陕西省1999～2002年检出脊髓灰质炎疫苗相关株病毒的急性弛缓性麻痹病例流行病学分析

分析了陕西省 1999～ 2 0 0 2年检出脊髓灰质炎 (脊灰 )疫苗相关株病毒的急性弛缓性麻痹 (AFP)病例的流行病学特征 ,以及疫苗相关麻痹型脊灰 (VAPP)的发生情况。结果显示 :AFP病例集中在 0～ 2岁儿童 ,占 6 8 6 % ;男性多于女性 ;发病无地区、时间分布特征 ;零剂次免疫和未全程免疫儿童占 6 2 9% ;VAPP发生率为 0 32 /10 0万 ,服苗者VAPP发生率和接触者VAPP发生率均为 0 16 /10 0万。建议提高VAPP诊断准确性 ,加强AFP病例监测 ,保证高水平免疫接种率。     

Molecular characterisation of type 1 polioviruses associated with epidemics in South Africa

The molecular epidemiology of wild-type 1 polioviruses isolated in South Africa during 2 major poliomyelitis epidemics in the 1980s and during the pre- and inter-epidemic periods was investigated by partial sequence analysis across the VP1/2A junction. Poliovirus-specific primers were used to amplify and subsequently sequence the region of interest. Viruses belonging to different genotypes were found to have been responsible for the 2 outbreaks. The Gazankulu outbreak in 1982 was caused by a poliovirus genotype which was unique to South Africa and which circulated endemically throughout much of the country between 1980 and 1985. Two additional genotypes, imported from the Middle East and West Africa, cocirculated endemically with the South African genotype between 1982 and 1985. The 1988 epidemic in Kwazulu-Natal was attributed to an imported genotype apparently introduced into South Africa in 1985 from countries north of the border. This genotype displaced the 3 genotypes previously in circulation and continued to be transmitted within the country until 1989, when the last confirmed cases of poliomyelitis associated with wild-type viruses were documented. All circulating wild-type poliovirus strains appear to have been eliminated from South Africa. J. Med. Virol. 52:42–49, 1997. © 1997 Wiley-Liss, Inc.     

Motor unit size estimation of enlarged motor units with surface electromyography

Surface EMG is hardly used to estimate motor unit (MU) characteristics, while its non-invasiveness is less stressful for patients and allows multi-electrode recordings to investigate different sites of the muscle and MU. The present study compares motor unit potentials (MUPs) obtained with surface EMG and macro EMG during voluntary contraction of the biceps brachii muscle of patients with enlarged MUs caused by prior poliomyelitis. Averaged surface MUPs were obtained by means of needle EMG (SMUP1) and surface EMG (SMUP2) triggering. The MUPs area and peak amplitudes correlated well when comparing the macro MUP and SMUP1 of the same MUs. When MU populations of different patients were compared, the SMUP1s and SMUP2s were equally sensitive to pathology as macro MUPs. In this, the late non-propagating positive wave (only present in unipolar recordings) is more robust than the triphasic propagating wave. Therefore, surface EMG can be used for detecting enlarged MUs. © 1998 John Wiley & Sons, Inc. Muscle Nerve 21:878–886, 1998.     

脊髓灰质炎后综合征的临床表现（附3例报道）

目的:研究脊髓灰质炎后综合征(PPS)的临床表现。方法:评价3例PPS患者的临床表现。结果:PPS的主要表现是新出现的肌无力、疲劳、疼痛和肢体及躯干缓慢进展的运动神经损害。PPS患者既往有脊髓灰质炎的病史,有部分或完全的神经功能恢复,有长达数十年的神经功能稳定期并除外其他疾病。结论:PPS是一种感染脊髓灰质炎后出现的缓慢进展性的运动神经元综合征。     

Recombinant murine L20B cell line supports multiplication of group A coxsackieviruses

Sensitive, reliable, and rapid methods of virus culture are essential for wild poliovirus isolation and identification from stool specimens collected from cases of acute flaccid paralysis. Recently, recombinant murine cell lines expressing human poliovirus receptor (CD155) on the cell surface have become available. These cells are sensitive selectively to poliovirus because the poliovirus receptor is not used by other enteroviruses. In early field studies non-polio enteroviruses were not isolated from stool samples of cases of acute flaccid paralysis using L20B cells. For the past 3 years, L20B cells were used extensively in our laboratory for virus culture. The objective of the present study was to identify non-polio enteroviruses causing cytopathic changes in L20B cells. Stool specimens collected from 1,153 cases of acute flaccid paralysis and 2,670 apparently healthy children were tested for enteroviruses using RD and L20B cell lines. A small number of viruses other than poliovirus causing cytopathic effect in L20B cells were isolated. Such isolates detected in other polio network laboratories in India were also included. The virus isolates were typed using partial VP1 nucleotide sequence analysis and virus neutralization tests. Of the 111 viruses studied, 8 were non-enteroviruses. Among the 103 non-polio enteroviruses, 73 were identified as group A coxsackieviruses. Of the 30 isolates that could not be characterized, 1 remained unidentified even by sequence analysis and 29 did not reach high titers in L20B as well as RD cells. In conclusion, coxsackie A viruses multiply in L20B cells causing cytopathic effect. Coxsackievirus A8 and coxsackievirus A10 were predominant among the eight coxsackie A virus types so far identified.     

深圳市1994～2001年检出脊髓灰质炎疫苗株病毒的急性弛缓性麻痹病例流行病学分析

为了解深圳市检出脊髓灰质炎 (脊灰 )疫苗株病毒的急性弛缓性麻痹 (AFP)病例流行病学特征及疫苗相关麻痹型脊灰 (VAPP)病例发生情况 ,对 1 994～ 2 0 0 1年检出脊灰疫苗株病毒的AFP病例进行分析。结果显示 :病例分布在 0～ 3岁儿童 ,男性多于女性 ;发病时间、地区无明显聚集趋势 ;无脊灰疫苗免疫史的占 55 .55 % ,均为外来流动儿童 ;检出脊灰疫苗株Ⅱ型病毒占 44 .45 % ,残留麻痹率高。VAPP发生率为 0 .90 / 1 0 0万 ,服苗者VAPP发生率为0 .68/ 1 0 0万 ,首次服苗VAPP发生率为 4 .0 9/ 1 0 0万 ,服苗接触者VAPP发生率为 0 .2 3/ 1 0 0万。提示应加强外环境中脊灰病毒的监测和相关研究     

杭州市急性弛缓性麻痹病例检出疫苗相关株病毒的调查分析

目的为维持无脊髓灰质炎脊灰阶段提供依据。方法分析无脊髓灰质炎阶段杭州市连续5年检出脊灰疫苗相关株病毒的急性弛缓性麻痹(AFP)病例的流行病学特征,以及疫苗相关麻痹型脊灰(VAPP)的发生情况。结果检出病毒相关株的AFP病例集中在2-3月龄的儿童占60%,全部为男性。零剂次免疫儿童占30%,VAPP的发生率为0.58/100万。结论提高VAPP诊断准确性,加强AFP病例监测,保证高水平免疫接种率。     

Acute flaccid paralysis and West Nile virus infection

Acute weakness associated with West Nile virus (WNV) infection has previously been attributed to a peripheral demyelinating process (Guillain-Barré syndrome); however, the exact etiology of this acute flaccid paralysis has not been systematically assessed. To thoroughly describe the clinical, laboratory, and electrodiagnostic features of this paralysis syndrome, we evaluated acute flaccid paralysis that developed in seven patients in the setting of acute WNV infection, consecutively identified in four hospitals in St. Tammany Parish and New Orleans, Louisiana, and Jackson, Mississippi. All patients had acute onset of asymmetric weakness and areflexia but no sensory abnormalities. Clinical and electrodiagnostic data suggested the involvement of spinal anterior horn cells, resulting in a poliomyelitis-like syndrome. In areas in which transmission is occurring, WNV infection should be considered in patients with acute flaccid paralysis. Recognition that such weakness may be of spinal origin may prevent inappropriate treatment and diagnostic testing.     

Correlation of motor units with strength and spectral characteristics in polio survivors and controls

The purpose of this study was to determine whether quantitative motor unit analysis in postpolio individuals correlates with muscle strength, endurance, work capacity, or power spectral characteristics of surface EMG and to determine whether power spectrum differentiates postpolio from control subjects. This study was designed to compare these variables in 34 symptomatic postpolio, 16 asymptomatic postpolio, and 41 control subjects. Quantitative motor unit analysis of the quadriceps femoris muscle was performed using a concentric needle electrode. Isometric knee extension peak torque, endurance (time to exhaustion) at 40% of maximal torque, work capacity (tension time index), and recovery of force through 10 minutes post-exhaustion were determined. Median frequency of the surface power spectrum was determined during the above testing. Power spectrum histograms were compared at the onset and termination of endurance exercise. Motor unit action potential variables did not correlate with isometric peak torque, tension time index, endurance time, recovery of strength, or with median frequency. Surface power spectrum did not differentiate postpolio from control subjects.