巨细胞病毒活动性感染时体液免疫的测定

<正> 已知巨细胞病毒(HCMV)可导致机体不同程度的免疫调节紊乱,最主要影响细胞免疫功能。目前有关HCMV对体液免疫影响的系统研究较少,迄今未见国内有此类报道。为此,我们对 80份 HCMV-IgM和/或RCMV-IgA阳性血清及75份阴性血清进行了免疫球蛋白和补体C_2测定,以探讨HCMV活动性感染时机体非特异性体液免疫的变化。     

病毒载量检测鉴别诊断HIV早期感染

目的 研究病毒载量检测在鉴别诊断HIV早期感染中的应用.方法 对13份HIV抗体检测结果高度提示为早期感染的样本进行病毒载量检测,并对这些个体进行随访和抗体检测以证实其感染状况.结果 13份样本中,有12份病毒载量阳性,随访确定1例HIV抗体阳性婴幼儿感染者,11例窗口期感染者;1例HIV抗体呈阳性的婴幼儿,病毒载量阴性,随访证实未感染.病毒载量检测结果与最终的感染状况相符.结论 通过病毒载量检测能够有效鉴别诊断早期感染中的婴幼儿感染(18个月以内抗体呈阳性)和窗口期感染者.病毒载量检测可以作为HIV感染早期不确定样本的诊断依据.     

不孕患者中宫颈HPV高危型别感染率及病毒载量的调查

目的调查高危型人乳头瘤病毒（HPV）在不孕患者宫颈细胞中的感染情况,探讨HPV病毒型别及其载量（viral load）对不孕发生的影响。方法对临床130份不孕患者的宫颈脱落细胞标本和在门诊体检的150份对照组的宫颈脱落细胞标本采用多通道实时荧光定量PCR仪进行八种高危HPvDNA分型及定量检测,该八种高危HPV型别为主要高危型：HPV16,18,45,31和次要高危型HPv33,52,58,67。结果不孕组阳性率为25．38％（33／130）,对照组的阳性率为11．33％（17／150）,两组间的阳性率差异有统计学意义。不孕组的33份阳性标本中病毒载量≥10^6为24例,病毒载量〈10^6为9例;对照组的17份阳性标本中,病毒载量≥10^6为4份,病毒载量〈10^6为13份,两组间的病毒载量有显著性差异。结论不孕组高危型HPV感染率比正常人群（对照组）高。对不孕组病毒载量的分析表明：不孕组人群中其病毒载量明显高于正常人群。此外,本研究还为分泌物核酸检测的定量设置了内标（β-球蛋白）,提出可供临床使用的分泌物取样的核酸定量检测方法。     

TrIFA检测HBV标志物与病毒载量的关系及临床意义

酶联免疫吸附试验（ELISA）是当今各临床实验室检测乙肝两对半的常用方法,以其简便、快速、特异及较高的灵敏度得到广泛应用,但与时问分辨免疫荧光技术（time-resolved immunofluorometric assay,TrlFA）相比灵敏度相对较低,     

先天性HCMV感染新生儿尿液中病毒载量与疾病严重度的关系探讨

目的探讨新生儿尿液中人巨细胞病毒（HCMV）病毒载量与先天性感染的关系及与HCMV所致疾病严重程度的关系。方法采集98例经PCR方法确诊的有症状及无症状的先天性HCMV感染新生儿尿液标本,用实时荧光定量PCR法（FQ—PCR）检测尿液中巨细胞病毒载量。结果98例先天性HCMV感染的新生儿中85例在出生后有临床症状（86％）。无症状感染和有症状感染的新生儿尿液中平均HCMV病毒载量分别是1．4×10^5拷贝／ml和3．1×10^6拷贝／ml,P〈0．01,差异有统计学意义。结论先天性HCMV感染的新生儿中无症状感染者尿液中病毒载量显著低于有症状感染者,提示病毒载量与疾病严重程度相关。     

孕妇血、新生儿脐血巨细胞病毒抗体IgM水平调查

巨细胞病毒(CMV)是人类最常见的病原体之一，并且是胎儿致畸，小儿病残的主要成因之一。近年来，人们又发现CMV感染是器官移植失败和艾滋病人死亡的重要原因，另有学者报道，CMV感染又是糖尿病和冠心病的致病因子。由于多数CMV感染者呈隐匿性亚临床感染，而病毒携带者的多种体液(唾液、乳汁、宫颈分泌物、精液)，可以排病毒，因此致使不同年龄人群的普遍感染。     

孕妇缺铁及其对新生儿的影响

目的探讨孕妇缺铁状态及其对新生儿的影响 .方法对 187名孕妇血液和产时脐血的 5项铁参数进行跟踪 ,其中 77名分为补铁组和对照组 .结果 (1)随着孕周的增加 ,孕妇的SI、TS、SF下降 ,TIBC上升 ,Hb先下降后上升 ,t检验各项铁参数有显著性差异 (p <0 .0 5 ) ;(2 )孕妇缺铁越早 ,其脐血Hb、SI、TS、SF越低 ,TIBC越高 ,孕 2 0～ 2 6W与临产比较SI和SF均差异显著 (p <0 .0 5和p <0 .0 1) ,脐血SI和SF与母血SF正相关 (r=0 .31,p <0 .0 1和r=0 .18,p<0 .0 5 ) ;(3)补铁组脐血的Hb、SI、TS、SF比对照组高 ,TIBC比对照组低 ,两组SI、SF差异显著 (SI:p <0 .0 5 ;SF :p <0 .0 1) .结论孕妇缺铁性贫血发生率高 ,新生儿铁贮备降低 ,必须进行补铁治疗 .     

孕妇缺铁及其对新生儿的影响

目的探讨孕妇缺铁状态及其对新生儿的影响.方法对187名孕妇血液和产时脐血的5项铁参数进行跟踪,其中77名分为补铁组和对照组. 结果(1)随着孕周的增加, 孕妇的SI、TS、 SF下降, TIBC上升, Hb先下降后上升,t检验各项铁参数有显著性差异(p＜0.05);(2)孕妇缺铁越早, 其脐血Hb、SI、TS、 SF越低,TIBC越高,孕20～26W 与临产比较SI和SF均差异显著(p＜0.05和p＜0.01),脐血SI和SF与母血SF正相关(r=0.31 p＜0.01和r=0.18 p＜0.05);(3)补铁组脐血的Hb、SI、TS、 SF比对照组高,TIBC比对照组低,两组SI、SF差异显著(SI:p＜0.05;SF:p＜0.01).结论孕妇缺铁性贫血发生率高,新生儿铁贮备降低,必须进行补铁治疗.     

妊娠与非妊娠妇女生殖道肺炎支原体感染的研究

目的：了解我国妊娠与非妊娠妇女生殖道肺炎支原体（Mpn)感染状况。方法：应用套式聚合酶链式反应（nPCR)、选择性培养和全自动DNA序列测定技术对100例妊娠妇女和100例非妊娠妇女的阴道拭子标本进行检测。结果：Mpn nPCR检测妊娠妇女阴性率为6％,非妊娠妇女为3％。Mpn nPCR呈阳性的标本经选择性培养均分离到Mpn。1例Mpn nPCR阳性产物经全自动DNA序列测定与Mpn标准株序列完全一致。结论：我国妊娠与非妊娠妇女生殖道均存在Mpn感染。     

天然免疫细胞对急性HBV感染作用机制研究进展

研究表明HBV感染能引起肝脏免疫损伤。过去认为适应性免疫应答在机体抗HBV感染及其引起的肝脏病变中发挥着主要作用。现在研究证实被誉为"机体天然免疫核心器官"的肝脏拥有大量天然免疫细胞,在HBV感染过程中扮演着重要角色,而且很有可能直接决定着急性HBV感染的临床结局和预后。急性HBV感染是感染HBV发病后的初期阶段,是乙肝治愈和防止转为慢性乙肝的关键。研究肝脏天然免疫细胞在急性HBV感染中的作用及机制对阐明HBV免疫致病机制、指导临床科学开展抗病毒治疗、防止急性感染的慢性化发展等方面有非常重要的意义。     

孕前及孕期妇女风疹免疫力调查和风疹近期感染检测

目的了解孕前妇女及孕期妇女风疹易感水平和近期感染状况，为预防先天风疹感染做好优生优育工作提供依据。方法用生物蛋白芯片技术对2986例孕前妇女及863例孕期妇女（包括725例正常妊娠和138例异常妊娠）进行风疹特异性抗体IgM、IgG检测。结果80．27％的孕前妇女具有免疫力，4．99％孕前妇女为风疹近期感染，14．03％妇女对风疹易感。89．00％的孕期妇女具有免疫力，1．96％孕期妇女为风疹近期感染，7．76％妇女对风疹易感。孕前妇女及孕期妇女的风疹近期感染率和易感率比较有显著性差异（χ^2=14．797、23．846，P〈0．001）；不良妊娠与正常妊娠之间风疹近期感染率和易感率比较有显著性差异（X。=30．635、4．174，P〈0．05）；市区与农村的孕前妇女及孕期妇女在风疹近期感染率和易感率比较无明显不同；孕前妇女及孕期妇女风疹近期感染月份分布均以5月最高。结论本地区孕前妇女风疹感染率高；风疹感染与不良妊娠密切相关：市区与农村妇女的风疹易感水平和近期感染状况相当。对孕前妇女及孕期妇女同时检测风疹特异性抗体IgM、IgG可以正确判定妇女的免疫状况，有效预防、主动发现并合理处理孕妇感染，从而降低风疹感染率提高优生优育水平。     

江苏地区中孕期妇女巨细胞病毒感染率及感染状态与不良妊娠结局的关系

目的江苏省中孕期妇女的巨细胞病毒（cytomegalovirus,CMV）血清流行率,探讨母孕期感染状态与不良妊娠结局的相关性。方法根据2002-2004年江苏省12个市县17661例孕妇的新生儿结局,527例有不良妊娠结局的孕妇纳入病例组,同时随机选取496例正常妊娠结局的孕妇为正常对照。检测孕妇妊娠15～20周外周血CMV IgG、IgM和IgG亲合力指数（avidity index,AI）。结果1023例孕妇的CMV IgG阳性率为98.7％,其中病例组和对照组孕妇阳性率分别为99.4％和98.0％（P=0.039）。病例组孕妇活动感染率,即CMV IgG＋／IgM＋,明显高于正常对照组（3.8％vs.1.6％,P=0.033）。CMV IgG AI检测结果显示,对照组孕妇AI均大于30%,说明无原发感染,而病例组孕妇5例（0.9％）AI〈30％,提示原发感染（P=O.084）,这5例母亲的新生儿均出现不良妊娠结局,包括新生儿死亡、头颅畸形和化脓性脑膜炎各1例,生长发育迟缓2例。多因素回归分析表明,母孕期CMV活动性感染是不良妊娠结局的独立危险因素（aOR 8.65,95％CI 1.85～40.41,P=0.006）。此外,母亲低学历和有既往不良妊娠史亦增加妊娠不良结局的发生风险。结论CMV感染在江苏地区孕妇人群中普遍存在。尽管仅少部分孕妇在孕期发生活动性感染,但仍是造成妊娠不良结局的独立危险因素。因此,应监测孕妇CMV感染状态并正确进行胎儿或新生儿感染风险的评估。     

Correlation between viral load,multiplicity of infection,and persistence of HPV16 and HPV18 infection in a Dutch cohort of young women

BackgroundPersistent high-risk human papillomavirus infection precedes the development of cervical cancer. Here we evaluated the contribution of HPV16/18 viral load and the presence of infections with multiple HPV types to persistence and clearance of HPV16/18 infections.MethodsVaginal self-swabs were obtained from young women (16–29 y) with one year interval. HPV genotyping was performed using the highly sensitive SPF10-DEIA-LiPA₂₅ system. HPV16/18 DNA loads were quantified via an adapted, highly sensitive qPCR protocol targeting the L1 gene.ResultsWe identified 227 HPV16 and 111 HPV18 infections with follow-up. For HPV16 132/227 (58%) were persistent and 95/227 cleared. For HPV18 49/111 (44%) infections were persistent and 62/111 cleared. Baseline viral load was significantly higher in persistent infections than in clearing infections for both HPV16 (p = 0.022) and HPV18 (p = 0.013). At baseline, only HPV16 viral load was significantly higher in multiple HPV infections compared with single infections (p = 0.003). In logistic regression analysis HPV16 and HPV18 viral load were found to contribute to persistency with OR = 1.279 (95%CI = 1.074–1.524) and OR = 1.256 (95%CI = 1.028–1.533) per log-unit increase HPV16 and HPV18 viral load respectively. The presence of multiple HPV type infections was not associated with higher persistency.ConclusionHPV16/18 viral load might be used as a marker for persisting infections and is affected by the presence of multiple HPV infections. Evaluation of these parameters at the population level may be of value to assess the presence of persistent or clearing HPV16/18 infections as an early marker, and may provide useful quantitative information in (epidemiological) vaccine monitoring studies.     

Virus-specific major MHC class II-restricted TCR-transgenic mice: effects on humoral and cellular immune responses after viral infection

A transgenic mouse expressing MHC class II-restricted TCR with specificity for a lymphocytic choriomeningitis virus (LCMV) glycoprotein-derived T helper cell epitope was developed to study the role of LCMV-specific CD4+ T cells in virus infection in vivo. The majority of CD4+ T cells in TCR transgenic mice expressed the transgenic receptor, and LCMV glycoprotein-specific TCR transgenic CD4+ T cells efficiently mediated help for the production of LCMV glycoprotein-specific isotype-switched antibodies. In contrast, LCMV glycoprotein-specific TCR transgenic mice exhibited a drastically reduced ability to provide help for the generation of antibody responses specific for the virus-internal nucleoprotein, indicating that intramolecular/intrastructural help is limited to antigens that are accessible to B cells on the viral surface. Antiviral cellular immunity was studied with noncytopathic LCMV and recombinant cytopathic vaccinia virus expressing the LCMV glycoprotein. TCR transgenic mice failed to efficiently control LCMV infection, demonstrating that functional LCMV-specific CD4+ T cells – even if activated and present at extremely high frequencies – cannot directly mediate protective immunity against LCMV. Despite the fact that LCMV-primed CD4+ T cells from TCR transgenic mice as well as from control mice showed low MHC class II-restricted cytotoxic activity in vivo, this did not correlate with protection against LCMV replication in vivo. In contrast, CD4+ T cells from TCR-transgenic mice mediated efficient protection against infection with recombinant vaccinia virus. These results further support the need for different immune effector functions for protective immunity against different viral infections.     

Viral determinants and host immune responses in the pathogenesis of HBV infection

Hepatitis B virus (HBV) is a virus that infects about 350,000,000 people worldwide with a clinical spectrum of acute hepatitis, the healthy carrier state, cirrhosis and hepatocellular carcinoma (HCC). The outcome of HBV infection is the result of complicated viral-host interactions. As in other infections with non-cythopatic viruses, the immune response is thought to play a crucial role in disease pathogenesis but there is increasing evidence that a variety of viral mechanisms, some depending on the function of virally encoded proteins, have a profound impact on the infected hepatocytes, the liver microenvironment, and host anti-viral responses. Indeed, the virus has evolved multiple mechanisms to ensure its success in infecting a susceptible host. The essential aspects of the life cycle of HBV and the host immune response are reviewed and recent new developments in the molecular virology of HBV, including experimental animal models, in the role of accessory viral proteins in disease pathogenesis and HCC development and in the characterisation of the T cell response in the control of HBV infection, are highlighted.     

奉贤地区HBsAg阴性的HBV自然感染母亲对新生儿影响的研究

目的　为揭示HBsAg阴性的乙型肝炎病毒 (HBV)自然感染孕妇的宫内感染及其危险因素。方法　采用多聚酶链反应 (PCR)技术结合酶联免疫吸附法 (ELISA) ,对奉贤地区 131例HBsAg阴性的HBV自然感染孕妇外周血 ,及其分娩后的脐带血进行HBV血清学标志物 (HBVM)和HBVDNA检测。结果　HBsAg阴性的HBV自然感染孕妇宫内的感染率 (除外单一抗 -HBs阳性 )为 5 2 6 7% ;脐血中不同HBVM组合的HBVDNA检出率依次为 :抗 -HBe( )、抗 -HBc( ) >抗 -HBs( )、抗 -HBe( )、抗 -HBc( ) >抗 -HBs( )、抗 -HBe( ) >抗 -HBs( )、抗 -HBc( ) >抗 -HBs( ) ;脐血HBVDNA总检出率为 16 79%。结论　HBsAg阴性的HBV自然感染孕妇也可能发生宫内感染。提议HBsAg阴性的HBV自然感染孕妇和新生儿有进行自动和被动免疫接种的必要性     

Bacterial adherence and humoral immune response in women with symptomatic and asymptomatic urinary tract infection

Purpose: To determine the role of humoral immune response and bacterial adherence in the pathogenesis of symptomatic and asymptomatic urinary tract infection in women. Methods: The study population consisted of 30 women with symptomatic UTI, 30 women with asymptomatic UTI and 30 healthy women as controls. Bacterial adherence to vaginal epithelial cells was studied and the concentration of serum and urine antibodies to mixed coliform antigen and clinical isolate was determined by ELISA. Surface hydrophobicity of the urine isolates was determined. Student’s unpaired t test and Pearson’s correlation coefficient test were used in the statistical analysis. Results: Compared to asymptomatic UTI, significantly more number of bacteria adhered to the epithelial cells of women with symptomatic UTI (P<0.001). All cases of UTI had significantly high concentration of urinary IgG antibody to mixed coliform antigens. Asymptomatic UTI cases had higher concentrations of urinary IgG, IgM and IgA antibodies to clinical isolate. Concentration of sIgA level was more in symptomatic UTI. Significant correlation was observed between urinary IgG and adherence of clinical isolate in case of asymptomatic UTI. Conclusions: The present study showed that greater receptivity of epithelial cells to bacteria may increase the susceptibility to UTI. Humoral immune response and local immunity may modify the pathogenesis of UTI.     

太原地区妊娠期感染TORCH的母婴传播及围产儿结局

目的：探讨妊娠妇女ＴＯＲＣＨ感染的母婴间传播及其围产儿不良结局。方法：收集８８６例孕妇的静脉血及其新生儿脐血,用ＥＬＩＳＡ法检测血清ＴＯＲＣＨ－ＩｇＭ抗体和ＨＢｓＡｇ及梅毒血清抗体。结果：孕妇血ＴＯＸ（弓形体）、ＲＶ（风疹病毒）、ＣＭＶ（巨细胞病毒）、ＨＳＶ－２（单纯疱疹病毒２型）ＩｇＭ抗体和ＨＢｓＡｇ,梅毒血清抗体的阳性率分别为０．２％、０．３％、１．７％、１．０％、０．７％、０．１％。２９例孕