Changes of HLA-DR15 and immunoglobulin, T lymphocyte subsets in patients with aplastic anemia, myelodysplastic syndrome and their significance / 中国实验血液学杂志

The objective of this study was to detect the expression frequency of HLA-DR15 in patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS), to investigate the relation of expression frequency with diseases and to analyze the relationship between immunoglobulin, T lymphocyte subsets and HLA-DR15. HLA-DR15 expression was detected by PCR-SSP; immunoglobulin was detected by immune turbidimetry; T cell subsets were detected by flow cytometry. The results showed that the expression rates of HLA-DR15 in AA and MDS as well as normal control groups were 78.6%, 63.2% and 24.6% respectively. The difference between AA, MDS and the normal control groups was statistically significant (p < 0.01). OR (odds ratios) values of AA and MDS groups were 11.262, 4.710 respectively. Compared with normal control group, expression rate of HLA-DR15 in hematologic malignancy group was not significantly different. The immunoglobulin level and abnormal T cell subsets in AA and MDS groups were statistically different between HLA-DR15 positive and negative groups (p > 0.05). It is concluded that the frequency of HLA-DR15 antigen in AA and MDS patients is significantly higher than that in normal control and hematologic malignancy group. OR value>1 showed a positive correlation between the diseases and HLA-DR15. HLA-DR15 is a susceptible gene in AA and MDS. The abnormalities of immunoglobulin level and ratios of T cell subsets in AA and MDS are common, but are not associated significantly with the expression of HLA-DR15.

Clinical analysis of histocytic necrotizing lymphadenitis / 中南大学学报(医学版)

OBJECTIVE@#To understand the clinical features and histopathology of histocytic necrotizing lymphadenitis (HNL) so as to better recognize the disease.@*METHODS@#The clinical features, histopathology, and diagnosis of 10 patients admitted to our hospital were retrospectively analyzed.@*RESULTS@#The clinical features of these 10 cases included: young females were the majority; lymphadenopathy and fever were the most common clinical manifestations; some cases were accompanied by connective tissue diseases. Histopathologic examination showed distinctive necrosis and around the necrotic foci, variable proliferations of histocytes but generally without infiltration of neutrophils.@*CONCLUSION@#HNL has some typical histopathological alterations and relatively fine prognosis,but it tends to be misdiagnosed as lymphoma or lymphoid tuberculosis and may be accompanied by other diseases.

Hematostatic function in myeloproliferative diseases / 中国实验血液学杂志

This study was purposed to investigate the change of early hemostatic function in patients with myeloproliferative diseases (MPD) and to explore its significance in combination with clinical data. The platelet aggregative function was measured by using ristomycin, adenosine diphosphate, collagen and adrenine as inductors, the plasma von Willebrand factor-associated antigen (vWF: Ag) level was measured by enzyme-linked immunosorbent assay (ELISA), the plasma von Wellebrand factor-ristomycin cofactor (vWF: Rco) activity was measured in 6 patients with obviously low ristomycin induced platelet aggregation (RIPA). The results showed that the platelet aggregative function obviously decreased in 35 patients, there were distinct differences in maximal platelet aggregative rate between patients and normal controls induced by 4 inductors respectively (P < 0.001, P < 0.001, P = 0.002, P < 0.001). There was no obvious difference between patients with MPD and healthy controls in plasma vWF: Ag level (P > 0.50). Plasma vWF: Rco activity in all 6 patients with MPD chosen was in the normal range, except one patient with essential thrombocytosis (ET) whose plasma vWF: Rco activity was much lower than normal. No correlation was found between platelet count and plasma vWF: Ag level in the patients (r = -0.180). No correlation was found between platelet count and maximal platelet aggregative rate induced by 4 inductors respectively in patients. It is concluded that the occurrence of abnormal platelet aggregative function is high in patients with MPD. The RIPA and vWF: Rco activity decrease in one patient with ET. However, the shortage of vWF polymer existed in his plasma have needs for further research. No correlation was observed between hemostasis and clinical manifestations. However, because of the high occurrence of platelet dysfunction in MPD patients, the clinical application of anti-platelet drugs should be considered carefully.

The dynamic analysis and the clinical significance of vascular endothelial cell markers and hemolysis parameters in thrombotic thrombocytopenic purpura / 中华血液学杂志

<p><b>OBJECTIVE</b>To monitor the changes of hemolysis parameters and endothelial cell markers in thrombotic thrombocytopenic purpura (TTP) and reveal the clinical significance of these changes.</p><p><b>METHODS</b>vWF-cleaving protease (vWF-CP) activity in 3 cases of TTP was detected by Western blot. The percentages of fragmented red cells (FRC) were counted throughout the entire clinical course. Levels of plasma thrombomodulin were detected by Western blot combined with density screening in TTP and healthy individuals (n = 3). Concentration of plasma VEGF was measured by enzyme-linked immunosorbent assay in TTP and healthy individuals (n = 9). Fundus fluorescein angiography was performed to search the evidence of microvascular thrombosis in one TTP patient with impaired visual acuity.</p><p><b>RESULTS</b>The lower vWF-CP activity was observed in TTP patients; the percentages of FRC in 3 cases of TTP were 1.65%, 2.50%, 3.32% respectively with an average of 2.49% at the onset of and decreased with the improvement of the disease. The levels of plasma TM and VEGF were significantly elevated in TTP than those in healthy individuals, and related to the severity of TTP. Fundus photography in one TTP patient with impaired visual acuity revealed vascular occlusion in fundus arteriole and venulae.</p><p><b>CONCLUSIONS</b>A decreased vWF-CP activity is in favour of TTP diagnosis. Dynamic monitoring of plasma TM and VEGF as well as percentages of FRC are useful indexes for reflecting the severity and evaluating therapeutic response of TTP. Selective fundus fluorescein angiography is useful for the judgement of microvascular thrombosis in TTP.</p>