莱姆病

莱姆病（ＬｙｍｅＤｉｓｅａｓｅ）亦称莱姆疏螺旋体病（ＬｙｍｅＢｏｒｅｌｉｏｓｉｓ）,是由若干不同基因种的伯氏疏螺旋体（Ｂｏｒｅｌｉａｂｕｒｇｄｏｒｆｅｒｉｓｅｎｓｕｌａｔｏ）引起的人兽共患病。主要传播媒介为蓖麻硬蜱复合体（ＩｘｏｄｅｓｒｉｃｉｎｕｓＣ...     

小学生接种乙型肝炎血源疫苗后七年效果观察

为了解乙型肝炎血源疫苗的免疫持久性，对３４４例小学生追踪随访，并采集血标本，以ＡｂｂｏｔＲＩＡ法检测ＨＢｓＡｇ、抗－ＨＢｃ和抗－ＨＢｓ。第七年时，抗－ＨＢｓ≥１０ＩＵ／Ｌ者为５５．４％～７５．０％，ＧＭＴ为２０．９～６５．３ＩＵ／Ｌ；抗－ＨＢｓ滴度越高，下降至１０ＩＵ／Ｌ以下的时间越长；免疫后７年时，对６６例抗－ＨＢｓ不同滴度者给予第４针（１０μｇ）疫苗后１月，抗－ＨＢｓ升高６．３～５７．７倍。说明儿童接种乙型肝炎血源疫苗后７年内可不必加强接种。     

对单项抗——HBc阳性的“健康”者进行乙肝疫苗免疫的研究

目的　探讨单项抗 Ｈ Ｂｃ阳性的健康者接种乙肝疫苗的免疫特点及其应答反应与白细胞介素２（ Ｉ Ｌ２）的关系。方法　对单项抗 Ｈ Ｂｃ 阳性的健康者按是否接种乙肝疫苗分为实验组和对照组１，乙肝五项标记物（ Ｈ Ｂ Ｖ Ｍ）全阴的健康者为对照组２，应用酶联免疫法动态检测其血清 Ｈ Ｂ Ｖ Ｍ 和 Ｉ Ｌ ２。结果　全程免疫后，实验组，对照组１ 和对照组２ 的抗 Ｈ Ｂｓ 阳转率分别为６３％ （６３／１００）、５７％ （２／３５）和７８３％ （４７／６０）。实验组和对照组２ 的抗 Ｈ Ｂｓ 阳转率无论从性别、年龄和抗体滴度比较均有相似的变化规律（ Ｐ＞ ００５）。两组抗 Ｈ Ｂｓ应答者的血清 Ｉ Ｌ ２ 浓度均明显高于各自免疫前的水平（ Ｐ＜ ００１），也明显高于各自同期无应答者（ Ｐ＜ ００５）；而两组无应答者的 Ｉ Ｌ ２ 水平均较各自免疫前升高不明显（ Ｐ＞ ００５）。结论　对单项抗 Ｈ Ｂｃ 阳性的健康者接种乙肝疫苗，可以达到类似 Ｈ Ｂ Ｖ Ｍ 全阴健康者的免疫效果；而不接种疫苗者很少能获得保护性抗体。体内 Ｉ Ｌ ２ 产生不足，可能是乙肝疫苗免疫失败的原因之一。     

新生儿接种乙肝疫苗3年后抗体水平的调查

本文采用酶联免疫法（ＥｌｅｃｔｒｏｉｍｍｕｎｏａｓｓａｙＥＩＡ）对我县１０００名学龄前儿童ＨＢｓＡｇ及相应抗（ＨＢｓＡｂ）进行了检测,结果表明：出生后立即接种的儿童产生抗体率为９８．４％,出生６个月－１年后接种的儿童立生的抗体率为８８．９％,３年以内未接种乙肝疫苗的儿童无一例产生抗体,而且ＨＢｓＡｇ携带率为３９．５％,现将调查结果报告道如下：     

国产基因工程乙肝疫苗对HBsAg／HBeAg阳性母亲的婴儿免疫后2年？…

用国产重组酵母和重组ＣＨＯ乙型肝炎疫苗对７５名ＨＢｓＡｇ／ＨＢｅＡｇ阳性母亲所生的婴儿进行免疫。结果在免疫后２年，基因重组乙肝疫苗的抗－ＨＢｓ阳性率仍保持较高水平，重组酵母乙肝疫苗期的抗－ＨＢｓ阳性率（１００．０％）则显著高于重组ＣＨＯ乙肝疫苗组（９１．４％）和血源性乙肝疫苗＋ＨＢＩＧ组（８０．０％），各组的抗－ＨＢｓ滴度（Ｓ／Ｎ值）在免疫后９个月时形成高峰，１２个月时开始下降，在２４个月时，５μ     

免疫母细胞淋巴结病的误诊分析

免疫母细胞淋巴结病的误诊分析苏州医学院附属第一医院（２１５００６）吴洁王翎衡伟免疫母细胞淋巴结病（ＩｍｍｕｎｏｂｌａｓｔｉｃＬｙｍｐｈａｄｅｎｏｐａｔｈｙ，简称ＩＢＬ）或称伴有异常蛋白血症的血管免疫母细胞性淋巴结病（Ａｎｇｉｏｉｍｍｕｎｏｂｌａｓｔ...     

我国不同人群及各型肝炎病人庚型肝炎感染检测分析

应用酶联免疫试验（ＥＩＡ）检测抗ＨＧＶ、ＨＢｓＡｇ、抗ＨＢｓ、抗ＨＢｃ和抗ＨＣＶ，对抗ＨＧＶ阳性的部分标本进一步用逆转录套式聚合酶链反应法（ＲＴｎＰＣＲ）检测ＨＧＶＲＮＡ。结果各类人群及肝炎病人抗ＨＧＶ阳性率分别是：一般人群１０％（４／３９５），献全血员３６％（１０／２７８），某单采浆点人群１２９％（７０／５４１），静脉毒瘾者１３５％（２２／１６２），血透析病人２１４％（１２／５６），ＨＢｓＡｇ携带者１２０％（３／２５），慢性乙型肝炎病人２６２％（１１／４０），慢性丙型肝炎病人１２５％（１７／１３６），肝硬化病人３６４％（４／１１），慢性非甲戊型肝炎病人１８８％（３／１６）。提示献血员、静脉毒瘾者、血透析病人及ＨＢＶ或ＨＣＶ感染者是ＨＧＶ感染的高危人群；ＨＧＶ常与ＨＢＶ或ＨＣＶ重叠／联合感染，也可单独感染；ＨＧＶ是非甲戊型肝炎的致病因子之一。抗ＨＧＶ阳性者中ＨＧＶＲＮＡ检出率为６６％（６４／９７），提示抗ＨＧＶＥＩＡ可用于ＨＧＶ感染的检测。     

应用振动态EIA快速检测乙肝表面抗原

为了适应临床检测的要求,目前许多厂家都推出快速法或立可读ＥＩＡ检测ＨＢｓＡｇ试剂盒。这种试剂虽然简化了操作步骤,缩短了操作时间,却出现了后滞现象［１，２］,以及灵敏度降低和重复性差的问题。为此我们探讨用振动态ＥＩＡ［３］克服上述缺点。１材料与方法１．１试剂常规ＥＩＡ和振动态ＥＩＡ使用的试剂盒均为上海实业科华生物技术有限公司提供的ＥＩＡ（快速法）检测ＨＢｓＡｇ试剂盒。１．２仪器ＭＭ-１型微量振荡器（江苏泰县医疗器械厂）,ＨＷＺ-Ａ恒温罩（北京海淀电子医疗仪器厂）,ＤＧ３０２２型酶联免疫检测仪（南京华东电子…     

我国部分地区献血员庚型肝炎病毒感染情况调查

用蛋白工程的方法，合成了庚型肝炎病毒（ＧＢＶＣ／ＨＧＶ）ＮＳ３区一段多肽，并用该条多肽初步建立了抗ＧＢＶＣ／ＨＧＶ酶联免疫试验方法（ＥＩＡ）。用该法检测我国部分地区２８７０份ＨＢｓＡｇ和抗ＨＣＶ均阴性的健康献血员血清。结果：抗ＧＢＶＣ／ＨＧＶ的流行率为３．４８％（１００／２８７０）。其中１００份抗ＧＢＶＣ／ＨＧＶ阳性血清用逆转录套式聚合酶链反应法（ＲＴＰＣＲ）检测，ＧＢＶＣ／ＨＧＶＲＮＡ的阳性率为６２．０％（６２／１００）。     

对4种国产抗—HCV试剂盒的对比研究

应用４种国产抗ＨＣＶ酶联免疫试剂盒（ＥＩＡ），对４６０份单采浆献血员血清进行了检测，结果该４种ＥＩＡ的抗ＨＣＶ检出率依次为１１．０９％、１０．６５％、１０．０％和８．２６％。对该４种ＥＩＡ检测结果不一致的血清，应用中和试验和重组免疫印迹试验（ＲＩＢＡ）确证，结果甲试剂盒的灵敏度和特异度最高，乙、丙、丁试剂盒有少数假阴性或假阳性，尤以丁试剂盒灵敏度最低，提示现行国产抗ＨＣＶＥＩＡ质量尚需进一步提高。     

海南人群及驻地官兵虫媒病毒血清流行病学调查

调查了解海南省人群及驻官兵虫媒病毒感染情况。方法应用间接免疫劳光法对海南省驻地部队和三个地区共６０７份人血清检测了１２种虫媒病抗体。结果：驻地部队３８５份人血清中,黄病毒抗体阳性率为５．７％,甲病毒抗体性为０．５２％;海南省当地２２２份人血清中,黄病毒抗体阳性率为１０．４％,甲病毒抗体阳性率为４．９％。     

检测SARS患者血清中抗-SARS-CoV IgG的四种试剂盒比较

目的比较4种试剂盒检测SARS患者血清中抗-SARS-CoX IgG的灵敏度和特异度。方法用2种酶联免疫吸附试验(EIA)和2种间接免疫荧光法(IFA)试剂盒分别检测18例SARS患者的99份系列血清及123份阴性参比血清标本中抗-SARS-CoV IgG。结果在患者发病第1周，4种试剂盒均未检出抗-SARS-CoX IgG；自发病第2周，除EIA甲未能检出外，EIA乙和2种IFA均从血清中检出抗-SARS-CoV IgG，其阳性率分别为57．1％(4／7)、57．1％(4／7)和42．9％(3／7)。4种试剂盒最早检出时间分别为发病后第16、12、13和9天。于发病后第3周该4种试剂盒的检出率分别为52．6％(10／19)、94．7％(18／19)、78．9％(15／19)和84．2％(16／19)。但自发病第4周后，该4种试剂盒的检出率相同。检测123份阴性参比血清表明，除EIA乙的特异度为94．9％外，其余3种试剂盒的特异度均为100％。结论2种IFA的灵敏度和特异度均较2种EIA高；2种国产EIA试剂盒质量尚需进一步提高。     

海南省东北部地区某类就诊患者莱姆病抗体检测结果分析

目的 了解海南省东北部地区人群莱姆病感染状况,为临床医生诊断莱姆病提供参考,为本省莱姆病的流行病学调查提供可靠的理论依据。 方法 收集海南省东北部地区三家医院1 334例有关节症状和(或)神经症状的患者血清,采用两步法检测莱姆病抗体,使用间接免疫荧光法(indirect fluorescent antibody test,IFA)初筛血清, 对IFA检测阳性血清用免疫印迹法(Western blot,WB)确证。 结果 IFA法筛查海南省东北部地区1 334例患者莱姆病抗体阳性60例,阳性率4.50%。海口、文昌和琼海地区的三家医院该类就诊患者莱姆病抗体阳性率分别为4.25%、1.40%和8.28%(IFA)。三家医院阳性率比较差异有统计学意义(χ²=25.640,P<0.05)。按不同性别、年龄分组海南省东北部地区三家医院莱姆病抗体阳性率比较差异均无统计学意义(χ²=2.306,P>0.05; χ²=1.015,P>0.05)。 WB法确证莱姆病抗体阳性28例,其抗体以31 KD的外膜蛋白A、33 KD-36 KD外膜蛋白B、39 KD膜脂蛋白、41 KD鞭毛蛋白和60 KD热休克蛋白抗体为主。 结论 海南省东北部地区存在人群感染莱姆病,应加强当地疾病预防和监测。     

Solitary IgM phase II response has a limited predictive value in the diagnosis of acute Q fever

SUMMARY We investigated the positive predictive value (PPV) of a solitary positive immunoglobulin M (IgM) phase II response for the serodiagnosis of acute Q fever detected with either an indirect immunofluorescence assay (IFA) or an enzyme-linked immunosorbent assay (ELISA). Initial and follow-up sera from patients suspected of acute Q fever were included if initially only IgM phase II tested positive with IFA in 2008 (n=92), or ELISA in 2009 (n=85). A seroconversion for Q fever was defined as an initial sample being IgG phase II negative but positive in the follow-up sample. The PPV of an initial isolated IgM phase II result detected by IFA or ELISA was 65% and 51%, respectively, and therefore appeared not to adequately predict acute Q fever. For this reason it cannot be used as a diagnostic criterion nor should it be included in public health notification without confirmation with other markers or a follow-up serum sample.     

使用多肿瘤标志物蛋白芯片诊断系统检测肺癌的临床意义

目的 研究多肿瘤标志物蛋白芯片诊断系统用于肺癌的临床诊断价值。方法 用多肿瘤标志物蛋白芯片诊断系统测定分析131例肺癌患者，20例肺良性疾病患者和177例正常对照人群血清的12种常见的肿瘤标志物：CA19-9、NSE、CEA、CA242、Fe、Beta-HCG、AFP、f-PSA、PSA、CA125、HGH、CA153。结果 131例肺癌患者有93例血清肿瘤标志物为阳性，阳性率为71．0％；20例肺良性疾病患者有2例血清肿瘤标志物阳性，阳性率为10．0％；177例正常对照血清中没发现阳性。结论 多肿瘤标志物蛋白芯片诊断系统的应用对肺癌诊断有较高的临床参考价值。     

2015-2017年无锡市副溶血性弧菌引起的食源性疾病流行病学特征分析

目的 了解无锡市副溶血性弧菌致食源性疾病的流行特征,提出相关预防控制措施建议。方法 通过医院肠道门诊和“国家食源性疾病监测报告系统”进行病例信息收集,对符合感染性腹泻诊断的病例采集粪便样本并进行病原学检测,分析人群副溶血性弧菌食源性疾病的发病特征。结果 2015-2017年无锡市收集5987例病例信息,其中采集粪便样本3929份,其中副溶血性弧菌检出205例,阳性率5.22%。各年龄组中,15~24岁年龄组的副溶血性弧菌检出率最高(14.99%);可疑食物中,水产动物及其制品中构成比最高,达12.19%;第三季度(7-9月)副溶血性弧菌检出率最高,总体检出率达9.02%。结论 初步了解无锡市副溶血性弧菌感染的流行特征;应继续加强监测科学性,开展疾病负担研究;应针对青少年人群特别加强预防宣传;应市售水产动物及制品开展专项风险监测。     

Leishmaniasis in Brazil. XIV. Leishmanial and trypanosomal IgA antibody in patients with leishmaniasis and Chagas's disease

Preserved sera from patients with various forms of leishmaniasis, acute and chronic Chagas's disease and from normal individuals were examined for the presence of IgG and IgA antibodies by the IFA test. The leishmanial antigen used in the IFA test was prepared from a hamster infected with the PH8 strain of Leishmania mexicana amazonensis; amastigotes were isolated from a skin lesion and fixed in formal phosphate-buffered saline-glucose for slide antigen. There were significantly more positive reactions with IgA conjugate in patients with mucocutaneous leishmaniasis than in those with other forms. There was no association between IgA and IgG titres. The only two sera with trypanosomal IgA antibody were from two patients with acute Chagas's disease but neither sera produced cytoplasmic or surface fluorescence of leishmanial amastigotes. The implications of the presence of leishmanial and trypanosomal IgA antibody is discussed in detail.     

A comparison of promastigote and amastigote antigens of Leishmania infantum in the diagnosis of visceral Leishmaniosis by ELISA and IFA tests in Turkey

This study was designed to evaluate the ELISA and IFA tests for diagnosis of visceral leishmaniosis (VL) using soluble and crude antigens from promastigote and amastigote forms of Leishmania infantum. A total of 70 sera were tested, including 30 patients who were suspected for Leishmaniosis (10 healthy persons, 10 patients with Toxoplasmosis, 10 patients with Giardiosis). In the 30 patients suspected to have Leishmaniosis, smears were prepared from bone marrow aspirates and all material aspirated was cultured in NNN medium. The results were compared with those of parasitological and serological tests. While 2 patients were serologically positive and parasitologically negative from the 30 patients, 8 patients were serologically and parasitologically positive. The amastigote and promastigote antigens were 100% specific. Using these antigens with ELISA and IFA tests did not result and diagnosis different than VL.     

Evaluation of antibodies to thymine ROS-modified DNA poly(dT), in patients with immunologic disorders: relationships to anti n-DNA and anti ENA autoantibodies

BACKGROUND: Hydroxyl radical, one of the most potent of all reactive oxygen species, is known to modify adenine and thymine in cellular DNA, producing some modified DNA fragments (ROS-DNA) with different antigenic properties. Despite several in vitro studies about ROS-DNA, data regarding their clinical significance are scanty. The aim of our study was to seek out the presence and clinical significance of the anti poly(dT) auto-antibodies in a group of patients suspected of autoimmune disease. METHODS: We initially evaluated more than 900 consecutive sera of hospitalized patients (range age from 6 to 70 yrs) referred to our laboratory during 18 months. Anti n-DNA, anti-ENA and poly(dT) autoantibodies were performed on 158 ANA positive sera and 28 ANA negative sera from patients strongly suspected of rheumatic diseases or affected by HCV infection. RESULTS: Anti poly (dT) were found in 22 out of 186 sera. As regards the clinical evaluation, 8 patients were affected by SLE, 5 by Scleroderma, 3 by HCV-related chronic hepatitis, 4 by recurrent abortions (without presence of the anti-cardiolipin antibodies and other clinical symptoms). In two patients the ACR criteria and the clinical aspects did not allow a definite diagnosis. Anti-Histones were detected in 18 out of 22 poly (dT) positive patients. CONCLUSIONS: Our data suggest that anti poly(dT) autoantibodies are sensitive markers of various autoimmune diseases, but with a minor specificity as compared to anti n-DNA for the diagnosis of SLE.     

Prevalence of antibodies to Bartonella henselae in patients with suspected cat scratch disease (CSD) in Italy

Cat scratch disease (CSD) is a relatively new diagnosed illness with clinical signs of self-limiting regional lymphadenopathy accompanied by symptoms of fever and malaise, to encephalopathy and neuropathy, occurring after a cat scratch or flea bite. Bartonella henselae is now accepted as the etiologic agent of CSD. From January 1994 to September 1998, 412 patients were evaluated for suspect CSD in Italy. Sera were tested for antibodies to B. henselae by a commercially available indirect immunofluorescent assay (IFA), based on B. henselae-infected Vero-cells as the antigen substrate. Of the 412 patients, 26 (6.3%) were considered positive having titers of immunoglobulin G (IgG) to B. henselae of 64 or higher. In these patients CSD was indeed confirmed by either histopathologic examination of lymph nodes biopsy or fourfold raise in antibody titers. Nevertheless, sera were tested by IFA for Afipia felis and one showed a double reactivity to B. henselae and A. felis. Finally, three sera, negative to B. henselae serology, were positive to A. felis. Three hundred and eighty-six patients received alternative diagnoses. One hundred and twenty-five serum samples from control subjects were negative by IFA for either B. henselae or A. felis. Moreover, a cross-reactivity with sera from patients affected by other diseases was not observed. Our study shows that the ascertained cases of CSD are etiologically determined by B. henselae, IFA assay is confirmed as a useful tool in the laboratory diagnosis and, over a 5 years period of study, the incidence of CSD in Italy has been low.