Cow's milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow's milk allergy infants

Background IgE‐mediated cow's milk proteins (CMPs) allergy shows a tendency to disappear with age. The sooner tolerance is detected, the earlier the substitute diets can be suspended and the quicker family emotional hardship is alleviated. Objective To analyse the specific IgE levels to cow's milk and its proteins, which help to separate tolerant from no tolerant children in the follow‐up of infants with allergy to cow's milk. Patients and methods Sixty‐six infants diagnosed with IgE‐mediated allergy to CMPs were included in this prospective follow‐up study. Periodic reassessments were carried out every 6 months until they were 2‐years old and then, annually, until tolerance arose or until the last reassessment in which tolerance had not been achieved. Non‐tolerant infants were followed, at least, for a period of 3 years. In each visit, the same skin tests and determination of specific IgE (CAP System FEIA) for milk and its proteins were carried out. The open challenge test was repeated unless a clear transgression to milk, which came to be positive, had taken place within the previous 3 months in each of the follow‐up visits. Specific IgE levels to milk and its proteins, in different moments of the follow‐up were analysed by means of the receiver‐operating characteristic curve to predict clinical reactivity. Results Throughout the follow‐up 45 (68%) infants became tolerant. The follow‐up mean for tolerant infants was 21.2 months whereas for non‐tolerant infants it was 58 months. The specific IgE levels which were predictors of the clinical reactivity (positive predictive value (PPV)90%), grew as the age of the infants increased: 1.5, 6 and 14 kU_A/L for milk in the age range 13–18 and 19–24 months and in the third year, respectively. Specific IgE levels to casein: 0.6, 3 and 5 kU_A/L, respectively, predicted clinical reactivity (PPV90%) in the different analysed moments of the follow‐up. The cut‐off points: 2.7, 9 and 24 kU_A/L for milk and 2, 4.2 and 9 kU_A/L for casein, respectively, predicted clinical reactivity with an accuracy 95% corresponding to a specificity of 90%. Conclusions Monitorization of specific IgE concentration for milk and casein by means of the CAP system in allergic children to CMPs allows us to predict, to a high degree of probability, clinical reactivity. Age factor must be taken into account to evaluate the specific IgE levels which are predictors of tolerance or clinical reactivity.     

肿瘤病人红细胞免疫功能与自然杀伤细胞活性的关系

①目的　探讨恶性肿瘤病人红细胞免疫功能与自然杀伤 (NK)细胞活性的关系。②方法　选择原发性肺癌、卵巢癌及白血病病人各 2 0例为研究对象 ,以 2 0名健康人为正常对照 ,采用免疫黏附法测定红细胞黏附肿瘤细胞的能力 ,采用MTT法测定NK细胞活性。③结果　恶性肿瘤病人红细胞黏附肿瘤细胞的能力和NK细胞活性明显低于正常对照组 (F =9.2 9、12 .85 ,q =5 .15～ 7.86 ,P <0 .0 1) ;正常人红细胞胞质液可以显著提高自身及病人NK细胞活性 (F =4 .32～ 5 .89,q =3.96～ 4 .4 9,P <0 .0 5、0 .0 1)。④结论　红细胞免疫功能与NK细胞活性密切相关。     

西咪替丁对血浆氨茶碱浓度的影响

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以液体稀释法比较了自制与进口十六烷基吡啶作用于4种口腔常见微生物的最低抑菌浓度和最低杀菌浓度的实验结果,经t检验证明两者间无显著差异,提示自制氯化十六烷基吡啶的药效质量可靠。并就控制接种菌量及杀菌机理等问题作了初步探讨。     

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建立了翁丹西隆的高效液相色谱测定法。血浆样品用醋酸乙酯萃取，以ＺｏｒｂａｘＳｉｌｉｃａ为固定相，６０％０．０２５ｍｏｌ／Ｌ乙酸钠缓冲液（ｐＨ４．２）、４０％乙腈为流动相，紫外３１０ｎｍ处测定。采用外标法峰高定量。最低检出浓度达１ｎｇ／ｍｌ，线性范围１．０～４０．０ｎｇ／ｍｌ（ｒ＝０．９９９６），平均回收率为（９５．２２±３．５８）％（ＲＳＤ３．７６％）。用本法测定人血浆中翁丹西隆浓度具有快速、简便、专一性和灵敏度高的优点。     

胃癌患者红细胞免疫功能的变化

运用简单形态学方法测定了３０例胃癌患者红细胞免疫功能，结果表明：胃癌患者红细胞Ｃ３ｂ受体花环率及肿瘤红细胞花环率显著低于正常对照（Ｐ＜０．０１）及慢性良性胃病患者（Ｐ＜０．０１），而免疫复合物花环率则高于正常人（Ｐ＜０．０１）及慢性良性胃病患者（Ｐ＜０．０１）；Ⅲ、Ⅳ期胃癌患者肿瘤红细胞复合物花环率明于低于Ⅰ、Ⅱ期患者（Ｐ＜０．０１）；贲门癌肿瘤红细胞花环率显著低于胃窦（体）癌患者（Ｐ＜０．０１）     

人大肠肥大细胞多态性光镜特征(两种新类群:CTMC-1与MMC-1的发现)

人体肥大细胞的多态性已受到广泛关注,对于肥大细胞分型的研究已成为这一问题的关键。本实验研究了42例人大肠4种肥大细胞类群光镜特征,其中两种为作者的新近发现,暂命名为结缔组织肥大细胞-1(CTMC-1)和粘膜肥大细胞-1(MMC-1)。     

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本文报告经皮球囊二尖瓣成形术治疗二尖瓣狭窄12例。10例术前平均左房压为18mmHg～40mmHg(26.7±7.15mmHg),术后即刻为4mmHg～18mmHg(10.6±3.86mmHg)P<0.01。跨瓣压差术前10mmHg～40mmHg(19.6±9.05mmHg),术后为0～5mmHg(2.65±2.21mmHg)P<0.01。1例失败,1例术后发生二尖瓣关闭不全急性左心衰竭死亡。