棘球蚴病CAb、CAg与CIC检测结果的评价

对棘球蚴病患者用ABC-ELISA法检测CAb,ABC-夹心双抗体法和Pernice法分别检测CAg和CIC,阳性率分别为87.0％(40/46)、15.6％(7/45)和17.8％(8/45)。在检测CAb阴性的6例中CAg阳性者4例,表明CAb与CAg同时检测可提高阳性检出率达95.6％(43/45)。 CAb阴性病例主要是肺棘球蚴病,占83.3％(5/6)。CAg的检出率仅15.6％,但特异性高,未出现交叉反应和假阳性反应。检测CIC不但检出率不高,而且非特异性反应与检测CAb时相似。     

包虫病人循环免疫复合物的初步研究

用包虫病人血清与亲和层析纯化的包虫病抗原制成人工免疫复合物,证实了可溶性免疫复合物主要为抗原轻度过剩的复合物成分。提示其具有致病的作用。用PEG沉淀法检测49例包虫病人血清免疫复合物的阳性率为22.45％。用Pernice法检测特异性免疫复合物的阳性率仅为8.16％。PEG沉淀物经8M尿素解离后,包虫抗原的检出率为20.4％。36例肝包虫病人pEG沉淀法阳性者10例(27.77％)尿素解离物中检出抗原者9例(25％)。8例肝包虫病人用pEG沉淀法未检出阳性,而解离物中检出抗原者1例(12.5％)。经IHA和间接ELISA法未检出血清抗体的包虫病人中,在pEG沉淀的解离物中检出抗原者各为18.18％(4/22)和10％(1/10)认为在血清pEG沉淀的解离物中检测包虫抗原是测定特异性免疫复合物的较好方法。     

血吸虫病患者血清CIC解离后特异性抗原／抗体检测的研究

将受检者血清免疫复合物（ＣＩＣ）用改进方法解离后，以多克隆、单克隆抗体（ＰｃＡｂ、ＭｃＡｂ）及可溶性血吸虫卵抗原（ＳＥＡ）作ＥＬＩＳＡ检测血吸虫特异性抗原（Ａｇ）及抗体（Ａｂ）。结果表明，检测ＣＩＣ解离后的Ａｇ（称为非游离性循环抗原，ＮＦ一ＣＡｇ）和Ａｂ（称为非游离性循环抗体，ＮＦ一ＣＡｂ），均显示满意的特异性和敏感性；用抗ＳＥＡ一ＰｃＡｂ与抗ＳＥＡ一ＭｃＡｂ和抗ＣＣＡ一ＭｃＡｂ对比检测ＮＦ一ＣＡｇ时，显示相似的检测效果；该法具有诊断病人和考核治疗效果的价值，且有互补诊断血吸虫病的效果。血清中ＣＩＣ解离后检测血吸虫特异性的ＮＦ一ＣＡｇ／ＮＦ一ＣＡｂ可望成为血吸虫病血清学诊断的新途径。     

SUBACUTE THYROIDITIS: ACTIVATED HLA-DR AND INTERFERON-γ EXPRESSING T CYTOTOXIC/SUPPRESSOR CELLS IN THYROID TISSUE AND PERIPHERAL BLOOD

Using a two-colour direct immunofluorescence staining technique, we investigated activated HLA-DR-expressing T helper and T cytotoxic/suppressor cells in peripheral blood of six patients with subacute thyroiditis at referral and at follow-up and in blood from 20 controls. In three of the patients, thyroid fine-needle aspirates were examined as well. At referral, all patients had elevated blood levels of activated T helper and T cytotoxic/suppressor cells 2 (2-4)%, median and range, vs 0 (0-2)%, P less than 0.001 and 12.5 (2-24)%, vs 0 (0-1)% P less than 0.001). At follow-up, the activated proportion of T helper cells had become normal whereas some activated T cytotoxic/suppressor cells remained, 7 (0-8)%. No significant changes in total T cell number were detected when data at referral and at follow-up were compared. In thyroid aspirates, HLA-DR expressing thyrocytes were observed; the total proportion of T cytotoxic/suppressor cells was elevated (70% compared with 35% in blood) and 70% of the T cytotoxic/suppressor cells were HLA-DR+. Furthermore, 55% of the thyroid-infiltrating lymphoid cells were positive for interferon (IFN-gamma+). The finding of activated T cytotoxic/suppressor cells in the blood and thyroid tissue in subacute thyroiditis is consistent with a viral aetiology. Furthermore, intrathyroidal IFN-gamma+ lymphocytes are likely to contribute to expression of major histocompatibility complex (MHC) class II antigens on thyrocytes. No autoantibodies, however, were detected, which suggests that aberrant expression of MHC class II molecules alone is not sufficient to provoke an autoimmune response.     

外周血原发性肝癌细胞检测的临床研究

目的探讨检测肝癌患者外周血中肝癌细胞ＡＦＰｍＲＮＡ，以动态观察原发性肝癌的转移状况。方法采用套式逆转录聚会酶联反应及ｃＤＮＡ定量等方法对３０例外周血肝癌细胞ＡＦＰｍＲＮＡ进行了检测。结果外周血肝癌细胞ＡＦＰｍＲＮＡ检出率与肝癌的肝内转移、肝内静脉癌栓形成、ｎｍ２３－Ｈ１表达以及细胞分化程度等密切相关。结论外周血ＡＦＰｍＲＮＡ可能是肝癌细胞入侵体循环，即将或已经开始转移的标记之一。     

DELAYED ADJUSTMENT OF THE PITUITARY RESPONSE TO VARIATIONS IN CIRCULATING THYROID HORMONES IN A CASE OF SUBACUTE THYROIDITIS

In a case of subacute de Quervain thyroiditis characterized by a period of pronouced hypermetabolism followed by hypometabolism, levels of T4, T3 and the TSH response to TRH were repeatedly measured. As expected, the response to TRH was absent or low during the hypermetabolic phase, high during the hypometabolic phase and returned to normal with recovery. However, at the beginning and at the end of the hypometabolic phase, while circulating levels of T3 and T4 both lay in the subnormal range, two periods of inadequate response to TRH could be demonstrated. During the first period, the response to TRH was zero or very small; during the second period, stimulation by TRH was exaggerated. The response to TRH thus depends not only on the level of circulating thyroid hormones but on other factors such as the previous state of pituitary stimulation or inhibition.     

PERNICIOUS ANIEMIA: INCIDENCE AND SIGNIFICANCE OF CIRCULATING ANTIBODIES TO INTRINSIC FACTOR AND TO PARIETAL CELLS

Intrinsic factor antibody was present in 54% and parietal cell antibody in 91% of 95 patients (26 men and 69 women) with Addisonian pernicious anæmia. The incidence of intrinsic factor antibody of 82% in 17 patients tested more than 10 years after diagnosis was significantly higher than the incidence of 47% in 78 patients tested within 10 years of diagnosis. The incidence of parietal cell antibody showed no significant variation with the duration of diagnosed pernicious anæmia. It is suggested that given sufficient time all patients with pernicious anæmia may develop detectable circulating antibody to intrinsic factor.     

桥本甲状腺炎与亚急性甲状腺炎的免疫组织学变化

用组织化学、免疫组织化学方法观察桥本甲状腺炎和亚急性甲状腺炎的甲状腺实质和间质的变化.结果显示:两病间质中浸润的Ig阳性细胞及Ig重链、轻链各亚型细胞和T细胞的数量、比例相近.浸润的巨噬细胞均与滤泡上皮相接、融合,提示免疫反应在两病的发病中存在着某些共司点.巨噬细胞在免疫反应中起到处理抗原并将其传递给抗原敏感的T、B淋巴细胞的双重作用.     

一种简单的检测甲型肝炎病人血清循环免疫复合物中HAV RNA的免疫捕获聚合酶链反应方法

目的 建立一种简单的检测甲型肝炎病人血清循环免疫复合物中HAV RNA的方法。方法 应用差速离心法分离甲肝病人血清中的循环免疫复合物,置于已用抗人μ链包被的离心管中吸咐,再用RT/PCR法扩增,用PAGE银染法检定扩增结果。结果 检测24份甲肝病人血清标本,其中19份为HAV RNA阳性,而检测正常人与乙型肝炎及丙型肝炎病人血清标本均为阴性。结论 该方法简便,敏感性及特异性较高,是检测甲型肝炎病人血清循环免疫复合物中HAV RNA的较好方法之一。     

家兔日本血吸虫循环抗原及其特异性免疫复合物的动态观察

应用单抗酶联免疫吸附试验（ＥＬｌｓＡ），对日本血吸虫感染兔肠相关蛋白糖阳极循环抗原（ＧＡｓｃＡＰ）及其特异性循环免疫复合物（ＧＡｓｃＡｐ－ＩＣ），进行了动态检测。中度（２００尾蚴／兔）和轻度（５０尾蚴／兔）感染家兔可在感染后第２周和第４周检出ＧＡＳＣＡＰ；第４和第６周检出ＧＡＳＣＡＰ－ＩＣ。ＧＡＳＣＡＰ和ＧＡＳＣＰ－ＩＣ的升降趋势，呈显著的伴随关系。感染兔在接受一次性吡喹酮治疗后，ＧＡＳＣＡＰ和ＧＡＳＣＡＰ－ＩＣ很快阴转，表明日本血吸虫病ＧＡＳＣＡＰ和ＧＡＳＣＡＰ－ＩＣ的检测具有早期诊断和疗效考核意义。     

PREDICTION OF THERAPEUTIC RESPONSE TO RADIOACTIVE IODINE IN GRAVES''DISEASE USING TSH-RECEPTOR ANTIBODIES AND HLA-STATUS

We have examined the combined usefulness of TSH-receptor antibody detection and HLA status on the therapeutic response to standard doses of radioactive iodine (RAI) in forty-three hyperthyroid Graves' patients. Twenty-three patients had detectable TSH-receptor antibodies as measured by 125I-TSH binding-inhibition (TBI) prior to administration of 7 mCi RAI. Eighteen (78%) of these patients were rendered euthyroid within 3 months. In contrast, twenty patients were TBI negative prior to RAI and sixteen (80%) of these individuals remained hyperthyroid at 3 months and required two, or more, doses of RAI to control their thyroid function. DR3 status alone was not strongly associated with resistance to RAI. However, of sixteen patients without detectable TBI activity and who required two or more doses of RAI, ten patients were DR3 positive (62%) compared with 25% in a control population. Only one patient who was both TBI and DR3 negative required more than one dose of RAI. These data indicate that TBI may be an accurate predictor of the therapeutic response to RAI in patients with hyperthyroid Graves' disease. Investigation of HLA status alone was of limited value, although it appeared that the combination of TBI and DR3 may be of additional help in developing an overall strategy for the treatment of hyperthyroid Graves' disease.