甲型副伤寒的腹部超声特征

目的探讨甲型副伤寒的腹部超声图像特征,以协助早期诊断。方法对1997年至2005年经血培养证实的364例甲型副伤寒的腹部超声表现作回顾性分析。结果甲型副伤寒的患者中脾肿大最多见,占57.1%,肝肿大占36.3%,胆囊炎症性改变占18.9%。结论腹部超声检查有助于甲型副伤寒的早期诊断。     

甲型副伤寒32例临床诊治分析

由于水源污染,2003年4～5月,常山县某中学发生一起严重的甲型副伤寒暴发流行。其中常山县人民医院共收治住院学生32例,现将32例的临床资料作一初步分析。     

甲型副伤寒沙门菌培养条件的优化

优化甲型副伤寒沙门菌的培养条件,提高菌体产量。方法通过单因素及正交试验,对影响甲型副伤寒沙门菌生长的培养温度、NaCl浓度和pH等条件进行优化。结果甲型副伤寒沙门菌在NaCl浓度0.75%、温度35℃、pH6.5时菌体产量最高。结论通过对甲型副伤寒沙门菌培养条件进行优化,获得较高的菌体产量,为后期诊断试剂盒的开发奠定了基础。     

121株甲型副伤寒病原菌的噬菌体型和脉冲场凝胶电泳型

目的认识甲型副伤寒疫病区甲型副伤寒沙门菌的噬菌体型和脉冲场凝胶电泳（PFGE）型,确定噬菌体型和PFGE型之间的关系以及菌型的分布和流行率。方法采用沙门菌组合噬菌体和SpeI、XbaI消化染色体DNA的PFGE对来自玉溪市7县（区）的121株甲型副伤寒菌进行分型。结果121株菌存在4个完全噬菌体型或1个噬菌体型;用SpeI或XbaI消化产物分别得出以SpeI01、SpeI02或XbaI01占优势的5种或4种PFGE型,SpeI01型和SpeI02型分别占37．2％和57．9％,XbaI01型占95．1％。结论121株菌的噬菌体型与PFGE型之间无一致性联系,PFGE型的SpeI01和SpeI02或XbaI01是玉溪地区的主要流行型,采用SpeI和XbaI的PFGE是鉴别甲型副伤寒菌流行克隆的一项有用技术。     

需氧厌氧培养方式对甲型副伤寒沙门菌检出率的影响

目的探讨需氧和厌氧血培养方式的选择对甲型副伤寒沙门菌检出率的影响。方法使用mini VI-TAL自动荧光血培养仪或BacT/Alert 3D培养仪对18684例疑似血流感染患者血液(含骨髓)标本进行需氧和(或)厌氧培养(其中仅做需氧培养935例,仅做厌氧培养16例,需氧和厌氧配对培养17733例,每瓶注入约5 ml血液)。结果18684例血液标本,共分离到甲型副伤寒沙门菌3888例(20.81%)。在17733例需氧和厌氧配对培养中检出3613例,其中仅需氧阳性406例占11.24%(406/3613),仅厌氧阳性405例占11.21%(405/3613),需氧和厌氧培养均阳性者2802例占77.55%(2802/3613),需氧和厌氧均生长的阳性报警时间分别为(22.56±13.22)h和(26.69±15.80)h,仅需氧阳性的报警时间为(32.85±23.33)h,仅厌氧阳性的报警时间为(34.46±18.44)h。结论需氧和厌氧血培养方式获得甲型副伤寒沙门菌的阳性率相同,采用需氧和厌氧瓶配对培养可提高阳性检出率,只做厌氧或需氧培养将有11.24%或11.21%阳性病例被漏检。     

甲型副伤寒238例临床分析

近年来,甲型副伤寒发病有增多趋势,而且早期缺乏典型临床表现,容易误诊。现将诸暨市人民医院2001年1月-2003年9月收治的血培养阳性的238例甲型副伤寒患者作一临床分析,以期对该病的早期诊断、治疗有所帮助。     

甲型副伤寒药敏与临床分析

目的：探讨耐氟喹诺酮甲型副伤寒的防治对策。方法：按稀释法药物敏感试验（MIC法）测定细菌对抗菌药物的敏感度。结果：30株甲型副伤寒杆菌,药敏试验对培氟沙星耐药率为46．7％（14／30）、中敏率为43．3％（13／30）、敏感率仅10％（3／30）,而对哌拉西林与第三代头孢菌素均敏感。5例患者静滴环丙沙星治疗仅1例有效,4例环丙沙星治疗无效及其他25例患者予静滴哌拉西林、头孢噻肟、头孢曲松、头孢哌酮2－7d体温降至正常。结论：本地区甲型副伤寒对氟喹诺酮耐药率高,宜选用哌拉西林或第三代头孢菌素治疗。     

甲型副伤寒并发浆膜腔积液

近年来温州地区甲型伤寒发病较前增多.甲型副伤寒是甲型副伤寒杆菌所致的败血症,常累及全身多部位,其临床表现多种多样,但出现浆膜腔积液者少见,往往不能及时被确诊.现将近五年来收住我院的甲型副伤寒并发浆膜腔积液患者8例报道如下.     

甲型副伤寒沙门菌的耐药现状与临床用药

近年来,甲型副伤寒(Paratyphoid A)的发病在沿海和一些边远地区有增多趋势[1-8]。为了更好地防治甲型副伤寒沙门菌感染,现就有关该菌的耐药现状以及临床用药中的一些问题简要综合评述如下。1药敏结果的差异性[9-24]纵观国内众多甲型副伤寒沙门菌对临床常用抗菌药物的药敏试验结     

单份血清肥达凝集试验在甲型副伤寒诊断中的价值

目的：评价疑似甲型副伤寒病例单份血清肥达凝集试验(WAT)的诊断价值。方法：以甲型副伤寒沙门菌血培养阳性和／或血清鞭毛特异性抗原阳性的甲型副伤寒病例(n=76)、血培养阴性和／或血清抗原阴性的对照发热病人(n=92)和健康饮食从业人员(n=63)为检测对象,用WAT测定以上三种人群血清甲型副伤寒沙门菌O、H、A抗体,分析评价不同O、H、A判断值诊断甲型副伤寒的敏感性、特异性、阳性预测值和阳性似然比等指标。结果：获得三种人群O、H、A凝集价的分布及其几何平均滴度,20％对照发热病人O抗体效价≥160,而健康从业人员仅有3．2％的O抗体效价≥160,对照发热病人和健康人相应H抗体效价分别占17％和4．8％,A抗体效价分别占16％和1．6％。53％血培养阳性和血清鞭毛抗原阳性甲型副份寒病例O抗体效价≥160,相应H、A抗体效价分别占41％和51％。用敏感性、特异性、阳性预测值、阳性似然比等指标评价单份血清WAT诊断甲型副伤寒的价值,提出O或H或A≥160和O≥160或A≥80可作为WAT辅助诊断甲型副伤寒的标准。结论：单份血清WAT有助于甲型副伤寒的诊断,该试验对血培养阴性的临床疑似甲型副伤寒病例及其高危人群中甲型副伤寒病例的诊断有实用意义。     

甲型副伤寒菌O-特异性多糖与破伤风类毒素结合菌苗的制备及其在小鼠体内的免疫原性

以脱毒后去除类脂A的甲型副伤寒杆菌高分子量O SP1和低分子量O SP2 为特异性抗原 ,以破伤风类毒素 (TT)为蛋白质载体 ,用己二酸二肼 (ADH)作为连接剂制备的两种结合物及其多糖免疫NIH小鼠 ,结果显示单独注射O SP1或O SP2 免疫小鼠后 ,均不能刺激小鼠产生抗 LPS抗体 ;而用O SP1 TT和O SP2 TT结合物免疫后 ,小鼠血清中均产生了特异性抗 LPSIgG和IgM抗体 ,且O SP1 TT免疫组血清中IgG抗体水平明显高于O SP2 TT免疫组 ,两组结合物免疫血清中抗体类型以IgG为主。O SP1 TT结合物免疫组第二次免疫和第三次免疫后IgG抗体水平均较前一次有显著升高 (p<0 0 1)说明 ,O SP1 TT结合物具有加强应答效果。补体介导的体外杀菌试验证明 ,O SP1 TT与O SP2 TT结合物免疫血清具有特异性杀菌活性。     

伤寒沙门氏菌SOD的提取及抗原性研究

经硫酸铵分级沉淀,ＤＥＡＥ纤维素柱层析提取了伤寒沙门氏菌ＳＯＤ。提取后酶的比活性为３２７０Ｕ／ｍｇ,经聚丙烯酰胺凝胶电泳,蛋白质染色及酶活性染色显示提取的ＳＯＤ达到了电泳纯。酶活性染色法和原子吸收分光光度法测定结果表明提取的ＳＯＤ为Ｆｅ－ＳＯＤ。双向琼脂扩散试验结果显示抗伤寒沙门氏菌Ｆｅ－ＳＯＤ血清与牛红细胞ＳＯＤ不形成沉淀线,提示伤寒沙门氏菌Ｆｅ－ＳＯＤ与牛红细胞ＳＯＤ无交叉反应,抗体对酶活性抑制试验结果显示抗Ｆｅ－ＳＯＤ血清可抑制伤寒沙门氏菌及鼠伤寒沙门氏菌的Ｆｅ－ＳＯＤ和Ｆｅ／Ｍｎ－ＳＯＤ活性,对Ｍｎ－ＳＯＤ活性无抑制作用,说明伤寒沙门氏菌和鼠伤寒沙门氏菌的ＳＯＤ之间有共同抗原,也提示ＳＯＤ的辅基似乎决定了其抗原特异性。     

Crystallization of lipopolysaccharide from a Salmonella typhimurium semi-rough (SR) mutant.

Salmonella typhimurium SR-form lipopolysaccharide (LPS), consisting of a single repeating unit of the O-antigenic polysaccharide, linked to the R-core consisting of oligosaccharide that is, in turn, linked to lipid A, formed crystals whose shapes were hexagonal plates, discoids, and solid columns when precipitated by the addition of 2 volumes of 95% ethanol containing 375 mM MgCl2 and kept in 70% ethanol containing 250 mm MgCl2 at 4 C for 10 days. Among these crystals, the basic form is considered to be the hexagonal plates. Analyses of hexagonal plate crystals showed that they consist of hexagonal lattices with a lattice constant (a axis) of 4.62 A and longitudinal axis (c axis) of approximately 100 A. In X-ray diffraction patterns in the low-angle region, crystals of S. typhimurium SR-form LPS exhibited much less distinct reflections when compared with crystals of synthetic Escherichia coli-type lipid A. In contrast to the previous finding that S. minnesota S-form LPS possessing the O-antigenic polysaccharide does not crystallize under the same experimental conditions as used in the present study, the presence of a single repeating unit of the O-antigenic polysaccharide does not inhibit crystallization.     

提高甲型副伤寒患者血培养阳性率的研究

目的确定甲型副伤寒（简称：甲副）患者血内细菌数及其变化规律,分析血细菌数、采血量、培养分离方法和血培养阳性率间的关系。方法采用定量全血培养技术检测300例临床诊断甲副病例血内细菌数;用标准血培养技术对3000例疑似甲副病例进行需氧和（或）厌氧血培养;用血清甲副病原菌（简称：甲副菌）鞭毛抗原检测的细菌半定量技术分析不同病程215例甲副患者血清甲副菌鞭毛抗原的检测情况。结果131例甲副患者血细菌数的中位数是0．5CFU／ml,全距是〈0．3～6CFU／ml;血细菌数范围为〈0．3、0．3～0．49、0．5～0．9、0．9～4．9和〉5的病例构成分别是22％、28％、33％、12％和5％;长病程甲副患者血清甲副菌鞭毛抗原阳性率比短病程者高（χ^2〉4．06。P〈0．050）;疑似甲副病例5ml和10ml静脉血甲副菌血培养阳性率分别为49．8％和72．8％（χ^2=70．9,P〈0．005）;病例标准需氧瓶和厌氧瓶配对培养总阳性率为51．3％,需、厌氧瓶的血培养结果存在相关关系（χ^2=14．5。P〈0．005）,厌氧培养瓶比需氧培养瓶更适合培养血内甲副菌（χ^2=5．0,P〈0．025）。结论甲副病例血内细菌数、采血量、病程、血培养方式是决定血培养阳性率的重要因素,增加采血量和采血次数并用两个以上培养瓶作配对血培养可把甲副患者血培养阳性率提高到接近99％。     

Structure and heterogeneity of the O-antigen chain of Salmonella Agona lipopolysaccharide

Lipopolysaccharide of Salmonella Agona smooth-type cells was obtained from bacteria by a hot phenol-water extraction procedure. Mild acid hydrolysis of lipopolysaccharide, followed by gel filtration, yielded the pure O-polysaccharide. Abequose, rhamnose, mannose, galactose and glucose in the molar ratio 0.8 : 1.0 : 1.0 : 1.1 : 0.5 were detected, and their linkages were established. Sugar configurations were determined by gas chromatography. Two repeating units, namely -->2)-[alpha-Abep-(1-->3)-]-alpha-d-Manp-(1-->4)-alpha-l-Rhap-(1-->3)-alpha-d-Galp-(1-->and -->2)-[alpha-Abep-(1-->3)-]-alpha-d-Manp-(1-->4)-alpha-l-Rhap-(1-->3)-[alpha-d-Glcp-(1-->4)-]-alpha-d-Galp-(1-->, were deduced from nuclear magnetic resonance studies. The effort to separate them was unsuccessful. An immunochemical test performed by means of Western blotting with anti O12 serum demonstrated that glucose was present in the longer lipopolysaccharide chains, at some distance from the core region.     

Preparation and purification of monoclonal antibodies against chloramphenicol

Monoclonal antibodies (McAbs) against chloramphenicol (CAP) were produced to detect CAP residues, which could be toxic and possesses a potential threat to human health. The CAP-BSA conjugate was obtained by bovine serum albumin (BSA) coupled with CAP, and used to immunize the mice. The splenocytes from the immunized mice were fused with mouse myeloma cells SP2/0 to form hybridoma, which may secrete McAbs against CAP. Hybridomas 1D₁ and 3G₁₂ secreting McAbs against CAP were obtained by screening. Ascites containing McAbs were prepared by injecting 1 x 10⁶ cells of hybridoma 1D₁ and 3G₁₂ into the abdomen of mice. Protein A affinity chromatography was used to purify McAbs against CAP in a single chromatographic step with recovery yield above 80% and purity above 95% and full recovery of antibody activity. Experiments showed that McAb 3G₁₂ was highly specific for CAP and had no cross-reactivity with analogues which have a structure similar to CAP. The IC₅₀ value was 50.8 ng/mL.     

Effect of saccharide length on the immunogenicity of neoglycoconjugates from synthetic fragments of the O-SP of Vibrio cholerae O1, serotype Ogawa

A synthetic hexasaccharide, identical to the terminal hexasaccharide of Ogawa LPS, coupled to bovine serum albumin induced protective antibodies in mice. To determine if there was a minimum saccharide length required for immunogenicity and efficacy, shorter (mono- to pentasaccharide) neoglycoconjugates (CHO-BSA) were tested in mice. The Ogawa CHO-BSA was inoculated at either a constant mass but differing moles, or equal moles but differing masses. Humoral responses were essentially the same when mice received 9 microg of the carbohydrate (0.007 mM with the pentasaccharide) in each of the neoglycoconjugates prepared from mono- through the pentasaccharide, or the same molar amount (0.007 mM), proportionally less by weight when going from the penta- to the monosaccharide. These data show that, within this dose range, the responses occurred virtually independently of the amount of immunogen. Humoral antibodies induced by these immunogens were generally not vibriocidal. Selected antisera induced by CHO-BSA immunogens were protective, but the ELISA titers of the sera were not predictive of the protective capacity. Purified, Ogawa LPS induced anti-Ogawa LPS IgM antibody titers similar to those induced by the Ogawa CHO-BSA conjugates. The anti-whole LPS sera were strongly vibriocidal, as were the previously reported sera induced by hexasaccharide conjugates. This suggests either that the shorter oligosaccharides lack a conformational epitope provided by the hexasaccharide or that the LPS has additional B cell epitopes or selects different B cells in the primary response.     

A Mu-class glutathione S-transferase from gills of the marine shrimp Litopenaeus vannamei: purification and characterization

Glutathione S-transferases (GSTs) are a family of detoxifying enzymes that catalyze the conjugation of glutathione (GSH) to electrophiles, thereby increasing the solubility of GSH and aiding its excretion from the cell. In this study, a glutatione S-transferase from the gills of the marine shrimp Litopenaeus vannamei was purified by affinity chromatography using a glutathione-agarose affinity column. GST was purified to homogeneity as judged by reducing SDS-PAGE and zymograms. This enzyme is a homodimer composed of approximately 25-kDa subunits and identified as a Mu-class GST based on its activity against 1-chloro-2,4-dinitrobenzene (CDNB) and internal peptide sequence. The specific activity of purified GST was 440.12 micromol/(min mg), and the K(m) values for CDNB and GSH are very similar (390 and 335 microM, respectively). The intersecting pattern of the initial velocities of this enzyme in the Lineweaver-Burke plot is consistent with a sequential steady-state kinetic mechanism. The high specific activity of shrimp GST may be related to a highly effective detoxification mechanism necessary in gills since they are exposed to the external and frequently contaminated environment.