IL-24 Contributes to Neutrophilic Asthma in an IL-17A-Dependent Manner and Is Suppressed by IL-37

PurposeNeutrophilic asthma is associated with asthma exacerbation, steroid insensitivity, and severe asthma. Interleukin (IL)-24 is overexpressed in asthma and is involved in the pathogenesis of several allergic inflammatory diseases. However, the role and specific mechanism of IL-24 in neutrophilic asthma are unclear. We aimed to elucidate the roles of IL-24 and IL-37 in neutrophilic asthma, the relationships with IL-17A and the mechanisms regulating neutrophilic asthma progression.MethodsPurified human neutrophils were isolated from healthy volunteers, and a cell coculture system was used to evaluate the function of IL-24 in epithelium-derived IL-17A-dependent neutrophil migration. IL-37 or a small interfering RNA (siRNA) targeting IL-24 was delivered intranasally to verify the effect in a murine model of house dust mite (HDM)/lipopolysaccharide (LPS)-induced neutrophilic asthma.ResultsIL-24 enhanced IL-17A production in bronchial epithelial cells via the STAT3 and ERK1/2 signaling pathways; this effect was reversed by exogenous IL-37. Anti-IL-17A monoclonal antibodies reduced neutrophil chemotaxis induced by IL-24-treated epithelial cells in vitro. Increased IL-24 and IL-17A expression in the airway epithelium was observed in HDM/LPS-induced neutrophilic asthma. IL-37 administration or IL-24 silencing attenuated neutrophilic asthma, reducing IL-17A levels and decreasing neutrophil airway infiltration, airway hyperresponsiveness, and goblet cell metaplasia. Silencing IL-24 inhibited T-helper 17 (Th17) immune responses, but not Th1 or Th2 immune responses, in the lungs of a neutrophilic asthma model.ConclusionsIL-24 aggravated neutrophilic airway inflammation by increasing epithelium-derived IL-17A production, which could be suppressed by IL-37. Targeting the IL-24/IL-17A signaling axis is a potential strategy, and IL-37 is a potential candidate agent for alleviating neutrophilic airway inflammation in asthma.     

重症监护室患儿心脏停搏后早期出现急性肾损伤的危险因素及预后分析

目的探讨心脏停搏（cardiac arrest，CA）患儿发生急性肾损O24;（acute kidney injury，AKI）的相关因素及预后的影响因素。方法回顾性收集2016年6月—2021年6月湖南省儿童医院儿童重症监护室发生CA患儿的病历资料。按CA恢复自发循环（return of spontaneous circulation，ROSC）48 h内是否发生AKI分为AKI组（n=50）和非AKI组（n=113），AKI组按ROSC 7 d时预后情况分为存活组（n=21）和死亡组（n=29）。采用多因素logistic回归分析CA患儿早期发生AKI的相关因素及预后影响因素。结果CA后AKI发生率为30.7%（50/163）。AKI组7 d及28 d病死率分别为58.0%（29/50）、78.0%（39/50），非AKI组为31.9%（36/113）、58.4%（66/113）。多因素logistic回归分析显示，心肺复苏时间长（OR=1.164，95%CI：1.088~1.246，P<0.001）、基线血清白蛋白低（OR=0.879，95%CI：0.806~0.958，P=0.003）、CA24d;应用肾上腺素（OR=2.791，95%CI：1.119~6.961，P=0.028）与CA后AKI发生密切相关；基线小儿危重病例评分低（OR=0.761，95%CI：0.612~0.945，P=0.014）、CA24d;应用肾上腺素（OR=7.018，95%CI：1.196~41.188，P=0.031）、CA24d;机械通气（OR=7.875，95%CI：1.358~45.672，P=0.021）与CA后AKI患儿死亡密切相关。结论CA后ROSC患儿应密切监测血清白蛋白，\24;其是心肺复苏时间长、基线小儿危重病例评分低、CA24d;应用肾上腺素、CA24d;机械通气者应及早识别和干预，以降低AKI发生率和病死率。     

Dietary Patterns of 479 Indonesian Adults and Their Associations with Sodium and Potassium Intakes Estimated by Two 24-h Urine Collections

The excess sodium (Na) intake and insufficient potassium (K) intake are frequently observed all over the world, including Indonesia. This study explored the dietary patterns of Indonesian people and evaluated their associations with Na and K intakes. Na and K intakes were assessed by repeated 24-h urine collection. The dietary patterns of the previous month were extracted by factor analysis using the Indonesian Food Frequency Questionnaire. The participants were community-dwelling Indonesian men and women (n = 479) aged 20 years and over. We identified four dietary patterns in each sex. After controlling for confounding factors, the high quantile of ‘Noodle, oil, and salty sea products’ pattern was associated with the high Na intake in both men and women (p = 0.02 and <0.001, respectively). The ‘Meat, vegetable, oil, and fruit’ pattern statistically significantly contributed to the high K intake in men (p = 0.04), but not in women (p = 0.26). The ‘Vegetable, non-oil, and milk’ pattern in men and ‘Meat, vegetable, and fruit’ pattern in women were associated with low Na:K ratios (p = 0.03 and 0.01, respectively). Neither ‘bread’ nor ‘fish’ appeared as a major determinant of any dietary patterns in this population. The ‘Noodle, oil, and salty sea products’ pattern should be avoided to reduce sodium intake.     

肥厚型心肌病磁共振钆剂延迟增强与心电图 QTe/RR的关系

摘要：目的 探讨肥厚型心肌病（HCM）磁共振钆剂延迟增强与动态心电图QTe/RR斜率的关系。方法 将本院 2016 年 1 月—2017 年 6 月接诊的 96 例 HCM 患者,根据心脏磁共振扫描（CMR）是否出现钆剂延迟增强（LGE）分为 LGE阳性组和LGE阴性组。采用评分法评估LGE阳性组患者LGE透壁程度。所有受试者行24 h动态心电图检查, 计算心率（HR）、QT间期及QTe/RR斜率。分析LGE阳性组总LGE评分与QTe/RR斜率之间的相关性,分析LGE透壁 程度和QTe/RR斜率与患者预后的关系。结果 CMR结果显示LGE阳性51例（53.13%）,LGE阴性45例（46.87%）; LGE阳性组与LGE阴性组左心室射血分数（LVEF：0.412±0.092 vs. 0.508±0.083）、左心室舒张末期容积［LVEDV（mL）： 173.91±43.68 vs.148.52±31.77］及左心室舒张末期后壁厚度［LVPWD（mm）：13.26±2.81 vs. 12.15±2.37］比较差异有统 计学意义（t分别为5.301、3.219、2.077,均P＜0.05）;LGE阳性组QT间期（ms：439.67±25.82 vs. 411.53±31.66）、QTe/RR 斜率（0.20±0.05 vs. 0.16±0.03）均高于 LGE 阴性组（t 分别为 4.794、4.674,均 P＜0.05）;LGE 阳性组总 LGE 评分为 （26.37±7.52）分,与QTe/RR斜率呈正相关（r=0.742,P＜0.001）;LGE阳性组室性心律失常、心源性猝死等不良反应发 生率高于LGE阴性组（17.65% vs. 4.44%,c2=4.107,P＜0.05）;总LGE评分、QTe/RR斜率与患者室性心律失常、心源性 猝死有关（P＜0.05）。结论 HCM患者LGE程度与QTe/RR斜率显著相关,综合评估两项指标可能更有助于HCM预 后判断     

基于HPLC-QAMS法的清肝降压胶囊中10个成分同时定量测定研究

目的:建立同时测定清肝降压胶囊中10个成分的高效液相色谱一测多评(HPLC-QAMS)方法,并验证其准确性和可行性。方法:采用Phenomsil C18色谱柱(4.6 mm×250 mm,5μm),以乙腈-0.1%磷酸水溶液为流动相,梯度洗脱;流速:1.0 mL·min^-1;柱温:30℃;检测波长:320 nm(检测2,3,5,4'-四羟基二苯乙烯-2-O-β-D-葡萄糖苷)、250 nm(检测3'-羟基葛根素、葛根素和3'-甲氧基葛根素)、208 nm(检测泽泻醇F、泽泻醇A、24-乙酰泽泻醇A和23-乙酰泽泻醇B)和270 nm(检测隐丹参酮和丹参酮ⅡA)。以葛根素为内参物,建立其与其他9种成分的相对校正因子(RCF),并计算含量,实现一测多评;同时采用外标法(ESM)测定清肝降压胶囊中10个成分的含量,比较一测多评法计算值与外标法实测值的差异。结果:10个成分的线性范围分别为8.136~162.7、7.488~149.8、30.54~610.9、14.11~282.2、0.3680~7.360、0.7040~14.08、0.4320~8.640、3.056~61.12、0.5120~10.24、0.8480~16.96μg·mL^-1,r为0.9992~0.9999;平均回收率分别为98.5%、98.0%、100.0%、100.0%、97.8%、98.5%、97.0%、99.1%、99.3%和100.1%,RSD为1.3%、1.1%、0.96%、0.64%、1.6%、1.5%、1.2%、0.83%、1.1%和0.72%;葛根素与2,3,5,4'-四羟基二苯乙烯-2-O-β-D-葡萄糖苷、3'-羟基葛根素、3'-甲氧基葛根素、泽泻醇F、泽泻醇A、24-乙酰泽泻醇A、23-乙酰泽泻醇B、隐丹参酮、丹参酮ⅡA的相对校正因子分别为1.1551、1.1262、1.2760、0.9643、0.8959、0.8593、1.3662、0.8399和0.9663;一测多评法计算值和外标法实测值之间无明显差异。结论:所建立的方法简便、准确,可用于清肝降压胶囊的质量评价研究。     

正常人心率减速力和心率变异性的变化及相关性

目的 测定不同年龄正常人心率减速力与心率变异性并分析其相关性,探讨其临床意义。方法 选取正常人90例,根据年龄将受试者分为青年组和老年组,进行24h动态心电图检查,离线计算DC、HRV时域指标及相关系数。结果 老年组DC和HRV值与青年组比较均降低,差异有统计学意义(P<0.05),且DC和HRV显著相关。结论 DC和HRV时域指标随着年龄的增加而减小,这些无创指标可以反映自主神经功能。     

A 24-hour rhythm in passive-avoidance behaviour in rats

The 24 h variation in the passive avoidance response of rats was measured. Different groups of 18 animals were tested at 4 hourly intervals throughout 24 h. In all cases, retention was measured 48 h after the first trial. All animals were housed under controlled conditions for 14 days before testing. A significant 24-h rhythm in passive avoidance response was found, the maximum and minimum effects being in the middle of the light and dark phases respectively.     

7种经方及中成药治疗室性早搏的网状Meta分析

目的：采用网状Meta分析方法对7种经方及中成药治疗室性早搏(Premature Ventricular Beat, PVB)的疗效进行临床评价。方法：制定检索策略,由2名独立人员共同检索并筛选国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)及中文科技期刊数据库(CCD)中的临床随机对照试验(RCT),时间限定为建库至2021年11月5日,对检索结果进行筛选,并采用Cochrane偏倚风险评估工具对所纳入文献进行质量评价,完成最终的资料提取。借助Stata16.0进行网状Meta分析。结果：共纳入RCT 64篇,包含4种经方及3种中成药,10种不同干预措施,涉及患者5 972例。临床总有效率：桂枝甘草龙骨牡蛎汤加味>桂枝甘草龙骨牡蛎汤加味联合西药常规>养心定悸胶囊联合西药常规>炙甘草汤加味联合西药常规>天王补心丹>心速宁胶囊联合西药常规>炙甘草汤加味=温胆汤加味联合西药常规>通脉养心丸联合西药常规>西药常规。治疗后24 h室性早搏减少有效率：天王补心丹>炙甘草汤加味联合西药常规>通脉养心丸联合西药常规>...     

天玑骨科机器人联合O臂导航系统辅助经皮微创治疗骨盆后环损伤

目的评价天玑骨科机器人联合O臂导航系统辅助经皮微创治疗骨盆后环损O24;的疗效。方法回顾分析2016年1月—2021年6月收治的76例骨盆后环损O24;患者临床资料，其中45例采用天玑骨科机器人联合O臂导航系统辅助经皮微创骶髂螺钉内固定术治疗（研究组），31例仅在C臂X线机引导下行经皮微创骶髂螺钉内固定术治疗（对照组）。N24;组患者性别、年龄、致O24;原因、骨折Tile分型、受O24;至24b;术时间等一般资料比较差异均无统计学意义（P>0.05）。记录N24;组患者24b;术时间、术中出血量、钉道调整次数和术中透视次数，采用Matta评分评价骨折复位质量；末次随访时采用Majeed评分评估患者骨盆功能恢复情况。 结果研究组共植入螺钉72枚，每例患者植入螺钉1（1，2）枚；对照组共植入螺钉47枚，每例患者植入螺钉1（1，2）枚；N24;组每例患者植入螺钉数比较差异无统计学意义（Z=−0.392，P=0.695）。研究组24b;术时间、术中出血量、钉道调整次数和术中透视次数均显著少于对照组（P<0.05）。240;有患者均获随访，随访时间6～24个月，平均14个月。术后和随访过程中均未见严重并发症。术后1周采用Matta评分评价骨折复位质量，N24;组差异无统计学意义（Z=−1.135，P=0.256）。末次随访时采用Majeed评分评价骨盆功能，N24;组差异无统计学意义（Z=−1.279，P=0.201）。 结论天玑骨科机器人联合O臂导航系统辅助治疗骨盆后环损O24;是一种可靠的24b;术方式，与C臂X线机引导下的传统24b;术方式相比减少了24b;术时间和透视次数，提高了24b;术安全性、准确性和24b;术效率。     

以CpG为佐剂的人IL-24多克隆抗体的制备

目的：采用在原核表达系统表达的人IL-24蛋白及人IL-24真核重组质粒免疫新西兰兔，制备兔抗人IL-24多克隆抗体。方法：利用IPTG诱导hIL-24在大肠杆菌中表达，纯化hIL-24重组蛋白，纯化后的蛋白经SDS—PAGE分析，同时提取hIL-24真核重组质粒，用以免疫新西兰兔，并以CpG为佐剂制备多克隆抗体。Western-blot鉴定抗体的特异性，ELISA法测定抗体效价。结果：人IL-24经IPTG诱导后可在大肠杆菌中大量表达，表达量占细菌总蛋白的30％，纯化后的蛋白纯度高；原核表达的重组蛋白和真核重组质粒免疫新西兰兔，通过抗体效价测定，获得了抗血清效价达1：640的多克隆抗体。结论：原核表达的hIL-24蛋白和hIL-24真核重组质粒均能刺激家兔产生抗体．其多克隆抗体的效价较高。