Objective To investigate the protective effects of antitumor necrosis factor-α antibody （TNF-αAb） on lung injury after cardiopulmonary bypass （CPB） and their mechanisms. Methods Forty healthy New Zealand white rabbits，weighting 2.0-2.5 kg，male or female，were randomly divided into 4 groups with 10 rabbits in each group. In groupⅠ，the rabbits received CPB and pulmonary arterial perfusion. In group Ⅱ，the rabbits received CPB and pulmonary arterial perfusion with TNF-αAb. In group Ⅲ，the rabbits received CPB only. In group Ⅳ，the rabbits only received sham surgery. Neutrophils count，TNF-α and malondialdehyde （MDA） concentrations of the blood samples from the left and right atrium as well as oxygenation index were examined before and after CPB in the 4 groups. Pathological and ultrastructural changes of the lung tissues were observed under light and electron microscopes. Lung water content，TNF-α mRNA and apoptoticindex of the lung tissues were measured at different time points. Results Compared with group Ⅳ，after CPB，the rabbitsin group Ⅰ to group Ⅲ showed significantly higher blood levels of neutrophils count，TNF-α and MDA（P＜0.05），higherTNF-α mRNA expression，apoptosis index and water content of the lung tissues （P＜0.05），and significantly lower oxyg-enation index （P＜0.05） as well as considerable pathomorphological changes in the lung tissues. Compared with group Ⅱ，after CPB，the rabbits in groups Ⅰ and Ⅲ had significantly higher blood concentrations of TNF-α （5 minutes after aortic declamping，220.43±16.44 pg/ml vs.185.27±11.78 pg/ml，P＜0.05；249.99±14.09 pg/ml vs.185.27±11.78 pg/ml，P＜0.05），significantly higher apoptosis index （at the time of CPB termination，60.7‰±13.09‰ vs. 37.9‰±7.78‰，P＜0.05；59.6‰±7.74‰ vs. 37.9‰±7.78‰，P＜0.05），significantly higher blood levels of neutrophils count and MDA （P＜0.05），significantly higher TNF-α mRNA expression and water content of the lung tissues （P＜0.05），and significantly loweroxygenation index （P＜0.05） as well as considerable pathomorphological changes in the lung tissues. Compared with groupⅠ，rabbits in group Ⅲ had significantly higher above parameters （P＜0.05） but lower oxygenation index （P＜0.05） only at 30 minutes after the start of CPB. Conclusion Pulmonary artery perfusion with TNF-αAb can significantly attenuate inflammatory lung injury and apoptosis of the lung tissues during CPB.
Objective To systematically review the diagnostic value of anti-HCV in serum tested by the third-generation enzyme-linked immunosorbent assay (ELISA 3) in patients with hepatitis C. Methods Such databases as PubMed, MEDLINE, EMbase, The Cochrane Library (Issue 1, 2013), EBSCO, CBM, CNKI, VIP and WanFang Data were electronically and comprehensively searched for relevant studies on the diagnostic value of anti-HCV in serum tested by ELISA 3 in patients with hepatitis C from inception to January 1st, 2013. Relevant journals were also manually retrieved. QUADAS items were used to evaluate the quality of the included studies. Then meta-analysis was performed using Meta-Disc 1.4 software to calculate pooled effect size in sensitivity (SEN), specificity (SPE), likelihood ratio (±LR), diagnostic odds ratio (DOR) and summary receiver operating characteristic curve (SROC curve), and area under the curve (AUC) as well. Results Finally, nine studies were included, involving 1 182 patients with hepatitis C diagnosed by the gold standard and 4 764 patients with non-hepatitis C diseases. The results of meta-analysis using random model showed (SEN=0.96, 95%CI 0.95 to 0.97; SPE=0.96, 95%CI 0.96 to 0.97; +LR=42.21, 95%CI 10.23 to 174.23; –LR=0.02, 95%CI 0.01 to 0.09; DOR=1 635.89, 95%CI 372.37 to 7 186.83; AUC=0.996 5). Conclusion Anti-HCV in serum tested by ELISA 3 has fairly high value in the diagnosis of patients with hepatitis C.
Objective To study the epidemic and clinical characteristics of three clusters of early cases of severe acute respiratery syndrome (SARS) in Shenzhen. Methods To retrospectively investigate three clusters of patients. To extract data on clinical presentation and laboratory studies. Results In the first cluster, one patient with SARS in Shenzhen had visited Hong Kong twice in one week. He had felt initial cold and fever in Hong Kong on January 14, while the second case had been onset of SARS when he had been back from Hong Kong. There were 5 people infected in the second cluster at the same time 1 week after they visited their father in a hospital in GuangZhou. Among the three clusters, two clusters had not been infected in ShenZhen, they are inputted, and another cluster is not clear, but it maybe inputted. Three clusters are distributed, they all had high fever. Among them, five had total body muscular soreness and unproductive cough, four with headache, three chill, and two dizziness and pharyngalgia. Three cases had asthma and diarrhea 1 week after the onset of SARS, and progressed to ARDS. The six patients with SARS in Shenzhen People’s Hospital tested positive for coronavirus-related anti-body (IgG) in their plasma 10-15 d after the onset. This IgG titres in one patient remained high (1∶640) 120 days after the onset. Neutrophilia and lymphopenia occurred in patients who died. The more severe the patients’condition was, the higher was the level of LDH increased. Conclusion In three clusters, most patients had not infected in Shenzhen, they are inputted and distributed. That patients with SARS tested positive for coronavirus-related IgG in their plasma.
Objective To assess the quality of diagnostic studies on detecting the tuberculosis antibody to diagnose tuberculosis.Methods CBM (1978 to 2006) and VIP (1994 to 2006) were searched; any author-claimed diagnostic studies which used the dot immunogold filtration assay (DIGFA) to detect the tuberculosis antibody and to diagnose tuberculosis were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to assess the quality of included diagnostic studies by two reviewers independently.Results Thirty-eight papers were included and assessed. We found that most of the quality items were not met with QUADAS. Most papers adopted the retrospective diagnostic case-control design. Thirty-one papers did not describe the selection criteria clearly, 18 did not describe whether all the included patients were verified by using a reference standard of diagnosis, 36 did not describe whether the index test results were interpreted without knowledge of the results of the reference standard, 37 did not report the uninterpretable/intermediate test results, and 34 did not report the withdrawals from the study.Conclusion There are few high quality studies on using DIGFA to detect tuberculosis antibody to diagnose tuberculosis.
Objective To evaluate the quality of diagnostic studies on detecting anti-cyclic citrullonated peptide antibody to diagnose rheumatoid arthritis. Methods We searched PubMed, EMbase, The Cochrane Library, and CBM to collect studies on using anti-cyclic citrullonated peptide antibody to diagnose rheumatoid arthritis. QUADAS items were used to evaluate the quality of included studies. Results A total of 195 studies were included. Sixty-nine were English studies and 126 were Chinese studies. All studies had good descriptions of the spectrum of patients and little potential for partial verification bias, differential verification bias, and incorporation bias. However, most studies were prone to disease progression bias, review bias, and clinical review bias. One study did not explain the intermediate test results, and another did not report part of the test results. The overall quality of English studies was better than that of Chinese studies. Conclusion The potential bias of the included studies mainly resulted from the absence of blinding when interpreting the test results. The reporting quality of the included studies was poor.
目的 探讨原发性干燥综合征周围神经病变的发生与干燥综合征A型/B型抗体（抗SSA/SSB抗体）的关系。 方法 纳入2009年1月－2011年12月期间门诊及住院收治的原发性干燥综合征患者88例。所有患者均接受神经系统检查，采用蛋白质印迹法检测抗SSA抗体和抗SSB抗体，利用全自动化学发光仪检测血清维生素B12水平。 结果 88例原发性干燥综合征患者中有27例（30.7%）存在周围神经病变。有或无周围神经病变的患者在年龄、性别、病程等一般情况方面无明显不同。有周围神经病变和无周围神经病变的原发性干燥综合征患者抗SSA抗体阳性率分别为70.4%（19/27）、70.5%（43/61），差异无统计学意义（χ2=0.000，P=0.991）；抗SSA/SSB抗体双阳性率分别为63.0%（17/27）、14.8%（9/61），差异有统计学意义（χ2=17.416，P=0.000）；血清维生素B12水平分别为（390 ± 55）、（410 ± 86）pg/dL，差异无统计学意义（t=0.908，P=0.370）。 结论 周围神经病变在原发性干燥综合征患者中较常见，且周围神经病变的发生多伴随血清抗SSA/SSB抗体阳性。
目的 探讨碘131（131I）治疗后Graves眼病（GO）预后与血清促甲状腺激素受体抗体（TRAb）水平变化之间的关系。 方法 选择2011年5月－12月初发Graves病患者238例，分为GO组124 例和非GO组114 例，分别检测131I治疗前及131I治疗后2、3、6个月甲状腺功能和TRAb，GO患者131I治疗前和治疗后6 个月进行临床活动度评分（CAS）。 结果 131I治疗前各组TRAb水平差异无统计学意义（P＞0.05），TRAb水平与GO CAS评分之间无相关；131I治疗后6个月所有患者TRAb水平显著增加；非GO组有5例新发GO，新发GO组与其他患者的TRAb水平分别为（58.7 ± 77.9）、（61.9 ± 81.1）U/L，差异无统计学意义（P＞0.05）；GO组又分为GO无变化29例，GO加重17例，GO缓解78例，三组患者TRAb水平分别为（53.5 ± 77.6）、（66.2 ± 89.9）、（66.8 ± 42.2）U/L，差异无统计学意义（P＞0.05）。 结论 131I治疗后患者TRAb水平显著增加，但TRAb水平的变化和GO预后无关，TRAb与GO的关系还需要进一步研究。
目的 探讨抗环瓜氨酸肽抗体（anti-CCP）与类风湿因子（RF）对类风湿关节炎（RA）的诊断效能，及RF分型检测在RA活动度判断中的价值。 方法 选取2012年3月－2013年2月就诊的64例RA患者为病例组，103例其他自身免疫性疾病患者为对照组，用酶联免疫吸附试验分别检测anti-CCP和RF-IgM/IgG/IgA，收集数据进行统计分析。 结果 anti-CCP与RF联合指标对RA的诊断灵敏度最高（92.2%），anti-CCP的特异度最高（95.1%）；RF-IgA的水平与骨关节侵蚀程度呈正相关（rs=0.987，P=0.000）；RF的3个亚型都可反映RA疾病的活动度（P＜0.05）。 结论 anti-CCP与RF联合诊断RA，可显著提高诊断灵敏度，RF的分型检测对于RA患者的活动度监测有重要价值。
目的：分析原发性胆汁性肝硬化(PBC)患者的临床特征,以提高对该病诊治的认识。方法：分析17例PBC患者的一般资料、临床表现、生化指标、免疫学指标及病理学改变。结果：PBC主要累及中年女性，易合并干燥综合征（SS）。胆管酶升高及抗线粒体M2抗体阳性有助于本病诊断。治疗首选熊去氧胆酸，糖皮质激素、免疫抑制剂适用于合并SS者。结论：早期诊断、早期治疗PBC是防止发展为终末期肝硬化的关键。