四种梅毒血清学检验方法的比较

目的了解梅毒快速血浆反应素试验(RPR)、梅毒甲苯胺红不加热血清试验(TRUST)、酶联免疫吸附试验(ELISA)和梅毒螺旋体抗体被动颗粒凝集试验(TPPA)的敏感性和特异性.方法采用RPR、TRUST、ELISA和TPPA同时对202份梅毒患者血清标本进行检测,以TPPA作为参考标准,分别统计RPR、TRUST和ELISA的敏感性和特异性.结果 RPR、TRUST、ELISA诊断梅毒的敏感性分别为84.16%、88.12%、98.51%;特异性均为96.67%;ELISA与TPPA检测阳性率差异无统计学意义,RPR、TRUST与TPPA法检测阳性率差异有统计学意义.结论 ELISA法具有较高的敏感性和特异性法,可用于临床筛查和梅毒感染的确证试验.     

三种梅毒检测方法的效果对比

目的:比较ELISA、TPPA和TRUST三种方法在梅毒螺旋体检测中的临床效果。方法:选取150例疑似梅毒螺旋体感染患者作为研究对象,均采用酶联免疫吸附试验(ELISA法)、梅毒螺旋体明胶颗粒凝集试验(TPPA)及甲苯胺红不加热血清试验(TRUST)法进行检测,比较三种检验方法的阳性检出率、敏感度及特异性。结果:ELISA法、TPPA法阳性检出率明显大于TRUST法(P<0.05);ELISA法、TPPA法检测敏感性、特异性及准确度高于TRUST法(P<0.05),ELISA与TPPA法敏感性和准确度比较无统计学差异(P>0.05);ELISA检测特异性明显低于TPPA检测(P<0.05)。结论:ELISA和TPPA检测方法在梅毒螺旋体检测中的临床效果均优于TRUST检测方法,而ELISA和TPPA的检验效果相差不大。     

梅毒4种检测方法的比较

目的探讨临床常用的4种梅毒血清学实验室检测方法对梅毒辅助诊断的价值。方法用酶联免疫吸附试验(ELISA-TP)、甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体明胶颗粒凝集试验(TPPA)与梅毒螺旋体特异性抗体胶体金法(SYP)4种检测方法对159份血清标本进行检测,比较4种检测方法的敏感性、特异性。结果 TPPA、TRUST、SYP与ELISA-TP的敏感性分别为96.8%、78.7%、94.7%与98.9%,特异性分别为98.5%、93.8%、98.5%与96.9%。TRUST与TPPA、SYP、ELISA-TP法阳性率比较差异均有统计学意义(P<0.05)。结论 ELISA-TP法、STP法和TPPA法检测梅毒抗体的敏感性远远大于TRUST,ELISA-TP、SYP和TPPA法与TRUST检测方法组合应用对梅毒的筛查和疗效判断具有重要意义。     

四种梅毒血清检测方法比较分析

目的比较四种梅毒血清学检测方法的准确性及在临床诊断中的意义。方法用甲苯胺红不加热血清试验（TRUST）做非特异性抗体半定量检测;用胶体金快速检测试验（SYP）、酶联免疫吸附试验（ELISA）、梅毒螺旋体明胶颗粒凝集试验（TPPA）做特异性抗体定性检测。结果在6215份标本中,TRUST、SYP、ELISA法的阳性检出率分别为0.77%,0.96%,1.19%。以TPPA作为确认实验,其阳性检出率为1.21%。TRUST、SYP、ELISA法敏感性分别为57.33%,76%,97.33%;TRUST、SYP、ELISA法特异性分别为99.91%,99.95%,99.98%。结论①使用SYP对临床上疑诊梅毒的患者进行筛选,结合TRUST的实验结果可对梅毒进行诊断。②ELISA方法操作简单,结果判断可标准化,其敏感性均优于TRUST、SYP,与TPPA符合率高,是目前梅毒血清学检测的首选方法。     

两种梅毒螺旋体血清学检测方法的临床应用评价

目的探讨TRUST和TPPA联合检测对梅毒的监控和诊治价值,为临床诊治梅毒提供实验依据。方法采用TRUST法和TPPA法测定2 083例血清标本（其中910例梅毒患者血清）。结果对910例梅毒患者血清检测,TRUST法检出773例阳性,敏感性为84.9%,特异性为96.1%。TPPA法检出899例阳性,敏感性为98.7%,差异有统计学意义（P〈0.05）;TPPA法具有很高的特异性和灵敏度。结论 TRUST和TPPA联合检测为临床诊治梅毒提供更有价值的实验依据,更有利于梅毒的监控和诊治。     

不同检验方法梅毒检验结果的准确率比较分析

目的:比较分析不同检验方法梅毒检验结果的准确率。方法:对100例梅毒患者的临床资料进行回顾性分析。结果:TRUST和ELISA的阳性检出率、敏感性和特异性之间差异无统计学意义(P>0.05);但是和TRUST、ELISA相比,TPPA具有明显较高的阳性检出率、敏感性和特异性,差异有统计学意义(P<0.05)。结论:TPPA检验方法在梅毒的检验中具有较高的阳性检出率、敏感性和特异性,在TRUST和ELISA检出标本的验证性检测中尤为适用,三种不同检测方法平行检测能够促进漏诊和误诊发生率的显著降低,临床应用价值良好。     

TRUST和TPPA联合检测梅毒的临床应用价值

目的 探讨甲苯胺红不加热血清实验(TRUST)和梅毒螺旋体明胶颗粒凝集试验(TPPA)联合检测梅毒的临床应用价值.方法 选择2016年1~12月在我院临床表现疑诊为梅毒的患者904例为研究对象,其中328例确诊为梅毒阳性者纳入梅毒组,576例梅毒阴性者纳入非梅毒组.所有患者均进行TPPA和TRUST检测,比较TRUST与TRUST联合TPPA检测的结果.结果 TRUST假阳性率为4.37%,明显高于TRUST联合TPPA的1.22%,差异有统计学意义(P<0.05);TRUST联合TPPA诊断梅毒的敏感性、特异性、阳性预测值、阴性预测值分别为99.09%、99.31%、98.78%、99.48%,均明显高于TRUST的85.59%、97.74%、95.63%、92.75%,差异均有统计学意义(P<0.05).结论 TRUST联合TPPA检测与TRUST相比,可以明显提高对梅毒的诊断价值.     

5种梅毒血清学检测方法的临床应用评价

目的比较5种不同的梅毒血清学检测方法的敏感性和特异性,筛选高敏感性和特异性的诊断方法和试剂。方法采用甲苯胺红不加热血消试验（TRUST）、梅毒螺旋体血球凝集试验（TPHA）、梅毒螺旋体明胶颗粒凝集试验（TPPA）、酶联免疫吸附试验（ELISA）、胶体金法检测150例梅毒患者血消标本。结果TRUST、TPHA、TPPA、ELISA、胶体金法的敏感性分别为86．0％、91．3％、97．3％、99.3％、89.3％,特异性为85．5％、96．4％、98．2％、98．2％、97．3％。ELISA灵敏性、特异性均较好,与其他四种方法比较,TRUST、TPHA、胶体金法的敏感性较低,差异有统计学意义（P〈0．05）,与TPPA差异无统计学意义。特异性方面,与TRUST差异有统计学意义（P〈0．05）,与TPHA、TPPA、胶体金法差异无统计学意义。结论ELISA法和TPPA法是较好的血消梅毒螺旋体的诊断试验,梅毒筛查应采用TRUST和ELISA（或TPPA）法进行联合检测。     

不同检验方法梅毒检验结果的准确率比较分析

目的分析检验梅毒的不同方法,探究出检验结果的准确率。方法研究对象是本院在2016年2月至2018年2月收治的梅毒患者共计300例,主要应用如下检测方式:甲苯胺红不加热血清试验(TRUST)、梅毒酶联免疫吸附试验(ELISA)、梅毒螺旋体明胶颗粒凝集试验(TPPA)。结果比较TRUST和ELISA这两种检测方法的检测特异性、阳性检出率、敏感性检测情况,差异无统计学意义(P0.05),应用TPPA检测的患者特异性、阳性检出率、敏感性检测均比其他两种检测方式有优势,结果比较,差异有统计学意义(P0.05)。结论分析检测梅毒患者的检测方法,应用TPPA检测方法能够得到较好的检测阳性率、特异性和敏感性,要将其作为TRUST与ELISA检出标本的验证环节之中,合理应用这三种检测方法,提高检测的准确性。     

三种梅毒螺旋体检测方法的临床评价

目的:探讨三种血清梅毒螺旋体检测方法的应用价值。方法:应用甲苯胺红不加热血清学试验(TRUST),酶联免疫吸附试验(ELISA)、梅毒螺旋体明胶凝集试验(TPPA)分别检测596份标本,其中57例确诊为梅毒感染。结果:ELLSA法与TPPA法检测结果之间无显著性差异(P>0.05),二者敏感性和特异性分别为94.7%,98.1%和91.2%,97.2%;TRWST与ELISA法、TPPA法之间有显著性差异(P<0.05)。结论:ELISA法和TPPA法在临床的诊断中是较好的血清梅毒螺旋体的检测方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.