呼吸道合胞病毒A、B亚型变异的进一步研究

利用抗呼吸道合胞病毒的单克隆抗体，通过间接免疫荧光法和免疫转印法对本室分离到的武汉地区1988年～1993年的72株呼吸道合胞病毒进行了分型，可将其分为A、B两型和B_1、B_2亚型；其中,A型株占29.2％，B型株占70.9％。流行病学分析显示，本地区呼吸道合胞病毒流行株5年中有4年以B型株为主；A、B两型的分布还具有局灶化特点；两型在性别、发病年龄方面无显著性差异。     

贵阳市甲型副伤寒沙门菌脉冲电场凝胶电泳分型分析

目的了解贵阳市甲型副伤寒沙门菌的分子流行病学特征,分析菌株的相似性,为追踪传染来源、查找传播途径提供线索。方法用脉冲电场凝胶电泳(pulsed field gelelectrophoresis,PFGE)方法进行分型。结果根据细菌染色体DNA的SpeI酶切图谱,将贵阳地区146株甲型副伤寒沙门菌分成10个PFGE带型,1型32株占21.9%,2型73株占50.0%,3型13株占8.9%,4型7株占4.8%,5型14株占9.6%,6型、7型、8型和9型各1株,各占0.7%,10型3株占2.7%,各型之间的相似性在98.1%～72.0%。暴发株24株被分为5个PFGE带型,1型占54.2%,带菌者1株为1型。各年菌株的PFGE带型不尽相同,1型和2型为常年流行带型。高流行区县的甲型副伤寒菌株被分为9个PFGE带型。结论贵阳地区甲型副伤寒沙门菌流行复杂以2型和1型为优势流行带型,提示存在同一克隆群的菌株广泛传播。该研究进一步证实PFGE是一种发现或预警暴发的可行服务手段。     

恶性肿瘤患者深部感染白色念珠菌的基因分型

目的对引起恶性肿瘤患者深部真菌感染的白色念珠菌进行基因分型。方法研究对象90例,CHROMagarCandida鉴定培养基分离鉴定白色念珠菌,PCR方法鉴定并进行ABC基因分型。结果引起恶性肿瘤患者深部真菌感染的白色念珠菌基因型分别为A型(36/90,40%)、B型(32/90,35.6%)、C型(22/90,24.4%),取自同一病人身体不同部位和相同部位的标本均分离出不同基因型白色念珠菌。结论恶性肿瘤患者深部白色念珠菌感染由不同基因型的白色念珠菌株引起。     

Epidemic serogroup B meningococcal disease in Oregon: the evolving epidemiology of the ET-5 strain

CONTEXT: In 1993, Oregon's incidence of serogroup B meningococcal disease began to rise because of a highly clonal group of strains designated enzyme type 5 (ET-5), the first such increase observed in the United States. OBJECTIVE: To evaluate the impact that the ET-5 strain has had on the epidemiology of meningococcal disease in Oregon. DESIGN AND SETTING: Epidemiologic analysis of surveillance data on Oregon meningococcal disease cases from 1987 through 1996 and multilocus enzyme electrophoresis typing of serogroup B isolates from June 1993 through April 1995 and from April through June 1996. PATIENTS: A total of 836 persons with invasive meningococcal disease. MAIN OUTCOME MEASURES: Disease frequency and clonality of strains. RESULTS: Serogroup B disease incidence rates more than doubled from the preepidemic period in 1987-1992 (1.0 case per 100000 population) to the recent epidemic period in 1995-1996 (2.2 cases per 100000). The age-specific incidence rate of serogroup B disease among those 15 through 19 years old increased 13-fold between the preepidemic period (0.5 case per 100000) and 1995-1996 (6.4 cases per 100000). However, the proportion of cases with meningococcemia and the case-fatality rate did not change. Of 99 Neisseria meningitidis isolates obtained from 1993-1995, 88 (89%) belonged to the ET-5 complex. Of these, 69 (78%) were a single clone, designated 301. Of 20 serogroup B isolates from 1996, 18 (90%) belonged to the ET-5 complex; 17 (94%) were the 301 clone. CONCLUSION: Serogroup B meningococcal disease incidence continues at high levels in Oregon with increasing predominance of the ET-5 clonal strains.     

氨基端不同二级结构的丙型肝炎病毒NS3/4A 复合体的丝氨酸酶活性差异研究

目的 探讨表达不同氨基端二级结构的丙型肝炎病毒非结构蛋白3/4A(HCV NS3/4A)各亚型丝氨酸酶活性及其对宿主细胞功能抑制作用的差异.方法 以pSG5/M-H05-5/4A为模板(A1-1),构建表达不同氨基端二级结构NS3/4A的点突变质粒,并分别命名为A1-2,A2-1,A2.2,B1-1,B1-2,B2-1,B2-2.Western印迹检测所有构建质粒的表达及各亚型顺式及反式NS3蛋白酶活性的差异.荧光素酶报告试验检测pSG5/M-H05-5/4A各个二级结构亚型对干扰素-β(IFN-β)产生及p53依赖的荧光素酶基因的转录活性的抑制作用以及各亚型之间抑制作用的差异.结果 Western印迹显示所有构建质粒均成功表达,而且A2-1和B2-1亚型NS3/4A存在不完全切割现象.表明与其他亚型相比,A2-1和B2-1顺式NS3丝氨酸蛋白酶活性较弱.与其底物NS5A/5BAC共表达后,A2-1和B2-1亚型未切割NS5A5B明显多于其他亚型,而切割 NS5A 则明显少于其他亚型.说明与其他亚型相比,A2-1和B2-1 亚型的反式NS3蛋白酶活性亦较弱.荧光素酶试验结果显示,所有亚型M-H05-5/4A均显著抑制IFN-β启动子活性(P＜0.01)和p53依赖的荧光素酶基因的转录活性(P＜0.01),A2-1和B2-1亚型的抑制作用显著弱于其他亚型(P＜0.05).结论 氨基端不同二级结构的HCV NS3/4A复合体具有不同的丝氨酸酶活性和宿主细胞功能抑制作用.     

Respiratory syncytial virus group A and B genotypes and disease severity among Cuban children

BACKGROUND: Respiratory syncytial virus (RSV) is the leading cause of serious lower tract infections in infants. Comorbid conditions such as chronic diseases and prematurity have been associated with greater severity illness, but virus genotypes and disease severity is still unknown. METHODS: Forty selected strains of RSV group A and B from Cuban infants with acute respiratory disease (ARD) over five seasons were studied. Viral RNA was extracted and polymerase chain reaction (PCR) was carried out using direct primers directed to parts of the nucleoprotein (N) and fusion (F) genes, respectively. Amplicons were digested using restriction fragment length polymorphism (RFLP) to define the association between virus and disease severity. Disease severity was assessed as very mild, mild, moderate, and severe. RESULTS: Three of six known N genotypes were detected. NP4 and NP3 were found more frequently; moreover, it was difficult to establish a relationship between N genotypes and disease severity. Five genotypes in F gene were found: F1, F2, F5, F9 and F11; F9 and F11 were associated with very mild disease, but F1 genotype appears to be associated with moderate to severe disease. CONCLUSIONS: At least five combinations of N and F genotypes circulated in the studied infants in Cuba. Patients with F1NP4 genotype showed moderate to severe disease. Relationship between genotypes and disease severity was established.     

聚肌胞、阿比朵尔呼吸道给药诱导产生干扰素时效性研究

目的 探讨高效干扰素（IFNs）诱导剂聚肌胞、阿比朵尔从鼻腔给药,分别诱导呼吸道局部黏膜产生干扰素达到峰值的时间,以及持续给药能否持续产生诱导作用.方法 用聚肌胞（A组）和阿比朵尔（B组）分别连续6 d（A1组、B1组）、10d（A2组、B2组）、14d （A3组、B3组）、18 d（A4组、B4组）从鼻腔滴入,然后检测鼻腔分泌物中干扰素含量,各小组间进行比较分析.结果 （1）A组、B组内各小组鼻腔分泌物中检测的干扰素含量均比空白对照组（C组）明显增高（P＜0.01）.（2）A组、B组达到峰值的时间均为10d （A2、B2组）,组内各小组间比较,除A2组与A3组比较差异有统计学意义（P＜0.05）、B2组与B3组比较差异无统计学意义（P＞0.05）外,与其他各小组比较,差异均有统计学意义（P＜0.01）.（3）整个实验过程中小鼠无活动弱、倦缩、食量减少、毛色差、嘶咬等不良反应,对鼻腔滴入上述制剂都有较好的适应性.结论 聚肌胞、阿比朵尔通过鼻腔给药对呼吸道黏膜干扰素的产生有明显诱导作用.聚肌胞组鼻腔分泌物中干扰素含量达到峰值时间为10d,阿比朵尔组鼻腔分泌物中干扰素含量达到峰值时间为10～14d.持续给药能持续产生诱导作用.     

天津市2018—2020年人轮状病毒株VP7、VP4和NSP4基因特征

目的 对天津流行的人A组轮状病毒VP7、VP4和NSP4基因进行分型和序列特征分析。方法 收集2018—2020年天津市急性腹泻A组轮状病毒（Rotavirus group A, RVA）阳性病例的粪便标本,提取核酸,进行RT-PCR扩增VP7、VP4和NSP4基因片段全长并进行测序和进化树分析。结果 本次研究所有RVA均属于G9P[8]基因型,进化树分析其VP7和VP4基因分别属于G9-VI和P[8]-3亚型。分析NSP4基因片段发现19株为E1型,12株为E2型。TJ株VP7、VP4、NSP4与疫苗株和参考株比对发现在关键位点有氨基酸替代现象。31个TJ-VP7氨基酸序列与 Rotavac G9 和Rotasiil G9 VP7相比,各有4个和3个替换位点。31例天津株VP8*核苷酸序列与Rotarix P[8]-1和RotaTeq相比,各有6个和3个氨基酸差异。天津株VP5*核苷酸与两种疫苗相比,仅在RotaTeq的5-1区I388L这一处发现氨基酸位点变异情况,其余11个氨基酸位点高度保守;而与Rotarix5-1到5-5区氨基酸序列完全一致。TJ E1株与疫苗株的NSP4序列相比在ASI和ASII区分别有2和3个氨基酸位点发生变异;TJ E2株与疫苗株的NSP4序列相比在ASI-ASIV分别有3、8、2和5个氨基酸位点发生替换。2018—2020年在天津地区检测到19株G9P[8]-E1型RVA,12株G9P[8]-E2型RVA,这是首次在天津发现G9P[8]-E2重组基因型。结论 与同基因型疫苗株和参考株相比,位于TJ株VP7、VP4和NSP4抗原位点的改变对于疫苗保护效力的影响还需进一步研究。需要对轮状病毒分子变异和重组现象进行持续监测,不只是单一监测G/P分型情况,要考虑多基因片段共同分析和全基因组测序,以便及时追踪和掌握轮状病毒的重组和变异情况。     

深圳市2005～2006年健康人群脑膜炎奈瑟菌带菌调查

目的了解2005—2006年深圳市健康人群脑膜炎奈瑟菌（Nm）的带菌状况，为制定有效的防制方案提供依据。方法将健康人群分为0-、5-、10-、15-、25-、35-和45-岁以上7个年龄组，采集咽拭子，进行Nm培养分离和鉴定，用血清学诊断和PCR方法分群。结果2005—2006年深圳市健康人群Nm带菌率为4．4％（55／1255），其中B群49株（89．1％），c群4株（7．3％），29E2株（3．6％）。在两次流脑疫情中各分离到1株B群Nm。结论2005—2006年深圳市健康人群主要携带B群Nm，未检出A群Nm，A群流脑传染源较少。     

预吸氧、缺氧和复氧时大鼠脑组织iNOS表达变化的研究

目的：观察在不同浓度预吸氧条件下,大鼠脑皮质在预吸氧、缺氧和复氧后诱导型一氧化氮合酶（iNOS）表达.方法：大鼠72只随机分成3组,A预吸氧组;B缺氧组;C复氧组,每组随机分成4个亚组,分别给予21%,50%,75%,98%氧气.免疫组化法观察iNOS表达;病理组织学方法观察脑组织损伤程度.结果：免疫组化发现缺氧组阳性细胞率增加,B2组阳性率最低.病理组织学发现缺氧后B2组损伤程度轻于B1组（P＜0.01）,复氧后C4组损伤最重.结论：较低浓度预吸氧可增强脑细胞的抗氧化损伤能力,而高浓度预吸氧则作用相反;iNOS表达的变化可能是不同浓度预吸氧引起脑细胞抗氧化能力改变的作用机制之一.     

ClinicalandExperimentalStudyonTreatmentofAcuteRespiratoryTractInfectionwithShuanghuanglianAerosol（双黄连气雾剂）

ＣｌｉｎｉｃａｌａｎｄＥｘｐｅｒｉｍｅｎｔａｌＳｔｕｄｙｏｎＴｒｅａｔｍｅｎｔｏｆＡｃｕｔｅＲｅｓｐｉｒａｔｏｒｙＴｒａｃｔＩｎｆｅｃｔｉｏｎｗｉｔｈＳｈｕａｎｇｈｕａｎｇｌｉａｎＡｅｒｏｓｏｌ（双黄连气雾剂）ＣｌｉｎｉｃａｌａｎｄＥｘｐｅｒｉｍｅｎ...     

Epidemic Type A Influenza in Southwestern Ontario in 1963

From February to April 1963 epidemic type A influenza occurred in Southwestern Ontario. Eighty cases were diagnosed virologically, 24 of them by isolation of virus. The epidemic strain of virus proved unusually difficult to adapt to growth in embryonated eggs, and it had low avidity for antisera. Antigenically it differed from A2 strains of earlier years and belonged to the subgroup of A2 influenza viruses characterized by the A2/Japan/170/62 strain. Antisera to A2 strains of earlier years neutralized the present strain, but antisera to the present strain failed to neutralize the earlier viruses. Some patients formed antibodies to the present epidemic strain alone, and others formed antibodies both to this strain and to earlier A2 strains.     

宁夏2011年肠道病毒71型VP1区域序列分析

目的 分析2011年宁夏肠道病毒71型分离株VP1的遗传特征.方法 对宁夏40株EV71分离株进行VP1区全长基因序列测定,并对核苷酸序列进行同源性比较及遗传进化分析.结果 2011年宁夏40株分离株与A、B、C型基因型代表株的核苷酸同源性分别为80.9%～82.7%、81.4%～84.8%、87.2%～93.7%,氨基酸同源性分别为94%～95%、96.6%～98%、97.7%～99.7%,与C4a亚型同源性最高;VP1区遗传进化分析表明,这40株同属于C4a亚型.结论 2011年宁夏流行的肠道病毒71型均为C4a亚型,病毒未产生明显的变异,其流行存在多条传播链.     

1997～2002年山东省HIV-1流行株env基因序列测定和亚型分析

①目的对1997～2002年间山东地区HIV-1各亚型分离株进行基因分型，了解各亚型的分布及其与传播途径的相互关系。②方法采集1997～2002年间山东省38例HIV-1感染者的抗凝全血标本，用巢式PCR技术扩增外周血单个核细胞中HIV-1前病毒env基因C2～V3区，并对C2～V3区的核苷酸序列进行测定和分析。⑧结果山东省38例HIV-1分离株中存在亚型和重组毒株4种（A、B、C、A／E）。其中A亚型5株，B亚型22株（其中包括泰国B亚型11株），C亚型10株，A／E重组毒株1株。各亚型内的离散率有差异，A、B、c亚型内基因离散率分别为1．5％、8．6％和1．9％。在性乱人群和静脉吸毒人群中以A亚型和C亚型为主；在职业献血和不安全血制品使用者中以B亚型为主。④结论1997～2002年间山东省HIV-1流行特点为A、B、c亚型共存，伴有重组毒株；传播途径复杂，基因变异较大，B亚型仍然为主要流行株。     

沙门菌携带者分离株血清学及PFGE分型研究

目的建立在健康携带者分离的沙门菌的血清型及PFGE分子型别图谱库,探讨其多态相关性关系。方法将预防性健康体检分离获得的21株沙门菌鉴定培养,进行血清分型;将确定后的菌株用限制性内切酶Xba I消化酶切其基因组DNA,在脉冲场凝胶电泳仪进行DNA电泳,所得的分子型别图谱用Bionumerics5.1软件建立图谱数据库,并进行聚类分析。结果21株沙门菌分属于O：4（B）、O：9（D1）和O：3,10（E1）3个菌群,8种血清型;以德尔卑沙门菌为主,共7株占所有分离株的占33.3%,其次为阿贡纳沙门菌19.1%（4/21）,鼠伤寒沙门菌14.3%（3/21）。经比对分析,18株沙门菌分为15个PFGE型别,菌株间的相似值在53.9%～100%之间,同一血清型别的沙门菌可对应多个PFGE型别。结论沙门菌的PFGE型别呈现多样性,脉冲场凝胶电泳对从业人员体检沙门菌有较高的分型能力,可为沙门菌的日常监测和相关疫情的处理提供重要的技术支撑。     

0～2岁婴幼儿呼吸道病毒监测及临床特征分析

目的 了解绍兴市妇幼保健院0～2岁婴幼儿急性呼吸道感染病毒病原学构成及临床特征,为临床诊疗提供参考。方法 2011年10月—2013年9月绍兴市妇幼保健院住院的呼吸道感染患儿共3677例。采集每例患儿鼻咽吸取物1份,用荧光免疫方法进行病毒检测,包括呼吸道合胞病毒、流感病毒A和流感病毒B、副流感病毒1、2、3、腺病毒。结果 总的病毒阳性检出率25.40%。检出率较高的前3位病毒分别为呼吸道合胞病毒55.03%（514/934）,其流行月份在1～2月和11～12月;副流感病毒3,占17.24%（161/934）,其流行月份在5～8月;流感病毒A,占10.06%（94/934）,其流行月份在3～5月。0～3月患儿主要感染呼吸道合胞病毒（22.84%）,1～2岁患儿流感病毒A感染（3.82%）及腺病毒感染（3.73%）也较常见。呼吸道合胞病毒主要引起肺炎及毛细支气管炎,临床表现以咳嗽、气喘为主;流感病毒A、腺病毒主要引起上呼吸道感染,临床表现以发热为主。结论 病毒是0～2岁婴幼儿急性呼吸道感染的主要病原,以呼吸道合胞病毒、副流感病毒3较为多见,其感染存在季节性特征,临床特征有差异,在临床诊疗时应加以注意。     

全国流感监测网络宁夏监测点2004-2005年度流行性感冒监测结果分析

目的了解宁夏监测地区2004-2005年度流行性感冒(流感)流行情况和病毒流行株及其构成。方法每周统计监测点流感样病例(ILI),采集ILI咽拭子标本,用鸡胚和狗肾传代细胞进行流感病毒分离,采用血凝抑制试验(HI)进行流感病毒型别鉴定。结果两所监测医院共统计上报流感样病例289例,采集ILI标本220份,分离出流感病毒26株,其中H1N1、H3N2和B型流感病毒分别为14株、6株和6株。结论2004-2005年度宁夏流感监测地区的流行情况较为平静,流行优势株为H1N1亚型流感病毒。     

Mortality associated with influenza and respiratory syncytial virus in the United States

CONTEXT: Influenza and respiratory syncytial virus (RSV) cause substantial morbidity and mortality. Statistical methods used to estimate deaths in the United States attributable to influenza have not accounted for RSV circulation. OBJECTIVE: To develop a statistical model using national mortality and viral surveillance data to estimate annual influenza- and RSV-associated deaths in the United States, by age group, virus, and influenza type and subtype. DESIGN, SETTING, AND POPULATION: Age-specific Poisson regression models using national viral surveillance data for the 1976-1977 through 1998-1999 seasons were used to estimate influenza-associated deaths. Influenza- and RSV-associated deaths were simultaneously estimated for the 1990-1991 through 1998-1999 seasons. MAIN OUTCOME MEASURES: Attributable deaths for 3 categories: underlying pneumonia and influenza, underlying respiratory and circulatory, and all causes. RESULTS: Annual estimates of influenza-associated deaths increased significantly between the 1976-1977 and 1998-1999 seasons for all 3 death categories (P<.001 for each category). For the 1990-1991 through 1998-1999 seasons, the greatest mean numbers of deaths were associated with influenza A(H3N2) viruses, followed by RSV, influenza B, and influenza A(H1N1). Influenza viruses and RSV, respectively, were associated with annual means (SD) of 8097 (3084) and 2707 (196) underlying pneumonia and influenza deaths, 36 155 (11 055) and 11 321 (668) underlying respiratory and circulatory deaths, and 51 203 (15 081) and 17 358 (1086) all-cause deaths. For underlying respiratory and circulatory deaths, 90% of influenza- and 78% of RSV-associated deaths occurred among persons aged 65 years or older. Influenza was associated with more deaths than RSV in all age groups except for children younger than 1 year. On average, influenza was associated with 3 times as many deaths as RSV. CONCLUSIONS: Mortality associated with both influenza and RSV circulation disproportionately affects elderly persons. Influenza deaths have increased substantially in the last 2 decades, in part because of aging of the population, underscoring the need for better prevention measures, including more effective vaccines and vaccination programs for elderly persons.     

Clinical study on effect of electro-acupuncture combined with different anesthetics on auditory-evoked potential index

Auto regressive with exogenous inputmodel (ARX-model) auditory evoked index(AAI) is an index that could continuously andaccurately reflect the real-ti me degree of an-esthesia, constituting some new content inanesthesia monitoring that has been studiedextensively in recent years . But there hasbeen so far no report published involving theeffect of electro-acupuncture on AAI under dif-ferent conditions of anesthesia.For this rea-son ,the authors conducted a clinical obser-vation on 48 patien…