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@#Abstract: Objective To investigate the influence of the variation of SARS-CoV-2 on the clinical feature, and to provide early warning signs for the variation of SARS-CoV-2 in clinical work. Methods From Jan 2, 2021 to Jun 30, 2021, a total of 105 COVID-19 patients were included in the study using a case-control method. Nasal swab samples were collected from the study subjects, the viral genes were sequenced, and patients were divided into Delta variant group and non-Delta variant group according to their gene sequences. Clinically relevant data were collected from the two groups, and indicators such as days of hospitalization, age distribution, lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, and IL-10 were compared; subgroup analysis was performed based on the number of days of viral negativity in the study subjects as the basis for grouping, and differences in immunological characteristics were compared, including lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, IL-10, etc. Results The theoretical hospitalization days of Delta variant group were (22.2±8.33) d, which were significantly longer than (17.6±10.50) d of non-Delta variant group (t=2.396, P<0.05). The total lymphocyte count and IL-4 of Delta variant group were (1.22±0.86) ×109/L and (0.80±0.23) ng/mL, which were significantly lower than corresponding (1.91±0.70) ×109/L and (1.59±0.59) ng/mL of non-Delta variant group (t=4.329, 9.072, P<0.05), while IL-10 was (7.16±7.77) ng/mL, which was significantly higher than (4.26±3.91) ng/mL of non-Delta mutation group (t=1.980, P<0.05). Subgroup analysis showed that the total lymphocyte count and IL-4 concentration in Delta variant group were (1.04±0.60) ×109/L and (0.74±0.25) ng/ml, which were significantly lower than corresponding (1.62±0.56) ×109/L and (1.56±0.52) ng/mL in non-Delta variant group, in patients with delayed discharge (P<0.05). Conclutions SARS-CoV-2 variant has an impact on clinical manifestations. The patient's B cell count and IL-10 concentration increased or IL-2 and IL-4 concentration decreased within 12 hours of admission indicated variant virus infection. The decrease of total lymphocyte count, especially T lymphocyte reduction, strongly suggests discharge delay due to viral clearance disorder.
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Objective: To investigate the efficacy of progesterone tablets in the patients with unexplained recurrent spontaneous abortion and the influence on cellular immunity factor.Methods: Totally 90 cases of unexplained recurrent spontaneous abortion patients were randomly divided into the observation group and the control group (45 ones in each).After pregnancy, the control group was given intramuscular injection of human chorionic gonadotropin, and the observation group started to be treated with progesterone tablets on the 35th day after menolipsis.The levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-17 (IL-17) and IFN-γ were determined, and the expression of T helper lymphocytes (Th17/CD4+), regulatory T lymphocytes (Treg/CD4+) and T helper lymphocytes regulatory T lymphocytes (Th17/Treg) was compared before and after the treatment.The pregnancy success rate and abortion rate were compared between the groups after the treatment, and adverse reactions were also observed.Results: After the treatment, the expression levels of IL-4 and IL-10 in the observation group were higher than those in the control group, and the expression levels of IL-17 in the observation group was lower than that in the control group, and the differences between the groups were significant (P＜0.05);after the treatment, the expression of Th17/CD4+ and Th17/Treg in the two groups decreased, and that in the observation group was lower than that in the control group;after the treatment, the expression of Treg/CD4+ in the two groups increased, and that in the observation group was higher than that in the control group, and the difference was significant (P＜0.05);after the treatment, the expression of IFN-γ in the two groups decreased, and that in the observation group was lower than that in the control group;after the treatment, the pregnancy rate in the observation group was higher than that in the control group with lower abortion rate, and the differences were statistically significant (P＜0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P＜0.05).Conclusion: Progesterone tablets in the treatment of unexplained recurrent abortion patients show significant effects, and can effectively improve the cellular immune factor in the patients, which is worth promoted application in clinics.