人类细小病毒B19与小儿皮肤病

人类细小病毒B19是一种单链小DNA病毒,它可引起人类多种疾病而日益受到广泛的重视。现就B19病毒感染的病毒学和生物学特征、B19病毒的特异性受体、流行病及与之相关的小儿皮肤病的临床表现有有关发病机制、B19病毒的实验室诊断和治疗等诸方面加以综述,并对B19病毒今后的发展趋势作一评述。指出B19病毒可以引起小儿红斑和丘疹－紫癜性袖袜套综合征。B19病毒特异性受体P抗原,是B19病毒的致病基础。为流行病学的阐述有利于感染的预防。对B19抗原抗体及DNA的实验室检测是有利的诊断手段。目前对B19病毒尚无特殊治疗,输注免疫球蛋白是一种比较有效的方法。     

结缔组织病与人细小病毒B19相关性的临床研究进展

结缔组织病是指与自身免疫性有关，侵犯多系统的组织、器官中疏松结缔组织胶原纤维和基质的一组疾病。主要包括系统性红斑狼疮、皮肌炎、硬皮病、类风湿关节炎及结节性多动脉炎等。这些疾病的共同病理改变为黏液水肿、纤维蛋白样变性和坏死性血管炎。其病因尚不明确，目前认为与遗传、环境、免疫等因素有关。近年来研究者发现一些病毒感染的相关证据，其中研究相对较多的病毒是人细小病毒B19（以下简称为B19病毒）。从近10年的相关文献中可以发现，B19病毒与结缔组织病密切相关。     

人类细小病毒B1 9与小儿皮肤病

人类细小病毒B19是一种单链小DNA病毒,它可引起人类多种疾病而日益受到广泛的重视.现就B19病毒感染的病毒学和生物学特征、B19病毒的特异性受体、流行病学及与之相关的小儿皮肤病的临床表现和有关发病机制、B19病毒的实验室诊断和治疗等诸方面加以综述,并对B19病毒今后的发展趋势作一评述.指出B19病毒可以引起小儿传染性红斑和丘疹-紫癜性袖袜套综合征.B19病毒特异性受体P抗原,是B19病毒的致病基础.对流行病学的阐述有利于感染的预防.对B19抗原抗体及DNA的实验室检测是有利的诊断手段.目前对B19病毒尚无特殊治疗,输注免疫球蛋白是一种比较有效的方法.     

综合医院203例HIV抗体阳性患者分析

目的 分析我院2010年7月至2011年6月就诊患者中人类免疫缺陷病毒(HIV)感染情况.方法 对我院1年内就诊患者采用酶联免疫吸附法(ELISA)检测血清HIV抗体,阳性者进行免疫印迹法(WB)确认,应用Excel软件从年龄,性别,感染途径,婚姻,职业等方面进行分析.结果 203例HIV感染者中(20~50)岁年龄段占81.3%,男:女为1.6:1,无业人员占69.5%,性传播占57.1%.结论 患者分布广,医务人员应提高意识,尽可能对所有患者进行HIV抗体筛查.     

2017年—2019年松江区人类免疫缺陷病毒抗体筛查阳性标本的确证假阳性结果分析

目的 了解上海市松江区的人类免疫缺陷病毒(HIV)感染状况,探索HIV抗体确证假阳性结果的影响因素,为制定针对性的艾滋病(AIDS)防治措施提供科学依据。方法 收集2017年—2019年上海市松江区各医疗机构送检的HIV抗体初筛阳性标本,对相关数据进行整理分析,采用Logistic回归模型分析确证假阳性的相关影响因素。结果 2017年—2019年松江区HIV初筛检测标本共656 955份,其中阳性934份,初筛阳性率为1.42‰。将其中526份初筛阳性标本进行确证试验,发现假阳性170份。多因素Logistic回归分析结果显示：女性(OR=7.804,95%CI:4.540～13.783)、≥60岁(OR=2.671,95%CI:1.267～5.740)、上海户籍(OR=3.532,95%CI:1.935～6.658)、已婚/离异(OR=2.263,95%CI:1.487～3.494)、医疗机构送检(OR=4.552,95%CI:1.321～17.081)和被动检测(OR=3.788,95%CI:1.408～11.437)是确证假阳性的主要影响因素。结论 应加强AIDS的健康宣教,动员...     

中医药治疗抗精子抗体阳性患者临床观察

目的:探讨中医药对于抗精子抗体阳性患者的治疗效果,评价其临床应用价值。方法:将2008年10月～2010年10月在本院进行治疗的60例患者随机分为两组,观察组患者给予中药治疗,对照组患者进行西医治疗,对两组患者的治疗有效率进行比较。结果:观察组患者的治疗有效率为93.3%(28/30),对照组患者治疗有效率为76.7%(23/30),观察组患者治疗有效率高于对照组患者,两组间差异具有统计学意义(P<0.05)。结论:中医药对于抗精子抗体阳性患者治疗效果较好,能够提高治疗有效率,具有很好的临床应用价值。     

银屑病患者血清抗EB病毒抗体的检测

目的：探讨EB病毒感染与银屑病的关系。方法：采用酶免疫法检测53例银屑病患者血清EB病毒抗壳抗原／IgG、IgM抗体，抗早期抗原－D／IgG抗体。抗核心抗原－1／IgG抗体。结果：银屑病患者血清抗ER病毒早期抗原－D／IgG抗体阳性率明显高于正常对照组（P＜0．001）。结论：银屑病患者体内EB病毒可能处于激活状态。     

抗U1RNP抗体阳性新生儿红斑狼疮一例

患儿女,于生后20d出现左足底红斑,几天后面部、躯干出现类似红斑,耳后较多。一般情况尚可,无发热,无腹泻。其母为第3胎第1产,前两次为人工流产,此次妊娠体检时未见异常,孕40周,剖腹产一足月女婴。患儿体重3．75b,身长5lcm,呼吸40次,心率140次,Apgar评分在5min与10min均为10分。     

“抗体平”对抗精子抗体阳性男性不育患者精子膜结构的影响

“抗体平”对抗精子抗体阳性男性不育患者精子膜结构的影响是1997年北京市中医药管理局中医药科技项目资助的研究课题。我们经过3年多的研究，按申请书（合同书）的要求，共观察60例抗精子抗体阳性男性不育患者服用中药“抗体平”（陈文伯方）前后血清中抗精子抗体和电子显微镜下经冷冻蚀刻后精子膜结构的变化（使用中国科学院生物物理研究所实验设备和技术），对“抗体平”治疗抗精子抗体阳性男性不育患者的疗效进行分析评价。现将研究结果总结报告如下。     

Angio-oedema in a neonate with IgG antibodies to parvovirus B19 following intrauterine parvovirus B19 infection

We report a neonate with angio-oedema following fetal hydrops caused by maternal parvovirus B19 infection. Levels of complement components, including total haemolytic complement activity and C1 inhibitor concentration, were within normal ranges in cord blood. Neonatal angio-oedema might be included in the clinical spectrum of parvovirus B19 infection in pregnancy.     

Increased prevalence of human parvovirus B19 DNA in systemic sclerosis skin

BACKGROUND: Human parvovirus B19 is a small, single-stranded DNA virus encoding two structural capsid proteins and a nonstructural protein. It is the aetiological agent of erythema infectiosum and transient aplastic crisis in patients with haemolytic anaemia, and has been associated with fetal death, arthritis and chronic anaemia. In recent years, the possible involvement of parvovirus B19 in systemic sclerosis (SSc) has been reported. OBJECTIVES: To determine whether human parvovirus B19 DNA can be detected in SSc skin tissue specimens. METHODS: Normal subjects (n = 97) and patients with SSc (n = 48), systemic lupus erythematosus (n = 16), dermatomyositis (n = 8), morphoea (n = 6) and graft-versus-host disease (n = 8) were studied. Crude DNA was extracted from skin tissue specimens. We attempted to determine whether human parvovirus B19 could be detected in the skin of SSc using nested polymerase chain reaction (PCR). PCR amplification was performed with specifically designed first and second primer pairs for parvovirus B19 DNA. RESULTS: After the first PCR, the occurrence rate of parvovirus B19 DNA in SSc skin tissues (36 of 48, 75%) was significantly elevated in comparison with that in normal controls (50 of 97, 52%) (P < 0.01). After the second PCR, the occurrence rate of parvovirus B19 DNA in SSc skin tissues (36 of 48, 75%) was significantly elevated compared with that in normal controls (53 of 97, 55%) (P < 0.02). The occurrence rates in the other diseases showed no significant difference from that in normal controls. CONCLUSIONS: The increased prevalence of human parvovirus B19 DNA in SSc skin showed the possibility that the virus may be involved in the formation of skin tissue abnormalities in the disease.     

Acute generalized exanthematous pustulosis associated with a human parvovirus B19 infection

Acute generalized exanthematous pustulosis (AGEP) is a reaction pattern with characteristic clinical features. AGEP typically presents with at least dozens of non-follicular sterile pustules in addition to fever and elevated blood neutrophils. The onset is acute and pustules tend to resolve spontaneously. We herein report the findings of a 33-year-old female who presented with erythema on her elbows and dorsal thighs. Before onset, she did not receive any medications. She had no history of psoriasis, had not touched mercury, did not use tampons and was not pregnant. On the third eruptive day, she developed more than 100 non-follicular pustules in diffuse edematous erythema on her trunk and extremities, predominantly involving the intertriginous areas and she also demonstrated high fever. Her temperature returned to within the normal limits on the fourth eruptive day and the pustules thereafter dramatically vanished until the fifth eruption day. Enzyme immunoassays (EI) were performed for anti-virus antibodies and revealed a seroconversion of antihuman parvovirus B19-specific immunoglobulin (Ig)G antibodies, thus indicating a primary human parvovirus B19 infection. The most frequent causes of AGEP seem to be a drug reaction and enterovirus infection. However, AGEP has not yet been reported to be associated with human parvovirus B19. We speculated that human parvovirus B19 may therefore be one of the causative agents of AGEP.     

Sensitive and rapid diagnosis of human parvovirus B19 infection by loop-mediated isothermal amplification

BACKGROUND: Human parvovirus B19 (B19) infections exhibit various skin manifestations that are similar to and hence hard to distinguish from many other skin diseases. The virological diagnosis of B19 infection is usually based on time-consuming serological tests and polymerase chain reaction (PCR). OBJECTIVES: In this study, a DNA amplification method, loop-mediated isothermal amplification (LAMP), was used for the diagnosis of B19 infection and was compared with PCR. METHODS: Ten patients with acute B19 infection and 16 patients with other skin diseases were enrolled. Sera and pharyngeal swabs were used directly as the templates in LAMP. The LAMP reaction was carried out at 63 degrees C for 1 h in a heat block. The reaction products were judged visually, by adding SYBR Green I into the tubes, and by gel electrophoresis. RESULTS: B19 DNA was detected by LAMP in 10 sera and all of seven tested pharyngeal swabs of 10 patients with acute B19 infection but not in samples from 16 patients with other skin diseases. The results were in agreement with those obtained by PCR except for one case. The reason for the single discrepancy may be that the sensitivity of LAMP is 10(2) times higher than PCR. CONCLUSIONS: Detection of B19 DNA by LAMP in serum and especially in the pharynx is a rapid and convenient method for the diagnosis of acute B19 infection.     

A high prevalence of parvovirus B19 DNA in patients with psoriasis

Psoriasis is a common inflammatory skin disease. Infectious models are considered to be of pathophysiological importance in psoriasis. The immunological profile of stable psoriasis plaques suggests that viral antigens may be important. Human parvovirus B19 (PVB19) is a single-stranded DNA virus that causes various clinical symptoms. Several case reports have suggested associations between PVB19 infection and various chronic autoimmune and dermatologic diseases. There has so far been no information regarding the role of PVB19 in psoriasis, except psoriatic arthritis. In this report, to investigate the role of PVB19 in psoriasis, we analyzed PVB19 DNA of peripheral blood from psoriatic patients (n = 47) in comparison with blood donors (n = 20). We also determined the presence of anti-PVB19 IgG and IgM antibodies by using enzyme-linked immunosorbent assay (ELISA). We found that the presence of PVB19 DNA in patients with psoriasis (38%) was significantly higher than in controls (0%, P < 0.01). Anti-PVB19 IgG antibodies were detected in 79% of the cases while only 6% had anti-PVB19 IgM antibodies. PVB19 DNA presence was associated with seropositivity for anti-PVB19 IgG (P < 0.05) but not with IgM antibodies, indicating subclinical activation of latent infection. No correlation was found between the presence of PVB19 DNA and a patient’s age, sex, type of psoriasis, or psoriasis area and severity index. The data demonstrated a statistically significant association between psoriasis and PVB19. Therefore, we suggest that PVB19 infection may be of pathophysiological importance in psoriasis.     

Simultaneous occurrence of pure red cell aplasia and papular-purpuric ''gloves and socks'' syndrome in parvovirus B-19 infection

Papular-purpuric 'gloves and socks' syndrome (PPGSS) has been associated with parvovirus B-19 infection. We report a case of an adult immunocompetent male who presented with PPGSS. Bone marrow examination revealed pure red cell aplasia. Parvovirus B-19 DNA was detected by polymerase chain reaction in the patient's serum, whole blood and in the cutaneous lesions. This report illustrates the variety of clinical manifestations caused by B-19 infection, presents for the first time the concurrent appearance of pure red cell aplasia and PPGSS in the same patient and, finally, suggests that PPGSS may be due to direct lytic effect of the virus.     

妇科门诊妇女人乳头瘤病毒感染情况分析

目的:调查我院妇科门诊就诊患者人乳头瘤病毒(HPV)的感染状况、基因分型,为预防HPV感染和宫颈癌防治提供理论依据。方法:采用HPV核酸扩增分型检测试剂盒对我院980例门诊女性进行HPV检测,并对其亚型感染情况进行分析。结果:980例受试者中,220例(22.45%)HPV阳性,均按各基因型HPV阳性率计算,单一基因型感染率为16.12%(158/980),多重感染率为6.33%(62/980);其中单纯高危型感染率为17.53%(170/980),单纯低危型感染率为3.57%(35/980),高危型/低危型感染率为1.53%(15/980)。高危型最高为HPV-16(6.12%),其次为HPV-52(3.57%)、HPV-58(2.96%)、HPV-56(2.14%),低危型主要为HPV-6(2.65%)与HPV-11(2.04%)。对220例HPV阳性感染者进行液基细胞学检测(LCT)检查,LCT阳性率为38.18%,同期102例HPV阴性的LCT阳性率为1.96%,HPV阳性与同期HPV阴性妇女的LCT结果的阳性率有显著差别(χ~2=20.343,P=0.01)。结论:本地区妇科门诊就诊患者HPV阳性率较高,以高危型为主,且HPV阳性率与宫颈癌变发生率有相关性。     

2368例女性健康体检者HPV感染相关因素分析

目的:探讨顺义区女性HPV感染情况和相关影响因素。方法:选取2016年3月至2016年6月在我院体检中心健康检查的2368例女性为研究对象,进行HPV检测和初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数、职业、学历等情况问卷调查。结果:HPV感染的危险因素分析显示,初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数方面,各组间相比较,差异有统计学意义(P0.01)。不同职业人群的HPV感染情况相比较,差异有统计学意义(χ2=103.8108,P=0.0000)。不同学历水平组HPV感染情况相比较,差异有统计学意义(χ2=60.5733,P=0.0000)。结论:妇女的HPV感染发生与初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数、职业、学历等方面密切相关。针对高危人群,加强HPV病毒上述易感因素的预防宣教,从而有效降低HPV感染,进而降低子宫颈疾病的发生。