不同程度的溶血对ELISA一步法检测HBsAb的影响

目的探讨不同程度溶血标本对ELISA一步法检测HBsAb结果的影响。方法分别用已知HBsAb和HBsAb阳性的血标本．人为造成不同程度的溶血，同时用ELISA一步法进行HBsAb检测，用酶标仪检测标本OD值，通过对检验结果的观察，分析溶血标本对ELISA一步法检测的干扰程度。结果以标本的OD：cut off≥1为阳性进行结果判读。结果当样本中游离血红蛋白≥8g／L时，对ELISA一步法检测有明显的影响，可造成结果假阳性。结论用ELISA一步法进行HBsAb检测时，如样本游离血红蛋白≥8g／L时，要重新取样进行复查。     

ELISA法用于患者输血前检测Tp设置灰区的意义

目前检测梅毒抗体的方法较多,选择合适的方法对于准确判断患者输血前感染状况至关重要。酶联免疫吸附试验(ELISA)检测梅毒螺旋体特异性抗体被认为是受血者输血前梅毒检测的常规方法[1]。但由于ELISA方法本身的局限性以及不同试剂的灵敏性和特异性的差异,在实际检测中存在假阳性和假阴性结果。以试剂盒阳性判断值(cut off)上下一段区域设定为灰区,对OD值落在灰区内的标本进行重新检测从而得出准确结果,直接关系到患者的诊断、治疗和输血安全,有利于防范医疗纠纷。1资料与方法1.1标本来源:2008-01~2009-06本院住院患者首次输血前血清标本6 807份,标本无溶血、脂血。1.2仪器:瑞士HAM ILTON公司,M icrolab AT P lus2全自动加样系统;M icrolab FAME全自动酶免处理系统。1.3试剂:ELISA试剂购自英科新创(厦门)公司和北京万泰生物药业公司;TPPA试剂为日本富士瑞必欧株式会社产品。抗-Tp质控品由全军血液监督检定中心提供。1.4方法:所有标本均经ELISA试剂常规检测。OD值落在灰区的标本37℃水浴箱孵育15 m in后重新离心,分别用原批号试剂和另一种试剂双孔复检...     

神经性梅毒引起酶联免疫吸附实验一步法“钩状效应”3例

酶联免疫吸附实验(Enzyme-linked immunosorbet assay, ELISA)一步法检测梅毒螺旋体抗体(TP-Ab)灵敏性高﹑特异性强,我院从2007年引进该方法对临床患者进行初筛、复检.但笔者在用ELISA一步法检测TP-Ab的工作中遇到3例神经性梅毒患者,血清结果均为阴性,而脑脊液(CSF)结果均为阳性.经进一步实验判断此结果是由于高浓度的TP-Ab血清标本引起"钩状效应"[1],现报告如下:     

受血者输血前检测梅毒抗体结果分析

目的：通过分析三种方法（TRUST法、ELISA法、TPHA法）检测受血者输血前梅毒抗体的结果,了解各法在临床应用中的特点,以提高输血安全系数和减少因输血引起的医疗纠纷和提供可靠的诊疗依据.方法：7733份标本中,3104份行TRUST法检测,4629份行ELISA法检测; 4629份标本中98份OD值（光密度值）在CO（cut off）值附近的标本再行ELISA法双孔复试和TPHA法确证试验.结果：TRUST法与ELISA法检测阳性率差异显著（u=11.41,P＜0.01）;ELISA法与TPHA法两阳性率之间存在显著性差异（χ2=5.8181, P＜0.05）.结论：有必要采用与献血员体检试剂敏感性和特异性相同的试剂,以掌握患者输血前梅毒感染情况;受血者梅毒抗体的检验方法应采用特异性高、结果判定客观的酶联免疫法;实验室应备两种以上能相互弥补优缺点的特异性抗体检测方法试剂盒,加强临界值标本复检,力求结果准确.     

老年患者梅毒螺旋体抗体阳性临床分析

 目的 探讨老年患者梅毒螺旋体( Treponema pallidum,TP)抗体阳性的临床价值.方法 对98例老年人采用酶联免疫吸附试验( ELISA)筛查梅毒抗体阳性标本,分别进行梅毒螺旋体血球凝集试验(treponema pallidum hemagglutination assay,TPHA)检测和快速血浆反应素诊断试验(rapid plasma regaining,RPR)检测,对实验结果 进行统计分析.结果 98例TP- ELISA阳性标本,用TPHA法检测阳性48例,阳性符合率48.98％.RPR法检测阳性44例,该44例仅16例用TPHA确证阳性.结论 老年人梅毒血清学试验阳性,只提示其体内有抗类脂抗体或抗TP抗体存在,不能作为感染梅毒螺旋体的绝对依据.     

化学发光检测梅毒特异性抗体反应性结果分析

 目的 分析梅毒特异性抗体(treponema pallidum antibody,TP)的有反应性结果,尤其是COI值较低的标本,为减少假阳性的发生提供依据.方法 选取129例用化学发光法检测梅毒特异性抗体有反应性的术前筛查标本,用梅毒螺旋体血凝试剂盒(treponema pallidum hemaglutination assay,TPHA)进行复检,分析比对两者的结果.结果 当切点S/CO值为5时,Syphilis TP阳性为96例,阴性为33例,两种方法差异无统计学意义(P＞0.05).结论 当TP有反应性时(尤其是S/CO值为1.0 ～5.0的标本),要综合考虑患者的年龄、病史,以及临床表现,可再用TPHA做复检,如两者均为阳性再报阳性,这样大大减少了假阳性的发生,降低了医疗纠纷的可能.     

微粒子化学发光法和梅毒螺旋体明胶颗粒凝集试验检测梅毒抗体的一致性比较

目的评价微粒子化学发光免疫技术(chemiluminescence microparticle immunoassay,CMIA)检测临床血清标本梅毒螺旋体抗体的敏感性和特异性。方法用梅毒螺旋体明胶颗粒凝集试验(treponema pallidum particle agglutination test,TP-PA)法作为对照标准,采用CMIA法检测4686例血清标本,并用Kappa检验评价两种检测方法对同一个样本的化验结果的一致性。结果 4686例血清标本中用CMIA法检出阳性率5.48%,TPPA法检出阳性率5.14%。以TPPA为金标准,CMIA法敏感性为99.17%,特异性为99.60%。其中CMIA法检测血清S/CO值>4.00的215例,用TPPA确认214例阳性,阳性预测值(PPV)为99.53%。结论 CMIA法可替代TPPA法进行梅毒螺旋体特异性抗体检测,对于CMIA法检测S/CO值1.0～4.0的需进一步复检。     

指末端毛细血管血检测CMV抗体的研究

本文用ELISA方法对110名住院病儿指末端毛细血管血和静脉血配对血标本中巨细胞病毒(CMV)抗体进行了对照研究。配对血标本检测CMV IgM、IgG抗体的一致性分别为99.09％和96.36％;敏感性分别为87.5％和95.58％;特异性分别为100％和98.48％。反复多次重复检测配对血标本中CMV抗体,结果均呈正相关。本结果表明:指末端毛细血管血可代替静脉血检测儿科病血中CMV抗体.这对儿科CMV感染病儿进行动态血清学监测具有重要意义。     

3TP法与ELISA法检测梅毒螺旋体抗体价值的比较

目的对3TP法与ELISA方法在梅毒螺旋体抗体检测能力及其在临床应用中的价值进行比较。方法应用3TP法与ELISA方法分别对85份确诊病例与体检正常TPHA方法确证为梅毒特异性抗体阴性的人员血清180份进行同时检测,检测结果进行χ2统计分析。结果总计265份标本检测3TP法阳性符合率100%,假阳性2例,灵敏度为100%,特异度98.9%;ELISA方法阳性符合率98.8%,假阴性1例,假阳性2例,灵敏度为98.8%,特异度为98.9%。两种方法间差异无统计学意义(P>0.05)。结论 3TP法与ELISA方法均具有高灵敏度、高特异度的特点,二者之间无统计学差异(P>0.05),3TP法可以替代现行的梅毒血清学筛检的ELISA方法;3TP法适用于自动生化分析仪,具有简便、快速的优势,可实现对血清梅毒抗体的定量检测,便于疗效和预后观察。     

无偿献血者梅毒抗体筛检方法与试剂的价值评价

目的：评价无偿献血者梅毒抗体筛检方法与试剂的筛检价值。方法：以卫生部临床检验中心梅毒抗体临床科研血清盘标本40份及随机抽取西安市无偿献血者梅毒抗体阴性血清100份为评价标本。用梅毒甲苯胺红不加热血清试验(TRUST)法，厦门新创梅毒抗体ELISA1诊断试剂盒(ELISA1)及北京金豪梅毒抗体ELISA诊断试剂盒(ELISA2)对评价标本作盲法筛检，以卫生部临床检验中心梅毒抗体已知阳性和阴性作为金标准。用四格表法评价真实性与可靠性指标，并对二种ELISA试剂盒的Cut-off值的合理性进行评价。结果：TRUST法、ELISA1及ELISA2试剂盒的灵敏度分别为68．2％，95．5％，100．0％，特异度分别为77．8％，94．4％，94．4％，约登指数分别为0．46，0．900．94，重复试验符合率分别为90．0％，100．0％，100．0％，二种ELISA试剂盒的Cut-off值较合理。结论：ELISA试剂盒的灵敏度、特异度及重复试验符合率要远高于TRUST法。尽管TRUST法的灵敏度与特异度较低，在无偿献血者的粗筛快检中可降低血液报废率，因而在无偿献血中的仍有很高价值，如果将ELISA试剂盒的灵敏度与特异度加以提高，将会具有更大的临床应用价值。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.