菌阴肺结核诊断方法研究

目的 :利用联合检测技术对菌阴肺结核作诊断价值的研究。方法 :痰标本采用聚合酶链反应 (PCR)TB DNA ,血清标本采用酶联免疫吸附试验 (ELISA) ,皮肤试验采用PPD 0 1U皮试 ,同步检测。结果 :单项检测的敏感性、特异性依次为 :PCR 96 8%、96 2 % ;LAMIgG 6 9 2 %、98 1% ;PPDIgG 6 2 1%、98 1% ;SCIC 32 2 %、98 1% ;PPD 0 1U 5 3 8%、98 1%。单项检测对菌阴肺结核的检出率相应为 41 7% ,2 8 9% ,44 4% ,2 8 9% ,2 1 4%。联合检测对菌阴肺结核的检出率 2、3、4、5联分别为 6 6 9%、75 0 %、80 4%及 85 7% ,均高于单项检测。联合检测特异性随联合种类增高而轻微下降。若采用联合检测同时阳性方法 ,2、3、4、5联特异性均为 10 0 % ,初治菌阴组阳性检出率 2联方法可达 45 9% ,比任何单项方法检出率要高。结论 :由于原五种方法联合检测特异性有所轻度下降 ,因此联合检测同时阳性判定的方法更适用于初治菌阴肺结核的诊断 ,值得推广     

Comparison of nested-polymerase chain reaction and virus culture for the diagnosis of genital herpes simplex virus infection

INTRODUCTION: This study was performed to compare nested-polymerase chain reaction (PCR) with viral culture as a diagnostic tool for genital herpes simplex virus (HSV) infection in a sexually transmitted infection (STI) clinic in Singapore. METHODS: 103 consecutive patients presenting with clinical features suggestive of genital herpes were enrolled in the study. Two swabs were obtained from each patient. On one swab, cell culture and typing was performed, and on the second swab, nested-PCR was performed and the infecting viral type was determined by using type-specific primers. RESULTS: 63 patients (61.2 percent) had a positive PCR test for HSV. Of these, 13 patients (20.6 percent) had HSV type 1 (HSV-1), 50 patients (79.4 percent) had HSV type 2 (HSV-2). HSV-1 and HSV-2 were detected by viral culture in only six patients and 24 patients, respectively. The sensitivity of cell culture compared to PCR was 46.1 percent for HSV-1 infection and 48 percent for HSV-2 infection. PCR further detected an additional 52.4 percent of HSV cases. The specificity of PCR was 100 percent. CONCLUSION: Nested-PCR has been shown in this study to be an effective diagnostic and typing method for HSV infection in a STI clinic in Singapore with its higher sensitivity and specificity to routine viral isolation in cell culture.     

单纯疱疹病毒感染诊断方法及标本选择的探讨

目的目的探讨单纯疱疹病毒（HSV）感染诊断方法及标本的选择对诊断结果的意义。方法选择117例疑似HSV感染的皮肤科门诊患者或神经内科脑炎脑膜炎患者血清，其中53例有明显疱疹症状者同时取疱液标本，78例脑炎脑膜炎患者同时采集脑脊液标本。应用ELISA法、免疫印迹法检测血清、脑脊液中HSV—IgM抗体，应用间接免疫荧光法（IIF）检测脑脊液、疱疹液HSV抗原。结果血清、脑脊液标本ELISA法和免疫印迹法检测HSV—IgM抗体阳性率分别为70．94％、6．41％和59．83％、3．85％。脑脊液、疱疹液TIF法检测HSV抗原阳性率分别是15．38％、67．93％。结论ELISA法与免疫印迹法检测HSV—IgM抗体阳性率无显著性差异（γ=0．017，P〉0．5）；脑脊液标本供检测HSV抗原与HSVIgM抗体的阳性率差异显著（γ=13．224，P〈0．05．）；对复发感染患者采用疱疹液抗原检测相对于采用血清检测抗体对诊断HSV感染更具有临床意义。在临床上，对不同病症病程的HSV感染，选择相应适宜的诊断方法及标本种类可取得更准确的检测结果。     

The rationale for the use of diagnostic tests in herpes simplex virus infection

All suspect herpes simplex lesions should be diagnosed by isolation methods where possible. Rapid tests ulitise antigen detection methods. The enzyme immunoassay method is the most sensitive of these, and the immunofluorescence method has the advantage of being able to type the virus, but has slightly lower sensitivity. Serological methods are only useful to exclude a herpes simplex infection in the past, and to establish a primary infection. They cannot be used to type an infection or give evidence of past infection to a particular type.     

三种方法检测生殖器疱疹病毒的临床应用价值

目的比较细胞培养、酶联免疫吸附试验(ELISA)和间接免疫荧光法(IFA)检测生殖器疱疹病毒的临床应用价值。方法用细胞培养、ELISA和IFA同时检测生殖器标本中的单纯疱疹病毒(HSV),与扩大金标准方法比较,分别计算三者的敏感性、特异性、约登指数、阳性预测值(PPV)和阴性预测值(NPV)。结果 318例标本中真阳性结果150例,真阴性结果168例,阳性率为47.2%。细胞培养、ELISA和IFA三种方法的敏感性分别为89.3%、98.0%和98.7%,特异性分别为100.0%、96.4%和97.6%,约登指数分别为89.3%、94.4%和96.3%,NPV分别为91.3%、98.2%和98.8%,经比较,ELISA和IFA方法的敏感性均高于细胞培养法,差异有统计学意义(P0.05);ELISA和IFA的特异性无统计学意义(P0.05);ELISA和IFA的约登指数差异无统计学意义(P0.05),ELISA和IFA方法的NPV均高于细胞培养法,差异有统计学意义(P0.05)。结论 ELISA和IFA法检测HSV有较高的灵敏度和特异性,均可为临床诊治提供可靠依据。     

结核病患者单纯疱疹病毒感染的检测及临床意义

目的了解结核病患者单纯疱疹病毒的感染情况,探讨其可能对结核病病情的影响。方法采用金标免疫斑点渗滤法分别检测51例肺结核患者和30例正常健康人血浆单纯疱疹病毒感染的IgM和IgG。结果肺结核患者组HsV—IgM的阳性率为88．24％与对照组（66．67％）相比,差异有统计学意义（P〈0．05）;HSV-IgG的阳性率为80．39％,与对照组（70．00％）相比,差异无统计学意义（P〉0．05）;有肺炎表现者HSV-IgG的阳性率为61．11％,与无肺炎表现的患者组（90．91％）相比,差异有统计学意义（P〈0．05）;经统计学处理,HSV的活动性感染与病程、分期、痰涂片阳性无相关性（P〉0．05）。结论肺结核患者存在较高的活动性单纯疱疹病毒感染,活动性单纯疱疹病毒感染与病情轻重有一定关系。     

结核蛋白芯片联合PPD检测对痰菌阴性肺结核的诊断价值

目的观察结核蛋白芯片和结核菌素纯蛋白衍生物(purifiedproteiderivative,PPD)实验对痰结核分枝杆菌阴性肺结核(菌阴肺结核)的诊断价值。方法采用结核蛋白芯片和PPD实验,检测53例痰菌阴性活动性肺结核和40例非结核性肺部疾病患者,观察两种方法检测的灵敏性、特异性、检测的一致性和联合检测阳性率。结果结核蛋白芯片诊断痰菌阴性肺结核的敏感性和特异性分别为62.3%、87.5%,敏感性明显高于PPD试验(41.5%),特异性无明显差异;两种方法检测一致率为69.8%;两种检测方法联用阳性检出率为88.7%,高于单独应用任一方法。结论结核蛋白芯片检测对痰菌阴性活动性肺结核病人具有较好的诊断价值,联用PPD检测可提高痰菌阴性肺结核患者检出率。     

Maternal herpetic breast infection: another hazard of neonatal herpes simplex.

After the death of an eight-day-old breast-fed neonate with disseminated herpes simplex, the mother was found to have herpes simplex infections of both nipples. This complication of neonatal herpes infection does not appear to have been reported previously.     

骨髓涂片和切片对细胞增生低下患者诊断价值比较

目的：比较涂片和切片对骨髓细胞增生低下的诊断价值。方法：对66例骨髓涂片示细胞增生低下（或极度低下）患者的同期同部位骨髓活检组织用石蜡包埋半薄切片，做常规HE染色及网状蛋白染色，光镜下观察。结果：涂片示细胞增生低下（或极度低下），而切片结果分为以下5类：细胞增生低下10例，细胞增生旺盛37例，网状纤维增生6例，骨髓细胞增生旺盛伴网状纤维增加9例，穿刺失败4例。结论：骨穿干抽或骨髓涂片示细胞增生低下（或极度低下）并非完全是骨髓细胞增生不良所致，骨髓涂片与活检相结合可提高对骨髓细胞增生程度及血液病诊断的正确性。     

Sexual behavior and herpes simplex virus 2 infection in college students

BACKGROUND: Given the relevance of HSV-2 infection in youth, the aim of this study was to determine the seroprevalence of HSV-2 in college students in Cuernavaca, Mexico, as well as the sociodemographic and sexual behavioral characteristics associated with this infection. METHODS: A cross-sectional study was carried out using convenience sampling with consenting students of both genders. Students answered a questionnaire and provided a blood sample to detect antibodies to HSV-2 by Western blot. To establish the magnitude of the association between the prevalence of HSV-2 infection and the selected risk factors, we estimated prevalence odds ratios by performing logistic analyses of these results RESULTS: Overall seroprevalence of HSV-2 was 5.9% (20/340; CI(95%) 3.7-8.9), 7.0% (14/200; CI(95%) 3.9-11.5) for women and 4.3% (6/140; CI(95%) 1.6-9.1) for men. HSV-2 infection was independently associated with female sex (POR=5.3, CI(95%) 1.4-19.7), age (26 years and over, POR=4.7, CI(95%) 1.0-22.2), number of sexual partners over the last year (two or more partners POR=4.1, CI(95%) 1.2-14.2), a history of genital ulcers (POR=6.1, CI(95%) 1.9-19.8), and having been paid for sex (POR=21.4, CI(95%) 1.0-447.5). CONCLUSIONS: The frequency of HSV-2 infection among these students was lower than in other Mexican populations who have high-risk sexual behavior. However, there was a subgroup of participants identified as having high-risk sexual behavior. These individuals could, therefore, be prone to acquiring and transmitting HSV-2 infection and represent the target group for whom preventive interventions against HSV-2 and other STIs might be developed.     

Transmission of herpes simplex virus type 1 infection in rugby players

Skin infections, both bacterial and viral, are endemic in contact sports such as wrestling and rugby football. In this report, we describe four cases of extensive cutaneous herpes simplex virus in players on a rugby team. All players had a prodrome of fever, malaise, and anorexia with a weight loss of 3.6 to 9.0 kg. Two players experienced ocular lesions associated with cutaneous vesicular lesions of the face. A third player, who had herpetic lesions on his lower extremity, experienced paresthesias, weakness, and intermittent urinary retention and constipation. All infected players on the team were forwards or members of the "scrum," which suggests a field-acquired infection analogous to the herpetic infections seen in wrestlers (herpes gladiatorum). Considering the serious sequelae of recurrent herpes simplex keratitis, the traumatic skin lesions in rugby football players should be cultured for herpes virus, and infected individuals should be restricted from playing until crusted lesions have disappeared.     

Characteristics of a macrophage culture persistently infected with herpes simplex virus type 1.

BACKGROUND: Persistence of herpes simplex type 1 (HSV-1) has been reported in sensory neurons, corneal epithelium, and lymphocytes, although other cell types such as macrophages should also be considered as hosts for HSV-1 persistence. Here we report the establishment and characterization of HSV-1 persistence in an immortalized murine macrophage-like cell line (P388D1). METHODS: The persistently HSV-1 infected culture (P388D1per) was obtained from surviving P388D1 macrophages infected with HSV-1 MP strain at multiplicity of 0.001. P388D1per was characterized by [corrected] extracellular production of viruses, cells expressing viral antigens, and cells releasing infectious viruses. Viral plaque size and cytophatic effect were determined in viruses (HSVA and HSVB) obtained from two different P388D1per passages. Host and viral proteins were detected in P388D1per and in P388D1 cells infected with HSV-1 by metabolic [35S]-methionine labeling assays. RESULTS: P388D1per culture was characterized [corrected] by cyclic production of infectious viruses from non-detectable to 10(6) TCID50/mL, [corrected] from 1.0 to 15.0% cells expressing viral antigens and macrophages released infectious viruses from 0.008 to 12.5%. Differences in viral plaque size and cytopathic effect morphology between HSVA, HSVB and HSV-1 were observed. Similar patterns of viral proteins were observed in P388D1per and in P388D1 infected with HSV-1. Nonetheless, the characteristic interference effect of HSV-1 on host protein synthesis was not observed in P388D1per culture. CONCLUSIONS: An HSV-1 persistently infected immortalized macrophage culture was established and characterized. Virus produced during persistence showed phenotypic alterations with respect to the original virus. P388D1per cell protein synthesis was not affected by the presence of HSV-1.     

PCR-RFLP法对单纯疱疹病毒感染诊断和分型的研究

目的 建立单纯疱疹病毒的聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测法,为生殖器疱疹的诊断及分型提供可靠而特异的方法。方法 以特异性引物法为对照,用一对单纯疱疹病毒外层通用引物扩增出长度为438bp的片断,并进行酶切以分型。结果 PCR-RFLP法可特异性检测出单纯疱疹病毒并进行分型,同特异性引物法比较。两种方法无显著性差异。结论 PCR-RFLP法是一种准确、特异的对单纯疱疹病毒感染进行诊断和分型的方法。