Identification of contact and respiratory sensitizers using flow cytometry

Identification of the chemicals responsible for respiratory and contact allergies in the industrial area is an important occupational safety issue. This study was conducted in mice to determine whether flow cytometry is an appropriate method to analyze and differentiate the specific immune responses to the respiratory sensitizer trimellitic anhydride (TMA) and to the contact sensitizer dinitrochlorobenzene (DNCB) used at concentrations with comparable immunogenic potential. Mice were exposed twice on the flanks (days 0, 5) to 10% TMA or 1% DNCB and challenged three times on the ears (days 10, 11, 12) with 2.5% TMA or 0.25% DNCB. Flow cytometry analyses were conducted on draining lymph node cells harvested on days 13 and 18. Comparing TMA and DNCB immune responses on day 13, we found obvious differences that persisted for most of them on day 18. An increased proportion of IgE+ cells correlated to total serum IgE level and an enhancement of MHC II molecule expression were observed in the lymph node B lymphocytes from TMA-treated mice. The percentage of IL-4-producing CD4+ lymphocytes and the IL-4 receptor expression were clearly higher following TMA exposure. In contrast, higher proportions of IL-2-producing cells were detected in CD4+ and CD8+ cells from DNCB-treated mice. Both chemicals induced a significant increase in the percentage of IFN-gamma-producing cells among CD8+ lymphocytes but to a greater proportion following TMA treatment. In conclusion, this study encourages the use of flow cytometry to discriminate between contact and respiratory sensitizers by identifying divergent expression of immune response parameters.     

贵州省首例半相合骨髓移植治疗急性白血病报告

目的 探讨半相合骨髓移植治疗急性白血病的疗效.方法 对1例男性47岁急性髓系白血病M2型患者采用半相合骨髓移植.预处理方案采用改良的BU/CY方案;GVHD的预防采用ATG+CSA+MMF +MTX方案;移植方式采用骨髓加外周血移植.结果 移植后19 d患者造血功能重建.移植后第30天、90天、180天行STR-DNA...     

腺病毒感染患儿急性胃肠炎表型列线图预测模型的建立及验证

摘要：目的　构建腺病毒感染患儿发生急性胃肠炎表型的列线图预测模型,并验证其可行性。方法　选取腺病毒感染患儿144例为训练集,其中40例（27.8%）为急性胃肠炎表型,104例（72.2%）为呼吸道表型。收集患儿年龄、性别、发热天数、扁桃体渗出情况、结膜充血状态、入院后丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（γ-GT）、白细胞介素（IL）-6、乳酸脱氢酶（LDH）、CD4＋T细胞百分比、CD8＋T细胞百分比及CD4＋T细胞/CD8＋T细胞比值。采用最小绝对值收敛和选择算子（LASSO）回归筛选急性胃肠炎表型的预测因子,多因素Logistic回归分析建立风险预测模型并绘制列线图。采用受试者工作特征（ROC）曲线、Brier评分分别评价模型的判别能力和校准能力。另选取35例腺病毒感染患儿对预测模型进行外部验证。结果　与呼吸道表型组相比,胃肠炎表型组患儿年龄偏小,女性比例、ALT水平较高,发热天数较短,IL-6、LDH水平较低（P＜0.05）。LASSO回归分析显示年龄、性别、发热天数、LDH是急性胃肠炎表型的预测因子。多因素Logistic回归分析显示女性、年龄小、发热时间短、LDH降低是儿童HAdV感染胃肠炎表型的危险因素。纳入上述因素构建的列线图模型的ROC曲线下面积（AUC）为0.951（95% CI：0.923~0.984）,敏感度为82.50%,特异度为95.19%。外部验证集中,35例患儿中8例为急性胃肠炎表型,AUC为0.925（95% CI：0.821~0.998）,敏感度为75.42%,特异度为95.90%。结论　本研究建立的预测模型适用于腺病毒感染患儿出现急性胃肠炎表型的早期诊断,预测效果较好,具有一定的临床价值。     

CRP与血常规联合检测在小儿急性上呼吸道感染中的临床价值分析

目的 分析C反应蛋白(CRP)与血常规联合检测在小儿急性上呼吸道感染中的临床价值.方法 60例小儿急性上呼吸道感染患儿,采用电脑随机数字法分为对照组和观察组,每组30例.对照组接受常规诊断,观察组接受CRP联合血常规检查.比较两组患儿的确诊率,感染因子(呼吸道合胞病毒、腺病毒、副流感病毒、流感病毒)诊断阳性率.结果 观...     

阿糖胞苷致急性白血病患者心包积液、急性心包填塞死亡

1例36岁男性患者因急性白血病给予DA方案（柔红霉素100mg,1次/d静脉滴注,第1～3天;阿糖胞苷早100mg、晚150mg静脉滴注,第1～7天）化疗。入院第6天胸部CT检查示心包增厚;入院第11天患者出现咳嗽、气短、心悸。BP145/105mmHg,HR120次/min,心音遥远。结合超声心动图,考虑为心包积液、急性心包填塞。急行心包穿刺术,穿刺失败,患者于入院第12天因呼吸循环衰竭死亡。     

Respiratory hypersensitivity to trimellitic anhydride in Brown Norway rats: analysis of dose-response following topical induction and time course following repeated inhalation challenge

Trimellitic anhydride (TMA) is a low-molecular-weight chemical known to cause occupational asthma. The dose-response study was designed to determine whether respiratory responses during a single inhalation challenge with TMA (25-30 mg/m3 for 30 min, 3 weeks after the initial induction), the ensuing non-specific airway hyperresponsiveness (AH) to methacholine (MCh) aerosol, and infiltration of eosinophilic granulocytes into the lungs of sensitized Brown Norway (BN) rats are associated and dependent on the concentration of TMA used for topical induction. The initial topical exposure concentrations were 1, 5, and 25% TMA in acetone:olive oil (AOO) followed by a booster induction 1 week later. In the time course study BN rats received AOO alone or were sensitized to the minimal sensitizing topical concentration of TMA (5%) and were the subsequently challenged with TMA on Days 17, 24, 41, 47, 55, and 66, followed by a MCh challenge 1 day later. One additional group of rats was sensitized to 5% TMA but were repeatedly challenged with MCh without prior TMA challenge. In the dose-response study the rats sensitized topically to TMA (5 and 25% in AOO) displayed unequivocal changes in breathing patterns upon challenge with TMA, including an increased responsiveness to MCh aerosol. These findings were associated with a sustained pulmonary eosinophilic inflammation. All endpoints demonstrated consistently that 5% TMA in AOO constitutes the minimal sensitizing concentration. When rats were topically sensitized with this concentration and repeatedly challenged with TMA over a time period of 7 weeks, it became apparent that challenge exposures in BN rats may be false negative when performed at time periods less than 3 weeks after the initial induction. Despite the time-related increased responsiveness elicited by the repeated TMA challenge exposures, the MCh challenge revealed increased non-specific airway hyperreactivity exclusively on Day 17. After the sixth TMA-challenge, the respiratory response and lung weights of rats sensitized topically were essentially similar to those observed in the repetitively re-challenged control group (induction: vehicle only; repeated booster challenge exposures with TMA). Thus, it appears, that in this animal model the effective concentration for successful topical sensitization must be at least approximately 5%. The repeated low-dose re-challenge with TMA in topically sensitized rats resulted in similar or slightly aggravated time-related responses over a period of 7 weeks. An over-proportionally increased susceptibility of rats receiving a topical priming dose prior to repeated inhalation challenge exposures was not observed. In summary, this study shows that the analysis of functional changes in breathing patterns is suitable to identify respiratory allergy. Repeated short-term inhalation exposures to mildly irritant concentrations (but low doses) of chemical asthmagens may be of higher concern than topical exposures.     

Respiratory hypersensitivity to trimellitic anhydride in Brown Norway rats: a comparison of endpoints

A rat bioassay has been developed to provide an objective approach for the identification and classification of respiratory allergy using trimellitic anhydride (TMA), which is a known respiratory tract irritant and asthmagen. Particular emphasis was placed on the study of route-of-induction-dependent effects and their progression upon inhalation challenge with TMA (approximately 23 mg m(-3) for a duration of 30 min), which included analysis of specific and non-specific airway hyperreactivity and pulmonary inflammation initiated and sustained by immunological processes. Refinement of the bioassay focused on procedures to probe changes occurring upon challenge with TMA or methacholine aerosols using physiological, biochemical and immunological procedures. Following challenge with TMA, the rats sensitized to TMA showed marked changes in peak inspiratory and expiratory air flows and respiratory minute volume. In these animals, a sustained pulmonary inflammation occurred, characterized by specific endpoints determined in bronchoalveolar lavage (lactate dehydrogenase, protein, nitrite, eosinophil peroxidase, myeloperoxidase). When compared with the naive controls, lung weights were increased significantly, as were the weights of lung-associated lymph nodes following inhalation induction and auricular lymph nodes following topical induction. The extent of changes observed was equal or more pronounced in animals sensitized epicutaneously (day 0:150 microl vehicle/50% TMA on each flank, day 7; booster administration to the skin of the dorsum of both ears using half the concentration and volume used on day 0) when compared with rats sensitized by 5 x 3 h day(-1) inhalation exposures (low dose: 25 mg TMA m(-3), high dose: 120 mg TMA m(-3)). In summary, the findings support the conclusion that the Brown Norway rat model is suitable for identifying TMA as an agent that causes both an immediate-type change of breathing patterns and a delayed-type sustained pulmonary inflammatory response. However, it remains unresolved whether the marked effects observed in the topically sensitized rats are more related to a route-of-induction or dose-dependent phenomenon.     

基于nNOS途径的天麻素注射液改善甲基苯丙胺诱导大鼠神经毒性损伤的作用机制研究

目的:研究天麻素注射液通过神经型一氧化氮合酶(nNOS)途径改善甲基苯丙胺诱导大鼠神经毒性损伤的作用机制。方法:将SD大鼠随机分为对照组、甲基苯丙胺组、常规剂量天麻素组、加倍剂量天麻素组、阴性对照(NC)腺病毒组、NC腺病毒+甲基苯丙胺组、NC腺病毒+天麻素组、n NOS腺病毒+天麻素组,每组10只。对照组大鼠腹腔注射生理盐水,每日2次;甲基苯丙胺组大鼠腹腔注射甲基苯丙胺(7.5 mg/kg),每日2次;常规剂量、加倍剂量天麻素组大鼠提前30 min分别腹腔注射不同剂量天麻素注射液(10、20 mg/kg),每日1次,再按甲基苯丙胺组方法注射甲基苯丙胺。NC腺病毒组大鼠在纹状体一次性注射NC腺病毒(4.8×107PFU)3μL+腹腔注射生理盐水,每日2次;NC腺病毒+甲基苯丙胺组大鼠同法注射NC腺病毒,然后腹腔注射甲基苯丙胺(7.5 mg/kg),每日2次;NC腺病毒+天麻素组大鼠同法注射NC腺病毒+甲基苯丙胺,同时在注射甲基苯丙胺之前30 min腹腔注射天麻素注射液(20 mg/kg),每日1次;nNOS腺病毒+天麻素组大鼠同法注射nNOS腺病毒和甲基苯丙胺,同时在注射甲基苯丙胺之前...     

Renal allograft dysfunction with acute hemorrhagic cystitis caused by adenovirus in a recipient of a transplanted kidney

We experienced acute hemorrhagic cystitis with renal dysfunction in a recipient of a transplanted kidney. This acute hemorrhagic cystitis was caused by adenovirus type 11. Either elevation of antibody titers or isolation in urine of adenovirus type 11 was identified in six cases out of 11 in seven reports which we collected. Graft dysfunctions were complicated on seven cases out of 11 in these seven reports. These graft dysfunctions have been considered as an acute rejection, but we suggest that they may be graft nephropathy caused by adenovirus type 11 infection.     

Sirolimus-itraconazole interaction in a hematopoietic stem cell transplant recipient

Interactions between azole antifungal agents and immunosuppressants that are metabolized by cytochrome P450 3A4 (chiefly calcineurin inhibitors) are well documented. Interactions between itraconazole and sirolimus are known to occur in patients after solid organ transplantation, but interactions in hematopoietic stem cell transplant (HSCT) recipients have yet to be reported in the literature. We describe an allogeneic HSCT recipient who experienced supratherapeutic trough levels of sirolimus as a result of its coadministration with itraconazole. This patient was a 20-year-old African-American man who underwent HSCT for treatment of myelodysplastic syndrome with severe aplastic anemia. After several regimen changes, the patient received oral itraconazole 200 mg every 12 hours and sirolimus at a dosage of 7 mg/day on days 76-80 and 5 mg/day on days 81 and 82. His sirolimus whole blood trough levels were 17.5 and 35.6 ng/ml on days 80 and 82, respectively (therapeutic range 5-15 ng/ml). An interaction between itraconazole and sirolimus was suspected, and sirolimus was withheld on days 83-90. On day 90, the patient's sirolimus trough level had normalized to 4.4 ng/ml. Sirolimus was resumed at 1-2 mg/day, with adjustments as needed to maintain trough levels of 10-15 ng/ml. Both the itraconazole and sirolimus were eventually were discontinued. The patient died, however, from a disseminated adenovirus infection leading to end-organ failure. Sirolimus is extremely sensitive to the inhibitory potential of azole antifungals. We propose that itraconazole also has a potent effect on sirolimus metabolism. Preemptive sirolimus dosage reduction and close monitoring of its whole blood trough levels are required whenever this combination is considered to avoid immunosuppressant toxicity in already critically ill patients.     

Alveolar macrophages suppress non-specific inflammation caused by inhalation challenge with trimellitic anhydride conjugated to albumin

Occupational exposure to low molecular weight chemicals, like trimellitic anhydride (TMA), can result in occupational asthma. Alveolar macrophages (AMs) are among the first cells to encounter these inhaled compounds and were previously shown to affect TMA-induced asthma-like symptoms in the Brown Norway rat (Valstar et al., Toxicol. Appl. Pharmacology 211:20–29, 2006). TMA is a hapten that will bind to endogenous proteins upon entrance of the body. Therefore, in the present study we determined if TMA conjugated to albumin is able to induce asthma-like symptoms and if these are affected by AM depletion. Female Brown Norway rats were sensitized by dermal application of TMA or received vehicle alone on days 0 and 7. One day prior to the inhalation challenge the rats were treated intratracheally with either empty liposomes or liposomes containing clodronate (dichloromethylene diphosphonate) to specifically deplete the lungs of AMs. On day 21, all groups of rats were challenged by inhalation of TMA-BSA. Breathing frequency, tidal volume, and minute ventilation were measured before, during, within 1 h, and 24 h after challenge and the gross respiratory rate score was determined during challenge. Total and TMA-specific IgE levels were determined in serum and lung lavage fluid and parameters of inflammation and tissue damage were assessed in lung lavage fluid and/or lung tissue 24 h after challenge. Sensitization with TMA had no effect on the lung function before challenge, but TMA-BSA challenge resulted in an early asthmatic response as compared to the non-sensitized rats, irrespective of AM depletion. AM depletion had no effect on the sensitization-induced serum and lung lavage fluid IgE levels. TMA-BSA inhalation did not induce airway inflammation and tissue damage irrespective of sensitization, unless AM were depleted. Data indicate that AMs inhibit immunologically non-specific damage and inflammatory cell influx into the lungs as caused by TMA-BSA inhalation. Since effects of inhalation challenge with TMA-BSA are partly different from those of TMA, challenge with the latter is to be preferred for hazard identification.     

Fundamental and clinical studies of aztreonam in the field of pediatric

The fundamental and clinical studies of aztreonam (AZT) were performed. The results were as follows: The MICs of AZT for E. coli and Salmonella sp. which were recently isolated in the pediatric field were less than 0.78 micrograms/ml. AZT also was effective against ABPC/PIPC-resistant bacteria. The MIC of AZT for V. parahaemolyticus was less than 1.56 micrograms/ml. The peak serum levels of AZT which were occurred just after the 1 hour drip infusion of 10-30 mg/kg were 60.5-136.8 micrograms/ml, and at 6 hours after infusion the serum levels were 1.3-6.1 micrograms/ml; therefore, the dose response was proved. The mean half-lives (T 1/2) were between 1.21 and 1.36 hours. The excretion rates in urine up to 6 hours after intravenous drip infusion were between 32.7 and 77.5%. The ratio of the cerebrospinal fluid concentration to serum in the child with purulent meningitis was 3.5% at 1 hour after the intravenous injection at the dose of 69 mg/kg, and the ratios of the subdural fluid levels to serum were 31.3-37.5%. The levels of AZT into the feces by the multiple dosage were 0-840 micrograms/g. Twenty-five pediatric patients with acute infections had been treated by intravenous injection or drip infusion at the doses of 49-120 mg/kg/day (almost 50-100 mg/kg/day) for 4 to 13 days. The efficacy rate of excellent + good was 84% and that of excellent + good + fair was 96%. The efficacy rate of excellent + good was 100% in all cases with upper/lower respiratory tract infection, bronchopneumonia, and acute urinary tract infection caused by Gram-negative rods. The clinical efficacy was observed in all cases with acute bacterial enteritis. Although AZT was clinically effective against Salmonella enteritis, bacteriological efficacy on the causative organisms was not observed in some cases. Although AZT was bacteriologically effective in 1 patient with typhoid, it did not alleviated fever. AZT showed activity to 9 strains isolated from the culture of throat swab, urine and feces. No side effects were clinically observed in all cases, while slight elevations of laboratory findings were observed in 4 cases.     

一起呼吸道腺病毒感染暴发流行的调查

目的探讨2009年驻豫某部队急性呼吸道感染暴发流行的流行病学特征及病原学病因。方法制定病例的临床诊断标准,采用统一的流行病学个案调查表对病例进行调查,描述流行特征;对流行区患者的咽拭子标本分离病原体,并对阳性分离株进行免疫荧光、聚合酶链反应(PCR)、电镜检测,对患者的双份血清进行中和试验。结果 2009-01～02驻豫某部队发生传染性急性呼吸道感染患者225例,疫情波及整个营区,2009-02-10形成发病高峰,患者100%为外省市入伍者,新兵占到68.9%。临床特征为发热(100%)、咳嗽(71.6%)、咽痛(49.3%)、头痛(45.3%),少数患者出现胸闷(13.8%)、呼吸困难(1.8%),无病死患者。咽拭子标本经实验室分离培养,53.3%的标本出现了明显的细胞病变效应,电镜下可见细胞核内大量呈晶格状排列的典型腺病毒颗粒,直接免疫荧光试验、PCR检测及双份血清中和试验均证实为腺病毒感染。结论发生在驻豫某部队传染性急性呼吸道感染暴发疫情的病原体为腺病毒,传播途径主要以空气传播为主。     

妊娠脂肪肝患者并发肺炎克雷伯菌血流感染治疗过程分析（英文）

妊娠期急性脂肪肝,是妊娠晚期特发性疾病,起病急而凶险,发病率低,但死亡率高。妊娠期急性脂肪肝伴多器官功能衰竭(MODS)并发重症感染,尤其是多重耐药病原菌引起的血行感染,治疗难度明显增大,生存几率可能更低,目前未见相关报道。本院治疗一例重症患者,31岁,孕37+5周,妊娠期急性脂肪肝伴MODS患者术后并发重症感染。血培养阳性,快速鉴定为产KPC酶肺炎克雷伯菌(CRKP)。结合联合药敏结果,使用亚胺培南西司他丁钠、替加环素、多粘菌素及磷霉素四联方案,成功治愈患者。针对妊娠期急性脂肪肝合并CRKP的血行感染的特点,快速鉴定并结合药敏结果,采用个体化、联合的抗菌药物治疗方案,成功救治患者。本例患者病情危重,在治疗过程中,需要临床医生、临床药师和微生物检验师协作,根据患者病理生理变化特点,共同讨论治疗方案,是本例患者救治成功的关键因素之一。     

小儿急性上呼吸道感染的护理分析

目的探讨临床合理、精心的护理措施对小儿急性上呼吸道感染的作用。方法对我院2011年1月至2012年7月期间收治的125例急性上呼吸道感染患儿的临床资料进行回顾性分析。结果本组125例患儿经常规治疗和精心护理后,疗效总有效率为97.6%。结论给予小儿急性上呼吸道感染常规治疗和精心的护理能够取得较好疗效,能够显著改善患儿的预后。     

The specific free radical scavenger edaravone suppresses bleomycin-induced acute pulmonary injury in rabbits

1. Intratracheal instillation of bleomycin induces a condition in rabbits that serves as a useful model of human pulmonary fibrosis. Bleomycin-induced production of reactive oxygen species leads to acute lung inflammation and induction of apoptosis, which is followed by pulmonary fibrosis at a later chronic stage. In the present study, we tested whether edaravone, a free radical scavenger, would suppress bleomycin-induced acute pulmonary inflammation. 2. Rabbits were divided into three groups (n = 10 in each): (i) a bleomycin-treated group, which received intratracheal instillation of 2 mg/kg bleomycin; (ii) a bleomycin + edaravone group, which received a 10 day regimen of daily intravenous injections of edaravone (3 mg/kg per day) beginning 3 days before bleomycin instillation; and (iii) a saline control group. Rabbits were killed for analysis 7 days after bleomycin administration. 3. In lung tissues from the bleomycin-treated group, marked infiltration of inflammatory cells, consisting mainly of lymphocytes, neutrophils and eosinophils, was observed. In addition, significantly increased numbers of TUNEL-positive (apoptotic) and transforming growth factor-beta-positive cells were seen. All these effects were significantly attenuated by treatment with edaravone. 4. The findings of the present study suggest that edaravone may be useful in the prevention of acute lung injury resulting from the production of reactive oxygen species.     

Respiratory allergy to trimellitic anhydride in rats: concentration-response relationships during elicitation

The present study investigated whether airway responses of sensitized rats to trimellitic anhydride (TMA) were concentration dependent and whether these were related to irritation by TMA. Groups of BN and Wistar rats were sensitized by two dermal applications of TMA (50% w/v, followed by 25% w/v in vehicle). Controls received vehicle (acetone-olive oil 4:1, v/v). All animals were challenged 3 wk after the first sensitization by inhalation of one of a range of concentrations of TMA (0.2-61 mg/m3 for BN rats, 15-250 mg/m3 for Wistar rats). Breathing pattern, breathing frequency, and tidal volume were measured before, during, and after challenge to assess allergic and irritative airway responses. One day after challenge, nonspecific airway responsiveness to a range of concentrations of methacholine was measured. At necropsy on the same day, blood was withdrawn for measuring total serum immunoglobulin E (IgE) and organs were weighed. Larynx, trachea and lungs were examined histopathologically. In BN rats, TMA sensitization elevated total IgE levels; subsequent inhalation challenge with 2 mg/m3 of TMA and higher caused laryngeal inflammation with squamous epithelial metaplasia, and pulmonary hemorrhages. Concentration-related decreases in breathing frequency and alterations in breathing pattern, which differed from the irritation-induced pattern, were also observed at these levels. Inhalation challenge with TMA concentrations of 12 mg/m3 and higher increased lung weight. Increased nonspecific airway responsiveness was observed at the 2 next higher tested concentrations of 46 and 61 mg/m3. In unsensitized BN rats, only laryngeal squamous metaplasia was observed, albeit at higher challenge concentrations of TMA, and decreased breathing frequency, a typical breathing pattern characteristic of irritation. Identically sensitized Wistar rats showed airway inflammation and pulmonary hemorrhages upon challenge with TMA, but no functional changes, even at distinctly irritating concentrations of TMA up to 250 mg/m3. In conclusion, TMA challenge of sensitized BN rats caused challenge concentration-related allergic airway inflammation, asthmalike changes in breathing pattern, and increased nonspecific airway responsiveness. The lowest no-observed-effect level (NOEL) based on the most sensitive endpoint investigated was 0.2 mg/m3, a value that is well below the irritation concentration. The presence of a NOEL in the sensitized BN rat suggests that assessment of safe human exposure levels is feasible.     

Alveolar macrophages have a dual role in a rat model for trimellitic anhydride-induced occupational asthma

Occupational exposure to low molecular weight chemicals, like trimellitic anhydride (TMA), can result in occupational asthma. Alveolar macrophages (AMs) are among the first cells to encounter inhaled compounds. These cells can produce many different mediators that have a putative role in asthma. In this study, we examined the role of AMs in lung function and airway inflammation of rats exposed to TMA. Female Brown Norway rats were sensitized by dermal application of TMA or received vehicle alone on days 0 and 7. One day before challenge, rats received intratracheally either empty or clodronate-containing liposomes to deplete the lungs of AMs. On day 21, all rats were challenged by inhalation of TMA in air. Lung function parameters were measured before, during, within 1 h after, and 24 h after challenge. IgE levels and parameters of inflammation and tissue damage were assessed 24 h after challenge. Sensitization with TMA led to decreased lung function parameters during and within 1 h after challenge as compared to non-sensitized rats. AM depletion alleviated the TMA-induced drop in lung function parameters and induced a faster recovery compared to sham-depleted TMA-sensitized rats. It also decreased the levels of serum IgE 24 h after challenge, but did not affect the sensitization-dependent increase in lung lavage fluid IL-6 and tissue TNF-alpha levels. In contrast, AM depletion augmented the TMA-induced tissue damage and inflammation 24 h after challenge. AMs seem to have a dual role in this model for TMA-induced occupational asthma since they potentiate the immediate TMA-induced decrease in lung function but tended to dampen the TMA-induced inflammatory reaction 24 h later.     

379例腺病毒3型急性呼吸道感染症临床流行病学研究

目的 探讨腺病毒3型所致轻型急性呼吸道感染症临床流行病学特点。方法 对收治住院的379例轻型急性呼吸道感染症患者进行病因和流行病学调查,分析临床诊疗特点。结果 该病的潜伏期为2～12d;主要临床表现有发热、咽痛、咳嗽、咽部充血和扁桃体肿大等。经PCR检测及序列分析和细胞分离培养鉴定病原体为腺病毒3型。经抗感染、抗病毒等综合治疗后全部治愈。结论 此次疫情是由腺病毒3型引起的轻型急性呼吸道感染症暴发,但临床特征符合急性上呼吸道感染。     

吉非替尼相关间质性肺炎致死亡

1例82岁男性患者行肺部肿瘤放射治疗(疗程44 d),同时口服吉非替尼250 mg,1次/d。第19天出现皮疹;第38天出现发热;第47天诊断放射性肺损伤,给予抗生素及糖皮质激素治疗后痊愈;第70天出现呼吸困难,呼吸32次/min,伴有咳嗽。实验室检查:白细胞计数4.0×109/L,中性粒细胞计数3.7×109/L。血气分析示pH 7.06,二氧化碳分压(PaCO2)36 mm Hg(1 mm Hg=0.133 kPa),氧分压(PaO2)45 mm Hg,氧饱和度0.55。结合X线胸片与临床表现考虑为吉非替尼相关间质性肺炎。立即停药,行气管插管并呼吸机机械通气,同时静脉滴注美罗培南和甲泼尼龙,1周后患者症状改善。间隔1周后,患者再次出现呼吸困难,血气分析示pH 7.43,PaCO234 mm Hg,PaO240 mm Hg,在短期内相继出现左侧心力衰竭、上消化道出血、Ⅱ型呼吸衰竭、肝肾功能不全、急性心肌梗死。虽经保肝、利尿等治疗,患者终因多器官功能衰竭死亡。