近期感染与老年脑梗死关系的临床研究

目的：探讨近期感染与脑梗死的关系。方法：随机回顾性调查1997年以来60岁以上脑梗死与脑出血住院患各238例,就发病前1周内有无发生感染的情况,结合临床进行比较分析。结果：（1）于发病前1周内有感染脑梗死组有48例,占20．17％,脑出血组有21例,占8．82％,两组差异显（P＜0．01）,发病有2－4周有感染两组差异无显性（P＞0．05）;（2）脑梗死组病前多以上呼吸道,肺部,胃肠道感染为主,脑出血组仅以上呼吸道感染为主,而感染病原体两组无明显差别;（3）既往有中风,TIA史以及病前有房颤,冠心病,糖尿病的患存在感染时易发生脑梗死。结论：近期感染也是发生或诱发脑梗死的重要危险因素之一,在重视防治缺血性脑卒中公认的危险因素外,也应积极关注对感染性疾病的防治。     

登革热循环免疫复合物特异性的检测分析

采用ＳＤＳ－聚丙烯凝胶电泳（ＳＤＳ－ＰＡＧＥ）和免疫转印技术对２８例登革热患者血清循环免疫复合物（ＣＩＣ）进行组份分析。结果显示在ＳＤＳ－ＰＡＧＥ电泳图谱上出现２０Ｋｕ、４６Ｋｕ及５７Ｋｕ３条主要条带。免疫识别结果表明登革热ＣＩＣ中存在特异性病毒抗原及ＩｇＧ、ＩｇＡ、ＩｇＭ抗体和补体Ｃ３组份。     

卫氏并殖吸虫感染犬循环免疫复合物和循环抗原的动态比较

卫氏并殖吸虫感染犬循环免疫复合物和循环抗原的动态比较段义农，邵义祥，朱顺星，彭光仁，张耀娟，章子豪，侯敏，吴观陵卫氏并殖吸虫病是我国流行较广的寄生虫病之一，病原学诊断较为困难。近年来，以虫源性ＣＡｇ为检测靶标的肺吸虫病血清学诊断技术，在早期诊断、指示...     

丙型肝炎患者循环免疫复合物特异性的检测分析

丙型肝炎是仅次于乙型肝炎的一种严重肝病,国内外的初步研究表明,病毒直接作用和免疫学发病机制在其发病过程中起一定作用,其中免疫学发病机制可能起更重要作用,在慢性肝病尤其如此,除细胞免疫外,曾有人在丙肝患者血清中检出了较多的循环免疫复合物。我们对丙肝患者循环免疫复合物进行了检测,证实了上述结果,为了进一步探讨丙肝患者循环免疫复合物的特异性,我们对丙肝患者循环免疫复合物进行了特异性分析,以探讨免疫     

肝硬化 肝癌患者血清循环免疫复合物的研究

采用一种简单、敏感的放射免疫法测定了101例肝病患者(25例肝癌,17例肝硬化,26例慢迁肝,33例乙肝病毒携带着)的血清循环免疫复合物,并观察了各组肝功能的变化以及HBV标志.结果表明:肝癌组的IgG-CIC含量及γ-GT含量明显高于其它各组.IgG-CIC 5.21(PHC),3.43(LC),2.41(CPH)及1.92(ASC),P<0.01.γ-GT 262(PHC).63.1(LC),44.7(CPH)以及18.7(ASC),P<0.01.伴有HBV感染的肝癌组中有80%可检出IgG-CIC,而CPH及ASC组中仅有50%可检出IgG-CIC.研究结果还表明:肝癌组中,IgG-CIC含量随着AFP含量的升高而上升.但在AFP过度升高时,IgG-GIC反而降低.这可能提示:随着肿瘤的生长,IgG-CIC升高,AFP值随肿瘤恶化逐渐上升,致使IgG-CIC从结合补体转变成非结合补体,导致IgG-CIC的下降.根据结果提示:HBV感染与肝癌发生有着密切关系.     

猪囊尾蚴特异循环免疫复合物致病作用的研究

本文对脑型和混合型猪囊尾蚴病患者脑脊液（ＣＳＦ）中特异循环免疫复合物（ＣＩＣ）进行了检测。其结果与患者ＣＴ表现及吡喹酮治疗第一个疗程过程中患者出现的高颅压情况存在一定联系。人工免疫复合物（ＩＣ）对ＢＡＬＢ／ｃ鼠作用后进行病理检查，发现脑实质和肾脏小血管均出现充血现象，部分小血管内皮细胞遭到破坏。因此认为特异循环免疫复合物可能是脑型、混合型猪囊尾蚴病患者在第一疗程中出现高颅压反应的主要因素之一。     

血管性头痛患者血清循环免疫复合物检测分析

本文对168例血管性头痛患者进行了血清循环免疫复合物(CIC)测定,并以100名健康人作对照,发现血管性头痛发作期患者CIC 平均含量较发作间歇期和对照组极显著增高(P<0.001);女性患者和年龄在20岁以下者CIC 平均含量较对照组显著增高(P<0.05).资料表明,血管性头痛不仅与CIC含量有关,而CIC 可能参与本病的发作过程,对本病的发病或发作起一定的作用.     

乙肝患者血清中HBeAg特异性循环免疫复合物的检测及意义

为了解循环免疫复合物在乙肝发病及转归中的意义，采用ＥＬＩＳＡ法测定ＨＢｅＡｇ特异性免疫复合物，并与非特异性循环免疫复合物结果相比较。检测乙肝病毒感染不同时期１２０名病全和４０名健康成人。结果：１．ＨＢｃ－ＩＣ与ＨＢＶ复制有关，其血清学标志的转换可作为预后的指标之一；２．ＣＩＣ与复制水平有关，ＨＢｅ－ＩＣ仅为ＣＩＣ的组成部分之一。     

应用单克隆抗体检测血吸虫人血清特异性循环免疫复合物的初步研究

抗血吸虫ＭｃＡｂ应用于ＥＬＩＳＡ（ＭｃＡｂ－ＥＬＩＳＡ）检测血吸虫病人血清中抗原特异性ＣＩＣ，并与其提取的ＣＩＣ沉淀物为对照，二者结果完全相同。另与“抗原非特异性”ＣＩＣ检测法（ＰＥＧ法）作对照。慢性血吸虫病患者６７例ＭｃＡｂ－ＥＬＩＳＡ有４６例呈阳性反应（６８．７％），２１例呈阴性反应（３１．３％），对肺吸虫病患者５９例、健康人２３例全部呈阴性反应；而ＰＥＧ法，肺吸虫病患者全部呈假阳性反应，健康     

近期感染与脑梗死发病的相关性研究

目的:探讨近期感染与脑梗死发病的关系,分析循环免疫复合物(circulatingimmunecomplex,CIC)、C反应蛋白(Creactiveprotein,CRP)、补体C4、C3、C1q与近期感染和脑梗死发病的关联。方法:调查了97例脑梗死患者与对照组83例,测定26例有近期感染史和71例无近期感染史的脑梗死病例及83例对照组的血清CIC、CRP、C4、C3、C1q含量,并进行分析。结果:经单因素Logistic回归显示:近期感染(OR,2.67;95%可信区间,1.2～5.9),CIC(OR,1.08;95%可信区间,1.03～1.12),CRP(OR,1.27;95%可信区间,1.16～1.39)水平升高,C1q(OR,0.88;95%可信区间,0.83～0.93),C3(OR,0.98;95%可信区间,0.96～0.99),C4(OR,0.93;95%可信区间,0.89～0.97)水平降低都是脑梗死的危险因素。但经多因素Logistic回归后仅CRP(OR,1.26;95%可信区间,1.12～1.43)水平升高,C1q(OR,0.88;95%可信区间,0.82～0.94),C3(OR,0.98;95%可信区间,0.96～0.99)水平降低是脑梗死的危险因素。经Spearman相关分析显示:感染与CIC有关(r=0.27,P=0.0008),与脑梗死发作有关(r=0.18,P=0.013)。脑梗死与CIC(r=0.3,P<0.0001),CRP(r=0.43,P<0.0001),C1q(r=-0.37,P=0.0001),C3(r=-0.26,P=0.0007),C4(r=-0.27,P=0.0004)水平有关。结论:感染是脑梗死的一个危险因素;循环免疫复合物CIC、CRP、补体C4、C3、C1q参与了脑梗死发病;循环免疫复合物既与感染有关联又参与了脑梗死的免疫损伤过程。     

老年脑梗死患者红细胞免疫功能动态观察

目的　研究老年脑梗死患者各期红细胞免疫功能状况的动态变化。探讨红细胞免疫系统与老年脑梗死发生发展的关系。　 方法 　采用红细胞酵母菌SPA混合花环试验测CR1活性及红细胞粘附免疫复合物的量及血清中红细胞免疫调节因子 (RAIF)的变化 ,间接免疫SPA法测定人外周血T淋巴细胞亚群 ,聚乙二醇沉淀法检测血清循环免疫复合物 (CIC)水平 ,单向免疫扩散法测血清C3含量。　 结果 　 ( 1)老年脑梗死患者存在红细胞C3b受体活性低下 (P <0 0 1) ,其表面免疫复合物明显增多 (P <0 0 1) ,尤以急性期显著 ,RAIF升高 ,以急性期显著 ;( 2 )在急性期、亚急性期、恢复期T细胞亚群CD4百分比降低 (P <0 0 5 ) ,而CD8百分比升高 (P <0 0 5 ) ,CD4/CD8比值明显降低 ,同时C3含量明显降低 (P <0 0 1) ,血清CIC明显增高 (P <0 0 1) ,以上各指标均随脑梗死病情的恢复而趋于正常 ;( 3)老年脑梗死的发病过程中 ,红细胞C3b受体花环率的变化与红细胞免疫粘附促进因子 (RAEF)、C3含量、CD4百分比呈正相关 ,而与RAIF、红细胞免疫复合物花环率 (RRSF)、CIC、CD8百分比呈负相关 ,与CD3百分比无关 ,CD4百分比的变化与RAIF呈明显的负相关 ,与RAEF正相关 ;而CD8的变化与RAIF正相关 ,与RAEF负相关。　 结论　老年脑梗死患者存在红细胞     

应用单克隆抗体检测血吸虫病人血清特异性循环免疫复合物的初步研究

抗血吸虫ＭｃＡｂ应用于ＥＬＩＳＡ（ＭｃＡｂ一ＥＬＩＳＡ）检测血吸虫病人血清中抗原特异性ＣＩＣ，并与其提取的ＣＩＣ沉淀物为对照，二者结果完全相同。另与“抗原非特异性”ＣＩＣ检测法（ＰＥＧ法）作对照。慢件血吸虫病患者６７例，ＭｃＡｂ一ＥＬＩＳＡ有４６例呈阳性反应（６８．７％），２１例呈阴性反应（３１．３％），对肺吸虫病患者５９例、健康人２３例全部呈阴性反应；而ＰＥＧ法，肺吸虫病患者全部呈假阳性反应，健康人６例呈假阳性反应（２６％）。初步结果表明，ＭｃＡｂ一ＥＬＩＳＡ检测血清ＣＩＣ具有较高的抗原特性。     

包虫病患者循环抗原检测中血清不同处理方法的比较研究

本文比较了在包虫病人循环抗原检测中，数种血清不同处理方法。结果证实，在检测包虫病人循环抗原时，预先用胰蛋白酶消化可以使血清免疫复合物中的循环抗原较彻底地游离。用３．５％聚乙二醇沉淀血清中的免疫复合物，再以１％胰蛋白酶消化，较不处理组敏感性提高６倍，较传统的酸解组增加４倍多。另外，将处理血清的稀释液中氯化钠浓度加大，或将血清用１０％牛血清白蛋白孵育，可明显降低本底值，Ｐ／Ｎ值可分别提高１．２倍和１．３倍。     

老年重症脑梗死发生肺部感染的相关因素及治疗

目的研究老年重症脑梗死发生肺部感染的相关因素及治疗效果。方法将2011年1月至2013年12月期间我院收治的老年重症脑梗死患者720例作为研究对象,观察肺部感染情况并分析危险因素。结果①共发生肺部感染90例,肺部感染发生率为12．50％;②不同年龄、有创操作、糖尿病史、气道慢性疾病史、血浆白蛋白水平、广谱抗生素使用情况、糖皮质激素使用情况、吸烟史患者肺部感染的发生率有差异;③高龄、有创操作、糖尿病史、气道慢性疾病史、低蛋白血症、应用广谱抗生素、应用糖皮质激素、长期吸烟史是脑梗死患者发生肺部感染的危险因素（OR值分别为2．885、3．611、3．284、2．592、3．705、3．186、2．904、2．862,P值均〈0．05）;④根据药敏结果给予抗生素治疗,患者肺部感染均得到有效控制,胸片征象消失时间为（6．34±0．75）d,肺部哕音消失时间为（4．85±0．65）d。结论老年重症脑梗死发生肺部感染与年龄、有创操作、糖尿病史、气道慢性疾病史、低蛋白血症、应用广谱抗生素和糖皮质激素、长期吸烟史密切相关,根据药敏结果给予抗生素治疗能够取得积极疗效。     

When is a malaria immune complex not an immune complex?

Immune complexes (ICs) are believed to play an important role in malaria pathology, and an interesting article by Mibei et al. recently published by Parasite Immunology suggests that IgG4 and IgE are particularly important. However, researchers should be aware of potential pitfalls to current assays aimed at measuring plasma ICs and correlating these to deposition in tissues.     

32例脑出血并肺部感染的临床护理观察

目的分析脑出血合并肺部感染临床护理方法及效果。方法将我院2013年1月到2014年1月收治的32例患者作为观察组,将2012年1月到2013年1月之前收治的32例作为对照组,对对照组采用常规护理,对观察组患者采用系统性护理,并观察两组患者护理效果。结果对照组患者满意率为84.38%,观察组患者满意率为96.88%,观察组患者满意率高于对照组,差异有统计学意义(χ2=13.254,P0.05)。结论对脑出血合并肺部感染患者实施系统性护理效果显著,满意度高,值得临床推广使用。     

From the Cover: Human Ebola virus infection results in substantial immune activation

Four Ebola patients received care at Emory University Hospital, presenting a unique opportunity to examine the cellular immune responses during acute Ebola virus infection. We found striking activation of both B and T cells in all four patients. Plasmablast frequencies were 10–50% of B cells, compared with less than 1% in healthy individuals. Many of these proliferating plasmablasts were IgG-positive, and this finding coincided with the presence of Ebola virus-specific IgG in the serum. Activated CD4 T cells ranged from 5 to 30%, compared with 1–2% in healthy controls. The most pronounced responses were seen in CD8 T cells, with over 50% of the CD8 T cells expressing markers of activation and proliferation. Taken together, these results suggest that all four patients developed robust immune responses during the acute phase of Ebola virus infection, a finding that would not have been predicted based on our current assumptions about the highly immunosuppressive nature of Ebola virus. Also, quite surprisingly, we found sustained immune activation after the virus was cleared from the plasma, observed most strikingly in the persistence of activated CD8 T cells, even 1 mo after the patients’ discharge from the hospital. These results suggest continued antigen stimulation after resolution of the disease. From these convalescent time points, we identified CD4 and CD8 T-cell responses to several Ebola virus proteins, most notably the viral nucleoprotein. Knowledge of the viral proteins targeted by T cells during natural infection should be useful in designing vaccines against Ebola virus.Ebola virus is a member of the Filoviridae family, which are filamentous, negative-stranded RNA viruses that are known to cause severe human disease (1). An ongoing outbreak of Ebola virus in West Africa has brought this virus and the disease it causes (Ebola virus disease; EVD) to the forefront. The World Health Organization has reported over 20,000 cases and 8,000 deaths in West Africa, with Sierra Leone, Guinea, and Liberia the most affected.Our knowledge of the human immune response to Ebola virus has been severely limited due to the lack of infrastructure to perform such analyses in high containment levels (biosafety level 4; BSL-4). Minimal data exist regarding the human cellular immune response during acute Ebola virus infection, which indicate that aberrant cytokine responses (2–6), decreased CD4 and CD8 T cells, and increased CD95 expression on T cells are all associated with fatal outcomes (4). In vivo studies have revealed an association between apoptosis of lymphocytes and fatal outcome (3), and lymphocyte apoptosis has been seen both in vitro in infected human cells and in vivo in mouse and nonhuman primate models (7–9).The natural serologic response to Ebola virus infection has been well-characterized, with specific IgM responses detected as early as 2 d after symptom onset but generally occurring 10–29 d after symptom onset in most patients. Ebola virus-specific IgG responses have been detected as early as 6 d post symptom onset, occurring ∼19 d after symptom onset in most individuals (10, 11). Serological responses to Ebola virus have been reported as absent or diminished in fatal cases; however, sample sizes have been very limited (3).Data from in vitro studies have demonstrated that Ebola virus-infected dendritic cells are impaired in their ability to produce cytokines and activate autologous T cells (12), whereas infected macrophages exhibit impaired maturation (13). Ebola virus also encodes several proteins that can interfere with the innate immune response in infected cells (14). These in vitro studies, combined with the limited human data showing T-cell apoptosis, lymphopenia, and absent antibody responses in fatal cases, have led to the assumption that Ebola virus infection is immunosuppressive.Here we examine the immune responses of four survivors of EVD who received care at Emory University Hospital. This first look, to our knowledge, at the human adaptive immune response during the acute phase of Ebola virus infection shows striking levels of T- and B-cell activation in all four patients.     

脑卒中患者发生院内感染的临床情况及血免疫指标影响研究

目的探讨脑卒中患者发生院内感染的临床情况以及免疫功能影响,为临床诊疗提供参考依据。方法回顾性分析2016年1月—2018年1月在我院就诊的360例脑卒中患者的临床资料。统计医院感染的发生率,并根据患者是否发生院内感染分为感染组(n=55)和未感染组(n=305)。统计分析患者感染部位、病原菌分布及影响因素,分析免疫功能免疫球蛋白A(immunoglobulin A,IgA)、IgG、补体3(complement 3,C3)、C4对患者的影响。结果360例脑卒中患者中男190例,女170例,年龄45~75岁,平均(60.12±4.89)岁。感染组以肺部感染为主,占比58.18%。55例感染患者共分离出病原菌76株,以革兰阴性菌为主,占比55.26%(42/76),其次为革兰阳性菌,占比31.58%(24/76),最后为真菌,占比13.16%(10/76)。年龄,性别,意识障碍,侵入性操作,住院天数,机械通气,吞咽困难,糖尿病,IgA、IgG、C3及C4水平下降与脑卒中患者发生院内感染有关(P均<0.05);多因素Logistic回归分析结果显示,意识障碍,性别,侵入性操作,机械通气,吞咽困难,糖尿病,IgA、IgG、C3及C4水平下降等是脑卒中患者发生院内感染的独立危险因素(P均<0.05)。结论脑卒中患者院内感染发生率较高,意识障碍,性别,侵入性操作,机械通气,吞咽困难,糖尿病,IgA、IgG、C3及C4水平下降等是脑卒中患者发生院内感染的独立危险因素,免疫功能降低与脑卒中患者发生院内感染密切相关,临床应注重对患者免疫功能监测,适当增强患者自身免疫功能。     

Murine Schistosoma bovis infection: analysis of parasitic and immune parameters

Humoral and cellular responses to Schistosoma bovis antigens have been evaluated over a period of 11 weeks in mice exposed to S. bovis cercariae and data analysed in the context of the parasitic parameters (worm and egg loads) recorded at days 30, 60 and 80 of the ongoing infection. Results revealed a decrease of worm burden, particularly marked for female worms, between day 60 and day 80 of infection suggesting a higher susceptibility of female schistosomes to attrition mechanisms. The B-cell response, studied by measuring the production of different isotypes, was directed against different stage specific antigens, with a predominance of IgG1 antibodies associated with a significant increase of IgA and IgE antibodies after egg deposition. The T-cell response, assessed after in vitro stimulation of splenocytes, showed a predominant production of Th-2 cytokines (IL-4, IL-5 and IL-10) occurring after egg laying. Interestingly in contrast to S. mansoni infection the Th-2 polarization did not seem to be exclusively triggered by egg-associated antigens since significant amounts of IL-10 were produced after stimulation with adult worm antigen preparation (SWAP) before the beginning of egg deposition .