感染途径不明的恙虫病1例

1临床资料 患者，女，36岁。发热、头痛2d就诊。查体：体温39．5℃，急性病容，球结膜充血，咽部充血，扁桃体无肿大，浅表淋巴结无肿大，心率110次／min，律齐、各瓣膜无病理杂音，两肺呼吸音啰、无干湿音。腹软无压痛，肝脾肋下未触及。     

恙虫病的声像图表现

本文对45例恙虫病患者作超声检查，结果表明患者心脏、胸腔、肝、脾、肾及睾丸等脏器声像图均有异常改变，同时发现声像图恢复较临床表现消失缓慢。如并发心肌炎、肾炎，则临床预后较差。     

粤北山区域恙虫病自然疫源地的研究

目的 了解粤北山区域是否存在恙虫病自然疫源地. 方法 采用分子生物学诊断技术结合间接免疫荧光方法调查粤北山区发热人群、宿主动物感染状况;采用荧光定量PCR技术对粤北山区域恙虫病病人的标本检测Ot-Sta56kDa基因片段,对阳性标本进行基因分型和序列分析,并与巢式PCR检测结果相比较. 结果 在660份发热人群血清标本...     

本地区小儿急性呼吸道感染病原体分布特征研究

目的分析该地区小儿呼吸道感染病原体分布特征。方法对2011年1月至2014年12月接受治疗的28 600例急性呼吸道疾病患儿9种呼吸道感染病原体间接免疫荧光法检测结果进行分析,包括感染患儿的时间、季节、性别及年龄分布特征。结果 28 600例患儿中,检出病原体感染患儿12 162例,其中单一病原体感染7 704例(63.34%),2种及以上病原体合并感染4 458例(36.66%)。急性呼吸道感染病原体感染患儿在不同时间、季节、性别及年龄的分布情况比较差异均有统计学意义(P0.05)。同一病原体在不同时间的感染率比较差异均有统计学意义(P0.05);相同时间内,肺炎支原体(MP)感染率最高;除MP、乙型流感病原体(IFB)感染率呈逐年上升趋势外,其余病原体感染率均呈逐年下降趋势。除嗜肺军团菌外,MP、Q热立克次体(COX)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(IFA)、乙型流感病毒(IFB)、副流感病毒(PIVs)感染率在不同季节的分布比较差异均有统计学意义(P0.05)。结论小儿急性呼吸道感染病原体分布与性别、年龄及季节变化有关。呼吸道感染病原体九联检可快速进行病原体检测,对疾病诊断及治疗药物选择有一定的指导意义。     

Proliferating sites of Rickettsia tsutsugamushi in mice by different routes of inoculation evidenced with immunofluorescence

The sites of multiplication of Rickettsia tsutsugamushi in mice by different routes of inoculation were investigated by means of immunofluorescence. R. tsutsugamushi (Kato, Karp, Gilliam and Miyake strains) inoculated by intraperitoneal route multiplied significantly in mesothelial and inflammatory cells of the peritoneal cavity of DDD and BALB/c (nu/nu) mice. The rickettsial growth was not detected in parenchymal cells of the liver, spleen, kidneys and lymph nodes of DDD mice, but slightly observed in those cells of the nude mice. When inoculated by subcutaneous route, the rickettsial antigens were detected in small amount in the peritoneal mesothelial and inflammatory cells, whereas a marked proliferation of R. tsutsugamushi was demonstrated in liver cells, Kupffer cells, and endothelial cells of the sinus of spleen and lymph nodes. A specific antibody to Karp strain, administered intraperitoneally, prevented effectively rickettsial growth in the peritoneal cavity of BALB/c (nu/nu) mice challenged intraperitoneally, 6 hours later, with Miyake strain (Karp type) and the animals were infected after a long-term incubation period showing the findings of rickettsial localization similar to that in subcutaneously inoculated animals. This fact suggests a partial involvement of humoral immunity in resistance of mice against R. tsutsugamushi infection. The potential importance of these findings in experimental infection with R. tsutsugamushi was discussed.     

山东南部再次发生恙虫病流行的调查

为了对肥城坡庄管区发生恙虫病临床病例而开展流行病学调查。采用微量补体结合试验方法检测患者血清、鼠血 ,同时解剖鼠取肝、脾、肾进行病原体分离试验。结果 :采集 18份病人血 ,阳性 15份 ,阳性率 83.33%。捕鼠 7只 ,其中褐家鼠 5只 ,黑线姬鼠、小家鼠各 1只。对 3只褐家鼠采血进行补体结合试验 ,阳性 1份。病原体分离试验仍在进行。结果 :确定了当地发生了一起恙虫病流行 ,当地存在恙虫病自然疫源地。     

实时荧光聚合酶链反应检测患儿手足口病病原体

目的采用实时荧光定量聚合酶链反应(FQ-PCR)检测患儿手足口病病原体,为防治手足口病提供依据。方法收集手足口病疑似患儿189例(按年龄分为<3岁组113例、3～5岁组76例)及39例手足口病密切接触儿童的咽拭子、疱疹液,用FQ-PCR检测标本中的肠道病毒通用型(EV)、肠道病毒71型(EV71)及柯萨奇病毒A组16型(CoxA16),并与酶联免疫吸附试验(ELISA)结果进行比对。结果 189例手足口病患儿疑似组FQ-PCR检测EV阳性141例,阳性率为74.6%,其中<3岁阳性91例、3～5岁阳性50例,3～5岁组EV检出率明显低于<3岁组(P<0.05);EV71阳性135例,CoxA16阳性65例;咽拭子标本阳性率为74.5%(120/161),疮疹液标本阳性率为82.1%(23/28);ELISA检测EV阳性76例(40.2%);39例手足口病密切接触者FQ-PCR检测EV阳性率为33.3%(13/39),ELISA检测阳性率为17.9%(7/39)。结论 FQ-PCR是一种特异性强、灵敏度高、检测较快速、效率高的方法,对检测手足口病病原体及进行相关流行病调研有重要价值。     

微创血肿粉碎穿刺术治疗高血压脑出血16例的护理观察

目的总结高血压脑出血行微创血肿粉碎穿刺术后患的护理经验。方法应用微创颅内血肿粉碎穿剌针在电钻动力下进行血肿抽吸、粉碎冲洗、液化及引流。结果本组治愈8例,好转3例,死亡5例。结论微创颅内血肿穿刺术治疗高血压脑出血疗效确切。加强基础护理,严密监测,预防和及时发现潜在并发症,将对患预后起积极作用。     

Germ cell-induced immune suppression in mice. Effect of inoculation of syngeneic spermatozoa on cell-mediated immune responses

Spleen cells from mice injected intravenously with syngeneic male germ cells exhibited reduced immune functions as determined by natural killer cell activity, mixed lymphocyte reactivity and cytotoxic lymphocyte (CTL) function. The decrease in CTL responses to trinitrophenyl-modified self (TNP-self) was detected as early as 4 d after sperm injection and was observed to H-2 alloantigens 3 wk after injection. Radiosensitive suppressor T cells were found to suppress the CTL response to TNP-self. Suppression lasted for a period of at least 7 wk after a single inoculation of the germ cells. Some variability in immune suppression capability was observed using different preparations of germ cells which are not yet completely understood. Sperm were more effective in inducing suppression than testicular cells derived from the seminiferous tubules. Furthermore, sperm from older animals were more effective than those from younger mice. These findings are discussed with respect to possible regulatory influences of germ cells on the immune system when the blood-testes barrier is broken.