INTRODUCTION: Kawasaki disease (KD) is a challenging diagnosis. Erythema and induration of the Bacillus Calmette-Guérin (BCG) site is increasingly recognised as a significant clinical clue. However, there is little data to support its specificity for KD as compared to other febrile illnesses. We aimed to evaluate BCG reaction or induration as a diagnostic tool for KD. METHODS: A retrospective case-controlled study of patients discharged with a diagnosis of KD from 2007 to 2010 was conducted. Another group of patients admitted over the same period for possible KD, but later found not to have KD, served as control. RESULTS: Significantly more infants with KD (69.7%) had BCG site changes than older children (27.8%; p < 0.001). It also presented earlier in the course of KD; < 5 days (53.3%) compared to ≥ 5 days of fever (30.0%; p < 0.001). Positive predictive value of BCG site reaction or induration for KD was 90.8% (95% confidence interval [CI] 0.819-0.962) for infants and 96.2% (95% CI 0.868-0.995) for older children. The prevalence rate of changes at the BCG site was 9.9% among patients with non-KD febrile illnesses and 42.6% among patients with KD. CONCLUSION BCG site reaction or induration is a useful clinical clue for the diagnosis of KD in both infants and older children, with a higher prevalence in infants. Physicians should consider KD in children with febrile illness and redness or crust formation at the BCG site, especially in view of low rates of BCG reaction or induration in non-KD febrile illnesses.
BCG Vaccine ; administration & dosage ; adverse effects ; Case-Control Studies ; Child, Preschool ; Erythema ; complications ; epidemiology ; Female ; Fever ; complications ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; epidemiology ; Risk Factors ; Singapore ; epidemiology

Animals ; Cells, Cultured ; Chitosan ; pharmacology ; DNA, Viral ; isolation & purification ; Hepatocytes ; virology ; Nanofibers ; Primary Cell Culture ; Swine ; Transplants ; virology

Objective To evaluation the performance of double antigen sandwich time-resolved fluoroimmunoassay(TRFIA)for specific total antibody to Treponema pallidum (TP).Methods Specific total antibody to TP was detected by a double antigen TRFIA based on recombinant multi epitope chimeric antigen.The methodological precision,low limit of detection,accuracy,linearity,reference standard coincidence rate and other analytical performance indicators were evaluated,and clinical comparison research trials were completed.The x2 test was used for the difference between two methods results,the P ＜0.05 which represents the difference was statistically significant.Results The intra-assay and inter-assay coefficients of var iation (CV) were both less than 10％ respectively.The low limit of detection was 0.05 mIU/ml.The relative deviation of de tecting the national standard was not exceed 10％.The linear range was 1.50～ 155.00 mIU/ml and the linear correlation co efficient could be reached 0.999 9.The performance of detection national reference could meet the national accreditation requirements.The consistent rate was 100 ％ when the TRFIA methodology detected the standardized serum plate.The parallel test of TRFIA and treponema pallidum gelatin agglutination test (TPPA) were completed,the total coincidence rate was 99.56％,and the Kappa index was 0.990 6.Conclusion Their result showed that the TRFIA methodology is high sensitivity,accuracy,wide linear range,and highly clinical coincidence rate,which is valuable for clinical application.

【Objective】To study retrospectively the serum hepatitis B surface antigen（HBsAg）and HBsAg normal⁃ ized to the same hepatic parenchyma cell volume（HPCV），namely，the same hepatic cell quantities，between HBeAg- positive and HBeAg-negative chronic hepatitis B（CHB）.【Methods】A total of 168 CHB patients who had undergone liv⁃ er biopsy and test of serum HBsAg levels due to their disease in the Third Affiliated Hospital of SunYat-sen University were selected as the study subjects. The serum HBsAg levels，as well as HBsAg levels normalized to HPCV（hepatic cell quantities）were compared between HBeAg-positive and HBeAg-negative CHB，respectively.【Results】There was statis⁃ tically significant difference in serum HBsAg levels between HBeAg-positive and HBeAg-negative CHB（P = 0.028）， while there was no statistical difference in HBsAg normalized to HPCV（P = 0.073）. There were no correlations between serum HBsAg and liver inflammation grades（HBeAg-positive：r s = 0.020，P = 0.876 & HBeAg-negative：r s = 0.037，P =0.711）. Similarly，there were no correlations between HBsAg and hepatic fibrosis stages（HBeAg-positive：r s = 0.087， P = 0.488 & HBeAg-negative：r s = 0.144，P = 0.148）. Nevertheless，statistically significant positive correlations were shown between HBsAg normalized to HPCV and liver inflammation grades（HBeAg-positive：r s = 0.309，P = 0.012 & HBeAg-negative：r s = 0.389，P < 0.001）. Similarly，the HBsAg normalized to HPCV and hepatic fibrosis stages were shown to be statistically significantly correlated（HBeAg-positive：r s = 0.490，P < 0.001 & HBeAg-negative：r s = 0.599， P < 0.001）.【Conclusions】Serum HBsAg normalized to HPCV but not HBsAg levels，is correlated with liver inflamma⁃ tion grades as well as hepatic fibrosis stages positively in both HBeAg-positive and HBeAg-negative CHB. But there is no difference in serum HBsAg levels normalized to HPCV between HBeAg-positive and HBeAg-negative CHB.