Determination of serum fibrosis indexes in patients with chronic hepatitis and its significance

Objectives To study the relationship between serum levels of hyaluronic acid (HA), type Ⅲ procollagen (PCⅢ), laminin (LN), type Ⅳ collagen (Ⅳ-C) and hepatic fibrosis and to determine their value in clinical practice. Methods 2600 serum samples from chronic hepatitis patients were assayed for fibrosis indexes including HA, PCⅢ, LN and Ⅳ-C with RIA. Liver biopsy was performed in 280 of those patients and the biopsy material was examined histopathologically. The inflammation grade of the liver, stage of fibrosis and degree of chronic hepatitis were recorded and were compared with fibrotic indexes. Results Among 2600 chronic hepatitis patients, every fibrotic index had a significant correlation with the inflammation grade, fibrosis staging and the degree of chronic hepatitis (P<0.01). The coefficient correlation of the results of histopathological examinations to HA was 0.544, 0.548 and 0.468 respectively, that to PCⅢ, 0.495, 0.424 and 0.335, that to LN, 0.214, 0.204 and 0.184, and that to Ⅳ-C, 0.406, 0.404 and 0.412, respectively. Conclusions Serum fibrosis indexes are fairly well correlated with the inflammation grade of the liver, fibrosis staging and the degree of chronic hepatitis. However, as diagnostic markers, they should be considered in combination with liver function tests, ultrasonography and clinical manifestations.<     

An enzyme-linked immunosorbent assay for detection of IgG1 antibodies specific to human cystic echinococcosis in Egypt

Human cystic hydatidosis (cystic echinococcosis) is a chronic zoonotic disease that results from infection with the dog tapeworm Echinococcus granulosus. In Egypt, cystic echinococcosis (CE) is recognized in slaughtered livestock by veterinarians, however, there is little information about human CE infection rates. We describe an immunological assay useful for the diagnosis of human cystic hydatidosis. Sera were collected from surgically confirmed hydatid cases (34), nonendemic subjects free from parasitic infection (20) and from subjects (109) infected with other helminths (Hymenolepis nana, Schistosoma mansoni, Fasciola hepatica and Ancylostoma duodenale). Hydatid cyst fluid (HCF) of camel origin was used as antigen in an ELISA format to measure total E. granulosus specific IgG antibodies and IgG subclasses. Sensitivity measurements of total IgG, and IgG1-4 were 100, 100, 79.4, 61.8 and 55.9%, respectively, whereas respective specificity reached 65.1, 97.7, 98.4, 96.1 and 83. 7%. The diagnostic value of measuring IgG1 (97.7%), as assessed by a rating index (J) for combined sensitivity and specificity, was superior to total IgG (65.1%) and IgG2-4 (77.8, 57.9 and 39.6%, respectively). These findings set the stage for field evaluation of the IgG1 assay in areas endemic with human cystic hydatidosis.     

Clinical Assessment and Improved Diagnosis of Bocavirus-induced Wheezing in Children, Finland

Human bocavirus (HBoV) is a widespread respiratory virus. To improve diagnostic methods, we conducted immunoglobulin (Ig) G and IgM enzyme immunoassays with recombinant virus–like particles of HBoV as antigen. Acute-phase and follow-up serum samples from 258 wheezing children and single serum samples from 115 healthy adults in Finland were examined. Our assays had a sensitivity of 97% and a specificity of 99.5%. Of adults, 96% had immunity; none had an acute infection. Of 48 children with serologically diagnosed acute HBoV infections, 45 were viremic and 35 had virus in nasopharyngeal aspirates (NPAs). Of 39 HBoV NPA PCR–positive children co-infected with another virus, 64% had a serologically verified HBoV infection. HBoV caused illness of longer duration than rhinovirus and of equal severity to that of respiratory syncytial virus. Among children with bronchiolitis, >25% had acute HBoV infections. Accurate HBoV diagnosis requires serologic analysis or PCR of serum; PCR of NPAs alone is insufficient.     

肝病患者的血清硒含量分析

作者应用荧光分光光度法测定了５０名健康人（对照组），１４例肝硬化和３０例肝癌患者的血清硒含量。对照组为０．７７９±０．１１６μｍｏｌ／Ｌ，肝硬化组为０．６８３±０．１３９μｍｏ／Ｌ，肝场组为０．６４６±０．２０８μｍｏｌ／Ｌ。测定结果与健康人组相比呈显著性（肝硬化组）和极显著性（肝癌组）差异，Ｐ值分别＜０．０５和＜０．０１，提示血清硒含量是肝病，特别是肝癌诊断的一项指标。     

人血清醇脱氢酶活性及其与肝炎的关系

利用醇脱氢酶在体内的特殊分布，对３５７例人血清醇脱氢酶活性进行测定分析。结果表明：正常人酶活性无地区、性别的显著差异（Ｐ＞０．０５），急慢性病毒性肝炎病人的酶活性明显高于正常人（Ｐ＜０．０５）。提示血清醇脱氢酶活性与肝脏的机能状态有密切关系。     

小儿肺炎血清sIL－2R的检测

用双抗夹心ＥＬＩＳＡ法测定了５３例小儿肺炎血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平。发现其水平（８５８３００±８２４７０Ｕ／Ｌ）明显高于健康对照组（４５５６７０±２４１３０Ｕ／Ｌ），增高达１．８８倍。其中支气管肺炎、毛细支气管炎、新生儿肺炎三者之间ｓＩＬ－２Ｒ水平无显著性差异。提示血清中高浓度的ｓＩＬ－２Ｒ可能是引起小儿肺炎患者细胞免疫低下的重要因素之一     

梅毒重组抗原酶联免疫吸附试验与快速血浆反应素试验的比较研究

目的 比较传统的快速血浆反应素试验（RPR）与重组梅毒螺旋体抗原为基础的梅毒快速试验的敏感性和特异性。方法 选择249例性传播疾病中心门诊患者,签署知情同意书后采集其静脉血,取血清进行梅毒螺旋体血球凝集试验（TPHA）、RPR试验和重组抗原的酶联免疫吸附试验并对结果进行比较。结果 以TPHA结果为标准,重组抗原的酶联免疫吸附试验血清敏感性为100％,特异性为98．4％。RPR试验血清敏感性为65．1％,特异性为98．4％。结论 以重组梅毒螺旋体抗原为基础的试验方法与RPR试验相比,具有更高的敏感性。     

Field evaluation of a one-step dipstick assay for the diagnosis of human leptospirosis in the Seychelles

OBJECTIVE AND METHOD: To compare the response of a dipstick assay (DSA) detecting Leptospira-specific immunoglobulin M (IgM) antibodies with that of an enzyme-linked immunosorbent assay (ELISA), an indirect haemagglutination assay (IHA), the microagglutination test (MAT) and a polymerase chain reaction assay (PCR) in patients with leptospirosis confirmed by MAT alone or by MAT and/or PCR (MAT/PCR). RESULT: In 75 patients with acute leptospirosis diagnosed by MAT (respectively, 90 patients diagnosed by MAT/PCR), the response in paired early and convalescent sera was positive in 78.9% (67.9%) by DSA, 76.0% (67.8%) by ELISA, 58.7% (55.6%) by IHA, 44.0% (53.3%) by PCR, and 100% (90.0%) by MAT. In early serum only, the response in patients diagnosed by MAT (respectively by MAT/PCR) was positive in 36.0% (38.9%) by DSA, 36.0% (37.8%) by ELISA, 14.7% (18.9%) by IHA, 39.2% (48.3%) by PCR, and 53.3% (58.9%) by MAT titre > or =1:100. DSA detected the main serogroups implicated in human leptospirosis in Seychelles and demonstrated sensitivity comparable to ELISA. In 124 single sera from control subjects without overt disease, the response was positive in 4.8% by DSA, 3.2% by ELISA, 3.2% by IHA, 13.8% by PCR, 37.9% by MAT titre > or =1:100, and 2.4% by MAT titre > or =1:800, giving evidence of the frequency of both past and current subclinical infection in Seychelles and that DSA was less sensitive than MAT to detect moderate levels of leptospiral antibodies. CONCLUSION: DSA is a simple and reproducible assay well adapted to field conditions and could usefully contribute to the evaluation of leptospirosis in areas devoid of serological laboratory facilities.     

Trustline结核分枝杆菌IgG/IgM抗体检测试剂盒(胶体金法)的临床应用评价

目的 评价Trustline结核抗体IgG/IgM检测试剂盒临床应用效果。 方法 选用3家医院的1009份血清标本,其中628份为结核病患者血清(308例菌阳病例,320例菌阴病例);对照组381份非结核病血清。采用Trustline试剂盒及一种已上市的试剂盒(对照试剂盒)分别检测1009份血清,计算多项检测指标,从而评价试剂盒的检测效果。 结果 通过检测1009份临床血清标本, Trustline试剂盒检测血清抗体(IgG+IgM)的灵敏度、特异度、阳性预测值、阴性预测值、 Youden 指数分别为61.3%、79.8%、 83.3%、 55.6% 和0.411,对照试剂盒检测血清抗体(IgG) 的结果分别为53.7%、89.0%、88.9%、 53.8%和0.426。经统计分析表明Trustline试剂盒的灵敏度显著优于对照试剂盒(P0.01),特异度低于对照试剂盒(P0.01),但阳性诊断效率和阴性诊断效率方面差异无统计学意义,Youden指数相接近。 进一步分析显示Trustline试剂盒对菌阳样本及菌阴样本的检出率分别77.6%和44.7%,对照试剂盒则为67.9%和40.0%,对菌阳样本检出率的差异有统计学意义。检测1009份标本,Trustline试剂盒共得IgM阳性35例,其中结核组阳性30例(4.8%),非结核组阳性5例(1.3%)。 结论 Trustline试剂盒检测结核抗体的灵敏度显著优于对照结核抗体试剂盒,并可同时用于检测IgG/IgM抗体,可以应用于结核病的快速诊断。