血吸虫病和土壤传播的蠕虫感染

通过肠寄生虫感染而受侵袭的人群 ,全球约有 2 0亿 ,其中严重发病者有 3亿。儿童最易并发由这些寄生虫感染导致的疾病 ,例如营养不良、贫血症、生长迟缓和识别损害 ,以及增加其它疾病感染的易感性 ,蛔虫感染可导致急性肠梗阻。妇女和青春期女孩子由于生育特殊负荷、缺铁性贫血 ,加上钩虫感染可形成更严重的感染性贫血症。如果幼年期持续严重感染血吸虫病 ,成年后可发生慢性不可逆的后遗症 ,例如肝纤维变性、尿道梗阻和膀胱癌。问题 :制约这些疾病有效控制措施实施的主要问题包括 :●世界卫生组织各成员国和国际社会对公共卫生的重要性、蠕虫…     

登革病毒感染及其实验室检查

登革热是登革病毒引起的一种急性传染病,是世界上蔓延速度最快的虫媒病毒感染疾病,WHO根据临床表现把登革热分为典型登革热(Dengue fever,DF)、登革出血热(Dengue haemorrhagic fever,DHF)和登革休克综合征(Dengue shock syndrome,DSS)三型。登革热广泛流行于全球热带及亚热带地区,严重威胁全球25亿人口的健康,每年有超过5000万人感染登革热。今年6月份以来,我国广东省登革热疫情呈暴发式增长,截至2014年10月10日零时,广东省卫计委最新通报显示全省共有20个地级市报告登革热临床诊断和实验室确诊病例27593例,较去年同期上升2610.51%,引起国人广泛关注。本文就该病毒的结构、生物学特性、流行病学、临床表现、诊断与鉴别诊断和实验室检查等作简要综述。     

455例季节性发热病人登革病毒感染情况分析

目的 对2014年8月至10月我院接受诊疗的季节性发热症状为主、怀疑登革热人群感染情况进行总结. 方法 455例怀疑登革病毒感染病例中,采用ELISA检测方法对146例疑似病例进行登革病毒NS1抗原检测,采用RT-QPCR方法对309例疑似病例进行登革病毒核酸检测,其中采用两种方法共同检测共76例. 结果 登革病毒NS1检测阳性率达43.1％,RT-QPCR检测阳性率达44.1％,两种方法检测阳性率无统计学差异.其中,重症登革热预警病例8例,登革Ⅱ型病例11例. 结论 2014年秋季广州市登革热处于疫情爆发期,重型病例较以往明显增多,同时今年新出现Ⅱ型病例明显增多,需要卫生部门加以注意,协同居民加强蚊媒传播疾病防治工作.     

登革病毒疫苗研究进展

登革热是由登革病毒(DENV)引起的急性传染病,广泛流行于全球热带和亚热带地区,是世界上发病患者数最多、分布最广的虫媒病毒病.疫苗是预防登革热最有效的途径,然而,迄今仍没有安全有效的疫苗用于登革热的特异性预防.根据抗原性的不同,DENV分为4个血清型(DENV 1、2、3、4).人类感染DENV后可产生型特异性中和抗体,对同型病毒的再感染具有免疫保护作用.     

登革病毒E蛋白抗原基因免疫诱导在小鼠免疫应答的初？…

目的：研究登革病毒Ｅ基因免疫的可行性,方法：用脂质体转染法将构建的Ｅ基因重组真核表达质粒ｐｃＤＮＡ３－Ｅ导入小鼠成纤维细胞ＮＩＨ３Ｔ３细胞,ＳＤＳ＿ＰＡＧＥ和蛋白质印迹实验检测Ｅ基因的体外表达,然后将重组真核表达质粒经肌肉注射免疫ＢＡＢＬ／ｃ小鼠,检测其诱发特异性体液和细胞应答水平。结果：重组真核表达质粒,ｐｃＤＮＡ３－Ｅ在小鼠体内诱发一一定水平的体液和细胞免疫应答,且持续时间较长,结论：登革病毒     

蠕虫蚴移行症的诊断和治疗--感染性疾病(11)

1引言 蠕虫蚴移行症(larva migrans)是指一些寄生于动物体内蠕虫的幼虫在人体各种器官组织中寄生、移行所引起的疾病.这些蠕虫蚴不能在人体内发育为成虫,即使偶可发育为成虫亦无繁殖能力.在其移行的过程中,被侵犯的组织可发生局部病变,并可引起全身症状.     

单纯疱疹病毒感染及免疫逃避监控机制

单纯疱疹病毒 (ＨＳＶ)可分为ＨＳＶ 1及ＨＳＶ 2两个血清型。ＨＳＶ 1主要引起口唇黏膜、眼结合膜、咽喉部的炎症和疱疹。ＨＳＶ 2主要通过性生活传播引起生殖器官的炎症和疱疹。据报道生殖器疱疹由ＨＳＶ 1引起者可占 13～ 40 % ,但ＨＳＶ 2感染所致的生殖器疱疹仍占绝对优势     

登革病毒感染小鼠模型研究进展

登革病毒(DENV)是黄病毒属的单股正链RNA病毒,其基因组全长约为10.7 kb,包含一个开放读码框架,编码3种结构蛋白和7种非结构蛋白.依据E蛋白的抗原性不同,DENV分为4个血清型(DENV 1～4).DENV主要以埃及伊蚊和白纹伊蚊为传播媒介,引起登革热(DF)和登革出血热(DHF).DF是一种急性自限性疾病,而DHF是DENV感染的重症表现,伴随血小板减少和毛细血管渗漏,甚至可能发展成威胁生命的登革休克综合征(DSS).     

呼吸道合胞病毒所致下呼吸道感染的免疫机制和干扰素治疗

呼吸道合胞病毒所致下呼吸道感染的免疫机制和干扰素治疗包军综述苏渊何英审校（上海第二军医大学附属长征医院儿科，上海２００００３）ＴｈｅＰａｔｈｏｇｅｎｅｓｉｓａｎｄＭｉｎｉｓｔｒｔｉｏｎｏｆＩｎｔｅｒｆｅｒｏｎｉｎＬｏｗｅｒＲｅｓｐｉｒａｔｏｒｙＴｒａ...     

Update: The diagnosis and management of dengue virus infection in North America

Dengue is a mosquito-transmitted infection that poses significant global health risks for travelers and individuals living in the tropics and subtropics. The reported global incidence has increased dramatically in the past century, with dengue now ranking as the most common cause of febrile illness in travelers. While sporadic cases have been reported within the southern United States since 1980, autochthonous outbreaks have now been described in Hawaii, St. Croix (US Virgin Islands), along the Texas-Mexico border, and, most recently, in Key West, Florida. Although many infections are mild or asymptomatic, 5-10% of patients may experience hemorrhagic disease, with shock and even death. Laboratory identification commonly involves serologic and nucleic acid amplification methods. Due to rising incidence worldwide, physicians should be familiar with the clinical manifestations, laboratory diagnosis, and management of this illness.     

Headache features in patients with dengue virus infection

The aim of this study was to describe the frequency and features of headache among patients with confirmed dengue virus infection and to compare the headache features in patients with dengue fever and dengue haemorrhagic fever, primary and secondary dengue infection, and patients with and without neurological involvement. Patients with classic dengue fever had a more intense headache than those with the more severe form of the disease, dengue haemorrhagic fever.     

2014年云南省瑞丽市登革1和2型病毒流行的分子流行病学研究

目的 阐明云南省中缅边境的瑞丽市2014年登革热流行的登革病毒血清型及分子流行病学特点。方法 收集登革热病例资料, 采集患者急性期血清标本, 用RT-PCR法检测登革病毒核酸, 并进行登革病毒C/PreM区核苷酸序列测定和分析。结果 2014年6-12月, 瑞丽市共确诊登革热病例292例, 其中本地感染病例139例(47.77%), 输入性病例153例(52.23%;缅甸输入152例, 广州输入1例)。2014年瑞丽市登革热本地感染病例发病率为72.77/10万。主要流行地区为瑞丽市城区、姐告开发区和勐卯镇。经登革病毒核酸检测和序列测定, 从患者血清中获得65株病毒的C/PreM区基因核苷酸序列, 其中本地感染40例, 缅甸输入25例。进化分析表明, 登革1型病毒53株(本地感染31例, 缅甸输入22例), 2型11株(本地9例, 缅甸输入2例), 4型1株(缅甸输入病例), 它们均与东南亚登革病毒流行株具有较近的亲缘关系。结论 2014年瑞丽市发生了输入性和本地感染并存的登革热流行, 缅甸木姐市和中国瑞丽市均存在登革1和2型病毒的共同流行, 来自缅甸木姐市的登革热输入性病例是引起瑞丽市登革热本地流行的主要原因。     

Evaluation of dengue nonstructural protein 1 antigen strip for the rapid diagnosis of patients with dengue infection

Two hundred twenty samples obtained from 104 patients with dengue infection (n = 89) and other febrile illnesses (n = 15) were assayed for dengue nonstructural protein 1 (NS1) antigen by enzyme immunoassay and by an immunochromatography (lateral flow) test strip. The sensitivity and the specificity of dengue NS1 antigen strip were 98.9% and 90.6%, respectively.     

杭州市首例本地感染登革热病例病原溯源调查

目的 对杭州市首例本地感染登革热病例开展调查及病原分子学溯源。方法 对首例本地感染登革热病例开展流行病学调查,采集患者血清进行登革病毒核酸和抗体检测。提取病毒核酸后扩增E基因并测序,利用生物信息学软件进行多序列比对排列及构建进化树。结果 该病例的登革病毒核酸及IgM抗体均为阳性,基因序列比对及进化分析,病毒株为登革病毒1型GⅣ亚型,与韩国2007年1例从菲律宾旅游输入病例分离的病毒株亲缘关系最近,核苷酸和氨基酸同源性为98.9%和99.6%,与菲律宾2010年的2株病毒核苷酸和氨基酸同源性为98.6%和99.6%,病毒株来源于菲律宾的可能性较大。结论 杭州市首例本地感染登革热病例可能是由菲律宾旅游归国的输入性病例引发的二代病例。     

登革热媒介控制研究进展

登革热是世界范围内传播速度最快的蚊传病毒性疾病。目前主要依靠蚊媒控制,切断传播途径以预防和控制登革热。蚊媒控制主要包括幼蚊控制和成蚊控制,幼蚊控制依赖容器管理、容器处理、社区运动和环境管理,成蚊控制则倚重空间喷雾、室内滞留喷洒和物理防制方法。此外,新的蚊媒控制手段不断发展,其中沃尔巴克氏体感染伊蚊、基因修饰伊蚊和改变伊蚊行为等方法是近年来的重要研究发现。杀虫剂抗药性管理和应对是登革热媒介控制中必须严肃对待的棘手问题。     

Kinetics of dengue virus NS1 protein in dengue 4-confirmed adult patients

In this work, the presence of NS1 protein as a possible early marker of dengue infection was studied in serum samples from confirmed adult patients with a primary and secondary dengue 4 infection. A total of 209 serum samples collected from day 2 up to day 7 of fever onset from 71 patients were tested by Platelia NS1 antigen capture ELISA kit (BioRad, Marnes-la-Coquette, France), and the results were compared with those obtained by capture antidengue virus IgM (MAC)-ELISA and ELISA inhibition method tests. The 83.3% of primary cases and 96.4% of secondary cases were NS1 positive. The kinetics of NS1 protein showed the highest values in optical density mean ratio or in percentage of positives between days 2 and 4. The results obtained in this study show the utility of the NS1 protein as a virologic early marker of dengue infection. Prospective studies should be carried out to confirm its utility as a prognostic marker of severe illness.     

Dengue fever leading to acute dengue hemorrhagic leukoencephalitis: A case report

Rationale: Dengue fever is a prevalent tropical infectious disease that has a broad panorama of presentations from mild febrile illness to life-threatening manifestations in the form of dengue hemorrhagic fever and dengue shock syndrome. Patient's concerns: A 20-year-old male presented with a 2-day history of fever, multiple episodes of vomiting, and altered sensorium. Diagnosis: Dengue fever leading to acute hemorrhagic leukoencephalitis. Interventions: Multiple transfusions of single donor platelets, intravenous methylprednisolone, intravenous immunoglobulin, anti-seizure prophylaxis, and broad-spectrum antibiotics. Outcomes: Repeat brain magnetic resonance imaging showed resolution of lesions. The patient was subsequently discharged from the hospital in a healthy state. Lessons: This report helps us to gain a better understanding of the patient's presentation, which will help to improve the timely recognition and prevention of this rare devastating presentation.     

Gallbladder wall thickening in dengue hemorrhagic fever: An ultrasonographic study

This study attempts to investigate whether gallbladder wall thickening (GBWT) measured by ultrasonography can be used in children as a reliable criterion to predict the onset of severe dengue hemorrhage fever (DHF). In this prospective study, we performed ultrasound examinations focusing on the gallbladder wall and the presence of intraperitoneal free fluid in 48 mild DHF cases (grades I–II) and 48 severe cases (grades III–IV). GBWT varied between 1 mm and 8 mm with a mean of 3.77 mm ± 2.04 mm. The mean value of DHF grades I and II (2.39 mm ± 1.48 mm) is significantly lower than that of grades III and IV (5.14 mm ± 1.54 mm), p < 0.001. GBWT exceeded 3 mm in only 16 of 48 (33.3%) grade I–II patients and in 45 of 48 (93.8%) grade III–IV patients. A significant positive correlation was apparent between GBWT and the severity of illness, p < 0.001. Patients with ascites have significantly thicker gallbladder walls than those without, p < 0.01. In clinically confirmed DHF cases, the sonographic finding of GBWT >3 mm to 5 mm, with 93.8% sensitivity, can be used as a criterion indicating the need for admission and monitoring. A GBWT of ?5 mm, with 91.7% specificity, is useful as a criterion for identifying DHF patients at high risk of developing hypovolemic shock. © 1995 John Wiley & Sons, Inc.