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Objective:To investigate the roles of T helper 17(Th17)cells and regulatory T(Treg)cells, interleukin(IL)-17 levels, and IL-6 levels in the pathogenesis of Henoch-Schonlein purpura(HSP)complicated with Helicobacter pylori(HP)infection in children. Methods:Children diagnosed with acute HSP and/or HP infection by the Department of Pediatrics, Xiamen Maternal and Child Health Care Hospital from January 2017 to December 2018 were enrolled in the study.There were 15 children with HSP complicated with HP infection(HSP-HP group), 26 children with HSP(HSP group), and 21 children with HP infection(HP group). Twenty healthy children of the same age over the same period were included in the healthy control group.The proportions of Th17 cells and Treg cells were tes-ted by flow cytometry(FCM), and concentrations of IL-17 and IL-6 in plasma were measured by enzyme linked immunosorbent assay(ELISA).Results:(1)Compared with that of the healthy control group [(1.42±0.63)%], the proportion of Th17 cells in the HSP-HP group, HSP group and HP group [(2.79±0.78)%, (2.04±0.77)%, (2.08±0.86)%] was significantly increased( F=5.271, P<0.05). The levels of IL-17 and IL-6 in the HSP-HP group [(552.16±121.13) ng/L and (12.36±6.55) ng/L], HSP group [(506.39±113.62) ng/L and(11.82±5.01) ng/L] and HP group [(483.14±121.77) ng/L and (10.19±3.87) ng/L] were significantly higher than those in the healthy control group [(302.96±82.83) ng/L and (7.81±2.04) ng/L]( F=13.113, 6.692, all P<0.01). The proportion of Treg cells in the HSP-HP group [(1.35±0.49)%], HSP group [(1.13±0.86)%] and HP group [(1.09±0.65)%] was significantly lower than that in the healthy control group [(2.31±0.83)%]( F=6.983, P<0.05). (2)The proportion of Th17 cells and the level of IL-17 in the HSP-HP group were significantly higher than those in the HSP and HP groups(all P<0.05). There was no significant difference in the proportion of Th17 cells and the level of IL-17 between the HSP group and HP group(all P>0.05). There was no significant difference in the proportion of Treg cells and the level of IL-6 among the HSP-HP group, HSP group, and HP group(all P>0.05). Conclusions:The imbalance of Th17/Treg cells in peripheral blood may contribute to the development of HSP-HP, HSP and HP infection in children.High expression of Th17 cells and their related IL-17 is more prominent in children with HSP-HP.
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Objective:To explore the clinical and genetic features of Xp21 contiguous gene deletion syndrome, in order to improve clinicians′ understanding of the disease.Methods:The clinical manifestations, diagnosis and treatment process as well as genetic characteristics of 3 brothers from 1 family with Xp21 contiguous gene deletion syndrome were studied.Literatures were retrieved with key words including " Xp21 contiguous gene deletion syndrome" and " complex glycerol kinase deficiency" in CNKI, VIP database, Wanfang database, Biomedicine Literature database (PubMed) and Web of Science from the database establishment to December 2019, and the relevant features were reviewed.Results:The surviving proband was a boy, the fourth child and the fourth birth.He was suspected as congenital adrenal hyperplasia(salt-losing type) because of significant hyperpigmentation and obviously increased plasma adrenocorticotropic hormone (ACTH)in the neonatal period.Serum triglyceride and creatine phosphokinase were elevated, and urine analysis revealed massive glyceroluriam in this patient.But his serum 17-hydroxyprogesterone was normal.5.16 Mbp deletion in Xp21.3p21.1 was detected by single nucleotide polymorphisms, and the diagnosis of Xp21 contiguous gene deletion syndrome was confirmed.After the supplements of hydrocortisone and fludrocortisone, pigmentation was improved, and the serum ACTH became normal.Now, the patient was 3 years and 8 months old, having pseudomuscle hypertrophy, intellectual and language developmental delay, but no the electrolyte disorder.His parents and 18-years-old sister were healthy.While his two elder brothers who were suspected as cerebral palsy and muscular atrophy due to the symptoms of dark skin color and psychomotor development delay after birth died at the age of 1 year and 1.5 years, respectively.Deletions in Xp21.3p21.1 region were found in his mother and elder sister.A total of 22 cases with full and complete clinical data and definite genetic diagnosis were collected from domestic and foreign literature, and 13 cases of them had the onset during the neonatal period.The main symptoms were congenital adrenal insufficiency, muscular dystrophy, hypertriglyceridemia, developmental retardation in most cases, and special facial features in a few cases.Besides, these patients had large fragment deletion in Xp21 region and the major deleted genes included NR0B1, GK and DMD genes, etc. Conclusions:Xp21 contiguous gene deletion syndrome has a complex clinical phenotype and is easy to be misdiagnosed, it can lead to adrenal insufficiency and poor prognosis in the neonatal period.It is necessary to make differential diagnosis by serum biochemical and genetic analysis.
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Objective To examine the effect of labouring in water on analgesia of vaginal delivery.Methods From June 2009 to February 2011,38 women who had volunteered to deliver in water in the obstetrical department were set as the observation group,another 70 women who chose vaginal delivery were named as the control group in the corresponding period.The items of labor pain,satisfaction with the birth experience,length of labor and neonatal outcomes were compared.Results The pain level of the observation group after labouring in water decreased compared with that before immersion in water.The delivery course was not influenced with a high rate of vaginal delivery.Conclusions Labouring in water can alleviate delivery pain,increase rate of vaginal delivery with no influence on delivery course and outcome of mothers and infants.It is a safe and effective analgesia method which should be widely applied.