肠道病毒71型感染手足口病患儿血清Th17Treg细胞表达与病情程度相关性及预后评估

目的探讨Th17和Treg细胞在肠道病毒71型感染手足口病(HFMD)患儿血清中的表达,并分析其与病情严重程度的相关性。方法选取2018年1月至2020年3月肠道病毒71型感染HFMD患儿80例,其中轻症组42例,重症组38例。30例同期体检健康患儿为对照组。检测3组患几外周血Th17和Treg细胞的表达并分析其与病情严重程度的相关性。根据随访结果将所有患儿分为预后良好组(n=76)和预后不良组(n=4),分析两组间Th17和Treg细胞的表达。结果与对照组比较,轻症组和重症组患儿血清Th17细胞百分比显著增加(P<0.05),重症组高于轻症组(P<0.05)。与对照组比较,轻症组和重症组患儿血清Treg细胞百分比降低(P<0.05),重症组低于轻症组(P<0.05)。Th17细胞百分比与病情严重程度呈正相关(Rs=0.489,P=0.009),Treg细胞百分比与病情严重程度呈负相关(Rs=-0.307,P=0.031)。预后良好组患儿血清Th17细胞百分比低于预后不良组(P<0.05),而Treg细胞百分比高于预后不良组(P<0.05)。结论HFMD患儿血清Th17细胞表达增加,并与病情严重程度正相关,与预后良好负相关。而Treg细胞在HFMD患儿血清中低表达,与病情严重程度负相关,与预后良好正相关。     

慢性荨麻疹患者血清25羟基维生素D水平检测及意义

目的 检测慢性荨麻疹患者血清25羟基维生素D水平,探讨25羟基维生素D（25HVD）在慢性荨麻疹（CU）发病中的作用。方法 收集50例CU患者及40例健康对照血清,同时应用CU症状评分标准（UAS）对疾病进行评分;用 ELISA测定血清25HVD、干扰素γ（IFN?γ）、白细胞介素4（IL?4）、免疫球蛋白E（IgE）水平。所得数据采用t检验、秩和检验、直线相关回归分析进行统计学分析。结果 CU组血清25HVD水平［（15.20 ± 7.72） μg/L］明显低于对照组［（21.54 ± 8.31） μg/L,t = 3.75,P < 0.05］,且两组25HVD水平分布比较,差异有统计学意义（H = 17.9,P < 0.05）。UAS评分重度组25HVD水平［（15.57 ± 7.38） μg/L］与轻度组［（14.86 ± 6.28） μg/L］差异无统计学意义（t = 0.37,P > 0.05）。CU组血清IFN?γ水平明显低于对照组（t = 15.34, P < 0.05）,但血清IL?4和IgE水平明显高于对照组（t值分别为6.54, 4.88,均P < 0.05）。CU组血清25HVD水平与IFN?γ水平呈正相关（r = 0.738,P < 0.05）,与IL?4水平呈负相关（r = -0.689,P < 0.05）,与IgE水平无相关性（r = -0.271,P > 0.05）。结论 CU患者血清25HVD水平明显降低,可能通过介导Th1细胞/Th2细胞失衡参与CU的发生。     

Resolvin D1 attenuates imiquimod-induced mice psoriasiform dermatitis through MAPKs and NF-κB pathways

Background

Resolvin D1 (RvD1), a pro-resolution lipid mediator derived from docosahexaenoic acid (DHA), has been described to promote several kinds of inflammatory resolution. However, the effects and anti-inflammatory mechanisms of RvD1 on psoriasis have not been previously reported.

Plasma trough levels of adalimumab and infliximab in terms of clinical efficacy during the treatment of psoriasis

We examined the relation between adalimumab and infliximab plasma trough levels, anti‐adalimumab and anti‐infliximab antibody formation. We analyzed plasma from 32 adalimumab‐treated and 20 infliximab‐treated psoriasis patients for evaluating trough levels of each drug. The presence of anti‐adalimumab and anti‐infliximab antibodies was analyzed and the severity of psoriasis was evaluated. At week 28, 25 out of 32 and at week 48, 21 out of 30 adalimumab‐treated patients maintained as more than PASI 75. At week 28, 12 out of 20 and at week 48, nine out of 18 infliximab‐treated patients were evaluated as more than PASI 75. In patients treated with 40 mg adalimumab every other week, the mean trough level was 7.62 μg/mL (range, 0.05–10.6) at week 48. In patients treated with 80 mg adalimumab every other week, the mean trough level was 8.61 μg/mL (range, 0.08–13.5) at week 48. Mean trough level of infliximab‐treated cases (4.1–5.2 mg/kg; mean, 4.6) was 4.64 μg/mL (range, 0.03–16.9) at week 48. Anti‐adalimumab antibody was detected in five out of 32 cases and anti‐infliximab antibody was detected in six out of 20 cases, respectively, at weeks 24 and 48. The optimal cut‐off values of adalimumab and infliximab concentration for more than PASI 75 were more than 7.84 μg/mL and more than 0.92 μg/mL, respectively. The trough levels of adalimumab and infliximab in psoriasis patients were positively associated with clinical response and were significantly lower in cases having anti‐adalimumab or anti‐infliximab antibodies.     

C-反应蛋白和乳酸脱氢酶检测对急性胰腺炎严重程度的诊断价值

目的：探讨C-反应蛋白（CRP）及乳酸脱氢酶（LDH）对急性胰腺炎（AP）严重程度的诊断价值。方法选取2011年7月-2016年7月我院收治的急性胰腺炎患者63例,按照病情程度分为轻型胰腺炎（MAP）组22例,中重症急性胰腺炎（MSAP）和重症胰腺炎（SAP）共41例,共同作为SAP组。检测患者入院24h内的血清CRP及LDH水平,绘制ROC曲线,以曲线下面积（AUC）评价CRP和LDH对AP严重程度的诊断价值。结果MAP组的血清CRP及LDH水平明显低于SAP组,差异具有统计学意义（t＝2．028,P＜0．05）;CRP、LDH及两者联合检测均对AP严重程度具有较高的诊断价值（ACU＝0．754、0．917、0．912）;CRP诊断SAP的敏感度、特异度和准确度分别为73．95％、82．84％、78．12％,最佳阈值为135．23mg／L;LDH诊断SAP的敏感度、特异度和准确度分别为81．23％、100．0％、91．35％,最佳阈值为301．64U／L;两者联合检测诊断SAP的敏感度、特异度和准确度分别为86．28％、88．41％、87．72％。结论入院24h内的CRP和LDH水平是判断AP患者严重程度的有效指标。     

疾病严重程度评价量表的建立与应用研究

目的 探讨护理分级中疾病严重程度的量化评估方法.方法 在李玉乐等研究的分级护理标准要素指标的基础上,参考国外危重疾病严重程度评分工具,采用专家小组讨论法,形成了疾病严重程度评价量表初表;首先对200例住院患者进行测试,调整各项指标赋予的分值及护理级别确定范围,形成最终的量表;用量表对我院2095例住院患者进行评定,将评分结果与医嘱的护理级别、标准的护理级别进行对比分析,以验证量表的可靠性.结果 医嘱组、评分组均与标准组呈正相关,但评分组与标准组相关性较高.3种方法划分的护理级别比较,医嘱组与标准组比较,差异有统计学意义(P＜0.05);评分组与标准组比较,差异无统计学意义(P＞0.05).4个护理级别中,特级护理在3组中差异无统计学意义(P＞0.05);一级、二级、三级护理在3组中,医嘱组与标准组比较,差异有统计学意义(P＜0.05),评分组与标准组比较,差异无统计学意义(P＞0.05).结论 疾病严重程度评价量表可作为划分护理级别的客观依据,具有一定的临床意义.     

简化CAPS在慢性阻塞性肺疾病急性加重期伴呼吸衰竭患者中的应用价值——附90例报告

目的：探讨简化慢性阻塞性肺疾病和支气管哮喘生理评分（CAPS）对判断慢性阻塞性肺疾病急性加重期（AECOPD）伴呼吸衰竭患者的病情和预后的价值。方法：90例AECO-PD伴呼吸衰竭患者按转归分为好转组（64例）和死亡组（24例）,用CAPS及简化CAPS评估病情。其中CAPS取患者入ICU后24h内生理参数和实验室检查结果的最差值,而简化CAPS则取患者入ICU时或转ICU前的所测值。比较好转组和死亡组的CAPS、简化CAPS、有创通气时间、住ICU时间。分析CAPS及简化CAPS与病死率的关系,计算并比较两种评分法的受试者工作特征（ROC）曲线下面积。结果：好转组的CAPS、简化CAPS、有创通气时间、住ICU时间分别为（28.6±9.3）分、（22.1±8.3）分、2～15（7）d、3～19（10）d,死亡组则分别为（37.4±8.8）分、CAPS（30.9±9.3）分、6～43（20）d、7～43（21）d,两组上述指标比较差异均有统计学意义（P〈0.05或0.01）。CAPS和简化CAPS均与AECOPD患者的病死率呈正相关（r分别为0.943、0.986,P均〈0.01）。CAPS的ROC曲线下面积为0.788,简化CAPS的ROC曲线下面积为0.780,两者比较差异无统计学意义（P均〉0.05）。结论：简化CAPS用于评估AECOPD伴呼吸衰竭患者的病情和预后是有效可行的。     

Hyperglycemia in COVID-19 infection without diabetes mellitus: Association with inflammatory markers

BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19) infection. Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia, but factors like direct severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-induced pancreatic β-cell failure have also been postulated to play a role.AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infectioninduced hyperglycemia, particularly the rationale ...