Antibody and memory B cell responses to the dengue virus NS1 antigen in individuals with varying severity of past infection

To further understand the role of NS1-specific antibodies (Abs) in disease pathogenesis, we compared neutralizing antibody levels (Nabs), NS1-Ab levels, IgG antibody subclass profiles and NS1-specific memory B-cell responses (Bmems) in individuals, with varying severity of past dengue. Nabs (Neut50 titres) were assessed using the Foci Reduction Neutralization Test (FRNT) and in-house ELISAs were used to assess NS1-Abs and NS1-Ab subclasses for all four DENV serotypes in individuals with past DF (n = 22), those with past DHF (n = 14) and seronegative (SN) individuals (n = 7). B-cell ELISpot assays were used to assess NS1-specific Bmem responses. 15/22 (68.18%) individuals with past DF and 9/14 (64.29%) individuals with past DHF had heterotypic infections. Neut50 titres were found to be significantly higher for DENV1 than DENV2 (p = 0.0006) and DENV4 (p = 0.0127), in those with past DHF, whereas there was no significant difference seen in titres for different DENV serotypes in those with past DF. Overall NS1-Ab to all serotypes and NS1-specific IgG1 responses for DENV1, 2 and 4 serotypes were significantly higher in those with past DHF than individuals with past DF. Those with past DHF also had higher IgG1 than IgG3 for DENV1 and DENV3, whereas no differences were seen in those with past DF. Over 50% of those with past DF or DHF had NS1-specific Bmem responses to >2 DENV serotypes. There was no difference in the frequency of Bmem responses to any of the DENV serotypes between individuals with past DF and DHF. Although the frequency of Bmem responses to DENV1 correlated with DENV1-specific NS1-Abs levels (Spearman r = 0.35, p = 0.02), there was no correlation with other DENV serotypes. We found that those with past DF had broadly cross-reactive Nabs, while those with past DHF had higher NS1-Ab responses possibly with a different functionality profile than those with past DF. Therefore, it would be important to further evaluate the functionality of NS1-specific antibody and Bmem responses to find out the type of antibody repertoire that is associated with protection against severe disease.     

肾综合征出血热患者血液透析前后的血液流变性及甲襞微循环变化

目的 探讨肾综合征出血热（ＨＦＲＳ）合并争性肾功衰竭（ＡＲＦ）患者血液透析（ＨＤ）前后的血液流变性及甲臂微循环的变化规律。方法 采用瑞曲Ｇａｍｂｒｏ公司生产的ＡＫ－１０型血液透析机治疗患者４５型,血液流变学及甲臂微循环指标分别采用成都仪器厂的ＮＸＥ－１型锥板式粘度计和徐州光学仪器厂的ＭＸ－７５３Ｂ微循环显微镜检测,所得数据按田牛氏综合定量评价方法,计算综合加权积分值。结果 ＨＤ前后患者血中ＢＵＮ,     

Clinical characteristics of haemorrhagic fever with renal syndrome in children

From January 1988 to September 1989, seven patients (4 girls and 3 boys, aged 3–12 years) with haemorrhagic fever with renal syndrome (HFRS) were hospitalised at the University Children's Hospital in Belgrade. In four patients the disease appeared as a family outbreak, the others were sporadic cases. In six patients the clinical presentation was suggestive of HFRS, as they had fever with headache, myalgia, sore throat and gastrointestinal illness followed by renal abnormalities. However, severe haemorrhagic syndrome with petechia, haematoma, haematemesis and melaena was present in one patient only. Renal disease presented as nephritic syndrome and/or acute renal failure. Five patients recovered after 2–3 weeks without sequellae, one patient had decreased renal function 17 months after the start of the disease and the remaining patient died. In six patients the diagnosis of HFRS was confirmed serologically by a significant rise in antibody titres against hantaviruses, while in the patient with the fatal and fulminant course of the disease, the diagnosis was established on the basis of epidemiological and autopsy findings. We suggest that children living in endemic areas who develop an ill-defined, febrile and gastrointestinal disease with renal dysfunction should be evaluated for HFRS.     

Infant influenza

Reports on the symptoms of infant influenza (less than 1 year of age) are very few. From 1989 to 1996, 105 infants with influenza were examined. The symptoms, nutrition and source of infection of the 105 patients were investigated in Sakuma Pediatric Clinic and viral studies were performed at the Kitakyushu City Institute of Environmental Sciences. The symptoms of patients under 6 months old are very mild, with a low maximum body temperature and a short duration of fever. Other complications are few. The symptoms gradually become more severe with each month of age. The ratio of patients displaying a diphasic fever with two peak temperatures increases with each month of age. Over 50% of patients over 9 months old have this diphasic fever with two peak temperatures. It is inconclusive whether an anti-infective factor in human milk exists or not. Of the 105 patients in this study, 28 were under 4 months of age; of these 28, all but 3 were infected by family members.     

血府逐瘀汤治疗髋关节置换术后非感染性发热

[目的]探讨髋关节置换术后非感染性发热的防治。[方法]应用血府逐瘀汤加减辨证论治。[结果]43例患者体温恢复正常,其中36例在3天内体温恢复正常。[结论]该方法对髋关节置换术后非感染性发热有较好作用。     

李跃华辨治焦虑症发热1例

焦虑抑郁症发病机制至今尚不明确,存在多种假说,其中以脑神经递质与抑郁症的关系研究最为深入。李跃华教授临床辨治1例发热原因不明的患者。患者自发热伊始,原因不明,间断发热,他院给予退热以及激素等治疗,连续应用5月患者病情未改善。患者情绪低落,紧张不安,生活兴趣丧失,李跃华教授以焦虑抑郁症中医辨证诊治,结合清热利湿,并口服西医对症抗焦虑抑郁药物治疗,患者发热好转。     

Oral antipyretic therapy: Evaluation of the N-aryl-anthranilic acid derivatives mefenamic acid,tolfenamic acid and flufenamic acid

Summary The antipyretic activity of three N-aryl-anthranilic acid derivatives, mefenamic acid, tolfenamic acid and flufenamic acid, was compared and their optimal antipyretic dose determined in a trial in 87 children (aged 5 months to 15 years), who suffered from infections and fever exceeding 38.5°C. Tolfenamic acid proved to be the most potent antipyretic agent of the three drugs; it was eight times more powerful than mefenamic acid and three times more powerful than flufenamic acid. The optimal antipyretic doses were: mefenamic acid 4 mg/kg, tolfenamic acid 0.5 mg/kg and flufenamic acid 1.5 mg/kg. It is evident that the antipyretic activity of these anthranilic acid derivatives is even greater than their antirheumatic effect, the difference being most noticeable in the case of tolfenamic acid.     

清热化瘀法治疗多囊肾发热浅析

认为多囊肾在合并感染或出血情况下的高热不退,其病机特点是邪热与瘀血相结合,可采用温病清热化瘀法进行治疗.运用该法的关键是以准确辨证为前提,并根据病程之久暂、血瘀之轻重灵活变化,施治得法,则可收明显疗效.     

恙螨体内汉坦病毒核酸的基因芯片检测

目的 建立快速、灵敏、特异的汉坦病毒基因芯片诊断方法。方法 根据发表的汉坦病毒属(HV)76-118株和R22株S基因核苷酸序列，设计引物和探针，制备寡核苷酸芯片。用CV3标记核苷和引物，运用不对称PCR技术制备单链荧光标记核苷酸片段，并与芯片上的寡核苷酸探针杂交，荧光扫描仪检测并分析信号。结果 研究制备的基因芯片能够检测汉坦病毒HTN型和SEO型病毒核酸的特异性荧光信号。结论 HV的基因芯片检测具有特异、灵敏、快速的优点。基因芯片的制备和检测技术的建立，可为肾综合征出血热等传染病的诊断和预防提供理想的方法。