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Objective:To investigate the value of autoantibodies and serum levels of IgG4 and CA19-9 in the diagnosis of IgG4 associated cholangitis (IgG4-SC).Methods:Detect the serum IgG4 and CA19-9 of 41 clinical cases of IgG4-SC patients,162 clinical cases of non IgG4-SC patients and 40 healthy human serum samples by immunoassay and direct chemiluminescence methods, also detect the antinuclear antibodies (ANA),anti neutrophil antibody (ANCA),anti smooth muscle antibody (SMA) and anti mitochondrial antibody (AMA) of the above serum samples by indirect immunofluorescence and analyze the detection results.Results:①The positive rates of ANA,ANCA,SMA and AMA in patients with IgG4-SC were 41.46%,7.32%,0 and 2.44%.Among them,the positive rate of ANA was significantly different from that of the normal control group(P<0.01),and the positive rate of SMA and AMA was significantly different from that of non IgG4-SC group(P<0.01),and so as the positive rate of ANCA do with that of PSC group.②The number of serum IgG4 and CA19-9 increased samples were significantly compared with the normal control group (P<0.01);the area under the ROC curve (AUC) was 0.979 and 0.646,respectively,and P<0.05.Conclusion:The high level of serum IgG4 and CA19-9 and autoantibody detection are of great accuracy and important clinical value in the differential diagnosis of IgG4-SC.
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Objective To investigate the distribution of Leptotrombidium deliense among different small mammal hosts in some areas of Yunnan province. Methods A field survey was carried out in some counties of Yunnan province and the small mammal hosts were captured, using mouse cages and traps with baits. Chigger mites on the surface of two auricles were scraped off by a bistoury, and then preserved in 70% ethanol. Every specimen of the chigger mites on the slides was finally identified into species under a microscope. Some conventional statistical methods were adopted to calculate all the collected chigger mite species and the constituent ratios of Leptotrombidium deliense in different areas and on different hosts, together with its prevalence and mean abundance on different hosts. Results A total of 10 222 small mammal hosts were captured from 19 counties and identified as 11 families, 34 genera and 62 species in 5 orders, and 92 990 individuals of chigger mites were collected from the body surface of these small mammal hosts. All the collected chigger mites were identified as 3 subfamilies, 22 genera, and 225 species. Meanwhile, Leptotrombidium deliensee only accounted for 1.659% of the total. The host specificity of Leptotrombidium deliense was very low and 1544 individuals of Leptotrombidium deliense collected from 8518 small mammal hosts belonged to 6 families, 13 genera and 19 species in 3 orders. Our results showed that Leptotrombidium delienses were mainly collected from Insectivora and Rodentia. Leptotrombidium deliense had long been considered as the dominant species of chigger mites and the main vector of tsutsugamushi disease in Yunnan province of China, but our results seemed not thoroughly supporting this point of view. Conclusion Traditionally, Leptotrombidium deliense was the dominant species and the main vectors of scrub typhus in Yunnan province. However, based on our results, the above view might be true in some local places and the composition of chigger mites and the main vector of tautsugamushi disease might be different in regions and habitats in Yunnan province.