新生儿早期先天性梅毒多脏器损害的护理探讨

目的　探讨新生儿早期先天梅毒多脏器损害护理的最佳模式。方法　对早期先天梅毒多脏器损害者进行特殊模式 (消毒隔离、皮肤特护和改进吸痰方法 )的护理。结果　所有病例均治愈出院或病情稳定出院。结论　早期先天梅毒新生儿多合并多脏器损害 ,而且具有传染性。因此 ,要做好消毒隔离 ,加强病情观察 ,在做好基础护理的同时 ,改进护理模式、做好卫生知识宣教及随访 ,对新生儿早期先天梅毒多器官损害的治疗和预后具有重要的意义。     

High-Throughput,High-Frequency 3-D Ultrasound for in Utero Analysis of Embryonic Mouse Brain Development

With the emergence of the mouse as the predominant model system for studying mammalian brain development, in utero imaging methods are urgently required to analyze the dynamics of brain growth and patterning in mouse embryos. To address this need, we combined synthetic focusing with a high-frequency (38-MHz) annular-array ultrasound imaging system for extended depth-of-field, coded excitation for improved penetration and respiratory-gated transmit/receive. This combination allowed non-invasive in utero acquisition of motion-free 3-D data from individual embryos in approximately 2 min, and data from four or more embryos in a pregnant mouse in less than 30 min. Data were acquired from 148 embryos spanning 5 d of early to mid-gestational stages of brain development. The results indicated that brain anatomy and cerebral vasculature can be imaged with this system and that quantitative analyses of segmented cerebral ventricles can be used to characterize volumetric changes associated with mouse brain development.     

PROTECTIVE ANTIBODIES IN THE SERUM OF SYPHILITIC RABBITS

1. When an emulsion containing virulent Treponema pallidum is added to serum from normal rabbits and from untreated immune syphilitic rabbits that have been infected with a homologous strain of T. pallidum the mixture incubated at 37°C., and injected intracutaneously into normal rabbits, typical syphilitic lesions commonly develop at the sites of inoculation of the normal serum-spirochete mixture, while at the sites of inoculation of immune serum-spirochete mixtures usually either no lesion develops or else the incubation period of the resulting lesions is shorter and the lesions remain smaller than those produced by normal serum-spirochete mixtures. 2. In a series of preliminary experiments, of 56 areas inoculated with serum-spirochete mixtures, in 42 the suppressive action of the syphilitic serum was manifest, in 10 areas questionable evidence of protection was noted, and in 4 areas there was no evidence that the syphilitic serum had exerted a suppressive or protective action. 3. The protective action of syphilitic serum seems to have been lessened by heating to 56°C. 4. The results of the protection test in three other series of experiments were as follows: (a) Of 12 areas in 6 rabbits inoculated with normal serum-spirochete mixtures typical syphilitic lesions developed, while in the same number of areas inoculated with immune serum-spirochete mixtures there was complete or partial suppression of lesions in all. (b) Of 45 areas inoculated with serum from 10 different immune syphilitic rabbits, definite evidence of protection was observed in 37, questionable evidence in 5, and no evidence of protection in 3. (c) Of 8 areas in 4 rabbits inoculated with immune serum-spirochete mixtures no lesions developed during the period of observation, while of 8 areas in the same rabbits inoculated with one of two normal serum-spirochete mixtures typical syphilitic lesions developed in each.     

FURTHER OBSERVATIONS ON THE RELATION OF THE EYE TO IMMUNITY IN EXPERIMENTAL SYPHILIS : III. THE INFLUENCE OF A NON-SPECIFIC INFLAMMATORY REACTION IN THE CORNEA ON THE DEVELOPMENT OF IMMUNITY IN THAT TISSUE AFTER INTRATESTICULAR INOCULATION

Two experiments are reported in which rabbits originally inoculated with syphilis and treated late in the course of the disease (174th to 210th day) were reinoculated subsequently in both corneas with the homologous strain of syphilitic virus. In each animal one cornea was inoculated with dead tubercle bacilli prior to reinoculation with the syphilitic virus. This procedure was carried out in order to bring about a non-specific inflammatory reaction with resultant vascularization, the intention being to find out if such vascularization would render the cornea more resistant to inoculation with the homologous strain of syphilitic virus. The results of both experiments were similar and while they were not conclusive, they indicated that there was a tendency for corneas which had been injected with dead tubercle bacilli to be more refractory to a subsequent inoculation with homologous syphilitic virus than the corneas of the same animals that had not been injected with dead tubercle bacilli. This tendency may be interpreted as suggestive evidence for the view that in the syphilitic rabbit there develop circulating antibodies toward the homologous strain of T. pallidum.     

A rare case of voluminous brain abscess due to Actinomyces meyeri and Aggregatibacter aphrophilus: is there any evidence for a prolonged antibiotic oral relay?

We present the case of a patient with a voluminous cerebral abscess caused by Aggregatibacter aphrophilus and Actinomyces meyeri occurring a week post dental scaling. Both these bacteria are rarely involved in brain abscesses, and so far, cases of cerebral actinomyces have mostly been treated surgically and with intravenous (IV) antibiotics for 3–4 months, then put on oral antibiotic therapy with penicillin or amoxicillin for a further 3–12 months. Our patient underwent drainage through craniotomy and was subsequently put on intravenous ceftriaxone for 3 months accompanied by brain imaging control at the end of this period which showed complete regression of the abscess. Following parenteral treatment, no oral antibiotics were given since pharmacokinetic properties do not allow to attain high tissue concentration in the brain. This treatment gave excellent results.     

SYPHILITIC MYOCARDITIS IN THE RABBIT

In the course of routine postmortem examinations of rabbits infected with Treponema pallidum, six cases of pronounced granulomatous myocarditis were encountered. Treponemata were not demonstrated in the lesions, but the clinical history, and the gross and microscopic appearance of the lesions seemed to warrant a diagnosis of syphilitic myocarditis. The lesions measured 1.0 cm. or more in diameter and histologically were practically identical with those described by Warthin in cases of syphilitic myocarditis in man. These are the first cases of syphilitic myocarditis or of visceral syphilis in the rabbit that have been reported.     

THE DIRECT CULTIVATION OF TREPONEMA PALLIDUM PATHOGENIC FOR THE MONKEY

A method for the direct cultivation of Treponema pallidum from human syphilitic lesions, by the employment of a solid medium, has been described. By means of it, three of the four strains worked with were successfully cultivated. The several pure cultures agree in morphological and cultural characters, grow only in the presence of sterile tissue under anaerobic conditions, and do not produce putrefactive odors. The morphology is typical under optimum cultural conditions; it becomes atypical when the conditions are unfavorable. In cultures, Treponema pallidum multiplies by longitudinal division. The process is usually symmetrical but occasionally appears to be asymmetrical. Inoculation of the pure cultures into the skin of two species of lower monkeys was followed by the production of lesions resembling the primary syphilitic lesion occurring in man and those caused in the monkey by inoculation of spirochætæ-containing serum from human sources. During the course of the positive inoculation in the monkey, the blood develops the property of giving a positive Wassermann reaction. Thus the relation of Treponema pallidum to this reaction is supported, and the identity of the cultivated strains with the species found in human syphilitic lesions established.     

The pathophysiology of acute syphilitic funisitis.

There is an increase in the number of cases of syphilis in pregnancy in the United States. Fetal death may occur in syphilis from acute or chronic infections. A case is presented in which an acute fetal infection occurred. The patient presented at 31 weeks' gestation, with a decrease in fetal movements and non-reactive cardiotocography. Ultrasound and Doppler analysis of the fetal heart, cerebral and umbilical arteries, aorta and umbilical vein led to the suspicion of acute cardiac failure. An amniocentesis yielded a white cell count of 1122 white blood cells, with 91% polymorphs, but the Gram stain was negative. The fetus developed a persistent bradycardia and was delivered. The diagnosis of acute severe syphilitic funisitis was suspected from histological sections of the cord. Diagnosis was established from maternal and fetal blood. Modern ultrasound techniques, including imaging, Doppler and cardiotocography, can lead to the analysis of the pathophysiology of disease states. An acute syphilitic infection should be suspected when this constellation of findings is found.     

A STUDY OF THE RELATION OF TREPONEMA PALLIDUM TO LYMPHOID TISSUES IN EXPERIMENTAL SYPHILIS

A widespread dissemination of Treponema pallidum from a local focus of inoculation in the rabbit constantly occurs by way of the lymphatics. Spirochetes were regularly recovered from the satellite lymph nodes by animal inoculation after scrotal inoculation; they were present as early as 2 days, when no specific primary reaction was detected, and at later periods of from 5 to 61 days after inoculation. Other superficial nodes at remote sites such as the popliteals and with no syphilitic lesions in the drainage area have also been shown to harbor active organisms. Although spirochetes were found in relatively few of the lymph node emulsions, the orchitis resulting from their injection was of a rapidly progressive type with an incubation period but slightly longer than that produced by a testicular or skin nodule emulsion rich in spirochetes. It has further been shown that a syphilitic infection is sufficiently established in the rabbit body within 48 hours after scrotal inoculation so that the primary lesion is no longer essential for its maintenance. Active treponemata survive in the popliteal lymph nodes for long periods of time and have been regularly recovered from them in cases of true latency. The lymph nodes, therefore, function as reservoirs of the organisms. The ability to recover the spirochetes from lymphoid tissue through successive generations is seen in the serial passage of lymph node emulsion to testicle during an 18 months period. The persistence of spirochetes in lymphoid tissue irrespective of the presence or absence of syphilitic lesions is a characteristic and fundamental feature of syphilis of the rabbit. The existence of infection, therefore, may be demonstrated at any time by the recovery of spirochetes from the popliteal lymph nodes by animal inoculation. This fact is of great practical importance in the therapy of the infection and may be profitably utilized in determining the ultimate effect of a therapeutic agent. These experiments demonstrate that the disease is not confined to the site of local inoculation but that lymphogenous dissemination of treponemata regularly takes place, and that during the course of this process organisms become localized in the lymph nodes and exist there indefinitely irrespective of the occurrence of manifestations of disease. The intimate relation of Treponema pallidum to lymphoid tissue is an essential concept of syphilis of the rabbit, and from this point of view, the infection is primarily one of lymphoid tissue.     

ON THE PRESENCE IN SYPHILITIC SERUM OF ANTIBODIES TO SPIROCHETES,THEIR RELATION TO SO CALLED WASSERMANN REAGIN,AND THEIR SIGNIFICANCE FOR THE SERODIAGNOSIS OF SYPHILIS

1. In confirmation of Gaehtgens, syphilitic human sera give positive complement fixation with cultures of so called T. pallidum (Reiter strain). Syphilitic rabbit sera are equally reactive. Syphilitic human and rabbit sera agglutinate these cultures, often in high titre (Beck). 2. Normal rabbit sera react weakly with the culture to give both agglutination and complement fixation in low titre. Normal human sera, despite the fact that they contain agglutinins in low titre, fail to fix complement with the Reiter strain of cultured spirochetes. Confirming Gaehtgens, the latter reaction is therefore of practical utility for the serum diagnosis of syphilis. 3. When syphilitic serum is heated at 63°C., there is no demonstrable difference in the thermolability of the antibody to spirochetes, and of the reagin which determines the Wassermann and flocculation tests. 4. (a) The absorption of syphilitic serum by spirochetal suspensions removes all reactivity, not only for the spirochetes, but for tissue lipoids (alcoholic beef heart extract) as well; the sera become Wassermann- and flocculation-negative. (b) Absorption of syphilitic serum with tissue lipoids renders the Wassermann and flocculation tests negative, but does not demonstrably change the reactivity of the serum with spirochetes. (c) Rabbits immunized to beef heart lipoid develop spirochetal agglutinins and complement-fixing antibodies (Reiter strain) in high titre. 5. It is concluded that these cultured spirochetes contain antigenic material serologically related to a substance present in mammalian tissue, as well as other antigenic factors not present in such extracts, but equally reactive with syphilitic serum. 6. These findings support the thesis that the primary serologic change in syphilis is the development of antibodies to T. pallidum. The Wassermann and flocculation tests would be explained on the basis that the tissue extracts used as "antigen" in these tests contain one or more substances serologically related to antigenic components of T. pallidum. Similarly, the cultured Reiter strain of spirochete is apparently sufficiently close serologically to T. pallidum to be agglutinated by and to give complement fixation with the antibodies to T. pallidum present in syphilitic serum. 7. Since suspensions of cultured spirochetes contain antigenic factors which react specifically with syphilitic serum, some of which are not present in ordinary Wassermann and flocculation "antigens," they may prove even more valuable than those tissue extracts in the serodiagnosis of syphilis.     

Effects of positive end-expiratory pressure on brain tissue oxygen pressure of severe traumatic brain injury patients with acute respiratory distress syndrome: A pilot study

PurposeTo verify whether high positive end-expiratory pressure levels can increase brain tissue oxygen pressure, and also their effects on pulse oxygen saturation, intracranial pressure, and cerebral perfusion pressure.Material and MethodsTwenty traumatic brain injury patients with acute respiratory distress syndrome were submitted to positive end-expiratory pressure levels of 5, 10, and 15 cm H₂O progressively. The 3 positive end-expiratory pressure levels were used during 20 minutes for each one, whereas brain tissue oxygen pressure, oxygen saturation, intracranial pressure, and cerebral perfusion pressure were recorded.ResultsBrain tissue oxygen pressure and oxygen saturation increased significantly with increasing positive end-expiratory pressure from 5 to 10 and from 10 to 15 cm H₂O (P = .0001 and P = .0001 respectively). Intracranial pressure and cerebral perfusion pressure did not differ significantly with increasing positive end-expiratory pressure from 5 to 10 and from 10 to 15 cm H₂O (P = .16 and P = .79 respectively).ConclusionsHigh positive end-expiratory pressure levels increased brain tissue oxygen pressure and oxygen saturation, without increase in intracranial pressure or decrease in cerebral perfusion pressure. High positive end-expiratory pressure levels can be used in severe traumatic brain injury patients with acute respiratory distress syndrome as a safe alternative to improve brain oxygenation.     

STUDIES IN EXPERIMENTAL SYPHILIS : IV. THE SURVIVAL OF TREPONEMA PALLIDUM IN THE INTERNAL ORGANS OF TREATED AND UNTREATED RABBITS.

Simultaneous transfers to the testes of normal rabbits of circulating blood, heart muscle, liver, brain, spleen and bone marrow (mixed), inoculated testicle, and popliteal lymph nodes from a series of untreated syphilitic rabbits, demonstrated the persistence of the original infection unifomnly in the lymph nodes and less regularly in the liver, mixed spleen and bone marrow, and testis originally inoculated. In one instance the circulating blood was found to be infectious. Transfer of similar tissues from syphilitic rabbits treated with arsphenamine late in the course of the disease failed to disclose syphilitic infection of any of these tissues. In one animal, in which keratitis developed both before and after treatment, the blood, internal organs, and lymph nodes were found to be non-infectious in spite of the fact that the cornea was shown to be the site of a syphilitic inflammation. Transfer of lymph nodes or internal organs of treated syphilitic rabbits is probably the best method of evaluating an antisyphilitic agent, but it must be supplemented by careful observation of treated animals over an appreciable interval of time following treatment. The results of this study support the idea that failure to reinoculate a treated syphilitic animal does not necessarily mean the existence of the first infection but might beinterpreted as indicating the presence of an acquired resistance which persists in rabbits in which no trace of the first infection can be demonstrated.     

MELANOMA (SARCOMA) OF THE EYE IN A SYPHILITIC RABBIT

A melanotic tumor developed in a defective eye of a syphilitic rabbit following repeated genital inoculations with Treponema pallidum. The appearance of the tumor coincided with the development of a syphilitic lesion in the same eye, suggesting a relation between the occurrence of the two lesions.     

BARIUM SULPHATE ABSORPTION AND THE SERUM DIAGNOSIS OF SYPHILIS

The so-called syphilitic antibodies can be removed from a serum by means of absorption with barium sulphate. The removal is due either to an adsorption or a mechanical absorption. The activity of the syphilitic antibodies is thereby unimpaired. The readiness with which the absorption is accomplished with barium sulphate varies considerably with different syphilitic sera. That barium sulphate exerts the same absorbing effect upon non-syphilitic serum components is made evident by the interfering property which the latter manifest in the absorption experiment of the syphilitic antibodies. The selective removal of the serum components, other than the syphilitic antibodies, by means of barium sulphate absorption is, therefore, impossible. On the other hand, a partial removal of these components, with but little removal of the syphilitic antibodies, may be effected when the content of a given serum is poor in syphilitic antibodies and comparatively rich in the indifferent serum components. But this is impossible if the conditions are reversed. The main reasons why some negative syphilitic sera may be so modified by the barium sulphate treatment as to give positive reactions, are explained below, but these apply only to those methods in which inactivated serum is employed. The inactivation reduces the antibody content to about one-fourth to one-fifth of the original. When the serum is very rich in antibodies, this does not affect the result of the fixation test. But when the amount of the antibodies is small, the process of inactivation creates conditions quite unexpected. It may produce such a condition that a given amount of the serum contains, after inactivation, only one or two antibody units, while the other serum components remain undiminished. Here one must not lose sight of the vital fact that these apparently indifferent serum constituents are not at all indifferent in the fixation processes. They may possess affinities which are similar to those of complement for the fixing combination of syphilitic serum and antigen. Speaking quantitatively, one unit of the syphilitic antibodies plus antigen will fix 0.1 cubic centimeter of guinea pig complement, but this unit can also be saturated and blocked by nearly the same amount of the seemingly indifferent serum component of the serum to be tested. Moreover, the regular amount of inactivated serum used in the Wassermann system is 0.2 cubic centimeter, a quantity sufficient to saturate two units of the fixing combination. Fortunately, this self-saturation of the syphilitic antibody-antigen combination by the other serum components is not constant in occurrence, owing to the wide variations of the fixability of the serum components of man. Here the benefit of Wechselmann''s procedure becomes obvious. By removing a surplus of the fixable indifferent serum components by means of barium sulphate, the serum is made to react positively, or more strongly than before the treatment with barium sulphate. This masking of the positive reaction through the self-saturation is liable to occur in any system in which inactivated serum is recommended. Another equally important factor in masking the positive reaction in a serum in which the antibodies are poor, is the presence in considerable amount of natural antisheep amboceptor in human serum. It is a plain and simple fact that an excess of hemolytic amboceptor renders a positive reaction feeble or completely negative. As we have shown in our present investigation, a hemolytic amboceptor can be removed from the serum by means of absorption with barium sulphate. Thus it is easy to understand why Wechselmann found that barium sulphate absorption improves the reaction in the original Wassermann system. The treatment of syphilitic serum with this salt can have a twofold benefit in the case of the original method of Wassermann; namely, the removal of certain interfering serum components and the removal or diminishing of the natural antisheep amboceptor present in the syphilitic serum. In the method of Noguchi, there is no necessity for applying the barium sulphate absorption. Noguchi recommends the use of unheated serum, hence the absolute amount of the serum employed is only one-half of the absolute amount of complement. Eventually an old serum may be anticomplementary and need inactivation, but if the result is doubtful in this instance, a fresh serum from the same patient may be secured and subjected to reëxamination. In this method there is no danger of introducing an amount of hemolytic amboceptor which is both unknown and uncontrollable, for the reason that human serum is usually devoid of isolysin (antihuman hemolytic amboceptor), and, if the latter is present, it never reaches the strength which shows any effect upon the hemolytic system employed. We conclude, therefore, that the barium sulphate absorption is to be recommended for the original method of Wassermann under certain conditions, but that it is unnecessary for the antihuman hemolytic system of Noguchi.     

Early brain injury after aneurysmal subarachnoid hemorrhage: a multimodal neuromonitoring study

IntroductionThere is a substantial amount of evidence from animal models that early brain injury (EBI) may play an important role for secondary brain injury after aneurysmal subarachnoid hemorrhage (aSAH). Cerebral microdialysis (CMD) allows online measurement of brain metabolites, including the pro-inflammatory cytokine interleukin-6 (IL-6) and matrix metalloproteinase-9 (MMP-9), which is indicative for disruption of the blood-brain barrier.MethodsTwenty-six consecutive poor-grade aSAH patients with multimodal neuromonitoring were analyzed for brain hemodynamic and metabolic changes, including CMD-IL-6 and CMD-MMP-9 levels. Statistical analysis was performed by using a generalized estimating equation with an autoregressive function.ResultsThe baseline cerebral metabolic profile revealed brain metabolic distress and an excitatory response which improved over the following 5 days (P <0.001). Brain tissue hypoxia (brain tissue oxygen tension of less than 20 mm Hg) was common (more than 60% of patients) in the first 24 hours of neuromonitoring and improved thereafter (P <0.05). Baseline CMD-IL-6 and CMD-MMP-9 levels were elevated in all patients (median = 4,059 pg/mL, interquartile range (IQR) = 1,316 to 12,456 pg/mL and median = 851 pg/mL, IQR = 98 to 25,860 pg/mL) and significantly decreased over days (P <0.05). A higher pro-inflammatory response was associated with the development of delayed cerebral ischemia (P = 0.04), whereas admission disease severity and early brain tissue hypoxia were associated with higher CMD-MMP-9 levels (P <0.03). Brain metabolic distress and increased IL-6 levels were associated with poor functional outcome (modified Rankin Scale of more than 3, P ≤0.01). All models were adjusted for probe location, aneurysm securing procedure, and disease severity as appropriate.ConclusionsMultimodal neuromonitoring techniques allow insight into pathophysiologic changes in the early phase after aSAH. The results may be used as endpoints for future interventions targeting EBI in poor-grade aSAH patients.     

Liver dysfunction in patients with early syphilis: a retrospective study

Syphilis is one of the unrecognized etiologies of liver dysfunction. The incidence of syphilitic hepatitis is currently unknown. We conducted a retrospective study of causative agents of liver dysfunction at the time of diagnosis of early syphilis. Our study shows that 39 % (44/112) of early syphilis patients have liver enzyme abnormalities at the time of diagnosis and that 2.7 % (3/112) of patients are diagnosed with syphilitic hepatitis. Clinicians should include syphilitic hepatitis in the differential diagnosis for those patients with sexually transmitted diseases presenting with liver enzyme abnormalities.     

脑出血后脑休克期临床研究

目的总结脑出血中后脑休克期的临床特征,旨在提高对脑休克的重视。方法选择2010年2月-2011年12月收治的136例脑出血患者,人院后48h完成巴塞指数（BI）评分、NIH卒中量表（NIHSS）评分,并分为有脑休克组和无脑休克组,比较两组的NIHSS、BI评分;并以NIHSS评分为基线,将136例患者配对为有脑休克组39例,无脑休克组39例（以NIHSS评分相差1～2分内进行配对）;6个月后,按mRS量表将两组配对患者分为预后良好和不良,比较两组预后良好率。结果136例卒中患者,有脑休克者95例,无脑休克者41例,脑出血后休克组患的NIHSS评分高于无休克组,巴塞指数评分低于无休克组;6个月后,两组配对患者中,有脑休克组死亡2例,失访1例,预后良好11例,预后不良25例;无脑休克组死亡1例,失访2例,预后良好29例,预后不良7例,伴有脑休克的患者预后差于无脑休克组。结论伴有脑休克的脑出血患者神经缺损症状重,生活自理能力差,脑休克期影响脑出血患者预后。对伴有脑休克的卒中患者及早进行干预,可望改善卒中患者预后。     

梅毒性主动脉瘤1例及文献复习

目的探讨梅毒性主动脉瘤的临床特点及诊断。方法报告1例梅毒性主动脉瘤,并复习近年来国内外发表的梅毒性主动脉瘤文献。结果本病例表现为进行性声音嘶哑伴心脏杂音。通过主动脉CT血管造影（CTA）及梅毒血清学试验确诊。因抗生素的广泛应用,梅毒性主动脉瘤在近年文献中十分罕见,其起病隐匿,表现多样,病死率高。结论随着HIV的流行和早期梅毒的增加,晚期心血管梅毒有上升趋势。应警惕年轻且无冠心病危险因素的主动脉瘤患者,发现升主动脉的扩张和钙化时,需行梅毒血清学检查。若临床疑诊,应考虑驱梅及手术治疗。     

STUDIES IN EXPERIMENTAL SYPHILIS : VII. REINOCULATION OF TREATED AND UNTREATED SYPHILITIC RABBITS WITH HETEROLOGOUS STRAINS OF TREPONEMA PALLIDUM.

Syphilitic rabbits, whether untreated or treated after the 90th day of infection, were found to be more refractory to subsequent inoculation with the homologous strain of Treponema pallidum than to inoculation with heterologous strains of the same organism, when clinical criteria alone were employed in judging the outcome of reinoculation. The incidence of second infection with homologous strains was 5.4 per cent, as against 50 per cent with heterologous strains.² The resistance which develops in rabbits during the course of a syphilitic infection appears therefore to be strain-specific rather than species-specific. The protection afforded against homologous strains was found to persist for at least as long as 6 months after treatment was discontinued. A given strain may afford a higher degree of protection against some strains than against others, but whether this is to be explained upon the basis of biologic relationship or of differences in virulence, or possibly as the result of both of these factors was not disclosed by the experiments. Rabbits infected with a strain (Nichols) which had been adapted to this species for over a decade could be infected with strains which had been recovered recently from the human body. The previous existence of a syphilitic lesion in the testis which was used as the site for reinoculation did not seem to exert any influence upon the incidence of successful second infections obtained with heterologous strains of Treponema pallidum. Sometimes the course of the second infection produced by inoculation with heterologous strains was less pronounced than that observed in the controls, but in most instances no significant alteration was observed. In syphilitic rabbits treated late in the course of the disease and reinoculated with heterologous strains of Treponema pallidum no lesion may develop at the site of reinoculation but nevertheless the Wassermann reaction may become positive and remain so for weeks thereafter. It is suggested that such animals may be examples of asymptomatic reinfection.     

CXCL8, CXCL9, and CXCL10 serum levels increase in syphilitic patients with seroresistance

BackgroundRecently, the rise of syphilitic seroresistance brings great confusion to the clinical diagnosis and treatment of syphilis, and no clear diagnostic marker has been found to distinguish syphilitic seroresistance from other progression of syphilis. This study evaluated the serum chemokines levels of CCL2, CXCL8, CXCL9, and CXCL10 and its correlation with blood routine, coagulation, and biochemical indexes in seroresistant syphilitic patients.MethodSerum levels of chemokines were quantitatively determined by Flow Cytometric Bead Array (CBA). The results expressed in pg/ml. Clinical parameters were detected and analyzed according to the clinical laboratory standards. A correlation analysis was subsequently performed.ResultsThe seroresistant syphilitic patients increased significantly serum chemokines levels of CXCL8 (***p < 0.001), CXCL9 (***p < 0.001), and CXCL10 (**p < 0.01) when compared to noninfected individuals, but the CCL2 was not statistically significant, and serum CXCL8 shows a strong association with platelets (r = 0.51, **p = 0.004) and serum CXCL10 was significantly positively related to INR levels (r = 0.49, **p = 0.007).ConclusionIncreasing serum abnormalities in CXCL8, CXCL9, and CXCL10 level combining with platelets of peripheral blood and plasmatic INR in syphilis patients may be helpful for the diagnosis of serofast state.