血清梅毒螺旋体IgM在先天梅毒诊断中的意义

目的探讨血清梅毒螺旋体IgM(TP-IgM)检测在先天梅毒诊断中的作用。方法回顾性分析了1215例初诊儿童的梅毒血清学检查结果,并与其临床资料作比较分析。结果梅毒血清学阳性率8.81%(107/1215),其中梅毒螺旋体IgM阳性率6.42%(78/1215)。107例梅毒血清学阳性患儿最后确诊为先天梅毒92例,TP-IgM阳性与先天梅毒确诊符合率为100%。结论血清梅毒螺旋体IgM是诊断婴幼儿先天梅毒有价值的梅毒血清学指标,对鉴别先天梅毒和被动梅毒血症有重要意义。     

三种梅毒血清学试验在梅毒诊断中的临床对比研究

目的：分析并比较甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶凝集试验（TPPA）以及酶联免疫吸附试验（TP—ELISA）三种梅毒血清学试验在梅毒诊断中的应用价值。方法：选择我院2011年1月至2013年3月收治的220例梅毒患者以及同期在我院进行健康体检的600名健康成人为研究对象,采用TRUST、TPPA、TP—ELISA方法对其进行梅毒血清学试验,比较三种检测方法测定的灵敏度、特异性和正确率。结果：TRusT、IPPA和TP—ELISA三种梅毒血清学检查方法的检测特异性均较高,而TPPA和TP—ELISA方法的检测灵敏度显著高于TRUST法,差异具有统计学意义（P〈0。05）。结论：TP—ELISA方法操作简便,检测准确率较高,灵敏度和特异性均较好,可用于梅毒筛选;TRIST方法可用于对既往存在梅毒的患者进行血清筛选;TPPA方法可用于梅毒确诊。     

HIV合并梅毒感染的实验诊断分析

目的:通过实验诊断方法,研究HIV与梅毒同时感染的相关性。方法:用梅毒螺旋体明胶凝集试验(TPPA)、梅毒甲苯胺红不加热法(TRUST)和电化学发光法(ECLA)同时检测192例HIV-Ab/P24阳性血清,包括疾控中心免疫印迹(WB)阳性血清77例(实验组),不确定和阴性血清115例(对照组),用χ~2检验统计分析。结果:实验组中,TPPA阳性36例(18.8%),TRUST阳性27例(14.1%),TPPA与HIV-Ab/P24差异有统计学意义(χ~2=21.08,P0.01);对照组中,TPPA阳性8例(4.2%),TRUST阳性2例(1.0%),TPPA与HIV-Ab/P24差异有统计学意义(χ~2=136.95,P0.01)。结论:HIV感染患者,合并感染梅毒的几率很大,且梅毒发作期患者比例高。     

不同检验方法用于梅毒不同时期的敏感性和特异性的临床检验效果对比分析

目的:分析并探讨不同检测方法用于梅毒不同时期敏感性和特异性的临床检验效果。方法:选取2014年1月至2016年1月在医院进行检验的梅毒患者160例为观察组,其中一期梅毒患者48例,二期梅毒患者112例;选取同期体检健康的160例为对照组。所有人群均经过酶联免疫吸附试验(ELISA)、梅毒螺旋体血球凝集试验(TPHA)和梅毒螺旋体明胶颗粒凝集试验(TPPA)三种方法进行检测,观察对比三种检测方法敏感性和特异性。结果:ELISA检测敏感性为98.8%,特异性为97.5%;TPPA检测敏感性为96.3%,特异性为98.8%;TPHA检测敏感性为90.0%,特异性为97.5%。ELISA与TPPA检测敏感性高于TPHA(P0.05),三组特异性无显著差异(P0.05)。结论:临床上TPHA检测梅毒敏感性较差,而ELISA与TPPA检测梅毒的敏感性和特异性均较高,值得临床上使用。     

不同检测法对梅毒临床诊断价值的比较

目的:对比梅毒螺旋体试验(TPPA)及酶联免疫吸附法对梅毒患者的临床诊断效果。方法:选取从2010年9月至2012年8月,于我院进行检查的疑似梅毒病患共103人,其中被确诊为梅毒的89人,其余14人正常。对103人采用TPPA和酶联免疫吸附法进行分组诊断,采用TPPA诊断的组别为观察组,采用酶联免疫吸附法的组别为对照组,比较两组临床诊断效果并进行分析。结果:观察组梅毒检测灵敏度和准确度均显著高于对照组,差异具有统计学意义(P<0.05)。观察组对Ⅰ期梅毒检出率高于对照组,差异具有统计学意义(P<0.05)。结论:TPPA灵敏度与准确度均高于酶联免疫吸附法,能较为清晰地观察病患的病情,给予正确的治疗,对于病患的身体健康提供极大的保障,且安全性较好,值得临床推荐。     

Examination of the correlation between the manual and automated serological testing methods for syphilis

We evaluated the correlation between the conventional manual serological testing method for syphilis and a novel automated serological testing method and between six different reagents used in the automated method. Twenty-six serum samples, which were positive on non-treponemal manual serological testing, were obtained from 19 patients with early syphilis. The samples were manually analyzed using the non-treponemal serological test for syphilis kit and automatically analyzed using six different reagents approved by the Ministry of Health, Labor and Welfare in Japan. Statistically significant correlations were observed between most of the reagents used in the automated testing (r = 0.652-0.996, P < 0.001), except for one combination of the reagents. In the simple regression analysis, the slope of the simple regression line (range, 0.014-3.040) and some of the regression coefficients were not equal to 1.0. Therefore, it is recommended that when the automated serological testing method is used to test for syphilis, the same reagent should be consistently selected to evaluate the changes in antibody titers. Statistically significant correlations were also observed between the manual method and all the reagents used in the automated method (r = 0.682-0.811, P < 0.001). In this case, the regression coefficients ranged 0.375-6.270, and the simple regression line intercept ranged -71.926 to 4.184. The regression coefficient and the intercept between the manual method and some of the reagents used in the automated method were not similar to the values described in the documentation attached to the reagents used in this study.     

妊娠期梅毒患者胎儿宫内感染的超声诊断研究

目的:探讨超声对诊断梅毒感染孕妇宫内感染的意义。方法:选取2012年4月至2014年3月来院就诊并确诊为妊娠合并梅毒的孕产妇46例,本研究根据所选妊娠合并梅毒孕妇是否发生宫内感染,分为发生宫内感染组(观察组)和未发生宫内感染组(对照组),对比两组患者的产前宫内超声诊断结果,分析可以用于判断早期胎儿宫内感染的指标。结果:将观察组和对照组患者的产前早中期超声检测结果进行统计学分析发现,两组检测指标在胎囊不规则(0 vs.23.1%),胎心异常(5.0%vs.19.2%)、胎动异常(10.0%vs.15.4%)和胎盘水肿(0 vs.23.1%)等方面均具有差异性(χ2=9.000,4.410,3.889,1.440,9.000,P<0.01),具有统计学意义。孕后期超声检查结果显示两组之间在宫内窘迫(15.0%vs.69.2%)、全身水肿(0 vs.46.2%)、腹水(0 vs.61.5)、肝肿大(0 vs.88.5%)和脾肿大(0 vs.88.5%)等方面差异显著,具有统计学意义(χ2=10.10,12.49,61.54,88.46,88.46,P<0.01)。结论:产前超声监测可以为临床医生提供全面且直观的临床数据,有利于诊断和评估患者的病情,减少新生梅毒儿的数量。     

梅毒螺旋体特异性抗体对梅毒早期诊断和治疗的评价

目的：为评价梅毒血清特异性抗体在梅毒早期诊断及治疗后的意义。方法：采用蛋白印迹法(Western blottinG,WB)、快速血浆反应素(RPR)试验、梅毒颗粒凝集试验(TPPA)3种方法．对67例梅毒及其中经治疗后随诊18～24个月的21例患者作血清检测。对5年来诊治的临床一期、二期梅毒血清抗体的变化进行分析。结果：20例一期梅毒WB检测出现不同抗体谱条带,其中均有相对分子质量为47000的条带,RPR试验及TPPA部分为阴性。经治疗后随诊18-24个月的21例梅毒患者．18个月内检测时WB9．52％阴转,24个月时28．57％阴转;TPPA阴转的情况同WB;RPR滴度随疗后时间的增加而逐渐下降．6个月内28．57％阴转,24个月85．71％阴转：结论：相对分子质量为47000、17000的条带对早期梅毒的诊断既敏感又特异：部分一期和二期梅毒患者在经过有效治疗后2年,梅毒抗体可以完全消失;RPR试验可用于梅毒治疗期间的疗效判定。     

2021年美国CDC梅毒诊疗指南注意事项读解

梅毒是由梅毒螺旋体苍白亚种感染引起的一种性传播疾病.尽管正确使用抗生素可治愈梅毒,但由于梅毒临床表现多样、检测结果解读困难以及神经梅毒诊断困难,梅毒的管理仍面临挑战.因此,2021年美国CDC发布了最新的梅毒诊疗指南,本文主要解读梅毒不同检测方法、反向筛查策略、神经梅毒检测、妊娠梅毒、吉海反应及性伴管理等方面的注意事项...     

Ungual hyalohyphomycosis caused by Fusarium proliferatum in an immunocompetent patient

The patient was a 73‐year‐old healthy female farmer who had been treated with terbinafine for 25.5 months by a primary physician. She exhibited a discoloration and thickening of the right big toenail. She had no concomitant paronychia. Direct microscopy revealed chlamydoconidia and hyphae, and periodic acid‐Schiff stained nail specimen showed septate hyphae. On the basis of these morphological features and gene analysis, the final diagnosis was ungual hyalohyphomycosis caused by Fusarium proliferatum. Topical application of 10% efinaconazole solution cured the disease in 10 months.     

Non‐equilibrium atmospheric pressure plasmas modulate cell cycle‐related gene expressions in melanocytic tumors of RET‐transgenic mice

The incidence of cutaneous malignant melanoma is increasing at a greater rate than that of any other cancer in the world. However, an effective therapy for malignant melanoma has not been established. Recently, some studies have shown an antitumor effect of non‐equilibrium atmospheric pressure plasmas (NEAPPs) in vitro. Here, we examined the in vivo effect of NEAPP on cell cycle regulators, key elements for malignant transformation, in spontaneously developed benign melanocytic tumors in a hairless animal model. NEAPP irradiation decreased expression levels of cell cycle promoters, Cyclin D1, E1 and E2, and increased expression level of a cell cycle repressor, p27^KIP1. Cyclin D1, E1 and E2 and p27^KIP expression levels were associated with malignant transformation of the benign tumor in the animal model. Our results suggest that NEAPP irradiation suppresses malignant transformation of a benign melanocytic tumor via control of the expression levels of cell cycle regulators.     

Family with MSH2 mutation presenting with keratoacanthoma and precancerous skin lesions

Muir–Torre syndrome (MTS) is a familial cancer syndrome characterized by a predisposition to keratoacanthoma (KA) and sebaceous tumors. Although MTS and hereditary non‐polyposis colorectal cancer (HNPCC) share the same genetic alterations in mismatch repair (MMR) genes, the other skin lesions in MTS or HNPCC have been only rarely reported. We report a family with an MSH2 mutation c.1126_1127delTT (p.Leu376Thrfs*12). A 46‐year‐old male proband developed KA with sebaceous differentiation, colon cancer and gastric cancer, and fulfilled the diagnostic criteria for MTS. His 80‐year‐old mother, diagnosed with HNPCC, presented with multiple gastrointestinal tract cancers, Bowen's disease and actinic keratosis. Immunostaining revealed attenuated MSH2 protein expression in KA, as well as in Bowen's disease and actinic keratosis lesions. These findings suggest that MMR gene abnormality is also critical in the development of benign or malignant cutaneous tumors such as actinic keratosis and Bowen's disease in MTS/HNPCC patients.     

E6 and E7 of human papillomavirus type 18 and UVB irradiation corporately regulate interleukin‐6 and interleukin‐8 expressions in basal cell carcinoma

The lack of a human papillomavirus (HPV)‐infected skin cancer cell line has hampered the investigation of the interaction of UV and HPV in skin carcinogenesis. We identified a human basal cell carcinoma (BCC‐1/KMC) cell line integrated with E6 and E7 genes of high‐risk HPV type 18 and demonstrated that repression of E6 and E7 results in proliferation inhibition. Sublethal ultraviolet‐B (UVB) irradiation induced the expressions of interleukin‐6 (IL‐6) and interleukin‐8 (IL‐8), as well as viral E6 and E7 genes, in BCC‐1/KMC cells. When E6 and E7 expressions were inhibited, IL‐6/IL‐8 expressions were repressed. Furthermore, IL‐6/IL‐8 remained inducible by UVB irradiation when E6 and E7 were inhibited. These results indicated that IL‐6 and IL‐8 can be upregulated by viral E6 and E7 proteins without UVB irradiation. Moreover, chronic exposure to UVB upregulates IL‐6 and IL‐8 when E6/E7 is induced by UVB.