儿童乙肝表面抗原阳性率明显降低

中华人民共和国卫生部疾病控制司2006年3月1日报告，我国全人群乙肝表面抗原阳性率为10％。由于乙肝疫苗的推广应用，我国东部、中部、西部3～12岁儿童乙肝表面抗原阳性率分别降至5．95％，4．22％，5．28％。其中，中部地区3～4岁儿童更降至2．06％。目前。我国儿童乙肝表面抗原阳性率显著低于全人群的阳性率，城市儿童阳性率显著低于农村儿童。除了少数几个省区外。多数省区儿童乙肝疫苗接种率在85％以上，但出生儿童乙肝全程接种率与首针及时接种率水平各地相差很大。东、中、西部地区出生儿童乙肝疫苗全程接种率，出生于医院者分别为94．94％，93．15％和82％。出生于家中者分别为78．11％，81．87％和38．3％;首针及时接种率，出生于医院者分别为84.25％，75．7％和64．83％，出生于家中者分别为29．43、47．01％和17．59％。     

乙型肝炎核心抗原检测及临床意义的探讨

目的 探讨HBcAg检测的临床意义。方法 对临床常规乙型肝炎两对半的ELISA方法检测结果与HBcAg，HBV DNA的检测进行比较。结果 共检测113例标本，HBsAg、HBeAg、HBcAb均为阳性时，HBcAg的阳性率为88．7％，HBsAg、HBeAg为阳性时，HBcAg的阳性率为100％，HBV DNA阳性标本中，HBcAg的阳性率为88．0％，HBeAg的阳性率为100％。结论 开展HBcAg的检测可以更全面准确地反映HBV的感染程度及复制情况；用ELISA方法检测HBcAg，HBeAg基本上可以代替PCR HBV DNA的检测来反映HBV的复制情况。     

2005年吉林省肾综合征出血热病毒抗原调查

目的掌握吉林省宿主动物携带肾综合征出血热（HFRs）病毒抗原的本底情况．为制定防控措施提供科学依据。方法在监测点捕捉并采集鼠类肺组织标本，用免疫荧光法检测病毒抗原携带率并进行分型。结果监测点鼠类HFRS抗原阳性率为6．93％，较2004年同期（5．09％）有所增加。在检测的693份鼠肺标本中病毒抗原阳性数为48份，其中姬鼠型占56％，家鼠型占44％（2004年同期为66％和34％）。结论吉林省2005年HFRS宿主动物携带病毒抗原阳性率继续升高，虽仍以姬鼠型为主，但造成疫情上升的主要原因是家鼠型疫源地在逐年增加。     

HLA-DR抗原与HBV宫内感染关系研究

目的 了解人类白细胞抗原-DR(HLA-DR)抗原与HBV宫内感染的关系，探索HBV宫内感染的遗传易感性。方法以1997年2月～1998年8月在太原市传染病医院分娩的HBsAg阳性孕妇新生儿为研究对象．随机选择发生及未发生HBV宫内感染的新生儿各20例，采用序列特异引物PCR(PCR-sequencelspecificprimer，PCR-SSP)技术扩增HLA-DR基因区18对等位基因。判定HLA-DR抗原的型别。计算HLA-DR抗原各型别出现频率并分析其在2组间的差别。结果 DR3、DR51在宫内感染组的频率较高，分别为45％，40％，在非宫内感染组分别为20％。15％，OR值分别为3．27(0．67～17．08)、3．78(0．69～23．02)．P分别为0．18，0．16。DR53在非宫内感染组的频率较高．为60％，在宫内感染组为35％，OR值为0．36(0、08～1．54)P为0．20，均未达显性差异。结论 DR3、DR51有可能是HBV宫内感染的易感型．DR53有可能具有保护作用．但需要扩大样本量进一步研究。     

乙型肝炎病毒抗原成分在其相关性肾炎中的分布

阴道加德纳菌（GV）目前被认为是细菌性阴道病的主要病原体，感染率高，并可经性传播，且与早产、妇产科手术后感染、子宫颈癌等密切有关。为了解不同人群妇女GV感染情况，对272名妇女进行了GV感染的初步调查。调查对象为新收容的性罪错妇女76名、STD门诊患者63例、妇科门诊患者61例、产科门诊孕妇38名、健康体检妇女（均系已婚）34名，年龄17～46岁，平均24．6岁。结果共52例检出GV。阳性率：STD患者30．2％，性罪错妇女26．3％，妇科门诊患者问．5％，孕妇7．9％，体检妇女8．8％，总阳性率19．1％。本研究表明：STD患者及性罪措妇…     

结核菌糖脂类抗原在结核病诊断中的应用研究

[目的]探讨TBGL结核抗体检测试剂对结核病的诊断价值。[方法]选取76例血清或血浆，使用TBGL，以ELISA方法检测结核抗体。[结果]TBGL检测活动性肺结核的敏感性为80％，检测肺外结核病的敏感性为83．3％，检测特异性为96．6％。[结论]TBGL在结核病临床诊断方面有较高的敏感性和特异性，是一项很有临床应用价值的结核抗体检测试剂。     

乙肝病毒前S1抗原在不同HBV血清标志物模式中的临床意义

目的：探讨乙肝病毒前SI（Pre-S1）抗原在不同HBV血清标志物模式中的临床意义。方法：收集HB-sAg阳性的乙肝病毒感染者血清1646例，检测Pre-S1抗原，HBV标志物，HBV-DNA及ALT酶。结果：1646份血清中，Pre-SI抗原的总阳性率达63．3％，其中模式①87．61％，②96．3％，③48．56％，④53．85％，⑤50％，HBeAg阳性模式组与阴性组比较差异有统计学意义（P〈0．01）；在HBV-DNA为阳性的①～④中，Pre-S1抗原检出率依次为92．91％、90％、80％、78．57％，各组之间比较差异无统计学意义（P〉0．05）；在ALT增高的①～④中，Pre-S1抗原的检出率依次为85．84％、92．31％、57．73％、50％，间BeAg阳性模式组与阴性组比较差异有统计学意义（P〈0．01）。结论：Pre-S1抗原是反映HBV感染者其传染性，病毒复制，肝细胞损伤，抗病毒治疗的检测崖指标。     

免疫性不育症与人类白细胞抗原相关性研究进展

90年代WHO报道大概10％～20％的不育为免疫因素引起。该文收集了近几年的相关资料，对免疫性不育症与人类白细胞抗原相关性研究进行了概述。     

乙肝表面抗原阳性病人的家庭预防指导

病毒性乙性肝炎是我国最严重的公共卫生问题之一，据调查，我国人群中有60％的人感染过乙肝病毒(HBV)，10％的人为HBV表面抗原(HBsAg)携带者，部分乙肝病毒携带者还将发展为肝炎、肝硬化，少部分慢性肝病患者还将转变为肝癌。乙肝病毒携带者在人托、入学、就业、婚姻等方面受到很大的影响，引起一系列的社会问题，这已经引起     

3187例HBsAg阳性者e抗原血清流行病学调查

目的 了解本区食品和公共场所从业人员HBeAg阳性情况。方法 通过采用ELISA法，对本站1996～2000年健康体检中的3187份HBeAg阳性血清进行HBeAg检测和分析。结果 3187份HBsAg阳性血清HBeAg只阳性率为22．65％，其中男性22．5l％，女性22．76％。各年份HBsAg阳性率有逐年增高趋势。不同年龄组以15～岁组36．43％为最高。在所有制形式中，个体阳性率最高。结论 对每年体检HBsAg阳性应重点跟踪调查，及时调离HBeAg阳性，把15～年龄组和个体企业从业人员作为重点体检人群。     

儿童幽门螺杆菌感染血清学研究

应用ＥＬＩＳＡ法对１８１份反复中上腹及脐周痛患儿血清及１９２份对照血清进行了抗幽门螺杆菌ＩｇＧ、ＩｇＭ测定。结果表明：有上述症状患儿血清抗－Ｈｐ ＩｇＧ检出率（５３％）明显高于其他对照组（３４．６％￣３５％），可作为Ｈｐ感染的辅助诊断指标，但其滴度与病程长短及病情严重程度无明显关系，不能反映现症感染。儿童抗－Ｈｐ ＩｇＧ检出率随年龄增加而上升，大年龄组儿童抗－Ｈｐ ＩｇＧ检出率与成人者相近。儿童血     

Sterilizing immunity against experimental Helicobacter pylori infection is challenge-strain dependent

The development of a murine model of Helicobacter pylori infection through serial in vivo passage of candidate strains has enabled a quantitative assessment of vaccine efficacy. In this study we compare infection with and protection against challenge from both CagA⁺ type I, and CagA⁻ type II in vivo adapted isolates. In vivo passage of a type II H. pylori isolate resulted in a highly infectious strain (X47-2AL), capable of reproducibly infecting mice to high density (10⁷ CFU/g of gastric tissue). Similarly adapted type I strains were found to colonize mice at a significantly lower level (10⁴–10⁵ CFU/g tissue). Mucosal immunization with recombinant urease (rUre) significantly protected animals against both types. Protection against X47-2AL was characterized by a ≥100-fold (or 2 log) reduction in bacterial density. However, the presence of a residual infection highlighted the inability to achieve sterilizing immunity against this strain. The level of protection appeared independent of challenge dose, and was stable for up to 6 months, all animals exhibiting a low-level residual infection that did not recrudesce with time. Similarly immunized mice challenged with isolates representing the residual infection were also protected, confirming that they did not represent a sub-population of H. pylori that could escape immunity. Immunization and challenge studies with type I adapted-isolates, demonstrated a similar 2–3 log reduction in the bacterial burden, but that in this instance resulted in sterilizing immunity. These results suggest varied specificity for the murine host by different Helicobacter strains that can influence the outcome of both infection and immunity.     

小儿幽门螺杆菌感染调查

１９９３年６月－１９９４年６月期间，采用ＥＬＩＳＡ检测血清中抗幽门螺杆菌尿素酶抗体，对３９４名小儿各年龄组自然人群感染率进行了调查。总体平均阳性率为１５．７％，具有随年龄增加而增加的总趋势，至１２岁组时阳性率达３０％。其中１－３岁及７岁组阳性率相对较高，可能与家庭及学校内密切接触有关。此外，反复发生腹痛者其阳性率较无症状者明显增高。     

中国幽门螺杆菌基因组多样性与种群结构分析

目的 了解中国幽门螺杆菌（Helicobacter pylori,HP）基因组特征及种群结构。方法 利用中国不同地域不同疾病分离的10株HP的基因组序列,并整合公共数据库中其他地域的HP基因组数据,通过比较基因组和生物信息学方法分析中国HP的基因组与种群结构特征。结果 中国HP核心基因为1 203个。菌株特异基因为19～32个,这些基因可能与中国HP在不同地域、不同疾病宿主中的适应性进化有关。基因组变异较大区域主要集中在编码限制修饰系统的基因和编码四型分泌系统的基因。基于核心基因组单核苷酸多态性（SNP）的种群分析确定中国菌株均属于hpEastAsia群,hspEAsia亚群,且不同地域菌株具有地域聚集性特点。在3株中国HP基因组序列中发现了前噬菌体序列,携带噬菌体组装所需的必要元件。结论 基于核心基因组SNP分析中国菌株均属于hpEastAsia群,hspEAsia亚群,且具有地域聚集性。为深入挖掘中国不同地域不同疾病相关HP的遗传特征及研究噬菌体在HP进化与致病中的作用奠定了基础。     

结核分枝杆菌4种新抗原的克隆表达及血清学评价

目的 初步评价结核分枝杆菌4种新抗原Rv0432、Rv0674、Rv1566c和Rv1547的血清学诊断价值。方法 以结核分枝杆菌实验室标准参照菌株H37Rv全基因组DNA为模板PCR扩增Rv0432、Rv0674、Rv1566c基因的完整序列,Rv1547基因分为两段（Rv1547-1和Rv1547-2）扩增,与PET-32a表达载体构建重组质粒,重组蛋白利用亲和层析的方法进行纯化。待检测血清和BL21（DE3）菌体蛋白孵育进行预处理。各重组抗原用ELISA对151份待检血清（41份健康组血清和110份细菌学阳性结核患者组血清）进行IgG抗体检测。检测结果用受试者工作特征曲线对其诊断效能进行分析和评价。采用t检验比较目的蛋白在结核患者组和健康组的差异性。结果 成功克隆表达和纯化了蛋白Rv0432、Rv0674、Rv1566c、Rv1547-1和Rv1547-2,ELISA结果显示Rv0432、Rv0674、Rv1566c、Rv1547-1和Rv1547-2的敏感性、特异性、阳性预测值、阴性预测值、约登指数和曲线下面积分别为43.64%~92.73%、80.49%~92.68%、0.92~0.94、0.38~0.80、0.363~0.732和0.649~0.915。目的蛋白在结核组检测到的IgG抗体水平均大于健康组（P<0.000 1）。结论 结核分枝杆菌新抗原Rv0432、Rv0674、Rv1566c、Rv1547-1和Rv1547-2具有良好的血清学检测价值,可作为结核病免疫学诊断的候选抗原。     

幽门螺旋杆菌药敏试验指导的治疗方案和新一线四联方案:网状Meta分析

目的 比较细菌培养药敏试验指导的幽门螺旋杆菌治疗方案和新一线4种方案（伴同疗法、混合治疗、序贯治疗、铋剂四联治疗）的疗效和不良反应，并进行概率排序为临床治疗提供科学依据。方法 系统检索电子数据库，筛选截至2015年6月比较细菌培养药敏试验指导治疗和新一线4种方案，包括基于细菌培养药敏试验指导治疗、伴同疗法、混合治疗、序贯治疗、铋剂四联治疗方案的随机对照试验。通过网状Meta分析和单组率的Meta分析，定量综合这些方案的相对和绝对疗效及不良反应。采用Jadad评分量表评价随机对照试验的方法学质量，构建漏斗图定性测量发表偏倚，其中不对称性检验使用Egger线性回归法或者Begg秩相关法。结果 共纳入20个初治幽门螺旋杆菌感染的随机对照试验，涉及6 753例患者。网状Meta分析表明，细菌培养药敏试验指导治疗的方案显著优于其他方案，根除率最高，不良反应发生率最低；伴同疗法虽然高效但最有可能出现不良反应事件；混合治疗和铋剂四联治疗方案具有较高的疗效、较低的不良反应发生率。结论 对于成年人幽门螺旋杆菌感染，细菌培养药敏试验指导的治疗方案显著优于伴同疗法、混合治疗、铋剂四联治疗和序贯治疗方案；医疗条件匮乏地区可选择混合治疗和铋剂四联治疗方案。     

纤维胃镜检查与幽门螺杆菌交叉感染检测报告

对胃镜检查导致幽门螺杆菌（Ｈｐ）交叉感染的可能性进行调查。结果从清洗消毒后胃镜活检吸引管道及活检钳采样培养出Ｈｐ。老年慢性胃炎患者随胃镜检查次数增多，Ｈｐ阳性率增高；Ｈｐ阴性胃炎患者随胃镜随访次数增加，Ｈｐ阳性率增高；Ｈｐ转为阳性随访者的平均年龄大于随机抽查、年龄匹配的正常和慢性胃炎对照中Ｈｐ阳性者。提示，胃镜及附件灭菌不严可成为Ｈｐ交叉感染的一个潜在途径，老年人接受多次胃镜检查可增加感染的危险性     

Prevalence of Helicobacter pylori in asymptomatic subjects—A nested PCR based study

The aim of the study was to see the prevalence of Helicobacter pylori in asymptomatic children and adults by using nested PCR which is considered to be more specific than serological methods. Saliva and stool samples of 137 healthy children (aged 8 months to 16 y) and 108 asymptomatic adults (aged 17–60 y) were collected. PCR with primers targeting Hsp60 gene sequence of H. pylori was used. H. pylori positivity with nested PCR was observed in 45.7% (112/245) of the saliva and 42.8% (105/245) of the stool specimens. Prevalence of H. pylori in saliva was found to be 2.1%, 22.7%, 55.9%, 56.0%, 68.9% and 62.9% in the age groups of <5 y, 6–10 y, 11–16 y, 17–30 y, 31–45 y and 45–60 y, respectively. The detection rates in stool were 4.25% in <5 y, 13.64% in 6–10 y, 50% in 11–16 y, 64% in 17–30 y, 58.62% in 31–45 y and 61.1% in 45–60 y of age groups. The most favourable age group for acquiring the infection was 11–16 y. H. pylori positivity increased with lowering of socioeconomic status. There was no gender bias in prevalence of the bacterium.     

Production and Evaluation of Toxoplasma gondii Recombinant Surface Antigen 1 (SAG1) for Serodiagnosis of Acute and Chronic Toxoplasma Infection in Human Sera

Background

The assays currently available for the detection of specific anti-Toxoplasma antibodies may vary in their abilities to detect serum immunoglobulins, due to the Lack of a purified standardized antigen. The aim of this study was evaluation the recombinant Toxoplasma gondii SAG1 antigen for the serodiagnosis of acute and chronic toxoplasmosis.

Methods

This study describes an ELISA using recombinant SAG1 for detection of IgM and IgG antibodies against Toxoplasma gondii in human sera. Genomic DNA of T. gondii (RH Strain) was isolated and PCR reaction was performed. Recovered DNA was cloned into PTZ57R cloning vector. The recombinant plasmid was detected by restriction analysis. The SAG1 gene was subcloned in the pET- 28a expression vector. Protein production was then induced with 1 mM isopropyl-D – thiogalactopyranoside (IPTG). A total of 204 sera were tested using a commercial IgG and IgM ELISA kit (Trinity, USA) as gold standard prior to testing them with the recombinant antigen.

Results

Tested sera were divided into the following groups:(a) The 74 T. gondii IgG positive (b) 70 T.gondii IgM positive (c) 60 sera who had no serological evidence of toxoplasmosis as negative sera.To determine the specificity of the test, we used other parasitic diseases including echinococusis (N=5), malaria (N=14), leishmaniasis (N=7),fasciolasis (N=4), sterengyloidiasis (N=1). Sensitivity and specificity of the generated recombinant IgG ELISA in comparison with commercial ELISA (Com ELISA) were 93% and 95%, and the sensitivity and specificity of the generated recombinant IgM ELISA were 87% and 95% respectively.

Conclusion

The results acquired here show that this antigen is useful for diagnostic purposes and could be replaced by lysed, whole cell antigens for diagnosis of chronic toxoplasmosis.     

Immunization of rhesus monkeys with a mucosal prime, parenteral boost strategy protects against infection with Helicobacter pylori

Rhesus monkeys were immunized with recombinant Helicobacter pylori urease vaccine given solely by the parenteral route or preceded by a priming dose given by the oral route. Two groups of monkeys received parenteral urease with either a synthetic glycolipid adjuvant (Bay) or aluminum hydroxide (alum) as adjuvants. A third group of monkeys received a priming dose of oral urease given with the mucosal adjuvant LT (Escherichia coli heat labile enterotoxin), followed by parenterally administered booster doses of urease adsorbed to alum. Monkeys receiving placebo served as controls. The monkeys received a total of 4 doses of vaccine with the first 3 doses given every 3 weeks and the last booster dose administered 14 weeks later. The monkeys were challenged orally with H. pylori one week after the last vaccine dose and euthanized 10 weeks after challenge, at which time, their stomachs were collected for determination of bacterial colonization and histopathology. Monkeys primed with the oral vaccine and boosted with the parenteral vaccine showed a statistically significant reduction in bacterial colonization when compared to sham-immunized control animals (P=0.05; Wilcoxon rank sums test). Monkeys receiving parenteral only regimes of urease plus Bay or alum showed no difference in bacterial colonization compared with sham-immunized controls (P=1.00 and P=0.33, respectively). The mucosal prime–parenteral boost regime did not cause gastropathy. There was no difference in any of the 3 treatment groups with respect to gastric epithelial changes compared to control animals. There was also no difference in the type and extent of gastric inflammatory cell infiltrates between animals vaccinated by the mucosal prime–parenteral boost strategy and sham immunized controls. However, monkeys receiving the two parenteral-only regimens had slightly elevated gastritis scores.