Mycobacterium tuberculosis latency-associated antigen Rv1733c SLP improves the accuracy of differential diagnosis of active tuberculosis and latent tuberculosis infection / 中华医学杂志(英文版)

BACKGROUND@#Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the accuracy of differential diagnosis of ATB and LTBI by using fluorescent immunospot (FluoroSpot) assay to detect specific Th1 cell immune responses. The novel mycobacterium tuberculosis (MTB) latency-associated antigens Rv1733c and synthetic long peptides derived from Rv1733c (Rv1733c SLP) were used based on virulence factors early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10).@*METHODS@#Fifty-seven ATB cases, including 20 pathogen-confirmed ATB and 37 clinically diagnosed ATB, and 36 LTBI cases, were enrolled between January and December 2017. FluoroSpot assay was used to detect the interferon γ (IFN-γ) and interleukin 2 (IL-2) secreted by the specific T cells after being stimulated with MTB virulence factors ESAT-6 and CFP-10, MTB latency-associated antigens Rv1733c and Rv1733c SLP. The receiver operating characteristic (ROC) curve was used to define the best cutoff value of latency-associated antigens in the use of differentiating ATB and LTBI. The sensitivity, specificity, predictive value, and likelihood ratio of ESAT-6 and CFP-10-FluoroSpot combined with latency-associated antigen in the differential diagnosis of ATB and LTBI were also calculated.@*RESULTS@#Following the stimulation with Rv1733c and Rv1733c SLP, the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP had the largest area under the ROC curve, which was 0.766. With a cutoff value of 1 (spot-forming cells [SFCs]/2.5 × 105 peripheral blood mononuclear cells) for frequency, the sensitivity and specificity of distinguishing ATB from LTBI were 72.2% and 73.7%, respectively. ESAT-6 and CFP-10-FluoroSpot detected the frequency and proportion of single IFN-γ-secreting T cells; the sensitivity and specificity of distinguishing ATB from LTBI were 82.5% and 66.7%, respectively. Combined with the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP on the basis of ESAT-6 and CFP-10-FluoroSpot, the sensitivity and specificity increased to 84.2% and 83.3%, respectively.@*CONCLUSION@#Rv1733c SLP, combined with ESAT-6 and CFP-10, might be used as a candidate antigen for T cell-based tuberculosis diagnostic tests to differentiate ATB from LTBI.

Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital, a General Tertiary Hospital in Beijing / 中国医学科学杂志(英文版)

Objective s To investigate the positive rate of different hepatitis B virus (HBV) serological markers, and the demographic factors related to HBV infection.Methods We enrolled all patients tested for HBV serological markers, such as HBV surface antigen (HBsAg), HBV surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb), HBV core antibody (HBcAb), and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital. The positive rate of each HBV serological marker was calculated according to gender, age, and de- partment, respectively. The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed.Results Among 27 409 samples included, 2681 (9.8%) were HBsAg positive. When patients were divided into 9 age groups, the age-specific positive rate of HBsAg was 1.2%, 9.6%, 12.3%, 10.9%, 10.3%, 9.7%, 8.0%, 5.8%, and 4.3%, respectively. The positive rate of HBsAg in non-surgical department, surgical department, and health examination center was 16.2%,5.8%,and 4.7%, respectively. The positive rate of HBsAg of males (13.3%) was higher than that of females (7.3%, P=0.000). Among the 2681 HBsAg (+) patients, 1230 (45.9%) had HBV-DNA test, of whom 564 (45.9%) were positive. Patients with HBsAg (+), HBeAg (+), and HBcAg (+) result usually had high positive rate of HBV-DNA Results (71.8%, P=0.000).Conclusions Among this group of patients in our hospital, the positive rate of HBsAg was relatively high. Age group of 20-29, males, and patients in non-surgical departments were factors associated with high positive rate of HBsAg.

Breast-conserving surgery for the treatment of early breast cancer:Analysis of 52 cases / 中国微创外科杂志

Objective To discuss curative results of breast-conserving therapy for early primary breast cancer. Methods Fifty-two patients with stage Ⅰ~Ⅱ breast cancer(solitary tumor ≤ 3 cm in size) underwent local lumpectomy and axillary lymph node dissection from March 2000 to September 2005 in this hospital.After operation,the radiation therapy,chemotherapy,and endocrine therapy were given.Results The breast specimens were pathologically examined and no infiltrating margin was found.The rate of good cosmetic effects was 86.5%(45/52).Follow-up examinations in 50 cases for 10~36 months(median,16 months) found no local recurrence and distant metastasis.Conclusions The cosmetic and clinical results of breast-conserving surgery for stage Ⅰ~Ⅱ primary breast cancer are satisfactory.

Detection of CMV pp65 antigenemia / 中华传染病杂志

Objective To evaluate the clinical utility of CMV pp65 antigenemia by CMV brite Kit for predicting active/reactive CMV infection S as well as of CMV diseases in bone marrow or peripheral stem cell transplant patients. We also investigated the efficacy of preemptive therapy guided by detection of CMV antigenemia. Methods A total of 210 EDTA anticoagulant plasma samples from 36 bone marrow or Peripheral Stem Cell Transplant Patients were prospectively collected from September 1999 to April 2000. The specific CMV antibody IgG/IgM of all patients were detected by ELISA. We detected CMV pp65 antigenemia by indirect immunofluorescence assay using CMV Brite Kit. All blood samples were detected weekly from week 3 after bone marrow transplantation until 100 days or antigenemia turning negative/dischage or death. Ganciclovir preemptive therapy was initiated at first positive pp65 antigenemia. Results Of 36 bone marrow or Peripheral Stem Cell Transplant Patients, 16 patients occurred positive pp65 antigenemia, 15 patients suffered from symptomatic CMV infections or CMV diseases. In 14 patients of positive pp65 antigenemia receiving gaciclovir therapy at first antigenemia, 2 patients died (mortality rate 14.2%), 12 patients of pp65 antigenemia became negative. Otherwise, 2 untreated cases died. The study showed a significant difference in mortality rate between treated and untreated patients (P