ELISA与TRUST检测梅毒螺旋体对比分析

目的酶联免疫吸附试验法(ELISA)梅毒抗体检测优于甲苯胺红不加热血清(TRUST)实验对梅毒螺旋体(TP)检测的临床对比分析。方法选择2016年2月—2017年2月于我院就诊的68例TP感染患者作为研究对象。采集68例TP感染患者的静脉血清样本6 m L,对其行ELISA法与TRUST实验。采用梅毒螺旋体明胶凝集检测法(TPPA)进行确证,对比ELISA法梅毒抗体检测与TRUST实验对本组68例患者TPPA检测结果的一致性,以及假阴性与假阳性率。结果 TRUST实验检测阴性18例,阳性50例。TRUST实验对本组TP检测的假阳性率、假阴性率37.50%、22.73%,均高于ELISA检测0.00%、0.00%(P0.05);ELISA检测与TPPA检测在TP检测的假阳性率、假阴性率对比中差异无统计学意义(P0.05)。结论与TRUST实验相比,ELISA法梅毒抗体检测TP感染的效果更为可靠,可作为诊断梅毒的首选方案应用于临床。     

梅毒血清学三种检测方法的比较

目的 比较三种用于梅毒检测的实验室诊断方法,选择合适的检测组合方案对孕产妇人群进行梅毒筛查.方法 检测2 075份用甲苯胺红不加热试验(TRUST)检测为阴性的孕产妇标本,用酶联免疫吸附试验(TP-ELISA)方法复检,复检为阳性的标本再用梅毒螺旋体明胶凝集试验(TPPA)确证.结果 TRUST法检测梅毒漏栓率为1.20%(25/2075),TP-ELISA方法复检有30例阳性,经TPPA确证25份为梅毒,TP-ELISA法假阳性率为0.24%(5/2075).结论 用TP-ELISA方法和TRUST方法同时筛查孕产妇梅毒,阳性标本再用TPPA方法确证,是提高梅毒检出率比较好的组合方案.     

四种梅毒血清学检测方法的比较

目的评价梅毒甲苯胺红不加热血清反应素试验(TRUST)、快速血浆反应素环状卡片试验(RPR)、梅毒酶联免疫吸附试验(TP-ELISA)和梅毒螺旋体明胶凝集试验(TPPA)在梅毒检测中的应用价值。方法同时用RPR、TRUST、TP-ELISA和TPPA法检测确诊为梅毒患者的血清87份、健康查体人员血清100份及非梅毒患者的血清50份,并评价TRUST、RPR、TP-ELISA和TPPA法检测结果的敏感性和特异性等。ELISA法结合TRUST法双法筛查梅毒抗体,阳性标本再用TPPA法甄别生物学假阳性。结果TRUST、RPR和TPPA法对87份TP-ELISA法检测为阳性标本的敏感性分别为75.86%,74.71%,98.90%,特异性为98.67%,98.67%和100.00%。RPR法与TRUST法、TPPA法与ELISA法比较差异均无显著性意义(P均>0.05);TRUST法与TPPA法、RPR法与TPPA法比较差异均有显著性意义(P均<0.01)。100份健康查体人员血清,RPR、TRUST、TP-ELISA和TPPA法检测均为阴性,50份非梅毒患者血清进行RPR和TRUST法检测,2份阳性。结论TP-ELISA可替代TPPA使用;RPR法和TRUST法存在不同程度的假阳性,TP-ELISA结合TRUST双法筛查血液,用TPPA报告确证试验阳性。     

梅毒螺旋体抗体酶联免疫吸附试验作为初筛方法的梅毒逆向筛查程序的可行性分析

目的:探讨TP-ELISA作为初筛方法的梅毒逆向筛查程序的可行性分析。方法:选择2016年1月至2017年6月在大连大学附属中山医院各门诊及病房就诊的梅毒筛查者,并收集其标本15378份,采用梅毒螺旋体抗体酶联免疫吸附试验(TP-ELISA)、梅毒螺旋体明胶颗粒凝集试验(TPPA)与甲苯胺红不加热血清学试验(TRUST)筛选分析。以TPPA为标准,比较各种方法的特异性、灵敏度以及总符合率,统计TP-ELISA的S/CO值与TPPA阳性结果的相关性。结果:TPPA筛查阳性率为3. 57%,TP-ELISA筛查阳性率为3. 83%,TRUST筛查阳性率为2. 38%。TP-ELISA的灵敏度(98. 9%)明显优于TRUST(64. 3%),差异具有统计学意义(P 0. 01)。TP-ELISA与TRUST特异性与符合率差异无统计学意义(P 0. 05)。梅毒筛查时,TP-ELISA与TPPA在梅毒筛查时有较好的一致性(K=0. 945),TRUST与TPPA一致性不明显(K=0. 639)。根据梅毒抗体检测的特点以及实验室TP-ELISA的检测方法,当≤1. 0时,S/CO为阳性, 1. 0时S/CO为阳性。TP-ELISA检测结果的假阳性样本率为75. 00%(54/72),其主要是发生在S/CO值1. 0～2. 99之间。随着TP-ELISA的S/CO的数值增高,TPPA的符合率也依次增加,S/CO 5. 0时,TPPA的阳性率为100%。TRUST的检测阳性样本有13例,患者主要有妇产科正常妊娠8例,口腔科牙周炎3例,心内、呼吸2例。TP-ELISA假阴性6例,其中分布为泌尿科患者3例,骨科患者1例,妇产科患者2例,其被疑为梅毒早期。TP-ELISA假阳性患者72例。结论:TP-ELISA的灵敏度和特异性显著优于TRUST,有利于梅毒筛查效果,值得临床上大样本筛查。     

三种常用的不同血清学诊断方法对梅毒螺旋抗体的检测效果分析

目的:探讨梅毒螺旋抗体采用三种血清学方式即化学发光免疫法(CLIA)、梅毒螺旋体明胶颗粒凝集试验(TPPA)及梅毒螺旋体抗体胶体金试验检测的临床效果。方法:随机选取我院门诊2014年12月至2015年12月收治的梅毒患者120例,设为阳性组,另选取同期健康人群120例设为阴性组,两组研究对象均实施CLIA、TPPA及梅毒螺旋体抗体胶体金试验三种血清学检测方法进行重复检测,对比分析三种检测方法在阳性组中的阳性率、特异性率、灵敏度和阴性组中的假阳性率情况。结果:本次研究中,CLIA法具有较高的阳性率95.8%,明显优于其他两种检测方法(P0.05),但其假阳性率也较高,为7.5%,TPPA法的假阳性率最低为1.7%,明显优于其他两种检测方法(P0.05);胶体金法的灵敏度(71.8%)和特异性(88.3%)较低,明显低于其他两种检测方法(P0.05)。结论:三种检测方法中,TPPA法检测梅毒螺旋抗体的阳性率高、假阳性率低、特异性和灵敏度均较高,综合效果最好;而CLIA阳性率最高,但其容易出现假阳性;胶体金试验的假阴性和假阳性均较多,临床可作为辅助检查应用。     

梅毒螺旋体抗体在诊断新生儿梅毒中的应用和讨论

目的:探讨梅毒螺旋体(treponema pallidum,TP)抗体在诊断新生儿梅毒中的应用。方法:分别用甲苯胺红不加热血清试验(TRUST)、TP-ELISA和密螺旋体颗粒凝集实验(TPPA)法对84例确诊新生儿梅毒患者与100例健康新生儿血清进行检测。结果:三种检测梅毒螺旋体抗体方法的灵敏度分别为51.2%、98.8%和100%,相对而言,TRUST法不适合作为诊断新生儿梅毒的初筛试验。结论:TP-ELISA法灵敏度与特异性相对较高,操作简便易行,建议作为诊断新生儿梅毒的初筛试验;TPPA法由于操作繁琐复杂,可结合临床作为新生儿梅毒的确诊试验。     

酶联免疫吸附试验、梅毒螺旋体颗粒凝集试验及甲苯胺红不加热血清试验在梅毒检测中的检验效能评价

目的:研究三种常用的不同血清学诊断方法对梅毒螺旋抗体的检测效果,从而为提高梅毒螺旋抗体的检出率提供较好的诊断方法。方法:选取2013年1月至2014年7月于我科门诊就诊的274例患者为观察对象,根据有无感染梅毒将其分为两组,其中177例感染梅毒患者为观察组,97例非梅毒患者为对照组,分别应用酶联免疫吸附试验(ELISA)、梅毒螺旋体明胶颗粒凝集试验(TPPA)、甲苯胺红不加热血清试验(TRUST)三种常用的不同血清学诊断方法对两组患者进行梅毒螺旋抗体的检测,分别比较三种检测方法检测的梅毒螺旋抗体的阳性例数、敏感性和特异性,并进行分析。结果:在检测梅毒患者血清标本的阳性率方面,ELISA法最高,为98.87%,TRUST法最低,为88.70%,ELISA法与TPPA法比较,差异无统计学意义(P0.05),TRUST法分别与ELISA法、TPPA法比较,差异均具有统计学意义(P0.05);ELISA法、TRUST法、TPPA法检测梅毒患者血清的敏感性分别为98.87%、88.70%、97.18%,特异性分别为98.97%、95.88%、100.00%,阴性预测值分别为97.96%、82.30%、95.10%,阳性预测值分别为99.43%、97.52%、100.00%;ELISA法敏感性和阴性预测值最高,与TRUST法比较,差异有统计学意义(P0.05);TPPA法特异性和阳性预测值最高,与TRUST法比较,差异有统计学意义(P0.05);三种血清学检测方法同时显示梅毒患者血清阳性者有155例,同时显示阴性者有1例,TRUST法显示阴性而TPPA法和ELISA法显示阳性者17例。结论:三种血清学检测方法的侧重点各不相同,ELISA法适用于大批量样本筛查、TPPA法适用于进行梅毒确诊、TRUST法应用于对梅毒患者治疗疗效及预后的判断,在临床中应结合实际情况进行选择。     

荧光PCR在早期梅毒患者诊断中的应用

目的探讨荧光PCR在早期梅毒诊断中的应用价值。方法应用FL-PCR方法检测40例一、二期梅毒患者皮损中梅毒螺旋体DNA,与传统的血清学TRUST和TPPA方法的检测结果进行比较。结果一期梅毒硬下疳损害中梅毒螺旋体DNA的检出率100.00%,血清TRUST阳性率为59.09%,TPPA阳性率为81.82%;二期梅毒扁平湿疣损害中梅毒螺旋体DNA的检出率100.00%,以斑疹和丘疹表现的二期梅毒疹中梅毒螺旋体DNA的检出率为60.00%,TRUST和TPPA法检测阳性率均为100.00%。结论荧光PCR法在一期梅毒诊断中有极高特异性和敏感性,可作为一期梅毒早期诊断的依据,二期梅毒诊断血清学方法优于荧光定量PCR法。     

三种梅毒血清学试验在梅毒诊断中的临床对比研究

目的：分析并比较甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶凝集试验（TPPA）以及酶联免疫吸附试验（TP—ELISA）三种梅毒血清学试验在梅毒诊断中的应用价值。方法：选择我院2011年1月至2013年3月收治的220例梅毒患者以及同期在我院进行健康体检的600名健康成人为研究对象,采用TRUST、TPPA、TP—ELISA方法对其进行梅毒血清学试验,比较三种检测方法测定的灵敏度、特异性和正确率。结果：TRusT、IPPA和TP—ELISA三种梅毒血清学检查方法的检测特异性均较高,而TPPA和TP—ELISA方法的检测灵敏度显著高于TRUST法,差异具有统计学意义（P〈0。05）。结论：TP—ELISA方法操作简便,检测准确率较高,灵敏度和特异性均较好,可用于梅毒筛选;TRIST方法可用于对既往存在梅毒的患者进行血清筛选;TPPA方法可用于梅毒确诊。     

梅毒螺旋体血清学检测方法的实验室评价

目的比较五种梅毒血清学实验方法的准确性及在临床诊断中的应用价值。方法应用甲苯胺红不加热血清试验(TRUST)、梅毒螺旋体血球凝集试验(TPHA)、梅毒螺旋体明胶凝集试验(TPPA)、梅毒酶联免疫吸附试验(ELISA)、荧光密螺旋体抗体吸收试验(FTA)检测252例血清样本。结果TRUST,TPHA,TPPA,ELISA,FTA的敏感性分别为88.3%,96.7%,99.2%,97.5%,93.3%;特异性为84.8%,91.7%,97.0%,90.2%,96.2%。其他四种方法与灵敏性、特异性均较好的TPPA比较,TRUST,FTA的敏感性较低,差异具有显著性(P<0.05)。特异性方面,除FTA与TPPA无显著性差异(P>0.05)外,其他三种方法均低于TPPA,差异具有显著性(P<0.05)。结论TPPA的敏感性、特异性均较好,为临床检测梅毒较理想的方法。     

37例麻风患者的家庭集聚性调查分析

目的:明确麻风家庭感染者的发病情况。方法:利用全国麻风病防治信息管理系统(LEPMIS)数据库,描述性分析麻风家庭感染者的发病情况。结果:符合条件的共17户家庭37例麻风患者,其中多菌型患者33例,少菌型4例;密切接触5年内发病4例(10.81%),5~10年发病者11例(29.73%),超过10年发病者13例(35.14%),不明时间者9例(24.32%);其中因父母子女关系感染17例(45.95%)、祖孙关系5例(13.51%)、兄弟关系2例(5.41%)。结论:多菌型麻风是家庭传染者的主要传染源。     

Dermatology in private practice in France in 2000

OBJECTIVES: Data regarding French dermatological practice are scarce. Our objective was to identify the skin disorders most commonly diagnosed by office-based dermatologists. We also documented the severity of these skin disorders, as reflected by the repercussions on patient's everyday life, and the way physicians managed patients. DESIGN: We carried out a one-day survey of visits to a randomly selected sample of 900 French office-based dermatologists. The randomization was stratified according to the five French different dialing area codes. RESULTS: Office-based dermatologists saw 6411 patients with 7839 skin disorders during the survey. The daily number of visits to French dermatologists was estimated at 47 000 and the annual number between 12 and 14 millions. Office-based dermatologists mostly managed warts, acne, nevus, dermatitis, malignancies and pre-malignancies, fungal infection and psoriasis. Repercussions on patients'everyday life were assessed by physicians as important or very important in 28 p. 100 of cases. Half of the patients received topical treatment, 20.5 p. 100 a systemic drug and 40 p. 100 a minor surgical procedure (including cryotherapy). CONCLUSION: Although dermatologists frequently see benign skin disorders such as warts or nevus, more severe diseases represent an important part of their activity.     

Progress in Malassezia Research in Korea

Yeasts of the genus Malassezia are part of the normal flora of human skin. However, they are also associated with various skin diseases. Since the introduction of Malassezia to the Korean Dermatologic Society two decades ago, remarkable progress has been made in our knowledge of this genus. In this paper, we review recent developments in Malassezia research, including taxonomy and methods for species identification, recent genome analyses, Malassezia species distribution in healthy conditions and in specific skin diseases, trials investigating the mechanisms underlying Malassezia-related diseases, as well as therapeutic options. This review will enhance our understanding of Malassezia yeasts and related skin diseases in Korea.     

Decrease in neutrophils observed in vivo in psoriatics after PUVA therapy

Summary In 56 patients leucocyte and differential counts were done before and at weekly intervals during PUVA treatment of chronic recalcitrant psoriasis. A statistical significant (P<0.01) decrease in the percentage of neutrophils was observed during the first week of the PUVA therapy. This observation could be closely related to the clinical clearing of psoriasis (P=0.02).The effect of PUVA therapy in psoriasis may be due to a decrease in the number of immunocompetent neutrophils demonstrated in psoriatic lesions.     

Experimental approaches to lymphocyte migration in dermatology in vitro and in vivo

Lymphocyte trafficking through the dermal compartment is part of the physiological surveillance process of the adaptive immune system. On the other hand, persistent or recurrent lymphocyte infiltrates are hallmarks of both types of chronic inflammatory skin diseases, Th1-type such as psoriasis or Th2/allergic-type like atopic dermatitis. A better understanding of the mechanisms underlying lymphocyte movements is one of the key prerequisites for developing more effective therapies. In this review, we introduce a range of simple-to-sophisticated experimental in vitro and in vivo approaches to analyze lymphocyte migration. These methods start from static in vitro adhesion and chemotaxis assays, include dynamic endothelial flow chamber, intravital dual photon, and transcutaneous live-video microscopy, and finally encompass specific genetically deficient or engineered animal models. Discussing pros and cons of these assay systems hopefully generates both state-of-the-art knowledge about the factors involved in most common chronic skin diseases as well as an improved understanding of the limitations and chances of new biologic pharmaceuticals that are currently introduced into clinical practice.     

Formaldehyde‐releasers in cosmetics in the USA and in Europe

Background: Frequencies of sensitization to formaldehyde among US patients patch tested for suspected contact dermatitis are higher than in Europe. Cosmetics are an important source of contact with formaldehyde. Objectives: To acquire data on the frequency of use of formaldehyde‐releasers in cosmetics sold in the USA and Europe and their use concentrations. To assess whether any observed differences may contribute to the discrepancies in sensitization rates. Methods: Enquiries with Food and Drug Administration (FDA), the European Cosmetics Association, and the Dutch Cosmetics Association. Reading the labels of skin care cosmetics in a local drugstore. Results: The FDA provided data on the presence of formaldehyde and releasers. Nearly one fifth of all cosmetics contain a releaser. In 25% of 496 examined skin care products, releasers were present. In comparable FDA data categories, the percentage was 24. No data were found on use concentrations of the releasers in cosmetics in either the USA or Europe. Conclusions: The percentages of stay‐on skin care products containing a formaldehyde‐releaser are virtually identical in the USA (FDA data) and our local drugstore sample. However, this does not necessarily imply that cosmetics play no part in the differences in formaldehyde sensitization rates.     

Hard cornification in reptilian epidermis in comparison to cornification in mammalian epidermis

The structure of reptilian hard (beta)-keratins, their nucleotide and amino acid sequence, and the organization of their genes are presented. These 13-19 kDa proteins are basic, rich in glycine, proline and serine, and different from cytokeratins. Their mRNAs are expressed in beta-cells. The central part of beta-keratins (this region has been previously termed 'core-box' and is peculiar of all sauropsid proteins) is composed of two beta-folded regions and shows a high identity with avian beta-keratins. This central part present in all beta-keratins, including feather keratins, is the site of polymerization to build the framework of beta-keratin filaments. Beta-keratins appear cytokeratin-associated proteins. Their central region might have originated in an ancestral glycine-rich protein present in stem reptiles from which beta-keratins evolved and diversified into reptiles and birds. Stem reptiles of the Carboniferous period might have possessed glycine-rich proteins derived from exons/domains corresponding to the variable, glycine-rich region of cytokeratins. Beta-keratins might have derived from a gene coding for small glycine-rich keratin-associated proteins. The glycine-rich regions evolved differently in the lineage leading to modern reptiles and birds versus that leading to mammals. In the reptilian lineage some amino acid regions produced by point mutations and amino acid changes might have given rise to originate the central beta-pleated region. The latter allowed the formation of filamentous proteins (beta-keratins) associated with intermediate filament keratins and replaced them in beta-keratin cells. In the mammalian lineage no beta-pleated region was generated in their matrix proteins, the glycine-rich keratin-associated proteins. The latter evolved as glycine-tyrosine-rich, sulphur-rich, and ultra-sulphur-rich proteins that are used for building hairs, horns and nails.