目的:观察α干扰素治疗HBeAg(+)慢性乙型肝炎患者过程中病毒学及血清学动态变化情况,通过早期疗效预测终末疗效。方法:观察144例HBeAg(+)慢性乙型肝炎患者经α干扰素治疗24WK及随访24WK 过程中HBV-DNA以及HBeAg变化情况.结果:经α干扰素治疗12、24、48WK时,HBV-DNA下降到可检测值以下病例数分别为32、32、31例;同期HBeAg发生血清转换病例数分别为16、17、21例。结论:干扰素治疗12WK时患者病毒学及血清学结果可早期预测终末疗效。
Objective To evaluate the diagnosis value of purified protein derivative (PPD) antibody tests in childhood tuberculosis. Methods We reviewed 126 cases of hospitalization children tested body fluid PPD antibody by Enzyme-Linked Immunosorbent Assay (ELISA). Twenty-two them were diagnosed with tuberculosis. We determined the sensitivity, specificity, diagnostic likelihood ratio, positive prognostic value, negative prognostic value, post-test probability, respectively. Results The following accuracy statistics for the PPD body liquid antibody tests in this study: sensitivity, 45.45%; specificity, 91.35%; diagnostic likelihood ratio positive, 5.25; diagnostic likelihood ratio negative, 0.597; positive predictive value, 52.63%; negative predictive value, 88.79% and post-test probability, 48.09% in 15% of prevalence. Conclusion This study shows that body fluid PPD tests have limited value for diagnosis of tuberculosis in pediatric tuberculosis. Clinic physicians should be wary of the positive results of body fluid PPD antibody tests. The value of diagnosis is related to prevalence of tuberculosis in the specific hospital.
Congestive pulmonary arterial hypertension (PAH) is one of the most common complications of left to right shunt congenital heart disease. With the pulmonary artery pressure increasing, the shunt direction will reverse, eventually develop into Eisenmenger syndrome, and affect the patients' life. Studies in recent years have found that angiotensin -(1-7) and brain natriuretic peptide can adversely affect renin-angiotensin aldosterone system (RAAS), stromal cell derived factor can delay the pulmonary vascular remodeling, von Willebrand factor marks the pulmonary vascular endothelial function impaired, microRNA causes damage and homocysteine play a protective role in pulmonary vascular endothelial function. The RAAS activation, pulmonary vascular remodeling and endothelial dysfunction are related to the formation and development of PAH. We produced a comprehensive literature review about serological indexes in congestive PAH in this review.
Objective To clarify the specific clinical predictive efficacy of CT and serological indicators for the progression of connective tissue disease-associated interstitial lung disease (CTD-ILD) to progressive pulmonary fibrosis (PPF). Methods Patients who were diagnosed with CTD-ILD in Chest Hospital of Zhengzhou University Between January 2020 and December 2021 were recruited in the study. Clinical data and high-resolution CT results of the patients were collected. The patients were divided into a stable group and a progressive group (PPF group) based on whether PPF occurred during follow-up. COX proportional hazards regression was used to identify risk factors affecting the progression of CTD-ILD to PPF, and a risk prediction model was established based on the results of the COX regression model. The predictive efficacy of the model was evaluated through internal cross-validation. Results A total of 194 patients diagnosed with CTD-ILD were enrolled based on the inclusion and exclusion criteria. Among them, 34 patients progressed to PPF during treatment, and 160 patients did not progress. The variables obtained at lambda$1se in LASSO regression were ANCA associated vasculitis, lymphocytes, albumin, erythrocyte sedimentation rate, and serum ferritin. Multivariate COX regression analysis showed that the extent of fibrosis, serum ferritin, albumin, and age were independent risk factors for the progression of CTD-ILD to PPF (all P<0.05). A prediction model was established based on the results of the multivariate COX regression analysis. The area under the receiver operator characteristic curve at 6 months, 9 months, and 12 months was 0.989, 0.931, and 0.797, respectively, indicating that the model has good discrimination and sensitivity, and good predictive efficacy. The calibration curve showed a good overlap between predicted and actual values. Conclusions The extent of fibrosis, serum ferritin, albumin, and age are independent risk factors for the progression of CTD-ILD to PPF. The model established based on this and externally validated shows good predictive efficacy.
Objective To analyze the clinical characteristics of individuals with high hepatitis B virus (HBV) pregenomic RNA (pgRNA), and further explore the value of pgRNA in the management of patients with chronic hepatitis B. Methods From December 1st, 2020 to April 1st, 2022, chronic hepatitis B patients who had been treated with nucleotide analogues for a long time and followed up in the Hepatitis Clinic of the Center of Infectious Diseases, West China Hospital, Sichuan University were included, and the clinical characteristics of chronic hepatitis B patients with high pgRNA were analyzed and summarized. Results A total of 107 patients were included. Male patients accounted for 66.4%, with an average age of 44.02 years. There were no statistically significant differences in gender, age, aspartate transaminase, alanine transaminase, γ-glutamyl transferase, HBV surface antigen, proportion of patients with HBV e antigen ≥0.1 U/mL, HBV DNA, and alpha fetoprotein between the high and low pgRNA groups (P>0.05). The proportion of patients with HBV surface antigen<100 U/mL in the high pgRNA group was lower than that in the low pgRNA group (4.4% vs. 22.6%, P<0.05). Conclusion The proportion of chronic hepatitis B patients with high pgRNA whose HBV surface antigen≥100 U/mL is higher.
Neurosyphilis is a group of clinical syndromes in which Treponema pallidum invades the nervous system and causes damage to the meninges, blood vessels, brain parenchyma or spinal cord. At present, there is no highly specific and sensitive method for the diagnosis of neurosyphilis, and its diagnosis mainly depends on clinical manifestations, abnormal cerebrospinal fluid and the comprehensive judgment of clinicians. Current studies show that some cytokines and chemokines are promising for laboratory detection of neurosyphilis. This article reviews the research progress of neurosyphilis from the aspects of traditional laboratory testing, polymerase chain reaction testing, cytokine and chemokine testing, and existing diagnostic criteria for neurosyphilis, in order to provide a reference for clinical testing and follow-up research.
【摘要】 目的 观察使用苄星青霉素正规治疗早期显性梅毒的临床疗效以及分析治疗前后的梅毒血清学试验结果。 方法 选择2006年6月-2007年12月门诊就诊有皮肤损害的早期梅毒患者48例，病程lt;2年，采用苄星青霉素240万U，肌内注射，1次/周，连续3周治疗。治疗后随访第3、6、9、12、18、24个月时的TRUST滴度。 结果 48例早期梅毒患者经治疗后1个月内皮损均消失。总的血清转阴率为66.67%。一期梅毒在治疗后3、6个月时的TRUST转阴率较二期梅毒高（Plt;0.05）。治疗前TRUST≥1∶8者TRUST滴度在治疗后下降较TRUST≤1∶4者快（Plt;0.05）。 结论 早期梅毒病程越短，治愈越快。治疗前血清学滴度越高，治疗后滴度下降越快。梅毒的治疗应强调早期、规范。【Abstract】 Objective To analyze the clinical efficiency and pre- and post- therapy serological results of benzathine benzylpenicillin treated for early symptomatic syphilis. Methods A total of 48 patients with early symptomatic syphilis diagnosed from June 2006 to December 2007 (the disease durationlt;2 years) were treated with benzathine benzylpenicillin. The patients underwent the intramuscular injection with 2.4 million units benzathine benzylpenicillin once per week (for continuous 3 weeks). The results of TRUST were detected 3,6,9,12,18,and 24 months after the treatment. Results All patients cured clinically within one month. The general seronegative rate was 66.67%. Three and six months after the treatment, the seronegative rate of primary syphilis were higher than that of secondary syphilis (Plt;0.05). The TRUST titer dropped faster after the treatment in the ones whose TRUST titer was ≥1∶8 than those whose TRUST titer was ≤1∶4 (Plt;0.05). Conclusion The shorter the duration of infection is, the faster the treatment may be. The higher the TRUST titers before the treatment are, the faster the titers decrease is. The treatment on syphilis should be as early as possible.