1.Establishment and preliminary evaluation of a fluorescent recombinase-aided amplification assay for detection of Strongyloides stercoralis
Xiaodan CHEN ; Wanqiong CHENG ; Xiaoyin FU ; Jiayin LÜ ; Jiayue SUN ; Qiuhua BAI ; Xue HAN ; Yunliang SHI ; Dengyu LIU
Chinese Journal of Schistosomiasis Control 2026;38(2):160-168
Objective To establish a fluorescent recombinase-aided amplification (RAA) assay for detection of Strongyloides stercoralis nucleic acid and to preliminarily evaluate its performance. Methods Six sets of specific primers targeting S. stercoralis 18S ribosomal RNA (18S rRNA) gene and one fluorescent probe were designed and synthesized. The optimal primer-probe set was determined through systematic screening and optimization to establish the fluorescent RAA assay. The assay was evaluated using S. stercoralis genomic DNA at concentrations of 100, 10, and 1 pg/μL, and 100, 10, and 1 fg/μL, as well as recombinant pUC57 plasmids containing the target gene fragments at 1 × 105, 1 × 104, 1 × 103, 1 × 102, 1 × 101, 1 × 100 copies/reaction, to determine the analytical sensitivity. Genomic DNA from Ascaris lumbricoides, Ancylostoma duodenale, Enterobius vermicularis, Angiostrongylus cantonensis, Trichinella spiralis, Clonorchis sinensis, Schistosoma japonicum, and Taenia saginata was used to assess assay specificity. A total of 25 stool samples from patients suspected of S. stercoralis infection were tested by the modified Baermann funnel technique, PCR, and the established fluorescent RAA assay. The sensitivity, specificity, concordance rate and their 95% confidence intervals (CI) of these three techniques were estimated, and agreement between methods was evaluated using the Kappa coefficient. Results Exo-4 was identified as the optimal primer set screened from the six primer sets, and the best amplification performance was achieved when the final concentrations of the forward and reverse primers were 0.44 μmol/L and a probe concentration was 0.20 μmol/L. The limit of detection of the fluorescent RAA assay was 100 fg/μL for genomic DNA of S. stercoralis and 1 × 100 copies/reaction for recombinant plasmids. Specific fluorescence signals were detected within 5 min, with no cross-reactivity observed with A. lumbricoides, A. duodenale, E. vermicularis, A. cantonensis, T. spiralis, C. sinensis, S. japonicum, or T. saginata. Among the 25 clinical stool samples from patients suspected of S. stercoralis infections, the modified Baermann funnel technique and fluorescent RAA assay detected 19 positives and 6 negatives, whereas PCR detected 18 positives and 7 negatives. The fluorescent RAA assay showed a sensitivity of 100.00% [95% CI: (82.35%, 100.00%)], specificity of 100.00% [95% CI: (54.07%, 100.00%)], concordance rate of 100.00% [95% CI: (86.28%, 100.00%)], and a Kappa coefficient of 1.00 [95% CI: (1.00, 1.00)] (P < 0.001) relative to the modified Baermann funnel technique, and a sensitivity of 100.00% [95% CI: (81.47%, 100.00%)], specificity of 85.71% [95% CI: (42.13%, 99.64%)], concordance rate of 96.00% [95% CI: (79.65%, 99.90%)], and a Kappa coefficient of 0.90 [95% CI: (0.70, 1.00)] (P < 0.001). Positive amplification products emitted green fluorescence under a portable blue-light device, enabling visual interpretation of results. Conclusions The fluorescent RAA assay established in this study is rapid, highly sensitive, and highly specific. It enables detection of S. stercoralis nucleic acid under isothermal conditions and allows visual interpretation of results, providing a novel tool for rapid clinical diagnosis and field screening of S. stercoralis infections.
2.Effect of illness perception on cardiac rehabilitation willingness in patients with coronary heart disease: the mediating role of kinesophobia
Qiuhua XUE ; Jianlin DU ; Xumin XIN ; Guangsu QU
Chinese Journal of Modern Nursing 2023;29(30):4085-4090
Objective:To explore the mediating role of kinesiophobia in the relationship between illness perception and cardiac rehabilitation willingness among patients with coronary heart disease.Methods:Using the convenient sampling method, a total of 255 patients with coronary heart disease who were admitted to Cardiovascular Department of the Second Affiliated Hospital of Chongqing Medical University from June to September 2022 were selected as the research objects. The survey was conducted using a general information questionnaire, Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart-C) , Heart Rehabilitation Scale and Chinese version of Brief Illness Perception Questionnaire.Results:The total score of TSK-Heart-C in 255 patients with coronary heart disease was (38.53±9.27) , the total score of Heart Rehabilitation Scale was (49.90±12.53) , and the total score of Chinese version of Brief Illness Perception Questionnaire was (53.04±15.90) . Disease perception had a direct effect on heart rehabilitation willingness (β=-0.378, P<0.01) , kinesiophobia played a mediating role between illness perception and heart rehabilitation willingness (β=-0.254, P<0.01) , and the mediating effect accounted for 40.19% of the total effect. Conclusions:Kinesiophobia is a mediating variable between cardiac rehabilitation willingness and illness perception. Medical staff should pay attention to the level of kinesiophobia in patients with coronary heart disease, provide correct health education, improve patients' correct understanding and compliance with the disease, take correct cardiac rehabilitation measures and effectively improve quality of life of patients.

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