多酶恒温扩增核酸试纸条法快速检测肺炎支原体方法的建立及应用

【背景】肺炎支原体是导致儿童和青少年呼吸道感染的重要病原体,长期以来由于其临床表现不特异而容易错过最佳治疗时期。【目的】结合多酶恒温扩增(multienzyme isothermal rapid amplification,MIRA)技术和核酸试纸条建立一种快速检测肺炎支原体的方法。【方法】以肺炎支原体社区获得性肺炎呼吸窘迫综合征(community acquired respiratory distress syndrome, CARDS)毒素编码基因为靶基因设计引物和探针,对反应体系的温度、时间等进行优化,评估其敏感性,通过检测肺炎支原体和其余7种病原体分析其特异性,并对35份临床样本进行验证。【结果】MIRA核酸试纸条法在37℃条件下,15 min内便可完成对肺炎支原体的检测,最低检出限为10 copies/μL;除肺炎支原体外,其余7种病原体均不能扩增,特异性较好。以实时荧光PCR检测为标准,MIRA核酸试纸条法对35份临床样本检测后的诊断特异度为100.00%、灵敏度为96.15%、阴性预测值为90.00%、阳性预测值为100.00%。【结论】本研究建立了MIRA核酸试纸条法...     

肺炎支原体肺炎患儿血清sB7-H3含量与细胞因子水平及病情严重程度的相关性研究

摘要 目的：研究肺炎支原体肺炎（mycoplasma pneumoniae pneumonia, MPP）患儿血清可溶性共刺激分子B7-H3（soluble co-stimulatory molecule B7-H3, sB7-H3）含量与细胞因子水平及病情严重程度的相关性。方法：收集2019年3月至2020年6月期间我院收治的MPP患儿共96例,根据患儿病情严重程度分为轻症MPP组和重症MPP组,另选取同期于我院体检中心体检的健康儿童50例作为对照组。收集所有受试者的一般资料、主要临床表现、临床指标及细胞因子水平,对各指标进行Pearson相关性分析和多元逐步回归分析。结果：与对照组相比,MPP组患儿的白细胞计数（white blood cell, WBC）、中性粒细胞计数（neutrophil, NE）、红细胞沉降率（erythrocyta sedimentation rate, ESR）、C反应蛋白（C-reactive protein,CRP）、sB7-H3、粒细胞-巨噬细胞集落刺激因子（granulocyte-macrophage colony stimulating factor, GM-CSF）、干扰素-γ（interferon-γ, IFN-γ）、白介素-10（interleukin-10,IL-10）和白介素-17A（interleukin-17A,IL-17A）均较高（P＜0.05）;与轻症MPP组患儿相比,重症MPP组患儿的WBC、NE、ESR、CRP、sB7-H3、GM-CSF、IFN-γ、IL-10和IL-17A均较高（P＜0.05）。Pearson相关性分析结果表明,sB7-H3与WBC、NE、ESR、CRP、GM-CSF、IFN-γ、IL-10和IL-17A呈正相关（P＜0.05）。多元线性回归分析显示,GM-CSF（β=0.103,P＜0.001）、IFN-γ（β=0.121,P＜0.001）、IL-10（β=0.026,P＜0.001）和IL-17A（β=0.093,P＜0.001）是sB7-H3的独立影响因素。结论：MPP患儿血清sB7-H3、GM-CSF、IFN-γ、IL-10和IL-17A与MPP的病情严重程度密切相关,且sB7-H3的表达水平与GM-CSF、IFN-γ、IL-10和IL-17A的水平呈正相关。     

用Ciprofloxacin去除传代细胞株中的支原体污染的研究

在应用细胞培养手段的生物学研究和生物工程产品中,支原体污染仍是一个非常棘手的问题。对Ｖｅｒｏ和ＳＰ２／０－Ａｇ１４等细胞,应用Ｃｉｐｒｏｆｌｏｘａｃｉｎ,１０μｇ／ｍｌ处理１４天,支原体检测全部转阴,经４个月的培养、传代、冻存、复苏,每次支原体检测均保持阴性。对去除了支原体的Ｖｅｒｏ和ＩＳＣ－１１６细胞株,测试了其生长特征和功能,均未见受影响。     

The preservation of Mycoplasma capricolum cell intactness after phospholipase A2 treatment

(1) By treating Mycoplasma capricolum cells with phospholipase A₂ about 80% of membrane phospholipids were rapidly hydrolyzed. The rate and extent of hydrolysis (at 37°C) were the same in intact cells and in isolated unsealed membranes. (2) Due to the low endogenous lysophospholipase activity detected in M. capricolum, phospholipase A₂ treatment resulted in the accumulation of lysophospholipids and free fatty acids. The free fatty acids were efficiently extracted from the cells by 1% bovine serum albumin whereas the lysophospholipids were almost fully retained within the cell membrane. (3) Following phospholipase A₂ treatment in the presence of 1% bovine serum albumin, cell intactness was preserved as indicated by the constant absorbance of the cell suspension and the retention of nucleic acids and NADH dehydrogenase activity within the cells. The treated cells showed, however, a slight decrease in K⁺ content and a decrease in cell viability. Viability was fully preserved after phospholipase A₂ treatment of cells grown with exogenous sphingomyelin. (4) Adapting M. capricolum to a cholesterol-poor medium resulted in a marked decrease in the cholesterol to phospholipid molar ratio (from about 1.1 to 0.3). Phospholipase A₂ treatment of the cholesterol-poor cells resuted in cell lysis. Cell lysis was induced in the cholesterol-rich cells by hydrolysing the lysophospholipids accumulated following phospholipase A₂ treatment. (5) It is suggested that after phospholipase A₂ treatment of M. capricolum cells, a relatively stable cell membrane is maintained and cell intactness is preseved due to the interaction of cholesterol, present in high amount in this membrane, with the lysophospholipids formed.     

Active K+ transport in Mycoplasma mycoides var. Capri. Net and unidirectional K+ movements

Analysis of the cation composition of growing Mycoplasma mycoides var. Capri indicates that these organisms have a high intracellular K⁺ concentration ($\text{K}{}_{\mathrm{<mtext>i</mtext>}}\text{: 200–300}\text{mM}$) which greatly exceeds that of the growth medium, and a low Na⁺ concentration ($\text{Na}{}_{\mathrm{<mtext>i</mtext>}}{}^{\mathrm{+}}\text{: 20}\text{mM}$). Unlike $\text{Na}{}_{\mathrm{<mtext>i</mtext>}}{}^{\mathrm{+}}\text{, K}{}_{\mathrm{<mtext>i</mtext>}}{}^{\mathrm{+}}$ varies with cell aging.The K⁺ transport properties studied in washed organisms resuspended in buffered saline solution show that cells maintain a steady and large K⁺ concentration gradient across their membrane at the expense of metabolic energy mainly derived from glycolysis. In starved cells, $\text{K}{}_{\mathrm{<mtext>i</mtext>}}{}^{\mathrm{+}}$ decreases and is partially compensated by a gain in Na⁺. This substitution completely reverses when metabolic substrate is added (K⁺ reaccumulation process). Kinetic analysis of K⁺ movement in cells with steady K⁺ level shows that most of K⁺ influx is mediated by an autologous K⁺-K⁺ exchange mechanism. On the other hand, during K⁺ reaccumulation by K⁺-depleted cells, a different mechanism (a K⁺ uptake mechanism) with higher transport capacity and affinity drives the net K⁺ influx. Both mechanisms are energy-dependent.Ouabain and anoxia have no effect on K⁺ transport mechanisms; in contrast, both processes are completely blocked by dicyclohexylcarbodiimide, an inhibitor of the Mg²⁺-dependent ATPase activity.     

Scanning electron microscopy ofMycoplasma pneumoniae on the membrane of individual ciliated tracheal cells

Summary Cell monolayer cultures were prepared from hamster tracheal explants by a collagenase exposure and subsequent incubation in Waymouth’s MAB 87/3 medium. The epithelial outgrowth occurred on glass cover slips. Cilia on the monolayers continued to beat normally after the “parent” explant was removed. Monolayer cultures infected withMycoplasma pneumoniae had significant amounts of attachment. A morphological analysis of the attachment was conducted with scanning electron microscopy. Clusters, cocci, and filaments ofM. pneumoniae all attached to the epithelial cells, but the filaments were especially common. Mycoplasmas were seen in association with both ciliated and nonciliated cell membranes. On ciliated cells, mycoplasmas were on the ciliary strands and on the cell membrane. When located immediately adjacent to or in between cilia, mycoplasmas were oriented vertically with the constricted attachment tip oriented down toward the host cell membrane. When located more than a micron away from the ciliary fibers, mycoplasmas lay horizontally along the epithelial cell membrane. The photographic data suggest that clusters or “sperules” of mycoplasmas may liberate individual mycoplasmas that attach to the cell membrane. It appears that the receptor sites forM. pneumoniae are rather uniformly distributed along the ciliated cell membrane, and are not restricted to the interciliary areas. Electron microscopy was done with the cooperation of Dr. R. Macleod and the staff of the Center for Electron Microscopy at the University of Illinois. Critical editorial review was provided by C. Dayton. This investigation was supported in part by grants to M. G. G. from the National Institute of Allergy and Infectious Diseases (AI 12559) and the National Heart, Lung, and Blood Institute (HL 23806), Bethesda, Maryland.     

肺炎支原体感染对儿童血常规参数及C反应蛋白水平的影响

摘要 目的：探讨肺炎支原体（Mycoplasma pneumoniae, MP）感染对儿童血常规数及C反应蛋白（C reactive protein, CRP）水平的影响。方法：以60例肺炎支原体抗体（MP-IgM）阳性患儿作为观察组,选取同期60名MP-IgM阴性儿童作为对照组,对两组患儿血常规参数和CRP水平进行回顾性分析。结果：与对照组比较,观察组红细胞压积、血红蛋白、单核细胞比例、单核细胞计数、中性粒细胞比例、中性粒细胞计数、红细胞计数均数或中位数升高,嗜碱性粒细胞比例、嗜碱性粒细胞计数、嗜酸性粒细胞比例、嗜酸性粒细胞计数、淋巴细胞比例（LY）、淋巴细胞比计数（LY#）、平均红细胞血红蛋白量、红细胞平均体积、平均血小板体积、血小板压积、血小板分布宽度、血小板计数、红细胞分布宽度均数或中位数降低;观察组患儿的CRP水平中位数显著高于对照组,以上差异有统计学意义（P<0.05）;Logistic多元回归分析结果显示,MP感染与淋巴细胞比例、淋巴细胞比计数降低具有正相关性（P<0.05）。结论：MP感染患儿的血常规参数和CRP水平均发生变化,临床医生应对这些参数给予关注和连续监测,从而提高诊疗效果。     

妇科门诊患者阴道分泌物检测及支原体感染情况和耐药性

目的分析妇科门诊患者阴道分泌物及支原体感染和耐药性情况。方法选取我院2017年7月至2018年7月于妇科门诊就诊的1 200例患者为研究对象,收集患者阴道分泌物并检测支原体感染情况及其耐药性。结果 1 200例患者中患滴虫性阴道炎者13例(1.08%),霉菌性阴道炎139例(11.58%),细菌性阴道病97例(8.08%)。阴道清洁度Ⅲ～Ⅳ度的患者滴虫性阴道炎、霉菌性阴道炎、细菌性阴道病的发生率显著高于清洁度Ⅰ～Ⅱ度的患者(均P0.05)。不同年龄段患者滴虫性阴道炎、霉菌性阴道炎和细菌性阴道病的发生率差异无统计学意义(均P0.05)。25岁的患者解脲支原体(Un)感染率最高(58.10%),35～44岁患者人型支原体(Mh)感染率最高(5.09%),25岁患者Un合并Mh感染率最高(21.91%)。支原体总敏感率较高的抗生素为美满霉素(95.86%)、强力霉素(95.15%)和交沙霉素(97.05%),敏感率较低的为甲砜霉素(19.15%),克林霉素(14.66%)和司帕沙星(27.77%)。结论阴道清洁度与阴道炎的发生具有相关性。患者阴道分泌物中支原体的检测及药敏试验可为临床治疗提供参考依据。     

肺炎支原体感染对川崎病的影响及机制探讨

目的分析肺炎支原体感染对川崎病的影响及其机制,以期指导临床诊疗。方法回顾性分析2013年8月至2018年8月我科住院的496例川崎病患儿临床资料,其中合并肺炎支原体感染组193例,未合并肺炎支原体感染组303例。应用倾向评分匹配法1∶1校正2组的年龄、性别、是否为不完全型川崎病、是否使用糖皮质激素、丙种球蛋白使用时间、丙种球蛋白使用方法和阿司匹林初始剂量,比较2组患儿的总发热天数、冠状动脉直径、冠状动脉扩张发生率、冠状动脉瘤发生率和丙种球蛋白无反应发生率。结果川崎病合并肺炎支原体感染组男性患儿多,更易发生颈部淋巴结肿大,年龄、中性粒细胞百分比、血沉和低密度脂蛋白高于川崎病未合并肺炎支原体感染组,血钾、血钙、高密度脂蛋白和白蛋白低于川崎病未合并肺炎支原体感染组,差异有统计学意义(均P<0.05)。应用倾向评分匹配法1∶1配对后发现,川崎病合并肺炎支原体感染组患儿总发热时间更长[8(6~10)d vs 7(6~9)d,Z=-2.089,P<0.05),冠状动脉直径值更大[(2.81±0.81)mm vs(2.63±0.45)mm,t=2.532,P<0.05],冠状动脉瘤发生率更高(5.5% vs 1.1%,χ²=5.516,P<0.05)。结论肺炎支原体感染可能引起川崎病患儿脂质代谢及电解质的紊乱,其炎症反应更强,持续时间更长,对冠状动脉损伤更大。     

阿奇霉素序贯治疗联合硫酸特布他林对肺炎支原体肺炎患儿肺功能和血清IL-6、CRP、PCT水平的影响

摘要 目的：探讨阿奇霉素序贯治疗联合硫酸特布他林对肺炎支原体肺炎（MPP）患儿肺功能和血清白介素-6（IL-6）、降钙素原（PCT）、C反应蛋白（CRP）水平的影响。方法：于2018年1月-2019年12月期间,选取80例来我院就诊的MPP患儿,根据入院顺序将患儿分为对照组（40例,阿奇霉素序贯治疗）和实验组（40例,阿奇霉素联合硫酸特布他林治疗）,对比两组疗效、住院时间及临床症状缓解时间、肺功能、不良反应及血清炎症因子水平。结果：实验组的胸片恢复正常时间、住院时间、啰音消失时间、退热时间、咳嗽消失时间短于对照组（P<0.05）。实验组治疗后的临床总有效率95.00%（38/40）高于对照组的77.50%（31/40）（P<0.05）。实验组治疗后用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、呼气峰值流速（PEF）均高于对照组,IL-6、PCT、CRP均低于对照组（P<0.05）。两组不良反应发生率组间对比无明显差异（P>0.05）。结论：阿奇霉素序贯治疗联合硫酸特布他林治疗MPP患儿,可有效缓解临床症状,降低机体炎症反应,改善患儿肺功能,不良反应轻微,协同作用显著。