伤寒Vi多糖菌苗接种反应观察

本文报告了对我国首次成功的伤寒Ｖｉ多糖菌苗进行人体接种反应观察结果,接种对象为２０至５４岁无伤寒病史,近年无伤寒菌苗接种史的健康人,共６０名,以完全随机的方法分为两组,实验组注射３０μｇＶｉ多糖菌苗,对照组注射Ｖｉ多糖菌苗的稀释液。其结果３０名Ｖｉ多糖菌苗接种者注射后体温无中重反应发生,局部红肿仅有１例中反应。注射后对血压、心律没有影响。红细胞计数,白细胞计数均在正常范围,与接种前相比,无显著差异     

伤寒Vi多糖结合疫苗免疫小鼠后的抗体类型及动态分析

伤寒Vi多糖结合疫苗和Vi多糖疫苗分别免疫小鼠,分离血清,采用间接ELISA法测定不同时点血清中特异性IgA、IgM、IgG及其亚类(IgG1、IgG2a、IgG3)的抗体滴度。结果显示,免疫一针后,Vi多糖结合疫苗组的IgG抗体GMT值明显升高,第二针有加强效应(P<0.01);所测3种IgG亚型中IgG2a抗体滴度升高明显;Vi多糖和结合疫苗免疫小鼠后,血清中IgA和IgM抗体滴度均有显著升高,但无加强应答。显示Vi多糖结合疫苗在诱导小鼠血清IgG应答方面有加强效应。     

莫西沙星治疗78 例伤寒的临床疗效观察

目的:探讨莫西沙星在伤寒治疗中的临床意义。方法:将我院2008年6月至2010年6月期间78例确诊的伤寒患者随机分为治疗组(39例)和对照组(39例),治疗组给予莫西沙星,对照组给予盐酸左氧氟沙星,均静脉滴注,每日1次,体温正常后7 d停药。结果:治疗组痊愈率94.8%,总有效率100%;对照组痊愈率92.3%,总有效率100%,两组痊愈率差异无统计学意义(P<0.05);治疗组开始退热和体温降至正常的时间均较对照组缩短,差异有显著意义(P<0.05)。治疗组不良反应发生率明显低于对照组(P<0.05)。结论:莫西沙星在伤寒治疗中具有疗效确切、无复发、副作用少等特点,在治疗非耐药和耐药伤寒中有重要作用,有较好的临床应用前景。     

伤寒Vi-rEPA结合疫苗在小鼠中的免疫原性研究

以伤寒Vi多糖疫苗及结合物含量分别为20％、40％、60％的伤寒Vi-rEPA结合疫苗经皮下免疫小鼠后眼眶采血分离血清,用ELISA法测血清抗体浓度。血清抗体分析表明,伤寒Vi多糖疫苗和伤寒Vi-rEPA结合疫苗均有良好的免疫原性,但伤寒Vi-rEPA结合疫苗的免疫原性优于伤寒Vi多糖疫苗;伤寒Vi多糖疫苗无加强免疫应答效应,而伤寒Vi-rEPA结合疫苗有加强免疫应答效应;不同高分子结合物含量的伤寒Vi-rEPA结合疫苗免疫小鼠,其结合物含量为40％、60％的伤寒Vi-rEPA结合疫苗比结合物含量为20％的结合疫苗具有更好的免疫原性,而前二者的免疫原性无显著性差异。     

冻干伤寒Vi＋A群流脑二联多糖疫苗的研究

将现行伤寒多糖疫苗和A群脑多糖疫苗各1人份,联合后以乳糖为保护剂冻干,制备成1人份二联冻干疫苗。并对该疫苗进行鉴别试验、伤寒Vi多糖含量测定、A群流脑多糖磷含量测定、安全试验、冻干二联苗与单价苗Sepharose CL-4B柱层析图比较以及免疫保护效果、动物血清抗体滴度和稳定性试验。试验初步表明,该二联多糖疫苗是安全的,混合后不会引起各自的主要成份、免疫保护效果和抗体应答水平发生变化。即相互没有干扰。一年后各项指标检测表明稳定性良好。可以作为二联苗接种同时预防伤寒和A群汉脑所引起的传染。     

Seasonality of Primarily Childhood and Young Adult Infectious Diseases in the United States

The Center for Disease Control (CDC) in the United States collects and maintains records of communicable (so‐called notifiable) infectious diseases that cause significant morbidity and mortality and impact the national economy. This investigation focused on seasonal patterns in the primarily childhood and young adult infectious diseases of meningococcal meningitis, mumps, pertussis, typhoid fever, streptococcal toxic shock syndrome (1990 to 2003 CDC database), and varicella (1993 to 2003 CDC database). Linear regression was performed to ascertain the trend in the incidence of each disease, and multi‐component cosinor analysis was applied to determine and describe periodicities. Significant decreasing trends in incidence were detected in meningococcal meningitis, mumps, typhoid fever, and streptococcal toxic shock syndrome, and increasing trends were found in pertussis and varicella. Significant annual patterns were documented in meningococcal meningitis (January peak), mumps (April peak), pertussis (August peak), varicella (April peak), typhoid fever (August peak), and in the hospital‐acquired streptococcal toxic shock syndrome (February peak). Such seasonal patterns and long‐term trends in infectious diseases are of practical public health significance in indicating which can benefit from timely prevention interventions.     

莫西沙星治疗78例伤寒的临床疗效观察

目的：探讨莫西沙星在伤寒治疗中的临床意义。方法：将我院2008年6月至2010年6月期间78例确诊的伤寒患者随机分为治疗组（39例）和对照组（39例）,治疗组给予莫西沙星,对照组给予盐酸左氧氟沙星,均静脉滴注,每日1次,体温正常后7d停药。结粜：治疗组痊愈率94．8％,总有效率100％;对照组痊愈率92．3％,总有效率100％,两组痊愈率差异无统计学意义（P〈0．05）;治疗组开始退热和体温降至正常的时间均较对照组缩短,差异有显著意义（P〈0．05）。治疗组不良反应发生率明显低于对照组（P〈0．05）。结论：莫西沙星在伤寒治疗中具有疗效确切、无复发、副作用少等特点,在治疗非耐药和耐药伤寒中有重要作用,有较好的临床应用前景。     

Combined high-resolution genotyping and geospatial analysis reveals modes of endemic urban typhoid fever transmission

Typhoid is a systemic infection caused by Salmonella Typhi and Salmonella Paratyphi A, human-restricted bacteria that are transmitted faeco-orally. Salmonella Typhi and S. Paratyphi A are clonal, and their limited genetic diversity has precluded the identification of long-term transmission networks in areas with a high disease burden. To improve our understanding of typhoid transmission we have taken a novel approach, performing a longitudinal spatial case-control study for typhoid in Nepal, combining single-nucleotide polymorphism genotyping and case localization via global positioning. We show extensive clustering of typhoid occurring independent of population size and density. For the first time, we demonstrate an extensive range of genotypes existing within typhoid clusters, and even within individual households, including some resulting from clonal expansion. Furthermore, although the data provide evidence for direct human-to-human transmission, we demonstrate an overwhelming contribution of indirect transmission, potentially via contaminated water. Consistent with this, we detected S. Typhi and S. Paratyphi A in water supplies and found that typhoid was spatially associated with public water sources and low elevation. These findings have implications for typhoid-control strategies, and our innovative approach may be applied to other diseases caused by other monophyletic or emerging pathogens.     

伤寒结合疫苗免疫原性和动物安全性研究

伤寒V i多糖与白喉类毒素(DT)蛋白以己二酰肼(ADH)作连接臂,在碳二亚胺(EDAC)的作用下结合成V i-DT结合物,进行抗原性、免疫原性和动物安全性试验。结果显示,3批结合物抗体阳转率均为100%,加强免疫一针后GMT值明显升高(p<0.001),免疫剂量以0.75μg/只抗体增长最为明显,甚至以低剂量0.375μg/只仍能获得较高的抗体滴度,多项动物试验证明该结合物是安全的。显示V i-DT结合物有很好的动物安全性和免疫原性,为临床试验提供实验室依据。