误诊为结核性脑膜炎的隐球菌脑膜炎1例

报道误诊为结核性脑膜炎的隐球菌脑膜炎1例。患者女性,49岁,间歇性头痛、低热,伴视力、听力进行性下降3个月余,诊断为结核性脑膜炎,行抗结核治疗1个月余。3d前患者体温骤升至39.4℃,伴剧烈头痛,呕吐。脑脊液真菌培养为隐球菌,脑脊液隐球菌抗原滴度1∶80。诊断:隐球菌脑膜炎。经抗真菌治疗半年后,患者一般情况好转,脑脊液病原学结果阴性。     

隐球菌脑膜炎患者治疗后隐球菌超微结构观察

目的研究隐球菌脑膜炎治疗后菌体超微结构的变化,探讨电镜检查在隐球菌活力检测中的应用。方法对8例经过两性霉素B和5-氟胞嘧啶联合治疗8周后,脑脊液中仍然可以查见隐球菌的患者,采用透射电镜对其脑脊液中的隐球菌进行超微结构观察。结果隐球菌菌体结构都显示了明显的变异：菌体大小差异显著,菌体形态变化明显;荚膜结构紊乱,菌体内可见空洞状或多个巨大脂滴,部分菌体胞膜破损,胞浆溢出。结论隐球菌脑膜炎治疗后虽然脑脊液中还存在菌体,但是菌体的超微结构已经发生了重大变化,提示菌体活力降低或死亡。电镜检查可以作为隐球菌活力判定的一种有效手段,提高隐球菌脑膜炎疗效判定的准确性。     

系统性红斑狼疮并发隐球菌性脑膜炎:1例报告并文献复习

目的探讨系统性红斑狼疮(SLE)合并隐球菌性脑膜炎的诊断及鉴别诊断。方法对1例SLE并发隐球菌性脑膜炎患者的临床及实验室检查特点进行分析,并结合文献复习进行讨论。结果患者出现中枢感染前长期使用泼尼松治疗,曾误诊为狼疮脑病应用激素冲击治疗无效;治疗过程中出现狼疮活动,激素加量后症状缓解。结论 SLE并发隐球菌性脑膜炎患者的临床表现缺乏特异性,感染相关症状与SLE表现部分重叠,腰穿脑脊液墨汁染色找隐球菌和隐球菌抗原乳胶凝集试验是诊断的主要手段。及时诊断和有效抗真菌治疗可改善患者的预后。     

脑脊液墨汁涂片阴性的儿童隐球菌脑膜炎1例:诊断与治疗

报道1例长期脑脊液墨汁涂片均为阴性的儿童隐球菌脑膜炎,并对此病的诊断方法进行探讨。脑脊液真菌培养和鉴定仍然应该是隐球菌脑膜炎诊断的“金标准”,脑脊液乳胶凝集实验结合真菌培养结果可以对此病的快速诊断做出早期提示,对脑脊液墨汁涂片阴性的检查结果需要结合其他指标进行综合考虑做出判断。     

肝移植后播散性隐球菌病1例及其实验研究

目的播散性隐球菌病临床及实验研究。方法患者女,47岁,肝移植术后2 d,面部、肩部、四肢皮肤出现多发溃疡,伴昏迷。通过脑计算机断层扫描、皮损组织病理检查、PAS染色、皮损组织真菌培养及激光俘获显微切割结合PCR扩增序列分析确诊,并对获得菌株进行尿素酶试验、API试验、PCR扩增测序等实验研究。结果皮损组织病理可见大量圆形和椭圆形菌体,PAS染色阳性。血液和脑脊液真菌镜检均为阴性。皮损组织真菌培养可见酵母样菌落生长,菌株尿素酶试验阳性,API试验鉴定为新生隐球菌。ITS区序列分析鉴定为新生隐球菌grub ii变种。激光俘获显微切割结合PCR扩增,序列分析与培养获得的菌株直接PCR扩增后序列分析结果一致。脑脊液特异性隐球菌抗原（＋＋）,血液特异性隐球菌抗原（＋＋＋＋）。脑CT显示为多发结节灶。依据临床及实验室检查确诊为播散性隐球菌病,致病菌为新生隐球菌grubii变种。结论通过对该病例的深入研究,为临床明确诊断播散性隐球菌病奠定基础,确立了显微切割技术在皮肤真菌感染中的应用价值。     

肾移植术后隐球菌性脑膜炎合并肺炎1例并文献复习

目的 探讨肾移植术后隐球菌性脑膜炎合并肺炎的诊断及治疗.方法 对1例肾移植术后隐球菌性脑膜炎合并肺炎患者的临床及实验室检查特点进行分析,并结合文献复习进行讨论.结果 给予患者两性霉素B脂质体联合伏立康唑诱导、伏立康唑维持治疗后头痛、咳嗽等症状消失,影像学检查示肺部病灶吸收.治疗过程中未发生急性排斥.结论 肾移植术后隐球菌性脑膜炎并发肺炎患者的临床表现缺乏特异性,脑脊液墨汁染色和隐球菌抗原乳胶凝集试验是诊断的主要手段.及时诊断和有效抗真菌治疗可改善患者的预后.治疗过程中免疫抑制药物需作相应调整.     

寡核苷酸探针悬浮芯片在病原体检测中的应用

悬浮芯片与固体芯片、荧光定量PCR并列成为核酸序列鉴定中的重要的分子生物学工具,并在病原菌检测方面显示出不同的应用领域.悬浮芯片能同时检测多种病原菌,具有处理多样本能力、使用灵活、低成本等特点,适合对未知样本检测及环境监控.能够在生物安全、公共卫生、工农业生产中发挥重要作用;而固体芯片能耦联成千上百个探针,但由于在多样本处理、成本方面欠缺,因此适合于对重要的未知病原体的鉴定;荧光定量PCR具较好特异性、灵敏度,以及多样本处理能力,但在高通量方面欠缺.适合有目的地检测已知病原体.目前已建立三种基于悬浮芯片的检测方法:多重PCR扩增、通用引物扩增16S/23S rDNA、直接对实际样本杂交检测.多重PCR具较好特异性,但其多重能力还难以满足悬浮芯片的高通量的需要;通用引物具较好灵敏度及扩增多靶分子能力,但也存在交叉反应等缺陷.同时,采用PCR扩增方法,悬浮芯片检测的是PCR产物,不能客观反应实际样本中存在病原菌数量及是否具生命力.直接杂交环境样本尽管避免了PCR的缺陷,但在灵敏度方面非常欠缺.目前,在环境样本处理上,仍然缺乏有效的、高通量、自动化的方法,不能满足PCR与悬浮芯片多样本检测的需要.     

油茶白绢病原菌齐整小核菌分子检测的研究

目的：设计特异性引物建立油茶白绢病齐整小核菌的快速分子检测体系。方法：扩增齐整小核菌核糖体DNA ITS区并测定其序列,比较该序列与GenBank中近似种的ITS序列差异,设计了特异性引物BF1和BR2。结果：该引物可以从齐整小核菌中扩增得到约540bp特异性条带,而扩增其它近似或相关菌株时没有相应的特异性条带。在25μL PCR反应体系中,引物BF1和BR2检测灵敏度为1pg浓度DNA。结论：利用设计的BF1和BR2特异性引物结合PCR方法可快速的扩增出齐整小核菌DNA,检测灵敏度为1pg.但在生产实践中诊断油茶白绢病发病前组织中的齐整小核菌还需要进一步研究。     

食源性致病菌多重PCR快速检测方法建立与应用

利用PCR技术,建立多组多重食源性致病菌PCR快速检测方法。设计受试菌特异性引物,反应体系中加入多对引物和多种DNA模板,采用正交试验优化PCR反应条件,进行特异性引物的PCR扩增。建立了多组多重食源性致病菌PCR快速检测方法,方法中所检测受试菌株和模拟样品均出现特异性扩增条带,结果与实际相符。所建立多组多重PCR快速检测体系符合设计要求,可以应用于食源性突发公共卫生事件的应急检测和日常样品检测工作。     

一种快速检测岷江百合总RNA样本中基因组DNA残留的方法

总RNA样本中残留基因组DNA会严重影响qRT-PCR的准确性。为了检测RNA样本中的DNA残留,依据持家基因TIP41-like的部分内含子序列设计了1对基因组DNA残留检测引物:LDRG-F:5'-CTCTTTTATGACGAGGTTGGTA-3'及LDRG-R:5'-CAGGGAAATCGGTCAGTGTT-3'。利用这对引物对3种不同RNA提取试剂盒提取的总RNA样本以及2种不同第1链c DNA合成试剂盒合成的cDNA样本进行PCR扩增检测,能高效快速地检测岷江百合总RNA以及cDNA样本中有无基因组DNA残留。     

Development of multisample detection system using a tag insertion primer and an electrochemical DNA chip

We have developed a novel multisample detection system by employing a technology combining a tag insertion primer and an electrochemical DNA chip. In the first application, Helicobacter species-infected mouse samples were detected. The primers that insert a different tag sequence in each sample were prepared, and loop-mediated isothermal amplification (LAMP) reaction was carried out. Then amplification products in which a part of the sequence was different in each sample could be obtained. The target sample in which these amplification products were mixed was injected into a cassette that included the DNA chip with immobilized probes. After the cassette was set in the DNA detection system, Genelyzer, the processes of hybridization, washing, and detection were performed by the system automatically. The positive and negative concordance rates of the existing nested polymerase chain reaction (PCR) method and this method were 100% (40/40 samples) and 97.3% (117/120 samples), respectively. This is a simple high-throughput method. Moreover, the cost per sample can be drastically lowered. Therefore, it is expected to contribute to the diagnosis of infectious agents in humans and animals.     

用环介导等温扩增技术快速检测粪便样本中的沙门菌

目的:建立快速检测粪便样本中的沙门菌的环介导等温扩增技术(LAMP),并着重在灵敏度和特异性方面对此方法进行评价。方法:利用LAMP针对沙门菌特定基因invA(靶基因)设计的6条特异引物,通过引物特异性识别特定基因invA上的8个独立区域来快速检测沙门菌;LAMP反应过程中会产生白色沉淀焦磷酸镁,故可以通过监测浊度来判定反应结果。结果:实时浊度仪监测反应结果表明,LAMP反应在60~65℃等温条件下50 min内完成;如果在反应前添加羟基萘酚兰,蓝色阳性结果很明显区别于紫色阴性结果;LAMP的最低检出限为6.97 pg/μL,PCR为69.7pg/μL,LAMP方法的检测灵敏度是PCR的10倍,且具有良好的特异性。结论:LAMP方法用于快速检测沙门菌,具有检测过程简单、实验装置简便、反应结果肉眼可辨、灵敏度高、特异性强的特点,对非沙门菌菌株的结果呈阴性,表明引物设计有很好的特异性。对粪便样本进行检测,发现具有同样的敏感性和特异性。这表明LAMP法是潜在的和有价值的在粪便样本中直接检测沙门菌的方法,具有快速、简便、低成本的特点。LAMP法适用于快速临床诊断。     

柑桔溃疡病菌滚环扩增检测体系的建立

根据柑桔溃疡病菌(Xanthomonas axonopodis pv.citri,Xac)独有的蛋白基因序列和锁式探针公共连接序列分别设计特异性的锁式探针及其扩增引物,优化系列反应条件,建立了特异性的柑桔溃疡病菌滚环扩增体系.初步检测结果表明该体系能够特异性地检出Xac的菌体细胞及其DNA,而检测不出供试的其它植物病原细菌和柑桔叶面常见的多种附生细菌;对Xac靶片段克隆质粒DNA的检测灵敏度为10 2 copy/μL,对Xac菌悬液的检测灵敏度为20 cfu/μL,比常规PCR的检测灵敏度稍高.用滚环扩增技术和常规PCR技术对田间采集的实际样品进行了检测,两种方法的检测结果没有显著差异(P＞0.01).由于锁式探针的公共连接序列对扩增的条件要求一致,本体系的建立可以为植物病原微生物多靶标检测和病害检疫检验提供新的技术支撑.     

Improvements of PCR-based identification targeting the DNA topoisomerase II gene to determine major species of the opportunistic fungi Candida and Aspergillus fumigatus

For the simple and rapid detection/identification of major pathogenic fungal species such as Candida albicans, C. tropicalis, C. parapsilosis, C. glabrata and Aspergillus fumigatus, common primers for these species and specific primers for each species, designed on the basis on the genomic nucleotide sequences of the DNA topoisomerase II genes, were prepared and tested for their specificities in PCR amplifications. Twelve specific primers were pooled and designated PsVI. Genomic DNAs were amplified by the common primer pair, and followed by PCR amplification using PsVI. Using PsVI, six unique DNA fragments, all of which corresponded to a Candida or A. fumigatus species, were specifically and acceptably amplified from each template DNA even in the presence of other DNAs. Similarly, the results of identification of clinical samples based on the PCR amplification coincided with those of conventional identification techniques. The sensitivities of the direct PCR and the nested PCR using PsVI were found to be 1,000 and 50 yeast cells, respectively.     

Selective and sensitive method for PCR amplification of Escherichia coli 16S rRNA genes in soil

A set of PCR primers targeting 16S rRNA gene sequences was designed, and PCR parameters were optimized to develop a robust and reliable protocol for selective amplification of Escherichia coli 16S rRNA genes. The method was capable of discriminating E. coli from other enteric bacteria, including its closest relative, Shigella. Selective amplification of E. coli occurred only when the annealing temperature in the PCR was elevated to 72 degrees C, which is 10 degrees C higher than the optimum for the primers. Sensitivity was retained by modifying the length of steps in the PCR, by increasing the number of cycles, and most importantly by optimizing the MgCl(2) concentration. The PCR protocol developed can be completed in less then 2 h and, by using Southern hybridization, has a detection limit of ca. 10 genomic equivalents per reaction. The method was demonstrated to be effective for detecting E. coli DNA in heterogeneous DNA samples, such as those extracted from soil.     

四引物扩增受阻突变体系PCR快速测定绵羊 BMPR-IB基因型方法的建立

四引物ARMS PCR是检测SNP有效、快速、简便的方法.绵羊BMPR-lB基因是控制Booroola绵羊多胎性状的主效基因,此研究目的在于建立一种对BMPR-IB基因四引物ARMS PCR检测方法.根据四引物ARMS PCR技术原理,在绵羊BMPR-IB基因突变位点(A746G)设计一对特异性引物,并在突变点两侧设计一对参照引物,用来扩增含有突变点的DNA片段,可在一步PCR反应中根据电泳图谱准确判断绵羊个体的BMPR-IB基因型,对比PCR-RFLP检测结果表明,所建立的方法简单,操作简便,大大提高了检测效率.     

利用PCR技术检测致病性腊样芽孢杆菌的研究

目的：利用PCR技术对致病性蜡样芽孢杆菌（Bacillus cereus）进行检测。方法：对致病性蜡样芽孢杆菌溶血素HBLa基因序列进行分析设计一对特异引物,通过优化PCR反应条件,来实现对致病蜡样芽孢杆菌的快速检测,结果：该方法具有较强的灵敏性及特异性,能够对肠毒素型腊样芽孢杆菌进行有效的检测,其最低检出限可达9CFU／ml,用PCR技术对食物样品中致病性蜡样芽孢杆菌的检测取得与普通生化检测方法一致的结果。结论：利用PCR技术对食品中蜡样芽孢杆菌的检测较常规的生化检测方法具有省时省力的特点且灵敏性较高,具有较强的实际应用价值。     

应用xMAP液态芯片多重快速检测四种病原微生物的研究

目的：建立一种多重、快速、特异性好、灵敏度高的病原微生物检测方法。方法：根据GenBank数据库中的小肠结肠炎耶尔森氏菌、单核细胞增生性李斯特菌、产气荚膜梭菌、鼠疫耶尔森氏菌基因序列,分别针对ail、hly、cpe、3a基因设计4对引物和4条探针。通过重叠PCR扩增各目的基因并构建重组质粒,以该重组质粒DNA为模板,通过多重PCR同时扩增上述4个基因,建立xMAP液态芯片检测技术,在此基础上对标准菌株基因组DNA进行检测并验证该方法的特异性和敏感性。结果：xMAP液态芯片对质粒DNA和标准菌株基因组DNA的检测结果与多重PCR结果一致。该方法能在3.5 h内同时完成对4种病原菌的检测,特异性好,且敏感性要高于PCR方法,灵敏度最高可达200CFU/ml。结论：xMAP液态芯片技术是病原微生物的多重快速检测的新方法,具有很好的应用价值和前景。     

Comparison of DNA extraction from cervical cells collected in PreservCyt solution for the amplification of Chlamydia trachomatis

OBJECTIVE: The aim of this study was to compare and evaluate three methods of DNA extraction for the amplification of Chlamydia trachomatis in uterine cervical samples collected in PreservCyt solution. ThinPrep is the trade name for the slide preparation. METHODS: Thirty-eight samples collected in LCx buffer medium, which were identified as C. trachomatis infected by ligase chain reaction (LCR), were selected for this study. DNA from the PreservCyt samples was extracted by three methods: (i) QIAamp kit, (ii) boiling in Tris-EDTA buffer with Chelex purification, and (iii) Proteinase K digestion with Chelex purification. Sample DNA was tested for the presence of C. trachomatis by PCR using cryptic plasmid research (CTP) primers and major outer membrane protein research momp gene (MOMP) primers. Real-time (LightCycler) PCR for relative C. trachomatis quantification following DNA extraction was performed using primers (Hsp 60) for the 60 kDa heat-shock protein hsp60 gene. RESULTS: Amplification using CTP primers was the most successful with each of the extraction protocols. Boiling in buffer was the least successful extraction method. QIAamp was the best extraction method, yielding the most positives with both the CTP and MOMP primers. Proteinase K-Chelex extraction gave similar sensitivity to QIAamp extraction with CTP primers but lower for MOMP primers. CONCLUSIONS: The DNA extraction method must be carefully selected to ensure that larger PCR amplicons can be successfully produced by PCR and to ensure high sensitivity of detection of C. trachomatis. In this study it was found that the QIAamp extraction method followed by PCR with the CTP primers was the most successful for amplification of C. trachomatis DNA.