[The subpopulation CD4(+); CD25(+); Foxp3(+);/CD127(low/-); regulatory T cells in peripheral blood of HIV-infected patients correlated with disease progression].

AIM: To explore the subpopulation of CD4(+); CD25(+); Foxp3(+); regulatory T cells (Treg), CD4(+); CD25(+); CD127(low/-); Treg in peripheral blood of HIV-infected patients and study its correlation with other immune indicators. METHODS: We enrolled 68 cases of HIV/AIDS patients without anti-HIV treatment [29 cases of long-term non-progressive (LTNP) group, 27 cases of typical progressive HIV infection group and 12 cases of AIDS group] and 20 healthy individuals as a control group. Blood samples of these cases were analyzed by flow cytometry after immunofluorescent staining to determine the levels of CD4(+); T cells, CD8(+); T cells, NK cells and CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg. RESULTS: Except CD8(+); T cells, the levels of CD4(+); T, NK cells and CD4(+);/CD8(+); in peripheral blood of HIV/AIDS patients were significantly lower than those in the control group (P<0.05); With the progression of disease, the percentage and absolute count of CD4(+);T cells, the absolute counts of CD8(+);T cells and NK cells, and CD4(+);/CD8(+); T cell ratio in the LTNP group, HIV group and AIDS group decreased gradually, while the percentage of CD8(+);T cells increased gradually. Our multiple comparison analysis revealed that the percentages of CD4(+); CD25(+); Foxp3(+); Treg and CD4(+); CD25(+); CD127(low/-); Treg in CD4(+); T cells were significantly different among groups (P<0.05). With the progression of disease, the percentages of CD4(+); CD25(+); Foxp3(+); Treg and CD4(+); CD25(+); CD127(low/-); Treg increased gradually; in addition, the difference in the absolute count of CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg was not statistically significant between LTNP group and healthy control group(P>0.05), so was between HIV and AIDS groups (P>0.05); no significant difference was found in every other two groups (P<0.05); the absolute count of CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg decreased gradually. CONCLUSION: CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg may play a role in the immunopathogenesis of persistent HIV infection.

[Discussion on the national standard, the Name and Location of Acupoints].

Location of a part of acupoints in the national standard, The Name and Location of Acupoints, are studied. In combination with anatomy, record of ancient literature and teaching experience, the location of Naohui (TE 13), Chengshan (BL 57), Fengshi (GB 31), Zhongdu (GB 32), Toulinqi (GB 15), Yinbao (LR 9) and Shaoshang (LU 11) in the national standard are analyzed and the relative location methods are raised.

[Randomized controlled trials of acupuncture at Tiaokou (ST 38) for treatment of periarthritis of shoulder].

OBJECTIVE: To study the basic therapeutic function of Tiaokou (ST 38). METHODS: According to clinically multi-central randomized controlled and single-blind test principle, 257 cases of periarthritis of shoulder were divided into two groups, a test group (n = 124) treated with oral anti-inflammatory analgesic medicine combined with acupuncture at Tiaokou (ST 38), and a control group (n = 133) treated with oral anti-inflammatory analgesic medicine. Their therapeutic effects were compared. RESULTS: The total effective rate for stopping pain was 96.0% in the test group and 91.7% in the control group with a very significant difference between the two groups (P< 0.01). And the total effective rate for improvement of shoulder activity was 86.3% in the test group and 59.4% in the control group with a very significant difference between the two groups (P<0.01). CONCLUSION: Oral anti-inflammatory analgesic medicine combined with acupuncture has obvious therapeutic effect on periarthritis of shoulder, which is better than that of simple oral anti-inflammatory analgesic medicine.

[Identification of IgG subclass and FVIII binding epitope of an acquired FVIII inhibitor in a bullous pemphigoid patient].

OBJECTIVE: To identify the clinical and laboratory diagnosis of a bullous pemphigoid patient with acquired hemophilia A (AH-A). To identify FVIII binding epitope and IgG subclass of the FVIII inhibitor, and explore the molecular mechanism for AH-A pathogenesis. METHODS: Plasma FVIII activity( FVIII: C) was determined by one-stage assay, the titre of FYIII inhibitor by Bethesda Unit (BU). IgG purification of patient plasma or normal pooled plasma was finished by protein A-agarose column chromatography. Activated partial thromboplastin time (APTT) was assayed for uncovering FVIII inhibitor effect on FVIII in vivo. Combined Western blot analysis by anti-IgG1, IgG2, IgG3 and IgG4 antibodies was used to determine the relative concentration of patient' s IgG subclass. IgG subclass concentrations were quantified by nephelometric method. Solid-phase binding assay of FVIII and FVIII inhibitor, combined with Western blot was used to recognize the binding epitope at which the FVIII inhibitor bound to FVIII. RESULTS: (1) Plasma APTT value of patient was prolonged evidently and could not be corrected by normal pooled plasma. Patient's FVIII: C was < 1.5%. The titre of FVIII inhibitor in patient plasma was 147.8 BU. (2) The purified patient IgG was able to inhibit FVIII: C of normal pooled plasma significantly with a dose dependent manner, and the patient plasma could prolong rabbit plasma APTT markedly with a time dependent manner. (3) The FVIII inhibitor was predominantly then of IgG4 subtype with a minority IgG1, and the concentration of IgG4 and IgG1 in the patient was higher than that in normal. The FVIII inhibitor reacted with FVIII 44 x 10(3) fragment epitope. CONCLUSIONS: The inhibiting effect of FVIII inhibitors on FVIII: C in the bullous pemphigoid patient with AH-A is determined and the IgG subclass of the FVIII inhibitor is identified. A binding epitope for the FVIII inhibitor is a FVIII 44 x 10(3) fragment. The results provides evidence for understanding the pathogenesis of AH-A.

[Changes in serum and urine ceruloplasmin concentrations in type 2 diabetes].

OBJECTIVE: To determine the changes in serum and urine ceruloplasmin (Cp) concentrations in type 2 diabetes, and to explore its clinical significance. METHODS: Cp concentrations of 57 serum samples were measured by radioimmunoassay and ratenephelometry. In the meantime, the serum and urine Cp concentrations in 110 healthy individuals and 104 type 2 diabetic patients were determined by ratenephelometry. For analysis and comparison, 104 type 2 diabetic patients were divided into imperfect glycemic control subgroup (n = 54) and perfect glycemic control subgroup (n = 50), diabetic nephropathy subgroup (n = 47) and non-diabetic nephropathy subgroup (n = 57). RESULTS: Serum Cp concentrations obtained with the radioimmunoassay and ratenephelometry methods were highly correlated and essentially indistinguishable. The cut-off point of the serum Cp concentrations was 542 mg/L and that of the ratio of Cp and creatinine was 0. 892 ng/mmol, which was determined according to the upper limit of 97.5% credit intervals or 97.5% percentile in 110 healthy individuals. Cp concentrations in type 2 diabetic patients were significantly higher than those in the healthy individuals (P <0.001). Of the type 2 diabetic patients, the imperfect glycemic subgroup had higher serum Cp concentrations than those of the perfect glycemic subgroup (P <0.01). The urine ratio of Cp and creatinine in diabetic nephropathy subgroup was significantly higher than that in non-diabetic nephropathy subgroup (P < 0.001). Urine ratio of Cp and creatinine in diagnosing diabetic nephropathy had 91.4% of sensitivity, 61.4% of specificity, and 75.0% of concordance. CONCLUSION: Detection of serum Cp levels has some reference value in understanding the state of diabetes. Combined determination of urine ratio of Cp and creatinine and ratio of albumin and creatinine is significant in the early diagnosis of diabetic nephropathy.