课程文献中心 更多>>

关键词： 慢性阻塞性肺疾病稳定期   盐酸氨溴索   多索茶碱   血清IL-33/sST2轴   肺泡氧合功能  

摘要： 目的观察盐酸氨溴索联合多索茶碱治疗老年慢性阻塞性肺疾病稳定期(SPCOPD)的疗效及对血清白介素-33(IL-33)/可溶性基质裂解素2(sST2)轴表达及肺泡氧合功能的影响。方法选取2021年1月—2022年12月北京大望路急诊抢救医院收治的SPCOPD患者212例,以随机数字表法分为研究组(n=106,多索茶碱联合盐酸氨溴索治疗)和对照组(n=106,多索茶碱治疗),2组均连续治疗14 d。比较2组临床疗效,治疗前后血清IL-33/sST2轴的mRNA相对表达与相关炎性因子水平、肺泡氧合功能指标及不良反应。结果研究组总有效率为93.40%,高于对照组的83.96%(χ^(2)=4.699,P=0.030)。治疗14 d后,2组血清IL-33、sST2的mRNA相对表达与IL-33、sST2水平低于治疗前,且研究组低于对照组(P<0.01);2组血氧分压、血氧饱和度、呼气流量峰值高于治疗前,且研究组高于对照组(P<0.01)。研究组与对照组不良反应总发生率比较差异无统计学意义(4.72%vs.2.83%,χ^(2)=0.520,P=0.471)。结论盐酸氨溴索联合多索茶碱治疗老年SPCOPD患者疗效较好,可降低血清IL-33/sST2轴活性,抑制炎性因子水平,并积极改善肺泡氧合功能,安全性较高。

关键词： 脑小血管病   认知障碍   IL-23/Th17免疫炎症轴   白细胞介素-6   转化生长因子β   血清   危险因素   预测效能  

摘要： 目的 分析白细胞介素(IL)-23/辅助性T细胞(Th)17免疫炎症轴在脑小血管病(CSVD)相关认知障碍(CI)中的临床意义。方法 选取2019-07—2022-06于临汾市人民医院神经内科住院的134例CSVD患者,根据是否并发CI分为CSVD-CI组[蒙特利尔认知评估(MoCA)评分<26分]60例以及CSVD-NCI组(MoCA评分≥26分)74例,另选取同期健康体检者50例为对照组。测量所有受试者于入院24 h内的转化生长因子β(TGF-β)及IL-6、IL-17、IL-23等指标水平,采用Logistic回归多元相关性分析获得风险比(HR),使用ROC曲线对CSVD患者并发CI的预测效能进行评估。结果 CSVD-CI组及CSVD-NCI组年龄、吸烟、高血压、糖尿病、SBP、DBP、FPG、既往卒中或TIA史等比较差异有统计学意义(P<0.05)。CSVD-CI组TGF-β、IL-6、IL-17、IL-23水平较CSVD-NCI组及对照组明显更高(P<0.01),CSVD-NCI组明显高于对照组(P<0.01)。Logistic回归分析显示,血清TGF-β、IL-6、IL-17、IL-23、糖尿病、高血压、FPG是影响CSVD患者并发CI的独立危险因素。ROC曲线分析显示,血清TGF-β、IL-6、IL-17、IL-23联合预测的AUC=0.955,高于单个指标。结论 联合检测血清TGF-β、IL-6、IL-17、IL-23水平能够早期预测CSVD患者并发CI,监测IL-23/Th17免疫炎症轴相关因子水平变化趋势有助于早期识别具有认知功能损伤高风险的患者。

关键词： 孕早期   PIGF   hs-CRP   IL-6   TNF-α   子痫前期   预测  

摘要： 目的评估孕妇孕早期联合检测胎盘生长因子(placental growth factor,PIGF)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),预测子痫前期(preeclampsia,PE)的能力。方法收集2022年1月至2023年3月在贵州省遵义市第一人民医院建档并规律产检分娩的1097例孕妇临床资料,确诊PE的152例作为PE组,根据病情程度分为轻度PE亚组89例和重度PE亚组63例。另外945例无PE的孕妇为对照组。对比孕早期(孕11~13^(+6)周)PIGF、hs-CRP、IL-6、TNF-α的表达水平,分析其与PE病情严重程度的关系。制作受试者工作特征(receiver operating characteristic,ROC)曲线以分析PIGF、hs-CRP、IL-6、TNF-α联合检测对PE的预测价值。结果PE组PIGF低于对照组,hs-CRP、IL-6、TNF-α高于对照组。PIGF与患者PE病情程度负相关(r=-0.333,P<0.001),hs-CRP、IL-6、TNF-α与患者PE病情程度正相关(r=0.277,0.670,0.572,均P<0.001)。ROC曲线分析揭示了PlGF对PE的预测能力较低(AUC:0.646,95%CI:0.600~0.693,敏感度44.7%,特异性76.6%),hsCRP对PE的预测能力一般(AUC:0.736,95%CI:0.695~0.778,敏感度75.0%,特异性87.2%)、IL-6对PE的预测能力一般(AUC:0.742,95%CI:0.703~0.780,敏感度69.7%,特异性65.8%)、TNF-α对PE的预测能力中等(AUC:0.840,95%CI:0.800~0.871,敏感度82.8%,特异性60.0%)。上述指标联合检测产生了很好的预测能力(AUC:0.892,95%CI:0.864~0.919,敏感度87.5%,特异性65.6%)。结论孕早期PlGF联合hs-CRP、IL-6、TNF-α检测对PE的预测具有较高的价值,此外PIGF、hs-CRP、IL-6、TNF-α水平可能与PE病情的严重程度相关。

关键词： CT23   癌–睾丸抗原   女性恶性肿瘤  

摘要： 目的:探讨CT23及其抗体在女性恶性肿瘤(乳腺癌、卵巢癌、子宫内膜癌)辅助诊断中的应用价值。方法:选取卵巢癌患者65例、乳腺癌患者54例、子宫内膜癌患者35例、盆腔良性肿瘤患者21例及健康对照组70例,通过ELISA检测血清中CT23含量及CT23抗体表达水平。结果:肿瘤组患者的CT23和CT23抗体平均含量均高于健康对照组,其中卵巢癌患者组与健康对照组差异具有统计学意义(P Purpose: To explore the application value of CT23 and its antibody in the auxiliary diagnosis of female malignant tumors (breast, ovarian, endometrial). Methods: A total of 65 patients with ovarian cancer, 54 patients with breast cancer, 35 patients with endometrial cancer, 21 patients with benign pelvic tumors, and 70 healthy controls were selected. The levels of CT23 and CT23 antibody in serum were detected using ELISA. Results: The average levels of CT23 and CT23 antibody in the tumor group were higher than those in the healthy control group, with statistically significant differences in the ovarian cancer patient group (P < 0.001). ROC curve analysis showed that CT23 had limited diagnostic value for female tumors, while CT23 antibody might be a moderate serum marker for breast cancer or ovarian cancer. Conclusion: CT23 antibody has certain reference value in the diagnosis of breast cancer and ovarian cancer, but its clinical significance requires further research and verification.

关键词： Gallic acid(GA)   Cisplatin   Esophageal cancer   Interleukin-6(IL-6)   Chemotherapy sensitivity   Signal transducer and activator of transcription 3(STAT3)/Notch pathway  

摘要： Background:Gallic acid(GA),a plant-derived polyphenol,possesses diverse biological functions such as reducing inflammation and against ***,the influence of GA on the resistance of esophageal squamous cell carcinoma(ESCC)cells to cisplatin(DDP)is not well ***:Cell counting kit-8 assay examined how GA affected KYSE30 and TE-1 cell viability.5-Ethynyl-2′-deoxyuridine and TdT-mediated dUTP Nick-End labeling staining detected cell proliferation and *** formation assay,flow cytometry,Carboxyfluorescein diacetate succinimidyl ester fluorescent probes,and Transwell assay determined cell biological properties,and 2′,7′-Dichlorofluorescin diacetate(DCFH-DA)fluorescent probes detected oxidative stress *** transducer and activator of transcription 3(STAT3)/Notch pathway protein levels after GA and/or Interleukin-6(IL-6)intervention were examined through Western ***,a model for subcutaneous graft tumors was established in nude ***:GA exerted suppressive effects on cell proliferation,and caused apoptosis of KYSE30 and TE-1 ***-6 intervention activated the STAT3/Notch pathway and promoted the malignant biological properties of ESCC *** contrast,GA attenuated the effects of IL-6,while STAT3 or Notch inhibitor further enhanced the effects of GA,suggesting that GA inhibited the IL-6/STAT3/Notch *** only that,GA promoted oxidative stress and enhanced cell sensitivity to DDP both in vitro and in ***:GA suppresses the malignant progression of ESCC and enhances cell sensitivity to DDP by hindering the IL-6/STAT3/Notch pathway.

关键词： 非酒精性脂肪性肝病   甲胎蛋白异质体3   白细胞介素-19   肠道菌群   相关性  

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)病人肠道菌群生态特征与血清甲胎蛋白异质体3(AFP-L3)、白细胞介素-19(IL-19)水平的相关性。方法选择2020年6月到2022年6月在郑州市第一人民医院接受治疗的NAFLD病人106例作为NAFLD组,同期选取体检健康志愿者106例作为健康组。采用酶联免疫吸附试验(ELISA)测定血清IL-19、AFP-L3水平;采用Pearson相关性分析检验肠道菌群生态特征与血清AFP-L3、IL-19水平之间的相关性。结果NAFLD组的谷草转氨酶、谷丙转氨酶、空腹血糖、尿酸、血尿素氮、血清肌酐、总胆固醇(TC)、甘油三酯(TG)均高于健康组,且差异有统计学意义(P<0.05)。NAFLD组的AFP-L3水平[(94.43±16.18)μg/L]高于健康组[(76.02±12.12)μg/L],NAFLD组的IL-19水平[(47.23±8.05)ng/L]低于健康组[(65.82±12.16)ng/L],差异有统计学意义(P<0.05)。NAFLD组乳酸杆菌、拟杆菌、双歧杆菌丰度少于健康组(P<0.05),粪肠球菌、屎肠球菌、大肠杆菌丰度多于健康组(P<0.05)。根据Pearson相关性分析可以得知,乳酸杆菌、拟杆菌、双歧杆菌丰度与AFP-L3水平呈负相关(P<0.05),与IL-19水平呈正相关(P<0.05);粪肠球菌、屎肠球菌、大肠杆菌丰度与AFP-L3水平呈正相关(P<0.05),与IL-19水平呈负相关(P<0.05)。结论肠道菌群生态特征与NAFLD病人血清中AFP-L3、IL-19水平密切相关。

关键词： 肿瘤免疫治疗   嵌合抗原受体   T细胞   精准医学   免疫细胞疗法  

摘要： 肿瘤是当前人类面对的主要致死类重大疾病。传统的治疗手段,如化疗、手术和放疗等在很长时间内依然将作为肿瘤治疗的主要方式,但效果仍有各自的局限性。近年,以免疫检查点抑制剂、嵌合抗原受体T细胞(CAR-T)过继疗法、抗肿瘤疫苗等策略的兴起,使肿瘤的免疫治疗备受瞩目。其中,CAR-T免疫疗法作为一种突破性的肿瘤免疫治疗方法,通过改造患者自身的T细胞,使其表达针对特定肿瘤抗原的重组抗原受体,突破了天然T细胞自身的主要组织相容性复合体(MHC)的限制性,在细胞和分子水平上精准地靶向肿瘤,从而能够高效特异地识别和杀伤癌细胞,为治疗肿瘤提供了新途径。自2017年美国食品药品监督管理局(FDA)批准首个CAR-T疗法以来,除在多种血液恶性肿瘤领域依然保持显著优势,也在部分实体瘤和自身免疫性疾病等的治疗和临床试验中取得了突出的进展。我们将对当前CAR-T技术的原理、应用及所要面临的挑战和发展方向进行简要综述。

关键词： 皮肌炎   抗黑色素瘤分化相关基因5   快速进展型间质性肺疾病   癌胚抗原   细胞角蛋白19血清片段21-1  

摘要： 目的 分析肿瘤相关抗原对抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎患者发生快速进展型间质性肺疾病(RP-ILD)的影响。方法 回顾性选取2018年8月至2023年7月于新乡医学院第一附属医院明确诊断的抗MDA5抗体阳性皮肌炎患者36例,根据是否发生RP-ILD将患者分为RP-ILD组(13例)和非RP-ILD组(23例)。收集患者临床资料,采用Logistic回归分析评估抗MDA5阳性皮肌炎患者发生RP-ILD的潜在风险因素。结果 RP-ILD组细胞角蛋白19血清片段21-1(CYFRA21-1)、癌胚抗原水平均高于非RP-ILD组(均P<0.05)。CYFRA21-1和癌胚抗原分别联合性别、抗Ro-52抗体、铁蛋白进行多因素Logistic回归模型分析,发现CYFRA21-1(比值比=1.137,95%置信区间:1.028~1.258)、癌胚抗原(比值比=1.348,95%置信区间:1.057~1.718)为发生RP-ILD的危险因素(均P<0.05)。结论 血清CYFRA21-1、癌胚抗原表达升高与抗MDA5抗体阳性皮肌炎患者发生RP-ILD的风险相关。

关键词： 支气管哮喘   老年   中药穴位贴敷   麻黄附子细辛汤   肺功能   TNF-α   CRP   HMGB1  

摘要： 目的:观察麻黄附子细辛汤化裁联合中药穴位贴敷治疗老年支气管哮喘患者疗效观察及其对肺功能和血清TNF-α(肿瘤坏死因子)、CRP(C反应蛋白)、HMGB1(高迁移率族蛋白1)水平的影响。方法:64例老年支气管哮喘患者随机分组,每组32例;2组患者均给予基础治疗,对照组根据发作严重程度分别给予丙酸倍氯米松鼻气雾剂、丙酸倍氯米松鼻气雾剂,并给予中药穴位贴敷,观察组在对照组基础上予麻黄附子细辛汤化裁,用药1周评定疗效。治疗前后进行主要症状(咳嗽、咯痰、喘息)评分,检测肺功能指标FEV1、FVC、PEF和FEV1/FVC,ELISA检测血清TNF-α、CRP、HMGB1。结果:观察组治疗1周疗效好于对照组(P<0.05);治疗1周后,2组患者主要症状(咳嗽、咯痰、喘息)评分明显降低(P<0.05),肺功指标FEV1、FVC、PEF和FEV1/FVC均有提升(P<0.05),血清TNF-α、CRP、HMGB1水平明显下降(P<0.05);观察组主症评分和血清TNF-α、CRP、HMGB1水平下降较对照组明显(P<0.05),肺功指标FEV1、FVC、PEF和FEV1/FVC提升较对照组明显(P<0.05)。结论:麻黄附子细辛汤化裁联合中药穴位贴敷治疗老年支气管哮喘有助于提高疗效,减轻症状,改善肺功能,降低炎症因子水平。

关键词： macrophage   interleukin 35   TGF-beta   regulatory B cell   PD-L1  

摘要： The interaction between immune regulatory cells, such as regulatory B cells (Breg) and pro-resolving macrophages (M2 macrophages), plays an important role in the restoration of immune homeostasis during inflammation. PD-L1 is one of the effector molecules that mediates the immune regulation function of M2 macrophages. The activation of PD-L1/PD-1 signaling promotes the differentiation of Breg. Previous studies have shown that Breg promoted M2 macrophage polarization and enhanced their function, but little is known about the regulatory function of M2 macrophages on Breg differentiation. This study aims to determine the effect of M2 macrophages on Breg induction and the potential mechanism in vitro. Bone-marrow-derived macrophages were isolated from wild-type (WT) mice and polarized into M2 using IL-4/IL-13. To investigate the role of PD-L1/PD-1 in M2 macrophage-induced Breg differentiation, spleen B cells were isolated from WT or PD-1 knockout (KO) mice and co-cultured with either na & iuml;ve (M0) or M2 macrophages for 48 h with or without trans-well inserts. The expression of IL-10, IL-35, and TGF-beta 1 in B cells was evaluated by flow cytometry and immunofluorescence staining. Recombinant PD-L1 was used to stimulate activated B cells, followed by the detection of IL-35 and TGF-beta 1. The results show that there was no significant difference in IL-10 expression among all groups. However, IL-35 and TGF-beta 1 expression in B cells was significantly increased in the M2+B, but not in M0+B, compared to B cells alone. Notably, such increases were diminished when M2 and B cells were separated by trans-well inserts. IL-35 expression was not significantly changed when B cells from PD-1 KO mice were co-cultured with M2 compared to the control. However, TGF-beta 1 expression was significantly increased when PD-1 KO B cells were co-cultured with M2 compared to the control. IL-35 expression in activated B cells was increased upon stimulation with PD-L1. However, TGF-beta 1 e