先天性出生缺陷儿童弓形虫感染血清学调查

目的探讨儿童先天性出生缺陷与弓形虫感染的关系。方法应用弓形虫间接血球凝集试验(IHA)和弓形虫膜抗原酶联免疫吸附试验(ELISA)检测300例先天性出生缺陷儿童血清弓形虫抗体,并以35例因后天获得性外伤或车祸致残儿童作为对照。结果300例先天性出生缺陷儿童弓形虫抗体阳性66例,阳性率为22.00%;显著高于后天获得性外伤或车祸致残儿童的弓形虫抗体阳性率8.57%(χ2=3.54,P<0.05)。同时在66例弓形虫抗体阳性的先天性出生缺陷儿童家庭中,其父母至少有一方弓形虫抗体阳性的家庭达38户,占弓形虫抗体阳性的先天性出生缺陷儿童家庭的57.58%。结论弓形虫感染是儿童出生缺陷的重要因素之一,对优生优育夫妇积极开展弓形虫感染的血清学监测,将对提高人口素质、控制先天性弓形虫感染的发生具有重要意义。     

先天性畸形儿母婴弓形虫感染的血清学研究

本文对先天性畸形儿母婴弓形虫感染进行了血清学研究.82例先天性畸形儿弓形虫抗体阳性率为32.89%,抗原阳性率为60.61%.79例畸胎儿产妇弓形虫抗体阳性率为25.21%,抗原阳性率为40.63%.两者弓形虫抗体阳性率均显著高于正常人群.77例病理组织诊断阳性的畸胎儿弓形虫抗体阳性率为41.56%,抗原阳性率为60.38%;其产妇弓形虫抗体阳性率为25. 81%,抗原阳性率为41.37%.弓形虫抗体阳性的畸形儿,其母血清抗体阳性率高达62.50%,而弓形虫抗体阴性的畸形儿其母亲血清阳性率只有18.20%,两组间差异非常显著.提示:弓形虫感染可能是造成先天性畸形的重要病因之一;母婴垂直传播是弓形虫先天性感染的途径.     

福建地区新生儿刚地弓形虫感染血清学调查

目的调查福建地区新生儿刚地弓形虫感染血清学阳性率,为制定先天性弓形虫病防控措施提供参考依据。方法以2017—2018年福建地区出生的1 045例新生儿作为研究对象,其中早产儿387例、足月儿658例。采集新生儿脐带血,检测并比较早产儿和足月儿血清抗弓形虫IgG抗体阳性率。收集早产儿和足月儿母亲肘静脉血,检测并比较早产儿和足月儿母亲血清抗弓形虫Ig G抗体阳性率。结果福建地区1 045例新生儿血清抗弓形虫IgG抗体阳性率为9.38%。387例早产儿血清抗弓形虫IgG抗体阳性率为18.35%,男婴和女婴血清抗体阳性率差异无统计学意义(17.69%vs. 18.75%,χ~2=0.07,P 0.05)。658例足月儿血清抗弓形虫IgG抗体阳性率为4.10%,男婴和女婴血清抗弓形虫IgG抗体阳性率差异无统计学意义(4.14%vs. 4.08%,χ~2=0,P 0.05)。早产儿血清抗弓形虫Ig G抗体阳性率显著高于足月儿(χ~2=58.17,P 0.01)。1 045例新生儿母亲血清抗弓形虫IgG抗体阳性率为15.02%,早产儿母亲血清抗弓形虫IgG抗体阳性率显著高于足月儿母亲(20.93%vs. 11.55%,χ~2=16.79,P 0.01)。结论福建地区早产儿及其母亲弓形虫感染血清学阳性率显著高于足月儿及其母亲;应加强孕前弓形虫感染检测和弓形虫病防护知识健康教育,从而有效降低先天性弓形虫病发病率。     

杭州市糖尿病患者弓形虫感染血清流行病学调查

目的了解杭州市糖尿病患者弓形虫感染情况。方法以2017年3月至2020年5月杭州市收治的337例1型糖尿病患者、624例2型糖尿病患者和384例妊娠糖尿病患者作为调查对象,按1:1的比例分别选择同期年龄和性别相匹配的健康体检者及无妊娠糖尿病孕妇作为对照。采用酶联免疫吸附试验检测糖尿病患者和对照者血清抗弓形虫IgG和IgM抗体,比较糖尿病患者及相应对照血清抗体阳性率差异。结果杭州市1型糖尿病患者血清抗弓形虫抗体总体阳性率(18.10% vs.4.45%,χ~2=31.38,P 0.01)和 IgG抗体阳性率(14.54% vs.2.97%,χ~2=28.28,P 0.01)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(3.56% vs.1.48%,χ~2=2.96,P 0.05)。2型糖尿病患者血清抗弓形虫抗体总体阳性率(23.56% vs.6.57%,χ~2=70.37,P 0.01)和IgG抗体阳性率(21.15% vs.5.45%,χ~2=66.73,P 0.01)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(2.40% vs.1.12%,χ~2=2.96,P 0.05)。妊娠糖尿病患者血清抗弓形虫抗体总体阳性率(26.30% vs.19.53%,χ~2=4.98,P 0.05)和IgG抗体阳性率(23.70% vs.17.71%,χ~2=4.20,P 0.05)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(2.60% vs.1.82%,χ~2=0.54,P0.05)。结论杭州市糖尿病患者弓形虫感染血清学阳性率显著高于健康对照,应加强糖尿病患者弓形虫感染筛查和相关健康教育。     

儿童先天性心脏病室间隔缺损致病因素分析

目的 :对儿童先天性室间隔缺损因素进行分析。方法 :报告 2 5 8例先天性室间隔缺损儿童 ,男性 14 4例 ,女性 114例 ,年龄 1～ 14岁。同时对 2 5 8例儿童的父母进行调查 ,调查对象为患先天性室间隔缺损儿童 ,儿童的父亲、母亲孕前和孕期多方面因素 ,将引起室间隔缺损的可能原因进行分析。结果 :发现家族中有遗传史 ,父母亲饮酒史 ,母孕期有感冒病史 ,母孕期服用抗病毒药物 ,父母孕期使用黄体酮及母孕期接触X射线 ,有较高先天性室间隔缺损的发病率。同时对患先天性室间隔缺损儿童血型分析 ,表明A型儿童和AB型儿童患先天性室间隔缺损频率较高 (分别为 4 2 2 5 %和 11 2 4 % )比值比(OR)分别为 1 6 3和 2 2 1。与对照组比较差异有显著性 (即A型 χ2 =7.0 2 ,P <0 0 0 1,AB型 χ2 =5 71,P <0 .0 5 )。A O ,AB O抗原患者组与对照组比较 ,OR分别为 1 72和 2 6 2 ,χ2 值分别为 6 72和 7 5 1均差异有显著性 (P <0 .0 0 1) ,而O型则相反患先天性室间隔缺损的机率相对减少。结论 :先天性室间隔缺损与家族遗传史、血型及父母孕期饮酒、服药等多方面因素有关。     

改良凝集试验用于检测禽类弓形虫感染的探讨

本文报道了应用改良凝集试验 ( MAT)检测禽类的弓形虫抗体水平。共检测了包括 41只家鸡在内的 77份禽类 (隶属5目、5科、13属、2 1种 )的血清 ,结果 MAT阳性 5份 ,阳性率为 6 .5 %。 4只阳性珍禽的弓形虫抗体滴度分别为 1∶ 2 0 ( 3禽 )和1∶ 6 40 ( 1禽 ) ,1只阳性家鸡的抗体滴度为 1∶ 40。珍禽的弓形虫抗体阳性率 ( 11.1% )高于家鸡的抗体阳性率 ( 2 .4% ) ,但二者无显著差异 ( P>0 .0 5 )。本文结果表明 ,简便、快速的 MAT适合于禽类弓形虫感染的血清学检测     

弓形虫感染者DNA和抗体变化的动态观察

本文对 5 0 0例有神经症状患者 ,用静脉抗凝血进行了弓形虫 DNA和抗体的检测 ,结果表明 :弓形虫 DNA阳性率2 9.2 % (146 / 5 0 0 ) ,抗体阳性率 32 .6 % (16 3/ 5 0 0 )。又对 146例弓形虫 DNA阳性者进行了治疗 1周、3周、5周、10周后 DNA及抗体变化的动态观察。结果可知 :弓形虫 DNA转阴率随治疗时间延长而提高 ,10周后全部转阴。抗体的产生为治疗 5周后达到高峰 95 .2 % ,仍有 4.8%未产生抗体。治疗 10周后阳性率只剩 2 4.7% ,以上结果显示 ,对弓形虫感染后治疗效果的观察有重要的指导意义     

酶联免疫吸附试验检测弓形虫体IgA抗体及其临床应用的初步研究

试用弓形虫膜抗原ELISA对先天性弓形虫感染的畸形围产儿和后天获得性弓形虫感染者进行了特导性IgA抗体检测。11例先天性弓形虫宫内感染畸形围产儿的15份标本,6份检出IgA抗体,7份同时检出IgA;IgM抗体,两份仅检出IgM抗体。8份弓形虫抗体阳性的孕妇血清皆检出较强的IgA抗体。后天获得性弓形虫近期感染者32份血清,IgA抗体阳性3份,IgA、IgM抗体阳性8份,IgM抗体阳性21份;30份慢性感染者血清未有测到IgA抗体。对照组30份抗体阴性的孕妇血清及其围产儿的脐血检测结果抗体皆为阴性。IgA抗体是弓形虫感染早期的一个重要标志物,与IgM、IgG抗体同时检测,对临床急性弓形虫感染的诊断和疗效观察有着极其重大意义。     

山西地区眼弓形虫病的调查

目的通过对眼病患者和健康人群弓形虫感染调查,探讨并分析眼病是否与弓形虫感染有关。方法采用ELISA检测160例眼病患者和160名健康人血清弓形虫IgM抗体,用PCR检测血液中弓形虫DNA。结果160例眼病患者,20例IgM抗体阳性,阳性率为12.50%;健康对照160例,9例阳性,阳性率为5.63%,差异有统计学意义(χ2=4.588,P<0.05)。眼病组中80例中渗患者IgM阳性15例,阳性率为18.75%;80例葡萄膜炎患者IgM阳性5例,阳性率为6.25%,二者差异有统计学意义(χ2=5.714,P<0.05)。健康对照组中,80名大学生3例IgM阳性,阳性率为3.75%;80名工人6例阳性,阳性率为7.50%,二者差异无统计学意义(χ2=1.060,P>0.05)。用Tox-PCR检测20例IgM阳性的眼病患者,均为阳性,健康对照组的9例IgM阳性者PCR阳性8例,二者差异有统计学意义(χ2=3.079,P<0.01)。结论眼病患者弓形虫感染率高于健康人,眼病中渗患者弓形虫感染率高于葡萄膜炎患者。因此认为某些眼病与弓形虫感染有关。     

孕妇弓形虫感染危险因素的病例对照分析

弓形虫病 (Toxoplasmosis)是人畜共患的传染性寄生虫病 ,人群中感染普遍 ,血清特异抗体阳性率平均为 2 5 %～ 5 0 % ,孕妇弓形虫感染率高达 6 .2 5 %～ 32 .9% [1 ] ,且有逐年上升的趋势。孕期感染弓形虫后绝大多数表现为无症状隐性感染 ,但无论是显性还是隐性感染均可经胎盘传染给胎儿 ,造成流产、死胎和先天性弓形虫病[2 ] 。为调查孕妇弓形虫感染的危险因素 ,作者采用病例对照研究方法对 38例孕妇弓形体感染者的感染因素进行了分析 ,结果报告如下。1　对象与方法1.1　对象　病例组为本院妇产科 2 0 0 1～ 2 0 0 2年收治的 ,经微量间接血…     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.