Modulation of polymorphonuclear leukocyte responsiveness by copper (II)2 (niflumate)4

Antiinflammatory activities and modulations of PMNL responses produced by treatment with tetrakis--2-[3-(trifluoromethyl)-phenyl] aminonicotinatodicopper (II) [Cu(II)₂(niflumate)₄] and niflumic acid were studied in isologous serum-induced rat pleurisy. Doses of 10 or 30 mg/kg (35 or 106 µmol/kg) of niflumic acid or Cu(II)₂ (niflumate)₄ (8 or 23 µmol/kg) caused significant (p < 0.01) reductions in pleural exudate and number of polymorphonuclear leukocytes (PMNLs) in the exudate. While both doses of Cu(II)₂(niflumate)₄ produced significant dose-related reductions in both parameters, only the higher dose of niflumic acid produced a significant dose-related reduction in both parameters. Boyden chamber measurements of N-formyl-methionyl-leucyl-phenylalanine (f-MLP) chemotaxis by PMNLs incubated with 10 or 30 µg/ml niflumic acid (35 or 106 nmol/ml) or Cu(II)₂(niflumate)₄ (8 or 23 nmol/ml) were significantly (p < 0.01 to p < 0.001) decreased in dose-related fashions. Chemotaxis of PMNLs from pleuritic rats treated orally with 10 or 30 mg/kg niflumic acid or Cu(II)₂(niflumate)₄ was significantly (p < 0.001) inhibited by the larger dose of niflumic acid and both doses of Cu(II)₂(niflumate)₄. Opsonized zymosan (OZ)-stimulated chemiluminescence (CL) of PMNLs from pleuritic rats treated orally with these same doses of niflumic acid or Cu(II)₂(niflumate)₄ was only significantly (p < 0.05 or p < 0.01 respectively) decreased by the larger doses. Superoxide (O ₂ ^- ) production by these cells was significantly decreased by the larger dose of niflumic acid (p < 0.05) while both doses of Cu(II)₂(niflumate)₄ produced significant (p < 0.05 to p < 0.01) decreases. Recovery of the decreased PMNL response in burned rats was also studied following treatment with these two compounds. Oral treatment of non-burned rats with 1 mg/kg niflumic acid (4 µmol/kg) or Cu(II)₂(niflumate)₄ (1 µmol/kg) did not affect OZ-stimulated O ₂ ^- production while decreased O ₂ ^- production in non-treated scald-burned rats was reversed by oral treatment with either niflumic acid or Cu(II)₂(niflumate)₄. It is concluded that Cu(II)₂(niflumate)₄ is a more effective antiinflammatory agent than niflumic acid and more effective modulation of PMNL responsiveness may explain its beneficial antipleuritic and burn-injury recovery effects. Formation of the copper complex of niflumic acidin vivo may also account for its beneficial antiinflammatory effects and recovery of depressed PMNL responsiveness in burned rats.     

结核性胸腔积液患者血清及胸腔积液中脯氨肽酶活性分析

目的了解结核性与非结核性胸腔积液患者的血清及胸腔积液中脯氨肽酶(PLD)活性的差异,分析PLD对结核性胸腔积液的诊断意义。方法用ELISA法测定26例结核性胸腔积液患者(观察组)和28例非结核性胸腔积液患者(对照组)血清及胸腔积液中PLD水平,应用t检验统计分析结果。结果观察组血清及胸腔积液PLD活性水平高于对照组(P<0.05)。结论 PLD活性检测对鉴别结核性胸膜炎和其他疾病所致胸腔积液有重要意义。     

尿激酶胸膜腔注入治疗结核性包裹性胸腔积液临床观察

目的 观察胸膜腔内注入尿激酶治疗包裹性结核性胸膜炎的效果。方法 对28例结核性胸膜炎于抽液后注入尿激酶10-25万IU并观察效果。结果 治疗组中治愈18例，有效8例，无效2例，和对照组相比（治愈3例，有效10例，无效7例），差异有统计学意义（P〈0．05）。结论 胸膜腔内注入尿激酶可有效溶解纤堆，促进胸水吸收。是治疗结核性包裹性胸膜炎的有效方法。     

结核性胸膜炎治疗预后分析

目的 探讨结核性胸膜炎治疗预后原因，提高病人治疗效果。方法 将就诊时间、年龄、胸水细胞数及蛋白量、抽液及抽液次数、胸水量与发生胸膜肥厚的关系进行临床分析。结果 就诊时间长、年龄大、胸水细胞数及蛋白含量高、未抽液或抽液次数少是引起胸膜肥厚的主要因素。结论 胸膜肥厚是结核性胸膜炎最常见的预后，只有在有效药物治疗的同时，尽可能将胸水抽尽，才能防止或减少胸膜肥厚发生，预后良好。     

结核包裹性胸膜炎的治疗方法探讨

目的探讨结核性包裹性胸膜炎的治疗方法。方法对88例收治的结核性粘连包裹性胸膜炎随机分为治疗组45例和对照组43例。治疗组于每次抽液后胸腔内注入尿激酶10万单位加异烟肼0.2克和丁胺卡那霉素0.4克;对照组43例采用每次抽液后胸腔内注入异烟肼0.2克和丁胺卡那霉素0.4克,其它治疗相同。结果治疗组胸腔积液吸收。胸膜肥厚的完全好转率为77.8%,对照组为41.9%,经统计学处理差异有显著性(P<0.01)。部分好转率治疗组为17.8%,对照组为20.9%。经统计学处理差异无显著性(P>0.05)。结论在规则抗结核治疗下,配合胸膜腔内注入抗痨药加尿激酶治疗结核性包裹性胸膜炎可减轻胸水渗出,减轻胸膜粘连、肥厚,并改善肺功能。     

56例肺及胸膜残腔曲菌病的诊断和手术治疗

目的 总结肺及胸膜残腔曲菌病的诊断和手术治疗经验。方法 对1972年9月至2003年6月我科诊治的56例肺曲菌病及胸膜残腔曲菌病患者的临床资料进行回顾性分析。本组肺曲菌病53例,胸膜残腔曲菌病3例。所有病例均行胸片或肺CT检查并行手术治疗,其中8例在术前经痰培养(5例)或肺组织穿刺活检(2例)或纤维支气管镜活检(1例)获得病原学诊断。53例肺曲菌病中,42例行肺叶切除术,3例行肺段切除术,8例行肺楔形切除术;3例胸膜残腔曲菌病在清除病灶后,2例行胸廓成形术,另1例延长胸腔闭式引流时间,并在残腔内反复注入氟康唑治疗1个月(每次200mg、100ml,1次／2～3d)。结果 全组患者均治愈,无手术死亡。术后随访无复发病例。结论 对肺及胸膜残腔曲菌病应采取积极的手术治疗,手术治疗效果较好。     

新疆克拉玛依地区结核性胸膜炎流行特点分析

目的了解新疆克拉玛依地区结核性胸膜炎的发病趋势及特征。方法对1996～2006年住院结核性胸膜炎进行回顾性分析,并与同期结核病防治所登记的活动性肺结核作比较。结果结核性胸膜炎青壮年高发,男多于女,少数民族多于汉族,右胸腔多于左胸腔,冬春季节发病率高,20.4%合并肺结核。结论结核性胸膜炎与本地肺结核疫情相似,且年发病趋势较稳定,可以作为地区肺结核病疫情分析的指标之一。     

儿童系统性红斑狼疮伴肺胸膜病变的临床特征分析

目的:了解儿童系统性红斑狼疮(SLE)肺胸膜病变受累的临床特征并分析其相关因素。方法:收集2001年1月至2010年12月共10年,收住在浙江大学医学院附属儿童医院初诊的非感染性SLE患儿133例的临床资料,回顾分析其肺胸膜病变的临床特征、影像学表现及相关实验室指标。结果:133例SLE患儿中并发肺胸膜病变者45例(33.83%),其中有呼吸系统表现者30例(66.67%),无呼吸系统表现者15例(33.33%);呼吸系统最常见临床症状为咳嗽咳痰(55.56%),其次为呼吸困难和胸痛(15.56%和11.11%);只有28.89%患儿肺部可闻及干和/或湿性罗音。肺胸膜病变类型以胸腔积液/胸膜炎最多(32例,71.11%),其次为支气管肺炎样改变(21例,46.67%)和肺间质病变(13例,28.89%)。与无肺胸膜病变组比较,肺胸膜病变组患儿白细胞减少、补体C3减低、抗dsDNA抗体(+)发生率更高,差异均有统计学意义(P<0.05);两组间血沉、C反应蛋白及血小板异常,免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)异常,以及抗核抗体(+)、抗SSA抗体(+)、抗SSB抗体(+)、抗Sm抗体(+)发生率的差异无统计学意义(P>0.05)。结论:儿童SLE累及肺胸膜病变发生率高,临床表现缺乏特异性,部分病例可无呼吸系统症状或体征,但白细胞减少、补体C3减低、抗dsDNA抗体(+)的SLE患儿肺胸膜病变发生率较高。建议SLE患儿常规行胸片或HRCT检查。     

NK cells from tuberculous pleurisy express high ICAM‐1 levels and exert stimulatory effect on local T cells

Tuberculous pleurisy, one of the most common manifestations of extrapulmonary tuberculosis, is characterized by a T‐cell‐mediated hypersensitivity reaction along with a Th1 immune profile. In this study, we investigated functional cross‐talk among T and NK cells in human tuberculous pleurisy. We found that endogenously activated pleural fluid‐derived NK cells express high ICAM‐1 levels and induce T‐cell activation ex vivo through ICAM‐1. Besides, upon in vitro stimulation with monokines and PAMP, resting peripheral blood NK cells increased ICAM‐1 expression leading to cellular activation and Th1 polarization of autologous T cells. Furthermore, these effects were abolished by anti‐ICAM‐1 Ab. Hence, NK cells may contribute to the adaptive immune response by a direct cell‐contact‐dependent mechanism in the context of Mycobacterium tuberculosis infection.