新兵人群A群流行性脑脊髓膜炎抗体的血清流行病学调查

Objective To investigate the distribution of serogroup A epidemic cerebrospinal meningitis antibody IgG in recruits, provide scientific evidence for further prevention and control of the disease. Methods By using ELISA, serogroup A epidemic cerebrospinal meningitis antibody IgG serum samples of 360 recruits, who came from 7 provinces during the past four years, were detected, and the positive rate was analysed. Results There was no statistical difference in serum serogroup A epidemic cerebrospinal meningitis antibody IgG levels in each years, which ranged from 66.67% to 96.67% with a average rate of 83.33%, content of antibody ranged from 6.23 μg/mL to 26.47 μg/mL with an average content of 12.42 μg/mL, regional difference existed. The higher level found in recruits from Hubei (96.67%) 、Shandong (91.43%)and Beijing (88.00%), and lower level from Henan (66.67%) and Shaanxi(72.50%). There was no significant correlation between the antibody IgG positive rate and education or occupation background of the recruits before their recruitment (χ2 = 0.12, P > 0.05). Conclusions The positive rate of serogroup A epidemic cerebrospinal meningitis antibody IgG in recruits range from 66.67% to 96.67%, antibody level range from 6.23 μg/mL to 26.47 μg/mL, with a average content of 12.42 (μg/mL. The positive rate for antibody IgG varies in different provinces. It is necessary to give vaccination and education for the recruits to prevent serogroup A epidemic cerebrospinal meningitis spreading.     

广西急性脑炎脑膜炎症候群的监测与研究

Objective To estimate disease burden and epidemiological characteristics of acute meningitis/encephalitis,and provide the basis for the disease control strategy development.Methods A syndrome surveillance system was established in Guigang city with a population of 5 020 000.For the suspected cases, serum and CSF were collected,and bacterial culture,latex agglutination test,real-time PCR and ELISA tests were carried out. All involved cases were identified to 6 categories according to WHO case definition. Results 1424 suspected cases were evaluated in a surveillance of 30 months,yielding the incidence,mortality and mortality of 11.35/100 000(1424/12 546 500 person years),0.43/100 000(54/12 546 500 person years),3.79%(54/1424)respectively.A total of 103 and 51 cases were confirmed for JE,bacterial meningitis,with a incidence of 0.82/100 000(103/12 546 500 person years),0.41/100 000(51/12 546 500 person years).96.10%(99/103)of JE sases and 37.30%(19/51)bacterial meningitis cages occurred in＜10 years old children and＜5 years old children.A clinical misdiagnosis rate of 19.42%(20/103)and 15.69%(8/51)were obserred for JE and bacterial meningitis.Conclusion Acute encephalitis,meningitis syndrome can cause a higher burden of disease.of which the main components of viral encephalitis.Most of syndrome is occurred in summer and autumn,mainly reported in children of younger than 10 years old.A quite misdiagnosis would be made among meningitis and encephalitis syndrome cases.     

广西急性脑炎脑膜炎症候群的监测与研究

Objective To estimate disease burden and epidemiological characteristics of acute meningitis/encephalitis,and provide the basis for the disease control strategy development.Methods A syndrome surveillance system was established in Guigang city with a population of 5 020 000.For the suspected cases, serum and CSF were collected,and bacterial culture,latex agglutination test,real-time PCR and ELISA tests were carried out. All involved cases were identified to 6 categories according to WHO case definition. Results 1424 suspected cases were evaluated in a surveillance of 30 months,yielding the incidence,mortality and mortality of 11.35/100 000(1424/12 546 500 person years),0.43/100 000(54/12 546 500 person years),3.79%(54/1424)respectively.A total of 103 and 51 cases were confirmed for JE,bacterial meningitis,with a incidence of 0.82/100 000(103/12 546 500 person years),0.41/100 000(51/12 546 500 person years).96.10%(99/103)of JE sases and 37.30%(19/51)bacterial meningitis cages occurred in＜10 years old children and＜5 years old children.A clinical misdiagnosis rate of 19.42%(20/103)and 15.69%(8/51)were obserred for JE and bacterial meningitis.Conclusion Acute encephalitis,meningitis syndrome can cause a higher burden of disease.of which the main components of viral encephalitis.Most of syndrome is occurred in summer and autumn,mainly reported in children of younger than 10 years old.A quite misdiagnosis would be made among meningitis and encephalitis syndrome cases.     

自身免疫性肝炎与病毒性肝炎的临床病理特点对照研究

Objective To explore the character of clinical manifestations and liver pathological features of autoimmune hepatitis (AIH) and improve the diagnostic accuracy in early stage of AIH patients. Methods 78 patients with AIH,31 patients with acute viral hepatitis(AH) and 31 patients with chronic hepatitis B (CHB) were collected. The liver function and immunoglobulins were compared among them as well as the comparison of chronic and acute onset AIH groups. A part of patients underwent liver, biopsy and HBsAg immunohistochemistry examination. Results AIH patients were dominated by female (94.87%) over 40 years old (78.21%). The level of AST/ALT, γ-glutamyl transferase (CGT), alkaline phosphatase(ALP), IgG, IgM and γ-globulin in AIH group were significantly higher than those in CHB and AH groups. Furthermore, the level of γ-globulin in chronic AIH group was higher than that in acute onset AIH group (P< 0.05). The positive rate of smooth muscle antibody(SMA) was 6.41%, and the positive rate of anti-nuclear antibody(ANA) was 79.49% in AIH patients. There was no difference in the titer of ANA between acute and chronic AIH groups(P> 0.03). Regarding the appearance of liver pathology, it was easy to distinguish AIH from AH, but difficult to differentiate AIH from CHB. liver tissues, loose degeneration, spotty necrosis and piecemeal necrosis accompanying with bridging necrosis were very common in AM. There were great numbers of lymphocyte infiltration in portal area that was often accompanied with varying degrees of fibrosis. The degree of hepatic inflammation and fibrosis were similar in acute and chronic AIH ( P > 0.05). Ihe degree of hepatic lesions in 2 AIH patients suffered with subacute liver failure didn' t agree with the severe clinical manifestations. Conclusions AIH patients are dominated with female over 40-year-old who often accompanied with elevation of AST/ALT, GGT, ALP and y-globulin as well as the appearance autoantibodies. The appearance of liver pathology is multiplicity that piecemeal of necrosis accompanying with bridging necrosis and lymphocytes infiltration is common. The degree of hepatic lesions is similar in aeute and chronic AIH. It's important to check the liver tissue for diagnose in early stage correctly.     

自身免疫性肝炎与病毒性肝炎的临床病理特点对照研究

Objective To explore the character of clinical manifestations and liver pathological features of autoimmune hepatitis (AIH) and improve the diagnostic accuracy in early stage of AIH patients. Methods 78 patients with AIH,31 patients with acute viral hepatitis(AH) and 31 patients with chronic hepatitis B (CHB) were collected. The liver function and immunoglobulins were compared among them as well as the comparison of chronic and acute onset AIH groups. A part of patients underwent liver, biopsy and HBsAg immunohistochemistry examination. Results AIH patients were dominated by female (94.87%) over 40 years old (78.21%). The level of AST/ALT, γ-glutamyl transferase (CGT), alkaline phosphatase(ALP), IgG, IgM and γ-globulin in AIH group were significantly higher than those in CHB and AH groups. Furthermore, the level of γ-globulin in chronic AIH group was higher than that in acute onset AIH group (P< 0.05). The positive rate of smooth muscle antibody(SMA) was 6.41%, and the positive rate of anti-nuclear antibody(ANA) was 79.49% in AIH patients. There was no difference in the titer of ANA between acute and chronic AIH groups(P> 0.03). Regarding the appearance of liver pathology, it was easy to distinguish AIH from AH, but difficult to differentiate AIH from CHB. liver tissues, loose degeneration, spotty necrosis and piecemeal necrosis accompanying with bridging necrosis were very common in AM. There were great numbers of lymphocyte infiltration in portal area that was often accompanied with varying degrees of fibrosis. The degree of hepatic inflammation and fibrosis were similar in acute and chronic AIH ( P > 0.05). Ihe degree of hepatic lesions in 2 AIH patients suffered with subacute liver failure didn' t agree with the severe clinical manifestations. Conclusions AIH patients are dominated with female over 40-year-old who often accompanied with elevation of AST/ALT, GGT, ALP and y-globulin as well as the appearance autoantibodies. The appearance of liver pathology is multiplicity that piecemeal of necrosis accompanying with bridging necrosis and lymphocytes infiltration is common. The degree of hepatic lesions is similar in aeute and chronic AIH. It's important to check the liver tissue for diagnose in early stage correctly.     

Analysis of TORCH screening results of 330 115 reproductive-age females who underwent pre-pregnancy health examination in Shenzhen北大核心CSCD

Objective To analyze the results of TORCH screening for reproductive-age females who underwent pre-pregnancy health examination in Shenzhen to guide scientific pregnancy preparation. Methods Cross-sectional study was performed on the TORCH screening results of 330 115 reproductive-age females who participated in free pre-pregnancy health examination in Shenzhen from January, 2013 to December, 2019. The ?2 test was used to analyze the differences of TORCH screening results among reproductive-age females in different years, administrative regions and demographic characteristics. Results The overall positive rates of screening for rubella virus (RV)- IgG, cytomegalovirus (CMV)-IgG, CMV-IgM, toxoplasma gondii (TOX)-IgG and TOX-IgM among reproductive-age females in Shenzhen were 85.54% (282 377/330 115), 96.36% (318 088/330 115), 0.31% (1009/330 115), 3.12% (10 292/330 115) and 0.64% (2114/330 115), respectively. Compared with 2013 to 2016, the average positive rates of RV-IgG and CMV-IgG among reproductive-age females in Shenzhen increased (P=0.003, P<0.001), while the average positive rates of TOX-IgG and TOX-IgM decreased from 2017 to 2019 (P<0.001). There were statistically significant differences in the positive rates of the five antibodies among different administrative regions (all P<0.001). Except for the differences in the positive rates of CMV-IgM and TOX-IgM among women of different ages, there were statistically significant differences in the positive rates of these five antibodies among reproductive-age females with other demographic characteristics (all P<0.05). There were statistical differences in the positive rates of TORCH antibodies among women with different demographic characteristics in different years. Conclusion Compared with 2013 to 2016, the positive rates of RV-IgG and CMV-IgG in reproductive-age females in Shenzhen from 2017 to 2019 were on the rise, while the positive rates of TOX-IgG and TOX-IgM were on the decline. The positive rates of these five antibodies were different among different administrative regions and among reproductive-age females with different demographic characteristics, which suggested that plans should be made according to local conditions and different objects in order to strengthen the awareness of eugenics and reduce the risk of congenital intrauterine infection with TORCH of the fetus during the propaganda and education of eugenics. © 2020 Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.     

慢性乙型肝炎患者配偶乙型肝炎病毒感染状况调查和分析

Objective To evaluate the influence of daily contact on HBV infection between hepatitis B virus carriers and their spouses by investigating the infection situation after marriage. Methods Premarital HBV carriers of serum HBV DNA positive were enrolled, family history, the histoty of blood donation, blood transfusion, drug abuse,physical examination, premarriage medical check, extramarital sex and hepatitis B vaccine were investigated in their spouses. Couples who were infected before marriage or vaccined with HBV vaccine were excluded. 68 couples were enrolled with an average marriage time of 12.5 years (0.5-35 years), their HBV serum markers and quantitative were performed. Results In the 68 couples, 54(79.4%) spouses were serum HBV marker positive, of the 54 spouses, 4 were HBV DNA positive. The chronic rate of HBV infection in the spouses was 7.4%, and was similar to the rate in general population(5%-10%). 48(88.9%) spouses were anti-HBs positive, the positive rate was similar to the rate in vaccinated population (85%-90%). Male spouses with at least one HBV marker positive were 22 cases (22/24), occupied 91.7% , female spouses were 32(32/44), occupied 72.7%, there was no difference between the male and female spouses(χ2 = 2.681, P > 0.05). Conclusions Whether HBV carriers' spouse infected with HBV is not correlated with marriage time, gender and HBV DNA level of carriers. HBV infection rate of the healthy people increases after marriage with HBV carriers, but the rate of chronic HBV infection is not increased obviouly.     

Toll样受体4在二氧化硅诱导巨噬细胞肿瘤坏死因子α合成中的作用

Objective To characterize the role of Toll-like receptor 4 (TLR4) in silica-induced pro-duction of tumor necrosis factor α(TNFα) from macrophage cell line. Methods The human macrophage cell line THP-1 was incubated with silica suspension. Cell media were collected and TNFα levels in the super-natants measured with ELJSA. To examine the involvement of TLR4 in silica-induced TNFα release, the neu-tralizing antibody (HTA125) against human TLR4 receptor was employed topretreat THP-1 cells prior to silica treatment. Moreover, murine macrophages expressing wild type or mutated TLR4 were also treated with silica to verify the effect of TLR4 in silica-induced TNFα release. Results Compared with the control group[(3.18± 0.41) pg/ml], the TNFα release in cells exposed to 100 μg/ml silica for 4 h and 8 h [(4.71±0.84),(6.22±0.58) pg/ml, respectively] increased 1.48 and 1.96 fold, respectively. Pretreatment of THP-1 cells with 20 μg/ml HTA 125 antibody significantly blocked silica-induced TNFα release by 27%. Furthermore, the TNFα content re-leased from cells expressing mutated TLR4 reduced by 30% in compared with that from the cells expressing wild type TLR4 after silica stimulation. Conclusion TLR4 mediates silica-induced TNFα release from macrophages.     

Toll样受体4在二氧化硅诱导巨噬细胞肿瘤坏死因子α合成中的作用

Objective To characterize the role of Toll-like receptor 4 (TLR4) in silica-induced pro-duction of tumor necrosis factor α(TNFα) from macrophage cell line. Methods The human macrophage cell line THP-1 was incubated with silica suspension. Cell media were collected and TNFα levels in the super-natants measured with ELJSA. To examine the involvement of TLR4 in silica-induced TNFα release, the neu-tralizing antibody (HTA125) against human TLR4 receptor was employed topretreat THP-1 cells prior to silica treatment. Moreover, murine macrophages expressing wild type or mutated TLR4 were also treated with silica to verify the effect of TLR4 in silica-induced TNFα release. Results Compared with the control group[(3.18± 0.41) pg/ml], the TNFα release in cells exposed to 100 μg/ml silica for 4 h and 8 h [(4.71±0.84),(6.22±0.58) pg/ml, respectively] increased 1.48 and 1.96 fold, respectively. Pretreatment of THP-1 cells with 20 μg/ml HTA 125 antibody significantly blocked silica-induced TNFα release by 27%. Furthermore, the TNFα content re-leased from cells expressing mutated TLR4 reduced by 30% in compared with that from the cells expressing wild type TLR4 after silica stimulation. Conclusion TLR4 mediates silica-induced TNFα release from macrophages.     

戊型肝炎病毒IgG抗体诊断试剂盒的研制及初步应用

Objective To establish an EliSA kit for serum anti-hepatitis E virus IgG detection using recombinant antigen expressed in E. Coli. Methods Utilizing the recombinant protein ORF23 of REV expressed in E. Coli as a coating antigen, the ELISA kit for detecting serum anti-HEV IgG was established. The serum samples from 100 HEV patients and 150 negative serum samples were measured, and the detecting results was compared with those of other two HEV kits(the kits from Genelabs company and Wantai Corporation). The specificity, sensitivity and stability of the kit were evaluated. The serum samples from another 500 clinical hepatitis patients were detected to evaluate the clinical application value of this kit. Results Both the specificity and sensitivity of the kit were 100% and the consistency rates to other kits were more than 95%. The kit showed a good stability and could be stable for at least 6 months under 4 ℃. 500 samples were 145 positive in 150 hepatitis E patients, the consistency rates were 96.67% . Conclusions The ELBA kit prepared with HEV recombinant antigen has good specificity and sensitivity for detecting anti-HEV IgG in serum, and may have potential evaluation in clinical diagnosis and epidemiological investigation for hepatitis E.