一期梅毒实验室诊断差异性研究

目的通过梅毒螺旋体初筛试验、确认试验和鉴别诊断试验,探讨一期梅毒实验室诊断差异性,最大限度减少漏诊与误诊,为深入研发新型早期梅毒诊断试剂奠定基础。方法依据2000年中国卫生部防疫司颁布的性病诊断标准,临床筛选一期梅毒患者86例（研究组）和非梅毒患者100例（对照组）,对患者血清进行甲苯胺红不加热血清试验（TRUST）初筛和梅毒螺旋体明胶颗粒凝集试验（TPPA）确认。筛选临床体征、TRUST法和TPPA法三者结果有差异的患者进一步鉴别诊断,鉴别诊断主要应用荧光定量PCR（FQ-PCR）法、免疫PCR法与自身抗体检测等试验。结果初筛TRUST法灵敏度和特异性分别为62．8％、93．0％;确认TPPA法灵敏度与特异性分别为66．3％、100％。TRUST法和TPPA法两者结果差异占12．8％;临床体征诊断、TRUST法和TPPA法三者结果差异占41．9％。TPPA法与TRUST法两者均阴性的一期梅毒患者中,FQ-PCR阳性率达88．0％,免疫PCR阳性率占40．0％。TPPA法阳性、TRUST法阴性的一期梅毒患者免疫PCR法与TPPA法结果一致;TPPA法阴性、TRUST法阳性11例患者中结核抗体阳性2例,类风湿因子阳性3例与抗Sm抗体结果阳性6例。结论一期梅毒患者实验室诊断结果差异性较大,漏诊与误诊的比例较高,有待研发新型的诊断试剂和提高诊断水平。     

梅毒血清抗体检测与临床的关系分析

目的探讨梅毒血清抗体检测与临床的相关性。方法对我院10710例进行梅毒血清抗体检测者,根据性别、年龄的不同比较它们之间的关系,并进行分析结果判断与临床的相关性。结果不同性别患者梅毒血清抗体检测无显著性差异（P〉0.05）,而不同年龄患者梅毒血清抗体检测有显著性差异（P〈0.01）。结论由于患者自身原因、试剂原因及HIV感染等因素,造成梅毒血清抗体试验有一定的假阳性和假阴性,因此对梅毒血清抗体试验结果应结合病史及临床情况进行综合分析判断。     

反向间接胶乳凝集试验法检测粪便A型产气荚膜梭菌肠毒素的结果及评价

本文以１０种５２株供试菌分别与７个不同年龄组的健康人粪便混合,共配成３６４份模拟标本,采用反向间接胶乳凝集（ＲＰＬＡ）试验法与生物学试验法（小鼠致死试验、豚鼠皮肤血管透性因子试验,Ｖｅｒｏ细胞毒性试验）检测各标本中的Ａ型产气荚膜梭菌肠毒素（简称Ｃｐ－Ｅｎｔ）。除产气荚膜梭菌之外的其他菌种培养液２３８份标本（３４株）,ＲＰＬＡ与生物学试验结果完全一致,均为阴性。产气荚膜梭菌１２６份标本（１８株）中有７０份标本的ＲＰＬＡ同生物学诸法完全一致地检出了Ｃｐ－Ｅｎｔ．有１株７份标本（ＣｐＮＣＴＣ８７９７）的ＲＰＬＡ为阳性,而各生物学试验却均为阴性,该菌株经ＰＣＲ检查证明确为肠毒素原性产气荚膜梭菌,表明ＲＰＬＡ比生物学试验法更灵敏。有５株（ＣｐＮＣＴｃ８２３８,ＣｐＮＣＴＣ１０６１１,ＣｐＮＣＴＣ１０６１４,ＣｐＮＣＴＣ１０６１２,ＣｐＬ－５２）３５份标本ＲＰＬＡ与各生物学试验结果均为阴性,但经ＰＣＲ检吉证明该５株菌均为肠毒素原性产气荚膜梭菌,后经超声波破碎菌体提取物对其中部分菌株进行试验的结果仍然显示了ＲＰＬＡ与生物学法的一致性。有２株（ＣｐＮＣＴＣ８６８６,ＣｐＮＣＴＣ８４４９）１４份标本的所有结果均为阴性,ＰＣＲ     

神经梅毒的诊断与治疗（附23例分析）

观察神经梅毒的临床特点,以提高对神经梅毒的诊断与治疗水平。回顾性分析哈尔滨医科大学附属第一医院2005年1月至2010年12月收治的23例神经梅毒患者的临床资料。神经梅毒患者男17例（73.9%）,女6例（26.1%）,男女比约为2.8∶1;年龄27~71岁,平均年龄43.1岁。本组首发症状：麻痹性痴呆（7例）、精神异常（3例）、急性脑梗死（3例）、癫痫（2例）、脊髓病变（2例）、颅高压（2例）、周围神经损害（2例）、脑神经损害（1例）、无症状性神经梅毒（1例）。23例患者血清及脑脊液快速血浆反应素实验及梅毒螺旋体血凝试验均呈阳性反应。颅脑电子计算机断层扫描（CT）和/或磁共振成像（MRI）检查多表现为额叶、顶叶、颞叶、基底节等多发病变。本组患者经大剂量青霉素治疗后病情有显著改善20例,死亡1例,自动出院2例。神经梅毒的临床表现复杂多样,神经系统各部位均可受累,诊断依靠病史及临床表现、实验室血清及脑脊液梅毒抗体检测,误诊率高,应早期诊断,诊断后应进行规范治疗,早期治疗效果较好。     

株纯化轴丝在梅毒血清学中初步应用

本试验以纯化的Reiter株轴丝为抗原,建立了AF—ELISA试验方法,用该方法检测了35份自家免疫病人血清、285份非梅毒病人血清及78份各期梅毒病人血清共398份血清,并同时与FTA-ABS等进行比较,结果AF-ELISA特异性为99.3%,FTA—ABS为99.7%,两者敏感性为100%.     

脑脊液TP-ELISA、TRUST和VDRL检测对神经梅毒的诊断价值探讨

摘要：目的 探讨脑脊液梅毒螺旋体抗体酶联免疫法（TP-ELISA）、梅毒甲苯胺红不加热血清试验（TRUST）和性病研究实验室试验（venereal disease research laboratory,VDRL）对于神经梅毒的诊断价值。方法 对我院2011年7月至2014年7月三年内123例疑似神经梅毒患者的临床资料及脑脊液等进行综合分析并对三种方法检测神经梅毒的敏感性与特异性进行比较。结果 共诊断25例神经梅毒患者,其中1例抗-HIV阳性,24例抗-HIV阴性;有症状神经梅毒患者8例,无症状神经梅毒患者17例;有症状神经梅毒患者平均白细胞计数>5×106/L,异常率为62.50%;无症状神经梅毒患者平均白细胞计数<5×106/L,异常率为58.82%。有症状神经梅毒患者平均脑脊液蛋白>0.5 g/L,异常率为75.00%;无症状神经梅毒患者平均脑脊液蛋白<0.5 g/L,异常率为64.71%。TP-ELISA检测神经梅毒的敏感性与特异性分别为100% 和43.88%,TRUST检测神经梅毒的敏感性与特异性分别为96.94%和100%,VDRL检测神经梅毒的敏感性与特异性分别为100%和100%。结论 脑脊液TP-ELISA不可作为神经梅毒的确诊病例标准,脑脊液TRUST可以代替 VDRL用于神经梅毒的诊断,亦可作为其疗效的参考指标。     

梅毒住院患者63例血清学及脑脊液的临床分析

目的了解梅毒住院患者的流行病学、临床和血清学特征。方法对63例患者的临床资料及血清学、脑脊液等进行综合分析。结果87．30％（55例）患者血清TRUST呈低滴度表现（1：1～1：8）,14．29％（9例）为早期潜伏梅毒,15．87％（10例）为神经梅毒,52．38％（33例）为晚期潜伏梅毒,17．46％（11例）为无法判断病期的潜伏梅毒。73．02％（46例）传播途径为非婚性接触为主,性别分类中女性（49例）多于男性（14例）,低学历（54例）、待业者（18例）及性活跃期人群发病率高。结论潜伏（隐性）梅毒在梅毒分期中占有较大的比例;有必要对血清TRUST滴度持续（≥2年）不转阴患者进行神经梅毒的排查;有必要加强宣传性保护的重要性。     

梅毒实验室诊断的分子生物学方法

本文综述了梅毒的实验室诊断的分子生物学方法,特别是多聚酶链反应（ＰＣＲ）和Ｗｅｓｔｅｒｎ免疫印迹等新的分子生物学检测技术在诊断早期梅毒、先天性梅毒和神经性毒素等方面的研究进展,着重讨论了ＰＣＲ诊断梅毒的多方面情况,并对ＰＣＲ、Ｗｅｓｔｅｒｎ免疫印迹技术与经典兔感染试验进行了评价。     

玉米赤霉烯酮单克隆抗体和免疫酶技术研究

采用蛋白质连接技术合成玉米赤霉烯酮抗原,免疫Ｂａｌｂ／ｃ鼠,通过淋巴细胞杂交瘤技术建立六株分泌抗玉米赤霉烯酮的单克隆抗体杂交瘤细胞株。间接酶联免疫吸附试验测定细胞上清抗体效价为１：２０８４（４Ｈ８）、１：２５６（６Ｈ９、４Ｈ３、２Ｈ５、２Ｃ８）１：１６（３Ｆ１０）;腹水抗体效价为１０＾９（４Ｈ３、４Ｈ８）、１０＾８（２Ｈ５）、１０＾７（６Ｈ９）、１０＾５（３Ｈ１０）。竞争间接酶联免疫吸附试验测定六     

STD门诊生殖器溃疡性疾病的病原学研究

目的 了解生殖器溃疡性疾病（GUD）的发病率、病因及其与HIV感染的关系。方法 用暗视野显微镜检查（D-F）、梅毒血清学试验（STS）、酶免疫法（EIA）检测HSV抗原和HD培养等方法检测322例生殖器溃疡标本中TP、HSV和HD,并进行血清HIV抗体检测。结果 在8 999例STD门诊患者中,GUD患者322例（3.58%,322/8 999）;在322例GUD患者中,梅毒85例（26.4%,85/322）,生殖器疱疹74例（26.09%,84/322）,软下疳0例（0,0/322）,病因不明的GUD为153例（47.52%,153/322）;其中GUD患者的HIV感染率为1.86%（6/322）,梅毒患者的HIV感染率为4.70%（4/85）,生殖器疱疹患者的HIV感染率为1.19%（1/84）,其他GUD的HIV感染率为0.65%（1/153）。比较三者的HIV感染率发现,梅毒的HIV感染率高于生殖器疱疹和其他GUD患者（4.70%vs1.19%,χ^2=0.24,P＞0.05,OR=3.04,95%CI=0.31-29.93;4.70% vs 0.65%,χ^2=1.29,P＞0.05,OR=5.63,95%CI=0.58-55.06）,但两者差异无显著性;GH患者的HIV感染率与其他GUD患者的HIV感染率相比,差异无显著性（1.19% vs 0.65%,χ^2=0.00,P＞0.05,OR=1.85,95% CI=0.11-30.00）。结论 在性病门诊中,GUD的主要病因为梅毒和生殖器疱疹,且存在混合性感染;梅毒与HIV的感染有一定关系.     

Antibiotics in the treatment of wounds in the victims of the earthquake in the Armenian SSR

Purulent wounds in 88 victims of the Armenian earthquake with the syndrome of long-term squeezing were examined microbiologically and the experience with using antimicrobial drugs for their treatment was analyzed. In all the cases microbial associations were detected, coliform and nonfermenting gram-negative bacilli, enterococci, anaerobes and yeast-like fungi being isolated from 80, 20, 15 and 25 per cent of the patients respectively. 130 bacterial strains were studied in detail. 80 to 100 per cent of the bacterial isolates were resistant to the antibiotics routinely used in surgical practice, i.e. benzylpenicillin, tetracycline, levomycetin, kanamycin, cephalothin and cefazolin and highly sensitive to new antimicrobial drugs belonging to ureidopenicillins (mezlocillin), quinolones (ciprofloxacin) and cephalosporins of the 3rd generation (cefoperazone and ceftazidime). Retrospective estimation of the antibiotic therapy revealed its inadequacy in 55.7 per cent of the patients for the most part because of the isolates resistance. The 19 variants of the antibiotic use prescribed by the physicians mainly included penicillins, aminoglycosides and their combinations (in 67.2 per cent of the cases). The use of the highly efficient drugs of the groups of ureidopenicillins and quinolones was extremely rare which was likely due to lacking of information on the drugs.     

Histogenesis of the taste buds of the vallate papilla in the in the rat in the postnatal stages of development

The developing taste buds of vallate papillae were studied with electron microscope in rats during the first 7 days after birth. Two types of cells--light and dark--are identified in the taste buds of a one day old animal. The apical parts of dark cells are characterized by numerous dark granules. A distinguishing feature of light cells is the presence of synaptic contacts with afferent intragemmal nerves. On the 4th day of development on the top of the apical parts of the cell, a microvillar apparatus is seen to form, which does not yet communicate with the oral cavity. On the 7th day, basal cells appear in the taste buds. Some of these cells are seen mitotically dividing. The differentiated microvillar apparatus now communicates with oral cavity. The structure of the taste buds is getting similar to that in the adults. The structural and functional peculiarities of the developing taste buds are discussed in association with the period of ontogenesis under consideration.     

Changes in the size of the nucleoli of the Purkinje cells in the canine cerebellum in the postresuscitation period

The changes in the size of Purkinje cell (PC) nucleolus in the lateral and medial cerebellum zones were studied in dogs with different degree of neurologic status recovery after clinical death of various etiology and duration. PC always possess one nucleolus in the control and experimental groups. In the case of complete neurologic status recovery of animals the area of PC nucleolus increases in both zones studied, irrespective of the cause of clinical death. In the case of neurologic disorders the increase in PC nucleolus area is clearly expressed only in the medial zone of the cerebellum, being insignificant in the lateral zone. It is suggested that adaptive characteristics of PC are distinct in the two compared zones, which leads to greater PC vulnerability in the lateral zone during deep hypoxia.     

Frequency of the stages in the cycle of the seminiferous epithelium in the rat

This study determined the optimum number of tubules to be counted per testis cross section, and the number of animals per treatment group, when changes in stage frequencies in the cycle of the seminiferous epithelium are criteria for assessing effects of treatment on spermatogenesis. A data base of 9,672 observed and staged tubules was collected from testicular cross sections of 15 Sprague-Dawley rats. A significant variation between animals was found for the frequencies of Stages I, II, IV, VI, VIII, and XIII. Computer simulation was used to randomly select different combinations of animal and tubule numbers from the observed data. Stage frequency means from each simulation experiment were compared statistically to observed mean frequencies. A model that used data from all 14 stages was analyzed. The following conclusions were made: a) a minimum of 200 tubule cross sections/testis is recommended for estimating stage frequencies; b) for a fixed number of tubules scored, the number of animals sampled is more important than the number of tubules per animal in reducing variance; c) to detect a difference of 2 standard deviations from the mean with a 2% error rate and examining 200 tubules/testis, at least 12 animals must be used per group when assessing all 14 stages; d) when individual stages are examined using 10 animals per group, only Stage VII has 80% or greater power of test (alpha = 0.05) to detect a frequency difference; e) pooling stages into 3-4 groups is recommended to improve the power of detecting a treatment difference.     

Psychological Attributes of the Culture of the Ukrainians in the Modern Stage of the Development of Society and Trends in Changes in These Attributes in the Post-Soviet Period

The authors of the article focus on the transition of the former Soviet state of Ukraine to a market economy. One aspect of the analysis is the cultural values and attitudes of the citizens in a new situation. Market economy and entrepreneurship demand new types of motivation and individual values from people. A challenge for social psychology in the country is the further elaboration of methodological basis of research.     

Immunohistochemistry of the cytoskeleton in the excurrent ducts of the testis in birds of the Galloanserae monophyly

The presence, location and degree of immunoexpression of various microfilament (MF) and intermediate filament (IF) systems (actin, cytokeratins, desmin, vimentin) were studied in the excurrent ducts of the testis in sexually mature and active galliform (Japanese quail, domestic fowl, turkey) and anseriform (duck) birds. These proteins were variably expressed between the epithelia and periductal tissue (periductal smooth muscle cell layer and interductal connective tissue) types and between species. Variable heterogeneous co-expression of filament systems was also found in the various duct epithelia and periductal tissue types: co-expression of filament systems was the rule rather than the exception. In the duck, neither vimentin nor cytokeratin was present in any of the tissues, whereas actin and desmin (absent in the rete testis) were co-expressed in the efferent ducts and epididymal duct unit (comprising the ductus conjugens, ductus epididymidis and ductus deferens). Actin, desmin and vimentin were generally co-expressed in the rete testis, efferent ducts and epididymal duct unit of the quail, domestic fowl and turkey, with vimentin being more strongly immunoreactive than actin and desmin in the epididymal duct unit, but more weakly immunoexpressed in the efferent ducts. Cytokeratin was present and co-expressed with actin, desmin and vimentin in the rete testis, efferent ducts and epididymal duct unit of the domestic fowl and turkey, but not in the quail and duck. The periductal smooth muscle cell layer and interductal tissue co-expressed actin, desmin and vimentin variably in all birds. Luminal spermatozoa of both the turkey and duck were immunonegative for all protein systems, whereas those of the quail and domestic fowl co-expressed actin, desmin and vimentin moderately or strongly. The tissues of the reproductive tract of male birds thus contain cytoskeletal protein systems that are variably but mostly co-expressed and whose contractile ability appears necessary and sufficient for transportation through the various excurrent ducts of the voluminous testicular fluid and its high sperm content, characteristic features of male avian reproduction.