细菌性阴道感染的鉴别诊断

目的 鉴别诊断细菌性阴道感染,指导临床合理用药.方法 使用需氧菌阴道炎/细菌性阴道病五项联合测定试剂盒对妇产科门诊患者1 114例进行鉴别诊断.结果 检出:厌氧菌感染患者399例(占受检人数的35.82％),需氧菌感染患者186例(占受检人数的16.70％),厌氧菌合并需氧菌感染患者74例(占受检人数的6.64％).结论 鉴别诊断细菌性阴道感染,可指导临床合理治疗,提高治愈率.需氧菌阴道炎/细菌性阴道病五项联合测定试剂盒反应灵敏、检测快速、结果可靠,适宜在各级医疗机构推广使用.     

联合法对5种常见下生殖道感染的鉴别诊断

目的摘要：目的对比分析白带常规镜检法、细菌预成酶谱分析法及联合法对5种常见下生殖道感染鉴别诊断的有效率。方法分别采用白带常规镜检法、细菌预成酶谱分析法对来我院就诊的3420例患者的阴道分泌物进行检测。结果采用白带常规镜检检出阴道感染患者1636例,其中BV患者543例、VVC患者820例、TV患者225例、CV患者48例;采用细菌预成酶谱分析法检出阴道感染患者1078例,其中AV患者461例、BV患者617例;采用联合法检出阴道感染患者2171例,其中AV患者461例、BV患者617例、CV患者48例、TV患者225例、VVC患者820例。结论联合法集白带常规镜检法和细菌预成酶谱分析法的优点与一体,能够鉴别诊断5种常见下生殖道感染。     

氧化酶和尿素酶试验对HP感染的鉴别诊断

目的 探讨氧化酶和尿素酶对幽门螺杆菌（HP）感染的检出率和鉴别诊断。方法 采用氧化酶和尿素酶和涂片对1738例胃病患者进行HP检测。结果 1738例中氧化酶试验、尿素酶试验试验阳性检出率分别为47．41％、89．99％,阳性预测值为89．76％,阴性预测值为95．3％;尿毒酶试验的敏感性为99．72％,特异性为96．02％,阳性预浊值为95．36％,阴性预测值为9．76％,两者相比较各个参数间均无明显差（P＞0．05）。结论 氧化酶试验和尿毒酶试验一样对检测HP快速有效,两者联合应用可提供对HP感染诊断和鉴别诊断的准确性。     

肾移植术后肺部感染的鉴别诊断

肾移植术后并肺部感染是重症监护病房患者死亡的重要原因,感染的症状及体症呈复杂多样化,变化迅速。肾移植后因长期使用免疫抑制剂,肺部感染的病原体多为混合性感染,常见的病原体如铜绿假单胞杆菌、大肠埃希菌、肺炎克雷伯氏杆菌、金黄色葡萄球菌、尤其是耐甲氧西林的金黄色葡萄球菌、结核杆菌、麻疹病毒、巨细胞病毒、呼吸道合胞病毒、真菌、军团菌及卡氏肺孢子虫等病原体引起的肺部感染,尤其是军团菌及卡氏肺孢子虫在免疫抑制患者中感染逐渐增加。从临床表现判断肺部感染病因的诊断较困难,病原学检查需要特殊的检查手段如肺泡灌洗及保护性样本刷取样,胸部X线表现具有一定的参考价值,尤其早期CT检查更有意义。为了明确肺部感染的病因学,患者表现、实验室检查结果及X线表现进行综合考虑是十分必要的,这有利于肺部感染的预防及控制。     

妊娠期女性常见阴道感染常规分析

【摘 要】 目的 调查妊娠期女性常见阴道感染的发病情况。方法 随机选取我院孕检妇女、妇科病普查妇女各200例,采用阴道分泌物常规镜检方法对其阴道分泌物进行常规分析。结果 200妊娠期孕检妇女中,检出清洁度Ⅰ～Ⅱ 88例（占受检人数的44%）、清洁度Ⅲ～Ⅳ 112例（占受检人数的56%）,阴道感染患者57例（占受检人数的28.5%）,其中外阴阴道假丝酵母菌病（VVC）37例（占受检人数的18.5%）、细菌性阴道病（BV）18例（占受检人数的9%）、滴虫性阴道炎（TV）2例（占受检人数的1%）;200例妇科病普查妇女中,检出清洁度Ⅰ-Ⅱ 94例（占受检人数的47%）、清洁度Ⅲ-Ⅳ 106例（占受检人数的53%）、阴道感染患者59例（占受检人数的29.5%）,其中外阴阴道假丝酵母菌病（VVC）34例（占受检人数的17%）、细菌性阴道病（BV）22例（占受检人数的11%）、滴虫性阴道炎（TV）3例（占受检人数的1.5%）。经卡方检验,妊娠期孕检妇女和妇科病普查妇女中VVC、BV和TV的发病率差异均无统计学意义（P>0.05）。 结论 大兴区妊娠期女性阴道感染以VVC为主。     

生命泉膏滋抗实验小鼠阴道单纯疱疹病毒2型感染的研究

目的：研究中药生命泉膏滋（FESOL）抗小鼠阴道HSV－2感染的药效学作用,方法：以不同剂量FESOL作用于阴道感染HSV－2实验小鼠,观察用药后动物的发病率,死亡率和病变发展速度及程度。结果：FESOL高,中剂量组,[8.33,1.67,0.34g/(kg.d)]能显著降低感染鼠的发病率,死亡率,同时显著减轻病变程度,减慢病变发展速度。结论：中药FESOL能有效抗小鼠阴道HSV－2感染。     

单纯疱疹病毒

<正>单纯疱疹病毒(HSV)是引起急性疱疹性齿龈口炎、口唇疱疹、咽扁桃腺炎、皮炎、生殖器疱疹、角膜结膜炎、脑炎、脑脊膜炎和新生儿疱疹等疾病的病原体,分为1型(HSV—1)和2型(HSV—2)。由于近年来出现了与初感染年龄上升相伴的重度初感染者增加的倾向,并开发了可用于治疗的acyclovir等抗病毒制剂,所以对HSV感染症早期诊断的重要性提高了。 在HSV感染症中,像口唇疱疹,典型生殖器疱疹等具特征性症状时,仅由临床所见便可确诊。但在皮疹中,HSV感染症需与水痘、带状疱疹病毒感染症等鉴别诊断,对脑炎、脑脊膜炎等由外表不能观察的病变也要进行实验室诊断。 在对HSV感染症迅速而简便的实验室诊断法中,有利用单抗的直接萤光抗体法。但在检样少或检样中蛋白等杂质多时往往难以检测到病毒抗原。     

385例女性阴道混合感染的临床分析

目的 通过对阴道分泌物进行微生态菌群检查,细菌、真菌培养鉴定及生殖道支原体检测,全面评估女性阴道混合感染的微生态状况,为临床诊断治疗提供适宜的依据.方法 2011年1月至201 1年8月,取在甘肃省妇幼保健院就诊的385例阴道炎患者阴道分泌物,革兰染色后油镜下观察阴道菌群,采用生化快速检测技术进行阴道微生态功能测定,同时进行细菌、真菌培养鉴定及解脲脲原体和人型支原体检测.结果 在385例患者中,单一感染90例(23.4％),混合感染154例(40.0％),菌群失调141例(36.6％).其中需氧菌阴道炎(AV)20例(5.2％)、细菌性阴道病( BV)27例(7.0％)、外阴阴道假丝酵母菌病(VVC)18例(4.7％)、生殖道支原体感染(MP) 25例(6.5％)、AV+BV+ VVC 18例(4.7％)、AV+ BV+ MP 72例(18.7％)、AV+ MP 18例(4.7％)、VVC+ MP 9例(2.3％)、AV+ TV 1例(0.25％).结论 阴道炎是妇科常见感染性疾病,混合感染和微生态失衡为其主要原因.客观评价阴道感染,及时、全面、有效的诊治是治疗阴道炎的关键.     

女性生殖道感染与阴道菌群失调的关系及治疗

生殖道感染（reproductive tract infection,RTI）是由正常存在于生殖道的微生物或外界微生物在医疗操作中或在性接触中在生殖道引起的感染。从感染的部位上,RTI分为下生殖道感染（外阴阴道炎及宫颈炎）以及上生殖道感染（盆腔炎性疾病）,上生殖道感染常在下生殖道感染的基础上发生,几种下生殖道感染可合并存在。生殖道感染未被及时发现或治疗不及时．可导致不孕、异位妊娠、流产、早产、胎膜早破、新生儿感染等一系列严重后果,此外,生殖道感染还与宫颈癌的发生呈现一定的相关性,也是导致艾滋病、性病易感染的因素之一,严重影响妇女的生活质量。据有关报道,我国已婚育龄妇女生殖道感染的发生率为42．1％,且农村地区患病率更高。     

单纯疱疹病毒感染单位核—巨噬细胞

本文综述国外近年来对单核－巨噬细胞受单纯疱诊病毒（ＨＳＶ）感染的研究成果。单核－巨噬细胞对ＨＳＶ感染具有天然的内在抗性,这种抗性受遗传基因控制,不依赖于干扰素（ＩＦＮ）。单核－巨噬细胞的这种抗性因其组织来源和分化状态的不同而有程度上的差异。佛波酯类（ＰＭＡ）,脂多糖（ＬＰＳ）,α－肿瘤坏死因子（ＴＮＦ－α）等可削弱这种抗性,促进ＨＳＶ在单核－巨噬细胞中增殖。     

Host genetic architecture in single and multiple infections

Hosts are often target to multiple simultaneous infections by genetically diverse parasite strains. The interaction among these strains and the interaction of each strain with the host was shown to have profound effects on the evolution of parasite traits. Host factors like genetic architecture of resistance have so far been largely neglected. To see whether genetic architecture differs between different kinds of infections we used joint scaling analysis to compare the genetic components of resistance in the red flour beetle Tribolium castaneum exposed to single and multiple strains of the microsporidian Nosema whitei. Our results indicate that additive, dominance and epistatic components were more important in single infections whereas maternal components play a decisive role in multiple infections. In detail, parameter estimates of additive, dominance and epistatic components correlated positively between single and multiple infections, whereas maternal components correlated negatively. These findings may suggest that specificity of host–parasite interactions are mediated by genetic and especially epistatic components whereas maternal effects constitute a more general form of resistance.     

Differential diagnosis of human retrovirus infections in the laboratory

Several human retroviruses have been discovered in the past decade, the majority of which have been implicated as etiological agents of severe disease entities. Thus, there is a clear need for accurate identification of human retroviruses in the laboratory. In this review, the classification and general properties of human retroviruses are outlined. Methods for detecting the presence of antibodies are reviewed. In addition, the principles of methods used for isolating and identifying retroviruses are discussed. Finally, techniques which detect the presence of retroviruses directly in clinical specimens without prior amplification in culture are summarized. Clearly, the ability to differentiate and recognize the different types of retrovirus is important for the proper treatment of diseases caused by these viruses.     

细菌性阴道病联合检测技术在阴道感染诊断中的应用

目的探讨细菌性阴道病(BV)联合检测技术在阴道感染诊断中的应用价值。方法取2009年9月至2010年2月至苏州市木渎人民医院妇科门诊就诊的6 500例育龄期妇女阴道分泌物,分别对霉菌、滴虫、清洁度进行生理盐水涂片的检测与过氧化氢、唾液酸苷酶和白细胞酯酶三项联合测定。结果应用湿片镜检发现霉菌性阴道炎1 274例,阳性率为19.6%,滴虫性阴道炎195例,阳性率为3.0%。应用BV三项联合技术测定6 500例患者的阴道分泌物,BV阳性1 612例,阳性率为24.8%,其中BV合并霉菌性阴道炎感染465例,占BV发病的28.9%,BV合并滴虫感染79例,占BV发病的4.9%。结论三项联合检测技术操作简单、快速、准确,从功能学分别反映阴道正常菌和致病菌的指标,可与白带常规镜检互补,建议作为阴道分泌物常规检查对阴道感染进行筛查。     

Immunologic studies on Heligmosomoides polygyrus infection in the mouse: the dynamics of single and multiple infections and the effect of DDT upon acquired resistance

Neilson J.T. McL., Forrester D.J. and Thompson N.P. 1973. Immunologic studies on Heligmosomoides polygyrus infection in the mouse: The dynamics of single and multiple infections and the effect of DDT upon acquired resistance. International Journal for Parasitology3: 371–378. Swiss Webster mice were given infections of 100,200, 300 and 400 Heligmosomoides polygyrus (= Nematospiroides dubius) larvae respectively at intervals of 4 weeks. Where appropriate, the preceding infection was terminated with anthelmintic 7 days prior to the subsequent infection. Animals were killed at regular inteivals following each infection and the worm burdens compared with those found in control mice given a primary infection of similar size. The expulsion of worms in mice given three previous infections occurred after day 3 and before day 7 postinfection indicating that those larvae moulting from the fourth to fifth stages may be most susceptible to the host's resistance mechanisms. The administration of p,p'-DDT to hyperinfected mice did not interfere with the immunologic expulsion of worms.     

Brugia pahangi: granulomatous lesion development in jirds following single and multiple infections

The development of adult worm burdens and microfilaremias were determined in jirds which received 2, 3, or 4 subcutaneous inoculations of 50 Brugia pahangi infective larvae. Parasite burdens in multiply inoculated jirds were compared to those in four different groups of jirds which received single inoculations of 50 infective larvae. One of each of these singly inoculated groups was infected on the same day that one of the inoculations was given to the multiply infected jirds. Thus, the duration of the infections in the four groups of jirds receiving one inoculation was 54, 118, 189, and 254 days. The development of lymphatic lesions and granulomatous hypersensitivity to B. pahangi antigen was assessed in all jirds at necropsy. The percentage recoveries of adult worms and their locations did not differ in the singly inoculated jirds with infections of different durations. A protective resistance to reinfection, as measured by adult worm recovery in multiply infected jirds, did not occur. The lymphatic lesion scores and numbers of intralymphatic thrombi was greatest in singly inoculated jirds examined 54 days after infection. Pulmonary granuloma areas around adult filarial antigen coated beads embolized in the lungs of jirds 3 days prior to necropsy were also greatest in singly inoculated jirds examined 54 days after infection. Using criteria of lesion scores and lymph thrombi numbers to assess lymphatic lesion severity, a decrease in lesion severity as well as pulmonary granuloma size around antigen coupled beads was seen by 118 days after infection in singly inoculated jirds.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dynamics of multiple infection and within-host competition in genetically diverse malaria infections

Within-host competition between coinfecting parasite strains shapes the evolution of parasite phenotypes such as virulence and drug resistance. Although this evolution has a strong theoretical basis, within-host competition has rarely been studied experimentally, particularly in medically relevant pathogens with hosts that have pronounced specific and nonspecific immune responses against coinfecting strains. We investigated multiple infection in malaria, using two pairs of genetically distinct clones of the rodent malaria Plasmodium chabaudi in mice. Clones were inoculated into mice simultaneously or 3 or 11 days apart, and population sizes were tracked using immunofluorescence or quantitative polymerase chain reaction. In all experiments, at least one of the two clones suffered strong competitive suppression, probably through both resource- and immune-mediated (apparent) competition. Clones differed in intrinsic competitive ability, but prior residency was also an important determinant of competitive outcome. When clones infected mice first, they did not suffer from competition, but they did when infecting mice at the same time or after their competitor, more so the later they infected their host. Consequently, clones that are competitively inferior in head-to-head competition can be competitively superior if they infect hosts first. These results are discussed in the light of strain-specific immunity, drug resistance, and virulence evolution theory.     

乳杆菌制剂治疗阴道混合感染的临床疗效观察

目的探讨乳杆菌活菌制剂联合不同药物治疗阴道混合感染的效果。方法 2011年2月至2011年5月在厦门市妇幼保健院确诊为阴道混合感染的117例患者,其中,VVC+AV感染51例(43.59%)、BV+AV感染49例(41.88%)、TV+AV感染5例(4.27%)、VVC+BV+AV感染5例(4.27%)、TV+BV+AV感染5例(4.27%)、TV+BV感染3例(2.53%)。患者在应用相应抗菌制剂的同时联合应用乳杆菌活菌胶囊(定君生),并于下次月经干净后再次应用乳杆菌活菌胶囊1疗程,巩固治疗。观察首次及巩固治疗后的有效率和复发情况。结果 117例患者首次治疗后痊愈82例,显效21例,有效率为87.18%;巩固治疗后痊愈94例,显效19例,有效率为96.58%。二者差异有统计学意义(P<0.05)。结论乳杆菌活菌胶囊(定君生)联合相应药物治疗阴道混合感染临床疗效好,无严重并发症,值得临床推广应用。     

Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4), which is an attribute of a healthy vagina. The effervescent mixture (citric acid and sodium bicarbonate) along with a superdisintegrant (Ac-Di-sol) was used to enhance the swellability of the bioadhesive tablet. The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as an antibacterial) were used in the formulation along with Lactobacillus acidophilus spores to treat mixed vaginal infections. From the ex vivo retention study it was found that the bioadhesive polymers hold the tablet for more than 24 hours inside the vaginal tube. The hardness of the acid-buffering bioadhesive vaginal tablet was optimized, at 4 to 5 kg hardness the swelling was found to be good and the cumulative release profile of the developed tablet was matched with a marketed conventional tablet (Infa-V). The in vitro spreadability of the swelled tablet was comparable to the marketed gel. In the in vitro antimicrobial study it was found that the acid-buffering bioadhesive tablet produces better antimicrobial action than marketed intravaginal drug delivery systems (Infa-V, Candid-V and Canesten 1).