手足口病患儿外周血单核细胞亚群的研究

目的：探讨未经治疗和随访1、3、5 d手足口患儿外周血单核细胞亚群的变化。方法流式细胞仪检测104例未经治疗手足口患儿（包括阴性患儿62例,EV71阳性患儿37例,CVA16阳性患儿5例）和随访1、3、5 d的患儿外周血单核细胞CD14highCD16-亚群、CD14highCD16＋亚群和CD14lowCD16＋亚群。结果与健康儿童组相比,手足口患儿CD14highCD16＋单核细胞亚群所占总单核细胞比例明显升高（t =4.092,P ＜0.001）;CD14highCD16-亚群比例明显降低。阴性、EV71型、CVA16型患儿之间CD14highCD16-亚群、CD14highCD16＋亚群和CD14lowCD16＋亚群差异均无统计学意义。结论未经治疗的手足口患儿外周血单核细胞亚群的变化可能与EV71及CVA16病毒的持续感染有关,与病毒种类相关性不明显。     

2例EV71死亡病例的病理特征及EV71宁波分离株全基因组序列分析

目的探讨2例感染EV71手足口病(HFMD)死亡病例的病理特征及其病原体的分子生物学特征。方法系统分析2例HFMD病例的临床资料及尸检病理结果,并对EV71的PCR结果进行序列分析。结果死者年龄均<3岁,病情进展快,最终出现肺水肿和肺出血死亡。尸检显示:病变主要在中枢神经系统、肺脏以及肠道。大脑及脑干可见明显充血、水肿、炎症、坏死及软化灶等,脑脊膜炎症明显;肺脏显著充血,主要为水肿和出血,肺间质及小血管周围少量炎细胞浸润;肠黏膜充血,空肠及回肠部分区域肠黏膜、黏膜下层、平滑肌层、浆膜均坏死,细胞核消失,胞质及间质溶解,肠壁变薄,肠系膜淋巴结肿大,肠系膜及肠黏膜下淋巴滤泡增生,生发中心坏死;心肌纤维细胞结构正常,心肌间质充血,心肌细胞水肿,心外膜少量炎性细胞浸润;肝、脾、肾、胰腺病理改变不明显。肠内容物及总肠道组织EV 71病毒核酸检测均为阳性。EV 71病毒全基因共7414个碱基,该2株EV71均为C4亚型。结论危重型HFMD(EV 71感染)患者神经系统、呼吸系统病变明显,严重的脑干脑炎、脑膜炎和神经源性肺水肿、肺出血是死亡的主要原因;C4亚型EV71感染的重症HFMD患儿肠道的损害亦极为显著,肠道功能保护不容忽视。     

浙江省2002－2018年病毒性脑膜炎病原学与分子流行病学特征

目的 了解2002-2018年浙江省病毒性脑膜炎病原学及分子流行病学特征。方法 从设立的监测点医院采集疑似病毒性脑膜炎患者样本2 173份,其中脑脊液1 718份、粪便455份,用荧光定量PCR方法检测脑脊液中人类肠道病毒(HEV)、腮腺炎病毒(MuV)、单纯疱疹病毒(HSV)、巨细胞病毒(CMV)和乙型脑炎病毒(JEV)核酸,粪便样本只检测HEV;用ELISA方法检测脑脊液中上述5种病毒IgM抗体;对HEV核酸阳性样本扩增病毒VP1基因和测序,确定病毒型别并进行进化分析。结果 在2002-2018年2 173份样本中检出HEV核酸阳性871份(40.1%),其中脑脊液1 718份、阳性654份(38.1%),粪便455份、阳性217份(47.7%);871份HEV核酸阳性样本,VP1扩增测序阳性670份,其中HEV-A 5份、HEV-B 665份,涉及23个病毒血清型,分别为柯萨奇病毒(CV)A组CVA4、CVA6、CVA9、CVA10,CVB组1~5, 埃可病毒(EchoV;E)E3、E4、E6、E7、E9、E11、E14、E16、E18、E21、E25、E30、E33和肠道病毒(EV)-71,位于前3位的分别为E30、E6和CVB5,该3个血清型间隔若干年呈现病毒活动性增强的趋势。从2012-2015和2018年795份脑脊液中检出HEV核酸阳性374份、MuV 6份、HSV和CMV均为5份,对其中的368份脑脊液同时检测5种病毒IgM抗体,HEV抗体阳性2份、JEV 6份、MuV 1份。670份HEV中除1份EV-71外,EchoV 517份、CV 152份,两者之比为3.4:1,两类病毒间隔3~5年存在优势株交替变化的趋势。VP1进化树显示,浙江省HEV位于HEV-A和HEV-B分支上,E30存在h和i基因亚型。结论 浙江省病毒性脑膜炎的主要病原为HEV-B;EchoV检出率明显高于CV,两类病毒存在交替变化的趋势;优势血清型E30、CVB5和E6间隔若干年呈现病毒活动性增强的趋势;监测点HEV活动强度与病毒性脑膜炎暴发疫情的发生两者之间在时间上有较好的相关性。     

Standardized flavonoid-rich fraction of Artemisia princeps Pampanini cv. Sajabal induces apoptosis via mitochondrial pathway in human cervical cancer HeLa cells

Ethnopharmacological relevance

Artemisia princeps Pampanini is widely used in Eastern traditional medicine for the treatment of circulatory disorders, such as, dysmenorrhea, hematuria, hemorrhoids, and inflammation, and is also used to treat chronic conditions, such as, cancers, ulcers, and digestive disorders.

Aim of the study

The purpose of this study is to investigate the effect of a standardized flavonoid-rich fraction of Artemisia princeps Pampanini cv. Sajabal (FRAP) on the induction of apoptosis and the molecular mechanism involved in human cervical cancer HeLa cells.

Materials and methods

Human cervical cancer HeLa cells were treated with FRAP and apoptosis was detected by cell morphologic observation, annexin-V-PI staning and western blot analysis on the expression of protein associated with cell death.

Results

FRAP led to the cleavages of caspase-3, -8, and -9 and the cleavage of poly (ADP-ribose) polymerase (PARP) in HeLa cells. Caspase-3 inhibitor (z-DEVD-fmk), caspase-8 inhibitor (z-IETD-fmk), caspase-9 inhibitor (z-LEHD), and broad caspase inhibitor (z-VAD-fmk) significantly suppressed the FRAP-induced accumulation of annexin V positive cells. Furthermore, it was found that FRAP caused a loss of mitochondrial membrane potential (MMP) and the release of cytochrome c to the cytosol. Furthermore, the overexpression of Bcl-xL significantly prevented FRAP-induced apoptosis, MMP changes, and the activations of caspase-3, -8, and -9. Interestingly, pretreatment with caspase-8 inhibitor significantly reduced the FRAP-induced activation of caspase-3 but not that of caspase-9, whereas the caspase-3 inhibitor, z-DEVD-fmk, markedly attenuated the FRAP-induced activation of caspase-8. In BALB/c^nu/nu mice bearing a HeLa xenograft, FRAP dosed at 25 or 50 mg/kg significantly inhibited tumor growth.

Conclusion

Our results indicate caspase-mediated activation of the mitochondrial death pathway plays a critical role in the FRAP-induced apoptosis of HeLa cells and that FRAP inhibits the in vivo tumor growth of HeLa xenograft mice.     

苏州市吴江区年手足口病发病与气候的关联分析

目的评价苏州市吴江区手足口病患者的发病及病情、病原体与气象特点的关联性,为本地区手足口病的防治提供参考。方法收集苏州市吴江区所具有儿科病房的3家医疗机构2016—2019年收治的手足口病(HFMD)患者发病特点、病原体分布,同时调查该地区平均气温、最高气温、最低气温、平均气压、降水量、平均相对湿度、平均风速等气象因素,分析气象因素与手足口病发病的相关性。结果苏州市吴江区于2016-2019年手足口病的发病情况如下:2016年5567例(675.1823/10万),2017年3238例(388.8373/10万),2018年7106例(845.1796/10万),2019年5085(594.1572/10万)。吴江区2016—2019年HFMD患者的病原体分布结果:EV71型:56.06%,57.13%,65.65%,77.99%。CoxA16型:22.65%,13.78%,16.16%,16.05。其他肠道病毒:21.16%,26.53%,17.44%,18.53%。EV71、CoxA是吴江区HFMD的主要致病源。在气象因素中,平均气温、降水量和HFMD的发病数成正相关(P<0.05);平均风速、相对湿度、日照时和HFMD的发病无相关性。结论气象因素中气温、降水量会增加HFMD的发病率,控制EV71、CoxA16病毒传播可有效控制HFMD的发生、传播。     

浙江新分离汉坦病毒ZT71株S基因片段的克隆及序列分析

目的为了获得浙江省汉坦病毒基因组更为详尽的资料,研究汉坦病毒的进化状况及变异程度,为疫苗病毒株的选择使用提供科学依据。方法本实验室利用RT-PCR方法扩增ZT71株S基因片段并克隆入质粒载体,进行核苷酸序列测定及分析。结果ZT71株S基因由1754个核苷酸组成,只有一个开放读码框架,共编码429个氨基酸。与HTN型病毒(76-118)的核苷酸和氨基酸同源性分别为72.0%和82.6%,与SEO型病毒(SR-11、R22、Guo3、8610)核苷酸和氨基酸同源性分别为88.4%—96.5%和98.1%—99.0%,与其它型汉坦病毒的同源都很低。结论表明此分离的病毒为SEO型汉坦病毒,为进一步研究其进化和变异提供了有利条件。     

Elevated antigen-specific Th2 type response is associated with the poor prognosis of hand,foot and mouth disease

The immunopathogenesis of severe hand, foot and mouth disease (HFMD) remains elusive. This study revealed that enterovirus 71 (EV71) epitope-specific CD4+ T cell responses of HFMD patients were skewed toward a Th2 cytokine profile. Patients that demonstrated higher levels of IL-4 expression in their CD4 T cells following antigen stimulation in vitro tended to have a more prolonged period of high fevers and a longer duration of illness. Thus, an increase of EV71 epitope-specific Th2 type response may portend the poor prognosis for some HFMD patients.     

Myocarditis,Microbes and Autoimmunity

Acute and chronic myocarditis can be caused by a number of infectious agents, including viruses, bacteria and protozoa. These diseases are refractory to treatment, and the development of rational therapies will require a detailed understanding of the mechanisms that underlie the pathological inflammatory responses. Here, we review three infectious myocarditides that, despite the dissimilarity of the microorganisms, share several common features: (i) the microbes replicate in the heart; but (ii) are difficult to isolate, in infectious form, during chronic disease; (iii) autoreactive antibodies and T cells specific for cardiac antigens have been identified in infected animals; and (iv) these autoreactive responses have been proposed as the main effectors of cell death, and myocardial damage. We critically evaluate the data, and we suggest that the findings can be reconciled without invoking autoimmunity as an effector mechanism. Alternative hypotheses to explain the tissue destruction are proposed.