鼠疫监测血清学中的非特异凝集反应

目的探讨鼠疫间接血凝中的非特异凝集反应的影响因素。方法股动脉采集、分离鼠类血清,56℃30m in灭活,首先进行鼠疫间接血凝的初筛试验。初筛检出的阳性血清,经醛化吸收后,再进行复判,严格按照中华人民共和国鼠疫诊断标准GB15991-1995执行。同时进行鼠疫血清的放射免疫沉淀试验。结果在广东省鼠疫疫源地(雷州市)采集鼠类血清799份,其中7份血清发生非特异凝集,初筛假阳性率0.9%。在广东鼠疫历史疫区(兴宁市)采集鼠类血清1 008份,其中56份血清发生非特异凝集,初筛假阳性率5.6%。在非鼠疫历史疫区(曲江)采集鼠类血清1 114份,其中64份血清发生非特异凝集,初筛假阳性率5.8%。但三个不同地区来源的127份非特异凝集血清,经复判结果全部为阴性;放射免疫沉淀试验也全部为阴性。在广东省鼠疫监测中鼠类血清发生间接血凝非特异凝集的假阳性率为4.4%。结论鼠疫血清的放射免疫沉淀试验的特异性远远高于间接血凝试验。在广东不同地区来源的鼠类血清样本中,间接血凝出现假阳性率明显不同,非疫区明显高于疫区。     

固相放射免疫试验检测鼠疫F1抗体

建立了固相放射免疫试验(SPRIA)检测鼠疫F1抗体的方法。被测抗体经F1抗原两次选择结合,提高了检测特异性。检测人和5种非鼠疫疫区动物血清205份,以及假结核菌等6株非鼠疫菌免疫动物血清,全部阴性。检测鼠疫康复人和接种鼠疫苗的7种动物血清8份,IHA和SPRIA全部阳性,放射免疫沉淀(SPA—RIP)有两种动物为阴性结果;阳性反应GMT、SPRIA比IHA高,比SPA—RIP低。试验表明SPRIA检测鼠疫F1抗体,具有良好的特异性和敏感性,操作简便、快速,可检测各种标本。     

应用RIP法检测小肠结肠炎耶氏菌对鼠疫F_1抗体的交叉反应性

利用放射免疫沉淀试验(RIP)检测鼠疫F_1抗体的敏感性与特异性均优于广泛应用的间接血凝试验(IHA)。本文将鼠疫抗血清用本室保存的小肠结肠炎耶氏菌抗原吸收后以RIP和IHA测定鼠疫抗血清的残留效价,观察小肠结肠炎耶氏菌对鼠疫F_1的交叉反应。现将结果报告如下。     

放射免疫沉淀试验检测鼠疫FI抗体的研究——Ⅰ.特异性与敏感性

试验证明,用放射免疫沉淀试验(RIP)检测鼠疫抗体时,将被试血清与相应的阴性对照血清的结合比定为≥3作为反应标准是适宜的;用RIP检测假结核,小肠结肠炎菌等抗血清30份,这些抗血清在1:10到1:100的各种稀释度中与~(125)I-鼠疫FI抗原均无交叉反应,从非鼠疫疫区收集的2196份哺乳动物血清,亦未发现阳性反应,说明该法特异性强。由于RIP是用分离剂沉淀鼠疫抗原-抗体复合物,故能检出不完全抗体,检出率不仅高于常规的间接血球凝集试验(IHA)和酶联免疫吸附试验(ELISA),且滴度往往高十几倍、几十倍,乃至几百倍。所以用RIP检测潜在性鼠疫疫源地、考核灭源效果以及在科研中用于检测微量鼠疫抗体具有重要意义。加之该法自动化程度高,测试信息以数字显示,因而指标客观,容易分析,适于大规模现场调查。     

广东省鼠疫静息期3种耶尔森氏菌鼠疫PCR检测

目的应用PCR试验对广东省3种耶尔森氏菌进行鼠疫的特异性基因检测。方法应用含内部对照PCR技术,以鼠疫菌特异基因fra、pla的2对引物进行PCR实验。结果假结核菌1株、11株小肠结肠炎菌O∶3、5株O∶9、1株中间型,结果全为阴性。结论该试验菌没有鼠疫菌的特异性基因fra、pla,可以进一步说明从1973～1986年雷州半岛用鼠疫IHA、RIHA从鼠类检出的阳性材料是特异的。     

鼠疫胶体金法快速诊断试剂盒的研制

目的 研制一种敏感、特异、快速并适用于非专业人员的鼠疫胶体金法快速诊断鼠疫FI抗体的试剂盒。方法 采用柠檬酸三钠还原法制备胶体金颗粒，标记金黄色葡萄球菌A蛋白作为探针，同时用鼠疫多糖抗原致敏硝酸纤维素膜，共同组装成基于免疫层析原理的胶体金法快速诊断盒。结果 间接血凝法检测阳性300份血清标本，胶体金法检测全部为阳性，间接血凝法检测阴性100份血清标本，胶体金法检测全部为阴性，两种方法符合率100％；并且鼠疫胶体金法快速诊断盒不与假结核耶尔森氏菌等相关细菌的免疫血清发生交叉反应。结论 鼠疫胶体金法快速诊断盒具有较好的特异性和敏感性，并且具有更简便快速的优点，适合基层单位现场使用。     

鼠疫间接血凝试验工作液的探讨

鼠疫间接血球凝集试验 (IHA)具有敏感、特异、简单、快速的特点。该法目前仍是鼠疫监测和现场应用中的重要手段 ,特别在轻型病人、病人的追溯诊断以及隐性感染病人的血清学诊断方面 ,有着独特的优势。常规用 1%健康家兔血清盐水作封闭和稳定液及血凝工作液 ;近年因鼠疫防治任务的不断加重 ,兔血清生产工作量和成本也逐年加大 ;笔者用同源的羊血清盐水试图代替兔血清盐水 ,探讨其作为 IHA工作液的可能性。1　材料鼠疫抗原致敏血球 (批号 980 4 ,本所生产 ) ,鼠疫 175抗血清 (批号 990 1) ,抗假结核伪 5血清 ,健康人血清、兔血清、羊血清、…     

鼠疫FI单克隆抗体致敏红细胞用于反向血凝抑制试验检测鼠疫FI抗体的试验研究

本文介绍了鼠疫FI MCAb致敏红细胞用于反向血凝抑制试验检测鼠疫FI抗体的试验。结果表明,用该法检测95份正常人和8种动物血清,7种非鼠疫菌免疫动物血清,全部阴性;检测9份抗鼠疫强毒株和1份弱毒株血清及1份接种鼠疫菌苗的人血清,全部阳性,滴度比间接血凝试验(IHA)高2~1～2~3。该法可省去另做一排抑制试验的操作程序,较IHA简便、快速,在鼠疫疫源地调查和疫情监测中有良好的应用前景。     

2002年陕西省鼠疫F1抗体放射免疫监测结果分析

自1985年以来,陕西省连续18年在鼠疫疫区开展了放射免疫监测,用放射免疫沉淀试验(RIP)方法,来检查被检血清中是否存在鼠疫F1抗体。现将2002年放射免疫监测结果报告如下。1 材料和方法1.1 血清来源:2002年采自本省鼠疫疫区定边县各种鼠类血清246份,微量间接血凝试验(IHA)全部为阴性。1.2 试剂盒:放射免疫沉淀试验(RIP)试剂盒,由全国鼠疫布     

鼠疫放射免疫沉淀试验在鼠疫监测中的应用及效果评价

目的：建立敏感性高、特异性强的鼠疫血清学诊断方法，应用于鼠疫血清学监测。方法：用标记的鼠疫菌FI抗原（^123I-FI）检测阳性血清、免疫黄鼠血清、实验区各种动物血清及正常血清。结果:建立鼠疫放射免疫沉淀试验（RIP），并确定其诊断标准，研制出了鼠疫抗体放免测定盒及其使用方法。RIP在鼠疫监测中的应用。结论：RIP的敏感性和特异性均明显高于IHA，是目前建立的鼠疫血清学方法中最为敏感特异的方法。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.