反复呼吸道感染儿sIL－2R和T细胞亚群的测定

本文采用双抗体夹心ＥＬＩＳＡ法分别测定了２１例反复呼吸道感染儿，３０例正常儿童，１０例新生儿脐血的血清可溶性白细胞介素２受体（ｓＩＬ＝２Ｒ）水平。结果患儿组ｓＩＬ－２Ｒ为７１６．６０±３０．１０Ｕ／ｍｌ；正常儿童组为３８４．４７±８８．０３Ｕ／ｍｌ（ｐ＜０．０１）；新生儿脐血为４４６．２０±５５．６８Ｕ／ｍｌ，与正常儿童比较Ｐ＞０．０５。同时采用间接免疫荧光技术测定了患儿Ｔ细胞亚群水平，结果ＣＤ８细胞数升高，ＣＤ３细胞和ＣＤ４细胞数、ＣＤ４／ＣＤ８比值下降，与正常儿童比较有显著性差别。提示反复呼吸道感染儿有细胞免疫功能降低及免疫调节紊乱。     

Baroreflex mechanisms in major depression

BACKGROUND: Recent studies have shown that depressive disorder is associated with impaired baroreceptor or baroreflex sensitivity, which is proposed to be a predisposing factor for sudden death in patients with manifest cardiac disease. These studies have not evaluated the afferent and efferent components of the cardiac baroreflex loop or other baroreflex mechanisms that regulate target processes (cardiac metabolism and blood pressure variability) related to the impairment. The objective of this study was to gain more insight into autonomic functioning in depressive disorder to more fully examine the potential basis for increased cardiac mortality. METHODS: The subjects were 28 women and men with unipolar major depression who were taking antidepressant medications and who were in partial remission and free of cardiovascular or other serious disease, and 28 healthy control subjects matched for sex, age, and ethnicity. The two samples were compared for negative affective dispositions (anger expression, hostility, defensiveness, anxiety), spontaneous (closed-loop) baroreflex activity, heart rate, heart rate variability, systolic blood pressure, and heart rate-systolic blood pressure double product under resting conditions. RESULTS: Depressed patients showed a general disposition to anger suppression coupled with higher hostility and anxiety, and lower defensiveness. The patients showed higher general sympathetic activity (high levels of blood pressure, low-frequency heart rate variability) and lower parasympathetic-related activity (high heart rate and reduced high frequency heart rate variability) with affected cardiac metabolism estimated by the double product. Depressed patients had lower baroreflex sensitivity related to a higher gain of the afferent component of the baroreflex without respective gain adjustment of its efferent component (reflex gain 'de-afferentation'). It was coupled with a compensatory higher number of effective baroreflex reactions (reflex gating 're-afferentation'). Antidepressant agents and depressed mood had additional independent effects on baroreflex sensitivity through the efferent component of the cardiac baroreflex loop. CONCLUSIONS: The data indicate that different baroreflex components and mechanisms may be impaired in patients with depression and may contribute to their increased cardiac risk.     

复可托和乌体林斯联合治疗小儿反复呼吸道感染疗效观察

目的：观察复可托联合乌体林新治疗儿童反复呼吸道感染（RRI）的临床疗效。方法：26例反复呼吸道感染患儿给予口服复可托2mg／天,2周,随后给予乌体林斯1．72μg肌注．每周1次,8次。疗程结束后随访1年,观察呼吸道感染发作次数及病情轻重、药物反应等,并检测T细胞亚群变化。结果：26倒忠儿治疗后显效率53．8％,有效率23．0％,总有效率76．8％,CD3、CD4、CD4／CD8明显升高,CD8明显下降。结论：反复呼吸道感染患儿应用复可托及乌体林新联合治疗后可明显改善免疫失衡状态。     

Prediction of contrast‐induced acute kidney injury by early post‐procedural analysis of urinary biomarkers and intra‐renal Doppler flow indices in patients undergoing coronary angiography

Background

The study was designed to evaluate the applicability of combined assessment of urinary biomarkers and intra‐renal Doppler flow indices for the prediction of contrast‐induced acute kidney injury (CI‐AKI) after coronary angiography/percutaneous coronary interventions (CA/PCI).

Methods

This prospective observational study covered 95 consecutive patients with coronary artery disease subject to elective or urgent CA/PCI. Doppler intra‐renal flow indices were assessed before and 1 h following CA/PCI. Urine samples were collected within 24 h before and 6 h after CA/PCI and assayed for urinary interleukin‐18 (IL‐18), liver‐fatty acid‐binding protein (L‐FABP), and kidney injury molecule‐1 (KIM‐1) using ELISA method. CI‐AKI was defined as ≥50% relative or ≥0.3 mg/dL absolute increase of serum creatinine concentration at 48 h post‐procedurally.

Results

CI‐AKI was confirmed in nine patients (9.5%). CI‐AKI onset was associated with significantly higher urinary KIM‐1 at 6 h (P = 0.003) and ΔKIM‐1 concentrations (P = 0.001), and urinary IL‐18 at 6 h (P = 0.014) and ΔIL‐18 concentrations (P = 0.012), however, L‐FABP and ΔL‐FABP levels were comparable in both groups. Receiver operating characteristic curve analysis denoted that post‐procedural IL‐18 levels at 6 h >89.8 pg/mg (AUC = 0.75, P = 0.007), KIM‐1 at 6 h >0.425 ng/mg (AUC = 0.81, P = 0.001), renal resistive index (RRI) at 1 h >0.73 (AUC 0.88; P < 0.0001), and renal pulsatility index (RPI) at 1 h >0.86 (AUC = 0.86; P < 0.0001) predicted CI‐AKI onset. Logistic regression analysis of postoperative predictors revealed that IL‐18 and RRI were independent predictors of CI‐AKI onset (AUC = 0.96; P < 0.0001).

Conclusions

Joint assessment of early post‐procedural urinary biomarkers and Doppler renovascular parameters aids early diagnosis of CI‐AKI in patients undergoing coronary interventions.

     

Receptor–receptor interactions: A novel concept in brain integration

A brief historical presentation of the hypothesis on receptor–receptor interactions as an important integrative mechanism taking place at plasma membrane level is given. Some concepts derived from this integrative mechanism especially the possible assemblage of receptors in receptor mosaics (high-order receptor oligomers) and their relevance for the molecular networks associated with the plasma membrane are discussed. In particular, the Rodbell's disaggregation theory for G-proteins is revisited in the frame of receptor mosaic model.     

小剂量锌对反复呼吸道感染患儿的胰岛素生长因子1及免疫球蛋白的影响

目的探讨小剂量锌对反复呼吸道感染(RRI)患儿胰岛素生长因子(IGF-1)及免疫球蛋白(IgG、IgM、IgA、IgE)的影响。方法将血清锌低于正常水平的RRI患儿45例,随机分为补锌组(25例)和对照组(20例)。两组在治疗前、后分别用放射免疫分析法及免疫比浊法测IGF-1、IgG、IgM、IgA、IgE,并进行统计学分析。结果治疗4个月后补锌组IGF-1、IgG、IgA、IgM、明显高于补锌前和对照组(P≤0．05)。结论小剂量补锌可提高RRI患儿IGF-1的分泌,增强机体免疫力。     

程家正治疗小儿反复呼吸道感染风热咳嗽经验

总结程家正教授临床经验。认为小儿反复呼吸道感染概由其脏腑娇嫩、易致邪热,肺常不足、心肝有余,误用寒凉、闭门留寇等所致;治疗应轻灵为要、兼固护本,清心泻肝、宣利肺气、勿过寒凉、顺势而为。并举验案2则。     

Effects of Respiratory Training on Heart Rate Variability and Baroreflex Sensitivity in Individuals With Chronic Spinal Cord Injury

Objective

To evaluate the effects of pressure threshold respiratory training (RT) on heart rate variability and baroreflex sensitivity in persons with chronic spinal cord injury (SCI).

运脾治疗对脾虚大鼠免疫功能的影响

目的探讨运脾治疗对脾虚大鼠免疫功能的作用。方法以黄芪、当归、苍术、龙骨等组成运脾基本方,加工制成糖浆制剂,应用利血平建立大鼠脾虚模型,以正常组、模型组、运脾治疗组对照,观察运脾方对脾虚大鼠主要免疫器官脾、胸腺组织结构,血清免疫球蛋白IgG、IgA、IgM及超氧化物歧化酶(SOD)的作用。结果运脾治疗对胸腺组织结构有较显著的恢复作用,可提高Ig、SOD的含量。结论通过提高SOD、Ig含量,促进胸腺组织结构恢复等作用,从而显著提高脾虚大鼠免疫功能。     

睡眠生理参数的去趋势波动分析

去趋势波动分析(DFA)适宜于研究各类非稳态时间序列的长程幂函数相关性。我们采用DFA方法分析脑电、心电RR间期序列和搏出量等睡眠生理参数,计算定标指数α,研究各睡眠阶段的特点。实验结果显示,各睡眠阶段的α值具有明显的差异,脑电和搏出量信号的规律相似,α随睡眠加深而增大,而RR间期序列的规律则相反,α随睡眠加深而减小。表明DFA在生理参数分析中具有良好的应用价值。