梅毒螺旋体检测方法及其临床应用

梅毒是一种严重危害人民健康的性传播疾病,了解并掌握梅毒螺旋体检测方法对早期发现和控制梅毒具有重要的意义.此文就梅毒螺旋体检测方法及其临床应用作一综述.     

梅毒螺旋体重组蛋白Tp0463的表达与抗原性鉴定

目的表达梅毒螺旋体(Tp)重组蛋白Tp0463(rTp0463)并鉴定其抗原性,为进一步探讨其在梅毒血清学诊断和免疫保护中的作用奠定基础。方法 PCR扩增Tp0463基因,构建原核表达重组体pET-28a(+)/Tp0463,转化宿主菌诱导表达重组蛋白,Ni-NTA亲和层析法纯化蛋白,Westernblot鉴定表达产物的抗原性。结果成功构建了原核表达重组体pET-28a(+)/Tp0463,经诱导高效表达了一分子量大约为16KDa的重组蛋白,以包涵体表达形式为主,纯化蛋白的纯度>90%;Westernblot结果显示纯化蛋白能被梅毒患者混合血清特异性识别。结论高效表达了rTp0463,该重组抗原有良好的抗原性。     

4178例海洛因滥用者梅毒螺旋体感染的调查

目的:研究海洛因滥用者梅毒螺旋体的感染情况,了解这一人群梅毒螺旋体感染的上升势头,探索减少梅毒螺旋体传播的途径.方法:采用梅毒甲苯胺红不加热血清试验(TRUST)对4 178例海洛因滥用者进行初筛,阳性者用梅毒螺旋体明胶颗粒凝集试验(TPPA)进行确诊.结果:4 178例海洛因滥用者中梅毒螺旋体感染者128例,占3.06%,其中男性50例,女性78例;感染者以静脉、肌肉注射为主,共有106例占83%.静脉注射者最短者一个月,最长164个月.女性滥用者中梅毒感染率为6.9%,明显高于男性滥用者中梅毒感染率1.64%,这说明女性更易感染梅毒.结论:海洛因滥用者是梅毒螺旋体易感人群;静脉注射毒品是感染梅毒的主要途径之一,另外相当一部分女性吸毒者卖淫等性病感染高危行为,造成了梅毒感染率的加大,因此加强毒品的滥用和梅毒的预防工作有利于截止梅毒的流行和传播.     

New inhibitors of complement fixation

A search for compounds that inhibit complement fixation revealed a number of new inhibitors. The presence of EDTA in the phosphate buffer containing complement and compound aided in the detection of compounds that inhibit complement fixation. Compounds were identified as inhibitors that previously could not be shown experimentally to inhibit complement fixation.     

酶联免疫吸附试验诊断梅毒螺旋体感染的临床价值

目的 探究梅毒螺旋体(TP)感染中应用酶联免疫吸附试验(ELISA)诊断的临床价值.方法 150例疑似梅毒螺旋体感染患者,分别采用酶联免疫吸附试验及快速血浆反应素环状卡片试验(RPR)进行诊断,以梅毒螺旋体明胶凝集试验(TPPA)检测结果为金标准,分析梅毒螺旋体感染阳性和阴性患者的检测结果,并对比酶联免疫吸附试验及快速...     

三种方法检测梅毒螺旋体抗体结果比较

目的比较甲苯胺红不加热血清试验（TRUST法）、ELISA法及明胶颗粒凝集试验（TPPA法）检测梅毒螺旋体抗体的结果符合率。方法对临床受血者输血前系列检查中TP-ELISA法阳性标本，进行双孔复检，仍阳性者进一步用TRUST法和TPPA法检测。结果44例TP-ELISA法阳性标本中，TRUST法阳性18例，TPPA法阳性39例。TRUST法与ELISA法的阳性符合率为40．9％，TRUST法与TPPA法的阳性符合率为43．6％，TPPA法与ELISA法的阳性符合率最高，为88．6％。结论TRUST法与ELISA法、TPPA法符合率均较低，适宜疗效观察；ELISA法与TPPA法的阳性符合率较高，结果较为准确可靠，适合大样本筛查。     

Comparison of home occult blood tests and interaction of tests with ibuprofen

The interaction of ibuprofen with home tests for occult blood was evaluated, and the accuracy of these tests was determined by validating the results with a specific quantitative assay of stool blood. Three home occult blood tests were evaluated: Early Detector, Fleet Detecatest, and CS-T Coloscreen Self Test. Fourteen men 19 to 35 years of age were instructed on how to use the tests and to record each day their dietary intake and stool consistency, the color of test control areas, the results, and the times of ibuprofen administration. The study consisted of a control period (days 0-5) and short-term (days 6-9) and long-term (days 10-14) ibuprofen periods. Each subject took two 200-mg tablets of ibuprofen three times daily beginning on day 6 and ending on day 14. During each study period, one stool sample was collected on each of three consecutive days. All three tests were performed on each sample, in addition to specific quantitative analysis with HemoQuant. All samples in the control period were negative for occult blood. Three positive results were reported by subject 4 in the short-term ibuprofen period, one with Fleet Detecatest and two with Early Detector. Subject 6 reported two positive Fleet Detecatest results and three positive Early Detector results during the long-term drug period. No positive results were detected with CS-T Coloscreen Self Test. The HemoQuant values showed that Early Detector produced one false-negative and two false-positive results.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of tests of contingency tables

We explore the use of bootstrap for testing independence of two categorical variables. We develop a theoretical justification for bootstrapping a contingency table and provide more accurate inference for small sample sizes. We also study the effect of equalized marginals on tests of independence. The small sample properties of the proposed and existing tests of independence are examined using Monte Carlo simulations. It is shown that the Fisher exact test and the Chi-squared test with continuity correction are very conservative and cannot be recommended to test independence with small sample sizes.     

多种不同梅毒检验方法检测梅毒螺旋体的结果准确率比较

目的对比三种不同梅毒检验方法检测梅毒螺旋体的结果准确率。方法选取该院确诊各期梅毒的39例患者,同期就诊的30例乙型肝炎患者与体检的30例健康受试者。采用梅毒酶联免疫吸附法、梅毒螺旋体明胶颗粒凝集试验及梅毒甲胺红不加热血清反应素试验进行检测并比较其结果。结果梅毒甲胺红不加热血清反应素试验的假阳性率为2.02%,另外两种检验方法的假阳性率均为0%。梅毒甲胺红不加热血清反应素试验的总阳性率为87.18%,假阴性率为12.82%;梅毒酶联免疫吸附测定法的总阳性率为97.43%,假阴性率为2.56%;梅毒螺旋体明胶颗粒凝集试验的总阳性率为100.00%,假阴性率为0%。梅毒螺旋体明胶颗粒凝集试验的敏感度明显高于梅毒甲胺红不加热血清反应素试验以及梅毒酶联免疫吸附测定法的敏感度(P0.05)。梅毒酶联免疫吸附测定法的敏感度明显高于梅毒甲胺红不加热血清反应素试验的敏感度(P0.05)。结论根据临床诊断和治疗的不同需要,采用适宜的梅毒检测方法,以满足临床需求的同时,尽量减少患者的经济压力,促进医患关系的和谐发展。     

弹性髓内钉固定与单纯石膏外固定治疗儿童稳定性胫骨骨折的比较

目的 比较弹性髓内钉(TENs)内固定与单纯石膏外固定治疗儿童胫骨稳定性骨折的疗效. 方法 回顾性分析2005年6月-2015年10月我院76例稳定性胫骨骨折患儿.49例患者采用TENs治疗(TENs组),27例患者采用保守治疗,闭合复位石膏外固定 (外固定组). 76例均获得6月以上的随访. 结果 所有患者随访6～14个月,平均10个月.TENs组骨折均愈合. 根据Flynn评价标准,优良率达到100％. 外固定组有11例患儿复查过程中出现骨折断端移位明显,单纯石膏外固定失败改行手术治疗. 优9例,良7例,差11例,优良率为59.2％. 两组差异有统计学意义(P<0.05). 结论 外固定治疗胫骨稳定性骨折易造成骨折端再移位,治疗效果较差. 而TENs固定治疗儿童胫骨骨折不易再移位,是治疗儿童胫骨骨折的理想方法.     

Comparison of respiration and luminescent tests in bacterial toxicity assessment

The toxicity assessment of chemicals on complex microbial communities are generally preferred to toxic tests conducted with pure cultures of bacteria. The purpose of this study is to compare the “Respiration” test studying metabolic criteria of mix bacterial populations and the “Microtox” test using lyophilized cultures of luminescent bacteria. The inhibition of oxygen consumption was compared with the inhibition of the bioluminescence of Photobacterium phosphoreum. In the first part of this study, the methodology of the “Respiration” test and the “Microtox” test was improved to optimize their performance in toxicity assessment. In the second part, toxicity of an organic chemical, the 3,5-Dichlorophenol, and an inorganic chemical, copper sulfate, was evaluated with the two tests. Results were compared and characteristics of the testing methods are discussed according to their sensitivity, reproducibility, representativity and ease of execution. The repeatability study for the “Respiration” test and the “Microtox” test gives variation coefficients less than 15% and 10% respectively. The variation coefficients concerning the reproducibility study are found to be 15% or 18% for the “Respiration” test, 5% or 28% for the “Microtox” test, depending on the tested toxicant. These two toxicity tests are easy to perform. But the “Microtox” test offers the advantage of being more sensitive and much faster. On the other hand, the “Respiration” test which was conducted on a microbial community is probably more representative of microflora in rivers.     

手法整复外固定支架固定与切开复位钢板内固定治疗克雷氏骨折的效果比较

目的 比较采用手法整复外固定支架固定与切开复位钢板内固定治疗克雷氏骨折的临床效果.方法 选取120例克雷氏骨折患者,利用随机数字表法进行分组,分别设为观察组和对照组,每组各60例.对照组采取手法整复外固定架固定治疗,而观察组则实施切开复位钢板内固定治疗.记录两组患者骨折预后情况及并发症发生率,并做好对比.结果 观察组总有效率为93.3％,对照组总有效率为91.7％,两组差异无统计学意义（x2 =2.083,P＞0.05）;观察组显效率83.3％,对照组显效率为66.7％,两组差异有统计学意义（x2=5.436,P ＜0.05）.观察组并发症发生率为3.3％ （2/60）,对照组为8.3％（5/60）,差异有统计学意义（x2 =6.172,P＜0.05）.结论 两种方案在治疗克雷氏骨折方面的效果相当,对不愿接受手术治疗患者可实施手法整复外固定架固定治疗,若存在粉碎性骨折则实施切开复位钢板内固定治疗.     

重建钢板内固定与克氏针内固定治疗锁骨骨折的疗效比较

目的探讨应用重建钢板内固定治疗锁骨骨折的临床疗效,并与克氏针内固定治疗锁骨骨折的临床疗效进行比较。方法48例锁骨骨折患者根据固定方法不同分为重建钢板内固定组（A组=24例）和克氏针内固定组（B组=24例）,比较两组的临床疗效。结果A组治疗总有效率（91．7％）明显优于B组（70．8％）（P〈0．05）,且A组术后并发症发生率（8.3％）明显低于B组（25．0％）（P〈0．05）。结论重建钢板内固定较克氏针内固定治疗锁骨骨折疗效确切,术后并发症发生率低。     

Isolation,characterisation and complement fixation activity of acidic polysaccharides from Argemone mexicana used as antimalarials in Mali

ContextGlobal studies on Argemone mexicana L. (Papaveraceae) traditionally used against malaria in Mali are limited to its low-mass compounds activities, and little information on its bioactive polysaccharides is available.ObjectiveThis study determines the structure and the immunomodulatory activity of polysaccharides from aerial parts of A. mexicana.Materials and methodsAcidic polysaccharides from this plant material named HMAmA1 and HMAmA2 were isolated from water extracts. Their monosaccharide composition was determined by gas chromatography. Glycosidic linkages were determined using GC-MS. NMR was also applied. The polymers were tested for effects on the human complement system in vitro at different doses.ResultsThe monosaccharide composition showed that the two polysaccharides contained in different amounts the following monomers: arabinose, rhamnose, galactose, and galacturonic acid. Overall structural analysis showed the presence of a low ratio of 1,2-linked rhamnose compared to 1,4-linked galacturonic acid with arabinogalactans substituted on position 4 of rhamnose. NMR data showed the presence of galacturonans alternated by rhamnogalacturonans bearing arabinose and galactose units. α-Linkages were found for l-arabinose, l-rhamnose and d-galacturonic acid, while β-linkages were found for d-galactose. The two polysaccharides exhibited strong complement fixation activities, with HMAmA1 being the highest potent fraction. ICH₅₀ value of HMAmA1 was 5 µg/mL, compared to the control BPII being 15.9 µg/mL.Discussion and conclusionsPolysaccharides form A. mexicana presented a complement fixation effect. The complement system is an important part of the immune defense, and compounds acting on the cascade are of interest. Therefore, these polymers may be useful as immunodulatory agents.     

可膨胀髓内钉Fixion系统与钢板内固定在肱骨干骨折中的应用对照研究

目的通过比较可膨胀髓内钉Fixion系统与钢板内固定在治疗肱骨干骨折的疗效,探讨可膨胀髓内钉Fixion系统在肱骨干骨折治疗中的作用。方法自2005年6月～2007年1月,50例采用可膨胀髓内钉Fixion系统与钢板内固定治疗的新鲜闭合性肱骨干中段骨折。按AO分型均为12中的各型,其中男36例,女14例,年龄23～67岁,平均35岁。应用可膨胀髓内钉组26例,其中12A型13例,12B型8例,12C型5例。钢板内固定组24例,其中12A型12例,12B型7例,12C型5例。观察手术时间、术中出血量;术后定期随访,观察骨痂出现时间、临床愈合时间、有无畸形愈合、延迟愈合、不愈合、感染等并发症,评价肩关节功能。结果50例均获得12～16个月随访,平均14.3个月。可膨胀髓内钉组:手术时间15～50min,平均25min,术中失血10～30ml,平均15ml,均未输血。X线片显示最早出现骨痂为术后4周,临床愈合时间为3～8个月,平均5个月,延迟愈合、不愈合0例,全部伤口获Ⅰ期愈合,无神经并发症;肩关节功能按Neer评分,结果优14例,良8例,可4例,差0例,优良率85%。钢板内固定组:手术时间50～150min,平均90min,术中失血100～500ml,平均120ml,其中1例需输红悬液2单位;X线片示最早出现骨痂为术后6周,临床愈合时间为3～16个月,平均8个月,骨折延迟愈合4例,不愈合0例,无畸形愈合;全部伤口获Ⅰ期愈合,有3例术后出现桡神经麻痹,3个月内恢复。肩关节功能按Neer评分,结果优15例,良6例,可3例;差0例,优良率87.5%。结论在治疗肱骨干骨折中可膨胀髓内钉系统与钢板内固定均可达到有效、可早期活动目的。而可膨胀髓内钉系统更具有微创、可行骨折闭合复位和固定、操作简便、失血少,骨折愈合快及并发症少等优点,是治疗肱骨干骨折的一种简单有效的方法。但在使用顺行进钉者肩关节活动术后略有影响,必须注意。     

梅毒特异性抗体检测方法比较及临床应用分析

目的:探讨四种梅毒特异性抗体检测方法对各期梅毒标本检测的临床应用价值.方法:用胶体金快速检测试验(ACONSYP)、酶联免疫吸附试验(ELISA)做梅毒特异性抗体定性检测;梅毒螺旋体血凝试验(TPHA)、梅毒螺旋体明胶颗粒凝集试验(TPPA)做特异性抗体定量检测.结果:SYP、ELISA、TPHA、TPPA四种方法对梅毒特异性抗体的定性检测结果差异无最著性;TPPA对特异性抗体检测的滴度水平普遍高于TPHA.结论:SYP适合用于对临床上疑诊梅毒的患者进行筛选,TPHA比TPPA更适合临床用于特异性抗体的定量检测.