百草枯中毒患者外周血淋巴细胞亚群变化及对预后判断的作用

采用流式细胞术检测22例百草枯中毒患者和22例健康对照者外周血中CD4~+T细胞(CD3~+CD4~+)、CD8~+T细胞(CD3~+CD8~+)、CD4~+/CD8~+、B细胞(CD3-CD19~+)和NK细胞(CD3-CD56~+)所占的比例,同时分析8例早期中毒死亡患者与14例非早期死亡患者淋巴细胞亚群的差异。百草枯中毒患者较健康对照者CD4~+T细胞所占比例下降、CD4~+/CD8~+比值下降、B细胞所占比例升高(P0.05);早期死亡患者的CD4~+T细胞、CD4~+/CD8~+水平明显低于非早期死亡组,B细胞水平明显升高(P0.05)。     

SLE患者外周血中淋巴细胞亚群的变化及临床意义

目的探讨系统性红斑狼疮(SLE)患者外周血中淋巴细胞亚群的变化及临床意义。方法采用流式细胞术检测30例活动期SLE患者、30例缓解期SLE患者及30名正常人的外周血T淋巴细胞(CD3+)及其亚群CD3+CD4+(CD4+)、CD3+CD8+(CD8+)、CD19+和CD16+56+(NK)细胞,并对结果进行比较。结果活动期SLE患者与对照组比较,CD4+、CD3+CD4+/CD3+CD8+比值、NK细胞降低(P<0.05),CD8+、CD19+增高(P0.05)。缓解期SLE患者各亚群与对照组差异无统计学意义(P>0.05)。活动期SLE患者与缓解期SLE患者比较,CD4+、CD3+CD4+/CD3+CD8+比值、NK细胞降低(P<0.05),CD8+、CD19+增高(P0.05)。结论 SLE患者活动期淋巴细胞亚群存在异常,细胞免疫功能异常,外周血淋巴细胞亚群分析有助于了解SLE患者免疫功能紊乱的状况。     

三氯乙烯药疹样皮炎患者淋巴细胞亚群与肝功能损害相关分析

[目的]研究三氯乙烯药疹样皮炎患者外周血淋巴细胞亚群与肝功能损害之间的关系,为探索其发病机制提供线索。[方法]对32例确诊为三氯乙烯药疹样皮炎患者在入院时采血进行外周血淋巴细胞亚群(在流式细胞仪上运用双标法检测)及肝功能检测,比较淋巴细胞亚群与正常参考值的差异,并与肝功能损害观察指标进行相关性分析。[结果]不同皮疹类型三氯乙烯药疹样皮炎患者之间的外周血淋巴细胞亚群比较,差异无统计学意义(P>0.05);患者外周血成熟T淋巴细胞(CD3+)、CD8+T淋巴细胞(CD3+CD8+)百分数明显升高,CD4+T淋巴细胞(CD3+CD4+)、NK细胞(CD3-CD₁₆₊₅₆+)、B淋巴细胞(CD19+)亚群百分数、CD4+/CD8+明显降低,差异有统计学意义(P<0.01);谷酰转肽酶与成熟T淋巴细胞(CD3+)百分数存在正的线性相关关系;胆碱酯酶、白蛋白与淋巴细胞、CD3+细胞百分数均存在负的线性相关关系。[结论]三氯乙烯药疹样皮炎患者存在细胞免疫和体液免疫功能紊乱;肝功能损害与细胞免疫系统的活跃存在相关关系。     

淋巴细胞亚群检测在重症肺炎治疗及预后评估中的意义

目的探讨淋巴细胞亚群检测在重症肺炎治疗及预后评估中的意义。方法采用多参数流式细胞术检测重症肺炎患者及对照组患者外周血T细胞(CD3~+)、Th细胞(CD3~+CD4~+)、Tc细胞(CD3~+CD8~+)、Th/Tc(CD3~+CD4~+/CD3~+CD8~+)、B细胞(CD19~+)、NK细胞(CD16~+56~+)的水平,并比较重症肺炎患者与对照组的差异以及好转患者治疗前后淋巴细胞亚群水平的变化。结果重症肺炎患者与对照组相比,T细胞、Th细胞及B淋巴细胞水平差异有统计学意义(P0.01);而Tc细胞、Th/Tc及NK细胞差异无统计学意义。在重症肺炎患者Th细胞治疗后水平增加,差异有统计学意义(P0.05);其他亚群变化差异无统计学意义。结论重症肺炎患者细胞免疫功能低下,体液免疫激活;监测重症肺炎患者淋巴细胞亚群水平,对评价患者的免疫功能及治疗和预后判断有指导意义。     

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。     

手足口病患儿淋巴细胞亚群免疫特征检测及价值

[目的]总结手足口病(HFMD)患儿外周血T淋巴细胞、B淋巴细胞、NK细胞及NKT细胞免疫特征,探讨其在HFMD疾病发生发展中的机制及临床检测价值。[方法]应用流式细胞术检测152例HFMD患儿、45例健康对照组幼儿外周血中T淋巴细胞(CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞)、B淋巴细胞(CD3-CD19+细胞)、NK细胞(CD3-CD56+细胞)、NKT细胞(CD3+CD56+细胞)百分率,采用SPSS 13.0统计分析软件,分别对HFMD发病期与健康对照组、HFMD发病期与HFMD恢复期、HFMD重型组与HFMD普通组进行各组淋巴细胞亚群百分率间均数比较,两组间均数的比较方差齐时采用两个独立样本的t检验,方差不齐时用t'检验,P0.05为差异有统计学意义。[结果]HFMD发病期CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NK细胞百分率及CD4+/CD8+比值低于健康对照组;NKT细胞、B细胞百分率HFMD发病期高于健康对照组,各组间均数的比较,差异均有统计学意义(P0.05)。HFMD发病期CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NKT细胞百分率及CD4+/CD8+比值低于HFMD恢复期;B细胞、NK细胞百分率HFMD发病期高于HFMD恢复期,各组间均数的比较,差异均有统计学意义(P0.05)。HFMD重型组CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NKT细胞百分率及CD4+/CD8+比值低于HFMD普通组;B细胞、NK细胞百分率HFMD重型组高于HFMD普通组,除NKT细胞外,其余各组间均数的比较,差异均有统计学意义(P0.05)。[结论]HFMD患儿淋巴细胞亚群免疫功能紊乱。HFMD发病期淋巴细胞亚群中CD3+细胞、CD3+CD4+细胞百分率降低,B细胞百分率增高;HFMD恢复期NKT细胞百分率增高。淋巴细胞亚群免疫特征检测可作为HFMD患儿疾病转归分析指标。     

尘肺患者外周血淋巴细胞亚群的变化及其意义

选取107例尘肺患者,其中石棉肺47例、矽肺45例、电焊工尘肺15例,单纯尘肺无并发症者53例,并发感染无慢性阻塞性肺病(COPD)者41例,并发COPD者30例(其中伴感染19例)。以同期40例健康检查者为对照组。分别空腹抽取静脉血2 ml,采用流式细胞术检测淋巴细胞亚群。与对照组比较,尘肺组外周血中CD3+总T细胞、CD3+CD4+辅助/诱导T细胞及CD3-CD16+CD56+NK三类细胞百分数均降低(P0.05);三种不同类型尘肺之间淋巴细胞亚群比较差异无统计学意义;尘肺并发感染者外周血中CD3+总T、CD3+CD4+辅助/诱导T、CD3+CD8+抑制/杀伤T细胞百分比升高(P0.05);并发COPD组外周血中CD3+总T、CD3+CD4+辅助/诱导T、CD3+CD8+抑制/杀伤T、CD3-CD16+CD56+NK细胞百分比以及CD4/CD8比值均降低(P0.05)。提示尘肺患者淋巴细胞尤其是T淋巴细胞亚群比例变化明显,并发肺部感染者T淋巴细胞亚群比例升高,并发COPD者免疫功能损伤严重。因此,对尘肺患者淋巴细胞亚群进行监测对阐明尘肺发病机制、监测疾病进展和改善预后起到十分积极的作用。     

肺癌患者外周血T淋巴细胞亚群的变化

目的研究肺癌患者外周血T淋巴细胞亚群的水平及变化特点。方法采用流式细胞技术,对41例肺癌患者术前检测外周血T淋巴细胞亚群水平,并与50例健康献血者作对照研究。结果与对照组比较,肺癌患者CD3+、CD4+、CD8+和NK细胞减少,CD4+/CD8+降低,差异均有统计学意义(P均<0.01)。淋巴细胞亚群变化与分期相关:Ⅰ期肺癌患者T淋巴细胞亚群未见明显抑制;Ⅱ期CD3+、CD4+、CD8+和NK细胞减少,但较Ⅰ期差异无统计学意义;Ⅲ期肺癌患者所有亚群均降低,分别与Ⅰ期和Ⅱ期比较,差异均有统计学意义;随着分期增加,CD4+/CD8+明显降低,各期之间差异均有统计学意义。淋巴结转移组NK细胞和CD4+/CD8+均明显低于无淋巴结转移组,差异均有统计学意义(P均<0.01)。结论肺癌患者存在免疫功能低下,免疫功能随着肿瘤的进展进一步受到削弱。     

慢性湿疹患者外周血淋巴细胞亚群及总IgE水平的检测分析

目的探讨慢性湿疹患者的外周血淋巴细胞亚群与总IgE水平相关性。方法通过流式细胞仪和BNII特定蛋白分析仪检测400例慢性湿疹患者外周血中淋巴细胞亚群及总IgE,并对其相关性进行分析。结果与正常组相比较,慢性湿疹组总IgE水平明显高于正常组,差异有统计学意义(P0.05);CD3~+T细胞、CD4~+T细胞、CD4~+/CD8~+比值均降低,CD8~+T细胞、CD3-CD16+56+NK细胞升高,差异有统计学意义(P0.05)。不同程度总IgE患者组的免疫功能相比较,CD3~+细胞与CD3-CD16+56+细胞差异有统计学意义(P0.05)。结论免疫功能的紊乱是慢性湿疹患者发病的一个重要机制,在慢性湿疹的发生、发展过程中可能起到重要的作用。     

乳腺癌患者外周血T细胞亚群与NK、NKT细胞检测的临床意义

目的:检测乳腺癌患者外周血T淋巴细胞亚群及NK、NKT细胞表达率的变化,探讨乳腺癌患者免疫状况与肿瘤分期的关系以及免疫指标变化在治疗前后的临床价值。方法 :采用荧光标记法与多参数流式细胞仪检测40例正常女性和120例乳腺癌患者的总T淋巴细胞(CD3+)、T辅助/T诱导细胞(CD3+CD4+)、T抑制/细胞毒细胞(CD3+CD8+)、自然杀伤细胞(NK)、NK样T细胞(NKT)的表达率,并进行统计学分析。结果:无淋巴结转移组乳腺癌患者治疗前CD3+、CD3+CD4、CD3+CD8+、CD4+/CD8+与对照组比较无统计学意义,NK、NKT显著低于对照组(P<0.05)。淋巴结转移组乳腺癌患者CD3+、CD3+CD4、CD3+CD8+、NK、NKT表达率均明显低于对照组(P<0.05)。经过综合治疗后乳腺癌组各项免疫指标均恢复到正常值。结论:外周血T细胞亚群的检测对判断乳腺癌患者的病情、临床分期有一定意义;经过治疗后能够有效地改善乳腺癌患者的免疫状态。     

Investigation and Control of Anthrax Outbreak at the Human–Animal Interface,Bhutan, 2010

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.     

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance,Epidemiology, and End Results Database

BackgroundActual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported.ObjectiveThis study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC.MethodsWe performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan–Meier analysis, and multivariate Cox proportional hazards model for the analyses.ResultsWe included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer–specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors.ConclusionsOvarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.     

Travel-associated Diseases,Indian Ocean Islands, 1997–2010

Data collected by the GeoSentinel Surveillance Network for 1,415 ill travelers returning from Indian Ocean islands during 1997–2010 were analyzed. Malaria (from Comoros and Madagascar), acute nonparasitic diarrhea, and parasitoses were the most frequently diagnosed infectious diseases. An increase in arboviral diseases reflected the 2005 outbreak of chikungunya fever.     

Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance

Pneumocystis pneumonia (PCP) remains a major cause of illness and death in HIV-infected persons. Sulfa drugs, trimethoprim-sulfamethoxazole (TMP-SMX) and dapsone are mainstays of PCP treatment and prophylaxis. While prophylaxis has reduced the incidence of PCP, its use has raised concerns about development of resistant organisms. The inability to culture human Pneumocystis, Pneumocystis jirovecii, in a standardized culture system prevents routine susceptibility testing and detection of drug resistance. In other microorganisms, sulfa drug resistance has resulted from specific point mutations in the dihydropteroate synthase (DHPS) gene. Similar mutations have been observed in P. jirovecii. Studies have consistently demonstrated a significant association between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim for PCP treatment remains unclear. We review studies of DHPS mutations in P. jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone.     

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Three days after donation of peripheral blood stem cells to a recipient with acute myeloblastic leukemia, dengue virus was detected in the donor, who had recently traveled to Sri Lanka. Transmission to the recipient, who died 9 days after transplant, was confirmed.     

Risk for Travel-associated Legionnaires’ Disease,Europe, 2009

Legionnaires’ disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires’ disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominator data from the Statistical Office of the European Union. Risk (number cases reported/number nights spent) was calculated by travel country. In 2009, the network reported 607 cases among European travelers, possibly associated with 825 accommodation sites in European Union countries. The overall risk associated with travel abroad was 0.3 cases/million nights. We observed an increasing trend in risk from northwestern to southeastern Europe; Greece had the highest risk (1.7). Our findings underscore the need for countries with high TALD risks to improve prevention and control of legionellosis; and for countries with high TALD risks, but low notification rates of Legionnaires’ disease to improve diagnostics and reporting.     

大龄单身女性寻求生育力保存的伦理问题探析

近年来,在肿瘤和卵巢相关疾病发生率逐年增加、不少大龄单身女性渴望为自己购买一份“生殖保险”等社会及个人因素催化下,人类对于生育力保存的需求急剧增加,满足这一需求正在或将成为重大挑战。对于寻求进行生育力保存的大龄单身女性来说,在合适的年龄应用玻璃化冷冻技术将其卵母细胞冻存是目前可采用的最佳生育力保存手段。而单身女性卵子冷冻将面临来自伦理道德、社会乃至法律的巨大挑战。本文概述国内外大龄单身女性卵子冷冻的现状,并对其可能涉及的相关伦理问题及解决途径进行综述,以促进理性正视单身女性卵子冷冻问题。     

Raccoons and skunks as sentinels for enzootic tularemia

We analyzed sera from diverse mammals of Martha's Vineyard, Massachusetts, for evidence of Francisella tularensis exposure. Skunks and raccoons were frequently seroreactive, whereas white-footed mice, cottontail rabbits, deer, rats, and dogs were not. Tularemia surveillance may be facilitated by focusing on skunks and raccoons.     

Epidemic cholera in a crowded urban environment, Port-au-Prince, Haiti

We conducted a case-control study to investigate factors associated with epidemic cholera. Water treatment and handwashing may have been protective, highlighting the need for personal hygiene for cholera prevention in contaminated urban environments. We also found a diverse diet, a possible proxy for improved nutrition, was protective against cholera.