共刺激分子在复感儿中医分型中的表达研究

[目的]通过观察反复呼吸道感染(RRTI)非急性感染期肺脾气虚、肺脾气阴两虚型患儿(简称"复感儿")T细胞CD8+CD28+的表达,探讨两个证型T淋巴细胞亚群的表达特点及临床意义,为RRll的中医辨证提供可能的物质基础及客观依据.[方法]选择RRTI非急性期肺脾气虚、肺脾气阴两虚患儿各30例,运用流式细胞仪对RRTI患...     

Ammonia, Hydrogen Peroxide, and Monochloramine Retard Gastric Epithelial Restoration in Rabbit Cultured Cell Model

Ammonia (NH₃), hydrogen peroxide(H₂O₂) and monochloramine(NH₂Cl) produced by Helicobacter pyloriinfection might be responsible for mucosal injury. Theaim of this study was to evaluate the role ofNH₃, H₂O₂, andNH₂Cl in the restoration of rabbit primarycultured gastric mucosal cells with a wound repairmodel. Artificial wounds were made in confluentmonolayer gastric epithelial cell sheets by mechanicaldenudation, and changes in the size of the cell-freearea were analyzed quantitatively. Cell proliferation was assessed by bromodeoxyuridine staining. Incontrols, the wound healed within 48 hr. However,mucosal cell repair was inhibited by treatment withNH₃, H₂O₂, andNH₂Cl in a dose-dependent manner. These resultsindicate that NH₃,H₂O₂, and NH₂Clretarded the wound healing, which included epithelialcell migration and proliferation of gastric mucosa. Therefore, it is suggestedthat NH₃, H₂O₂, andNH₂Cl delays the healing process of pepticulcers.     

Early infections in patients undergoing high-dose treatment with stem cell support: a comparison of patients with non-Hodgkin lymphoma and multiple myeloma

Abstract

Background: Infections are life-threatening complications in patients undergoing high-dose chemotherapy with stem cell support (HDT). Knowledge of the infectious pathogens is essential to make a safe outpatient setting.

Methods: We conducted a retrospective study of 208 patients treated with HDT. The population included non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. No patients received prophylactic antibacterial treatment.

Results: Pathogens were isolated from 44% of all patients. MM patients more frequently had multiple pathogens in blood cultures (38% versus 25%). Transplantation related mortality was similar between the groups.

Conclusion: The frequency of isolated pathogens, positive blood cultures, and the diversity of pathogens were higher in MM patients as compared to NHL patients. However, this did not translate into higher transplantation-related mortality, probably because broad-spectrum antibiotic treatment could be initiated immediately. A safe outpatient setting with prophylactic antibiotic treatment is dependent on continuous collection and registration of microbiological findings.     

速肤保的主要药效及安全性研究

本文探讨了外用新中成药速肤保的主要药效及安全性。实验结果表明:速肤保具有如下药理作用:1.对创伤感染常见的病原菌和条件致病菌均有不同程度的抗菌作用;2.有一定的抗炎作用。能抑制巴豆油混合致炎液所致的小鼠耳肿胀,抑制大鼠蛋清性足肿胀,对二甲苯所致小鼠毛细血管通透性增高有拮抗作用,能减少小鼠烫伤组织的含水量;3.有一定的镇痛作用。能抑制醋酸所致的小鼠扭体反应,提高小鼠痛阈,减轻热刺激所致的疼痛;4.有一定的止血作用。能缩短小鼠的出血时间。实验还证明,速肤保对小鼠无明显毒性作用,对新西兰大白兔正常及损伤皮肤均无明显刺激性,对豚鼠皮肤亦未产生过敏反应。本实验结果为速肤保的有效性和安全性提供了一定的药理学依据。     

Continuous positive pressure ventilation in children with bronchopneumonia

The application of a small end-expiratory pressure of 5 cmH2O to the assisted ventilation of nineteen children (mean age 19 months) with bronchopneumonia was compared with intermittent positive pressure ventilation. Within 1 h of introducing continuous positive pressure ventilation the alveolar-to-arterial oxygen gradient was reduced in most patients, with an increase in functional residual capacity and a decrease in total pulmonary blood shunt. Physiological dead space was also reduced, a feature not observed in other studies, and the significance of this finding is discussed. The use of continuous positive pressure ventilation in broncho-pulmonary infection was shown to be effective even at small pressures, and can be recommended especially for patients requiring long-term ventilation.     

Beta-thromboglobulin and platelet counts - effect of malignancy, infection, age and obesity

Plasma levels of beta-thromboglobulin (BTG) and platelet count were studied in 69 control subjects, 19 patients with operable abdominal malignancy, and 9 patients with acute bacterial infection. In control subjects there was a significant rise in BTG and fall in platelet count with age, and a negative correlation of BTG with obesity. BTG and platelet count were normal in patients with operable malignancy, but significantly increased in patients with acute bacterial infection. These effects must be considered in studies of BTG and thrombosis.     

Immune Response to Persistent Staphyloccocus Aureus Periprosthetic Joint Infection in a Mouse Tibial Implant Model

Staphyloccocus aureus is one of the major pathogens in orthopedic periprosthetic joint infection (PJI), a devastating complication of total joint arthroplasty that often results in chronic and persistent infections that are refractory to antibiotics and require surgical interventions. Biofilm formation has been extensively investigated as a reason for persistent infection. The cellular composition, activation status, cytokine profile, and role of the immune response during persistent S. aureus PJI are incompletely understood. In this study, we used histology, multiparametric flow cytometry, and gene expression analysis to characterize the immune response in a clinically relevant orthopedic PJI model. We tested the hypothesis that persistent S. aureus infection induces feedback mechanisms that suppress immune cell activation, thereby affecting the course of infection. Surprisingly, persistent infection was characterized by strikingly high cytokine gene expression indicative of robust activation of multiple components of innate and adaptive immunity, along with ongoing severe neutrophil-dominated inflammation, in infected joint and bone tissues. Activation and expansion of draining lymph nodes and a bone marrow stress granulopoiesis reaction were also maintained during late phase infection. In parallel, feedback mechanisms involving T-cell inhibitory receptors and exhaustion markers, suppressive cytokines, and regulatory T cells were activated and associated with decreased T-cell proliferation and tissue infiltration during the persistent phase of infection. These results identify the cellular and molecular components of the mouse immune response to persistent S. aureus PJI and indicate that neutrophil infiltration, inflammatory cytokine responses, and ongoing lymph node and bone marrow reactions are insufficient to clear infection and that immune effector mechanisms are suppressed by feedback inhibitory pathways. These immune-suppressive mechanisms are associated with diminished T-cell proliferation and tissue infiltration and can be targeted as part of adjuvant immunotherapeutic strategies in combination with debridement of biofilm, antibiotics, and other therapeutic modalities to promote eradication of infection. © 2021 American Society for Bone and Mineral Research (ASBMR).     

Chronic Systemic Infection of Mice with Leishmania infantum Leads to Increased Bone Mass

Vector-borne infections of humans with the protozoan parasite Leishmania (L.) infantum can cause a systemic and potentially lethal disease termed visceral leishmaniasis. In the corresponding mouse model, an intravenous infection with L. infantum leads to the persistence of parasites in various organs, including bone marrow (BM). Considering the anatomical proximity between the BM and the cortical bone, we investigated whether a chronic infection with L. infantum affected bone homeostasis. Unexpectedly, chronic infection with L. infantum caused an increase in bone mass in mice. In vivo, an increased number of osteoblasts and osteocytes and a decreased maturation of osteoclasts characterized the phenotype. Confocal laser scanning fluorescence microscopy confirmed the infection of BM macrophages but also revealed the presence of parasites in osteoclasts. In vitro, mature osteoclasts took up L. infantum parasites. However, infection of osteoclast progenitors abolished their differentiation and function. In addition, secretory products of infected BM–derived macrophages inhibited the maturation of osteoclasts. Both in vitro and in vivo, infected macrophages and osteoclasts showed an enhanced expression of the anti-osteoclastogenic chemokine CCL5 (RANTES). Neutralization of CCL5 prevented the inhibition of osteoclast generation seen in the presence of culture supernatants from L. infantum-infected macrophages. Altogether, our study shows that chronic infection with Leishmania increases bone mass by inducing bone formation and impairing osteoclast differentiation and function. © 2022 American Society for Bone and Mineral Research (ASBMR).     

Comparative Safety and Effectiveness of Denosumab Versus Zoledronic Acid in Patients With Osteoporosis: A Cohort Study

Limited head‐to‐head comparative safety and effectiveness data exist between denosumab and zoledronic acid in real‐world healthcare. We aimed to examine the safety and effectiveness of denosumab compared to zoledronic acid with regard to risk of serious infection and cardiovascular disease (CVD) and osteoporotic fracture. We conducted a cohort study using claims data (2009–2013) from a US commercial insurance plan database. We included patients aged ≥50 years who were newly initiated on denosumab or zoledronic acid. The primary outcomes were (1) hospitalization for serious infection; (2) composite CVD endpoint including myocardial infarction, stroke, coronary revascularization, and heart failure; and (3) nonvertebral osteoporotic fracture including hip, wrist, forearm, and pelvic fracture. To control for potential confounders, we used 1:1 propensity score (PS) matching. Cox proportional hazards models compared the risk of serious infection, CVD, and osteoporotic fracture within 365 days after initiation of denosumab versus zoledronic acid. After PS matching, a total of 2467 pairs of denosumab and zoledronic acid initiators were selected with a mean age of 63 years and 96% were female. When compared with zoledronic acid, denosumab was not associated with an increased risk of serious infection (HR 0.81; 95% confidence interval [CI], 0.55 to 1.21) or CVD (HR 1.11; 95% CI, 0.60 to 2.03). Similar results were obtained for each component of CVD. The risk of osteoporotic fracture was also similar between groups (HR 1.21; 95% CI, 0.84 to 1.73). This large population‐based cohort study shows that denosumab and zoledronic acid have comparable clinical safety and effectiveness with regard to the risk of serious infection, CVD, and osteoporosis fracture within 365 days after initiation of medications. © 2016 American Society for Bone and Mineral Research.     

60例截瘫患者尿路感染疗效分析

尿路感染是截瘫患者最常见的并发症之一。通过对60例截瘫患者尿路感染病情及疗效分析,我们认为:保留导尿、输尿管返流是诱发尿路感染的最主要原因,宿主的防御功能低下是构成尿路感染的条件;在病程的不同阶段尿路感染各有特点;减少这一并发症的关键在于预防;采用中西医结合疗法能明显提高疗效。