Lupus erythematosus (LE) cells in ascites: initial diagnosis of systemic lupus erythematosus by cytological examination: a case report

Systemic lupus erythematosus (SLE) is an autoimmune disease, involving multiple organs. Diverse manifestations may obscure the diagnosis and confuse our thinking process, especially when few clues are present at the beginning. Serositis is one of the various presentations, and the presence of lupus erythematosus (LE) cell in body fluid may be a hint for the final diagnosis of SLE. Herein, we present a young female patient diagnosed of SLE with initial presentation of lupus peritonitis. Finding of LE cell in ascites prompted us for immunologic survey. Diagnosis of SLE was confirmed with high titer of anti-nuclear antibody and antibody to double-stranded DNA. Cytologic examination of body fluid is mainly useful in detecting malignant cells, but high specificity of this marker aids in early diagnosis of SLE.     

Cytokine analysis as a tool to understand tumour-host interaction in ovarian cancer

Epithelial ovarian cancer (EOC) is an immunogenic tumour and exploits many suppressive ways to escape immune eradication. EOC is known to spread primarily by tumour cell implantations in peritoneal cavity. Therefore, ascites may be an ideal fluid compartment to unravel the immune status of the peritoneal cavity.We analysed the expression of IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IFN-γ, TNF-α, TNF-β, TGF-β and CCL22 in ovarian cancer ascites, representing immune activating and suppressing cytokines.We observed high expression of pro-inflammatory cytokines IL-6, IL-8 and immune suppressive cytokines IL-10, CCL22 and TGF-β in most samples whereas Th1 (IL-12p70, IFN-γ) and Th2 (IL-4, IL-5) cytokines were only detectable in 13% of the samples. TGF-β was only detected in latent form, questioning its immune suppressive role. CCL22 was in similar levels present in early stage compared to advanced stage tumours. At advanced stage, we observed a negative correlation with CCL22 levels and Th1/2 cytokine expression. We found a positive correlation between IL-6 concentration in ascites and residual disease after debulking. Additionally, IL-6 levels were remarkably higher at recurrence compared to primary advanced disease, which opens an opportunity for inhibition of IL-6 expression in the prevention of recurrence. Despite the heterogeneity of EOC and the complexity of cytokine functions, our results show that cytokine analysis in ascites may aid in understanding tumour-host interaction in EOC.     

腹水回输术治疗顽固性腹水临床效果研究

目的探讨腹水回输治疗顽固性腹水的有效性、安全性。方法对2005年1月至2008年12月收治的33例顽固性腹水病例资料进行统计分析。结果本组病例33例,其中男18例,女15例,治愈26例,症状明显缓解7例。结论腹水回输治疗肾性顽固性腹水效果好,操作简便,安全。     

183例肝硬化腹水患者的护理干预与分析

目的探讨综合护理干预对肝硬化腹水患者疗效的影响。方法选择住院的肝硬化腹水183例,随机分为综合护理组94例和常规护理组89例,两组患者均给予常规治疗。结果规护理组患者的有效率为69．66％,综合护理组患者的总有效率为88．30％,两组问差异有统计学意义（P〈0．05）。结论综合护理干预可提高肝硬化腹水患者的治疗效果,明显优于常规护理干预。     

肿瘤标志物对良恶性腹水鉴别诊断价值的探讨

目的　探讨鉴别良恶性腹水的新方法。方法　比较几组患者 15 2例血清及腹水肿瘤标志物 (AFP、CEA、CA19-9及CA12 5 )的情况。结果　恶性腹水组血清AFP、CEA、CA19-9及CA12 5水平较良性腹水组显著升高 (P <0 0 1)。血清AFP、CEA、CA19-9及CA12 5诊断恶性腹水的敏感性分别为 75 0 % ,73 8% ,63 6%及 66 7% ,特异性分别为 86 4% ,77 6% ,88 4%及74 1%。在鉴别结核、肝硬化与恶性腹水时 ,以CA12 5≥ 40 0KU/L为阳性界值更为适当 ,可提高诊断的特异性及准确性。以AFP≥40 0ng/ml为阳性界值可提高诊断原发性肝癌的特异性。血清AFP及CEA联合检测可提高诊断恶性腹水的敏感性至 94 7%。结论检测肿瘤标志物 (AFP、CEA、CA19-9及CA12 5 )有助于良恶性腹水的鉴别诊断 ,血清AFP及CEA联合检测可提高诊断恶性腹水的敏感性。     

重症胰腺炎性腹水对腹腔巨噬细胞功能影响

目的 观察大鼠重症胰腺炎性腹水对腹腔巨噬细胞功能及活性的影响，以了解腹腔巨噬细胞在重症胰腺炎病理生理演变和继发性胰腺感染中的作用，为重症胰腺炎的临床诊治提供指导。方法 通过离体细胞培养，分别在重症胰腺炎性腹水处理腹腔巨噬细胞1、3、6、12、14、24h后测定其吞噬功能、细胞活性扣肿瘤坏死因子分泌功能。结果 中性红吞噬功能试验、肿瘤坏死因子酶联免疫测定和噻唑蓝比色法细胞活性测定显示，随处理时间的延长，腹腔巨噬细胞的吞噬功能、肿瘤坏死因子分泌功能和细胞活性逐渐下降。结论 重症急性胰腺炎腹水降低了腹腔巨噬细胞的吞噬功能、细胞活性和肿瘤坏死因子分泌，是继发胰腺和胰周感染以及肠道细菌移位的促进因素之一。     

肝硬化患者的肺功能损害

将52例失代偿期肝硬化患者的5项肺功能测定值与健康配对组比较,肝硬化患者的VC、TLC、D_LCO降低,RV/TLC增加(P<0.05～0.001);按可能的致病因素进行分类比较,以腹水对肺功的影响最明显,除上述4项指标的改变外,FRC也降低(P<0.01),血清白蛋白降低的患者(≤30g/L)与血清白蛋白未降低患者相比,显示VC_LTLC和D_LCO降低;排除腹水的影响,发现食道静脉重度曲张与RV/TLC升高和D_LCO下降也相关。文内还对上述改变的可能机制进行了讨论.     

腹水的超声诊断及声像图分析

目的探讨超声在诊断腹水中的应用价值。方法对190例腹水患者进行超声检查并诊断。结果经腹水穿刺及临床证实,超声检查腹水检出率100%,对引起腹水的病因检出率80%。结论超声是诊断腹水诊断的首选方法。方便简捷,可重复使用,并能准确定位。结合临床可对腹水定性。