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Cough variant asthma （CVA） is a chronic respiratory disease with cough as its main symptom. The occurrence of CVA is closely related to non-specific airway inflammation， and its pathogenesis involves environmental， genetic， immune， and other factors. In recent years， the advantages of traditional Chinese medicine （TCM） in the treatment of CVA have attracted the attention of experts and scholars in China and abroad， especially its prominent role in regulating immune balance， relieving cough symptoms in CVA patients， and reducing recurrence. T Helper cells 1 （Th1）， T helper cells 2 （Th2）， T helper cells 17 （Th17）， and regulatory T cells （Treg） are derived from CD4+ T cells. Immune imbalance of Th1/Th2 and Th17/Treg is a new hotspot in the pathogenesis of CVA and a potential key target in the treatment of CVA by TCM. Th cell subsets are in dynamic balance under physiological conditions， maintaining respiratory immune homeostasis in which pro-inflammatory cytokines and anti-inflammatory cytokines are balanced. Immature helper T cells （Th0） can be differentiated into Th1， Th2， Th17， Treg， and other cell subsets due to cytokine types in the microenvironment in the stage of CVA maturation. The proliferation of Th2 cells leads to eosinophilic airway inflammation. Excessive differentiation of Th17 cells induces neutrophil airway inflammation. Th1/Th2 and Th17/Treg cells are mutually restricted in number and function， and the immune imbalance of Th1/Th2 and Th17/Treg is easy to aggravate the generation of inflammatory response. Restoring immune balance is particularly important for the airway anti-inflammatory therapy of CVA. In this paper， the imbalance of Th1/Th2 and Th17/Treg and the pathogenesis of CVA were systematically expounded. Meanwhile， the latest research on the regulation of immune imbalance by TCM compound， single TCM， and its effective ingredients in the treatment of CVA was reviewed. It provides ideas and references for revealing the scientific connotation of TCM regulating immune balance therapy of CVA， as well as the development of clinical treatment and basic research of CVA.
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Objective:To explore the possible correlation between serum detection of IL-7, IL-21, HBV-specific cytotoxic T lymphocytes (CTLs), HBV DNA, and the expression of CD127 on the T lymphocytes, and discuss the effect of IL-7 to cellular immune response in patients with chronic hepatitis B (CHB).Methods:Five hundred and sixty serum samples were collected from patients with CHB in Beijing Friendship Hospital from September 2017 to March 2020. The serum IL-7 and IL-21 were detected by enzyme-linked immunosorbent assay (ELISA), and HBV-specific CTLs and the expression of CD127 on the T lymphocytes were determined by flow cytometry. While HBV DNA were tested using quantitative real-time PCR (qRT-PCR). Subjects were divided into groups A, B, and C, according to the IL-7 levels (low: IL-7<20 pg/ml, medium: 20 pg/ml≤IL-7<30 pg/ml, and high: IL-7≥30 pg/ml).Results:The average concentration of serum IL-7 in patients with CHB was significantly lower than that of healthy controls ( P<0.01), and the difference among three groups was statistically significant ( P<0.01). Meanwhile, levels of IL-21, percentages of HBV-specific CTL, and the expression of CD127 on the CD8 + T lymphocytes showed an upward trend among groups, and there were significant differences among three groups ( P<0.01) with a positive correlation between each two variables ( P<0.01). However, HBV DNA showed a downward trend in group A, B and C, and the difference of the three groups were statistically significant ( P<0.01), which were negatively correlated with other variables ( P<0.01). Multiple linear regression analysis showed that HBV-specific CTL was an independent influencing factor for HBV DNA ( P<0.01), and IL-7, the expression of CD127 on the CD8 + T lymphocytes and IL-21 had an independent effect on HBV-specific CTL ( P<0.05). Conclusions:IL-7 could regulate HBV-specific immune response, and might be used as an effective cellular immune indicator to evaluate the cellular immune status of patients with chronic hepatitis B.
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Objective:To investigate characteristics and changes of skin microbiota in atopic dermatitis-like mouse models induced by different concentrations of 2,4-dinitrochlorobenzene (DNCB) .Methods:Totally, 30 male specific-pathogen-free BALB/c mice were randomly divided into 3 groups by using a random number table: negative control group topically treated with 200 μl of mixture of acetone and olive oil at a volume ratio of 3∶1 on the back twice a week for 6 consecutive weeks; high-and low-concentration DNCB groups both topically treated with 200 μl of 1% DNCB on the first and third day at the first week, followed by topical application of 200 μl of 0.5% and 0.1% DNCB, respectively, twice a week for 5 weeks from the second week. Twenty-four hours after the last treatment, the severity of skin lesions was evaluated, and the transepidermal water loss and stratum corneum hydration were measured. After the experiment, the mice were sacrificed, and skin tissues were resected from the back of the mice for histopathological examination. Full-thickness skin tissue samples were obtained from the back of 3 mice in each group. Illumina Miseq PE300 high-throughput sequencing was performed to sequence the V3-V4 variable region of 16S rRNA gene of skin microbiota on the back of the mice, and the composition and structure of the skin microbiota and changes in the relative abundance of different genera were analyzed. One-way analysis of variance was used to analyze differences in indices among the 3 groups, and the Games-Howell method was used for multiple comparisons.Results:The severity scores of skin lesions were significantly higher in the high-and low-concentration DNCB groups (9.83 ± 2.45 points, 2.71 ± 0.56 points, respectively) than in the negative control group (0.51 ± 0.12 points, t=-7.19,-2.85, respectively, both P < 0.05) . Compared with the negative control group, the high-and low-concentration DNCB groups showed significantly increased transepidermal water loss ( t=-7.72,-2.68, respectively, both P < 0.05) , but significantly decreased stratum corneum hydration ( t=6.77, 5.99, respectively, both P < 0.05) ; the transepidermal water loss was significantly higher in the high-concentration DNCB group than in the low-concentration DNCB group ( t=2.76, P < 0.05) , while no significant difference in the stratum corneum hydration was observed between the high-and low-concentration DNCB groups ( P > 0.05) . There was a significant difference in the relative abundance of Corynebacterium among the 3 groups ( F=249.85, P < 0.001) , which was highest in the high-concentration DNCB group. No significant differences in the observed species and Chao1 index of the skin samples were observed among the 3 groups (both P > 0.05) , and the Shannon index was significantly lower in the high-concentration DNCB group than in the low-concentration DNCB group and negative control group ( t=6.96,-6.37, respectively, both P < 0.05) . Conclusion:DNCB could induce atopic dermatitis-like dermatitis in mice, and the severity of skin lesions and degree of barrier function impairment were related to the concentration of DNCB; the species diversity of skin microbiota markedly decreased in the high-concentration DNCB group, indicating that high-concentration DNCB modeling has more advantages in studying microbiological changes associated with atopic dermatitis.
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OBJECTIVE：To investigate the problem s and improvement measures in the application of automatic drug delivery system in outpatient pharmacy of our hospital ，and to provide reference for the construction of automatic drug delivery system in outpatient pharmacy. METHODS ：Combined with the pharmacy module function of HIS system in our hospital and the actual needs of the pharmacist in drug delivery process ，the automatic delivery system of our hospital （including automatic delivery machine ， prescription dispensing and delivery mode ，intelligent medicine basket ）was established for operation and optimization. RESULTS ： After six months of running period ，the hardware of the automatic dispensing machine had been stabilized ，and the software functions had been optimized ，including the mode of pre-dispensing ，drug storage ，system prompt ，quantity of dispensing ， management of the drug period of validity ，and the mode of dispensing at the peak of drug taking. At the same time ，the emergency plan was formulated for automatic dispensing system. The application of the automatic dispensing machine shared 80％ of pharmacists ’prescription dispensing on an average day ，saved labor cost （reduce the labor cost of about 2 pharmacists）， shortened patients ’waiting time for drug-taking （down from 7.45 min to 6.61 min on average ，P＜0.01），reduced prescription dispensing error rate （down from 0.040 9％ to 0.019 5％ on average ，P＜0.01）. CONCLUSIONS ：The establishment of automatic drug delivery system in our hospital has reduced the workload of pharmacists ，improved the work efficiency ，decreased prescription dispensing error and promoted the quality of pharmaceutical care.
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Objective:To investigate the correlation of serum hepatitis B virus large protein (HBV-LP), HBV-DNA, and Pre S1 antigen (Pre S1-Ag) with HBV replication.Methods:Serum samples were collected from 650 patients with chronic hepatitis B (CHB) who were treated in Beijing Friendship Hospital from March 2017 to March 2019. Serum HBV-LP and Pre S1-Ag were detected by enzyme-linked immunosorbent assay (ELISA). HBV markers (HBV-M) were measured using chemiluminescent microparticle immunoassay (CMIA). Quantitative real-time PCR (qRT-PCR) was used to detect HBV-DNA. The positive detection rates of HBV-DNA, HBV-LP and Pre S1-Ag were calculated and compared, and the correlation of HBV-LP (S/CO value) and hepatitis B surface antigen (HBsAg, log 10 IU/ml) with HBV-DNA(log 10 IU/ml)was analyzed. Results:In the 650 CHB patients, the positive rates of HBV-DNA, HBV-LP and Pre S1-Ag were 65.4% (425/650), 79.2% (515/650) and 43.1% (280/650), respectively ( P<0.01). The positive rates of HBV-DNA and HBV-LP in 243 HBeAg-positive patients were 93.0% (226/243) and 94.6% (230/243), and no significant difference was found between them ( P=0.45). However, there was significant difference between the positive rates of HBV-DNA and HBV-LP in 407 patients negative for HBeAg [48.9% (199/407) vs 70.0% (285/407), P<0.01]. The positive rates of HBV-DNA and HBV-LP in HBsAg-, HBeAg- and HBcAb-positive groups were 92.8% (206/222) and 94.1% (209/222), which showed no significant difference ( P=0.56). In HBsAg-, HBeAb- and HBcAb-positive groups, the positive rates of HBV-DNA and HBV-LP were 45.4% (124/273) and 69.9% (191/273) ( P<0.01). The detection rate of HBeAg was lower than that of HBV-LP significantly in both HBV-DNA-positive and HBV-DNA-negative groups ( P<0.01). With the increasing of HBV-DNA load, the S/CO value and the positive rate of HBV-LP increased significantly ( P<0.05). Conclusions:HBV-LP had a good correlation with HBV-DNA load as compared with Pre S1-Ag, HBeAg and HBsAg. HBV-LP in combination with HBV-M might be used as predictive markers that could efficiently reflect the status of HBV replication.
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Objective To evaluate the value of four methods in diagnosis of pulmonary tuberculosis,including T-SPOT,fluo-rescent PCR,anti-TB antibody test,and acid-fast staining.Methods Retrospective analysis of 530 cases between January 2012 and December 2014 who had taken four methods,and calculated the sensitivity specificity,positive predictive value,neg-ative predictive value,Kappa value,Youden index,positive likelihood ratio,negative likelihood ratio,Pairedχ2 test.Consider clinical diagnosis as the gold standard.Results The sensitivity,negative predictive value,Youden index of T-SPOT were 95.90%,97.29%,0.82,respectively,and all of these were the highest.The negative likelihood ratio of T-SPOT was 0.05, which was the lowest.Misdiagnosis rate of PCR was 87.18%,which was the highest.Positive likelihood of anti-TB antibody test was the lowest,6.48,while other indicators were no advantage.The specificity,positive predictive value and positive likelihood ratio of acid-fast staining were 99.70%,98.90%,153.83,respectively,and the three of these were highest.Pair-wise comparison between the four methods were significantly different.Conclusion The T-SPOT and acid-fast staining can be used as important methods,and the anti-TB antibody can provide result quickly,and PCR method is more suitable for ex-amination of sterile body fluids.
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Objective In order to prevent the infection of Acinetobacter baumannii and use antibiotics rationally,the clinical infection and drug resistant data of multi-drug resistance Acinetobacter baumannii (MRAB)detected in intensive care unit (ICU)of Beijing Friendship Hospital from 2011 to 2013were analyzed.Methods This study is a retrospective study.One hundred and eighty five strains of MRAB were collected from the patients in ICU from January 2011 to December 2013.Identificationand antibiotic susceptibility of strains were determined with Vitek-2 Compact automatic bacteria identification system.The annual infection rate of MRAB was counted.PCR was used to detect the resistance genes.The clinical features of the patients with MRAB were analyzed.The average age,acute physiology and chronic health evaluation (APACHE) Ⅱ score,duration in ICU and mortality ratio of the MRAB patients were compared with the patients without MRAB.Rank-sum test was used to analyze the average age,APACHE Ⅱ score and duration in ICU.Chi-squared test was used to analyze the mortality ratio and annual infection rate.Results The average age [(67 ± 17)vs (59-± 19) years old,Z =-5.365,P =0],APACHE Ⅱ score [(25.68±7.93) vs (17.62±8.39),Z=-14.821,P=0],duration in ICU [(27 ±29) vs (5 ±8) d,Z =-4.342,P =0] and mortality ratio [10.82％ (53/185) vs 28.65％ (147/1 359),x2 =45.92,P =0] of the patients infected by MRAB were significantly higher than those without the infection.The MRAB was found mostly in sputum and bronchial precipitates (83.78％,155/185).Though detection rate reduced yearly and there was a significant reduction in 2013 compared with 2011 [11.07％ (69/469) vs 8.37％ (52/621),x2 =8.755,P =0.003],the drug resistant rate was in high level and did not show any change in the 3 years.OXA-23 and OXA-51 were detected in all MRAB.Conclusions The main drug resistant mechanism of MRAB in ICU is related to OXA-23.More active methods of coutrol and prevention of MRAB should be used in elderly aud severely pneumonic patients.Intensive disinfection and isolation measures can decrease MRAB detection rate.Combined antibiotics should be used in patients with MRAB infection.
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Objective To compare the load of EB virus in peripheral white blood cell,plasma and serum in the patients with he-matologic diseases,and to discuss the feasibility of detecting EB virus load by using plasma or serum instead of peripheral white blood cell.Methods Venous blood of 125 patients with hematologic diseases were collected,and peripheral white blood cell,plasma and serum were isolated.The real-time quantitative PCR was used to detect the virus load in three kinds samples with the EB virus load in peripheral blood cell as the gold standard.Results Compared to peripheral white blood,the EB virus load in plasma and ser-um showed no statistical difference(P >0.05).Conclusion Using plasma or serum instead of peripheral white blood cell for con-ducting the quantitative detection of the load of EB virus will be a reliable method.
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Objective To evaluate the activity of antibiotics against pan-drug-resistant (PDR) Acinetobacter baumannii by combination antimicrobial susceptibility test in viro with epsilometric methods (Etest method) and microdilution checkerboard (CB method),and to detect a good correlation between timekill curve with the above mentioned two assays.Methods Thirty-one clinical isolates of PDR Acinetobacter baumannii were selected for mono and combination antimicrobial susceptibility test in vitro by E-test and CB method,then a comparison was conducted between the test results and the time-kill curve.Mono drugs involved tigecycline,colistin,imipenem and amikacin,and combinations involved two of drugs above,and three drugs involved imipenem/tigecycline,plus amikacin combination.Results Synergistic effect was detected in imipenem plus colistin and tigecycline plus imipenem combination.A high comparability was revealed between the E-test method with antimicrobial drugs added into the culture medium and the time-kill curves.Synergy in the combination of imipenem/tigecycline,plus amikacin was detected by the CB method and time-kill curves.Conclusion The results showed that the effect of specific combination of antibiotics against PDR Acinetobacter baumannii could be predicted by testing their synergistic effect with combination antimicrobial susceptibility test.
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Objective To evaluate the activities of 18 pairs of antimicrobials combinations against non - duplicate clinical isolates of multidrug resistant Acinetobacter baumannii (MDRAB) in vitro.Methods Collect isolates of Acinetobacter baumannii from different patients from October 2009 to May 2010,which were isolated in Clinical Laboratory Center of Beijing Friendship Hospital,Capital Medical University.Use broth microdilution method to detect MIC of mono-antimicrobial,and checkerboard broth microdilution method to detect combinatied MIC,and calculate fractional inhibitory concentration (FIC) index to determine drug combinations effects.When the performance of the same drug combinations conflicted,appropriate strains were selected for screening of drug-resistant mechanisms by polymerase chain reaction( PCR),including efflux pump genes.Results In tests in vitro,rifampicin and polymyxin B,imipenem and gentamicin,cefepime and levofloxacin showed synergy at high proportion,68.1％,45.5％,40.9％,respectively.Minocycline and rifampicin,ampicillin/sulbactam and tobramycin.Ceftazidime and ciprofloxacin showed additive effect at high proportion,81.8％,68.2％,68.2％,respectively.There were several combinations which appeared the opposite effects to tested strains.Strains No.19 corresponding reaction was synergy and No.21,No.26 corresponding reactions were antagonism.The three strains above were selected for screening resistant mechanisms.The difference is that genotypes of adeS were negative in No.19 and positive in No.21 and No.26.Conclusion Rifampicin and polymyxin B combination showed synergy against the MDRAB in vitro,which can be considered as the treatment choice for critical infections caused by MDRAB.Imipenem and gentamicin,cefepime and levofloxacin also showed synergy in vitro,but in some isolates showed antagonism.This phenomenon may be due to the gene adeS activated by certain antibiotics,and the activated adeS drived efflux pump express or overexpress,which made the drugs in bacterial cells pumped out,causing antagonistic effect.The individual differences in strains should be considered when clinic strain apply these two combinations above.
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Objective To investigate the expression of Fascin-1 protein in colorectal adenocarcinoma,and the relationship with its clinicopathologic features.Methods The expressions of Fascin-1 protein in colorectal adenocarcinoma tissues of 60 cases,colorectal adenoma tissues of 30 cases and normal mucosa tissues (4 cm distance to neoplasm) of 30 cases were detected by Microwave-EliVisionTM immunohistochemistry method,and the relationship between the expression of Fascin-1 protein in colorectal adenocarcinoma tissues and its clinicopathologic characteristics was analyzed.Results The expression of Fascin-1 protein was located in cytoplasm.The positive expression rates of Facsin-1 protein were 3.3% (1/30),30.0% (9/30) and 53.3% (32/60) in normal mucosa tissues,colorectal adenoma tissues and colorectal adenocarcinoma tissues,respectively.The expression of Fascin-1 was gradually increased in these three tissues,and there was statistical difference among the three tissues (P0.05).Conclusion The high expression of Fascin-1 protein is correlated to high invasion ability and lymph node metastasis,which can play as a sensitive index in predicting the invasion and metastasis of colorectal adenocarcinoma.