髋关节置换术后血沉、C反应蛋白、血清淀粉样蛋白A的定量分析及其临床意义

目的  检测红细胞沉降率（ESR）、C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）在人工髋关节置换术前后的临床反应参数,探讨3者在人工髋关节置换术后的临床意义。方法  选取人工髋关节置换术患者81例,动态监测术前、术后第1、3、5、7和14天及第1和3个月末血清ESR、CRP、SAA的浓度变化。结果  所有患者术后CRP、SAA值均升高,3 d达峰值,平均浓度分别为（125.35±40.43）和（284.54±87.11）mg/L,1个月后回落至正常水平。ESR第7天时达最大值,平均浓度为（68.41±27.51）mm/h,3个月末回落至正常水平。ESR、CRP、SAA术后呈峰状改变,相对ESR而言,CRP、SAA高峰出现早,回落周期短,稳定性好。结论  血清ESR、CRP及SAA水平的变化反映人工髋关节术后炎症反应严重程度。与ESR比较,CRP、SAA具有敏感性、准确性高的优点,联合3者的临床反应参数对早期髋关节置换术后感染判断具有一定的临床意义。

     

黄芪注射液对小儿呼吸道感染红细胞免疫指标的影响

目的：观察黄芪注射液对小儿反复呼吸道感染红细胞免疫指标的影响。方法：对体检的健康儿童６０例（对照组）进行红细胞Ｃ３ｂ受体花环试验、淋巴细胞绝对值测定和植物血凝素（ＰＨＡ）皮肤试验。６０例呼吸道反复感染患儿（治疗组）除常规治疗外，并给予黄芪注射液静滴，于治疗前后分别进行上述检验。结果：治疗组治疗后总有效率达９８．３％。治疗后免疫功能３项指标均明显优于治疗前（Ｐ均＜０．０１）；治疗组治疗后免疫功能３项指标与健康对照组比较均无显著性差异（Ｐ均＞０．０５）。结论：在西药抗生素及抗病毒治疗基础上，加用黄芪注射液具有增强免疫功能的作用，是治疗小儿反复呼吸道感染及免疫功能低下的一种新途径。     

Chlorpyrifos‐based insecticides induced genotoxic and cytotoxic effects in the ten spotted live‐bearer fish,Cnesterodon decemmaculatus (Jenyns, 1842)

Mortality, genotoxicity, and cytotoxicity of the 48% chlorpyrifos (CPF)‐based formulations Lorsban* 48E^® and CPF Zamba^® were evaluated on Cnesterodon decemmaculatus (Jenyns, 1842) (Pisces, Poeciliidae) under laboratory conditions. Induction of micronucleus (MN) and alterations in the erythrocyte/erythroblast frequencies were employed as end points for genotoxicity and cytotoxicity, respectively. For Lorsban* 48E^®, mean values of 0.13 and 0.03 mg/L were determined for LC₅₀ at 24 and 96 h, respectively, and these concentrations reached mean values of 0.40 and 0.21 mg/L for CPF Zamba^®. Mortality values increased as a positive linear function of the CPF Zamba^® concentrations, but not for Lorsban* 48E^® concentrations. There was no significant relationship between mortality and exposure time within the 0–96 h period for both formulations. LC₅₀ values indicated that the fish were seven fold more sensitive to Lorsban* 48E^® than to CPF Zamba^®. Lorsban* 48E^® within the concentration range of 0.008–0.025 mg/L increased MN frequency at both 48 and 96 h of treatment. Similar results were also observed when fish were exposed to 0.052–0.155 mg/L of CPF Zamba^®, regardless of the exposure time. Cellular cytotoxicity was found after Lorsban* 48E^® and CPF Zamba^® treatments for all concentrations and time exposures, estimated by a decrease in the frequency of mature erythrocytes and a concomitant enhanced frequency of erythroblasts in circulating blood. Furthermore, our results demonstrated that Lorsban* 48E^® and CPF Zamba^® should be considered as CPF‐based commercial formulations with marked genotoxic and cytotoxic properties. © 2013 Wiley Periodicals, Inc. Environ Toxicol 29: 1390–1398, 2014.     

In vitro selection of Plasmodium falciparum 3D7 for expression of variant surface antigens associated with severe malaria in African children

P. falciparum-infected red blood cells (IRBC) can adhere to endothelial host receptors through parasite-encoded, clonally variant surface antigens (VSA). The VSA-mediated IRBC adhesion and the acquired VSA-specific antibody response have both been linked to IRBC organ tropism and disease severity. Parasites isolated from young children with severe malaria (SM) tend to express a limited and conserved set of VSA (VSASM) that are both stronger and more commonly recognized by IgG in the plasma of malaria-exposed individuals than VSA (VSAUM) expressed by parasites causing uncomplicated malaria (UM) in older semi-immune children. Establishment of the genetic mechanism underlying changes in VSA expression in response to in vitro selective pressure is now possible because of the availability of the entire genomic sequence of the P. falciparum clone 3D7. As a first step towards direct molecular identification of VSASM-encoding genes in 3D7, we report here a method of enforcing expression of VSASM-like antigens in this parasite clone by a novel selection method using plasma from semi-immune children with low VSAUM-specific, but high VSASM-specific, IgG reactivity. In addition to the resulting increase in VSA-specific IgG recognition, VSASM-expressing 3D7(3D7-Dodowa1) showed reduced adhesion to CD36. Finally, levels of IgG specific for the VSA expressed by 3D7-Dodowa1 were uniformly higher than those of IgG with specificity for VSA expressed by the unselected 3D7 in plasma samples from geographically and epidemiologically diverse areas of endemic parasite transmission. The described selection method appears a useful tool in the identification of genes encoding VSA involved in severe and life-threatening P. falciparum malaria.     

Noninvasive Monitoring After Azathioprine Withdrawal in Patients With Inflammatory Bowel Disease in Deep Remission

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Detection of genital tuberculosis among women with infertility using best clinical practices in India: An implementation study

BackgroundDiagnosis of genital tuberculosis (TB) as a cause of infertility still remains a diagnostic dilemma for clinicians, as no standard guidelines exist. The recently proposed best practices for genital TB diagnosis have not been evaluated yet in India.ObjectivesTo implement best practices to diagnose and treat likely genital TB as a cause of infertility.MethodsBetween April 2016 and June 2018, consenting women seen at a tertiary hospital infertility clinic were assessed by thorough TB related clinical history, ultrasonography, tuberculin skin test (TST), and ESR. Those with suspected genital TB underwent laparohysteroscopy. Clinical and laboratory characteristics were compared between likely (microbiologically confirmed or probable TB) and unlikely (possible and no genital TB) genital TB. Fertility outcome was assessed among women initiated on anti-TB treatment (ATT).ResultsOf 185 women seeking infertility care, likely genital TB was identified among 29 (15.7%) women, with 6 (21%) confirmed and 23 (79%) probable genital TB. Compared to unlikely genital TB cases, the likely genital TB group were found to have past history of TB (p < 0.001); positive TST (p = 0.002) and elevated ESR (p = 0.001). Among the likely genital TB group, all 6 confirmed genital TB were started on ATT and 2 (33.3%) conceived. Of 5 probable genital TB started on ATT, 3 (60%) conceived.ConclusionApproximately 1/6th of women seeking infertility care met the criteria for likely genital TB. Conception among over-half of treated probable genital TB cases provides preliminary evidence that best clinical practices can be utilized, but needs further confirmatory studies.     

大骨节病患者淋巴细胞亚群及sIL-2R的检测意义

目的　探讨大骨节病患者外周血淋巴细胞分布形式、血清可溶性白细胞介素 - 2受体 (s IL- 2 R)及其与硒的相关性。方法　在大骨节病病区随机选取经 X线和临床检查确诊的大骨节病儿童 ,同时在该病区和非病区分别选取健康儿童作为对照组。采用单克隆抗体 (抗 CD4 ,CD8)免疫细胞组化法检测淋巴细胞亚群。s IL- 2 R的测定采用双抗体夹心 EL ISA法。结果　大骨节病病区儿童外周血单核细胞 (PBMC)中 CD4 +、CD8+率显著低于非病区水平 (P <0 .0 5 ) ,CD4 / CD8各组间没有差异 (P >0 .0 5 )。患儿组血清 s IL- 2 R水平显著高于非病区水平 (P =0 .0 38)。病区健康儿童组较非病区有升高趋势 ,但差异无显著意义。另外 ,病区儿童红细胞硒水平仍显著低于非病区 (P <0 .0 0 1)。相关分析表明 ,红细胞硒水平与 CD4 +率呈典型正相关 (r=0 .6 2 5 ,P <0 .0 5 ) ,与血清 s IL-2 R水平则无明显相关关系。结论　大骨节病病区儿童外周血处于一种免疫抑制状态 ,以 CD4 + 、CD8+ 比例的减少尤为明显。硒通过影响 PBMC中 T淋巴细胞亚群的分布形式从而在这种免疫紊乱中发挥了重要作用。建议把血清 s IL - 2 R的测定作为检出大骨节病儿童的一种参考指标。     

A 20-year long term experience of the Italian Diamond-Blackfan Anaemia Registry: RPS and RPL genes,different faces of the same disease?

Diamond–Blackfan anaemia (DBA) is a rare and heterogeneous disease characterised by hypoplastic anaemia, congenital anomalies and a predisposition for malignancies. The aim of this paper is to report the findings from the Italian DBA Registry, and to discuss the Registry’s future challenges in tackling this disease. Our 20-year long work allowed the connection of 50 Italian Association of Paediatric Haematology and Oncology (AIEOP) centres and the recruitment of 283 cases. Almost all patients have been characterised at a molecular level (96%, 271/283), finding a causative mutation in 68% (184/271). We confirm the importance of determination of erythrocyte adenosine deaminase activity (eADA) and of ribosomal RNA assay in the diagnostic pipeline and characterisation of a remission state. Patients with mutations in large ribosomal subunit protein (RPL) genes had a significant correlation with the incidence of malformations, higher eADA levels and more severe outcomes, compared to patients with mutations in small ribosomal subunit protein (RPS) genes. Furthermore, as a consequence of our findings, particularly the incidence of malignancies and the high percentage of patients aged >18 years, we stress the importance of collaboration with adult clinicians to guarantee regular multi-specialist follow-up. In conclusion, this study highlights the importance of national registries to increase our understanding and improve management of this complex disease.