全国哨点监测性病流行情况初步分析(1993-1996)

目的 　了解我国性病的现况、流行趋势和有关因素 ,作为制订性病防治规划的依据。方法　 我国在 1 993～ 1 996年建立了性病哨点监测系统。该系统在原有性病发病较高的 1 6个城市监测点的基础上进行调整 ,在全国建立了 2 6个性病监测哨点。对哨点加强管理 (如督导和反馈 ) ,收集完整的监测资料 ,并进行专项调查。结果　 4年内哨点监测系统共报告性病 2 0 2 86 6例 ,年平均发病率为 1 41 .46 / 1 0万 ,发病率逐年增长 ,但其速度较过去有所减慢。报告的病例男性多于女性 ,其性别比有逐年下降趋势。 2 0～ 39岁组患者占病例数的 82 .37% ,但儿童性病比过去明显增加。城市哨点发病率最高( 1 81 .86 / 1 0万 )。淋病仍为优势病种 ,但其发病呈逐年下降趋势 ;梅毒增加较快 (包括儿童梅毒 )。此系统已开始有 HIV/ AIDS病例的个别报告。在传染源中 ,暗娼占有相当高的比例。结论　 哨点监测系统由于加强了管理 ,能较准确地描述当地的性病流行情况 ,特别是其流行趋势。     

重症急性胰腺炎并发深部真菌感染21例分析

目的探讨SAP并发深部真菌感染的易感因素以及防治的方法。方法分析1998年9月至2004年10月收治的81例SAP患者资料，其中并发深部真菌感染的21例作为真菌感染组，其余60例作为非感染组，比较两组患者的诊治方法与措施，分析真菌感染的危险因素。结果经糖皮质激素应用、腹腔灌洗、胃肠减压等一系列诊治措施，真菌感染组19例患者病愈出院，2例死亡。两组在糖皮质激素应用、中心静脉置管、全胃肠外营养、空肠营养、呼吸机支持、腹腔灌洗和囊肿穿刺等方面差异显著（P〈0．05）。结论糖尿病、老年、呼吸机支持和重症监护客观因素等为真菌感染的危险因素。合理应用抗生素和预防性应用抗真菌药物可以减少感染机会，提高SAP的救治存活率。     

Abdominal zygomycotic thromboangiitis in a patient with AML and t(1;13;14)

 The case report of a 61 year-old man with AML M2 FAB, t(1; 13; 14) and zygomycotic mesenterial thromboangiitis is presented. Two induction cycles of chemotherapy were administered due to primary drug resistance. They were complicated by pneumonia, colonic pseudo-obstruction and perforation with peritonitis. The patient died on the 40th day of therapy, 4 days after undergoing palliative surgery. Zygomycotic thromboangiitis, which very probably contributed to the intestinal perforation, was confirmed morphologically at necropsy. The novel complex chromosomal translocation t(1; 13; 14) (q31; q32; q24) and the problems connected with the diagnosis of invasive fungal infections are discussed. Received: 26 January 1996 / Accepted: 12 June 1996     

左氧氟沙星治疗细菌性感染70例

目的：观察左氧氟沙星治疗细菌感染的疗效和安全性。方法：以左氧氟沙星治疗细菌性感染７０例（男性３５例，女性３５例，年龄５４±ｓ１５ａ），其中下呼吸道感染４０例，尿路感染３０例，剂量一般为０．２ｇ，ｐｏ，ｂｉｄ，疗程７～１４ｄ；单纯性下尿路感染为０．２ｇ，ｐｏ，ｑｄ，疗程５～７ｄ。结果：总有效率９３％，细菌清除率８８％，不良反应轻微，呈一过性，发生率为６％。结论：左氧氟沙星治疗细菌性感染有效而安全。     

Rapid diagnosis of parasitic diseases: current scenario and future needs

Background

Parasitic diseases are one of the world's most devastating and prevalent infections, causing millions of morbidities and mortalities annually. In the past, many of these infections have been linked predominantly to tropical or subtropical areas. Nowadays, however, climatic and vector ecology changes, a significant increase in international travel, armed conflicts, and migration of humans and animals have influenced the transmission of some parasitic diseases from ‘book pages’ to reality in developed countries. It has also been noted that many patients who have never travelled to endemic areas suffer from blood-borne infections caused by protozoa. In the light of existing knowledge, this new trend can be explained by the fact that in the process of migration a large number of asymptomatic carriers become a part of the blood bank donor and transplant donor populations. Accurate and rapid diagnosis represents the crucial weapon in the fight against parasitic infections.

HLA-A,B,C and DR antigen frequencies in acquired immunodeficiency syndrome (AIDS) patients with opportunistic infections

During the past three years, an epidemic of acquired immunodeficiency syndromes (AIDS) involving the presence of specific forms of cancer (notably Kaposi's sarcoma) and infection (e.g., pneumocystis carinii) ordinarily seen only in severely immunosuppressed hosts has occurred among active homosexuals, Haitian immigrants, drug users, and hemophiliacs in large cities in the United States and elsewhere. An as yet unidentified viral agent is presumably the cause of the initial immunodeficiency and host genetic factors may influence the subsequent development of different clinical symptoms in different patients. We have previously reported that the HLA antigens DR5 and DR2 are associated with susceptibility to Kaposi's sarcoma (KS) in different Caucasian subpopulations. We now have also noted that AIDS patients with opportunistic infections have a normal frequency of DR2 and DR5 and a significantly increased frequency of DR3 and that the ultimate clinical expression of AIDS in patients with unexplained lymphadenopathy may depend upon genetic factors associated with these particular DR types.     

Intestinal Spirochetosis and Acquired Immunodeficiency Syndrome: Ultrastructural Studies of Two Cases

Two cases of intestinal spirochetosis (IS) with acquired immunodeficiency syndrome are reported. In case 1, a 48-year-old homosexual black man presented with a 1-month history of alternating watery diarrhea and constipation, which dissipated following the removal of two colonic hyperplastic polyps containing IS. In case 2, a 26-year-old homosexual black man presented with a 3-month history of persistent bloody diarrhea and was found to have chronic shigellosis and IS. Pathologic findings of IS were similar in both cases. Basophilic fringes typical of IS covered the surfacing colonic epithelium and consisted of dense growths of spirochetes adherent to and oriented perpendicular to the plasma membranes of the surfacing epithelium. The spirochetes measured 3 to 5 μm in length and 0.2 (im in width, contained four to eight axial fibrils, and closely resembled Brachyspira aalborgi ultrastructurally. These cases are notable because the histopathologic changes of IS were more extensive than generally described. There was involvement of both the right colon and rectum by IS in case 2, and in both cases there was extension of the IS down into the crypts of Lieberkiihn, spirochetal invasion of the colonic mucosa, and a conspicuous inflammatory response by macrophages in the underlying lamina propria.     

Dominant IgM synthesis against the soluble form of the prevailing variant surface glycoprotein from TeAp-N/D1 Trypanosoma equiperdum throughout the experimental acute infections of horses with non-tsetse transmitted Trypanozoon parasites

ABSTRACT

Two horses were infected with distinct non-tsetse transmitted Trypanozoon Venezuelan stocks, namely TeAp-N/D1 Trypanosoma equiperdum and TeAp-El Frio01 Trypanosoma evansi. Preceding reports have revealed that a 64-kDa antigenic glycopolypeptide (p64), which is the soluble form of the predominant variant surface glycoprotein from TeAp-N/D1 T. equiperdum, can be used as a good antigen for immunodiagnosis of animal trypanosomosis. Here, the course of the experimental acute infection in both horses was monitored by evaluating total anti-p64 IgG and particular anti-p64 γ-specific IgG and μ-specific IgM isotypes in sera using indirect enzyme-linked immunosorbent assays. Both equines showed a maximum of whole anti-p64 antibody generation, which dropped to readings below the maximum but always above the positive cutoff point. Levels of specific IgG and IgM isotypes oscillated throughout the course of the experiments. Essentially, the γ-specific IgG response remained very close to the cutoff point, whereas the μ-specific IgM response displayed values that were mostly above the positive cutoff point, showing a major peak that coincided with the maximum of complete anti-p64 IgG production. These results showed that horses infected with non-tsetse transmitted Trypanozoon parasites developed an immune reaction characterized by a dominant IgM generation against the p64 antigen.     

Histopathology of mixed anaerobic intraabdominal infection in mice

Summary This study characterized acute peritonitis and chronic abscess formation resulting from experimental mixed anaerobic infection withBacteroides melaninogenicus andFusobacterium necrophorum. At intervals after infection liver and spleen samples were obtained, fixed, and processed for histological examination. An acute to chronic infection progressed in mice infected with this mixture of anaerobic bacteria, whereas, no infection resulted when either organism was injected alone. Acute inflammatory cell infiltrates were noted in tissue samples at 12 h postinfection. Small, discrete areas of liver cell necrosis with neutrophilic infiltrates were observed as early as 24 h. By 48 h after infection the liver parenchyma was infiltrated with both acute and chronic inflammatory cells, with moderate to severe hepatocyte degeneration recognized at 72 h. Large intrahepatic abscesses were present in the subphrenic (upper lobe) area 2 to 6 weeks after experimental infection.     

Selective IgG subclass deficiency: quantification and clinical relevance

Each of the four human IgG subclasses exhibits a unique profile of effector functions relevant to the clearance and elimination of infecting microorganisms. The quantitative response within each IgG subclass varies with the nature of the antigen, its route of entry and, presumably, the form in which it is presented to the immune system. This results in antibody responses to certain antigens being predominantly or exclusively of a single IgG subclass. An inability to produce antibody of the optimally protective isotype can result in a selective immunodeficiency state. This is particularly apparent for responses to certain bacterial carbohydrate antigens that are normally of IgG2 isotype. A failure to produce the appropriate specific antibody response may result in recurrent upper and/or lower respiratory tract infection. Careful patient investigation can identify such deficiencies and suggest appropriate clinical management. In this review we outline the biology and clinical relevance of the IgG subclasses and summarize current rational treatment approaches.