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Objective:To analyze the clincial characteristics and laboratory findings of patients with neurobrucellosis (NB).Methods:Using retrospective analysis, clinical diagnosed patients with NB from June 2016 to February 2019 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analyze the general characteristics, clinical symptoms, laboratory examination results [white blood cell (WBC), hemoglobin(Hb), c-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), cerebrospinal fluid routine and biochemical, serum tube agglutination test (SAT), blood culture and cerebrospinal fluid culture of Brucella] , diagnosis and treatment effect. Results:A total of 25 patients were diagnosed with NB, including 19 males and 6 females, with an average age of (41.7 ± 14.2) years old, ranged from 11 to 70 years old. The main clinical symptoms were fever, headache, joint pain, vomiting and sweating, which accounted for 92.0% (23/25), 88.0% (22/25), 76.0% (19/25), 64.0% (16/25), and 64.0% (16/25), respectively. Positive neck ankylosis and mumbness of lowerlimbs were both 9 cases (36.0%), and mental disorders were 7 cases (28.0%). In 25 patients with NB, the WBC increased in 5 cases (20.0%), Hb decreased in 4 cases (16.0%), CRP increased in 13 cases (52.0%), ALT and AST both increased in 6 cases (24.0%), TP decreased in 21 cases (84.0%); SAT was positive in 25 cases (100.0%), cerebrospinal fluid SAT positive in 7 cases (28.0%); and blood culture was positive in 2 cases (8.0%). Cerebrospinal fluid changes were mainly manifested in 14 cases (56.0%) of chloride reduction, 13 cases (52.0%) of gluose reduction and 19 cases (76.0%) of protein increase. In 25 patients with NB, 17 cases were treated with doxycycline + rifampicin + ceftriaxone, 7 cases with etimicin + rifampicin + ceftriaxone, and 1 case with doxycycline + rifampicin + piperacillin sulbactam. After 6 to 12 months follow-up, 21 cases recovered well, whereas mild sequelae were observed in 4 patients.Conclusion:Clinical features of NB are hetorogeneous, and nerurological symptoms and cerebrospinal fluid examination are of great value in the diagnosis of NB.
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Objective:To investigate the clinical significance of six serological methods for diagnosis of brucellosis.Methods:Totally 160 cases of brucellosis patients were selected as the case group and 235 cases of health medical examiners were selected as the control group from January to June 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital. Six methods were used for detection of brucellosis, including Rose Bengal plate agglutination test (RBPT), fluorescence polarization assay (FPA), indirect enzyme linked immunosorbent assay (iELISA), cysteine agglutination test, standard tube agglutination test (SAT), and anti-globulin test (Coomb's). The consistency of the 4 preliminary screening methods (RBPT vs FPA, iELISA, cysteine agglutination test), and 2 diagnosis methods (SAT vs Coomb's) was compared, and the sensitivity, specificity, rates of missed diagnosis and misdiagnosis were analyzed. Results:In the preliminary screening methods, the consistency of RBPT with FPA and iELISA was relatively consistent (Kappa = 0.872, 0.784), and the consistency with cysteine agglutination test was generally consistent (Kappa = 0.543). In the diagnosis methods, the consistency between SAT and Coomb's was relatively consistent (Kappa = 0.861). The sensitivity of FPA, iELISA, cysteine agglutination test and Coomb's was 91.03%, 75.00%, 56.41% and 80.14%, respectively. The specificity was 95.81%, 100.00%, 98.74% and 100.00%, respectively. The rates of missed diagnosis were 8.97%, 25.00%, 43.59% and 19.86%, respectively. The rates of misdiagnosis were 4.19%, 0, 1.26%, and 0, respectively.Conclusions:FPA and iELISA have high sensitivity and specificity, and are suitable for clinical promotion. The combined detection of multiple serological methods will reduce the probability of misdiagnosis and missed diagnosis of brucellosis, thereby improving the diagnostic level of brucellosis.
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Objective To investigate the characteristics of five hormone levels of hypertension in patients with essential hypertension,and explore the correlation between them and essential hypertension.Methods The clinical data of 1 731 patients with essential hypertension and 305 healthy people in General Hospital of Heilongjiang Province Land Reclamation Bureau from April 2018 to March 2019 were analyzed retrospectively.The levels of renin,angiotension Ⅱ (AT Ⅱ),aldosterone,adrenocorticotropic hormone (ACTH) and cortisol were measured by magnetic particle chemiluminescence,and the ratio of aldosterone to renin (ADRR) was calculated.Results The renin,AT Ⅱ,aldosterone,ACTH,cortisol and ADRR in patients with essential hypertension were significantly higher than those in healthy controls:(13.58 ± 9.78) ng/L vs.(9.20 ± 2.12) ng/L,(181.06 ± 89.82) ng/L vs.(133.49 ± 5.47) ng/L,(174.96 ± 103.14) ng/L vs.(136.04 ± 15.48) ng/L,(76.39 ± 61.43) ng/L vs.(26.98 ± 5.10) ng/L,(176.4 ± 88.8) μg/L vs.(145.1 ± 18.9) μg/L and 27.71 ± 18.37 vs.15.18 ± 1.77,and there were statistical differences (P＜0.01).The renin and AT Ⅱ in male patients with essential hypertension (904 cases) were significantly higher than those in female patients with essential hypertension (827 cases):(16.04 ± 10.67) ng/L vs.(10.34 ± 8.59) ng/L and (194.28 ± 96.22) ng/L vs.(166.37 ± 83.42) ng/L,the aldosterone was significantly lower than that in female patients with essential hypertension:(166.31 ± 101.91) ng/L vs.(184.68 ± 104.37) ng/L,and there were statistical differences (P＜0.01 or ＜0.05);there were no statistical difference in ACTH,cortisol and ADRR (P＞0.05).The renin and AT Ⅱ in patients aged 51 to 60 years (610 cases) and ＞60 years (572 cases) were significantly lower than those in patients aged ＜ 50 years (549 cases):(12.67 ± 10.76),(12.43 ± 8.29) ng/L vs.(16.05 ± 10.29) ng/L and (172.62 ± 81.63),(166.04 ± 79.09) ng/L vs.(208.94 ± 108.75) ng/L,and there were statistical differences (P＜0.05 or ＜0.01);there were no statistical difference in aldosterone,ACTH,cortisol and ADRR (P＞0.05).Multivariate linear regression analysis result showed that renin and AT Ⅱ were negatively correlated with systolic blood pressure and diastolic blood pressure (P＜0.01 or ＜0.05),and aldosterone,ACTH and cortisol were positively correlated with systolic blood pressure and diastolic blood pressure (P＜0.05 or ＜0.01).Conclusions Renin and AT Ⅱ are negatively correlated with systolic blood pressure and diastolic blood pressure;aldosterone,and ACTH and cortisol are positively correlated with systolic blood pressure and diastolic blood pressure.The five hormone levels of hypertension can reflect the function of renin-angiotension-aldosterone (RAAS) system and hypothalamus pituitary adrenocortical axis (HPA axis),which are the influencing factors of essential hypertension.
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Objective@#To evaluate the clinical value of four items of thrombosis detection, including thrombin-antithrombin complex (TAT), α2-plasmin inhibitor-plasmin complex (PIC), thrombomodulin (TM) and tissue plasminogen activator-inhibitor complex (t-PAIC), combined with D-dimer (D-D) and fibrin degradation products (FDP) in venous thrombosis in patients with malignant tumor.@*Methods@#A total of 904 patients with malignant tumor from October 2017 to March 2019 in General Hospital of Heilongjiang Province Land Reclamation Bureau were selected (malignant tumor group), and 200 healthy physical examination patients were selected as healthy control group. Among 904 patients with malignant tumor, 92 patients had venous thrombosis (thrombosis group), and 812 patients had not venous thrombosis (non-thrombosis group). The TAT, PIC, TM, t-PAIC, FDP and D-D were detected. The relationship between TAT, PIC, TM, t-PAIC, D-D, FDP and venous thrombosis was analyzed by binary Logistic regression. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance of each index, and the maximum value of the Youden index was the optimal cut-off value.@*Results@#The TAT, PIC, TM, t-PAIC, D-D and FDP in malignant tumor group were significantly higher than those in healthy control group, and there were statistical differences (P<0.01). The TAT, PIC, TM, t-PAIC, D-D and FDP in thrombosis group were significantly higher than those in non-thrombosis group: 20.20 (12.30, 59.45) μg/L vs. 8.60 (4.87, 15.15) μg/L, 1.23 (0.69, 2.84) mg/L vs. 0.70 (0.37, 1.45) mg/L, 14.55 (8.12, 21.10) kU/L vs. 10.05 (7.975, 13.90) kU/L, 10.20 (7.30, 15.17) μg/L vs. 7.40 (5.20, 12.65) μg/L, 3.42 (1.38, 7.07) μg/L vs. 1.69 (0.53, 4.64) μg/L, 6.41 (3.21, 17.05) mg/L vs. 5.15 (2.26, 10.01) mg/L, and there were statistical differences (P<0.01 or <0.05). Binary Logistic regression analysis result showed that TAT, PIC, TM, t-PAIC, D-D and FDP were correlated with venous thrombosis in patients with malignant tumor (OR = 1.277, 1.209, 1.107, 1.089, 1.260, 1.078 and 0.002; P<0.01 or <0.05). ROC curve result showed that the optimal cut-off values of TAT, PIC, TM, t-PAIC, D-D and FDP in the diagnosis of venous thrombosis in patients with malignant tumor were 24.450 μg/L, 2.624 mg/L, 17.750 kU/L, 13.250 μg/L, 5.290 μg/L and 22.435 mg/L; and the area under curve (AUC) were 0.788, 0.659, 0.621, 0.597, 0.626 and 0.598, respectively. The AUC of TAT + PIC + TM + t-PAIC and TAT + PIC + TM + t-PAIC + D-D + FDP in the diagnosis of venous thrombosis in patients with malignant tumor were significantly higher than D-D + FDP (0.808 and 0.796 vs. 0.633). Ninety patients with TAT>24.450 μg/L or PIC>2.624 mg/L were selected. Fourty-five cases of them were injected with low molecular weight heparin (experimental group) for 6 weeks, and another 45 cases were not treated with low molecular weight heparin (control group). Both groups were followed up for 1 year. The incidence of venous thrombosis in the experimental group was significantly lower than that in control group: 2.22% (1/45) vs. 15.56% (7/45), the survival time was significantly longer than that in control group: (10.6 ± 3.1) months vs. (8.5 ± 2.8) months, and there were statistical differences (P<0.05), and no bleeding occurred in experimental group.@*Conclusions@#Four items of thrombosis detection combined with D-D and FDP is better than single detection. It is the best non-invasive method to detect venous thrombosis. It can predict the possibility of venous thrombosis in patients with malignant tumor at an early stage, and help patients actively use preventing drug, determine the best and most reasonable treatment time, improve the prognosis of patients, and prolong survival time.
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Objective@#To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis.@*Methods@#In-patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis.@*Results@#There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3-6 years old of age had the highest incidence (64.44%, 29/45). The patients were mainly rural residents (97.78%, 44/45). The onset time was mainly from March to June of the year (46.67%, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78% (44/45) and 57.78% (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22% (19/45) and 35.56% (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t=4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00%, 36/45) had positive blood culture, which turned negative after the treatment.@*Conclusions@#The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.
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Objective To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis. Methods In - patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis. Results There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3 - 6 years old of age had the highest incidence (64.44％, 29/45). The patients were mainly rural residents (97.78％, 44/45). The onset time was mainly from March to June of the year (46.67％, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78％ (44/45) and 57.78％ (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22％ (19/45) and 35.56％ (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t = 4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00％, 36/45) had positive blood culture, which turned negative after the treatment. Conclusions The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.
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Objective To analyze the epidemiology and clinical characteristics of Brucella infection in Heilongjiang Province,and to provide experience and basis for clinical treatment and prevention of brucellosis.Methods Using retrospective analysis method,clinically diagnosed patients with brucellosis from December 2016 to December 2017 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms,laboratory examination results,diagnosis and treatment effect.Healthy subjects undergoing health check-up at the same period were randomly selected as control group for laboratory blood biochemical test.Results A total of 396 patients were included in the brucellosis group,including 298 males and 98 females,with an average age of (43.6 + 15.6) years old,ranged from 1 to 75 years old.The control group included 125 cases,including 83 males and 42 females,with an average age of (41.7 ±+ 18.0) years old,ranged from 7 to 71 years old.There were no significant differences in age and gender between the two groups (t =1.083,x2 =3.789,P ＞ 0.05).The patients of ＞ 14-64 years old of age had the highest incidence (90.15％,357/396).The patients were mainly rural residents (76.01％,301/396) and the majority of them were farms (50.51％,200/396).The onset time was mainly from March to June of the year (47.73％,189/396).Clinical symptoms were fever,joint or muscle pain and hyperhidrosis,which accounted for 91.16％ (361/396),76.26％ (302/396) and 44.19％ (175/396),respectively.The levels of C-reactive protein (CRP),seropropane alanine aminotransferase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptadase (γ-GT),alkaline phosphatase (ALP),α-hydroxybutyrate dehydrogenase (HBDH),and lactate dehydrogenase (LDH) in patients with brucellosis were significantly higher than those in the control group (t =4.956,2.746,4.019,3.272,7.008,3.728,3.409,P ＜ 0.01 or 0.05),while total protein (TP) and albumin (ALB) levels were reduced (t =-7.252,-8.601,P ＜ 0.01).After treatment,the test results of CRP,ALT,AST,γ-GT,TP,ALB,ALP,HBDH and LDH were compared with those before the treatment,and the differences were statistically significant (t =2.291,4.393,3.382,2.608,-7.516,-4.710,3.509,4.585,4.473,P ＜ 0.01 or 0.05).Conclusions The patients with brucellosis in Heilongjiang Province are mainly male farmers,and the onset time is mostly concentrated in March-June.The clinical manifestations of brucellosis are varied,clinicians should strengthen discrimination and prevent misdiagnosis.Medicines for brucellosis might be cautiously used in clinical trial,and changes in liver function and myocardial enzyme activity should be monitored.
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Objective To study clinical and laboratory features of children with brucellosis and to provide a theoretical basis for clinical diagnosis and treatment.Methods Using the retrospective analysis method,the clinical diagnosed information of child patients with brucellosis from January 2013 to January 2016 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms and laboratory examination results.At the same time,follow the case control method,dadult brucellosis laboratory results were selected,and the laboratory examination results were compared between child and adult patients.Results The children of ＞ 12-15 years of age had the highest incidence in 65 cases of brucellosis,and the rate was 47.7％ (31/65).Clinical symptoms were fever and joint pain,which accounted for 83.1％ (54/65) and 84.6％ (55/65),respectively.The mean values of γ-glutamyl transpeptadase (γ-GT),α-hydroxybutyric dehydrogenase (HBDH),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) were compared between child brucellosis and adult brucellosis,and the differences were statistically significant [(30.66 ± 27.05) vs (82.80 ± 36.34) U/L,(287.40 ± 35.02) vs (180.08 ± 40.90)U/L,(20.88 ± 13.01) vs (11.70 ± 4.13)U/L,(328.69 ± 37.86) vs (217.88 ± 45.67)U/L,t =-4.243,3.396,3.756,3.135,all P ＜ 0.05].After treatment,the test results of children with aspartate transaminase (AST),alanine aminotransferase (ALT),γ-GT,total protein (TP),albumin (ALB),HBDH,CK-MB and LDH were compared with those of before the treatment,the differences were statistically significant [(56.95 ± 29.50) vs (23.00 ± 12.26) U/L,(57.60 ± 35.65) vs (23.94 ± 13.38) U/L,(30.66 ± 27.05) vs (18.45 ± 12.62) U/L,(63.77 ± 5.51) vs (67.42 ± 3.50) g/L,(39.15 ± 3.89) vs (43.06 ± 3.11) g/L,(287.40 ± 35.02) vs (139.23 ± 51.70) U/L,(20.88 ± 13.01) vs (11.61 ± 10.26) U/L,(328.69 ± 37.86) vs (187.77 ± 42.32) U/L,t =4.848,2.717,2.182,-5.442,-13.752,6.989,4.749,5.993,all P ＜ 0.05].Conclusions Liver and heart of children with brucellosis are injured.By monitoring the changes of myocardial enzymes,medicines for children might be cautiously used in clinical trial,and myocardial damages of children with brucellosis can be protected and prevented.
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Objective To analyze the epidemiologic features and laboratory findings of acute and chronic brucellosis.Methods Two hundred and ninety-two patients with brucellosis admitted in Heilongjiang Agricultural Reclamation Bureau General Hospital during June 2015 to February 2017 were retrospectively reviewed,including 170 acute cases and 122 chronic cases;95 healthy subjects undergoing health check-up at the same period were randomly selected as control group.Epidemiological characteristics,clinical symptoms and findings of laboratory tests of acute and chronic brucellosis were analyzed with SPSS 18.0 software.Results The male to female ratio were 3.15 to 1 and 3.21 to 1 for acute and chronic brucellosis,respectively.The patients were mainly rural residents (74.12％ and 77.05％) and the majority of them were farmers (62.94％ and 66.39％).The onset time was mainly from March to June of the year (47.06％ and 46.72％).The proportion of acute brucellosis patients ≤ 14 years was higher than that of chronic brucellosis group (x2 =5.022,P ＜ 0.05);the proportion of acute brucellosis patients ＞ 64 years old was lower than that of chronic brucellosis group (x2 =3.900,P ＜ 0.05).The symptom of sweating and myosalgia in acute brucellosis was more frequent than that in chronic brucellosis (x2 =10.764 and 10.479,both P ＜ 0.01);while the symptom of weakness in chronic brucellosis was higher than that in acute brucellosis (x2 =5.347,P ＜ 0.05).The AST,ALT,γ-GT,ALP,LDH and HBDH levels in patients with acute and chronic brucellosis were significantly higher than those in the control group (t =3.602 and 5.205;2.529 and 2.682;2.669 and 1.941;5.169 and 7.068;3.601 and 2.240;3.469 and 3.954;P ＜ 0.05 or 0.01);while TP and ALB levels were reduced (t =-5.880 and-8.923;-8.106 and-8.774;all P ＜ 0.01).The CRP in the acute brucellosis group was significantly higher than that in the chronic brucellosis group (t =6.717,P ＜0.01).The therapeutic regimes for acute brucellosis and chronic brucellosis were same,the symptoms dissolved after successful treatment.Conclusion There are different clinical manifestations between acute and chronic brucellosis.Medication for brucellosis should be cautious and the changes of myocardial enzymes should be monitored.
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Objective To analyze the diagnostic value of fluorescence polarization assay (FPA) for human brucellosis.Methods From April 2013 to August 2014,240 positive sera of brucella patients were collected as case group and 287 normal sera as control group in Heilongjiang Agricultural Reclamation Bureau General Hospital.Four milliliters of venous blood were withdrawn for separation of serum.Fluorescence polarization assay was used and the consistency,sensitivity and specificity were compared with those of four classical serological methods,including rose bengal plate agglutination test (RBPT),standard tube agglutination test (SAT),Coomb's test and cysteine test.Results The results of FPA were complied with those of the four conventional serological methods,Kappa ≥ 0.75.The sensitivity of FPA (89.17％) was higher than that of RBPT (87.08％),SAT (85.00％),Coomb's (74.17％) and cysteine test (75.83％).The specificity of FPA (94.08％) was higher than that of RBPT (89.90％) and Coomb's (81.53％),but lower than that of SAT (98.95％) and cysteine test (99.30％).Conclusion FPA can be used as a laboratory diagnostic method for human brucellosis,which is worthy to be widely used.
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Objective To investigate the differents of rapid enzyme-linked immunosorbent assay(IELISA) and the traditional serological methods in diagnosis of human brucellosis.Methods Brucella antibody was detected by IELISA,rose bangel plate test (RBPT),standard agglutination test (SAT),Coomb's test and cysteine test of serological methods in 430 confirmed and suspected patients and 300 healthy controls during the same period.The consistency was analyzed between IELISA and other tests.Results Positive rates of patients were significandy higher than those in healthy controls (IELISA:83.49％ vs.0;RBPT:86.97％ vs.0;SAT:76.27％ vs.0;Coomb's:65.58％ vs.0.02％;and cysteine test:67.91％ vs.0,x2 =535.05,412.47,437.66,339.22,489.49,all P ＜ 0.01).Positive consistency rates between IELISA and other tests were 87.19％,79.39％,71.59％ and 76.60％,the highest was between IELISA and RBPT,the lowest was between IELISA and Coomb's.Conclusions Brucella antibody is detected conveniently,quickly,and accurately by the joint application of RBPT and IEHSA,which provides important technical support for prevention and control of brucellosis.It is worthy of application extensively.