Quantitative assessment of global cerebral metabolic rate of oxygen (CMRO2) in neonates using MRI

The cerebral metabolic rate of oxygen (CMRO₂) is the rate of oxygen consumption by the brain, and is thought to be a direct index of energy homeostasis and brain health. However, in vivo measurement of CMRO₂ is challenging, in particular for the neonatal population, in whom conventional radiotracer methods are not applicable because of safety concerns. In this study, we propose a method to quantify global CMRO₂ in neonates based on arteriovenous differences in oxygen content, and employ separate measurements of oxygenation and cerebral blood flow (CBF) parameters. Specifically, arterial and venous oxygenation levels were determined with pulse oximetry and the novel T₂ relaxation under spin tagging (TRUST) MRI, respectively. Global CBF was measured with phase contrast (PC) flow velocity MRI. The proposed method was implemented on a standard 3‐T MRI scanner without the need for any exogenous tracers, and the total scan duration was less than 5 min. We demonstrated the feasibility of this method in 12 healthy neonates within an age range of 35–42 gestational weeks. CMRO₂ values were successfully obtained from 10 neonates. It was found that the average CMRO₂ in this age range was 38.3 ± 17.7 µmol/100 g/min and was positively correlated with age (p = 0.007; slope, 5.2 µmol/100 g/min per week), although the highest CMRO₂ value in this age range was still less than half of the adult level. Test–retest studies showed a coefficient of variation of 5.8 ± 2.2% between repeated CMRO₂ measurements. In addition, given the highly variable blood flow velocity within this age range, it is recommended that the TRUST labeling thickness and position should be determined on a subject‐by‐subject basis, and an automatic algorithm was developed for this purpose. Although this method provides a global CMRO₂ measure only, the clinical significance of an energy consumption marker and the convenience of this technique may make it a useful tool in the functional assessment of the neonatal population. Copyright © 2014 John Wiley & Sons, Ltd.     

梅毒螺旋体抗体筛查及其临床意义

目的研究梅毒螺旋体的感染状况，探讨梅毒螺旋体抗体筛查的现实意义。方法采用酶联免疫分析法（ELIsA）检测梅毒螺旋体抗体，阳性者再使用甲苯胺红不加热血清试验（TRusT）和梅毒螺旋体明胶凝集试验（TPPA）做进一步检测。结果5998例住院患者ELISA法共检测出阳性86例，TPPA法检测出阳性78例，TRUST法检测出阳性22例。高龄（〉70岁）患者的阳性检出率高于其它年龄组。结论住院患者常规筛查梅毒螺旋体抗体可有效检测出隐性梅毒患者，不仅可以早诊断、早治疗，减少医疗纠纷的发生，也可以预防院内交叉感染。     

3种梅毒检测方法的比较

目的：对3种梅毒检测方法进行对比分析，选择合适的方法进行献血者的筛查。方法：用非特异性的甲苯胺红不加热血清试验（TRUST）、酶联免疫吸附试验（ELISA）方法对献血者进行梅毒筛检，阳性标本用梅毒确证试验（TPPA）法进行确证。结果：TRUST法灵敏度为60％（42／70），假阳性率6．67％（3／45），漏检率40％（28／70）；ELISA法灵敏度为98．57％（69／70），假阳性率2．82％（2／71），漏检率为1．43％（1／70）。结论：ELISA法具有较高的灵敏度和特异性，漏检率较低，非常适合用于献血者的梅毒筛查。     

比较三种梅毒检测方法

目的：对TP－ELISA,TP－PA,TRUST3种梅毒检测方法进行比较,根据各试验的优点和不足,选择一种常规梅毒筛查的理想方法。方法以TP－ELISA,TPPA,TRUST同时检测样本2115例。结果 ELISA阳性者80例,检出率3．8％（80／2115）,TP－ELISA阳性同时TPPA阳性77例,符合率96．2％（77／80）,TP－ELISA阳性, TPPA阴性3例,假阳性率为3．75％（3／80）。TRUST阳性20例,符合率25％（20／80）,TRUST阴性60例,占75％（60／80）。3例ELISA阳性TPPA阴性的TRUST检测结果均为阴性。结论 TP－ELISA可作为梅毒筛查的理想方法。     

TRUST和TP-EIA法联合检测在梅毒血清学诊断的临床价值

目的:检测梅毒的血清学方法很多,通过比较找出简单、快速适合临床需要的最佳的梅毒血清学实验。方法:对9865例病人血清标本分别用TRUST法和TP-EIA法进行梅毒抗体的检测,阳性者再用TPPA进行确证。结果:9865例血清标本TRUST法的阳性率为2.33%,TP-EIA法阳性率为2.92%,阳性者均经TPPA确证;进一步分析表明:TRUST阳性标本的TP-EIA的光密度值90%以上>1.0;而TRUST阴性标本的TP-EIA的光密度值90%以上<1.0;而且TRUST的滴度随病程变化而变化,而TP-EIA则不随病程变化而改变。结论:同时采用TRUST和TP-EIA进行血清学联合检测,阳性者再经TPPA确认,这样可互补两实验不足,提高阳性符合率,更好辅助临床诊断及疗效观察。     

梅毒三种不同检测方法的比较

目的对TPPA、ELISA、TRUST3种梅毒检测方法的优越性及不足进行分析比较,选择适合输血患者输血前筛查梅毒的方法,避免输血相关传染病,保护患者和医院利益。方法用甲苯胺红不加热血清试验（TRUST）、酶联免疫吸附试验（TPELISA）和梅毒螺旋体明胶凝集试验（TPPA）三种方法对153例临床确诊的梅毒阳性血清标本和75例正常血清标本进行对比检测。结果TRUST试验敏感性为72．5％,特异性为72．0％;ELISA试验敏感性为96．1％,特异性为96．0％,TPPA试验敏感性为98．0％,特异性为100％,TRUST与ELISA和TPPA差异均有统计学意义（P〈0．01）。结论TPPA特异性好,可作为梅毒的确证实验;抗TPELISA法特异性和灵敏度接近于TPPA法,是目前用于检测梅毒抗体的首选方法;TRUST法特异性差,但可作为抗TPELISA法的补充。     

基层医院输血前梅毒检验方法正确选用的探讨

<正>梅毒血清学试验大体可分2类:一类是检测非特异性梅毒螺旋体抗体:如RPR、TRUST、USR等试验;另一类是检测特异性梅毒螺旋体抗体:如TPPA、TP-ELISA、胶体金免疫层     

HIV合并梅毒感染的实验诊断分析

目的:通过实验诊断方法,研究HIV与梅毒同时感染的相关性。方法:用梅毒螺旋体明胶凝集试验(TPPA)、梅毒甲苯胺红不加热法(TRUST)和电化学发光法(ECLA)同时检测192例HIV-Ab/P24阳性血清,包括疾控中心免疫印迹(WB)阳性血清77例(实验组),不确定和阴性血清115例(对照组),用χ~2检验统计分析。结果:实验组中,TPPA阳性36例(18.8%),TRUST阳性27例(14.1%),TPPA与HIV-Ab/P24差异有统计学意义(χ~2=21.08,P0.01);对照组中,TPPA阳性8例(4.2%),TRUST阳性2例(1.0%),TPPA与HIV-Ab/P24差异有统计学意义(χ~2=136.95,P0.01)。结论:HIV感染患者,合并感染梅毒的几率很大,且梅毒发作期患者比例高。     

梅毒血清学假阳性疾病分析及与梅毒的对比

目的了解可出现TRUST生物学假阳性的疾病和血清学特点,为试剂改进和结果分析提供参考。方法对本院住院患者21 560例进行甲苯胺红不加热血清试验(TRUST)及梅毒螺旋体明胶凝集试验(TPPA)检测,对于TRUST假阳性患者所患疾病进行总结,并与梅毒患者进行对比。结果TRUST生物学假阳性病例共计152例,平均滴度(1∶1.22)±(1∶1.69),以脑部病变及肿瘤为主。门诊梅毒患者190例,TRUST平均滴度(1∶14.45)±(1∶4.85)。结论TRUST生物学假阳性的疾病以脑部病变和肿瘤为主,且滴度明显低于梅毒患者。