Two cases of sporadic severe food-borne botulism / 中华全科医师杂志

Two female patients with acute onset of sporadic food-borne botulism are reported. Both patients presented cranial nerve palsy symptoms and rapidly involving respiratory muscles causing respiratory failure. The tracheal intubation, mechanical ventilation and active supportive measures were given at admission. The skull imaging and cerebrospinal fluid examination were negative, and the electromyography showed peripheral motor nerve damage. One patient was complicated with severe pneumonia. The botulinum toxin test was positive, and botulism poisoning was diagnosed. After early targeted treatment, patients were improved and discharged. Both patients had no complications and recurrence after discharge in 8 months of follow-up.

The regulatory activity of interleukin-35 to CD4+and CDS+T cells in sepsis patients / 中华急诊医学杂志

Objective To investigate plasma interleukin-35(IL-35)expression in sepsis patients,and to assess the regulatory activity of IL-35 on CD4+and CD8+T cells in sepsis patients.Methods A prospective study was conducted.Forty-one sepsis patients and nineteen healthy controls were enrolled in this study.According to the survival outcome on 28 day after admission,sepsis patients were further divided into the survival group(n=30)and death group(n=11).Peripheral blood samples were collected within one hour of visit.Plasma IL-35level was measured by enzyme linked immunosorbent assay(ELISA),while CD3+,CD4+,and CD8+T cell counts were measured by flow cytometry.The correlation between IL-35 expression/T cell counts and sequential organ failure assessment(SOFA)score was also assessed.Peripheral CD4+and CD8+T cells from sepsis patients were purified and stimlated with recombinant human IL-35 for 48 h.mRNA relative levels of T-bet,GATA-3,FoxP3,and RORγt in CD4+T cells and perforin,granzyme B,and FasL in CD8+T cells were measured by real-time PCR.Interferon-γ(IFN-γ,IL-4,IL-10,IL-17,and tumor necrosis factor-α(TNF-α)levels in the cultured supernatants were measured by ELISA.Transcription factor level and cytokine expression was compared prior to and post IL-35 stimulation.Results Plasma IL-35 was significantly elevated in sepsis patients when compared with controls [(76.76±10.33)pg/mL vs(27.53±8.31)pg/mL,P＜0.01],however; it did not correlate with SOFA score(r=O.172,P=0.281).Plasma IL-35 was also notably increased in the death group when compared with the survival group [(83.18±6.48)pg/mL vs(74.40±10.55)pg/mL,P=0.014].Plasma IL-35lvel in the death and survival groups were analyzed by receiver operating characteristic curve with an area under curve of 0.770(P=0.009).There were no remarkable differences of CD3+,CD4+,and CD8+T cell counts between sepsis patients and controls,or between the death and survival groups(all P＞0.05).Moreover,T cell counts were negatively correlated with SOFA score(P＜0.01).IL-35 stimulation resulted in the reduction of mRNA relative level of Th1 transcription factor T-bet and Th17 transcription factor RORγt in CD4+T cells from sepsis patients(P＜0.01),while elevation in regulatory T cell transcription factor FoxP3 mRNA(P＜0.01).However,IL-35 stimulation did not affect Th2 transcription factor GATA-3 mRNA in CD4+T cells(P=0.745).IFN-γ and IL-17 production by CD4+T cells was significantly decreased in response to IL-35 stimulation(P＜0.05),while IL-10 was increased(P＜0.01)and IL-4 was comparable(P=0.536)between CD4+T cells with and without IL-35 stimulation.IL-35 stimulation led to the down-regulation of mRNA relative level of perforin and granzyme B(P＜0.01).However,FasL mRNA was comparable between CD8+T cell with and without IL-35 stimulation(P=0.795).IFN-γ and TNF-α secretion was also reduced in response to IL-35 stimulation(P＜0.05).Conclusion Elevated plasma IL-35 level is an important indicator for poor prognosis of sepsis patients.IL-35 inhibits the activity of CD4+and CD8+T cells in sepsis patients,and might take part in the pathogenesis of sepsis.

The regulatory activity of interleukin-35 to CD4+ and CD8+ T cells in sepsis patients / 中华急诊医学杂志

Objective@#To investigate plasma interleukin-35 (IL-35) expression in sepsis patients, and to assess the regulatory activity of IL-35 on CD4+ and CD8+ T cells in sepsis patients.@*Methods@#A prospective study was conducted. Forty-one sepsis patients and nineteen healthy controls were enrolled in this study. According to the survival outcome on 28 day after admission, sepsis patients were further divided into the survival group (n=30) and death group (n=11). Peripheral blood samples were collected within one hour of visit. Plasma IL-35 level was measured by enzyme linked immunosorbent assay (ELISA), while CD3+, CD4+, and CD8+ T cell counts were measured by flow cytometry. The correlation between IL-35 expression/T cell counts and sequential organ failure assessment (SOFA) score was also assessed. Peripheral CD4+ and CD8+ T cells from sepsis patients were purified and stimulated with recombinant human IL-35 for 48 h. mRNA relative levels of T-bet, GATA-3, FoxP3, and RORγt in CD4+ T cells and perforin, granzyme B, and FasL in CD8+ T cells were measured by real-time PCR. Interferon-γ (IFN-γ), IL-4, IL-10, IL-17, and tumor necrosis factor-α (TNF-α) levels in the cultured supernatants were measured by ELISA. Transcription factor level and cytokine expression was compared prior to and post IL-35 stimulation.@*Results@#Plasma IL-35 was significantly elevated in sepsis patients when compared with controls [(76.76±10.33) pg/mL vs (27.53±8.31) pg/mL, P<0.01], however, it did not correlate with SOFA score (r=0.172, P=0.281). Plasma IL-35 was also notably increased in the death group when compared with the survival group [(83.18±6.48) pg/mL vs (74.40±10.55) pg/mL, P=0.014]. Plasma IL-35 level in the death and survival groups were analyzed by receiver operating characteristic curve with an area under curve of 0.770 (P=0.009). There were no remarkable differences of CD3+, CD4+, and CD8+ T cell counts between sepsis patients and controls, or between the death and survival groups (all P>0.05). Moreover, T cell counts were negatively correlated with SOFA score (P<0.01). IL-35 stimulation resulted in the reduction of mRNA relative level of Th1 transcription factor T-bet and Th17 transcription factor RORγt in CD4+ T cells from sepsis patients (P<0.01), while elevation in regulatory T cell transcription factor FoxP3 mRNA (P<0.01). However, IL-35 stimulation did not affect Th2 transcription factor GATA-3 mRNA in CD4+ T cells (P=0.745). IFN-γ and IL-17 production by CD4+ T cells was significantly decreased in response to IL-35 stimulation (P<0.05), while IL-10 was increased (P<0.01) and IL-4 was comparable (P=0.536) between CD4+ T cells with and without IL-35 stimulation. IL-35 stimulation led to the down-regulation of mRNA relative level of perforin and granzyme B (P<0.01). However, FasL mRNA was comparable between CD8+ T cells with and without IL-35 stimulation (P=0.795). IFN-γ and TNF-α secretion was also reduced in response to IL-35 stimulation (P<0.05).@*Conclusion@#Elevated plasma IL-35 level is an important indicator for poor prognosis of sepsis patients. IL-35 inhibits the activity of CD4+ and CD8+ T cells in sepsis patients, and might take part in the pathogenesis of sepsis.

Effects of bilirubin on oxygen free radicals and caspase-3 in acute lung injury rats / 中国病理生理杂志

AIM:To investigate the mechanisms by which bilirubin inhibits acute lung injury(ALI).METHODS: 30 female Wistar rats were divided into normal group,ALI group and bilirubin treatment group.ALI was induced by intravenous injection of LPS.The contents of OH-,H2O2 and O——?-2 in the lung as well as the expression of caspase-3 in the lungs were investigated.RESULTS:(1) The contents of OH-,H2O2 and O——?-2 in the lung homogenate and the expression of caspase-3 in the lungs in ALI group increased compared with those in normal group(P