Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation

We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000 mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.     

ABO血型与肝炎病毒感染关系的探讨

目的：探讨ABO血型与肝炎病毒感染的关系，方法：应用疾病关联分析方法对HBsAg和,抗－HCV阳性献血者与同期健康献血者的ABO血型资料进行比较分析。结果：ABO血型与HBsAg和抗－HCV阳性率之间无显著性相关关系（P＞0．05），结论：乙型肝炎和丙型肝炎病毒感染与ABO血型无显著性相关。     

Histologic Findings One Year After Positive Crossmatch or ABO Blood Group Incompatible Living Donor Kidney Transplantation

Recent protocols have allowed successful positive crossmatch (+XM) and ABO incompatible (ABOI) kidney transplantation, although their long-term outcome is not clear. To begin to assess this issue we compared protocol biopsies performed 12 months posttransplant in 37 +XM, 24 ABOI and 198 conventional allografts. Although the majority in all three groups had only minimal histologic changes, transplant glomerulopathy (TG) was significantly increased in +XM (22% vs. 13% ABOI vs. 8% conventional, p = 0.015), and correlated with prior humoral rejection (HR) by multivariate analysis (odds ratio 17.5, p < or = 0.0001). Patients with a prior history of HR also had a significant increase in interstitial fibrosis (No HR 54% vs. HR 86%, p = 0.045). In the absence of HR no difference in histologic changes was seen between groups, although all three groups had a demonstrable mild increase in interstitial fibrosis from biopsies performed at the time of transplant. Thus, although HR is associated with an increase in TG, in its absence allograft histology is similar in +XM, ABOI and conventional allografts 1 year posttransplant.     

炎症性肠病患者生存质量与其应对方式和社会支持的相关性

目的探讨炎症性肠病(IBD)患者的生存质量及其与应对方式和社会支持的相关性.方法应用中文IBD问卷(IBDQ)、简明健康调查问卷(SF-36)、简易应对方式问卷、社会支持评定量表对71例IBD患者(IBD组)进行调查,并与103名正常人(对照组)进行比较.结果IBD患者SF-36及各维度评分显著低于对照组(均P＜0.01),积极应对评分亦显著低于对照组(P＜0.01).IBD患者的积极应对和社会支持与其生存质量呈正相关(P＜0.05,P＜0.01),消极应对与生存质量呈负相关(P＜0.05,P＜0.01).结论IBD患者的生存质量水平较低,良好的应对方式和社会支持能提高其生存质量.     

Combination of ABO blood group incompatibility and glucose-6-phosphate dehydrogenase deficiency: effect on hemolysis and neonatal hyperbilirubinemia

The incidence (%) of hyperbilirubinemia (serum bilirubin ≥257 μmol/l) was similar in neonates with a combination of ABO incompatibility and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency (45%), with ABO incompatibility (54%) or G-6-PD deficiency (37%), alone (ns). Carboxyhemoglobin values, corrected for inspired CO, were similarly elevated in all three groups (0.87 ± 0.32%, 0.82 ± 0.29%, 0.76 ± 0.18%, respectively, ns), but correlated with bilirubin only in those with ABO incompatibility alone. ABO-incompatible/G-6-PD-deficient neonates, compared with those with either condition alone, are not at increased risk for hemolysis or hyperbilirubinemia.     

基因分型技术首次应用于类孟买型家系ABO基因的研究

目的 探计将基因分型技术用于解决临床输注中血型血清学难题。方法 报告首次在国内用基因分型技术用于一个类孟买型家系5口人ABO基因多态性的研究。在吸收放散试验、唾液血型物质凝集抑制等血清学试验基础上，采用快速盐析法提取外周血中的DNA，用PCR—SSP法扩增ABO血型等位基因。结果 一家5人中，兄弟3人均为类孟买型，ABO基因分型分别为A102B、A102B、Al20O1，而其父母血型基因与血清学血型相符合。结论 ABO PCR—SSP基因分型是一种方便、快速、可靠的技术，与血型血清学相比有着显优势。     

ABH- und Lewis-Antigene der Trachealdrüsen

Zusammenfassung In 23 Sektionsfällen, bei denen am Leichenblut der erythrocytäre Typ Le (a–b–) festgestellt worden war, wurden an paraffineingebetteten Trachealwandproben immunhistochemische Studien durchgeführt. Die Antigendarstellungen erfolgten nach der indirekten Immunperoxidasemethode mit monoklonalen Antikörpern gegen Le^a, Le^b, A und B als primären Antikörpern; das H-Antigen wurde mit UEA 1 dargestellt. Das Markierungsverhalten der mukösen Drüsen für die ABH-Antigene erlaubte eine eindeutige Differenzierung zwischen Sekretoren und Nonsekretoren. Das Lewis-Markierungsverhalten war in 11 Fällen mit demjenigen Lewis-positiver Individuen identisch. Statistische Betrachtungen legen nahe, daß es sich bei dieser Gruppe tatsächlich um Lewis-positive Individuen handelt, deren erythrocytäre Lewis-Merkmale im gealterten Leichenblut nicht erfaßt wurden. Die übrigen 12 Fälle zeigten ein völlig anderes immunhistochemisches Bild: a) Die Sekretoren (n=9) waren für Le^a vollständig negativ; Le^b war in einem Falle nicht, in den übrigen Fällen innerhalb muköser Epithelien in minimaler Quantität und atypischer, granulärer Verteilung nachweisbar. b) Nonsekretoren (n=3) wiesen umgekehrt bei völliger Negativität für Le^b abortive Markierungen für Le^a auf. Diese Beobachtungen, die mit bekannten serologischen Befunden an den Sekreten gut übereinstimmen, sprechen dafür, daß auch in Abwesenheit des Le-Gens in geringer Menge Lewis-Antigene synthetisiert und sezerniert werden können: Möglicherweise kodiert das Allel le eine -4-l-Fucosyltransferase geringer Effizienz.     

新生儿溶血病的不典型表现(附8例报告)

本文报道了8例新生儿溶血病的不典型临床表现及其实验窒检查。其中ABO不合7例,Rh不合1例。不典型表现是黄疸均在生后48小时后出现,还可出现后期贫血、低钙性抽搐、迁延性黄疸、肝炎综合征等,对其机制进行了探讨。     

Polymorphism of the ABO blood group genes in Han, Kazak and Uygur populations in the Silk Route of northwestern China

Genetic polymorphism in the ABO blood group gene of Han, Kazak and Uygur populations inhabiting the most northwestern part of China was investigated using polymerase chain reaction-based techniques. The present study enrolled 43 healthy unrelated Han, 37 Kazak and 59 Uygur volunteers. The allele in A1 blood group is distinguished A0101 and A0102 in difference of nucleotide position 467. The A0101 allele is more frequent in Caucasian and the A0102 allele is characteristic in Mongoloid. It must be notable that A0201 in the A2 group (with a single base deletion at nucleotides 1059 to 1061) which was characteristic of Caucasian was observed in Kazak and Uygur populations but not in Han. Further, 00201 (with no nucleotide deletion at 261 and three nucleotide differences), which is frequent in different races including Caucasian except for Mongoloid, was detected also in Kazak and Uygur populations. The frequencies of B0101 in Kazak, Uygur and Han were comparable to those of other Asian populations but higher than those of Caucasian populations. Collectively, these results reveal that the allele frequencies of Kazak and Uygur at the ABO blood group locus are an intermediate between those of Mongoloid and Caucasian, suggesting the admixed feature of Kazak and Uygur with Mongoloid and Caucasian.     

产前血型IgG抗体水平的检测及其临床意义

目的探讨ABO血型不合孕妇的产前IgG抗体水平,了解IgG抗体效价异常在孕妇中所占比率及临床意义,为预防及诊治新生儿溶血病（HDN）采取有效的防治措施。方法用抗人球蛋白试管凝集法进行IgG抗A或抗B的ABO血型抗体效价检测。结果910例孕妇中,血清效价大于64者有108例,异常检出率为11.9%。IgG抗A效价大于64者有64例,检测率为11.8%;检测IgG抗B效价大于64者有54例,检测率为14.1%。讨论妊娠中IgG抗体效价与新生儿溶血密切相关,ABO血型不合的孕妇应及时作产前血清学的检测,可预防新生儿溶血病的发生及减轻胎儿受害的程度。