伯氏疏螺旋体与嗜吞噬细胞无浆体混合感染的实验研究

目的应用动物模型探讨蜱传病原体伯氏疏螺旋体和嗜吞噬细胞无浆体混合感染对组织螺旋体载量、莱姆关节炎严重性、宿主免疫功能的影响。方法建立伯氏疏螺旋体和嗜吞噬细胞无浆体混合感染和伯氏疏螺旋体单一感染小鼠模型，在不同时间点研究各组小鼠组织中的螺旋体载量、关节炎严重性和血清IgG效价，并对数据进行统计学分析。结果与单一感染组相比，在螺旋体感染后18d和30d，混合感染组小鼠组织螺旋体载量显著增高，关节炎明显严重，血清IgC效价显著偏低。结论伯氏疏螺旋体和嗜吞噬细胞无浆体混合感染显著增加小鼠组织螺旋体载量、加重关节炎症状和病理改变，且抑制体液免疫功能。     

Endoscopic anti-reflux therapy for gastroesophageal reflux disease

Gastroesophageal reflux disease has an increasing incidence and prevalence worldwide. A significant proportion of patients have a suboptimal response to proton pump inhibitors or are unwilling to take lifelong medication due to concerns about long-term adverse effects. Endoscopic anti-reflux therapies offer a minimally invasive option for patients unwilling to undergo surgical treatment or take lifelong medication. The best candidates are those with a good response to proton pump inhibitors and without a significant sliding hiatal hernia. Transoral incisionless fundoplication and nonablative radiofrequency are the techniques with the largest body of evidence and that have been tested in several randomized clinical trials. Band-assisted ligation techniques, anti-reflux mucosectomy, anti-reflux mucosal ablation, and new plication devices have yielded promising results in recent noncontrolled studies. Nonetheless, the role of endoscopic procedures remains controversial due to limited long-term and comparative data, and no consensus exists in current clinical guidelines. This review provides an updated summary focused on the patient selection, technical details, clinical success, and safety of current and future endoscopic anti-reflux techniques.     

Molecular survey and genetic characterization of Anaplasma centrale,A. marginale and A. bovis in cattle from Algeria

Bovine anaplasmosis could be caused by several Anaplasma species. The causative agents are transmitted by ticks and haematophagous arthropods with a high impact on both human and animal health. This study was conducted to estimate the infection rate and to characterize Anaplasma spp. in cattle from Algeria. A molecular survey was performed in Setif district (Northeast Algeria) where a total number of 180 cattle blood samples were collected and tested for the presence of Anaplasma spp. by PCR . Positive samples were genetically characterized based on the 16S rRNA and msp4 genes. PCR s revealed that the infection rates of Anaplasma spp., Anaplasma centrale , Anaplasma marginale and Anaplasma bovis were 42.2%; 39.4%; 11.1% and 4.4%, respectively. All tested animals were negative for A. phagocytophilum . Co‐infection occurred in 10% (18/180) of the tested animals, and the most common co‐infection pattern was an association between A. centrale and A. marginale (5.5%). Five cattle (2.7%) were co‐infected by the three Anaplasma species. Holstein animals (58.1%) were more infected by A. centrale than the other breeds (p  = .01). The molecular prevalence of A. centrale was significantly higher in males (54.2%) than in females (34.1%) (p  = .001). A. marginale msp4 genetic analysis indicated a high sequence diversity of Algerian strains, suggesting the importation of live cattle from different origins. Phylogenetic analysis of the 16S rRNA gene of A. bovis and A. centrale revealed a low degree of genetic diversity. Our study suggests that different species of Anaplasma are simultaneously present in the Algerian cattle. To the best of our knowledge, this is the first molecular study and genetic characterization of Anaplasma spp. in Algerian cattle.     

中国嗜吞噬细胞无形体分离株多间隔序列分型分析

目的 对我国嗜吞噬细胞无形体分离株进行多间隔序列分型（MST）分型。方法 根据GenBank收录的4株无形体全基因组序列，利用Mauve 2.3.1软件行种内基因组比对，选择具有变异间隔区进行引物设计，通过引物特异性及扩增效率等预实验筛选引物，并对实验菌株进行PCR扩增，分析单核苷酸多态性（SNPs）。将每株菌间隔序列拼接后进行分型分析并构建进化树，分析不同地区、不同动物种类来源菌株遗传变异关系。结果 共筛选出22对引物，用于我国11株无形体分离株 MST 分型，SNPs 分析显示，碱基转换发生率最高（60.2%，251/417），其中 A-G 转换居首（18.9%，79/417），颠换占23.0%（96/417），插入及缺失发生率占16.7%（70/417）。11株菌22条间隔序列拼接后（约11 047 bp）均为独立变异型。进化分析发现山东省莱州地区重症患者分离株（LZ-H1、H2、H3、H4、H5）及当地长角血蜱分离株 LZ-T1 与美国 Webster 株及 HZ 株聚为一簇，而北京分离株BJ-H1 与新疆分离株 XJ-H1 和 XJ-H3 聚为一类。莱州地区另一蜱分离株 LZ-T2 与新疆另外一人源分离株聚为一类，与莱州重症患者分离株遗传关系密切。结论 我国无形体分离株间隔序列存在明显的遗传多态性，MST分型技术可用于无形体疫情暴发时的快速诊断和疫情追踪。     

Primary pulmonary malignant melanoma diagnosed with percutaneous biopsy tissue: A case report

BACKGROUNDPrimary malignant melanoma of the lung (PMML) is a rare and highly malignant tumor with a poor prognosis. Here, we report a PMML case diagnosed by computed tomography (CT)-guided percutaneous biopsy, describe its pathological features and review relevant literature to improve our understanding of this tumor.CASE SUMMARYA 64-year-old Chinese female presented with productive cough for 7 mo. A chest CT scan showed a large and space-occupying lesion in Lingual lobe. Positron emission tomography-CT revealed multiple nodules located in the superior lobe apicoposterior segment of her left lung. Brain magnetic resonance imaging showed numerous enhancing nodules, suggesting brain metastasis. Abdominal CT scan did not show any abnormalities. By CT-guided percutaneous biopsy, four pieces of gray and taupe tissues (1 cm length and 0.1 mm in diameter) were obtained. After pathologic examination, the tumor was found to consist of epidermal and nested small round cells, fibrosis and thin-walled blood vessels. The finding was suggestive of malignant melanoma. To confirm the diagnosis, pathological morphology and immunophenotypic features of the biopsy specimens were observed. The patient denied any history of skin tumors. No abnormal lesions were detected in other sites of the body. Molecular testing was positive for wild-type EGFR and KIT gene mutations. Finally, the clinical and pathological findings suggested PMML. CONCLUSIONPMML is very rare, and the percutaneous biopsy tissue is limited. Therefore, comprehensive consideration of histology, immunohistochemistry, imaging, and clinical information is important for the diagnosis of PMML.     

Detection and identification of Anaplasma phagocytophilum, Borrelia burgdorferi, and Rickettsia helvetica in Danish Ixodes ricinus ticks

Borreliosis is an endemic infection in Denmark. Recent serosurveys have indicated that human anaplasmosis may be equally common. The aim of this study was to look for Anaplasma phagocytophilum and related pathogens in Ixodes ricinus ticks and estimate their prevalence, compared to Borrelia, using PCR. Ticks were collected from three locations in Denmark: Jutland, Funen, and Bornholm. Ticks from Jutland and Funen were analysed individually, ticks from Bornholm were analysed in pools of 20. A. phagocytophilum was found in ticks from all areas. A. phagocytophilum was found in 23.6% of ticks from Jutland and Funen, while 11% were positive for Borrelia burgdorferi. The Borrelia genotype B. afzelii was most prevalent, followed by B. valaisiana, B. burgdorferi s.s. and B. garinii.A. phagocytophilum was found in 14.5% of nymphs and 40.5% of adult ticks, while Borrelia was found in 13% of nymphs and 8% of adult ticks. The difference in prevalence between Anaplasma and Borrelia in adult ticks supports the idea that their maintenance cycles in nature may be different. Ticks were also infected with Rickettsia helvetica. Our study indicates that A. phagocytophilum prevalence in ticks in Denmark is as high as Borrelia prevalence and that human anaplasmosis may be unrecognized.     

嗜吞噬细胞无形体研究进展

本文重点阐述了嗜吞噬细胞无形体Anaplasmaphagocytophilum的病原学、生态学方面的研究进展：简要介绍了人群中嗜吞噬细胞无形体感染流行的特征、主要临床特点和治疗要点；概括了嗜吞噬细胞无形体感染的预防控制手段；分析了嗜吞噬细胞无形体相关研究存在的一些不足及其今后的研究方向。     

Detection of Anaplasma phagocytophilum in animals by real-time polymerase chain reaction

The aim of this study was to detect Anaplasma phagocytophilum in wild and domesticated animals and to identify the phylogenetic relationships of different strains of this bacterium. We adapted six published conventional methods targeting 16S fragments for real-time polymerase chain reaction. Initial screening of samples from 419 animals found 37 Anaplasma positives, later confirmed with several different primers and a TaqMan probe. We also performed DNA quantification and melting curve analysis. The nucleic acid of Anaplasma sp. was detected in a higher percentage of cases in members of the deer family, hares, bank voles and mice (12.5 approximately 15%) than in foxes, boars, cows, and horses (around 4 approximately 6%). We also performed blood analysis of cows, horses, mice, and ticks removed from animals, evaluating the presence of antibodies against granulocytic Anaplasma sp. Finally, we subjected 11 randomly selected PCR amplified products to direct sequencing and we constructed the corresponding phylogenetic tree with respect to the Ehrlichia equi sequence, homologous to the human granulocytic ehrlichiosis agent. Mutual identity of the sequencing ranged from 99% to 100%.