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1.
目的 探讨舌下含服粉尘螨滴剂脱敏治疗对特应性皮炎(atopic dermatitis,AD)患者辅助性T细胞(T helper cells,Th)的作用.方法 用酶联免疫吸附测定(enzyme-linked immuno sorbent assay,ELISA)方法检测AD患者舌下含服粉尘螨滴剂组(sublingual immunotherapy,SLIT组)和对照组治疗前后的外周血Th1(IFN-γ)、Th2(IL-4)、Th17(IL-17)的水平,用流式细胞技术检测两组治疗前后的调节性T细胞(regulatoryT cells,Treg)数量.然后用两独立样本t或校正t(t')检验对两组患者治疗前和治疗后的组内以及治疗后组间的IFN-γ、IL-4、IL-17和Treg水平分别进行对比研究.结果 SLIT组治疗后IL-4、IL-17较治疗前明显下降,IFN-γ和Treg较治疗前明显升高,差异有统计学意义(P<0.05).且SLIT组治疗后较对照组治疗后IL-4、IL-17下降更明显,IFN-γ升高更明显,差异有统计学意义(P<0.05).SLIT组治疗后Treg细胞数量较对照组治疗后升高更多,但差异无统计学意义(P>0.05).结论 在AD患者中,舌下含服粉尘螨滴剂治疗能降低其外周血IL-4、IL-17,升高IFN-γ和Treg水平而达到治疗的目的.  相似文献   

2.
目的:探讨Th17细胞、CD4+CD25+调节性T细胞(regulatory T cell,Treg)及其特异性转录因子RORγt和FoxP3在儿童过敏性紫癜(Henoch-Schonlein purpura,HSP)发病机制中的作用,为儿童HSP的治疗从调控Th17/Treg失衡作为切入点提供一条新思路。方法:以2012年2月——2013年3月我院(四川省人民医院)儿科诊治的初次发病的HSP急性期患儿40例作为研究对象,以及同期来我院体检的健康儿童40例作为对照,采用SYBR Green I实时荧光定量PCR技术测定外周血单个核细胞中RORγt mRNA和FoxP3 mRNA的表达水平;用流式细胞术测定外周血T淋巴细胞中Th17细胞和Treg细胞的表达水平;用双抗夹心ABC-ELISA技术测定血清IL-17A、TGF-β1、IL-2和IL-6浓度。结果:HSP组Th17细胞(2.75±0.60%)及RORγt mRNA(1.11±0.51)明显高于对照组Th17细胞(1.41±0.29%)及RORγt mRNA(0.65±0.24)(P0.01),而Treg细胞(4.56±1.26%)及FoxP3 mRNA(1.15±0.45)明显低于对照组Treg细胞(7.85±1.97%)及FoxP3 mRNA(2.32±1.13)(P0.01);HSP组血清IL-17A(40.40±11.81 pg/ml)、IL-6(75.38±27.19 pg/ml)、TGF-β1(309.41±81.03 pg/ml)与对照组IL-17A(20.32±10.70 pg/ml)、IL-6(25.16±8.31 pg/ml)、TGF-β1(236.34±66.01 pg/ml)相比明显升高(P0.01),而血清IL-2(25.60±13.19 pg/ml)水平与对照组(34.42±11.69 pg/ml)比较则降低(P0.01);在HSP组Th17细胞表达与RORγt mRNA、IL-17A、IL-6表达呈正相关,相关系数分别为0.887,0.938,0.934(P0.01);Treg细胞表达与FoxP3 mRNA,IL-2表达呈正相关,相关系数分别为0.834,0.932(P0.01)。结论:急性期HSP患儿存在Th17细胞、RORγt mRNA及IL-17A表达水平升高,Treg细胞和FoxP3 mRNA表达水平降低,Th17/Treg细胞的失衡;急性期HSP患儿存在血清TGF-β1、IL-6水平增高,IL-2水平降低,且Th17细胞表达水平与IL-6表达呈正相关,Treg细胞表达水平与IL-2表达呈正相关。  相似文献   

3.
陈月婵 《检验医学与临床》2020,17(14):2033-2035
目的分析原因不明复发性流产患者调节性T(Treg)细胞分泌的细胞因子、外周血自然杀伤(NK)细胞亚群及辅助性T(Th)相关细胞因子水平。方法选取该院2018年2月至2019年2月收治的41例原因不明复发性流产患者作为实验组;选取同期于该院进行检查的41例健康早孕者作为对照组。检测两组人群Treg细胞分泌的细胞因子(TGF-β、IL-10)、NK细胞亚群(CD56~+CD16~-、CD56~+CD16~+、CD56~-CD16~+)及Th1型细胞因子IL-2、IFN-γ,Th2型细胞因子IL-4、IL-10水平。结果实验组Treg细胞分泌的TGF-β、IL-10水平显著低于对照组(P0.05)。实验组CD56~+CD16~-、CD56~-CD16~+NK细胞亚群百分比显著低于对照组(P0.05),CD56~+CD16~+NK细胞亚群百分比显著高于对照组(P0.05)。实验组外周血IL-2、IFN-γ细胞因子水平显著高于对照组(P0.05);实验组IL-4、IL-10等细胞因子水平显著低于对照组(P0.05)。结论外周血Treg细胞分泌的细胞因子、NK细胞亚群及Th相关细胞因子水平可作为诊断原因不明复发性流产患者的重要参考指标。  相似文献   

4.
目的探究白介素37(IL-37)在变应性鼻炎(AR)患者外周血单核细胞(PBMCs)的表达水平及对相关细胞因子的免疫调控分析。方法选取120例AR患者作为研究组,另选择同期健康志愿者120例作为对照组,检测各组血清IL-37蛋白及mRNA表达,辅助性T细胞1(Th1)、Th2、Th17、CD4+CD25+调节性T细胞(Treg细胞)和Foxp3+CD4+CD25+Treg细胞百分比及相关细胞因子水平;提取2组PBMCs,并应用浓度为100、200 ng/mL的重组人IL-37蛋白(rIL-37)干预,分析干预前后相关细胞因子水平变化。结果研究组血清IL-37水平及IL-37 mRNA表达均显著低于对照组,Th1细胞、Th17细胞百分比及Th1/Th2比例显著高于对照组,Th2细胞、CD4+CD25+Treg细胞、Foxp3+CD4+CD25+Treg细胞百分比显著低于对照组,差异有统计学意义(P<0.05)。研究组IL-1β、IL-6、IL-17水平显著高于对照组,IL-4、IL-10、IL-27、IFN-γ、TGF-β1水平显著低于对照组,差异有统计学意义(P<0.05)。血清IL-37与IL-1β、IL-6、IL-17存在负相关性,与IL-4、IL-10、IL-27、IFN-γ、TGF-β1存在正相关性(P<0.05)。rIL-37干预后,研究组IL-1β、IL-4、IL-6、IL-10、IL-17、IL-27、IFN-γ、TGF-β1各指标变化更加显著,差异具有统计学意义(P<0.05)。200 ng/mL组干预PBMCs细胞各细胞因子变化水平相较于100 ng/mL组各指标变化更显著(P<0.05)。结论变应性鼻炎患者IL-37表达明显下降,进而影响了Th1/Th2、Th17/Treg细胞平衡,导致抑炎因子水平降低,促炎因子水平升高,在AR发病中具有重要作用。  相似文献   

5.
本研究旨在探讨成人再生障碍性贫血(aplastic anemia,AA)外周血Th17和CD4+CD25+调节性T细胞(Treg)表达情况。45例初发AA患者分为轻型AA(n=25)和重型AA(n=25)两组,15例正常人作为对照。应用流式细胞术检测AA患者外周血中Th17和CD4+CD25+Treg的比例,ELISA检测血清及刺激后外周血单个核细胞(PBMNC)上清液中的白介素(IL-17)、γ干扰素(IFN-γ)及肿瘤坏死因子-α(TNF-α)水平,并与正常对照组比较。结果表明:重型AA(SAA)组外周血Th17细胞比例,血清中IL-17及IFN-γ表达高于轻型AA(MAA)和正常人组,而重型AA组外周血CD4+CD25+Foxp3+Treg细胞比例降低。与轻型AA和正常对照相比,重型AA患者单个核细胞培养后上清液中IL-17及IFN-γ表达水平显著增加。AA患者血红蛋白计数与Th17细胞及血清IL-17表达呈负相关,与CD4+CD25+Treg表达成正相关。结论:重型AA患者外周血Th17细胞应答增强,而CD4+CD25+Treg细胞缺乏,贫血的严重程度与外周血Th17/Treg免疫应答失衡密切相关。  相似文献   

6.
目的研究小细胞肺癌(SCLC)患者外周血中辅助性T细胞1(Th1)、Th2、Th17及调节性T淋巴细胞(Treg)的表达情况,探讨其在SCLC进展中的作用。方法选择2016年1月至2018年4月本院收治的44例住院的SCLC患者(SCLC组)及24名健康者(对照组)作为研究对象。采用流式细胞法检测两组研究对象外周血中Th1、Th2、Th17及Treg细胞的表达情况,应用微量样本多指标流式蛋白定量技术(CBA)检测血清中的细胞因子IFN-γ、IL-17及IL-10的表达情况。结果SCLC组患者的外周血中Th1细胞、Th1/Th2、IFN-γ表达水平显著低于对照组,差异具有统计学意义(P<0.01)。SCLC组患者的外周血中Th2、Treg、Th17、Treg/Th17、IL-17、IL-10表达水平显著高于对照组,差异具有统计学意义(P<0.01)。结论SCLC患者外周血中Th1/Th2的降低、Treg/Th17的升高可能与SCLC的致病机理及预后密切相关,该结论将为SCLC的治疗提供新的思路。  相似文献   

7.
目的研究T淋巴细胞亚群与炎性因子检测在再生障碍性贫血(AA)病情及预后评估中的价值。方法选取本院收治的40例AA患者作为AA组,并进一步分为急性再生障碍性贫血(AAA)组和慢性再生障碍性贫血(CAA)组;同时选取同期于本院体检的40例健康者作为对照组。比较两组患者的血常规指标、外周血T淋巴细胞亚群百分率和血清炎性因子水平。结果AA组患者外周血辅助性T淋巴细胞(Th)Th1、Th17细胞百分率及Th1/Th2、Th17/调节性T淋巴细胞(Treg)比例均高于对照组(P0.05),Th2、Treg细胞百分率低于对照组(P0.05);AAA组外周血Th1、Th17细胞百分率及Th1/Th2、Th17/Treg比例高于CAA组,Th2、Treg细胞水平低于CAA组(P0.05)。AA组患者血清白细胞介素(IL)-2、IFN-γ、IL-17水平高于对照组,IL-4、IL-6、IL-10水平低于对照组,差异均有统计学意义(P0.05);AAA组血清中IL-2、干扰素-γ(IFN-γ)、IL-17水平高于CAA组,IL-4、IL-6、IL-10水平低于CAA组,差异均有统计学意义(P0.05);血红蛋白(Hb)水平、PTL与Th1、Th17细胞水平及IL-2、IFN-γ、IL-17水平呈负相关,与Th2、Treg细胞水平及IL-4、IL-6、IL-10水平呈正相关。结论 AA患者外周血中T淋巴细胞亚群百分率及血清炎性因子水平存在异常,而且与反映病情严重程度及预后的指标具有良好的相关性。  相似文献   

8.
目的研究调节性T细胞(Treg)与Th细胞因子IFN-γ、IL-4在子宫颈癌患者外周血中的表达水平,探讨其与人乳头瘤病毒(HPV)感染的宫颈疾病之间的关联。方法应用流式细胞及酶联免疫吸附技术检测40例子宫颈癌、35例宫颈上皮内瘤变(CIN)、20例宫颈炎患者及20例健康对照组外周血中Treg及IFN-γ、IL-4的水平;统计观察Treg与IFN-γ及IL-4水平的相关性。结果子宫颈癌组Treg的水平显著高于健康对照组、宫颈炎组及CIN组,差异有统计学意义(P0.05)。子宫颈癌患者血清中IFN-γ水平明显低于健康对照组及宫颈炎组(P0.05)。子宫颈癌患者血清中IL-4水平明显高于健康对照组、宫颈炎组及CIN组(P0.05)。Treg的水平与IFN-γ的水平呈负相关关系(r=-0.291,P0.05);而与IL-4水平呈正相关关系(r=0.383,P0.05)。结论 Treg的高水平以及Th细胞因子失衡可能在子宫颈癌患者免疫耐受以及子宫颈癌前病变进展至子宫颈癌的过程中发挥重要的作用;Treg与IFN-γ及IL-4存在相关性,Treg与Th细胞因子IFN-γ及IL-4可能共同参与了子宫颈癌的发病机制。  相似文献   

9.
《现代诊断与治疗》2015,(10):2254-2255
将200例反复呼吸道感染患儿随机分两组(匹多莫德组和对照组)。每组100例,匹多莫德组在常规治疗的基础上给予匹多莫德口服,对照组只给予常规治疗。随访一年,详细记录两组患儿治疗前后的临床症状及T细胞亚群的检测结果。检测同期来我院体检的2~13岁正常儿童T细胞亚群做治疗前对照。结果治疗前RRTI组较对照组CD4+、CD4+/CD8+值明显降低(P<0.05);匹多莫德组治疗有效率明显高于对照组(P<0.05),治疗后匹多莫德组CD4+水平、CD4+/CD8+值明显升高,与对照组比较P<0.05,有统计学意义。RRTI患儿T细胞亚群功能明显低下,匹多莫德通过调节反复呼吸道感染患儿的T细胞亚群的平衡,提高了患儿的细胞免疫功能,对反复呼吸道感染患儿的治疗有明显疗效,且无明显不良反应。  相似文献   

10.
目的观察儿童过敏性紫癜(Hench-schonlein purpura,HSP)急性期T细胞亚群及B细胞的变化,探讨其在HSP发病机制中的作用。方法四川省人民医院儿科2015年8月至2016年5月收治的急性期HSP患儿46例(HSP组)以及健康对照儿童30例(对照组),采用流式细胞仪检测两组患儿外周血T细胞亚群CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD4^+CD25^+及B细胞CD19^+、CD19^+CD23^+的表达。采用ELISA法测定血清IFN-γ、IL-4浓度。结果 HSP组CD3^+、CD3^+CD4^+、CD4^+/CD8^+、CD4^+CD25^+较对照组降低(P<0.01),CD3^+CD8^+较对照组升高(P>0.05)。HSP组B细胞CD19^+、CD19^+CD23^+及血清IL-4水平高于对照组(P<0.01),血清IFN-γ水平低于对照组(P<0.01)。结论 HSP患儿急性期存在Th1/Th2失衡,Th2优势活化;CD4^+CD25^+调节性T细胞功能低下;CD3^+、CD3^+CD4^+、CD3^+CD8^+T淋巴细胞亚群的功能紊乱及B淋巴细胞的增殖、活化。  相似文献   

11.
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.  相似文献   

12.
ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.  相似文献   

13.
14.
Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.  相似文献   

15.
Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.  相似文献   

16.
This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.  相似文献   

17.
目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高<20%视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P<0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P<0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P<0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.  相似文献   

18.
The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.  相似文献   

19.
20.
Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.  相似文献   

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