银屑病角质形成细胞p16基因微卫星杂合性缺失研究

目的探讨银屑病皮损区角质形成细胞p16基因D9S171,D9S1604微卫星位点杂合性缺失(lossofheterozygosity,LOH)与银屑病发病的关系。方法采用聚合酶链反应-变性聚丙烯酰胺凝胶电泳-银染技术对体外原代培养的银屑病皮损区和非皮损区角质形成细胞LOH进行分析。结果23例银屑病患者皮损区体外培养的角质形成细胞在D9S171和D9S1604两个微卫星位点,LOH分别为5例和10例。在非皮损区的相应位点LOH分别为2例和3例。D9S1604LOH频率明显高于非皮损区角质形成细胞(P<0.05);寻常性银屑病患者皮损区角质形成细胞中两位点LOH发生频率分别为23.5%(4/17)和47.1%(8/17),非寻常性银屑病分别为16.7%(1/6)和33.3%(2/6),两型银屑病两位点LOH发生频率相比差异均无显著性(P>0.05)。结论D9S1604微卫星位点LOH与银屑病的发生发展相关,而与临床类型相关无显著性。     

尖锐湿疣组织中微卫星DNA的改变与HPV感染的相关性

目的探讨特定位点的微卫星不稳定性(MSI)及杂合性丢失(LOH)在尖锐湿疣(CA)组织中的检出情况及其与人乳头瘤病毒(HPV)感染的关系。方法选取D3S1234,D3S1611,D9S171,D10S1687和D17S16785个微卫星位点,应用聚合酶链反应(PCR)和变性聚丙烯酰胺凝胶电泳-银染色技术对40例CA组织及11例CA癌变组织进行微卫星分析,并采用核酸分子快速导流杂交基因芯片技术检测HPV的基因分型。结果 CA及CA癌变组织中LOH的总检出率分别为22.50%(9/40)和63.64%(7/11),差异有统计学意义(P<0.05),两组中LOH发生频率最高的位点均为D9S171,其次为D17S1678位点。MSI的发生率较低,CA组中频率为10.00%(4/40),CA癌变组为18.18%(2/11)。CA组及CA癌变组标本,高危型HPV感染者LOH阳性率明显高于低危型HPV感染者,差异有统计学意义(P=0.019);两组中MSI阳性的6例样本均为高危型HPV感染。结论高频LOH位点D9S171和D17S1678连锁的抑癌基因p16,p53可能在CA癌变的发生过程中起着重要作用;另外,该结果也说明HPV感染,尤其高危基因型病毒是CA癌变的因素之一。微卫星DNA的改变与高危型HPV的感染有一定的相关性。     

6号染色体短臂存在银屑病易感基因的证据

目的 鉴定6号染色体短臂上是否存在寻常性银屑病的易感基因.方法用6号染色体短臂上的8个微卫星标记对46个寻常性银屑病家系共272个个体(包括143例患者和129例非患者)进行基因分型研究,并用Genehunter软件(2.0 Version)对基因分型结果进行两点和多点参数和非参数连锁分析.结果①两点连锁分析:非参数连锁分析揭示3个相邻的标记D6S276、D6S1610和D6S1575的NPL值分别为2.69、3.58和2.84,对应的P值分别为0.0 048、0.0 006和0.0 033;参数分析在D6S1610位点处得出HLOD=4.01和较高的连锁家系比例α=70%.②多点连锁分析:在44.9-62.3 cM的染色体区域内,非参数连锁分析的NPL值均＞3,D6S276(44.9 cM)、D6S1610(53.9 cM)和D6S1575(62.3 cM)均位于这个范围内,其中在D6S1610处NPL值达到最高为4.11,对应的P值为0.0 002;参数分析在D6S1610处,得出多点分析的HLOD峰值为3.17,连锁家系比例为60%.结论6号染色体短臂上存在寻常性银屑病的易感基因。     

银屑病患者外周血的淋巴细胞分型

应用混合玫瑰花形成试验,检测100例银屑病患者外周血的淋巴细胞型别,并随机抽样19例,用单克隆抗体Leu系统行酶免疫技术的ABC染色法,观察T细胞亚群.见外周血中T细胞%较正常人明显下降(P<0.001), T抑制细胞(2a)%上升(P<0.05), T辅助细胞(3 a)%和3a/2a皆显著下降(P<0.05), B. N.D细胞%皆明显上升(P<0.05).     

中间丝聚合蛋白基因多态性与特应性皮炎发病及临床表型的相关性

目的 探讨中间丝聚合蛋白(FLG)基因多态性与特应性皮炎(AD)发病及临床表型的相关性.方法 采用问卷调查的形式收集261例AD患者伴发过敏性鼻炎、哮喘病史和疾病严重度评分等资料,对部分患者进行混合食物过敏原和混合吸人性过敏原筛选、血清总IgE抗体和嗜酸性粒细胞阳离子蛋白水平检测.采用重叠PCR和DNA测序法对上述AD患者和276例健康对照FLG基因3号外显子17个多态性位点(R444G、T454A、P478S、H519N、D836D、S1482Y、A1805V、R1891Q、1961Q、S2166S、Y2194H、H2330H、D2339N、S2366T、E2398Q、K2444E、E2652D)进行基因分型.结果 二项逻辑回归分析和卡方检验未发现17种FLG多态位点与AD发病相关(均P＞0.05).H519N与AD伴发哮喘相关(x2=8.680,P=0.011),AA基因型可增加AD患者发生哮喘的风险(P=0.004,OR=1.061,95％ CI 1.016 ～ 1.109).S2366T和K2444E与AD患者食物敏感相关(x2值分别为6.520和6.121,P值分别为0.038和0.047),S2366T的GG+ GC基因型(P=0.012,OR=1.396,95％CI 1.054～1.849)和G等位基因(P=0.037,OR=1.350,95％CI 1.008～ 1.807)可提高AD患者食物敏感的风险.K2444E的AA+ AG基因型(P=0.013,OR=1.393,95％ CI 1.049 ～ 1.850)和G等位基因(P=0.028,OR=1.380,95％ CI 1.025 ～ 1.857)可提高AD患者食物敏感的风险.结论 中国汉族人群FLG基因多态性可能是一些AD相关临床表型的危险因素,H519N可能与AD伴发哮喘相关,S2366T和K2444E则可能与AD伴食物敏感相关.     

银屑病家系易感基因定位的研究

目的:探讨银屑病易感基因与第4、6、17号染色体上7个微卫星标记的连锁关系,初步对汉族鲁系银屑病易感基因进行定位研究。方法:选择22个银屑病家系中75例患者和正常人51例。选择7个微卫星标记(STR):D6S276、D6S1610、D4S403、D4S424、D4S415、D17S949、D17S784,利用ABI3730测序仪进行电泳测序,并用与之配套的GeneScan、GeneMapper软件进行基因分型。利用GENEHUNTER软件对STR的基因分型数据进行连锁分析。结果:D17S949、D17S784位点的最大两点LOD值,最大两点NPL值均大于1(P<0.05),提示存在连锁关系。结论:染色体17q23~17q25区域内存在寻常型银屑病易感基因。     

男性STD后性功能障碍36例临床分析与治疗

目的:分析男性STD后性功能障碍临床资料,探讨治疗方法。方法:对我院门诊2001～2004年36例男性S T D后性功能障碍的患者临床资料进行回顾性分析。结果:本组36例经心理与中西药结合治疗治愈21例,显效7例,总有效率77.8%,好转6例,无效2例。结论:STD后出现性功能障碍主要是心理因素造成,心理治疗是主要手段,结合临床症状辨证论治以疏肝解郁、活血化瘀为主。     

1q31-32存在新的银屑病易感基因

目的:确定染色体1q是否存在中国汉族寻常型银屑病易感基因位点.方法: 用覆盖染色体1q的12个微卫星标记,对36个寻常型银屑病家系共190个个体(包括92例患者与98例正常亲属)进行基因组扫描研究,并用LINKAGE、ETDT及GENEHUNTER软件进行统计处理.结果:①LINKAGE分析示D1S2891的LOD值为1.0750(θ=0.2),支持连锁;②GENEHUNTER示D1S249、D1S2772和D1S2891的NPL值均大于1.6,相应P<0.05;③ETDT示D1S249 170 bp等位基因和D1S413 258 bp等位基因分别优先传递给正常子代.结论: 中国汉族人1q31-32区存在银屑病易感基因.     

尖锐湿疣患者HPV感染与细胞免疫功能的相关性

目的研究尖锐湿疣初发、复发患者之间,以及不同病程患者之间T淋巴细胞亚群的表达情况。方法选择56例尖锐湿疣患者,经冷冻治疗后至疣体消失后随访3个月,未复发者计入A组(20例),再次复发者计入B组(36例),应用三色荧光抗体染色法检测各组患者外周血CD4+,CD8+T淋巴细胞的表达,比较A,B两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。同时根据病程长短,病程<3个月者计入C组(37例),病程≥3个月者计入D组(19例),比较C,D两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。结果①初发及复发患者组T淋巴细胞亚群的变化:A组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(34.61±4.98)%,(29.46±4.56)%和(1.20±0.22),B组分别为(30.33±4.84)%,(33.10±5.90)%和(0.94±0.21),正常对照组分别为(39.58±4.31)%,(25.44±3.54)%和(1.57±0.17),与正常对照组相比,A,B两组CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.05),且B组变化更为明显,与A组差异有统计学意义(P<0.05);②不同病程患者组T淋巴细胞亚群的变化:C组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(33.03±4.51)%,(30.60±5.36)%和(1.11±0.23),D组分别为(29.57±5.98)%,(34.12±5.73)%和(0.89±0.22),C,D两组与正常对照组相比,CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.01),且D组变化更为明显,与C组差异有统计学意义(P<0.05)。结论与正常对照组比较,尖锐湿疣患者存在细胞免疫功能降低,且随着病程延长、病情反复,全身细胞免疫功能降低更为明显,导致CA迁延不愈。     

毛囊角化病一家系及三例散发患者ATP2A2基因突变研究

目的：对毛囊角化病（Darier's disease, DD）一家系及三例散发患者进行ATP2A2基因的突变分析。方法：收集先证者及其家系成员、散发病例的临床资料和外周血,采用PCR技术扩增ATP2A2基因所有编码区及侧翼序列,用Sanger法测序检测潜在的突变,选取与患者无亲缘关系的100例健康人作为对照,同时对已报道的ATP2A2基因突变进行文献回顾。结果：家系中三例患者均检测出ATP2A2基因第5号外显子c.380 G>A(p.G127D)新发错义突变;散发患者S1检测出第13号外显子C.1676G>A(p.R559Q)错义突变,散发患者S2检测出第14号外显子c. 2001C>T(p.D667D)同义突变,散发患者S3未检测出突变。结论：本研究中共发现三个突变,其中c.380G>A(p.G127D)在中国人群中首次报道,拓展了ATP2A2的基因突变谱。     

Hiv infection in patients of sexually transmitted disease

A total of 1027 male patients suffering from sexually transmitted diseases (STD) during 1990 to 1996 were screened for HIV infection. All cases were in the age group 17 years to 48 years. One hundred and sixty-seven STD cases (16.3%) were found to have HIV infection. A rising trend in incidence of HIV infection in STD patients from 1990 (2.8%) to 1996 (27.8%) was noticed countrary to declining trend of STDs from 213 cases in 1990 to 79 cases in 1996. The incidence of HIV infection was 30.3% in lymphogranuloma venereum, 19.5% in chancroid, 13.5% in syphilis, 17.6% in herpes genitatis, 6.7% in gonorrhoea and 11.2% in other STD cases.     

A study on the present scenario of STD management in an urban clinic in Kolkata

A total of 4129 patients attended the STD clinic from 1996 to 1999. Of those 25.75% were STD cases. Male and female cases comprised 86% and 14% respectively. Majority were in the age group between 18 to 38 years. Chancroid was the commonest STD (37.7%). Other STDs in order were syphilis (30.66%), NGU (15.71%), gonorrhoea (7%), venereal wart (3.57%), candidiasis (2.53%), trichomonal vaginitis (1.6%), herpes genitalis (0.65%) and LGV (0.47%). No case of Donovanosis or HIV was detected. 13.7% of STD cases were reactive for VDRL test and 8% of the antenatal attendants were strongly VDRL test reactive. The urethral discharge on gram staining was positive for gonococcus, in 29%. 68% of the clinic attendants were given safer sex education and served condom.     

STD trends in regional institute of medical sciences, Manipur

A study carried out among the 2230 STD patients during 1996-2000 shows the types, distribution and trends of the various STDs seen in our hospital. STDs contribute 3.30% of the total skin OPD cases. Males dominate with 89.3% of STD cases. Bolanoposthitis (22%) was the commonest STD, followed by gonorrhoea (11.8%) and nongonococcal urethritis (NGU) being 11.2%. Syphilis was seen in 6.2% of the cases. The prevalence of VDRL reactivity and HIV reactivity remains almost the some being 8.49% and 8.21% respectively. There is increased occurrence of various psychosexual disorders among the affected patients.     

High seroprevalence of HSV-1 and HSV-2 in STD clinic attendees and non-high risk controls: a case control study at a referral hospital in south India

BACKGROUND: In Asia, HSV seroprevalence studies are sparse and they have recorded lower prevalence of HSV infection, especially HSV-2. AIMS: To ascertain the seroprevalence of HSV-1 and HSV-2 in patients attending a STD clinic in a referral hospital in south India and to compare it with a control group. METHODS: The study included 135 consecutive STD cases having history of ulcerative or non-ulcerative STD in the present or in the past 5 years and 135 age and sex-matched controls. Diagnostic serology was done for HSV-1 and HSV-2 using type specific IgG by indirect immunoassay using ELISA. The results were analyzed utilizing Chi- square test. RESULTS: Amongst 135 STD clinic cases, 106 cases were males and 29 cases were females with male to female ratio of 3.65:1. The mean age was 32.2 years (range 16-65 years). Among study group cases, 112 (82.9%) cases were co-infected with HSV-1 and HSV-2, 11 (8.1%) cases were seropositive for HSV-1 alone and 3 (2.2%) cases were seropositive for HSV-2 alone. In the control group, 112 (82.9%) cases were co-infected with HSV-1 and 2, 12 (9.6%) for HSV-1 alone and 1(0.8%) for HSV-2 alone. Correlation of HSV-1 and HSV-2 serology with various demographic and behavioral factors was statistically insignificant. CONCLUSIONS: Seroprevalence of HSV-1 and HSV-2 in STD clinic cases and control group is high, similar to that recorded in sub-Saharan Africa. Thus, serological studies for HSV-1 and HSV-2 cannot be taken as a marker of sexual behavior in our set of population.     

A survey of sexually transmitted diseases/HIV coinfection testing and reporting practices among health care providers in New Jersey

OBJECTIVES: A survey was conducted to ascertain the adherence of health care providers (HCPs) to national guidelines recommending human immunodeficiency virus (HIV) testing among persons with sexually transmitted diseases (STDs) and STD testing among HIV-infected persons. STUDY: A random sample of HCPs reporting STD and HIV cases in New Jersey were surveyed regarding their STD/HIV testing and reporting practices. RESULTS: Questionnaires were returned by 90 of 162 (55.5%) STD and 73 of 135 (54.1%) HIV HCPs. Sixty-six percent of STD HCPs reported offering HIV testing to persons with gonorrhea, chlamydia, or syphilis. However, up to 42.1% of HIV HCPs who managed HIV-positive patients never or almost never performed initial STD screening in these patients. Among HIV-infected patients, 36.4% of HIV HCPs reported that they never or almost never conducted annual gonorrhea or chlamydia screening in women; 48.6% never conducted screening in men. CONCLUSIONS: Further efforts are needed to optimize the implementation of national guidelines for STD/HIV coinfection testing.     

上海市金山区卖淫嫖娼人员892人性病状况分析

目的了解上海市金山区2005～2007年公安强制送检的892名卖淫嫖娼人员的性病状况及其特点,为制订防病政策提供依据。方法对892名金山区各派出所强制送检的卖淫嫖娼人员的一般资料进行分析,对采集的标本进行淋病奈瑟菌(NG)的分离培养、解脲脲原体(UU)培养、沙眼衣原体(CT)检测、梅毒甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体抗体凝集试验(TPPA)及人类免疫缺陷病毒(HIV)1+2型抗体(ELISA)的检测。结果892名卖淫嫖娼人员中以外省人员居多(880人),文化程度初中及以下最多(771人);该3年平均阳性检出率:448名卖淫人员中NG感染为10.49%,UU感染为74.33%,CT为感染7.14%,梅毒12.28%,HIV为0;444名嫖娼人员依次分别为2.25%,45.27%,1.35%,2.93%,0人;同时患两种性病的卖淫人员17.41%,多于嫖娼人员的2.93%,同时患3种性病的卖淫人员4.02%,多于嫖娼人员的0.68%,同时患4种性病的0.22%,多于嫖娼人员的0人。结论卖淫嫖娼人员性病感染率较高,尤其UU感染和梅毒,是艾滋病性病的重要传染源。加强对卖淫嫖娼人员的主动监测和规范治疗,提倡安全性行为,是预防与控制艾滋病性病的有效措施。     

性病门诊366例女性下生殖道STD病原体分析

目的：了解性病门诊女性下生殖道STD病原体感染情况。方法：利用淋球菌（NG）培养,支原体（Uu,Mh)培养,沙眼衣原体（CT）培养,白色念珠菌（以下简称白念）培养,阴道毛滴虫（以下简称滴虫）镜检等方法,于1996年4-2000上4月对366例性病门诊女性下生殖道STD病原检查。结果：366例女性下生殖道感染STD病原体303例,感染率为82．79％,其中Uu感染率为65．57％,Mh为27．87％,CT为19．67％,白念为21．31％,滴虫为4．10％,NG为1．64％。结论：性病门诊女性下生殖道感染,STD病原有多种,以Uu最为多见,其次是Mh,再次为CT及白念,NG感染率较低,STD病原体混合感染较严重。     

Factors associated with newly diagnosed HIV among persons with concomitant sexually transmitted diseases

OBJECTIVE: We evaluated Illinois and Chicago Departments of Public Health surveillance databases to determine risk factors associated with newly diagnosed HIV among persons with bacterial sexually transmitted diseases (STDs). METHODS: Test results for Chlamydia, gonorrhea, early syphilis (primary, secondary, and early latent), and HIV from public health clinics in Illinois in 2002 were merged with demographic and behavioral survey data collected during patient visits. STD was defined as any positive non-HIV result. RESULTS: Among 43,517 patient encounters, 5814 (13.4%) had positive STD test results. There were 308 (0.7%) positive new HIV test results, of which 71 (23.1%) had concomitant infection with an STD. Compared with STD-positive, HIV-negative cases, age >30 years (OR = 1.9, 95% CI, 1.0,4.4), men who have sex with men (MSM) (OR = 22.2, 95% CI 11.3-43.7), and bisexual male (OR = 22.4, 95% CI 7.8-64.8) were independently associated with STD and HIV coinfections. Among distinct STDs, syphilis (n = 438) was the least frequent (7.5%), but was reported in the highest proportion (10.1%) of all new HIV infections and conferred the greatest risk (OR = 11.0, 95% CI 7.7-15.8) for newly diagnosed HIV. CONCLUSIONS: MSM were at increased risk for newly diagnosed HIV with STD coinfection. Persons with a concomitant STD and HIV were older than US populations that generally constitute the greatest proportion of STD cases. These results highlight the role in particular of syphilis among populations at high risk for HIV transmission. Public health interventions targeting MSM and older adults for effective testing and prevention strategies are critically needed within high-risk networks for cotransmission of STDs and HIV.     

Passive sentinel surveillance system for sexually transmitted diseases in primary healthcare sites in Ethiopia, 1991-3

BACKGROUND: In 1989 the ministry of health of Ethiopia launched an STD control programme to strengthen the STD case management capabilities at public health centres and hospitals. The programme included the introduction of a syndrome based system for notification of STD cases. We here report the data originated by the syndromic case reporting system under programme conditions. METHODS: 35 (17%) of the total 225 hospitals and public health centres of Ethiopia were included in the programme. Information relevant to the years 1991 to 1993 was analysed at mid 1994. RESULTS: 32 clinical sites (91% of the total) provided at least one monthly report. The proportion of monthly reports received was 65% of those due, ranging from 51% in 1991 to 73% in 1992 and 42% in 1993. A total of 77,294 consultations for STD related symptoms were recorded, including 70,200 new cases, 6588 repeated consultations, and 506 partners of STD patients. Among first attendant patients 38,459 (52.7%) were males with a male to female ratio of 1:1. Urethral discharge and vaginal discharge were the leading cause of consultation among males (58%) and females (64%) respectively. The frequency of genital ulcer diseases was 26% among males and 15% among females. Inguinal adenopathy in the absence of genital ulcers was also frequent, accounting for 10% of consulting males and 5% of females. Based on Gram stain, gonorrhoea was identified in 64% of the cases of urethral discharge, while trichomoniasis and candidiasis were identified by wet mount in 28% and 16% of the cases of vaginal discharge respectively. CONCLUSIONS: STDs are a common cause of consultation at public health centre sites in Ethiopia. A syndromic case reporting system proved to be efficient and produced valuable information to initiate assessment of the problem and to set up bases for monitoring trends of STD morbidity.     

Incidence of HIV seropositivity in STD cases

Two hundred patients comprising of 144 males and 56 females ranging in age from 10 years to 68 years were studied. The incidence of HIV positive cases in STD patients was 13.5%. Maximum incidence of STD cases were seen in the age group between 21-25 years (27%). Maximum incidence of HIV seropositivity was seen in 19 and 20 years age group (33.8%). In HIV positive cases, there was a male predominance (62.9%). Most of the patients were from low socio-economic status, CSW were the common source and GUD was the most common STD association.