ELISA等3种方法检测血清TPIgG的比较研究

目的：探讨ELISA方法测定血清TPIgG诊断梅毒的应用价值。尤其是对大批标本检测的应用。方法：随机抽取245例卖淫嫖娼人员的血清标本,分别用ELISA与TRUST,TPPA3种方法检测。比较三者间的敏感性和特异性。结果：ELISA法与TRUST法符合率99．18％,ELISA对TRUST的敏感率为99．03％,特异性99．03％,ELISA与TPPA结果符合率99．18％,ELISA对TPPA敏感率为99．51％,特异性为97．30％,结论：3种方法比较,差异无显著性,ELISA方法检测梅毒有较高应用价值。     

HA，LN，PⅢP及Ⅳ—C测定对慢性肝炎和肝硬化的诊断价值

①目的探讨血清透明质酸(HA)、层黏蛋白(LN)、Ⅲ型胶原前肽(PⅢP)、Ⅳ型胶原(Ⅳ-C)在慢性肝炎和肝硬化中的诊断价值.②方法应用放免法测定慢性肝炎、肝硬化病人血清HA,LN,PⅢP,Ⅳ-C的含量,同时与正常对照组进行比较.③结果重度肝炎、肝硬化病人的血清HA,LN,PⅢP,Ⅳ-C含量与对照组比较均有显著差异(F=32.4～113.9,q=6.208～23.125,P＜0.01).④结论血清HA,LN,PⅢP及Ⅳ-C的测定,对判断慢性肝炎和肝硬化倾向有一定的临床意义.     

感染依赖性抗原Tp0470的鉴定及在梅毒诊断中的应用

为筛选新型梅毒诊断抗原,以改进梅毒早期诊断及预后判断血清学诊断方法,本研究在鉴定Tp0470蛋白为感染依赖性抗原的基础上,建立基于Tp0470的ELISA方法,检测468份临床血清标本,并与TPPA、LZ-ELISA及RPR结果比较,初步评价该蛋白的诊断价值;同时对Tp0470-ELISA A₄₅₀值与RPR滴度进行相关性分析。结果显示:Tp0470-ELISA的灵敏度和特异度分别为95.32%和95.66%,ROC分析其AUC值为0.907。与TPPA、LZ-ELISA及RPR结果相比,Tp0470-ELISA的符合率分别为95.51%(kappa=0.907)、94.87%(kappa=0.897)、88.67%(kappa=0.771)。Tp0470-ELISA的A₄₅₀值与RPR滴度的相关系数为0.38,P=0.96。以上结果表明基于Tp0470蛋白的ELISA在梅毒血清学诊断中具有较高的潜在应用价值。     

血清CA242检测在结直肠癌中的临床价值

目的探讨血清CA242检测在结直肠癌中的临床价值.方法用酶联免疫方法测定57例结直肠癌、64例其他消化道肿瘤、108例消化道良性疾病病人及36例健康对照者血清CA242.结果结直肠癌病人组血清CA242的含量(42.92±38.81 U*ml-1)和阳性率(56.14%)均显著高于其他消化道恶性肿瘤如胃癌、肝癌、食道癌(P＜0.01)、良性消化道疾病(P＜0.001)及正常对照组(P＜0.001).且血清CA242对结直肠癌诊断的有效率、特异性、准确性、假阳性、假阴性、阳性结果预报价值和阴性结果预报价值分别为43.6%、77.9%、73.2%、22.1%、43.8%、41.0%和86.6%.若联合检查B超、ERCP、腹部螺旋CT和/或MRCP,可排除胰腺、胆系肿瘤.结直肠癌组中Dukes C-D期病人血清CA242的含量(57.63±48.91 U*ml-1)和阳性率(64.71%)显著高于Dukes A-B期 (26.16±27.03 U*ml-1,21.73%,P＜0.05).血清CA242阳性和增高程度与结直肠癌Dukes分期呈正比.肿瘤部位、细胞分化程度与血清CA242无关.结直肠癌病人经手术治疗,血清CA242含量随时间推延明显降低(P＜0.05);一旦复发和/或转移,可在腹部CT、钡剂灌肠或纤维肠镜阳性发现前测得血清CA242又复增高.结论血清CA242是一项对结直肠癌较为敏感的辅助性诊断指标,其检测对结直肠癌的诊断、手术疗效的评定、术后病情和复发转移的监测具有重要意义.     

Prevalence of Treponema pallidum DNA among blood donors with two different serologic tests profiles for syphilis in São Paulo,Brazil

The presence of Treponema pallidum DNA was assessed by real‐time PCR in samples of blood donors with reactive serologic tests for syphilis. Treponema pallidum DNA was detected in two (1·02%) of 197 samples of VDRL>8, EIA+ and FTA‐ABS+ donors, and in no sample from 80 VDRL?, EIA+ and FTA‐ABS+ donors. Donors VDRL?, EIA+ and FTA‐ABS+ lack demonstrable T. pallidum DNA in their blood and are unlike to transmit syphilis. Donors VDRL>8, EIA+ and FTA‐ABS+ carry the risk of syphilis infectivity even in concomitance to antibodies detection. Serologic screening for syphilis may still play a role to prevent its transfusion transmission.     

早期麻风血清学诊断方法的评价及应用研究

目的：评价现有的早期麻风菌感染检测方法的实用性，探讨它们的潜在应用前景。方法：共比较了１２种血清学检测方法，将之按４个“Ｓ”标准和疾病筛检标准评价，并动态观察在亚临床感染及疾病检测中的实用意义。结果：结果表明各方法间的结果是可以比较的。方法敏感性高，特异性强，且简便，廉价，实用。     

Comparison of serological and clinical findings in Turkish patients with cystic echinococcosis

Summary Cystic echinococcosis (CE), caused by the cestode Echinococcus granulosus, is potentially dangerous for humans. The aim of this study was to examine serological and clinical findings regarding cysts localisation and individual responses in 54 patients with CE. The majority of patients in this study were females (63 %) and the average age was 46.3 years. Most of the patients lived in rural areas or kept a dog (46 %) for a long time. The most frequent symptoms were hypochondrial pain (48.9 %), epigastrial discomfort (27.7 %), vomiting (21.3 %), minor cough (12.8 %), urticaria (6.3 %), weakness (4.3 %), fever (2.1 %), side-or back-ache (4.3 %). However, 17 % of the patients showed no symptoms. In every case, the ultrasound (USG) and/or computer tomography (CT) investigations were positive. In most cases (53.2 % of the patients) a single cyst was found but 46.8 % of the patients had multiple cyst formations (from 2 to 9 cysts) located in the liver. Sporadic lung, splenetic, mesenterial, tibial and cerebral localisations were also found. The patients were individually treated with albendazol (10–15 mg/kg) five days prior and six months after the surgical treatment. Serum samples were investigated by the serological techniques: IHAT, ELISA and Western blot using hydatid fluid antigen. In the patient sera, the specific antibody levels were mostly increased after surgery. Different results were obtained only in two patients. In the first case, seroconversion was delayed. In the other case all ELISA results were negative, however, the Western blot analysis and surgery proved the presence of CE. The results suggest that the different antibody response of patients depends on the individual immune response. Multiple localization and various stages of CE cysts demonstrate the necessity of a complex approach for the confirmation of a correct diagnosis.     

HIV testing among clients in high HIV prevalence venues: disparities between older and younger adults

The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (aged ≥50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N = 1238) seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. ≥50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (odds ratio [OR] = 0.6; 95% confidence interval [CI] = 0.40–0.90) or ever (OR = 0.6; 95% CI = 0.40–0.90). Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis.     

CysA2: A candidate serodiagnostic marker for Mycobacterium tuberculosis infection

Background and objective: It is important to identify and test serologically active antigens in order to devise a mixture of antigens or peptides that is most useful for serodiagnosis. This study evaluated the serodiagnostic potential of CysA2, which has not previously been described as a serological antigen, together with those of PstS1, HspX, antigen 85 complex and CFP‐10 proteins. Methods: Serum IgG antibody titres against each antigen and a mixture of the antigens were measured by ELISA, in subjects with pulmonary tuberculosis and in healthy control subjects. Results: CysA2 showed diagnostic value comparable to that of PstS1 and HspX. Mixtures of these three proteins provided the highest diagnostic sensitivity. CysA2 was useful for identifying patients who did not react to HspX or PstS1, and was most valuable in increasing the sensitivity of testing. Furthermore, CysA2 efficiently overcame the limitation associated with use of PstS1, that is, significantly lower sensitivity for subjects who are negative for acid‐fast bacilli. Conclusions: These findings suggest that CysA2 can be used in combination with HspX and/or PstS1 to increase the accuracy of tuberculosis diagnoses.