小鼠局部淋巴结检测结合耳肿胀程度鉴别光敏物的评估

目的 建立小鼠局部淋巴结检测结合耳肿胀程度评估的方法鉴别光敏物。方法 受试物加UVA照射(剂量10J/cm²)连续3d在BALB/c小鼠耳背部进行激发,最后一次照射结束后24h切取引流的局部淋巴结,用淋巴细胞计数和MTT比色法测定淋巴细胞增殖率反映局部淋巴结的增殖情况;同时测量小鼠耳肿度以反映皮肤的刺激反应;用双抗体夹心ELISA法进一步测定局部淋巴结细胞72h培养上清液中干扰素-γ(IFN-γ),白介素-2(IL-2)以及白介素-4(IL-4)的含量。结果 强光变应原四氯水杨酰苯胺引起局部淋巴结的增殖反应而不伴耳肿胀反应;弱光变应原6甲基香豆素既不引起局部淋巴结的增殖反应又不出现耳肿胀反应;光毒物质8-甲氧补骨脂素同时引起局部淋巴结增殖和耳肿胀反应。用四氯水杨酰苯胺预先致敏后再进行激发,局部淋巴结中IL-4的分泌量明显升高(P<0.05)。结论 小鼠局部淋巴结检测结合耳肿胀程度评价的方法可较快鉴定较强的接触性光变应原和光毒物质,但对识别较弱的光变应原敏感性不足;预先致敏后激发阶段局部淋巴结中IL-4的分泌量明显升高是光变应原区别于光毒物质的突出特点。     

Cutaneous T‐cell Lymphoma of 12 Years Duration Initially Presenting in a Two Year Old

A 67‐year‐old Chinese man presented with a longstanding history of asymptomatic, brown‐red macules that diffusely involved his trunk and the extremities and was associated with generalized lymphadenopathy. His serum protein electrophoresis revealed a polyclonal hypergammaglobulinemia. No monoclonal Bence Jones protein was detected in the urine. Flow cytometry of his peripheral blood revealed a normal polyclonal population of B and T cells. Histopathologic examination demonstrated a dense nodular infiltrate of lymphocytes and numerous mature plasma cells in the reticular dermis. Immunoperoxidase studies for kappa and lambda light chains failed to demonstrate clonality. In addition, immunoglobulin gene rearrangement studies failed to reveal a monoclonal band. A bone marrow biopsy showed no abnormality. Cutaneous and systemic plasmacytosis is a rare lymphoproliferative disorder that is an important consideration in the differential diagnosis of cutaneous infiltrates in which plasma cells predominate.     

Asymptomatic urethritis and detection of HIV-1 RNA in seminal plasma

OBJECTIVE: To define risk factors for detection of HIV-1 RNA in semen in men attending the two largest HIV clinics in the West Midlands. METHODS: 94 HIV-1 seropositive men at any stage of infection donated matched semen and blood samples. 36 subjects (38%) were on no antiretroviral treatment, 12 (13%) were on dual therapy, and 46 (49%) were on three or more drugs. Median CD4 count was 291 cells x 10(6)/l. 87 subjects underwent a urethritis screen (Gram stained urethral smear and culture for gonococcus, and LCR for Chlamydia trachomatis on first pass urine). Quantitative cell free HIV-1 RNA was determined by commercial nucleic acid sequence based assay with a lower detection limit of 800 copies/ml for semen and 400 copies/ml for blood. Independent risk factors for seminal HIV RNA detection were defined by logistic regression. RESULTS: In univariate analysis, subjects not taking antiretrovirals were 11 times more likely to shed HIV RNA (21/36 (58%) v 6/58 (10%); p < 0.0001). Seven subjects (8%) had urethritis (including one C trachomatis infection). Urethritis was significantly associated with detection of seminal HIV RNA (adjusted OR, 80.2; p = 0.006), as was blood plasma viral load (adj OR, 19.3 per factor 10 increase; p < 0.001) and age (adj OR, 1.16 per 1 year older; p = 0.001). Antiviral treatment status, absolute CD4 and CD8 count, clinical stage, treatment centre, ethnicity, and risk factor were not independent predictors. No subject with undetectable blood viral load had detectable seminal HIV RNA. CONCLUSION: Asymptomatic urethritis is independently associated with seminal HIV RNA shedding.