生殖道局部细胞免疫与黄体功能不全患者不孕的关系

目的:探讨生殖道局部细胞免疫与黄体功能不全患者不孕的关系.方法:研究纳入21例确诊为黄体功能不全(luteal phase deficiency,LPD)的患者作为研究组,同时纳入18例健康体检者最为对照组,使用放射免疫法(radiation immunity analysis,RIA)对排卵期两组血清、宫颈黏液中白细胞介素1-β(IL-1β)以及肿瘤坏死因子-α(TNF-α)的表达进行检测;使用化学发光免疫分析仪检测两组黄体期的血清孕酮水平.结果:黄体期,研究组血清孕酮水平明显高于对照组,差异有统计学意义(P＜0.05);排卵期,研究组宫颈黏液中IL-1β以及TNF-α水平与对照组比较,差异有统计学意义(P＜0.05);研究组宫颈黏液中IL-1β以及TNF-α水平与黄体中期血清孕酮水平存在负相关(r=-0.888,P＜0.05;r=-0.849,P＜0.05);宫颈黏液中IL-1β水平与TNF-α水平存在正相关(r=0.797,P＜0.05).结论:排卵期生殖道局部细胞免疫受到激活,可能是LPD患者发生不孕的主要免疫因素之一,亦能够间接的影响黄体发育从而造成LPD的发生.     

贵州都匀牛带绦虫实验感染家猪研究

通过都匀牛带绦虫感染家猪,了解贵州省都匀是否存在牛带绦虫亚洲亚种。对都匀地区绦虫病患者进行驱虫,从孕节分离虫卵感染家猪,收集囊尾蚴并观察其特征。都匀牛带绦虫可以在家猪体内发育为囊尾蚴,感染率为87.5%。囊尾蚴回收率为0.266%,囊尾蚴只分布在肝脏,并以肝实质为多见。未成熟囊尾蚴最早在感染后10天发现。成熟囊尾蚴大小为(2362±621)μm×(1635±489)μm,外壁上有小的疣状形成物,头节上可见吸盘、顶突和两圈逗点样结构,未发现有明显小钩。家猪可以作为贵州都匀牛带绦虫的实验中间宿主,该地区可能存在牛带绦虫亚洲亚种局部流行。     

Extensive cutaneous iatrogenic Kaposi’s sarcoma after bullous pemphigoid treatment with oral methylprednisolone: a rare Chinese case report

Bullous pemphigoid (BP) is an autoimmune disease that requires immunosuppressive therapy. Systemic corticosteroids are considered the standard treatment for moderate-to-severe BP. Kaposi’s sarcoma (KS) is a rare multifocal endothelial tumour that affects the skin, mucosa and viscera. As an angioproliferative disease of obscure aetiopathogenesis and histogenesis, KS is associated with human herpesvirus 8 (HHV-8). This current case report describes a rare occurrence of extensive cutaneous KS in a 60-year-old Chinese male patient after oral methylprednisolone treatment for BP with an emphasis on its pathological characterization. A total of more than 40 nodules were found on his trunk and lower limbs covering more than 20% of his body surface area. Immunohistochemical staining of biopsy samples from the lesion showed the patient was positive for HHV-8, CD31, CD34, XIIIa, ERG and Ki-67. The Epstein–Barr virus test showed the patient tested negative for immunoglobulin (Ig)A and IgM, but was positive for IgG. Immunosuppression associated with the treatment for BP may activate a latent HHV-8 infection and induce the development of KS.