传染性非典型肺炎的血清学诊断研究

目的 评估传染性非典型肺炎(世界卫生组织又称严重急性呼吸综合征，SARS)血清病毒特异性抗体检测在SARS诊断中的实用价值，了解免疫荧光抗体法(IFA)和酶联免疫吸附法(ELISA)对SARS病毒特异性抗体检测结果的一致性程度。方法 用IFA和ELISA检测267例不同病程SARS患和132例对照组血清SARS病毒特异性抗体，以敏感度、特异度、阳性预测值(17PV)、阴性预测值(NPV)和准确度评价其诊断价值，并以Kappa值评价两种检测方法结果的一致性。结果 以IFA检测的血清特异性IgM类和IgG类抗体阳性率在病程第11天明显增高，病程≥11天，IgM类抗体诊断SARS的敏感度为65．6％，特异度100．0％，PPV 100．0％，NPV 71．0％，准确度81．3％；IgG类抗体则分别为敏感度91．1％，特异度97．0％，PPV 97．3％，NPV 90．1％，准确度93．8％。以ELISA方法所测结果与IFA结果相仿。对IFA和ELISA法检测的一致性检验示Kappa值分别为0．640和0．779。结论 血清病毒特异性抗体在SARS发病10天以上阳性率高，抗体检测有助于确立发病10天以上SARS的血清学诊断。IFA和ELISA检测SARS病毒抗体的一致性较好。     

金标免疫渗滤法诊断试剂盒诊断血吸虫病的价值研究

目的：评价金标免疫渗滤法诊断试剂盒（DIGFA－kit)用于血吸虫病血清流行病学调查的价值。方法：采用DIGFA与ELISA单盲平行检测各期血吸虫病病人血清，非流行区人群血清，疫区人群血清和血吸虫病已控制地区人群血清共2304份。结果：DIGFA检测血吸虫抗体的敏感性为96．8％，对非流行区健康人群的特异性为100％，该法检测疫区居民血清508份，抗体阳性检出率为35．6％，在Kato法粪检阳性的81人中，其中抗体阳性79人，阳性符合率为97．5％；检测血吸虫病已控制地区人群血清，抗体阳性率为4．6％，根据DIGFA的敏感性和对非流行区人群的特异性，计算其Youden's指数为0．926，上述各项结果与ELISA比较，差异无显著性（P＞0．05），结论：DIGFA与ELISA有相似的敏感性和特异性，且方法简便，快速，胶体金标记物制备容易，试剂稳定，运送方便，在现场和临床诊断更具有优越性。     

陕西延安地区肾综合征出血热流行情况研究报告

目的 明确陕西延安地区为肾综合征出血热疫源地及病毒基因型别。方法 择有疫情报告地,进行人群疫情调查及健康人群特异性抗体检测;用夹夜法捕鼠,调查鼠种及鼠密度,采集鼠肺、血标本。人血、鼠血分别用IFA和ELISA法检测IgG抗体;鼠肺采用RT-PCR检测汉坦病毒(HV)RNA,测定PCR产物并与HV代表株76-118和Seoul序列进行比较。结果 对延安市防疫站2001年统计的7例HFRS患者进行流行病学调查,均属在当地感染;检测延安市洛川县交口河镇245例人血标本HV特异性IgG抗体,阳性50例,人群隐性感染率为20.41％。22份鼠肺及鼠血标本,IFA抗HV IgG阳性3例,ELISA阳性5例。从一只鼠血抗体阳性的鼠肺中检测到HV RNA,序列测定符合Seoul S片段序列(94％)。结论 延安市洛川县交口河镇为HFRS疫源地及新疫区,洛川交口河镇健康人群、褐家鼠、小家鼠中有HV感染,病毒型别为SEO型。     

三种肾综合征出血热诊断方法的比较

目的探索一种更为敏感而特异的肾综合征出血热特异性抗体的检测方法。方法采用免疫-PCR、ELISA和IFAT三种方法检测130份HFRS患者血清中抗HFRS-IgG抗体。结果免疫-PCR方法的灵敏度为78．5％，特异性为100％；ELISA法和IFAT法的灵敏度分别为47．7％和49．2％。结论免疫-PCR方法的敏感性高于ELISA法和IFAT法．是适用于肾综合征出血热特异性抗体检测的好方法。     

SARS-CoV抗体实验诊断的特异性研究

为探讨严重急性呼吸综合征(SARS)病毒(SARS-CoV)抗体在SARS病原学诊断中的特异性，应用酶联免疫吸附试验(ELISA)和荧光定量RT-PCR技术检测了80例非SARS患者SARS-CoV抗体的阳性率。结果在23例健康人中，SARS-CoV-IgG抗体的阳性率为8．7％(2／23)，20例肿瘤患者中，阳性率为20％(4／20)；18例自身免疫性疾病患者中，SARS-CoV-IgM抗体和SARS-CoV-IgG抗体阳性率分别为11．1％(2／18)和22．2％(4／18)；19例系统性红斑狼疮(SLE)患者中，SARS-CoV-IgM抗体和SARS-CoV-IgG抗体阳性率分别为21．1％(4／19)和47．4％(9／19)，SARS-CoV-IgG抗体和SARS-CoV-IgM抗体同时阳性率为15．8％(3／19)。证实SARS-CoV-IgM抗体诊断SARS的特异性为92，5％；SARS-CoV-IgG抗体诊断SARS的特异性为76．25％；两种抗体同时阳性诊断SARS的特异性为96．25％。经RT-PCR证实上述抗体单项阳性均为假阳性。认为两种抗体同时测定可提高诊断的特异性，出现假阳性的原因可能与包被的抗原中存在细胞膜、胞浆、核和抗细胞核成分的自身抗体有关。     

基于重组优势多表位抗原的梅毒间接酶联免疫吸附试验与梅毒螺旋体血凝试验和甲苯胺红不加热血清试验检测梅毒螺旋体抗体的比较研究

目的：建立操作简便、特异性好、敏感性高的血清梅毒抗体的间接酶联免疫吸附试验（ELISA）。方法：通过计算机分析选择梅毒螺旋体优势抗原表位，构建了梅毒螺旋体多表位优势嵌合抗原(rTpN15-TpN17-TpN42-TpN47)表达载体，转化宿主菌HB101进行表达，纯化获得高纯度融合抗原。在此基础上，以纯化抗原包被酶联板，建立检测血清中梅毒抗体的间接ELISA法。利用该方法与梅毒螺旋体血凝试验（TPHA）和甲苯胺红不加热血清试验（TRUST）同时检测了126例梅毒可疑血清样本，对检测结果进行了比较研究。结果：梅毒螺旋体多表位优势嵌合抗原（rTpN15-TpN17-TpN42-TpN47)在大肠杆菌中获得了高效表达，并成功建立了检测血清中梅毒抗体的间接ELISA法及试剂。对126例梅毒可疑血清样本的检测结果，ELISA、TRUST、TPHA的检出阳性率分别为75．40％（95／126）、72．22％（91／126）、70．63％（89／126）， 其中TRUST有29例，TPHA有6例为可疑阳性。TPHA检测的6例可疑阳性中，有5例ELISA、TURST均为阳性；而TRUST测出的29例可疑样品中，仅7例ELISA、TPHA阳性。结论：多表位嵌合抗原ELISA试剂在特异性、敏感性与TPHA法相近，但明显优于TRUST法。     

抗去唾液酸糖蛋白受体酶联免疫检测法的建立及临床初评

目的 建立肝脏特异性自身抗体的ELISA检测方法，辅助自身免疫性肝炎的诊断。方法 利用亲和层析法从人肝脏组织中直接纯化去唾液酸糖蛋白受体(ASGPR)，经免疫学鉴定后以此纯化抗原包被微孔板，酶联免疫固相吸附试验检测去ASGPR的自身抗体(抗-ASGPR)。结果 本研究从10g肝组织纯化ASGPR，总量为1．6mg。经SDS-PAGE和Dot-ELISA验证，纯化ASCGPR纯度高、具有抗原活性。ASGPR预吸附可阻断血清抗体与ASGPR间的免疫反应，类风湿因子、梅毒阳性血清不干扰本ELISA法的抗原抗体反应。33例自身免疫性肝炎(AIH)患者中检出抗-ASGPR24例，阳性率为72．7％。在临床上高度怀疑AIH的10例患者中，抗-ASGPR阳性者有7例。原发性胆汁性肝硬化、病毒性肝炎、肝炎后肝硬化、肝癌、胆囊炎患者中阳性检出率分别为21．4％(9／42)、16．8％(16／95)、16．1％(10／62)、10．7％(3／28)、14．3％(1／7)。药物性肝炎、酒精性肝炎、系统性红斑狼疮和类风湿性关节炎患者中未检测到抗-ASGPR。200名健康体检者阳性率为4．6％。抗-ASGPR检测对AIH诊断的特异性为89．6％。结论 本研究所建立的抗-ASGPR ELISA检测方法可靠、特异性好。抗-ASGPR检测有助于AIH的诊断，尤其是对那些抗核抗体、平滑肌抗体、肝肾微粒体-1型抗体等自身抗体均阴性、临床高度怀疑AIH病例的诊断可能更为有用。     

应用捕获ELISA检测肾综合征出血热患者尿液中特异性IgM抗体

目的 检测紧综合征出血热患者尿液中特异性IgM抗体,研究早期诊断方法。方法：用MacELISA法检测不同病日HFRS病人尿液中特异性IgM抗体。结果：HFRS病人尿夜中特异性IgM抗体总阳性率为76.47%,第3病日即可出现阳性,7－9病日阳性率可达83.87%,与同期HFRS病人血清抗体检测对比无显著性差异（P＞0.05）。结论：用MacELISA检测HFRS尿液中特异性IgM抗体敏感性高,特异性强,适合早期诊断。     

干血点法检测HIV-1抗体在高危人群普查中的应用

目的 采用干血点法检测艾滋病病毒1型(HIV-1)抗体。方法 用干血点法对391例吸毒者、HIV感染的高危人群进行了HIV-1抗体的检测，并用常规酶联免疫吸附试验(ELISA)进行对比，阳性结果用免疫印迹法(WB)进行确认。结果 391例吸毒者中，共检出39例阳性，阳性率为9．95％，干血点法与ELISA法的结果完全一致，结果符合率为100％。39例阳性经WB法确认为HIV感染。结论 干血点法进行HIV-1抗体检测准确可靠，有较高的灵敏度与特异性，成本低廉，标本易采集，且样本无传染性，方便邮寄等诸多优点，可以广泛应用于流行病学调查，家庭匿名检测HIV及不便采血的广大农村地区。     

免疫-PCR检测肾综合征出血热患者血清中抗核衣壳蛋白抗体方法的建立

目的　建立高灵敏性和高特异性的免疫 -PCR方法检测肾综合征出血热 (HFRS)患者血清中抗核衣壳蛋白抗体。方法　用汉坦病毒 ( 76 - 118株 )重组核衣壳蛋白为抗原包被聚苯乙烯微滴度板 ,与经ELISA法和临床均已确诊为HFRS患者的血清进行抗原抗体特异性反应 ,以链霉亲和素为桥梁将生物素标记的抗体与生物素标记的DNA指示分子相连 ,PCR扩增DNA指示分子 ,通过检测指示分子DNA来反映肾综合征出血热患者血清中抗核衣壳蛋白抗体的水平 ,并与传统的ELISA法进行比较。结果　免疫 -PCR检测肾综合征出血热患者血清中抗核衣壳蛋白抗体的敏感性是ELISA法的 2 5 0 0 0倍 ;30例HFRS阳性患者血清免疫 -PCR检测均为阳性 ,2 0例甲型肝炎阳性血清和 2 0例正常人血清免疫 -PCR检测均为阴性。结论　免疫 -PCR方法敏感性高 ,特异性强 ,有可能作为一种高敏感性的检测方法用于HFRS的临床辅助诊断     

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.