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。     

儿童过敏性哮喘尘螨特异性免疫治疗中干扰素-γ白介素4 T-bet和GATA-3 mRNA表达变化的研究

目的　探讨在过敏性哮喘尘螨特异性免疫治疗（SIT）过程中，与TH1/TH2细胞分化相关的干扰素-γ（IFN-γ）、白介素4（IL-4）、T-bet和GATA-3 mRNA 在外周血单个核细胞（PBMCs）中表达的变化。方法 根据进行抗原特异性免疫治疗（SIT）的时间，采集郑州大学第一附属医院儿科门诊2007年11月至2008年9月 收治的过敏性哮喘患儿36例，对其SIT治疗前、治疗16周后和治疗1年后的外周静脉血分离外周血单个核细胞，提取总RNA，逆转录成cDNA，利用SYBR GreenⅠ荧光 定量PCR的方法检测每组中IFN-γ、IL-4、T-bet和GATA-3 mRNA表达情况。同时，观察患儿治疗前后的临床疗效。结果 随着SIT治疗的进行，患儿临床症状明显 减轻，外周血中在mRNA表达水平IFN-γ/IL-4和T-bet/GATA-3的比值逐渐升高。结论 哮喘患儿特异性免疫治疗有效；治疗后TH1/TH2细胞的失衡得到一定的纠正 ；T-bet和GATA-3转录因子在哮喘的发生和SIT治疗中起重要作用。     

IL-10对人早孕蜕膜基质细胞的细胞因子信号抑制因子(SOCSs)基因表达的调控作用

目的:研究细胞因子信号抑制因子SOCS1、SOCS2、SOCS3基因在正常人早孕蜕膜基质细胞的表达及其意义。方法:体外分离培养人早孕蜕膜基质细胞,采用逆转录聚合酶链反应(RT-PCR)及Western blotting法检测SOCS表达,酶联免疫吸附剂测定(ELISA)法检测细胞IL-10、IFN-γ的分泌。结果:无血清培养蜕膜基质细胞未见SOCS1表达,但表达SOCS2、SOCS3;细胞培养14h所分泌的IL-10高于细胞培养2h时的水平(P<0.05),IFN-γ分泌则无明显变化(P>0.05);IL-10(0.1ng/ml)作用蜕膜基质细胞14h内,不同程度上调SOCS2、SOCS3表达。结论:人早孕蜕膜基质细胞自分泌、旁分泌的IL-10可能诱导细胞SOCS2、SOCS3的表达。     

Aortic and pulmonary blood velocities during the first 3 days of life

Newborn infants undergo major cardiovascular changes to accomplish the transition from fetal to newborn circulation. These include a drop in pulmonary vascular resistance and closure of the ductus arteriosus. We measured blood velocities by pulsed-Doppler ultrasound in the great vessels of normal newborns during this transition period. Our goals were to understand the timing of these changes and to assess cardiac function as measured by flow velocities. We concluded that shunting of blood through the ductus arteriosus continues for 1-2 days after birth without apparent hemodynamic consequences, cardiac function, as assessed by the Doppler technique, remains remarkably stable during this time period, the timing of ductal closure is not affected by the mode of delivery, and Doppler ultrasound is a portable, reproducible method which is useful in assessing the cardiovascular system of the neonate.     

子宫内膜异位症致不孕的机理探讨－血清中肿瘤坏死因子、白细胞介素Ⅱ、抗心磷脂抗体的检测

检测２４例子宫内膜异位症（ＥＭ）及１１例非子宫内膜异位症（ＮＥＭ）患者血清中的肿瘤坏死因子（ＴＮＦ）、白细胞介素Ⅱ（ＩＬ－２）及抗心磷脂抗体（ＡＣＡ）。结果：（１）３５例样本除ＥＭ组一例ＴＮＦ呈明显升高，其余均低于正常值（２μｇ／ｍｌ）；（２）ＥＭ组患者血清中ＩＬ－２的平均浓度为３１．１４６±２．２５１μｇ／ｍｌ，而ＮＥＭ组为８．２１７±３．８４４μｇ／ｍｌ，两者有显著性差异（Ｐ＜０．０１）；（３）ＥＭ组患者血清中ＡＣＡ阳性率为１６．６７％，ＮＥＭ组为２７．２７％。两者无显著性差异（Ｐ＞０．０５）。结论：ＥＭ患者血清胚胎毒性作用可能与ＩＬ－２有关，ＡＣＡ可能是非特异性的，而ＴＮＦ则无明显相关性。     

IL-10对人滋养层细胞中HLA-GmRNA表达和HCG分泌的影响

目的研究白介素-10(IL-10)对人滋养层细胞中人类白细胞抗原-G(HLA-G)mRNA表达及人绒毛膜促性腺激素(HCG)分泌的影响,探讨IL-10在母-胎免疫耐受机制中的作用.方法选取正常妊娠6～8周妇女行人工流产术后的绒毛组织21例,每1例标本随机平均分为实验组和对照组,加入IL-10 培养和单独培养72小时,每组均采用逆转录-聚合酶链式反应(RT-PCR)及放射免疫测定(RIA)的方法分别检测HLA-G mRNA的表达量及HCG的分泌水平.结果①两组滋养层细胞中均有HLA-G mRNA的表达及HCG的分泌,实验组HLA-G mRNA的平均表达峰度值为0.28±0.07,对照组HLA-G mRNA的平均表达峰度值为0.15±0.04,差异有非常显著性(P＜0.01);实验组HCG浓度为27.20±4.16 U/L,对照组HCG浓度为23.98±2.27 U/L ,差异有非常显著性(P＜0.01).②直线相关分析表明,滋养层细胞中HLA-G mRNA的表达与HCG分泌之间无相关性.结论IL-10诱导人滋养层细胞中HLA-G mRNA的表达增高及HCG的分泌增加,对促进母-胎之间免疫耐受的形成具有重要作用.     

Mechanical stretching induces interleukin-8 gene expression in fetal membranes: a possible role for the initiation of human parturition

Objective: Interleukin-8 (IL-8) is known to play a crucial role in human parturition. We aimed to study the effect of mechanical stretching on the expression of IL-8 in fetal membranes (amniochorion) and decidua. Study design: We examined the expression of IL-8 and its receptor in fetal membranes (amniochorion) and decidua by immunohistochemical staining. Also, we studied the synthesis of IL-8 messenger RNA (mRNA) in the fetal membranes before and after stretching. Results: We found that mechanical stretching within physiological limit increased IL-8 messenger RNA (mRNA) synthesis in fetal membranes and decidua in a time-and load-dependent manner. Application of mechanical force led to markedly increased staining of IL-8 receptor in decidual cells but not in amnion or chorion cells. Conclusion: These results suggested that mechanical stretching was a candidate for one of the signals important for production of IL-8 in fetal membranes and decidua and probably for initiation of a cytokine network at amniochorio-decidual interface through increased expression of IL-8 receptors.     

Association between hypocapnia and ventilation during the first days of life and brain injury in asphyxiated newborns treated with hypothermia

Purpose: Therapeutic hypothermia is the standard treatment for asphyxiated newborns. Since hypocapnia is common in these newborns, the aim of this study was to assess the association among hypocapnia, ventilation, and brain injury.

Methods: We conducted a retrospective cohort study of all asphyxiated newborns treated with hypothermia from 2008 to 2014. Partial pressure of carbon dioxide (pCO₂), ventilatory status, and modes of ventilation were recorded during the first 4 days of life. Brain injury was evaluated using brain magnetic resonance imaging. Differences between intubated and nonintubated newborns and between the newborns who developed brain injury or not were assessed.

Results: One hundred ninety-eight asphyxiated newborns were treated with hypothermia. During the first 2 days of life, intubated newborns had consistently lower pCO₂ levels (respectively, 29.01?±?8.55, p?p?=?.004 on day 2 of life). Fifty-nine percent of the intubated newborns developed brain injury versus only 43% of the nonintubated newborns (p?=?.046). The lowest pCO₂ levels averaged over the first 4 days of life were significantly decreased in newborns developing brain injury (p?=?.02) and significantly associated with brain injury severity (p?=?.01). After adjusting for potential cofounders, the lowest pCO₂ averaged over days 1–4 of life remained significantly associated with an increased risk of brain injury (odds ratio [95%CI]: 1.07 [1.00–1.14]; p?=?.04).

Conclusions: Intubated and ventilated asphyxiated newborns experienced more severe hypocapnia, and had higher incidences of brain injury. Hypocapnia during the first 4 days of life was associated with an increased risk of developing (more severe) brain injury.     

Interleukin-6 (IL-6) production in carcinoma of the cervix

Interleukin-6 (IL-6) is a pleiotropic cytokine that is not only a mediator in major immunologic reactions but also a growth factor of keratinocytes. We studied the IL-6 secretion in vitro of 15 human cell lines derived from both squamous cell carcinoma (SCC) and adenocarcinoma of the uterine cervix. Four of the eight well differentiated SCC secreted a large amount (> 1500 pg/48 h/10⁶ cells) of IL-6 in nude mice. In contrast, poorly differentiated SCC cell lines and all of the 7 adenocarcinoma cell lines secreted a small amount (< 500 pg/48 h/10⁶ cells of IL-6). The expression of IL-6 mRNA of the cell lines correlated well with their IL-6 secretion potential. However, the expression of IL-6 receptor did not correlate with the IL-6 secretory potential. We also studied the IL-6 secretion of freshly isolated normal squamous epithelium and of dysplastic epithelium. In culture, two normal squamous epithelia secreted a large amount (> 2000 pg/48 h/10⁶ cells), whereas 8 dysplasia epithelia secreted an extremely small amount (< 10 pg/48 h/10⁶ cells). About one-third of patients with SCC had a raised serum IL-6 value. IL-6 production may help to differentiate between SCC and adenocarcinoma of the uterine cervix. IL-6 regulation seems to change in the course of SCC carcinogenesis.     

Hypercapnia during the first 3 days of life is associated with severe intraventricular hemorrhage in very low birth weight infants.

OBJECTIVE: To examine whether hypercapnia in very low birth weight (VLBW) infants during the first 3 days of life is associated with severe intraventricular hemorrhage (IVH). STUDY DESIGN: Retrospective cohort study of inborn VLBW infants between January 1999 and May 2004 with arterial access during the first 3 days of life. A multiple logistic regression analysis was used where IVH was dichotomized ((grades 0/1/2) = non-severe; (grades 3/4) = severe). Measures of hypercapnia were entered into the model to ascertain their association with severe IVH. RESULTS: In total, 574 VLBW infants met entry criteria. Worst IVH grade was 0 in 400; 1: 54; 2: 42; 3: 47; and 4: 31 infants. The logistic regression model consisted of the following predictors of severe IVH: gestational age, gender, 1 min Apgar score (dichotomized into two groups: >3 vs < or =3), multifetal gestation, vasopressor use, and maximum PaCO(2). CONCLUSION: In addition to traditional risk factors, it appears maximum PaCO(2) is a dose-dependent predictor of severe IVH during the permissive hypercapnia era.     

Interleukin-2 receptor positive cells in human decidua during the first trimester of pregnancy and their association with macrophages

Summary Maternal immune rejection of the fetus could sometimes be the cause of unexplained recurrent spontaneous abortion. Components of the T cell-mediated immunity were investigated in the first trimester of pregnancy in women having spontaneous abortion and compared to those with normal pregnancy having a termination on social grounds. Interleukin 2 (IL-2) had no proliferative effect on the trophoblasts of chorionic villi and there were also no IL-2 receptors in these cells. However IL-2 receptor positive cells were found in the decidua in 7 out of 24 women with normal pregnancy and in 12 out of 18 with spontaneous abortion. A high density of macrophages showed an association with IL-2 receptors in both groups. There were no differences with respect to T-cytotoxis cells and T-helper cells in cases of normal pregnancy (with and without IL-2 receptor positive cells), whereas in women having spontaneous abortion we found lower densities of T-helper and T-cytotoxic cells in those without IL-2 receptors than in those with IL-2 receptors.     

精浆中男性抑制物对白细胞介素1和白细胞介素2产生及反应性的影响

本文采用Sephadex G100柱层析从精浆中制备出男性抑制物(male inhibition material MIM),观察MIM对白细胞介素1(Interleukin 1,IL-1)和白细胞介素2(Interleukin 2,IL-2)的产生及反应性的影响,实验结果表明MIM对IL-1、IL-2产生及反应性的抑制率分别为42.22%、24.23%、72.37及78.71%。提示精浆中MIM可能也通过对IL-1和IL-2的抑制作用,在调节局部或全身免疫应答反应,保护受精卵免遭排斥,维持正常的生育过程中有一定意义。     

宫腔灌注自体外周血单个核细胞治疗对反复种植失败患者妊娠结局的影响及相关机制

目的探讨宫腔灌注自体外周血单个核细胞(PBMCs)治疗对反复种植失败(RIF)患者妊娠结局的影响及相关机制。方法 36名RIF患者于冻融胚胎移植(FET)前24 h行自体PBMCs宫腔灌注,随访妊娠结局;酶联免疫吸附试验(ELISA)检测宫腔灌注前、后外周血及宫颈分泌物中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果 RIF患者经宫腔灌注自体PBMCs治疗后得到了较高的临床妊娠率(47.22%);宫颈分泌物中IL-6、IL-6/TNF-α均显著升高(P0.05),TNF-α水平无统计学差异(P0.05),外周血中IL-6、TNF-α水平均无统计学差异(P0.05)。结论宫腔灌注自体PBMCs治疗能提高RIF患者宫腔局部IL-6水平及IL-6/TNF-α比值,有效改善RIF患者临床妊娠率。     

滋养细胞肿瘤几种细胞因子的变化

目的 研究滋养细胞肿瘤患者血清中的细胞因子水平、探讨与病因的关系。方法 以双抗体、夹心ＥＬＩＳＡ法检测３０例滋养细胞肿瘤患者血清中肿瘤坏死因子白细胞介素－６、８、１０的水平。其中绒毛膜癌１８例,侵蚀性葡萄胎１２例,并以正常早、中期妊娠女２８例、晨孕妇２０例作为对照组。结果 正常孕妇组ＩＬ－６．８、１０均高于正常非孕妇组,其中正常孕妇组ＩＬ－６和ＩＬ－８水平明显升高,而ＩＬ－１０水平略升高,无统计学     

Growth parameters of discordant preterm twins during the first year of life

Abstract

Objective: To evaluate and compare growth parameters (weight, length and head circumference) of discordant preterm twins during the first year of life.

Methods: Retrospective data were collected on 78 pairs of >10% discordant preterm twins. Data regarding short-term neonatal outcome were recorded. Growth parameters were recorded at birth and again at 1 year of age, as collected by phone interview.

Results: At 1 year of age, the gap was significantly reduced between the group of smaller twins and the group of larger twins on all the parameters studied. Discordance in weight decreased from a mean of 22% at birth (calculated from the weight of the larger twin) to 8.9%, in length from 6.5% to 2.5% and in head circumference from 5.5% to 1.3% at 1 year of age. While length and head circumference (HC) z-scores improved in both the large and the small siblings, weight z-score decreased significantly among the large twins and decreased mildly among the small twins.

Conclusions: The gaps in growth parameters between the smaller twins of preterm discordant twins and their larger siblings are significantly reduced during the first year of life. The impact of the differential growth patterns between the two siblings should be further evaluated.