三氯乙烯药疹样皮炎患者治疗前后肝功能与外周血淋巴细胞亚群变化相关分析

目的 研究三氯乙烯药疹样皮炎患者治疗前后肝功能与外周血淋巴细胞亚群的变化特点,探索两者之间的联系,为该病发病机制的研究提供线索。 方法 采用双标法在流式细胞仪上对14例确诊为三氯乙烯药疹样皮炎的患者(其中9例为剥脱性皮炎、5例为多形红斑)在入院时及治疗2~3月后(停用糖皮质激素)进行外周血淋巴细胞亚群检测及肝功能指标检测,比较治疗前后肝功能与淋巴细胞亚群的变化情况。 结果 与正常参考值相比,治疗前患者均存在不同程度肝损伤,治疗后患者肝功能基本恢复正常。患者治疗前后的CD3+细胞、CD8+T细胞(CD3+CD8+)百分数均高于正常参考值,差异有统计学意义(t=2.283~6.841,P < 0.05或0.01);而CD4+T细胞(CD3+CD4+)、NK细胞[CD3-CD (16+56)+]、B淋巴细胞(CD3-CD19+)百分数、CD4+/CD8+比值均低于正常参考值,差异有统计学意义(t或Z=-14.49~-2.310,P < 0.05或0.01)。与治疗前比较,剥脱性皮炎患者治疗后的CD8+T淋巴细胞、B淋巴细胞百分数降低,趋于正常水平,差异有统计学意义(t=2.814、2.877,P < 0.05);其他指标在治疗前后比较,差异无统计学意义(P>0.05)。多形红斑患者各指标在治疗前后比较,差异均无统计学差异(P>0.05)。与入院时相比,免疫球蛋白M (IgM)、免疫球蛋白A (IgA)水平下降,差异有统计学意义(t=2.256、2.293,P < 0.05);免疫球蛋白G (IgG)水平在治疗前后比较,差异无统计学意义(t=1.783,P>0.05)。治疗前谷酰转肽酶水平与成熟T淋巴细胞(CD3+)、CD8+T细胞百分数均存在正相关关系(r=0.496、0.470,P < 0.05);胆碱酯酶、白蛋白等指标与成熟T淋巴细胞、CD8+T细胞百分数均存在负相关关系(r=-0.567、-0.475、-0.501,-0.516,P < 0.05)。 结论 三氯乙烯药疹样皮炎患者在较长的时间内存在免疫功能紊乱,三氯乙烯药疹样皮炎可能为细胞免疫与体液免疫共同作用的结果,CD8+T细胞的增殖可能与其肝脏和皮肤损害的机制有关。     

Reduced concentration of hepatic alpha-tocopherol in patients with alcoholic liver cirrhosis.

The concentration of alpha-tocopherol was measured in liver biopsy specimens obtained from 83 patients with alcoholic and non-alcoholic liver diseases. The mean hepatic vitamin E content (as alpha-tocopherol) was significantly lower in 23 patients with alcoholic cirrhosis (17.6 +/- 12.1 nmol/mg wet weight liver), compared with 12 patients with normal liver histology (39.2 +/- 29.7 nmol/mg, P less than 0.01). The mean serum concentration of alpha-tocopherol was lower in patients with alcoholic cirrhosis (13.9 +/- 7.0 mumol/l) than in individuals with alcoholic fatty liver (21.3 +/- 9.3 mumol/l, P less than 0.01) and patients with normal liver histology (23.4 +/- 11.6 mumol/l, P less than 0.01). A decreased ratio of serum alpha-tocopherol/total serum lipids was also observed in patients with alcoholic cirrhosis, compared with patients with normal liver histology (P less than 0.05). There was a significant correlation between concentrations of alpha-tocopherol in liver and serum (r = 0.43, P less than 0.001). Furthermore, serum alpha-tocopherol correlated with retinol (r = 0.53, P less than 0.001), selenium (r = 0.45, P less than 0.001), and albumin (r = 0.37, P less than 0.001) in serum. We suggest that the reduced content of hepatic alpha-tocopherol observed in some patients may play a role in ethanol-induced lipid peroxidation.     

淋巴细胞主动免疫治疗对不明原因复发流产患者 Treg/Th17平衡的影响

目的：探讨淋巴细胞主动免疫治疗（LIT）对不明原因复发流产（URSA）患者的 Treg／Th17免疫平衡的影响。方法应用流式细胞学技术及 ELISA 法测量 URSA 患者 LIT 治疗前、后外周血 Treg、Th17细胞所占淋巴细胞比例和血清 IL-10、IL-17、TGF-β1水平,并对比及分析关联性。结果40例 URSA 患者 LIT 治疗后外周血CD4＋CD25＋Treg、CD4＋CD25＋CD127 low Treg 细胞所占比例高于治疗前,CD8-CD3＋IL-17A ＋Th17细胞所占比例低于治疗前,且与前两者的改变分别呈负相关（r ＝－0.724,P ＜0.01;r ＝－0.571,P ＜0.01）,Treg／Th17比例高于治疗前,差异有统计学意义。LIT 治疗后血清 IL-10、TGF-β1水平较治疗前升高,且分别与 CD4＋CD25＋Treg 细胞比例的改变呈正相关（r ＝0.654,P ＜0.01;r ＝0.658,P ＜0.01）,IL-17水平降低,且与 CD8-CD3＋IL-17A ＋ Th17细胞比例的改变呈正相关（r ＝0.693,P ＜0.01）,差异有统计学意义。结论 LIT 可能影响 URSA 患者的 Treg／Th17免疫平衡,提高 Treg 细胞亚群的数量、功能,降低 Th17细胞亚群的数量、功能,以此发挥治疗作用。     

甲基汞对小鼠睾丸功能的影响

The results showed that the amount of methylmercury (MeHg) in testis correlated positively with exposure doses (r = 0.99 P less than 0.01). MeHg affected the process of spermatogenesis, causing decrease of sperm count and increase of sperm abnormalities. Pathological and electron microscopic examinations indicated that spermatogenic cells were damaged by MeHg especially spermatogonium and spermatocyte. Changes of microstructure were mainly degeneration, fragmentation vacuolation and large lipid drop formation of spermatogenic cells. The acrosome of many spermatids showed obvious changes. Destruction of blood-testis barrier was observed in 1/10 LD50 group. Quantitative histological examination also confirmed that MeHg resulted in lessening of its area of seminiferous tubules and reduction of germ cells. The contents of testosterone were not decreased in the treated groups other than the 1/10 LD50 group.     

甲醛致胎鼠肝微核率及染色体畸变的研究

目的探讨甲醛致胎鼠肝微核率与染色体畸变。方法随机将妊娠小鼠(孕13天)分为5组:腹腔注射甲醛(0.00、0.20、2.00、20.00mg/kg)染毒组、环磷酰胺(30mg/kg)阳性对照组,实验至妊娠第14天即染毒后18小时脱颈椎处死孕鼠,剥离两侧子宫,每侧各取一胎鼠,断头放出外周血,取胎肝,采用胎肝微核试验和胎肝染色体畸变试验,检测胎肝血微核率和染色体畸变率。结果2.00、20.00mg/kg甲醛染毒组胎肝微核率及胎肝染色体畸变率与阴性对照组比较差异有显著性(P<0.01);染色体畸变主要表现为染色体断裂、多倍体等畸形。结论甲醛可致胎鼠肝微核率与染色体畸变。     

放射工作人员外周血淋巴细胞染色体畸变率分析

目的 分析介入放射工作人员外周血淋巴细胞染色体畸变率，为放射职业防护与管理提供依据。方法 收集2020—2021年在湖南省职业病防治院进行职业健康体检的1 243名医疗机构放射工作人员的体检资料进行分析。将职业类别为介入放射学的514人作为介入组，职业类别为诊断放射学的729人作为普放组。对两组人员的双着丝粒体+着丝粒环（dic+r）、无着丝粒体（ace）和染色体畸变异常检出率进行分析。结果 介入组dic+r为（0.03±0.23）%,ace为（0.01±0.13）%，染色体畸变异常检出率为2.335%，均高于普放组的（0.01±0.09）%、（0.00±0.05）%、0.549%，差异有统计学意义（P <0.05）。介入组不同性别的工作人员的Dic+r、ace和染色体畸变异常检出率差异均无统计学意义（P> 0.05）；介入组40岁以上人员的Dic+r和染色体畸变异常检出率高于≤40岁的人员（P <0.05）；介入组人员的Dic+r、ace和染色体畸变异常检出率均有随工龄增加而增加的趋势（P <0.05）。结论 介入放射工作人员染色体畸变检出率高于诊断X射线放射...     

Relation between pyridoxal and pyridoxal phosphate concentrations in plasma, red cells, and white cells in patients with critical illness

BACKGROUND: Evidence suggests that the relation between plasma and red cell vitamin B-6 concentrations is perturbed as part of the systemic inflammatory response in critically ill patients. OBJECTIVE: The aim was to examine the cross-sectional and longitudinal interrelations between pyridoxal (PL) and pyridoxal phosphate (PLP) concentrations in plasma and red and white cells in patients with critical illness. DESIGN: PLP and PL concentrations were measured by HPLC in plasma and red and white cells in normal subjects (n = 126) and critically ill patients (n = 96) on admission and on follow-up. RESULTS: On admission, compared with the controls, median plasma PLP and PL (P < 0.001 and < 0.01, respectively) and red cell PLP and PL (P < 0.001 and < 0.05, respectively) and their ratio (PLP:PL) in plasma and red cells (P < 0.001 and < 0.01, respectively) were significantly lower in the critically ill. In critically ill patients, plasma PLP:PL was significantly lower than red cell PLP:PL (P = 0.001) and white cell PLP:PL (P = 0.008). Plasma PL concentration was directly associated with both red cell PL (r(s) = 0.73, P < 0.001) and white cell PL (r(s) = 0.68, P < 0.001). Red cell PL and white cell PL were directly associated with red cell PLP (r(s) = 0.82, P < 0.001) and white cell PLP (r(s) = 0.68, P < 0.001), respectively. Longitudinal measurements (n = 48) were similar. CONCLUSIONS: The relation between plasma PLP and PL was significantly perturbed in critical illness. This effect was less pronounced in red and white cells. Therefore, these results confirm the hypothesis that intracellular PLP concentrations are more likely to be a reliable measure of status than are plasma measurements in the critically ill patient.     

Mechanism of increased osmotic resistance of red cells in workers exposed to lead.

In order to clarify the mechanism of the increased osmotic resistance of red blood cells in lead workers 19 men employed in a lead refining factory and 18 control male workers employed in railway construction were examined for red cell count, haematocrit, MCV, blood and urine lead concentrations, urine coproporphyrin and delta-aminolevulinic acid, osmotic resistance of red cells, lecithin-cholesterol acyltransferase (LCAT) activity in serum, and cholesterol content and cholesterol-to-phospholipid ratio of the red cell membrane. The results were: (1) The osmotic resistance of the red cells (p less than 0.05), cholesterol content of the red cell membrane, blood and urine lead, urine coproporphyrin, and urine delta-ALA concentrations (p less than 0.01) were higher in the lead workers than in the controls. (2) In the lead workers close relationships were observed between the osmotic resistance and the blood lead concentration (r = -0.515, p less than 0.05), osmotic resistance and LCAT activity (r = 0.596, p less than 0.01), and osmotic resistance and cholesterol of the red cell membrane (r = -0.492, p less than 0.05).     

Low level lead and inhibition of erythrocyte pyrimidine nucleotidase.

Pyrimidine 5'-nucleotidase (P5N, EC 3.1.3.5) appears to be a sensitive index of exposure to low level lead. In 21 children 2 to 5 years old with blood leads of 7 to 80 micrograms/dl there was a negative linear correlation of blood lead and red cell P5N: r = -0.60 (P less than 0.01), Y = -0.11X + 12.3. In rats, the enzyme assay was quantitatively similar to that of the human. A treatment group of 12 rats received lead acetate, 36 mg/kg/day, of lead as 0.17 M lead acetate for 24 days. The blood lead of treated rats increased from the control value of 8.3 +/- 1.3 to 36.0 +/- 0.5 on day 24; P5N decreased from 18.3 +/- 0.8 units to 9.0 +/- 1.0 and was below control values at a blood lead of 25. There was a significant negative linear correlation of blood lead and P5N: r = -0.85; n = 17; P less than 0.001; Y = 0.34X + 20.9 that was independent of the correlationship with the reticulocytes. At these levels of blood lead and P5N there was no significant change in the hexokinase, hemoglobin or red cell count and no evidence of stippling.     

The evaluation of serum creatine phosphokinase for estimation of energy expenditure in human subjects]

We investigated the relationship between serum creatine phosphokinase (CPK) activity and energy expenditure in young adults and evaluated whether serum CPK activity is a useful index of energy expenditure. These data were obtained from 225 (men: 94, women: 131) healthy young adults. The results of the survey were as follows: In men, there was a statistically significant correlation between serum CPK activity and energy expenditure (r = 0.370; p less than 0.01; y = 1986.0 + 8.2x), energy expenditure/body weight (r = 0.270; p less than 0.01 y = 35.4 + 0.06x) and daily activity index (r = 0.357; p less than 0.01; y = 0.38 + 0.0030x) In women, there was a statistically significant correlation between serum CPK activity and energy expenditure (r = 0.207; p less than 0.05; y = 1895.0 + 3.0x), and daily activity index (r = 0.194; p less than 0.05; y = 0.432 + 0.0017x). The higher the proportion of exercising subjects, the higher was the serum CPK activity. These results suggest that measurement of serum CPK activity can be used to evaluate energy expenditure.