Early fluid and protein shifts in men during water immersion

Summary High precision blood and plasma densitometry was used to measure transvascular fluid shifts during water immersion to the neck. Six men (28–49 years) undertook 30 min of standing immersion in water at 35.0±0.2‡ C; immersion was preceded by 30 min control standing in air at 28±1‡ C. Blood was sampled from an antecubital catheter for determination of blood density (BD), plasma density (PD), haematocrit (Ht), total plasma protein concentration (PPC), and plasma albumin concentration (PAC). Compared to control, significant decreases (p<0.01) in all these measures were observed after 20 min immersion. At 30 min, plasma volume had increased by 11.0±2.8%; the average density of the fluid shifted from extravascular fluid into the vascular compartment was 1006.3 g · l⁻¹; albumin moved with the fluid and its albumin concentration was about one-third of the plasma protein concentration during early immersion. These calculations are based on the assumption that the F-cell ratio remained unchanged. No changes in erythrocyte water content during immersion were found. Thus, immersion-induced haemodilution is probably accompanied by protein (mainly albumin) augmentation which accompanies the intravascular fluid shift.     

丙种球蛋白对重症病毒性脑炎疗效的Meta分析

目的:分析评价静脉注射大剂量丙种球蛋白(IVIG)对儿童重症病毒性脑炎(SVE)疗效的随机对照研究(RCT)。方法:根据纳入和排除标准,从医学电子数据库中筛选相关RCT文献,应用Cochrane Handbook for Systematic Reviews of Intervention质量评价标准进行质量评价,用Review Manager 5.0软件进行Meta分析。疗效判断指标为观察期内退热时间、惊厥停止时间、意识恢复时间、脑膜刺激征消失时间、平均住院时间。结果用均差(MD)及其可信区间(CI)表示,以P<0.05为差异有统计学意义。结果:共有6个RCT入选,Meta分析结果显示:治疗组和对照组在退热时间上差异有统计学意义[MD=-2.49,95%CI(-3.75-1.24),P<0.01],惊厥停止时间上差异有统计学意义[MD=-42.86,95%CI(-51.43-34.29),P<0.01],意识恢复时间上差异有统计学意义[MD=-1.73,95%CI(-2.21--1.24)],脑膜刺激征消失时间上差异有统计学意义[MD=-3.25,95%CI(-5.66--0.84),P<0.01],平均住院时间上差异也有统计学意义[MD=-3.25,95%CI(-5.66--0.84),P<0.01]。结论:在儿童重症病毒性脑炎治疗中,大剂量IVIG能有效缩短退热时间、惊厥停止时间、意识恢复时间、脑膜刺激征消失时间、平均住院时间,临床值得推荐使用。开展多中心、大样本、严格试验设计的临床试验有助于进一步明确大剂量IVIG在儿童SVE治疗中的有效性和安全性。     

抗胸腺细胞球蛋白联合环孢素与雄激素及造血生长因子治疗重型再生障碍性贫血的临床研究

目的 观察抗胸腺细胞球蛋白（ATG）联合环孢素、雄激素及造血生长因子治疗重型再生障碍性贫血（SAA）的疗效及安全性. 方法 2007年1月至2009年12月应用ATG联合环孢素、雄激素及造血生长因子对21例SAA患者进行治疗,检测其治疗前后血象及骨髓象的变化,分析临床疗效. 结果 21例SAA患者中,基本治愈3例,缓解4例,明显进步7例,无效5例,死亡2例;总有效率为66.7%. 结论 联合应用ATG、环孢素、雄激素及造血生长因子治疗SAA,疗效肯定,不良反应相对较轻,值得临床广泛应用,是SAA长期无病生存的重要治疗方法.     

内毒素性休克大鼠脑组织和血浆神经球蛋白水平的变化

目的 评价内毒素性休克大鼠脑组织和血浆神经球蛋白(Ngb)水平的变化.方法 健康清洁级SD大鼠70只,7周龄,雌雄不拘,体重250～300 g,随机分为2组:对照组(C组,n=10)和内毒素性休克组(ES组,n=60).ES组经尾静脉注射内毒素16 ms/ks制备内毒素性休克模型,C组注射等容量生理盐水.ES组于注射内毒素后3、6、12、24、48和72 h(T1-6)时取颈静脉血和脑脊液(CSF)标本,随后处死大鼠,取额叶皮质和海马组织,采用ELISA法和Western blot法测定血浆、CSF、额叶皮质和海马组织Ngb的表达水平,并计算脑水含量.结果 与C组比较,ES组T2-6时血浆、CSF、海马和额叶皮质Ngh水平和脑水含量升高(P<0.01);与T2时比较,ES组T3-6时Ngb水平和脑水含量升高(P<0.01);与T5时比较,ES组T2-4时Ngb水平和脑水含量降低(P<0.01),T6时差异无统计学意义(P>0.05);脑水含量与血浆、CSF、海马和额叶皮质Ngb水平呈正相关(r分别为0.631、0.719、0.707和0.706,P<0.01).结论 大鼠内毒素性休克时机体Ngh水平上调,此变化可能是机体内源性保护机制之一.     

恶性肿瘤患儿血清β_2－微球蛋白的测定

采用放射免疫分析法对２８例恶性肿瘤、１５例良性肿瘤和５７例正常小儿血清β_２－微球蛋白（β_２－Ｍ）进行测定。结果恶性肿瘤组β_２－Ｍ明显高于其他两组，Ｐ值分别小于０．０５和０．００２；高β２－Ｍ率恶性肿瘤组为５７．４％，良性肿瘤组为１０．７％；术前血清β２－Ｍ高于３．０ｍｇ／Ｌ，提示可能短期复发，预后不良。因此，测定血清β２－Ｍ对小儿恶性实体肿瘤的诊断及预后估计有参考价值。     

电免疫扩散法测定正常人血触珠蛋白

本文应用电免疫扩散法对220例健康人进行血触珠蛋白测定。正常值为0.86±0.28μmol/L(256.51±82.88mg/dl),血清和血浆中触珠蛋白含量一致,与性别无关,但与年龄有关。采用3mm孔径,5mm孔距,结果与2mm孔径,7mm孔距者一致,前者操作简便,测样数量多,可代表后者。     

Serum IgG,IgA and IgM concentration in 1,038 patients with various neurological disorders

Summary Concentration of serum IgG, IgA and IgM in 1,038 unselected patients with various neurological diseases was determined. In 521 instances, the levels of CSF IgG, IgA and IgM were also established. In serum, the most frequent selective quantitative abnormality was found in the IgA concentration. In CSF, an increased level of IgG with normal IgA concentration and undetectable IgM was established about 8 times more frequently than isolated increase of CSF IgA. Selective quantitative abnormalities in serum IgG were observed in 35% of patients with subacute sclerosing panencephalitis as compared to 5% in instances in the definite MS group. Abnormal bands in the serum gamma-globulin field were most frequently seen in electropherograms from patients with subacute sclerosing panencephalitis, in cases of malignant lymphoproliferative disorders and in patients with definite MS. No correlation between the concentration of serum and CSF immunoglobulins could be established. Most frequent quantitative abnormalities in serum IgG, IgA and/or IgM were established in malignant lymphoproliferative disorders, in patients with myopathies including myositides and in subacute or chronic inflammatory CNS disorders. Highest incidence of increased CSF IgG, IgA and/or IgM concentration was detected in patients with inflammatory CNS disease, in instances of definite MS and in malignant lymphoproliferative disorders with CNS symptomatology. Increased CSF IgG and IgA concentration with detectable levels of IgM in patients with elevated CSF total proteins indicated alterations in the blood/CNS barrier structures.Supported by PHS grants NB05450 and 06793.     

Cerebrospinal fluid measles antibody titer and γ globulins in subacute sclerosing panencephalitis

Summary Measles antibody determination on a series of CSF's confirm the physiopathological significance of measles in SSPE. The comparison of CSF protein electrophoretic patterns in agar gel and measles antibody titers contributes to the differential diagnosis of SSPE and other neurological disorders.

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Zusammenfassung Masern-Antikörperbestimmungen in einer Serie von Liquorproben bestätigen die physiopathologische Bedeutung der Masern bei der SSPE. Der Vergleich von Agar-Gel-Elektrophorese-Diagrammen der Liquorproteine mit Masern-Antikörper-Titer ist für die Differentialdiagnose der SSPE und anderer neurologischer Störungen aufschlußreich.

     

食物不耐受与人体免疫功能关系探讨

目的 探讨食物不耐受在体检人群中的检测现状及对机体免疫、炎症指标的早期影响.方法 采用酶联免疫吸附法对257例体检人群的血清标本进行食物特异性IgG抗体检测,比较检测结果阳性组和阴性组血白细胞、嗜酸性粒细胞、球蛋白、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗核抗体(ANA)及T细胞功能差异.采用SAS软件对相关资料进行t检验或卡方检验.结果 257例受检人群中,食物特异性IgG抗体阳性134例,阳性率为52.14％.排名前三位的阳性食物分别是鸡蛋、螃蟹、牛奶,中、重度不耐受食物主要是鸡蛋和牛奶.比较食物不耐受检测阳性组和阴性组的血嗜酸性粒细胞、球蛋白水平,差异均有统计学意义(t=-0.07,x2=8.91,P＜0.05)；比较两组血白细胞、ESR、CRP、RF、ANA及T细胞功能,均差异无统计学意义(P＞0.05).结论 在临床症状或慢性疾病发生之前,食物不耐受人群的血嗜酸性粒细胞、球蛋白有明显升高,建议加强对这些人群的监测；而对机体血白细胞、ESR、CRP、RF、ANA及T细胞功能等免疫炎症指标无明显影响.     

原发性血小板减少性紫癜患者血清触珠蛋白的研究

用火箭电泳法测定53例原发性血小板减少性紫癜患者血清触珠蛋白均值为0.47±0.22g/L,明显高于正常人(P<0.01)。当病情改善时,触珠蛋白水平恢复正常,且先于(至少是同时)血小板的改变。本测定可以作为诊断原发性血小板减少性紫癜的一个指标,据其可估计病人的预后。并初步探讨了其免疫学机制。