免疫印迹法检测抗胆碱能毒蕈碱受体3抗体及其在干燥综合征诊断中的意义

目的建立免疫印迹法(WB)检测抗毒蕈碱受体3(M3受体)抗体的方法，探讨该抗体对干燥综合征(SS)诊断的意义。方法建立WB测定抗M3受体抗体的方法，检测80例SS患者、80例其他风湿性疾病及40名正常对照者血清中的抗M3受体抗体，并分析该抗体与SS的临床及实验室指标的关系。结果抗M3受体抗体在80例SS患者中的阳性率为83．8％(67／80)，而在系统性红斑狼疮(SLE)及正常人中分别为5．0％(2／40)和2．5％(1／40)，类风湿关节炎(RA)中无1例阳性。抗M3受体抗体对SS的敏感性和特异性分别为83．8％和97．5％，阳性预测值为95．7％，阴性预测值为90．0％。抗M3受体抗体在抗SSA抗体、抗SSB抗体、α-胞衬蛋白抗体阴性的SS患者血清中的阳性率分别为80．0%、82．5％及81．2％。该抗体在抗SSA抗体、抗SSB抗体及α-胞衬蛋白抗体阳性的SS患者血清中的阳性率分别为87．5%、88．2％及85．4%。抗M3受体抗体阳性的SS患者与该抗体阴性的SS患者在口干、眼干、脏器受累的发生率，IgG、IgA、血沉(ESR)升高及抗核抗体(ANA)、类风湿因子(RF)阳性率方面无统计学意义。结论利用sf9细胞表达的重组M3受体蛋白可以检测SS患者血清中的抗M3受体抗体。该抗体是一种对SS诊断较为特异的标记性抗体之一。     

快速ELISA检测血清抗PPD-IgG对肺结核的诊断价值

目的评价抗PPD－IgG检测对活动性肺结核的诊断价值。方法采用快速酶联免疫吸附法(ELISA)检测340例活动性肺结核、56例非活动性肺结核、88例非结核性病人血清中的抗PPD－IgG。结果活动性肺结核组抗PPD－IgG阳性率为83．8％,其中痰涂片(＋)组为92．2％,涂片(－)组为78．7％。非活动性肺结核组3例阳性,非结核组5例阳性,假阳性率分别为7．1％和5．7％。本法敏感性为83．8％,特异性为93．8％,准确性为86．8％,阳性预测值为96．9％,阴性预测值71．1％。结论。提示血清抗PPD－IgG测定是肺结核病人一项有用的辅助诊断手段。     

应用PCR技术检测HLA—B27

应用多聚酶链反应（ＰＣＲ）技术检测了８１例广东地区汉族健康人群和４８例类风湿关节炎病人的ＨＬＡ－Ｂ２７的频率分布，阳性率分别为４．９３％和６．２５％。同时对血清学方法检测ＨＬＡ－Ｂ２７为阳性的８５例和阴性的１６例强直性脊柱炎病人的标本应用ＰＣＲ技术进行检测，发现血清学方法检测为阳生的标本中８４例为阳性，符合率为９８．７％；阴性标本中６例为阳性，误判率为３７．４％。通过引进一对内对照引物，避免假阴性     

云南省1981∽2001年包虫病资料分析

目的掌握云南省包虫病的地区分布、流行程度、流行特点及防治现状。方法采用回顾性调查方法．收集、整理、分析1981～2001年云南省包虫病资料。结果经手术确诊包虫病病例24例，分布于云南省西部、西北部和中部7个地州的12个县市，占全省129个县市的9．30％。包虫病流行区人群血清流行病学调查．包虫抗体阳性率11．34％。门诊包虫病血清学检测84人，包虫抗体阳性29人。云南省包虫病的流行特点为：流行区集中；病例少、散在分布，呈轻度流行；动物包虫病的地区分布比人体包虫病的分布更广。结论三江地区是云南省人体包虫病的重要流行区，也是今后防治包虫病的重点地区。     

传染性非典型肺炎的血清学诊断研究

目的 评估传染性非典型肺炎(世界卫生组织又称严重急性呼吸综合征，SARS)血清病毒特异性抗体检测在SARS诊断中的实用价值，了解免疫荧光抗体法(IFA)和酶联免疫吸附法(ELISA)对SARS病毒特异性抗体检测结果的一致性程度。方法 用IFA和ELISA检测267例不同病程SARS患和132例对照组血清SARS病毒特异性抗体，以敏感度、特异度、阳性预测值(17PV)、阴性预测值(NPV)和准确度评价其诊断价值，并以Kappa值评价两种检测方法结果的一致性。结果 以IFA检测的血清特异性IgM类和IgG类抗体阳性率在病程第11天明显增高，病程≥11天，IgM类抗体诊断SARS的敏感度为65．6％，特异度100．0％，PPV 100．0％，NPV 71．0％，准确度81．3％；IgG类抗体则分别为敏感度91．1％，特异度97．0％，PPV 97．3％，NPV 90．1％，准确度93．8％。以ELISA方法所测结果与IFA结果相仿。对IFA和ELISA法检测的一致性检验示Kappa值分别为0．640和0．779。结论 血清病毒特异性抗体在SARS发病10天以上阳性率高，抗体检测有助于确立发病10天以上SARS的血清学诊断。IFA和ELISA检测SARS病毒抗体的一致性较好。     

西藏部分地区人群弓形虫感染血清学调查

1989年4～10月,对拉萨、日喀则、泽当镇、错那县城关医院不同民族的门诊病人和接受健康检查与普查者采血,用IHA法进行了弓形虫感染血清学调查。结果共检测血清标本468份,阳性48份,总阳性率10.26％;检测我所门诊病例血清标本87份,阳性5份,阳性率5.75％,二者有显著性差异(P<0.05)。西藏地区人群弓形虫IHA抗体滴度平均为1:64的35例,1:256的11例,1:1024的2例;GMRT为98.7。藏族341人中,阳性率为11.14％;汉族119人为8.40％,二者无显著性差异;其它门巴、回、满族8人均为阴性。性别年龄及职业人群弓形虫抗体阳性率均无显著性差     

细粒棘球蚴重组抗原B 8-kDa亚单位1对囊型包虫病的血清学诊断价值

目的通过基因工程技术获得细粒棘球蚴抗原B8-kDa亚单位1重组蛋白(rEgAgB8/1),探讨其对囊型包虫病(CE)的血清学诊断价值。方法将构建的rEgAgB8/1原核表达质粒(pET32b-rEgAgB8/1)转化至E.coli BL-21(DE3)中,用IPTG诱导表达,经亲和层析纯化获得高纯度rEgAgB8/1,以rEgAgB8/1为抗原,应用ELISA和Immuno blotting方法对31例手术确诊的囊型包虫病病人血清进行了回顾性检测与分析。结果ELISA和Immuno blotting方法检测CE病人血清阳性率均为90.3%(28/31),3例血清学检测阴性的CE病人均为初次诊断为CE及单纯性肝脏单发感染的病人;血清抗体水平随着病人棘球蚴囊数目增加而有所增加,棘球蚴囊的数目与血清抗体水平的比较用单因素方差分析有显著性差异(F=5.06,P=0.0142),1个囊与2个囊/3个囊组间血清抗体水平有显著差异,2个囊与3个囊组间差异无统计学意义。结论rEgAgB8/1重组蛋白抗原对囊型包虫病有较高的血清学诊断价值,多囊型包虫病人血清抗体水平高于单囊型包虫病人。     

细粒棘球蚴原头节18ku纯化抗原ELISA的建立及其对两型包虫病鉴别诊断的意义

目的 用细粒棘球蚴原头节18ku纯化抗原建立ELISA诊断方法,用于两型包虫病的鉴别诊断。方法 用18ku纯化抗原ELISA方法对44例泡型包虫病（AE）、70例囊型包虫病（CE）、29例囊虫病和30例健康人血清中特异性抗体进行检测,同时用羊包囊液抗原（Bu)常规ELISA法检测上述血清做比较。结果 18ku纯化抗原检测不同血清的阳性率为：AE90．91％、CE111．43％、囊虫病和健康人血清均为阴性;Bu抗原分别为：AE97．73％、CE88．57％、囊虫病51．72％和健康人10．0％。18ku-ELISA对AE血清诊断敏感性为90．91％、特异性93．80％、阳性预示值为83．33％、阴性预示值96．80％。结论 两型包虫病患者体内18ku抗体水平存在明显差异,纯化抗原18ku-ELISA可用于两型包虫病的鉴别诊断、较免疫印渍法简便快速。     

包虫病人特异性IgM型和IgE型循环免疫复合物的初步研究

应用ABC-捕获ELISA法研究了包虫病人血清中特异性IgM型和IgE型循环免疫复合物(IgM-CIC,IgE-CIC)。IgM-CIC的检出率为47.6％,IgE-CIC为64.3％。肺包虫病人中CIC的检出率略高于肝包虫病,但无显著性差异。特异性IgE抗体阴性的包虫病人中,IgE-CIC检出率达89.5％,而抗体阳性者中为57.7％。在5例特异性IgM抗体阴性的肺包虫病人中,有4例IgM-CIC阳性,而4例IgM抗体阳性者中仅1例CIC阳性。表明由于CIC的形成可造成特异性IgM和IgE游离抗体的“耗竭”。用8M尿素处理后,三种特异性CIC均可被解离。用单克隆抗体检测解离抗原的阳性率在IgG-CIC中为51.3％,在IgM-CIC中为75.0％,在IgE-CIC中为75.9％,证明解离效率与相应抗体的亲和力呈反比。作者认为,包虫病人特异性抗体的检出,不能反映抗体应答的真正水平,抗体阳性加上抗体阴性而CIC阳性者,才能完全反映抗体应答的频率:在IgG为95.2％,IgM为85.1％,IgE为95.6％。提示包虫病人IgM-CIC和IgE-CIC的检测可大大提高免疫诊断的价值,有实际意义。     

包虫病血清抗体测定的流行病学意义

利用包虫病间接血凝试验检查了新疆巴音布鲁克草原牧民923人,抗体滴度≥128者22人,抗体阳性率2.38％。阳性率随年龄增长而升高,35～44岁年龄组最高(5.38％)。对抗体滴度≥64的43人进行体检,以X线胸片和腹部B型超声探查而临床诊断为包虫病者13例,患病率为1.41。抗体滴度≥64者中临床诊断包虫病人占30.23％;≥128者中为57.89％;≥256者中87.50％;≥512者全部诊断为包虫病人。在血清学筛查的13例病人中仅1例有自觉症状。在门诊健康检查中发现的3例病人均自觉症状。无症状病人与有症状病人之比为15:1。认为血清抗体调查结果可以反映人群患病状况。在危险人群中进行大规模血清学筛查,可以发现大量无症状包虫病人。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.