Expressions of helper T cells and regulatory T cells in peripheral blood of children with dust mite allergic asthma and their clinical significance / 中华实用儿科临床杂志

Objective To analyze the expressions of helper T cells (Th) and regulatory T cells (Treg) in peripheral blood of children with dust mite allergic asthma and their clinical significance.Methods Thirty asthmatic children with dust mite positive were included in the study as asthmatic group.Thirty healthy subjects,age and sex matched,were included as healthy control group.Peripheral blood mononuclear cells (PBMC) were isolated by densitygradient centrifugation over Ficoll-Hypaque cushions.The expressions of interferon-γ (IFN-γ),interleukin-4 (IL-4) and Foxp3 in CD4 + T cells with or without dust mite stimulation were assessed by intracellular staining and flow cytometry (FCM).The anti-inducible costimulatory molecule (ICOS),anti-CD2s or anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibodies were added to PBMC and co-cultured for 3 days after dust mite stimulation.The expressions of Thl (CD4 + IFN-γ+ T cells),Th2 (CD4 + IL-4 + T cells) and Treg(CD4 + CD25 + Foxp3 + T cells) were analyzed.The data were analyzed by using statistical software.Results Compared with the healthy control group,in dust mite positive asthma group,the percentage of Thl cells was remarkably increased (P ＜ 0.05),while that of Treg cells was significantly decreased (P ＜ 0.05),and that of Th2 cells were not significantly different (P ＞ 0.05).Compared with nonstimulated PBMC of asthma group,the percentages of Thl and Treg had no significant variation (all P ＞ 0.05),while that of Th2 cells was notably increased (P ＜ 0.01).In the present of anti-ICOS or anti-CD2s antibodies,no significant variation were found about the percentages of Th1 and Treg (all P ＞ 0.05),while expressions of Th2 cells were significantly decreased (all P ＜0.0001).However,in the present of anti-CTLA-4 antibodies,the percentages of Th1,Th2 and Treg had no significant difference (all P ＞ 0.05).Conclusions There is a constructive,allergen independent Th1 activation and Treg deficiency as well as allergen inductivity,ICOS-and CD2s-dependent Th2 activation in the peripheral blood of children with dust mite allergic asthma.

Risk factors for acute fulminant myocarditis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for fulminant myocarditis by analyzing clinical symptoms/signs or laboratory findings in children with viral myocarditis.</p><p><b>METHODS</b>The medical data of 71 children with acute viral myocarditis from March 2005 to September 2008 were retrospectively studied. They were classified into fulminant (n=16) and non-fulminant myocarditis groups (n=55). Chi-square and Student's t-test were used to analyze the clinical presentations, laboratory data, EEG and cardiac ultrasound findings on admission. The multiple regression analysis was used to identify the independent risk factors for fulminant myocarditis.</p><p><b>RESULTS</b>Eight children (50%) died in the fulminant myocarditis group, but none in the non-fulminant group. The following factors were closely related to the fulminant course of myocarditis: lower blood pressure, higher serum CK-MB level, positive cTnI, complete atrioventricular block and left bundle branch block, ST segment alterations, prolonged QRS complex, and decreased left ventricular ejection fraction and short axis fractional shortening. Multiple regression analysis revealed that prolonged QRS complex (OR=1.139; CI=1.014-1.279, P<0.05) and decreased left ventricular ejection fraction (OR=0.711; CI=0.533-0.949, P<0.05) were independent risk factors for fulminant myocarditis.</p><p><b>CONCLUSIONS</b>The mortality of fulminant myocarditis is high in children. Prolonged QRS complex and decreased left ventricular ejection fraction on admission are independent risk factors for fulminant myocarditis in children.</p>

Association of Toll-Like Receptor 4 and CD_(14) Gene Polymorphisms with Kawasaki Disease Susceptibility / 实用儿科临床杂志

Objective To explore the association of Toll-like receptor 4 TLR4 and lipopolysaccharide receptor CD14 gene polymorphisms with Kawasaki disease (KD) susceptibility.Methods Three-color fluorescent staining flow-cytometry was used to detect the expression of TLR4 in peripheral blood white blood cell of 76 KD children and 118 healthy control group.The gene of TLR4 (-896A/G), (-1196C/T) and CD14 (-260C/T) polymorphisms was identified by polymerase chain reaction-restriction fragment length polymorphisms; and the relationship between genotype and KD was analyzed.Results 1.The values of mean fluorescence intensity (MFI) of TLR4 in peripheral blood white blood cell of the KD groups and the healthy control groups were 2.87?0.96, 10.55?4.87, 23.36?8.28 and 3.26?0.65, 7.55?1.21, 25.41?6.97, respectively; There was a gradual increase of these values on lymphocyte, neutrophilic leukocyte and mononuclear cell in both groups.2.(-896A/G), (-1196C/T) polymorphisms of TLR4 gene were not found in both groups.3.The frequency of each genotype of CD14 gene (-260C/T) was 35.5%CC, 30.3%CT, 34.2%TT in KD group and 38.1%CC, 47.5%CT, 14.4%TT in healthy control group.The frequency of each genotype was significantly different in 2 groups(?2=11.62 P

Matrix metalloproteinase-1 expression in the circulation of patients with Kawasaki disease and its role in the pathogenesis of coronary artery lesions / 中华儿科杂志

<p><b>OBJECTIVE</b>Kawasaki disease (KD) is an acute and self-limited systemic vasculitis syndrome of unknown origin that mainly affects small and medium-sized arteries, particularly the coronary arteries, which is followed by aneurysm formation. Increased levels of matrix metalloproteinase-1 (MMP-1) have been detected in aortic aneurysms in adults, suggesting an important role of MMP-1 in arterial wall destruction and resultant aneurysm formation. The aim of this study was to investigate the potential role of MMP-1 in the pathogenesis of coronary artery lesions in patients with KD.</p><p><b>METHODS</b>Forty patients with KD, including 23 patients without coronary artery lesions (CAL) and 17 patients with CAL, as well as age-matched 10 febrile and 10 healthy afebrile controls were studied. The duration of KD was divided into three phases: the acute phase, the subacute phase and the convalescent phase. Enzyme-linked immunosorbent assay was used to detect the protein levels of MMP-1 in the sera. MMP-1 mRNA expression in the circulating leucocytes was studied using reverse transcription-polymerase chain reaction.</p><p><b>RESULTS</b>Levels of MMP-1 protein in serum and MMP-1 mRNA expression in the leucocytes were significantly elevated at the acute phase in the two groups of KD patients (CAL group: 14.91 +/- 3.88 ng/ml and 0.89 +/- 0.15 ng/ml; NO-CAL group: 11.27 +/- 3.28 ng/ml and 0.77 +/- 0.14, respectively), compared with febrile (7.05 +/- 1.98 ng/ml and 0.45 +/- 0.12 ng/ml, respectively) and afebrile (5.13 +/- 1.20 ng/ml and 0.29 +/- 0.12 ng/ml, respectively) controls (P < 0.01). Furthermore, MMP-1 protein and MMP-1 mRNA levels were significantly higher in KD patients with CAL than in KD patients without CAL (P < 0.05). There was a significantly positive correlation between the serum protein level of MMP-1 at the acute phase of KD and the circulating leucocytes counts (r = 0.750, P < 0.01). The MMP-1 serum protein level and mRNA expression in the leucocytes at the acute phase of the two KD groups decreased obviously from the subacute through the convalescent phases (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>The expression of MMP-1 at the acute phase of KD was significantly elevated, especially in KD patients with CAL. MMP-1 might be involved in the formation of coronary artery lesions and pathogenesis of KD.</p>

Clinical features and management of Crohn's disease in Chinese patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An increasing incidence of Crohn's disease has been found in China in recent years. Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn's disease in order to improve early diagnostic accuracy and therapeutic efficacy.</p><p><b>METHODS</b>Thirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.</p><p><b>RESULTS</b>Most patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract (from the mouth to the anus). In this study, the colon and small bowel were the major sites involved. Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host's nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported.</p><p><b>CONCLUSION</b>Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.</p>

Clinical Significance of Serum Cardiac Troponin in Patients with Dilated Cardiomyopathy / 实用儿科临床杂志

Objective To observe the serum cardiac troponin I (cTnI) level and to analysis the relations between the serum cTnI level and prognosis in patients with dilated cardiomyopathy (DCM) and Cardiac Dysfunction.Methods Serum cardiac cTnI level was measured by enzyme-linked immunosorbant assay. Results The serum cTnI level in DCM patients with class IV cardiac function (0.53 ?0.31) ?g/L was significantly higher than in DCM patients with class Ⅲ cardiac function (0.45?0.27) ?g/L.There was significantly difference in serum cTnI levels between DCM patients with class Ⅲ cardiac function and DCM patients with class Ⅱ cardiac function(0.29?0.27) ?g/L.Conclusion The higher serum cTnI level is correlated with the severity of cardiac function and may be useful for evaluating prognosis in patients with DCM.

Effect of agonist anti-CD40 mAb 5C11 on the induction and biological characteristics of leukemic dendritic cells / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the impact of an agonist anti-CD(40) monoclonal antibody 5C11 on the induction and biological characteristics of leukemic dendritic cells.</p><p><b>METHODS</b>Combinations of 5C11 and different cytokines were used to induce differentiation of leukemic blasts into dendritic cells. Morphology was observed by light microscopy. Surface antigens of the induced cells were analyzed by fluorescence-activated cell sorting (FACS), the yields of dendritic cell by cell counting, the levels of IL-6 and IL-12 by ELISA, T cell proliferating activity by allo-mixed lymphocyte reaction (MLR) in vitro. Allogeneic T cells were stimulated with leukemic dendritic cells and T-cell cytotoxicity was measured by MTT assay.</p><p><b>RESULTS</b>When cultured with combinations of 5C11 and different cytokines, the leukemic cells isolated from the patients could differentiate into dendritic cells. The morphology showed typical features of dendritic cells, which expressed high levels of CD(40), CD(80) and CD(86). In comparison with the original leukemia cells, the leukemic dendritic cells secreted less IL-6 but more IL-12 (P < 0.05). The leukemic dendritic cells were potent to stimulate the proliferation of allogeneic T cells, and the latter was able to lyse the original leukemia cells.</p><p><b>CONCLUSION</b>Leukemic blasts could be induced to differentiate into functional dendritic cells. It may be of great value in the adoptive immunologic therapy of leukemia.</p>