流行病学,分子

摘要： 目的 探讨烧伤患者感染肺炎克雷伯菌对碳青霉烯类抗生素高水平耐药的分子机制.方法 采用回顾性分析方法,收集南昌大学第一附属医院2014年7月至2015年6月烧伤患者分离的非重复碳青霉烯类耐药肺炎克雷伯菌(CR-KP)18株.测定菌株最低抑菌浓度(MIC),对菌株进行特异性PCR扩增和序列分析、质粒接合试验、Southern杂交以及外膜蛋白分析.多位点序列分型(MLST)分型技术和脉冲场凝胶电泳(PFGE)分析菌株同源性.结果 药敏试验显示所有碳青霉烯类耐药肺炎克雷伯菌(CR-KP)具有多重耐药,对哌拉西林/他唑巴坦、头孢曲松、左氧氟沙星、环丙沙星、庆大霉素、妥布霉素、头孢替坦、头孢他啶、头孢吡肟、氨曲南、亚胺培南、美罗培南全部耐药,耐药率100％(18/18);对替加环素、复方新诺明、阿米卡星对耐药率分别为0％(0/18)、61.1％(11/18)、72.2％(13/18).接合试验可使受体菌大肠埃希菌J53对碳青霉烯的MIC值从≤0.0625或0.125μg/ml上升到16或32μg/ml.特异性PCR扩增和序列分析发现18株产NDM-1菌株,5株KPC-2菌株.接合试验证实blaNDM-1可以通过质粒传播.Southern杂交显示blaNDM-1基因定位于46Kb大小的质粒上,质粒复制子分型显示为IncX3型.PFGE共7种细菌基因型,而MIST分型发现18株CR-KP分别属于ST11、ST395、ST17、ST37、ST263、ST14和ST76型.外膜蛋白的SDS-PAGE和ompK35/36基因序列分析发现ST11、ST395和ST37型CR-KP菌株OmpK36膜孔蛋白缺失,而其他ST分型菌株OmpK36膜孔蛋白表达量降低.结论 本院烧伤患者分离的肺炎克雷伯菌对碳青酶烯类药物高水平耐药的主要机制是质粒介导的NDM-1型金属β-内酰胺酶的产生合并OmpK36膜孔蛋白表达降低或缺失,并且发现了同时携带NDM-1和KPC-2种碳青霉烯酶的肺炎克雷伯菌.%Objective To investigate the antimicrobial resistant mechanisms of high level carbapenem resistant Klebsiella pneumoniae infection of burn patients .Methods A retrospective study was conducted on totally 18 non-repetitive high level CR-KP which were isolated from burn patients hospitalized between July 2014 and June 2015.MIC of antibiotics were determined by using the GN 13 cards and agar dilution method.The specific PCR and DNA sequence analysis were performed to confirm the β-lactamase type.Plasmid conjugation transfer experiments and southem hybridization were applied to study the mode of carbapenem resistance transmission .Outer membrane proteins ( Omps) were isolated and examined by PCR and ( sodium dodecyl sulfate polyacrylamide gel electrophores ) SDS-PAGE.Pulsed-field gel electrophoresis( PFGE ) and Multilocus sequence typing ( MLST ) was used to determine the genotypes . Results Susceptibility of antimicrobial agents indicated that all these strains with multiple drug resistance . The resistance rate to piperacillin/tazobactam, ceftriaxone, levofloxacin, ciprofloxacin, gentamicin, tobramycin, cefotetan, ceftazidime, cefepime, aztreonam, imipenem, and meropenem was 100％ (18/18).Moreover, the resistance rate of CR-KP isolates to amikacin was 72.2％ ( 13/18 ) , compound sulfamethoxazole was 61.1％(11/18), tigecycline was 0％(0/18).Conjugation study with Escherictda coli J53 resulted in the transfer of significant reduced carbapenem susceptibility from donors (MICs increased at least 8-fold).By PCR, eighteen strains of Klebsiella pneumoniae carried NDM-1 gene, 5 strains carried KPC-2 gene.The blaNDM-1 was transferable by plasmids.Southern blot hybridization indicated that the blaNDM-1 gene was located on plasmid in size of 46 kb.The plasmid belonged to incompatibility group IncX 3.Seven types of CR-KP were detected by PFGE.In addition, MLST assigned them to sequence type ( ST)11, ST395, ST17, ST37, ST263, ST14 and ST76 types.SDS-PAGE and ompK35/36 genes sequence analysis of Omp indicated that there was absence of outer membrane proteins OmpK 36 in ST11, ST395, ST37 strains.However, the other STs strains expressed lower quantities of OmpK 36.Conclusions High level carbapenem resistance in K.pneumoniae causing infection in burn patients is attributable to production of plasmid-mediated metallo· β-laetamase NDM-1 combined with porin OmpK36 deficiency or low expression .The K.pneumoniae with NDM-1 and KPC-2 carbapenemase were detected .

摘要： 目的 回顾性分析2011年浙江省内碳青霉烯类耐药肺炎克雷伯菌(carbapenem resistant K lebsiella pneumoniae,CRKP)的分布、分子流行病学特征及耐药基因的携带情况.方法 选取浙江大学医学院附属邵逸夫医院保存的收集于2011年浙江省内9家医院临床标本中分离的肺炎克雷伯菌772株,采用纸片法和微量肉汤稀释法进行药物敏感试验,PCR检测耐药基因,多位点序列分型和脉冲场凝胶电泳进行分子分型.结果 9家医院共筛选到CRKP 48株(6.2%),PCR结果显示有39株携带碳青霉烯类耐药基因,其中37株携带blaKPC-2基因(77.1 %),2株携带blaIMP-4基因.多位点序列分型结果显示ST11为主要ST型(30株,62.5 %),脉冲场凝胶电泳显示48株肺炎克雷伯菌可分为15个克隆型.除温州、嘉兴和绍兴的临床菌株中未分离到碳青霉烯类耐药肺炎克雷伯菌之外,其余6家医院均有此类耐药菌分布.结论 2011年CRKP在浙江省内大部分地区均有分布,产KPC-2型碳青霉烯酶是肺炎克雷伯菌最主要的碳青霉烯类耐药机制,ST11为最流行的ST型.%Objective To retrospectively investigate the distribution,molecular epidemiology and carbapenemases-encoding genes of carbapenem resistant K lebsiella pneumoniae(CRKP)in Zhejiang Province.Methods A total of 772 clinical isolates of K.pneumoniae isolated from 9 hospitals in Zhejiang Province in 2011 were selected,and antimicrobial susceptibility testings were carried out with disk diffusion or broth microdilution method.Polymerase chain reaction(PCR)was used to detect resistant genes,and molecular typing was performed by multilocus sequence typing(MLST)and pulsed field gel electrophoresis(PFGE).Results A total of 48 CRKP(6.2%)were screened in 9 hospitals. Carbapenemase-encoding genes were detected in 39 isolates by PCR,among which 37(77.1%)were identified as blaKPC-2and 2 were blaIMP-4.MLST showed that ST11 was the dominant ST type(30, 62.5%).Results of PFGE showed that 48 CRKP can be divided into 15 types.CRKP was found in 6 hospitals except hospitals in Wenzhou,Jiaxing and Shaoxing.Conclusions In 2011,CRKP is distributed in most areas of Zhejiang Province.The production of KPC-2 is the most important carbapenem resistance mechanism and ST11 is the most prevalent ST type.

摘要： 目的 了解广东省HIV-1 CRF07_BC病毒株gag-pol基因的遗传变异特征.方法 收集广州市第八人民医院2015年2月至9月78例CRF07_BC基因亚型HIV感染者抗病毒治疗前血浆,提取病毒RNA,反转录套式PCR扩增并拼接获得病毒gag和pol区基因序列.对获得的序列进行进化树、基因离散率、核苷酸多态性、选择压力和变异特征分析.结果 人群主要传播途径为同性传播(80.77％,63/78),gag-pol基因进化树分成两个亚簇,不同传播途径毒株没有完全成簇聚集.gag基因平均基因离散率及平均熵值均大于pol基因.gag基因的p17区和p6区的平均基因离散率及平均熵值均大于p24区;pol基因的pr区平均基因离散率及平均熵值均大于rt区.gag和pol基因的平均ds/dn值均＞1.将GAG区共享序列与选取的我国常见HIV相关抗原表位(A2、A11、B39、B60两个、Cw1、Cw3、Cw8)比较,发现P17区CTL抗原表位突变多于P24区CTL抗原表位.表位保守率分别为26.92％、0、1.28％、0、96.15％、82.05％、84.62％和98.72％.对pol区基因序列进行HIV耐药性分析,耐药突变发生率为2.56％(2/78).结论 广东省CRF07_BC毒株的gag和pol基因均发生突变.gag基因变异度大于pol基因,且gag基因的变异主要体现在p17和p6区;gag和pol基因均受负向选择压力;P17蛋白CTL抗原表位变异度大于P24蛋白抗原表位;耐药突变发生率低于警戒线,可以继续监测耐药毒株传播情况.%Objective To investigate the genetic variations of gag-pol gene in human immunodeficiency virus-1(HIV-1) CRF07_BC strain in Guangdong Province.Methods From February to September in 2015,plasma samples of 78 cases with HIV 1 CRF07_BC infection in Guangdong were collected before antiretroviral treatment.Viral RNA was extracted from plasma.Gene (gag and pol) sequences were amplified by reverse transcriptase and nested-PCR using specific primers.Phylogenetic tree,genic dispersion rate,nucleotide polymorphism,selection pressure and variation characteristics were analyzed.Results The main transmission route of the enrolled patients was homosexual transmission (80.77％,63/78).The gag pol gene phylogenetic tree was divided into two sub-clusters.The strains from different transmission routes were not in cluster.The average genetic dispersion rate and average entropy of gag gene were both higher than those of pol gene.The average genetic dispersion and average entropy of p17 and p6 regions of gag gene were both higher than those of p24.The average genetic dispersion and average entropy of pol gene were higher than those of rt region.The average ds/dn values of gag and pol genes were greater than one.Compared with the common HIV-related antigenic epitopes (A2,A11,B39,B60,Cw1,Cw3,Cw8),the cytotoxic lymphocyte (CTL) epitope mutations in the P17 region were more in the consensus of GAG region than those in the P24 region.The epitope conserved rates were 26.92％,0,1.28％,0,96.15％,82.05％,84.62％ and 98.72％,respectively.The drug resistance rate of pol gene was 2.56％ (2/78).Conclusions The gag and pol genes of CRF07_BC strain in Guangdong are all mutated.Diversity of gag gene is greater than that of pol gene,and gag gene variation is mainly in p17 and p6 regions.gag and pol genes are both affected by negative selection pressure.P17 protein CTL epitope variability is greater than P24 protein epitope.The prevalence of drug resistance mutation is lower than the threshold.It's important to monitor the spread of drug-resistant strains.

摘要： 目的 了解云南省腾冲市入境人群中HCV基因型的流行特点和流行规律,分析其可能的传播途径,为HCV防治提供理论依据.方法 2009年6月至2016年6月腾冲市入境人群抗HCV阳性样品54份,采用反转录PCR进行NS5B片段扩增和测序,并对序列进行同源关系分析确定基因型.结果 腾冲市入境人群中HCV感染率为0.45％(54/12 059).其中,45例样本获得有效分型,该人群中以3b为主要亚型,占28.89％(13/45),其他亚型依次为6n(20.0,9/45)、1b(17.78％,8/45)、3a(13.33％,6/45)、2a (11.11％,5/45)、1a(2.22％,1/45)、6a(2.22％,1/45).缅甸籍入境人群主要以6型为主,而中国感染者以1型为主.该人群中6型流行株同时与中国流行株和东南亚流行株显示紧密亲缘关系;3型则全部与国内流行毒株形成紧密簇.结论 云南省腾冲市入境人群中的HCV基因型分布可能受到云南本地与邻近国家的双重影响.该人群作为HCV传播的媒介和桥梁,可能影响腾冲及周边HCV流行特征.%Objective To investigate the characteristics of epidemic and genotype/subtype distribution of hepatitis C virus (HCV) among entry travelers at Tengchong port,to provide references for HCV prophylaxis and treatment.Methods A total of 54 serum samples were collected from anti-HCV positive travelers at Tengchong port from June 2009 to June 2016.HCV NS5B gene was amplified using reverse transcription polyonerase chain reation (RT-PCR) and subsequently sequenced.Based on the obtained sequences and retrieved reference sequences,phylogenetic analysis was conducted to determine HCV genotype/subtype.Results HCV infection rate among entry travelers at Tengchong ports was 0.45 ％ (54/12 059).Forty five samples were successfully genotyped.Phylogenetically,HCV genotype 3b was revealed to be the predominant subtype (28.89 ％,13/45) in this population,followed by genotype 6n (20.0％,9/45),genotype 1b (17.78％,8/45),genotype 3a (13.33％,6/45),genotype 2a (11.11％,5/45),genotype 1a (2.22％,1/45) and genotype 6a (2.22％,1/45).The major genotype in Myanmar travelers was genotype 6,while in Chinese population,genotype 1 predominated.Genotype 6 in the population showed close phylogenetic relationship with strains prevalent in China and Southeast Asia.Genotype 3 was closely clustered with strains prevalent in China.Conclusions The distribution of HCV genotypes among entry travelers at Tengchong port is impacted by HCV epidemic strains both in Yunnan province and neighboring regions.This population serves as a transmitting media which may influence the epidemiological characteristics of HCV in Tengchong and neighboring areas.

摘要： 目的：初步了解沧州市结核分枝杆菌临床分离株的基因多态性和分子流行病学特征，探讨各基因型与表型耐药之间的关系。方法收集结核病患者经临床分离培养得到的结核分枝杆菌菌株及相应病例信息，提取菌株DNA，采用间隔区寡核苷酸基因分型法进行基因分型研究，采用BACTECTMMGITTM960液体培养技术进行一线抗结核药物敏感试验。运用BioNumerics 5.0软件进行聚类分析，运用Graphpad Prism 5.0软件进行数据分析。结果154例患者中男109例，女45例；初治121例，复治33例；34例有吸烟史，12例合并糖尿病。48株（31.2%）至少对链霉素、异烟肼、利福平、乙胺丁醇中的1种药物耐药。复治患者的耐药率（63.6%）显著高于初治患者耐药率（22.3%）。典型北京型菌株占所有菌株的91.6%，非典型北京型菌株占8.4%。典型北京型与非典型北京型在患者性别、治疗情况、吸烟史、糖尿病史及耐药分布上的差异均无统计学意义。结论沧州市结核分枝杆菌呈现明显的基因多态性。典型北京型菌株是该地区的优势菌株，且基因型与耐药性无关。%Objective To identify the genetic polymorphism and molecular epidemiological characteristics of Mycobacterium tuberculosis (TB) clinical isolates in Cangzhou, and explore the association between genotypes and drug resistance phenotypes. Methods Mycobacterium tuberculosis isolates were collected from TB patients treated in the Cangzhou Infectious Disease Hospital, and corresponding clinical data were also collected. The genomic DNA was extracted. Spacer oligonucleotide typing (spoligotyping) was applied to genotype the isolates. Drug susceptibility testing of first-line anti-TB drugs (streptomycin, isoniazid, rifampin, ethambutol) was performed using the BACTECTMMGITTM960 liquid medium. Cluster analysis was done by BioNumerics 5.0. Data was analyzed by Graphpad Prism 5.0 software. Results Of the 154 patients, 109 were male and 45 were female. And 121 patients were treated for the first time, 33 were retreatment, 34 had smoking history, 12 were complicated with diabetes mellitus. Fourty-eight strains (31.2%) were resistant to at least one of streptomycin, inoniazid, rifampicin and ethambutol. Initial drug resistance rate was 22.3%and acquired drug resistance rate was 63.6%. The drug resistance rate was significantly higher in retreatment patients than that of new cases. The Beijing family strain accounted for 91.6% of all isolates and the non-Beijing family strain accounted for 8.4%. There were no significant differences in gender, treatment history, smoking history and diabetes history between patients with the Beijing genotype and patients with non-Beijing genotype. Conclusion Mycobacterium tuberculosis in Cangzhou exhibits high genetic diversity. The Beijing genotype is the predominant no association with drug resistance.

摘要： 目的:了解浙江省台州市HIV共感染夫妻(以下简称“双阳夫妻”)双方危险行为及行为网络特征,判断双方HIV传播关系.方法:以2008至2011年期间浙江省台州市艾滋病疫情报告中双阳夫妻为研究对象,分别调查双阳夫妻各自在HIV诊断前艾滋病相关危险行为及行为网络信息.综合危险行为及行为网络、流行病学信息和分子生物学结果判断双阳夫妻间HIV传播关系.结果:共有27对双阳夫妻纳入本次研究,HIV基因亚型以CRF01_AE (61.1％)为主.男性(88.9％,24/27)报告多性伴比例高于女性(37.0％,8/27).共有20对双阳夫妻仅一方报告有多性伴(其中17例为男性配偶,3例为女性配偶).综合行为学和分子生物学信息判断,20对双阳夫妻存在直接HIV传播,4对存在潜在的HIV传播,3对不存在HIV互相传播即存在不同的HIV感染来源.另外,在27个行为网络中,有4个网络共6例未接受抗病毒治疗的HIV感染者存在HIV耐药(即原发性耐药),其中2对双阳夫妻存在HIV耐药传播.结论:台州市HIV双阳夫妻双方感染HIV的病毒株亚型呈现多样性,CRF01 _AE是主要类型.一方高危行为感染后经婚内性传播是夫妻人群感染HIV的主要模式.个别HIV感染个体存在原发性耐药,并提示存在夫妻间HIV耐药传播的潜在风险.因此,建议在婚前向配偶双方同时提供HIV检测和咨询服务,以减少夫妻间HIV二代传播.

摘要： Objective To investigate the feature of antimicrobial resistance,homology and other molecular epidemiology of methicillin-resistant staphylococcus aureus(MRSA) in Department of Critical Care Medicine (ICU).Metoods From October 2010 to December 2011,149 strains of MRSA were collected and identified through sputum culture of patients from 10 ICUs of 10 teaching hospitals distributed in 9 chinese central city of China.Susceptibility testing to 18 kinds of antibiotic was performed,the method of pulsed field gel electrophoresis (PFGE) was used to analyze the homology,and the technique of multilocus sequencing typing (MLST) was used to identify the sequence type (ST).Results Antibiotic susceptibility testing implied that vancomycin,daptomycin and linezolid are 100％ sensitive to collected 149 strains of MRSA.Cotrimoxazole resistance rate is about 0-11.1％.Rifampicin resistant rate was less than 25％ in 2 hospitals;the resistance rate of gentamicin and moxifloxacin were more than 80％ besides of 50％ to70％ in 3 hospitals;beta lactam resistant rate was 100％.In 149 strains of MRSA,the main types of PFGE were J (28.9％),C (19.5％),G (10.7％),F (8％) types.J,C,G types mainly distributed in the North,while the F type only distributed in the Guiyang region.The MLST type:8 ST types were determined ultimately.In which,was dominated by ST-239 (67 strains,45％),distributed in the South and North;followed by ST-5 (54 strains,36.2％),mainly in the Northeast region (x2 =26.42,P ＜ 0.01).Conclusions Vancomycin,daptomycin and linezolid are 100％ sensitive drugs to MRSA in ICU;Higher regional homology for MRSA were observed and it is probably that homologic disseminated infection exited in ICU.It is necessary to enhance continuous monitoring and take effective nosocomial infection control action to avoid MRSA homologic outbreak.%目的 了解重症医学科(ICU)内耐甲氧西林金黄色葡萄球菌(MRSA)的耐药性、同源性等分子流行病学特点.方法 收集鉴定2010年10月至2011年12月全国10家医院ICU患者痰培养的MRSA菌株149株.检测其对18种抗菌药物的耐药性,利用脉冲场凝胶电泳(PFGE)技术进行同源性分析,并应用多位点序列分析(MLST)技术进一步进行序列型(ST)分型.结果 149株MRSA对万古霉素、达托霉素及利奈唑胺100％敏感,复方新诺明耐药率约在0～11.1％之间;利福平在2家医院耐药率＜25％;庆大霉素、莫西沙星的耐药率除3家在50％ ～ 70％外均在80％以上;β-内酰胺类的耐药率高达100％.149株MRSA中,PFGE主要型别为J(28.9％)、C(19.5％)、G(10.7％)、F(8.0％)4型,J、C、G3型主要分布在北方地区,而F型只分布在贵阳地区.MLST分型:最终确定了8个ST型别,其中以ST-239为主(67株,45.0％),在南北方均有分布;其次为ST-5(54株,36.2％),主要分布在东北地区(X2=26.42,P＜0.01).结论 ICU内MRSA对万古霉素、达托霉素及利奈唑胺仍100％敏感;MRSA的区域性同源性较高,可能存在同源性播散性情况,需要继续加强监测并采取有效的院感控制措施避免MRSA同源暴发流行.

摘要： Objective To understand the genetic characteristics of wild measles virus in Hubei province during 2008-2012.Methods To collect throat swab specimens from measles outbreak or sporadic cases in Hubei province during 2008-2012,and perform viral isolation using Vero/SLAM cell,then genotype identification and phylogenetic analysis were performed.Results 26 measles virus strains were isolated from clinical specimens collected in the 9 cities in Hubei province from 2008-2012,they all belong to H1a subgenotype within the wild type measles viruses of H1 genotype,no imported genotypes were found.The nucleotide and amino acid identities among 26 measles virus strains of H1 a subgenotype were for 97.1％-100％ and 95.3％-100％,respectively.And compared with the Chinese vaccine strain (Shanghai191 strain),the nucleotide and amino acid identity were 91.8％-92.5％ and 87.4％-90.0％,respectively.Genetic phylogenetic analysis showed that all 26 measles virus strains belong to two different evolutionary branches,represent two transmission chains,and close to the measles virus isolated in other provinces in genetic phylogeny and endemic time.Conclusion H la subgenotype of measles virus continues to spread in Hubei province from 2008-2012,the measles viruses in Hubei province co-evolved with the viruses in other provinces in China.This study provides an important scientific basis for measles elimination in Hubei province.%目的 了解2008-2012年湖北省流行麻疹野病毒的基因特征.方法 采集2008-2012年间麻疹暴发或散发病例的咽拭子标本,使用Vero/SLAM细胞进行病毒分离,并对分离到的麻疹病毒进行基因型的鉴定和基因亲缘关系分析.结果 2008-2012年从湖北省共9个地市采集的339份临床标本中分离到26株麻疹病毒株,均属于麻疹野病毒H1基因型中的H1a基因亚型,未发现输入基因型麻疹病毒.26株H1a基因亚型麻疹病毒株的核苷酸和氨基酸之间的同源性分别为97.1％～100％和95.3％ ～100％.与我国疫苗株(Shanghai191株)相比,其核苷酸和氨基酸同源性分别为91.8％ ～92.5％和87.4％ ～90.0％.基因亲缘性分析结果显示,26株麻疹病毒属于两个不同的分支,为两个不同的麻疹病毒传播链,并与其他省份流行的麻疹病毒在基因亲缘关系和流行时间上都很接近.结论 H1a基因亚型麻疹病毒在湖北省持续传播,湖北省麻疹病毒与我国其他各省流行的麻疹病毒在共同进化.本研究为湖北省控制和消除麻疹工作提供了重要的科学依据.

摘要： 目的 了解男男性行为者(MSM)肛门生殖器部位人乳头瘤病毒(Human papilloma virus,HPV)不同基因型别的流行情况及其临床意义.方法 采取调查问卷方法收集2013年10月至2015年3月在上海市皮肤病医院性病科门诊就诊的301例男男性行为者的临床资料,同时检测其肛门生殖器HPV感染情况.结果 在301患者中,有肛周及肛管内尖锐湿疣(condyloma acuminatum,CA) 164例,同时伴有阴茎尖锐湿疣18例.301份肛周及肛管内脱落细胞标本中HPV阳性检出率为78.7％ (237/301),其中高危型50.5％ (152/301),以HPV16型(143％)和HPV52型(14.3％)最常见;低危型69.1％ (208/301),其中HPV6型43.9％ (132/301)和HPV11型21.6％ (65/301)为常见型别.143例阴茎部脱落细胞标本中HPV阳性检出率为44.8％ (64/143),高危型为20.3％(29/143),以HPV33型(4.9％)最常见;低危型33.6％ (48/143),以HPV11型17.5％ (25/143)最常见.高危型HPV16、HPV33、HPV52、HPV53和HPV56在肛周及肛管的感染率比阴茎部位高(P＜0.05).在16例肛周CA,36例肛管CA、112例肛周肛管CA和22份阴茎部CA标本中,肛周和阴茎部HPV均以单一型感染为主,其中HPV6/11为常见感染型别.肛管CA多重HPV感染为主(88.8％),以HPV16型、HPV52型、HPV56型常见.结论在男男性行为者中,肛周和肛管HPV感染率较高,且肛管CA以混合型HPV感染为主.高危型HPV在肛管感染率比生殖器部位高,筛查MSM肛管HPV感染可为早期防治肛管恶性肿瘤提供依据.

摘要： 目的：了解 HIV-1 CRF01 AE 毒株在我国的分子流行特征。方法计算机检索相关数据库并结合文献追溯的方法提取数据，按地区和研究人群分组进行 Meta 分析，计算 HIV-1 CRF01 AE感染者占不同高危人群的比例。从美国洛斯阿拉莫斯国家实验室 HIV 基因数据库（Los Alamos database）中下载中国地区的 CRF01 AE pol 区基因序列，利用 FastTree2．1构建系统进化树进行成簇分析。根据 BEAST V 1．6．2和 Spread 计算贝叶斯因子分析空间地理传播关联。结果 HIV-1 CRF01 AE 毒株在我国6个地区的 MSM 人群中所占比例均＞45．0％；在东部、北部、西南和中南地区的异性性行为人群中所占比例均＞30．0％；在中南地区的静脉药瘾人群中所占比例最高，为57．3％（95％CI ：35．1％～79．6％）；而输血传播人群仅在中南地区占有较低的比例，为10．6％（95％CI ：6．2％～14．9％）。系统进化分析表明，该毒株在我国形成7个独立的传播簇，其中簇1、3、5主要流行于异性性行为感染人群中，簇2及簇6主要流行于 MSM 人群中，簇4主要流行于性行为感染人群中。簇1～5均在西南地区流行，中南地区主要流行簇7和簇1，北部地区主要流行簇2和簇6，东部地区主要流行簇2和簇4，东北地区主要流行簇6。贝叶斯因子分析结果显示，该毒株在我国东部、中南部、西南部、北部及东北部的省份之间传播关系错综复杂。结论 CRF01 AE 毒株活跃在我国各个地区的多个高危人群中，不同地区之间的传播关联错综复杂。%Objective To understand the molecular epidemiological characterization of human immunodeficiency virus (HIV)-1 CRF01 AE strains in China.Methods Data were extracted by a systematic search in the databases combined with literature review.Data were then grouped according to the sites and risk groups for a Meta-analysis.Sequences of CRF01 AE pol genes from China were downloaded from Los Alamos database to build phylogenetic trees by means of FastTree2.1 .The Bayes factor test was calculated by BEAST V1 .6.2 package and Spread to explore spatial transmission links. Results Meta-analysis demonstrated that CRF01 AE strains accounted for more than 45 .0% of all subtypes among men who have sex with men (MSM)in six areas of China.Among heterosexuals in eastern,northern,southwestern and south-central China,the proportions of CRF01 AE strains exceeded 30.0%. The strains were also prevalent among intravenous drug users in south-central regions, accounting for 57.3% (95 %CI :35 .1 %-79.6%),and were only detected among blood donors in south-central China (10.6%,95 %CI :6.2% - 14.9%).Seven distinct phylogenetic clusters of CRF01 AE strains which were transmitted independently were identified.Clusters 1 ,3 and 5 were prevalent among heterosexuals,while clusters 2 and 6 were found primarily among MSM,and clusters 4 was detected chiefly among sexual contact people.Geographically,clusters 1,2,3,4 and 5 were prevalent in southwestern areas. Clusters 1 and 7 were circulating in south-central areas.Clusters 2 and 6 were prevalent in northern areas,while clusters 2 and 4 were dominant in eastern regions and cluster 6 was prevalent in northeastern China.The Bayes factor test reveals the complexity of transmission links among eastern,south-central,southwestern, northern,and northeastern provinces.Conclusion CRF01 AE strains are prevalent in most high risk groups in multiple regions of China and the transmission between different regions is complicated.

摘要： 公开了一种检测SARS病毒的流行病阶段的方法，该方法包括步骤：检测SARS病毒的核酸序列，与SEQ ID NO：1的序列对比，其中不同的核苷酸突变可表示SARS病毒所处的不同流行阶段(果子狸、早早期、早期、中期I型、中期II型和晚期型)。本发明还公开了具有SEQ ID NO：1的序列并具有上述突变的SARS病毒核酸序列以及用于该方法的试剂盒。

摘要： 本发明涉及医疗数据处理技术领域，具体是基于医疗大数据的关键单病种流行病学分析系统，包括病学分析平台、数据采集模块、病学分析模块、病学数据处理模块、数据应用模块和单病种信息储存模块；所述病学分析平台采用云服务平台，所述数据采集模块用于信息患者信息的采集工作，所述病学分析模块用于患者病理和治疗方法的分析，本发明能够对单病种流行病学进行统一，并规划科研平台，其在使用的过程中，能够对历史数据进行对比，同时设置有不同的数据处理模块，这样不容易出现遗漏病例情况，而且对临床实验和科研所需数据进行收集分类；而且该本发明能够快速的进行病历查找、归档、科研数据收集、个体化治疗的工作。

摘要： 本说明书实施例公开了一种用于流行病学分析的温控显微系统及其操作方法，至少包括：倒置显微镜和精准温控载玻片；精准温控载玻片包括：载玻片基底，温度传感元件，图案化加热层，保护层，以及透明保护罩；在实验时，基于图案化加热层来灵活精准控制温度以观测样品液中微生物在不同温度下的反应，且利用透明保护罩对样品液进行保护，防止样品液被污染，避免实验时样品液中微生物扩散而感染工作人员；鉴于透明保护罩的存在，可基于倒置显微镜近距离对样品液中微生物进行观测，达到更好的观测效果。进而，不需要反复进行温度处理和样品制备，在观察过程中进行精准温度控制，实验手段灵活且加多样化，实验结果更加精确，避免反复制备样品而带来的致病菌感染风险。

摘要： 本发明提供了一种地中海贫血分子流行病学调查信息数据分析方法和系统，其中方法包括：获取患者个人信息并建立与所述个人信息对应的样本编号；将所述样本编号与所述患者的生化检测结果进行关联；所述生化检测结果包括血常规和电泳检测结果，以及基因检测结果；根据所述样本编号导入患者的生化检测结果；调取所述生化检测结果中出现异常结果的患者并进行分析和测序。本发明通过对血常规检测结果、电泳检测结果和基因检测结果三个生化检测结果进行整合，从而进行流行病学的调查和研究，可更好的对地中海贫血进行确诊，为地中海贫血的流行病学研究提供了数据基础。

摘要： 公开了一种检测SARS病毒的流行病阶段的方法，该方法包括步骤：检测SARS病毒的核酸序列，与SEQ ID NO：1的序列对比，其中不同的核苷酸突变可表示SARS病毒所处的不同流行阶段(果子狸、早早期、早期、中期I型、中期II型和晚期型)。本发明还公开了具有SEQ ID NO：1的序列并具有上述突变的SARS病毒核酸序列以及用于该方法的试剂盒。

摘要： 本说明书实施例公开了一种用于流行病学分析的温控显微系统，至少包括：倒置显微镜和精准温控载玻片；精准温控载玻片包括：载玻片基底，温度传感元件，图案化加热层，保护层，以及透明保护罩；在实验时，基于图案化加热层来灵活精准控制温度以观测样品液中微生物在不同温度下的反应，且利用透明保护罩对样品液进行保护，防止样品液被污染，避免实验时样品液中微生物扩散而感染工作人员；鉴于透明保护罩的存在，可基于倒置显微镜近距离对样品液中微生物进行观测，达到更好的观测效果。进而，不需要反复进行温度处理和样品制备，在观察过程中进行精准温度控制，实验手段灵活且加多样化，实验结果更加精确，避免反复制备样品而带来的致病菌感染风险。

摘要： 一种用于流行病学分析的显微成像系统及其载样装置，其中一种用于流行病学分析的显微成像系统，包括显微镜本体，其特征在于，还包括载样装置和载物台；其中，所述载样装置包括载玻片和盖玻片，所述载玻片下表面镀覆第一ITO膜层，第一电极与所述第一ITO膜层电连接；所述盖玻片上表面镀覆第二ITO膜层，第二电极与所述第二ITO膜层电连接；所述载玻片和盖玻片之间设置样品液；所述载物台用于放置所述载样装置，其上表面设置有用于分别与所述第一电极和第二电极电连接的触点；本实用新型能够在显微观察的过程中利用高能电磁杀死细菌，观察其失活过程。

摘要： 本说明书实施例公开了一种用于流行病学分析的温控显微系统，包括：倒置显微镜和精准温控培养皿；精准温控培养皿包括：培养皿主体、盖体、图案化加热层以及温度传感元件；图案化加热层的两个第一触点以及温度传感元件的两个第二触点分别通过倒置显微镜载物台上设置的电连接柱连接温控单元，以控制精准温控培养皿内样品液达到预设温度。在实验时，基于图案化加热层控制温度以观测精准温控培养皿内样品液中菌株在不同温度下的反应，且样品液始终密封在精准温控培养皿内，不需要反复进行温度处理和样品制备，保证实验精准性和稳定性，实验手段灵活且多样，还可避免样品液的扩散，降低工作人员被感染以及样品液被污染的风险，提升安全性。

摘要： 本实用新型公开了一种用于流行病学分析的显微成像系统，包括：显微镜本体，配合所述显微镜本体使用的载玻片和盖玻片，以及光源装置；其中所述盖玻片设置在所述载玻片中靠近所述显微镜本体中物镜的一表面，所述载玻片与所述盖玻片之间设置有样品液，所述光源装置能够通过发射的紫外线照射所述载玻片上的样品液，以对样品液中细菌灭活；所述盖玻片的上表面上还覆盖着防紫外线膜，用于遮挡照射在所述载玻片上的紫外线进入所述显微镜本体的物镜；本实用新型能够在显微观测过程中利用紫外线使其失活。

摘要： 本实用新型涉及采集设备技术领域，且公开了一种具备防止异物进入分子流行病学实验标本采集装置，包括采集瓶，所述采集瓶的顶部活动安装有瓶盖，所述采集瓶的内部活动安装有一端贯穿并延伸至瓶盖上方的采集管，采集管的内部固定安装有过滤层，所述瓶盖的内部开设有与采集管相适配的安装孔。该具备防止异物进入分子流行病学实验标本采集装置，通过设置往复弹簧，当采集瓶内的标本采集完成后，采集管抽离，往复弹簧恢复弹性形变从前后推动活动密封板向中间移动，将安装孔密封起来，实现了采集瓶的快速封口，能够有效防止异物进入到采集瓶内，确保标本不受到污染，保证了实验研究的精准性，有利于流行病学的分子机制研究。