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Objective To compare diagnosis value and the clinical application of enzyme linked immunosorbent assay (ELISA) method and the immune turbidimetric method detecting serum anti cyclic citrullinated peptide (CCP)antibody in patients with RA.Methods Collected fresh serum specimen of 267 inpatients with RA in Rrheumatism Department of Xi’an Institu-te of Rheumatism from December 2014 to February 2015,and fresh serum specimen of 50 healthy blood donors from the Blood Center of Shaanxi Province respectively.Anti CCP antibody was detected by enzyme-linked immunosorbent assay (ELISA)method and the latex immunoturbidimetry assay.Evaluated the correlation of the results and clinical application to RA diagnosis.Results Sensitivity,specificity and diagnostic consistency of ELISA and latex immunoturbidimetry assay were 77.3%,86.8%,94.3% and 76.2%,80.2%,77.9% respectively.Compared two kinds of methods,the value of Kappa was 0.756,for having consistency.Throughχ2 test (χ2 =1.85,P >0.05),there was no significant difference between two meth-ods.Area of ELISA and lateximmunoturbidimetry under the ROC curve were 0.876 and 0.832 respectively.Conclusion De-tection of serum anti CCP antibody has diagnostic value in RA patients.The ELISA method and the latex immunoturbidime-try assay for detection of anti CCP antibodies had consistency.Two methods had no statistical difference,and the latex turbi-dimetric method is suitable for grassroots medical institutions.
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Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation (all-HSCT),and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients.Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation,14 d,28 d,3 m,6 m,9 m,1 y,1.5 y,2 y,2.5 y,and above 2.5 y after HSCT,and analyse thymic output function and related factors after HSCT.sjTREC levels in 24 normal individuals were also determined to use as the normal range.Results The mean of Log (sjTREC copies/ml) in normal individuals was 3.74±0.26.Negative correlation existed between thte Log sjTREC and the age (r =-0.65,P ＜ 0.01).There was no clear association between the TREC and the gender.Log sjTREC in pre-transplantation patients was 3.09±0.52,and the levels of sjTREC in 14 d,28 d,6 m,1 y after HSCT were 1.18±0.22,2.16±0.31,1.31±0.2,1.83±0.31,respectively.There was no significant difference between normal individuals and patients 1.5 years after HSCT.The post-transplantation level of sjTREC was not related to the age,but was negatively correlated to the acute graft versus host disease (aGVHD) 1 year after HSCT.There was no difference between patients with or without aGVHD 1.5 years post-HSCT.Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT.The recovery of thymic output function after allo-HSCT is slow,in which aGVHD may have a negative effect.
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Objective To explore the high-risk factors,clinical characteristics,therapy and prognosis of invasive fungal infection (IFI)in patients underwent allogeneic haemopoietic stem cell transplantation (AlloHSCT). Methods One hundred patients underwent Allo-HSCT at our department from March 2002 to July 2010 were analyzed retrospectively,among whom 26 patients had invasive fungal infection(IFI). Seven patients had pulmonary IFI before allo-HSCT, 14 patients had pulmonary IFI after allo-HSCT,3 patients had respiratory tract system IFI, and 2 patients had intestinal IFI. We observed the occurrence of Graft-versus-host disease (GVHD) ,cytomegalovirus( CMV )infection, Lymphocyte subsets and chronic basic diseases in patients with IFI. The twenty six cases were divided into two groups: experience therapy group with 12 cases and preemption therapy group with 14 cases. Results Among 26 patients with IFI,20 cases suffered from GVHD,6 cases had CMV infection,19 cases had low cellular immune function simultaneously. 1 case had diabetes,3 patients had pulmonary tuberculosis and 1 case had bronchiectasis as complications. In experience therapy groupe: 8 cases (67%)recovered completely but 1 case(8% )suffered from progressive infection. In preemption therapy groupe:3 cases ( 21% ) recovered completely but 5 cases ( 36% ) suffered from progressive infection. Conclusion Clinician should pay close attention to the patients with high-risk factors of IFI after allo-HSCT.
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Objective To evaluate the therapeutic effects of allogeneic hematopoietic stem cell transplantat (allo-HSCT) for severe aplastic anemia (SAA). Methods Four patients of SAA underwent allo-HSCT at the bonemarrow transplant unit in our hospital from March 2003 to May 2009. Stem cell source was an HLA (human leukocyte antigen) matched related donor (MRD) in 3, HLA 1 (B) mismatched related donor in 1 patient A retrospective analysis was performed on interval from diagnosis to transplant,HSCT manners,conditioning regimens, hematopoiesis reconstitution, effectiveness and complication. Results The interval from diagnosis to transplant was 70 (19 - 180) days. Three patients (MRD) underwent BM + PBSCT, one was undergone BM + PBSC + CBSCT. Conditioning regimens of all patients were CY/ATG. Hematopoiesis reconstitution was achieved in 4 patients (100%). The median time of neutrophils which reached 0. 5 x 109/L and platelets reached 20 × 109/L were 14. 5 (9-28) and 16(9 -28) days. Two cases developed grade Ⅰ acute graft-versus-host diseaes (aGVHD), chronic local GVHD occurred in one patient. Four patients are alive with a median time of 40. 6(2 -63) months at the end of the following-up. Conclusions Allo-HSCT are an efficient and safe therapy for the patient with SAA,not only for patients with HLA matched related donor,but also for those only HLA mismatched related donor available.
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Objective:To establish the technique for T lymphocytes inducted and differentiated by using human hematopoietic stem/progenitor cells ex vivo and to provide a technological platform for studying T cells biological characteristics and cellular immune.Methods:Human CD34-positive cells were isolated from umbilical cord blood by using a high-gradient magnetic cell sorting system(MACS) and CD34+ cells were seeded on human fetal thymic stromal monolayer system.Liquid culture system contains hematopoietic cytokines(FL+IL-12+IL-7+IL-2) and 20% human AB serum.Non-adhension cells were obtained after 7?14?28?35?42 days of culture respectively to analysis T cells phenotype by FACS using T cells specific monoclonal antibody.T cells morphology were also studied.Results:After 2 weeks of culture CD4+CD8+ immature T lymphocytes wre about 0 3%～13 3% and the peak value is 16 6%～26 5% at 4～5 weeks of culture.CD4-CD8+ and CD4+CD8- T cells that coexpressed CD3 cells increased at 26 5%～64 9% and 11 6%～38 9% after 6 weeks of culture.Wright staining shows that the mature T cells harvested after mitogenic stimulation have the presence of large cells with lymphoblast morphology.Conclusion:Human umbilical cord blood CD34+ cells could be differentiated into T lymphocytes by the culture conditions of human fetal thymic stromal monolayer system and the cytokine combination of FL+IL-12+IL-7+IL-2,and the T cells can be stimulated by IL-2+PHA.