Objective To investigate the expression of T cell subsets and CD3 + CD56 + NKT cells in the patients with rheumatoid arthritis (RA) and RA associated interstitial lung disease (RA-ILD).Methods Peripheral blood mononuclear cells of 30 cases RA,23 cases normal control group,and 11 cases RA-ILD patients were collected,and T cell subsets and CD3 +CD56 + NKT cell were detected.Results In peripheral blood of RA patients at active stage,CD3 + CD56 + NKT cells were significantly increased (P ＜0.01),while increased CD3 + CD8 + cells (P ＜ 0.05) and CD3 + CD4 + cells (P ＜ 0.01) were also found,compared with normal controls.The changed immunocyte pattern tended to be normal when RA patients went into remission.In PBMC of patients with RA-ILD,CD3 + CD56 + NKT cells were significantly increased (P ＜ 0.05),while increased CD3 + CD8 + cells (P ＜ 0.01) and decreased CD3 + CD4 + cells (P ＜ 0.01) were also found.Conclusion T cell subsets and NKT cells in patients with acute exacerbation of RA and RA-ILD may be involved in the progression of disease.

Objective To explore an economical, safe and effective measures for the treatment of acne.Methods 476 patients with acnes were divided into three g roups.In group A (n=120),patients received topical application of iodine-co ntained tincture produced by Second Military Hospital plus ultraviolet negative ion spray.In group B (n=316),patients received besidesmeasures in group A,al so took erythromycin ethylsuccinate orally.In group C (n=40),patientsreceive d erythromycin ethylsuccinate 0.125 g.4 times a day, plus applying chloromycetin washing solution locally.These measures in 3 groups were compared with their ef fectiveness,safety,receptivity of patients,etc.. Results Therapeutic effect took place generally on the se cond day.Curative rates in group A and B were significantly higher than that of the C.Generally,only about 5 times of topical treatment were needed.They were ea sily operated and were receptible by the patients. Conclusion Measures in B and A are economical,safe and pr ompt in treatment of acnes,its advantages include curing and preventing lesions, together with cleaning and beautifying skin,etc..

慢性骨髓增殖性疾病(CMPD)是一组克隆性造血干细胞病,共同特点为骨髓中髓系细胞(粒细胞、单核细胞、红细胞、巨核细胞)程度不等的增殖,成熟分化基本正常,以至外周血粒细胞、红细胞和(或)血小板数增多,如真性红细胞增多症、特发性血小板增多症及慢性粒细胞白血病等.

高白细胞性白血病是指外周血白细胞计数≥100×109/L的急性白血病.由于高白细胞对机体的严重影响及化疗产生的不良反应,使其治疗效果较差,早期病死率较高.我院2001年10月至2003年9月,采用白细胞单采术治疗37例高白细胞性白血病患者,取得较好效果,报道如下.

1临床资料 患者,男,52岁,因面颈及手背起皮疹到其他处诊治无效来诊.一月前,面颈及手背起皮疹,到其他处诊断为"湿疹,"给静脉注射葡萄糖酸钙加维生素C,外用尤卓尔,无效,来门诊就医.患者为建筑工程师,常到室外现场办公,发病前曾频繁到工地指导工人焊接技术,无服药及接触其它物质的历史.查体：系统检查未见异常.

1临床资料 患者男,22岁,因右侧背部色素沉着伴局部多毛10余年来诊.10余年前,因于右臂预防接种局部红肿,不久,在接种部皮肤出现色素沉着,渐扩展,后又于右肩岬骨部皮肤生出浓粗长毛.否认家族遗传史.体检:系统检查未见异常.皮肤科检查:从右上肢肱骨中段到肩部及右后腰骶部皮肤不间断咖啡色色素沉着,以脊椎中线与左侧皮肤形成明显分界,右肩岬骨尖部皮肤见一片儿掌大小之黑色粗浓长毛,约5.5 cm,光滑亮泽,向外上方倾斜生长,与直立身体约成60度夹角.

1 临床资料 患者1,男性,46岁.左足大拇趾甲缝缘赘生物半年,近来出血伴疼痛.半年前,左足大拇趾甲内侧缝缘长出一赘生物,自行拔除,不久又于原部长出一相同新生物,逐渐增大,近来甲缝出血伴疼痛,来医院就诊.体检:系统检查未见异常.皮肤科检查:左足大拇趾甲缝缘有一杏核大小的球形赘生物,以蒂与机体相连,赘生物表面光滑细腻无耗毛呈淡红肉质色,部分区域呈紫蓝色,蒂呈扁平型,约0.2 cm×0.4 cm×0.6 cm,蒂根部有鲜血流出,足趾皮肤及甲板无异常,但有酸臭味从赘生物发出,翻转赘生物,与蒂相连处凹陷,边缘有3个圆锥型刺突,穿破包被呈放射状伸向外上方,表面呈淡红色颗粒状,如同桑椹.治疗:手术切除.病理诊断:血管瘤.

1临床资料 患者男,65岁,纺织厂退休工人,因左额皮肤起水疱自觉灼痛3 d,躯干起水疱1 d就诊.3 d前,无原因左额皮肤起水疱自觉瘙痒,2 d后水疱结痂、灼痛,躯干开始起水疱.体检:系统检查未见异常.皮肤科检查:左颜面轻度肿胀,左上睑红肿,左眼流泪,左额皮肤有一片簇集性结痂水疱,左面颊部有数个散在的结痂水疱;胸、腹及背部皮肤见散发丘疹及水疱,疱液清亮,周边绕以红晕,未见结痂之水疱.

肿瘤生长和转移需要肿瘤细胞间以及肿瘤细胞与宿主间的相互作用.原发肿瘤要从机体获得血供并逃逸机体的免疫监视,降解包绕其周围的角蛋白,浸润或通过淋巴血循环进入靶器官粘附才能生长.血小板内皮细胞粘附分子(CD31)和凝血酶敏感蛋白(thrombin-sensitive protein,TSP)为细胞表面分子,参与细胞粘附并对新生血管生长有调节作用,与肿瘤的转移有关.为此,我们采用流式细胞术,测定了恶性肿瘤患者和正常人血中血小板和非红细胞表面CD31和TSP的表达,以探讨其在不同临床分期肿瘤患者中表达量的差异,现报告如下.

Objective　To explore the relationships between the origin, the progression, chemotherapy of human solid malignant neoplasm and their immunological parameters: CD3, CD4, CD8, CD4/CD8, CD19.Methods　Peripheral blood from 71 cancer patients and 60 normal controls were drawn. Routine fluorescence flow cytometry method was used to detect immunological parameters.Several comparisons were made, including (1) average value of each parameter between patients and controls; (2) average value of each parameter between patients who received no chemotherapy and controls; (3) abnormal percentage of each parameter between patients received chemotherapy and those who didn't; (4) abnormal percentage of each parameter before and after chemotherapy; (5) abnormal percentage of each parameter in patients between patients who had a P.S. score ≤ 2 and score ≥ 3.Results　In patients suffered with solid malignant neoplasm, the mean values of CD3, CD4, CD4/CD8, CD19 were lower , and CD8 was higher than those of controls. Abnormal percentage of CD3 in patients who received chemotherapy was significantly higher than patients who received no chemotherapy. Abnormal percentages of both CD3 and CD4 were also higher in patients before receiving chemotherapy than after receiving chemotherapy. Abnormal percentages of CD3 and CD4 were higher in patients who had P.S. score ≥3 than P.S. score ≤2 .Conclusion　The immune function of the patients suffered with solid malignant tumors seems to be related with the origin and the progression of the disease. Chemotherapy may kill immune cells of the body and may have double effects. Physical condition of the individual also seems to relate with immune ability.

材料和方法 204例寻常性银屑病患者为西安医科大学二附院皮肤科银屑病专科门诊确诊的病例,有家族史60例,其中3代同患者14例,无家族史144例.33例乳腺增生病例为乳腺病专科门诊确诊的患者,40例肺鳞状上皮癌为呼吸内科经支气管镜或病理检查确诊的病例.用皮纹调查表对受试者皮纹的简弓、帐弓、简斗、双箕斗、尺箕、桡箕、十指纹线总数、atd角、大小鱼际及第一、二、三、四指间区真实花纹进行印记,以张海国等[1]中国人皮纹测定正常值为对照作显著性检验后进行对比分析.

TORCH抗体系指弓形虫Tox(Toxoplasma gondii)、风疹病毒RV(Rubella virus)、巨细胞病毒CMV(Cytomegalo virus)、单纯疱疹病毒HSV2(Herpes simplex virus)一组由非细菌性微生物感染机体引起的血清特异性抗体,包括IgM和IgG.由TORCH引起的感染目前认为主要危害孕妇可导致流产、死胎和胎儿畸形[1].

目的探讨染色体的变化与银屑病的关系.方法外周静脉血培养制备淋巴细胞G显带染色体和高分辨染色体,核型分析观察其数目和结构在寻常性银屑病中的表现,并与对照组比较.结果银屑病患者染色体裂隙和断裂的检出率显著高于对照组,急性发作期显著高于恢复期,恢复期与对照组差异无显著性;D、G组染色体花形联合率显著高于对照组,同时见随体联合.结论银屑病患者染色体上的裂隙和断裂可能是不稳定损伤的表现,这与该病不治自愈又时常反复发作有关;花形联合与随体联合可能是染色体生物化学和生物物理学性状改变的结果,它与rDNA含量有关,有家族特性.

1 临床资料 患者男，67岁，因左脚底发疹、左腿麻木活动受限7天来诊，此前曾到其它医院内科就诊，按“神经炎”、“神经痛”治疗，效果不佳来本院。查体：左足底正中有一椭圆形红斑，约3．5 cm×4．0 cm，与足长轴方向一致，上见多个赤豆大小的尖头丘疹，顶部有脱皮，还见少数几个暗红色绿豆大小之血疱样损害，触之疼痛，左脚其它部位和整个左下肢皮肤无发疹，触觉正常，临床诊断为带状疱疹，给威乐星口服液1支每日3次口服抗病毒，转移因子1U肌肉注射，隔日1次提高机体免疫力，野木瓜片每次3片每日3次口服镇痛，维生素B1、B2、E每次各10毫克，每日3次口服促进神经损害恢复及防止后遗神经痛发生等治疗，5天后复诊症状减轻，继续上述治疗痊愈。

骨肉瘤是青少年中常见的恶性肿瘤.目前我院骨肉瘤外科治疗根据手术指征选择骨肉瘤切除灭活再植术辅以全身化疗者占多数,但骨肉瘤组织类型、分化程度及个体差异常影响化疗疗效[1],为此本研究试图建立适应临床检测特点的体外骨肉瘤化疗预测系统,以指导临床用药.

感染、贫血和出血是造血系统疾病常见的并发症,而肛周感染在医院内感染的局部炎症中多见,发生率较高且难治愈.局部表现为红、肿、热、痛,重者可形成脓肿,全身症状表现为寒战、高热,体温有时高达39℃以上,甚至发生败血症.患者坐位、卧床及排便都很痛苦.笔者根据对10余例肛周感染的观察和护理,体会如下.