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Vitreoretinal lymphoma (VRL) is a rare variant of primary central nervous system lymphoma (PCNSL), mostly of diffuse large B cell lymphoma, which affects the retina and/or the vitreous with or without optic nerve involvement. The disease course is aggressive. Up to 90% of the patients develop central nervous system lymphoma within one year. The diagnosis of VRL is challenging due to nonspecific chronic and relapsing uveitis and is made by anterior chamber tab or vitreous aspirate biopsy. There is no established treatment protocol for VRL patients with bilateral involvement without CNS involvement. There are suggestions to use only intravitreal chemotherapy with methotrexate and/or rituximab. Alternatively, systemic high-dose MTX treatment or external beam radiotherapy is used. Further studies are needed to prove and confirm the prophylactic systemic therapy in preventing CNS involvement in limited VRL.

The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus–associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children. In this prospective study, Th1/Th2 cytokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ, were analyzed in patients with EBV-HLH or sepsis at the onset of disease by flow cytometry. IL-10, IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 were higher and IL-6 was lower in EBV-HLH patients compared to sepsis patient levels. When using the criteria of IL-10 >20.9 pg/mL, IFN-γ >17.9 pg/mL, IL-10/IL-6 >0.5 and IFN-γ/IL-6 >0.7, the sensitivity was 89.8%, 93.2%, 93.2%, and 91.5%, while the specificity was 89.8%, 100%, 94.9%, and 100%, respectively. After treatment of EBV-HLH patients, IL-6, IL-10, TNF-α, and IFN-γ were significantly reduced (IL-6: P<.001; IL-10: P<.001; TNF-α: P=.011; IFN-γ: P<.001). This study showed that IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 are novel specific indicators for differential diagnosis of EBV-HLH. Additionally, IL-6, IL-10, TNF-α, and IFN-γ are useful indices for monitoring the effects of treatment on EBV-HLH. •IFN-γ, IL-10/IL-6 and IFN-γ/IL-6 are new, specific indicators for the differential diagnosis of EBV-HLH.•IL-6, IL-10, TNF-α, and IFN-γ are useful indices for the observation of a curative effect in EBV-HLH.

目的研究弥漫性轴索损伤（DAI）后患者外周血CD4＋/CD8＋T细胞比值及炎症因子IL-6、IL-10水平的变化,探讨影响DAI患者预后的相关危险因素及可能的预测因子。方法收集115例DAI患者的相关临床资料及伤后至少6个月的随访结果,并将采集的患者外周血采用流式细胞仪检测CD4＋、CD8＋T细胞及其比值,ELISA法检测IL-6、IL-10水平,对免疫炎症指标及临床资料进行单因素和多因素分析,多因素分析采用Logistic回归分析。结果DAI后合并其他脑损伤、瞳孔改变、伤后昏迷时间及入院时GCS评分是影响患者预后的危险因素,而其他因素则与预后不相关。CD4＋/CD8＋T淋巴细胞比值降低是DAI后发生ARDS/ALI的危险因素,CD4＋/CD8＋T淋巴细胞比值与患者预后关系不大,而ARDS/ALI的发生则是影响DAI患者预后的重要危险因素。IL-6增加与DAI后ARDS/ALI密切相关,可作为ARDS/ALI发生的预测因子,其水平是患者预后的危险因素,而IL-10则在此过程中与ARDS/ALI不相关,且与患者预后无关。结论 CD4＋/CD8＋T淋巴细胞比值降低是DAI后发生ARDS/ALI的危险因素,IL-6可作为ARDS/ALI发生的预测因子。DAI后与患者预后相关的危险因素包括合并其他脑损伤、瞳孔改变、伤后昏迷时间、入院时GCS评分、IL-6水平及并发ARDS/ALI。

目的 研究甲基苯丙胺(methamphetamine,ma)急性处理对lps诱导的小鼠脾脏il-6、il-10和tnf-α表达的影响.方法 选用c57bl/6j小鼠,分别腹腔注射(intraperitoneally,i.p.)生理盐水(ns)或ma(5 mg/kg),10 min后,再分别i.p.ns和lps(150 μg/kg),予lps后30 min和60 min,取脾脏,检测这两个时间点小鼠脾脏il-6、il 10和tnf-α的水平.结果 ma可显著提高lps诱导的脾脏il-6和il-10的表达(p＜0.01).对于脾脏il-6的水平存在ma+ lps的交互效应(p＜0.01),在i.p.lps60min后ma+ lps组脾脏il-6水平较ns+ lps组明显升高(p＜0.01).对于脾脏il -10的水平也存在ma+ lps的交互效应(p＜0.01),在i.p.lps30min后ma+ lps组脾脏il-10水平较ns+ lps组明显升高(p＜0.01).对于tnf-α,在这两个时间点既无显著的ma的主效应,也无ma+ lps的交互效应,ma组较ns组几乎没有差异(p=1.00).同一组别两个时间点的比较发现,无lps刺激,小鼠脾脏il-6、il-10和tnf-α的水平在两个时间点无差异；给予lps刺激,i.p.lps后60 min小鼠脾脏il-6、il-10和tnf-α的水平较30 min显著增高(p＜0.01).结论 ma处理小鼠后短时间内可显著增加lps诱导的脾脏il-6和il-10的表达,但对tnf-α表达无影响.