简介：摘要目的了解高效抗逆转录病毒治疗(highly active antiretroviral therapy，HAART)后HIV/AIDS患者T淋巴细胞免疫活化及CD4＋CD45RA＋ T细胞的亚群变化，探讨抗病毒治疗对HIV感染者免疫恢复的影响。方法前瞻性分析105例接受HARRT治疗的HIV/AIDS患者，流式细胞仪检测治疗前和治疗后1、3、6及12个月T淋巴细胞活化水平(CD38、HLA-DR的表达)及CD4＋CD45RA＋ T淋巴细胞；同时选取未暴露且HIV-1抗体检测阴性者35名作为健康对照。结果HAART治疗前HIV/AIDS患者T淋巴细胞活化水平显著高于健康对照(P<0.01)，HAART治疗后随治疗时间延长活化水平明显下降，治疗1个月时CD4＋CD38＋ HLA-DR＋及CD8＋CD38＋ 、CD8＋ HLA-DR＋ T淋巴细胞首先出现降低，治疗6个月时包含CD8＋CD38＋HLA-DR＋ T在内的4项活化指标均明显下降，差异有统计学意义(P<0.01)；治疗12个月与6个月相比，CD8＋CD38＋HLA-DR＋ T表达水平继续降低(P<0.01)，而其余3项活化指标差异无统计学意义。但HAART治疗12个月后，4项活化指标仍全部高于健康对照组(P<0.01)。CD4＋CD45RA＋ T淋巴细胞百分比在治疗前及治疗后12个月均明显低于健康对照组。结论HIV/AIDS患者在HAART治疗后6个月免疫活化水平降低，但HAART并不能使免疫活化逆转；HAART治疗也不能恢复HIV感染后降低的CD4＋CD45RA＋ T淋巴细胞的水平。

简介：摘要RA是以滑膜炎为病理基础的自身免疫病，辅助性T细胞（Th）17和调节性T细胞免疫失衡在其发病机制中发挥重要作用。随着对IL-2从促炎因子到调节免疫耐受因子的重新认识，与IL-2共享γ链的IL-2家族成员IL-9作为一种多效性因子受到越来越多的关注，同时发现其主要来源于一种新型T细胞亚型Th9细胞。许多研究认为Th9/IL-9可能通过调控Th17/调节性T细胞免疫平衡从而参与RA滑膜炎症和病情活动，与RA发生发展有关。本文对Th9/IL-9调控RA患者Th17/调节性T细胞免疫平衡的最新研究进展予以综述。

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简介：AbstractBackground:Cell salvage has recently been recommended for obstetric use in cases with a high risk of massive hemorrhage during cesarean section (CS). However, limited data are available to support the use of one suction device to collect lost blood. This study aimed to investigate the volume of red blood cells (RBCs) salvaged and the components of amniotic fluid (AF) in blood salvaged by one suction device or two devices during CS in patients with placenta previa and/or accrete.Methods:Thirty patients with placenta previa and/or accrete undergoing elective CS in the Women’s Hospital of Zhejiang University School of Medicine were recruited for the present study from November 1, 2017 to December 1, 2018. The patients were randomly assigned to one of the two groups according to an Excel-generated random number sheet: Group 1 (n = 15), in which only one suction device was used to aspirate all blood and AF, and Group 2 (n = 15), in which a second suction device was mainly used to aspirate AF before the delivery of the placenta. Three samples of blood per patient (pre-wash, post-wash, and post-filtration) were collected to measure AF components. The salvaged RBC volumes were recorded. Continuous data of pre-wash, post-wash, and postfiltration samples were analyzed by using one-way analysis of variance with Tukey’s test for multiple comparisons, or Kruskal-Wallis test with Dunn test for multiple comparisons. Comparisons of continuous data between Group 1 and Group 2 were conducted using Student’s t test or Mann-Whitney U test.Results:The salvaged RBC volume was significantly higher in Group 1 than that in Group 2 (401.6 ± 77.2 mL vs. 330.1 ± 53.3 mL, t = 4.175, P < 0.001). In both groups, squamous cells, lamellar bodies, and fat were significantly reduced by washing (all P<0.001) and squamous cells were further reduced by filtering (P < 0.001). Squamous cells were found in six post-filtration samples (three from each group). Lamellar bodies and fat were completely removed by filtering. Insulin-like growth factor binding protein 1, alphafetoprotein, albumin, lactate dehydrogenase, and potassium were significantly reduced post-wash (all P < 0.05), with no further significant reduction after filtration in either group (all P > 0.05). The mean percentage of fetal RBCs post-filtration was (1.8 ± 0.8)% with a range of 1.0% to 3.5% and (1.9 ± 0.9)% with a range of 0.7% to 4.0% in Groups 1 and 2, respectively, showing no significant difference between the two groups (U= 188.5, P = 0.651).Conclusion:Cell salvage performed by one suction device could result in higher volume of salvaged RBCs and can be used safely for CS in patients with placenta previa and/or accrete when massive hemorrhage occurs.

简介：AbstractBackground:Numerous studies have focused on lymphoma among patients infected with human immunodeficiency virus (HIV). However, little is known about the treatment options and survival rate of lymphoma in the Chinese people living with HIV (PLHIV). Our study aimed to investigate the prognosis and compare outcome of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R) with standard cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab(R-CHOP) as front line therapy for PLHIV with diffuse large B-cell lymphoma (DLBCL) receiving modern combined antiretroviral therapy (cART).Methods:A retrospective analysis evaluating PLHIV with DLBCL was performed in Shanghai Public Health Clinical Center from July 2012 to September 2019. The demographic and clinical data were collected, and overall survival (OS) and progression-free survival (PFS) analyses of patients receiving R-CHOP or DA-EPOCH-R therapy were performed by Kaplan-Meier analysis. Additionally, a Cox multiple regression model was constructed to identify related factors for OS.Results:A total of 54 eligible patients were included in the final analysis with a median follow-up of 14 months (interquartile range [IQR]: 8-29 months). The proportion of high international prognostic index (IPI) patients was much larger in the DA-EPOCH-R group (n = 29) than that in the R-CHOP group (n = 25). The CD4 cell counts and HIV RNA levels were not significantly different between the two groups. The 2-year OS for all patients was 73%. However, OS was not significantly different between the two groups, with a 2-year OS rate of 78% for the DA-EPOCH-R group and 66% for the R-CHOP group. Only an IPI greater than 3 was associated with a decrease in OS, with a hazard ratio of 5.0. The occurrence of grade 3 and 4 adverse events of chemotherapy was not significantly different between the two groups.Conclusions:Outcomes of R-CHOP therapy do not differ from those of DA-EPOCH-R therapy. No HIV-related factors were found to be associated with the OS of PLHIV in the modern cART era.

简介：摘要目的了解γδT细胞、CD4+CD25+调节性T细胞(Treg)在HIV感染者/AIDS患者外周血中的表达水平，探讨γδT细胞、CD4+CD25+ Treg在HIV感染/AIDS病情进展中的相关性以及可能的作用机制。方法采用免疫荧光单克隆抗体标记技术、流式细胞术检测AIDS患者12例、HIV中期感染者19例、HIV早期感染者15例、健康体检者30例外周血中CD3+T细胞、CD4+T细胞、CD8+T细胞、γδT细胞、CD4+CD25+ Treg的表达水平；采用Pearson分析γδT细胞与CD4+CD25+Treg相关性。结果γδT细胞在AIDS组、HIV感染中期组、HIV感染早期组、健康对照组外周血中的表达(Mean±SD, %)分别为：4.46±1.37、3.59±0.67、3.12±0.33、1.73±0.36，组间比较差异有统计学意义(F＝6.091，P＝0.018)。CD4+CD25+Treg在AIDS组、HIV感染中期组、HIV感染早期组、健康对照组外周血中的表达(Mean±SD, %)分别为：10.28±1.94、7.37±1.03、6.68±0.58、4.03±0.82，差异有统计学意义(F＝13.568，P＝0.020)。γδT、CD4+CD25+Treg在4组中的比较，有明显统计学意义，AIDS组>HIV感染中期组>HIV感染早期组>对照组。相关性方面，γδT、CD4+CD25+Treg与CD4+T细胞呈负相关(r分别为-0.982、-0.712, P值分别为0.001、0.002)，与CD8+T细胞计数呈正相关(r分别为0.873、0.809, P值分别为0.000、0.000)；γδT细胞与CD4+CD25+Treg呈正相关性(r＝0.911, P＝0.000)。结论HIV感染诱导了γδT细胞、CD4+CD25+Treg的增殖，两者可能参与了机体感染HIV后引起的免疫应答。γδT细胞与CD4+CD25+Treg成正相关，两者可能具有协同作用。

简介：摘要目的观察人白细胞抗原G(human leukocyte antigen G，HLA-G)在人T淋巴细胞白血病1型病毒(human T-cell leukemia virus type 1，HTLV-1)阳性T细胞中的表达情况，研究其在影响HTLV-1感染发生发展中的作用。方法采用Western blot及real-time PCR检测HLA-G在HTLV-1阳性T细胞系(MT2和MT4)中的表达。构建HLA-G基因沉默的siRNA，用于敲低MT2和MT4细胞中的HLA-G，在mRNA和蛋白质水平观察HLA-G对HTLV-1蛋白Tax、P19表达的影响，同时在RNA水平监测HLA-G基因沉默后MT2和MT4细胞中细胞因子的表达变化。CCK8法观察MT2和MT4细胞的增殖能力，Western blot检测信号传导与转录激活因子3(signal transducer and activator of transcription 3，STAT3)通路相关蛋白。结果与HTLV-1阴性T细胞(Jurkat和MOLT4)比较，MT2和MT4细胞均高表达HLA-G分子。siRNA敲低MT2和MT4细胞中的HLA-G后，HTLV-1 Tax和P19的mRNA和蛋白质表达水平均下降，抗病毒因子IFN-γ和TNF-α表达升高，MT2和MT4细胞的增殖能力和STAT3磷酸化水平均降低。结论HTLV-1能诱导T细胞高表达免疫耐受分子HLA-G，抑制HLA-G表达可促进抗病毒因子的产生，降低IL-6及STAT3磷酸化水平，从而有效抑制HTLV-1的复制。

简介：摘要目的通过与传统定量方法进行对比，验证合成MRI对纵向弛豫时间(longitudinal relaxation time，T1)、横向弛豫时间(transverse relaxation time，T2)定量计算的准确性及可重复性。材料与方法针对3.0 T MRI设备，使用灰质、白质、脑脊液模体分别进行合成MRI序列和传统定量成像扫描，共进行四次重复采集。对传统定量图像，通过拟合计算方法得到相应的T1、T2值；对合成MRI图像，使用专用后处理软件计算T1、T2值。对两种方法得到的定量值进行差值计算和重复测量方差分析。结果合成MRI和传统定量方法计算的T1值之间差异无统计学意义(F=0.113，P=0.7537)，并且四次测量之间差异无统计学意义(F=0.613，P=0.4968)；同样地，两种方法计算的T2值之间差异无统计学意义(F=0.001，P=0.9737)，四次测量之间差异无统计学意义(F=1.162，P=0.3498)。结论合成MRI对T1、T2弛豫定量测定结果准确，可应用于临床中的定量研究。

简介：摘要目的观察前列腺癌患者CD4＋T细胞T盒子转录因子T-bet的表达，并探讨对程序性死亡因子-1(PD-1)表达的影响。方法利用免疫组织化学比较中山大学附属第一医院泌尿外科就诊的未进行治疗的初步确诊的前列腺癌患者前列腺癌和癌旁组织中CD3＋PD-1＋T细胞的浸润，以及CD3＋T细胞T-bet的表达。本研究免疫组化染色收集临床前列腺癌患者肿瘤组织作为实验组，患者对应癌旁组织作为对照组；研究涉及的细胞实验以前列腺癌患者血样来源的CD4＋T细胞作为实验组，健康志愿者血样来源的CD4＋T细胞作为对照组。流式和蛋白质印迹法(Western blot)分析健康人和前列腺癌患者外周血中CD4＋T细胞活化3 d后T-bet和PD-1的表达差异。通过基因双调控影响HC和PCa CD4＋T细胞的T-bet基因水平并在体外活化增殖3 d后，利用qPCR确定敲低效率；通过流式和Western blot检测PD-1和T-bet的表达。两组间比较采用t检验。结果前列腺癌组织中CD3＋PD-1＋T细胞浸润明显，且癌组织中浸润CD3＋T细胞T-bet表达减少。与健康人的CD4＋T细胞比较，前列腺癌患者CD4＋T细胞的T-bet表达水平低(35.500±4.041比16.700±2.472，n＝4，t＝3.968，P<0.01)，同时伴随着PD-1的表达明显增高(8.353±0.103比12.440±0.814，n＝4，t＝4.977，P<0.01)，差异有统计学意义。健康人来源CD4＋T细胞T-bet表达水平降低后PD-1的表达明显增加(Western blot：0.027±0.003比0.123±0.015, n＝3，t＝6.485，P<0.01；流式：8.470±1.288比19.560±1.664, n＝3，t＝5.271，P<0.01)，差异有统计学意义。上调前列腺癌患者来源CD4＋T细胞T-bet表达至正常水平，检测到PD-1表达被明显抑制(Western blot：0.787±0.023比0.240±0.035，n＝3，t＝13.090，P<0.01；流式：20.320±3.880比8.013±0.154，n＝3，t＝3.169，P<0.05)，差异有统计学意义。结论前列腺癌患者来源CD4＋T细胞中T-bet表达缺陷引起细胞膜表面PD-1表达增高，上调PD-1/PD-1配体(PD-L1)通路，抑制机体抗肿瘤免疫反应，促进肿瘤的发生发展。

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简介：摘要现在造船业仍在经历寒冬，船舶的建造质量与效率对于造船企业的生存发展更显得尤为重要。本文针对槽型隔舱结构钢板厚度薄、完工平整度要求高的特点，通过对原槽型隔舱结构施工变形原因及制作方法进行分析，提出了船舶槽型隔舱部件制作的优化工艺，记录了制造过程中的工艺和过程探索，为该类型结构提供了一套较为详细的施工作业程序。本文为后续同类型产品的制造提供了可借鉴的经验。

简介：内容摘要随着探测技术的飞速发展,隐身性能成为武器装备的一项关键技术指标。对于各种隐身手段来说,隐身涂料是目前用得最多、最有效的隐身技术手段之一。隐身涂料在现代隐身技术中具有广阔的发展和应用前景。隐身涂料的涂装技术尤为重要。

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简介：摘要目的探究基于3.0 T MRI T2 mapping的纹理特征在膝关节骨性关节炎(keen osteoarthritis，KOA)患者不同程度软骨损伤分级中的诊断性能。材料与方法回顾性分析实验组骨性关节炎患者72个膝关节及对照组健康志愿者22个膝关节。通过矢状位T2 mapping生成T2伪彩图，在T2伪彩图中画取ROI并标记国际软骨修复学会(International Cartilage Repair Society，ICRS)分级，选取ICRS MRI分级与关节镜分级一致的201个关节面图像，采用OK软件提取、分析纹理参数。按7∶3的比例随机选取143个关节面图像作为训练集，剩余58个关节面图像作为验证集。对训练集的参数用Spearman及sbf (select by filter)进行特征过滤，用随机森林函数进行特征选择，用ctree建立模型，给出特征在鉴别正常软骨及不同软骨损伤分级中的权重。用曲线下面积(area under the curve，AUC)，敏感度、特异度，准确度来评价模型预测正常软骨及不同软骨损伤分级的性能。结果MinLocation、MaxSize及Maximun3DDiameter权重均一致较大，其中MinLocation在各损伤分级中权重均最大，超过0.75。集训集中正常软骨的AUC值为0.91，Ⅰ级损伤的AUC值为0.82，Ⅱ级损伤的AUC值为0.84，Ⅲ级损伤的AUC值为0.88；验证集中正常软骨的AUC值为0.87，Ⅰ级损伤的AUC值为0.74，Ⅱ级损伤的AUC值为0.84，Ⅲ级损伤的AUC值为0.96。AUC最高的是验证集中Ⅲ级损伤软骨，为0.96；其次是训练集中正常软骨，为0.91。无论在训练集还是验证集中都表现出了良好的预测价值。敏感度最高的是训练集中Ⅰ级损伤软骨，为0.83；特异度最高的是训练集中Ⅲ级损伤软骨，为0.98。结论通过T2 mapping提取的纹理参数在不同软骨损伤程度中有较好的鉴别能力。