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儿童抗癫痫药物超敏综合征临床特征及其护理干预策略分析 预览
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作者 徐尔辉 陈嘉蕾 林振秀 《实用心脑肺血管病杂志》 2019年第10期83-86,共4页
目的分析儿童抗癫痫药物超敏综合征(AHS)的临床特征及其护理干预策略。方法选取电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院儿童神经科2007年10月-2017年9月收治的AHS患儿32例,回顾性分析其临床表现、并发症发生... 目的分析儿童抗癫痫药物超敏综合征(AHS)的临床特征及其护理干预策略。方法选取电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院儿童神经科2007年10月-2017年9月收治的AHS患儿32例,回顾性分析其临床表现、并发症发生情况及临床转归,并总结其护理干预策略。结果32例AHS患儿中出现发热24例,粟粒样皮疹15例,Stevens-Johson综合征(SJS)8例,中毒性表皮松解症(TEN)5例,伴口腔黏膜溃疡8例,唇及眼周红肿糜烂6例,会阴糜烂2例;出现单核细胞及嗜酸粒细胞计数升高21例,肝功能损伤13例,心肌损伤7例,肾功能损伤2例。32例AHS患儿经1~4周治疗及护理后均痊愈出院。结论儿童AHS主要临床表现为发热、皮疹和脏器损伤,对护理人员要求较高,因此应熟练掌握其临床特征以提高护理预见性,改善患儿预后。 展开更多
关键词 癫痫 抗惊厥药 超敏反应 药物 抗癫痫药物超敏综合征 儿童 疾病特征 护理
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鼻一氧化氮在慢性鼻-鼻窦炎伴或不伴鼻息肉诊断中的应用研究
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作者 刘承耀 王向东 +4 位作者 李琴 郑凯莉 郑铭 刘仲燕 张罗 《中国耳鼻咽喉头颈外科》 CSCD 2019年第6期315-320,共6页
目的评价鼻呼出气一氧化氮(nasal nitric oxide,nNO)在鉴别慢性鼻-鼻窦炎不伴鼻息肉(chronicrhinosinusitis without nasal polyps,CRSsNP)和慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)诊断中的临床应用... 目的评价鼻呼出气一氧化氮(nasal nitric oxide,nNO)在鉴别慢性鼻-鼻窦炎不伴鼻息肉(chronicrhinosinusitis without nasal polyps,CRSsNP)和慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)诊断中的临床应用及其与鼻窦CT的相关关系。方法本研究收集连续88例慢性鼻-鼻窦炎(CRS)患者和20名健康志愿者。使用NIOX设备测量呼出的nNO水平。鼻内镜检查和鼻窦计算机断层扫描评估受试者的鼻腔及鼻窦炎症状态,皮肤点刺试验用于确认特应性状态。结果CRSsNP患者的nNO水平高于CRSwNP患者[(591±153)ppbvs(360±181)ppb,P<0.001],而CRS患者的nNO水平低于对照组[(449±204)ppbvs(881±161)ppb,P<0.001].在特应性和非特应性CRS患者中,nNO水平与Lund-Mackay评分呈负相关(r=-0.45,P=0.016;r=-0.600,P<0.001).与特应性患者相比,伴或不伴鼻息肉的非特应性患者表现出较低的nNO水平[非特应性CRSsNPvs特应性CRSsNP,(503±92)ppbvs(734±120)ppb,P<0.001;非特应性CRSwNPvs特异性CRSwNP,(299±150)ppbvs(518±161)ppb,P<0.001].接受者操作特征(ROC)曲线分析CRSwNP、CRSsNP和健康对照以及特应性和非特应性亚组中的患者,具有可接受的敏感性和特异性(超过70%-90%).结论nNO水平可用于区分CRSwNP和CRSsNP,且和鼻窦CT评分呈负相关。然而,作为CRS的诊断或监测生物标志物,nNO受患者特应性状态的影响。 展开更多
关键词 一氧化氮 呼气 鼻窦炎 鼻息肉 超敏反应 体层摄影扫描仪 X线计算机
哌拉西林钠舒巴坦钠致皮试阴性患者迟发性剥脱性皮炎
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作者 孙智辉 张红梅 +1 位作者 侯继秋 李艳华 《药物不良反应杂志》 CSCD 2019年第5期385-386,共2页
1例59岁女性患者因肝硬化、肺炎,给予复方甘草酸苷等药物保肝及哌拉西林钠舒巴坦钠(2.5g静脉滴注、2次/d,皮试阴性)抗感染治疗。第4天,患者颜面部出现散在细小斑丘疹,继而皮疹增多,遍布全身,以躯干为重,呈红色类圆形或不规则状,伴口周... 1例59岁女性患者因肝硬化、肺炎,给予复方甘草酸苷等药物保肝及哌拉西林钠舒巴坦钠(2.5g静脉滴注、2次/d,皮试阴性)抗感染治疗。第4天,患者颜面部出现散在细小斑丘疹,继而皮疹增多,遍布全身,以躯干为重,呈红色类圆形或不规则状,伴口周局部肿胀,口唇干裂。考虑为哌拉西林钠舒巴坦钠引起,停用该药,并立即给予甲泼尼龙、枸地氯雷他定及外用药物对症支持治疗。保肝药继续使用,换用莫西沙星抗感染。停药次日,患者鼻、颈等多处散在皮肤脱屑,诊断为剥脱性皮炎。入院第8天,全身红斑颜色变浅,无新发皮疹,停用甲泼尼龙。第13天,患者原皮疹颜色变浅、结痂,部分消退。 展开更多
关键词 超敏反应 迟发型 皮炎 剥脱性 哌拉西林 舒巴坦 皮肤试验
脐血IgE与儿童过敏性疾病的相关性研究
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作者 唐琳 余文 +8 位作者 张晓璟 朱晨琛 吴巧玲 肖烨 蔡眉 魏冰 罗军 李莉 唐振华 《中华检验医学杂志》 CAS CSCD 北大核心 2019年第9期757-761,共5页
目的探讨新生儿脐血IgE水平与36月龄儿童过敏性疾病(特应性皮炎、食物过敏、喘息和过敏性鼻炎)的相关性。方法采用队列研究设计,2012年10月1日至2014年5月31日在上海交通大学医学院附属国际和平妇幼保健院产科收集779例足月产孕妇分娩... 目的探讨新生儿脐血IgE水平与36月龄儿童过敏性疾病(特应性皮炎、食物过敏、喘息和过敏性鼻炎)的相关性。方法采用队列研究设计,2012年10月1日至2014年5月31日在上海交通大学医学院附属国际和平妇幼保健院产科收集779例足月产孕妇分娩时新生儿脐血。随访幼儿至36月龄638名儿童,问卷调查特应性皮炎、食物过敏、喘息和过敏性鼻炎的患病情况。采用化学发光免疫分析法检测样本IgE水平,多元Logistic回归分析脐血IgE水平与儿童过敏性疾病的关系。结果本研究共纳入638对孕妇与儿童。孕妇年龄(29.7±3.3)岁,脐血中IgE水平分布范围在0.1~8.43IU/mL。在剖宫产产妇中,脐血IgE升高与儿童致敏以及特应性皮炎、喘息及过敏性鼻炎发病风险增高有关(OR=1.87,P<0.01;OR=1.86,P=0.01;OR=1.28,P=0.01;OR=1.98,P=0.01)。结论在剖宫产中,脐血IgE水平升高与儿童过敏性疾病的发生有一定的相关性。 展开更多
关键词 超敏反应 免疫球蛋白E 胎血
Chronic Food Antigen-specific IgG-mediated Hypersensitivity Reaction as A Risk Factor for Adolescent Depressive Disorder
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作者 Ran Tao Zhicheng Fu Lijun Xiao 《基因组蛋白质组与生物信息学报:英文版》 CAS CSCD 2019年第2期183-189,共7页
Major depressive disorder (MDD) is the most common nonfatal disease burden world-wide. Systemic chronic low-grade inflammation has been reported to be associated with MDD pro-gression by affecting monoaminergic and gl... Major depressive disorder (MDD) is the most common nonfatal disease burden world-wide. Systemic chronic low-grade inflammation has been reported to be associated with MDD pro-gression by affecting monoaminergic and glutamatergic neurotransmission. However,whether various proinflammatory cytokines are abnormally elevated before the first episode of depression is still largely unclear. Here,we evaluated 184 adolescent patients who were experiencing their first episode of depressive disorder,and the same number of healthy individuals was included as con-trols. We tested the serum levels of high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),IgE,14 different types of food antigen-specific IgG,histamine,homocysteine,S100 calcium-binding protein B,and diamine oxidase. We were not able to find any significant dif-ferences in the serum levels of hs-CRP or TNF-αbetween the two groups. However,the histamine level of the patients (12.35μM) was significantly higher than that of the controls (9.73μM,P<0.001,Mann–Whitney U test). Moreover,significantly higher serum food antigen-specific IgG positive rates were also found in the patient group. Furthermore,over 80% of patients exhibited prolonged food intolerance with elevated levels of serum histamine,leading to hyperpermeability of the blood–brain barrier,which has previously been implicated in the pathogen-esis of MDD. Hence,prolonged high levels of serum histamine could be a risk factor for depressive disorders,and antihistamine release might represent a novel therapeutic strategy for depression treatment. 展开更多
关键词 Major DEPRESSIVE disorder Blood-brain barrier HISTAMINE HYPERSENSITIVITY reaction Inflammation
Effect of the interleukin 10 polymorphisms on interleukin 10 production and visceral hypersensitivity in Chinese patients with diarrhea-predominant irritable bowel syndrome
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作者 Shi-Wei Zhu Zuo-Jing Liu +1 位作者 Qing-Hua Sun Li-Ping Duan 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第13期1524-1532,共9页
Background:Irritable bowel syndrome (IBS),a functional gastrointestinal disorder,is characterized by cytokine imbalance.Previously,decreased plasma interleukin 10 (IL-10) level was reported in patients with IBS,which ... Background:Irritable bowel syndrome (IBS),a functional gastrointestinal disorder,is characterized by cytokine imbalance.Previously,decreased plasma interleukin 10 (IL-10) level was reported in patients with IBS,which may be due to genetic polymorphisms.However,there are no reports correlating the IL-10 polymorphisms with IL-10 production in patients with IBS.This study aimed to analyze the effect of IL-10 polymorphisms on IL-10 production and its correlation with the clinical symptoms in Chinese patients with diarrhea-predominant IBS (IBS-D).Methods:Two IL-10 single nucleotide polymorphisms (rs1800871 and rs1800896) were detected in 120 patients with IBS-D and 144 healthy controls (HC) using SNaPshot.IBS symptom severity score,Bristol scale,hospital anxiety,and depressive scale (HADS) were used to evaluate the clinical symptoms,as well as the psychological status and visceral sensitivity of the subjects.IL-10 levels in the plasma and peripheral blood mononuclear cell (PBMC) culture supernatant were measured using enzyme-linked immunosorbent assay,while those in ileal and colonic mucosal biopsies were measured using immunohistochemistry.Results:The frequency of rs1800896 C allele was significantly lower in the patients with IBS-D than that in the HC (odds ratio:0.49,95% confidence interval:0.27-0.92,P =0.0240).The IL-10 levels in the plasma (P =0.0030) and PBMC culture supernatant (P =0.0500) of the CT genotype subjects were significantly higher than those in the TT genotype subjects.The CT genotype subjects exhibited a higher pain threshold in the rectal distention test than the TT genotype subjects.Moreover,IL-10 rs1800871 GG genotype subjects showed an increase in the HADS score compared to other genotype subjects.Conclusions:IL-10 rs1800896 C allele is correlated with higher IL-10 levels in the plasma and the PBMC culture supernatant,which is associated with a higher pain threshold in the Chinese patients with IBS-D.This study provides an explicit relationship of IL-10 polymorphisms with IL-10 production,which 展开更多
关键词 IRRITABLE BOWEL syndrome INTERLEUKIN 10 POLYMORPHISMS VISCERAL HYPERSENSITIVITY Depression
Nucleus tractus solitarius mediates hyperalgesia induced by chronic pancreatitis in rats 预览
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作者 Yang Bai Ying-Biao Chen +10 位作者 Xin-Tong Qiu Yan-Bing Chen Li-Tian Ma Ying-Qi Li Hong-Ke Sun Ming-Ming Zhang Ting Zhang Tao Chen Bo-Yuan Fan Hui Li Yun-Qing Li 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第40期6077-6093,共17页
BACKGROUND Central sensitization plays a pivotal role in the maintenance of chronic pain induced by chronic pancreatitis(CP).We hypothesized that the nucleus tractus solitarius(NTS),a primary central site that integra... BACKGROUND Central sensitization plays a pivotal role in the maintenance of chronic pain induced by chronic pancreatitis(CP).We hypothesized that the nucleus tractus solitarius(NTS),a primary central site that integrates pancreatic afferents apart from the thoracic spinal dorsal horn,plays a key role in the pathogenesis of visceral hypersensitivity in a rat model of CP.AIM To investigate the role of the NTS in the visceral hypersensitivity induced by chronic pancreatitis.METHODS CP was induced by the intraductal injection of trinitrobenzene sulfonic acid(TNBS)in rats.Pancreatic hyperalgesia was assessed by referred somatic pain via von Frey filament assay.Neural activation of the NTS was indicated by immunohistochemical staining for Fos.Basic synaptic transmission within the NTS was assessed by electrophysiological recordings.Expression of vesicular glutamate transporters(VGluTs),N-methyl-D-aspartate receptor subtype 2B(NR2B),andα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor subtype 1(GluR1)was analyzed by immunoblotting.Membrane insertion of NR2B and GluR1 was evaluated by electron microscopy.The regulatory role of the NTS in visceral hypersensitivity was detected via pharmacological approach and chemogenetics in CP rats.RESULTS TNBS treatment significantly increased the number of Fos-expressing neurons within the caudal NTS.The excitatory synaptic transmission was substantially potentiated within the caudal NTS in CP rats(frequency:5.87±1.12 Hz in CP rats vs 2.55±0.44 Hz in sham rats,P<0.01;amplitude:19.60±1.39 pA in CP rats vs 14.71±1.07 pA in sham rats;P<0.01).CP rats showed upregulated expression of VGluT2,and increased phosphorylation and postsynaptic trafficking of NR2B and GluR1 within the caudal NTS.Blocking excitatory synaptic transmission via the AMPAR antagonist CNQX and the NMDAR antagonist AP-5 microinjection reversed visceral hypersensitivity in CP rats(abdominal withdraw threshold:7.00±1.02 g in CNQX group,8.00±0.81 g in AP-5 group and 1.10±0.27 g in saline group,P<0.001).In 展开更多
关键词 RAT Chronic pancreatitis Visceral hypersensitivity Nucleus tractus solitarius Excitatory synaptic transmission
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Clinical characteristics and outcomes of hypersensitivity pneumonitis: a population-based study in China
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作者 Li-Jing Wang Hou-Rong Cai +2 位作者 Yong-Long Xiao Yang Wang Meng-Shu Cao 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第11期1283-1292,共10页
Backgrounds:Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) that develops in response to the inhalation of various antigens. The clinical pathologies are very complex and undete... Backgrounds:Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) that develops in response to the inhalation of various antigens. The clinical pathologies are very complex and undetermined. The clinical features and outcomes of HP have not been fully elucidated. The aim of this study was to analyze the incidence, clinical features, and outcomes of HP patients and construct a simple clinical model for diagnosing chronic HP (CHP). Methods: The cohort study included 101 patients with HP admitted to the Nanjing Drum Tower Hospital from January 2009 to December 2017. The patients were categorized into acute HP (AHP, n = 72) and CHP (n = 29) groups according to the updated international criteria. The clinical, imaging, treatment, and follow-up data were retrospectively reviewed. All patients were followed up until December 31,2017. Statistical analysis was performed, and a clinical scoring system for CHP was constructed by SPSS 20.0 software. Results: The incidence of HP was 2.4% in ILD inpatients in our center. Patients in the CHP group were older =-2.212, P = 0.029), had more smokers (x^2 = 8.428, P = 0.004), and longer duration of symptoms (t =-4.852, P < 0.001) than those in the AHP group. Weight loss, crackles, digital clubbing, and cyanosis were more common in the CHP group than those in the AHP group (x^2 = 5.862, P < 0.001;x^2 = 8.997, P = 0.003;x^2 = 11-939, P = 0.001;and x^2 = 4.025, P = 0.045, respectively). On chest high-resolution computed tomography (HRCT), reticular patterns, traction bronchiectasis, and accompanying honeycombing were more common in CHP cases than those in AHP cases (x^2 = 101.000, P < 0.001;x^2 = 32.048, P < 0.001;a n d /2 = 36.568,P < 0.001, respectively). The clinical scoring system for CHP was established based on the clinical variables (age [A], duration of symptoms [D], smoking history [S], unidentified exposure [U], and chest HRCT [C];ADSUC)(area under the curve 0.935, 95% confidence interval: 0.883-0.987, P < 0.001). Eleven patients (15.3%) in t 展开更多
关键词 HYPERSENSITIVITY PNEUMONITIS Chronic INTERSTITIAL lung disease FIBROSIS
2013至2017年11641例患者常见过敏原流行特征分析
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作者 刘平 陶淇惠 +2 位作者 李志艳 冯珍如 闫存玲 《中华检验医学杂志》 CAS CSCD 北大核心 2019年第5期371-374,共4页
目的分析常见过敏原检测结果及其流行特征,为过敏性疾病诊疗提供有价值的参考依据。方法该研究为回顾性数据收集研究,收集2013至2017年在北京大学第一医院进行过敏原检查患者11641例,按照年龄、季节和年度等统计各过敏原阳性率,分析流... 目的分析常见过敏原检测结果及其流行特征,为过敏性疾病诊疗提供有价值的参考依据。方法该研究为回顾性数据收集研究,收集2013至2017年在北京大学第一医院进行过敏原检查患者11641例,按照年龄、季节和年度等统计各过敏原阳性率,分析流行特征和变化趋势。结果共收集总IgE检测数据20636项次,过敏原特异性IgE检测数据45620项次,总IgE阳性率达47.8%(9874/20636);吸入性过敏原阳性率前3位依次为粉尘螨(28.1%,509/1812)、户尘螨(26.8%,503/1876)和艾蒿(24.7%,240/971);食物过敏原阳性率前3位依次为鸡蛋(17.3%,188/1088)、牛奶(16.7%,186/1114)和小麦(15.3%,127/829)。吸入性过敏原(以吸入物筛查phad为例)的阳性率逐年升高,食物过敏原(以常见食物混合组fx5为例)的阳性率在2015年达到最高(16.3%,511/3139),近两年呈现下降趋势(2016年13.0%,571/4396;2017年7.4%,330/4461)。吸入性过敏原中,各种杂草花粉在秋季阳性率明显升高。混合霉菌和尘螨的阳性率在夏季升高较明显。食物过敏原随季节变化不明显。结论本研究在一定程度上反映了过敏性疾病患者的过敏原分布特征,为过敏性疾病的防治提供了流行病学资料和临床依据。 展开更多
关键词 超敏反应 变应原 发病率 年龄因素 季节
基于GC-MS的工作场所空气中4种氯苯化合物的高灵敏同时检测 预览
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作者 尹雪花 颜海龙 +1 位作者 陈阳 李元星 《分析仪器》 CAS 2019年第5期40-45,共6页
本研究提出了一种可同时检测工作场所空气中氯苯、1,2-二氯苯、1,4-二氯苯、1,2,4-三氯苯的高灵敏方法。基于气相色谱质谱联用(GC-MS)技术,通过优化分离条件与扫描模式,明确最优解吸溶剂,成功实现了4种氯苯化合物的采集、分离和检测。... 本研究提出了一种可同时检测工作场所空气中氯苯、1,2-二氯苯、1,4-二氯苯、1,2,4-三氯苯的高灵敏方法。基于气相色谱质谱联用(GC-MS)技术,通过优化分离条件与扫描模式,明确最优解吸溶剂,成功实现了4种氯苯化合物的采集、分离和检测。研究发现,该方法具有较宽的线性范围(0~250μg·mL^-1),较低的检出限(0.07~3.44μg·mL^-1,S/N=3),线性相关系数为0.9997~0.9999,相对标准偏差低于2%(n=7)。本方法已成功应用于某工作场所中实际空气样品的4种氯苯化合物的准确检测。 展开更多
关键词 氯苯化合物 同时检测 高灵敏 工作场所 气相色谱质谱联用
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盐酸吗啡注射液安全性实验评价 预览
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作者 魏文芝 孙继超 +2 位作者 朱从会 张敏娟 王天学 《医药导报》 CAS 北大核心 2019年第2期159-162,共4页
目的对盐酸吗啡注射液进行安全性实验研究。方法采用家兔耳缘静脉注射,同体左右侧自身对比方法进行血管刺激性实验;采用家兔股四头肌注射,同体左右侧自身对比方法进行肌肉刺激性实验;采用豚鼠隔日腹腔注射盐酸吗啡注射液2.8mg·kg^-... 目的对盐酸吗啡注射液进行安全性实验研究。方法采用家兔耳缘静脉注射,同体左右侧自身对比方法进行血管刺激性实验;采用家兔股四头肌注射,同体左右侧自身对比方法进行肌肉刺激性实验;采用豚鼠隔日腹腔注射盐酸吗啡注射液2.8mg·kg^-1进行致敏,连续给药3次,末次给药后第14天激发并观察动物过敏情况;实验用兔红细胞混悬液(2%)与盐酸吗啡注射液温育,观察溶血情况。结果血管刺激性实验家兔给药侧耳缘静脉未见相关刺激性,家兔给药侧股四头肌部位未见局部刺激性,全身过敏性实验中豚鼠未出现变态反应,溶血性实验未发现盐酸吗啡注射液有溶血作用。结论盐酸吗啡注射液未见明显的血管刺激性、肌肉刺激性、致敏作用与溶血作用,可为其临床安全用药提供参考。 展开更多
关键词 吗啡注射液 盐酸 安全性 刺激性 过敏性 溶血性
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外周血单个核细胞中CD69、CD40L表达在识别抗结核药物诱导超敏反应致敏药物中的价值 预览
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作者 吴于青 姜国强 宗佩兰 《实用医学杂志》 CAS 北大核心 2019年第12期1875-1879,共5页
目的观察药物刺激后抗结核药物超敏反应患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)中CD69、CD40L的表达变化,与药物激发试验结果比较,评价其在识别此类患者致敏药物中的价值。方法选择在我院初治肺结核治疗过程... 目的观察药物刺激后抗结核药物超敏反应患者外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)中CD69、CD40L的表达变化,与药物激发试验结果比较,评价其在识别此类患者致敏药物中的价值。方法选择在我院初治肺结核治疗过程中出现超敏反应的患者26例为病例组,同期未出现超敏反应的对照组10例,采外周静脉血进行细胞原代分离后分别加入结核药进行细胞培养,通过流式细胞仪检测细胞中CD40L和CD69两种蛋白的表达。结果根据后期药物激发试验结果将入组患者分为致敏药物组和非致敏药物组;与对照组相比,致敏药物组患者PBMCs中表达CD40L、CD69的细胞比例明显升高,而非致敏药物组PBMCs中表达CD40L、CD69的细胞比例无明显差异性,同时致敏药物组与非致敏药物组相比差异有统计学意义。结论抗结核药物超敏反应患者外周血单个核细胞经致敏药物刺激后CD69、CD40L表达增加,这可能是一种用于识别此类患者致敏药物的有意义的体外检测方法。 展开更多
关键词 结核病 超敏反应 致敏药物 流式细胞检测
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羊水栓塞的发病机制与临床诊治特点 被引量:1
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作者 林乐毅 冯烨 +2 位作者 陆芸 杨慧霞 胡灵群 《中华围产医学杂志》 CAS CSCD 北大核心 2019年第4期220-222,共3页
羊水栓塞是一种致死性的产时并发症,有2种表现类型。典型的羊水栓塞表现为呼吸循环衰竭,随后出现弥散性血管内凝血;非典型羊水栓塞仅表现为不能解释的弥散性血管内凝血,此型存活率较高。羊水栓塞的病生理机制为类过敏炎症反应。临床用... 羊水栓塞是一种致死性的产时并发症,有2种表现类型。典型的羊水栓塞表现为呼吸循环衰竭,随后出现弥散性血管内凝血;非典型羊水栓塞仅表现为不能解释的弥散性血管内凝血,此型存活率较高。羊水栓塞的病生理机制为类过敏炎症反应。临床用药选择上,米力农能降低肺动脉压力,同时有正性肌力、降低心率的作用,可改善右心室功能,是目前治疗羊水栓塞引发的呼吸循环衰竭的首选药物。对羊水栓塞的抢救需多学科团队合作进行,熟练掌握重症医学知识和技能的麻醉科医师常在抢救中起到举足轻重的作用。 展开更多
关键词 栓塞 羊水 肥大细胞增多 超敏反应
以肝功能异常伴发热为首发表现的药物超敏反应综合征1例 预览
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作者 王晶晶 纪冬 陈国凤 《中国肝脏病杂志(电子版)》 CAS 2019年第3期79-84,共6页
药物超敏反应综合征属严重药物不良反应,在皮肤科疾病中属重症药疹之一,但在肝病领域诊治经验较少,如未能及时有效诊治,病死率极高.本文现报道1例以肝功能异常及发热为首发表现的典型药物超敏反应综合征,以提高肝病领域中对少见病药物... 药物超敏反应综合征属严重药物不良反应,在皮肤科疾病中属重症药疹之一,但在肝病领域诊治经验较少,如未能及时有效诊治,病死率极高.本文现报道1例以肝功能异常及发热为首发表现的典型药物超敏反应综合征,以提高肝病领域中对少见病药物超敏反应综合征的认识,避免漏诊及误诊. 展开更多
关键词 肝功能异常 发热 药物 超敏
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Effect of mild moxibustion on intestinal microbiota and NLRP6 inflammasome signaling in rats with post-inflammatory irritable bowel syndrome 预览
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作者 Chun-Hui Bao Chun-Ye Wang +8 位作者 Guo-Na Li Yi-Lu Yan Di Wang Xiao-Ming Jin Lu-Yi Wu Hui-Rong Liu Xiao-Mei Wang Zheng Shi Huan-Gan Wu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第32期4696-4714,共19页
BACKGROUND About one-third of refractory irritable bowel syndrome(IBS)cases are caused by gastrointestinal(GI)infection/inflammation,known as post-infectious/postinflammatory IBS(PI-IBS).Although it is known that inte... BACKGROUND About one-third of refractory irritable bowel syndrome(IBS)cases are caused by gastrointestinal(GI)infection/inflammation,known as post-infectious/postinflammatory IBS(PI-IBS).Although it is known that intestinal microbiota and host NOD-like receptor family pyrin domain containing 6(NLRP6)inflammsome signaling are closely related to PI-IBS and moxibustion has a therapeutic effect on PI-IBS,whether moxibustion regulates the intestinal flora and host NLRP6 events in PI-IBS remains unclear.AIM To examine the regulatory effect of moxibustion on intestinal microbiota and host NLRP6 inflammatory signaling in PI-IBS.METHODS Sprague-Dawley rats were divided into a normal control group,a model control group,a mild moxibustion group,and a sham mild moxibustion group.PI-IBS rats in the mild moxibustion group were treated with moxibusiton at bilateral Tianshu(ST 25)and Zusanli(ST36)for 7 consecutive days for 10 min each time.The sham group rats were given the same treatment as the mild moxibustion group except the moxa stick was not ignited.Abdominal withdrawal reflex(AWR)score was measured to assess the visceral sensitivity,and colon histopathology and ultrastructure,colonic myeloperoxidase(MPO)activity,and serum C-reactive protein(CRP)level were measured to evaluate low-grade colonic inflammation in rats.The relative abundance of selected intestinal bacteria in rat feces was detected by 16S rDNA PCR and the NLRP6 inflammsome signaling in the colon was detected by immunofluorescence,qRTPCR,and Western blot.RESULTS The AWR score was significantly decreased and the low-grade intestinal inflammation reflected by serum CRP and colonic MPO levels was inhibited in the mild moxibustion group compared with the sham group.Mild moxibustion remarkably increased the relative DNA abundances of Lactobacillus,Bifidobacterium,and Faecalibacterium prausnitzii but decreased that of Escherichia coli in the gut of PI-IBS rats.Additionally,mild moxibustion induced mRNA and protein expression of intestine lectin 1 but inhibited the ex 展开更多
关键词 Moxibustion Post-inflammation irritable bowel syndrome INTESTINAL microbes NLRP6 INFLAMMASOME INTESTINAL INFLAMMATION VISCERAL HYPERSENSITIVITY Traditional Chinese medicine
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耐药结核病化疗过程中药品不良反应处理的专家共识
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作者 《中国防瘠杂志》编委会 中国医疗保健国际交流促进会结核病防治分会全国耐药结核病协作组 +1 位作者 范琳 肖和平 《中国防痨杂志》 CAS CSCD 2019年第6期591-603,共13页
耐药结核病具有疗程长、用药种类多、不良反应发生率高的临床特征,如何正确处理药品不良反应是提高耐药结核病治疗转归的重要因素之一。本专家共识从不同药品发生不良反应的处理、各类系统不良反应的处理、药品不良反应的监测等方面进... 耐药结核病具有疗程长、用药种类多、不良反应发生率高的临床特征,如何正确处理药品不良反应是提高耐药结核病治疗转归的重要因素之一。本专家共识从不同药品发生不良反应的处理、各类系统不良反应的处理、药品不良反应的监测等方面进行阐述,提出了较为规范的处理方法及原则。 展开更多
关键词 结核 抗多种药物性 抗结核药 药物毒性 超敏反应 人群监测 处理方法
变应性支气管肺真菌病研究进展
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作者 申舟如 邓静敏 《国际呼吸杂志》 2019年第19期1504-1507,共4页
变应性支气管肺真菌病是一种变态反应性肺部疾病,最常见的致病真菌为曲霉,近些年相关指南及研究不断有报道,但非曲霉引起的变应性支气管肺真菌病及相关诊治少有报道.本文就变应性支气管肺真菌病流行病学特点、病因及发病机制、临床表现... 变应性支气管肺真菌病是一种变态反应性肺部疾病,最常见的致病真菌为曲霉,近些年相关指南及研究不断有报道,但非曲霉引起的变应性支气管肺真菌病及相关诊治少有报道.本文就变应性支气管肺真菌病流行病学特点、病因及发病机制、临床表现及影像学、治疗等方面研究进展进行综述,同时回顾非曲霉引起的变应性支气管肺真菌病相关研究进展. 展开更多
关键词 真菌病 超敏反应 曲霉菌病
抗体类药物超敏反应研究进展
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作者 宫新江 邵雪 +10 位作者 张旻 朱飞鹏 闫莉萍 于冰 叶旋 刘轶博 周植星 崔岚 赵华琛 王庆利 王海学 《中国新药杂志》 CAS CSCD 北大核心 2019年第21期2651-2657,共7页
抗体类药物在临床应用中很可能导致不同类型的超敏反应(hypersensitivity reaction,HSR)。在近期某些创新单抗或双功能抗体的非临床研究中,相关动物种属或人源化动物模型给予候选分子也常见非预期HSR,严重时可能对药效学、药动学和/或... 抗体类药物在临床应用中很可能导致不同类型的超敏反应(hypersensitivity reaction,HSR)。在近期某些创新单抗或双功能抗体的非临床研究中,相关动物种属或人源化动物模型给予候选分子也常见非预期HSR,严重时可能对药效学、药动学和/或毒理学研究结果的解读和评价以及人体不良反应的预测造成干扰。探索HSR发生的机制有助于科学分析非临床研究的结果,并对临床试验中人体用药风险的评估和相应的风险缓解策略的制定提供更有价值的参考信息。本文对抗体类药物导致的HSR类型、临床表现和诊断方法、可能的发生机制进行了综述,并对非临床研究中HSR相关标志物的检测方法和必要性进行了探讨,以供研究者和监管机构关注或参考。 展开更多
关键词 抗体类药物 超敏反应 非临床研究 临床试验 机制
北京地区霉菌诱导过敏性鼻炎患者血清特异性IgE水平分析
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作者 孔瑞 兰天飞 王学艳 《中国耳鼻咽喉头颈外科》 CSCD 2019年第1期42-44,共3页
目的 了解北京地区不同性别、年龄霉菌诱导过敏性鼻炎患者血清烟曲霉及链格孢霉特异性IgE(specific IgE,sIgE)水平差异。方法 本研究采用回顾性横断面研究,纳入我科2016年8月~2017年7月因过敏性鼻炎就诊,烟曲霉或链格孢霉至少一项sIgE... 目的 了解北京地区不同性别、年龄霉菌诱导过敏性鼻炎患者血清烟曲霉及链格孢霉特异性IgE(specific IgE,sIgE)水平差异。方法 本研究采用回顾性横断面研究,纳入我科2016年8月~2017年7月因过敏性鼻炎就诊,烟曲霉或链格孢霉至少一项sIgE阳性患者85例。采用Immuno Cap 250TM系统进行检测,比较两种霉菌sIgE水平差异,以及不同性别、年龄患者霉菌sIgE水平差异。结果烟曲霉平均sIgE水平明显低于链格孢霉(P<0.05),这种差异不受单一或双重霉菌过敏的影响。烟曲霉过敏患者中,年龄与sIgE水平呈明显正相关(P<0.05);链格孢霉过敏患者中,年龄与sIgE水平明显负相关(P<0.05)。结论 烟曲霉及链格孢霉是两种常见霉菌过敏原,检测霉菌的sIgE水平对不同年龄段可疑霉菌过敏患者过敏性鼻炎及其余呼吸系统过敏性疾病的诊断有明确的指导意义。 展开更多
关键词 超敏反应 曲霉菌 免疫球蛋白E 链格孢霉 特异性IGE
Altered profiles of fecal metabolites correlate with visceral hypersensitivity and may contribute to symptom severity of diarrhea-predominant irritable bowel syndrome 预览
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作者 Wen-Xue Zhang Yu Zhang +4 位作者 Geng Qin Kai-Min Li Wei Wei Su-Yun Li Shu-Kun Yao 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第43期6416-6429,共14页
BACKGROUND Fecal metabolites are associated with gut visceral sensitivity,mucosal immune function and intestinal barrier function,all of which have critical roles in the pathogenesis of irritable bowel syndrome(IBS).H... BACKGROUND Fecal metabolites are associated with gut visceral sensitivity,mucosal immune function and intestinal barrier function,all of which have critical roles in the pathogenesis of irritable bowel syndrome(IBS).However,the metabolic profile and pathophysiology of IBS are still unclear.We hypothesized that altered profiles of fecal metabolites might be involved in the pathogenesis of IBS with predominant diarrhea(IBS-D).AIM To investigate the fecal metabolite composition and the role of metabolites in IBSD pathophysiology.METHODS Thirty IBS-D patients and 15 age-and sex-matched healthy controls(HCs)underwent clinical and psychological assessments,including the IBS Symptom Severity System(IBS-SSS),an Italian modified version of the Bowel Disease Questionnaire,the Bristol Stool Form Scale(BSFS),the Hospital Anxiety and Depression Scale,and the Visceral Sensitivity Index.Visceral sensitivity to rectal distension was tested using high-resolution manometry system by the same investigator.Fecal metabolites,including amino acids and organic acids,were measured by targeted metabolomics approaches.Correlation analyses between these parameters were performed.RESULTS The patients presented with increased stool water content,more psychological symptoms and increased visceral hypersensitivity compared with the controls.In fecal metabolites,His[IBS-D:0.0642(0.0388,0.1484),HC:0.2636(0.0780,0.3966),P=0.012],Ala[IBS-D:0.5095(0.2826,0.9183),HC:1.0118(0.6135,1.4335),P=0.041],Tyr[IBS-D:0.1024(0.0173,0.4527),HC:0.5665(0.2436,1.3447),P=0.018],Phe[IBS-D:0.1511(0.0775,0.3248),HC:0.3967(0.1388,0.7550),P=0.028],and Trp[IBS-D:0.0323(0.0001,0.0826),HC:0.0834(0.0170,0.1759),P=0.046]were decreased in IBS-D patients,but isohexanoate[IBS-D:0.0127(0.0060,0.0246),HC:0.0070(0.0023,0.0106),P=0.028]was significantly increased.Only Tyr was mildly correlated with BSFS scores in all subjects(r=-0.347,P=0.019).A possible potential biomarker panel was identified to correlate with IBS-SSS score(R2 Adjusted=0.693,P<0.001).In this regression model,the l 展开更多
关键词 Fecal metabolite Irritable bowel syndrome Amino acids Organic acids Short chain fatty acids Visceral hypersensitivity
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