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OBJECT IVE To evaluate the application effect of the whole cour se medication management mode led by pharmacists in rheumatic immune diseases. METHODS A total of 122 patients treated with tacrolimus or cyclosporine in the department of rheumatology and immunology of Wuhan No. 1 Hospital from 2018 to 2020 were selected as the study subjects. Among them ，44 cases in the control group were under the traditional supervision mode ；78 patients in the observation group adopted the whole course medication management mode led by pharmacists ，that was ，individual pharmacists and specialist clinical pharmacists cooperated and led ，and not only participated in the whole process of drug treatment but also involved in the whole process of therapeutic drug monitoring （TDM）. On the basis of the control group ，the division of labor and cooperation among medical，pharmaceutical and nursing parties were strengthened ，and the homogeneous supervision was carried out for the outpatients and inpatients from admission to discharge . The daily dose of medication ，the rate of reaching the standard of blood drug concentration ，the incidence of problematic samples （the sample was calculated by the number of times ），the average hospitalization days ，the re-admission rate within 6 months after discharge ，the medication compliance score and the patient ’s satisfaction rate were compared between the two groups. RESULTS In the control group ，53 times of TDM were performed ， including 18 times of tacrolimus monitoring and 35 times of cyclosporine monitoring ；in the observation group ，123 timesof TDM were performed ，including 55 times of tacrolimus monitoring and 68 times of cyclosporine monitoring. The daily dose of tacrolimus ，the daily dose of cyclosporine ，the rate of reaching the standard of cyclosporine blood drugconcentration，the inc idence of problematic samples ，the rate of re-admission within 6 months after discharge ， the medication compliance score and the patient ’s satisfaction rate in the observation group were significantly better than those in the control group （P＜0.05）. CONCLUSIONS It can effectively improve the effect of the quality of pharmaceutical care to implement whole course and homogeneous medication management led by pharmacists and provide precise drug guidance for patients with rheumatic and immune diseases.
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Rheumatoid arthritis (RA) is the most common eause of autoimmune arthritis in the world.In RA patients serum or plasma cytokine levels may indicate the severity of the disease.Cytokine gene polymorphism can be used as a marker of RA susceptibility and severity.Rheumatoid arthritis is a systemic connective tissue disease.Not only joints, but other organs (lungs.lymph nodes, spleen, skin, heart or eyes) may also he involved.'Hie main goal of treatment for rheumatoid arthritis is to avoid joint destruction through early and aggressive anti-inflammatory treatment.In the past few decades, various therapies were used for patients when methotrexate was ineffective or intolerant to alter the joint and systemic prognosis and the patients' disability.Among them, cytokine targeted therapy have long been identified to be the most promising therapy.This article re- views the effector functions of different inflammatory factors and their role in the RA pathogenesis and the targeted inhibitors targeting inflammatory factors that can currently be used for the treatment of RA.
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@#Rheumatic immune disease, as a group of recurrent systemic diseases, involves the vascular system through inflammatory factors. Eye reaction can be used as a sign of rheumatic immune reactivation or disease aggravation, together with the first systemic manifestation of rheumatic immune disease. As a part of the most abundant blood flow in the eyes, choroid is an excellent evaluation index for ocular involvement, and it is greatly affected by systemic vascular diseases. And optical coherence tomography provides a scientific and accurate measuring tool for the observation of choroid thickness. However, whether changes in choroid thickness can be utilized as markers of disease activity, and progression, our results require further research. In this paper, the changes of choroid thickness in rheumatic immune diseases are analyzed.
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Introduction : Les patients présentant une affection systémique ont un risque accru d'infections. Leur prise en charge au cours de la pandémie au COVID19 constitue un défi qui doit prendre en considération plusieurs aspects. Nous rapportons les caractéristiques épidémiologiques, cliniques, et évolutives des patients COVID positifs suivis pour une maladie auto-immune (MAI). Patients et méthode : étude rétrospective, descriptive et analytique menée au centre de traitement des épidémies du centre hospitalier universitaire (CHU) Le Dantec de Dakar durant les périodes du 30 Avril au 30 Octobre 2020 puis du 30 Décembre 2020 au 30 Avril 2021. Etaient inclus tous les dossiers des patients suivis pour une maladie systémique hospitalisés pour COVID-19 confirmée à la RT-PCR. Résultats : treize patients étaient inclus dans l'étude, composés de 8 femmes et de 5 hommes. L'âge moyen était de 59 ans [16 à 74 ans]. Il s'agissait de 8 cas de maladies auto-immunes systémiques (MAIS) : polyarthrite rhumatoïde (n=3 ; 37,5%), Sjögren primitif (n=2 ; 25%), lupus systémique, dermatomyosite, arthrite à cellules géantes chacun 1 cas (12,5%) et 5 cas de maladies auto-immunes spécifiques d'organes (MASO) : maladie de Basedow (n=1 ; 20% de MASO), thyroïdite de Hashimoto (n=1 ; 20%), myasthénie (n=1 ; 20%), diabète de type 1 (n=1 ; 20%) et maladie de Biermer (n=1 ; 20%). Les formes cliniques étaient modérées (6 cas ; 46,1%), sévères (2cas ; 15,4%) et critiques (2cas ; 15,4%). Huit patients (8/13) avaient au moins une comorbidité associée. Deux décès (2/13) étaient notés. Conclusion : il n'a pas été trouvé une augmentation des complications sévères dues au COVID-19 chez les patients suivis pour une maladie auto-immune. Leur pronostic n'est pas différent de celui de la population générale.
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Humanos , Masculino , Femenino , Artritis , Artritis Reumatoide , Pronóstico , Enfermedades Autoinmunes , Comorbilidad , Dermatomiositis , Diabetes Mellitus Tipo 1 , COVID-19 , Anemia PerniciosaRESUMEN
BACKGROUND: Studies have confirmed that anti-zona zona antibodies can accelerate the destruction and depletion of oocytes, thereby causing premature ovarian failure. OBJECTIVE: To investigate the time of establishing autoimmune premature ovarian failure model in BALB/c mice induced by zona pellucida 3 peptides. METHODS: Thirty healthy female BALB/c mice (7-8 weeks) were randomly divided into immune experimental group (20 mice) and the control group (10 mice). In the experimental group, the mice were given immunization injection starting at 0 week, 0.15 mL of immune reagent injected into the soles at both sides and the lower abdomen. The vaginal exfoliated cell smears were observed every morning to observe the changes in the estrous cycle of the mice. After 2 weeks of injection, 0.15 mL of immune enhancement agent was injected subcutaneously into the same site. On the first day of weeks 4 and 6, the immune agent or immune enhancement agent was injected alternatively. Blood samples were collected before each injection and the serum sex hormone level was measured by enzyme-linked immunosorbent assay. Finally, ovarian tissue and uterus morphology were observed. RESULTS AND CONCLUSION: There was no difference in serum follicle stimulating hormone and estrogen levels between the first immunization injection and 2 weeks after the injection. The serum estrogen level in the experimental group was significantly lower than that in the control group at 4 weeks after injection. The serum estrogen level of the experimental group was significantly lower than that of the control group at 6 weeks after injection (P < 0.05), and meanwhile the serum follicle stimulating hormone level was significantly higher than that of the control group (P < 0.01). The degree of ovarian interstitial fibrosis in the experimental group was more obvious than that in the control group. The ovarian volume decreased and the uterus atrophied in the experimental group. The number of primitive follicles, primary follicles and secondary follicles in mice was significantly lower in the experimental group than the control group, and the number of atresia follicles was significantly higher than the control group (P < 0.05). Therefore, 75 μg of zona pellucida 3 peptides can be used to establish an autoimmune premature ovarian failure disease model in BALB/c mice, and a good modelling effect can be achieved at 6 weeks after immunization.
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A series of clinical problems caused by mucosal immune damage in children's immune diseases need to be paid more attention.The pathogenesis is complex and the clinical manifestations are various,which may lead to misdiagnosis and missed the right treatment.The clinical phenotypes of allergic,autoimmune and inflammatory diseases,and primary immunodeficiency diseases often overlap.The immunological characteristics of mucosal immune system,the characteristics of several related clinical immune diseases,the characteristics of serum immunoglobulin (Ig) E and IgG,the difference roles between specific IgE and IgG in allergic and autoimmune diseases,the role of mucosal immune system and probiotics,mucosal immune system and vaccine,the role of mucosal immune system in the diagnosis and treatment in the related immune diseases were reviewed in this article.The treatment of IgG4-related diseases and other aspects are elaborated to show the research progress of blood IgE and mucosal immune damage in immune diseases.
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Objective:To explore the serum IgG4 level in patients with IgG4-related Hashimoto thyroiditis(IgG4 HT),and its clinical implications.Methods:The serum IgG4 was determined in 129 patients with HT using enzyme-linked immunosorbent assays and classified into two subgroups based on IgG4 level:IgG4 HT group(IgG4≥135 mg/dl)and non-IgG4 HT group(IgG4<135 mg/dl).And the levels of serum thyroid hormone and thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibodies(TgAb)were measured by electro-chemiluminescence immunoassay.Ultrasonic imaging of the thyroid gland were detected.Results:The TPOAb levels correlated significantly with both serum IgG4 levels(r=0.437 1,P=0.012 7)and IgG4/IgG ratios(r=0.396 2,P=0.023 5)in the patients with HT.Compared with that of non-IgG4 HT group(n=97),IgG4 HT group(n=32):①The mean age was lower(P=0.029 3);②Higher levels of serum TPOAb(P=0.002 1)and TgAb(P=0.012 8);③Ultrasound imaging:the more obvious thyroid nodule(P=0.022 6);④Logistic regression analysis showed that serum IgG4 and TPOAb were the risk factor for thyroid nodules(OR=1.672,P=0.021;2.549,P=0.014 ).Conclusion: IgG4 HT patients existed corresponding clinical characteristics.For the HT-patients with elevated serum IgG4,thyroid function and morphology should were more closely monitored.
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Acquired immune deficiency syndrome, a disease in which there is a severe loss of the body's cellular immunity, greatly lowering the resistance to infection and malignancy. The cause is a human immune deficiency virus, or HIV transmitted in blood and in sexual fluids. AIDS was first reported June 5, 1981. A combination of several antiretroviral drugs, called highly active antiretroviral therapy (HAART), has been very effective in reducing the number of HIV particles in the bloodstream. The best treatment for AIDS in humans is prevention by vaccination.
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A safe and effective method for separating albumin from autoplasma by heatwas introduced.Immunological analysis,showed that such an albumin solutionhad the same identity as human serum albumin.Determination by acetate cellu-lose electrophoresis showed the purity of the albumin was over 90%.Determination by polyacrylamide gel electrophoresis showed that one of thealbumin monomers was over 97%.Detection by double radial immunodiffusionindicated that there were no any new antigens in it.The recovery of the albuminwas more than 80%.
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Objective To establish a SYBR Green Ⅰ quantitative real-time PCR method for detecting the expression of APRIL gene(a proliferation-inducing ligand,APRIL) in peripheral blood of patients with auto-immune diseases,e.g.,systemic lupus erythematosus(SLE) and rheumatoid arthritis(RA),and investigate the relationship of APRIL mRNA expression with pathogenesis and prognosis of auto-immune diseases.Methods Plasmid PGEM-T easy-APRIL was cloned as the standard template.SYBR Green Ⅰ quantitative real-time PCR was set up to examine the expression of APRIL mRNA in peripheral blood of 58 patients with auto-immune diseases and 20 healthy controls using Line Gene FQD-33A Detection System.Results The obtained data were normalized by dividing the copy number of target cDNA by those of GAPDH(glyceraldehycle-3-phosphate dehydrogenase,GAPDH).APRIL expression levels ranges from 3.95 to 192 and mean value was 29.68?4.5.APRIL expression of twenty healthy controls showed range from 3.1 to 18.7 and mean value of 10.56?2.0.APRIL expression levels in patients with auto-immune diseases were higher than those in healthy controls.In auto-immune diseases group APRIL expression levels of untreated patients were higher than those of the other patients,and a statistical significance was found.Conclusions APRIL mRNA was successfully detected by SYBR Green Ⅰ quantitative real-time PCR and the method was accurate and reliable.The expression of APRIL mRNA of auto-immune disease patients was higher than those of healthy controls,and the expression of untreated patients was the highest.This method may be used for further study on the high-level expression of APRIL mRNA in mechanism of auto-immune diseases as well as the development and prognosis of diseases.