TP-ELISA法检测梅毒抗体假阳性结果的影响因素

目的：探讨TP-ELISA法检测梅毒特异性抗体假阳性结果的影响因素。方法采用TP-ELISA法对2619例标本进行检测,初检阳性者再行TRUST试验和TPPA确认试验,结果判定以TPPA为准,比较TP-ELISA法与TPPA法的符合率。结果231例TP-ELISA法检测阳性标本中S/CO值＞1．0者201例,经TRUST复检后阳性者169例,经TPPA确认阳性者196例,TP-ELISA法和TPPA的符合率为97．5％。在S/CO为0．70～1．0的30例标本中,经TRUST复检后阳性者12例,经TPPA确证为阳性者19例,TP-ELISA法和TPPA的符合率为63．3％。结论 TP-ELISA法检测阳性标本中S/CO值为0．70～1．0者应采用TRUST和 TPPA法联合检验,以减少误诊及漏检。     

两种梅毒检测方法对比

目的：比较甲苯胺红不加热血清试验（TRUST）、螺旋体明胶颗粒凝集试验（TPPA）两种梅毒血清学试验的检测结果。方法：将2008-2009年性病门诊138例确诊梅毒患者血清同时用甲苯胺红不加热血清试验TRUST试验、螺旋体明胶颗粒凝集试验TPPA试验检测,比较两种梅毒检测实验方法的灵敏度和特异性。结果：138份血清中,98份血清TRUST阳性,17份经抗梅毒治疗血清TRUST阴性,TPPA试验132份血清为阳性。结论：TRUST试验可作为梅毒的人群筛查、疗效、复发或再感染的检测指标,TPPA试验是检测梅毒螺旋体抗体的特异性方法,主要作为梅毒的确证试验。两种不同方法同时进行梅毒检测,将减少漏诊、误诊率,为梅毒的确诊提供参考依据,并且在判定梅毒的发展、痊愈及药物疗效方面都具有十分重要的意义。     

CLIA、TRUST和TPPA3种梅毒检测方法的比较

目的 通过比较化学发光免疫分析（CLIA）、梅毒螺旋体明胶凝集试验（TPPA）、甲苯胺红不加热血清试验（TRUST）3种梅毒检测方法的优缺点,为临床选择合适的梅毒检验方法.方法 随机选取已确诊为梅毒感染的患者446例和非梅毒感染的健康体检者398例.分别采用CLIA、TRUST、TPPA法对血清中的梅毒抗体进行检测,评价3种方法之间的差异及临床应用.结果 在对梅毒患者的血清检测中,CLIA、TRUST和TPPA的灵敏度分别为98.2％,80.3％和94.8％;特异度分别为98.5％、76.4％和99.7％.在对照组中,CLIA、TRUST和TPPA的假阳性率分别为1.5％、23.6％和0.2％.结论 CLIA的灵敏度高于TPPA,重复性好,操作简便,可用于梅毒初筛,但CLIA的特异度低于TPPA,因此CLIA的阳性标本应结合TPPA及临床症状确诊.TRUST的灵敏度及特异度均低于CLIA和TPPA.因此,TRUST主要用于梅毒的临床疗效观察.     

高危人群梅毒检测结果分析

目的：了解陕西省汉中市略阳县高危人群梅毒感染情况,为制定相应的干预措施和实验室检测策略提供依据。方法：对2010年组织到我院体检的高危人群采用梅毒螺旋体ELISA试验（TP-ELISA）方法进行检测,阳性结果用梅毒螺旋体明胶凝集试验（TPPA）进行确认。结果：2010年共129份血清样本（上半年61份,下半年68份）,ELISA法共检出阳性16例,阳性率为12.40%,有2例经TPPA法确诊为阴性,特异性为89.15%。结论：本地区高危人群梅毒感染率高,实验室应该尽快制定相应的预防、检验和治疗策略,控制梅毒的性传播途径,降低梅毒感染带来的危害性;同时证明ELISA检测法特异性好,可作为高危人群梅毒感染的一种理想检测方法,但对ELISA阳性标本应做TPPA确认。     

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。     

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.     

酶联免疫吸附法检测与甲苯胺红不加热血清试验在梅毒检验中应用价值的比较

目的 比较酶联免疫吸附法检测与甲苯胺红不加热血清试验在梅毒检验中应用价值.方法 选取2016年1月-2017年1月进行梅毒筛查的160例患者临床资料为研究对象,分别采用酶联免疫吸附法(ELISA)与甲苯胺红不加热血清试验(TRUST)检测,对比两种检测结果.结果 ELISA法检测血清阳性率明显高于TRUST,差异有统计下意义(P<0.05);ELISA检测结果的敏感性、特异性、阴性预测值、阳性预测值均高于TRUST,差异有统计学意义(P<0.05).结论 ELISA法在梅毒检验中阳性率较高,适用于大量样本筛查,值得临床推广和应用.     

用ELISA评价胶体金测试卡检测乙型肝炎病毒血清标志物两对半的性能

目的用酶联免疫吸附法（ELISA）评价胶体金测试卡检测乙肝两对半的性能。方法选用ELISA检测乙肝表面抗原（HbsAg）阴性100例,阳性者200例,用胶体金测试卡和ELISA分别检测乙肝两对半对比结果和检测用时。结果胶体金测试卡单个标本的检测时间为25min,而ELISA的为1h。100例HbsAg阴性标本除2例HbcAbELISA检测阳性而胶体金测试卡检测阴性外,其他结果均相同。200例HbsAg阳性标本中,胶体金测试卡法检测6例HbsAg阴性,符合率97．0％;9例HBeAb检测阴性,符合率92．9％;7例HbcAb检测阴性,符合率96．5％。结论胶体金测试卡与ELISA相比。不需要特殊设备,易于观察结果,快速检测单个标本,操作简便,特异性较高,能满足急诊的需要。     

某地区服刑人员TP-ELISA与RPR检测在梅毒筛查中的应用效果观察

目的:观察TP-ELISA与RPR检测在梅毒筛查中的应用效果.方法:选取2015年9月～2017年8月之间在我院进行检验的2860例服刑人员的血清进行TP-ELISA检查、RPR检查,二者和(或)为阳性反应,再进行TPPA检查.比较TP-ELISA与RPR检测在梅毒筛查中准确性.结果:检查结果显示,RPR检测法检测出34例梅毒,检出率为1.18％.TPELISA检测法检测出72例梅毒,检出率为2.51％.TPPA法和RPR法的符合率为43.2％,和TP-ELISA法的符合率为97.2％.两种符合率之间的差异具有统计学意义(P＜0.05).结论:在梅毒的临床筛选检查中,TP-ELISA检测法准确率较RPR检测要高,假阳性率更低,临床可以将TP-ELISA检测法和TPPA检测法结合使用,而RPR法更适用于梅毒患者的临床药物治疗指征.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.