儿童社区获得性肺炎血清免疫学病毒特异性抗体检测与呼吸道病毒核酸检测结果一致性分析

目的:探讨儿童社区获得性肺炎的病毒血清特异性抗体检测与呼吸道病毒核酸检测结果的一致性,以指导其临床应用。方法:109例经鼻咽拭子标本实时荧光定量PCR检测诊断为病毒感染的社区获得性肺炎患儿,采集其急性期和恢复期血清标本,采用间接免疫荧光法检测呼吸道常见病毒(呼吸道合胞病毒、腺病毒、甲型流感病毒、乙型流感病毒和副流感病毒...     

儿童呼吸道感染临床病毒学研究

目的 了解广州地区呼吸道病毒感染情况。方法 采用咽拭子和部分血清进行病毒分离、红细胞凝集试验、红细胞凝集抑制试验和免疫酶村固相吸附试验进行研究。结果 4298例咽拭子中分出流感病毒200例,其中上呼吸道流感病毒172例阳性,占流感病毒阳性率的86．0％;分出呼吸道合胞病毒150例,下呼吸道合胞病毒139阳性,占呼吸道合胞病毒阳性率92．7％;及分出单疱病毒20例;单疱病毒阳性率0．5％。460例肺炎和支炎血清检测巨细胞病毒IgM82例阳性,CMV－IgM阳性率17．7％。结论 流感病毒为上呼吸道感染的主要病原,呼吸道合胞病毒、巨细胞病毒是下呼吸道感染的主要病原。流感病毒流行有2个高峰（每年3－4月及7－8月份）。单疱病毒在上下呼吸道感染中为散发病例。     

过敏性紫癜患者血清中IL-27、IL-17的表达及意义

目的 探讨过敏性紫癜(Henoch-Schoenlein purpura,HSP)患者急性期血清中IL-27、IL-17的表达水平。方法 以本院2017年12月至2018年11月收治的56例急性期过敏性紫癜患者为研究对象,同期行健康体检的28例志愿者为对照组,采用酶联免疫吸附法(ELISA)检测入选者外周血IL-27、IL-17的表达情况;采用相关分析法分析IL-27与IL-17表达的相关性以及与患者临床资料指标白细胞(WBC)、血小板(PLT)、C反应蛋白(CRP)、血沉(ESR)、(D-二聚体)D-Dimer、补体(C3、C4)、类风湿因子(RF)、胱抑素C(Cys-C)、免疫球蛋白(IgA、IgG、IgM、IgE)、抗链球菌溶血素O(ASO)的关系。结果 HSP患者急性期血清IL-27的水平较正常对照组降低,IL-17的水平较正常对照组增高,差异均具有统计学意义(P0.05);IL-27与IL-17、抗溶血性链球菌O(ASO)呈负相关(P=0.016;P=0.034),IL-17与免疫球蛋白IgA呈正相关(P=0.002)。结论 过敏性紫癜患者血清中IL-27降低,IL-17升高,且IL-27水平与IL-17呈负相关,说明IL-27可能对IL-17具有免疫调节的作用,可能参与过敏性紫癜的致病过程并在疾病发展过程中发挥保护性作用。     

石家庄市不同人群呼吸道感染病原体调查分析

目的 了解本地区急性呼吸道感染患者8种呼吸道病原体的流行情况.方法 选取2014年1月1日至2015年12月31日在石家庄市第一人民医院诊治的7545例呼吸道感染患者,对血清进行8种常见呼吸道病原体的IgM抗体检测.结果 本地区2014年检出率较高的呼吸道病原体依次是流感病毒B(17.5％)、流感病毒A(12.9％)、肺炎衣原体(11.8％),2015年检出率较高的呼吸道病原体依次是流感病毒B(20.6％)、肺炎支原体(20.0％)、流感病毒A(11.0％).2015年较2014年流感病毒A、流感病毒B、肺炎衣原体、嗜肺军团菌4种病原体IgM抗体阳性率有所降低,肺炎支原体IgM抗体阳性率有所升高;各年龄组八种病原体抗体阳性率均存在差异,与0～3岁组比较4～15岁组肺炎衣原体、流感病毒A、流感病毒B、副流感病毒、嗜肺军团菌、呼吸道合胞病毒IgM抗体阳性率较高,15岁以上组腺病毒、嗜肺军团菌、呼吸道合胞病毒IgM抗体阳性率较高;与4～15岁组比较15岁以上组腺病毒、嗜肺军团菌IgM抗体阳性率较高;且秋冬季与春夏季比较流感病毒A、流感病毒B、副流感病毒IgM抗体阳性率较高,而肺炎支原体IgM抗体阳性率较低.结论 本地区呼吸道感染的病原体以流感病毒A(INFA)、流感病毒B、肺炎支原体为主,不同年份、不同季节、不同年龄组病原体的种类和感染率具有一定差异性.     

儿童呼吸道感染临床病毒学研究

目的了解广州地区呼吸道病毒感染情况.方法采用咽拭子和部分血清进行病毒分离、红细胞凝集试验、红细胞凝集抑制试验和免疫酶标固相吸附试验进行研究.结果 4298例咽拭子中分出流感病毒200例,其中上呼吸道流感病毒172例阳性,占流感病毒阳性率的86.0%;分出呼吸道合胞病毒150例,下呼吸道合胞病毒139阳性,占呼吸道合胞病毒阳性率92.7%;及分出单疱病毒20例;单疱病毒阳性率0.5%.460例肺炎和支炎血清检测巨细胞病毒IgM 82例阳性,CMV-IgM阳性率17.7%.结论流感病毒为上呼吸道感染的主要病原,呼吸道合胞病毒、巨细胞病毒是下呼吸道感染的主要病原.流感病毒流行有2个高峰(每年3～4月及7～8月份).单疱病毒在上下呼吸道感染中为散发病例.     

呼吸道合胞病毒抗原酶联免疫吸附测定检测方法的建立及应用

目的建它呼吸道合胞病毒抗原酶联免疫吸附测定(ELISA)检测方法,应用其对来源于本院的临床样本进行检测.方法建立ELISA方法,检测标本中的呼吸道合胞病毒,与呼吸道合胞病毒细胞培养检测方法进行对照,并利用该方法进行该病毒2007年在广州市的流行性分析.结果本方法的灵敏度略高于呼吸道合胞病毒的细胞培养检测方法,对甲型流感病毒(H3N2亚型、H1N1亚型)、乙型流感病毒、副流感病毒(Ⅰ型、Ⅲ型)、呼吸道腺病毒(Ⅲ型、Ⅶ型)无特异性反应.结论本呼吸道合胞病毒抗原ELISA检测方法可用于呼吸道合胞病毒感染的临床诊断和鉴别诊断.     

重组人干扰素α-2b喷雾剂预防SARS等呼吸道病毒感染的人群试验研究

目的评估重组人干扰素α2b喷雾剂(远策素喷雾剂)预防SARS等常见呼吸道病毒感染的效果。方法研究对象共14391人,用药剂量为90万IU/次,每日2次,连用5d,未次用药后15d取血,或用药前和用药3周后采取双份血清。采用随机、对照方法检测血清抗SARSCoVIgG抗体;采用双盲、随机、安慰剂对照方法测定血清抗常见呼吸道病毒(B型流感病毒、副流感病毒1～3型,呼吸道合胞病毒及腺病毒3、7型)的血清IgM抗体。结果两次实验中,干扰素组血清SARS病毒IgG抗体阳性率均较试验组高,但差异无统计学意义(P>0.05)。但用药组应用干扰素后副流感病毒1～3型,B型流感病毒,腺病毒3、7型和呼吸道合胞病毒IgM抗体阳性率(依次为6.45%、4.52%、4.30%和17.20%)均低于对照组(依次为19.40%、13.60%、7.12%和25.62%)。其中副流感病毒、B型流感病毒、腺病毒3种病毒IgM抗体阳性率差异均有统计学意义(P<0.01)。结论应用远策素喷雾剂鼻和咽部喷雾能不同程度地降低用药人群常见呼吸道病毒的感染率。     

慢性阻塞性肺疾病急性加重患者呼吸道病毒的检测分析

目的 探讨呼吸道病毒感染与慢性阻塞性肺疾病急性加重(AECOPD)的相关性.方法 随机选择140例慢性阻塞性肺疾病急性加重(AECOPD)患者,60例健康老年志愿者为对照组,分别检测呼吸道合胞病毒(RSV)、单纯疱疹病毒(HSV)、腺病毒(ADV)、巨细胞病毒(CMV)、副流感病毒(PIV)、流感病毒A/B(FluA/B)特异性抗体IgM水平,对组间阳性率进行比较.结果 AECOPD组患者中IgM阳性率依次为RSV＞PIV＞ FluA/B＞CMV＞ADV＞ HSV.AECOPD组与对照组各病毒抗体阳性率比较差异有统计学意义(P＜0.05).结论 病毒感染是AECOPD重要因素,病毒感染参与了AECOPD病情的进展过程,在呼吸道病毒流行的季节应做好预防工作.     

呼吸道合胞病毒不同感染时间对过敏性气道炎症反应的作用研究

目的:探讨呼吸道合胞病毒(RSV)不同感染模式对花粉诱导的气道过敏性炎症反应的影响。方法:用花粉抽提物JCP致敏BALB/c鼠,在致敏前或致敏后的不同时间点经鼻粘膜感染RSV。HE染色法分类肺泡灌洗液中炎症细胞类型并计数其数量;ELISA法检测血清中过敏原特异性抗体含量;细胞因子检测试剂盒检测肺组织细胞培养上清中IL-17和IL-5水平。结果:与对照JCP组相比,JCP致敏前RSV感染组肺组织炎症细胞浸润程度明显减轻,炎症细胞总数及嗜酸性粒细胞数量明显下降;血清IgE总量及JCP特异性IgE和IgG1抗体水平显著降低;肺组织淋巴细胞IL-17分泌水平升高,而IL-5分泌减少。与致敏前RSV感染模式不同,致敏后RSV感染无论是对JCP诱导的气道过敏性炎症反应,亦或对血清抗体水平和细胞因子分泌活性均无明显影响。结论:RSV不同感染模式对JCP诱导的过敏性气道炎症具有不同的作用特点,致敏前RSV感染降低过敏原诱导的气道炎症反应。     

慢性阻塞性肺疾病急性加重患者常见病毒感染分析CSCD

目的 分析慢性阻塞性肺疾病（Chronic obstructive pulmonary disease,COPD）急性加重期患者感染病毒特点,及病毒感染在COPD急性加重中的作用.方法 将武警四川省总队医院2015年4月-2016年3月收治的COPD急性加重期患者193例为A组,同期COPD稳定期患者50例为B组.检测两组患者呼吸道合胞病毒、腺病毒、副流感病毒、甲型流感病毒、乙型流感病毒的IgM抗体.结果 两组患者在年龄、性别、病程方面差异无统计学意义（P＞0.05）.A组病毒感染率13.47％,高于B组（Х^2=5.29,P＜0.05）.A组感染的病毒以乙型流感病毒最多见（感染率12.44％）,之后依次为甲型流感病毒（感染率7.78％）、副流感病毒（感染率7.25％）、腺病毒（感染率2.63％）、呼吸道合胞病毒（感染率1.32％）.单一病毒感染占COPD急性加重期感染病毒患者的34.6％,2种病毒感染占15.4％,3种或3种以上病毒感染占50％.夏秋季病毒感染率高于冬春期,但差异无统计学意义（P＞0.05）.结论 COPD急性加重患者有13.47％存在病毒感染,且大部分为2种或2种以上病毒感染,病毒感染可能在COPD急性加重中起重要作用,需重视COPD患者病毒感染的预防和治疗.     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.