications. Intervention of HMGB1 expression and release presumably provides a potentially effective way to regulate both excessive inflammatory and immune response, thereby as a measure to improve the prognosis of severe sepsis secondary to major trauma.

微波治疗慢性咽痛的效果观察

Background: Microwave is a kind of magnetic wave with high frequency. It produces pyretic effect when it acts on biological tissue, which will be propitious to the absorption of inflammation and edema of pharyngeal tissue, enhance the tissue blood circulation as well as the metabolism and immune function.

目的:本研究观察低剂量全身照射对荷瘤小鼠免疫功能的影响.方法:C57BL/6J小鼠右后肢肌肉内接种Lewis肺癌细胞,10 d后给予75 mGy X射线全身照射,在照射后18 h处死小鼠并采用3H-TdR掺入法或释放法测定荷瘤小鼠的胸腺细胞自发增殖力、脾细胞对ConA和LPS的反应性、脾脏内特异性细胞毒性淋巴细胞(CTL)和自然杀伤细胞(NK)以及淋巴因子激活的杀伤细胞(LAK)的细胞毒效应.结果:75 mGy X射线全身照射后荷瘤小鼠的上述免疫学参数明显高于假照射荷瘤小鼠(P<0.01).结论:低剂量辐射可显著提高荷瘤小鼠的免疫功能,可能在癌症防治中具有实际应用意义.

茶多糖对实验性免疫力低下小鼠免疫功能的影响

茶是世界三大饮料之一,茶叶中含有多种保健和药理活性成分,如茶多酚、茶色素、生物碱和挥发油等[1],还含有茶多糖(Tea-polysaccharide,TPS).TPS系茶叶中重要的生理活性成分,它主要包括L-岩藻糖、D-甘露醇、D-葡萄糖、D-半乳糖、阿拉伯糖和葡萄糖醛酸等[2、3].

铅暴露对机体免疫功能的影响

近几年来,人们进一步认识到铅不仅具有神经毒性,而且还具有免疫毒性。许多动物实验及临床报告均已证实,铅暴露能削弱机体的抵抗力,使机体对细菌、病毒感染的易感性增加。同时临床上也发现,铅暴露可使自身免疫功能紊乱而导致某些自身免疫性疾病。近研究表明,0.483μmol/L的血铅浓度虽然不足以引起临床症状,但已能损害免疫系统[1]。本文就近几年来关于铅暴露对机体免疫功能的影响作一综述。铅暴露对T淋巴细胞的影响 T淋巴细胞(TL)依其膜表面CD分子的差异而分为CD+4的Th细胞和CD8+的Ts及Tc细胞(CTL)。Undeger[2]等检测了25名蓄电池厂工人的静脉血T淋巴细胞,发现CD4+T细胞显著下降,CD8+T细胞无明显改变。Fischbein[3]等检测了51名射击指导的血铅和免疫功能,也证实了长期铅暴露使CD4+T细胞绝对数和相对数都明显减少,CD4+与CD8+T细胞比例显著下降。长期铅暴露对CD4+T细胞的抑制,可能与铅对免疫器官的抑制有关。Kishikawa[4]等报道,将BALB/C小鼠通过饮水暴露于2nM的醋酸铅溶液中,3周后,肌注李斯忒菌作为抗原诱导,发现小鼠胸腺发生了严重萎缩,胸腺中的CD4-、CD8-、CD4+和CD8+细胞下降,同时,小鼠脾脏重量及脾脏中T淋巴细胞数也显著下降。

脾功能亢进的实验研究及其临床应用

保留牌脏及其免疫功能治疗脾亢,近年来国内外学者从不同角度进行了研究.迄今尚未取得突破性进展.本文结扎家犬脾静脉制做动物睥亢模型后,选择40%尿素进行治疗.并经脾动脉插管连续注入40%尿素临床治疗小儿脾亢9例,年龄1.5～11岁,术后有8例随访6～30个月,患儿血象及免疫指标稳定,临床症状消失,无复发,生长发育正常.

Objective:The aim of this study was to evaluate the ef ect of Jinlong capsule on the immune function for inter-vened patients with primary liver cancer. Methods:Matched the inclusion criteria, 60 patients were selected and randomly divided into two groups. The treatment group had 30 cases treated with Jinlong capsule combined with the transcatheter arterial chemoembolization (TACE);the control group had 30 cases treated with TACE. Each group was treated 30 days as a cycle, which had completed at least two cycles. Indicators of cellular immune function about the activity of CD3, CD4, CD8, CD4/CD8 and natural kil er (NK) cellwere detected before and after treatment, then to compare and analysis with each other. Results:Before treatment, the activity of peripheral blood CD3, CD4, CD8, CD4/CD8 and NK cellin the two groups was no significant dif erence (P>0.05);after treatment, the activity of CD3, CD4 and NK cellin the treatment group was significantly increased, the ratio of CD4/CD8 increased, and the value of CD8 decreased (P<0.05), the activity of CD3, CD4 and NK cellin the control group was significantly decreased, the ratio of CD4/CD8 decreased (P<0.05), and the value of CD8 slightly higher than before treatment (P>0.05), the dif erence between the two groups indicated the statistical significance (P<0.05). Incidence of gastrointestinal reactions, leucopenia, hemoglobin, platelet decline in the treatment group was lower than those in the control group, but without presenting the statistical significance (P>0.05). Conclusion:Jinlong capsule with hepatic arterial infusion chemotherapy can improve the patients’ immune function, and reduce the adverse reactions of interventional chemotherapy. Hence,it deserves to be promoted in clinical y.

阿片类物质对机体免疫系统的影响

The abuse and dependence of opioids can seriously damage the users' health physically and psychologically. The authors reviewed the inhibitory effects of opioid on the immune system and related mechanisms involving cellular, humoral, and unspecific immune processes, which would cast light on the treatment of opioid-induced immunodeficiency and infectious diseases in clinical practice.