1.Study and application of immunogold filtration assay for detecting serum antibodies against helicobacter pylori.
Ruishu ZHU ; Rui ZHOU ; Bo LU
Chinese Journal of Practical Internal Medicine 2001;0(02):-
Objectives To establish a simple,quick,accurate serodiagnostic assay for detecting serum antibodies against Helicobacter pylori(H.pylori).Methods We established quick immunocolloidal gold filtration assay(DIGFA) by combining colloidal gold labelling technique with filtration method.145 sera from cases with H.pylori infection were detected by DIGFA,and the results were compared with that of ELISA and pathological examinations.In addition,blocking test and human IgG protein detection were conducted.The sensitivity,specificity of DIGFA were analysed.Besides,DIGFA was applied to investigate the H.pylori infection situation among persons of different ages.Results The coincidence rate reached 95 1% compared with the ELISA,and it was 88 8% compared with pathological the examination.The detectable minimum amount of IgG was 10?g/mL.The antibodies detected by DIGFA proved to be specific antibodies by blocking test.The human H.pylori infection rate among 216 persons reached 42 5% by DIGFA.Conclusions DIGFA can be applied effectively in clinical diagnosis and epidemiological survey.
2.Clinical characteristics and treatment of central nervous system aspergillosis: an analysis of 37 cases
Ruishu TAN ; Jiatang ZHANG ; Yuheng SHAN ; Yubao MA ; Lei WU ; Hu YUAN ; Lei CHEN ; Tao ZHOU ; Liping ZOU ; Jian ZHU ; Quangang XU ; Shengyuan YU
Chinese Journal of Neurology 2023;56(1):55-65
Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.