HIV1+2抗体筛查阳性与免疫印迹试验结果分析

目的 对比HIV1+2抗体筛查试验阳性与免疫印迹蛋白试验（WB）结果，探讨筛查与确认实验结果之间的关系，为HIV抗体诊断提供科学依据。方法 按照《全国艾滋病检测技术规范》2020修订版对河南省漯河市艾滋病筛查实验室送检疑似样本复核，采用酶联免疫吸附试验（ELISA）和快速胶体金试验（RT）两种方法检测，经复检后任何1种筛查试验结果呈现HIV阳性反应需进行WB试验，2种试剂复核结果与WB结果比较研究。结果 复检1 564份疑似样本经WB确认，1 420份呈现HIV型抗体阳性（90.79%）,74份阴性（4.73%）、70份不确定（4.48%）。2种筛查试验与WB结果的阳性符合率为90.93%和91.94%。结论 复核实验中酶联免疫试验吸光度值/临界值（S/CO）值越高，RT检测带越深，WB试验结果的阳性率也越高，HIV抗体阳性确认结果以WB为准。ELISA、RT存在一定的假阳性，而WB试验结果为HIV抗体阴性或不确定。     

622例HIV抗体筛查阳性病例采用免疫印迹试验确认结果分析

目的探讨HIV抗体ELISA筛查阳性与免疫印迹试验（WB）确证结果的关系,为HIV感染诊断提供科学依据。方法622例ELISA阳性标本与WB确证结果进行比较,采用SAS9.1进行数据描述统计和关联性分析。结果 364例确证为HIV-1抗体阳性,ELISA阳性与WB阳性符合率为58.52%。经spearman相关分析,ELISA S/Co比值与确证阳性密切相关。结论 ELISA筛查试验存在一定假阳性,高S/Co也并不代表HIV感染。     

HIV抗体检测替代策略Ⅱ在云南省应用的可行性探讨

目的 评价用艾滋病病毒(HIV)抗体检测替代策略Ⅱ检测HIV抗体的可靠性,探讨HIV抗体检测替代策略Ⅱ在云南省应用的可行性.方法 对所有筛查阳性标本同时用替代策略Ⅱ及免疫印迹法(WB)检测,并对检测.结果 进行比较.结果 915份初筛阳性的标本中,两种酶联免疫吸附试验(ELISA)检测.结果 阳性且S/CO≥6的有854份,明胶颗粒凝集试验(PA)检测.结果 均为阳性,WB确认为阳性,符合率为100%;两种ELISA法检测.结果 均阳性,但其中1种或2种S/CO在1.0～5.9之间的共有61份,经WB确认检测,其中32份为阳性,28份为不确定,1份为阴性.结论 两种ELISA试剂和第三种高特异性筛查试剂联合检测HIV抗体,可以替代90%以上的WB确认检测.当两种ELISA法检测.结果 S/CO＞6,且第三种高特异性筛查试剂检测.结果 为阳性时,与WB确认检测.结果 符合率是100%;当1种或2种ELISA法检测.结果 1＜S/CO＜6时,三种方法与WB确认检测.结果 符合率仅为52.5%.因此,在使用HIV抗体替代策略Ⅱ时,应同时考虑ELISA法的反应强度(S/CO值)和其他筛查方法的.结果 .在综合考虑了以上因素后,HIV抗体检测替代策略Ⅱ在云南省应用是可行的.     

136份初筛抗-HIV1+2阳性而复检阴性标本的分析

目的了解山东省历年来艾滋病病毒(HIV)抗体检测中筛查试验假阳性结果的真实情况,更加合理地开展HIV抗体日常检测。方法检测及结果判断按《全国艾滋病检测技术规范》进行,对比分析HIV抗体筛查试验为阳性而免疫印迹试验(WB)为阴性的标本的结果以及相关资料。结果136份筛查试验为阳性反应、WB确认为HIV抗体阴性的标本,占所有送检标本的6.70%,占筛查试验阳性标本的13.39%。136份标本中,明胶颗粒凝集试验(PA)阳性的119份,占87.50%;酶联免疫吸附试验(ELISA)阳性33份,占24.26%,S/CO值平均为0.8005(0.2319~5.544)。结论日常检测必须遵从先筛查再确认的检测程序,筛查试验阳性的不能直接出HIV抗体阳性报告,应确认后再出。     

HIV抗体筛查试验阳性-确证试验阴性标本的分析

目的了解HIV抗体筛查试验假阳性现象的特点及引起假阳性反应的原因。方法对2004～2009年本实验室常规监测检测中筛查试验阳性-确证试验阴性标本的相关资料进行分析。结果394例筛查试验阳性-确证试验阴性标本主要来源于没有或甚少高危行为的各类普通人群;采用"明胶颗粒凝集试剂(PA)+ELISA"或双ELISA试剂组合检测,83%以上为一阴一阳结果,近70%的标本ELISAS/CO值在1～4之间;采用"吉比爱ELISA+第3代梅里埃ELISA"或"吉比爱ELISA+第4代梅里埃ELISA"组合检测,S/CO值同处于1～6范围的标本分别占78.95%和64.0%。结论HIV抗体筛查检测假阳性存在主、客观原因;实验室应采取应对措施最大限度地保证结果的准确以及对检测结果进行正确的解释。     

蛋白免疫印迹试验在HIV确证检测中的漏检及原因分析

目的探讨蛋白免疫印迹试验（WB）在艾滋病病毒（HIV）确证检测过程中的漏检问题,可能的原因及解决方法。方法 40份酶联免疫吸附试验（ELISA）和（或）胶体金法筛查阳性、WB实验确证阴性的样本,分析其来源、S/CO值,并进行抗体追踪复检。结果 40份样本中检出9份HIV阳性,28份阴性,3份样本流失。阴性者均来源于没有高危行为的普通人群,其中无偿献血人群13份,ELISA S/CO均〈3。9份阳性样本中,6例为男男性行为人群（MSM）,自愿咨询检测（VCT）3例。其中ELISA S/CO值〈6的5例,〉10的4例,6例最后考虑为窗口期感染,3例可能为WB试剂中反应膜出现问题。结论 WB检测漏检,可能是样本处于窗口期感染或试剂反应膜问题,实验室应综合分析筛查阳性而WB确证阴性的检测样本,要进行追踪检测,以确定其真实的HIV-1感染状况,防止漏检。     

化学发光法在HIV抗体/抗原检测中的应用及确证结果分析

目的:评估罗氏化学发光免疫试验(CLIA)检测人类免疫缺陷病毒(HIV)抗体/抗原的特异性,了解CLIA法检测HIV的初筛阳性反应与免疫印迹试验(WB)阳性结果的关系。方法:用CLIA法检测拟定输血患者血清中HIV抗体/抗原标本,保留CLIA法检测的阳性标本,再用WB法对初筛阳性标本进行确认,分析CLIA法在HIV抗体/抗原检测中的应用及HIV确证结果。结果:CLIA法检测552例阳性,WB法检测108例阳性(19.57%);WB法证实HIV阳性率在1500 5个区间中,其阳性率分别为0.28%、12.51%、66.70%、100.00%、91.89%,5组HIV确诊阳性率差异有统计学意义(χ²=247.81,P<0.01)。WB法确诊感染者108例,其中男70例(65.0%),女38例(35.0%)。根据受试者工作特征曲线(ROC)分析,55.37 S/CO作为罗氏CLIA法检测HIV初筛试验的分界值。该值对应的灵敏度、特异度和...     

两种不同初筛酶联免疫吸附试验试剂联合检测以替代艾滋病病毒抗体蛋白印迹试验确认检测的对比分析

目的 为评价两种不同初筛酶联免疫吸附试验（ELISA）试剂联合检测艾滋病病毒（HIV）抗体的可靠性，以替代艾滋病病毒（HIV）蛋白印迹（Western blotting,WB)确认法。方法 79份初检与HIV抗体阳性的吸毒人员血清，重新统一用两种抗体初筛ELISA试剂（Vironostika HIV Uni-FormⅡ plus 0和UBI HIV-1/2EIA)进行复测，之后随机选择前51份样品进一步做WB确认，并做对比分析。结果 51份血清中，有49份样品2次初筛复测时至少有1次复测的结果显示为S／CO≥6，它们的WB确认结果均为HIV抗体阳性；其余的2份样品2次初筛复测时，其S／CO均＜6，但其中1份（样品“05”）的WB结果为HIV抗体阴性，1份（样品“584”）为HIV抗体阳性。确认为HIV阴性的样品“05”，在整个初筛的3次检测中曾2次出现过S／CO＞1；确认为HIV抗体阳性的样品“584”，虽然3次初筛检测中S／CO值均＞1，但因本试验中2次复测得到的S／CO都＜6，因而其确认结果亦显示出较少抗原带，即只有p24和Gp160。结论 两种不同原理的ELISA试剂（最好为进口试剂）联合检测HIV抗体可替代WB确认法，以监测具有一定HIV流行率的风险人群（如哨点监测人群）的HIV／艾滋病疫情。报告为HIV抗体阳性的临界判断指标采用2次初筛S／CO≥6应是可靠的；初筛中，对6＞S／CO≥1的样品在报告群体疫情时需用WB法进一步证实。凡涉及通知被检测者本人结果的样品，为慎重起见，应该采用WB法确认，即使2次初筛结果均为HIV抗体阳性的样品也需如此。     

HIV抗体筛查实验的检测策略评价

目的以蛋白印迹试验（WB）结果为金标准,对实验室的HIV抗体筛查,包括酶联免疫吸附试验（ELISA）和免疫层析快诊实验的检测策略进行回顾性分析与评价。方法参照2004年《全国艾滋病检测技术规范》的要求,对2007-2011年之间HIV抗体初筛呈阳性反应的标本,采用WB进行确证。结果727例HIV抗体复查标本中,确证试验阳性为540例,占筛查阳性总数的74.28％;其中两种ELISA及免疫层析快诊都呈阳性反应的为558例,确诊540例,不确定’18例,与确证试验的阳性符合率为96.77％;其余的ELISA呈阳性反应结果加上快诊结果与WB的阳性符合率为0,其中不确定72例,阴性97例。ELISA结果的1≤S／Co〈3,与确证试验阳性符合率为0.85％;S／Co值在3～6之间,与确证试验阳性符合率为11.11％;S／Co〉6,与确证试验阳性符合率为94.51％。阳性与不确定’、阳性与阴性的S／Co、不确定。的各组之间差异均有统计学意义（P均=0.00）,不确定’与阴性之间差异有统计学意义（P=0.032）;而不确定。组之间差异均无统计学意义（均P〉0.05）。结论ELlSA检测试剂存在一定的假阳性,随着S／Co值的增高,与确证试验的阳性符合率也将升高,但是高S／Co值的样本并不代表感染HIV,HIV抗体阳性报告建议以确证试验结果为准;WB确证方法在不确定标本中存在一定的缺陷,快诊与ELISA的联合运用可以有效区分WB结果的感染一不确定与未感染一不确定,建议根据初筛结果,分类做好不确定人群的管理,尤其对两种ELISA及快诊均呈阳性反应的人群,应加大力度做好随访工作,确保无一例漏访。     

HIV抗体筛查试剂联合检测替代免疫印迹法的对比分析

目的探讨用两种不同厂家或原理的HIV抗体初筛试剂联合检测,以替代免疫印迹法(WB),用于检测某些高危人群或特殊人群。方法用包括快速检测和酶联免疫吸附试验(ELISA)试剂在内的9种HIV抗体筛查试剂,对200份样本进行联合检测,对任意一种试剂检测阳性的样本进行WB检测。结果ELISA初筛有阳性反应(S/CO值>1)的样本,WB确认阳性率为81.93%。初筛阳性且有1种ELISA试剂S/CO值>6的样本,WB确认阳性率为100%。两种快速试剂检测均为阳性反应的,WB确认阳性率为100%。结论可以用两次ELISA、两种快速试剂或一种快速试剂加一种ELISA试剂联合检测替代WB。     

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.     

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.     

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.     

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.