71例天疱疮的棘层松解位置分析

目的 探讨天疱疮的棘层松解位置,为天疱疮出现不同位置棘层松解的表现提供解释.方法 收集43例寻常型天疱疮和28例落叶型天疱疮患者的临床资料、组织病理、免疫病理、天疱疮抗体指标值进行分析.结果 寻常型天疱疮中有35例棘层松解的位置发生在基底层上方,8例发生在表皮中上部,落叶型天疱疮中有25例棘层松解的位置发生在颗粒层、棘层上方,3例发生在表皮中下部,落叶型天疱疮患者抗Dsg1抗体指标较寻常型天疱疮患者显著升高(P=0.047),寻常型天疱疮棘层松解的位置发生在表皮中上部的患者抗Dsg1、3抗体指标值与棘层松解发生在基底层上方的患者相比有差异,但无统计学意义.结论 寻常型天疱疮及落叶型天疱疮患者组织病理中,棘层松解的位置可发生于表皮中上部、表皮中下部.棘层松解的位置可能与抗Dsg1抗体和抗Dsg3抗体指标值等相关.     

IgA型基底膜带自身抗体研究近况

研究发现,瘢痕性类天疱疮、大疱性类天疱疮、获得性大疱表皮松解症、大疱性系统性红斑狼疮及线状IgA大疱病等表皮下大疱病均存在IgA型基底膜带自身抗体。线状IgA大疱病与瘢痕性类天疱疮、大疱性类天疱疮、获得性大疱表皮松解症不仅IgA型基底膜带自身抗体在基底膜带处沉积和结合方式相似,而且IgA型基底膜带自身抗体的靶抗原亦可相互重叠。大疱性类天疱疮及大疱性系统性红斑狼疮IgA型基底膜带自身抗体与疾病严重程度相关。     

人唾液天疱疮抗原的纯化

已知对表皮自身抗原发生免疫耐受性障碍并形成自身抗体为天疱疮病人的特征。致敏的表皮自身抗原为鳞状上皮细胞的正常表面成分。作者先前已报道在人的唾液中存在有天疱疮表皮自身抗原。本文报道关于从人的唾液中分离天疱疮表皮自身抗原的程序和结果。用天疱疮抗体与鼠舌上皮发生反应以使间接免疫荧光染色反应被阻断的方法测定天疱疮表皮自身抗原。将新鲜的人全唾液与天疱疮病人血清进行孵育从而全部阻断了天疱疮抗体和鼠舌上皮产生间接免疫荧光染色反应。在7名供体(包括1例天疱疮病人)的唾液中测得天疱疮表皮自身抗     

1例在病变部表皮下见有补体C_3沉积的寻常性天疱疮

作者报告1例用直接免疫荧光检查见表皮细胞间均有IgG沉积、表皮下层有C_3沉积的39岁女性的寻常性天疱疮。总结过去10年日本报告的天疱疮病例的结果,寻常性天疱疮患者43例中有28例(65%)有C_3沉积,有报告C_3沉积率更高。在28例中C_3沉积在表皮下层有11例(39%),而象本例一样C_3沉积在表皮下层,IgG在表皮细胞间均有的病例有9例(32%),IgG单独沉积的表皮上中层朱发生棘层松解,而IgG、C_3沉积的表皮下层则发生了棘层松解由此推测补体与寻常性天疱疮的病变发生部位有关。对于天疱疮的其他类型,落时性天疱疮有较多病例C_3沉积在表皮上层,但红斑性天疱疮大多在基底膜处有C_3沉积,与水疱发生的部位不一致。对于补体     

红斑性天疱疮 Senear-Usher综合征

天疱疮是一种自身免疫性大疱性皮肤病,其组织学特征是表皮内棘层松解。临床上分为4型:寻常性天疱疮、增殖性天疱疮、落叶性天疱疮和红斑性天疱疮(PE)。1979年,Leyer根据棘层松解性大疱在表皮内的位置,将天疱疮分为两大类,由于增殖性天疱疮基底层上有裂隙,故认为是寻常性天疱疮的变型,PE的大疱发生在角层下,认为是落叶性天疱疮的变型。     

立足临床,开拓发展

自身免疫性大疱病是指一组发生在皮肤和黏膜,以水疱、大疱为基本损害的器官特异性自身免疫性皮肤病,特征是患者血清中存在破坏皮肤黏附结构的自身抗体.其表现形式多样,根据水疱所在部位及自身抗体靶向结构蛋白的不同可分为表皮内水疱病和表皮下水疱病.表皮内水疱病以天疱疮为代表,表皮下水疱病包括大疱性类天疱疮、瘢痕性类天疱疮、线状Ig...     

天疱疮发病机理的新概念

天疱疮是一种侵犯人的复层鳞状上皮组织的、自身免疫性的、表皮内大疱性疾病.在免疫学上的特征为对表皮自身抗原的免疫耐性破坏,产生抗表皮细胞表面的自身抗体—天疱疮抗体(PAb).近年来,对PAb、天疱疮抗原(PAg)、天疱疮棘层松解的发病机理以及补体与棘层松解的关系,进行了深入的研究,现将部分文献综述如下:     

大疱及疱疹性皮肤病

982191 免疫印迹技术检测天疱疮患者血清结合的天疱疮抗原/顾富祥（南京鼓楼医院皮肤科）…//中华皮肤科杂志.-1998,31（1）.-47～48 应用免疫印迹,以正常表皮提取物为抗原,检查18例天疱疮患者血清。结果显示4例寻常性天疱疮（PV）血清都与表皮提取物中130000分子反应,4例疱疹样天疱疮（PH）血清2例与表皮提取物中130000蛋白反应,另2例与表皮提取物中160000反应,1例落叶性天疱疮（PF）和9例红斑性天疱疮（PE）血清中有4例与表皮提取物160000蛋白反应。表明免疫印迹技术能准确地测定天疱疮患者血清中自身抗体所对应的自身抗原的分子量,从而准确地诊断天疱疮,并可进一步加以分型。4例PH患者血清反应不同,因为它既可以转变为PV,也可以转化为PF,说明免疫印迹对不典型的天疱疮亦能诊断。图2参5 （张小莲）     

IgA型基底膜带自身抗体研究近况

研究发现，瘢痕性类天疱疮，大疱性类天疱疮，获得性大疱表皮松解症，大疱性系统性红斑狼疮及线状ＩｇＡ大疱病等表皮下大疱病均存在ＩｇＡ型基底膜带自身抗体。线状ＩｇＡ大疱病与瘢痕性类天疱疮，大疱性类天疱疮，获得性大疱表皮松解症不仅ＩｇＡ型基底膜带自身抗体在基底膜带处沉积和结合方式相似，而且ＩｇＡ型基底膜带自身抗体的靶抗原亦可相互重叠。     

用不同抗原来源进行免疫印迹法分析巴西落叶型天疱疮抗原

本文作者用人表皮提取物以及以牛鼻表皮提纯的桥粒体制剂为抗原,用免疫印迹法检查了27份巴西落叶型天疱疮(BPf)、13份日本散发性落叶型天疱疮(Pf)和7份寻常型天疱疮(Pv)血清.取其结果进行比较.作者用各型天疱疮血清进行间接免疫荧光法检     

Absenteeism in leprosy patients in a rural area in Tamil Nadu

Of the 3382 leprosy patients taking treatment in Hemerijckx Rural Centre Area, 150 randomly selected patients, who were irregular for treatment, were matched with 150 patients who were regular for treatment, by age, sex and type of disease. The characteristics and the reasons for regularity/irregularity in treatment of these 300 patients were studied. There were more Lepromatous patients (20%) among regulars. A greater proportion of irregulars belonged to backward (54%) and scheduled castes (35%). The proportion of irregulars were more (32%) in the initial phase of the disease. There were more irregular patients among the illiterate group (61%). The knowledge of the irregular patients about early sign, causation, spread, curability and duration of treatment were found to be lacking. The clinic timing was unsuitable for 33% of irregular patients. 23% of irregulars experienced some intolerance to DDS. When 94% of regulars attended clinic in order that they may be 'cured', 63% of irregulars stayed away because of 'work'.     

Changing trends in the epidemiology of contact dermatitis in Singapore

All patients seen in the Contact Dermatitis Clinic of the National Skin Centre, Singapore (and the former Middle Road Hospital) between January 1986 and December 1990 were analysed retrospectively. 5557 patients comprising 2634 (47.4%) males and 2923 (52.6%) females were patch tested. 3154 (56.8%) patients had 1 or more positive reactions. The majority of the patients were Chinese (78.0%), followed by Malays (11.5%), Indians (8.1%) and other minority races (2.4%). The majority of positive reactions belonged to the 21-40 age group. The incidence of positivity decreased after 60 years. The commonest allergens responsible were nickel (17.7%), fragrance (13.3%), neomycin (6.9%), colophony (6.6%) and proflavine (6.5%). Both neomycin and proflavine were commonly used as over-the-counter medicaments. Compared to an earlier report in 1988, there were differences in the incidence of contact sensitivity to some allergens. Potassium dichromate, which used to be a common allergen, was less common. Some allergens (carba-mix, naphthyl-mix, caine-mix and PCMX) have been removed from our standard series as they were uncommon causes of contact allergy. Thimerosal and Amerchol L-101 were added in their place.     

Dermatology survey in four villages in Iran

Four villages in the Kavar area of Pars Province (Southern Iran) were visited and all the inhabitants examined for evidence of skin disease. Two of these villages had had some primary medical care given by paramedical helpers (village health workers) for the preceding 2 years and two were about to get the same care. The incidence of skin disease in all four villages was the same showing that the village health workers were not adequately trained in the recognition of skin diseases. The major problems were pediculosis capitis and corporis, pityriasis versicolor, eczema and skin tumours.     

山东省 2017年梅毒血清学检测室间质量评价结果分析

目的: 评价山东省二级以上医疗机构、妇幼机构与疾控机构性病实验室梅毒血清学检测能力。方法:梅毒盲样统一采购,分发至560家参评机构, 要求进行梅毒螺旋体血清学（TT）定性实验和非梅毒螺旋体血清学（NTT）定性和定量实验,将回报的检测结果进行统计分析。结果: 560家参评机构中优秀536家（95.71%） ,合格19家（3.39%） ,不合格5家（0.89%）;梅毒螺旋体血清学实验总体符合率为99.82% ,非梅毒螺旋体血清学实验定性、定量符合率分别为98.54%和96.43%。结论: 各参评机构梅毒血清学检测整体较好,但性病实验室规范化建设需进一步加强。     

Chromomycosis in Zaire

Abstract: Biopsy specimens from 17 Zairians with chromomycosis are described. Patients ranged in age from 20 to 50 years, with a mean of 37.2 (10.2). Chromomycosis was suspected clinically in only 3 of the 17 patients. In 14 patients the lesions were on the lower limbs and in 3 on the arms. The lesions were chronic, in one patient persisting (or 9 years. The diagnosis was established in each patient by finding typical thick-walled brown fungi within the lesions. Some fungi were in abscesses, others were in histiocytes or giant cells. The fungi and the inflammatory reaction were concentrated in the upper dermis. Acanthosis, hyperkeratosis, and parakeratosis were constant features and pseudoepithe- liomatous hyperplasia (PEH) was a feature in 10 patients. Transepithelial elimination (TEE) of fungi was a conspicuous feature in eight specimens. Microscopic features suggested TEE in an additional three. PEH and TEE were associated in all specimens. In patients with TEE, the diagnosis may he confirmed quickly by smearing surface scrapings and finding the characteristic brown fungi.     

Chromomycosis in Zaire

Biopsy specimens from 17 Zairians with chromomycosis are described. Patients ranged in age from 20 to 50 years, with a mean of 37.2 (+/- 10.2). Chromomycosis was suspected clinically in only 3 of the 17 patients. In 14 patients the lesions were on the lower limbs and in 3 on the arms. The lesions were chronic, in one patient persisting for 9 years. The diagnosis was established in each patient by finding typical thick-walled brown fungi within the lesions. Some fungi were in abscesses, others were in histiocytes or giant cells. The fungi and the inflammatory reaction were concentrated in the upper dermis. Acanthosis, hyperkeratosis, and parakeratosis were constant features and pseudoepitheliomatous hyperplasia (PEH) was a feature in 10 patients. Transepithelial elimination (TEE) of fungi was a conspicuous feature in eight specimens. Microscopic features suggested TEE in an additional three. PEH and TEE were associated in all specimens. In patients with TEE, the diagnosis may be confirmed quickly by smearing surface scrapings and finding the characteristic brown fungi.     

我国6省城乡居民安全知识与急救技能现状研究

目的了解我国居民安全知识与急救技能现状,为制定卫生政策和健康教育干预措施提供依据。方法采用多阶段、分层、与人口规模成比例抽样（PPS抽样）方法,对我国6省65个区县22508名15-69岁居民开展安全知识与急救技能问卷调查。结果收回有效问卷21494份,有效率为95．5％。其中,城市居民占45．2％,农村居民占54．8％;男性占51．0％,女性占49．0％。调查对象对安全知识的平均知晓率为68．9％,对急救技能的平均知晓率为67．0％。各项安全知识中,“食品标签的内容”知晓率最高,为95．2％,“蔬菜残留农药的处理”知晓率最低,为36．5％;各项急救技能中,“火灾逃生”知晓率最高,为76．0％,“抢救呼吸心跳骤停者”知晓率最低,为48．7％。安全知识和急救技能平均知晓率,城市居民分别为74．5％和73．2％,均高于农村居民的64．3％和61．9％,P（0．05;男性分别为69．6％和67．6％,均高于女性的68.1％和和66．3％,P〈0．05;文化程度高者均高于文化程度低者,P〈0．05,其中大专／本科及以上者安全知识和急救技能平均知晓率分别为81．4％和78．9％,而不识字／少识字者仅为54．3％和52．3％。结论我国居民安全知识和急救技能知晓率较低,应以农村为重点地区,以文化程度较低者为重点人群,以急救技能为重点内容,开展公众安全与急救健康教育。     

228名女性桑拿按摩从业人员性病调查分析

目的:为了解我市高危人群性病的流行情况,对我市10家酒店的228名桑拿按摩女性从业人员进行性病调查。结果:发现性病72例,检出率31.57％,其中,细菌性阴道病14.91％(34/228),淋病7.9％(18/228),非淋球菌性宫颈炎7.46％(17/228),尖锐湿疣0.88％(2/228),软下疳0.44％(1/228)。结论:桑拿按摩女性从业人员是性病的高危人群,应主动对该人群进行监测,并加强行为干预和防治。     

云南省2009年性传播疾病疫情分析

目的了解云南省2009年性病流行情况,为性病防治策略制定提供依据。方法通过中国疾病监测信息报告管理系统上报的性病数据,对淋病、梅毒、尖锐湿疣、生殖器疱疹、生殖道沙眼衣原体感染等性病疫情进行分析,并与2008年进行比较。结果2009年全省通过网络直报共报告性病9573例。其中男性报告病例数为4838例,女性报告病例数为4735,男女性别比为1．02：1,发病率为21．07／10万。梅毒发病率为10．76／10万,淋病发病率为4．28／10万。2008年全省报告性病病例8355例,发病率为18．39／10万。梅毒发病率为7．84／10万,淋病发病率为5．50／10万。结论2009年全省报告病例数较2008年增加了14．58％,推测与我省加大梅毒检测力度及规范性病疫情报告有关,需要进一步加强性病防治及疫情报告工作。     

Correlation between quantitative in vivo and in vitro responses in nickel-allergic patients

Forty-three nickel-allergic patients (40 females and 3 males) participated in this study which was designed to elucidate the correlation between quantitative in vivo and in vitro responses. All were patch-tested with various concentrations of nickel-sulphate serial-diluted in water. The lowest concentration eliciting a cutaneous reaction (indicating the severity of the allergy) was recorded for each individual and compared with the in vitro lymphocyte response, using the lymphocyte transformation test. The best correlation coefficients obtained were 0.42 and 0.46, tested for linear and logarithmic correlation respectively. However, there were individuals who showed a weak cutaneous response and high lymphocyte reactivity. The converse situation was also found, however, indicating that other mechanisms than those mediated via lymphocytes may be of significance in the patch test response.