联合检测对类风湿性关节炎的诊断及临床意义

目的探讨类风湿因子（RF）、抗环瓜氨酸多肽抗体（Anti—CCP）、抗核抗体（ANA）、抗双链DNA抗体（抗ds—DNA）、抗ENA抗体联合检测对类风湿性关节炎（RA）患者的诊断及临床意义。方法分别检测20例RA患者（RA组）;20例确诊为非RA自身免疫痛患者（非RA患者组）和20例健康体检者（对照组）的RF、Anti—CCP、ANA、抗ds—DNA、抗ENA抗体。RF采用速率散射比浊法、Anti—CCP采用化学发光微粒予免疫检测法,ANA,ds—DNA抗体检测采用间接免疫荧光法,抗ENA抗体检测采用免疫印迹法。结果1．RA组患者的RF的阳性率为55％、And—CCP的阳性率为80％、ANA阳性率分别为65．0％、抗ds—DNA的阳性率为5．0％、抗ENA抗体阳性率为5．0％,五者联合检测的阳性率为95．0％,明显高于对照组（P〈0．01）。2．非RA组患者的RF的阳性率为20．0％、Anti—CCP的阳性率为5．0％、ANA阳性率分别为60．0％、抗ds—DNA的阳性率为5．0％、抗ENA抗体阳性率为30．0％,五者联合检测的阳性率为85．0％,明显高于对照组（P〈0．01）、结论RA患者中RF、AInj—CCP阳性率较高．五者的联合捡测可提高捡出率．对RA病情的鉴别诊断及发展和疗效的观察均有重要的意义。     

抗环瓜氨酸肽抗体、类风湿因子和抗核抗体检测诊断类风湿关节炎的应用价值

目的探讨抗环瓜氨酸肽抗体(ACCP)、类风湿因子(RF)和抗核抗体(ANA)检测诊断类风湿关节炎(RA)的应用价值。方法随机选择RA患者(RA组)、非RA自身免疫性疾病患者(非RA组)和健康对照者(健康对照组)各80例,检测并比较血清ACCP、RF、ANA阳性率;分析并比较3个指标诊断RA的灵敏度、特异度及其差异性。结果 RA组、非RA组和健康对照组血清ACCP阳性率分别为82.5%、2.5%、0.0%,RF阳性率分别为97.5%、25.0%、15.0%,ANA阳性率分别为30.0%、22.5%、5.0%。ACCP、RF和ANA对RA的诊断灵敏度分别为82.5%(66/80)、97.5%(78/80)和30.0%(24/80),特异度分别为100.0%、85.0%和95.0%,非RA自身免疫性疾病的诊断灵敏度分别为2.5%(2/80)、25.0%(20/80)和22.5%(18/80),特异度分别为100.0%、85.0%和95.0%。结论 RF诊断RA灵敏度较高,但特异度相对较差;ACCP诊断RA具有较高的特异度和灵敏度,可作为鉴别RA与其他自身免疫性疾病的有效指标;RF、ACCP联合检测有助于提高RA的早期确诊率;ANA对RA有辅助诊断价值。     

类风湿关节炎患者3项联合检测分析

目的分析类风湿关节炎(RA)患者类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)、抗核抗体(ANA)检测结果,探讨这些指标在RA诊断中的临床应用价值。方法 RF检测采用胶乳凝集法,抗CCP抗体检测采用酶联免疫吸附试验(ELISA)、ANA检测采用间接免疫荧光法。结果 128例RA患者中,RF阳性率75%,抗CCP抗体阳性率72.7%,ANA阳性率达79.7%。联合检测RF、抗CCP抗体、ANA 3项指标可将RA诊断的敏感性提高到95.3%。抗CCP抗体检测结果与RF检测结果呈正相关。RA患者中ANA≥1∶320阳性时的荧光模式主要是核均质型。结论对RA患者进行RF、抗CCP抗体、ANA联合检测,可以明显提高RA诊断的灵敏度,并且能提示患者血清中存在的自身抗体,从而为RA的诊断和疗效观察提供重要的参考指标。     

RF，抗RA33抗体，CRP，ANA与ENA联合检测在间质性肺炎及相关疾病中的临床研究

目的 了解引起间质性肺炎的发病情况及相关因素,探讨血清RF,抗RA33抗体,CRP,ANA及ENA联合检测在间质性肺炎及相关疾病诊断、治疗及预后中的作用.方法 采用ELISA法对32例间质性肺炎患者,37例类风湿性关节炎患者,30例普通肺炎患者和30例健康对照者进行抗RA33抗体的检测,间接免疫荧光法检测ANA,免疫印迹法检测ENA,免疫比浊法进行类风湿因子(RF)及CRP的检测.结果 间质性肺炎组患者RF水平与类风湿性关节炎组比较,差异非常显著(P<0.01);间质性肺炎组患者CRP水平与健康对照组比较,差异非常显著(P<0.01);间质性肺炎组患者抗RA33抗体水平与健康对照组比较,差异显著(P<0.05).各疾病组间抗RA33抗体水平比较,差异无统计学显著性意义(P>0.05);RF,抗RA33抗体,CRP及ANA诊断间质性肺炎灵敏度分别为:34.38%,25.00%,56.25%,78.13%;诊断普通肺炎灵敏度分别为:10.00%,6.67%,80.00%,16.67%;诊断类风湿性关节炎的灵敏度分别为:81.08%,32.45%,43.24%,62.16%.RF,抗RA33抗体,CRP及ANA诊断各疾病组的特异度分别为:93.33%,93.33%,90.00%,96.67%.ENA的检出率各组间均较低.结论 对间质性肺炎患者进行RF,抗RA33抗体,CRP,ANA,ENA联合检测,对于疾病的进展、病因分析、指导治疗和改善预后均具有重要实用价值.     

类风湿关节炎实验室诊断的应用探讨

目的通过类风湿因子(RF)与多项新的类风湿关节炎(RA)标志性自身抗体的相关性比较,了解几种与RA相关的实验室指标在临床诊断中的意义。方法收集临床上有关节肿痛症状表现的门诊和住院患者血清178例,进行比浊法检测RF;ELISA法检测环状胍氨酸肽(CCP)抗体和RF IgA、IgG、IgM及间接免疫荧光法检测抗角蛋白抗体(AKA)。结果 178例患者血清RA相关自身抗体检测表现异常,其中75例RF阳性,103例RF阴性。在阳性者中有56例抗-CCP阳性、57例AKA阳性、53例RF IgA、IgG、IgM增高,阳性率分别占RF阳性的74.7%、76.0%、70.7%;RF阴性患者中有17例抗-CCP阳性,12例AKA阳性,14例RF IgA、IgG、IgM均增高,15例RF IgA、IgM均增高,59例RF IgM增高。阳性率分别占RF阴性的16.5%、11.7%、13.6%、14.6%、57.3%。各自身抗体水平均与CRP、红细胞沉降率(ESR)呈高度相关性。结论比浊法检测RF特异性和敏感性较差,多项指标联合检测可提高RA诊断的特异性和敏感性,可弥补RF检测阴性的不足。     

类风湿关节炎患者血清IgG及亚类的水平和临床意义

目的探讨类风湿关节炎(RA)患者血清IgG及亚类的水平和临床意义。方法选择2018年10月至2019年6月该院风湿免疫科收治的RA患者54例纳入RA组,选择同期36例健康体检者纳入对照组。采用双抗体夹心法ELISA检测血清IgG亚类水平;采用免疫散射比浊法检测免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4)和类风湿因子(RF)水平;采用流式点阵免疫发光法检测抗环瓜氨酸肽(CCP)抗体水平。比较两组各检测指标水平,分析RA患者血清IgG亚类与IgG、IgA、IgM、C3、C4、RF及抗CCP抗体之间的相关性。结果RA组血清IgG、IgA、RF和抗CCP抗体水平显著高于对照组(P<0.05),但IgM、C3和C4水平差异无统计学意义(P>0.05)。RA组血清IgG1和IgG3水平显著高于对照组(P<0.05),两组血清IgG2和IgG4水平差异无统计学意义(P>0.05)。与对照组比较,RA组IgG1/IgG和IgG3/IgG显著升高(P<0.05),而IgG2/IgG显著下降(P<0.05)。Spearman相关分析显示,RA组患者血清IgG1水平与IgG呈高度正相关(r=0.865,P<0.05);IgG2、IgG3水平与IgG均呈中度正相关(r=0.613、0.644,P<0.05);IgG4水平与IgG呈低度正相关(r=0.271,P<0.05);IgG2水平与IgA呈低度正相关(r=0.399,P<0.05);IgG3水平与IgM呈低度正相关(r=0.343,P<0.05)。IgG各亚类与RF、抗CCP抗体之间均无相关性(P>0.05)。结论RA患者血清IgG水平显著升高,并且存在IgG亚类水平变化。IgG亚类检测对RA早期诊断价值有限。     

抗CCP抗体、抗RA33抗体、抗Sa抗体和RF联合检测对类风湿性关节炎诊断的意义

目的 探讨抗CCP抗体、抗RA33抗体、抗Sa抗体和类风湿因子(RF)联合检测对类风湿关节炎的诊断的意义.方法 对118例RA患者(A组)、86例其它结缔组织疾病患者(B组)、70例正常对照(C组)用ELISA法检测抗CCP抗体、抗RA33抗体及RF,免疫印迹法检测抗Sa抗体.结果 118例RA患者中抗CCP抗体、抗RA33抗体、抗Sa抗体和RF的阳性率分别为80.5%、33.9%、41.5%和83.1%,显著高于非RA患者和正常对照组(P＜0.01).四种指标两两联合检测对RA的诊断都具有较好的特异性,而敏感性以抗CCP抗体+RF最高(76.3%).结论 选择适当的指标联合检测可提高对RA诊断的特异性,有助于早期RA的诊治.     

类风湿关节炎患者抗核抗体类型及相关抗体的研究

目的 研究类风湿关节炎(rheumatoid arthritis,RA)病人抗核抗体(antinuclear antibody,ANA)阳性的比例及类型,进一步探讨ANA阳性对应的相应抗体以及RA患者ANA与血清类风湿因子(rheumatoid factor,RF)和抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide antibody,ACPA)水平的关系,从而对RA患者的病因进行研究。方法 选取山东中医药大学附属医院风湿免疫科的病人462例。其中RA患者342例,骨关节炎患者120例。分别检测两组患者的ANA阳性率、ANA类型和ANA谱以及ANA阳性率与RF和ACPA水平的关系。结果 342例RA患者中,ANA阳性的比例为64.04%,而骨关节炎患者ANA阳性率仅为4.17%,二者相比差异有统计学意义(χ²=127.47,P<0.01)。RA患者的ANA阳性类型以核颗粒型和核均质型为主(占71.69%)。研究RA患者ANA阳性率与血清RF和ACPA水平的关系发现血清RF和ACPA水平高的患者ANA阳性率要高于RF和ACPA水平低的病人(χ²=46.33, P<0.05)。结论 RA患者的ANA阳性率明显高于正常人,其类型以核颗粒型和核均质型为主。RA的ANA阳性率与血清RF和ACPA的水平呈正相关。抗核抗体在RA的发病中可能发挥着重要的作用。     

抗CCP抗体、抗RA33抗体、抗Sa抗体和RF联合检测对类风湿性关节炎诊断的意义

目的探讨抗CCP抗体、抗RA33抗体、抗Sa抗体和类风湿因子(RF)联合检测对类风湿关节炎的诊断的意义。方法对118例RA患者(A组)、86例其它结缔组织疾病患者(B组)、70例正常对照(C组)用ELISA法检测抗CCP抗体、抗RA33抗体及RF,免疫印迹法检测抗Sa抗体。结果118例RA患者中抗CCP抗体、抗RA33抗体、抗Sa抗体和RF的阳性率分别为80.5%、33.9%、41.5%和83.1%,显著高于非RA患者和正常对照组(P<0.01)。四种指标两两联合检测对RA的诊断都具有较好的特异性,而敏感性以抗CCP抗体 RF最高(76.3%)。结论选择适当的指标联合检测可提高对RA诊断的特异性,有助于早期RA的诊治。     

类风湿关节炎患者血清中抗天然Ⅱ型胶原抗体水平检测（附89例报道）

目的检测类风湿关节炎(Rheumatoid arthritis,RA)患者血清中抗天然Ⅱ型胶原抗体(抗NatⅡ抗体)的水平变化,探讨其在类风湿关节炎的发病及诊断中的作用。方法89例门诊确诊为RA的患者,38例非类风湿关节炎的结缔组织病变者和45例健康体检者,测定类风湿关节炎患者的抗NatⅡ抗体水平、类风湿因子(RF)及C反应蛋白(CRP),研究抗NatⅡ抗体与RF、CRP的关系。结果RA患者组的抗NatⅡ抗体阳性率较非RA结缔组织病组和正常对照组显著升高(P<0.05),RA患者组和非RA结缔组织病组的RF阳性率显著高于健康对照组(P<0.05),而非RA结缔组织病组的RF阳性率与RA患者组相比,差异无统计学意义(P>0.05);抗NatⅡ抗体阳性的特异性高于RF阳性,而敏感性低于RF阳性;RA患者组血清中的CRP高于正常对照组,RA患者组中抗NatⅡ抗体阳性患者的CRP水平高于抗NatⅡ抗体阴性患者,差异均有统计学意义(P<0.05)。结论抗NatⅡ抗体可以作为RA诊断中的血清学指标。     

Cellular uptake and efflux of azithromycin, erythromycin, clarithromycin, telithromycin, and cethromycin

Macrolide antibiotics have an outstanding ability to concentrate within host cells, particularly phagocytes. In the study described in this paper five different macrolide antibiotics were compared regarding the uptake and release kinetics in human peripheral blood polymorphonuclear neutrophils (PMNs) and three different cell lines, two phagocytic cell lines (RAW 264.7 and THP-1) and an epithelial cell line (MDCK). Based on the results obtained, the substances tested could be clustered into different groups. Azithromycin constituted the first group, characterized by rapid and nonsaturable uptake into phagocytic cells and a high degree of retention in the preloaded cells. The second group included erythromycin and clarithromycin. These two substances do not exhibit cell specificity; consequently, they are taken up to a similar extent and are released by all cell types studied. Ketolides constituted the last group. Their uptake was saturable in cells of monocytic lineage as well as in nondifferentiated cells of myeloid lineage, and they were rapidly released from all the cell lines studied. However, in PMNs, ketolide uptake was not saturable; and unlike telithromycin, cethromycin rapidly egressed from the loaded cells.     

Comparative Activities of Clinafloxacin, Grepafloxacin, Levofloxacin, Moxifloxacin, Ofloxacin, Sparfloxacin, and Trovafloxacin and Nonquinolones Linozelid, Quinupristin-Dalfopristin, Gentamicin, and Vancomycin against Clinical Isolates of Ciprofloxacin-Resistant and -Susceptible Staphylococcus aureus Strains

The activities of eight fluoroquinolones and linezolid, quinupristin-dalfopristin (Synercid), gentamicin, and vancomycin were tested against 96 ciprofloxacin-susceptible and 205 ciprofloxacin-resistant Staphylococcus aureus strains. Overall, clinafloxacin, followed by moxifloxacin and trovafloxacin, was the most active quinolone tested. For all isolates, linezolid and quinupristin-dalfopristin showed activities that were at least comparable to vancomycin, with no cross-resistance to any other test compound.     

Absorption, distribution, metabolic fate, and elimination of pefloxacin mesylate in mice, rats, dogs, monkeys, and humans

Pefloxacin mesylate is well absorbed by the oral route. The antimicrobial activity in dog, cynomolgus monkey, and human plasma was essentially due to unchanged drug which respectively accounted for 64, 94, and 84% of the total activity (ratios derived from relative area under the curve [AUC] values). Half-lives ranged from 1.9 h in mice to 8.6 h in humans. Protein binding was weak, about 20% in plasma. Except in brain, concentrations in most of the organs and tissues tested in rats and dogs were higher than the plasma levels. Microbiological activity in urine was mainly due to pefloxacin and norfloxacin, the N-desmethyl metabolite. The norfloxacin/pefloxacin ratios were 0 in mice, ca. 1 in rats and dogs, 1.6 in cynomolgus monkeys, and 2.3 in humans. The principal urinary compounds were unchanged drug in mice, pefloxacin glucuronide and pefloxacin N-oxide in rats and dogs, norfloxacin and pefloxacin in monkeys, and pefloxacin N-oxide and norfloxacin in humans. The urinary recovery of identified metabolites was 29.5% of the dose in mice, 37.8% in rats, 36.3% in dogs, 26.5% in monkeys, and 58.9% in humans. Biliary excretion occurred and was extensive in rats and dogs, mainly as a glucuronide conjugate of the drug. In rat and human bile, the main active compound was unchanged pefloxacin.     

Cancers of the prostate, penis, and testicles: epidemiology, prevention, and treatment

Cancer is a disease that most people fear. Nurses are required to provide information on how to avoid cancer, and, once the diagnosis is made, how to cope with it. Prevention and early detection of the cancers described in this article are in the very early stages of knowledge development, but general health promotion guidance can be offered on how to avoid most cancers (ie, no tobacco use, a high-fiber and low fat diet, exercise, and maintaining a normal weight). Nurses also can advise patients to be screened for colorectal cancer at the appropriate ages and time intervals and to be aware as new developments occur in the scientific base for screenings in the areas of prostate, penile, and testicular cancer. Finally, coping with these forms of cancer often requires the patient to make major lifestyle and psychological changes, especially if surgery in the genital area occurs. Decreased libido, incontinence, and impotence are major complications that can occur with these illnesses. The male cancers described vary tremendously in their prevalence, incidence, mortality, treatment, and survival rates. Within this group, there are remarkably positive outcomes and outcomes much in need of improvement. Penile and testicular cancers are the bright spots in this picture; both are uncommon, and both are eminently treatable. Prostate cancer, on the other hand, is quite common, difficult to screen, difficult to treat without major sexual problems, and yet receives relatively little funding from the NIH. Although as many men die from prostate cancer as women die from breast cancer, NIH funds breast cancer research at much higher levels than prostate cancer. According to the latest data available at the NIH Web site, during the 1990s, the amount of NIH funding varied from four times more for breast cancer (1993) to 2.9 times more in 1999. For fiscal year 2002, NIH is providing $522 million in funding for breast cancer and $278 million for prostate cancer. Private foundation funds for prostate cancer are much smaller than those available for breast cancer. Both types of cancer are extremely important to address, and both should receive adequate research attention. Nurses can advocate for more funding for prostate cancer, from basic science approaches to behavioral science strategies.     

Effect of 5-fluorouracil, mitoxantrone, methotrexate, and vincristine on the antibacterial activity of ceftriaxone, ceftazidime, cefotiam, piperacillin, and netilmicin

Using the checkerboard agar dilution technique, antibacterial activity and in vitro interactions of 4 antineoplastic agents and 5 antimicrobial drugs were examined against 56 strains of 7 bacterial species. 5-fluorouracil was found to inhibit all strains of Staphylococcus aureus and of Staphylococcus epidermidis at a concentration of 0.8 micrograms/ml or less. 84% of all gram-negative strains were inhibited synergistically when 5-fluorouracil was combined with beta-lactam antibiotics. Methotrexate and cefotiam were antagonistic in 42% of all combinations, especially when tested against Escherichia coli and Klebsiella pneumoniae.     

Attributional,life-event,and affective predictors of onset of depression,anxiety, and negative attributional style

This investigation examined (1) the extent to which negative attributional style and life events predict the development of depression and anxiety, and (2) the extent to which measures of life events, depression, and anxiety predict the development of negative attributional style. Sets of questionnaires, including the Attributional Style Questionnaire (ASQ), the Multiple Affect Adjective Check List (MAACL), the Beck Depression Inventory (BDI), the Stimulus-Response Inventory of General Trait Anxiousness (SR-GTA), and the Life Experiences Survey (LES), were administered to 80 undergraduate students on two occasions separated by a 1-month interval, between midterm and final examination periods of an academic semester. Results of hierarchical multiple regression analyses indicated that (1) composite negative attributional style predicted the onset of anxiety, measured by the MAACL anxiety scale, and (2) depression, measured by the MAACL depression scale, and low amounts of desirable life events each predicted the onset of composite negative attributional style.This research was partially supported by the Temple University Research Incentive Fund to the second author. We thank Edward Gracely for his assistance in the data-analytic process.