全血法鸡淋巴细胞转化试验最佳试验条件的研究

通过丝裂原浓度、血液稀释度、灭活犊牛血清浓度和培养时间四个参数的测定，确定了鸡全血淋巴细胞转化试验的最佳培养条件。最佳试验方法如下：采用不含灭活犊牛血清的ＲＰ－ＭＩ１６４０培养液，刺激管中ＣｏｎＡ浓度为４５μｇ／ｍｌ或ＬＰＳ浓度为２５μｇ／ｍｌ，血液稀释度为１２０，４０℃培养５６ｈ，在培养结束前１６ｈ加３Ｈ－胸腺嘧啶核苷（３Ｈ－ＴｄＲ）。本法简单方便，可检测Ｔ。

Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids

We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid(ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury,and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa,from the rectum to the anus,and this is the first description of a case that developed a severe liver disorder after this treatment; hence,an analysis of future cases as they accumulate is desirable.

药物淋巴细胞刺激试验诊断抗结核药物所致超敏反应的临床价值研究

目的分析药物淋巴细胞刺激试验(DLST)诊断抗结核药物所致超敏反应的临床价值。方法选取2015年1月—2016年12月在江西省胸科医院住院的初治肺结核治疗过程中发生超敏反应的患者60例。同期选取本院初治肺结核治疗过程中未发生超敏反应的患者60例作为对照组。以药物激发试验(DPT)作为判定何种药物所致超敏反应的金标准;分析DLST对4种一线抗结核药物[异烟肼(INH)、乙胺丁醇(EMB)、利福平(RFP)、吡嗪酰胺(PZA)]所致超敏反应的诊断价值。结果 DLST诊断INH、EMB、RFP、PZA所致超敏反应的灵敏度分别为52.38%、50.00%、43.48%、58.33%,特异度分别为97.98%、99.09%、97.94%、100.00%。结论 DLST在诊断患者因何种抗结核药物所致超敏反应上具有较高的特异度,对指导临床应用抗结核药物有较大的意义。

药物性急性间质性肾炎的临床及病理

本文分析14例药物性急性间质肾炎的临床与病理特点,并在国内首次用药物淋巴细胞转化试验辅助诊断致病药物。结果表明,药物性急性间质肾炎临床表现多样,肾活检是确诊的主要手段,药物淋巴细胞转化试验有助明确致病药物,早期诊断、及时治疗后肾功能大都可以恢复。

药物淋巴细胞刺激试验在药物性肝损伤诊断中的意义

目的评估药物淋巴细胞刺激试验(drug lymphocyte stimulation test,DLST)对药物性肝损伤(Drug induced liver injury,DILI)临床诊断的意义。方法对84例临床诊断为DILI、17例疑诊、17例有服药史的非DILI患者行DLST检测,结合其人口学资料、临床分型、临床生化指标等进行非随机对照的回顾性分析,进一步评价DLST在临床的应用价值。结果 101例临床诊断或疑诊DILI患者中,共36例DLST阳性,DLST特异度为98.6%,在所有DILI患者中(包括过敏特异质和遗传特异质)敏感度35.6%。DLST阳性与RUCAM有较好的相关性(P=0.015)。结论药物淋巴细胞刺激试验对药物导致的肝损伤具有较高的诊断特异性,结合RUCAM评分可提高DILI的诊断标准性。

Oxaliplatin-Induced Lung Injury with Allergic Reaction

A 79-year-old man was diagnosed as stage IV colon cancer and treated with a modified FOLFOX6 （mFOLFOX6） regimen.On the 12th cycle,we observed erythema and dyspnea.Radiographs showed ground grass opacities.Blood tests showed elevated levels of eosinophils and immunoglobulin E.We diagnosed this finding as response to drug allergy and administered high-dose methylprednisolone.The treatment was successful and he was discharged.The drug lymphocyte stimulating test against oxaliplatin was positive,indicating a type I and IV allergic reaction due to oxaliplatin.Regimens including oxaliplatin must be carefully monitored and frequent blood tests and chest radiographs are needed.

药物性急性间质性肾炎的临床及病理研究

目的 了解药物性急性间质肾炎(D-AIN)的临床及病理特点,以求提高诊治水平。方法 分析14例D-AIN的临床表现及肾脏病理、免疫病理特征,并用药物淋巴细胞转化试验辅助诊断致病药物。结果 D-AIN临床表现多样,缺乏特征性;肾活检是确诊的主要手段。结论 药物特异性淋巴细胞转化试验有助于明确致病的过敏药物。