严重急性呼吸综合征T细胞亚群Meta分析

目的：研究严重急性呼吸综合症（SAPS）患者T细胞亚群变化。方法：检索2003年2月-2004年1月有关SAPS患者T细胞亚群计数研究的论文，汇合成大样本资料，借助先进的RevMan4．2分析软件对这些资料进行二次分析以探讨该病患者T细胞亚群变化。结果：SAPS病程〈14天期间，患者与正常对照比较，CD3^＋细胞、CD4^＋细胞、CD8^＋细胞均显著降低（均P〈0．01）。其中，重症病人（包括重型和极重型）比非重症病人（包括轻型和普通型）降低更显著（均P〈0．01）。病程〉14天恢复期病人与病程〈14天病人比较，CD3^＋细胞虽然有了上升，但无显著差异（Z=1．56，P=0．12）。CD4^＋细胞、CD8^＋细胞均恢复性上升，差异显著（均P〈0．01）。病程〉14天恢复期病人与正常对照比较，CD3^＋细胞、CD4^＋细胞仍然显著降低（均P〈0．01）。两者的CD8^＋细胞有差异（Z=2．28，P=0．02）。结论：①SAPS患者整个病程中都存在CD3^＋细胞、CD4^＋细胞、CD8^＋细胞数量暂时性、严重性、可逆性降低；②患者T细胞亚群数量的下降以重症病人为甚；③这种降低是可逆性的，随着病程进入恢复期，患者T细胞亚群开始恢复性上升。     

SARS患者急性期病情严重程度与康复期免疫功能的关系

目的考察SARS患者发病期病情轻重程度与康复期机体免疫功能受损的关系。方法将患者分为未使用呼吸机组（A）和使用过呼吸机组（B），通过回顾性分析SAILS患者住院期间和康复期的病例资料，比较两组患者肺部病灶阴影范围和吸收时间、WBC总数及其分类、康复期淋巴T细胞亚群与活化分子等。结果B组的肺部病灶范围在第2周内显著性大于A组，吸收时间也长于A组；A组的WBC总数，中性（N）、淋巴细胞（L）计数和百分数均在正常参考值范围，B组WBC总数、N计数与百分数高于A组，L百分数低于A组；第1次随访B组CD8^＋、CD8^＋／CD28^-、CD3^＋／HLA-DR^＋T细胞显著性高于A组，CD3^-／HLA—DR^＋细胞显著低于A组；第2次随访仅B组CD3^-／HIA—DR^＋细胞仍显著低于A组，其余免疫细胞无统计学差异。结论SAILS患者未使用呼吸机组较使用过呼吸机组肺部病理性损害小，免疫功能基本正常或受损程度很小。     

SARS疫情期间公众心态影响及变化趋势分析

目的：探索重大突发性公共卫生事件对社会公众心理行为的影响，以及在不同阶段中公众心态变化的特点。方法：对SAILS流行期间374人次的心理咨询记录进行分析，依据疫情发展情况，比较各阶段的差异。结果：在咨询者中，女性(59．4％)多于男性(40．6％)；根据疫情变化将咨询记录数据划分为三个阶段，分析发现随着疫情缓和，针对SARS症状的咨询者显著减少，从13．1％降低到1．8％；有关社会生活的咨询者显著增多，从8．7％上升到12．3％；在有关情绪问题的咨询者中，伴有相关症状者显著减少，从23．0％降低到4．5％；不伴相关症状者显著增多，从77．0％上升到95．5％。结论：整个SAILS疫情期问，情绪问题始终占第一位；随SARS疫情缓和，社会公众对于疾病本身的关注减少，而与疫情有关的社会生活问题增多；面对突发性公共卫生事件，及时开通心理咨询热线电话是十分必要的。     

Persistent infection of SARS coronavirus in colonic cells in vitro

Severe acute respiratory syndrome coronavirus (SARS-CoV) can produce gastrointestinal symptoms. The intestinal tract is the only extrapulmonary site where viable viruses have been detected. This study examined seven established human intestinal cell lines, DLD-1, HCT-116, HT-29, LoVo, LS-180, SW-480 and SW-620, for their permissiveness to SARS-CoV infection. The results showed that only LoVo cells were permissive to SARS-CoV infection as evident by positive findings from indirect immunofluorescence staining for intracellular viral antigens, in situ hybridization for intracellular viral RNA, and electron microscopy for intracellular viral particles. In contrast to Vero cells, SARS-CoV did not produce cytopathic effects on LoVo cells. However, LoVo cells were found to be highly permissive for productive infection with a high viral titre (>3 x 10(7) viral copies/ml) produced in culture supernatant following a few days of incubation. SARS-CoV established a stable persistent chronic infection that could be maintained after multiple passages. Being a cell line of human origin, LoVo cells could be a useful in vitro model for studying the biology and persistent infection of SARS-CoV. Our results on the expression of angiotensin-converting enzyme 2 (ACE2), a recently identified cellular receptor for SARS-CoV, in these cell lines indicated that it might not be the sole determinant for cells to be susceptible to SARS-CoV infection.     

Presenting characteristics,comorbidities, and outcomes of patients coinfected with COVID-19 and Mycoplasma pneumoniae in the USA

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is spreading at a rapid pace, and the World Health Organization declared it as pandemic on 11 March 2020. Mycoplasma pneumoniae is an "atypical" bacterial pathogen commonly known to cause respiratory illness in humans. The coinfection from SARS-CoV-2 and mycoplasma pneumonia is rarely reported in the literature to the best of our knowledge. We present a study in which 6 of 350 patients confirmed with COVID-19 were also diagnosed with M. pneumoniae infection. In this study, we described the clinical characteristics of patients with coinfection. Common symptoms at the onset of illness included fever (six [100%] patients); five (83.3%) patients had a cough, shortness of breath, and fatigue. The other symptoms were myalgia (66.6%), gastrointestinal symptoms (33.3%-50%), and altered mental status (16.7%). The laboratory parameters include lymphopenia, elevated erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase, interleukin-6, serum ferritin, and D-dimer in all six (100%) patients. The chest X-ray at presentation showed bilateral infiltrates in all the patients (100%). We also described electrocardiogram findings, complications, and treatment during hospitalization in detail. One patient died during the hospital course.     

Serum neopterin for early assessment of severity of severe acute respiratory syndrome

Neopterin and C-reactive protein (CRP) concentrations were determined in serum samples from 129 severe acute respiratory syndrome (SARS) patients and 156 healthy blood donors. In the patients with confirmed SARS, an early neopterin elevation was detected already at the day of onset of symptoms and rose to a maximum level of 45.0 nmol/L 3 days after the onset. All SARS patients had elevated neopterin concentrations (>10 nmol/L) within 9 days after the onset. The mean neopterin concentrations were 34.2 nmol/L in acute sera of SARS patients, 5.1 nmol/L in convalescent sera, and 6.7 nmol/L in healthy controls. In contrast, the mean CRP concentrations in both acute and convalescent sera of SARS patients were in the normal range (<10 mg/L). Serum neopterin level in SARS patients was associated with fever period and thus the clinical progression of the disease, while there was no significant correlation between the CRP level and the fever period. Serum neopterin may allow early assessment of the severity of SARS. The decrease of neopterin level was found after steroid treatment, which indicates that blood samples should be collected before steroid treatment for the neopterin measurement.     

Longitudinal alteration of circulating dendritic cell subsets and its correlation with steroid treatment in patients with severe acute respiratory syndrome

In this study, we found that 74 patients with severe acute respiratory syndrome (SARS) exhibited a rapid, dramatic decrease in numbers of circulating myeloid and plasmacytoid dendritic cells (mDCs and pDCs) during the first 2 weeks of illness (5.3- and 28.4-fold reductions for mDCs and pDCs compared with 25 healthy individuals, respectively), with slow return to normal cell numbers during convalescence (weeks 5–7 of illness on average). In addition, numbers of circulating CD4 and CD8 T cells exhibited milder reductions (2.1- and 1.8-fold at week 1) and earlier return to normal at a mean of weeks 3 and 4, respectively. A significant inverse correlation was found between numbers of DC and T-cell subsets and high-dose steroid treatment. Our novel findings thus suggest that the acute SARS-coronavirus infection probably contributes to the initial reduction of DC and T-cell subsets in blood, and that high-dose steroid administration may subsequently exacerbate and prolong low expression of the cell subsets. These findings will aid the framing of further studies of the immunopathogenesis of SARS.     

非典型肺炎病人免疫功能分析

目的 :动态监测非典型肺炎 (SARS)病人免疫功能 ,为临床诊疗提供帮助。方法 :采用回顾性及随访研究方法 ,对本院收治 10 3例SARS病人分别在入院初期、中期、高峰期、恢复期和随访时作C反应蛋白 (CRP)、免疫球蛋白、补体、纤维蛋白原 (Fib)、血沉 (ESR)、和CD4、CD8等免疫功能检查 ,并进行描述性分析及方差分析。结果 :从发病初期至恢复期CRP、Fib、ESR均有程度不同的升高 ,以CRP异常率最高。总蛋白、白蛋白、白蛋白 /球蛋白比值在疾病过程呈下降趋势。在SARS疾病过程中和随访时存在免疫球蛋白变化、补体消耗和CD4、CD8细胞减少。结论 :SARS病人免疫功能可能低于正常人。其免疫功能的检测有利于协助诊断和疗效判断     

SARS疫苗研究进展

2003年世界性的流行病——严重急性呼吸综合症（SAILS）引发了各国科学家对SARS相关冠状病毒（SARS-Coy）的研究热潮。SARS-Coy是一种新的冠状病毒，其致病机制还不清楚，目前尚无有效治疗SARS的抗病毒药物，研制一种安全有效的疫苗是阻止SARS再次流行最有效的方式。目前研究较多且有发展前景的SARS疫苗有：灭活疫苗、DNA疫苗和表位疫苗等。但在SARS疫苗的研究过程中也遇到了很多问题，如没有标准的动物模型、SARS-Coy变异快等问题。所以，研发一种安全有效的SARS疫苗任重而道远。