穴位注射防治反复呼吸道感染临床研究

目的：观察穴位注射防治反复呼吸道感染的临床疗效及细胞免疫功能的影响。方法：将120例反复呼吸道感染的患者随机分为两组各60例。对照组采用双肺俞穴位注射核酪注射液,治疗组在对照组基础上联合大椎、足三里穴治疗。疗程均为3个月。观察患者治疗前、后3个月呼吸道感染次数、天数以及治疗前后外周血T淋巴细胞亚群变化。结果：治疗组治疗后呼吸道感染次数、天数明显减少,总有效率98.33%,与对照组38.33%比较,差异有显著意义,P〈0.01;治疗组治疗后T淋巴细胞亚群与治疗前比较有显著性差异,P〈0.01;与对照组治疗后比较亦有显著性差异,P〈0.05。结论：双肺俞联合大椎、足三里穴位注射防治反复呼吸道感染疗效优于双肺俞。     

特发性血小板减少性紫瘢患者外周血淋巴细胞亚群和调节性T细胞的变化及临床意义

 Objective To study the changes and clinical significance of lymphocyte subsets and regulatory T cells in peripheral blood of patients with idiopathic thrombocytopenic purpura （PITP）. Methods Peripheral blood lymphocyte subsets and regulatory T cells of 40 ITP patients and 40 normal controls were measured with flow cytometry. Results Compared with the normal group,the percentage of CD3+ T lymphocyte,CD4+T lymphocyte and CD16+ /56+ NK cell and ratio of CD4+ /CD8+ decreased markedly in ITP group （P < 0.01）,while the percentage of CD8+T lymphocyte increased slightly（P > 0.05）and CD19+B lymphocyte increased significantly（P < 0.01）. In ITP patients,the proportion of CD4+ CD25+ T cells in CD4+T cells was higher than that of the control group （P < 0.05）and the proportion of CD4+CD25high T cells was slightly higher（P > 0.05）,while the proportion of CD4+ CD25+ Foxp3+ regulatory T cells was lower（P < 0.05）. Con-clusion Cellular immune function in patients with ITP is obviously abnormal and the decreased proportion of CD4+CD25+ Foxp3+ regulatory T cells may be related to the immune pathogenesis of ITP. Detection of lymphocyte subsets and regulatory T cells is of some clinical value in evaluation of therapeutic effect and prognosis of ITP.     

Age-related changes in memory and effector T cells responding to influenza A/H3N2 and pandemic A/H1N1 strains in humans

Age-dependent changes in the cellular immune response have been mainly described in CD8+ T cells, with relative sparing of CD4+ T cells. We show that in older compared to young adults, effector memory and effector CD8+ T-cell subsets responding to influenza A/H3N2 challenge have diminished cytolytic activity. In contrast, effector CD4+ T-cell subsets in older adults share similar phenotypic and functional characteristics with those from young adults. Further, we observed a diminished cytolytic T-cell response to both seasonal influenza A/H3N2 and pandemic H1N1 (pH1N1) strains in older compared to young adults who had received seasonal influenza vaccine. These results are consistent with the observed rates of serious complications from seasonal and pandemic influenza infections in different age groups, and suggest that CD4+ T cells may provide a compensatory response to influenza infection when CD8+ T cells become compromised during the aging process.     

女性不孕症患者抑郁症状与机体细胞免疫的相关性探讨

目的探讨女性不孕症患者抑郁症状及与机体细胞免疫相关性。方法采用自评抑郁量表（SDS）对214例女性不孕症患者进行抑郁障碍量化评分检查,应用流式细胞术测定部分患者外周血T细胞亚群,分析比较不孕症伴抑郁组与不孕症非抑郁组外周血T细胞亚群的差异。结果女性不孕症伴抑郁者SDS评分高于不孕非抑郁者和全国常模者（P〈0.05）;不孕症非抑郁者与正常对照者相比CD3＋T细胞、CD4＋T细胞和CD4＋/CD8＋、CD8＋T细胞差异无统计学意义（P〉0.05）,不孕症抑郁组与正常对照组和不孕非抑郁组相比外周血CD4＋T细胞和CD4＋/CD8＋下降,CD8＋T细胞升高,差异有统计学意义（P均〈0.05）,CD3＋T差异无统计学意义（P〉0.05）。结论女性不孕症患者人群中抑郁的发生率远高于正常人群;女性不孕伴发抑郁者可降低细胞免疫功能。     

会阴侧切切口感染危险因素及对患者Th1/Th2细胞因子水平的影响

目的探究会阴侧切切口感染危险因素及对患者Th1/Th2细胞因子水平的影响。方法从2018年1月-2019年1月于乳山市人民医院足月分娩行会阴侧切的产妇中随机抽样150例作为研究对象,根据是否继发切口感染,分为感染组52例和未感染组98例;制定调查表格,收集患者的临床资料,分析感染影响因素。所有受检对象均抽取外周静脉血3 ml,采用流式细胞分选技术(fluorescence-activated cell sorting,FACS)检测Th1、Th2细胞水平,计算Th1/Th2比值,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)法检测γ-干扰素(Interferon-γ,IFN-γ)、白细胞介素-4(interleukin 4,IL-4)水平,计算两者比值。结果单因素分析显示:体质量指数、产程、妊娠期糖尿病、贫血、羊水污染及感染前住院时间是产妇会阴侧切术后切口感染的影响因素(P<0.05);多因素回归显示:体质量指数≥25 kg/m^2、产程≥8 h、合并妊娠期糖尿病、贫血、羊水污染及感染前住院时间≥72 h是产妇会阴侧切术后切口感染的危险因素(P<0.05);感染组的Th1细胞(15.29±4.52)、Th2细胞(7.13±2.89)高于非感染组,而Th1/Th2比值(2.47±0.86)低于非感染组(P<0.05);感染组的血清IFN-γ(31.46±4.19)pg/ml、IL-4(23.42±2.87)pg/ml高于非感染组,而IFN-γ/IL-4(1.25±0.13)低于非感染组(P<0.05)。结论产妇会阴侧切术后切口感染的影响因素较多,应采取针对性的干预措施,降低感染发生率。侧切切口感染产妇体内存在Th细胞亚群失衡现象,炎症因子水平紊乱。     

维生素A营养状况对学龄前支气管哮喘患儿T淋巴细胞亚群、相关炎症介质及预后转归的影响

目的 研究维生素A营养状况对学龄前支气管哮喘患儿T淋巴细胞亚群、相关细胞因子及预后转归的影响,为支气管哮喘防治提供理论依据。方法 收集2017年6月-2019年6月鄂东医疗集团黄石市妇幼保健院收治的学龄前支气管哮喘患儿120例的临床资料(病例组),同期选择本院体检的健康的学龄期儿童80例对照组。将病例组按照住院期间维生素A营养状况分为维生素A正常组、维生素A边缘缺乏组、维生素A缺乏组。比较病例组和对照组维生素A营养状况,并记录不同维生素A状况组干预前后T淋巴细胞亚群、相关炎症介质及预后转归。结果 病例组维生素A水平[(0.73±0.32)μmol/L]显著低于对照组[(1.02±0.23)μmol/L](t=5.957,P＜0.05),且病例组维生素A营养状况显著差于对照组(Z=4.865,P＜0.05),维生素A缺乏组治疗后的CD4+、CD4+/CD8+均低于另外两组,CD8+高于另外两组,差异有统计学意义(P＜0.05)。维生素A缺乏组治疗后的hs-CRP、EOS、IL-6高于另外两组,差异有统计学意义(P＜0.05)。三组治疗临床疗效比较差异有统计学意义(χ²=13.165,P＜0.05),其中以维生素A缺乏组临床疗效最差(52.17%),维生素A正常组最高(94.74%)。结论 维生素A边缘缺乏或缺乏在学龄前支气管哮喘患儿中较为常见,对患儿细胞免疫功能、炎症反应的改善及疾病的预后转归造成不良影响,临床应当加强患儿维生素A的监测,适时酌情补充维生素A制剂以改善患儿预后。     

Prognostic Inflammation Score in Surgical Patients with Colorectal Cancer

Several inflammatory markers have been investigated as prognostic parameters in a variety of cancer population with mostly favorable results. This study aimed to verify the significance of common inflammatory markers as prognostic variables and assess whether a selective combination of them as prognostic inflammation score (PIS) could further improve their prognostic values in surgical patients with colorectal cancer (CRC). A total of 265 patients who had undergone curative resection of CRC were reviewed retrospectively. Preoperative levels of inflammatory markers such as serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), and neutrophil/lymphocyte ratio (NLR) were assessed by uni- and multivariate survival analysis with disease-free (DFS) and disease-specific survival (DSS). PIS was constructed with a selective combination of inflammatory markers which were independently significant. On univariate analysis, CRP, ESR, and NLR were significantly associated with DFS and DSS. On multivariate analysis, CRP and NLR were independently significant prognostic variables for DSS and DFS respectively (P=0.013, P=0.021). When PIS was constructed with combination of CRP and NLR, it was independently and significantly associated with both DFS and DSS (P=0.006, P=0.010). Furthermore, PIS was superior to CRP for DSS (HR=15.679 vs. HR=5.183), and NLR for DFS in terms of prognosticating power (HR=4.894 vs. HR=2.687). When PIS is constructed with combination of CRP and NLR, it is a potentially significant prognostic variable associated with poor survival regardless pathologic prognostic variables in patients with CRC after curative resection.     

支原体肺炎患儿免疫功能变化的检测价值

目的分析免疫功能变化在支原体肺炎感染患儿中的检测价值。方法在2016年8月-2018年8月在医院接受诊治的114例支原体肺炎患儿与114例健康体检者作为本次研究。按根据是否属于支原体肺炎划分为试验组与常规组。试验组与常规组均接受免疫功能变化检测,总结并对比两组补体、免疫球蛋白水平、红细胞免疫水平以及T淋巴细胞亚群水平。结果试验组患儿的各项补体、免疫球蛋白水平相对于常规组而言均有明显数据差异(P<0.05);试验组患儿的各项细胞免疫水平相对于常规组而言均有明显数据差异(P<0.05);试验组患儿的各项T淋巴细胞亚群水平相对于常规组而言均有明显数据差异(P<0.05)。结论免疫功能变化在支原体肺炎感染患儿中的检测价值突出,可以作为患儿症状的检测与症状严重程度的判断依据。     

Efficacy and safety of mycophenolate mofetil versus levamisole in frequently relapsing nephrotic syndrome: an open-label randomized controlled trial

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