Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Severeacuterespiratorysyndrome(SARS)isanewlyariseninfectiousdiseasewithrespiratorytractasthechiefpathwayoftransmission.Thisisespecial lytrueforSARSpatientsofseveretypeduetoitsse riouscondition,whichresultsinhighmortalityandgreatdifficultiesinitstreatment.InordertoexploretheeffectivewaysintreatmentofSARS,clinicalstudiesontreatmentofSARSbyintegrativeChineseandwesternmedicine(ICWM)havebeencarriedoutbytheauthorsandthepreliminarysummaryisre portedasfollows.METHODSClinicalMaterials　　 T…     

Clinical Characteristics of 42 SARS Patients and Their Treatment of Integrative Chinese and Western Medicine

Objictive:To understand the clinical manifestation of severe acute respiratory syndrome(SARS)and explore its effective treatment with integrative Chinese and western medicine(ICWM).Methods:The data of patients,whose diagnosis of SARS had been confirmed were summarized and ana-lyzed,and clinical observation was conducted when the patients were treated with ICWM.Results:In theearly stage of the 42 patients,the symptoms revealed were fever in 100％ of SARS patients,headache in92.9％,aversion to cold in 76.2％,chest stuffiness in 76.2％,cough in 73.8％and myalgia in 88.1％;Pulmonary lesion Involves ≥3 lobes in 42.9％,2 lobes in 47.6％ and 1 lobe in 9.5％;61.9％ of themshowed liver function abnormality(increase of ALT or AST),47.6％ showed elevated myocardial enzyme(CK or CK-MB),0.48％ showed an inclination of renal function(higher of BUN or Cr);in their T lym-Phocyte subsets,91.2％(31/34 Patients)had lowered CD_3 and 76.5％(26/34 Patients)lowered CD_4/CD_8ratio.In the mid-late stage,the symptoms were lass     

自体CIK细胞对晚期不同阶段肿瘤患者免疫状态和生活质量的影响

目的 探讨自体细胞因子诱导的杀伤细胞（CIK）治疗晚期恶性肿瘤患者,对其免疫状态和生活质量的影响。方法 选取2013年2月至2016年3月合肥市第一人民医院血液肿瘤科收治的42例晚期肿瘤患者,按照预计生存期分为A组（预计生存期<3个月）20例、B组（预计生存期≥3个月）22例,检测治疗前后A、B组患者外周血T细胞亚群的变化。观察治疗前后A、B组患者免疫功能的变化,生活质量改善情况及治疗相关不良反应。结果 CIK细胞治疗后,A组患者CD₃⁺T细胞水平较治疗前降低（P<0.05）;B组治疗后CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺水平较治疗前明显升高（P<0.05）,CD₈⁺T淋巴细胞亚群水平较治疗前降低（P<0.05）。A、B两组患者治疗后KPS评分分别较治疗前均有提高,其中A组差异无统计学意义（P>0.05）,而B组差异有统计学意义（P<0.05）。42例患者在输注CIK过程中未出现明显不良反应。结论 CIK细胞回输安全、副作用小,自体CIK细胞治疗可提高晚期恶性肿瘤患者的免疫功能,改善其生活质量,但应尽早进行。     

Effect of Tiotropium Bromide on Expression of CD_8~＋CD_（25）~＋FoxP_3~＋ Regulatory T Cells in Patients with Stable Chronic Obstructive Pulmonary Disease

The expression of CD8+CD25+FoxP3+ regulatory T cells(CD8+Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD),and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8+Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide(18 μg daily) for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoclonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8+T cells,CD8+CD25+T cells,CD8+Tregs,CD4+T cells,CD4+CD25+T cells and CD4+CD25+FoxP3+ regulatory T cells(CD4+Tregs) respectively.The percentage of CD4+T cells was increased from(27.82±2.18)% to(35.53±1.3)%(t=3.20,P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4+CD25+T cells was decreased from(10.03 ±1.42)% to(4.21 ±0.65)%(t=3.78,P=0.001),and that of CD8+Tregs was increased from(8.41 ±1.68)% to(21.34 ±4.20)%(t=2.72,P=0.013).At baseline,CD8+T cells,CD8+CD25+T cells and CD4+Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4+T cells and CD4+CD25+T cells was negatively correlated with the ratio of change in CD8+Tregs before and after treatment(r=-0.61,P=0.013;r=-0.72,P=0.001 respectively).In the peripheral blood of patients with stable COPD,there was the expression of CD8+Tregs and CD4+Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4+T cells,inhibit the expression of CD25+T cells,and enhance the expression of CD8+Tregs.CD8+Tregs and CD4+Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.     

Clinical Observation on Shuanghuanglian powder in treating viral myocarditis of childrenin treating viral myocarditis of children

Objective: To study immune function of children viral myocarditis and to evaluate the clinical effect of Shuanghuanglian Powder (SHLP) by injection.Methods: The 62 patients of viral myocarditis were divided into two groups randomly, the SHLP group (n = 32) treated with conventional therapy plus SHLP and the conventional treatment group (n = 30) with conventional therapy alone. Their serum antibody of Coxsackie virus group B (COXB-IgM), T-lymphocyte subsets including CD₃ ⁺, CD₄ ⁺, CD₈ ⁺ and CD₄ ⁺/CD₈ ⁺ were determined with ELISA and indirect immunofluorescent assay.Results: COXB-IgM was positive in 39 of the 62 patients, which was significantly different with those of normal controls (P< 0.001). Patients’ serum level of CD₄ ⁺ cells and CD₄ ⁺/CD₈ ⁺ ratio decreased while CD₈ ⁺ increased. After treatment, the recovery of symptoms, signs and immune function in patients of the SHLP group were significantly better than those in patients treated with conventional treatment alone (P<0.01).Conclusion: Immunoregulatory disturbance is involved in children with viral myocarditis and SHLP is an effective drug in the treatment of children viral myocarditis.     

Changes in T cell subsets and T suppressor cell function and their relationship in human schistosomiasis japonica

Summary The function of spontaneous T suppressor cell (STs) of peripheral blood was examined in 56 patients with schistosomiasis japonica at various stages. The subsets of T cell were simultaneously phenotyped in 46 cases. The percentages of CD₃ ⁺(pan T cell), CD₄ ⁺ (helper/inducer T cell) and CD₈ ⁺ (suppressor/cytotoxic T cell) in patients with acute schistosomiasis japonica were significantly higher than those in the normal controls. In patients with chronic and advanced schistosomiasis japonica, the percentage of CD₈ ⁺ T cell and the function of STs were greatly increased, but the percentage of CD₃ ⁺ T cell and the ratio of CD₄ ⁺/CD₈ ⁺ were obviously reduced. All of these markers changed more significantly in patients with advanced schistosomiasis japonica. The percentage of CD₈ ⁺ T cell in patients with acute schistosomiasis japonica was negatively correlated with the function of STs. In patients with chronic and advanced schistosomiasis japonica the percentage of CD₈ ⁺ T cell was correlated positively and the ratio of CD₄ ⁺/CD₈ ⁺ negatively with the function of STs. The results indicated that the cellular immunity was significantly increased in cases of acute schistosomiasis japonica and decreased in those with chronic or advanced schistosomiasis japonica. The increased CD₈ ⁺ T cell may be principally cytotoxic T cells in patients with acute schistosomiasis japonica, but suppressor T cells in patients with chronic and advanced schistosomiasis japonica. The subsets of T cells and the function of T suppressor cells may play an important role in the immunoregulation of schistosomiasis japonica.     

Effect of TCM combined with chemotherapy on immune function and quality of life of patients with non-small cell lung cancer in stage III-IV

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage III-IV.Methods: One hundred cases with stage III-IV NSCLC were randomly divided into two groups. The treated group (n = 50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD₃ cell count, CD₄ cell count, CD₄/ CD₈ ratio and NK cell activity were higher than those in control group, while CD₈ cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05).Conclusion: TCM combined with CT could raise the patients’ ability in tolerating CT in stage III-IV NSCLC.     

Bailong tablet and chemotherapy in the treatment of moderate and advanced cancersand chemotherapy in the treatment of moderate and advanced cancers

Objective: To determine the effectiveness of Bailong Tablet and chemotherapy on treatment of moderate and advanced cancers.Methods: The patients were divided randomly into two groups. The treated group (n= 41) was treated with chemotherapy plus Bailong Tablet; and the control group (n= 22) treated with chemotherapy alone. Treatment effectiveness was measured with Karnofsky scores.Results: Karnofsky performance status in the treated group before and after treatment was 66.0 ± 8.7 and 68.0 ± 5.9 respectively, that in the control group was 67. 0 ± 6.8 and 53. 0 ± 7.3 respectively. The completion rate of chemotherapy in the treated group (92.6%, 38/41) was higher than that in control (77.2%, 17/22,P < 0.05). The side-effects caused by chemotherapy in the treated group were lower than that in the control group (P < 0.05). CD₃ ⁺, CD₄ ⁺ and CD₄ ⁺ /CD₈ ⁺ ratio were higher in the treated group.Conclusion: Bailong Tablet can enhance the therapeutic effect and reduce the side-effects of chemotherapy. One possible mechanism is the modulation of cellular immune function.     

Randomized double-blinded and controlled clinical trial on treatment of HIV/AIDS by Zhongyan-4

Objective: To assess the efficacy and safety of Zhongyan-4 (ZY-4, a Chinese herbal preparation worked out according to the therapeutic principle of supplementing qi, nourishing Yin, clearing heat and detoxication) in treating HIV/AIDS patients in the early or middle stage.Methods: Adopted was randomized double-blinded and placebo-parallel-controlled method, with 72 HIV/AIDS patients randomly divided into the ZY-4 group (36 patients) treated with ZY-4 and the control group (36 patients) treated with placebo. The treatment course was six months. The index of CD ₄ ⁺ , CD ₈ ⁺ counts, body weight, clinical symptom scoring were estimated at 4 time points (0, 1, 3 and 6 month in the course), and also the viral load before and after treatment. The whole course of observation was completed in 63 patients, 30 in the ZY-4 group and 33 in the control group.Results: CD ₄ ⁺ count in the ZY-4 group got elevated by 7.70 ± 150.96/mm³ on average, while that in the control group lowered by 27.33 ± 85.28 /mm³. Fifteen out of the 30 patients in the ZY-4 group had their CD ₄ ⁺ count increased, which was evidently much higher than that in the control group (8/33,P<0.05), suggesting that the efficacy of ZY-4 is superior to that of placebo in elevating CD ₄ ⁺ count. Moreover, ZY-4 showed actions in elevating CD₄₅RA⁺ and CD ₈ ⁺ count, reducing HIV virus load, improving clinical symptom/sign and increasing body weight of patients. No obvious adverse reaction was found in the clinical trial.Conclusion: ZY-4 has an immunity-protective and/or rebuilding function in HIV/AIDS patients in the early and middle stage, and also shows effects in lowering viral load, increasing body weight and improving symptoms and signs to a certain degree. Supported by the Projects of Ministry of Science and Technology for 10th Five-year Plan (2001BA701A18)     

Clinical controlled study of integrative Chinese and western medicine in treating 49 cases of SARS

Objective:To evaluate the efficacy of integrative Chinese and western medicine(ICWM)in treating severe acute respiratory syndrome(SARS)patients.Methods:Through parallel control design,49 SARS patients were observed.Used as control,there were in the western medicine(WM)group 29 pa-tients,who were treated with Ribavirin,Levofloxacin,Thymopentin,Azithromycin,methylprednisolone,etc.,on the basis of“Recommended Protocol for Infectious Atypical Pneumonia”(abbreviated as“Recom-mended Protocol”)issueed by Ministry of Health.As the treated group,there were in the ICWM 20 ca-ses.The protocol for treatment of SARS in“Special Science and Technological Action to Prevent andTreats SARS”(abbreviated as“Special S-T Action”),issued by Ministry of Science and Technology,to-gether with the same WM as those for the control group.Results:(1)Time from the disease onset to thesymptom improvement were 5.10±2.83 days and7.62±2.27 days ICWM and WM group respectively,P<0.05;(2)As to corticosteroid(CS)amount and days bef     

Effects of Integrative Chinese and Western Medicine on Arterial Oxygen Saturation in Patients with Severe Acute Respiratory Syndrome

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treat     

95例SARS患者T细胞及其亚群动态变化的观察

对 95例SARS患者的T淋巴细胞亚群动态变化进行分析。其中 85例痊愈 ,1 0例死亡。 85例痊愈患者 ,病程第 7天平均CD4 + ( 3 2 5± 1 90 )个 /μL ,CD8+ ( 3 1 9± 3 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 5± 0 .71 ,与我国正常人相比〔平均CD4 + ( 72 7± 2 5 5 )个 /μL、CD8+ ( 5 3 9± 1 3 4)个 /μL ,CD4 + /CD8+ 1 .49〕 ,T淋巴细胞亚群明显下降 (P =0 .0 0 1 )。病程第1 4天左右免疫功能逐渐恢复 ,平均CD4 + ( 5 61± 5 2 2 )个 /μL ,CD8+ ( 3 70± 2 71 )个 /μL ,CD4 + /CD8+ 1 .68± 1 .1 1。 2 1d后免疫功能基本恢复正常 ,平均CD4 + ( 675± 448)个 /μL ,CD8+ ( 4 67± 2 41 )个 /μL ,CD4 + /CD8+ 1 .48± 0 .68。 1 0例死亡患者的T细胞亚群在入院后逐渐出现下降趋势 ,病程第 7天CD4 + ( 2 48± 82 )个 /μL ,CD8+ ( 2 3 3± 1 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 1± 0 .40 ,第 1 4天T淋巴细胞继续下降 ,平均CD4 + ( 1 81± 1 2 8)个 /μL ,CD8+ ( 1 73± 1 0 9)个 /μL ,CD4 + /CD8+ 1 .1 7± 0 .45 ,2 1d后CD4 + 细胞继续下降 ,平均CD4 + ( 1 2 5± 46)个 /μL ,CD8+ ( 94± 3 8)个 /μL ,CD4 + /CD8+ 1 .44±0 .5 9。结果提示 :SARS患者早期可能存在异常的免疫反应 ,这种异常免疫反应可能是导?     

Separation and expansion of tumor infiltrating lymphocytes of digestive systemin Vitro and their cytotoxicity

Summary Primary tumor tissues in the digestive system were harvested form 15 patients. By mincing, enzymatic digestion and gradient density separation, sufficient TILs (>5 × 10⁶) were obtained from 13 of 15 (88. 7 %) patientsin vitro in the presence of 500 μ/ml of recombinant interleukin-2 and 5 % fetal calf serum after one month culture. 92. 3 % (12/13) of TILs proliferated wellin vitro (92. 3%). TILs expanded from 10²-folds to 10³-folds after being cultured for one month. CD₂₅ ⁺ cell of the most fresh TILs was more than that of peripheral blood lymphocytes. CD₂₅ ⁺ cells of TILs during 4th week of the culture was significantly greater (P <0. 01) than that of fresh TILs. CD₄ ⁺/CD₈ ⁺ ratio was decreased during four culture weeks because of increase of CD₈ cells. By using modified colonmetric MTT assay for measuring activity of TILs against various tumor cells the results showed that cytotoxicity of gastro-intestinal TILs amtologous tumor cells is greater than on the other tumor cells.     

严重急性呼吸综合征死亡原因分析

为分析导致SARS患者死亡的危险因素 ,对 2 0 0 3年 3月至 6月在佑安医院死亡的 1 5例SARS患者的死亡原因进行分析。结果 :1 5例患者年龄 2 3～ 81岁 ,平均 ( 5 0 .7± 1 8.8)岁 ,其中年龄大于 5 0岁的 7例。基础病 :合并糖尿病 5例 ,高血压病 5例 ,慢性肾功能不全、尿毒症期 2例。T细胞亚群 :病程第 1周CD4 + T淋巴细胞明显降低 ,平均CD4 + ( 2 48± 82 )个 /μL ,第 2和第 3周继续下降 ,分别为 ( 1 81± 1 2 8)个 /μL和 ( 1 2 5± 46)个 /μL ,与痊愈组患者比较差异具有显著性 (P <0 .0 5 )。胸部影像学变化 :1 5例中 7例患者胸部影像学显示均在 7d内进展到双肺广泛磨玻璃样变或实变。CK及CK MB :平均CK( 2 69.3± 3 99.9)U/L ,CK MB( 3 1 .1± 2 6.1 )U/L。提示 :SARS患者若伴有高龄、多合并症、T细胞亚群进行性下降、快速进展的双肺广泛实变、CK及CKMB升高等情况时 ,预后极差     

乳腺癌患者细胞免疫水平与预后危险因素的关系及临床意义

目的：探讨乳腺癌患者细胞免疫状态与预后危险因素之间的关系。方法：回顾性分析1997年至2002年收治的110例女性乳腺癌患者的临床资料,分析其一般情况及CD⁺₃T、CD⁺₄T、CD⁺₈T、CD⁺₄/CD⁺₈、淋巴细胞转化率（LTR）的变化及其与乳腺癌肿块大小、淋巴结转移情况及癌胚抗原（CEA）的关系。结果：①乳腺癌不同肿块大小患者中CD⁺₄T、CD⁺₈T、CD⁺₄/CD⁺₈水平差异有统计学意义（P＜0.01或P＜0.05）,在肿块较小时即有CD4+T水平的降低和CD⁺₈T水平的升高,而CD⁺₄/CD⁺₈水平随着肿瘤负荷的增大而降低;②淋巴结转移组［LN(+)］与未转移组［LN(-)］比较,CD⁺₄/CD⁺₈在LN(+)组中显著降低(P＜0.05);CD⁺₃T、CD⁺₄T、CD⁺₈T在LN(+)组中表达增高,CD⁺₃T、CD⁺₈T的升高有统计学意义(P＜0.05或P＜0.01)。 ③CEA在LN(+)组中明显升高(P＜0.05), 在不同肿瘤负荷组间比较差异无统计学意义（P＞0.05）。CEA（+）组和CEA（-）组之间比较,CD⁺₄T升高及CD⁺₄/CD⁺₈水平降低差异均有统计学意义（P＜0.01）, 且CEA与CD⁺₄T及CD⁺₄/CD⁺₈水平密切相关（P＜0.01）。结论：乳腺癌患者存在不同程度的细胞免疫状态紊乱,且与乳腺癌CEA水平及肿块大小、淋巴结转移情况密切相关。     

Determination of CD30 expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome by FCM

Summary To determine the CD₃₀ expression on peripheral blood T lymphocyte subsets in patients with hemorrhagic fever with renal syndrome (HFRS) and its clinical implications, double immunofluorescence technique and flow cytometry were used. There was no significant difference among the severe group, mild-moderate group and normal control group in the CD+CD₃₀ T lymphocyte subset. While the CD₄ ⁺CD₃₀ ⁻ T cells of HFRS patients were increased and the difference between severe group and mild-moderate group or normal control group were very significant (P<0.01) and the difference between the mild-moderate group and normal control group was also significant (P<0.05). The CD₈ ⁺CD₃₀ ⁻ T cells were increased while the CD₈ ⁺CD₃₀ ^- T cells decreased obviously in HFRS patients, and the differences among three groups in both subsets were very significant (P<0.01). The results showed that the humoral immunity and cellular immunity are overactive in HFRS patients during acute phase. The loss of balance between T lymphocyte subsets may play an important role in the pathophysiology of HFRS and is closely correlated with the severity of the HFRS. This project is supported by the grant of the Ministry of Health (Serial No. 96-2-116).     

孟鲁司特治疗重度慢性阻塞性肺疾病急性加重对免疫功能影响的分析

目的探讨孟鲁司特联合舒利迭治疗重度慢性阻塞性肺疾病（COPD）急性加重对免疫功能的影响。方法将113例重度COPD急性加重期患者,随机分为孟鲁司特联合舒利迭治疗组57例,单纯舒利迭治疗组56例,治疗14 d后,评价所有患者治疗前、后T细胞亚群CD₃⁺、CD₄⁺及CD₄⁺/CD₈⁺的变化。结果治疗组CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺指标差异有统计学意义（P<0.05）,而对照组无明显变化,药物冶疗安全性好。结论孟鲁司特钠联合舒利迭治疗中重度COPD急性加重期,能有效改善患者免疫功能,提高患者免疫力。     

他克莫司联合中药热敷及激光照射改善白癜风患者的疗效及机制

观察在他克莫司软膏治疗的基础上配合中药热敷与308nm准分子激光照射对白癜风的治疗效果的影响,并探讨其机制。结果显示中药热敷与308nm准分子激光照射能改善他克莫司对白癜风的治疗效果,并且可提高患者血清CD₄⁺,CD₂₅⁺,Treg,CD₄⁺CD₂₅⁺FOXP₃⁺Treg浓度。表明他克莫司联合中药热敷、308nm准分子激光照射治疗白癜风可显著提高临床疗效,其机制可能通过调控调节性T细胞CD₄⁺CD₂₅⁺FOXP₃⁺改善机体免疫机能。     

严重急性呼吸综合征的临床特征及其治疗与预后——附220例临床报告

为探讨严重急性呼吸综合征(SARS)的临床特征以及治疗与预后,对2003年5月6日至6月27日宣武医院收治的220例SARS患者的临床、实验室、影像学资料,临床治疗及转归进行回顾性分析。结果220例SARS患者年龄7～86岁,平均(41.33±18.40)岁。男性112例(50.9%),女性108例(49.1%)。医务人员33例(15.0%)。有明确接触史148例(67.3%)。并存基础病60例(27.3%)。临床表现发热218例(99.1%),咳嗽144例(65.5%),畏寒64例(29.1%),气促91例(41.4%),胸闷80例(36.4%),肌痛66(30%)。血常规早期白细胞总数正常或降低、淋巴细胞降低。T细胞亚群CD3、CD4、CD8绝对值降低。胸部X线或高分辨率CT早期单侧或双侧局灶性斑片状渗出性改变,影像多变、短期内增多,进展高峰期呈云雾、磨玻璃影或实变影增大。在可分析的145例血气中,低氧血症63例(43.4%)。220例SARS患者发展为急性呼吸窘迫综合征(ARDS)25例(11.4%);使用机械通气31例(14.1%)。201例康复出院,19例死亡,病死率8.64%。早期鼻导管吸氧、进展期合理使用激素及机械通气可阻止病情进展。合理使用抗生素及抗真菌药物可预防及治疗混合感染(细菌、真菌)。提示流行病接触史、发热、白细胞计数正常或减少、淋巴细胞降低、胸部X线或CT显示渗出病灶是诊断SARS的临床依据。年龄、合并基础病、肺?     

IGF-1在妊娠期糖尿病胎盘组织中的表达及其对新生儿T淋巴细胞亚群的影响

目的 分析胰岛素样生长因子-1(IGF-1)在妊娠期糖尿病(GDM)胎盘组织中的表达及其对新生儿T淋巴细胞亚群的影响。方法选取本院GDM患者(研究组)和同期健康孕妇(对照组)各40例。两组孕妇均于胎儿、胎盘分娩后于胎盘中央带取材,行常规HE染色和IGF-1抗免疫组织化学染色,比较两组孕妇胎盘组织中IGF-1表达强度和分娩的新生儿T淋巴细胞亚群指标的差异,并进行相关性分析。结果研究组IGF-1表达强于对照组。IGF-1主要存在于滋养层上皮细胞胞浆和少数血管内皮细胞中。与对照组孕妇新生儿比较,研究组孕妇新生儿CD⁺₃、CD⁺₄、CD⁺₄/CD⁺₈显著较低,CD⁺₈显著较高。相关性分析结果显示孕妇胎盘组织中IGF-1表达强度与CD⁺₃、CD⁺₄、CD⁺₄/CD⁺₈呈正相关,与CD⁺₈呈负相关。结论GDM胎盘组织中的IGF-1表达水平较健康孕妇高,GDM胎盘组织中的高IGF-1表达可显著影响新生儿T淋巴细胞亚群,导致新生儿免疫功能低下。