ABSTRACT
Objective To investigate the clinical value of lymphangiography in the diagnosis and treatment of cervical chylous fistula.Methods The clinical data of 7 patients with chylous fistula at Department of Lymph Surgery,Capital Medical University Affiliated Beijing Shijitan Hospital from Jul 2010 to Aug 2015 was retrospectively analyzed.Lymphangiography was performed to investigate the site of fistula and condition of thoracic duct.Results There were 1 male and 6 female patients aging from 22 to 59 years.All patients underwent lymphangiography successfully with dynamic imaging clearly,which accurately showed the location of the leakage and the anatomy of the thoracic duct.There was compensatory branch or trunk drainage in 2 cases which underwent successful conservative treatment,the other 5 cases with leak ＞ 500 ml a day without clear compensatory branch underwent surgical treatment and were cured with no major complications.Conclusion Lymphangiography not only clearly locates the leakage and anatomical relationship of the thoracic duct,but also guides the choice of treatment and precise surgery,avoiding the secondary injury.
ABSTRACT
Objective@#To investigate the imaging features and etiology of lymphatic trunk in primary facial lymphedema.@*Methods@#26 patients with primary facial lymphedema patients (F/M, 13/13, ages 21.8 ± 13.9 years old) were recruited from January 2015 to October 2017 in this study, with 32 sides facial lymphedema reported, including 6 right facial lymphedema, 14 left facial lymphedema, and 6 bilateral facial lymphedema. And all the patient data and imaging were retrospective analysis to summarize the MR imaging features of thoracic duct and right lymphatic duct, meanwhile compared with surgical results.@*Results@#For all 26 patients, MR imaging result in thoracic duct manifests 32 lymphatic duct, including 20 thoracic duct and 12 right lymphatic duct. The imaging features demonstrate two typical findings: dilated(13 cases) and slim(7 cases) demonstrations. While for right lymphatic duct, the MR result included three types: dilated(6 cases), slim(4 cases) and no sign of manifestations(2 cases). In surgery, the thoracic duct in cervical segment demonstrated abnormal structures, including capsulated by fibrous tissues in peripheral area(30 sides), surrounded by internal jugular vein sheath(11 sides), external pressed by venae cervicalis transversa(5 sides) and lymphatic trunk dysplasia(2 sides).@*Conclusions@#MR thoracic duct and right lymphatic duct imaging can be used as an effective diagnostic imaging method for primary facial lymphedema, and the structural anomaly of the upper cervical catheter and the right lymphatic catheter may be one of the pathogenic factors of primary facial lymphedema.
ABSTRACT
Objective To optimize the condition of converting murine naive CD4+ CD25-T cells ( effector T cells,Teffs) to CD4-CD8-double negative regulatory T cells ( DN Tregs) in vitro.Methods Naive Teffs from C57BL/6 mouse were isolated with magnetic activated cell sorting( MACS)and co-cultured with DBA/2 mature dendritic cells (mDCs) with different doses of recombinant murine interleukin-2 (IL-2).The percentage of converted DN Tregs was examined by flow cytometry after 6 days.Purified DN Tregs were co-cultured with CFSE labeled Teffs.The proliferation rate of Teffs were evaluated by flow cytometry.Results Without IL-2,the percentage of CD4-CD8-T cells was 6.21％ ± 2.03％.With IL-2,the percentage was 14.77％ ± 2.15％ ( 25 ng/ml),21.29％ ± 2.68％ (50 ng/ml),43.45％ ±4.45％ (75 ng/ml),and 28.59％ ±3.05％ ( 100 ng/ml) respectively.The IL-2 concentration of 75 ng/ml signilicantly enhanced the conversion of Teffs to DN Tregs ( separately t =10.700,8.288,6.158,3.932,all P ＜ 0.05).Highly purified DN Trega significantly suppress the proliferation of Teffs in vitro.Conclusions Teffs are converted to DN Trega in vitro with the LPS-activated allogeneic mDCs and that 75 ng/ml of IL-2 is the optimal concentration for the conversion of Teffs to DN Trogs in vitro.
ABSTRACT
ObjectiveTo study the effect on humoral immunity with combination of CsA and IL-2 fusion protein. MethodsForty C57/B6 mice were evenly divided into four groups,after receiving skin graft from DBA mouse.Mice in the experimental group was given CsA(30 mg/kg,ip) plus IL-2/Fc (1μg,ip) while the control group was only given CsA,each group was given HBV vaccine after skin graft surgery (2 μg,im),while blank group was only given vaccine after skin transplantation.The fourth group were left intact.Fourteen days later,the level of HBSAb,IL-4,IL-10,IFN-γ,IL-2 were measured with ELISA and IL-21and FoxP3 expression level and Tfh percentage of mixed lymphocytes detected. ResultsThe HBSAb level in experimental group is significantly higher than that in the control group and the survival time of skin graft is longer than that in the control group ( F =29.886,P =0.010 ; F =29.772,P =0.011).IL-2,IFN-γ are significantly higher than that in the control group( F =18.156,P =0.0020;F =90.042,P =0.003 ),but the Th2 cytokines such as IL-4,IL-10 are lower ( F =42.102,P =0.009 ; F =23.734,P =0.015 ).The expression level of both IL-21and FoxP3 are significantly higher than control group( F =9.784,P =0.048 ;F =27.883,P =0.012). ConclusionsCombination of CsA and IL-2 fusion protein can significantly enhance the immunogenicity of HBV vaccine and prolong graft survival time.It may be related to the higher expression level of IL-21and FoxP3.