妊娠合并风疹病毒感染的临床进展

风疹病毒（rubella virus．RV）属于一种小型RNA病毒.风疹（rubella）是由RV引起的急性上呼吸道传染病。儿童常见，成人也可发病。人类是风疹病毒唯一的宿主也是唯一的传染源。人对风疹普遍易感，尤其儿童和妊娠期妇女。孕妇感染后，不论是显性还是隐性，均可使胎儿受感染，导致先天性风疹综合征（congenital rubella syndrome，CRS）儿，而被国内外产科和免疫预防工作者所重视。妇产科及免疫预防工作者了解有关RV感染的知识和进展．对更主动地发现、合理处理和有效预防孕妇感染，减少CRS发生，提高新生儿身体素质，降低新生儿的死亡率有重要意义。     

疑为风疹病毒感染导致胎儿发育不良1例报告

1临床资料患者女,2 7岁,妊娠16周。于2 0 0 3年2月在省属某医院进行围产期检查时,发现胎儿发育与妊娠月份不符,即行彩色多普勒超声检查,超声所见:胎头位于宫底部,呈长椭圆形,双顶径5 .6cm ,其内部结构正常;胸腔直径3 .13cm ,心脏占据大部分,直径约2 .0 9cm ;胎心14 8次/min、规则;双肾约1.5 8×0 .8cm ;肱骨长4.13cm ,羊水过少( <1cm) ,胎盘壁厚约4.0cm ,中部一囊性液明区,直径1.3cm ,内无血流充盈。超声提示:宫内中期妊娠,胎儿发育不良(肺、肾、骨骼) ,羊水过少,胎盘囊肿。经详细询问孕期史,了解到该孕妇在妊娠约14周时曾出现咳嗽、流涕、…     

风疹病毒血清流行病学和风疹疫苗免疫学效果研究

风疹病毒是一种致畸性病毒，可以通过感染孕妇而引起流产、死胎或先天性风疹综合征。我区过去未获得过有关风疹病毒自然感染的资料。采用疫苗免疫是控制风疹流行的主要措施。本项目通过综合的研究，成功地获得了我区人群风疹自然感染状况的资料，为我区风疹防治工作的开展打下了基础；也是在国内较早取得这方面资料的省份，揭示了南方地区在人群感染率方面与北方地区的差异。     

安徽省2018-2022年风疹病毒流行株基因特征

目的 分析安徽省风疹病毒(Rubella virus, RV)流行株基因特征。方法 对安徽省2018-2022年RV阳性咽拭子标本开展RV分离、靶基因序列扩增和序列测定分析，构建与1E和2B基因亚型参考株之间的基因亲缘性关系树，鉴定RV基因亚型，分析核苷酸和氨基酸序列同源性。结果 2018-2021年共分离获得83株RV毒株，其中1E-L2基因亚型81株，来自2018-2020年13个地市；2B-L2c基因亚型2株，来自2019年和2021年2个地市；2022年未获得RV毒株。与其他省份同期的相应RV代表株相比，1E-L2基因亚型流行株的核苷酸和氨基酸序列同源性分别为99.32%-100%和98.78%-100%,2B-L2c基因亚型流行株的核苷酸和氨基酸序列同源性分别为99.59%-99.86%和100%。结论 安徽省2018-2021年RV流行株为输入性的1E-L2和2B-L2c基因亚型，其中1E-L2基因亚型RV为2018-2020年优势流行株。2022年流行RV基因型别不详，需加强风疹病原学监测。     

山东省正常人群风疹病毒IgG的检测

目的了解山东省正常人群风疹病毒自然感染状况,为保护易感人群及制定合理的预防接种方案提供科学依据。方法采用间接酶联免疫吸附试验(ELISA)检测山东省部分地区正常人群血清中风疹病毒特异性抗体IgG。结果该人群RV-IgG阳性率为80.20%,其中,≤20岁组人群抗体的阳性率为66.87%,>20岁组人群抗体阳性率为82.86%,差异有统计学意义(P<0.05);男性人群抗体阳性率为77.37%,女性人群的抗体阳性率为83.37%,差异有显著性意义(P<0.05);不同职业及不同地区人群抗体阳性率的差异亦均有统计学意义(P<0.05,P<0.05)。结论低龄儿童和青少年风疹免疫水平较低,是风疹免疫的主要对象。育龄妇女也是风疹免疫的重点对象。不同的工作环境和生活习惯对风疹病毒的感染率有一定的影响。     

2011—2021年云南省风疹病毒分子流行病学研究

目的了解云南省流行风疹病毒(RuV)基因型分布及传播模式。方法采集云南省2011—2021年9个州/地级市的风疹暴发和散发病例的咽拭子标本, 对RuV阳性标本进行病毒分离、靶基因的扩增和序列测定, 并与基因型和亚型参考株进行比对确定基因型别, 同时与同期我国其他省份流行的RuV病毒株进行系统发育分析。结果 2011—2021年间在云南省流行的RuV呈现明显的基因多样性, 监测到1E-L1、2B-L1和1E-L2三种基因亚型;发现RuV发生两次基因亚型转换, 包括2012—2013年间1E-L1至2B-L1基因亚型流行的转换, 以及2018年后2B-L1至1E-L2基因亚型的替换, 两次基因亚型转换的时间与云南省2012年以及2018—2019年间风疹暴发流行的时间基本吻合;RuV病毒株氨基酸序列水平高度保守, 重要功能区域均未发生改变。结论云南省RuV的传播模式与全国各省流行趋势基本一致。     

风疹病毒检测方法研究进展

风疹是由风疹病毒(rubella virus,RV)引起的急性呼吸道传染病。我国虽然已将其列入监测管理疾病,但风疹疫苗接种尚未列入计划免疫范畴。RV最严重的危害是经垂直传播导致胎儿先天性感染,未感染过RV的孕妇,以孕期3个月内感染RV对胎儿危害最大,可引起胎儿死亡或出生后表现为先天性心脏病、耳聋、白内障、智力发育低下等畸形,称为先天性风疹综合征(CRS)。近年来,优生优育日益受到重视,RV感染作为出生缺陷监测中的重要内容,需要较高水平的检测方法。现就RV检测方法研究进展综述如下。     

肿瘤的分子诊断及其研究进展（综述）

肿瘤的发生从遗传学角度上来说是一种基因病。在分子水平上,肿瘤的发生常涉及多基因参与,是一个多阶段、多步骤的复杂的生物学过程。而肿瘤分子诊断则是伴随细胞分子生物学理论和技术迅速发展而产生的一种新型诊断技术,并已日趋完善,尤其是DNA芯片技术、DNA生物传感技术的研究,其前景更是令人瞩目的。可以预见,随着肿瘤分子诊断水平的提高,人类将最终认清肿瘤的本质并攻克肿瘤。     

HSV及其实验室检测研究进展（综述）

单纯疱疹病毒（HSV）是一类严重危害人类健康、引起人类多种疾病的常见病原体,尚缺乏简便有效、临床实用的实验室检测手段。目前实验室检测方法主要有：病毒分离培养、免疫荧光检测（IFA法）、分子生物学检测（PCR法）、免疫印迹检测（WB法）以及抗体检测（ELISA法）,但仍以从水疱或体液中分离培养出HSV病毒作为＂金标准＂。     

Surveillance of congenital rubella syndrome (CRS) in tertiary care hospitals in Hanoi,Vietnam during a rubella epidemic

ObjectiveTo describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam.MethodsProspective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study.ResultsDuring the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1–152 days) and 61% were female. Clinical manifestations of CRS included low birth weight <2500 g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92–1.34).ConclusionsThese preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential.     

间接免疫荧光试验在检测风疹病毒感染中的应用

目的建立检测风疹病毒(RV)抗原E1、E2、C的间接免疫荧光试验(IFA),为快速、敏感地检测临床标本中的RV提供一种重要的检测手段。方法采用荧光素标记的羊抗鼠IgG抗体,检测病毒抗原与抗风疹病毒衣壳蛋白E1、E2、C蛋白的单克隆抗体的结合物。用该系统测定中国麻疹实验室网络送检的咽拭子标本,并与病毒分离结果和临床诊断进行比较。结果IFA方法可以快速、敏感地检测临床标本中的RV。经检测咽拭子标本38份,其中28份采集于临床诊断风疹病例;6例采集于出疹患者,但诊断不明;4份采集于风疹病例的接触者。检测结果有22份风疹阳性标本。IFA的结果与病毒分离结果完全一致,但与临床诊断不一致,IFA结果的阳性数低于临床诊断风疹病例数。结论IFA方法简单可行、敏感特异,结果易于判断,是中国麻疹实验室网络中进行RV检测的重要方法之一。同时IFA方法也可以作为临床快速诊断RV感染的备选方法之一。     

Rubella virus immunization status in preconception period among Chinese women of reproductive age: A nation-wide,cross-sectional study

ObjectivePopulation-based studies on sero-epidemiology of Rubella in women before conception are lacking. The aim of this study was to investigate the sero-prevalence of Rubella in a nationwide survey among Chinese women planning to get pregnant within six months.MethodsThis population-based, cross-sectional, sero-survey of Rubella virus infection was a part of the National Free Preconception Health Examination Project covering all 31 provinces in Mainland China. Women intending to get pregnant within six months was enrolled between 2010 and 12. Information on demographic characteristics (age, residence status, race, education and occupation) and vaccination history was obtained by interviews. Rubella virus IgG sero-positivity was determined using venous blood samples.ResultsOf 2,120,131 women recruited to the study, Rubella virus IgG serology was available in 1,974,188 (99.3%). Participating women were of young age (median = 28 years), mostly engaged in agricultural activities (78%), and the majority (90%) had high school education or lower. The overall prevalence of Rubella virus IgG sero-positivity was 58.4% (1,161,129); geographical variation ranged from 92.5% in Jilin to 20.1% in Qinghai and 0.0% in Tibet. Only 4.6% (n = 91,604) women reported to have had Rubella virus vaccination, and it varied from 18.6% (Guangdong) to 0.2% (Qinghai). Self-reported vaccination status did not correlate with Rubella virus IgG seropositivity.ConclusionsPrevalence of Rubella sero-positivity is low among Chinese women of reproductive age and there are significant regional differences. Over 40% of women being susceptible to Rubella in preconception period calls for a targeted screening and vaccination strategy.     

Models of strategies for control of rubella and congenital rubella syndrome—A 40 year experience from Australia

We investigated the impact of vaccination on rubella epidemiology in Australia, using a mathematical model fitted to Australian serosurvey data and incorporating pre-vaccination European estimates of rubella transmissibility. Mass infant measles–mumps–rubella (MMR) vaccination produced a 99% reduction in both rubella and congenital rubella syndrome (CRS) incidence by 2010 compared to the pre-vaccination era (1960–70). The model is consistent with reductions in CRS based on surveillance of congenital hearing impairment. Model simulations suggest that selective schoolgirl vaccination (1971–88) was associated with a 90% reduction in CRS incidence, but only a 1–4% reduction in rubella incidence. Our model predicted that these reductions in rubella were much less vulnerable to reductions in MMR vaccine coverage than for measles. In the future, a less than 15% decrease in MMR vaccine coverage is estimated to have minimal impact before 2060, but a 20% reduction may result in a 7-fold increase in rubella incidence, with the effective reproductive number R rising from 0.28 to 0.78 by 2060. The 99% reduction in both rubella and CRS incidence and low effective reproductive number (R ≤ 0.28) we documented after 2010 are consistent with Australia having achieved rubella elimination.     

1种新的国产风疹病毒IgG抗体化学发光检测试剂的 性能评价

摘要:目的　评价一种新的国产风疹病毒IgG抗体化学发光检测试剂的检测性能。方法　收集临床血液样本350份,同时用评价试剂和比对试剂盲法检测风疹病毒IgG抗体。以此新的国产风疹病毒IgG抗体化学发光测定试剂作为评价试剂,以意大利索灵风疹病毒IgG抗体检测试剂盒（化学发光法）为比对试剂,2种试剂检测结果不一致者以第三方试剂Trinity风疹病毒IgG抗体检测试剂盒（酶联免疫法）验证,对临床血液样本进行等效性评价。结果　评价试剂和比对试剂测定结果阳性符合率为98.06%［95% CI:95.84%,99.11%］,阴性符合率为100.00%［95% CI:91.24%,100.00%］,总符合率为98.29%［95% CI:87.47%,100.00%］,不一致者以第三方试剂验证后可得灵敏度为98.06%［95%CI:95.84%,99.29%］,特异性为100.00%［95%CI:91.19%,100.00%］,阳性预测值为100.00%［95%CI:98.79%,100.00%］,阴性预测值为86.96%［95%CI:73.74%,95.06%］。评价试剂和比对试剂的ROC曲线下面积分别为0.998和1.000,诊断效能与比对试剂无统计学差异。Passing-Bablok回归分析显示两者存在显著的线性关系。结论　该新的国产风疹病毒IgG抗体化学发光测定试剂敏感性和特异性很高,能为临床风疹病毒IgG抗体的检测提供可靠的实验室诊断依据。     

Immunization of woodchucks (Marmota monax) with hepatitis delta virus DNA vaccine

We investigated the DNA immunization approach in order to induce a protective immune response against hepatitis delta virus (HDV) superinfection of chronically woodchuck hepatitis virus (WHV) infected woodchucks. The animals were immunized with an expression vector encoding HDAg by gene gun. T cell and humoral immune responses induced by this protocol were determined and compared with those induced by HDAg immunization using a CpG oligonucleotide as an adjuvant. After immunization the woodchucks were challenged with 10⁶ genome equivalents of HDV. The protein immunization with HDAg induced good humoral and T helper cell responses in the woodchucks, but did not protect them from HDV superinfection. The DNA immunized woodchucks were also not protected from HDV superinfection, however, the course of infection was modified: HDV viremia occurred later, the typical fluctuation of the HDV RNA titer with several peaks was absent, and antibodies to HDV were not detectable.     

Immunization of woodchucks (Marmota monax) with hepatitis delta virus DNA vaccine

We investigated the DNA immunization approach in order to induce a protective immune response against hepatitis delta virus (HDV) superinfection of chronically woodchuck hepatitis virus (WHV) infected woodchucks. The animals were immunized with an expression vector encoding HDAg by gene gun. T cell and humoral immune responses induced by this protocol were determined and compared with those induced by HDAg immunization using a CpG oligonucleotide as an adjuvant. After immunization the woodchucks were challenged with 10⁶ genome equivalents of HDV. The protein immunization with HDAg induced good humoral and T helper cell responses in the woodchucks, but did not protect them from HDV superinfection. The DNA immunized woodchucks were also not protected from HDV superinfection, however, the course of infection was modified: HDV viremia occurred later, the typical fluctuation of the HDV RNA titer with several peaks was absent, and antibodies to HDV were not detectable.     

2007～2008年流感监测季北京地区H3N2亚型流感病毒抗原性与HA1基因特性分析

目的:了解2007~2008年流感监测季北京地区分离的H3N2亚型流感病毒抗原性及血凝素基因变异情况。方法:选取2007~2008年流感监测季中分离的首株H3N2亚型毒株及其后不同时间、不同地点共9株毒株,通过单向血凝抑制试验进行抗原性分析;测定血凝素基因的HA1区核苷酸序列并推导出其氨基酸序列,进行基因进化特性分析。结果:与我国代表株A/江西/东湖/312/2006本身的血凝抑制效价相比,9株病毒中3株有4倍及以上差异。HA1区核苷酸序列和氨基酸序列分析表明,有部分毒株的氨基酸发生下述替换:3 L→F、53 D→N、57 Q→H、157 L→S、158 K→R、171 N→K、173 K→N、182 V→I、194P→L、261 R→Q、272 A→V、291 N→D、299 K→R;其中53、157、158、171、173、194位氨基酸位于抗原决定簇。结论:北京地区2007~2008年流感监测季分离的H3N2亚型流感病毒有部分毒株已发生抗原性及基因特性的改变。     

基于上转化发光免疫层析技术建立发热伴血小板减少综合征病毒总抗体快速检测方法

目的基于上转化发光(UPT)免疫层析技术,建立发热伴血小板减少综合征病毒(SFTSV)总抗体的现场快速检测方法。方法将SFTSV重组NP蛋白与上转化发光颗粒(UCP)偶联,制备UCP-NP免疫层析试纸条,评价该试纸条检测SFTSV总抗体的灵敏性、特异性和稳定性,并检测SFTSV血清254份,与酶联免疫法(ELISA)比较。结果该方法可在15min内完成SFTSV总抗体检测,可检测1∶500稀释度的SFTSV阳性血清,与其他出血热病毒无交叉反应,加样14d内稳定性较高。UPT免疫层析法与ELISA法检测临床血清样品一致性极高(Kappa=0.967),约登指数为0.973。结论建立了基于UPT免疫层析技术的SFTSV总抗体快速检测方法,该方法灵敏、特异,且操作简便、快速,结果稳定,适合在基层门诊和体检现场推广。     

A new recombinant Orf virus (ORFV, Parapoxvirus) protects rabbits against lethal infection with rabbit hemorrhagic disease virus (RHDV)

This report describes the generation of a new recombinant Orf virus (ORFV; Parapoxvirus) expressing the major capsid protein VP1 (VP60) of the calicivirus, rabbit hemorrhagic disease virus (RHDV). Authentic expression of VP1 could be demonstrated in cells infected with the recombinant D1701-V-VP1 without the need for production of infectious ORFV progeny. Notably, infected cells also released empty calicivirus-like particles (VLPs). Challenge experiments showed that even a single immunization with ≥10⁵ PFU of D1701-V-VP1 protected rabbits against lethal RHDV infection. ELISA tests indicated that the protective immunity mediated by D1701-V-VP1 did not strictly depend on the presence of detectable RHDV-specific serum antibodies. The induction of interleukin-2 found only in the sera of rabbits immunized with the D1701-V-VP1, but not in sera of rabbits immunized with the inactivated commercial vaccine RIKA-VACC, might indicate also some involvement of T-cells in protection. Collectively, this work adds another example of the successful use of the ORFV vector system for the generation of a recombinant vaccine, and demonstrates its potential as an alternative vaccine to protect rabbits against RHDV infection.