Is hyperuricemia an independent prognostic factor for IgA nephropathy: a systematic review and meta-analysis of observational cohort studies

BackgroundHyperuricemia has been reported to be correlated with IgA nephropathy (IgAN). However, whether hyperuricemia or elevated serum uric acid (SUA) is an independent prognostic factor of IgAN remains unknown. Therefore, this systematic review and meta-analysis evaluated the prognostic value of hyperuricemia and elevated SUA in IgAN.MethodsDatabases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Open Gray were reviewed systematically. The kidney failure events of IgAN were defined as a doubling of serum creatinine, halving of eGFR, end-stage renal disease (ESRD), or death. The risk ratio (RR) between hyperuricemia and IgAN-caused kidney failure was evaluated before and after adjustment for relevant covariates. The RR between elevated SUA and IgAN-caused kidney failure was evaluated after adjustment for relevant covariates.ResultsA total of 11 548 patients from 14 studies were included in this meta-analysis. Hyperuricemia was found to be an independent prognostic factor of IgAN (unadjusted RR = 2.79, 95% CI = 1.93–4.03, p for heterogeneity <0.00001, I² = 91%; adjusted RR = 2.12, 95% CI = 1.64–2.73, p for heterogeneity = 0.86, I² = 0%). Subgroup and sensitivity analyses confirmed the stability of these results. Similarly, elevated SUA was positively correlated with kidney failure events of IgAN (adjusted RR = 1.25, 95% CI = 1.19–1.31, p for heterogeneity = 0.6, I² = 0%).ConclusionOur meta-analysis showed that hyperuricemia and elevated SUA were both independently associated with an increased incidence of kidney failure events in IgAN patients.     

针刺"治风六穴"治疗慢性荨麻疹疗效观察

目的观察针刺“治风六穴”治疗慢性荨麻疹的临床疗效。方法将106例慢性荨麻疹患者随机分为观察组和对照组,每组53例。观察组予“治风六穴”针刺治疗;对照组给予氯雷他定口服。观察两组治疗前后症状总积分,血清白细胞介素4(IL-4)、免疫球蛋白E(IgE)、γ-干扰素(IFNγ-)水平变化,并比较两组临床疗效。结果观察组总有效率为92.5%,明显高于对照组的75.5%(P<0.05)。观察组治疗后临床症状各项评分、皮肤病生活质量指数(DLQI)评分明显低于对照组(P<0.05);观察组血清IL-4和IgE水平明显低于对照组,IFNγ-水平明显高于对照组,差异有统计学意义(P<0.05)。结论针刺“治风六穴”能明显改善慢性荨麻疹患者瘙痒、风团症状及生活质量,对血清IL-4、IgE和IFNγ-水平有明显的调节作用。     

纳米膜过滤和低pH孵放法去除/灭活静注人免疫球蛋白中病毒效果的验证

目的:验证纳米膜过滤法和低pH孵放法去除/灭活静注人免疫球蛋白中病毒的效果。方法:纳米膜过滤法选用猪细小病毒为指示病毒,低pH孵放法选用水疱性口炎病毒、辛德比斯病毒、HIV和伪狂犬病毒为指示病毒,高浓度静注人免疫球蛋白在pH4.6～5.0、30～32 ℃条件下作用不同时间后,取样检测样品中残余病毒滴度以评价病毒灭活效果...     

不同过滤条件对去除血浆组分Ⅱ溶解液中IgA的效果初探

目的:初步筛选去除血浆组分Ⅱ溶解液中IgA效果最佳的pH条件和滤膜载量。方法:以不同pH组分Ⅱ溶解液进行过滤,比较浊度、IgA含量、分子大小分布、纯度。结果:pH7.25～7.90,滤膜载量300～400 L/m 2时,组分Ⅱ溶解液经滤膜组合过滤后滤液浊度下降45.8%～60.5%、IgA含量下降68%～8...     

人免疫球蛋白和重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗中毒性表皮坏死松解症的对比研究

目的:评价静脉注射人免疫球蛋白（IVIG）及重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（rhTNFR：Fc）治疗中毒性表皮坏死松解症（TEN）的疗效。方法:收集2013—2019年武汉市第一医院使用IVIG及rhTNFR：Fc治疗的TEN患者资料。IVIG组11例,男3例,女8例,年龄25 ~ 72岁,中位TEN疾病严重...     

EV71感染手足口病患儿血清炎性细胞因子及免疫球蛋白水平的变化及意义

目的 观察肠道病毒71型（EV71）感染手足口病（HFMD）患儿血清细胞因子及免疫球蛋白水平变化,探讨炎症及免疫学机制在手足口病发病中的意义。方法 选择2015年6月~2016年8月收治的65例EV71感染HFMD患儿为观察组,65例健康儿童为对照组。酶联免疫吸附试验法（ELISA法）检测血清中IL-6、IL-8、TNF-α水平,免疫散射比浊法检测血清IgA、IgG、IgM水平。结果 与对照组相比,观察组血清IL-6、1L-8及TNF-α水平显著升高（t值分别为7.94、6.87、9.56,P<0.01）,血清免疫球蛋白IgA、IgG及IgM水平也有上升,差异有统计学意义（t值分别为6.71、7.96、8.39,P<0.01）。结论 炎性细胞因子和免疫失衡在手足口病中的发生、发展中发挥重要作用,观察IL-6、IL-8、TNF-α、IgA、IgG及IgM水平的动态变化对判定HFMD病情和疾病防治具有一定的临床应用价值。     

Elevated platelet activating factor in the tracheal aspirate at birth and signs of intra-uterine inflammation in infants with neonatal pulmonary emphysema

To investigate the pathophysiology of the neonatal pulmonary emphysema, we assayed platelet activating factor (PAF) in the tracheal aspirates of the low birth weight infants. A total of 29 neonates (birth weight <1750 g) who required mechanical ventilation were enrolled. Tracheal aspirates were obtained within 48 h and blood samples collected within 24 h of life. PAF was assayed on the basis of its ability to cause aggregation of washed rabbit platelets. PAF was significantly elevated in four infants who showed pulmonary emphysema within the 1st week of life (median 24 pg/g lipid phosphorus, range 9.9–200) compared with those detected in the other three groups of infants; infants with respiratory distress syndrome (RDS) in whom chronic lung disease (CLD) did not develop (median 1.8 pg/g lipid phosphorus, range 0–30; P < 0.05), infants without RDS nor CLD (median 0.64 pg/g lipid phosphorus, range 0–14; P < 0.05) and infants with other types of CLD (median 1.1 pg/g lipid phosphorus, range 0–1.8; P < 0.01). The four infants who developed pulmonary emphysema within the 1st week of life, had significantly elevated serum IgM and neutrophilia at birth. The increased amount of PAF in the tracheal aspirates shows the presence of inflammation in the lung at birth. The elevated serum IgM level and neutrophilia indicate that the inflammation begins in utero. Conclusion Our data suggest that neonatal pulmonary emphysema is caused by intra-uterine inflammation increasing platelet activating factor in the lungs. Platelet activating factor may play a role in aggravating the process of pulmonary emphysema. Received: 20 July 1998 / Accepted: 14 February 1999     

抗胃癌鼠单抗3H11 Fab段载体的构建、表达及抗体活性检测

目的 构建和表达抗胃癌鼠单抗３Ｈ１１的Ｆａｂ段小分子抗体。方法 采用ＲＴ－ＰＣＲ方法,利用第一骨架区通用引物扩增重链Ｆｄ段和ｋ链的基因,克隆到Ｆａｂ表达载体中,并根据已克隆的３Ｈ１１ ＶＬ的真实序列,重建设计ｋ链５‘端引物,将骨架区引物在ｋ链５’端所造成的氨基酸残基改变纠正为原始序列,再次构建Ｆａｂ表达载体。结果 利用第一骨架区通用引物构建的Ｆａｂ在大肠杆菌中获得表达但未检测到抗原结合活性,将骨架     

Development of the early B cell population in Xenopus

Like mammals, the amphibian Xenopus uses combinatorial joining of the immunoglobulin V, D and J elements and multiple rearrangements to generate its B cell repertoire. Xenopus larvae hatch 2 days after fertilization and individuals are under pressure to develop an immune repertoire when the number of available cells is small (approximately 5 and 200 IgM-positive cells on days 5 and 11 after fertilization, respectively). In the liver, in a first phase of differentiation spanning days 5 – 12 after fertilization before immunological competence, the heavy (H) chain locus starts rearranging followed by the light (L) chain locus 3 days later. By immunohistology the first B cells expressing H and L chain are detectable on day 10. Despite the small number of cells available and the lack of external antigen selection at these early stages, the repertoire is heterogeneous. The V_H families are used stepwise, although their genes are interspersed in the genome. The earliest family used (V_H1) is homologous to the V_H3 family of human and to the V_H7183 of the mouse which are also overrepresented in early mammalian development. In the second phase, from day 12 – 13 onwards, the spleen differ entiates and the animal becomes immunologically competent. The V, D and J usage is similar to that of adults although VDJ junctions lack N nucleotides until metamorphosis. A preferential reading frame for D and one specific DJ junction are overrepresented during this second phase. The visible bias toward homology-based junction results in fact from selection after rearrangement.