The role of neutrophils in asthma / 浙江大学学报·医学版

Bronchial asthma is a chronic respiratory disease，characterized by airway inflammation，airway hyperresponsiveness，reversible airway obstruction and airway remodeling，in which a variety of cells including airway inflammatory cells and structural cells are involved. Previous studies have shown that asthma is mainly driven by Th2 cytokines IL-4，IL-5，and IL-13，leading to airway eosinophil inflammation. With further research，however，it has been found that neutrophils are also closely related to asthma. Numbers of neutrophils are elevated in airway through increased chemotaxis and decreased apoptosis，which is earlier than eosinophils，leading to airway neutrophilic inflammation. Neutrophils can produce elastase，myeloperoxidase，neutrophil extra- cellular traps，chemokines and cytokines，participating in the occurrence and development of asthma. The antagonists against these molecules，such as anti-IL-8 receptor antibody，anti-IL-17 antibody，and DNase，have shown positive effects on neutrophilic asthma，but further studies are needed to support their clinical application. This article mainly reviews the role of neutrophils in asthma and related mechanisms.

Investigation of pregestational diabetes mellitus in 15 hospitals in Guangdong province / 中华妇产科杂志

Objective To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods A total of 41338 women delivered in the 15 hospitals during the 6 months,195 women with PGDM(PGDM group) and 195 women with normal glucose test result(control group)were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups. In the PGDM group, pregnancy outcomes were analyzed in women who used insulin treatment (n=91) and women who did not (n=104). Results (1)The incidence of PGDM was 0.472%(195/41338). Diabetes mellitus were diagnosed in 59 women (30.3%, 59/195) before pregnancy, and 136 women (69.7%,136/195) were diagnosed as PGDM after conceptions. Forty-six women (33.8%) were diagnosed by fasting glucose and glycohemoglobin (HbA1c) screening. (2) The maternal age, pre-pregnancy body mass index (BMI), prenatal BMI, percentage of family history of diabetes, incidence of macrosomia, concentration of low density lipoprotein were significantly higher in PGDM group than those in control group (all P<0.05). Women in PGDM group had significantly higher HbA1c concentration((6.3±1.3)% vs (5.2±0.4)%), fasting glucose [(6.3±2.3) vs (4.8±1.1) mmol/L], oral glucose tolerance test(OGTT)-1 h glucose((12.6±2.9) vs (7.1± 1.3) mmol/L)and OGTT-2 h glucose [(12.0±3.0) vs (6.4±1.0) mmol/L] than those in control group (P<0.01). (3)The morbidity of preterm births was significantly higher (11.3% vs 1.0%, P<0.01), and the gestational age at delivery in PGDM group was significantly smaller [(37.6±2.3) vs (39.2±1.2) weeks, P<0.01]. Cesarean delivery rate in the PGDM group (70.8% vs 29.7%) was significantly higher than the control group (P<0.01). There was significantly difference between PGDM group and control in the neonatal male/female ratio (98/97 vs 111/84, P=0.033). The neonatal birth weight in PGDM group was significantly higher((3159±700) vs (3451±423) g, P<0.01). And the incidence of neonatal hypoglycemia in the PGDM group was higher than the control group (7.7% vs 2.6%, P=0.036).(4)In the PGDM group, women who were treated with insulin had a smaller gestational age at delivery [(36.9±2.9) vs (37.9±2.5) weeks, P<0.01], and the neonates had a higher neonatal ICU(NICU)admission rate (24.2% vs 9.6% , P<0.01). Conclusions The morbidity of PGDM in the 15 hospitals in Guangdong province is 0.472%. The majority of PGDM was diagnosed during pregnancy; HbA1c and fasting glucose are reliable parameters for PGDM screening. Women with PGDM have obvious family history of diabetes and repeated pregnancy may accelerate the process of diabetes mellitus. Women with PGDM have higher risk for preterm delivery and neonatal hypoglycemia. Unsatisfied glucose control followed by insulin treatment may increase the need for NICU admission.

Relationship between C reactive protein and metabolic syndrome during pregnancy / 中国综合临床

Objective To discuss the effect of C?reactive protein(CRP) levels in pregnant women with gestational metabolic syndrome ( GMS ) , and to analyze the risk factors of GMS. Methods Seventy pregnant women with GMS received regular check and hospital delivery in Yuebei People’ s Hospital Affiliated to Shantou University from May 2012 to May 2015 were selected as study group,and 100 normal pregnant women as control group. Information regarding age,gestational weeks,admission blood pressure,height and body mass index( BMI) before pregnancy was recorded. Biochemical indicators including C?reactive protein ( CRP ) , fasting plasma glu?cose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL?C),high density lipoprotein ( HDL?C) were tested. The correlation between CRP and GMS was calculated and the risk factors of GMS were analyzed. According to CRP levels,all pregnant women were divided into four groups to based on quartile method subjects, and the relationship of CRP levels and the incidence of GMS were evaluated between four groups. Results ( 1) The age,pre?pregnancy BMI,baseline blood pressure of GMS group were higher,gestation?al weeks was smaller than the control group(P0. 05). (3)Multiple regression analysis showed that the risk factors of GMS were age,pre?pregnancy BMI,CRP,TG and TC(OR 1. 530(1. 095?2. 136),18. 427(4. 402?77. 142),4. 917 (1. 928?12. 537),2. 665(1. 379?5. 149),4. 114(2. 304?7. 348),P0. 05). (4)According to CRP levels,the incidence rate of GMS was 20. 69%,42. 67%,56. 06% and 72. 00%(χ2=15. 28,P=0. 002) . When CRP≥20. 0 mg/L,the incidence rate of GMS was significantly higher than the other three groups, and there were statistically differences between different groups ( P<0. 01 ) . Conclusion There are pre pregnancy overweight and / or obesity,abnormal glucose metabolism,blood pres?sure,lipid metabolism disorders such as multiple metabolic abnormalities aggregation in pregnant women with GMS. BMI and TC are the significantly risk factors for GMS. The gestational weeks,HDL?C and LDL?C have less importance in identifying GMS. The blood serum CRP is closely related to GMS and involved in the pathogenesis of GMS. THe increase of CRP level is one of the important signs of the onset and progression of GMS.

Immune function of red blood cells in chronic gastritis and duodenal ulcer disease / 中国综合临床

Objective To explore changes of the immune function of red blood cells in gastric disease.Methods RBC C3b receptor rosette(RBCC3bRR)and RBC immune complex rosette(RBCICR)were tested in chronic gastritis group(n =103),duodenal ball ulcer group(n =75)and control group(n =30)to evaluate the immune function of RBC.Results RBCC3bRR were(20.83 ± 5.16)％ in the control group,(16.26 ±5.17)％ in the chronic gastritis group and(13.65 ± 5.19)％ in the duodenal ball ulcer group.RBCICR were respectively(7.63 ± 4.09)％,(10.59 + 4.45)％ and(10.04 ± 4.13)％ in these three groups.RBCC3bRR of chronic gastritis and duodenal ball ulcer were lower than control group(P ＜0.0l),while RBCICR were higher than normal control group(P ＜0.05 and P ＜0.01 respectively).There was no significant difference on RBCC3bRR and RBCICR between HP negative chronic gastritis and HP negative duodenal ball ulcer and between HP positive chronic gastritis and HP positive duodenal ball ulcer(P ＞ 0.05).RBCC3bRR of HP positive chronic gastritis and duodenal ball ulcer was significantly lower than that of HP negative(P ＜ 0.05and P ＜ 0.01 respectively),RBCICR significantly higher than that of HP negative(P ＜ 0.01).After HP eradication,RBCC3bRR of patients with chronic gastritis and duodenal ball ulcer was increased significantly (P＜0.05 and P ＜ 0.01 respectively).RBCICR was significantly lower than before treatment(P ＜ 0.01).Conclusion HP infection,chronic gastritis and duodenal ulcer can decrease the immune function of red blood cells.