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Objective To analyze the immune privilege of lung in acute graft-versus-host disease (aGVHD).Methods The models of aGVHD were established,and C57BL/6J→C57BL/6J model was used as control.The clinical scores and survival were observe& The pathological injuries were compared between the lung and traditional target organs (liver,small intestines and skin).The expression of IFN-γ in different organs after transplantation was detected by ELISA.Results Allogeneic hematopoietic stem cell transplantation (HSCT) mice had high 42-day survival rate (20 ％) post-transplantation,and recipients of allogeneic grafts showed classical symptoms and histological injury,and pathological changes of lung were not as serious as the liver,small intestine,skin at day 28 after transplantation.Syngeneic mice all survived at day 42 after transplantation,without GVHD symptoms and pathological changes.The mice in MHC-disparate mice (2 ∶ 1 and 4 ∶ 1 groups) died significantly faster at a median of 12 days after transplantation,with severe changes of clinical symptoms and pathology of classical organs,and MHC-disparate mice (4∶1 groups) had developed severe interstitial pneumonitis.The mean IFN-γ concentration in the lung of allogeneic HSCT mice was obviously increased in the first and second week after transplantation,the IFN-γ concentrations of target organs (liver,small intestines,skin) were slightly increased in the first and second week after transplantation,and there were statistically significant difference from lung (P＜0.05).Condmion There wasrelativeimmune privilege of lung in a murine model of aGVHD induced by HSCT,which was associated with the expression of MHCin the mice and IFN-gamma of lungs after transplantation.
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Objective To study the clinical characteristics,pathogens,drug sensitivity and prevention measures in malignant hematological disease combined with septicemia.Methods The clinical data of 95 malignant hematological disease combined with septicemia patients from January 2009 to June 2013 were retrospectively analyzed.Results One hundred and ten episodes of septicemia occurred in all the 95 patients,among which acute leukemia patients accounted for 69.1％ (76/110),patients with neutrophil counts ＜0.5 × 109/L accounted for 82.7％ (91/110),and patients with agranulocytosis time ＞7 days accounted for 66.4％(73/110).Major pathogenic bacteria was gram negative bacteria,including Escherichia coli 30.9％(34/110),Klebsiella pneumoniae (14.5％,16/110),Pseudomonas aeruginosa (12.7％,14/110).Carbapenems and amikacin was the most sensitive in susceptibility testing.Ninety-eight episodes of septicemia cured or improved,and 12 patients died,with a mortality of 12.6％ (12/95).Fifteen patients had septic shock,of whom 7 patients were dead.Conclusions Septicemia is very serious for malignant hematological patients,which may lead to rapidly progress,high incidence to septic shock and high mortality.Early prevention and treatment is important for patients,and strong anti-infection and supportive treatment is needed.