Objective To identify the Borrelia burgdorferi in Glires in Huzhu, Zekog, and Qilian county, Qinghai province. Methods A total of 202 Glires were collected from forest in the counties, Qinghai province. All the collected samples were examined for B. burgdorferi by nested PCR. Results In total of 202 samples, 49 samples were tested positive by 24.26%. Positive rate was 17.91% (12/67) in Huzhu county, 34.62% (27/78) in Zekog county and 17.54% (10/57) in Qilian county. There was significant difference with positive rate of B. burgdorferi in Glires among these three counties(χ²=7.40, P<0.05). Conclusion Our research confirmed the existence of B. burgdorferi in Glires in three counties in Qinghai province. We suggested that the further investigation on local vectors and human infections be conducted for prevention and control of Lyme disease.

Objective To provide a scientific basis for confirmation of typical Lyme disease by serological analysis of the first suspected case of Lyme disease in Shanxi province, China and to improve the clinicians’recognition of Lyme disease for prompt diagnosis and treatment. Methods Using indirect immunofluorescence assay (IFA) and Western blot (WB), the patient suspected of Lyme disease was tested for anti-Borrelia burgdorferiIgM and IgG antibodies. A comprehensive analysis was conducted given clinical symptoms. Tests were repeated half a month later. Results In the first test, IgM antibodies were detected by IFA and WB. The titer of IgM antibodies was1∶64 in IFA, and two protein bands, P41 and P31, were present in WB.IgG antibodies were not found by any of the two tests. In the second test half a month later, IgG antibodies were positive in both IFA and WB. The titer of IgG antibodies went up to1∶256 in IFA, and two protein bands, P41 and P31, were present in WB. IgM antibodies were not found by any of the two approaches. Conclusion Based on the clinical history and progression of disease, as well as the serological results of this research, the diagnosis of Lyme disease can be confirmed, indicating the existence of typical Lyme disease in Shanxi province.

Objective To investigate the natural progression of Borrelia burgdorferi infection among the human population in some natural foci in Xinjiang, China and the genotypes of B. burgdorferi. Methods In 2006, 119 human subjects, who were randomly selected from 1390 negative cases of 1406 individuals receiving a seroepidemiological survey of B. burgdorferi infection in the summer of 2002, as well as the 16 positive cases in the 2002 survey, were included in the study. Serum samples of each individual were collected in 2002 and 2006 and examined for the IgM and IgG to B. burgdorferi by Western blot, and a questionnaire survey was performed to investigate the frequency of manifestation of Lyme disease. In addition, urine samples were collected from the 135 subjects and examined by nest PCR to amplify 5S-23S rRNA intergenic spacer of B. burgdorferi;some of the PCR positive products were sequenced to determine the genotypes of B. burgdorferi. The PCR detection results were compared with the serological test results. Results Of the 1406 serum samples in 2002, 16 (1.14%) were positive for B. burgdorferi antibodies. In the 16 positive cases, 12 were positive for IgM, 2 were positive for IgG, and 2 were positive for both IgM and IgG. In 2006, 7 (43.75%) of the 16 positive cases in 2002 became seronegative, 4 IgM-positive cases became IgG-positive, and 5 cases remained IgM-positive. Of the 119 negative cases in 2002, 58 (48.74%) became seropositive, including 14 IgM-positive cases, 25 IgG-positive cases, and 19 IgM-and IgG-positive cases, and 2 cases had a confirmed diagnosis of Lyme disease. In 2006, 67 (49.63%) of the 135 subjects were positive for B. burgdorferi antibodies, including 58 newly found cases and 9 cases that remained positive since 2002. Asymptomatic IgG positive seroconversion rate was 34.07% (46/135) (in 2002, 4 IgM-positive cases became IgG-positive; in 2006, 25 negative cases became IgG-positive and 19 negative cases became IgM-and IgG-positive, and 2 cases had a confirmed diagnosis of Lyme disease). Only 3 (2.22%) of the 135 subjects developed Lyme disease. Of the 135 urine samples, 22 (16.30%) had positive results in PCR detection. The sequence analysis of 8 PCR positive products revealed that 7 of them were B. garinii and the other was B. afzelii. Conclusion Most cases of B. burgdorferi infection are asymptomatic among the human population in the natural foci of Xinjiang, and this infection rarely results in Lyme disease. The most and second most frequent genotypes of B. burgdorferi among Xinjiang population are B. garinii and B. afzelii.

Objective To evaluate the application of multiple-locus variable-number tandem-repeat (VNTR) analysis (MLVA) and multi-locus sequence analysis (MLSA) in the genotyping of Borrelia burgdorferi sensu lato. Methods Thirty-one strains of B. burgdorferi sensu lato were genotyped by MLVA and MLSA, and the genotyping results were subjected to comparative analysis. Results The MLVA showed that the 31 strains were divided into 4 clusters, with 24 genotypes, 21 of which were unique genotypes; the clustered rate was 24/31, and the distinguishability was 0.969. The MLSA showed that the 31 strains were divided into 4 clusters; every strain was able to be identified separately, but there were 3 nodes with bootstrap values lower than 50%. Conclusion Both MLSA and MLVA are suitable for the genotyping of Lyme disease Borrelia, and a combination of MLVA and MLSA are very useful for genotyping of those uncertain strains.

Objective To study the effect of nested polymerase chain reaction (PCR) of rrf(5S)- rrl(23S) intergenic spacer rRNA in serum for diagnosing suspected Lyme disease patients. Methods Serum samples, epidemiological data, and clinical information of suspected Lyme disease patients were collected. Then, DNA were extracted from the serums and detected by nested PCR and conventional PCR. Results Out of 102 serum samples collected from suspected Lyme disease patients, 39 positive ones were detected by nested PCR, with a positive rate of 38.23%; the bite time of 33(84.62%) was within two months. Only one was positive by conventional PCR, with a positive rate of 0.98%, far less than nested PCR(38.23%). Conclusion For suspected Lyme disease patients' serum samples, nested PCR of rrf(5S)- rrl(23S) intergenic spacer rRNA could be a method to diagnose Lyme disease etiologically.

Objective To compare the effectiveness of indirect immunfluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA) and western blot (WB) in serologic diagnosis of Lyme disease. Methods Serum samples, epidemiological data and clinical information of potential Lyme disease patients were collected. Serum antibodies (IgM, IgG) against Borrelia burgdorferi were detected by IFA, ELISA and WB. Results were interpreted based on clinical manifestations and epidemiological data. Results Of the 398 serum samples collected from suspected patients, 86 were ELISA-positive (21.61%), including 27 IgM positives and 59 IgG positives; 82 were IFA-positive (20.60%), including 26 IgM positives and 56 IgG positives; and 83 were WB-positive (20.85%), including 31 IgM positives and 52 IgG positives. The positive rate of WB for the diagnosis of patients with erythema migrans (EM) was significantly higher than that of ELISA and IFA (χ²＝6.34, P＜0.05）. Conclusion The combination of IFA, ELISA and WB may improve the sensitivity and specificity of the laboratory diagnosis of Lyme disease. WB has a lower false positive rate than ELISA and IFA.

Objective To analyze the serological Results derived from suspected Lyme Disease patients for efficient diagnosis and treatment. Methods Using the indirect immunofluorescence assay(IFA), enzyme-linked immune sorbent assay (ELISA) and western blot(WB), suspected Lyme Disease patients were tested for Borrelia burgdorferi IgM and IgG antibodies. A comprehensive analysis was conducted in combination with clinical cases. Results IgG antibodies were positive as shown by IFA, ELISA and WB methods. The titer of IgG antibodies was up to 1∶128 as shown in IFA and two protein bands, P83 and P39, were present in WB. IgM antibodies were negative as shown in the three test approaches. Conclusion Based on the typical clinical course and positive laboratory Results of the patients, the diagnosis of Lyme disease can be confirmed.

Objective To identify the status quo of Lyme infections among the population, vector ticks and host animal rats in the forest region of Changbai and Tonghua counties, Jinlin province. Methods Serological samples were collected in the forest area in Changbai and Tonghua. Ticks and rats were captured at random sites. Indirect immunofluorescence assay (IFA) was used for serological detection and nested-PCR for etiological detection of tick and rodent samples as well as gene sequencing typing. Pathogenic isolation and culture was done using BSK culture media. Results The seroprevalence of Borrelia burgdorferi IgG was 12.04% (36/299) in human in Changbai and 9.35% (23/246) in Tonghua. The carrying rate in ticks was 27.08% and 20.41% in Changbai (39/144) and Tonghua (20/98), respectively, while the carrying rate in rodents was 10.00% in both counties (4/40, 1/10). The sequence homology analysis showed that the ticks and rats were carrying the genotype Borrelia garinii. Conclusion Lyme infection was serologically evident in human in Changbai and Tonghua’s forest areas. Etiological Results showed that Ixodes persulcatus and Apodemus agrarius were the key vector and host of Lyme disease in this region.

Objective To identify the clinical manifestations and regional distribution of Lyme disease by analyzing the serological testing for suspected patients, providing scientific evidence for proper management of the disease. Methods The indirect immunofluorescence assay (IFA) and the enzyme-linked immune sorbent assay (ELISA) were employed for the detection of serum antibodies(IgM, IgG) against Borrelia burgdorferi for suspected Lyme disease patients. The results were then comprehensively interpreted combining clinical manifestations. Results From 2007 to 2008, a total of 105 suspected Lyme disease patients were subject to the analysis, resulting in 16 positives (15.24%), including 4 out of 44 patients with neurological disorders; 1 out of 5 patients with cardiovascular conditions, 6 out of 25 patients with skin lesions; 1 out of 10 fever patients; 2 out of 14 arthralgia patients; and 2 out of 7 patients with mental disorders. Of the 16 patients distributed in 9 provinces, 87.50% responded favorably to the application of antibiotics. Most confirmed patients were from Heilongjiang, Jilin and Inner Mongolia. Conclusion Sporadic spirochete infections were observed in Chinese population. Serological testing contributes to the early detection of Lyme disease and the improvement of efficient diagnosis and treatment.

【Abstract】 Objective To understand the situation of the reservoir hosts and vectors infected by Borrelia burgdorferi, the distribution of the reservoir hosts and the seasonal fluctuation of ticks in Miyun area.  Methods Ticks were caught with flag method, which were identified by Inverted microscope. The night trapping method was used to catch rats.  The pathogen from ticks and rodents was isolated with BSKⅡculture. The nested PCR was used to do etiological detection. The antibody of B.burgdorferi from goat serum was tested by indirect immunofluorescence. Results Ticks caught in Miyun area were all Haemaphysalis longicornis, which growth curve was obviously seasonal. The rate of ticks bearing pathogen was 10.16% after detection by nested PCR. Apodemus agrarius and Niniventer confucianus were the dominant species in the area, and the rate of rodents bearing pathogen was  4.26%.  The  positive  rate  of  goats  stocked  in  the  local  was  12.00%.  Conclusion The  specific fragment of B.burgdorferi was found in ticks and rodents, which showed that Miyun area maybe one of the epidemic focus of Lyme disease.

【Abstract】 Objective To learn the infection status of Lyme disease in Diebu county, the change of natural focus and the situation of the host infected by Lyme disease. Methods The antibody of Borrelia burgdoferi in the crowd serum was detected by immunofluorescence, and the spirochete DNA was tested with PCR. Results A total of 522 serums were sampled from the people in 5 forestry centres and 7 villages of Dieby county, and the antibodies of B.burgdoferi were positive in 57 serums with the positive rate of 10.92%. Sixty nine species of rat-shapes were captured, and the average capture rate was 15.33%. Among them, there were 25 Niniventer confucianus Hodgsons,18 Rattus norvegicus Berkenhouts, 15 Apodemus specious Temminck, 9 Apodemus specious Linnaeus, 1 Mus musculus and 1 Apodemus agrarius Pallas, which accounted for 36.23%, 26.09%, 21.74%, 13.04%, 1.45% and 1.45%, respectively. Six spleens and five kidnies were positive in 62 rats?spleens and 66 rat-kidnies, and the positive rate was 15.15%（10/66）. The positive samples included  6  R.niviventer  Hodgsons,  2  R.norvegicus  Berkenhouts, 1 A.specious Temminck and 1 A.specious Linnaeus three strains of B.burgdoferi were isolated from rats kidnies and bladders with BSK culture medium. Conclusion The natural foci of Lyme disease were widely distributed in Diebu county, and the infection rate in the crowd was higher.

Objective To understand the gene species of lyme agents and provide basic information for lyme disease prevention and control in Jilin province,we investigated the species and distribution of ticks,isolated bacteria from ticks and identified genomic species of Borrelia burdorferi sensu lato.Methods(1)Ticks were caught with flagging method;(2)BSKⅡculture medium was used to isolate the agent,specific McAbs were used to identify the bacteria;(3)PCR-RFLP method was used to identify the species of spirochetes.Results Ticks collected from 11 areas of Jilin province were classified in to two species, Ixodes persulcatus Schulzeand Haemaphysalis concinna Kock.We got seven spirochetes from I.persulcatus Schulze,six strains were belong to B.garinii,another strain is B.afzelii. Conclusion The main vector of lyme disease in Jilin province maybe is I.persulcatus Schulze.There are at least two gene species, B.garinii and B.afzelii.These two genespecies are pathogenic to people,so we should improve the prevention and control of lyme disease in Jilin province.

Objective Analysis the result of blood serum test for suspected Lyme disease patients,to clear the clinical manifestation and distributed situation of Lyme disease,and provides scientific basis for diagnosis and treatment of Lyme disease.Methods With indirect immunofluorescence assay(IFA) and enzyme-linked immunosorbent assay(ELISA),an investigation on antibodies(IgM,IgG) of Borrelia burgdorferi was carried out in sera of 827 suspected Lyme disease patients.Results From 2001 to 2006,we examined 827 suspected Lyme disease patients,135 patients of them were antibody positive(16.32%).The positive constitution ratio of the neurological disorders,cardiovascular system patients,skin disorders and fever patients was 65.18%(88/344),2.22%(3/39),22.22%(30/193),and 4.44%(6/102),respectively.Five specimens of 105 patients with arthritis was positive.Among the forty-four psychiatric derangements,three specimens was positive.Ninety-two percent of the total 135 positive patients had good curative effects after the treatment of antibiotic.There are Lyme disease in eighteen provinces,metropolises and autonomous regions in China.There are more confirm cases in Heilongjiang,Jilin,Neimenggu,Xinjiang than Qinghai,Sichuan,Guizhou,Yunnan,Zhejiang and so on.Conclusion There are lots of sporadic cases of Lyme disease in China,we can find out these patients early by blood serum test,and improved the efficient of diagnosis and treatment.

Objective We searched and reviewed medical evidence to find treatment for arthritis of Lyme disease. Methods Firstly,we put forward the clinical questions. secondly,we searched medical evidence from Cochrane library(2005.2),Medline(1966-2005.5),CBMDISC(1978-2005) and VIP(1989-2005),and then we reviewed the searching results. The kords we used were “Lyme disease; arthritis” and “Systematical review or randomized control trial or case control trial”. Results By our searching; we got 11 papers including 3 randomized control trial; 3 case control trial and 5 other case reports. It showed that large dose penicillin had a good effect on arthritis of Lyme disease. The results can be used to treat our patient. Conclusion After treating the patient based on those evidence; we cured the patient with large dose penicillin and got a satisfied effect.

Objective To investigate the Lyme Borreliosis status of infection of population in Xinjiang Prospecting Bureau of Henan oilfield to provide scientific basis for Lyme disease prevention and cure. Methods With census method epidemiological investigations were carried out in the crowd. All serum samples were detected by IFAT and ELISA for antibodies (IgG/IgM) against Borrelia burgdorferi. Cases of Lyme disease were made a definite diagnosis by epidemiology,clinical symptoms and serological results. The results were analyzed with χ ^>2 test. Results Total 7 956 people were investigated in five times of which 1 037 people had a significant antibody titer,the average positive rate was 13.03% ( 12.07%-14.07% ). Among different professional populations,the positive rate in the wild prospecting population was the highest ( 16.36% ),in the wild constructing population was the second ( 12.63% ),and in the service population was the lowest ( 7.58% ),in which there were significant difference ( χ ²=101.1, P<0.01). The youngest infected with Lyme spirochete was 6 years old and the oldest was 61,but there were no significant difference in age groups ( χ²=7.1,P>0.1). 665 cases with Lyme disease were confirmed,the prevalence rate was 8.36% . Conclusion The results showed that the population of Xinjiang Prospecting Bureau of Henan oilfield were infected with Lyme borreliosis,and in which Lyme disease has occurred. So the prevention and treatment must be enhanced.