绝经期女性阴道微生态状况及发生生殖道萎缩程度的相关性

目的:评估绝经期女性阴道微生态状况,分析其与发生生殖道萎缩程度的相关性。方法:回顾性分析2015～2018年于本院妇科门诊就诊的120例绝经期女性患者的临床资料,获取所有患者阴道分泌物清洁度,优势菌群种类、密集度、多样性,阴道p H值、H_2O_2、白细胞酯酶、唾液酸苷酶,阴道假丝酵母菌病(VVC)、滴虫性阴道炎(TV)、细菌性阴道病(BV)、需氧菌性阴道病(AV)阳性率;采用相关统计资料分析阴道微生态状态与发生生殖道萎缩相关性。结果:绝经期女性阴道清洁度Ⅲ/Ⅳ度占比70%、Ⅰ/Ⅱ度占比30%;优势菌群以G染色不定球杆菌、G-大杆菌为主,G-小杆菌较少;菌群密集度、多样性程度较高;PH值为4.5占比70%,提示阴道环境处于中性/碱性状态居多;H_2O_2、白细胞酯酶、唾液酸苷酶、VVC、BV阳性占比高而TV、AV阳性占比低。清洁度Ⅰ/Ⅱ度、菌群密集度+++/++++、菌群多样性+++/++++、PH值3.8～4.5、H_2O_2(-)、唾液酸苷酶(-)、VVC(-)、BV(-/中介)时阴道萎缩发生率低于清洁度Ⅲ/Ⅳ度、菌群密集度未见/+、菌群多样性未见/+、p H值4.5、H_2O_2(+)、唾液酸苷酶(+)、VVC(+)、BV(+)时阴道萎缩发生率(P0.05);清洁度Ⅰ/Ⅱ度、菌群密集度+++/++++、菌群多样性+++/++++、p H值3.8～4.5、H_2O_2(-)、唾液酸苷酶(-)、BV(-/中介)时阴道萎缩严重程度更低(P0.05)。清洁度、菌群密集度、菌群多样性、p H值、H_2O_2、唾液酸苷酶、BV是阴道萎缩病情进展为中/重度独立影响因素(P0.05)。结论:绝经期女性阴道微生态处于失衡状态,且微生态状况与阴道萎缩发生及发展密切相关。     

宫颈癌术后HPV持续感染者阴道微生态状况分析

目的通过宫颈癌术后HPV持续感染者阴道微生态状况分析,探讨发病的特点,为恢复阴道微生态平衡,HPV转阴,提供治疗依据。方法对75例(肿瘤组)宫颈癌术后HPV持续感染者取阴道分泌物,并取50例绝经期体检妇女作为对照组。结果发现肿瘤组阴道微生态失调占72.0%,优势菌占50.7%,菌群密集度++~+++为46.7%,菌群多样性++~+++为42.7%,pH值≤4.5为28.0%;与对照组比较差异有统计学意义(P0.05)。肿瘤组≤55岁组阴道优势菌占59.1%,与55岁组比较差异有统计学意义(P0.05),其余阴道菌群密集度、菌群多样性、pH、阴道微生态失调、VVC、BV差异无统计学意义。结论 (1)肿瘤组阴道微生态失调;(2)肿瘤组内55岁组的阴道优势菌有更明显差异;(3)评价宫颈癌术后HPV持续感染阴道微生态的状况,对治疗纠正微生态,及HPV的转阴有重要的指导意义。     

阴道菌群结构分析在 宫腔粘连患者中的临床意义

目的对宫腔粘连患者菌群结构进行评价,探讨阴道微生态在宫腔粘连中的临床意义。方法选取2014年8月至2016年8月在我院计划生育病区诊断为宫腔粘连的患者100例为试验组,同期门诊100例健康体检者为对照组。对其阴道分泌物进行湿片镜检及微生态学检测,比较两组研究对象的阴道微生态情况。结果宫腔粘连组与对照组在阴道分泌物的多样性、密集度、优势菌、pH、清洁度和病原体检出率等方面比较差异有统计学意义(Ps0.05)。宫腔粘连组阴道微生态失调检出率(48%)高于对照组(31%),差异有统计学意义(P0.05)。结论宫腔粘连患者阴道微生态失调发生率明显增高,阴道微生态失调可能与宫腔粘连的发生有关。     

复发性外阴阴道念珠菌病的阴道微生态特征分析

目的拟从阴道菌群的微生态特征入手,旨在探讨阴道微生物群落结构与外阴阴道念珠菌病(Vulvovaginal Candidiasis,VVC)发病的潜在联系。方法 2013年1月~2014年12月,126名处于VVC急性发作且以往有RVVC史的非孕育龄妇女作为研究对象,另有120名正常育龄期体检女性作为对照组。测定阴道p H值,并采集阴道分泌物行革兰染色镜检,行Nugent评分。同时,通过阴道菌群密集度、菌群多样性、优势菌等指标对阴道微生态进行评价。结果患者组的阴道p H值(4.51±0.3 Vs 4.11±0.2,P0.05)和Nugent评分(4.21±0.81 Vs 1.31±1.19,P0.05)显著高于对照组。患者组乳酸杆菌密集度显著低于对照组,而阴道加特纳菌/普雷沃菌、革兰阳性球菌和其他细菌的密集度显著高于对照组(P0.05)。同时,患者组菌群多样性显著高于正常组;且患者组乳酸杆菌优势比例显著低于对照组(55.56%Vs 95.00%,P0.05),而阴道加特纳菌/普雷沃菌(23.02%Vs 1.67%,P0.05)和革兰阳性球菌优势比例显著高于对照组(17.46%Vs 1.67%,P0.05)。结论RVVC患者阴道微生态特征与正常育龄妇女存在显著差异,生物屏障的削弱可能是VVC反复发作的风险因素。新型阴道乳酸菌制剂的研发和应用可能在重建阴道微生态,预防VVC复发方面获得突破。     

1500例女性阴道微生态状况分析

目的女性阴道微生态状况调查与分析。方法采用阴道pH、阴道涂片Gram染色镜检(菌群密集度、菌群多样性、优势菌、真菌孢子、滴虫和炎性反应等)、阴道微生物功能测定,评估1 500例体检者阴道微生态状况。结果微生态正常830例(55.7%),微生态失调者670例(44.6%)。在670例微生态失调患者中,需氧菌阴道炎156例(23.3%),细菌性阴道病265例(39.6%),外阴阴道假丝酵母菌病31例(4.63%),滴虫性阴道炎2例(0.29%),混合感染216例(32.2%)。结论阴道微生态评价有助于筛查无症状阴道微生态失调患者,对指导临床评价感染及预防阴道感染具有重要的临床意义。     

腹腔镜联合GnRH-a治疗后Ⅲ-Ⅳ期子宫内膜异位症患者妊娠情况与阴道微生态的相关性

目的 探讨腹腔镜联合GnRH-a治疗后Ⅲ-Ⅳ期子宫内膜异位症(EMS)患者妊娠情况与阴道微生态的相关性。方法 经腹腔镜联合GnRH-a治疗后的196例EMS患者根据妊娠情况分为妊娠组(n=98)和未妊娠组(n=98),比较两组阴道微生态差异。将已成功妊娠的患者按照阴道微生态情况分组探讨阴道微生态对妊娠结局的影响和相关性。结果 治疗前未妊娠组与妊娠组的pH值、H₂O₂值、菌群密集度、菌群多样性、Nugent评分、AV评分差异无统计学意义(P>0.05),但治疗后未妊娠组上述指标异常的病例比例显著高于妊娠组(P<0.05)。在已成功妊娠的EMS患者中,阴道微生态异常的患者发生不良妊娠结局的比例显著高于阴道微生态正常的患者(P<0.05)。pH值、H₂O₂值、菌群密集度和多样性、Nugent评分和AV评分的异常可导致不良妊娠结局。结论 阴道微生态失衡是经腹腔镜和GnRH-a联合治疗后的Ⅲ-Ⅳ期EMS患者不能成功妊娠或妊娠后发生不良妊娠结局的重要原因。     

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。     

宫颈癌癌前病变及宫颈癌患者阴道微生态失调相关因素

目的探讨宫颈癌癌前病变及宫颈癌患者阴道微生态失调相关因素。方法选择2016年7月至2018年12月我院收治的200例宫颈癌和癌前病变患者为研究对象,其中宫颈癌患者100例(宫颈癌组),癌前病变患者100例(癌前组),另选50例健康女性为对照组。观察各组对象阴道微生态指标(菌群密集度、菌群多样性、pH和H_2O_2)水平、HPV感染情况及乳杆菌分布情况。分析患者阴道微生态变化与HPV感染的关系。结果癌前组和宫颈癌组阴道菌群密集度Ⅰ-Ⅳ级的患者分别占33.00%和42.00%,显著高于对照组的10.00%(χ~2=15.762 9,P=0.000 1);菌群多样性Ⅰ-Ⅳ级的患者分别占35.00%和41.00%,同样高于对照组的6.00%(χ~2=19.783 1,P0.000 1)。癌前组和宫颈癌组阴道pH4.5的患者分别占53.00%和56.00%,高于对照组的12.00%(χ~2=29.267 3,P0.000 1);H_2O_2阴性患者占比分别为63.00%和70.00%,显著高于对照组的18.00%(χ~2=39.343 7,P0.000 1);此外,癌前组和宫颈癌组患者HPV检测阳性率分别为62.00%和73.00%,显著高于对照组的6.00%(χ~2=63.624 2,P0.000 1)。癌前组和宫颈癌组患者阴道乳杆菌定植密度中位数分别为115(97～279)个/HP和107(81～201)个/HP,显著低于对照组的279(157～365)个/HP(χ~2=8.742 1,P0.000 1)。在HPV感染患者中,乳杆菌阳性率及乳杆菌定植密度中位数均低于对照组。Spearman相关分析显示HPV感染与患者阴道微生态正常程度呈负相关,阴道微生态失调与癌前病变分级呈正相关。结论宫颈癌前病变和宫颈癌的发生与患者阴道微生态失调、HPV感染、乳杆菌减少密切相关;同时癌前病变的发展与阴道微生态失调具有相关性。     

4 630例绝经后妇女阴道微生态状况分析

目的分析绝经后妇女阴道微生态状况,为临床诊疗提供实验室依据。方法以2018年1月至2019年9月在我院妇科门诊就诊的4 630例绝经后妇女作为研究对象,对其阴道微生态检查结果进行回顾性分析。结果 4 630例患者中阴道微生态正常者409例(8.83%),阴道微生态异常者4 221例(91.17%)。阴道微生态异常者中不能通过镜检明确病原菌者1 758例(37.97%),包含优势菌异常1 406例(30.37%)、菌群抑制351例(7.58%)、菌群增殖过度1例(0.02%);通过镜检明确病原菌者2 463例(53.20%),包含细菌性阴道病(BV)1 237例(26.72%)、需氧菌性阴道炎(AV)1 001例(21.62%)、外阴阴道假丝酵母菌病(VVC)159例(3.43%)、滴虫性阴道炎(TV)66例(1.43%)。不同年龄段绝经后妇女阴道微生态构成存在差异,其阴道清洁度(Ⅲ/Ⅳ)、菌群密集度(未见/Ⅰ)、菌群密集度(Ⅳ)、菌群多样性(未见/Ⅰ)、菌群多样性(Ⅳ)、优势菌(无)、优势菌(G~+大杆菌)、优势菌(G~-弧形菌)、优势菌(G~+球菌)、VVC、TV、β-氨基半乳糖苷酶(+)、唾液酸苷酶(+)、过氧化氢(+)、阴道pH4.5、微生态异常发生率在不同年龄段之间的分布差异均有统计学意义(均P0.05)。结论阴道微生态异常在妇科门诊绝经后妇女中发生率较高,且不同年龄段妇女阴道微生态异常构成存在差异,提示应结合年龄治疗阴道疾病,同时积极恢复阴道微生态环境。     

腹腔镜下全子宫切除术后阴道微生态乳杆菌干预的影响

目的探讨腹腔镜下全子宫切除术后阴道微生态乳杆菌干预的影响。方法 2018年3月—2019年3月间在本院接受腹腔镜下全子宫切除术治疗的患者106例,经随机数表法分为对照组、研究组,各53例。研究组患者在术后1月开始接受乳酸杆菌干预、对照组未采取任何措施。持续干预3个疗程后比较研究组、对照组患者的阴道微生态指标(pH值、菌群密集度、菌群多样性、优势乳杆菌分级),女性性功能指数(FSFI),阴道微生态失衡,阴道炎发生率以及研究组患者乳酸杆菌胶囊相关不良反应发生情况。结果术后2月,研究组、对照组pH值、菌群密集度、菌群多样性、优势乳杆菌分级差异有统计学意义(P0.05);研究组患者阴道微生态失衡、阴道炎发生率均低于对照组(P0.05)。术后6月,研究组患者FSFI评分值高于对照组患者(P0.05)。研究组患者在使用乳酸杆菌胶囊干预期间,未出现明显不良反应。结论腹腔镜下全子宫切除术后早期使用乳酸杆菌干预,在优化阴道微生态、减少阴道炎发生方面具有一定作用,且不会引发明显不良反应。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.