用聚合酶链反应（PCR）检测支气管肺泡灌洗（BAL）液中的嗜肺军团杆菌

本文研究了由嗜肺军团杆菌的巨噬细胞感染性增效子（ｍｉｐ）基因设计的一对引物，用ＰＣＲ扩增嗜肺军团杆菌３、５、７、８血清型的４个标准菌株的特异ＤＮＡ序列，研究了用该引物扩增ＢＡＬ液中嗜肺军团菌特异ＤＮＡ序列的方法、灵敏度及特异性。结果表明：用上述引物扩增嗜肺军团菌４个标准菌株的ＤＮＡ，均可得到２０７ｂｐ的特异扩增产物，ＢＡＬ液中的军团菌经离心及裂解液裂解后，可直接进行ＤＮＡ扩增，当ＢＡＬ与液中军团菌量为２×１０３ＣＦＵ／ｍｌ时，即可检测出特异扩增带（电泳法），除军团菌外，其它受试细菌均无此特异性扩增，用本法对４２例临床非典型肺炎患者的ＢＡＬ液进行嗜肺军团菌的检测，在４２份嗜肺军团菌培养均为阴性的ＢＡＬ液中，其中一例ＰＣＲ检测军团菌为阳性。本研究提示：用ＰＣＲ检测ＢＡＬ液中的军团菌是可行的，并有快速、灵敏、特异之忧点。

纤支镜灌洗液经变色液体培养基快速培养结核分枝杆菌对涂阴肺结核诊断价值的研究

目的评价纤维支气管镜小量肺泡灌洗液经变色液体培养基快速培养结核分枝杆菌对涂阴肺结核的诊断价值。方法对40例涂阴肺结核患者分别行纤支镜小量肺泡灌洗、刷检或活检,将灌洗液经变色液体培养基快速培养结核分枝杆菌。结果纤支镜肺泡灌洗40例,灌洗液培养出结核分枝杆菌17例,阳性率42.5%,刷检32例,阳性5例,活检8例,阳性3例,刷检+活检阳性率20%,P<0.05有统计学意义。快速培养检出时间平均13.5天。结论纤支镜灌洗液经变色液体培养基快速培养结核支杆菌,可提高涂阴肺结核中结核分枝杆菌的检出率,缩短了细菌培养检出时间。

Do Not Play with Fire

We report a case of exogenous lipoid pneumonia caused by inhalation of liquid paraffin in a fire eater young man. The patient was admitted to the Emergency Department because of acute retrosternal pain, dry cough and dyspnea. Chest radiograph showed multiple bilateral basal alveolar opacities associated to left pleural effusion;CT chest scan showed multiple bilateral areas of consolidation with cavity areas. BAL cytologic examination revealed abundant lipid-laden macrophages. Clinical symptoms resolved after corticosteroid treatment. Lipoid pneumonia is a rare and often underdiagnosed entity. The presence of lipid-laden macrophages in sputum or BAL fluid helps to confirm the diagnosis.