T-SPOT.TB与PPD在消化系统结核感染鉴别诊断中的价值

目的评估快速T细胞计数体外酶联免疫斑点技术(T-ELISPOT.tuberculosis,T-SPOT.TB)与PPD试验在消化系统结核感染的诊断价值。方法回顾性分析2011年6月-2013年7月于南京军区南京总医院消化内科收治的60例患者,其中14例确诊为结核感染的患者,46例为非结核感染的消化系统疾病患者,抽取患者外周血送检,T-SPOT.TB与PPD试验结果的准确性进行比较。结果 14例确诊结核感染患者,46例非结核感染的患者,T-SPOT.TB的灵敏度与PPD试验相近,差异无统计学意义(78.6%vs71.4%,P=1.000);T-SPOT.TB的特异性显著大于PPD试验(91.3%vs 69.6%,P=0.009);T-SPOT.TB阳性预测率显著大于PPD试验(73.3%vs 41.7%,P=0.001);T-SPOT.TB阴性预测率与PPD试验相近,差异无统计学意义(93.3.%vs 91.1%,P=1.000)。T-SPOT.TB与PPD试验在诊断消化系统结核感染方面有较好的吻合性(K=0.341,P=0.018)。结论 T-SPOT.TB应用于消化系统感染的诊断,尤其适合PPD阳性的疑似消化系统结核感染患者的鉴别诊断。     

20(S)⁃原人参二醇止血作用及其机制

目的通过体内和体外实验研究20(S)?原人参二醇对小鼠凝血系统的作用和对人/鼠血小板的活化作用,探讨原人参二醇的止血作用及相关的作用机制。方法小鼠断尾和肝划痕法观察小鼠出血时间;自动血液分析仪检测大鼠血常规;自动凝血分析仪检测大鼠凝血四项指标;酶联免疫吸附法检测血小板中环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP)水平;Cytation 5多功能酶标仪检测洗涤人血小板内钙离子的浓度([Ca²⁺]i);比色法观察血小板的聚集率;流式细胞术检测洗涤人血小板中CD62P和PAC?1相关表达。结果原人参二醇能缩短小鼠的出血时间;增加红细胞参数中的红细胞数量(RBC)和红细胞压积(HCT),提高血小板参数中血小板数量(PLT)和血小板压积(PCT);缩短大鼠活化部分凝血活酶时间(APTT),中剂量和高剂量组可增加纤维蛋白原的表达。同时,原人参二醇能提高大鼠洗涤血小板cAMP水平、血小板内[Ca²⁺]i和血小板聚集度;增加洗涤人血小板CD62P释放和PAC?1表达。结论原人参二醇具有一定的止血作用,一方面通过激活大鼠的内源性凝血系统,影响体内血小板和红细胞参数,促进血浆中纤维蛋白原生成;另一方面通过影响钙离子和cAMP信号通路,增加血小板Ca²⁺内流、CD62P释放和促进PAC?1的表达,最终诱导血小板聚集,形成血栓,发挥止血作用。     

Introduction of a methoxymethyl side chain into p-phenylenediamine attenuates its sensitizing potency and reduces the risk of allergy induction

The strong sensitizing potencies of the most important primary intermediates of oxidative hair dyes, p-phenylenediamine (PPD) and p-toluylenediamine (PTD, i.e. 2-methyl-PPD) are well established. They are considered as the key sensitizers in hair dye allergic contact dermatitis. While modification of their molecular structure is expected to alter their sensitizing properties, it may also impair their color performance. With introduction of a methoxymethyl side chain we found the primary intermediate 2-methoxymethyl-p-phenylenediamine (ME-PPD) with excellent hair coloring performance but significantly reduced sensitizing properties compared to PPD and PTD: In vitro, ME-PPD showed an attenuated innate immune response when analyzed for its protein reactivity and dendritic cell activation potential. In vivo, the effective concentration of ME-PPD necessary to induce an immune response 3-fold above vehicle control (EC3 value) in the local lymph node assay (LLNA) was 4.3%, indicating a moderate skin sensitizing potency compared to values of 0.1 and 0.17% for PPD and PTD, respectively. Finally, assessing the skin sensitizing potency of ME-PPD under consumer hair dye usage conditions through a quantitative risk assessment (QRA) indicated an allergy induction risk negligible compared to PPD or PTD.     

学校涂阳肺结核密切接触者筛查及预防性服药效果分析

目的对学校涂阳肺结核疫情发生后密切接触者进行筛查,并观察预防性服药的效果。方法选取2008-2012年嵊州市6起学校涂阳肺结核,疫情发生后密切接触者和一般接触者进行结核菌素试验（PPD试验）,PPD强阳性胸片未见异常者建议给予抗结核预防性服药,并随访观察预防性服药的效果。结果6起学校肺结核疫情共确诊肺结核34例,密切接触者710人,一般接触者190人。密切接触者中179名PPD筛查呈强阳性,其中86名开展预防性服药,随访1年无人发病;93名未服药的学生随访1年后,23人（24．73％）发病。预防性服药过程中,4人出现轻度的胃肠道反应,3人出现肝功能异常,停药好转后继续治疗,无严重不良反应发生。结论通过PPD试验筛查,掌握密切接触者结核分枝杆菌感染状况,有针对性地进行预防性服药,能有效控制结核病扩散。     

Evaluation of T and B lymphocyte function in clinical practice using a flow cytometry based proliferation assay

The golden standard for functional evaluation of immunodeficiencies is the incorporation of [³H]-thymidine in a proliferation assay stimulated with mitogens. Recently developed whole blood proliferation assays have the advantage of parallel lymphocyte lineage analysis and in addition provide a non-radioactive alternative. Here we evaluate the Flow-cytometric Assay for Specific Cell-mediated Immune-response in Activated whole blood (FASCIA) in a comparison with [³H]-thymidine incorporation in four patients with severe combined immunodeficiency. The threshold for the minimum number of lymphocytes required for reliable responses in FASCIA is determined together with reference values from 100 healthy donors when stimulated with mitogens as well as antigen specific stimuli. Finally, responses against PWM and SEA + SEB stimuli are conducted with clinically relevant immunomodulatory compounds. We conclude that FASCIA is a rapid, stable and sensitive functional whole blood assay that requires small amounts of whole blood that can be used for reliable assessment of lymphocyte reactivity in patients.     

艾滋病与结核病双重感染的研究

目的 调查HIV感染者和AIDS病人感染结核杆菌情况,了解HIV/AIDS与结核病的相关性。方法对202例健康者及40例经WB确证的HIV感染者和AIDS病人做结核菌素（PPD）试验,CD4、CD8淋巴细胞计数。结果 HIV感染者和 AIDS病人中PPD阳性率12.5％,而健康对照 PPD阳性率28.2％（P<0.05）。CD4细胞计数<200/mm3者PPD均为阴性。CD4/CD8比值<1者达90％。结论 HIV感染者和AIDS病人机体免疫力降低,PPD反应明显下降。对HIV/AIDS病人使用化学药物预防以控制和减少结核病发病及制定相关政策提供依据。     

Evidences for the regulation of GnRH and GTH expression by GnIH in the goldfish, Carassius auratus

Gonadotrophin-inhibitory hormone (GnIH) plays an important role in regulating of reproduction in teleosts. To clarify the mode of action of GnIH on the synthesis of gonadotropin releasing hormone (GnRH) and gonadotrophin (GtH), three GnIHR cDNAs were cloned from the goldfish brain. In situ hybridization results showed that GnIHRs were localized to the hypothalamus and pituitary. In the hypothalamus, GnIHRs were found in the NPP, NPO and NLT, whereas sGnRH neurons were reported to be located, and potentially regulated by GnIH. In the pituitary, only two GnIHRs were observed and they were localized to the PI instead of the adenohypophysis where GtH-expressing cells are localized, suggesting indirect regulation of GtH by GnIH. In vivo, intraperitoneal (i.p.) injections of synthetic goldfish GnIH-II peptide and GnIH-III peptide significantly decreased sGnRH and FSHβ mRNA levels. Only GnIH-II decreased LHβ mRNA levels significantly. In vitro, both GnIH-II and GnIH-III showed no effect on GtH synthesis, but an inhibition of GnRH-stimulated LHβ and FSHβ synthesis was observed when GnIH-III was applied to primary pituitary cells in culture. Thus, GnIH could contribute to the regulation of gonadotropin in the brain and pituitary in teleosts.