儿童哮喘发作期血清调节性T细胞和辅助性T细胞表达分析

目的分析儿童哮喘发作期血清调节性T细胞和辅助性T细胞的表达。方法选择2016年10月至12月沈阳市儿童医院收治的支气管哮喘患儿55例为研究对象,根据临床表现所属的中医证候类型分为寒哮证组26例和热哮证组29例。同期选取参加体检结论健康儿童为对照组28例。3组对象均接受血清调节性T细胞(CD4CD25~+Treg和CD4~+CD25~+Foxp3~+Treg)和辅助性T细胞(CD4~+、CD8~+、CD4~+/CD8~+)表达水平测定。结果寒哮证组和热哮证组血清CD4CD25~+Treg和CD4~+CD25~+Foxp3~+Treg浓度显著低于对照组,寒哮证组血清CD4CD25~+Treg和CD4~+CD25~+Foxp3~+Treg浓度显著低于热哮证组,差异均有统计学意义(P0.05)。寒哮证组和热哮证组血清CD4~+浓度显著高于对照组,而血清CD8~+浓度及CD4~+/CD8~+比值均显著低于对照组;寒哮证组血清CD4~+和CD8~+浓度显著低于热哮证组,差异均有统计学意义(P0.05)。结论寒哮证和热哮证患儿均存在明确的血清调节性T细胞和辅助性T细胞表达异常,且以寒哮证病患儿更为显著。     

喜炎平注射液辅助改善肺炎支原体肺炎患儿免疫功能的研究

目的观察喜炎平注射液辅助阿奇霉素治疗对肺炎支原体肺炎(MPP)患儿免疫功能的影响。方法选取2014年1月至2016年10月朝阳市第二医院儿科门诊收治的MPP患儿60例,随机分为观察组和对照组各30例。对照组应用静脉滴注阿奇霉素治疗,观察组在对照组治疗基础上加用喜炎平注射液静脉滴注。7d为1个疗程,连续治疗2个疗程。观察两组临床疗效、细胞免疫功能(CD4~+、CD8~+水平)及体液免疫功能(IgA、IgG、IgM水平)。结果观察组患儿总有效率为90.0%(27/30),显著高于对照组66.7%(20/30),差异有统计学意义(P0.05)。治疗后两组CD4~+水平以及CD4~+/CD8~+值均显著高于治疗前,CD8~+水平显著低于治疗前,差异有统计学意义(P0.05);治疗后观察组CD4~+水平以及CD4~+/CD8~+值显著高于对照组,而CD8~+水平显著低于对照组,差异有统计学意义(P0.05)。治疗后两组患儿血清IgM、IgA水平显著低于治疗前,而IgG水平高于治疗前,差异有统计学意义(P0.05)。治疗后观察组血清IgM、IgA、IgG水平均显著低于对照组,差异有统计学意义(P0.05)。结论相较于单独应用阿奇霉素,喜炎平可辅助性地从细胞免疫和体液免疫两方面增强MPP患儿的机体免疫功能,提高临床疗效。     

中药支原清方治疗儿童肺炎支原体肺炎的疗效观察及对T淋巴细胞亚群的影响

目的观察中药验方"支原清"对儿童肺炎支原体肺炎的临床疗效及对T淋巴细胞亚群(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)数值变化的影响。方法 2013-07/2015-03选择江苏省第二中医院儿科收治肺炎支原体肺炎患儿60例,随机分为观察组和对照组各30例,观察组采用中药"支原清"口服治疗21d,对照组用阿奇霉素颗粒联合急支糖浆口服液治疗21d。治疗结束后比较两组患儿的临床疗效,并观察治疗前后两组患儿血清T淋巴细胞亚群数值的变化。结果两组总有效率均为100%(30/30),但观察组临床控制率为86.66%(26/30),对照组临床控制率为40%(12/30),两组比较差异有统计学意义(P0.01);观察组外周血CD3~+、CD4~+细胞明显高于对照组,CD8~+细胞低于对照组,两组比较差异有统计学意义(P0.01);观察组外周血CD4~+/CD8~+数值高于对照组,两组比较差异有统计学意义(P0.05)。结论中药验方"支原清"治疗儿童肺炎支原体肺炎安全有效,在T淋巴细胞亚群数值的调节中作用明显,有利于提高细胞免疫功能。     

肺炎支原体肺炎患儿红细胞膜CD35 CD58的定量测定及意义

目的通过检测肺炎支原体肺炎(MPP)患儿红细胞膜表面CD35、CD58的数量变化，探讨其在MPP发病中的作用。 方法对2001-09—2002-08唐山市人民医院收治的37例MPP患儿，按病情程度分为2组：轻症组(无并发症组)；重症组(有并发症组)。对照组为正 常儿童。采用酶联法测定MPP患儿及正常对照儿童红细胞膜CD35、CD58数量变化并进行对比。 结果MPP患儿CD35低于正常对照儿童,尤其是伴有其他系统并发症的重症组下降明显，差异有显著性；MPP患儿CD58水平低于正常对照组，尤以伴 有肺外并发症的重症组为显著。 结论红细胞膜CD35、CD58变化在MPP发病机制中起重要作用，对判断病情及预后、观察疗效、指导治疗，尤其是对伴有肺外并发症的重症患儿有 临床实用价值。     

子痫前期患者外周血协同刺激分子CD28/CTLA-4的表达研究

目的:研究子痫前期患者外周血协同刺激分子CD28、CTLA-4、CD28/CTLA-4在CD3+CD4 +T细胞和CD3+ CD8+T细胞上的表达,探讨CD28/CTLA-4在子痫前期发病中的作用.方法:采集22例正常妊娠妇女(正常妊娠组),45例子痫前期患者(子痫前期组)外周血,用流式细胞技术分别检测外周血T淋巴细胞CD3+、CD4+、CD8+的表达和CD28、CTLA-4、CD28/CTLA-4在CD3+ CD4+T细胞和CD3+ CD8+T细胞上的表达.结果:子痫前期组外周血T淋巴细胞中CD3+及CD8+的表达低于正常妊娠组(P＜0.05),而CD4+及CD4 +/CD8+的表达高于正常妊娠组(P＜0.05).与正常妊娠组相比,子痫前期组CD28在CD3+ CD4+T细胞和CD3+ CD8+T细胞上的表达低于正常妊娠组,但差异无统计学意义(P＞0.05);CTLA-4在CD3+ CD4+T细胞和CD3+ CD8+T细胞上的表达高于正常妊娠组,且重度子痫前期组高于轻度子痫前期组,差异均有统计学意义(P＜0.05);CD28/CTLA-4比率在CD3+ CD4+T细胞和CD3+ CD8+T细胞上的表达低于正常妊娠组,且重度子痫前期组低于轻度子痫前期组,差异均有统计学意义(P＜0.05).结论:子痫前期患者外周血T细胞亚群明显偏移,且协同刺激分子CD28/CTLA-4表达异常,高表达的CTLA-4导致T淋巴细胞亚群失衡,这可能是促使子痫前期发生的重要原因之一.     

小儿肺炎支原体肺炎60例临床特点分析

目的总结肺炎支原体肺炎(MPP)临床特点及中西医结合诊治方法。方法对60例小儿MPP采用西医药物为主,中医治疗为辅的治疗方法,观察临床表现,总结实验室检查及治疗转归。结果 60例患儿经中西医结合的辨证施治,咳嗽明显减轻或消失。出院时肺部症状及体征、并发症均消失。结论 MPP既表现于肺系特点,同时又伴发多种肺外表现,在西药基础上加服中药不但缩短病程,减轻症状,还能减少副反应的发生。     

小儿肺炎支原体肺炎64例肺外并发症分析

目的总结小儿肺炎支原体肺炎(MPP)的肺外并发症,以提高诊治水平,减少误诊误治。方法分析168例MPP患儿中64例有肺外并发症患儿的临床资料。结果 64例患儿主要有消化系统、皮肤黏膜、神经系统、心血管系统、浆膜腔、泌尿系统等受累。结论肺炎支原体感染可引起机体多系统损害,部分患儿可同时有两种或两种以上的并发症,少数以肺外并发症为首发症状,易误诊、漏诊,应引起重视。     

T淋巴细胞亚群与MIF在自身免疫性卵巢早衰患者中的应用价值研究

目的探讨自身免疫性卵巢早衰患者中关于巨噬细胞移动抑制因子(MIF)与T淋巴细胞亚群在自身免疫性卵巢早衰患者中的应用价值。方法选取2015年7月至2017年2月在山东省巨野县人民医院妇科接受治疗的自身免疫性卵巢早衰患者45例作为观察组,并选择同期体检卵巢功能正常者43例为对照组。测定并比较两组血清自身免疫反应性指标水平、MIF水平以及T淋巴细胞亚群水平。结果两组血清自身免疫反应性指标检测阳性率相比,抗卵巢抗体、抗甲状腺球蛋白抗体、抗透明带抗体及MIF差异有统计学意义(P0.05);两组MIF水平相比,差异有统计学意义(P0.05);观察组与对照组CD4+T细胞差异无统计学意义(P0.05),CD8+T细胞明显高于对照组(P0.05),CD4+/CD8+明显下降,两组相比,差异有统计学意义(P0.05);MIF阳性组与MIF阴性组CD4+T细胞差异无统计学意义(P0.05),CD8+T细胞明显高于MIF阴性组(P0.05),MIF阳性组CD4+/CD8+比值明显低于MIF阴性组(P0.05)。结论 MIF在卵巢早衰患者血中浓度及检出率较高,提示MIF在卵巢早衰的发生发展中起重要的作用。CD8+T细胞升高及CD4+/CD8+比值下降与卵巢早衰患者的自身免疫功能紊乱密切相关。     

泼尼松治疗原发性肾病综合征对患儿CD4+CD25+调节性T细胞的影响分析

目的　观察原发性肾病综合征（PNS）患儿泼尼松治疗前后CD4+CD25+ 调节性T细胞（CD4+CD25+ Tr）的变化,阐明肾上腺糖皮质激素治疗儿童PNS的免疫机制。方法　选择2004—2007年在深圳市儿童医院住院治疗的初发PNS患儿42例,其中激素敏感型32例,激素耐药型10例。同期25例健康体检儿童作为对照组。流式细胞术检测泼尼松治疗前后外周血CD3+CD4+CD8-、CD3+CD4-CD8+、CD4+CD25+Tr的比例,荧光定量聚合酶链反应（Real-time PCR）检测泼尼松治疗前后外周血单个核细胞（PBMC）叉头型基因P3（Foxp3）、细胞毒性T淋巴细胞相关抗原4（CTLA-4）和糖皮质激素诱导的肿瘤坏死因子受体 （GITR）基因mRNA的表达。结果 　与对照组比较,PNS患儿外周血CD3+CD4+CD8- T细胞、CD3+CD4-CD8+ T细胞、CD4+CD25+ Tr比例无明显改变（P > 0.05）。激素敏感型PNS患儿CD4+CD25+Tr比例在泼尼松治疗后明显增高,差异有统计学意义（P < 0.01）;激素耐药型PNS患儿CD4+CD25+Tr比例在泼尼松治疗前后无明显改变（P > 0.05）。激素敏感型PNS患儿在泼尼松治疗后PBMC细胞Foxp3、CTLA-4和GITR基因mRNA的表达明显增高;而激素耐药型PNS患儿泼尼松治疗前后Foxp3、CTLA-4基因表达无明显改变,仅GITR表达明显增高。 结论 泼尼松等肾上腺糖皮质激素类药物可通过上调激素敏感型PNS患儿CD4+CD25+调节性T细胞的表达发挥免疫治疗作用。     

肺炎支原体肺炎患儿血清及诱导痰中白细胞介素-4及γ-干扰素的测定

目的研究肺炎支原体肺炎(MPP)患儿血清及诱导痰中白细胞介素-4(IL-4)及γ-干扰素(IFN-γ)质量浓度变化，探讨其在MPP发病机制中的作用。 方法2003年2~8月对中国医科大学附属二院儿科住院的MPP患儿38例，用ELISA法测定38例血清及24例诱导痰中急性期及恢复期的IL-4及IFN-γ质量浓度。 结果MPP患儿血清及诱导痰IL-4质量浓度急性期明显高于恢复期和正常对照组(P<0.01);IL-4/IFN-γ比值急性期高于恢复期和正常对照组(P<0.05)。MPP患儿急性期血清及诱导痰IL-4质量浓度重症组明显高于轻症组(P<0.01),急性期血清及诱导痰IL-4/IFN-γ比值重症组高于轻症组(P<0.05);诱导痰与血清两种标本检测结果一致，诱导痰中的质量浓度高于血清中的质量浓度，两者呈正相关。 结论MPP患儿存在TH1/TH2功能紊乱，MPP患儿TH2反应占优势，IL-4及IFN-γ参与MPP患儿的免疫状态改变，在MPP发病机制中发挥一定作用。     

Outcome of Treatment with Bromocriptine in Patients with Hyperprolactinaemia

Results in 136 hyperprolactinaemic women who presented with infertility, amenorrhoea, menstrual irregularities and/or galactorrhoea are reported. There was radiographic evidence of pituitary microadenoma in 21 (15.4%) patients and 5 (3.7%) had macroadenoma. Four patients were taking antidepressants, 2 antihypertensive drugs and 7 had taken oral contraceptives for a period of 6 months to 5 years. The remaining patients had no obvious cause for elevated prolactin levels. Patients with pituitary adenoma had a significantly higher (p less than 0.001) baseline serum prolactin level (182 +/- 4.6 ng/ml) than those with no adenoma (59.2 +/- 4.2 ng/ml). All patients in the study were treated with bromocriptine (2.5-10 mg) to normalize serum prolactin or to achieve a pregnancy. The patients without an adenoma required a significantly smaller dose of bromocriptine (2.5-5.0 mg) (p less than 0.005) than those with an adenoma. Galactorrhoea disappeared in all 64 patients within 2-4 months of treatment, sixty-six (71%) of the 93 patients who desired pregnancy achieved it within 3 to 8 months of bromocriptine therapy; 32 of these patients received additional treatment with clomiphene and human chorionic gonadotrophins for induction of ovulation. In the remaining 70 patients menstruation became regular and ovulation was evident in 40% of them. There was no significant difference in the pregnancy rate between the patients with or without pituitary adenoma. Similarly, presence of galactorrhoea or a high level of prolactin did not influence the pregnancy rate. No complications were observed during pregnancy related to pituitary adenomas; 8 (12%) pregnancies ended in first trimester abortion. No lethal congenital fetal abnormalities were observed in the patients treated with bromocriptine.(ABSTRACT TRUNCATED AT 250 WORDS)     

Management of pregnancy-induced hypertension with pindolol--comparative study with methyldopa

Thirty-two consecutive women with pregnancy-induced hypertension of early onset were randomly allocated to treatment with pindolol or methyldopa. There was no difference between the groups in regard to the average time of delivery (36.33 vs. 36.6 weeks) and weight of the newborn (2850 vs. 2870 g). A significant drop in systolic (P less than 0.005) and diastolic (P less than 0.05) blood pressure was observed in the group of patients treated with pindolol as compared with the methyldopa group. In the pindolol group an improvement in renal function was observed as determined by CCT and serum creatinine. There were no side effects from the drugs in the mother or in the newborn.     

Working with survivors of torture in Sarajevo with Reiki

While working as a nurse/therapist in Sarajevo, I had the opportunity to work in an experimental situation at a center for torture survivors. This was to see if the use of Reiki would have a beneficial effect on this type of patient. It involved a rethink on traditional Reiki hand positions, music, and the general set-up of the room being used. It was a challenge, and one I was delighted to have had. The people I worked with were wonderful, and the changes in them over the period were so positive. The staff at the Center were delighted; I was delighted; but so much more importantly, the patients were delighted. The ground has now been broken and hopefully will be considered in a positive light for other traumatized patients.     

Treatment of men with oligoasthenozoospermia and asthenozoospermia with kallikrein

A randomised group of 75 men with idiopathic oligoasthenozoospermia and asthenozoospermia were subjected to control study with kallikrein. Kallikrein was given to 45 men 600 units daily in a period of 3-6 months. The other group of 30 infertile men was followed during the same period of time. Percentage of motile sperm was significantly improved after 3-6 months treatment with kallikrein. Sperm count and percentage of morphologically normal sperm showed improvement but was not statistically significant. Infertile men with sperm count below 20 X 10(6)/ml had greater improvement in sperm count than men with sperm count over 20 X 10(6)/ml. This study emphasizes that kallikrein is a relatively good drug for restoring sperm motility in idiopathic oligoasthenozoospermia and asthenozoospermia.