Effect of Astragalus Injection on Levels of Blood Selenium and Immunity Function in Children with Viral Myocarditis

Objective: To observe the effect of Astragalus Injection (AI) on levels of blood selenium (Se)and cytokines, and T cellular immune function with viral myocarditis (VM) in children. Methods: Eighty children with VM were randomly divided into 2 groups. The control group consisted of 38 patients, to whom conventional therapy, including energy mixture, vitamin C and coenzyme Q10, etc. were given. The treated group (n=42), to whom combination therapy of conventional therapy and AI were given. The levels of blood Se and cytokine, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and also evaluation of T lymphocyte subsets and cardiac function were observed. Results: The results showed that after treatment, the levels of blood Se were significantly higher (P＜0.01), while IL-1, IL-6 and TNF-αwere significantly lower (P＜0.01) than those before treatment in the control group. The left ventricular end diameter (LVED) were significantly decreased (P＜0.01), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly increased than those before treatment in the treated group(P＜0.01, P＜0.05). T lymphocyte subsets got normalized (P＜0.01), and compared with the control group, the difference was significant (P＜0.01). Conclusion: Astragalus membranaceus possesses anti-viral effect, adjusts the balance of cytokine and T cellular immunity, and improves the clinical manifestation and cardiac function. It is an effective approach in treating viral myocarditis.     

QUANTITATIVE ANALYSIS OF IL-2 AND IMMUNOMODULATING EFFECT OF IL-2 ON NK ACTIVITY OF HEPATITIS B PATIENTS

Using~(125)I-UDR labelled K562 cells as target cells, we assay the natural killer cell (NK) activity in peripheral blood mononuclear cells (PBMCs) from 36 cases of various types of viral hepatitis B (HB), together with 33 healthy adults as controls. At same time the NK activity was detected when PBMCs were pretreated with recombinant IL-2 (rIL-2) in 19 patients with various types of HB and 14 normal controls. We also determined the IL-2 activity produced by PBMCs in 26 HB patients and 14 normal controls. The following results were obtained: (1) The NK activity was markedly elevated in early acute hepatitis B (AH) (P<0.01); significantly decreased in chronic active hepatitis (CAH), chronic persistent hepatitis (CPH) and fulminant hepatitis (FH) (P<0.01), while that of convalescents with AH was within normal range 35.85±12.52%. (2) The early rise of NK activity in acute infection and the decline in convalescence and also the parallel change in SGPT level in 3 AH cases were observed. (3) The amount of IL-2 produced by PBMCs in HB patients was lower than that of normal controls (P<0.01 ). (4)There was no correlation between the change of IL-2 activity and NK activity in HB patients (r=0.15; P>O.05). (5) The NK activity of most normal subjects were enhanced when the PBMCs were pretreated with rIL-2 but the latter was still within the normal ranges. These results suggest that the mechanism of the effect of IL-2 in modulating the NK activity of HB patients is very complicated. IL-2 not only directly enhances the low NK activity of HB patients, but also depresses the high NK activity. This immunomodulating effect may be influenced by serum inhibitory facts as well as the amount and the combining ability of IL-2 receptor or on NK cell surface.     

Effect of Radix Isatidis Polysaccharides on Immunological Function and Expression of Immune Related Cytokines in Mice

Objective:To investigate the effect of Radix Isatidis polysaccharides (RIP) on the immunological function and expression of immune related cytokines in mice.Methods:Sixty mice were randomly divided into six groups,the normal group,cyclophosphamide (Cy) model group,Levamisole (positive control) group,RIP low,medium and high dose groups (0.08 g/kg,0.16 g/kg,0.32 g/kg,respectively),ten in each group.By detecting the value of abdominal macrophage phagocytic index,serum hemolysin (HC50),proliferation of lymphocytes and expression of related cytokines,interleukin (IL-2)and interferon γ (INF-γ),the effect of RIP on immunological function and its mechanism were studied.Results:RIP could improve the level of hemolysin in immunological function depressed mice.The results showed that the value of macrophage phagocytic index in the high dose RIP group increased from 1.11±0.13 to 1.42±0.26.The level of IL-2 and INF-γ,could be decreased by Cy to 38.12±6.88 ng/L and 139.23± 29.87 ng/L,respectively,while RIP in high dose could increase the secretion of IL-2 and INF-γto 53.54±14.43 ng/L and 189.91±32.63 ng/L,respectively.Conclusion:RIP could enhance non-specific immunological function,humoral immunity and cellular immunity in mice.     

Efficacy of Telbivudine in the Treatment of Chronic Hepatitis B and Liver Cirrhosis and Its Effect on Immunological Responses

This study was aimed to evaluate the long-term effects of telbivudine(Ld T) in the treatment of chronic hepatitis B(CHB) and HBV-related liver cirrhosis(LC) and to observe the changes of immunological responses during Ld T treatment. Clinical data of 80 CHB and 28 HBV-related LC patients who were administered with Ld T for 108 weeks and followed up were retrospectively analyzed. The liver function indicators including ALT, AST and γ-GT, HBV DNA copy number in serum and the rates of hepatitis B e antigen(HBe Ag) seroconversion were analyzed before and 12, 24, 36, 48, 60, 72, 84, 96 and 108 weeks after Ld T treatment in CHB and LC groups. Four serum fibrosis-related markers, including hyaluronic acid(HA), human laminin(LN), human type Ⅳ collagen(Ⅳ-C) and human N-terminal procollagen Ⅲ peptide(PC-Ⅲ), were detected before and after Ld T treatment in LC group. The results showed favorable viral suppression and biochemical responses after treatment with Ld T for 12 weeks, and a high rate of virological and biochemical control was maintained during the course of 108-week treatment in both CHB and LC groups. The four fibrosis-related markers, especially HA and LN, were down-regulated to some degrees in LC group. Moreover, Ld T treatment led to the fluctuation of the circulating interferon-γ(IFN-γ) and interleukin-10(IL-10) levels at different time points in CHB group. It was concluded that Ld T could favorably lead to the virological suppression and biochemical remission. Besides, IFN-γ and IL-10 may represent a suitable and effective predictor of responsiveness during Ld T therapy.     

A pilot study on the combined therapy of granulocyte-macrophage colony-stimulating factor and hepatitis B vaccine on chronic hepatitis B virus carrier children

Objective To observe the efficacy of treating intrauterine infected chronic hepatitis B virus (HBV) carrier children with a combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) or hepatitis B immunoglobulin (HBIG) plus recombinant hepatitis B vaccine (rHBvac).Methods A total of 27 chronic HBV infected children, who were born to HBV carrier mothers and received hepatitis B immunoprophylaxis at birth, were randomized into 2 groups: one receiving a combined therapy of 50 μg of GM-CSF plus 10 μg of rHBvac injected intramuscularly at the same location (GM-CSF group, 14 children) or 200 IU HBIG and 10 μg rHBvac in different muscles (HBIG group, 13 children) on a monthly four-dose schedule. HBV-DNA quantification and other HBV serological markers were tested before and after the four-dose therapy. Results Twelve children in each group completed the study. Of them, 3 children in the GM-CSF group and 4 in the HBIG group had elevated serum alanine transaminase (ALT) before the trial, and then 2 in each group became ALT normal after the treatment. Before the therapy, hepatitis B e antigen (HBeAg) positivity was found in nine children in the GM-CSF group and 10 in the HBIG group. One from each group had an HBeAg/anti-HBe seroconversion after the treatment. The quantity of HBV-DNA was significantly lower after the treatment (P=0.023) in GM-CSF group, but was not significantly reduced in HBIG group. No subjects were found to be negative for hepatitis B surface antigen (HBsAg) after the treatment, and no serious adverse events occurred in either group. Conclusion Combined GM-CSF and rHBvac therapy inhibit HBV replication in carrier children who were not protected after treatment with immunoprophylaxis.     

Effect of ω-3 polyunsaturated fatty acid on toll-like receptors in patients with severe multiple trauma

This study examined the effects of ω-3 polyunsaturated fatty acid(ω-3PUFA) on the expression of toll-like receptor 2(TLR2),toll-like receptor 4(TLR4) and some related inflammatory factors in peripheral blood mononuclear cells(PBMCs) of patients with early-stage severe multiple trauma.Thirty-two patients who were admitted to the Department of Traumatic Surgery,Tongji Hospital(Wuhan,China) between May 2010 and November 2010,and diagnosed as having severe multiple trauma with a injury severity score(ISS) no less than 16,were enrolled in the study and divided into two groups at random(n=16 in each):ω-3PUFA group and control group in which routine parenteral nutrition supplemented with ω-3PUFA or not was administered to the patients in two groups for consecutive 7 days.Peripheral blood from these patients was collected within 2 h of admission(day 0),and 1,3,5 and 7 days after the nutritional support.PBMCs were isolated and used for detection of the mRNA and protein expression of TLR2 and TLR4 by using real-time PCR and flow cytometry respectively,the levels of NF-κB by quantum dots-based immunofluorescence assay,the levels of TNF-α,IL-2,IL-6 and COX-2 by ELISA,respectively.The results showed that the mRNA and protein expression of TLR2 and TLR4 in PBMCs was significantly lower in ω-3PUFA group than in control group 5 and 7 days after nutrition support(both P<0.05).The levels of TNF-α,IL-2,IL-6 and COX-2 were found to be substantially decreased in PBMCs in ω-3PUFA group as compared with control group at 5th and 7th day(P<0.05 for all).It was concluded that ω-3PUFA can remarkably decrease the expression of TLR2,TLR4 and some related inflammatory factors in NF-κB signaling pathway in PBMCs of patients with severe multiple trauma,which suggests that ω-3PUFA may suppress the excessive inflammatory response meditated by the TLRs/NF-κB signaling pathway.     

参芍汤对动脉粥样硬化大鼠模型主动脉炎症反应的影响

Objective: To investigate the effect of Shenshao Decoction (参芍汤) on the in?ammatory status in the aorta in a rat model of atherosclerosis. Methods: Forty Sprague-Dawley rats were randomly divided into five groups, 8 rats in each group: control untreated group, atherosclerosis group, atherosclerosis with Shenshao Decoction (low dose) group, atherosclerosis with Shenshao Decoction (high dose) group, atherosclerosis with simvastatin group. To stimulate atherosclerosis, the rats were fed vitamin D3 and a high-cholesterol diet. Four weeks later, treatments were maintained for eight weeks. Morphology changes were investigated by hematoxylin and eosin staining. Serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) were obtained by enzymatic assays with use of an automated biochemical analyzer. The expression of malondialdehyde (MDA), glutathione peroxidase (GSH-PX) were detected by enzyme-linked immunosorbent assay. The expression levels of interleukin (IL)-1β, IL-17A, and IL-23 were detected by immunoblotting. Results: Shenshao Decoction treatment decreased TC, TG, LDL-C and MDA and increased GSH-PX levels (P<0.01). Compared with the control group, IL-1β, IL-17A, and IL-23 were lower in the high and low dose Shenshao Decoction groups and the simvastatin group (P<0.01). Conclusions: Shenshao Decoction could attenuate the progression of aortal atherosclerotic plaques by inhibiting the in?ammatory response in a rat atherosclerotic model.     

Influence of iron deficiency on serum IgG subclass and pneumococcal polysaccharides specific IgG subclass antibodies.

The serum IgG subclass concentrations in 47 cases and specific IgG subclass antibodies against pneumococcal polysaccharides (PnPs) were measured in 18 cases with iron deficiency. IgG subclass deficiencies were found in 28 (59.6%) cases with the frequency in order as IgG4 (27.7%, 13 / 47), IgGl (21.3%, 10/47), IgG3 (14.9%, 7/47), and IgG2 (2.1%, 1 / 47). Compared with age-atched healthy children, the mean concentration of serum IgG4 and IgGl, and PnPs specific IgGl, IgG2 antibodies were decreased in children with iron deficiency. Decreased CD4 cells and CD4 / CD8 ratio in peripheral blood, low interleukin? (IL-6) activity, reduced lymphocyte proliferative responsiveness and increased recurrent respiratory tract infections (RRTI) were found in iron deticiency children. These results suggested that serum IgG subclass and PnPs specific IgG subclass antibody deficiencies caused by dysfunction of the regulation of T lymphocyte on B lymphocyte may be related to the susceptibility to RRTI in children with iron     

Effects of Chinese Medicine Shen-Fu Injection(参附注射液)on the Expression of Inflammatory Cytokines and Complements during Post-Resuscitation Immune Dysfunction in A Porcine Model

Objective:To investigate the action of Shen-Fu Injection(参附注射液,SFI) in regulating the expression of the serum complements and inflammatory cytokines synthesized and released in response to the stress of global ischemia accompanying cardiac arrest(CA) and resuscitation.Methods:Thirty pigs were randomly divided into the sham(n=6) and 3 returns of spontaneous circulation(ROSC) groups(n=24).After 8-min untreated ventricular fibrillation and 2-min basic life support,24 pigs of the ROSC groups were randomized into three groups(n=8 per group),which received central venous injection of SFI(SFI group),epinephrine(EP group),or saline(SA group).Hemodynamic status and blood samples were obtained at 0,0.5,1,2,4,6,12,and 24 h after ROSC.Results:Serum concentrations of specific activation markers of the complement system C3,C4 and C5b-9 were increased during cardiopulmonary resuscitation th rough1 24 h after ROSC.There were intense changes of various pro-inflammatory cytokines and anti-inflammatory cytokines as early as 0.5 h after CA.Compared with the EP and SA groups,SFI treatment reduced the proinflammatory cytokines levels of interleukin(IL)-6,IL-8and tumor necrosis factor α(TNF-α,P0.05),and increased the anti-inflammatory cytokine levels of IL-4 and IL-10(P0.05).Further,SFI treatment decreased the values of C3,C4 and C5b-9 compared with the EP and SA groups.Conclusions:SFI,derived from the ancient Chinese medicine,has significant effects in attenuating post-resuscitation immune dysfunction by modulating the expression of complements and cytokines levels.The current study provided an experimental basis for the clinical application of a potential pharmacologic target for post resuscitation immune dysfunction.     

Different plasma levels of interleukins and chemokines: comparison between children and adults with AIDS in China

Background The immunological differences between children and adults with AIDS in China are not well documented. Th1/Th2 cytokines and chemokines are two types of immune factors intimately involved in disease progression of HIV-1 infection. This study aimed to identify changes in plasma levels of Th1/Th2 cytokines inerleukin （IL）-18, IL-16, IL-10 and chemokines regulated on activation, normal T cell expressed and secreted （RANTES）, stromal cell-derived factor-1 （SDF-1） and monocyte chemoattractant protein-1 （MCP-1） in HIV-l-infected children and adults in China. Methods Seventy-five children with AIDS and 35 adult AIDS patients were recruited and clinical data were collected. CD4^＋ T lymphocyte counts were measured by flow cytometery and plasma HIV RNA levels were measured by quantitative RT-PCR. Plasma levels of IL-18, IL-10, IL-16, RANTES, MCP-1, SDF-1a and SDF-1β were quantified by enzyme-linked immunosorbent assay. The levels of β2-microglobulin （β2-MG） and soluble Fas （sFas） were measured to validate the level of humoral and cellular immune activation. Results The mean levels of all cytokines in pediatric and adult AIDS patients were significantly higher than in their healthy controls （P 〈0.01）. The mean levels of these cytokines were higher in pediatric patients than in adult patients （P 〈0.05, except for SDF-la and β2-MG）. Some of the cytokine levels in patients younger than 6 years old was higher than in older children and adults with AIDS （IL-10, IL-18, SDF-la, MCP, RANTES and sFas, P 〈0.05）. Levels of IL-18, IL-10, RANTES and β2-MG of pediatric patients increased as the levels of viral load increased （P 〈0.05）. Conclusions Abnormal immune activation can be measured in Chinese pediatric and adult patients with AIDS, and is higher in children than in adult patients. The cytokines levels coincide with disease progression of AIDS, but have no direct relationship with total CD4^＋ T cell count.     

Flashes,floaters, and a field defect

A 65 year old woman presents to her general practitioner with a three clay history of flashing lights in her right eye. She has also noticed a new floaler in her temporal field of vision. She deseribes this as resembling a ＂ fly ＂ or ＂ cobweb. ＂ Reassuringly, she has not been aware of a shadow in her field of vision.     

闪光感、飞蚊症和视野缺损

一位65岁的中老年妇女去看医生,她感觉有眼有闪光感3天了,而且在有眼的外侧视野里出现一些漂浮物,形状就像是苍蝇或者蜘蛛网。令人放心的是,在她视野中没感觉到有固定黑影遮挡。     

Tong-xie-ning, a Chinese herbal formula, in treatment of diarrhea-predominant irritable bowel syndrome: a prospective, randomized, double-blind, placebo-controlled trial

Currently the main components of treatment for irritable bowel syndrome （IBS） include patienteducation and reassurance, dietary modification, symptomatic treatment, and psychological treatment, but little evidence exists that the current pharmaceutical agents routinely used in treating IBS patients are efficacious.1 Partly from lack of effective conventional therapeutics and in search of better treatment options, many patients with IBS in both the east and west have turned to complementary and alternative approaches, including traditional Chinese medicine （TCM）.     

神经淋巴瘤病一例报告

神经淋巴瘤病(neurolymphomatosis,NL)是指非霍奇金淋巴瘤浸润周围神经系统,临床表现以周围神经损害为主,病理检查可以发现肿瘤细胞在神经组织浸润伴随有髓神经纤维轴索或髓鞘损害.本文报道1例通过神经活检证实的神经淋巴瘤病.