Variable CSF findings in early and late Lyme neuroborreliosis: A follow-up study in 47 patients

The cerebrospinal fluid (CSF) of 37 patients with early Lyme neuroborreliosis (ELN) and of 10 patients with late Lyme neuroborreliosis (LLN, duration of symptoms 7 months) was investigated for typical features differentiating between acute and chronic courses of disease. Individual patients were studied after 2 and 4 weeks, and 3, 6, and 12 months. Patients with ELN presented predominantly with symptoms of the peripheral nervous system, while patients with LLN generally suffered from symtoms of the central nervous system. At the first lumbar puncture, patients with ELN revealed a more intense pleocytosis in the CSF (P < 0.02) and a higher intrathecal synthesis of total IgM (P < 0.0003) and ofBorrelia burgdorferi-specific IgM antibodies (P < 0.01). At the same time, in patients with LLN, the blood-CSF barrier was more severely impaired (P = 0.03), and local production of total IgG (P = 0.0001), ofB. burgdorferi-specific IgG antibodies (P = 0.03) and of total IgA (P = 0.001) was more markedly increased. The quantity of intrathecally producedB. burgdorferi-specific IgA antibodies did not differ between the two study groups. Clinical recovery was usually accompanied by a considerable improvement of the blood-CSF barrier function and pleocytosis. After 6 months, the intrathecal synthesis of total IgG had significantly decreased in patients with ELN but not in those with LLN. At the same time, the CSF of most patients in both study groups still contained intrathecally producedB. burgdorferi-specific IgG antibodies. In the absence of clinical illness or symptoms of inflammation 6 and 12 months after treatment,B. burgdorferi-specific IgG antibodies in the CSF might simply indicate an anamnestic reaction to a previous infection of the central nervous system. Six months after antibiotic treatment, patients with ELN still revealed evidence of intrathecal synthesis of total IgM, whereas those with LLN did not. These antibodies, however, were not related toB. burgdorferi.     

胎儿先天性心脏病筛查方法的研究

为尽早确诊胎儿先天性心脏病(简称先心病),对200例胎儿进行B超心动图检查,发现心脏异常36例(18%),其中先心病26例(13％)。测定有高危因素的103例孕母血清风疹病毒抗体IgM,10例阳性(9.7％),其中7例胎儿有先心病(70%),其灵敏度为70％,特异度为92.3％,可做为胎儿先心病的筛查方法。两项检查合用,可提高胎儿先心病的诊断水平。同时提示胎儿超声心动图检查中增加卵圆孔直径和血流的评定可作为房间隔缺损的诊断标准。     

HBV感染孕妇血清HBVM与TORCH抗体检测

目的了解ＨＢＶ感染孕妇血清ＨＢＶＭ与ＴＯＲＣＨ抗体阳性率。方法应用ＥＬＩＳＡ法筛查出９３例ＨＢＶ感染孕妇,并用ＰＣＲ检测ＨＢＶ－ＤＮＡ。分娩时取脐血测弓形体（Ｔｏｘ）、风疹病毒（ＲＶ）、巨细胞病毒（ＣＭＶ）、单纯疱疹病毒Ⅱ型（ＨＳＶ－Ⅱ）四种病原血清特异性ＩｇＭ和风疹病毒ＩｇＧ抗体。结果９３例ＨＢＶ感染孕妇中ＴＯＲＣＨ总感染率４７．３１％。单项抗体阳性率２５．８１％,７例为２项抗体阳性,２例３项抗体阳性。原发宫内感染以Ｔｏｘ最高（１２．９０％）,ＣＭＶ次之（６．４５％）,随后ＨＳＶ－Ⅱ（５．３８％）,ＲＶ最低（３．２３％）。孕妇ＨＢｓＡｇ阳性组,ＰＣＲＨＢＶ－ＤＮＡ阳性率７６．９２％,ＴＯＲＣＨ感染率６１．５４％。ＨＢｓＡｇ阴性组,ＰＣＲＨＢＶ－ＤＮＡ阳性率３８．８９％,ＴＯＲＣＨ感染率３７．０４％。结论脐血ＴＯＲＣＨ感染率与母血ＨＢｓＡｇ、ＨＢｅＡｇ、ＨＢＶ－ＤＮＡ相关（相关系数分别为０．１４、０．２９、０．１５）。乙肝感染孕妇ＴＯＲＣＨ的抗体筛查对优生优育是非常有用的指标。     

江苏省正常人群破伤风抗体水平监测

用间接血凝法检测了江苏省862名0～39岁正常人的破伤风抗体,结果显示：破伤风抗体阳性率为77．26％,平均抗毒素为0．0543IU／ml,比1985年有极显著提高。不同年龄组中以2～4岁平均抗毒素和保护率最高,3月龄最低,18岁以后随着年龄增长抗体阳性率下降到75％．育龄期妇女抗体阳性率为75．49％,21～30岁生育高峰年龄抗体阳性率仅为69．67％．江苏省南北不同地区人群破伤风免疫水平的差异有极显著的统计学意义,不同性别间差异无显著的统计学意义．     

海南省流动儿童计划免疫现况分析

为更好地了解流动儿童计划免疫管理现况,１９９７年海南省组织了专题调查,发现流动儿童以县内流动为主,流动儿童上卡率为７６．６％,五苗接种率分别为卡介苗６９．４％,脊灰糖丸６５．１％,百白破６３．６％,麻疹５９．９％,ＨＢＶ５６．９％,均远未达到目标要求,脊达抗体ＧＭＴ流动儿童为１：１５３．２０,常住儿童为１：２４３．６１,两者有显著性差异,这表明,加强流动儿垢计划免疫管理,最今后计免工作的重点和难点     

抗核抗体在甲型病毒性肝炎中的检测

目的:探讨抗核抗体在甲型病毒性肝炎中的检测及意义。方法:用间接免疫荧光法对58例正常献血员和39例甲型病毒性肝炎患者进行抗核抗体(ANA)的检测。结果:甲型肝炎中抗核抗体阳性率为77%(339),3例阳性均为甲肝急性期患者。结论:ANA存在甲型肝炎中,虽阳性率低,仍提示甲型病毒性肝炎中可能存在自身免疫现象     

湖南省肾综合征出血热Ⅰ型灭活疫苗效果免疫(感染)增强和免疫策略研究

采用ＩＦＡＴ法检测特异ＩｇＧ荧光抗体,用ＭＣＰＥＮＴ法检测中和抗体滴度,追踪流行病学防病效果。结果表明,该疫苗的安全性较好,总反应率为３１９％,中强反应１８２％,反应以局部一过性疼痛多见,无异常反应。疫苗３针全程免疫后２周、加强前、加强后２周、１年和２年,３年中和抗体阳转率分别为３１４０％、９３３％、８７５０％、５３８５％、３８１０％和３５００％。荧光抗体阳转率分别为８４９１％、２２５０％、８５００％、１５７９％、１０２０％和９０５％。疫苗的流行病学防病效果好,３针全程免疫后（１９９５４）至今（１９９９．３）接种者无人发病,对照组发病８例,保护率为１００００％,观察到试区疫情较四周非试区低,疫苗复盖率达５０％以上,似可有效控制疫情。发现有１例接种者在经过一个流行高峰期后荧光抗体较前呈４周以上增高,但无临床表现。未发现接种人群中有免疫（感染）增强问题。     

2264例海洛因依赖者HIV抗体检测结果分析

目的：了解海洛因依赖者HIV抗体阳性率并对阳性人群的相关情况进行分析。方法：对所有检测病例抽静脉血3ml，先用HIV(1 2)抗体酶联免疫吸附法进行初筛试验，阳性者送浙江省疾病控制中心用蛋白印迹法进行确诊试验，仍为阳性者确诊为HIV抗体阳性。结果：2264例海洛因依赖者中HIV抗体阳性21例，阳性率为0．93％，全部为男性，且全部为有互用针头及注射器行为的静脉注射者，年龄24～39岁，平均29．3岁，多见于原籍新疆、广西等边远贫困地区的无业人员，文化程度多在初中以下。结论：海洛因依赖者，特别是互用针头及注射的静脉注射者是HIV感染高危人群，新疆、广西等边远贫困地区，男性、无业、初中以下文化水平的青壮年感染率高。     

Analysis of the immune response induced by a scorpion venom sub-fraction, a pure peptide and a recombinant peptide, against toxin Cn2 of Centruroides noxius Hoffmann.

Three different immunogens from the venom of the Mexican scorpion Centruroides noxius Hoffmann were used to study protective antibody response in mice and rabbits, challenged with toxin Cn2, one of the most abundant toxic peptide of this venom. The immunogens were: Cn5, a crustacean specific toxin; a recombinant protein containing the peptide Cn5 linked to the maltose transporter and a sub-fraction (F.II.5) containing 25 distinct peptides, among which is Cn5. Mice immunized with these three preparations, when directly challenged with Cn2 presented no apparent protection, whereas anti-sera produced in rabbits with these three immunogens were capable of partially neutralizing the effect of Cn2, when injected into naive mice. Cn5 rabbit anti-serum showed a better protective effect on mice, than the rabbit sera obtained against the two other antigens. The subcutaneous route of challenging mice was shown to be better than intraperitoneal injections. Comparative structural analysis of Cn5 with other toxins of this venom showed that our results are important to be taken into consideration, when choosing appropriate immunogens aimed at the production of better anti-venoms or for the rational design of possible vaccines.     

抗体夹心酶联免疫吸附法测定重组E.coli L-门冬酰胺酶研究

用重组E.coliL-门冬酰胺酶免疫家兔，DEAE-纤维素柱层析纯化IgG，采用二步戊二醛交联法将辣根过氧化物酶标记抗体，建立抗体夹心酶联免疫吸附法，测定大鼠血浆中重组E.coliL-门冬酰胺酶浓度。本测定方法的线性范围为1～64U/L，灵敏度为0.4U/L。建立的抗体夹心酶联免疫吸附法测定大鼠血浆中重组E.coliL-门冬酰胺酶具有良好的精密度、回收率、灵敏度和特异性。