BV三联法在细菌性阴道病诊断中的应用与评价

目的探讨BV三联法在诊断细菌性阴道病中的临床价值方法用BV三联法（检测患者阴道分泌物中的过氧化氢浓度、唾液酸苷酶、白细胞脂酶）和Amsel法（检测阴道分泌物并对阴道分泌物进行涂片革兰染色镜检）。结果BV三联法与Amsel法结合涂片革兰染色结果差异无显著性（P〈0．05）。结论BV三联法是一种新型、简便、快速的方法,可用于临床辅助诊断细菌性阴道病。     

阴道微生态与高危型人乳头瘤病毒感染及宫颈病变的相关性

目的探究阴道微生态与高危型人乳头瘤病毒(HR-HPV)感染以及宫颈病变之间的相关性,为后续研究提供参考。方法选择2018年1月至2019年6月就诊于石河子大学医学院第一附属医院妇科门诊,同时行爱必维(细菌性阴道病五项联合测定试剂盒)检测、HR-HPV检测及宫颈组织病理检查的343名妇女作为研究对象,分析相关检测数据并探究阴道微生态与HR-HPV感染以及宫颈病变的相关性。结果过氧化氢阳性、唾液酸苷酶阳性、白细胞酯酶阳性、乳杆菌数量减少及阴道清洁度3～4度的妇女感染HR-HPV及发生宫颈病变的可能性显著大于过氧化氢阴性、唾液酸苷酶阴性、白细胞酯酶阴性、乳杆菌数量较多及阴道清洁度1～2度的妇女,差异均有统计学意义(均P0.05)。经多因素Logistic回归分析发现,过氧化氢、唾液酸苷酶、白细胞酯酶及阴道清洁度3～4度均为影响宫颈病变的危险因素(均P0.05)。结论阴道微生态失衡与HR-HPV感染以及宫颈病变有一定关联,纠正阴道微生态失衡可一定程度上预防HR-HPV感染及宫颈病变。     

利用X-Neu5Ac为底物测定唾液酸酶活性在诊断细菌性阴道病的价值

目的利用5溴-4氯-3吲哚乙酰基神经氨酸盐（X-Neu5Ac）为底物测定阴道唾液酸酶活性诊断细菌性阴道病（bacterial vaginosis,BV）的价值.方法健康妇女30例,临床Amsel法诊断为BV的患者45例,共计75例进行了阴道分泌物分析和检测,并与唾液酸酶活性法诊断作了对比研究.取阴道分泌物作为标本分别进行唾液酸酶活性和阴道菌群定量分析,检测细菌包括乳酸杆菌、类杆菌、肠杆菌、葡萄球菌、肠球菌和阴道加德纳菌.唾液酸酶活性测定利用的底物为X-Neu5Ac,特异活性用其产物 ——甲氧基苯酚的纳摩尔数来表示.结果阴道液唾液酸酶活性测定诊断细菌性阴道病的敏感性、特异性、阳性预期值和阴性预期值分别为88.9%、90%、93%和84.3%.唾液酸酶法在检测细菌性阴道病上和传统的Amsel法比较,差异无显著性（P＞0.05）.唾液酸酶阳性组Gv活菌数（6.96 log CFU/g）明显高于唾液酸酶阴性组（2.05 log CFU/g）（P＜0.01）.唾液酸酶阳性组产H2O2阴道乳杆菌（LB＋）活菌数（4.26 Log CFU/g）明显低于唾液酸酶阴性组（8.66 Log CFU/g）（P＜0.01）.唾液酸酶阳性组与唾液酸酶阴性组两组的阴道液中需氧菌活菌数差异无显著性（P＞0.05）,主要包括金黄色葡萄球菌、肠球菌和肠杆菌.结论利用X-Neu5Ac作为唾液酸酶的底物测定唾液酸酶活性的方法是诊断细菌性阴道病的有效检测方法.阴道内唾液酸酶活性增强,厌氧菌数量增加,LB＋数量减少,提示BV发生恶化.     

阴道分泌物微生态检测指标的临床应用

目的为向妇科临床诊断、疗效观察、治愈标准判定、微生态状况提供依据。方法对1935例门诊妇女阴道分泌物进行过氧化氢浓度、唾液酸苷酶、白细胞酯酶3项指标联合检测,结合运用涂片多项检验快速染色镜检技术(GTB)进行比对检测。结果573例过氧化氢(H2O2)浓度<2μmol/L的阴道分泌物主要指标检出率为:少量乳酸杆菌为97.0%、唾液酸苷酶为34.2%、线索细胞为25.5%、白细胞酯酶为74.3%、白细胞计数≥15/高倍视野为90.4%、滴虫10.3%、霉菌21.5%;1362例过氧化氢≥2μmol/L的检出率为:少量乳酸杆菌为4.1%、唾液酸苷酶为8.6%、线索细胞为8.2%、白细胞酯酶为36.0%、白细胞计数≥15/高倍视野为55.9%、滴虫2.1%、霉菌11.9%,2组各项指标差异有非常显著性(P>0.01)。结论过氧化氢浓度检测可作为阴道微生态状况敏感指标,可替代阴道杆菌镜检判断,唾液酸苷酶可作为细菌性阴道病诊断的可行依据,提示阴道加德纳菌等大量病原菌定居和繁殖,白细胞酯酶可提示阴道分泌物有大量多核白细胞,提示阴道黏膜受损可与染色镜检互相印证。     

阴道用乳杆菌活菌胶囊在宫颈癌前病变LEEP术后应用价值的临床研究

目的研究阴道用乳杆菌活菌胶囊在宫颈癌前病变LEEP术后应用的临床价值。方法采用前瞻性对照研究方法,将符合纳入标准的168例研究对象,按照试验组和对照组1∶2的比例随机分配,试验组56例,对照组112例。两组对象的平均年龄、孕次和产次相比,差异均无统计学意义(Ps0.05)。两组对象在LEEP术后第1、2、3月在非经期用阴道内重组人干扰素α-2b阴道泡腾胶囊(80万IU每晚一粒,阴道用药,连用10天);试验组在术后第4、5、6月在非经期用阴道用乳杆菌活菌胶囊(0.25g每晚一粒,阴道用药,连用10天),对照组在术后第4、5、6月不用任何药物,LEEP术后第7月两组研究对象在月经干净后3~7d内复查。研究高危型人乳头瘤病毒(HR-HPV)、细菌性阴道病、阴道微生态指标的阳性率在两组之间的差异。结果在LEEP术后第7月,试验组和对照组的HR-HPV阳性率(19.64%和37.50%),细菌性阴道病(BV)阳性率(0.00%和12.50%),微生态四项指标(pH值4.5、唾液酸苷酶、过氧化氢和白细胞酯酶)全部异常阳性率(0.00%和9.82%)相比较,差异均具有统计学意义(Ps0.05)。结论在宫颈癌前病变LEEP术后,可以应用阴道用乳杆菌活菌胶囊改善阴道微环境,减少细菌性阴道病的发生,促进阴道内微生态平衡,以降低HR-HPV的持续阳性率。     

妊娠中晚期阴道微生态失调及乳酸菌胶囊干预对不良妊娠结局的作用

目的观察妊娠中晚期妇女阴道微生态状况,探讨应用乳杆菌活菌胶囊纠正阴道微生态失调对不良妊娠结局的预防价值。方法选择孕13~36周单胎妊娠期妇女560例,取其阴道分泌物,经革兰染色后油镜下观察,进行阴道微生态(阴道菌群的密集度、多样性、优势菌、炎症反应等)状况评价,检测阴道分泌物成分、阴道病原菌类型。对阴道微生态失调孕妇,根据是否接受乳杆菌活菌胶囊治疗分为治疗组和对照组,治疗组给予乳杆菌活菌胶囊,对照组不采用药物干预。追踪随访所有孕妇的妊娠情况,比较阴道微生态正常组、微生态失调治疗组及微生态失调对照组的不良妊娠结局。结果 560例研究对象中,阴道微生态正常335例(59.82%),微生态失调225例(40.18%)。225例微生态失调孕妇中,细菌性阴道病(bacterial vaginosis,BV)32例(14.22%),阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)56例(24.89%),滴虫性阴道炎(triehomonal vaginitis,TV)11例(4.89%),BV和VVC混合感染4例(1.78%),BV和TV混合感染3例(1.33%),菌群增殖过度75例(33.33%),菌群抑制44例(19.56%)。微生态失调组pH值4.5、过氧化氢、白细胞酯酶、唾液酸苷酶、脯氨酸氨基肽酶、乙酰氨基葡萄糖苷酶阳性比例均明显高于微生态正常组(χ2=55.59~340.06,Ps0.05)。微生态失调孕妇中,治疗组135例,对照组90例,对照组胎膜早破、早产、产褥感染、新生儿感染及低出生体重儿发生率均明显高于微生态正常组(χ2=12.63~32.42,Ps0.05)和微生态失调治疗组(χ2=5.16~12.28,Ps0.05),微生态正常组与微生态失调治疗组之间差异无统计学意义(P0.05)。结论妊娠中晚期容易导致阴道微生态失调,造成不良妊娠结局,乳杆菌活菌胶囊纠正阴道微生态失调对于改善不良妊娠结局有较好的预防作用。     

BV三项在阴道分泌物检测中的应用及临床结果分析

目的探讨阴道分泌物BV三项检测在妇科患者诊断细菌性阴道病中的临床价值及BV阳性患者与妇女盆腔炎症的相互关系。方法对520例阴道分泌物进行BV三项检测（唾液酸苷酶、过氧化氢酶、白细胞酯酶）和显微镜检测,并对其中正常阴道组、滴虫性阴道炎和霉菌性阴道炎与BV进行对照比较。结果根据临床表现和BV三项检测,BV的发病率高达50．96％,滴虫性阴道炎占8．65％,霉菌性阴道炎占17．10％,BV的盆腔炎症明显高于各类阴道病组。结论BV在妇科门诊的发病率为最高,并与妇科盆腔炎症呈正相关性,在妇科门诊进行BV常规筛选是必需的。     

乳杆菌活菌制剂对细菌性阴道病局部免疫的调节

目的检测正常人和细菌性阴道病(BV)患者治疗前后阴道局部细胞因子的变化,探讨乳杆菌活菌制剂对女性生殖道免疫的影响,为阴道微生态平衡与阴道黏膜免疫屏障的关系的研究提供一定的依据。方法用乳杆菌活菌制剂治疗BV,通过酶联免疫吸附试验法即ELISA法来检测BV患者治疗前后及正常健康妇女阴道局部细胞因子sIgA、IL-2、IL-13的水平。结果 sIgA、IL-13水平治疗前组较对照组明显升高(P<0.01),治疗后组较治疗前组水平下降(P<0.05),治疗后组较对照组水平升高(P>0.05);IL-2水平治疗前组较对照组明显降低,治疗后组较治疗前组明显升高(P<0.05),治疗后组较对照组下降(P<0.05)。结论 BV患者阴道局部免疫功能发生了改变;乳杆菌活菌制剂对BV患者阴道局部免疫具调节作用.     

五联检检测3988例阴道分泌物结果分析

目的 探讨过氧化氢浓度、唾液酸酶、白细胞酯酶、脯氨酸氨基肽酶和乙酰氨基葡萄糖苷酶检测对阴道微生态的改变所致妇科疾病的诊断意义.方法 对妇科门诊3 988例阴道分泌物进行五联检检测及Amsel法的检测.结果 五联检法检测3 988例阴道分泌物的结果阳性率:细菌性阴道病(BV)为30.1%,念珠菌为40.1%,滴虫为21....     

青海高原地区7325例 藏族妇女阴道分泌物五联检测

目的了解青海高原地区藏族妇女阴道分泌物病原体感染情况。方法对本院2016年7月至2016年12月妇科门诊就诊的7 325例患者阴道分泌物五联检测结果进行回顾性分析。结果 7 325例阴道分泌物样本中过氧化氢阳性占82.8%,唾液酸苷酶阳性占53.5%,白细胞酯酶阳性占74.6%,β-葡萄糖醛酸苷酶阳性占75.9%,凝固酶阳性占70.5%。阴道分泌物样本中乳杆菌少或无占82.8%,其检出病原菌5 771例,阳性检出率为78.8%。各种阴道炎的构成比中需氧菌性阴道炎(AV)占25.4%,细菌性阴道炎(BV)占17.8%,念珠菌性阴道炎(VVC)占11.5%,滴虫性阴道炎(TV)占9.3%,混合性感染占36.0%。结论青海高原地区藏族妇女阴道病比较常见的是AV、BV、VVC,TV也多发,广大妇女应该给予重视,定期进行阴道分泌物常规检查,以便及时发现疾病,采取有效的防治措施,避免性传播疾病感染扩散。     

BCL2-CISD2

CISD2, an ER BCL2-associated autophagy regulator also known as NAF-1, is responsible for the human degenerative disorder Wolfram Syndrome 2. In order to interrogate the physiological role of CISD2 we generated and characterized the Cisd2 gene deletion in mice. Cisd2 null mice manifest significant degeneration in skeletal muscle tissues, which is accompanied with augmented autophagy, dysregulated Ca²⁺ homeostasis and elongated mitochondria. Our findings describe a novel role for BCL2-CISD2 in the homeostatic maintenance of skeletal muscle. It remains to be elucidated how and if the antagonism of the BECN1 autophagy-initiating complex and modulation of ER Ca²⁺ homeostasis by BCL2-CISD2 are interconnected.     

Synthesis of [11-2H2], [8-2H2], [7-2H2], [6-2H2], [5-2H2], [4-2H2] and [3-2H2] cis-9-octadecenoates

Deuterated oleates have been synthesized by semihydrogenation of acetylenic intermediates. [11-²H₂]Oleate was prepared by two-carbon chain extension of the C₁₆ alcohol obtained from [1-²H₂]octyl bromide and 7-octyn-1-ol. [8-²H₂] and [7-²H₂]oleates were both prepared from dimethyl suberate, tetradeutero intermediate C₁₆ alcohols were synthesized from [1,8-²H₄] and [2,7-²H₄]octane diols by monobromination, conversion to deuterated 9-decyn-1-ols and reaction with octyl bromide. Oxidation gave [8-²H₂]-9-octadecynoate and [2,7-²H₂]-9-octadecynoate, after semihydrogenation of the latter, deuterons at C-2 were removed by exchange with aqueous alkali. [6-²H₂] and [5-²H₂]oleates were obtained from methyl 5-tetradecynoate, semihydrogenation, deuterium exchange at C-2 and two malonate extensions gave [6-²H₂]oleate; reduction with lithium aluminum deuteride, two malonate extensions and semihydrogenation gave the [5-²H₂] ester. [4-²H₂] and [3-²H₂]oleates were both obtained from methyl 7-cis-hexadecenoate, exchange of the α protons and chain extension gave the [4-²H₂] ester and reduction with lithium aluminum deuteride and chain extension gave the [3-²H₂] ester.     

Synthesis and physicochemical properties of 2'-deoxy-2',2'-difluoro-beta-D-ribofuranosyl and 2'-deoxy-2',2'-difluoro-alpha-D-ribofuranosyl oligonucleotides

We present procedures for nucleoside and oligonucleotide synthesis, binding affinity (Tm) and structural analysis (CD spectra) of 2'-deoxy-2',2'-difluoro-alpha-D-ribofuranosyl and 2'-deoxy-2',2'-difluoro-beta-D-ribofuranosyl oligothymidylates. Possible reasons for the thermal instability of duplexes formed between these compounds and RNA or DNA targets are discussed.     

Stereospecific 2'-amination and 2'-chlorination of adenosine by Actinomadura in the biosynthesis of 2'-amino-2'-deoxyadenosine and 2'-chloro-2'-deoxycoformycin

2'-Amino-2'-deoxyadenosine and 2'-chloro-2'-deoxycoformycin (2'-CldCF) are two nucleoside antibiotics produced by Actinomadura. The biosynthesis of these two nucleoside antibiotics has been studied by the addition of [U-14C]adenosine with or without unlabeled adenine to cultures of Actinomadura. By this experimental approach, it is possible to demonstrate that adenosine is the direct precursor for the biosynthesis of 2'-amino-2'-deoxyadenosine and 2'-CldCF. These conclusions are based on the observation that the percentage distribution of 14C in the aglyconic and pentofuranosyl moieties of 2'-amino-2'-deoxyadenosine and 2'-CldCF were similar to the distribution of 14C in the adenine and ribosyl moieties of the [U-14C]adenosine (i.e., 48:52) added to cultures of Actinomadura. Experimentally, the percentage distribution of 14C in the (i) adenine:2-amino-2-deoxy-beta-D-ribofuranose of 2'-amino-2'-deoxyadenosine is 51:49; (ii) 8-(R)-3,6,7,8-tetrahydroimidazo[4,5-d]-[1,3-diazepin-8-o1]:2 -chloro-2- beta-D-ribofuranose of 2'-CldCF is 45:55; and (iii) adenine:ribose of the adenosine isolated from the RNA of Actinomadura is 42:58. Further proof that adenosine is the direct precursor for the biosynthesis 2'-amino-2'-deoxyadenosine and 2'-CldCF was demonstrated by the addition of 75 mumol of unlabeled adenine together with [U-14C]adenosine to nucleoside-producing cultures of Actinomadura. The percentage distribution of 14C in the aglycon and the sugar moieties of 2'-amino-2'-deoxyadenosine and 2'-CldCF were 46:54 and 47:53, respectively; the percentage distribution of 14C in the adenine and ribose moieties of the adenosine isolated from the RNA of Actinomadura was 51:49. These data show that the hydroxyl on C-2' of the ribosyl moiety of adenosine undergoes a replacement by a 2'-amino or a 2'-chloro group to form 2'-amino-2'-deoxyadenosine or 2'-CldCF with retention of stereconfiguration at C-2'. Finally, Actinomadura can utilize inorganic chloride from the medium as demonstrated by the isolation of [36Cl]2'-CldCF following the addition of [36Cl]chloride to the culture medium. Mechanisms for the regioselective modification of the C-2' hydroxyl group and stereospecific insertion of the amino and chloro groups are discussed.     

Stereospecific formation of alpha-hydroxycarboxylato oxo peroxo complexes of vanadium(V). Crystal structure of (NBu4)2[V2O2(O2)2(L-lact)2] x 2H2O and (NBu4)2[V2O2(O2)2(D-lact)(L-lact)] x 2H2O

An overview of structurally characterized alpha-hydroxycarboxylatodioxo- and alpha-hydroxycarboxylatooxoperoxovanadates(V) is presented and the geometric parameters of the V2O2 bridging core are discussed. The first case of a stereospecific formation of oxoperoxovanadates(V) is reported: The crystal structures of the isomeric compounds (NBu4)2[V2O2(O2)2(L-lact)2] x 2H2O and (NBu4)2[V2O2(O2)2(D-lact)(L-lact)] x 2H2O (lact = C3H4O3(2-), the anion of the lactic acid) differ mainly in the arrangement of the V2O2 core and in mutual orientation of the V=O bonds. The complexes with achiral ligands adopt the same structural type as the complexes formed from a racemic mixture of a chiral ligand, while the structure obtained using an enantiopure L,L-hydroxycarboxylate is different.     

Convenient synthesis of 2'-deoxy-2-fluoroadenosine from 2-fluoroadenine

A convenient synthesis of 2'-deoxy-2-fluoroadenosine from commercially available 2-fluoroadenine is described. The coupling reaction of silylated 2-fluoroadenine with phenyl 3,5-bis[O-(t-butyldimethylsilyl)]-2-deoxy-1-thio-D-erythro-pentofuranoside gave the corresponding 2-fluoro-2'-deoxyadenosine derivative (alpha/beta = 1:1) in good yield. The alpha- and beta-anomers were separated by chromatography, and then desilylated to give compounds 1a and 1b.     

Stereoselective Synthesis of 2-Amino-2-deoxy-d-arabinose and 2-Deoxy-d-ribose

An efficient method for the stereoselective synthesis of 2-amino-2-deoxy-d-arabinose and 2-deoxy-d-ribose is described.

The key step in this method was accomplished by the nucleophilic addition of methyl isocyanoacetate to 2,3-O-isopropylidene-d-glyceraldehyde with high erythro-selectivity (nearly 100%).

Subsequent intermolecular cyclization predominantly gave the desired oxazoline derivative (trans-form), in which two new chiral centers were formed. The oxazoline derivative was efficiently converted to both 2-amino-2-deoxy-d-arabinose and 2-deoxy-d-ribose.