Cytomegalovirus infection in melanoma patients

The occurrence of active cytomegalovirus (CMV) infection in 30 patients with skin melanoma, aged 18-76 years, was studied with the enzyme immunoassay, the direct immunofluorescence test and the polymerase chain reaction. The patients were divided into two groups: group I consisted of 20 patients examined in a month after radical surgical treatment, group II consisted of 10 patients at the stage of the process generalization. For comparison, group III was formed consisting of 89 patients with diagnosed secondary immunodeficiency and clinical manifestations of CMV infection. The control group included 80 donors. The study showed that in group II the occurrence of active CMV infection was 4 times higher than in group I and practically coincided with the results registered in group III. In the evaluation of the immune status of the members of group II the most profound changes were revealed in T-cell mediated immunity and in phagocytic immunity; the adequate production of tumor necrosis factor alpha and interleukin 1beta was absent, which created prerequisites for the activation of CMV and the aggravation of the prognosis.     

Immune stimulation may contribute to enhanced progression of SIV induced disease in rhesus macaques

Abstract: A number of rhesus macaques experimentally infected with SIV isolates such as SIVmac251, fail to seroconvert, develop high plasma viremia and die rapidly (within 6–7 months p.i.). We hypothesized that such rapid progression is a result of a state of hyperimmune activation and concomitant immune suppression of these animals at the time of virus challenge. In efforts to test the hypothesis that immune activation leads to rapid progression of lentivirus-induced disease, adult rhesus macaques were infected with SIVmac251 and received an alternate monthly schedule of repeated immunization with allogeneic cells, keyhole limpet hemocyanin and tetanus toxoid (group I). For purposes of controls, a group of monkeys was infected with the same pool and dose of virus but were not immunized (group II) and a group was immunized with the same schedule of multiple antigens as group I but were not infected with SIV (group III). All the animals in group I (n ? 3) either failed to seroconvert or developed very low levels of SIV antibodies, had high plasma p27 defined antigenemia, and died within 8 months (2/3 died within 4 months). Of the animals in group II (n = 8), two patterns emerged as we had noted before. One subgroup (3 animals), displayed the same profile as group I (failure to fully seroconvert, high p27 levels and death by 8 months), whereas the other subgroup (5 animals) seroconverted, had low plasma p27 levels, and survived past 11 months (2/5 still alive past 22 months). All 3 animals in group III remained healthy. The data provided herein suggest that either experimental or natural (due to factors not clear at present) immune stimulation may lead to accelerated lentivirus induced disease progression most likely due to immune suppression and has implications for the understanding of the mechanisms for the rate of disease progression in human HIV-1 infection.     

Cytokine production by peripheral blood mononuclear cells in recurrent miscarriage

It has been postulated that a proportion of recurrent miscarriage (RM) might be due to immune causes. The objective was to determine whether cytokine expression in peripheral blood mononuclear cell is altered in patients with a history of RM. We compared the levels of IL-2, IL-4, IL-10, IL-13, TGFbeta1 and IFNgamma in the supernatant of Phytohemagglutinin stimulated mononuclear cells in 21 women with RM at the time of 3rd or higher abortion (group I), 32 women who were at least 3 months past their 3rd or higher abortion (group II) and 32 pregnant women with no history of abortion (group III). Gestational age was matched between groups I and III. Group I had higher level of IL-2 than group III (P=0.001). Group II showed higher level of IL-2 (P=0.001) and IFNgamma (P=0.015) than group III. The production of IL-10 by mononuclear cells of group III was higher than both group I (P=0.002) and group II (P=0.001). There was no difference in the levels of IL-2, IL-10 and IFNgamma between groups I and II. Also, the levels of IL-4, IL-13, and TGFbeta1 were similar among the groups. The data indicate an elevation of Th1 cytokines in women with RM as compared to normal pregnant women, and IL-10 is an important cytokine in the maintenance of pregnancy.     

TSH and prolactin secretions in Hashimoto's thyroiditis following withdrawal of thyroid hormone therapy

Changes in the pituitary-thyroid axis in patients with Hashimoto's thyroiditis following withdrawal of thyroid suppressive therapy were analyzed. The group of patients with thyroid adenoma served as control (group I). Patients with Hashimoto's thyroiditis were divided into 2 groups on the basis of serum TSH levels 8 weeks after discontinuing the exogenous thyroid hormone (group II, less than 10 microunits/ml; group III, more than 10 microunits/ml). During treatment with L-T4(200 micrograms/day) or L-T3(50 micrograms/day), there was no significant difference in serum T4-I and T3 levels among the three groups. Following L-T4 withdrawal, basal serum TSH levels were higher at 2 to 8 weeks in groups II and III than in group I. Serum TSH response to TRH was greater at 4 to 8 weeks in groups II and III than in group I. Following L-T3 withdrawal, basal serum TSH levels were higher at 1 and 2 weeks in group II than in group I, while those of group III were consistently higher during the study. Higher TSH responses to TRH were observed at 1 to 8 weeks in groups II and III. Neither basal nor TRH-induced prolactin (PRL) secretion differed significantly among the three groups. We have demonstrated that pituitary TSH secretion in patients with Hashimoto's thyroiditis is affected more by withdrawal of thyroid hormone therapy than in patients with thyroid adenoma. In addition, the present findings suggest a difference between the sensitivity of thyrotrophs and lactotrophs in Hashimoto's thyroiditis after prolonged thyroid therapy is discontinued.     

The immunological aspects of predicting antibiotic therapy efficacy in peritonitis patients]

The analysis of the impact of various group antibiotics on the mechanisms of development and correction of pathogenetically heterogeneous immune deficiency in 235 patients at age of 17 to 85 years with local (80 patients) and general (155 patients) peritonitis is presented. Cephalosporins and fluoroquinolones promoted restoration of the immune and interleukin (IL-1 and IL-2 of donors, IL-1r and IL-2r of patients) status and lowered the immunodepressive effect of glucocorticoids (GC) at the organism (cortisol, ACTH and cortisol-binding globulin) and cellular (GC receptors III) levels. Aminoglycosides and penicillins had no significant action on the immune and interleukin status but lowered the EG effect at the organism (aminoglycosides) and cellular (penicillins) levels. It is recommended that the antibiotics be used with an account of their involvement in the systemic reactions of the host.     

Lymphocyte transformation to connective tissue antigens in adult and juvenile rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, systemic lupus erythematosus, and a nonarthritic control population

Transformation of peripheral blood lymphocytes after exposure to connective tissue antigens was measured in patients with adult (n = 35) and juvenile rheumatoid arthritis (n = 34), osteoarthritis (n = 21), ankylosing spondylitis (n = 15), and systemic lupus erythematosus (n = 26) and in control subjects (n = 36). The connective tissue antigens included homologous cartilage-type proteoglycan, cyanogen bromide-derived peptides of type I, II, and III collagens, and type I and II helical collagens. Lymphocyte transformation was not detected in the osteoarthritic and control groups, with one exception. Sensitization to at least one connective tissue antigen was detected in approximately one-third of the rheumatoid arthritic and lupus patients and in one-quarter of the juvenile rheumatoid patients. In ankylosing spondylitis, positive responses occurred to proteoglycan in 20% of patients tested but never to collagens or peptides. Sensitivity to proteoglycan was detected only in ankylosing spondylitis except for one patient with juvenile rheumatoid arthritis. In patients with systemic lupus erythematosus and both forms of rheumatoid arthritis, lymphocyte transformation was usually more frequently detected to peptides than to the helical collagens. In adult rheumatoid arthritis, type II peptides elicited an elevated number of responses (14%) as did type I (9%) and III (8%) peptides to lesser degrees. Responses to type I (4%) and II (4%) helical collagens were infrequent. Rheumatoid arthritic patients usually exhibited sensitivity to only one antigen and lymphocyte transformation was often detected when the arthritis was improving. In juvenile rheumatoid arthritis, lymphocyte transformation was detected to peptides of type I (16%), II (9%), and III (29%) collagens and to helical type I (12%) and II (8%) collagens. In systemic lupus erythematosus, sensitization was detected to peptides of type I (13%), II (20%), and III (14%) collagens and to helical type I collagen (18%) but not type II collagen. Simultaneous sensitivity to several antigens often occurred in both systemic lupus erythematosus and juvenile rheumatoid arthritis. Examination of individual patients in all three rheumatic disease groups revealed that immune sensitivity developed to collagen peptides rather than to the helical molecules, particularly in the case of type II collagen. Thus, some patients with inflammatory arthritis exhibit immune responses to connective tissue components which are, as a group, characteristic for each type of arthritis. These responses, which were not obviously associated with disease activity, may develop as a result of inflammation or trauma which destroys connective tissue and exposes molecules, in either a native or degraded state, to cells of the immune system. Expression of sensitivity to these tissue antigens may contribute to the chronicity of the inflammatory arthritides.     

Agarose gel electrophoretic analysis of damage to supercoiled DNA by adriamycin in the presence of beta-NADH dehydrogenase

In a cell-free system, the anticancer anthracycline antibiotic adriamycin was able to convert purified covalently closed circular, superhelical, form I bacteriophage PM2 DNA to relaxed circular form II DNA in the presence of either sodium borohydride (NaBH4), NADPH cytochrome P-450 reductase or beta-NADH dehydrogenase isolated from myocardial cells. There was no detectable increase in the amount of form III linear duplex DNA formed during the reaction even at high drug concentrations. Less drug was required for the conversion of form I to form II DNA in the presence of the enzymic reducing agents than in the presence of NaBH4. Form II DNA, prepared by irradiation using a Cs-137 source, was not degraded to form III linear duplex DNA. However, form I0 DNA, covalently closed circular DNA without superhelical turns, freshly prepared using topoisomerase I, was converted to form II DNA similar to the conversion of superhelical form I to form II DNA. Again, no increase in the amount of form III linear duplex DNA could be detected.     

右美托咪定在血管外科介入手术麻醉中的应用

目的:探讨靶控输注不同浓度右美托咪定对血管外科介入手术的效果。方法:选择周围血管疾病成年患者60例,随机分为I、II、III三组,每组20例。各组右美托咪定靶控输注浓度分别为0.2μg/kg/h,0.3μg/kg/h和0.4μg/kg/h,术中监测并记录各组手术开始前(T1),手术开始10 min(T2),手术开始30 min(T3),手术开始60 min(T4)四个时间点的平均动脉压(MAP),心率(HR),血氧(Sp O2),脑电双频指数(BIS)。结果:T2、T3、T4时平均动脉压Ⅰ组与Ⅱ组比较P0.05,Ⅰ组与Ⅲ组比较P0.05。T2时Ⅲ组与Ⅰ、Ⅱ组比较P0.05,T3、T4时Ⅱ、Ⅲ组与Ⅰ组比较均P0.05。结论:右美托咪定靶控输注浓度为0.3μg/kg/h和0.4μg/kg/h时,对血管外科介入手术能产生良好的镇静作用,并且可保证术中循环的稳定。     

胆道支架置入联合介入化疗对恶性胆道梗阻患者肝功能及预后的影响

目的:研究胆道支架置入联合介入化疗对恶性胆道梗阻患者肝功能及预后的影响,为临床治疗提供依据。方法:选取2013年2月到2015年2月我院收治的恶性胆道梗阻患者90例,按照随机数字表法将患者分为Ⅰ组、Ⅱ组和Ⅲ组,每组30例,Ⅰ组给予胆道支架置入联合介入化疗,Ⅱ组给予单纯胆道支架置入,Ⅲ组给予保守治疗,比较三组治疗前、后肝功能、并发症、支架通畅率及生存期。结果:治疗前三组谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨酰转移酶(r-GT)比较无统计学意义(P0.05),治疗后Ⅰ组和Ⅱ组AST、ALT和r-GT均显著改善,与治疗前和Ⅲ组比较差异具有统计学意义(P0.05),且I组显著优于Ⅱ组,比较差异具有统计学意义(P0.05),Ⅲ组治疗后AST、ALT和r-GT与治疗前比较差异无统计学意义(P0.05);Ⅰ组、Ⅱ组和Ⅲ组并发症发生率比较无统计学意义(P0.05);Ⅰ组术后3个月、6个月和12个月支架通畅率均显著高于Ⅱ组,比较差异具有统计学意义(P0.05);I组生存期显著高于Ⅱ组和Ⅲ组,Ⅱ组高于Ⅲ组,比较差异具有统计学意义(P0.05)。结论:胆道支架置入联合介入化疗治疗恶性胆道梗阻具有较好效果,能明显改善患者肝功,延长患者生存期。     

Protective effect of chromium(III) on acute lethal toxicity of carbon tetrachloride in rats and mice.

Trivalent chromium (Cr(III)) preadministered intraperitoneally (5 mg Cr/kg body weight) to rats and mice protected these animals from acute lethal toxicity of carbon tetrachloride (CCl4). Some other metals, Cr(VI), Cu(II), and Zn(II), had no effect on CCl4 lethal toxicity. DL-alpha-tocopherol, one of the antioxidative agents, showed similar protective effects to Cr(III). Activities of serum GOT and GPT in mice were increased sharply by the administration of CCl4, but these elevations were depressed by Cr(III) preadministration. Serum glucose levels of mice increased transiently after CCl4 administration and then in the control group fell to hypoglycemic levels after 6 hr, whereas the Cr(III)-pretreated group kept to homeostatic levels. Lipid peroxidation of microsomes in mice 24 hr after Cr(III) administration was lower than that of the control. These results suggest that Cr(III) preadministered to mice might act as a radical scavenger to CCl4 to form trichloromethyl radicals which are a major initial product of CCl4 in liver cells.     

Effect of selenium-induced oxidative stress on the oxidation reduction system and reproductive ability of male mice

The present study was carried out to evaluate the effect of selenium (Se)-induced oxidative stress on the oxidation reduction system and the fertility status of male mice. Different levels of Se, a potent antioxidant, were fed in three separate groups for 8 wk to create the different oxidative stress in mice. A significant decrese in the glutathione peroxidase (GSH-Px) in both liver and testis was observed in the Se-deficient (0.02 ppm) group I, whereas enzyme levels in the Se-excess (1 ppm) group were comparable to the Se-adequate (0.2 ppm) group. Glutathione-S-transferase activity was enhanced in group I in comparison to group II; however, no change was seen in group III. The glutathione reductase and superoxide dismutase activities were decreased in the Se-deficient group, whereas the enzyme levels were significantly increased in the Se-excess group. The fertility status of the animals studied in terms of percentage fertility and litter size showed a significant decrease in the reproductive ability of male mice in group I when compared to group II. No changes in the fertility status of animals were observed in group III. Thus, the data clearly indicate the effect of oxidative stress generated by feeding various Se levels on the oxidation reduction system and, consequently, its effect on the reproductive ability of male mice.     

内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响

摘要 目的：探讨内镜下负压套扎术对Ⅱ、Ⅲ度痔疮患者肛肠动力学、炎症反应及免疫功能的影响。方法：选择2021年3月到2023年3月期间邯郸市中心医院收治的120例Ⅱ、Ⅲ度痔疮患者。按照手术方式的不同将患者分为A组（传统外剥内扎术,n=58）和B组（内镜下负压套扎术,n=62）。对比两组围术期指标、肛肠动力学、炎症反应及免疫功能变化情况,同时观察两组并发症发生率。结果：B组术中出血量少于A组,手术时间、首次排便时间、住院时间短于A组,术后24 h疼痛视觉模拟量表（VAS）评分低于A组（P<0.05）。两组术后3个月直肠最大耐受量、直肠感觉阈值、肛管静息压、肛管最大收缩压下降,且B组低于A组（P<0.05）。两组术后3 d白介素-6（IL-6）、白介素-8（IL-8）、白介素-12（IL-12）、C反应蛋白（CRP）升高,但B组低于A组（P<0.05）。两组术后3 d CD8⁺升高,但B组低于A组,CD3⁺、CD4⁺、CD4⁺/CD8⁺下降,但B组高于A组（P<0.05）。B组的并发症发生率低于A组（P<0.05）。结论：与传统外剥内扎术治疗相比,内镜下负压套扎术用于Ⅱ、Ⅲ度痔疮,具有创伤小,术后恢复快的优势,同时还可促进机体肛肠动力学恢复,减轻炎症反应和免疫抑制,降低术后并发症发生率。     

Low T3 syndrome in cancer patients in relation to weight loss, intravenous hyperalimentation therapy and age

In order to investigate the relation of weight loss and intravenous hyperalimentation therapy to low T3 syndrome, serum T3, T4. rT3 and TBG were determined by radioimmunoassay in 105 cancer patients. The cancer patients were classified into 3 groups, Group I, II and III depending on the grade of weight loss, ranging up to a 5% change in weight loss from a healthy condition, from 5 to 9%, and more than 10%, respectively. Cancer patients under age 59 showed no significant difference in serum T3, T4, rT3 and TBG among these 3 groups. However serum T3 and T3/T4 in cancer patients at age 60 and over were significantly reduced in group III, compared to groups I and II. Serum rT3 values were significantly elevated in group III of elderly cancer patients. The incidence of low T3 syndrome in group III of elderly cancer patients was also significantly higher than in groups I and II. In three out of 5 cancer patients with low T3 syndrome, serum T3 values increased after the intravenous hyperalimentation therapy, whereas no significant change in serum T3 values was observed in two patients who died within one day after the final examination. It is concluded that weight loss produced different effects on peripheral conversion of T4 to T3 between cancer patients under age 59 and over age 60 and glucose plays an important role in the pathogenesis of low T3 syndrome except cases with very poor prognosis.     

An immunophenotyping of renal clear cell carcinoma with characteristics and a potential therapeutic target for patients insensitive to immune checkpoint blockade

Renal clear cell carcinoma (RCC) patients who do not achieve optimal control of progression with immune checkpoint blockade (ICB) should be further studied. Unsupervised consensus clustering was used to group 525 RCC patients based on two typical ICB pathways, CTLA-4 and pogrammed death 1 (PD-1)/programmed death-ligand 1 (PD-L1), as well as two new discovered regulators, CMTM6 and CMTM4. Three immune molecular subtypes (IMMSs) with different clinical and immunological characteristics were identified (type I, II, and III), among which there were more stage I and low-grade tumors in type I RCC than in type II and III. The proportion of males was highest in type II RCC. Overall survival of type II and III was similar (5.2 and 6 years) and statistically shorter than that of type I (7.6 years) before and after adjusting for age and gender. When conducting stratified analysis, our IMMSs were able to identify high-risk patients among middle-aged patients, males, and stage IV patients. Among the differentially expressed genes, approximately 84% were highly expressed in type II and III RCC. Genes related to ICB (CTLA-4, CD274, and PDCD1LG2) and cytotoxic lymphocytes (CD8A, GZMA, and PRF1) were all highly expressed in type II and III RCC. These results documented that patients with type II and III cancer may be more sensitive to anti-CTLA-4 therapy, anti-PD-1/PD-L1 therapy, and a combination of immunotherapies. High expression of CMTM4 in type I RCC (69%) and a statistically significant interaction of CD274 and CMTM6 indicated that CMTM4/6 might be new therapy targets for type I, who are resistant to ICB.     

Oxidant balance in brain of rats receiving different compounds of selenium

The influence of two organic selenocompounds and sodium selenite on oxidant processes in rat brain tissue was investigated. The study was performed on male Wistar rats. The animals were divided into four groups: I—control; II—administered with sodium selenite; III—provided with selenoorganic compound A of chain structure 4-(o-tolyl-)-selenosemicarbazide of 2-chlorobenzoic acid and IV—provided with selenoorganic compound B of ring structure 3-(2-chlorobenzoylamino-)-2-(o-tolylimino-)-4-methyl-4-selenazoline. Rats were treated by stomach tube at a dose of 5 × 10^?4 mg of selenium/g of b.w. once a day for a period of 10 days. In brain homogenates total antioxidant status (TAS), activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx), concentrations of ascorbic acid (AA) and reduced glutathione (GSH) as well as concentration of malonyl dialdehyde (MDA) were determined. TAS was insignificantly diminished in all selenium-supplemented groups versus control. SOD was not significantly influenced by administration of selenium. GPx was markedly decreased in group III versus control, whereas increased in group IV versus control and group III. Selenosemicarbazide depleted AA in well-marked way versus group II. GSH was significantly depressed in group III versus both control and group II and diminished in group IV versus group II. MDA was significantly decreased in group III versus both control and group II, whereas in group IV increased versus group III. As selenazoline A did not decrease elements of antioxidant barrier and increased GPx activity, it seems to be a promising agent for future studies concerning its possible application as a selenium supplement.     

循环流水鱼草共生生态系统的鱼草配比试验研究

通过不同鱼草配比试验 ,探讨循环流水鱼草共生生态系统的结构优化问题。5组试验组的罗非鱼 (Oreochromis niloticus)初始养殖密度分别为 2 .0 0 (I)、1.6 1(II)、1.38(III)、1.2 0 (IV)和 0 kg/ m3(CK) ,牧草 (L olium multiflorum L am .)初始生物量相同。结果表明 :试验组 III和 IV的养殖废水经牧草的净化基本符合渔业水质标准 (除 TP外 ) ;试验组 II、III和 IV养殖废水中的营养基本上能符合多花黑麦草的生长要求 ;试验组 III养鱼效益综合指标最高 ,该组在试验结束时的鱼草质量比为 0 .2 2 1,不但鱼获得较高的生长速度 (平均增重 2 8.3g) ,而且牧草也得以正常生长。     

Systematic construction and validation of an immune prognostic model for lung adenocarcinoma

Lung adenocarcinoma (LUAD), the most common non‐small‐cell lung cancer, is characterized by a dense lymphocytic infiltrate, which indicates that the immune system plays an active role in the development and growth of this cancer. However, no investigations to date have proposed robust models for predicting survival outcome for patients with LUAD in terms of tumour immunology. A total of 761 LUAD patients were included in this study, in which the database of The Cancer Genome Atlas (TCGA) was utilized for discovery, and the Gene Expression Omnibus (GEO) database was utilized for validation. Bioinformatics analysis and R language tools were utilized to construct an immune prognostic model and annotate biological functions. Lung adenocarcinoma showed a weakened immune phenotype compared with adjacent normal tissues. Immune‐related gene sets were profiled, an immune prognostic model based on 2 immune genes (ANLN and F2) was developed with the TCGA database to distinguish cases as having a low or high risk of unfavourable prognosis, and the model was verified with the GEO database. The model was prognostically significant in stratified cohorts, including stage I‐II, stage III‐IV and epidermal growth factor receptor (EGFR) mutant subsets, and was considered to be an independent prognostic factor for LUAD. Furthermore, the low‐ and high‐risk groups showed marked differences in tumour‐infiltrating leucocytes, tumour mutation burden, aneuploidy and PD‐L1 expression. In conclusion, an immune prognostic model was proposed for LUAD that is capable of independently identifying patients at high risk for poor survival, suggesting a relationship between local immune status and prognosis.     

激光联合紫外线治疗II 期、III期压疮患者的疗效观察

目的：研究激光联合紫外线治疗II期和III期压疮患者的疗效。方法：回顾性分析2010 年7 月至2014 年7 月我科收治的59 例II期和III 期压疮患者的临床资料,按照护理方式的不同分为对照组（30 例）和联合组（29 例）,对照组在基础治疗的基础上进 行传统护理,联合组在基础治疗的基础上加用激光联合紫外线护理,两组治疗14 天后,采用压疮愈合评估量表（PUSH）评分比较 两组疗效。结果：两组患者治疗后PUSH评分均降低,且联合组降低幅度显著高于对照组,差异均有统计学意义（P<0.001）。结论： 激光联合紫外线治疗对II期和III期压疮患者的恢复具有显著促进作用,值得推广使用。     

不同比例肠内联合肠外营养治疗方案对重型颅脑创伤患者的影响

摘要 目的：探讨不同比例的肠内联合肠外营养治疗方案对重型颅脑创伤患者（sTBI）的影响。方法：选择2020年10月-2022年8月重庆市急救医疗中心神经重症监护室收治的sTBI患者为研究对象。将符合纳入和排除标准70例患者随机分为实验组和对照组各35例。计算患者每日所需热量,按不同比例的肠内联合肠外营养方案给予营养支持。实验组为按2：1比例肠内联合肠外营养支持,对照组为按1：1比例肠内联合肠外营养支持。统计比较两组的营养状态指标（血红蛋白、白蛋白、前白蛋白、总蛋白）,免疫功能指标[CD3、CD4、CD4/CD8、免疫球蛋白（Ig）A、IgM、IgG],炎症指标[C-反应蛋白（CRP）、降钙素原（PCT）、白介素-6（IL-6）]并发症的差异。结果：在免疫功能方面,营养支持14 d后实验组患者的CD4、CD4/CD8、IgA水平高于对照组患者,差异有统计学意义（P<0.05）;而在营养状态、炎症指标及并发症等方面两组患者差异无统计学意义（P>0.05）。结论：肠内营养为主的联合营养支持方式更能促进sTBI患者的免疫功能恢复,但不同比例肠内联合肠外营养治疗方案在营养状态、炎症指标及并发症等指标方面无明显差异。     

地佐辛联合帕瑞昔布钠预防全身麻醉苏醒期躁动

目的：探讨术中应用地佐辛联合帕瑞昔布钠预防全麻苏醒期躁动的效果。方法：选择ASAI～II级全身麻醉下进行开腹胆囊切除术患者75例,随机分为3组,各25例。I组给予地佐辛5mg;II组给予地佐辛10mg;Ⅲ组给予地佐辛5mg联合帕瑞昔布钠40mg。在手术进行到关腹时静脉给药,观察比#苏醒期三组患者的躁动发生情况、疼痛评分及不良反应（恶心、呕吐等）。结果：II组和Ⅲ组患者躁动发生率和疼痛评分均低于I组（P〈O．05）,II组和Ⅲ组间差异无显著性（P〉0．05）。Ⅲ组不良反应发生率小于I组和II组（P〈0．05）。结论：术中应用地佐辛联合帕瑞昔布钠对预防全麻苏醒期躁动具有良好的效果,并能降低不良反应发生率。