Herpes simplex encephalitis and subsequent cytomegalovirus encephalitis after chemoradiotherapy for central nervous system lymphoma: a case report and literature review

Neurological complications during the treatment of hematological malignancies have a wide range of causes. Treatment-related leukoencephalopathy has been recognized as a major complication of combined chemotherapy and radiotherapy for central nervous system (CNS) lymphoma, and can complicate the diagnosis of CNS infection. Herein, we present a patient with diffuse large B-cell lymphoma who developed herpes simplex encephalitis (HSE) and subsequent cytomegalovirus encephalitis after chemoradiotherapy for CNS relapse. Although cerebrospinal fluid examination (CSF) showed no significant pleocytosis, brain magnetic resonance imaging and polymerase chain reaction analysis of the CSF were useful in the diagnosis. With a review of the literature on the association between HSE and radiotherapy for CNS malignancies, our case suggests that an awareness of viral encephalitis is important in the differential diagnosis of acute neurologic disturbance during chemoradiotherapy for CNS lymphoma.     

高效液相色谱法测定飞蛇水中藤黄酸含量及临床应用

目的测定飞蛇水中藤黄酸的含量,控制每毫升≥60mg·mL-1。方法采用HPLC法色谱柱为Phenomenex-Luna C18色谱柱(250cm×4.6mm,5μm);进样量:10μL,流动相为乙腈-0.1%磷酸(95∶5);流速为1.0mL·min-1,检测波长为360nm。结果飞蛇水检品藤黄酸及其异构体色谱峰重合,无干扰,色谱峰的对称度为1.18、分离度大于1.5,塔板数大于8000。测定3批飞蛇水中含藤黄酸,含量均大于60.0mg·mL-1。结论该方法准确、可靠,可用于飞蛇水中藤黄酸的含量测定。本品用于治疗带状疱疹有效率达91.7%。     

蓝芩口服液联合干扰素雾化吸入治疗小儿疱疹性咽峡炎

目的:观察蓝芩口服液联合干扰素雾化吸入治疗小儿疱疹性咽峡炎的临床疗效和安全性。方法:疱疹性咽峡炎患儿随机分为两组,在支持治疗的基础上,对照组(57例)予利巴韦林静滴,观察组(58例)口服蓝芩口服液联合干扰素雾化吸入。观察比较两组临床症状消失时间及治疗总有效率和药品不良反应。结果:观察组症状消失时间较对照组明显缩短(P<0.05),治疗总有效率明显优于对照组(P<0.05)。两组药品不良反应均少而轻微。讨论:蓝芩口服液联合干扰素雾化吸入治疗小儿疱疹性咽峡炎疗效肯定,临床症状消失快,使用方便,且安全性好,值得临床推广应用。     

A recombinant varicella vaccine harboring a respiratory syncytial virus gene induces humoral immunity

The varicella-zoster virus (VZV) Oka vaccine strain (vOka) is highly efficient and causes few adverse events; therefore, it is used worldwide. We previously constructed recombinant vOka (rvOka) harboring the mumps virus gene. Immunizing guinea pigs with rvOka induced the production of neutralizing antibodies against the mumps virus and VZV.Here, we constructed recombinant vOka viruses containing either the respiratory syncytial virus (RSV) subgroup A fusion glycoprotein (RSV A–F) gene or RSV subgroup B fusion glycoprotein (RSV B–F) gene (rvOka-RSV A–F or rvOka-RSV B–F). Indirect immunofluorescence and Western blot analyses confirmed the expression of each recombinant RSV protein in virus-infected cells. Immunizing guinea pigs with rvOka-RSV A–F or rvOka-RSV B–F led to the induction of antibodies against RSV proteins. These results suggest that the current varicella vaccine genome can be used to generate custom-made vaccine vectors to develop the next generation of live vaccines.     

腺病毒介导 HSV-2 gD 基因修饰的树突状细胞疫苗制备

目的：生殖器疱疹尚无彻底治愈的方法。研制有效的生殖器疱疹病毒疫苗是预防和治疗HSV-2感染的关键,文中探讨制备腺病毒介导的HSV-2 gD基因修饰的树突状细胞（ dendritic cell , DC）疫苗的可行性。方法将HSV-2 gD蛋白基因克隆到质粒载体Shuttle-2,重组质粒酶切鉴定、测序鉴定后构建重组腺病毒pAdeno-HSV-2 gD。分离小鼠骨髓DC细胞, pAdeno-HSV-2 gD转染DC细胞后用流式细胞术检测DC表型,用免疫组化法、RT-PCR、SDS-PAGE和Western blot 方法检测HSV-2 gD的表达情况。结果以HSV-2病毒DNA为模板,采用gD基因引物扩增出相应的目的片段。琼脂糖凝胶电泳显示,PCR产物gD基因同预期的大小一致（1182 bp）。 pAdeno-gD DNA用脂质体法转染293细胞10 d,反复冻融获得pAdeno-HSV-2 gD重组腺病毒,活性为4×1010 IU／mL。流式细胞仪检测结果显示：成熟DC和腺病毒感染后DC,CD40含量为（74．2±3．9）％、（81．3±3．1）％,CD80含量为（73．9±4．1）％、（80．4±2．9）％,CD86含量为（76．1±5．5）％、（83．7±3．9）％,均较不成熟DC的CD40、CD80、CD86含量[（9．7±0．5）％、（7．5±1．2）％、（5．2±1．1）％]升高（P＜0．01）。 pAdeno-HSV-2 gD-DC和细胞因子刺激诱导成熟的DC细胞表面分子表达差异无统计学意义（P＞0．05）。 RT-PCR、免疫组织化学方法证明HSV-2 gD能在DC细胞内表达,表达产物的SDS-PAGE和Western blot分析发现,在相对分子质量为43000处有外源蛋白表达,与预期蛋白条带一致。结论成功制备了pAdeno-HSV-2 gD-DC疫苗。     

Antiviral Therapies for Herpesviruses: Current Agents and New Directions

Purpose

The objective of this review was to summarize the recent literature describing the current burden of disease due to herpesviruses in the antiviral and transplant era; describe mechanisms of action of antiviral agents and the development of resistance; summarize the literature of recent antiviral agents brought to market as well as agents under development; and to present literature on future strategies for herpesvirus therapeutics.

57例恶性肿瘤合并带状疱疹的回顾性分析

目的：分析恶性肿瘤合并带状疱疹的临床特点。方法回顾性分析2003年9月至2014年11月在该院住院的恶性肿瘤合并带状疱疹57例患者的抗肿瘤治疗史及带状疱疹的临床特点。结果大多数患者年龄在60岁以上,手术及放化疗后2年内带状疱疹发病率高,带状疱疹发病部位以胸背部最多见。结论老年、手术、放化疗等抗肿瘤治疗,机体营养状态差等因素加重或促进带状疱疹的发生。     

135例带状疱疹发病及后遗神经痛相关因素临床回顾研究

目的探求与带状疱疹发病及发生后遗神经痛可能的相关因素。方法收集2007年1月至2012年8月期间北京东直门医院皮肤科135例符合入选标准的带状疱疹患者的住院病历进行回顾性分析。应用SPSS 17.0统计软件进行统计学处理。结果年龄与疱疹前驱痛、疼痛程度均无明显相关性;年龄、疱疹前驱痛、皮损疼痛程度、基础慢性病及开始治疗时间均可能是发生带状疱疹后遗神经痛的相关因素。结论带状疱疹发病、发生后遗神经痛均有一定相关因素,早发现、早治疗,尤其对于老年患者或伴有基础慢性病者防治更有意义。