The effect of phenytoin in vitro on normal human mononuclear cells and on human lymphoblastoid B cell lines of different Ig isotype specificities

The anticonvulsant drug phenytoin, in less than cytotoxic concentrations, caused significant reductions in Ig secretion by unstimulated or EBV-stimulated normal MNC, as measured by PFC or secretion of Ig into the culture medium. Isotype-specific LBL varied in their sensitivity, the secretion of IgA (1 line) and IgG (3 lines) being reduced by phenytoin near therapeutic concentrations, whereas that of IgM (1 line) was resistant. Six-day exposure of MNC to phenytoin caused no selective depletion of or enrichment for B cells, monocytes or T cell subsets. The results suggest that the reduction in serum Ig levels reported in phenytoin-treated epileptic patients is, at least in part, due to a direct effect of the drug on the B lymphocyte. However, among EBV-activated normal MNC, those secreting IgA were no more sensitive to the drug than those secreting IgG or IgM, and other factors may, therefore, operate to cause the preferential reduction in serum IgA in phenytoin-treated patients.     

特发性血小板减少性紫癜实验室特点与临床意义

目的 研究特发性血小板减少性紫癜实验特点与临床诊断、治疗效果的关系。方法对57例ITP患儿和15例健康儿童进行血小板计数(BPC)、平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板压积(PCT)测定;对57例ITP患儿用酶联免疫法(ELISA)检测血小板相关抗体(PAIgG、PAIgM);用聚合酶链反应(PCR)检测VB19、EBV、CMV;42例患儿接受地塞米松联合丙种球蛋白治疗。结果①治疗前,ITP组的BPC、PCT明显降低,与对照组比较有统计学意义(P<0.05),急性ITP(AITP)的PDW、MPV明显增加(P<0.05),慢性ITP(CITP)组PDW、MPV无明显变化(P>0.05)。②治疗后,AITP组PDW、MPV与对照组比较无明显变化(P>0.05);CITP组BPC、PCT仍明显减少,MPV呈明显增大(P<0.05),PDW呈分布宽度差异性变大。③丙种球蛋白治疗效果与血小板相关抗体(PAIgG、PAIgM)的表达有统计学意(X2值分别为5.03、3.96,P<0.05)。结论 血小板参数可作为ITP的诊断、病情严重程度的判别指标;血小板相关抗体PAIgG和PAIgM的表达对于指导丙种球蛋白临床治疗有一定的意义。     

8个省（自治区）乙型肝炎病毒表面抗原阳性产妇筛查及新生儿免疫预防措施的调查

目的评价乙型肝炎（乙肝）病毒表面抗原[Hepatitis B Virus（HBV）Surface Antigen,HBs Ag]阳性产妇筛查及新生儿母婴阻断措施开展情况。方法在云南、湖南、广西、安徽、甘肃、贵州、内蒙古、四川8个省（自治区,下同）,选取2010年新生儿乙肝疫苗（Hepatitis B Vaccine,Hep B）及时接种率（Timely Birth Dose Rate,TBD）〈75%的设区的市（地区、州）,以2011年产前筛查出的HBs Ag阳性住院分娩产妇及其新生儿为观察对象,开展流行病学调查,了解产妇HBV血清学标志物筛查情况,孕期是否采取阻断措施,新生儿首剂（First Dose）Hep B（Hep B1）及乙肝免疫球蛋白（Hepatitis B Immunogloblin,HBIG）接种情况等。产妇在分娩前采集静脉血5毫升（ml）,在省级疾病预防控制中心（Center for Disease Prevention and Control,CDC）实验室采用酶联免疫吸附试验（Enzyme-linked Immunosorbent Assay,ELISA）对HBs Ag、乙肝病毒e抗原（HBV e Antigen,HBe Ag）和抗乙肝病毒e抗原抗体（Antibody to HBe Ag,Anti-HBe）进行复核检测。结果调查地区医疗机构产妇HBV血清学标志物筛查多采用国产ELISA试剂。经省级CDC实验室复核检测,初筛HBs Ag阳性产妇HBs Ag、HBe Ag、Anti-HBe复核一致率分别为95.93%、83.28%、75.44%。调查9999名HBs Ag阳性产妇的新生儿全部接种了Hep B1,79.58%的新生儿接种10微克（μg）重组Hep B（酵母）;TBD为97.05%,早产儿、低体重儿TBD低于足月儿（χ2=80.72,P〈0.05）、正常体重儿（χ2=175.16,P〈0.05）,差异均有统计学意义;婴儿Hep B1和HBIG联合接种率为67.17%,产妇HBe Ag阳性、阴性或未检测者,其新生儿联合接种Hep B和HBIG的比例差异无统计学意义（χ2=0.72,P〉0.05）。结论需继续加强HBs Ag阳性母亲的早产儿、低体重儿Hep B1及时接种,以及HBs Ag和HBe Ag双阳性产妇的新生儿Hep B1和HBIG联合接种。     

抗狂犬病病毒的初步研究

目的选取盐酸氯胺酮,重组人干扰素α1b以及人狂犬病免疫球蛋白治疗带毒犬,力图为犬伤后寻找有效治疗。方法取经过盐酸氯胺酮,重组人干扰素α1b以及人狂犬病免疫球蛋白治疗的带毒犬唾液,采用快速狂犬病酶联免疫诊断(RREID),检测唾液标本中狂犬病病毒抗原转阴率分别为36.36%,7.14%,和10.00%。结果氯胺酮治疗组与干扰素及免疫球蛋白治疗组比较,病毒抗原转阴率差异有统计学意义(P<0.05)。结论盐酸氯胺酮在处理严重的犬咬伤抗狂犬病毒上具有一定效果。     

抗人T淋巴细胞猪免疫球蛋白急性毒性实验研究

目的观察拟生产药物抗人T淋巴细胞猪免疫球蛋白（ALG）对小鼠的急性毒性作用。方法 ICR小鼠,体质量18～22g,雌雄各半,分别采用腹腔注射限度试验和尾静脉注射最大受试药量试验法,连续观察14d后处死全部小鼠,并进行尸体解剖、大体肉眼观察,发现异常的组织或器官进行病理切片送检。结果两种试验方法结果均显示：所有试验动物存活,供试品的LD50〉5g/kg,但尾静脉注射最大给药量试验时,发现给药2d内动物的一般情况较差,处死并解剖后发现用药组有少数小鼠出现肝、肾的感染性侵害。结论 ALG的LD50值大于5g/kg,约相当于临床用量的250～333倍,提示该药物比较安全,但在过量静脉注射后短期内对小鼠仍有一定毒性。     

The adsorption behaviour of two commercial IgG-preparations onto a polystyrene latex surface

The adsorption behaviour of two commercial preparations of human IgG onto a polystyrene latex surface was studied. The adsorption isotherms obtained differed markedly, one preparation showed a plateau value of 0.4 μg cm^?2 which was reached at 0.1g I^?1, whereas the other preparation showed no plateau value within the concentration range studied (0.1–7.0 g I^?1). Characterization by means of iso-electric focusing and HPLC also showed differences between the two preparations. No differences were observed when immuno-electrophoresis was carried out These results stress the necessity for proper characterization of proteins used in adsorption studies.     

Surface immunoglobulin restriction in B-non Hodgkin's lymphomas in cell suspension and on frozen tissue sections

The diagnostic relevance of different tests for detection of surface immunoglobulin on tumour cells of B-type non-Hodgkin's lymphomas (B-NHL) was investigated by comparison of the direct antiglobulin rosetting reaction (DARR) in suspension with two-colour direct immunofluorescence (DIF) on frozen tissue sections. In benign lymph nodes (n = 27) the κ/λ ratio by DARR test ranged from 0.9 to 2.8. Tested by suspension and frozen tissue analysis, light chain restriction was found in 24 and 27 of 31 cases of B-NHL, respectively. Heavy chain restriction was found in half of the cases (14 of 26) studied in suspension and in almost all (28 of 31) tested on sections. In 9 cases DARR tests showed restriction of more than one Ig class on tumour cells, which was infrequent (2 of 28) in frozen section analysis. Although both tests appeared valuable for routine diagnostic purposes, we found the DIF analysis on tissue sections somewhat more discriminative, especially in detection of heavy chain restriction in B-NHL.     

截哮口服液防治病毒诱发小儿哮喘的临床研究

目的：观察截哮口服液防治病毒诱发小儿哮喘的疗效及可能的作用机理。方法：将160例有哮喘史的病毒性上呼吸道感染患儿随机分为两组。治疗组患儿在出现急性上呼吸道感染(AURTI)症状24h内服用截哮口服液,对照组使用病毒唑10～15mg·kg^-1·d^-1,疗程均为7日,并观察患儿临床体征、疗效,检测肺功能、免疫球蛋白等的变化。结果：治疗组总有效率83．8％,临床控制率48．8％,与对照组(分别为62．5％、23．8％)比较,差异均有显著性(P<0．01)。截哮口服液对患儿FEV1、PEF有明显改善作用,与治疗前比较,差异有显著性(P<0．01),与对照组比较,差异亦有显著性(P<0．05)。治疗组自身前后对照及与对照组治疗后比较IgE降低,差异均有显著性(P<0．01),IgA、IgG、IgM变化无统计学意义。结论：截哮口服液有较好的防治病毒诱发小儿哮喘的效果;具有改善患儿肺功能,调节免疫的作用。     

Clonally unrelated Hodgkin's disease following autologous stem cell transplant for B-cell lymphoma

Lymphoproliferative disorders after autologous stem cell transplantation (SCT) are rare. We describe two cases of Hodgkin's disease (HD) as a late secondary neoplasia following autologous SCT for mantle cell lymphoma and B-cell chronic lymphocytic leukaemia respectively. Both HD cases were of mixed cellularity type, showed Epstein-Barr virus (EBV) positivity and followed an aggressive course. Clonal analysis of rearranged immunoglobulin genes from the primary B-cell neoplasm and the secondary HD provided evidence of separate clonal origins of the two tumours in both patients, thus excluding secondary transformation of the original B-cell clone through EBV as the causative event for development of HD.