疱疹病毒抗体阳性肺炎支原体肺炎患儿免疫状况及临床特征

目的探讨疱疹病毒抗体阳性的肺炎支原体肺炎(MPP)患儿免疫状况及临床特征。方法回顾分析2015年1月—2017年5月收治的360例2个月～16岁因MPP住院的患儿临床资料,以EB病毒(EBV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)任一疱疹病毒IgM抗体阳性的162例患儿为抗体阳性组,另198例EBV、CMV、HSV抗体均阴性的患儿作为对照组,两组进行分析比较。结果 360例MPP患儿中男188例、女172例,合并疱疹病毒IgM抗体阳性162例,其中EBV IgM阳性97例,阳性率26.9%;CMV IgM阳性39例,阳性率10.8%;HSV IgM阳性97例,阳性率26.9%。所有患儿均未予抗病毒治疗,经治疗症状缓解好转出院。抗体阳性组重症MPP、大叶性实变、并发呼吸衰竭的比例均高于对照组,血清IgM、CD~(4+)T细胞、CD~(8+)T细胞、淋巴细胞、NK细胞、白细胞计数、乳酸脱氢酶、丙氨酸氨基转移酶均高于对照组,大环内酯类抗生素使用时间长于对照组,使用激素率高于对照组,差异均有统计学意义(P均0.05)。MPP合并2种病毒IgM抗体阳性者的血IgM和三酰甘油水平高于合并1种者,差异有统计学意义(P0.05)。合并3种病毒IgM抗体阳性者与合并1种者比较,住院时间、发热时间、大环内酯类抗生素使用时间均有延长,血IgM、丙氨酸氨基转移酶水平更高,重症MPP发生率增高,差异均有统计学意义(P0.05)。结论疱疹病毒IgM抗体阳性MPP患儿的炎症反应强烈,临床症状重,病程长,并发症多,需更长时间的治疗。     

Intravesical instillation therapy with bacillus Calmette-Guérin for superficial bladder cancer: Study of the mechanism of bacillus Calmette-Guérin immunotherapy

AIM: In order to clarify the initial step of the mechanism by which bacillus Calmette-Guérin (BCG) exhibits antitumor activity via the immune response induced in the bladder submucosa after intravesical BCG therapy for human bladder cancer, various cytokines secreted in the urine after BCG instillation were measured. METHODS: After transurethral resection of bladder cancer, a 6-week course of BCG instillation was performed. At the first and sixth weeks' dosings, spontaneously excreted urine was collected before and 4, 8, and 24 h after BCG instillation. The urinary cytokines were determined by Sandwich enzyme-linked immunosorbent assay using monoclonal antibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor (TNF)-alpha, granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-1beta, IL-8, interferon (IFN)-gamma, and IL-12. RESULTS: After the BCG therapy, various cytokines, such as GM-CSF, TNF-alpha, G-CSF, IL-1beta, IL-8, IFN-gamma, and IL-12 were secreted, comprising the immune response cascade. The mean urinary excretions of GM-CSF and TNF-alpha 4 h after the sixth week's instillation were significantly higher than the pre-instillation levels. There were no significant increases in the urinary IFN-gamma or IL-12 levels between 4 and 24 h after the sixth week's instillation. The TNF-alpha level 4 h after the sixth week's instillation had a strong tendency towards the absence of recurrence, with a mean follow-up of 54.1 months. The Kaplan-Meier curve showed the 2, 5, and 10-year recurrence-free survival rates were 72.4%, 65.8%, and 56.4%, respectively. CONCLUSIONS: We suggested that the urinary levels of TNF-alpha might be essential in antitumor activity after BCG therapy and might play an important role in the prevention of bladder tumor recurrence.     

Anti-gal-C antibody in autoimmune neuropathies subsequent to mycoplasma infection

Four of 82 patients with Guillain-Barré syndrome (GBS) and 1 of 12 with multifocal motor neuropathy (MMN), who previously had had Mycoplasma pneumoniae infections, had serum antibody to galactocerebroside (Gal-C). Two patients with GBS without mycoplasma infection also had anti-Gal-C antibody, whereas none of the normal or the disease controls had it. As Gal-C is a major glycolipid antigen in myelin, anti-Gal-C antibody may function in the pathogenesis of autoimmune demyelinative neuropathies. Mycoplasma pneumoniae appears to be an important preceding infectious agent in autoimmune neuropathies with anti-Gal-C antibody. © 1995 John Wiley & Sons, Inc.     

1 240例女性生殖道支原体感染分析

目的 为了解生殖道支原体在晚期孕妇、育龄妇女、念珠菌性阴道炎和淋球菌性阴道炎患者中的感染状况。方法 采用套式聚合酶链反应技术，对962例晚期孕妇、85例育龄妇女、90例念珠菌性阴道炎和103例淋球菌性阴道炎患者的宫颈拭子标本进行了生殖道支原体检测。结果 在晚期孕妇、育龄妇女、念珠菌性阴道炎和淋球菌性阴道炎患者中生殖道支原体的检出率分别为4．16％、3．52％、11．1l％和13．59％。结论 生殖道支原体在晚期孕妇、育龄妇女、念珠菌性阴道炎和淋球菌性阴道炎妇女中均有一定的检出率。     

硒和维生素A对支原体肺炎的治疗效果观察

观察硒和维生素A(VA)对支原体肺炎的治疗效果.方法 采用双盲随机对照2×2析因实验设计,选择100例住院支原体肺炎患儿,分为补硒组26例,补VA组23例,补硒和VA组30例以及病例对照组21例,正常组21例.一次补硒量为1mg亚硒酸钠和/或15万单位VA,对照病例组给予常规治疗.结果 与对照组比,治疗后3个补充组的症状和体征缓解天数均有不同程度缩短(P<0.05),补硒组白细胞硒和谷胱甘肽过氧化物酶水平显著上升(P<0.05),补VA、补硒组血清VA水平上升(P<0.01),细胞免疫功能有所改善.结论 硒和VA有协同作用,补充硒或同时加VA,作为辅助治疗支原体肺炎的方法,安全、有效.     

79例人流术后支原体感染分析

７９例人流术后支原体感染分析陆海音，杨红英，周曾娣，张明秋，汤国民Ａｎａｌｙｓｉｓｏｆｋｙｃｏｐｌａｓｍａｓｉｎｆｅｃｔｉｏｎｓｉｎ７９ｗｏｍｅｎｗｉｔｈｉｎｄｕｃｅｉａｂｏｒｔｉｏｎＬｕＨａｉ－ｙｉｎ，ｙａｎｇＨｏｎｇ－ｙｉｎ，ＺｈｏｕＺｅｎｇ－ｄ...     

泌尿生殖道患者沙眼衣原体和支原体检测及支原体药敏分析

目的　检测皮肤性病门诊泌尿生殖道患者沙眼衣原体 (CT)和支原体感染情况及支原体培养加药敏分析。方法　对5 0 95例泌尿生殖道感染者用金标法检测沙眼衣原体抗原 ,用微量肉汤稀释法检测解脲支原体 (Uu)和人型支原体 (Mh)并进行 8种抗生素的药敏试验。结果　 5 0 95例泌尿生殖道感染者中衣原体阳性 417例 ,总阳性率为 8 2 % ,女性患者阳性率 ( 11 2 % )明显高于男性患者阳性率 ( 6 2 % ) ,有显著性差异 ( χ2 =40 1,P <0 0 1) ;检出支原体 172 8例 ,总阳性率为 3 3 9% ,女性患者阳性率 ( 4 3 0 % )明显高于男性患者阳性率 ( 2 8 0 % ) ,有显著性差异 ( χ2 =114 8,P <0 0 1) ;其中Uu感染 ( 12 5 1例 ,2 4 6% )明显高于Mh感染 ( 71例 ,1 4% )和Uu +Mh混合感染 ( 4 0 6例 ,8 0 % )。Uu对红霉素、罗红霉素、交沙霉素、阿奇霉素、强力霉素、美满霉素、氧氟沙星、环丙沙星的高度敏感率分别为 60 3 %、67 5 %、73 2 %、85 3 %、5 5 7%、40 1%、2 5 6%、2 7%。Uu +Mh混合感染对 8种抗生素均出现不同程度的耐药菌株。结论　湖南地区泌尿生殖道感染患者中 ,衣原体、支原体感染处于国内较高水平。支原体对不同种类抗生素有较高的耐药性 ,特别是Uu +Mh混合感染 ;临床上做支原体培养加药敏试验 ,对指导     

女性生殖道不同部位检测支原体的序贯试验分析

目的探讨解脲脲原体和人型支原体在女性生殖道的主要寄生部位.方法采用载量一致的标准无菌棉拭子分别于女性阴道穹窿和宫颈口采样,用法国生物梅里埃ID试剂进行解脲脲原体和人型支原体的培养鉴定及半定量计数,按照双向质反应开放型序贯试验设计,对检测结果进行比较分析.结果阴道穹窿部位标本中两种支原体的总阳性数和≥10^4ccu/ml半定量阳性数均高于宫颈口标本.结论对女性进行生殖道支原体感染的检测时应采集阴道穹窿标本,以提高检出率.