Objectives To detect the clinical significance of high sensitive C-reactive protein (hs-CRP) and immune function in children with Mycoplasma pneumoniae pneumonia (MPP). Methods 103 children with MPP, 47 cases of systemic inflammatory response syndrome (SIRS group), 56 cases of non-systemic inflammatory response syndrome (non-SIRS group) were recruited. 26 healthy children served as the control group. ELISA was used to detect the level of serum hs-CRP, immune in-dexes, IgG, IgA, and IgM, Cellular immune CD3+, CD4+, CD8+, CD4+/CD8+. Results The level of serum hs-CRP、IgG、IgM and CD8+in control group were significantly lower than those in non-SIRS group and SIRS group (P<0.05). The level of IgA、CD3+, CD4+, CD4+/CD8+in control group were significantly higher than those in non-SIRS group and SIRS group (P<0.05). The level of serum hs-CRP、IgG in SIRS group were significantly higher than those in non-SIRS group (P<0.05). The level of IgA、CD3+、CD4+、CD4+/CD8+in SIRS group were significantly lower than those in non-SIRS group. There was no significant difference in non-SIRS group and SIRS group of IgM and CD8+(P>0.05). The level change of serum hs-CRP were positively related with IgG (r=0.66,P=0.001) and were negatively related with IgA、CD4+、CD4+/CD8+(r=0.79, 0.67, 0.82, P all were<0.05) in chil-dren with MPP. Conclusion Children with MPP have Immunity function( including humoral immunity and cellular immunity) disorder which is related to the disease status. The level of hs-CRP could be an anpation index for the severity and immune func-tion of the children with MPP.

10.3969/j.issn.1000-3606.2013.06.004

Objective To investigate the expression levels and the roles of IL-17 and IL-23 in children with Mycoplasma pneumoniae (MP) pneumonia. Methods One hundred and three children with pneumonia admitted to pediatric department from February to May in 2012 were divided into MP pneumonia group and non-MP pneumonia group according to the results of MP antibody tests. Meanwhile, 42 healthy children were chosen as normal controls. Serum levels of IL-17, IL-23 and MP antibodies were measured in all children. Immunoglobulin, C reactive protein, total white blood cell count and granulocyte count were detected in children with pneumonia. Results The serum levels of IL-17 and IL-23 were signiifcantly different among three groups (P<0.05). The children in MP pneumonia group had higher levels of IL-17 and IL-23 than those in non-MP pneumonia group (P<0.05). Compared with the control group, levels of IL-17 and IL-23 were higher in two pneumonia groups (P<0.05). There was no signiifcant difference in levels of IL-17 and IL-23 between pneumonia patients with normal and with abnormal levels of immunoglobulin (P>0.05), while IL-17 and IL-23 levels were both positively correlated with granulocyte count (P<0.05).Conclusion IL-17 and IL-23 may be involved in the immune response of MP pneumonia and may contribute to the clearance of pathogens.

Objective To explore the relationship between childhood asthma and pregnant and neonatal risk factors, thus provide evidence for early prevention of childhood asthma. Methods 162 children diagnosed asthma and 213 healthy children in pediatric outpatient and the inpatient services of our hospital who was born and living in Baotou city were retrospectively analyzed. The pregnancy related factors (parity, fever during pregnancy, pregnancy-induced hypertension syndrome, gestational diabetes mellitus, history of overdose in early-pregnancy) and the neonatal period related factors (surface defects, asphyxia, rough placenta, birth weight, number of fetus during this pregnancy, gestational age, premature birth, cesarean section) were investigated. The sex and age showed no signiifcance between childhood asthma and control group. Results Eight pregnant and neonatal factors (fever during pregnancy, pregnancy-induced hypertension syndrome, history of overdose in early-pregnancy, surface defects, asphyxia, rough placenta, birth weight, premature birth, cesarean section) showed signiifcant difference between the two groups (P<0.05). Multifactor regression analysis found fever during pregnancy (OR=9.43, 95%CI:3.08~28.82), rough placenta (OR=2.15, 95%CI:1.29~3.59), premature birth (OR=5.16, 95%CI:1.53~17.39) and cesarean section (OR=4.05, 95%CI:2.40~6.86)are independent risk factors for childhood asthma. Conclusions Fever during pregnancy, abnormal placenta;premature birth and cesarean section are likely risk factors of childhood asthma.

Objective To investigate the effects of writing to express positive emotion on well-being in single intrauterine fetal demise (sIUFD)women.Methods According to inclusion criteria,100 sIUFD women were recruited from January 2012 to January 2015.These candidates were randomly divided into control group and observation group with 50 members respectively.The patients of observation group were given conventional nursing instructions and provided with a written expression which written 30 -45 minutes a day and last 4 weeks.The patients of control group were given the conventional nursing instructions only.General Well-Being Schedule (GWB)was measured before and after the interventions.Results Before the interventions,the GWB score were no significant difference between two groups (P >0.05 ).After the intervention,the observation group GWB scores were (77.7 ±9.58),while the control group GWB scores were (70.3 ±8.45) (P <0.05).Conclusions The writing to express positive emotions can promote well-being in sIUFD women.

Objective:To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods:Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results:A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%) , 61 with complicated allergic rhinitis (82.4%) , 6 with complicated atopic dermatitis (8.1%) , and 4 with food allergy (5.4%) . Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001) ; after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001) ; among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment ( t = 15.04, 10.01, respectively, both P < 0.001) , and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions:In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.

OBJECTIVE: To test the performance of CHADS-VASc score in predicting stroke recurrence in first-ever ischemic stroke survivors without atrial fibrillation (AF). METHODS: A total of 768 patients were included in this study, including 475 male (61.85%) and 293 female patients (38.15%) with a mean age of 61.52±12.59 years (17-90 years). The baseline information of the patients was collected by face-to-face questionnaire survey and electronic medical record review, and their follow-up information was collected by telephone follow-up once every 3 months. Chi-square test and Wilcoxon rank sum test were used to compare the baseline characteristics between the patients regularly followed up and those withdrawn from the study. The area under the ROC curve (AUC), sensitivity, specificity, positive likelihood ratio and other indicators of CHADS-VASc score were determined, and C-index based on Cox proportional hazards model was used to evaluate the performance of CHADS- VASc score in predicting the risk of stroke recurrence in patients at different time points during the follow-up. RESULTS: The 1-year, 3-year, and 5-year recurrence rate of stroke was 10.59%, 20.45%, and 29.46% in these patients, respectively. The AUC value, Optimal Operating Point (OOP) and the corresponding positive likelihood ratios (LR+) for predicting stroke recurrence were 0.558 (95%: 0.492-0.624), 4.5, and 1.256 at 1 year; 0.574 (95%: 0.517-0.630), 4.5, and 1.397 at 3 years; and 0.604 (95%: 0.548-0.661), 4.5, and 1.655 at 5 years, respectively. Sensitivity analysis of congestive heart failure showed that the predictive effect of CHADS-VASc score was basically unchanged. CONCLUSIONS CHADS-VASc score can be used to predict the 3-year and 5-year risk of stroke recurrence in first-ever ischemic stroke survivors without AF. The score has a better prediction ability for long-term stroke recurrence, but the prediction value remains low, suggesting the need to further improve the score or establish a new score for predicting stroke recurrence.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation ; Brain Ischemia ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; Stroke ; Survivors ; Young Adult