ABSTRACT
Objective To assess the efficacy of combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen for pulmonary tuberculosis complicating cervical lymph node tuberculosis in the aged. Methods A total of 103 aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis were enrolled and randomly allocated to either a standardized anti-tuberculosis therapeutic regimen group (control group with 51 patients) or a standardized anti-tuberculosis therapeutic regimen plus Jiehe pellet group (treatment group with 52 patients). The patients in the control group and the treatment group received the treatment with 2HRZE/4HR and 2HRZE/4HR plus Jiehe pellet for 6 months, respectively. The abscessed lymph nodes were treated by either total excision or incision and drainage after 4 weeks of medicine treatment in both groups. Sputum smear was examined for acid-fast bacilli. The CD8 cells expressing natural killer T cells receptors NKG2A, NKG2D in peripheral blood were detected by flow cytometry. The treatment outcome was measured at the end of treatment. Results The rates of lesion resolution (78.85%vs. 58.82%;χ2=4.439, P<0.05) and cavity closure (62.86% vs. 35.48%;χ2=3.893, P<0.05) in the treatment group were significantly higher than those in the control group. In the end of 2, 4 and 6 months of treatment, cumulative rates of sputum conversion from positive to negative in the treatment group were significantly higher than those in the control group (χ2 were 5.343, 5.067 and 4.118,all P<0.05). The CD8 cells expressing NKG2A after treatment in the treatment group were significantly lower than those before treatment in the treatment group (t=9.510, P<0.01) and after treatment in the control group (t=9.832, P<0.01);the CD8 cells expressing NKG2D after treatment in the treatment group were significantly higher than those before treatment in the treatment group (t=10.622, P<0.01) and after treatment in the control group (t=10.433, P<0.01). The serum levels of IL-6 and TNF-αafter treatment were significantly lower than those before treatment in both groups (t were 17.344 and 21.142 in the treatment group, 10.984 and 12.203 in the control group;all P<0.01 );the serum levels of IL-6 and TNF-α after treatment in the treatment group were significantly lower than those after treatment in the control group (t were 7.832 and 5.478,all P<0.01). The serum IL-10 levels after treatment were significantly higher than those before treatment in both groups (t were 12.454 in the treatment group, 7.934 in the control group; all P<0.01 ); and the serum IL-10 level after treatment in the treatment group was significantly higher than that after treatment in the control group (t=4.720, P<0.01). The effective rate for cervical lymph node tuberculosis in the treatment was significantly higher than that in the control group (88.5%vs. 64.7%;χ2=6.855, P<0.01). Conclusion Combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen may improve immune function, increase the rate of sputum conversion from positive to negative, and facilitate lesion resolution in aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis.
ABSTRACT
Objective To analyze the relationship between serum 25 hydroxy vitamin D (25OHD) levels and semen pa?rameters. Methods The serum levels of 25OHD were examined in 68 healthy men, who were divided into three groups. Twenty-two cases were included in 25OHD normal group (30μg/L≤25OHD<40μg/L), 20 cases were in 25OHD relatively insufficient group (20μg/L≤25OHD<30μg/L), and 26 cases were in 25OHD deficiency group (25OHD<20μg/L). The se?rum reproductive hormones including follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2), prolactin (PRL) and testosterone (T) were detected by chemiluminescence immune analysis. Semen samples were collected by mastur?bation after a period of abstinence for 3 and 7 days. The total sperm count, sperm concentration, percentage of progressive motile sperm and percentage of normal morphology sperm were measured by sperm quality analyzer. Results There were no significant differences in FSH, LH, E2, PRL and T levels between three groups, and which were all in normal ranges. The total sperm count, sperm concentration, percentage of progressive motile sperm and percentage of normal morphology sperm were significantly lower in 25OHD relatively insufficient group and 25OHD deficiency group than those in 25OHD normal group. The total sperm count and the percentage of progressive motile sperm were significantly lower in 25OHD deficiency group than those in 25OHD relatively insufficient group (P<0.05). There were no statistical differences in sperm concentra?tion and percentage of normal morphology sperm between 25OHD deficiency group and 25OHD relatively insufficient group. Conclusion The decrease of semen quality may be related to serum 25OHD at the relatively insufficient and deficiency lev?els. The effect of 25OHD on semen parameters may not be mediated by reproductive hormones.