结核病患者白细胞减少原因探讨及治疗观察

目的分析结核病患者白细胞减少的原因,探讨防治措施。方法观察肺结核患者抗结核治疗前后血液白细胞总数变化,对其中104例出现血液白细胞减低患者抗结核治疗以前用药情况、造血功能、免疫功能及抗结核药物治疗因素等进行分析,根据不同病因给予相应治疗。结果104例白细胞减少患者中因结核感染所致11例,占10．6％;抗结核治疗前及治疗过程中应用非抗结核性药物25例,占24．0％,其中头孢类抗生素为主;抗结核药物（包括喹诺酮类）44例,占42．3％;免疫功能异常12例,占11．5％;其他如放射检查治疗10例,占9．6％。结论结核病患者白细胞减少原因不同,给予相应措施预防及治疗可取得满意结果。     

Responses of the murine esophageal microcirculation to acute exposure to alkali, acid, or hypochlorite

Background/Purpose

Although ingestion of alkali-based and/or hypochlorite-based household cleaners as well as strong acids remains a major cause of esophageal wall injury, little is known about the mechanisms that underlie the injury response to these toxic agents. This study examined the roles of vascular dysfunction and inflammation to the esophageal injury response to different caustic substances in mice.

Methods

The esophageal responses to sodium hydroxide (10%, 5%, and 2.5%), potassium hydroxide (10%, 5%, and 2.5%), sodium hypochlorite (5.25%), and hydrochloric acid (10%, pH 2) were evaluated by intravital videomicroscopy and histopathology. Intravital microscopy was used to monitor changes in the diameter of arterioles and venules, the adhesion and movement of leukocytes in venules, and the time of cessation of arteriolar blood flow in mouse esophagus. The esophageal mucosa was exposed to caustic substances for 0 to 60 minutes before evaluation.

Results

The higher concentrations of sodium hydroxide and potassium hydroxide elicited rapid stasis in both arterioles and venules, which was accompanied by arteriolar constriction and thrombosis. An accumulation of adherent leukocytes in venules was not observed with any agent. Histopathological evaluation revealed marked cellular and interstitial edema in the mucosa with alkali, whereas hydrochloric acid and sodium hypochlorite decreased the thickness epithelial layer.

Conclusion

These findings suggest that ischemia and thrombosis are dominant processes, whereas inflammation is less important in the pathogenesis of acute corrosive injury to the esophageal mucosa.     

SERIAL PHENOTYPIC ANALYSIS OF MOUSE PERIPHERAL BLOOD LEUKOCYTES

Repeated phenotypic analysis of mouse peripheral blood leukocytes over short periods of time (2 weeks) has been difficult because of the very limited volumes of blood available under guidelines of the Institutional Animal Care and Use Committee. The loss of leukocytes and variations among laboratories during conventional flow cytometry sample preparation based on lysing and repeated washing have been limiting factors when measuring multiple parameters in small samples. We describe a method of phenotypic analysis using a no-lyse, no-wash staining technique combined with fluorescent triggering for data collection that can be performed on volumes of 20 μL or less of whole blood per set of markers in one tube. This method allows repeated phenotypic analysis of peripheral whole blood from mice. Fluorescent triggering with anti-CD45-PE/Cy5 antibody allows high-quality phenotypic data to be collected for CD4, CD8, TcR- β, CD45R (B220), CD11b, and Gr-1 epitopes on leukocytes from mouse peripheral blood without lysis. The markers selected cover the major populations in peripheral mouse blood. Reproducibility and time-course data are presented for sampling periods as long as 4 weeks. Data produced by flow cytometers manufactured by two different companies show well-correlated results. An instrument equipped with a gated amplifier or a photomultiplier tube suitable for Cy7 conjugates could measure additional parameters. Because of interference from unlysed erythrocytes, scatter parameters are not useful for identifying cell populations with this method.     

Impaired leukocyte trafficking and skin inflammatory responses in hamsters lacking a functional circadian system

The immune system is under strong circadian control, and circadian desynchrony is a risk factor for metabolic disorders, inflammatory responses and cancer. Signaling pathways that maintain circadian rhythms (CRs) in immune function in vivo, and the mechanisms by which circadian desynchrony impairs immune function, remain to be fully identified. These experiments tested the hypothesis that the hypothalamic circadian pacemaker in the suprachiasmatic nucleus (SCN) drives CRs in the immune system, using a non-invasive model of SCN circadian arrhythmia. Robust CRs in blood leukocyte trafficking, with a peak during the early light phase (ZT4) and nadir in the early dark phase (ZT18), were absent in arrhythmic hamsters, as were CRs in spleen clock gene (per1, bmal1) expression, indicating that a functional pacemaker in the SCN is required for the generation of CRs in leukocyte trafficking and for driving peripheral clocks in secondary lymphoid organs. Pinealectomy was without effect on CRs in leukocyte trafficking, but abolished CRs in spleen clock gene expression, indicating that nocturnal melatonin secretion is necessary for communicating circadian time information to the spleen. CRs in trafficking of antigen presenting cells (CD11c⁺ dendritic cells) in the skin were abolished, and antigen-specific delayed-type hypersensitivity skin inflammatory responses were markedly impaired in arrhythmic hamsters. The SCN drives robust CRs in leukocyte trafficking and lymphoid clock gene expression; the latter of which is not expressed in the absence of melatonin. Robust entrainment of the circadian pacemaker provides a signal critical to diurnal rhythms in immunosurveilliance and optimal memory T-cell dependent immune responses.     

Chicken NK cell receptors

Natural killer cells are innate immune cells that destroy virally infected or transformed cells. They recognize these altered cells by a plethora of diverse receptors and thereby differ from other lymphocytes that use clonally distributed antigen receptors. To date, several receptor families that play a role in either activating or inhibiting NK cells have been identified in mammals. In the chicken, NK cells have been functionally and morphologically defined, however, a conclusive analysis of receptors involved in NK cell mediated functions has not been available. This is partly due to the low frequencies of NK cells in blood or spleen that has hampered their intensive characterization. Here we will review recent progress regarding the diverse NK cell receptor families, with special emphasis on novel families identified in the chicken genome with potential as chicken NK cell receptors.     

纯蛇粉的抗自由基作用及其对免疫功能影响的研究

目的 :研究纯蛇粉的抗自由基作用及其对机体免疫功能的影响。方法 :实验动物给予纯蛇粉 0 .0 5、0 .2 5g/kg,连续给药 14～ 30d后分别测定红细胞中超氧化物歧化酶 (SOD)活性、脑组织过氧化脂质 (LPO)、T 淋巴细胞转化、溶血素 (IgM )含量及外周血中白细胞数 (W .B .C)。结果 :纯蛇粉可提高大鼠SOD活性 ,降低小鼠脑组织的LPO ,增加T 淋巴细胞转化 ,提高IgM含量以及升高W .B .C。 结论 :纯蛇粉能提高实验动物的抗自由基能力及增强免疫功能。     

白细胞过滤器过滤前后血液质量变化观察及临床应用

目的　探讨应用白细胞过滤器过滤前后血液质量的变化及其临床非溶血性输血反应发生率的程度。方法　将 4 0 0毫升 袋的全血用白细胞过滤器滤除白细胞。取过滤前后血液标本进行血液质量检测 ,并观察临床应用效果。结果　过滤后的白细胞去除率 98.5 8% (P <0 .0 0 1) ,红细胞计数、血红蛋白含量、红细胞膜渗透脆性试验及游离血红蛋白含量等均无明显变化 (P >0 .0 5 ) ,过滤前后红细胞的形态可见明显改变 (P <0 .0 1)。结论　白细胞过滤器可选择性地滤除白细胞 ,能显著降低临床非溶血性输血反应的发生率     

急性脑梗死患者颈动脉斑块与血清C反应蛋白及白细胞计数的关系

目的　研究急性脑梗死患者颈动脉斑块与血清C反应蛋白 (CRP)、白细胞计数的关系。方法　应用颈动脉彩色超声多普勒 (HDI 5 0 0 0型 )检查 12 1例急性脑梗死患者颈动脉内膜 中层厚度 (IMT) ,用散射浊度计法检测血清CRP。根据颈动脉超声检查结果分为斑块组 (IMT≥ 1 2mm)与非斑块组 (IMT <1 2mm)。结果　颈动脉斑块组患者的年龄明显高于正常组 (P =0 0 0 1) ,伴有高血压及糖尿病的例数也明显高于非斑块组 (P <0 0 1,P <0 0 5 )。两组血白细胞计数比较无明显差异 (P >0 0 5 )。颈动脉斑块组患者血CRP水平增高例数多于非斑块组 (P <0 0 5 )。结论　血CRP水平增高对反映急性脑梗死患者颈动脉粥样硬化病变有显著临床意义。     

Chronic granulocytic leukemia in children

Over a period of four years, we observed 12 cases of chronic granulocytic leukemia in the pediatric age group. Eight of them were of the adult type and differed from that in adults in only their age at presentation and presence of greater degree of anemia. The remaining four cases were of the juvenile type, all below four years of age, were Ph’ negative, had normal leukocyte alkaline phosphatase (LAP) score, raised fetal hemoglobin and a strong monocytic component. In one case heterophil antibodies using the Paul Bunnell test were positive, indicating an EBV infection. The incidence of juvenile CGL in our experience was 2·6% of all childhood leukemias. The relevance of the monocytic component and the association of EBV infection with juvenile CGL is discussed.