ABSTRACT
Non-IgE-mediated food allergy most often presents with gastrointestinal symptoms such as diarrhoea, mucus stools, bloody stools, reflux and vomiting a few hours to days after exposure to the allergenic food.The pathogenesis may be related to the activation of intestinal T lymphocytes to secrete pro-inflammatory cytokines such as TNF-α and IL-4 by food allergens, leading to migration of neutrophils and eosinophils into the intestinal lumen, causing an intestinal inflammatory response and increased intestinal permeability.There is no rapid and specific diagnostic method.The diagnosis is mainly based on clinical manifestations combined with food avoidance and oral food challenge.In recent years, fecal biomarkers have been widely used as specific indicators for determining intestinal inflammation as an aid to diagnosis and condition assessment of intestinal infections and inflammatory bowel diseases, but their application in gastrointestinal allergic diseases is rarely reported.In this paper, we will focus on the significance of fecal calprotectin, fecal eosinophil-derived neurotoxin in non-IgE-mediated food allergy.
ABSTRACT
Objective To study and explore the clinical effect of saline lavage on patients with acute oral poisoning. Methods From January 2014 to January 2017, 100 cases of patients with acute oral drug poisoning who admitted in the emergency department of our hospital were selected as the research object, the patients were randomly divided into the control group and the observation group by taking digital computer random grouping method, 50 cases in each group, the control group used clean water to lavage, the observation group used saline to gastric lavage, the success rate of rescue, serum sodium concentration, mean arterial pressure and complication rate were compared between two groups. Results The success rate of rescur in the observation group was significantly higher than the control group (P<0.05); after gastric lavage, serum sodium concentration and mean arterial pressure in the observation group had not appear obvious fluctuation, and serum sodium concentration and mean arterial blood pressure in the control group were lower than those before gastric lavage (P<0.05); the incidence of complications in the observation group was significantly lower than that the control group (P<0.05). Conclusion The use of physiological saline for acute oral poisoning patients with gastric lavage, can effectively improve the success rate of rescue, reduce complications, but also to avoid water and electrolyte disorders.
ABSTRACT
Objective In this study,we measured the levels of urinary monocyte chemoattractant (MCP)-1 and interferon-γ-inducible protein (IP-10) and further analyzed their associations with clinical and pathological data in lupus nephritis patients in order to find the non-invasive biomarkers which canpredict disease activity.Methods MCP-1,IP-10,VEGF levels were measured in urine samples from 64 lupus nephritis patients and 20 healthy volunteers.Clinical disease activity was determined by SLEDAI and BILAG scores.The lupus nephritis patients were divided into two groups:active disease group (SLEDAI scores ≥ 10points,n=36) and non-active group (SLEDAI score＜10 points,n=28).Of all patients enrolled,37 patients had a concomitant kidney biopsy performed at the time of urine collection.The predictive performance of uri-nary MCP-1 and IP-10 for renal flare,the Student's t test,Mann-Whitney U test,Chi-square test,and re-ceiver operating characteristic (ROC) curves were constructed for analysis.Results The urinary MCP-1 and urinary IP-10 levels of the active group was significantly higher than that of the non-active group [MCP-1672.39(318.05,2 554.23)pg/ml vs 152.52,(55.61,330.44)pg/ml,Z=-4.717,P＜0.01; IP-10 (38±19) pg/ml vs (22±16) pg/ml,t=3.576 P＜0.01].The level of urinary MCP-1 was positively correlated with the levels of hematuria and 24 hours protein quan-tification,as well as the scores of SLEDAI and BILAG (rbemahuria=0.570,P=0.000; r24hpro=0.569,P=0.000; rSLEDAI=0.600,P=0.000; rBILAG=0.606,P=0.000),and it was also positively correlated with the scores of cellular crescent,wire loop,and AI (rCC=0.405,P=0.015; rwire loop=0.430,P=0.014; rAI=0.352,P=0.003),while nega-tively correlated with the level of C3 and plasma albumin (rc3=-0.564,P=0.000; ralb=-0.587,P=0.000).It had no correlation with the scores of wire loop and CI (P＞ 0.05).The level of uIP-10 was positively correlated with the protein quantification in 24 hours and the scores of SLEDAI and BILAG (r24hpro=0.305,P=0.018; rSLEDAI=0.334,P=0.009; rSILAG=0.496,P=0.000),while negatively correlated with the level of C4 (rC4=-0.301,P=0.016).The R0C curve of uMCP-1 to predict the activity of SLE showed that its specificity was 75.0％,sensitivity was 83.3％,and the area under the ROC curve was 0.85±0.05.The ROC curve of urinary IP-10 to predict the activity of SLE showed that its specificity was 50.0％,sensitivity was 97.2％,its area under the ROC curve was 0.74±0.06.The ROC curve of urinary MCP-1 to predict renal flare shows that its specificity was 45.5％,its sensitivity was 100％,and the area under the ROC curve was 0.74±0.80.The ROC curve of urinary IP-10 to predict renal flare showed that its specificitywas 36.4％,its sensitivity was 73.3％,and its area under the ROC curve was 0.49 ±0.10.Conclusion Urinary MCP-1 and urinary IP-10 predict renal flare in patients with lupus nephritis.Furthermore,urinary MCP-1 is a more specific and sensitive forecaster of renal flare in patients with a history of lupus nephritis than urinary IP-10.