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Objective To investigate whether the expression frequency and function of peripheral and liver NK cells was correlated with the liver injury in patients with hepatitis B virus related acute-on-chronic liver failure(HBV-ACLF).Methods Peripheral blood samples were obtained from fifteen HBV-ACLF patients and fifteen chronic hepatitis B patients.The frequency of peripheral NK cells (CD3-CD56+) and CD107a expression on surface of peripheral NK cells were detected by multicolor flow cytometry.Expression of IFN-γ by peripheral NK cells was detected by intracellular cytokine staining.Needle biopsy liver tissues were obtained from twenty patients with HBV-ACLF,ten patients with mild CHB,and expression of live NK cells (CD3-CD57+) was analyzed by dual immmunohistochemical staining of CD 3 and CD57.Results There was no significant difference in the frequency of peripheral NK cell and IFN-γ expression by peripheral NK cells between HBV-ACLF and mild CHB patients.However,CD107a expression on surface of peripheral NK cells of HBV-ACLF patients was remarkably higher than that of CHB patients.The frequency of liver CD57+NK cell of HBV-ACLF patients was remarkably higher than that of CHB patients(95.1 ±21.3/low power field vs 9.5±10.6/low power field,P＜0.01).Further analysis revealed that the frequency of liver CD57+ NK cells in HBV-ACLF patients was positively correlated with the TBIL level.Conclusion The enhanced cytotoxic activity of peripheral NK cells and the recruitment of liver CD57+ NK cells may aggravate immune-mediated liver injury and promote the apoptosis and necrosis of hepatocytes.
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Objective To investigate the clinical characteristics of skin lesions of tsutsugamushi disease.Methods The skin lesions and clinical characteristics of 17 hospitalized patients with tsutsugamushi disease were analyzed. Results Of the patients, 88.2% (15/17) developed eschar and skin ulcer, 64.7% (11/17) had skin rashes. The patients often developed solitary, painless and nonpruritic eschar 4 to 10 days after the occurrence of fever, with indefinite locations and average diameter of 1.2 cm (range: 0.5 - 3.0 cm). The eschar was covered with a black and dry surface and surrounded by a ring-shaped erythematous halo, and usually shedded 5 to 9 days after the appearance with the formation of shallow ulcer. Superficial lymphadenectasis was observed near the eschar in 80% of the patients with eschar, and no eschar was observed at the first visit in 66.7% of the patients. Skin rashes mainly included nonpruritic congestive papules (45.5%) and maculopapular rashes (54.5%), and often subsided 2 to 5 days after emergence. Conclusions The skin lesions of tsutsugamushi disease include eschar and skin rashes. Eschar is an important characteristic and highly suggestive of this entity.
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OBJECTIVE: To study the relationship between the infection of hepatitis B virus (HBV) in gastric mucosa and the syndrome of disharmony between liver and stomach. METHODS: Subjects were divided into 2 groups: 30 patients with chronic hepatitis B (CHB) and the syndrome of disharmony between liver and stomach in hepatitis group, and 30 patients with chronic gastritis and the syndrome of disharmony between liver and stomach in gastritis group. Liver function and the markers of HBV were detected. The contents of HBV-DNA in serum and in gastric mucosa were assayed respectively by fluorescence quantitative polymerase chain reaction (FQ-PCR). RESULTS: (1) The incidence of gastric mucosal lesion in hepatitis group was up to 96.7% (29/30). (2) Scores of the syndrome of disharmony between liver and stomach in hepatitis group were significantly lower than those in gastritis group (P<0.05). The positive rates of HBV-DNA in serum, gastric fundus, body and antrum were 56.7%, 76.7%, 76.7% and 70.0%, respectively. (3) A positive correlation was found not only among the content of HBV-DNA in serum and the contents of HBV-DNA in gastric mucosa (r=0.66-0.94, P<0.01), but also among the contents of HBV-DNA in serum, gastric mucosa and the total score of the syndrome of disharmony between liver and stomach in hepatitis group (r=0.36-0.52, P<0.05). CONCLUSION: The infection of HBV is involved in the syndrome of disharmony between liver and stomach. Gastric mucosal lesion is universal in CHB patients with the syndrome of disharmony between liver and stomach.