新生儿眼部沙眼衣原体感染初步调查

应用荧光标记的抗沙眼衣原体单克隆抗体检测32份外阴尖锐湿疣孕妇宫颈及40份新生儿眼结膜涂片沙眼衣原体结果,阳性率分别为6.4%(2/32)和7.5%(3/40)。从而证实尖锐湿疣孕妇存在沙眼衣原体的感染,并且有垂直感染新生儿问题。     

睑结膜部炎症者肺炎衣原体、沙眼衣原体核酸检测

目的 探讨我国睑结膜部炎症者病灶部是否存在肺炎衣原体（Cpn)。方法 收集39例慢性结膜炎、沙眼患者的睑结膜病灶部刮取物,应用nested PCR(nPCR)技术检测肺炎衣原体（Cpn)和沙眼衣原体（Ct)核酸。并随机抽取2例Cpn nPCR阳性产物进行全自动DNA测序,加以佐证。结果 39例患者中Cpn阳性13例（33．3％）,Ct阳性5例（12．8％）。慢性结膜炎和沙眼病例均有Cpn和Ct阳性者。2例Cpn nPCR阳性产物经全自动DNA测序与Cpn(CWL-29株）高度同源。结论 我国睑结膜部炎症者病灶部存在Cpn。     

沙眼衣原体与沙眼的研究进展

沙眼衣原体感染为眼科最常见的细菌性疾病。据世界卫生组织(WHO)统计，每年有9200万新的沙眼衣原体感染病例发生。沙眼衣原体可引起沙眼、结膜炎、肺炎、泌尿生殖道感染及性病淋巴肉芽肿等。对沙眼衣原体感染所致沙眼的流行病学、免疫病理学及遗传限制性的研究，可进一步降低沙眼的发病率，使有效而全面控制沙眼的流行成为可能。     

新生儿沙眼衣原体结膜炎的临床分析

目的 探讨新生儿沙眼衣原体（chlamydia trachomatis,CT)结膜炎的发病情况及临床特点。方法 对117例新生儿结膜炎患者作沙眼衣原体PCR检测，PCR－CR－DNA阳性患儿，作产妇宫颈CT检测。结果 新生儿结膜炎，PCR－CT－DNA阳性率为48．7％，母婴传播率为84．2％，新生儿肺炎并发率36．7％。结论 沙眼衣原体为新生儿结膜炎主要的致病菌，产道感染为CT感染的重要感染途径；沙眼衣原体也为小儿肺炎的主要致病菌。     

荧光定量聚合酶链反应检测沙眼衣原体

沙眼是一种由沙眼衣原体引起的常见病,多发病。目前由于抗生素的应用,临床表现多不典型,易漏诊误诊。荧光定量聚合酶链反应(FQ-PCR)融汇了PCR高灵敏性,DNA杂交技术高特异件和光谱技术高精确定量三大技术,能简便、微量、快速、高特异、高敏感、定量、无污染地检测沙眼衣原体。我们用FQ-PCR对20例结膜炎患者进行了检测,结果报道如下。     

沙眼依原体单克隆抗体在眼科临床的应用

利用沙眼依原体单克隆抗体免疫荧光直接法诊断和鉴别诊断３０例沙眼及其它眼病。结果２０例临床诊断为沙眼，检测均为阳性。５例慢性结膜炎，其中２例为阳性。５例疑为病毒性结角膜炎，２例为阳性。５例正常人结膜上皮涂片，均为阴性。结果证明，沙眼依原体荧光单克隆抗体具有临床诊断和鉴别诊断价值。     

聚合酶链反应检测新生儿眼炎沙眼衣原体感染

应用聚合酶链反应（ｐｏｌｙｍｅｒａｓｅｃｈａｉｎｒｅａｃｔｉｏｎＰＣＲ）对４８例新生儿眼炎进行沙眼衣原体感染检测，发现新生儿眼炎３５．４％由沙眼衣原体感染所致。同时追踪检测患儿父母生殖泌尿系发现新生儿眼炎的沙眼衣原体来源于其母垂直感染，是眼科一种严重的性传播疾病，应加强防治。同时认为ＰＣＲ是一种特异性强、灵敏度高、可快速自动化操作的新的病原学检测方法。     

沙眼衣原体--发现与贡献

沙眼是一种古老的眼病,世界性广泛流行,曾是致盲首因,严重危害人类健康.自19世纪初,沙眼病原问题即受到微生物界、眼科学界极大重视.     

应用聚合酶链反应检测新生儿沙眼衣原体感染

近年来国内外对新生儿衣原体感染的报道较多,我院于１９９７年至１９９８年间,应用聚合酶链反应（ＰＣＲ）技术,对１２００例新生儿进行沙眼衣原体感染的检测,其中阳性１４６例,现报告如下。对象和方法１．对象：均为我院新生儿,年龄为生后７天内。２．方法：用无菌...     

Incidence and clinical presentation of chlamydial keratoconjunctivitis: A preliminary study

Using a direct immunofluorescent technique and monoclonal antibody, chlamydia trachomatis was detected in the conjunctival smears of 13 out of 47 patients presenting with conjunctivitis or keratoconjunctivitis (an incidence of 28%). Two patients presented with acute symptoms of few days duration, whereas the condition was chronic and of long duration in 11 patients. Conjunctival changes noted were upper and lower palpebral conjunctival follicles and papillae (11 patients), chemosis (5 patients), upper tarsal scar (2 patients) and pseudomembrane (one patient). Corneal involvement was detected in 9 patients and was manifested as micropannus (6 patients), multiple small epithelial punctate stains (3 patients), extensive pannus affecting the upper third of the cornea (2 patients), subepithelial punctate infiltrates similar to that of adenovirus infection (2 patients) and upper limbal follicles (one patient). Identification of chlamydia trachomatis in conjunctival smears by use of the monoclonal antibody is a simple, rapid and relialble laboratory procedure.     

我国北方两地区小学生沙眼衣原体检测及基因分型研究

目的 对我国北方两地区小学生沙眼患者结膜样本进行聚合酶链反应（PCR）检测,并分析其病原流行株的基因类型.方法 按照世界卫生组织沙眼分期标准,在宁夏回族自治区银川市和河北省武强县两地采集临床诊断为沙眼的小学生结膜样本共213份.同时在两地分别采集正常小学生结膜样本作对照.利用PCR检测沙眼衣原体质粒片段,对质粒PCR检测阳性者通过套式PCR扩增沙眼衣原体主要外膜蛋白（MOMP）基因（omp-1）第4可变区片段,再经序列分析进行基因分型.结果 银川市45份样本中,质粒PCR检测阳性22份,检出率为48.9%;对17份样本进行套式PCR基因分型,显示B型为16份（94.1%）,C型为1份（5.9%）.武强县168份样本中,质粒PCR检测阳性109份,检出率为64.9%;对34份样本进行套式PCR基因分型,显示B型为28份（82.4%）,C型为6份（17.6%）.结论 沙眼在中国西北部银川市和华北部武强县的小学生中仍有流行,其流行株的基因类型以B型为主.     

Risk of Infection with Chlamydia trachomatis from Migrants to Communities Undergoing Mass Drug Administration for Trachoma Control

Abstract

Purpose: To determine the risk of infection with Chlamydia trachomatis in children who are migrants to communities who are undergoing mass drug administration (MDA), and if their neighborhoods have higher rates of infection over time.

Methods: In four communities in Kongwa, Tanzania, all children were enrolled in a longitudinal study of infection and trachoma. New children were identified at census updates as having not been in the community at the previous census. Within communities, neighborhoods were defined as spatially close groups of households, or “balozi”. All children in the communities were invited to be examined for trachoma, and have ocular swabs taken for evidence of infection. Trachoma was graded using the World Health Organization simplified grading scheme, and swabs were processed using Amplicor.

Results: Children who were migrants were more likely to be infected and to have trachoma than children who were resident in the community, which was significant by the time of the survey following the third year of MDA (odds ratio, OR, 2.49, 95% confidence interval, CI, 1.03–6.05). The neighborhoods where newcomers resided were more likely to have infection a year later than neighborhoods with no migrants, which was most pronounced following the third year of MDA (OR 2.86, 95% CI 1.07–7.65).

Conclusion: Migrants to communities may be an important source of re-emergent infection, especially as MDA lowers infection among residents. Highly migrant populations may need a special surveillance and treatment program to avoid slowing progress in communities under MDA.     

Evaluation of a Single Dose of Azithromycin for Trachoma in Low-Prevalence Communities

Purpose: Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide and is targeted for elimination as a public health problem. We sought to determine whether a one-time azithromycin mass treatment would reduce trachomatous inflammation–follicular (TF) levels below the elimination threshold of 5% in communities with disease prevalence between 5 and 9.9%.

Methods: The study was conducted in 96 sub-village units (balozis) in the Kongwa district of Tanzania which were predicted from prior prevalence surveys to have TF between 5 and 9.9%. Balozis were randomly assigned to the intervention and control arms. The intervention arm received a single mass drug administration of azithromycin. At baseline and 12-month follow-up, ocular exams for trachoma, ocular swabs for detection of chlamydial DNA, and finger prick blood for analysis of anti-chlamydial antibody were taken.

Results: Comparison of baseline and 12-month follow-up showed no significant difference in the overall TF_1-9 prevalence by balozi between control and treatment arms. In the treatment arm there was a significant reduction of ocular infection 12 months after treatment (p = 0.004) but no change in the control arm. No change in Pgp3-specific antibody responses were observed after treatment in the control or treatment arms. Anti-CT694 responses increased in both study arms (p = 0.009 for control arm and p = 0.04 for treatment arm).

Conclusion: These data suggest that a single round of MDA may not be sufficient to decrease TF levels below 5% when TF_1-9 is between 5 and 9.9% at baseline.     

Evaluation of patients with dry eye disease for conjunctival Chlamydia trachomatis and Ureaplasma urealyticum

AIM: To determine the possibility of the development of dry eye disease (DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients. METHODS: This study was conducted on 58 patients of age range 20-50y, diagnosed with DED confirmed by Schirmer I test and tear breakup time. The non-dry eye control group included 27 subjects of the same age. Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture, the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody (DFA) assay and polymerase chain reaction (PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively. Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method. Both organisms were identified in only 37.9% of DED patients found to be infected. Control subjects had a 22% detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method. The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common (50%) followed by Staphylococcus aureus (20%), whereas gram negative microorganisms occurred in 25% of cases, isolating Moraxella spp. as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED, and could be a fair possibility for its development. PCR is more reliable in detecting Chlamydia trachomatis than DFA technique. The presence of isolated conjunctival bacterial microflora can be of some potential value.     

FLK-1单克隆抗体抑制实验性脉络膜血管新生

目的：探讨FLK-1单克隆抗体对小鼠脉络膜新生血管（choroidal neovascularization,CNV）的治疗作用。 方法：采用激光击射的方法诱导成年C57BL/6小鼠CNV模型,术前及术后3,6,9d利用腹腔注射的方法给与实验组小鼠FLK-1单克隆抗体500μg,激光术后10d处死小鼠,行脉络膜灌流铺片及组织病理学检查观察CNV的发展,定量评价FLK-1单克隆抗体对于实验性CNV的治疗作用。 结果：术后10d所有激光光斑均发展为实验性CNV,脉络膜灌流铺片及组织病理学检查结果一致表明实验组小鼠CNV的发展受到明显抑制（P〈0.001）。 结论：FLK-1单克隆抗体可以抑制实验性CNV的发展,提示拮抗FLK-1可能成为治疗CNV有效的生物学方法之一。     

抗腺病毒3型单克隆抗体的制备及临床应用研究

目的制备特异性抗腺病毒3型（ADV-3）的单克隆抗体（mAB），并用于腺病毒性角膜结膜炎的临床实验室诊断。方法用密度梯度超速离心技术纯化ADV-3免疫5只BALB／c小鼠，取脾细胞及骨髓瘤细胞按常规方法融合、筛选、克隆化及腹水注射制备mAb。采用ELISA及免疫组织化学技术进行鉴定。结果经3次克隆化获得了3株可分泌抗ADV-3mAb的杂交瘤细胞株，经多次复苏传代仍能稳定分泌抗体，分别命名为E7、B9和G11。1株（E7）Ig重链为IgG2b，2株（B9、G11）为IgG1，轻链均属于K型。ELISA效价均〉10^4，相对亲合力E7〉B9〉G11，相对亲合力常数分别为8．14×10^9±1．48、2．03×10^8±0．43和1．63×10^7±0．15。腹水中mAb滴度为1×10^5-1×10^6。用抗腺病毒ADV-3E7检测临床诊断为病毒性角膜结膜炎患者标本30例，阳性者20例，阳性率66．7％，PCR检出阳性者21例，阳性率70％，两种检测方法的阳性检出率差异无统计学意义（P〉0．05）。结论3株杂交瘤细胞株分泌的抗体对ADV-3抗原具有高特异性和亲和力，用于腺病毒性角膜结膜炎的临床诊断具有速度快、阳性率高的优点。     

抗肿瘤坏死因子-α单克隆抗体抑制大鼠角膜移植排斥反应

目的:探讨肿瘤坏死因子-α(TNF-α)在角膜移植免疫排斥反应中的作用以及抗TNF-α单克隆抗体(TNF-α mAb)对排斥反应的抑制作用。方法:以近交系大鼠30只制作穿透性角膜移植模型(F344→Lou),随机等分入移植治疗组(每日结膜下注射0.5g/L抗TNF-α mAb 0.1mL)和移植模型组(结膜下注射等量生理盐水)。利用酶联免疫吸附实验(ELISA)技术分别检测术后3,7d及发生排斥反应时大鼠外周血清中TNF-α的水平,并观察移植角膜的组织病理学变化及植片存活情况。结果:角膜移植术后早期各组大鼠血清TNF-α浓度均有升高,与移植治疗组相比,移植模型组升高速度更快,水平更高(P<0.05);但当发生排斥反应时,二者已无显著性差异(P>0.05)。移植模型组大鼠植片存活时间为10.2±1.9d,而抗体治疗组平均13.8±2.2d,二者相比差异有显著性(P<0.01)。结论:TNF-α在角膜移植免疫排斥反应中发挥一定作用。动态检测外周血TNF-α浓度有助于预测、诊断排斥反应。应用抗TNF-αmAb治疗可部分延长植片存活时间。     

柔红霉素与抗兔晶状体上皮细胞单克隆抗体偶联物的制备及其免疫学特性

目的 评价柔红霉素((daunorubicin,DNR)与抗兔晶状体上皮细胞单克隆抗体免疫偶联物对兔晶状体上皮细胞的免疫特异性。方法 采用过碘酸盐氧化法将抗兔晶状体上皮细胞单克隆抗体LM1与柔红霉素结合；Bradford蛋白检测法和紫外吸收光谱法检测偶联物中LM1与DNR的克分子比；ELISA法检测LM1与DNR偶联后抗体活性的变化；免疫组织化学法检测偶联物在兔眼组织的免疫特异性。结果 偶联物表现出单抗LM1和DNR的生物学活性及紫外光谱特征，偶联产物中DNR与LM1的克分子比约为12：1，即每个抗体分子可以携带约12个药物分子。偶联后抗体的活性保持为原有活性的76．5％以上。免疫组化显示偶联物仅在兔晶状体上皮细胞呈阳性表达，在其他眼组织为阴性表现。结论 抗兔晶状体上皮细胞单克隆抗体与柔红霉素的免疫偶联物在体外可以选择性地结合到兔晶状体上皮细胞并保持特异的免疫活性。     

抗ICAM-1单克隆抗体抑制大鼠角膜移植排斥反应的实验研究

目的 :探讨应用抗细胞间粘附分子 (Intercellularadhesionmolecule 1,ICAM 1)单克隆抗体中和治疗大鼠角膜移植排斥反应的效果。方法 :应用两种主要组织相容抗原完全不同的大鼠Louis和RCS鼠 ,建立近交系大鼠穿透性角膜移植动物模型 ,分三组给药 ,其分别是抗细胞间粘附分子单克隆抗体组 (抗ICAM 1抗体组 )、生理盐水组和环胞霉素A(CsA)组。观察角膜移植排斥发生的时间及治疗效果。标本作HE染色及免疫组化染色 ,观察免疫排斥反应的程度及炎症程度。结果 :三组角膜植片平均存活时间为 :生理盐水组角膜移植排斥反应平均发生时间为术后 12 .1天 ,CsA组为18.3天 ,抗ICAM 1抗体组为 2 0 .2天。HE染色显示抗ICAM 1抗体组及CsA组的炎症反应较生理盐水组明显减轻 ,免疫组化染色显示抗ICAM 1抗体组和CsA组的ICAM 1表达较生理盐水组明显减少。结论 :抗ICAM 1单克隆抗体中和治疗可减少移植角膜ICAM 1表达及免疫炎性细胞的浸润 ,减轻角膜移植免疫排斥反应 ,延长移植片的存活时间 ,是一种有效的新型免疫抑制剂