联合检测血清抗日本血吸虫IgM和IgG4抗体意义的探讨

目的探讨联合检测血清特异性IgM和IgG4对日本血吸虫病的诊断价值。方法采用间接ELISA法检测急性血吸虫病、慢性血吸虫病及慢性血吸虫病患者治疗12月、24月后特异性IgM和IgG4的抗体变化。结果急性血吸虫病患者特异性IgM和IgG4阳性率分别是100%、87.9%,慢性血吸虫病患者特异性IgM和IgG4阳性率分别是45.5%、68.2%,联合检测急性血吸虫病和慢性血吸虫病患者特异性IgM和IgG4阳性率分别是100%和75.8%,慢性血吸虫病患者治疗12月、24月后特异性IgG4阳性率分别是16%、5%。结论并联检测特异性IgM和IgG4对急性血吸虫病早期诊断及慢性血吸虫病疗效考核具有较好的应用价值。     

血吸虫病现场数据管理系统软件的研制与应用

目的研制现场工作数据管理软件,用于多中心的血吸虫病流行病学现场研究工作,以实现现场工作的系统化、规范化,确保现场工作质量。方法采用程序设计语言VB、ACCESS数据库、ActiveX、标签打印等技术,根据血吸虫病现场工作流程,设计相应的功能模块,并将各个模块衔接组成1个完整的管理系统。结果成功研制出血吸虫病现场数据管理系统V1.0软件,并将其应用于多个血吸虫病调查研究现场,取得了很好的效果。结论血吸虫病现场数据管理系统V1.0软件为血吸虫病现场调查工作提供了简便、高效的管理工具,可大大提高血吸虫病现场工作的效率和质量。     

快速ELISA检测机的研制及在血吸虫病诊断的应用

利用电子振频原理,设计一种简易的半自动化的PVC薄膜ELISA快速检测机,使孵育、洗涤、观察结果在同一仪器上进行,可缩短反应时间,简化操作程序,较手工操作的PVC薄膜ELISA原法可提高工效10-20倍,使ELISA的检测达到流程化、同步化和规范化,该仪器成本低,体积小,重量轻,适于血吸虫病现场大规模查病使用。     

检测日本血吸虫抗体标准化间接血凝试剂盒的研制

目的研制检测日本血吸虫抗体(IHA)的标准化间接血凝试剂盒。方法通过不同筛目尼龙绢和低频超声等方法制备、纯化日本血吸虫可溶性虫卵抗原,致敏人"O"型血红细胞;按医学决定水平确定免疫学质量控制标准及参考,优选原材料质量,规范生产工艺,研究制定反应体系的标准化,生产IHA试剂盒并进行鉴定。结果用生产的IHA试剂盒检测50例急性血吸虫病人血清全部阳性,检测201份慢性血吸虫病患者血清,193份阳性,敏感性96.0%;200份健康人血清均为阴性,特异性100%;肝吸虫、姜片虫、钩虫及乙肝患者血清均为阴性,肺吸虫病的交叉反应率为19.4%(6/31)。IHA试剂盒批内变异和批间变异小,有效诊断率为97.9%。同一批试剂盒在室温、4℃条件下保存3年未见效价明显改变。结论研制的IHA试剂盒具有较高的特异性和敏感性,可标准化生产。该试剂盒具有操作方便、快速、结果判断容易,不需要特殊的仪器设备,价格低廉等优点,可广泛用于现场查病。     

应用重组信号蛋白14-3-3间接ELISA诊断日本血吸虫病

目的探讨重组日本血吸虫信号蛋白14-3-3(rSj14-3-3)间接ELISA用于血吸虫病免疫诊断的价值。方法表达并利用纯化的rSj14-3-3与成虫抗原(SjAWA)间接ELISA法分别检测51份急性和49份慢性日本血吸虫病患者和50份正常人血清,以上血清标本同时用SEA致敏的间接血凝试验(SEA-IHA)检测。再以3种方法检测30份华支睾吸虫感染者、24份卫氏并殖吸虫感染者和31份钩虫感染者血清,分析其交叉反应性。结果51份急性和49份慢性血吸虫病患者血清的rSj14-3-3抗体阳性率分别为98.0%和91.8%;SjAWA的检出率分别为96.1%和90.0%;IHA的阳性率分别为98.0%和93.9%。经统计学分析,以上结果无显著性差异(P>0.05)。Sj14-3-3间接ELISA、SjAWA间接ELISA和SEA-IHA对于30份华支睾吸虫感染者的交叉反应性分别为13.3%、20.0%和16.7%,24份卫氏并殖吸虫感染者分别为8.3%、12.5%和12.5%,31份钩虫感染者分别为12.9%、16.1%和12.9%。经统计学分析结果也无显著性差异(P>0.05)。结论rSj14-3-3抗原间接ELISA法诊断日本血吸虫病,具有高度的敏感性和特异性,可用于血吸虫病的免疫诊断。     

糖化血红蛋白检测标准化及有关问题

糖化血红蛋白（GHb）一直是评价血糖控制情况的重要指标,近年又被建议作为糖尿病诊断指标。糖尿病防治工作需要准确、可比的GHb检测结果。国际GHb标准化取得显著成效,但我国GHb检测质量尚存一定差距。我国需在GHb标准化方面做出进一步努力。     

免疫增强剂“425”及／或吡喹酮治疗血吸虫病患者前及后的抗体水平和超声影像的观察

本试验分为“４２５”制剂１０天肌肉注射合并吡喹酮顿服疗法（组Ⅰ）、单用“４２５”制剂１０天疗法（组Ⅱ）和“４２５”制剂７天疗法（组Ⅲ）三组。试验结果显示,三种疗法均可不同程度地改善病人的肝脾肿大并使肝内门静脉内径缩小,试验结果还显示,“４２５”制剂与吡喹酮合并治疗可显著地增高病人血清中特异性抗体水平。临床验证结果也提示,“４２５”制剂可诱导宿主的体液免疫应答,使虫卵肉芽肿病变减弱,导致病人临床体征的改善。本研究通过临床观察,已取得具有实用意义的结果。     

血浆醛固酮与肾素活性比值测定方法标准化问题的探讨

血浆醛同酮与血浆肾素活性比值(ARR)已广泛应用在高血压患者中筛查原发性醛同酮增多症(原醛).研究表明,不同的临床状况(测定方法)会得出不同的ARR.由于没有统一的ARR标准,使得其临床应用难以适从.因此,应该根据所选用的测定方法和本单位的试验条件,采用相应的,同时具最高敏感性、特异件和准确件的ARR.近年来通过控制测定条件,即所谓测定方法标准化,包括:停用降压药2～4周、取同定体位、上午8:00～12:00之间采血、充分钠摄入以及低血钾者补钾等,发现原醛的ARR范围大致在23.6～26.0 ng·dl-1·ng-1·ml-1·h-1之间,说明ARR筛查方法标准化有助于确定和统一筛查原醛的ARR标准.     

检测日本血吸虫抗体的胶体金-葡萄球菌A蛋白试剂盒研制

目的研制胶体金-葡萄球菌A蛋白试剂盒用于检测日本血吸虫抗体。方法通过不同筛目尼龙绢和低频超声等方法,制备、纯化日本血吸虫可溶性虫卵抗原,研制胶体金-葡萄球菌A蛋白试剂盒。用该试剂盒检测人血清中日本血吸虫特异性抗体,并用ELISA方法进行平行比较。结果胶体金-葡萄球菌A蛋白试剂盒检测慢性血吸虫病的敏感性为93%,检测急性血吸虫病的敏感性为100%,检测健康人血清的特异性为96%,检测肺吸虫病的交叉反应为40%,对其他寄生虫和乙肝未见有交叉反应。与ELISA检测结果比较,两种方法具有良好的一致性。结论胶体金-葡萄球菌A蛋白试剂盒具有快速、简便、不需要仪器、敏感性高和特异性强等优点,可广泛用于血吸虫病流行区现场查病。     

日本血吸虫抗体检测试剂盒（IHA法）现场筛查效果的评估

目的评估日本血吸虫抗体检测试剂盒（IHA法）的现场筛查效果。方法选择安徽省长江流域3个血吸虫病流行区7个流行村的6～65岁居民为查病对象,在用改良加藤厚涂片法（Kato—Katz法,一粪三检）合并尼龙绢集卯孵化法进行病原学检测的同时,采用日本血吸虫抗体检测试剂盒（IHA法）进行血清特异抗体检测,评估其现场筛查效果,并与胶体染料试纸条法（DDIA）和酶联免疫吸附试验（ELISA）检测结果比较。结果7个村共有3004人同时接受2种病原学检测和3种血清免疫学检测,IHA、DDIA和ELISA法的阳性率分别为40．81％、59．79％和59．25％,与病原学检测阳性率2．46％比较差异有统计学意义（P〈0．005）。以病原学检测为金标准,IHA法的特异度、约登指数、一致率和阳性预测值高于DDIA和ELISA法,分别为60．48％、52．37％、61．25％和5．55％;敏感度和阴性预测值分别为91．89％和99．66％,均介于DDIA法和ELISA法之间。IHA法与DDIA和ELISA法的一致率分别为65．25％和69．91％,IHA检测结果与DDIA和ELISA比较差异均有统计学意义（P〈0．05）;病原学检测阳性者中,IHA法与DDIA和EI,ISA法的一致率均为90．54％,IHA检测结果与DDIA和ELISA比较差异无统计学意义（P〉0．05）。结论日本血吸虫抗体检测试剂盒（IHA法）适用于血吸虫病流行区人群筛查,但需进一步提高该试剂盒的特异度,最大限度地排除阳性者中已经治愈的中远期感染者。     

规范肺功能测定技术提高肺功能测定水平

国外最早开始测量肺功能是在17世纪80年代。1979年美国胸科学会制定了肺功能测定操作规范，8年后，即1987年又对该操作规范进行了修订和补充。     

Development of subaortic stenosis and regurgitation several years after successful operation on a common atrium

A patient who had had successful operation for a common atrium subsequently developed subaortic stenosis and regurgitation several years later. The diagnosis of subaortic lesion was confirmed by echocardiography. This case shows that the left ventricular outflow tract gradient should be measured before operation for common atrium and that after operation such cases should be examined by cross sectional echocardiography at follow up visits.     

Development of subaortic stenosis and regurgitation several years after successful operation on a common atrium.

A patient who had had successful operation for a common atrium subsequently developed subaortic stenosis and regurgitation several years later. The diagnosis of subaortic lesion was confirmed by echocardiography. This case shows that the left ventricular outflow tract gradient should be measured before operation for common atrium and that after operation such cases should be examined by cross sectional echocardiography at follow up visits.     

Physical limitations and loneliness: The role of guilt related to self-perception as a burden

Background

Limitations in performing physical activities have been associated with greater loneliness in older adults. This association could be moderated by maladaptive social cognition or feelings, such as guilt related to perceiving oneself as a burden. This study analyzes the effect of guilt related to self-perception as a burden on the relationship between physical limitations and loneliness in older adults.

Methods

Participants were 190 community-dwelling people aged over 60 years who did not show cognitive or functional limitations in daily life activities. We used linear regression to test the influence of guilt related to self-perception as a burden on the association between physical limitations and loneliness.

Results

The interaction between physical limitations and guilt related to self-perception as a burden was found to be significant in the explanation of loneliness, explaining 18.10% of the variance. Specifically, the relationship between physical limitations and loneliness was stronger when levels of guilt related to self-perception as a burden were high or medium than when these levels were low.

Conclusions

The findings suggest that feelings of loneliness are more frequent in people who report more physical limitations and, at the same time, report guilt for perceiving themselves as a burden. Guilt related to perceiving oneself as a burden seems to be a relevant modulator variable for understanding the effects of physical limitations on loneliness.     

Identification of a protein related to tubulin in the postsynaptic density.

The postsynaptic density is a unique subcellular organelle associated with the synaptic complex and appears as an electron-dense area immediately subjacent to the postsynaptic plasma membrane. The postsynaptic density was isolated from the synaptosomal fraction and the protein constituents were analyzed by polyacrylamide gel electrophoresis. Polypeptides closely related to tubulin were identified as a major component of the postsynaptic density on the basis of molecular weight, subunit structure, and peptide map criteria.     

低密度脂蛋白受体的研究进展

丙型肝炎病毒(hepatitis C virus,HCV)受体的研究,主要集中在CD81分子和低密度脂蛋白受体(loW density li-poprotein-receptor,LDL-R)两种穿膜蛋白分子[1]。最近的研究表明,LDL-R可能是HCV感染肝细胞的受体候选分子[2]。 一、HCV与血清脂蛋白的结合 1992年Thomssen等[3]发现了含有HCV RNA的病毒颗粒     

心脏外科手术相关医源性乳糜胸的治疗

目的探讨心脏外科手术后发生医源性乳糜胸的可能机制和预防经验,以减少术后乳糜胸的发生。方法回顾分析自2003年5月至2012年6月4320例心脏外科手术中出现的37例乳糜胸患者的临床资料,其中男性24例,女性13例,年龄6个月至75岁,平均年龄22．3岁。患者在禁食基础上采用胸导管结扎术,胸腔闭式引流术,静脉高营养,强心、利尿,高糖溶液、滑石粉、红霉素等胸腔内注射,使胸膜固定等综合措施进行治疗。结果住院时间10-150d,胸腔引流4-35d。全组死亡2例,其中因肺部感染再次插管,死于多器官功能衰竭1例,右心功能不全合并DIC死亡1例。随访30例,随访时间1-8年,失访5例,随访期间无乳糜胸复发。结论行心脏直视手术后发生乳糜胸可能与手术时损伤较小的淋巴侧支有关,采用禁食,胸腔闭式引流,胸导管结扎术,静脉高营养,高糖溶液、滑石粉、红霉素等胸腔内注射,胸膜固定等治疗效果满意。     

Predictive tests for the response to cancer chemotherapy: limitations related to the prediction of rare events

The reliability of a predictive test may be characterized by its sensitivity and specificity. The probability that a predicted event will actually occur depends on these indexes as well as the frequency of the predicted event. If such a test is used to predict for the therapeutic effect of single-agent chemotherapy in cancer patients, its predictive value is markedly affected by a generally low therapeutic efficacy in an unselected population.