临床标本钩端螺旋体L型的分离与形态学鉴定

应用钩体Ｌ型培养基成功地从钩体病神经系统后发症患者的血液和／或脑脊液标本中分离到钩体Ｌ型。将Ｌ型阳性培养物转种于钩体Ｌ型固体平板培养,发现基落形态呈丝状（Ｆ）型。对所分离到的Ｌ型进行形态学鉴定表明：Ｌ型呈球状体、螺旋状的丝状体等多形性改变,电镜下见Ｌ型推动部分或全部细胞壁,Ｌ型经免疫标记技术鉴定证实为钩体的Ｌ型。     

20例脑动脉炎钩端螺旋体L型的调查报告

本文报道２０例钩端螺旋体（简称钩体）Ｌ型脑动脉炎,其中右侧偏瘫８例、左侧偏瘫５例、双侧瘫２例,共济失调２例。血培养原形钩体阳性２例、钩体Ｌ型阳性１４例;ＣＳＦ培养原形钩体阳性１例、Ｌ型阳性７例。脑ＣＴ证实脑出血２例、脑梗塞８例。研究表明本病的发生可能与钩体Ｌ型直接损伤脑血管密功相关。甲硝哒唑易透过血脑屏障,能损伤钩体ＤＮＡ结构,疗效显著,可减少钩体病后发症。     

间接FLISA法检测钩端螺旋体特异性IgM方法的探讨

为研制钩端螺旋体（钩体）特异性IgM检测试剂,并用于早期诊断钩体病,以钩体外膜蛋白为抗原,探索间接ELISA法检测钩体特异性IgM的各项实验条件,并对钩体病患者血清标本进行检测,结果,１０５份健康人血ＩgM阴性,钩体IgM阳性血清可被特异性阻断,２－巯基乙醇破坏试验阳性,试剂存放４℃和３７℃4天的检测结果基本一致,检测临床钩体病人112份血清,IgM阳性83份,阳性率74．11％,与常规TAT法基本一致,0－7病日的阳性率明显高于MAT法,说明该法检测钩体病IgM具有特异,敏感,快速,稳定,简便等优点,对钩体病早期诊断有一定的价值。     

钩端螺旋体的几种检测方法

钩端螺旋体的几种检测方法万成松张文炳曹虹（第一军医大学微生物学教研室,广州５１０５１５）钩端螺旋体（简称钩体,Ｌｅｐｔｏｓｐｉｒａ）是一类细长、弯曲、两端呈钩状的螺旋体,钩体种类很多,分类学上归细菌范畴,可分致病性和非致病性两大类。钩体病是由致病性钩...     

北京地区首次发现赖型钩端螺旋体

采用分群和分型因子血清经显微镜凝集试验（ＭＡＴ）对由北京市顺义县某农场稻田周围黑线姬鼠肾组织分离获得的４株钩端螺旋体（钩体）进行了血清学分类检定。均属黄疸出血群赖型钩体。这在北京地区尚属首次分离发现。     

人感染钩体菌群与免疫血清群及交叉凝集关系研究

为了解人间自然感染各群钩端螺旋体（钩体）后产生的免疫抗体血清群、交叉凝集（交凝）、效价及相互关系,作者对病原学阳性并做过双份血清ＭＡＴ的６４份资料作了综合分析,结果表明：６４株钩体属于１２个群,其中１３株菌的感染者血清呈阴性反应,占２０．３１％;５１例呈阳性,占７９．６９％,有１４个血清群,效价１∶１００～１∶６４００;１２个菌群感染者的血清交凝反应较为普遍,效价１∶１００～１∶３２００;效价高低及交凝群数,因感染菌群而异。较为特殊的是１１个菌群感染者的血清中均不见与流感伤寒群钩体的交凝现象。本文对人间分离钩体菌群与免疫血清群构成比例互不吻合的问题作了解释,为钩体病的免疫及血清流行病学补充了新论据     

DAKO-M1在胃癌组织表达的免疫组织化学研究

对９５例胃癌组织进行ＤＡＫＯ－Ｍ１（ＤＡＫＯ－ＣＤ１５）表达的免疫组织化学研究。结果发现,ＤＡＫＯ－Ｍ１在胃癌中的阳性率（８６．３％）显著高于癌旁粘膜和正常胃粘膜（Ｐ＜０．０５和０．００５）。其定位分布有３种类型：即腺腔缘型（Ａ型）、胞膜型（Ｍ型）和胞浆型（Ｃ型）。胃非肿瘤性粘膜组织仅为Ａ型。胃癌３型兼有,高分化癌Ａ型（１８．２％）和Ｍ型（６１．４％）均显著高于低分化癌（Ｐ值均＜０．００５）;低分化癌和粘液癌Ｃ型（各占７２．０％和５３．８％）均显著高于高分化癌（２０．５％）,Ｐ＜０．００５和０．０２５。ＤＡＫＯ－Ｍ１Ｃ型和Ｍ型淋巴结转移率（分别为９７．１％和６９．２％）均显著高于Ａ型（３３．３％）者,Ｐ＜０．００５和０．０５。结果提示,ＤＡＫＯ－Ｍ１是判断胃癌分化水平、恶性程度及预测淋巴结转移的一种有用标志物     

绿脓杆菌MSHA菌毛株菌苗对反复发作性尿路感染的治疗及其机制研究

采用绿脓杆菌ＭＳＨＡ菌毛株菌苗（ＰＡ－ＭＳＨＡ菌苗）治疗了４０例使用抗生素无效的ＲＵＴＩ,取得了满意的疗效,有效率９５％（３８／４０）,治愈率９２．５％（３７／４０）。对其中１８例进行了治疗前后血清抗ＭＳＨＡ菌毛株抗体效价和外周血Ｔ淋巴细胞亚群测定。疗后患者血清中抗ＭＳＨＡ菌毛株抗体效价较疗前增高８～６４倍;同时外周血Ｔ淋巴细胞亚群的比例得到了改善,ＣＤ３＾＋和ＣＤ４＾＋Ｔ细胞的百分率显著提高（Ｐ〈０．０１）,而ＣＤ８＾＋Ｔ细胞的百分率则显著下降（Ｐ〈０．００１）。治疗过程未见明显的副作用。研究表明：ＰＡ－ＭＳＨＡ菌苗对反复发作性尿路感染治愈率高,安全可靠,患者的免疫低下状态得到改善,且对多种病原菌（包括革兰阴性杆菌及其Ｌ型、金黄色葡萄球菌及其Ｌ型）所致的ＲＵＴＩ效果都很好。     

玉米雌穗离体培养诱导孤雌生殖结实

离体条件下,用１６种不同的玉米材料未授粉的雌穗进行整个直插或切段直插培养。培养在２８℃培养箱和室内散射光下,其培养基为：ＭＳ＋０．１ｍｇ／Ｌ２,４－Ｄ＋２ｍｇ／ＬＮＡＡ＋２ｍｇ／ＬＫＴ＋５００ｍｇ／ＬＬＨ＋４％蔗糖＋０．６％琼脂（ＰＨ５．８）和ＭＳ＋０．０５ｍｇ／Ｌ２,４－Ｄ＋２ｍｇ／ＬＮＡＡ＋２ｍｇ／ＬＫＴ＋４％蔗糖＋０．６％琼脂（ＰＨ５．８）。从未授粉的雌穗（成熟胚囊期）获得结实。这些种子萌发     

神经激肽A注入大鼠外侧风状核或中缝大核产生的镇痛效应

本工作采用核团内微量注射的方法,以甩尾反向潜伏期（ＴＦＬ）为痛阈指标,在线麻状态下的大鼠上,对神经激肽Ａ（ＮＫＡ）在我侧网状核（ＬＲＮ）和中缝大核（ＮＲＭ）中的作用作了探讨。研究结果表明,ＮＫＡ（０．５μｇ／０．５μｌ）注入ＬＲＮ后的１０ｍｉｎ内大鼠ＴＦＬ明显延长（ｎ＝１２,Ｐ〈０．００１）,同样剂量ＮＫＡ注入ＮＲＭ后的５ｍｉｎ内,ＦＴＬ也明显延长ｎ＝１３,Ｐ〈０．００１）,提示ＮＫＡ可能是ＬＲＮ     

金黄色葡萄球菌抗体在诊断金黄色葡萄球菌L型败血症中的意义

目的：探讨测定金黄色葡萄球菌（简称金葡菌）抗体在金葡菌Ｌ型败血症中的意义。方法：金葡菌Ｌ型败血症的细菌诊断组３８例,临床诊断组４６例及对照组４１例的血清做试管定量凝集反应测定其效价。并以金葡菌细菌型和Ｌ型分别感染动物,停止感染两个月后测定抗体滴度。结果：以１：８０以上作为阳性,阳性率细菌诊断组９４７％、临床诊断组８６９％、而对照组仅１４６％。细菌诊断组及临床诊断组均明显高于对照组（Ｐ〈０００５）,而细菌诊断组与临床诊断组比较无显著差异（Ｐ〉００５）。结论：金葡菌抗体在金葡菌Ｌ型败血症中具有快速的病原学辅助诊断作用。     

结核菌L型感染与无反应性结核病关系的研究

本文应用改良抗酸染色及免疫组织化学染色等方法对４２例非特异性炎、肉芽肿性炎及肿瘤进行抗酸及免疫组化染色,观察抗酸菌Ｌ型感染与无反应性结核病的关系进行了初步研究。抗酸染色结果阳性率为８０．９５％;免疫组化染色为７８．５７％。     

Overlooked Risk for Chronic Kidney Disease after Leptospiral Infection: A Population-Based Survey and Epidemiological Cohort Evidence

Background

Leptospirosis is the most widespread zoonosis. Chronic human infection and asymptomatic colonization have been reported. However, renal involvement in those with leptospira chronic exposure remains undetermined.

Methods and Findings

In 2007, a multistage sampling survey for chronic kidney disease (CKD) was conducted in a southern county of Taiwan, an area with a high prevalence of dialysis. Additionally, an independent cohort of 88 participants from a leptospira-endemic town was followed for two years after a flooding in 2009. Risks of CKD, stages of CKD, associated risk factors as well as kidney injury markers were compared among adults with anti-leptospira antibody as defined by titers of microscopic agglutination test (MAT). Of 3045 survey participants, the individuals with previous leptospira exposure disclosed a lower level of eGFR (98.3±0.4 vs 100.8±0.6 ml/min per 1.73 m², P<0.001) and a higher percentage of CKD, particularly at stage 3a-5 (14.4% vs 8.5%), than those without leptospira exposure. Multivariable linear regression analyses indicated the association of leptospiral infection and lower eGFR (95% CI -4.15 to -1.93, P < 0.001). In a leptospiral endemic town, subjects with a MAT titer ≥400 showed a decreased eGFR and higher urinary kidney injury molecule–1 creatinine ratio (KIM1/Cr) level as compared with those having lower titers of MAT (P<0.05). Furthermore, two participants with persistently high MAT titers had positive urine leptospira DNA and deteriorating renal function.

Conclusions and Significance

Our data are the first to show that chronic human exposure of leptospirosis is associated significantly with prevalence and severity of CKD and may lead to deterioration of renal function. This study also shed light on the search of underlying factors in areas experiencing CKD of unknown aetiology (CKDu) such as Mesoamerican Nephropathy.     

恶性淋巴瘤组织切片中结核菌L型的检出及其意义

本文应用Ｉｎｔｅｎｓｉｆｉｅｄｋｉｎｙｏｕｎ（ＩＫ）改良抗酸染色和结核菌抗休免疫组织化学染色检测了５１例恶性淋巴瘤组织功片内结核菌及其Ｌ型感染率。结果发现５１例恶性淋巴瘤组织功片中,ＩＫ染色阳性２５例（４９％）,免疫组化染色阳性２６例（５０．９％）,并发现结核菌Ｌ型感染与恶性淋巴瘤的疗效有关（Ｐ＜０．０１）。故认为恶性淋巴瘤中,结核菌Ｌ型感染是一个值得进一步研究的课题。     

金黄色葡萄球菌L型的药敏试验分析

本文从血液和骨髓标本中分离出的金黄色葡萄球菌Ｌ型,分别用Ｌ型平板和ＭＨ平板做药敏试验,结果显示庆大霉素（ＧＥＮ）、氯霉素（ＣＭＰ）、红霉素（ＥＲＹ）、氧哌青霉素（ＰＩＰ）、卡那霉素（ＫＡＮ）、万古霉素（ＶＡＮ）在ＭＨ平板上比在Ｌ型平板上的药物敏感率高,耐药中低（Ｐ＜０．０５）;而氨苄青霉素（ＡＭＰ）、羧苄青霉素（ＣＡＲ）、先锋霉素（ＣＥＦ）、丁胺卡那霉素（ＡＫＮ）、氟哌酸（ＦＰＡ）、先锋必（ＥＦＯＢＩＤ））、螺旋霉素（ＳＰＩ）药物敏感中比Ｌ型平板上低,耐药率高（Ｐ＜０．０５）。苯唑青霉素（ＯＸＡ）、菌必治（ＲＯＣ）、利福平（ＲＩＦＰ）、麦迪霉素（ＭＩＤ）则在两种培养基上的敏感和耐药率基本相同（Ｐ＞０．０５）。     

尿路感染患者尿中细菌L型培养的意义

目的通过对尿路感染患者尿标本中的细菌（普通型和L型）检测,以确定L型菌检测的临床价值。方法采用一般培养法和特殊（L型菌）培养法对临床标本检测。结果364份标本中一般培养法检出细菌112株,阳性率为30．8％,而特殊培养法共培养细菌及L型菌共162株,细菌总检出率为44．5％,其中单独检出L型菌50株。结论细菌在一定条件下可演变成L型菌,增加临床标本中L型菌的培养可明显提高尿路感染的细菌阳性检出率。     

钩端螺旋体外膜疫苗的反应性和免疫效果研究

对国内首次研制的钩端螺旋体外膜疫苗接种人体的反应性,血清学效果和流行病学效果进行研究。先后对两价（含黄疸出血群赖型,七日热群七日热型）,三价（含黄疸出血群赖型,七日热群七日热型,流感伤寒群流感伤寒型,五价（含黄疸出血群赖型,七日热群七日热型,流感伤寒群流感伤寒型,秋季热群秋季热型,犬群犬型）外膜疫苗,菌体疫苗和安慰剂,分组进行全身和局部反应观察;并以显微镜凝集试验测定各型抗体;对两价外膜疫苗进行流行病学保护效果考核。结果两价和多价钩体外膜疫苗反应轻微,安全性良好;血清学效果显示,抗体阳转率和滴度均高于同期相应菌体疫苗诱导的同型抗体水平2倍以上,提示外膜疫苗有较好的免疫原性,流行病学效果在湖北省荆州和石首两市考核,按血清学阳性病例统计,其保护率可达95．57％以上。说明上述疫苗性质稳定,反应轻微,安全性良好,血清学效果理想,两价疫苗有较好的保护效果,可以逐步推广应用。     

子宫内膜细菌L型感染与不孕症的关系

本文通过426例不孕症患者子宫内膜的病原学检查和免疫组织化学研究,发现①83.1%的患者有细菌L型感染;②主要表现为间质性子宫内膜炎(P<0.01);③内膜炎症和L型菌对精子的粘附和破坏作用可导致受孕率降低。     

Aseptic meningitis caused by Leptospira spp diagnosed by polymerase chain reaction

Leptospirosis is a zoonotic disease caused by the pathogenic Leptospira spp. The clinical presentations are diverse, ranging from undifferentiated fever to fulminant disease including meningeal forms. The neurological leptospirosis forms are usually neglected. The aim of this study was to investigate leptospirosis as the cause of aseptic meningitis using different diagnostic techniques including the polymerase chain reaction (PCR). Thirty-nine cerebrospinal fluid (CSF) samples from patients presenting with meningeal abnormalities, predominance of lymphocytes and negative results by traditional microbiological tests were processed by leptospiral culture, anti-leptospiral antibody response and PCR. Leptospira spp DNA was detected in 23 (58.97%) of the CSF samples. Anti-leptospiral antibodies were found in 13 (33.33%) CSF samples. Twelve CSF samples were positive by PCR assay and negative by microscopic agglutination test (MAT) assay. Two CSF samples were positive by MAT and negative by PCR. The positive and negative agreement between both tests was 11 and 14, respectively. CSF samples from six cases of unknown diagnosis were positive by PCR assay. Eight cases showed positive results using PCR and MAT. Leptospirosis could be detected by PCR assay from the 3rd-26th day after illness onset. The sensitivity of the PCR was assessed with confirmed cases of leptospirosis (by MAT) and found to be 89.5%. All CSFs were negative by culture. PCR was found to be a powerful tool for diagnosing meningitis cases of leptospirosis. We recommend that it may be used as a supplementary diagnostic tool, especially in the early stages of the disease, when other diagnostic techniques such as serology are not sensitive.     

Eltor型霍乱弧菌L型的诱导及形态学观察

本文主要介绍Eltor型霍乱弧菌在液体和固相的青霉素诱导下形成L型的过程及其菌落和菌体的形态学改变。Eltor型霍乱弧菌在被诱导3—5次即可出现典型的L型菌落。本试验共诱导10次,获得稳定的L型菌株,菌落形态除油煎蛋样外,还可见到双重心样菌落、靶环样菌落、纤维型菌落。菌体的正常状态为徽弧状,经青霉素作用后,微弧状消失,膨大变直,继尔变成杆状和杆状长链。菌落中心多为相互盘绕、交织成网状的丝状体。