目的 探讨妊娠早期维生素D缺乏对妊娠期糖尿病(GDM)发生及妊娠结局的影响.方法 收集2018年1月至2019年12月在佛山市妇幼保健院进行产检的孕妇1,516例,均在妊娠11～14周检测血液总25(OH)D含量和血清Ca2+、Mg2+、碱性磷酸酶、孕妇骨密度值等其它实验室指标,在妊娠24～28周进行75?g葡萄糖耐量试验,共有264例孕妇诊断为GDM.根据年龄±3岁并按1:2的比例匹配了528例非GDM孕妇进行研究.应用配对二分类logistic回归分析孕早期维生素D缺乏与GDM发生的关系.应用非条件二分类logistic回归分析孕早期维生素D缺乏及GDM发生与妊娠结局的关系.结果 单因素及多因素logistic回归分析结果显示,维生素D缺乏[25(OH)D<50?nmol/L]与GDM发生无相关,且无统计学意义(P>0.05).在调整了潜在混杂因素后,妊娠早期维生素D缺乏的早产发生风险较高,OR值为2.124(95％CI:1.111～4.060,P=0.023).未发现妊娠早期维生素D缺乏与其他妊娠结局如胎儿窘迫、胎膜早破和低出生体重儿等有关.结论 妊娠早期维生素D缺乏可能增加早产发生的风险,定期检测维生素水平,指导维生素D缺乏孕妇积极补充维生素D,可以改善妊娠结局.

Background The association between serum 25-hydroxy vitamin D (25(OH)D) status and gestational diabetes mellitus (GDM) gained attention in recent years, however the conclusion is still controversial due to many interfering factors, such as region of living, environment, lifestyle, and food supplements. Other metabolites (laboratory parameters) are also important in reflecting gestational states. This study aimed to investigate the association of serum 25(OH)D status in early pregnancy with GDM and other laboratory parameters in pregnant women. Methods A total of 1516 pregnant women whose blood glucose were normal before pregnancy in the city of Foshan in Guangdong, China were enrolled in this study. GDM was diagnosed between 24 to 28 weeks of pregnancy following the guidelines from the American Diabetes Association. Maternal serum 25(OH)D and other laboratory parameters—including hematology, coagulation, chemistry, and bone density—were measured utilizing various analytical methods in clinical laboratory at gestational weeks 11 to 14. Results The average 25(OH)D concentration was 59.1 ± 12.6 nmol/L. None of the study subjects had 25(OH)D < 25 nmol/L; 434 (28.6%) women had 25(OH)D deficiency (< 50 nmol/L), 882 women (58.2%) had 25(OH)D insufficiency (50–74 mmol/L) and 200 women (13.2%) had 25(OH)D sufficiency (≥ 75 nmol/L). There were 264 (17.4%) women diagnosed with GDM. There was not, however, an association between serum 25(OH)D in early pregnancy and GDM. Interestingly, women with more parity and high serum alkaline phosphatase levels had higher serum 25(OH)D levels. There was a possible positive association between serum 25(OH)D and pre-albumin, and a possible negative association between serum 25(OH)D, creatinine, and thrombin time. This study did not find an association between serum 25(OH)D and bone density. Conclusions There were no associations between maternal serum 25(OH)D concentration in early pregnancy and the risk of GDM or bone density. There were, however, correlations between serum 25(OH)D and parity, seasoning at sampling, serum alkaline phosphatase, creatinine, pre-albumin, and coagulation factor thrombin time, which need further study to explain their pathophysiology and clinical significance.

目的 通过检测多囊卵巢综合征(PC OS)患者血清中半乳糖凝集素-3(Gal-3)、白细胞介素-6(IL-6)的水平变化及其与临床指标的关系,探讨Gal-3在PCOS发生发展中的可能机制.方法 选择2017年1-9月在该院初诊的98例PCOS患者作为PCOS组,另选择同期在门诊就诊的因输卵管因素或男方因素导致不孕的72例妇女作为对照组.记录受试者相关临床资料,测量妇科内分泌五项、血脂四项、空腹血糖(FPG)及空腹胰岛素水平,应用ELISA方法测定Gal-3、IL-6水平.分析Gal-3、IL-6的水平变化及其与临床指标的关系.结果 PCOS组Gal-3、IL-6浓度较对照组均升高(P＜0.05).PCOS胰岛素抵抗组Gal-3水平均高于对照胰岛素抵抗组(P＜0.05),PCOS非胰岛素抵抗组Gal-3水平均高于对照非胰岛素抵抗组(P＜0.05);与PCOS非胰岛素抵抗组对比,PCOS胰岛素抵抗组Gal-3水平升高,差异有统计学意义(P＜0.05).PCOS胰岛素抵抗组IL-6水平高于其他3组,差异有统计学意义(P＜0.05);PCOS非胰岛素抵抗组、对照非胰岛素抵抗组、对照胰岛素抵抗组之间IL-6水平比较,差异无统计学意义(P＞0.05).Gal-3与IL-6在PCOS患者中水平升高,并呈正相关关系(r=0.647,P＜0.001).结论 PCOS患者中Gal-3及IL-6水平升高,PCOS患者中Gal-3与IL-6呈正相关关系.它们可能通过胰岛素抵抗及慢性炎症协同作用在PCOS的发病中起作用.

肺炎支原体(mycoplasma pneumonia,MP)感染作为小儿下呼吸道感染的一个不可忽视的问题,已受到临床越来越多的重视.MP感染可引起重症肺炎,如坏死性肺炎,肺大叶实变,中至大量胸腔积液,合并闭塞性支气管炎等表现[1].目前认为,MP感染除了对机体细胞直接产生损害外,其所引起的免疫反应在肺炎支原体肺炎(mycoplasma pneumoniaepneumonia,MPP)的发生、发展过程中起重要作用.该研究通过检测重症MPP患者支气管肺泡灌洗液(BALF)中的白细胞介素-4 (IL-4)及干扰素-γ(IFN-γ),研究Th1/Th2细胞免疫应答的状况及其临床意义,以期为MPP的诊治提供依据.

OBJECTIVE To investigate the epidemiological characteristics and the incidence rate of pediatric atypical respiratory infections so as to provide the basis for clinical diagnosis and treatment .METHODS The serum samples were collected from 8698 cases of children with acute respiratory infections admitted in the hospital from Jan .2012 to Dec .2013 .Indirect immunofluorescence was applied to detect the IgM antibody .All data were statistically ana‐lyzed by SPSS 17 .0 software .RESULTS Among the 8698 pediatric cases with acute respiratory infections ,the positive IgM antibodies of 9 kinds of respiratory pathogens were found in 3298 cases ,with the positive rate of 37 .8% .Among them ,641 cases were found to have mixed infections ,mainly caused by Mycoplasma pneumonia (MP) combined with influenza B virus ,with adenovirus ,or with respiratory syncytial virus .The positive rate of IgM antibodies in infections caused by M . pneumoniae combined with other pathogens was over 93 .3% . CONCLUSION MP is the leading cause of pediatric acute atypical respiratory infections in Foshan .The combined detection of IgM antibodies of 9 kinds of respiratory pathogens in the pediatric cases with acute atypical respiratory infections in Foshan provides an important basis for the diagnosis .

Objective:To develop a new method for detection of anti endometrium antibody (EMAb) with immune colloidal gold infiltration technology. Methods:Using human endometrium antigen source, colloidal gold particles conjugated goat anti-human IgG antibody is labeled in accordance with the principles of immune colloidal gold infiltration technology, build an new method for detect endometrium antibodies in human serum. 73 positive serum anti endometrium antibodies samples and 87 serum samples of normal physical examination female serum were detected, and the result was compared with enzyme-linked assay (ELISA).Results:Compared with the result of ELISA, the consistency rate was 90.63%. The sensitivity of the assay was 93.10% and specificity was 87.67%. The preparation was stable after 6 months refrigerator storage. Conclusions:Immune colloidal gold infiltration technology can quickly and accurately measured serum anti endometrium antibody, easy to popularize.

目的 探讨封闭抗体(BA)和抗心磷脂抗体(ACA)在不同育龄妇女人群中的表达情况,研究BA和ACA与复发性自然流产(RSA)的相关性.方法 收集2013年8月至2014年6月RSA患者、继发性不孕患者和正常生育组的血清.采用ELISA法检测各组病例中的ACA和BA的表达,统计各自的阳性率和阴性率.结果 RSA组的ACA阳性率为17.33％,介于继发性不孕组和正常对照组之间,其中IgM类的阳性率为10.67％,高于IgM类,二者分别与其它组进行x2检验,组间差异有统计学意义(P＜0.01);RSA组BA的阴性率为88.00％,均高于其它两组,组间差异有统计学意义(P＜0.01).结论 抗心磷脂抗体和封闭抗体与复发性自然流产密切相关,应加强其检测与治疗.

目的：探讨4种不同的梅毒血清学检测方法在梅毒诊断和治疗中的临床应用价值。方法选取144例经病史、临床特征、血清学确诊的梅毒患者血清采用甲苯胺红不加热血清反应素试验（TRUST）、联合应用酶联免疫吸附试验（ELISA）、梅毒螺旋体明胶凝集试验（TPPA）、胶体金法进行检验。结果 TRUST法阳性检出率为77.1%，胶体金法检出率为85.4%，ELISA法检出率为93.6%，TPPA法检出率为98.6%，TPPA法阳性检出率显著高于TRUST法、胶体金法和ELISA法，差异显著（P＜0.05）。结论4种不同的梅毒血清学检测方法各有优缺点，应结合临床上不同的检测目的，合理选用不同的梅毒血清学试验方法。

Objective To detect the peripheral blood cortisol and interleukin-6 levels changes in sepsis children,and evaluate the protective effect of stress-dose of methylprednisolone on sepsis children.Methods The sepsis children were randomly divided into observation group(35 cases) and control group(35 cases).Patients in observation group were given low-dose methylprednisolone(MP) treatment and routine treatment.Patients in control group were given routine treatment.The levels of plasma cortisol,interleukin-6 were detected before treatment and 3 days after treatment.Results ①After treatment,the cortisol level in the observation group was significantly higher than before treatment and that of the control group(P0.05).②In the observation group,the interleukin-6 level after treatment was significantly lower than before treatment and that of the control group(P0.05).Conclusion The treatment of stress-dose methylprednisolone has clinical significance in patients with sepsis.

【Objective】 To study the changes and clinical significance of serum interleukin(IL)-6,IL-10,and IL-17 levels in the children with hand foot and mouth disease(HFMD).【Method】 The serum concentration of IL-6,IL-10,and IL-17 in 19 cases of HFMD children(acute stage and convalescence) and 20 cases of healthy controls were measured by ELISA.The cytokines levels were compared.【Results】 1.Compared with healthy controls,the levels of IL-6,IL-10,and IL-17 in acute stage of HFMD were significantly increased in HFMD children(P 0.01).There was no significant difference of the levels of IL-6 and IL-17 between the convalescence of HFMD and healthy children(P 0.05),However the levels of IL-10 in convalescence of HFMD were higher than healthy children(P 0.01).2.Spearman correlation analysis revealed that IL-6 and IL-17 were negatively correlated with IL-10(P 0.05);IL-6 positively correlated with and IL-17 in acute stage(P 0.01).In convalescence IL-6 was negatively correlated with IL-10(P 0.05),positively correlated with IL-17(P 0.01);IL-10 and IL-17 have no correlative relation(P 0.05).【Conclusions】 1.The levels of IL-6 and IL-17 were significantly increased in acute stage of HFMD children.2.The persistent elevation of serum IL-10 level was found in HFMD patients after convalescence.