Objective To investigate the effects of methylprednisolone on airway inflammation of chronic bronchitis in rats, and to explore its possible mechanism. Methods Forty SD rats were randomly divided into five groups, ie. a blank control group, amethylprednisolone control group, a model group, and two methylprednisolone intervention groups. Chronic bronchitis model was established by cigarette inhalation in the model group and two intervention groups. Methylprednisolone was injected intraperitoneally in the two intervention groups before exposing to cigarette smog ( at the dose of 1 mg/ kg and 10 mg/ kg, qd,respectively) . The protein expression of phosphodiesterase 4D ( PDE4D ) in trachea and lung samples was determined by immunohistochemical staining. The average optical density of positive staining of PDE4D was determined by image analysis technique and gray scale scanning. Bronchoalveolar lavage fluid ( BALF) was collected for total and differential cell counts, and the concentrations of TNF-αand interleukin-8 ( IL-8) in BALF were detected by ELISA. Results Cigarette smoking induced obvious airway inflammation in themodel group, and the inflammation was alleviated in the two methylprednisolone intervention groups.Compared with the two control groups, the expression of PDE4D was obviously elevated in tracheal and lungs in the model group( P lt; 0. 05) . Moreover, the increased expression of PDE4D was positively related with theincreased release of TNF-αand IL-8 in BALF. The expression of PDE4D and the release of TNF-αand IL-8 in BALF were decreased after the treatment with methylprednisolone in a dose-dependent manner ( P lt;0. 05) . Compare with the low dose intervention group, there was no markedly difference related to PMNnumber and TNF-α release in the high dose intervention group ( P gt; 0.05) . Conclusions Methylprednisolone may alleviate airway inflammation of chronic bronchitis by inhibiting the expression of PDE4D in rats. Inhibition of PDE4D may down-regulate TNF-αactivity, which may further reduce IL-8 release and alleviate airway inflammation.
【摘要】 目的 觀察人類免疫缺陷病毒（HIV）感染后對人體各個系統的影響，為其診斷和治療提供經驗。 方法 回顧性分析2005年1月—2010年6月于華西醫院確診為HIV感染13例患者的臨床表現和相關實驗室指標。 結果 13例HIV感染患者均合并其他感染，以結核病最為常見；除有T淋巴細胞異常外，多數患者可合并出現血液學異常，包括貧血、白細胞和血小板降低；生化異常，包括球蛋白升高、白蛋白降低；HIV感染患者可合并出現風濕病癥狀和免疫學異常。 結論 HIV感染患者臨床表現復雜多樣，可合并出現多種感染和風濕病癥狀，血液學及免疫學異常也比較常見。【Abstract】 Objective To observe the impact of human immunodeficiency virus (HIV) on each system of human body after its infection, in order to provide experiences for diagnosis and treatment of this disease. Methods The clinical manifestations and related laboratory results of 13 inpatients treated in West China Hospital of Sichuan University from January 2005 to June 2010 were reviewed retrospectively. Results The incidence of infection in these patients was 100% with tuberculosis as the most common infection. Apart from the abnormality of T lymphocytes, most patients had a change of hematology and biochemistry, including anemia, depression of leucocytes and platelets, hyperglobulinemia and hypoproteinemia; HIV-infected patients may also presented with rheumatic manifestations or abnormality in the immune system. Conclusion The clinical manifestations of patients with AIDS are complicated. Many kinds of infections and rheumatic manifestations may merge and the change in hematology and immunology is common.
Objective To verify the applicability of AGREE-China and select high-quality clinical practice guidelines (CPGs) or consensus for the management of fragility fractures (FF) in China by evaluating their methodological quality. Methods CBM, CNKI, WanFang Data, VIP databases and related CPGs websites were electronically searched. Two reviewers independently screened literature, extracted data, and checked each other. Quality appraisal of CPGs or consensus were evaluated by AGREE Ⅱ and AGREE-China, and weighted Kappa value and intraclass correlation coefficients (ICC) were calculated to illustrate the consistency of the two tools. Results Nine CPGs and sixteen consensuses were included. Among the six domains in AGREE Ⅱ, "scope and purpose" domain (62.22%) scored higher than "clarity of presentation" domain (45.67%). The "stakeholder involvement" domain (34.89%) and "applicability" domain (38.17%) both exceeded 30%, while "rigor of development" domain (18.79%) and "editorial independence" domain (13.33%) were lower. Among the five domains in AGREE-China, "conflict of interest" domain (72.80%) was higher, followed by "usability/feasibility" domain (49.87%), while "scientificity/preciseness" domain (20.36%), "effectiveness/safety" domain (25.20%) and "economic efficiency" domain (14.40%) were lower. The weighted Kappa value of recommendations from the two tools was 0.694 (P<0.001), showing moderate consistency. ICC values of the same items and two evaluators were all greater than 0.85 (P<0.001) with high consistency. Three high-quality CPGs were consistently selected by the two tools. Conclusion AGREE Ⅱ holds high consistency with AGREE-China; however, AGREE-China is more suitable for the quality appraisal of Chinese CPGs or consensus. The methodological quality of CPGs or consensus for the management of FF in China needs to be further improved.
目的 分析輪狀病毒性腹瀉患兒心肌受損情況和所伴隨生化檢驗指標改變。 方法 2008年7月－2010年7月收治腹瀉患兒80例，年齡6～27個月，平均12.9個月。其中有50例為輪狀病毒腹瀉（A組），30例為非輪狀病毒性腹瀉（B組）。A組患兒均符合輪狀病毒腹瀉診斷標準，有心肌損傷的異常指標但達不到心肌炎診斷標準者診斷為心肌損害。B組患兒有水樣腹瀉，但癥狀較輕，病程較短，輪狀病毒抗原檢測陰性。用全自動生化分析儀測定血清谷草轉氨酶、乳酸脫氫酶、肌酸磷酸激酶和肌酸磷酸激酶同工酶，免疫親和層析法測定血清肌鈣蛋白值，并進行心電圖檢查。 結果 A組50例輪狀病毒性腹瀉患兒中，44例（88.0%）存在心肌損害，其血清谷草轉氨酶（74.32 ± 13.77）U/L、肌酸磷酸激酶（52.01 ± 10.37）U/L、肌酸磷酸激酶同工酶（273.43 ± 27.55）U/L均升高，且明顯高于B組[（24.98 ± 7.03）、（17.11 ± 6.52）、（151.46 ± 16.52）U/L]，差異有統計學意義(P＜0.05)。兩組患兒的乳酸脫氫酶變化差異無統計學意義(P＞0.05)。 結論 輪狀病毒性腹瀉患兒往往伴有心肌損害及相應的血液生化檢測指標改變；以肌酸磷酸激酶同工酶作為近期心肌損害的診斷指標更為特異和敏感。