Clinical Characteristics of Children with Hemophagocytic Syndrome with Different EB Virus DNA Loads / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical characteristics of hemophagocytic syndrome (HLH) children with different EB virus (EBV) DNA loads, and to explore the relationship between differential indicators and prognosis.@*METHODS@#Clinical data of 73 children with HLH treated in our hospital from January 2015 to April 2022 were collected. According to EBV DNA loads, the children were divided into negative group (≤5×102 copies/ml), low load group (>5×102-<5×105 copies/ml) and high load group (≥5×105copies/ml）. The clinical symptoms and laboratory indexes of the three groups were compared, and the ROC curve was used to determine the best cut-off value of the different indexes. Cox regression model was used to analyze the independent risk factors affecting the prognosis of children, and to analyze the survival of children in each group.@*RESULTS@#The proportion of female children, the swelling rate of liver and spleen lymph nodes and the involvement rate of blood, liver, circulation and central nervous system in the high load group were higher than those in the negative group. The incidence of disseminated intravascular coagulation(DIC) and central nervous system(CNS) involvement in the high load group were higher than those in the low load group. The liver swelling rate and circulatory system involvement rate in the low load group were higher than those in the negative group(P<0.05). PLT counts in the high load group were significantly lower than those in the negative group, and the levels of GGT, TBIL, CK-MB, LDH, TG, SF, and organ involvement were significantly higher than those in the negative group. The levels of CK, LDH, SF and the number of organ involvement in the high load group were significantly higher than those in the low load group. The levels of GGT and TBIL in low load group were significantly higher than those in negative group. In terms of treatment, the proportion of blood purification therapy in the high and low load group was significantly higher than that in the negative group(P<0.01). ROC curve analysis showed that the best cut-off values of PLT, LDH, TG and SF were 49.5, 1139, 3.12 and 1812, respectively. The appellate laboratory indicators were dichotomized according to the cut-off value, and the differential clinical symptoms were included in the Cox regression model. Univariate analysis showed that LDH>1139 U/L, SF>1812 μg/L, dysfunction of central nervous system, number of organ damage, DIC and no blood purification therapy were the risk factors affecting the prognosis of children (P<0.05); Multivariate analysis shows that PLT≤49.5×109/L and dysfunction of central nervous system were risk factors affecting the prognosis of children (P<0.05). Survival analysis showed that there was no significant difference in the survival rate among the three groups.@*CONCLUSION@#The incidence of adverse prognostic factors in children with HLH in the EBV-DNA high load group is higher, and there is no significant difference in the survival rate of the three groups after blood purification therapy. Therefore, early identification and application of blood purification therapy is of great significance for children with HLH in the high load group.

Clinical analysis of 252 children with Epstein-Barr virus infection / 中国基层医药

Objective:To investigate the clinical manifestations of Epstein-Barr virus infection in children and the efficacy of interferon combined with ganciclovir.Methods:A total of 252 children with Epstein-Barr virus infection who received treatment in Liaocheng Maternal and Child Health Hospital from June 2018 to February 2020 were included in this study. They were randomly assigned to undergo treatment either with ganciclovir alone (control group, n = 126) or interferon combined with ganciclovir (experimental group, n = 126). General condition, clinical manifestation, clinical outcomes, and clinical efficacy were compared between the two groups. Results:The 252 children with Epstein-Barr virus infection were divided into four groups according to different age brackets: infancy (3.97%), early childhood (53.57%), preschool (28.97%), school age (13.49%). Children at the early childhood and preschool ages accounted for high proportions. Their clinical manifestations included fever, pharyngeal congestion, cervical lymph node swelling, and pharyngeal pain. Children with hepatosplenomegaly accounted for the highest proportion (44.12%) among those at the school age, and children with binocular edema accounted for the highest proportion (10.37%) among those at the early childhood age. The time to defervesce, eyelid edema, and lymph node regression in the experimental group were (3.55 ± 1.58) hours, (3.82 ± 1.17) hours, and (9.55 ± 1.60) hours respectively, which were significantly shorter than those in the control group [(4.40 ± 1.80) hours, (5.33 ± 1.58) hours, (10.44 ± 1.66) hours, t = 3.64, 2.47, 2.67, P < 0.001, P = 0.024, 0.009]. The total response rate was significantly higher in the experimental group than in the control group [96.03% (107/126) vs. 84.92% (121/126), χ2 = 9.03, P = 0.003]. Conclusion:Epstein-Barr virus infection has different clinical manifestations in children at different ages. Interferon combined with ganciclovir is more effective on Epstein-Barr virus infection than ganciclovir alone.

Morphological Characteristics of Bone Marrow Cells in Patients with EB Virus Infection / 中国实验血液学杂志

OBJECTIVE@#Review and analyze the characteristics of bone marrow cell morphology in patients with Epstein-Barr virus (EBV) infection, and explore the diagnostic value of bone marrow cell morphology for the early identification of EBV infection.@*METHODS@#A total of 33 patients with EBV-DNA positive detection in the First Affiliated Hospital of Guangxi Medical University from January 2018 to May 2021 were collected as the research objects. Bone marrow cell morphology and peripheral blood cell analysis were performed, and the significance in disease diagnosis was analyzed by statistical methods.@*RESULTS@#The sampling satisfaction of 33 patients with EBV infection was 100%. In the clinical diagnosis of all cases, 7 cases were IM, 17 cases were EBV-HLH, 3 cases were lymphoma, 2 cases were EBV-associated lymphoid hyperplasia, and 4 cases were not diagnosed. Among them, 31 patients had active bone marrow hyperplasia or above, 26 patients had active granulocytic hyperplasia or above, 21 patients had active erythroid hyperplasia or above, and 17 cases of megakaryocyte production platelet function decreased. The abnormal components of bone marrow mainly indude atypical lymphocyte cells (33 cases), hemophagocytic cells (22 cases), abnormal histiocyte (10 cases).@*CONCLUSION@#According to the proliferation of granulocytes, erythrocytes and megakaryocytes in the bone marrow, and the emergence of abnormal components such as atypical lymphocytes, hemophagocyte, abnormal histiocyte. Bone marrow cell morphological examination can indicate the possibility of EBV infection, which is certain diagnostic value for early identification of EBV infection.

Analysis of clinical prognosis and mutant gene phenotype in children with hemophagocytic lymphohistiocytosis / 中国小儿急救医学

Objective@#To investigate the clinical manifestations, prognosis and gene mutation phenotypes of hemophagocytic lymphohistiocytosis(HLH)in children of our hospital.@*Methods@#The clinical data of 42 patients with HLH from April 2013 to December 2018, and the genetic data of 8 patients with familial HLH(FHL)were collected retrospectively.The age, clinical manifestation, laboratory examination, prognosis and the characteristics of gene mutation phenotype of patients with HLH and FHL were analyzed emphatically.Furthermore, the clinical manifestations and prognosis of patients with HLH were analyzed according to whether EB virus was infected.@*Results@#Among these 42 patients with HLH, the onset age was ranged from 1 month to 13 years old and most of them were younger than 5 years old.The main clinical manifestations included cytopenia, prolonged fever, enlargement of liver and spleen and lymph nodes enlargement and serosal effusion.Laboratory examination showed that lactate dehydrogenas, ferritin, erythrocyte sedimentation rate and triglyceride increased significantly.The survival rate of the group in ferritin exceeding 4 500 μg/L and non-chemotherapy was lower than that of the group of ferritin less than 4 500 μg/L and chemotherapy in clinical prognosis(P<0.05). Ten patients of them survived after chemotherapy, and 2 patients survived for 5 to 6 months after hematopoietic stem cell transplantation in FHL.Patients with EB virus infection were older than those without EB virus infection.They had longer fever duration and higher proportion of lymph nodes enlargement and ferritin more than 4 500 μg/L(P values were 0.01, 0.04, 0.03, 0.03 respectively). However, there was no significant difference in survival time between the two groups.Eight patients had mutations in UNC13D(50.00%), PRF1(25.00%), PRKDC(12.50%)and IL2RG(12.50%)genes respectively, and most of the mutations were complex heterozygous mutations(62.50%). All the mutations were originated from their parents.@*Conclusion@#HLH is characterized by cytopenia, prolonged fever, enlargement of liver and spleen.HLH is more common in children under 5 years old.The clinical manifestations of HLH with EB virus infection are more severe while the prognosis is not statistically significant.The incidence of FHL is higher.There are more UNC13D gene mutations and complex heterozygous mutations.Children with HLH should be detected and treated with standardized therapy as soon as possible.Hematopoietic stem cell transplantation is a good treatment for HLH, especially for FHL patients.

Clinical characteristics, diagnosis and efficacy of primary lymphoepithelial carcinoma of the parotid gland / 中华放射肿瘤学杂志

Objective@#To analyze the clinical features, diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland.@*Methods@#Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed. The median follow-up time was 38.5 months. All patients received radiotherapy after operation.@*Results@#Of 13 patients, 9 cases were male and 4 female. The median age was 33 years. At the initial diagnosis, 9 cases had primary lesions limited to the parotid gland, and 4 cases of lymph node metastases located in Ⅰb and Ⅱ regions of the neck. According to UICC2010 staging, 1 case was classified as stage Ⅰ, 1 as stage Ⅱ, 6 as stage Ⅲ and 5 as stage Ⅳ, respectively. Eleven surgically pathological specimens were tested with EBER in-situ, and 10 cases were positive for EBER. No patient died in the whole group. The 3-year overall survival rate was 100%. The 3-year progression-free survival rate was 76%. The 3-year local control rate was 92%. The 3-year metastasis-free survival rate was 84%.@*Conclusions@#The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low. The pathological features are associated with EB virus. It is prone to present with cervical lymph node metastasis. The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment. At present, surgery combined with postoperative radiotherapy is the main treatment. The overall survival is favorable. Local recurrence and distant metastasis are the main causes of treatment failure.

Analysis of clinical prognosis and mutant gene phenotype in children with hemophagocytic lymphohisti-ocytosis / 中国小儿急救医学

Objective To investigate the clinical manifestations,prognosis and gene mutation pheno-types of hemophagocytic lymphohistiocytosis(HLH)in children of our hospital. Methods The clinical data of 42 patients with HLH from April 2013 to December 2018,and the genetic data of 8 patients with familial HLH(FHL)were collected retrospectively. The age,clinical manifestation,laboratory examination,prognosis and the characteristics of gene mutation phenotype of patients with HLH and FHL were analyzed emphatical-ly. Furthermore,the clinical manifestations and prognosis of patients with HLH were analyzed according to whether EB virus was infected. Results Among these 42 patients with HLH,the onset age was ranged from 1 month to 13 years old and most of them were younger than 5 years old. The main clinical manifestations in-cluded cytopenia,prolonged fever,enlargement of liver and spleen and lymph nodes enlargement and serosal effusion. Laboratory examination showed that lactate dehydrogenas,ferritin,erythrocyte sedimentation rate and triglyceride increased significantly. The survival rate of the group in ferritin exceeding 4 500 μg/L and non- chemotherapy was lower than that of the group of ferritin less than 4 500 μg/L and chemotherapy in clinical prognosis(P<0. 05). Ten patients of them survived after chemotherapy,and 2 patients survived for 5 to 6 months after hematopoietic stem cell transplantation in FHL. Patients with EB virus infection were older than those without EB virus infection. They had longer fever duration and higher proportion of lymph nodes enlargement and ferritin more than 4 500 μg/L(P values were 0. 01,0. 04,0. 03,0. 03 respectively). Howev-er,there was no significant difference in survival time between the two groups. Eight patients had mutations in UNC13D(50. 00%), PRF1 ( 25. 00%), PRKDC ( 12. 50%) and IL2RG ( 12. 50%) genes respectively, and most of the mutations were complex heterozygous mutations(62. 50%). All the mutations were originated from their parents. Conclusion HLH is characterized by cytopenia,prolonged fever,enlargement of liver and spleen. HLH is more common in children under 5 years old. The clinical manifestations of HLH with EB virus infection are more severe while the prognosis is not statistically significant. The incidence of FHL is higher. There are more UNC13D gene mutations and complex heterozygous mutations. Children with HLH should be detected and treated with standardized therapy as soon as possible. Hematopoietic stem cell transplantation is a good treatment for HLH,especially for FHL patients.

Clinical characteristics, diagnosis and efficacy of primary lymphoepithelial carcinoma of the parotid gland / 中华放射肿瘤学杂志

Objective To analyze the clinical features,diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland.Methods Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed.The median follow-up time was 38.5 months.All patients received radiotherapy after operation.Results Of 13 patients,9 cases were male and 4 female.The median age was 33 years.At the initial diagnosis,9 cases had primary lesions limited to the parotid gland,and 4 cases of lymph node metastases located in Ⅰb and Ⅱ regions of the neck.According to UICC2010 staging,1 case was classified as stage Ⅰ,Ⅰ as stage Ⅱ,6 as stage Ⅲ and 5 as stage Ⅳ,respectively.Eleven surgically pathological specimens were tested with EBER in-situ,and 10 cases were positive for EBER.No patient died in the whole group.The 3-year overall survival rate was 100％.The 3-year progression-free survival rate was 76％.The 3-year local control rate was 92％.The 3-year metastasis-free survival rate was 84％.Conclusions The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low.The pathological features are associated with EB virus.It is prone to present with cervical lymph node metastasis.The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment.At present,surgery combined with postoperative radiotherapy is the main treatment.The overall survival is favorable.Local recurrence and distant metastasis are the main causes of treatment failure.

Progress of EB virus related lymphomas / 白血病·淋巴瘤

The occurrence and development of some lymphomas are closely related to EB virus, including B cell lymphoma, NK/T cell lymphoma, Hodgkin lymphoma and post-transplant lymphoproliferative disorder. Many studies have shown that some gene expression products that related to EB virus latent infection play a crucial role in the development of lymphoma. In this paper, the structure and biological characteristics of EB virus, its gene expression products, the mechanism of tumorigenesis and the related lymphomas are reviewed.

Virus infection and limbic encephalitis: Clinical analysis of 5 cases of anti-N-methyl-D-aspartic receptor encephalitis and literature review / 中华实验和临床病毒学杂志

Objective@#To have a profound understanding of anti-N-methyl-D-aspartic receptor (anti-NMDAR) encephalitis, through the clinical analysis of 5 cases of anti-NMDAR encephalitis, and literature review.@*Methods@#This is a retrospective analysis. Five cases of anti-NMDA receptor encephalitis treated from May 2010 to June 2015, in the Department of Neurology, Beijing Friendship Hospital affiliated to Capital Medical University, were included in this study. The clinical data, including clinical manifestation, past history, radiological features, serum and cerebral spinal fluid examinations, treatment and prognosis, were analyzed.@*Results@#Among the 5 cases, 3 young female and 2 middle-to old-aged male. The clinical features of the onset was mental and behavior disorder, as well as seizure and extrapyramidal features, like facial and limbic involuntary movements or tremor. Coma and hypopnea was severe in 3 young female cases, needing assistance of mechanical ventilator, while the manifestation of 2 male patients was much mild, need not assisted respiration. 1 case had teratoma of ovary, 1 case had Vogt-Koyanagi-Harada syndrome. The anti-NMDA receptor antibody was positive in cerebraospinal fluid of all 5 cases, but in serum of 3 cases, serum and CSF Epstein-Barr virus (EBV) IgM antibody was positive in 1 case, while herpes simplex I virus (HSV-1) IgM antibody positive in another case, and anti-myelin oligodendrocyte glycoprotein (MOG) antibody was seen in serum and CSF in 1 case. The time interval from the onset to treatment was 10-37 d (18.8±9.8 d). IVIG was used in all of the 5 cases, glucocoticoid in 4 cases, and plasma exchange in 3 cases. One case with Vogt-Koyanagi-Harada syndrome, having a long time before diagnosis and treatment, died, while the other 4 cases had good prognosis, and had no relapse.@*Conclusions@#Mental and behavior disturbance is common at onset of anti-NMDAR encephalitis. The radiological and lab examination may be normal. It may be accompanied with HSV-1 or EBV infection, anti-MOG antibody may be positive in this disease. Active treatment is important.

EB virus infection with facial paralysis in children:a case report and literature review / 临床儿科杂志

Objective To explore the treatment of children with EB virus infection accompanied by facial paralysis. Method The clinical data of a child with EB virus infection accompanied by facial paralysis was analyzed retrospectively, and the related literature were reviewed. Results A 2-year-old boy was admitted to hospital due to fever and mouth askew for 4 days. After admission, he was confirmed to have EB virus infection and viremia by serology and polymerase chain reaction, and then treated with acyclovir. The symptoms of facial paralysis and EB viremia disappeared completely 14 days after antiviral treatment. There was no recurrence in the short-term follow-up. Interestingly, the literature analysis shows that there is still limited evidence for the antiviral treatment by acyclovir in children with acute infection of EB virus associated with facial paralysis. Conclusion Antiviral treatment may be beneficial to EB viremia with facial paralysis.

Changes and Significance of Patients′ Blood Routine and T lymphocyte Subsets with Lymphoma and EB Virus Infection / 现代医院

Objective To investigate the changes and significance of patients′ T lymphocyte subsets with lymphoma and EB virus infection.Methods 57 patients with malignant lymphoma who were admitted to our hospital between January 2015 and January 2017 were divided into A group (with EB infection, n=31) and B group (without EB infection, n=26).The other 30 healthy cases were selected as control group (group C) at the same time.The fasting venous blood of all subjects was collected, and the levels of T lymphocyte subsets were measured by flow cytometry.Results Compared with group C, the levels of CD3+, CD4+ and CD4+/CD8+ in A group and B group were significantly lower while the levels of CD8+ were significantly higher (P<0.05).Compared with B group, the levels of CD3+, CD4+ and CD4+/CD8+ in A group were significantly lower while the levels of CD8+ were significantly higher (P<0.05).Conclusion The levels of T lymphocyte subsets can be used as important indexes to judge the severity of lymphoma.When there is severe T lymphocytes immune dysfunction, EB virus infection should be considered, and timely diagnosis and early treatment should be carried out.

The research of rBCG inhibiting function on EB virus positive tumors / 中华实验和临床病毒学杂志

Objective@#The inhibition function on EB virus positive tumors with rBCG (recombinant BCG) was researched.@*Methods@#After cancer models of EB virus positive tumor cells(GT39)were established in C57BL/6 mice, the mice survival conditions, tumor weight and tumor formation time were analyzed, flow cytometry was used to research the proliferation of CD4+ T. Inhibition of rBCG to cancer was researched, HE staining of the mice tumor tissue was used to detect and analyze lymphocyte infiltration. Single factor analysis method of variance (One-way ANOVA) was processed for rBCG′s inhibition evaluation by SPSS 11.0 statistical software.@*Results@#Compared with the control group, rBCG group significantly slowed tumor growth, tumor formation time was delayed, rBCG significantly prolonged survival time of the mice.@*Conclusions@#rBCG had inhibition to EB virus positive tumors in mice.

Expression of Epstein-Barr Virus DNA in Peripheral Blood Lymphocytes and Plasma in Patients with EBV-Associated Diseases / 现代检验医学杂志

Objective To explore the expression of Epstein-Barr virus DNA(EBV DNA)in the peripheral blood lymphocytes and plasma of patients with EBV-associated diseases.Methods The whole blood samples were collected from 112 patients with suspected EB virus infection diseases,including 14 cases of nasopharyngeal carcinoma(NPC),16 cases of infectious mononucleosis(IM),22 cases of lymphoma,23 cases of autoimmune disease,26 cases of upper respiratory tract infection, and 11 cases of abnormal liver function.The levels of EBV DNA in lymphocytes and plasma of the same sample were detec-ted by fluorescence quantitative PCR(FQ-PCR).Results The EBV DNA positive rates in lymphocytes and plasma of all 112 patients were 83.0%(93/112)and 27.7%(31/112)respectively,with statistically significant difference(χ2=60.02,P<0.01).The positive rate and the load of EB virus DNA in lymphocytes and plasma of 14 patients with nasopharyngeal car-cinoma(NPC)had no statistical difference(χ2=2.25,t=-1.04,all P>0.05).However,patients with lymphoma,infec-tious mononucleosis,upper respiratory tract infection,autoimmune disease or abnormal liver function,the positive rates and the concentration of EBV DNA in the plasma were dramatically lower than those in the peripheral blood lymphocytes,and the difference was statistically significant(χ2=4.17~15.06,all P<0.05;t=3.94~10.45,all P<0.01).Conclusion The detection of EB DNA in peripheral blood lymphocytes of non NPC patients by FQ-PCR might be better than that in plasma. There was no statistical difference between the detection of EBV DNA in lymphocytes and plasma of patients with nasopha-ryngeal carcinoma.Appropriate specimen type could be selected according to clinical consideration.

The clinical features and prognosis of EBER negative extranodal natural killer/T-cell lymphoma / 中国癌症杂志

Background and purpose:Extranodal natural killer/T-cell lymphoma (ENKTL) is a form of non-Hodgkin’s lymphoma. The ENKTL incidence in China is much higher than that in the Western countries. The disease is highly malignant, not sensitive to chemotherapy, has short survival period and poor prognosis. Epstein-Barr virus (EBV) infection has close relationship with the development of the disease. However, there are still a few patients without EBV infection. This study aimed to discuss the clinical features and prognosis of EBV-encoded small RNA (EBER) in situ hybridization negative ENKTL.Methods:From Aug. 2011 to Oct. 2015, 326 cases were diagnosed with ENKTL from the First Affliated Hospital of Zhengzhou University. The expression of EBER was detected by in situ hy-bridization technique. The clinical pathological characteristics and prognosis of EBER-negative patients were analyzed. Results:In 326 patients with ENKTL, the negative rate of EBER was 2.45% (8/326). In 8 EBER-negative patients, the median survival time was 17 months. The log-rank test revealed that there was a signiifcant difference between EBER-negative and EBER-positive curves (χ2=6.407,P=0.011). Multivariate Cox proportional hazards regression analysis showed that in EBER-negative ENKTL, only lactate dehydrogenase (LDH) predicted survival time (P=0.008). EBV-DNA copy number in plasma was not signiifcantly correlated with survival time (P>0.05).Conclusion:The inci-dence of EBER-negative ENKTL is low. Patients with EBER-negative ENKTL have poorer prognosis than EBER-posi-tive patients. Elevated LDH may be a factor indicating poor prognosis.

Expression of EB virus in peripheral blood mononuclear cells in children with systemic lupus erythematosus / 中华实用儿科临床杂志

Objective To discuss the role of EB virus (EBV)in the pathogenesis of systemic lupus erythematosus(SLE) in children through investigating the copies of EBV DNA and expression of EBV genes in peripheral blood mononuclear cells(PBMCs).Methods (1)PBMCs were isolated from 30 patients with SLE and 12 healthy normal controls respectively and DNA was extracted from PBMCs.(2) PBMCs were co-cultured with EBV for 12 days and RNA was extracted from PBMCs.(3)Real-time fluorescence quantitative PCR(Real-time PCR) was applied to detect the copies of EBV DNA in PBMCs.(4)Reverse transcription PCR was applied to detect expression of EBV genes.Results (1) Compared with the healthy control group [(40.1 ± 11.6) copies/μg],a significant increase of EBV DNA copies was observed in SLE group[(658.6 ± 183.6) copies/μg] (P ＜0.05).The EBV DNA copies in the active SLE group [(785.2 ± 179.2) copies/μg] were significantly higher than those in the non-active SLE group [(586.0 ± 193.1) copies/μg] (P ＜ 0.05).(2)There was no correlation between EBV DNA copies and systemic lupus erythematosus disease activity index (r =0.03,P ＞ 0.05).(3) After PBMCs got co-cultured with EBV,expression of latent EBV genes and lytic genes were both increased in the patients and healthy controls.The latent EBV genes including latent membrane protein 1 (LMP1),LMP2,EBV nuclear antigen 1 and the lytic genes including BCRF1,BLLF1 were all increased significantly in the patients compared with the healthy controls (all P ＜ 0.05).Conclusions There is a significant increase of EBV DNA copies and aberrant expression of EBV genes in SLE patients,which suggests that EBV may contribute to the pathogenesis of SLE.

Study of T lymphocyte subsets in infectious mononucleosis syndrome / 中国医师杂志

Objective T lymphocyte subsets in children with characteristics observed with infec-tious mononucleosis (infectious mononucleosis,IM),to explore its reference value.Methods January 2011 to December 2014 during a pediatric door altogether 115 cases of hospitalized children were divided in-to three groups,51 cases of IMgroup,33 atypical group,31 patients flyers syndrome,selecting outpatient healthy children as 101 cases the control group.For each group T lymphocyte subsets:CD3 + CD4 +,CD3 +CD8 +,CD4 +/CD8 + ratio,analyze the differences between the groups was significant.Results Compared four groups of T lymphocyte subsets (CD3 +,CD3 +CD4 +,CD3 +CD8 +,CD4 +/CD8 + ratio)change char-acteristics,IMgroup,atypical group,flyers syndrome group and the control group,the difference was sta-tistically significance (P 0.05),two groups of children described in T there was no significant difference in lymphocyte immune.Conclusions T lymphocyte subsets have some reference value in the differential diagnosis of IM,and prompt clinical attention to EB virus infection in chil-dren whose immune function,can help prevent and treat.

Sequential diffuse large B-cell lymphoma after peripheral T-cell lymphoma not otherwise specified: a case report and review of literature / 白血病·淋巴瘤

Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

Analysis of immune function in children with EB virus EBV-IgM positive patients / 国际检验医学杂志

Objective To explore children infected immune functional state and change .Methods using nephelometry in 58 ca‐ses of EBV‐IgM positive children serum immunoglobulin ,T lymphocyte subsets CD3+ ,CD4+ ,CD8+ ,CD19+ blood flow cytometry peripheral detection at the same period ,50 cases of healthy children as control group in the same index .Results EBNA‐IgG nega‐tive group of children IgG ,IgA was EBNA‐IgG positive group and control group decreased significantly ,the difference was statisti‐cally significant(P 0 .05) .The EBNA‐IgG negative group of CD3+ ,CD4+ ,CD4+ /CD8+ , CD19+ in children with EBNA‐IgG positive group and control group decreased significantly ,the difference was statistically signifi‐cant(P<0 .05) ,while CD8+ was the EBNA‐IgG positive group and the control group increased significantly ,the difference was sta‐tistically significant(P<0 .05) .Conclusion EBNA‐IgG positive immune function of children with close to healthy group is better than that of EBNA‐IgG negative group ,the emergence of EBNA‐IgG status on immune function of children do preliminary assess‐ment ,through the detection of immunoglobulin and T cell subsets ,B lymphocyte ratio can understand the immune state of children′s infection ,further evaluation of infection phase .

Lymphoepithelioma-like gastric carcinoma:a clinicopathologic study of six cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features and immunophenotype as well as its association with EBV infection of lymphoepithelioma-like gastric carcinoma (LLGC). Methods The clinical pathological data were reviewed, morphological changes were observed and immunohistochemical staining was done in 6 cases of LLGC. The expression of EBV-encoded small RNA ( EBER) in the 6 cases of LLGC were carried out by in situ hybridization. Results All of the six patients were male, the age was arranged 47 to 68 years, with mean of 55 years. All of the six cases, the lesions were located in gastric body. Microscopically, the undifferentiated carcinoma cells were arranged in cords and nests, scattering in the lymphoid-rich stroma, occasionally poor development tubular struc-tures were seen in the near surface of mucosa. Lymphoid follicles could be seen with lack of fibrous tissues reaction in the tumor stro-ma. Immunohistochemical staining and in situ hybridization showed the tumor cells were diffusely positive for CKpan, CK19, CEA and EBER, but negative to CK7, CK20, CK5/6 and LMP1; interstitial lymphocytes expressed CD3 or CD20, while lost expression of EBER. Follow-up for 6-57 months, all of the 6 patients were survived without tumor. Conclusions The LLGC is a rare and unique subtype of gastric carcinoma with good prognosis, which is often associated with EBV infection.

An analysis on clinical efficacy of Qinchai Kangdu mixture for treatment of infantile EB virus infectious mononucleosis with flaring heat in Qifen and Yingfen / 中国中西医结合急救杂志

Objective To observe the clinical efficacy of self made Qinchai Kangdu mixture for treatment of infantile EB virus (EBV) infectious mononucleosis and explore its potential mechanism. Methods A prospective study was conducted. One hundred and twenty children with pediatric EBV infectious mononucleosis and traditional Chinese medicine (TCM) syndrome of flaring heat in Qifen and Yingfen in Wuhan Children Hospital were randomly divided into observation group and control group (each, 60 cases). Conventional western medical treatment was given to the two groups for 7-10 days;the observation group was additionally given Qinchai Kangdu mixture which included the following ingredients:Scutellariae Radix 10 g, Bupleuri Radix 10 g, Artemisiae Annuae Herba 10 g, Forsythiae Fructus 20 g, Arctii Fructus 10 g, Paeoniae Radix Rubra 10 g, Cinnamomi Ramulus 6 g, Moutan Cortex 10 g, Trionycis Carapax 10 g, Isatidis Radix 20 g, Citri Reticulatae Pericarpium 10 g, Glycyrrhizae Radix 10 g, orally, once daily for 7-10 days. The times of returning to normal for clinical symptoms and signs, white blood cell count (WBC), peripheral blood abnormal lymphocyte ratio and the level of alanine aminotransferase (ALT) were observed in the two groups. And the clinical efficacy, changes in score of TCM syndrome and adverse reactions were also investigated in the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group [93.33%(56/60) vs. 76.67%(46/60), P<0.05]. In observation group, the duration of fever (days:6.9±2.3 vs. 7.7±3.4), and the recovery times to normal for body temperature (days:2.9±1.4 vs. 4.8±1.7), angina (days:7.2±3.3 vs. 8.0±3.2), lymph node reduction in size (days: 6.6±2.1 vs. 10.2±2.0), enlarged liver bounce back in size (days: 7.8±1.7 vs. 9.6±2.0), WBC (days:7.22±1.78 vs. 10.67±1.97), peripheral blood abnormal lymphocyte ratio (days:7.24±1.86 vs. 11.15±1.65), and ALT (days:8.44±1.83 vs. 11.43±2.65) were all significantly shorter than those in the control group (all P < 0.05). No adverse reactions occurred in the therapeutic course in the two groups. Conclusions Qinchai Kangdu mixture can effectively improve the clinical symptoms of infantile EBV infectious mononucleosis with TCM syndrome of flaring heat in Qifen and Yingfen. The mixture may also promote the enlarged liver and spleen to contract in size at early stage and peripheral blood abnormal lymphocyte ratio and other laboratory indexes return to normal in time.