ABSTRACT
Objective To investigate the Th1/Th2 cytokines and chemokine CXCL 13 levels in peripheral blood and cerebrospinal fluid(CSF)of patients with neurosyphilis and their clinical significance. Methods Forty seven HIV negative patients with neurosyphilis, 36 syphilis patients without neurological involvement(syphilis group)and 23 patients without infectious intracranial diseases(control group) admitted in Hangzhou Third Hospital during July 2011 to December 2014 were enrolled in the study.CSF pressure, protein contents, white blood cell counts and IgG index were detected in patients with neurosyphilis.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Th1 cytokines (IL-2,IL-12 and IFN-γ),Th2 cytokines(IL-6,IL-10)and CXCL13 in serum and CSF in three groups.Th1/Th2 cytokines,CXCL13 levels and CSF routine were also examined in neurosyphilis patients after treatment for 3 and 12 months.ANOVA, Kruskal-Wallis test and Spearman correlation were used for data analysis.Results The levels of IL-6 and IL-10 in serum and CSF from neurosyphilis patients were higher than those in syphilis group and control group(χ2IL-6=15.43, 15.39 and 14.44, 20.01,χ2 IL-10 =16.46, 23.86 and 15.11,24.44;P<0.05 or <0.01), while the levels of IL-2, IL-12 and IFN-γin the serum and CSF were lower than those in syphilis group and control group(χ2IL-2=14.55,17.14 and 16.14,17.97;χ2IL-12=13.65,20.50 and 18.48,21.04;χ2IFN-γ=16.95,17.53 and 16.00,15.21;P<0.05 or <0.01). CXCL13 contents in CSF of neurosyphilis patients were significantly higher than those in other two groups (χ2=52.51 and 53.76, P <0.01), and were positively correlated with leucocyte counts, protein concentrations,IgG index,IL-6 and IL-10(r=0.325,0.544,0.750,0.333 and 0.382,P<0.05 or <0.01),but were negatively correlated with IL-12 levels in neurosyphilis patients(r=-0.303,P<0.05). In neurosyphilis patients,CXCL13 and IL-6 levels were reduced after treatment for 12 months(χ2=102.00 and 22.17,P<0.05 and <0.01), while the levels of IL-2 and IL-12 were increased(χ2=18.28 and 24.10,P<0.05 and <0.01).Conclusion Chemokine CXCL13 and Th1/Th2 cytokines are involved in the immune response in neurosyphilis patients, which may be used for the diagnosis and evaluation of therapeutic efficacy in patients with neurosyphilis.
ABSTRACT
Objective To discuss the distribution laws of TCM syndromes of early threatened abortion; To analyze the related factors of pregnancy outcome of early threatened abortion. Methods The study included 1010 hospital patients who were diagnosed as early threatened abortion. Excel2010 was used to establish database in order to collect general information such as the age, menstrual history, times of abortion and adverse pregnancy, incidence of solar term and pregnancy week, the type of TCM syndromes and the pregnancy outcome (at least 3 months after being out of hospital) of patients. The distribution laws of TCM syndromes, and related factors of pregnancy outcome were analyzed. Results Among the 1010 cases, 762 cases were with kidney deficiency syndrome (75.4%); followed by blood heat syndrome, a total of 178 cases, accounting for 17.6%; qi and blood deficiency syndrome, a total of 40 cases, accounting for 4%; blood stasis syndrome, a total of 15 cases, accounting for 1.5%; liver stagnation syndrome, a total of 15 cases, accounting for 1.5%. The distribution of TCM syndromes was statistical significance in the different age groups and the incidence of pregnancy week (P0.05). Among the 1010 cases, follow-up to 698 cases, 567 cases were successful pregnancies, accounting for 81.2% of the follow-up of patients; 131 cases were failed pregnancies, accounting for 18.8% of the follow-up of patients. In the study, it found that there was statistical significance between different age groups and pregnancy outcomes (P=0.026). The pregnancy outcomes were related to the age groups (P=0.012, OR=1.063), and it was not related to TCM syndromes, times of abortion, times of adverse pregnancy, menstruation, pregnancy week. Conclusion Kidney deficiency syndrome is the main syndrome of early threatened abortion. The distribution of TCM syndromes is related to the age group and the incidence of pregnancy week of patients. Age of patients is the related factor affecting the pregnancy outcome.