PCR法检测乙型肝炎患者外周血单个核细胞中HBV DNA

采用ＰＣＲ法检测了７７例乙肝患者外周血单个核细胞（ＰＢＭＣ）中ＨＢＶＤＮＡ，２７例阳性，总阳性率为３５．１％。慢性活动性肝炎（９／２１，４２．９％），肝炎后肝硬化（９／１９，４７．４％）及重型肝炎（８／１６，５０．０％）患者ＰＢＭＣＨＢＶＤＮＡ阳性率明显高于慢迁肝（１／１４，７．１％）和急肝（０／７）患者。结果提示ＰＢＭＣ中ＨＢＶＤＮＡ的存在在乙肝发病机理中具有一定意义。     

血清cccDNA在阿德福韦酯治疗慢性乙型肝炎中的预测作用

目的探讨血清共价闭合环状DNA(cccDNA)在阿德福韦酯(ADV)治疗慢性乙型肝炎(CHB)中的临床价值。方法选取81例确诊为CHB的病例,检测其血清cccDNA;根据血清cccDNA的检测结果,将81例患者分为cccD-NA阳性组和cccDNA阴性组,给予阿德福韦酯治疗,并随访到96周,随访时对两组病毒学指标(HBV DNA、HBeAg、HBe-Ab)及丙氨酸转氨酶(ALT)进行比较。结果两组在年龄及性别上的比较差异无统计学意义(P>0.05)。cccDNA阳性组血清的cccDNA与HBV DNA、HBeA及ALT呈正相关性。随访24、48周时两组HBV DNA阴转率、HBeAg血清学转换率及ALT复常率比较均无统计学意义(P>0.05);72周时HBV DNA阴转率和HBeAg血清学转换率比较有统计学意义(P<0.05),ALT复常率无统计学意义(P>0.05);96周时HBV DNA阴转率、HBeAg转阴率、HBe-Ab阳转率及ALT复常率比较差异有统计学意义(P<0.05)。随着治疗时间的延长,cccDNA阴性组在病毒、血清及生化学应答上明显高于cccDNA阳性组。结论阿德福韦酯能够有效抑制病毒复制,血清cccDNA对阿德福韦酯的远期疗效有一定的预测意义。     

乙型肝炎病毒对T细胞亚群的侵犯及对其功能的影响

以单克隆抗体补作溶解法分离T4、T8细胞亚群，PCR检测65例各型乙肝患者T细胞亚群和PBMCs中的HBVDNA，结合细胞免疫功能改变探讨HBV侵犯免疫细胞对其功能的影响。结果表明：PBMCs中HBVDNA阳性24例（24／65，36．92％），不同类型乙肝患者阳性率差异较大；T4、T8、细胞亚群中HBVDNA阳性分别为16例和21例，HBVDNA阳性组IL2R表达明显降低，抑制细胞功能有不同程度的下降；提示HBV对T8细胞可能更具亲嗜性，HBV对免疫细胞的侵犯是乙肝患者细胞免疫功能紊乱的原因之一。     

RSV下呼吸道感染患儿辅助性T细胞亚群Th1/Th2及相关因子的研究

目的　探讨辅助性T淋巴细胞Th1 /Th2亚群及其相关细胞因子IFN γ、IL 4在呼吸道合胞病毒 (RSV)下呼吸道感染患儿发病机制中的作用。方法　用单克隆抗体双色免疫荧光FITC/PE双标记 ,流式细胞仪检测 3 0例RSV下呼吸道感染患儿急性期外周血单个核细胞(PBMCs)辅助性T淋巴细胞CD+4及其Th1亚群CD+4CD45RA+,Th2亚群CD+4CD45RO+的表达 ,并用ELISA方法同时检测患儿血清中细胞因子IFN γ、IL 4水平。同期检测 1 5例年龄、性别无差异的健康婴儿为对照。结果　RSV下呼吸道感染组患儿外周血辅助性T淋巴细胞CD+4明显低于对照组 (P <0 .0 5 ) ,Th1细胞CD+4CD45RA+明显下降 (P <0 .0 5 ) ,Th2细胞CD+4CD45RO+虽有下降 ,但与对照组相比无统计学差异 (P >0 .0 5 )。Th1 /Th2比值与对照组相比明显降低 (P <0 .0 5 )。RSV下呼吸道感染组患儿血清中IFN γ、IL 4水平均有降低 ,以IFN γ水平下降最为明显 (P <0 .0 1 ) ,IFN γ/IL 4比值降低 (P <0 .0 5 )。结论　婴幼儿RSV下呼吸道感染急性期的免疫功能紊乱主要表现为Th1及其功能下降 ;Th2及其功能相对增强 ,Th1 /Th2的失衡是导致该病发生Th2样反应的重要免疫机制。     

拉米呋啶治疗后乙肝病毒聚合酶YMDD的变异

目的观察拉米呋啶治疗慢性乙肝患者1年前后,患者体内HBV DNA多聚酶结构域C的酪氨酸—甲硫氨酸—天门冬氨酸—天门冬氨酸(YMDD)基因变异情况,及其与血清HBV DNA、丙氨酸氨基转移酶(ALT)水平及乙肝标志物变化的关系。方法采用实时荧光定量PCR、ELISA及速率法分别检测60例乙肝患者经拉米呋啶治疗后其血清YMDD、HBV DNA、乙肝标志物及ALT的变化情况。结果拉米呋啶治疗9月、1年后YMDD的变异率分别为5%、13.3%。YMDD变异组HBV DNA阴转率为12.5%,无变异组HBV DNA阴转率为67.3%,两组阴转率相比差异有统计学意义(P<0.01)。拉米呋啶治疗1年后YMDD变异组ALT为(40.7±14.7)u/L,无变异组ALT为(26.5±10.1)u/L,两组相比差异有统计学意义(P<0.01)。5名HbeAg阴转患者无YMDD变异。结论乙肝患者经拉米呋啶治疗后,YMDD变异率随用药时间的延长可逐渐增加,当其HBV DNA、ALT含量出现明显反跳时,应及早改变治疗方案。     

乙型肝炎病毒感染者白细胞介素2活性的改变及其与病毒复制的关系

本文采用ConA活化小鼠脾细胞~(125)I—UdR掺入法,对111例各型乙肝病毒(HBV)感染者外周血单个核细胞(PBMC)诱生的白细胞介素2(IL-2)活性进行了检测,发现:①除急性肝炎患者和无症状HBsAg携带者外,其他各型HBV感染者IL-2活性均较正常对照组显著降低(P<0.01～0.05),降低程度与临床病型有关;②病毒复制指标(HBeAg、HBV—DNA)阳性组IL-2活性显著低于阴性组(P<0.01)。结果提示IL-2活性的改变在乙型肝炎发病机理中具有重要意义。     

实验性肝硬化大鼠细胞因子IL-18、TNF-α、IFN-γ的变化及意义

目的 探讨在四氯化碳(CCl4) 复合因素诱导实验性肝硬化大鼠的形成过程中,白介素18(IL-18)、肿瘤坏死因子α(TNF-α)、γ干扰素(IFN-γ)的变化及意义.方法 将80只清洁级雄性SD大鼠随机分为正常对照组和造模2周组、4周组、6周组,每组20只.予以CCl4复合因素诱导大鼠肝硬化,并在2、4、6周3个时间点分别处死6只大鼠.采用ELISA法检测大鼠血清IL-18、TNF-α、IFN-γ和肝脏组织匀浆上清液中的IL-18含量;HE染色观察肝脏的组织病理学变化.结果 ①CCl_4复合因素诱导的实验性大鼠,组织病理学观察发现,2周时大鼠肝脏组织细胞肿胀变性,6周时有大量纤维增生,部分肝组织有假小叶的形成;②随着造模时间的延长,实验大鼠血清IL-18、TNF-α、IFN-γ水平逐渐升高,造模6周组与正常对照组比较差异有统计学意义(P<0.01);③造模组肝脏组织匀浆中IL-18随肝损害程度的加重而升高,造模6周组与正常对照组比较差异有统计学意义(P<0.01).结论 在CCl_4复合因素诱导大鼠肝硬化的形成过程中,IL-18、TNF-α、IFN-γ水平逐渐升高,提示该3种细胞因子与肝硬化的形成及发展有关.     

乙型肝炎病毒B、C基因型与乙肝临床特征的相关性

目的探讨乙型肝炎病毒(HBV)B、C基因型与乙肝临床表现与转归的关系。方法对300例乙肝患者进行B、C基因型检测,比较这两种基因型的临床差异,并对影响乙肝的各种因素进行Logistic回归分析。结果在肝硬化、肝癌组中C基因型构成比和HBeAg阳性率显著高于B型(P分别为0、0.01);两种基因型在患者年龄、性别、丙氨酸氨基转移酶(ALT)水平及HBV含量上的差异无统计学意义(P>0.05);Logistic回归分析表明,C基因型肝癌的发生率是B型的5.43倍(OR=5.43,P=0.01)。结论 HBV基因型是乙肝临床转归的重要因素之一。与B基因型比较,C型HBeAg阴转率较低,更容易导致严重的肝病。     

HBeAg特异免疫复合物检测及临床意义

采用单克隆抗－ＨＢｅ固相ＥＬＩＳＡ法检测１１８例ＨＢＶ感染者血清中ＨＢｅＡｇ特异免疫复合物（ＨＢｅＡｇ／ＩＣ），结果表明∶ＨＢｅＡｇ／ＩＣ与ＨＢＶ复制相关，可作为ＨＢＶ复制的一种血清学标志，ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性者中，６２．２％患者ＨＢｅＡｇ／ＩＣ阳性，提示ＨＢｅＡｇ／ＩＣ的形成致使夹心法不能检出ＨＢｅＡｇ，这类患者仍可以是ＨＢＶ野毒株感染，并非均为ＨＢｅＡｇ缺陷变异株感染；ＨＢｅＡｇ／ＩＣ阳性血清ＡＬＴ异常率明显高于ＨＢｅＡｇ／ＩＣ阴性血清（Ｐ＜０．０１），提示ＨＢｅＡｇ／ＩＣ存在与肝损伤有关。     

更年期大鼠Th1/Th2平衡与脾细胞凋亡

目的了解更年期大鼠脾细胞凋亡与辅助性T细胞1(T-helper l,Th1)和辅助性T细胞2(T-helper 2,Th2)型细胞因子的增龄性改变。方法应用Annexin V-FITC/PI双染色流式细胞仪测定脾细胞凋亡率;ELISA法测血清γ-干扰素(interferon-γ,IFN-γ)、白介素-4(interleukin-4,IL-4)水平。结果更年期组大鼠脾细胞凋亡率(10.3%vs.7.7%,P<0.05)、血清IFN-γ质量浓度明显高于年轻组大鼠(23.80 ng/Lvs.10.92 ng/L,P<0.01);更年期组大鼠与年轻组相比血清IL-4质量浓度有下降趋势,但差别无显著意义(0.1296 ng/Lvs.0.3094 ng/L,P>0.05);更年期组血清IFN-γ/IL-4比值明显高于年轻组(183.64vs.35.29,P<0.01),Th1/Th2平衡朝Th1漂移。结论大鼠衰老过程中Th1/Th2平衡朝Th1漂移,脾细胞凋亡增加与IFN-γ水平增高有关。     

CpG寡核苷酸对人外周血单个核细胞的免疫刺激作用

目的　观察CpGODN、GM CSF、CD40 L对正常人外周血单个核细胞 (PBMC)的免疫刺激作用 ,以期筛选出一种高效的疫苗佐剂。方法　用CpGODN 2 0 0 6、GM CSF、CD40 L刺激正常人PBMC ,48h后采用ELISA法检测培养上清液中IFN γ、IL 12及IL 10水平 ;应用免疫荧光法检测PBMC上CD40、CD86、HLA DR的表达。结果　CpGODN 2 0 0 6能诱导正常人PBMC分泌较高水平的IL 12、IFN γ ,抑制IL 10的分泌 ;上调PBMCCD40、CD86、HLA DR表达的作用最强。结论　CpGODN 2 0 0 6是一种免疫刺激作用强大的新型佐剂 ,可用于多种疫苗的制备。     

血凝法测定正常人及乙型肝炎患者血清多聚白蛋白受体的临床应用

应用血凝法检测正常人及乙型肝炎患者血清多聚白蛋白受体(polymerized human serum albumin PHSA)。HBeAg阳性的患者受体滴度显著高于抗-HBe阳性的患者(HBeAg阴性),P<0.01。其PHSA几何平均滴度和阳性率分别为:30例正常人2.2±1.42(3.3％);15例慢性活动性肝炎66.9±7.2(80％);15例慢性迁延性肝炎43.73±41.5(73％);17例急性乙型肝炎10.8±9.4(58.5％);16例无症状HBsAg携带者17.5±16.8(25％)。本文结果说明,检测HBsAg颗粒上的PHSA受体对于HBeAg阳性的慢性乙肝患者和HBsAg无症状携带者的区别上是一项有用的临床指标。     

THE EFFECT OF FCγ RECEPTOR ON THE PATHOGENESIS OF GRAVES'' DISEASE

Objective To explore the roles of Fcγ receptor in the pathogenesis of Graves' disease. Methods Fcγ receptor gene knockout mice(Fcγ R KO mice) which were rooted in C57BL/6 mice and wild type C57BL/6 mice were immunized by hTSH receptor expressing cells (DAP3.WT).1-2×107 DAP3.WT cells were peritoneally injected into mice every two weeks for a total of six times.Two weeks after final immunization, mice were killed for measurement of total thyroxine,TRAb and pathological examination.Results The thyroxine level of the immunized Fcγ receptor gene knockout mice was significantly lower than that of the immunized wild type control mice (2.2±0.31 vs.3.32±0.59g·dL-1,P<0.05), but there was no significant difference between immunized Fcγ R KO mice and non-immunized wild type control group.The TRAb levels of the immunized Fγ R KO mice significantly increased compared to those of the immunized wild type mice (21.75±8.21 vs.14.11±6.21, P<0.05). The lymphocyte cells infiltration and destruction of thyroid follicles were found in the thyroid gland of the immunized Fcγ R KO mice. Conclusion　These results suggest that Fcγ receptor may be involved in the pathogenesis of Graves'disease.     

白细胞介素-12对哮喘患者Th细胞的作用

目的　观察白细胞介素 12 (IL 12 )对哮喘患者辅助性T淋巴细胞 (Th)的分化和细胞因子分泌的影响 ,探讨IL 12对哮喘治疗的机制及应用。方法　从哮喘患者外周血分离出单核细胞和CD4 + T(Th)细胞 ,单核细胞被尘螨变应原刺激活化后同CD4 + T细胞分别与 1μg·L-1和 5 μg·L-1IL 12共培养 ,对照组不加IL 12。 72h后收集培养上清 ,ELISA法检测IL 4、IL 5和IFN γ的生成量。培养细胞用荧光标记的单克隆抗体染色 ,流式细胞仪 (FCM)检测细胞内特异性细胞因子。结果　与对照组相比 ,实验组IL 4、IL 5的产生量明显减少 ,IFN γ的产生量显著增加 (P <0 .0 1) ,而且这种变化趋势在 1μg·L-1、5 μg·L-1IL 12间也有统计学差异 (P <0 .0 5 )。实验组Th1/Th2向Th1方向漂移 ,Th1/Th2增加 (P<0 .0 1)。结论　IL 12可调节Th的分化方向及不同类型细胞因子的分泌 ,并在一定浓度范围内呈量效依赖性。提示IL 12可作为一种新的哮喘治疗途径     

Increased expression of the 20S proteasome in peripheral blood mononuclear cells of type 2 diabetic patients

Objective To investigate the dynamic expression of the 20S proteasome in peripheral blood mononuclear cells (PBMCs) of type 2 diabetic patients without vascular complications. Methods PBMCs were prepared from 30 type 2 diabetic patients and 30 nondiabetic controls. The general indexes including weight, height and blood pressure were recorded. Fasting plasma glucose, fasting plasma insulin and glycosylated hemoglobin were measured. The protein level of the 20S proteasome was measured by Western blotting. The mRNA expression levels of the 20S proteasome β1, β2 and β5 subunits were detected by real-time PCR. Results Compared with that in the nondiabetic controls, the protein level of the 20S proteasome was significantly increased in the diabetic patients and was positively associated with glycosylated hemoglobin. Conclusion Type 2 diabetic patients without vascular complications have an increased 20S proteasome expression, the significance of which needs to be explored by further study.     

抗HER-2嵌合抗体chA21对卵巢癌细胞MMP-2和TIMP-2表达的影响

目的观察抗HER-2嵌合抗体chA21对卵巢癌细胞MMP-2和TIMP-2表达的影响。方珐采用免疫细胞化学法检测不同质量浓度chA21（6mg／L和12mg／L组）作用36h后，培养的高表达HER-2人卵巢癌细胞株SKOV3中MMP-2和TIMP-2表达的变化；建立SKOV3裸小鼠移植瘤模型，制作组织芯片，观察chA21（30mg／kg）对肿瘤组织MMP-2和TIMP-2表达的作用。站杲细胞实验显示，随着chA21浓度的升高，MMP-2明显降低（P〈0．01，r=-0．945），而TIMP-2显著升高（P〈0．01，r=0．926），MMP-2／TIMP-2比值也明显降低（P〈O．01，r=-0．945），且均呈浓度依赖性改变；裸鼠荷瘤实验结果显示，chA21能明显下调MMP-2的表达（P〈0．01），上调TIMP-2的表达（P〈0．01），并使MMP-2／TIMP-2明显降低（P〈O．01）。结论chA21能调节高表达HER-2人卵巢癌细胞SKOV3的MMP-2和TIMP-2表达水平。     

氧化苦参碱对小鼠哮喘模型气道炎症及细胞因子的影响

目的　探讨中药氧化苦参碱 (Oxymatrine)对小鼠哮喘模型气道炎症及细胞因子的影响。方法　 4 0只BALB/c小鼠随机分为正常对照组 (A组 )、哮喘模型组 (B组 )、地塞米松干预组 (C组 )和氧化苦参碱干预组 (D组 )。B、C、D组采用卵蛋白 (OVA)腹腔注射致敏与雾化吸入激发制作哮喘模型。致敏第 15天开始每次雾化激发前 1h给予腹腔注射地塞米松干预 (C组 )、氧化苦参碱治疗 (D组 ) ,连续 7d。在OVA激发结束后 2 4h收集支气管肺泡灌洗液 (BALF)计数炎性细胞总数及嗜酸性粒细胞 (EOS)数目 ,并测定BALF上清液中白细胞介素 4、5 (IL 4 ,IL 5 )和干扰素 γ(IFN γ)水平变化。结果　氧化苦参碱干预治疗能显著降低小鼠BALF中炎性细胞总数及EOS数量 ;BALF上清液中IFN γ水平明显升高 ,IL 4、IL 5水平显著下降。D组与A组、B组有显著性差异 (P <0 .0 1) ,C组与D组无显著性差异 (P>0 .0 5 )。结论　氧化苦参碱能明显降低哮喘小鼠BALF中炎性细胞数量 ,影响细胞因子水平变化 ,从而改善哮喘气道炎症。     

慢性乙肝患者HBV核心蛋白启动子变异的初步研究

目的　通过对乙型肝炎病毒 (HBV)基本核心基因启动子 (BCP)变异的研究 ,阐明HBV准种在慢性感染者中存在的意义。方法　以中国株HBV基因序列为依据 ,设计特异性多聚酶链反应 (PCR)引物 ,自 4 0例慢性HBV感染患者血清中扩增HBV的BCP基因 ,采用聚丙烯酰胺凝胶电泳 (PAGE)技术展示缺失突变 ,DNA测序确定病毒的变异程度。结果　聚丙烯酰胺凝胶电泳结果发现 ,6 0 % (2 4 / 4 0 )患者血清中可见 2～ 3条扩增条带 ;测序结果发现BCP区存在多种突变形式 :点突变中以 14 0nt(T→C)最为常见 ,缺失突变多见于TA1,TA2及TA3,多表现为 8bp和 2 0bp的缺失。 结论　HBVBCP区内有一缺失高变区 ,并在患者体内存有多种变异形式 ;TA1,TA2和TA3的变异可能影响e抗原的表达。HBV慢性携带者体内有HBV准种共存     

Effect of acitretin on the T helper cells of psoriasis vulgaris

Objective To investigate the effects of acitretin on T helper cell (Th) 1/Th2 balance and Th17 cells in psoriasis vulgaris (PV) patients. Methods A total of 13 men and 17 women with PV were investigated. 10 mg of acitretin was administered twice a day for 8 weeks for intervention therapy. Serum levels of interferon-gamma (IFN-γ), interleukin (IL)-4 and IL-17 were measured by enzyme-linked immunosorbent assay. T, Th1, Th2 and Th17 cells in skin biopsies were counted with double-labeled immunofluorescence. Psoriasis Area and Severity Index (PASI) score was calculated before and 8 weeks after treatment. Results Before treatment PV patients had higher serum levels of IFN-γ and IL-17, and increased T, Th1 and Th17 cells in skin biopsies. After treatment, both serum levels of IFN-γ and IL-17, and T, Th1 and Th17 cells infiltrating in PV skin decreased significantly. Th1/Th2 balance was restored to normal. However, their IL-4 and Th2 cells showed no significant change throughout the therapy. Conclusion Acitretin exerts influence on dermal Th1/Th2 balance and Th17 cell infiltration, so does it on production of systematic inflammatory cytokines IFN-γ and IL-17 in PV patients. However, Th2 cells and its derivative cytokine-IL-4 are not affected.     

THE HUMORAL AND CELLULAR IMMUNE RESPONSES INDUCED BY HPV18L1-E6/E7 DNA VACCINES IN MICE

Objective To construct eukaryutic expression vector of HPV18 L1- E6, E7 chimeric gene and examine the humorul and cellular immune responses induced by this DNA vaccines in mice. Methods The C-terminal of major rapsid protein L1 gene and mutant zinc finger domains of early E6/7 oncogenes in HPV18 were integrated and inserted into eukaryotic expression vector pVAX1 to generate vaccines pVAX1-L1E6Mxx, ETMxx. CHO cells were transiently transfected with the individual construct. Target protein expressions in the lysate of the transfected cells were measured by ELISA and immunocytochemistry After BALB/c mice were vaccinated with various recombinant plusmids（pVAX1- L1-E6M3 or pVAX1-L1-E7M3 ） and immunie adjuvants （pLXHDmB7-2 or LTB） through different administration routes （intramuscular or intranasal） , the great cellular immune responses were produced us revealed by delayed-type hypersensitivity （DTH） and lymphocyte proliferation, and the expression of IL-4 and IFN- 7 cells in CD4^＋ and CD8^＋ subpopulations. Results The highly efficient expression of pVAX1-L1E6Mxx, E7Mxx vector in host eukaryotic cells were demonstrated both by ELISA and immunocytochemistry. The level of specific serum IgG against HPV in experiment groups mice was much higher than that of control group, and intranuscular immunization group had the highest antibody level. Intramuscular immunization groups were superior to intranasal immunization groups in DTH response, splenocyte proliferation and CD8^＋ IFN-γ^＋ cells number, but CD4^＋ IL4^＋ cell number was higher in intranasul immunization groups. The immunization groups using pLXHDmB7.-2 as adjuvant were superior to other groups in immunorespouse. Conclusion These DNA vaccines produce remarkable cellular and humorul immune responses in the mouse and may provide us prophylatic and therapeutic candidates for HPV induced cancer treatment.