支原体肺炎(mycoplasma pneumoniae pnenmonia,MPP)是由肺炎支原体(Mycoplasma pneumoniae,MP)引起的肺炎.MPP起病缓,有发热、阵发性刺激性咳嗽,少量黏液性或黏液脓性痰.MPP多发于儿童或青少年,占肺炎总数的15％～30％[1].大多数MPP患儿血液中单核细胞百分比高于正常值(3.5％～7.9％),可达65.3％,这是否提示具有肺炎症状且伴有单核细胞增多的患儿为MP感染.为此,我们对2000-2011年住院治疗的MPP患儿的临床资料进行分析,报告如下.

目的探讨外周血单核细胞增多与儿童肺炎支原体肺炎(MP)的临床特点及治疗转归。方法我科收治住院治疗的儿童肺炎支原体肺炎539例临床资料进行分析。结果 539例支原体肺炎,治疗给予阿奇霉素10mg/kg.d,静滴,539例患儿中有10例用药不满意,临床症状改善不明显,有2例患儿遗留左上肺叶肺不张,另529例(98.1%)预后良好。结论临床上MP感染的表现可为多样性,465例(86.2%)在MP感染中,外周血单核细胞增高出现时间早,增高的比例往往与MP-IgM阳性比呈正相关,单核细胞增多是否参与细胞免疫反应,有待进一步研究探讨。

Objective:To investigate the drug sensitivity of mycoplasma pneumoniae isolated from patients.Methods:Samples of throat swab were cultivated in selective culture medium,and then they were detected by PCR.Mycoplasma pneumoniae were mixed with different quantity of antibiotics.If one drug could kill the microorganism,the color of the media would not change.Results: One clinical mycoplasma pneumoniae type was isolated successfully.When the concentration of azithromycin,erythromycin and cefuroxime sodium were diluted to 31 μg/mL,125 μg/mL,500 μg/mL,respectively,mycoplasma pneumoniae were supressed.Ceftriaxone sodium,mezlocillin and ampicillin had no effect on the growth of mycoplasma pneumoniae.Conclusions: The growth of mycoplasma pneumoniae isolated from throat swab samples is inhibited easily by azithromycin.Erythromycin and cefuroxime sodium also had inhibitory effect on mycoplasma pneumoniae.

目的通过对新生儿高胆红素血症的病因分析,探讨新生儿高胆红素血症的防护措施。方法选取150例新生儿高胆红素血症住院患儿的临床资料进行回归性分析归纳。结果早发型母乳性黄疸51例,占34%;ABO血型不合溶血27例,占18%;感染因素24例,占16%;围生期因素21例,占14%;其他因素27例,占18%。结论新生儿高胆红素血症病因与诊治护理非常重要,通过寻找危险因素并在新生儿没有出现黄疸之前通过针对性预防护理措施能有效降低高胆红素血症的发生率。

Human cytomegalovirus glycoprotein complex II (gC II) consists of two glycoproteins, gM and gN. Although gC II specific IgG purified from HCMV positive patient sera can neutralize HCMV, there has been no report on the generation of virus-neutralizing antibodies by immunizing with one epitope of gM. The epitope, termed MAD, was screened from random phage peptide library by subtractive strategy. The peptide sequence of MAD was highly homologous with 32 similar to 38 amino acids of HCMV gM. Mice immunized with MAD coupled with keyhole limpet hemocyanin (KLH) could produce specific antibodies against MAD, and the antibodies obtained could bind not only native HCMV particles, but also the recombinant gM30 similar to 78 peptide. ELISA analysis results showed that MAD could specifically bind HCMV-positive human serum samples. Virus-neutralizing assay results demonstrated that the antibodies against MAD could inhibit HCMV strain AD169 entering the human embryonic lung cells. The results suggested that MAD could be used as a new potential protective antigen in the development of HCMV vaccine.

We identified the critical amino-acid residues in antigen M derterminant (MAD) epitope of human cytomegalovirus protein M. On the basis of the peptide sequence of MAD, some conservative residues were mutated into the glycine residue. Then the gene fragment of mutants linked to amino terminal of Fc were cloned into the plasmid pET32-Fc and expressed by fusion with Fc. After purified by protein A affinity chromatography, the activity of mutants binding the goat polyclonal antibodies against human cytomegalovirus (HCMV) were detected by ELISA and Western blotting. Our results showed that when glutamine residue was mutated into glycine residue, the activity of MAD(Q --> G) binding the goat polyclonal antibodies against HCMV was reduced apparently. Other mutants did not have the same characteristics. The activity of MAD was closely related to the conformation of glutamine residue.

Objective:To clone and express the epitope AD1 and AD2 of HCMV glycoprotein B(gB) in Escherichia coli,to purify the expression product and to detect sera from HCMV positive patients by ELISA assay for further clinical study.Methods:AD1 and AD2 genes were cloned by PCR using HCMV genome DNA as template and the recombinant expression vectors pET32-NusA-AD1 and pET32-NusA-AD2 were constructed.E.coli BL21(DE3)pLysS bearing the plasmids was induced with IPTG for protein production.The proteins NusA-AD1 and NusA-AD2 were purified by Ni2+ affinity chromatography and used to detect HCMV positive human sera by ELISA method.Results: The recombinant antigens NusA-AD1 and NusA-AD2 were expressed solubly.Of eight HCMV-IgG positive serum samples,five were found positive by NusA-AD1,and six were positive by NusA-AD2.Conclusion: Most HCMV positive human sera could be detected by recombinant antigens NusA-AD1 and NusA-AD2.