产后子宫内膜炎与围生期解脲脲原体感染有关

为了探讨围生期支原体感染与产后子宫内膜炎的关系及治疗,本研究选取产后子宫内膜炎患者73例作为观察组,同时选取正常产妇80例作为对照组。通过检测两组解脲脲原体(Uu)和人型支原体(Mh)感染情况,同时给予观察组常规治疗,本研究发现观察组Uu阳性比例为32.88%,明显高于对照组(p<0.05);观察组和对照组Mh阳性差异比较无统计学意义(p>0.05);观察组Uu阳性和Mh阳性产妇发生早产或胎膜早破的比例分别为62.50%和25.00%,明显高于支原体感染阴性产妇(p<0.05);观察组Uu阳性、Mh阳性和阴性患者治疗效果比较差异无统计学意义(p>0.05);观察组治疗后Uu阳性率为10.96%,明显较治疗前降低(p<0.05);观察组治疗前后Mh阳性率比较差异不显著(p>0.05)。本研究表明,Uu感染与产后子宫内膜炎发生有一定关系,围生期应加强Uu感染筛查,并及时进行治疗。     

常见支原体感染误诊与对策

临床支原体感染易发生误诊,不但加重患者精神和经济负担,而且延误患者病情,甚至留下后遗症。为此,我们综述了常见支原体感染误诊的特点和原因,深挖其中思维和思想根源,探讨减少或避免该类误诊现象的策略,旨在为临床医护人员和检验技术人员提供参考建议。     

妇科肿瘤患者支原体感染及耐药分析

目的了解妇科肿瘤患者支原体感染及耐药情况。方法采用液体培养法鉴定解脲脲原体（Uu）和人型支原体（Mh）,并进行9种抗菌药物的体外敏感性试验。结果1058例妇科肿瘤感染患者支原体感染率为31．6％,其中Uu阳性率为20．7％,Mh阳性率为5．8％,Uu和Mh混合感染率为5．1％。219株Uu对9种抗菌药物的敏感率在90％以上的有强力霉素93．6％（205／219）和美满霉素93．2％（203／219）;61株Mh对药物敏感率在80％以上的有强力霉素86．9％（53／61）和美满霉素88．8％（54／61）。Uu和Mh混合感染者,各种抗菌药物的耐药率均明显升高。结论Uu和Mh在妇科肿瘤患者中具有一定比率的感染率,并对抗菌药物产生了不同程度的耐药性,建议对妇科肿瘤患者常规进行宫颈分泌物支原体培养、鉴定和药敏试验。     

男性泌尿生殖道支原体感染及药敏分析

探讨男性尿道炎患者支原体感染率及其敏感性,为临床治疗支原体感染导致的疾病提供合理用药的参考依据。采用海泰生物的史原体分离鉴定试剂盒,取前列腺液或尿道分泌物,对1116份疑为泌尿生殖系统感染的男性患者进行了支原体检测和抗生素敏感性检测。1116份男性患者标本中共分离出274株支原体,242株Uu对美满霉素、强力霉素、环雨沙星、司帕沙星、氧氟沙星、阿齐霉素、罗红霉素、交沙霉素、克拉霉素、壮观霉素的敏感率分别为95．1％、94．6％、17％、70．3％、31．1％、76％、77．7％、92．6％、83．5％、43．8％。30椿Uu＋Mh对美满霉素、强力霉素、环丙沙星、司帕沙星、氧氟沙星、阿齐霉素、罗红霉素、交沙霉素、克拉霉素、壮观霉素的敏感率分别为70％、66．7％、20％、40．1％、26．8％、23．4％、23．4％、50％、23．3％、20％。泌尿生殖道支原体的耐药性监测对指导临床治疗具有重要意义,可以根据药敏结果指导临床合理使用抗菌药物。     

四川地区孕妇产后子宫内膜炎主要致病菌的检测及其耐药性分析

大肠杆菌(Escherichia coli)、化脓隐秘杆菌(Trueperella pyogenes,Arcanobacterium pyogenes)和坏死梭杆菌(Fusobacterium necrophorum)是与子宫内膜病变相关的主要病原体。本研究使用聚合酶链式反应(PCR)直接鉴定四川地区139例孕妇宫颈分泌物中的病原体,而不进行细菌培养。此外,对上述3种病原体的耐药性进行了考察。结果显示,第1次生产后检查发现子宫内膜炎的发生率(35.25%)高于第2次生产后检查(15.53%)。在6个样品中检测到大肠杆菌,在11个样品中检测到化脓隐秘杆菌,并在10个样品中检测到坏死梭杆菌。在第1次检查中,化脓隐秘杆菌和坏死梭杆菌的子宫污染感染高于第2次检查。药敏实验结果显示,大肠杆菌、化脓隐秘杆菌和坏死梭杆菌分别对9种、6种和7种药物产生耐药性。总之,本研究建立了用于诊断孕妇产后子宫内膜炎的3种主要病原体的标准PCR,该方法更简单、成本低和快捷,且对主要细菌检测具有较高的灵敏度。此外,大肠杆菌的耐药性高于另外2个菌种。     

大学生尿沉渣中解脲脲原体和人型支原体感染情况分析

目的了解解脲脲原体(Ureaplasma urealytium,Uu)和人型支原体(Mycoplasma homanis,Mh)在大学生泌尿道中的感染情况.方法采用培养方法对37例正常的在校大学生的尿沉渣进行Uu和Mh的培养.结果采用培养方法检测21.6%(8/37)的大学生Uu感染为阳性,其中分离阳性者全部是女生(8/20,40%),13.50%(5/37)大学生Mh培养为阳性,其中阳性者亦全部为女生,占女生人数的25%(5/20).结论Uu和Mh可能是女性泌尿道的正常寄生的微生物之一.     

长沙地区1409例泌尿生殖道支原体感染者的感染状况及药敏分析

目的了解长沙地区普通人群泌尿生殖道支原体感染的现状及药敏情况,为临床合理用药提供依据。方法收集并回顾性分析湖南省人民医院1 409例门诊泌尿生殖道感染者的支原体培养鉴定结果及其药物敏感试验结果。结果 1 409例门诊样本中,支原体总阳性率为15.3%(215/1409);其中,解脲脲原体(Uu)和人型支原体(Mh)阳性率为11.5%和6.2%,单独感染Uu、单独感染Mh和混合感染Uu+Mh阳性率分别为9.1%、3.8%和2.4%;女性支原体阳性率为22.3%,明显高于男性的3.3%(χ~2=92.378,P0.01);药物敏感性较高的为强力霉素、美满霉素和交沙霉素,耐药性较高的有喹诺酮类和罗红霉素;女性感染者对交沙霉素和壮观霉素的敏感性高于男性,对其他药物的敏感性则明显低于男性。单独Uu感染者对各抗菌药物(环丙沙星和壮观霉素除外)的敏感性均高于单独Mh感染者,而混合Uu+Mh感染者则为药物敏感性最低的一组(对大部分药物的敏感性低于40%)。结论长沙地区普通人群泌尿生殖道支原体感染的阳性率总体较低,但耐药问题依然突出,临床用药时可把四环素类药物和交沙霉素纳入首选,同时依据感染者的性别、感染类型等选择适宜药物进行治疗。     

泌尿生殖道支原体感染检测及药敏试验

目的了解本地区泌尿生殖道解脲脲原体（Uu）和人型支原体（Mh）感染状况及药物敏感性,指导临床医生合理应用抗生素。方法应用法国生物梅里埃公司提供的IST试剂盒进行支原体鉴定及9种药物敏感检测,并对结果进行统计分析。结果1210例门诊患者检出支原体阳性683例,总感染率为56.4%,其中Uu单独感染占628例（占51.9%）,Mh单独感染14例（占1.2%）,Uu和Mh混合感染41例（占3.4%）。交沙霉素和原始霉素敏感率最高,对Uu分别为98.5%和97.0%,对Uu和Mh混合感染率都为100%;氧氟沙星敏感率最低,分别为1.5%和0.0%。结论泌尿生殖道系统感染主要由解脲支原体引起,交沙霉素和原始霉素敏感率最高,氧氟沙星敏感率最低。临床应选用培养敏感的抗菌药物,提高治疗效果。     

1796例泌尿生殖道支原体培养及药敏结果分析

目的分析新乡地区1796例泌尿生殖道标本的支原体培养及抗生素药物敏感试验,指导临床合理使用抗生素。方法支原体培养鉴定、药敏试剂盒购自贝瑞特公司。同时检测解脲支原体和人型支原体,并进行10种抗生素的药敏试验。数据统计采用χ^2检验。结果支原体培养1596例标本中,541例解脲脲原体（Uu）阳性,阳性率为33.9%;39例人型支原体（Mh）阳性,阳性率为2.4%;解脲脲原体、人型支原体均阳性76例,阳性率为4.8%。200例正常对照组27例阳性,阳性率为13.5%。药敏结果显示,强力霉素、克拉霉素和美满霉素的抗菌活性较强。结论支原体感染以Uu为主,Uu＋Mh次之,正常人泌尿生殖道支原体阳性率为13.5%。只有某些血清型感染且在达到一定浓度以上同时宿主处于多种病原体感染或免疫机制紊乱时,Uu才能致病。避免滥用抗生素引起生殖道菌群失调。临床上治疗Uu感染、Mh感染或Uu＋Mh混合感染时,建议选用强力霉素、克拉霉素和美满霉素。     

女性生殖道支原体感染现状及耐药性调查分析

目的 了解女性生殖道支原体感染现状及耐药性,采取有效措施降低感染率,同时为临床合理用药提供依据.方法 对415例疑似生殖道感染标本采用珠海迪尔生物有限公司生产的试剂盒进行支原体培养和药敏试验.结果 415例女性生殖道标本中,支原体感染209例,阳性率为50.4％(209/415),其中单纯解脲脲原体(Uu)感染141例,阳性率34.0％(141/415),单纯人型支原体(Mh)感染25例,阳性率6.0％ (25/415),Uu和Mh混合感染43例,阳性率为10.4％ (43/415);药敏试验结果表明:Uu、Uu+ Mh、Mh对强力霉素、交沙霉素、美满霉素、四环素敏感性普遍较高,相反对红霉素、环丙沙星、罗红霉素、氧氟沙星等敏感性较差.结论 女性生殖道支原体感染率较高,已婚育龄妇女应加强妇科检查,做到早检查、早诊断、早治疗.同时,临床医生应结合药敏试验结果合理用药,以降低女性生殖道支原体感染的发生率.     

Association between endometritis and endometrial cytokine expression in postpartum Holstein cows

The endometrium regulates the inflammatory response after infection by production and release of cytokines and chemokines. The objective was to compare gene expression of important pro-inflammatory (TNFα, IL-1β, IL-6) and anti-inflammatory (IL-10) cytokines, and the main neutrophil chemokine (IL-8), from calving to Week 7 after calving, in cows that developed endometritis and healthy control cows. Uterine biopsies were obtained at calving and at Weeks 1, 3, 5 and 7. Endometritis was evaluated at Week 5 by uterine lavage and cytology; cows with ≥ 10% neutrophils were considered to have endometritis. Real-time RT-PCR threshold values (Ct) were used to calculate the fold difference in gene expression, using the 2^−ddCt method, normalized to GAPDH and calibrated to the average dCt for all cows at calving. Serum IL-8 concentrations were measured with ELISA. The analysis included 28 cows (11 had endometritis) for the PCR data and 44 cows (20 had endometritis) for ELISA. Expression of the TNFα gene in uterine tissue was decreased in cows with endometritis compared to control cows at calving (P = 0.09) and at Week 1 (P = 0.05). Iterleukin-1β gene expression tended to be decreased (P = 0.08) in cows with endometritis compared to control cows at Week 1, but tended to be increased (P ≤ 0.10) at Weeks 5 and 7. Cows with endometritis had increased (P < 0.05) IL-6 gene expression at calving and at Week 7 compared to control cows. Interleukin-8 gene expression was increased (P = 0.03) in endometritic cows compared to control cows at Week 7. Uterine disease was not significantly associated with IL-10 gene expression. A lower local level of expression of pro-inflammatory cytokines in the endometrium soon after calving might impair activation of inflammation and clearance of bacteria, and lead to development of endometritis.     

Sleep,daily activity rhythms and postpartum mood: A longitudinal study across the perinatal period

Women with a diagnosis of bipolar and major depressive disorders are at higher risk to develop postpartum depression. The primary objective of this longitudinal study was to determine whether daily activity rhythms and sleep parameters differ between women with and without a history of a mood disorder across the perinatal period. A secondary objective was to determine whether changes in these parameters were associated with postpartum mood. In total, 33 women were included in this study, 15 of which had a history of a mood disorder (high-risk group) and 18 who did not (low-risk group). Sleep and daily rhythms were assessed subjectively and objectively during the third trimester (≥26 weeks gestation) and again at 6–12 weeks postpartum. Mood was also assessed at both time points. Women in the high-risk group showed greater subjective daily rhythms and sleep disturbances across the perinatal period. Objective sleep efficiency was worse in the high-risk group in the postpartum period. Changes in both subjective daily rhythms and objective sleep efficiency were predictive of changes in depressive symptoms across the perinatal period. These findings encourage the development of preventative therapeutics to ensure circadian rhythm and sleep stability throughout the perinatal period.     

Risk factors for clinical endometritis in postpartum dairy cattle

Bacterial contamination of the uterine lumen after parturition occurs in most dairy cattle. The presence of clinical endometritis beyond three weeks post partum depends on the balance between microbes, host immunity, and other environmental or animal factors. The present study tested the hypothesis that clinical endometritis is associated with animal factors, such as retained fetal membranes, assisted calving and twins, as well as fecal contamination of the environment. The association between selected risk factors and the lactational incidence risk of clinical endometritis was examined in 293 animals from four dairy herds. Multivariate analysis was used to identify risk factors and quantify their relative risk (RR) and population attributable fraction (PAF) based on the proportion of cows exposed to each factor. The lactational incidence of clinical endometritis was 27% and significant risk factors for clinical endometritis were retained fetal membranes (RR = 3.6), assisted calving (RR = 1.7), stillbirth (RR = 3.1), vulval angle (RR = 1.3), primparity (RR = 1.8), and male offspring (RR = 1.5) but not the cleanliness of the environment or the animal. The highest PAF was associated with male offspring (0.6) so the use of sexed semen has the greatest potential to reduce the incidence of clinical endometritis. The dominant association between retained fetal membranes and clinical endometritis was supported by an expert panel of clinicians. The risk factors for clinical endometritis appear to be associated with trauma of the female genital tract and disruption of the physical barriers to infection rather than fecal contamination.     

生殖道支原体定植与阴道菌群结构的关联性

目的 探索女性性工作者生殖道中支原体定植与否与菌群结构的关联。方法 研究对象为2015年12月于云南红河州河口地区接受横断面调查的女性性工作者,采用PCR技术检测阴道中解脲脲原体（Uu）、人型支原体（Mh）和生殖支原体（Mg）的定植情况。将三种支原体任意一种检测阳性定义为支原体阳性,并依此将人群分为两组。在两组研究对象中各随机抽取9份样本行细菌16S rDNA基因的V3‒V4区高通量测序,通过生物信息学方法,比较两组研究对象阴道菌群结构差异。结果 支原体阳性组微生物群落的Shannon与Simpson指数均高于阴性组（Ps<0.05）,通过主成分分析图可以直观显示两组研究对象菌群结构具有明显差异,阳性组菌群结构更加多样化,没有集中趋势。支原体阳性组的乳杆菌属相对丰度低于阴性组（P<0.001）,而链球菌属（P=0.015）、普氏菌属（P=0.047）的相对丰度高于阴性组。结论 生殖道中支原体的定植与菌群结构有关,菌群结构的改变可能是支原体致病的重要条件之一。     

Interrelations between neural elements and tanycytes during the perinatal period of the rat

Summary The present study has utilized a correlative scanning-transmission electron microscopic technique to examine interrelations between neural elements and differentiated tanycytes and to identify supraependymal cells in the ventral region of the 3rd ventricle during the perinatal period in the rat. From the 18th day of fetal life monoaminergic and/or peptidergic axons penetrate into the ventricle between the tanycytes. After birth, they form an extensive network covering the surface of the infundibular recess. The axons possess morphological characteristics suggestive of neurohormone secretion. From the 20th day of prenatal life subependymal axons begin to innervate the tanycytes. Supraependymal cells differ in their shape and ultrastructure, but all of them bear resemblance to macrophages, as they contain numerous lysosomes and phagosome-like bodies.     

Endometrial cytology and ultrasonography for the detection of subclinical endometritis in postpartum dairy cows

The objectives of the study were to validate the use of endometrial cytology (EC) and ultrasonography (US) to diagnose subclinical endometritis in clinically normal postpartum dairy cows, and to measure the impact of subclinical endometritis on reproductive performance. Holstein cows from two dairy farms were examined at Visit 1 (V1) at 20-33 days in milk (DIM), and clinically normal cows (n = 228), based on the absence of abnormal discharge on external inspection and vaginoscopy, were selected. The reproductive tract of selected cows was evaluated by transrectal palpation, US and EC. All cows in the study were re-examined at Visit 2 (V2) at 34-47 DIM (2 weeks after V1) and were subsequently followed for a minimum of 8 months (until pregnant or culled). Survival analysis was used to derive a case definition of subclinical endometritis, based on factors associated with decreased relative pregnancy rate. Positive EC at V1 (>18% polymorphonuclear leukocytes; PMN) or fluid in uterus at V1 (FIU1) were associated with a significant reduction in the relative pregnancy rate and identified cows with subclinical endometritis. Similarly, a positive EC (>10% PMN) at V2 or fluid in the uterus at V2 (FIU2), identified cows with subclinical endometritis. Cows with subclinical endometritis at V1 and at V2 had a relative pregnancy rate of 41 and 51% (hazard ratio for pregnancy of 0.59 and 0.49), respectively, compared to cows without subclinical endometritis. Given EC or US findings, no diagnostic criteria based on transrectal palpation of the uterus had predictive value for risk of pregnancy. In conclusion, subclinical endometritis, diagnosed by EC or US, was associated with reduced relative pregnancy rate.     

皮肤真菌感染与银屑病的相关性

随着近年来银屑病的发病率逐步增加,关于银屑病病因的研究更加深入。除了遗传、免疫和环境等相关因素,微生物与银屑病的关系也备受关注。关于真菌感染与银屑病的相关性研究始于19世纪,认为糠秕马拉色菌可能是银屑病的致病因子,与银屑病的发生发展密切相关。随后也有研究指出白念珠菌通过超抗原等作用诱发或加重银屑病。但银屑病患者依据自身IL-17增高的特点可以起到一定抵抗微生物感染的作用,因此真菌感染与银屑病的关系暂无定论。随着近年来关于两者之间关系的研究逐渐增多,真菌感染仍是银屑病患者不可忽视的诱发或加重因素之一。明确真菌感染在银屑病患者体内的作用有助于更好地研究银屑病的发病机制以及改善预后。     

A comparison of diagnostic techniques for postpartum endometritis in dairy cattle

Holstein cows (n=221) from eight commercial dairy herds were examined for endometritis between 28 and 41 days postpartum using 5 diagnostic techniques: (1) vaginoscopy; (2) ultrasonographic assessment of uterine fluid volume; (3) ultrasonographic assessment of endometrial thickness; (4) endometrial cytology collected by cytobrush; and (5) endometrial cytology collected by uterine lavage. Concordance correlation was used to evaluate the reliability of cytobrush and lavage cytology. Cytobrush cytology was found to have the greatest intraobserver repeatability (cytobrush, rho(c)=0.85 versus lavage, rho(c)=0.76) and was chosen as the reference diagnostic test. Pregnancy data at 150 days postpartum was available for 189 cows. Survival analysis was used to determine the lowest percentage of polymorphonuclear cells associated with time to pregnancy. The sensitivity and specificity of the diagnostic techniques was determined using pregnancy status at 150 days and cytobrush cytology as the diagnostic standards. The risk of non-pregnancy at 150 days was 1.9 times higher in cows with more than 8% PMNs identified using cytobrush cytology than in cows with less than 8% PMNs (P=0.04). Twenty-one cows of 189 cows (11.1%) had >8% PMNs and were considered to be positive for endometritis. Cows with endometritis had a 17.9% lower first service conception rate (P=0.03) and a 24-day increase in median days open (P=0.04). The sensitivities of all five diagnostic tests relative to 150-day pregnancy status ranged from 7.1 to 14.3% and the specificities from 84.0 to 93.3%. Relative to cytobrush cytology, the respective sensitivity and specificity values are as follows: vaginoscopy (53.9%, 95.4%); lavage cytology (92.3%, 93.9%); ultrasonographic assessment of uterine fluid (30.8%, 92.8%); and ultrasonographic assessment of endometrial thickness (3.9%, 89.2%). Endometritis impaired reproductive performance. Cytobrush cytology was the most reliable method of diagnosing endometritis in cattle.     

Methods of local antimicrobial therapy and prevention of postpartum endometritis]

To increase the effect of the treatment of puerperal endometritis, long-term washing of the uterus cavity with cool solutions of furacillin was used in 57 puerpera. The most favourable results were observed in 27 patients who at the final stage of the washings were treated with antibiotic solutions administered to the uterus cavity. The recovery terms, as well as the terms of the hospitalization lowered. For confirming the diagnosis of endometritis and control of the therapy efficacy cytograms of the metroaspirates were used. High efficacy of the prophylactic administration of antibiotics to the myometrium tissues during the cesarean section with high risk of infectious complications was also shown. Both the methods were recommended for their wide use in obstetric hospitals.