单份血清肥达凝集试验在甲型副伤寒诊断中的价值

目的：评价疑似甲型副伤寒病例单份血清肥达凝集试验(WAT)的诊断价值。方法：以甲型副伤寒沙门菌血培养阳性和／或血清鞭毛特异性抗原阳性的甲型副伤寒病例(n=76)、血培养阴性和／或血清抗原阴性的对照发热病人(n=92)和健康饮食从业人员(n=63)为检测对象,用WAT测定以上三种人群血清甲型副伤寒沙门菌O、H、A抗体,分析评价不同O、H、A判断值诊断甲型副伤寒的敏感性、特异性、阳性预测值和阳性似然比等指标。结果：获得三种人群O、H、A凝集价的分布及其几何平均滴度,20％对照发热病人O抗体效价≥160,而健康从业人员仅有3．2％的O抗体效价≥160,对照发热病人和健康人相应H抗体效价分别占17％和4．8％,A抗体效价分别占16％和1．6％。53％血培养阳性和血清鞭毛抗原阳性甲型副份寒病例O抗体效价≥160,相应H、A抗体效价分别占41％和51％。用敏感性、特异性、阳性预测值、阳性似然比等指标评价单份血清WAT诊断甲型副伤寒的价值,提出O或H或A≥160和O≥160或A≥80可作为WAT辅助诊断甲型副伤寒的标准。结论：单份血清WAT有助于甲型副伤寒的诊断,该试验对血培养阴性的临床疑似甲型副伤寒病例及其高危人群中甲型副伤寒病例的诊断有实用意义。     

INHIBITORY ACTION OF PARATYPHOID BACILLI ON THE FERMENTATION OF LACTOSE BY BACILLUS COLI. I

Bacteria of the paratyphoid group may be divided into two classes according to the behavior of 4 day cultures in lactose bouillon after a second inoculation with certain types of Bacillus coli. One class includes all true hog-cholera bacilli, the other nearly all true paratyphoid and enteriditis types. Under the imposed conditions Bacillus coli produces the usual amount of gas in the presence of the first group. In the presence of the second no gas or only a bubble appears. The production of acid is not interfered with. The significance of the inhibition was investigated in a variety of ways suggested by the particular hypothesis entertained at the time. Two main possibilities presented themselves; first, the direct association of the inhibition with living paratyphoid bacilli, and, second, the existence of a ferment or other product of growth as the inhibiting agent. The theory that the living bacilli or those killed at the lowest possible temperature are responsible was favored by a number of experiments. Thus the complete removal of bacteria by filtration, or by centrifugation combined with the use of kaolin to produce a clear fluid restored gas production. The presence of a fine cloud of bacteria was sufficient to inhibit. On the other hand, the addition of large numbers of living bacteria from agar slants or from lactose bouillon after the requisite incubation period to fresh lactose bouillon failed to inhibit gas production when Bacillus coli was added simultaneously. When the inhibiting culture was heated at 62°C. for 35 minutes to sterilize it, gas production was still largely inhibited. But it was restored when higher temperatures were used, completely at 100°C. and above. It was also gradually restored by exposing the heated culture to 37°C. for 3 or more days. The presence of variable amounts of lactose, or even the complete absence of lactose did not interfere with the development of the inhibitory factor. The activity of the inhibition factor presents itself in the form of a curve, beginning at 0 when both paratyphoid and colon bacilli are inoculated simultaneously and rising as Bacillus coli is inoculated at longer intervals from the paratyphoid bacilli. The maximum of inhibition is reached at about the 4th day; thereafter it remains at the same level for a few days and then gradually falls until it is lost within 3 or 4 weeks. The curve of the hog-cholera group is delayed in that the maximum inhibition is reached at the end of 3 weeks. These curves have not been accurately determined. Taking into consideration all the accumulated data the writers tentatively present the hypothesis that the inhibitory factor is some metabolic product of the paratyphoid bacillus, possibly an enzyme, which is destroyed at a temperature somewhat above the thermal death point of the bacilli and which more gradually disappears from incubated cultures. The substance fails to pass Berkefeld filters. It is carried down mechanically with substances clearing the culture fluid. The experiments support current theories which hold that the acid-producing and gas-producing entities in cultures are distinct.     

CD34+-derived CD11c+ + + BDCA-1+ + CD123+ + DC: expansion of a phenotypically undescribed myeloid DC1 population for use in adoptive immunotherapy

BACKGROUND: DC are commonly defined as HLA-DR+/Lin- cells that can be CD11c+ + + CD123+/ -, termed DC1/myeloid DC that induce a Th1 response, or CD11c- CD123+ + +, termed DC2/lymphoid DC that induce a Th2 response. However, significant heterogeneity within DC preparations is apparent and supports the existence of several distinct DC subpopulations. This study aimed to expand and characterize CD34+ DC for use in immunotherapy. METHODS: CD34+ cells were seeded at 1 x 10(5)/mL and expanded for 14 days in RPMI + 10% autologous plasma supplemented with GM-CSF, IL-4, Flt-3L and SCF. Maturation was induced with TNF-alpha and PGE2 for 2 days. DC were analyzed morphologically, phenotypically with a panel of MAb to lineage and DC markers, and functionally in MLR, T-cell assays and T-cell cytokine secretion by ELISA. RESULTS: Significant cellular expansion was observed: 60+/-5 x 10(6) DC from 1 x 10(6) CD34+ cells (n=28). Phenotypically DC were characterized as HLA-DR+ +, CD11c+ + +, CD80+ +, CD83+, CD86+ +, CD123+ +, CD15+ +, CD33+ +, BDCA-1+ +, CD4+ and Lin-. DC displayed potent allostimulatory capacity and efficient presentation of KLH and tetanus toxin. DC-primed T cells secreted IFN-gamma (Th1); however, no detectable IL-4 (Th2) was noted. DISCUSSION: We present features of CD34+ DC that have not been previously described. The CD34+ DC generated represent a population of myeloid DC functioning as DC1 but phenotypically expressing markers characteristic of both DC1 and DC2. This novel DC population is capable of inducing naive T-cell responses and can be expanded to clinically useful numbers. CD34+-derived DC represent attractive candidates for use in adoptive T-cell immunotherapy.