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        west china medical publishers
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        find Author "虞竹溪" 5 results
        • 單核細胞 HLA-DR 和 T 淋巴細胞亞群預測嚴重創傷繼發感染的臨床研究

          目的 探討連續監測單核細胞人類白細胞抗原 DR(HLA-DR)表達率變化及外周血 T 淋巴細胞亞群比例變化對嚴重創傷繼發感染的預測價值。 方法 納入 2014 年 6 月至 2016 年 6 月南京大學醫學院附屬鼓樓醫院重癥醫學科收治的 26 例嚴重創傷患者,用流式細胞學方法檢測其入院當天及第 3、5、7 d 外周血 HLA-DR 表達率及 T 淋巴細胞亞群比例,根據患者 28 d 內感染情況分為非感染組、局部感染組和全身感染組,分析 HLA-DR 表達率變化規律和 T 淋巴細胞亞群比例變化規律與感染的關系。 結果 26 例嚴重創傷患者中發生局部感染 10 例,全身感染12 例,感染率達 84.6%。與非感染組及局部感染組比較,全身感染組第 7 d 的 HLA-DR 表達率顯著降低。與非感染組比較,局部感染組和全身感染組第 7 d 的 CD4+/CD8+ 比例顯著降低。 結論 外周血單核細胞表面 HLA-DR 表達率及外周血 T 淋巴細胞亞群比例的連續監測在預測嚴重創傷患者繼發感染、判斷預后和預防治療感染中具重要價值。

          Release date:2017-07-24 01:54 Export PDF Favorites Scan
        • 可溶性髓樣細胞觸發性受體1 對感染性疾病的診斷價值

          感染性疾病的發病率高, 給社會經濟帶來沉重負擔, 感染性疾病的早期診斷和治療對提高臨床療效和降低死亡率有重要意義。髓樣細胞觸發性受體1 ( triggering receptor-1expressed on myeloid cells, TREM-1) 在炎癥反應的發生發展過程中起著重要的作用。Bouchon 等[ 1] 在2000 年首先發現TREM-1 選擇性表達于中性粒細胞、CD14 + 單核細胞膜表面。后來的研究發現TREM-1 也表達于上皮細胞、多核巨細胞、腹膜巨噬細胞、淋巴結巨噬細胞、肺泡巨噬細胞, 纖維肉瘤細胞膜表面[ 2-5] 。人的TREM-1 由胞外區、跨膜區、胞漿區共同組成, 跨膜區含有1 個帶正電荷的賴氨酸殘基, 它可與接頭蛋白DAP12 跨膜區內的帶負電荷的天冬氨酸相偶聯, 并通過胞漿區中的免疫受體酪氨酸活化基序( ITAM) 來激活下游信號傳導, 促進促炎因子的分泌[ 6] 。TREM-1 激發、放大炎癥反應的同時促進抗炎因子的下調[ 1, 2, 7] 。‥‥‥

          Release date:2016-08-30 11:53 Export PDF Favorites Scan
        • The Signal Transduction Pathway of TREM-1 on Endotoxin-Induced Acute Lung Injury in Mice

          Objective To investigate the transduction pathway of TREM-1 during endotoxininduced acute lung injury ( ALI) in mice through the specific activating or blocking TREM-1.Methods 40 mice were randomly divided into a saline control group, an ALI group, an antibody group, and a LP17 group ( 3.5 mg/kg) . All mice except the control group were intraperitoneally injected with lipopolysaccharide ( LPS) to establish mouse model of ALI. Two hours after LPS injection, anti-TREM-1mAb ( 250 μg/kg) was intraperitoneally injected in the antibody group to activation TREM-1, and synthetic peptide LP17 was injected via tail vein in the LP17 group to blocking TREM-1. After 6,12,24, 48 hours, 3 mice in each group were sacrificed for sampling. The expression of NF-κB in lung tissue was determined by immunohistochemistry. The levels of TNF-α, IL-10, TREM-1, and soluble TREM-1 ( sTREM-1) in lung tissue and serumwere measured by ELISA. Pathology changes of lung were observed under light microscope, and Smith’s score of pathology was compared. Results Administration of anti-TREM-1mAb after ALI modeling significantly increased the NF-κB expression in lung tissue at 48h, resulting in a large number of pro-inflammatory cytokines releasing in the lung tissue and serumand lung pathology Smith score increasing. Administration of LP17 after modeling significantly down-regulated the expressions of NF-κB and pro-inflammatory cytokines, while led to a slight increase of anti-inflammatory cytokines and a decline of lung pathology Smith’s score.Conclusion TREM-1 may involve in inflammatory response by promoting the generation of inflammatory factors via NF-κB pathway, thus lead to lung pathological changes in ALI.

          Release date:2016-09-13 03:46 Export PDF Favorites Scan
        • 危重患者持續靜靜脈血液濾過時血糖監測的影響因素研究

          目的 觀察危重患者持續靜靜脈血液濾過( CVVH) 過程中血糖監測的影響因素。方法 選擇CVVH治療的危重患者30 例, 根據其入選時的循環狀態將患者分為休克組和非休克組, 同時監測兩組患者動脈血糖、末梢血糖及CVVH 導管動脈端血糖, 比較同一時點各部位血糖監測值。結果 所有患者動脈血糖值與末梢血糖值比較有顯著差異( P lt; 0. 05) , 動脈血糖值與CVVH 導管動脈端血糖值差異無統計學意義( P gt; 0. 05) , 且二者存在明顯相關性( r = 0. 989, P lt; 0. 001) , 末梢血糖值與CVVH導管動脈端血糖值差異有統計學意義( P lt;0. 05) ; 休克組末梢血糖值較動脈血糖值低, 差異有統計學意義( P lt; 0. 05) , 非休克組末梢血糖值與動脈血糖值差異無統計學意義( P gt;0. 05) 。結論 危重患者末梢血糖監測值偏低, 該差異在休克患者中更加明顯; CVVH時可通過導管動脈端采血監測血糖。

          Release date:2016-08-30 11:52 Export PDF Favorites Scan
        • Application of metagenomic next-generation sequencing in diagnosis of Psittacosis: a report of eight cases

          ObjectiveTo improve the understanding of psittacosis, the clinical data of 8 cases are reviewed. The application of pathogen metagenomics next-generation sequencing (mNGS) in the diagnosis of nocardiosis is also investigated.MethodsThe clinical data of eight patients with psittacosis diagnosed by mNGS in Nanjing Drum Tower Hospital from January 2018 to May 2020 were reviewed. The clinical characteristics, laboratory examination characteristics and imaging changes were analyzed, and the treatment outcome was followed-up.ResultsAmong the eight cases, there were six males and two females, aged 43~83 years old, with an average age of 64±12 years old. Six of them had a clear history of poultry exposure. The major clinical manifestations were fever, cough, dyspnea, etc. Chest high-resolution computed tomography (HRCT) may have solid shadow, ground glass like shadow. Chlamydia psittaci was detected by mNGS in eight patients’ bronchoalveolar lavage fluid. Minocycline or moxifloxacin were administrated, six patients were discharged after their condition improved, and two patients died.ConclusionsThe incidence of psittacosis is low, and its clinical manifestations lack specificity. In the course of the disease, there may be different degrees of fever, cough, sputum, dyspnea and other symptoms. The lungs can be heard with wet rales, chest HRCT can be seen ground glass shadow, consolidation shadow, accompanied by air bronchogram. Chlamydia psittaci can be detected in alveolar lavage fluid by mNGS. The patients need to be treated for a long time, lasting at least 10 to 14 days. Tetracycline drugs should be the first choice, and can be combined with other antibiotics with activity against gram-positive and gram-negative bacteria in critical patients.

          Release date:2021-08-30 02:14 Export PDF Favorites Scan
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