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目的:观察白虎加桂枝汤对尿酸性肾病(HN)大鼠的治疗效果,并从肾小管损伤角度探讨其作用机制。方法:将60只无特定病原体(SPF)级SD雄性大鼠随机分为正常对照组、模型组、白虎加桂枝汤高剂量组(BHJGZ高组)、白虎加桂枝汤中剂量组(BHJGZ中组)、白虎加桂枝汤低剂量组(BHJGZ低组)、别嘌醇组,每组10只。采用腺嘌呤灌胃联合腹部皮下注射氧嗪酸钾构建大鼠尿酸性肾病模型,连续造模18 d。造模成功后,正常对照组及模型组给予等体积蒸馏水灌胃,其余各组给予对应药物灌胃,连续干预8周。观察大鼠体质量、活动能力、精神状态及毛色,检测大鼠血清尿酸(UA)、血清尿素氮(BUN)、血清肌酐(Scr)、24 h尿蛋白定量(24 h UTP),通过HE染色、过碘酸希夫(PAS)染色和Masson染色,观察高尿酸血症(HUA)大鼠肾脏组织形态学、肾小球系膜增生以及肾间质纤维化情况。结果:与模型组比较,治疗6周后,白虎加桂枝汤各剂量组大鼠体质量增加,活动能力、精神状态及毛色好转(P<0.05)。BHJGZ中组可显著降低大鼠血清Scr水平(P<0.01),BHJGZ中组、BHJGZ高组可明显降低大鼠血清BUN水平(P<0.01);白虎加桂枝汤各剂量组均可明显降低HUA大鼠血清UA、24 h UTP水平并改善肾组织形态学、肾小球系膜增生及肾间质纤维。结论:白虎加桂枝汤可能通过抑制肾小球系膜基质增生、减少肾小管损伤及肾间质纤维化,延缓HN进展。  相似文献   
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BackgroundGenital tuberculosis (TB) continues to remain an important cause of infertility in women, especially in developing countries. It is mostly consequent to a primary infection elsewhere in the body. The diagnosis is challenging, considering its paucibacillary nature. Although there are many studies on association of genital tuberculosis with infertility, there is paucity of literature on impact of extragenital tuberculosis on fertility of women through involvement of female reproductive organs. The various diagnostic modalities available have limitations and quest is ongoing for the best diagnostic test.MethodThis was a prospective observational study conducted at the infertility clinic of a tertiary care health facility where 60 infertile women with either tubal factor or unexplained infertility with or without past history of extragenital tuberculosis were enrolled as study subjects or controls respectively. Mantoux test was performed in all women and diagnostic laparo-hysteroscopy was performed in all women to look for any evidence of uterine and/or tubal damage. The peritoneal fluid was sent for GeneXpert and Liquid culture for mycobacterium tuberculosis. Results of Mantoux test, GeneXpert and liquid culture were compared with the laparohysteroscopic findings.ResultOf the thirty infertile women in the study group, 27/30 (90%) had a history of pulmonary tuberculosis and 3/30 (10%) had history of tubercular cervical lymphadenopathy. It was observed that Mantoux test was positive (induration >10 mm) in 27/30 (90%) of women in the study group as compared to only 4/30 (13.3%) controls. Abnormal hysteroscopic findings were documented in 26.6% (8/30) study group women as compared to 6.6% (2/30) women in the control group. Similarly, 60% (18/30) of women in the study group had abnormal laparoscopic findings compared to 33% (10/30) in the control group. Seven out of thirty (23.3%) women were positive for GeneXpert in the study group compared to only 1/30 (3.3%) in the control group. Similarly, liquid culture was positive in 6/30 (20%) of women in the study group as compared to 1/30 (3.3%) in the control group. All the above differences were statistically significant. We observed that the sensitivity of Mantoux test (75.8%) stand alone was higher than the other tests combined (50%). However, specificity and positive predictive value (PPV) increases markedly (up to 100%) to when all the three tests are combined.ConclusionThe authors conclude that all women presenting with infertility should be screened for a past history of tuberculosis and actively worked up for genital tuberculosis in case the history is positive. The various available tests (Mantoux test, GeneXpert and liquid culture) have their limitations for the diagnosis of genital tuberculosis. Thus an approach of early resort to laparohysteroscopy in suspected patients is desirable so that definitive management may be instituted timely and promptly.  相似文献   
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目的探讨血清基质金属蛋白酶-9(MMP-9)测定联合肺泡灌洗液Xpert MTB/RIF检测、γ-干扰素(INF-γ)释放试验对肺结核的诊断效能。方法选取2019年5月—2020年5月河北省胸科医院200例疑似肺结核患者,根据检查结果分为菌阳肺结核组(62例)、菌阴肺结核组(88例)、非肺结核组(50例),比较3组血清MMP-9、白细胞介素(IL)-15、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、红细胞沉降率(ESR)和INF-γ释放试验、结核分枝杆菌(MTB)培养、肺泡灌洗液Xpert MTB/RIF检测结果的差异,多因素分析采用Logistic回归分析,采用受试者工作特征(ROC)曲线评价血清MMP-9测定、肺泡灌洗液Xpert MTB/RIF检测、INF-γ释放试验单独和联合诊断肺结核的效能。结果菌阳肺结核组、菌阴肺结核组及非肺结核组MMP-9、INF-γ水平差异均有统计学意义(P<0.05),其他指标差异均无统计学意义(P>0.05)。肺结核患者MMP-9、INF-γ水平均高于非肺结核患者(P<0.05)。菌阳肺结核组Xpert MTB/RIF阳性率明显高于菌阴肺结核组(P<0.05),2个组之间INF-γ释放试验阳性率及INF-γ水平差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,MMP-9[比值比(OR)值为1.687,P=0.004]、INF-γ(OR=2.511,P=0.005)和Xpert MTB/RIF(OR=1.340,P=0.005)是肺结核的危险因素。Xpert MTB/RIF检测诊断肺结核的敏感性为86.7%,特异性为96.0%,准确性为89.0%;INF-γ释放试验诊断肺结核的敏感性为80.0%,特异性为62.0%,准确性为75.5%;MMP-9诊断肺结核的敏感性为80.7%,特异性为60.0%,准确性为75.0%;3种方法联合诊断肺结核的敏感性为90.7%,特异性为78.0%,准确性为87.5%。结论MMP-9和INF-γ高表达、Xpert MTB/RIF阳性是肺结核的危险因素,3种方法联合诊断肺结核的敏感性和特异性明显增强,具有一定的临床意义。  相似文献   
5.
The performance of enzyme linked immunosorbent assays (EAST) for identifying six indoor allergens was evaluated using skin prick test (SPT) as reference tests in 154 children with allergic rhinitis. Sensitivity of EAST ranged from 9% (cat) to 54% (HDM) with specificity of 74%(cockroach) to 100% (cat) with an agreement ranged from 58 to 86%. Cut off values ?> ?0.35 kU/L showed best sensitivity and specificity. Our findings agree with extant literature which suggests that the ability of EAST to determine the precipitating allergen is moderate. Assays for definitively identifying the inhalant allergen are currently not available.  相似文献   
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目的初步研究睡眠质量对听力正常青年人DPOAE和噪声下言语识别的影响。方法将50例听力正常在校大学生根据匹兹堡睡眠质量指数量表(Pittsburgh sleep qualily index,PSQI)评分分为睡眠质量较差组(PSQI评分≥7分,25例)和睡眠质量较好组(PSQI评分<7分,25例),对两组进行DPOAE及对侧抑制试验,以及-2、-5 dB信噪比(SNR)噪声下言语识别测试,比较两组结果。结果睡眠质量较差组在1.5、4.0 kHz的DPOAE幅值小于睡眠质量较好组(P<0.05),其他频率两组间差异无统计学意义(P>0.05);两组受试者在中低频处(0.75、1.0、1.5、2.0 kHz)均出现显著的对侧抑制效应(P<0.01),睡眠质量较差组在中低频处(0.7、1.0、1.5 kHz)的抑制幅度要小于睡眠质量较好组(P<0.05)。睡眠质量较差组在-5、-2 dB SNR噪声下言语识别率均小于睡眠质量较好组(P<0.05)。结论睡眠质量较差会对青年人DPOAE及其对侧抑制试验、噪声下言语识别造成潜在影响。  相似文献   
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PurposeCartridge based nucleic acid amplification test (CBNAAT) has been endorsed by the WHO as the screening test for diagnosing extrapulmonary tuberculosis (EPTB). In the present study we report the agreement between CBNAAT (Xpert MTB/RIF), liquid culture (LC) and line probe assay (LPA) for diagnosis of Mycobacterium tuberculosis and detection of drug resistance among EPTB cases.MethodsThe EP samples were subjected to CBNAAT (Xpert MTB/RIF, Cepheid, USA) and wherever possible, to LC (MGIT 960, Becton Dickinson, USA) followed sequentially by first line and second line-LPA (FL-LPA, SL-LPA, Hain Lifescience, Germany) on the isolates.ResultsTotal 566/4080 (13.9%) EP samples were detected positive for M. tuberculosis on CBNAAT. Aspirates from lymph nodes were most often positive (11/30; 36.6%), followed by pus (240/873; 27.5%) and CSF samples (166/104; 15.8%). The detection of M. tuberculosis was more in adults than children except in tissue biopsy samples. Rifampicin resistance was also higher among adults except CSF in which resistance was more in children. Total 185 of 566 (32.7%) CBNAAT positive and 770 of 3510 (21.9%) CBNAAT negative samples could be cultured of which 110/185 (59.4%) and 33/770 (4.3%) respectively turned positive. FL-LPA and SL-LPA of 143 culture isolates showed that 27 isolates had drug resistance, of which 3 (2.1%) were XDR, 11 (7.7%) were Pre-XDR (FQ) and 13 (9.1%) were MDR. Of these 27 resistant isolates, 12 were negative by CBNAAT and two were mislabeled as Rifampicin sensitive or indeterminate based on the unique RpoB gene mutation patterns on LPA. The positive and negative agreements between LC and CBNAAT for detection of M. tuberculosis were 67.1% and 92.7% respectively and between LPA and CBNAAT for rifampicin resistance detection were 98.9% and 92.9% respectively.ConclusionsFor EPTB, CBNAAT should be accompanied with LC wherever possible irrespective of the CBNAAT result.  相似文献   
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IntroductionSmart Gene is a point-of-care (POC)-type automated molecular testing platform that can be performed with 1 min of hands-on-time. Smart Gene SARS-CoV-2 is a newly developed Smart Gene molecular assay for the detection of SARS-CoV-2. The analytical and clinical performance of Smart Gene SARS-CoV-2 has not been evaluated.MethodsNasopharyngeal and anterior nasal samples were prospectively collected from subjects referred to the local PCR center from March 25 to July 5, 2021. Two swabs were simultaneously obtained for the Smart Gene SARS-CoV-2 assay and the reference real-time RT-PCR assay, and the results of Smart Gene SARS-CoV-2 were compared to the reference real-time RT-PCR assay.ResultsAmong a total of 1150 samples, 68 of 791 nasopharyngeal samples and 51 of 359 anterior nasal samples were positive for SARS-CoV-2 in the reference real-time RT-PCR assay. In the testing of nasopharyngeal samples, Smart Gene SARS-CoV-2 showed the total, positive and negative concordance of 99.2% (95% confidence interval [CI]: 98.4–99.7%), 94.1% (95% CI: 85.6–98.4%) and 99.7% (95% CI: 99.0–100%), respectively. For anterior nasal samples, Smart Gene SARS-CoV-2 showed the total, positive and negative concordance of 98.9% (95% CI: 97.2–99.7%), 98.0% (95% CI: 89.6–100%) and 99.0% (95% CI: 97.2–99.8%), respectively. In total, 5 samples were positive in the reference real-time RT-PCR assay and negative in the Smart Gene SARS-CoV-2 assay, whereas 5 samples were negative in the reference real-time RT-PCR assay and positive in the Smart Gene SARS-CoV-2 assay.ConclusionSmart Gene SARS-CoV-2 showed sufficient analytical performance for the detection of SARS-CoV-2 in nasopharyngeal and anterior nasal samples.  相似文献   
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