桃红二芍汤对血瘀型寻常型银屑病临床疗效及血清免疫细胞的影响

目的:血瘀型寻常型银屑病患者服用桃红二芍汤,对治疗银屑病的临床疗效进行分析及探讨对血清免疫细胞的影响。方法:选取我院血瘀型寻常型银屑病患者104例,采用随机分配法,分为对照组及治疗组,每组52例。对照组给予常规的阿维A药物治疗,治疗组在此基础上用桃红二芍汤进行治疗,比较治疗前后银屑病的皮损面积和严重度指数评分及记录起效时间和复发时间,并测定血清免疫细胞因子水平。结果:与对照组相比较,治疗组患者的皮损面积和严重度指数评分均较阿维A对照组明显降低,组间差异具有显著性(P<0.05)。治疗后治疗组患者起效时间较对照组起效时间要延迟,复发率降低。治疗组的CD4+、CD4+/CD8+水平较对照组明显升高(P<0.05)。而CD8+水平在治疗前与治疗后无明显差异性(P>0.05)。结论:桃红二芍汤可明显降低血瘀型寻常型银屑病患者的皮损面积和严重度评分,有效改善血清免疫细胞水平,虽中药汤剂起效时间较长,但复发率降低,在临床治疗中可应用。

自拟养血排毒汤对老年银屑病患者血清免疫细胞因子的影响研究

目的:研究自拟养血排毒汤对老年银屑病患者血清免疫细胞因子的影响效果。方法:选择我院2015年5月~2016年8月收治的86例老年银屑病患者,按照随机数字法分为研究组和对照组,每组各43例,研究组采取自拟养血排毒汤,对照组采取常规治疗,比较两组患者治疗效果。结果:研究组总有效率有93.02%,明显较对照组81.40%高(χ~2=6.053,P<0.05);治疗前两组IFN-γ、TNF-α以及IL-6水平均无明显差别(t=0.276,1.024,0.306,P>0.05);治疗后发现研究组各项免疫细胞因子水平均较对照组改善,差别具有统计学意义(t=-9.379,-5.456,-9.762,P<0.05)。结论:老年银屑病患者采取自拟养血排毒汤效果较好,可有效改善患者免疫细胞因子水平,缓解皮损情况,促进病情恢复。

黄芪对儿童过敏性鼻炎哮喘综合征血清总免疫球蛋白E及嗜酸性粒细胞的影响

目的观察黄芪对儿童过敏性鼻炎哮喘综合征血清总免疫球蛋白E(IgE)及嗜酸性粒细胞(EOS)计数水平的影响。方法过敏性鼻炎哮喘综合征儿童30人,分别在服用黄芪前及服用黄芪1,3,6个月时,监测血清总lgE及EOS计数水平,观察血清总lgE及EOS计数水平的变化。结果黄芪可使血清总lgE及EOS计数水平下降,在服用3,6个月时,血清总lgE及EOS计数水平下降明显,差异具有统计学意义。结论黄芪能有效降低儿童过敏性鼻炎哮喘综合征血清总IgE及EOS计数水平,预防并控制过敏性鼻炎哮喘综合征。

血清sTREM-1、sTim3、cullin4A与肺结核患者肺部受累情况的相关性

目的研究血清可溶性髓系细胞触发受体-1(sTREM-1)、可溶性T细胞免疫球蛋白黏蛋白3(sTim-3)、泛素连接酶4A(cullin4A)在反映4MRZE化疗方案的疗效及肺结核患者肺部受累情况中的价值。方法将2018年1月至2021年1月武汉市金银潭医院及赤壁市人民医院收治的265例肺结核患者根据治疗方案的不同分为采用2H3R3Z3E3/4H3R3标准四联疗法方案治疗的对照组(n=97)、4MRZE超短程化疗方案治疗的4MRZE组(n=88)和2HRZE/4HR方案治疗的2HRZE/4HR组(n=80)。比较3组治疗后临床疗效,以及治疗前和治疗2、4个月血清sTREM-1、sTim3、cullin4A水平变化,分析血清sTREM-1、sTim3、cullin4A在反映肺结核患者肺部受累情况中的价值。结果4MRZE组、2HRZE/4HR组治疗2、4个月时的痰菌转阴率及病灶有效吸收率均高于对照组(P<0.05),且4MRZE组高于2HRZE/4HR组(P<0.05);在治疗过程中,3组患者血清sTREM-1、sTim3呈下降趋势,而cullin4A mRNA呈上升趋势,且4MRZE组患者治疗2、4个月的血清sTREM-1、sTim3显著低于2HRZE/4HR组、对照组(P<0.05),而cullin4A mRNA显著高于2HRZE/4HR组、对照组(P<0.05)。但是治疗完成后,3组痰菌转阴率、病灶有效吸收率,以及血清sTREM-1、sTim3水平比较,差异无统计学意义(P>0.05)。结论4MRZE化疗方案在肺结核治疗中具备治疗周期短的同时保证治疗效果良好的优点。血清sTREM-1、sTim3、cullin4A水平在反映痰菌转阴及病灶有效吸收中具有一定价值。

氧氟沙星结合奥硝唑对慢性盆腔炎患者的疗效及价值体会

探讨针对收诊的慢性盆腔炎患者施展药物联合治疗(即:氧氟沙星+奥硝唑),观察体会其医治价值。方法 研究地址为笔者所在医院,并于2022年1月及至2023年6月区间段收诊的以慢性盆腔炎为诊断患者100例作为目标对象,依照抽签形式分2组,每一组涵括50例病例,即:对照组(予以奥硝唑药物医治)、观察组(予以氧氟沙星+奥硝唑药物医治)。结果 对两派在临床症状改善方面施予评定,医治后得出,观察组的白带增多、盆腔积液等各个方面的所有数据都处于较低级别(P<0.05)。对两派血清炎性因子水平检验数值施加统计,凸显医治后观察组各检验值均为更低级别(P<0.05)。对两派的血清免疫因子的化验数据予以统计,突出观察组医治完毕后所得各项目数据均处于更高趋向(P<0.05)。对两派的卵巢血流动力学指标行统计工作后发现,观察组各指标均显赫高于对照组(P<0.05)。对两派的不良反应发生数据展开比拟,呈现在服药治疗期间两组数据差异较小(P>0.05)。对两派的医治有效率施展比拟,呈现观察组为更高倾向(P<0.05)。对两派疾病复发率施加统计,得出观察组2.00%,对照组数据为14.00%,显然前者数据为更低(χ2=5.357,P=0.021)。结论 针对收诊的慢性盆腔炎患者施展药物联合治疗(即:氧氟沙星+奥硝唑),相较单纯奥硝唑用药治疗,在临床上更具有多方面优势,即:改善临床症状明显,利于炎症消散,提高机体免疫功能,改善卵巢血流水平,用药更为安全有效,降低反复发作,作用效果显著。

手足口病患儿血清淋巴细胞免疫分型的水平变化及临床意义

目的探讨手足口病患儿中血清淋巴细胞免疫分型水平变化,为诊断及治疗手足口病提供临床诊治意义。方法选取四川省宜宾市第一人民医院2013年3月~2015年3月儿科手足口患儿150例(分为重症组54例,轻症组96例)及行儿科保健健康儿童105例;采用流式细胞仪进行血清淋巴细胞免疫分型的水平检测,并行组间比较。结果重症患儿血清淋巴细胞免疫分型水平较轻型低,轻型较健康儿童水平低,差异有统计学意义(P<0.05)。结论手足口病患儿免疫功能较正常健康儿童呈降低趋势,其中重症患儿免疫功能更低,分析血清淋巴免疫细胞分型水平可作为手足口病患儿判断疾病病情变化及临床治疗观察的一种方法。

New multi protein patterns differentiate liver fibrosis stages and hepatocellular carcinoma in chronic hepatitis C serum samples

AIM： To identify a multi serum protein pattern as well as single protein markers using surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry （SELDI-TOF-MS） for detection and differentiation of liver fibrosis （F1-F2）, liver cirrhosis （F4） and hepatocellular carcinoma （HCC） in patients with chronic hepatitis C virus （HCV）. METHODS： Serum samples of 39 patients with F1/F2 fibrosis, 44 patients with F4 fibrosis, 34 patients with HCC were applied to CM10 arrays and analyzed using the SELDI-TOF ProteinChip System （PBS-Ⅱc; Ciphergen Biosystems） after anion-exchange fractionation. All patients had chronic hepatitis C and histologically confirmed fibrosis stage/HCC. Data were analyzed for protein patterns by multivariate statistical techniques and artificial neural networks. RESULTS： A 4 peptide/protein multimarker panel （7486, 12843, 44293 and 53598 Da） correctly identified HCCs with a sensitivity of 100% and specificity of 85% in a two way-comparison of HCV-cirrhosis versus HCV-HCC training samples （AUROC 0.943）. Sensitivity and specificity for identification of HCC were 68% and 80% for random test samples. Cirrhotic patients could be discriminated against patients with F1 or F2 fibrosis using a 5 peptide/protein multimarker pattern （2873, 6646, 7775, 10525 and 67867 Da） with a specificity of 100% and a sensitivity of 85% in training samples （AUROC 0.976） and a sensitivity and specificity of 80% and 67% for random test samples. Combination of the biomarker classifiers with APR/score and alfa-fetopotein （AFP） improved the diagnostic performance. The 6646 Da marker protein for liver fibrosis was identified as apolipoprotein C-I. CONCLUSION： SELDI-TOF-MS technology combined with protein pattern analysis seems a valuable approach for the identification of liver cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis C. Host probably a combination of different serum markers will help to identify liver cirrhosis and early-stage hepatocellular carcinomas in the future.

Serum levels of soluble Fas, nitric oxide and cytokines in acute decompensated cirrhotic patients

AIM： To evaluate plasma levels of nitrite/nitrate （NOx）, soluble Pas （spas） antigen, tumor necrosis factor alpha （TNF-α） and interleukin-6 （IL-6） in patients with compensated and acute decompensated cirrhosis and to evaluate mediators causing acute decompensation in liver cirrhosis, METHODS： This prospective study was conducted in the medical intensive care unit of an academic tertiary center, Fifty-five patients with acute decompensation （gastrointestinal hemorrhage, encephalopathy, hydropic decompensation） and twenty-five patients with compensated liver drrhosis were included, Blood samples were taken for analyses of spas, Nox, IL-6, TNF-α, Liver enzymes and kidney functions were also tested, RESULTS： In patients with acute decompensation, plasma spas levels were higher than in non-decompensated patients （15305 ± 4646 vs 12458± 4322 pg/mL, P 〈 0.05）. This was also true for the subgroup of patients with alcoholic liver cirrhosis （P 〈 0.05）. The other mediators were not different and none of the parameters predicted survival, except for ALT （alanine-aminotransferase）. In patients with portal-hypertension-induced acute hemorrhage, NOx levels were significantly lower than in patients with other forms of decompensation （70.8 ± 48.3 vs 112.9 ± 74.9 pg/mL, P 〈 0.05）. When NOx levels were normalized to creatinine levels, the difference disappeared. IL-6, TNF-α and spas were not different between bleeders and non-bleeders. In decompensated patients spas, IL-6 and NOx levels correlated positively with creatinine levels, while IL-6 levels were dependent on Child class. CONCLUSION： In acute decompensated cirrhotic patients sPas is increased, suggesting a role of apoptosis in this process and patients with acute bleeding have lower NOx levels, However, in this acute complex clinical situation, kidney function seems to have a predominant influence on mediator levels,

L-arginine administration ameliorates serum and pulmonary cytokine response after gut ischemia-reperfusion in immature rats

AIM: Small intestinal ischemia-reperfusion (IR) has been demonstrated to result in both local mucosal injury and systemic injuries. The exact role of nitric oxide (NO) in intestinal IR is unclear. We propose that NO and some other cytokines change in the reperfusion period and these changes are associated with lung injury. The aim of this study was to determine the effect of supplementing NO substrate, L-arginine (L-arg), on serum and pulmonary cytokine production during small intestinal IR in immature rats. METHODS: Immature rats underwent 60 min. of superior mesenteric artery occlusion followed by 90 min of reperfusion. L-arg (250 mg/kg) was given intravenously to the experimental group (IR+L-arg) which received L-arg after 45 min of intestinal ischemia. Serum and lung endothelin-1 (ET-1), NO, malondialdehyde (MDA), and tumor necrosis factor a (TNFα) were measured. Sham operation (SHAM) and intestinal IR (IR) groups were performed as control. The lavage fluid of the lung was collected by bronchoalveolar lavage (BAL) and white blood cells and polymorphonuclear cells (PMNs) were immediately counted to identify lung damage. RESULTS: When L-arg was given during small intestinal IR, serum NO concentration increased significantly in IR+L-arg group (162.17±42.93 μmol/L) when compared with IR group (87.57±23.17 μmol/L, t=3.190, P= 0.008 <0.01). Serum MDA reduced significantly in IR+L-arg group (8.93±1.50 nmol/L) when compared with SHAM (23.78±7.81 nmol/L, t= 3.243, P= 0.007<0.01) and IR (25.54±9.32 nmol/L, t= 3.421, P= 0.006<0.01). ET-1 level in lung tissues was significantly lower in IR+L-arg group (13.81±7.84 pg/mL) than that in SHAM (35.52±10.82 pg/mL, t= 2,571, P= 0,03<0.05) and IR (50.83±22.05 pg/mL, t= 3.025, P= 0.009<0.01) groups. MDA contents in lung tissues were significantly lower in IR+L-arg group (10.73±1.99 nmol/L) than in SHAM (16.62±2.28 nmol/L, t= 3.280, P = 0.007<0.01) and IR (21.90±4.82 nmol/L, t= 3.322, P= 0.007<0.01) groups. Serum and lung TNFα concentrations were not significantly different in three groups. NO contents in lung homogenates and white blood cell counts in BAL had no significant difference in three groups; but the percentage of PMNs in BAL was 13.50±8.92, 33.20±16.59, and 22.50±6.09 in SHAM, IR, and IR+L-arg groups, respectively. CONCLUSION: Small intestinal IR induced increases of pulmonary neutrophil infiltration in immature rats. Neutrophil infiltration in lung tissues was reduced by L-arg administration but remained higher than in SHAM group. L-arg administration during intestinal IR enhances serum NO production, reduces serum MDA and lung ET-1 and MDA levels, resulting in the improvement of systemic endothelial function. L-arg supplementation before reperfusion may act as a useful clinical adjunct in the management of intestinal IR, thus preventing the development of adult respiratory distress syndrome, even multiple organ dysfunction syndrome (MODS).

Role of serum interleukin-18 as a prognostic factor in patients with hepatocellular carcinoma

AIM:To determine whether serum interleukin-18 (IL-18) levels correlated with clinicopathologic features and prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Serum IL-18,IL-6 and IL-12 levels were measured by enzyme-linked immunosorbent assay (ELISA) from 70 patients with HCC and 10 healthy controls. RESULTS:Serum IL-18,IL-6 and IL-12 levels of patients with HCC were significantly higher that those of the controls. The levels of IL-18 correlated significantly with the presence of venous invasion and advanced tumor stages classified by Okuda's criteria. Patients with high serum IL-18 levels (≥ 105 pg/mL) had a poorer survival than those with low serum IL-18 levels (< 105 pg/mL) (4 and 11 mo,respectively,P = 0.015). Multivariate analyses showed that serum IL-18 level,but not IL-6 and IL-12 levels,was a significant and independent prognostic factor of survival. CONCLUSION:These findings demonstrate that serum IL-8 may a useful biological marker of tumor invasiveness and an independent prognostic factor of survival for patients with HCC. Thus,the detailed mechanisms of IL-18 involving in tumor progression should be further investigated.

Serum-free culture of H pylori intensifies cytotoxicity

AIM： To perform a long culture passage of H pylori without serum, taking into account its cytotoxicity and the presence of the probable new cytotoxic factor. METHODS： One sample of H pylon 60190 （ATCC 49503） was grown on Brain Heart Infusion （BHI） agar containing 0.5% 2,6-di-O-methyl-β-cyclodextrin without any serum, being passaged 70-100 times every 3-4 d for approximately 2 h, while another sample of H pylori contained 70 mL/L fetal calf serum without 2,6-di-O- methyl-β-cyclodextrin. Their supernatant and extract after 16 h in culture were evaluated for changes in cell morphology and for cell viability using HeLa cells. Furthermore, the characteristics of the probable cytotoxic factor in the extract were examined on partial purification studies and its oytotoxicity was evaluated in various human cells. RESULTS： The supernatant and the extract of the bacterium grown on serum-free medium had strong cytotoxicity compared with those grown on serumcontaining medium. They irreversibly damaged HeLa cells without vacuolation that was altogether different from that of the bacterium when grown with serum. Their cytotoxicity was easily measured by cell viability assay. The probable cytotoxic factor partially purified and detected by chromatography had characteristics difference from that of vacuolating toxin and a broad cytotoxicity toward various cell lines. CONCLUSION： Serum-free long culture method of H pylorl makes its supernatant and its extract cytotoxic enough to be easily measured by cell viability assay. The probable cytotoxic factor has a unique characteristic and might be a new cytotoxin.

Preparation of BFV Gag Antiserum and Preliminary Study on Cellular Distribution of BFV

Viruses (e.g. Human immunodeficiency virus, Human simplex virus and Prototype foamy virus) are obligate intracellular parasites and therefore depend on the cellular machinery for cellular trafficking. Bovine foamy virus (BFV) is a member of the Spumaretrovirinae subfamily of Retroviruses, however, details of its cellular trafficking remain unknown. In this study, we cloned the BFV gag gene into prokaryotic expression vector pET28a and purified the denaturalized Gag protein. The protein was used to immunize BALB/c mouse to produce antiserum, which could specifically recognize the BFV Gag protein in BFV-infected cells through western blot assay. Additionally, these results demonstrated that both the optimal and suboptimal cleavage of Gag protein occur in BFV-infected cells. Subsequently, the Gag antiserum was used to investigate subcellular localization of BFV. In immunofluorescence microscopy assays, colocalization microtubules (MTs) and assembling viral particles were clearly observed, which implied that BFV may transport along cellular MTs in host cells. Furthermore, MTs-depolymerizing assay indicated MTs were required for the efficient replication of BFV. In conclusion, our study suggests that BFV has evolved the mechanism to hijack the cellular cytoskeleton for its replication.

Acute liver failure caused by drug-induced hypersensitivity syndrome associated with hyperferritinemia

Drug-induced hypersensitivity syndrome(DIHS) is a severe reaction usually characterized by fever,rash,and multiorgan failure,occurring 2-6 wk after drug introduction.It is an immune-mediated reaction involving macrophage and T-lymphocyte activation and cytokine release.A 54-year-old woman was diagnosed with rheumatic arthritis and initiated salazosulfapyridine by mouth.About 10 d later,she had a high fever,skin rash and liver dysfunction.She was admitted to hospital and diagnosed with a drug eruption.She was treated with oral prednisolone 30 mg/d;however,she developed high fever again and her blood tests showed acute liver failure and cytopenia associated with hyperferritinemia.She was diagnosed with acute liver failure and hemophagocytosis caused by DIHS.She was transferred to the Department of Medicine and Bioregulatory Science,Kyushu University,where she was treated with arterial steroid injection therapy.Following this treatment,her liver function improved and serum ferritin immediately decreased.We hypothesized that an immune-mediated reaction in DIHS may have generated over-activation of macrophages and T-lymphocytes,followed by a cytokine storm that affected various organs.The measurement of serum ferritin might be a useful marker of the severity of DIHS.

Clinical study on radiofrequency combined with ^(131)I therapy for dedifferentiated thyroid carcinomas

Objective:The aim of this study was to explore clinical efficiency of radio frequency combined with 131I therapy for dedifferentiated thyroid carcinoma.Methods:All patients have been treated by radiofrequency connected with 131I in 29 cases of dedifferentiated thyroid carcinoma which performed radionuclide imaging and Ig array of blood serum before and after therapy,respectively.Results:There were 4(4/29) positive cases of radionuclide imaging before treatment and 19(19/29) cases 2 weeks after therapy,25(25/29) cases of overall efficacy and 15(15/29) curative cases. Conclusion: Radiofrequency connected with 131I improve clinical efficacy of 131I treatment for dedifferentiated thyroid cancer of thyroid in view of higher absorbing 131I of thyroid cancerous cell.

SERUM HAPTOGLOBIN SUPPRESSES T-LYMPHOCYTE FUNCTIONS FOLLOWING BURNS

It is well known that serum immunosuppressive factors play an important role in the mechanism of postburn immunosuppression.This study was intended to investigate the effect of haptoglobin, purified from the serum of burned patients by affinity chromatography,on the proliferation and interleukin-2(IL-2) secretion of normal murine thymocytes induced by ConA and the proliferation of IL-2 dependent cell line(CTLL-2) stimulated by recombinant human IL-2,so as to elucidate the role of serum haptoglobin in postburn T-lymphocyte dysfunction.The results showed that purified haptoglobin,at the level equivalent to the concentration found in serum of burned patients,significantly inhibited the proliferation and IL-2 secretion of normal murine thymocytes as well as CTLL-2 proliferation;whereas it exhibited no immunosuppressive effects at the level equivalent to the concentration found in serum of nomal volunteers.According to the results reported here,it is suggested that extraordinary increase in serum haptoglobin level may be an important factor of impaired T-lymphocyte responses following burns.

MEASUREMENT OF SERUM GRANULOCYTE COLONY-STIMULATING FACTOR LEVELS IN PATIENTS WITH DIFFERENT PHASE OF INFECTION

Objective To detect the serum granulocyte colony-stimulating factor (G-CSF) levels betweenthe patients with frequently repeated infection ( repeaters) and others (non-repeaters) in different phase of infection.Methods An enzyme-linked immunosorbent assay (ELISA) method was used to detect serum G-CSF levels in 50cases (32 non-repeaters and 18 repeaters) with acute phase of infection. Serum G-CSF levels were detected inrecovery phase in 10 cases. Results Serum G-CSF levels were significantly higher (1429. 97 ±506. 43ng/L) in32 non-repeaters with acute infection. There was a positive correlation between white blood cell count ( WBC) andserum G-CSF level (r =0. 396, P <0. 05). There was also a positive correlation between absolute neutrophil count(ANC) and serum G-CSF level (r =0. 346,P <0. 05). Serum G-CSF levels were higher (98. 62 ±56. 40ng/L) in18 repeaters with acute infection. It was showed that serum G-CSF levels were significantly higher in non-repeatersthan in repeaters with acute phase of infection (P <0. 001). In the meanwhile, the body temperature was signifi-cantly higher in non-repeaters than in repeaters with acute infection (37. 95 ±0. 14 vs 36. 91 ±0. 13 ,P<0. 001). There were no significant differences in age, WBC, ANC, type of bacterial, liver function and renal func-tion (P >0. 05). Serum G-CSF levels in recovery phase of the two groups were below the sensitivity of the assay( <60 ng/L). Conclusion It is suggested that application of recombinant G-CSF may be useful for the patientswith repeated infection.

Biological indicators of sub-optimal health status

OBJECTIVE:To investigate biological indicators of sub-optimal health status and provide means of objective assessment of sub-optimal health status.METHODS:We set the unified standards for diagnosing a SHS.We tested various laboratory indicators in 407 cases that we selected randomly from2807 subjects and collected 15 mL of fasting venous blood from each case.We measured serum immunoglobulin A(IgA)and immunoglobulin G(IgG)concentrations,serum beta endorphins(β-EP),cortisol(C),testosterone(T),plasma adrenocorticotropic hormone(ACTH)and serum T lymphocyte subsets CD3+and CD4+.RESULTS:Mean serum testosterone concentrations and their ratio to cortisol(C)concentrations weresignificantly higher in the healthy group than in those with sub-optimal health status(P<0.01).Mean serum CD3+concentrations were significantly higher in those with sub-optimal health status than in the healthy group(P<0.05).CONCLUSION:Decreased serum testosterone/cortisol ratio may be an objective indication of sub-optimal health status.Changes in neuroendocrine and immunological indicators may explain some of the symptoms,including malaise and poor work performance,attributable to persistent or relapsing fatigue in subjects with sub-optimal health status.