Apport de la PCR quantitative dans le diagnostic de la toxoplasmose : la voie de la standardisation ?

Severity of toxoplasmosis is highly correlated to the immune status of the infected individual. Foetus and immunocompromised patient are mostly at risk to develop life threatening forms. In this situation, serological diagnosis gives poor information. DNA detection using polymerase-chain-reaction technology (PCR) has significantly improved the management of this disease. Even so, the growing number of conventional PCR assays has finally led to variable performance results. Real-Time PCR (RT-PCR) in toxoplasmosis has been developed since 2000. This new technology can improve standardisation. Moreover, quantification of parasitic load in samples becomes possible. This review describes the main RT-PCR procedures actually under use and the studies comparing different target genes. The effective benefit of quantification is also discussed. Reducing number of procedures and more systematic external quality control should be considered, in order to improve reliability in PCR results, which has undoubtedly become a major tool in toxoplasmosis diagnosis.     

Quel est le rôle des parasites et des levures dans la genèse des blépharites chroniques ?

INTRODUCTION: The chronic blepharitis is a current ophthalmic disease posing a therapeutic problem. The etiologic diagnosis is essential for adapting the treatment. PURPOSE: The aim of this study is to describe the role of Demodex sp, Malassezia sp and Candida sp in the pathogenesis of chronic blepharitis. PATIENTS AND METHODS: It's a prospective study realized during a period of 14 months. It interested 69 patients with chronic blepharitis and 96 controls. The prevalence of Demodex sp, Malassezia sp and Candida sp on the eyelash of chronic blepharitis patients and controls was investigated. RESULTS: Demodex folliculorum was found in 58% of patients with chronic blepharitis and in 15,6% of controls. The difference between the two groups was statistically significant (P<0,00001). The sex and the age intervene neither in the frequency, nor in the abundance of D. folliculorum in the two groups. Malassezia sp was identified in 10,4% of the control group and 31,88% of the group with chronic blepharitis. The difference is significant (P<0,00001). There is no correlation between frequency and abundance of Malassezia, sex and age in the two groups. CONCLUSION: In our study, D. folliculorum and Malassezia sp seem to be accused in the genesis of the chronic blepharitis. Their systematic search is necessary in order to adapt the treatment.     

&#183;读者&#183;作者&#183;编者&#183;

2009年，《中国心理卫生杂志》步入自己的第23个年头。从1991年以来，本刊一直是医学领域的核心期刊，同时在心理学、社会学、教育学等相关领域，也有一定的学术影响。取得这样的成绩，离不开广大读者和作者的支持和厚爱。因此，本刊一向重视倾听读者、作者的声音，不论是对本刊的建议、要求还是批评，本刊都努力作出读者、作者满意的答复。为了更好地与广大读者、作者交流，提高大家参与《中国心理卫生杂志》办刊的热情，我们除对读者、作者进行个别答复外，还特设置《读者&#183;作者&#183;编者》专栏，主要刊登读者的来信，内容包括对已发表论文进行学术点评，对一些学术问题进行讨论，或者指出本刊的问题和提出刊物发展的建议。对读者提出的有代表性的学术问题，将邀请我们的编委、相关学术领域的专家作答。读者来信一经采用，将致稿酬。     

Y a-t-il un changement perceptible dans l'écologie des Candida species responsables de fungémie ? Observation de 2000 à 2006 à l'hôpital Foch

Some Candidemia studies have documented changes in epidemiology of Candida species and some species were reported as emerging species. We conducted a study over a 6 years period and until 2005 we do not noticed any change in epidemiology of Candida even if Candida albicans still the most common species followed by Candida glabrata. No increase of candidemia was observed from 2000 to 2005 and we observed a decrease during the year 2006, this fact have to be confirm and may be related to other data: reinforcement of hygienic measures in our hospital, changes in treatment or preemptive treatment of yeasts and fungi with new azoles or candines molecules. On another side, patients from intensive care units and patients suffering of cancer were, as expected, the most represented population in our study.     

Allogreffe de cellules souches hématopoïétiques à partir d’un sang cordon non apparenté : quelle unité choisir ?

In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the choice of optimal unrelated cord blood unit in terms of cell dose, HLA-matching and other characteristics.     

Mesure de la parathormone : facteurs de variation et problèmes de standardisation

The parathyroid hormone (PTH) assay still involves some problems, considering the molecular heterogeneity and the different specificity of the available sandwich immunometric methods. A number of preanalytical variation factors can affect the PTH measurement: the intraindividual biological variability (pulsatile secretion, circadian rhythm) and the interindividual variability (sex, age, genetics factors), as well as the sample typology and way of storage, can be mentioned. Beside the molecular heterogeneity (C-terminal fragments, included the recently identified non-(1–84)) molecular forms which may interfere with "intact molecule" PTH methods), the factors affecting the analytical variability concern the antibody interference (anti-PTH autoandibodies and heterophilic antibodies) and particularly the calibration differences existing among the commercially available assays. In order to evaluate these differences, we performed recovery tests with both synthetic hPTH(1–84) from Bachem and recombinant hPTH(1–84) 95/646 from NIBSC. The results are similar to those recently obtained by UK-NEQAS and highlight remarkable between-method calibration differences, which are the main reason for the disagreements among PTH values obtained with different kits. On the contrary, no relationship apparently exists between the cross-reactivity with synthetic hPTH(7–84) fragment and the method bias (UK-NEQAS, 2001). Therefore the lack of an International Standard is the main obstacle to solving the problems related to PTH measurement?     

胡萝卜&#183;鸡蛋&#183;咖啡豆

一个女儿对父亲抱怨她的生活不如意，不顺心，事事那么艰难，不知道该如何应付，她不再想抗争和奋斗了。     

Thérapies anticancéreuses ciblées : vers une nouvelle toxicologie ?

Targeted therapies (TT) represent since 10 years, an interesting progress in oncology for many cancers in adjuvant, neoadjuvant or palliative situation. The development of this new class of drugs, with an original mechanism of action, their easy administration, mainly per os, and a particular toxicity profile different from "classical" chemotherapy (CT) leads them entering in the therapeutic arsenal of breast, digestive tract, lung and hematologic cancers, in association with CT. Medical oncologists took rapidly the train of TT, managing a new and original skin, digestive, cardiovascular, endocrine and pulmonary toxicity profile, that remains relatively less important than "classical" CT.     

浅淡解剖学教学中的“新&#183;近&#183;益&#183;活&#183;馈&#183;美“

B.S.布卢姆的教学思想是使学生能进行有效的学习 ,在一定的时间条件下学习教学内容 ,并达到掌握水平 ,其策略的实质是在教学中辅之以对每个学生所需要的频繁的反馈与个别化的矫正帮助。如何使教学有效是布卢姆教学思想的关键 ,这就要求我们改进旧的教学方式 ,如教师包办到底 ,嚼得细烂 ,学生学起来没劲 ,忽视了学生的主体能动性 ,这叫包而无效 ;超书超纲 ,即算是新东西 ,学生接受不了 ,加重了学生的负担 ,这叫超而无效。笔者多年从事解剖学及组织胚胎学教学 ,近年来 ,把“新·近·益·活·馈·美”贯穿于教学中 ,发现不但能解决以前存在的…     

读者&#183;作者&#183;编者

关于论文摘要的书写要求 本刊论文摘要的书写必须采用结构式（目的、方法、结果、结论）,论著须附相对应的中、英文摘要,以300字左右为宜。英文摘要一般与中文摘要内容相对应,但为了对外交流的需要,可以略详。摘要须用第三人称撰写,不得用“本文”、“本院”等作为主语,不列图、表,不引用文献,不加评论和解释。结果部分应列出主要数据,结论必须从结果的数据中可得出或推导出。英文摘要还应包括题名、作者姓名（汉语拼音,姓每个字母大写,名首字母大写,双字名中间加连字符）、单位名称、所在城市名、邮政编码及国名。     

知足&#183;简单&#183;快乐

哲人说：从圆心可以画出多少条半径来，生活方式就有多少种。一个人选择什么样的生活方式，和他的价值观、财富观是密不可分的。我很欣赏威尼斯商人的财富观，他门的店门在营业时间永远半开半闭，代表着他们对金钱的态度：没有不行，但也不需要太多，所以，不让店门完全地敞开。在威尼斯商人看来，贫穷和钱多了都是麻烦。     

Radio-immunodosage en milieu liquide pour la détection et la quantification de l'antigène p24 du virus de l'immunodéficience humaine type 1 dans le sérum

Among the less costly viral assays that may be appropriate for resource-poor countries, the workshop steering committee (A meeting organized by the Forum for Collaborative HIV Research April 22, 2002 Washington, DC) selected the heat-denatured p24 assay for consideration at this meeting because of its advanced stage of development. Developed by Jörg Schüpbach (University of Zurich), this assay for HIV p24 antigen is more sensitive than the original p24 assay used as a viral marker in early clinical trials of HIV therapies. The assay uses heat denaturation in a conventional p24 antigen Elisa assay. Boiling for 5 minutes destroys antibody and preserves antigen. Our test called ØCGEACRENK HIV-p24 RIA" is a transposition of signal-amplification-boosted of head-denatured plasma Elisa (1) to a radioimmunoassay performed with in-house reagents. The radioimmunoassay technique is based on the competitive binding of the serum HIV-1 p24 and radiolabel recombinant p24 preparation. They compete for binding to an antibody specific present in a substoichiometric amount. Complex of radiolabeled and unlabeled p24 antigen were separated from unbound species by reaction with an anti-rabbit sheep immunoglobulin as second antibody (house made). The detection limit of p24 was 0.05 pg/ml with as little as 10 ul of serum. This paper describes, for the first time, the successful production of polyclonal antisera specific for HIV-1 p24 and the radio iodination of recombinant HIV-1 p24 using exhaustive chloramin-T oxidation and the development of a sensitive radioimmunoassay (RIA) for measuring HIV-1 p24 in serum.     

Portage d’entérocoques résistants aux glycopeptides : les techniques d’isolement et d’identification actuelles sont-elles suffisantes ?

The monitoring of infection by glycopeptide-resistant enterococci (GRE) is one of the main elements of hospital hygiene policy. It involves systematic rectal swabs in clinics at risk (asymptomatic carriage).

Aim

We compare two GRE screening methods and evaluate a new kit associating multiplex PCR and hybridization (Génotype^® Enterococcus, Hain Lifescience) on a panel of 448 samples collected over a 4-month period.

Patients and methods

The first method is based on direct inoculation of the sample; the second one involves a preliminary enrichment phase followed by molecular diagnosis allowing the identification of species of enterococci as well as glycopeptide resistance genes.

Results

All the resistant strains were isolated using the enrichment technique. The incidence of GRE (VanA) carriage was 0,55% (two out of 362 patients, two out of 448 isolates) with two Enterococcus faecium VanA. Six Enterococcus gallinarum VanC1 and two Enterococcus casseliflavus VanC2/C3 were also isolated and identified. The main clinics concerned are intensive care and hematology. The two patients with E. faecium VanA had been previously given glycopeptides for 10 days. For three strains, the molecular method allowed to correct prior erroneous results based on rapid identification (RapidID32Strep V2.0).

Conclusion

The method using direct samples inoculation underestimates real incidence of GRE carriage. The performances of Génotype^® Enterococcus molecular method, evaluated for other parameters using reference strains and DNA sequencing, offer new possibilities applicable to routine laboratory.