Correlation between the Expression of Fas, Bcl-2 in Peripheral Blood Lymphocytes and the LeveL of IFN-γ,IL-4 in Serum of Patients with Condyloma Acuminata

In order to investigate the correlation between the expression of the apoptotic regulatory proteins (Fas, Bcl 2) in peripheral blood lymphocytes (PBLC) and the level of IFN γ and IL 4 in serum of the patients with condyloma acuminata (CA) in the immune pathogenesis of CA, indirect immunofluorescence labeling method of flow cytometer and solid sandwich ELISA method were performed for detecting the expression of Fas, Bcl 2 in PBLC and the level of IFN γ and IL 4 in serum of 60 cases of CA. The results showed the expression level of Fas in PBLC of CA was significantly higher than in the normal control group, but the expression level of Bcl 2 was significantly lower (both P< 0.01). The level of IFN γ in serum of CA was significantly lower than in the normal control group ( P< 0.01), but IL 4 was significantly lower (both P< 0.01). The expression of Fas in PBLC had a negative correlation with the level of IFN γ in serum of patients with CA, but had a positive correlation with the level of IL 4; The expression of Bcl 2 had a positive correlation with the level of IFN γ, but had a negative correlation with the level of IL 4. All the correlation coefficients had significant differerce by t test ( P< 0.01). It was suggested abnormal apoptosis in PBLC, the suppressed secretion of the THl associated cytokines (eg: IFN γ) and the increased secretion of the TH2 asssociated cytokines (eg: IL 4) existed in the patients with CA and might play an important role in the immune pathogenesis of CA.

The Expression of Fas/FasL in Peripheral Blood Lymphocytes and the Level of IL-2 in Serum of Patients with Condyloma Acuminata

In order to investigate the role of the expression of the Fas/FasL in peripheral blood lymphocytes and the level of IL 2 in serum of patients with condyloma acuminata in the immune pathogenesis of CA, flow cytometry, indirect immunofluorescence labeling and ELISA were performed to detect the expression of the apoptotic regulatory proteins Fas/FasL in PBLC and the level of IL 2 in serum of 60 patients with different course of CA. The results showed that the expression of Fas/FasL in PBLC of the group of short course in CA was significantly higher than that of the normal controls ; the expression of Fas, FasL in PBLC of the group of long course CA was significantly higher than that of the group of short course and the normal controls ( P <0.05 and P <0.01, respectively); the level of IL 2 in serum of the group of short and long course CA was significantly lower than that of the group of normal controls ; the negative relation was revealed between the expression of Fas/FasL in PBLC and the level of IL 2 in serum of patients with CA . It was suggested that the abnormal apoptosis in PBLC and decreased level of IL 2 in serum of CA might play an important role in the course of CA.

COMPARISON BETWEEN IMMUNOFLUORESCENCE AND PCR IN DETECTING HUMAN PAPILLOMA VIRUS IN CONDYLOMA ACUMINATA

Objective To compare the effectiveness of immunofluorescence and polymerase chain reaction (PCR) in detecting human papilloma virus (HPV) in condyloma acuminata (CA). Methods HPVs in CA tissues from 60 patients were detected by immunofluorescence and PCR, respectively. Different subtypes of HPVs were also identified with restriction fragment length polymorphism (RFLP). Results The positive detective rates of immunofluorescence and PCR were 56.67% (34/60) and 96.67% (58/60), respectively (P<0.01). RFLP results showed HPV6 and HPV11 were the main subtypes in the detected virus, which accounted for 98.28%. Conclusion The sensibility of PCR is superior to that of immunofluorescence.

TLMA Expression in Condyloma Acuminata from Patients with High and Low Risk HPV

Objective: To detect the activated expression oftelomerase in condyloma acuminata lesions in low-risk (6/11)and high-risk (16/18) human papilloma virus (HPV)infection and examine the role played by telomerase in theoccurrence, development and carcinomatous change ofcondyloma acuminata. Methods: Assaying the expression of telomerase and thetype of HPV in damaged skin of 42 CA patients and normalskin of 30 healthy control individuals through telomeraserepeat amplification protocol (TRAP) and polymerase chainreaction (PCR). Results: In all the normal skin controls, PCR for HPV wasnegative and only 16.7% of samples were positive for TLMAexpression; in CA lesions, HPV testing was positive in all (32cases were low-risk, 3 were high-risk, and 7 were of mixedtype) and all were positive for TLMA expression. Conclusion: TLMA may be activated by HPV infection,and in turn cause the hyperplasia of epidermal cells. It wasalso indicated that HPV, especially high risk types, canactivate TLMA. The activation of TLMA may play animportant role in abnormal hyperplasia and carcinomatouschanges in CA lesions.

Evaluation of the Effectiveness of Nd:YAG Laser under Urethroscope in the Treatment of Intraurethral Condyloma Acuminata (CA) in Males

Objective: To evaluate the therapeutic effect of Nd:YAG laser under urethroscope for the treatment of intraurethral Candyloma Acuminata (CA) in males. Method: Nd:YAG laser under urethroscope was employed to remove the warts. Result: Seventeen patients out of eighteen cases with CA were cured after the first procedure. The cure rate was 94.4%.For second treatment, the cure rate was 100% and no relapse occurred after observation for 12 - 24 months. Conclusion: Nd:YAG laser by urethroscope is a very good method for the treatment of intraurethral CA.

DIFFERENTIATION OF PSEUDOCONDYLOMA OF VULVA AND CONDYLOMA ACUMINATA BY DOT BLOT HYBRIDIZATION AND POLYMERASE CHAIN REACTION

ＤＩＦＦＥＲＥＮＴＩＡＴＩＯＮＯＦＰＳＥＵＤＯＣＯＮＤＹＬＯＭＡＯＦＶＵＬＶＡＡＮＤＣＯＮＤＹＬＯＭＡＡＣＵＭＩＮＡＴＡＢＹＤＯＴＢＬＯＴＨＹＢＲＩＤＩＺＡＴＩＯＮＡＮＤＰＯＬＹＭＥＲＡＳＥＣＨＡＩＮＲＥＡＣＴＩＯＮＬｉｕＹｕｅｈｕａ刘跃华；Ｗａｎｇ...

Etiology and Prevention of Recurrent Condyloma Accuminata

Abstract: The possible causes of condyloma acuminatarecurrence are summarized: such as patients with cellularimmune deficiencies, physical therapy triggering subclinicalinfective foci, sowing of the virus particles, and insufficienttherapy. Corresponding preventive measures are addressed,including: immunomodulators improving cellular immunity,ensuring the range and depth of physical therapy, and treatingsexual partners simultaneously.

环磷酰胺联合光动力疗法治疗尖锐湿疣的临床研究

目的探讨环磷酰胺联合光动力疗法(PDT)治疗尖锐湿疣(CA)的临床效果。方法收集2017年5月—2020年5月本院就诊的120例CA患者临床资料,按随机数字表法分为A、B、C 3组。A组实施PDT联合25 mg/d环磷酰胺方案,B组实施PDT联合50 mg/d环磷酰胺方案,C组实施PDT联合75 mg/d环磷酰胺方案。术后进行为期3个月的随访,比较3组患者治疗前及治疗3个疗程后的细胞因子指标[白细胞介素-4(IL-4)、IL-10、IL-2和干扰素-γ(IFN-γ)]、免疫功能指标(CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+))、不良反应以及复发率发生率差异。结果与治疗前比较,3组治疗后IL-2、IFN-γ、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显升高(均P<0.05),与A组比较,B组和C组升高较为明显,C组升高更为显著(均P<0.05);3组治疗后IL-4、IL-10均明显降低,且C组降低更为显著(均P<0.05)。3组治疗期间不良反应发生率比较差异均无统计学意义(均P>0.05)。3组复发率比较C组<B组<A组[2.50%(1/40)<7.50%(3/40)<20.00%(8/40),均P<0.05]。结论在CA患者中实施PDT联合75 mg/d环磷酰胺方案,能有效诱导IL-2和IFN-γ的表达、抑制IL-4和IL-10的表达,改善患者免疫功能指标,降低复发率,不会明显增加用药不良反应。

尖锐湿疣患者外周血IL-2、IL-12、IFN-γ、IL-4因子水平检测及临床价值研究

目的探讨采用外周血IL-12水平、IFN-γ水平、IL-2水平、IL-4因子水平检测方法对尖锐湿疣患者进行诊断后获得临床效果。方法选取2020年2月—2022年5月枣庄市皮肤病性病防治院100例尖锐湿疣患者作为研究组;选取同一时间段100名健康体检者作为参照组;针对所有研究对象的外周血IL-12、IFN-γ、IL-2、IL-4因子水平、Th1/Th2、CD3^(+)、CD8^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平展开对应分析。结果研究组IL-12(2.39±0.52)pg/mL、IFN-γ(1.85±0.55)pg/mL、IL-2(2.25±0.22)pg/mL以及Th1/Th2(1.13±0.25),均低于参照组的IL-12(4.49±0.25)pg/mL、IFN-γ(6.03±0.22)pg/mL、IL-2(6.78±1.13)pg/mL以及Th1/Th2(5.69±0.49),差异有统计学意义(t=36.396、70.564、39.349、82.895,P<0.05)。研究组CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)均低于参照组,CD8^(+)高于参照组,差异有统计学意义(P<0.05)。结论患者在患有尖锐湿疣疾病后,临床对其实施IL-12、IFN-γ、IL-2水平检测,会发现同健康者比较异常情况显著,对尖锐湿疣患者展开上述指标检测具有临床价值。

Fas FasL TRAIL分子在尖锐湿疣皮损中的分布

目的 探讨Fas、FasL和TRAIL介导的细胞凋亡在尖锐湿疣发病中的可能作用及意义。方法 用免疫组化方法检测了 30例尖锐湿疣患者皮损中Fas、FasL和TRAIL的表达。结果 所有尖锐湿疣标本 ( 10 0 % )Fas均阳性 ,2 3例 ( 76 .7% )FasL阳性 ,2 1例 ( 70 .0 % )TRAIL阳性 ,三者分布基本一致 ,正常表皮基本不表达。且FasL和TRAIL分子与真皮单一核细胞浸润呈显著负相关 (γ =-0 .5 0 6和γ =-0 .45 0 ,P均 <0 .0 5 )。结论 尖锐湿疣组织中细胞凋亡相关分子Fas、FasL和TRAIL表达异常 ,且Fas、TRAIL分子表达影响局部免疫反应 ,考虑凋亡失控可能参与尖锐湿疣发病 ,引起复发。

更昔洛韦静脉滴注治疗尖锐湿疣54例

目的 观察更昔洛韦治疗尖锐湿疣 (CA)后的复发率降低情况。方法 CA患者祛除疣体后静脉滴注更昔洛韦 0 .2 5g ,1次 /d ,共 6天。观察 3个月内CA的复发率。结果 观察组CA 3个月的复发率为 2 4.1% ,比对照组显著性降低 (P <0 .0 1)。结论 更昔洛韦安全、有效 ,能降低CA的复发 ,有较好的抗HPV作用。

肛管及肛门区尖锐湿疣组织中人乳头瘤病毒基因类型的研究

目的高危型人乳头瘤病毒(high-risk human papillomavirus,HPV)感染是宫颈癌的主要致病原因,现已发现HPV感染可诱发人类的许多肿瘤和疣。文中旨在探讨南京地区肛管及肛门区尖锐湿疣(condyloma acuminata,CA)患者中HPV基因类型的感染情况及其临床意义。方法从86份肛管及肛门区CA石蜡组织标本中提取23种HPVDNA,采用基因扩增芯片技术对其组织进行23种HPV基因类型的检测,并对其患者进行临床病理资料分析。结果 86份肛管及肛门区CA患者组织标本中检出HPV阳性66例,感染率为76.74%(66/86),其中单一型的阳性检出率为56.98%(49/86);单一型的感染中HPV11型为26例,其阳性检出率为30.23%(26/86),是最主要的感染类型;其次HPV6型为23例,阳性检出率为26.74%(23/86);混合型HPV感染17例,阳性检出率为19.77%(17/86);其中HPV6+11型8例,占混合型感染的47.06%(8/17),是混合型感染的主要类型;其次是5例4种类型的混合感染,占混合型感染的29.41%(5/17)。结论 HPV11型、6型、6+11型、4种类型的混合感染是肛管及肛门区CA的主要致病类型,基因扩增芯片检测技术是一种比较适合临床进行HPV分型检测的、敏感性高和特异性好的诊断方法,尤其适合开展某种病变中HPV感染的分子流行病学的研究。

尖锐湿疣皮损中朗格汉斯细胞的变化

目的了解尖锐湿疣(CA)皮损中朗格汉斯细胞(LC)的变化。方法采用免疫组化法对34例CA皮损进行LC染色,光镜下观察其形态和数量变化,并对其中6例标本行电镜观察。结果与正常皮肤相比,CA皮损表皮内LC分布不规则,少见典型的树突状细胞,细胞突明显减少、缩短或消失,半定量计数显示CA皮损中LC为(13.15±9.42)个,较正常明显降低(P<0.01)。超微结构表明LC中的特征性结构———朗格汉颗粒(LG)不仅数目减少,而且形态也不典型。结论CA皮损中LC形态及数量均发生变化,可能在CA的发病中起着一定作用。

尖锐湿疣的临床与实验研究

对本科性接触传播疾病（ STD）专科门诊 1989～ 1996年间的各种 STD数据统计发现，尖锐湿疣位居各种性传播疾病病例数的第一位或第二位。用 PCR和斑点杂交等方法检测尖锐湿疣组织标本中 HPV DNA，表明 PCR方法更加敏感。用 PCR方法检测宫颈鳞癌及宫颈和外阴尖锐湿疣 HPV感染，证实宫颈鳞癌以高危型 HPV16为主，而外阴及宫颈尖锐湿疣均以低危型 HPV6/11为主。为了鉴别尖锐湿疣与假性湿疣，进行了组织病理、电镜观察和 HPV DNA检测，结果显示超微结构的某些变化有助于两者的鉴别诊断 ,证实 HPV DNA检测是鉴别尖锐湿疣与假性湿疣的较有用的方法。研制高纯度鬼臼毒素并对其进行药效学研究，结果其与进口鬼臼毒素治疗生殖器疣的疗效相当，使用 3周的治愈率均超过 80％。局部注射不同的干扰素治疗尖锐湿疣具有一定疗效。

326例尖锐湿疣患者肛门及肛管组织HPV基因型检测及性别对比研究

目的国内有关肛门及肛管尖锐湿疣(CA)组织HPV分型研究的大样本资料报道极少。文中旨在探讨以江苏省为主的区域性男女肛门及肛管CA组织中HPV感染基因型分布状况和分型的临床意义。方法收集1985年8月至2017年7月江苏省和安徽省4家医院病理组织学诊断为两性肛门及肛管乳头瘤样增生伴挖空细胞(疑似CA)的石蜡组织标本326例。从其CA组织中抽提HPV DNA,对HPV感染型别分布状况进行分析。结果 326例两性肛门及肛管CA患者中,HPV总检出率为74.85%(244/326)。其中女147例,男179例,HPV总检出率分别为73.47%、75.98%。两性肛门及肛管CA组织阳性者检出不同型别HPV出现频数合计342次,低危型HPV出现频数合计267次,高危型HPV出现频数合计75次。其中6、11、16、18型HPV感染频数占前4位。30岁以下女性CA发病率较男性显著升高(32.65%vs 16.20%,P<0.05)。结论两性肛门及肛管CA组织中,以6、11、16、18型HPV感染最为常见;30岁以下女性CA发病率较高,应引起疾病预防和临床诊治的高度重视。

尖锐湿疣人乳头瘤病毒的基因分型

目的 检测尖锐湿疣中人乳头瘤病毒 (HPV )的基因型别。方法 用通用引物进行聚合酶链反应 ,扩增尖锐湿疣中HPVDNA ,用生物素标记的特异性基因分型探针 ,对聚合酶链反应扩增后的HPVDNA进行斑点杂交。结果 5 0例尖锐湿疣标本经PCR扩增后 48例HPVDNA阳性 ,阳性标本中HPV 6、11、16、18型的检出率分别为 16.7% ( 8/48)、3 7.5 % ( 18/48)、14 .6% ( 7/48)、4.2 % ( 2 /48) ,多重型别检出率为 2 2 .9% ( 11/48)。结论 HPV11型感染是尖锐湿疣发病的首要原因。

重组人干扰素α-2a凝胶预防尖锐湿疣复发的随机双盲多中心临床研究

目的评价重组人干扰素α-2a凝胶(抗尖锐湿疣凝胶)预防尖锐湿疣复发的有效性和安全性。方法与安慰剂对照,尖锐湿疣患者经激光、冷冻或电灼清除疣体后,每日外用药物4次,疗程8周,再随访至第20周。共入选尖锐湿疣患者154例。结果在用药第2,4,8,12,16,20周,试验组复发率明显低于安慰剂组,统计学上有显著性差异。结论重组人干扰素α-2a凝胶对尖锐湿疣治愈后、预防复发的疗效肯定,耐受性好。

温州地区尖锐湿疣组织人乳头瘤病毒检测及型别分析

用人乳头瘤病毒（ＨＰＶ）通用引物（ＧＰ）及型特异性引物（ＳＰ）６、１１、１６、１８对４２例尖锐湿疣（ＣＡ）组织和４８例对照组进行多聚酶链反应（ＰＣＲ）检测。结果：ＣＡ组织五组引物扩增阳性率分别为８５．７％（３６／４２）、７３．８％（３１／４２）、１９．１％（８／４２）、２．４％（１／４２）、４．８％（２／４２），多重型别阳性率为１１．９％（５／４２）；对照组ＨＰＶ阳性率为６．３％（３／４８）。

尖锐湿疣患者外周血淋巴细胞表型及治疗后的变化

采用ＩＩＦ技术对３５例ＣＡ病人治疗前后外周血Ｔ淋巴细胞亚群进行检测。结果表明：ＣＡ病人外周血中细胞百分比升高，细胞百分率、比率下降；治疗后３个月内未复发的７名患者，Ｔ细胞亚群恢复到正常范围，而１６名复发者，治疗前后比较各群细胞均无明显变化。提示病人机体内存在细胞免疫缺陷，检测外周血Ｔ细胞亚群对疗效的预测有帮助。

外阴、阴道和宫颈尖锐湿疣组织中HPV感染的对比研究

目的研讨外阴、阴道和宫颈尖锐湿疣(CA)组织中人乳头瘤病毒(HPV)感染型别的分布状况以及临床意义。方法应用基因芯片结合PCR技术对63例外阴尖锐湿疣、61例阴道尖锐湿疣和65例宫颈尖锐湿疣组织行23种HPV基因型检测,并分析患者的临床病理资料。结果 63例外阴尖锐湿疣组织中检出HPV阳性者56例,HPV感染率为88.89%(56/63);61例阴道尖锐湿疣组织中检出HPV阳性者55例,HPV感染率为90.16%(55/61);65例宫颈尖锐湿疣组织中检出HPV阳性者62例,HPV感染率为95.39%(62/65)。结论 HPV感染与外阴、阴道和宫颈尖锐湿疣的发病密切相关,HPV6和11是主流型别,以外阴尖锐湿疣最为常见。基因芯片结合PCR技术是适合应用于临床行HPV分型诊断的一种方法,具有敏感性好、特异性高的特点。对女性外阴、阴道和宫颈尖锐湿疣的临床诊断、治疗及其疫苗的研究具有重要的意义。