血清幽门螺杆菌抗体分型检测在健康体检中的临床意义

目的探讨血清幽门螺杆菌抗体分型检测在健康体检中的临床意义。方法收集健康体检者356例血清样本,先后进行幽门螺杆菌抗体分型检测(免疫印迹法)、胶体金法血清抗体检测及14C-尿素呼气试验。以14C-尿素呼气试验结果为诊断依据,比较免疫印迹法及胶体金法检测幽门螺杆菌感染的灵敏度及特异度;分析幽门螺杆菌抗体分型的诊断意义。结果免疫印迹法检测灵敏度高于胶体金法(χ2=21.620,P0.05),胶体金法特异度略高于免疫印迹法,但差异无统计意义;免疫印迹法及14C-尿素呼气试验检测234例同为阳性者中,血清抗体分型结果显示:Ⅰ型幽门螺旋杆菌感染175例,Ⅱ型幽门螺旋杆菌感染59例。结论在进行幽门螺旋杆菌根除治疗时,先通过血清幽门螺杆菌抗体分型检测,可对临床用药予以指导,减少治疗费用和耐药的发生,具有较高的临床应用价值。     

探究不同免疫检验法对乙肝病毒感染血清标志物检验的效果

目的 研究乙肝病毒感染患者血清标志物检验中不同免疫检验法的应用效果。方法 选取江苏省句容市人民医院2020年3月—2022年4月收治的207例乙肝病毒感染患者为研究对象,入组者均采集5 mL空腹静脉血,均采用化学发光法、酶联免疫吸附法(enzyme linked immunosorbent assay, ELISA)测定血清标志物,对比不同免疫检验法对血清标志物检验阳性率,分析不同免疫检验法对乙肝病毒感染诊断准确度、误诊率及漏诊率,并对比不同免疫检验法的检验成本。结果 化学发光法的HBeAb、HBeAg、HBcAb、HBsAb阳性率(18.84%、27.05%、60.39%、20.77%)高于酶联免疫吸附法(16.91%、15.46%、57.97%、10.14%),差异有统计学意义(χ²=87.138、77.383、7.149、110.535,P<0.05);酶联免疫吸附法的检验成本为(30.59±2.46)元,低于化学发光法(113.29±2.98)元,差异有统计学意义(t=304.367,P<0.05);化学发光法的误诊率、漏诊率低于酶联免疫吸附法...     

邵阳市幽门螺杆菌血清尿素酶抗体阳性率分析

目的了解幽门螺杆菌血清尿素酶抗体在邵阳市健康人群中阳性率情况。方法采用胶体金法检测血清幽门螺杆菌尿素酶抗体1 520例,并对检测结果进行分析。结果 1 520例体检者幽门螺杆菌血清尿素酶抗体阳性率为55.5%,男女幽门螺杆菌血清尿素酶抗体阳性率差异有统计学意义(P<0.05);不同年龄组幽门螺杆菌血清尿素酶抗体阳性率差异亦有统计学意义(P<0.05)。结论邵阳市幽门螺杆菌感染率很高,应引起重视。     

5种幽门螺杆菌检测方法的比较

目的通过对不同幽门螺杆菌检测方法的比较为临床检测提供参考。方法于2012年1月～2015年1月采集537例消化道疾病患者的胃黏膜组织、血液、粪便等标本,综合应用胃黏膜组织染色法、快速尿素酶试验法、13C-尿素呼气试验、血清抗体检测法和粪便抗原HpSA法进行幽门螺杆菌检测,观察各方法的敏感度、特异度、准确度以及与诊断标准的吻合度。结果537例受检者中共检出幽门螺杆菌感染327例,占60.9%;男性患者感染率为61.4%、女性患者感染率为60.5%,两者比较差异无统计学意义(χ2=1.437,P=0.067)。5种检测方法中,组织染色检测的灵敏度最高,为0.979;血清抗体检测的灵敏度最低,为0.896,总体差异有统计学意义(χ2=7.465,P=0.027)。13C尿素呼气试验检测的特异度最高,为0.900;血清抗体检测特异度最低,为0.810,总体差异有统计学意义(χ2=13.733,P=0.000)。13C尿素呼气试验的准确度最高,达0.946,各方法总体差异有统计学意义(χ2=8.753,P=0.007),5种方法的吻合度κ值为0.789～0.913,13C尿素呼气试验最高,血清抗体最低。结论5种方式均能有效检测幽门螺杆菌,13C尿素呼气试验诊断价值较高,适合在临床推广。     

3种血清法检测小儿肺炎支原体的结果比较

目的比较3种血清法检测小儿肺炎支原体的阳性率。方法将该院收治的180例疑似肺炎支原体感染患儿作为研究对象,分别应用被动凝集法(甲组)、酶联免疫吸附法(乙组)及胶体金法(丙组)进行检测,比较各组的检测阳性率,同时比较3种方法检测不同性别患儿间的阳性率。结果 3组检测阳性率比较,差异有统计学意义(P0.05),两两比较结果:甲组检测阳性率(95.0%)与乙组检测阳性率(96.67%)比较,差异无统计学意义(χ~2=0.626,P=0.428);甲组与丙组检测阳性率(81.67%)比较,差异有统计学意义(χ~2=15.525,P=0.000);乙组与丙组检测阳性率比较,差异有统计学意义(χ~2=20.963,P=0.000)。3种方法在不同性别间的检测阳性率比较,差异无统计学意义(P0.05)。结论应用被动凝集法与酶联免疫吸附法检测小儿肺炎支原体感染具有较高的检测阳性率,但开展酶联免疫吸附法检测需设置阴性、阳性对照,所以不适合在基层社区医院开展,且会增加医院成本。采用被动凝集法、胶体金法检查时,临床医师可结合患儿临床症状及时给予复查,以防止漏诊。     

慢性幽门螺杆菌感染与冠心病发病及其危险因素的关系

目的：探讨幽门螺杆菌感染与冠心病及多种危险因素的关系,观察幽门螺杆菌感染对脂质代谢、血管内皮功能、炎症介质及血清免疫学的影响.方法：应用酶联免疫吸附试验法测定冠心病组（100例）和非冠心病组（100例）血清幽门螺杆菌抗体,确证慢性幽门螺杆菌感染,分别应用酶联免疫吸附试验法及放射免疫法测定冠心病组内皮素-1.结果：（1）冠心病组血清幽门螺杆菌抗体阳性率明显高于非冠心病组（57%vs32%, P〈0.05）;（2）冠心病组慢性幽门螺杆菌感染者血浆内皮素-1水平明显高于非幽门螺杆菌感染者（P〈0.05）.结论：幽门螺杆菌慢性感染与冠心病有关,可能是冠心病发病的独立危险因索; 幽门螺杆菌慢性感染者血浆内皮素水平显著升高,可能是其导致冠心病的发病机制之一.     

酶联免疫吸附试验在梅毒螺旋体感染诊断中的检验价值分析

目的探索分析酶联免疫吸附试验用于诊断梅毒螺旋体感染的检验价值。方法将我院2016年1～12月收治的疑为梅毒螺旋体感染患者180例,分别接受酶联免疫吸附试验检测和甲基胺红不加热血清试验检测,对照临床确诊结果,分析其检测价值。结果酶联免疫吸附试验检测梅毒螺旋体感染诊断准确率高达95.00%(171/180),显著性超过甲基胺红不加热血清试验检查梅毒螺旋体感染诊断准确率82.78%(149/180),差异有统计学意义(P<0.05)。酶联免疫吸附试验检测检查梅毒螺旋体感染的准确度、灵敏度、特异度、阴性预测值及阳性预测值均高于甲基胺红不加热血清试验,差异有统计学意义(P<0.05)。结论酶联免疫吸附试验用于诊断梅毒螺旋体感染,效果显著,值得临床推广应用。     

不同人群血清丙型肝炎病毒抗体检测的临床意义

目的对不同人群血清丙型肝炎病毒抗体(抗-HCV)检测,分析丙型肝炎病毒(HCV)感染途径及造成感染不断增高原因,达到早预防的目的。方法采用酶联免疫吸附试验(ELISA)法对6784例不同人群血清进行抗-HCV检测,分3组,即住院组(Ⅰ组)、门诊组(Ⅱ组)、体检组(Ⅲ组)。结果 3组不同人群血清抗-HCV感染例数进行χ2检验:Ⅰ组与Ⅲ组比较差异有统计学意义(χ2=7.598,P0.01);Ⅱ组与Ⅲ组比较差异有统计学意义(χ2=4.649,P0.05);Ⅰ组与Ⅱ组比较差异无统计学意义(χ2=0.157,P0.05)。结论用ELISA法检测抗-HCV适合HCV感染者的初筛检测,在人群普查中可使用该方法 。     

4种幽门螺杆菌抗体检测试剂盒筛查幽门螺杆菌感染的性能研究

目的 评价4种幽门螺杆菌抗体试剂盒筛查幽门螺杆菌感染的能力,为临床选择诊断方法提供依据.方法 以14C-尿素呼气试验作为参比对照方法,选取3种基于胶体金免疫层析原理、1种基于颗粒增强胶乳浊度测定法的幽门螺杆菌抗体试剂盒为评价试剂盒,对114例研究对象进行检测,用χ2检验进行统计学处理.结果 与参比方法对比,4种评价试剂盒间对幽门螺杆菌感染诊断的灵敏度为8%~60%,特异度为64%~81%,一致性为46%~68%,差异有统计学意义(P<0.05);4种评价试剂盒相互之间的一致性为61%~72%,差异有统计学意义(P<0.05).结论 4种幽门螺杆菌抗体检测试剂盒对幽门螺杆菌感染的筛查有一定作用,多种方法联合检测更佳.     

免疫印迹法检测幽门螺杆菌及其分型的临床应用价值探讨

选取2013年1月²014年1月本院收治的158例胃部疾病幽门螺旋杆菌感染患者,采取免疫印迹法检测幽门螺杆菌及其分型等。结果 I型Hp感染患者中慢性胃炎、胃溃疡、十二指肠溃疡、胃癌的发生率明显高于Ⅱ型感染患者,差异显著,具有统计学意义(P<0.05)。I型在胃癌组中感染率高于慢性胃炎组,差异显著,具有统计学意义(P<0.05)。应用免疫印迹法检测幽门螺杆菌及其分型,可科学指导用药,减少耐药菌株的产生,提高治疗效果。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.