天津市育龄妇女血清中抗风疹病毒抗体分析

测定了天津市区１５３名正常育龄妇女和１０３名有异常孕产史妇女血清中抗风疹病毒（ＲＶ）ＩｇＧ抗体，对其中１８７名妊娠妇女测定了特异性ＩｇＭ。结果显示，正常育龄妇女ＲＶ－ＩｇＧ阳性率为８６．９％，孕妇ＲＶ－ＩｇＭ阳性率为３．２％。有自发流产史妇女ＲＶ－ＩｇＧ滴度显著高于正常妇女（Ｐ＜０．０５），有异常孕产史妇女ＲＶ－ＩｇＧ滴度在四个季度间有显著变化（Ｐ＜０．００５）。提示风疹感染与自发流产关系密切。     

异常孕产史妇女与沙眼衣原体感染关系的研究

本文用聚合酶链反应（ＰＣＲ）检测１５１例异常孕产史妇女和３２例正常孕产史妇女宫颈粘液中沙眼衣原体（ＣＴ）的感染。结果：异常孕产史妇女ＣＴ－ＰＣＲ阳性率为２５１７％,正常孕产史妇女的阳性率为６２５％,两者差异具有显著性（Ｐ＜００５）;其中流产史、死胎史、畸形儿史妇女的阳性率分别为２３１９％、３０５６％和２３９１％。结论：ＣＴ感染极可能是引起异常孕产史的主要原因之一。提出应重视妇女孕前、孕期ＣＴ感染的检测,以防止异常妊娠的出现。     

深圳地区泌尿生殖道解脲支原体和沙眼衣原体感染对妊娠的影响

采用聚合酶链反应（ＰＣＲ）技术，对不孕妇女７９人进行生殖道解脲支原体（ＵＵ）及沙眼衣原体（ＣＴ）检查，结果ＵＵ－ＤＮＡ阳性５６人占（７０．９％），ＣＴ－ＤＮＡ阳性２６人（占３３％），其中１８人ＵＵ－ＤＮＡ和ＣＴ－ＤＮＡ均为阳性。这些患者在治疗不孕症过程中首先治愈ＵＵ或ＣＴ感染，其治疗效果与５１例同类病例进行比较，治愈率有明显提高，差异有极显著意义（Ｐ＜０．０１），结果提示，泌尿生殖道解脲支原体及沙眼衣原体感染与女性不孕症有密切的关系，应引起临床医师的重视。     

单纯疱疹病毒Ⅱ型和人乳头瘤病毒的感染与人工流产术后不孕症的关系

目的探讨性传播病毒和不孕症的关系。方法应用聚合酶链反应（ＰＣＲ）对６０例人工流产术后不孕症妇女和３９例正常妇女进行了生殖道单纯疱疹病毒Ｉ型（ＨＳＶ２）和人乳头瘤病毒（ＨＰＶ）的检测。结果不孕组和对照组ＨＳＶ２的阳性检出率分别是８０．０％和２５．５％，两组间有极显著性差异（Ｐ＜００１）；ＨＰＶ的阳性率分别是５３３％和３３３％，两组间无显著性差异（Ｐ＜０．０５）；ＨＳＶ和ＨＰＶ在两组中的混合感染的阳性率分别是４３．３％（２６／６０）和２３．１％（９／３９），两者有显著性差异（Ｐ＜０．０５）。表明ＨＳＶ２或ＨＳＶ２和ＨＰＶ的混合感染与人工流产术后不孕症有显著的相关性，很可能是不孕的原因之一。两组９９份标志中，ＨＳＶ２和ＨＰＶ混合感染的阳性率为３５．３５％，统计学分析表明，ＨＳＶ２和ＨＰＶ感染与不孕有极显著的相关性χ＝１２．５，Ｐ＜０．０１。结论ＨＳＶ２和ＨＰＶ的感染和不孕症相关     

4212例泌尿生殖道感染沙眼衣原体PCR检测研究

４２１２ 例泌尿生殖道感染患者沙眼衣原体（ＣＴ） 行ＰＣＲ 检测，总阳性率２２－７９％ ；ＣＴ 阳性者中，合并１３ 项其他（ＮＧＨ、ＵＵ、ＨＰＶ）感染的占６８－７５％ ，ＣＴ 感染率男性（２２－８６ ％） 与女性（２２－７６％ ）十分相近，但合并感染率女性（７１－４３ ％ ）显著高于男性（６２－５ ％） ，Ｐ＜ ０－０１。本组结果显示，ＣＴ 主要通过性接触传染。     

阴道炎患者的生殖支原体套式PCR检测研究

目的：研究生殖支原体（Ｍｇ）感染与女性阴道炎的关系。方法：应用套式ＰＣＲ技术检测了１５３ 例阴道炎患者以及３８ 例健康妇女的阴道分泌物中的ＭｇＤＮＡ。结果与结论：健康妇女Ｍｇ 的阳性检出率为５．３％（２／３８），阴道炎妇女Ｍｇ 的阳性检出率高达３７．３％（５７／１５３）。后者明显高于前者（ Ｐ＜ ０．０１）。经计算Ｍｇ 感染对阴道炎的相对危险性高达１０．７（ Ｐ＜ ０．０１）。表明Ｍｇ 感染与女性阴道炎相关。     

TORCH感染与自然流产相关性研究

应用ＥＬＩＳＡ法,对３１２名正常育龄妇女和１９７名有自然流产史妇女,和应用ＰＣＲ技术,对１４例流产组织同时进行ＴＯＲＣＨ感染检测。有自然流产史妇女活动性感染率分别为ＣＭＶ２３．９６％、ＲＶ１６．４３％、Ｔｏｘ１１．５４％、ＨＳＶⅡ５．３６％。明显高于对照组（Ｐ＜０．０１）。１４例流产组织中ＴＯＲＣＨ－ＤＮＡ阳性１１例,感染率７８．５７％（１１／１４）,其中两种以上病原体感染７例,占感染总数的６３．６４％（７／１１）。表明：妇女ＴＯＲＣＨ感染与自然流产有相关性。孕早期活动性感染和两种以上病原体的混合感染对胎儿影响非常显著,造成现症流产。     

沙眼衣原体套式（Nested）PCR检测研究

本文报告沙眼衣原体（ＣＴ）的套式（Ｎｅｓｔｅｄ）ＰＣＲ检测方法，本方法ＣＴ隐匿性质粒为靶基因，外套引物采用国外学者所报告灵敏度和特异性较高的序列，内套引物自行设计，经方法学考核表明本法灵敏度和特异性极高。１４６例临检标本套式ＣＴ，ＰＣＲ阳性检出率为３６．３％而市售ＰＣＲ试剂盒（其引物序列与本文外套引物相同）阳性检出率仅为４．１％，前者明显高于后者（Ｐ〈０．０１）。     

NIDDM患者不同血管并发症ApoE基因型频率分布的研究

采用多聚酶链反应（ＰＣＲ），研究ＮＩＤＤＭ患者不同血管并发症ＡｐｏＥ基因型及其等位基因频率分布。结果：（１）并发冠心病（ＣＨＤ）组∈３／３基因型频率为５２％，显著低于对照组７６％（Ｐ＜０．０１）；∈４／３基因型频率为３４％，显著高于对照组１２％（Ｐ＜０．０１）；∈４等位基因频率为２１％，显著高于对照组９％（Ｐ＜０．０５），∈３频率为７４％，显著低于对照组８６％（Ｐ＜０．０５）。（２）大血管病变组∈３／３、∈４／３、∈４频率分别为５６％、３０％、２０％；∈３／３低于，∈４／３、∈４高于对照组（Ｐ＜０．０５）。（３）高血压组和微血管病变组亦有类似变化，但差异无统计学意义。因此推断，∈４等位基因增加ＮＩＤＤＭ患者血管并发症，尤其是ＣＨＤ的危险性。     

NIDDM患者不同血管并发症ApoE基因型频率分布的…

采用多聚酶链反应（ＰＣＲ），研究ＮＩＤＤＭ患者不同血管并发症ＡｐｏＥ基因型及其等位基因频率分布。结果：（１）并发冠心病（ＣＨＤ）组∈３／３基因型频率为５２％，显著低于对照组７６％（Ｐ〈０．０１）；∈４／３基因型频率为３４％，显著高于对照组１２％（Ｐ〈０．０１）；∈４等位基因频率为２１％，显著高于对照组９％（Ｐ〈０．０５），∈３频率为７４％，显著低于对照组８６％（Ｐ〈０．０５）。（２）大血管病变组∈     

PCR法检测不孕症妇女二种病原体(CT,UU)结果分析

目的 :探讨不孕症患者沙眼衣原体 (CT)和解脲支原体 (UU)感染的相关性。方法 :采用聚合酶链反应 (PCR)技术对 1 31 6例不孕症患者及 1 84例正常对照者进行宫颈沙眼衣原体 (CT)和解脲支原体 (UU)检测。结果 :不孕组宫颈分泌物的CTDNA和UUDNA阳性检出率显著高于对照组 (p <0 0 1 )。 结论 :对不孕症患者 ,尤其对原因不明的不孕症、继发性不孕症患者 ,应将生殖道CT及UU检测列为常规     

Serological study of parvovirus B19 infection in women with recurrent spontaneous abortions

The feto-pathogenic association of parvovirus B19 (B19) has been sparingly studied in women with abortion, but not in women with recurrent spontaneous abortions (RSA). Serum samples from 116 women with RSA who were pre-screened for S-TORCH, Chlamydia trachomatis infections, anatomical, chromosomal, endocrinal abnormality and Rh incompatibility and those who had no such known causes of abortion were included in the study. Sera were also collected from 136 normal pregnant women and 120 normal non-pregnant women as disease and normal control respectively. All sera were tested at 1:400 dilutions for B19 IgM by in-house ELISA using cloned and baculovirus expressed VP1 and VP2 antigens of B19. The frequency of anti-B19 IgM antibodies in women with RSA was 19.8%, in pregnant females it was 11% and in normal non-pregnant female was 5%. Sera of 23 women with RSA which were positive for B19 IgM tested negative for B19 DNA by PCR. Patients with RSA should be screened for B19 infection and guidelines for treatment should emerge.     

Chlamydia trachomatis: impact on human reproduction

Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections (STI) recognized throughout the world. Worldwide, the magnitude of morbidity associated with sexually transmitted chlamydial infections is enormous. C.trachomatis is a common cause of urethritis and cervicitis, and sequelae include pelvic inflammatory disease (PID), ectopic pregnancy, tubal factor infertility, epididymitis, proctitis and reactive arthritis. The sharp worldwide increase in the incidence of PID during the past two decades has led to the secondary epidemics of tubal factor infertility and ectopic pregnancy. Chlamydial PID is the most important preventable cause of infertility and adverse pregnancy outcome. Chlamydial infections, like STI in general, are primarily a woman's health care issue since the manifestations and consequences are more damaging to the reproductive health in women than in men. Based on the available evidence, approximately 20% of women with chlamydial lower genital tract infection will develop PID, approximately 4% develop chronic pelvic pain, 3% infertility, and 2% adverse pregnancy outcome. However, these estimates are based on relatively weak evidence. Research on the link between C.trachomatis and male aspects of infertility has been much more limited. Currently recommended treatment regimens include azithromycin in a single dose or doxycycline for 7 days. These therapies are highly efficacious. Timely management of sex partners is essential for decreasing the risk for re-infection. Immunopathogenesis of C.trachomatis infection is one of the main focal points of current research into Chlamydia. Chlamydial infection fills the general prerequisites for disease prevention by screening, i.e. chlamydial infections are highly prevalent, usually asymptomatic, are associated with significant morbidity, can be reliably diagnosed, and are treatable. Screening programmes for C.trachomatis will be of paramount importance in the prevention of long-term sequelae. The cost of screening is only a fraction of the health care costs incurred due to complications resulting from undiagnosed and untreated chlamydial infections. Current strategies to control C.trachomatis still largely depend on clinic-based screening of symptomatic patients, and have not been successful. The development of highly sensitive and specific nucleic acid amplification tests for the diagnosis of chlamydial infections has been an important advance in the ability to conduct population-based screening programmes to prevent complications. Thus, the case for screening is clearly made, but much detail remains to be worked out.     

血清中EmAb、AsAb、UU及CT水平与女性不孕不育的关系

目的探讨血清中抗子宫内膜抗体（EmAb）、抗精子抗体（AsAb）、解脲支原体（uu）及沙眼衣原体（CT）水平与女性不孕不育的关系及其临床应用价值。方法2011年6月至2014年5月采用酶联免疫法测定120例不孕不育患者及120例健康女性体检者（对照组）血液EmAb、AsAb蛋白表达水平,应用胶体金方法测定两组血清中UU及CT水平。结果不孕不育组血清中EmAb、AsAb、UU、CT阳性率分别为81．67％、76．67％、68．33％、70．83％高于对照组6．67％、4．17％、10．00％、6．67％,与单一检测相比,血清及宫颈粘液中EmAb、AsAb、UU及CT联合检测的准确性、灵敏性、阳性预测值、阴性预测值较高,差异有统计学意义（P〈0．05）。结论Emhb、Ashb、UU及CT水平与女性不孕不育具有密切的关系,可作为女性不孕不育的常规检查项目。通过联合检测的方法可提高诊断灵敏性及特异性。     

拟诊为淋病患者中泌尿生殖道沙眼衣原体基因分型及序列分析

目的 了解深圳市拟诊为淋病患者中泌尿生殖道沙眼衣原体的合并感染情况及其基因型分布和序列变异特点.方法 采集401例拟诊为淋病患者的泌尿生殖道分泌物样本,应用Roche Amplicor全自动核酸检测系统对样本进行淋球菌和沙眼衣原体双检,提取DNA,应用巢式聚合酶链反应(nested-PGR)扩增沙眼衣原体主要外膜蛋白基因(omp1)中的VS1～VS2片段,并对其进行序列测定,所获得的序列利用Mega4.0软件与标准参考株进行比对,分析确定其基因型及序列变异情况.结果 401例拟诊为淋病患者中淋球菌的感染率为82.3%(330/401),沙眼衣原体的感染率为24.2%(97/401),淋球菌和沙眼衣原体的合并感染率为21.7%(87/401).97份沙眼衣原体阳性样本中获得73份沙眼衣原体基因片段序列,共检出8个基因型,分别为E型(27.4%)、G/Ga型(23.3%)、D/Da型(16.4%)、F型(13.7%)、J型(11.0%)、H型(5.5%)、B和K型(各1.4%).序列分析发现3例(4.1%)菌株发生错义突变,分别为D/Da型、E型、G/Ga型;F型、H型、J型和K型序列虽多见碱基突变,但均为同义突变.结论淋病患者合并感染沙眼衣原体的比例较高,且泌尿生殖道沙眼衣原体的基因型以E、G/Ga、D/Da和F型为主.序列分析可以为泌尿生殖道沙眼衣原体的分子流行病学研究提供依据.     

Reduced levels of gamma-interferon secretion in response to chlamydial 60 kDa heat shock protein amongst women with pelvic inflammatory disease and a history of repeated Chlamydia trachomatis infections

Peripheral lymphocytes in uninfected fertile controls, women with various histories of Chlamydia trachomatis infection, pelvic inflammatory disease (PID) and infertility not due to C. trachomatis infection (endometriosis) were cultured overnight with PHA mitogen and the 60 kDa chlamydial heat shock protein. Plasma samples were then assayed for levels of gamma-interferon and IL-10 using a commercial ELISA system. Women with PID and those with a history of multiple C. trachomatis infections showed reduced gamma-interferon production in response to cHSP60, not seen in women infected only once and those with infertility due to other causes (endometriosis). Secretion of IL-10 in response to cHSP60 did not vary significantly across the various patient groups, though all patients showed elevated levels of total IL-10 compared with uninfected controls.     

Seroprevalence of Chlamydia trachomatis in women with bad obstetric history and infertility

50 sera each from women with infertility, bad obstetric history and healthy pregnant women were tested for the presence of antichlamydial IgG antibodies. Antichlamydial IgG antibodies were present in 68% of women with infertility, 50% of women with bad obstetric history and 10% in healthy pregnant women. As culture methods are cumbersome so diagnosis can be made by serological tests, which are sensitive, specific and non invasive. Chlamydia trachohmatis is one of the most common bacterial sexually transmitted disease and most infections caused by Chlamydia trachomatis being asymptomatic, result in a large reservoir of unrecognized, infected individuals capable of transmitting the infection to sexual partners. Chlamydia trachomatis if detected earlier and given proper treatment, can minimize the complications in these patients.     

抗子宫内膜抗体和抗精子抗体在临床中的价值探讨

目的探讨抗精子抗体和抗子宫内膜抗体在临床上检测原发性不孕和复发性自然流产的价值。方法回顾性分析2018年1月至2018年12月在复旦大学附属妇产科医院诊治的原发性不孕患者及复发性自然流产患者病史,以同期进行常规检查的孕妇作为对照,对比研究对象抗子宫内膜抗体、抗精子抗体的水平,分析抗子宫内膜抗体、抗精子抗体在原发性不孕和复发性自然流产中可能的相关性。结果收集到原发性不孕患者170例及复发性自然流产患者238例病史资料,以同期进行常规检查的孕妇208例作为对照组。原发性不孕患者抗精子抗体检测阳性例数显著高于对照组,但抗子宫内膜抗体并无显著改变;复发性自然流产患者抗子宫内膜抗体检测阳性率显著高于对照组,但抗精子抗体并无明显不同;早孕期流产患者抗精子抗体检测阳性率显著高于对照组;发生复发性自然流产在4次以上的病人,其体内抗子宫内膜抗体和抗精子抗体的水平均显著高于对照组。结论抗子宫内膜抗体和抗精子抗体检测在复发性自然流产和原发性不孕患者中具有相关的临床价值,应加强备孕人群的筛查工作,及早干预。     

Intranasal immunization induces long-term protection in mice against a Chlamydia trachomatis genital challenge.

In an attempt to confer long-term protective immunity, BALB/c female mice were immunized intranasally with 10(4) inclusion-forming units (IFU) of the Chlamydia trachomatis mouse pneumonitis biovar (MoPn). Animals were subsequently challenged in the ovarian bursa with 10(5) C. trachomatis MoPn IFU at 60, 120, or 180 days post-intranasal immunization. Two control groups were included in the study. One control was sham immunized and mock challenged, and another group was sham immunized and challenged with 10(5) C. trachomatis MoPn IFU. Vaginal cultures were collected at regular intervals following the intrabursal challenge. In comparison with the sham-immunized mice, the animals that were intranasally immunized with C. trachomatis had significant protection, as shown by a reduction in the number of animals that had positive vaginal cultures and by a decrease in the intensity and length of the shedding. Furthermore, histopathological characterization of the genital tract following challenge, in the three groups of mice, showed a minimal inflammatory infiltrate in the C. trachomatis-immunized animals, when compared with the sham-immunized control group. Subsequently, the three groups of female mice that were challenged at 60, 120 and 180 days postimmunization were mated at 6 weeks following the challenge. Overall, in the mice intranasally immunized with C. trachomatis the fertility rates and the number of embryos were similar to those in the sham-immunized and mock-challenged group. In contrast, there was a significant increase in infertility in the groups of mice that were sham immunized and C. trachomatis challenged. In conclusion, intranasal immunization with C. trachomatis induces long-term protection against a genital challenge as shown by a decrease in the infection and infertility rates when compared with sham-immunized animals. Thus, this model may help to characterize the parameters of the immune response that are important in maintaining long-term protection and may aid in identifying the antigenic determinants involved in eliciting protection.     

荧光定量PCR检测新疆地区不孕不育患者UU、CT结果分析

目的利用实时荧光定量PCR技术了解新疆地区不孕不育患者解脲支原体（UU）和沙眼衣原体（CT）感染情况,通过对实验结果的统计学处理分析不孕不育与UU、CT感染率及感染量之间的关系,方法采用实时荧光定量PCR技术检测新疆地区不孕不育患者及能正常生育人群解脲支原体-DNA和沙眼衣原体-DNA含量并进行统计学分析。结果不孕不育患者UU-DNA阳性率52.18%,CT-DNA阳性率3.65%,正常对照组则分别为46.08%、1.00%,两组间的差异显著性有统计学上的意义,不孕不育组UU和CT的感染率明显高于对照组（P〈0.05）。不同性别,不用民族的UU阳性检出率不同。结论新疆地区不孕不育患者中UU和CT感染是引起男女不孕不育的重要原因之一,且女性UU阳性率高于男性,维吾尔族UU阳性率高于其它民族。