T-SPOT联合颗粒酶B阳性Ts淋巴细胞对成人结核病诊断的价值

目的探讨结核感染T细胞斑点试验(T-SPOT.TB)联合颗粒酶B(GrB)+CD8^(+)T淋巴细胞在诊断结核病中的价值。方法选取南昌大学第一附属医院2021年2月至2022年3月疑似结核病患者212例,所有患者均保留T-SPOT结果,流式细胞仪检测外周血中T淋巴细胞亚群及其穿孔素和GrB的表达,根据出院最终诊断分为结核病组和非结核病组,比较两组间T-SPOT斑点数和淋巴细胞亚群及其穿孔素和GrB表达差异,ROC曲线分析ESAT-6斑点数,CFP-10斑点数,结核特异性抗原(TBAg)与植物血凝素(PHA)斑点数的比值(TBAg/PHA)(ESAT-6/PHA和CFP-10/PHA中较大的一个),GrB^(+)Ts(CD8^(+)T)及“结核比值”[TBAg/(PHA*GrB^(+)Ts)]的诊断效能。结果GrB^(+)Ts细胞百分比在结核组中显著高于非结核组(44.95±2.98 vs 33.49±1.87,P<0.05),而总T细胞、穿孔素+T细胞,GrB^(+)T细胞,Ts细胞和穿孔素+Ts细胞百分比差异无统计学意义(P>0.05);非结核组T-SPOT.TB阳性率为51.85%,明显低于结核组的92%,且结核组的A抗原斑点数及B抗原斑点数显著大于非结核组(P<0.05),ROC曲线显示A抗原诊断结核病的灵敏度和特异性分别为80.0%和56.8%,曲线下面积(AUC)为0.748,约登指数为0.368;B抗原的灵敏度和特异性为分别62.0%和77.8%,AUC为0.758,约登指数为0.398;A抗原+B抗原灵敏度和特异性为72.0%和74.1%,AUC为0.796,约登指数为0.461;结核组的TBAg/PHA比率要显著高于非结核组(1.21±0.17 vs 0.26±0.02,P<0.001)以0.59为cut-off值时,诊断结核病的灵敏度和特异性分别为66%和91.4%,AUC高达0.852,约登指数为0.574;结核组的“结核比值”要显著高于非结核组(4.58±0.87 vs 1.71±0.24,P<0.01),以1.24为cut-off值时,诊断结核病的灵敏度和特异性分别为82.0%和72.2%,AUC为0.794,约登指数为0.542。结论应用TBAg/PHA比率和TBAg/(PHA*GrB^(+)Ts)比值诊断结核病的效能要优于常规的T-SPOT检测,两者结合使用对结核病诊断可能具有重要价值。

6-48月龄婴幼儿Spot屈光度异常结果分析

目的:分析6-48月龄婴幼儿Spot屈光异常情况,为婴幼儿屈光不正矫正及弱视早期防治提供依据。方法:对6-48月龄婴幼儿使用Spot双目视力筛查仪进行自然状况下验光,根据Spot屈光筛查仪4岁以下儿童转诊标准,收集屈光异常婴幼儿临床资料;使用睫状肌麻痹剂视网膜检影验光,并对验光结果进行统计分析。结果:根据转诊标准共收集Spot屈光度异常婴幼儿168例336眼。其中远视及散光异常占比高,分别为38.4%和28.6%,而近视占比低(12.2%)。168例Spot屈光度异常婴幼儿中,屈光参差(≥1.00 D)共90例,其中散光性屈光参差41例(45.6%)、远视性屈光参差33例(36.7%),近视性屈光参差16例(17.8%)占比最少。共109例Spot屈光度异常婴幼儿完成睫状肌麻痹剂视网膜检影验光。对其Spot屈光度与睫状肌麻痹后检影验光结果差异及相关性分析结果显示,两者散光度差异为0.34±0.64 D(P<0.001),远视度差异为-2.10±1.27 D(P<0.001),近视度差异为-0.43±0.91 D(P=0.023);虽然二者结果存在统计学差异,但二者散光度、远视度及近视度均呈正相关(r=0.694、0.762、0.909)。结论:6-48月龄婴幼儿Spot屈光异常主要以散光、远视异常和屈光参差为主,近视异常较少;对Spot筛查异常者应进一步睫状肌麻痹剂视网膜检影验光,给予配镜矫正,有效防止婴幼儿屈光性弱视。

Development characteristics and controlling factors of fractures in lacustrine shale and their geological significance for evaluating shale oil sweet spots in the third member of the Shahejie Formation in the Qikou Sag, Bohai Bay Basin

Natural fractures are critical for shale oil and gas enrichment and development. Due to the extremely high heterogeneity of shale, the factors controlling the formation of internal fractures, especially horizontal fractures, remain controversial. In this study, we integrate thin section analysis and microcomputed tomography(CT) data from several lacustrine shale samples from the third member(Es3) of the Shahejie Formation, Qikou Sag, Bohai Bay Basin, to assess the fractures in detail. The goal is to reveal the development characteristics, controlling factors, and geological significance for evaluating sweet spots in a shale oil play. The fractures in the Es3contain high-angle structural and horizontal bed-parallel fractures that are mostly shear and extensional. Various factors influence fracture development,including lithofacies, mineral composition, organic matter content, and the number of laminae. Structural fractures occur predominantly in siltstone, whereas bed-parallel fractures are abundant in laminated shale and layered mudstone. A higher quartz content results in higher shale brittleness, causing fractures, whereas the transformation between clay minerals contributes to the development of bedparallel fractures. Excess pore pressure due to hydrocarbon generation and expulsion during thermal advance can cause the formation of bed-parallel fractures. The density of the bed-parallel and structural fractures increases with the lamina density, and the bed-parallel fractures are more sensitive to the number of laminae. The fractures are critical storage spaces and flow conduits and are indicative of sweet spots. The laminated shale in the Es3with a high organic matter content contains natural fractures and is an organic-rich, liquid-rich, self-sourced shale play. Conversely, the siltstone, massive mudstone, and argillaceous carbonate lithofacies contain lower amounts of organic matter and do not have bed-parallel fractures. However, good reservoirs can form in these areas when structural fractures are present and the source, and storage spaces are separated.

Effects of Poria cocos polysaccharide on growth performance,physiological parameters,and lipid metabolism of spotted sea bass Lateolabrax maculatus

The aquaculture industry has developed significantly over the past few decades and has had a substantial impact on the global food supply and marine fisheries resources.However,some problems arise behind the scenes due to excessive intensive farming,such as slow animal growth,frequent disease,and lipid metabolism disorders.These problems have limited the sustainable development of the aquaculture industry,and a continuable solution is required.The use of fungal polysaccharide appears to provide a solution to these problems.Therefore,different supplemented levels of Poria cocos polysaccharide(PCP)(0,0.4,0.8,1.2,1.6,and 2.0 g/kg,respectively)were fed to spotted sea bass(Lateolabrax maculatus)in similar size(30.28±0.18 g)in current study.The effects of PCP on growth,physiological parameters,and lipid metabolism of spotted sea bass were investigated after a 4-week rearing period.Results showed,fish with PCP intake presented a significantly higher weight gain,specific growth rate,and a significantly lower feed conversion ratio.Significantly higher trypsin activity in liver and intestine were observed in fish with PCP intake.The superoxide dismutase activity in serum and liver of fish with PCP intake were significantly improved,while significantly higher serum total antioxidant capacity and hepatic catalase activity were also observed.However,no significant differences in lysozyme and alkaline phosphatase activity were evident among groups.Fish with PCP intake showed a significantly lower total cholesterol,but no noteworthy change in triglyceride and lipid-metabolismrelated genes expression were observed among groups.Results indicated that intake of PCP has a positive effect on growth and antioxidant capacity of spotted sea bass,but seems to have a limited effect on the non-specific immunity and lipid metabolism of spotted sea bass.Based on the regression analysis results,1.4 g/kg of PCP is the optimal dose for spotted sea bass in size(30.28±0.18 g).

Effects of spot size on the operation mode of Ga As photoconductive semiconductor switch employing extrinsic photoconductivity

To guide the illuminating design to improve the on-state performances of gallium arsenide(GaAs)photoconductive semiconductor switch(PCSS),the effect of spot size on the operation mode of GaAsPCSS based on a semi-insulating wafer with a thickness of 1 mm,triggered by a 1064-nm extrinsic laser beam with the rectangular spot,has been investigated experimentally.It is found that the variation of the spot size in length and width can act on the different parts of the output waveform integrating the characteristics of the linear and nonlinear modes,and then significantly boosts the PCSS toward different operation modes.On this basis,a two-channel model containing the active and passive parts is introduced to interpret the relevant influencing mechanisms.Results indicate that the increased spot length can peak the amplitude of static domains in the active part to enhance the development of the nonlinear switching,while the extended spot width can change the distribution of photogenerated carriers on both parts to facilitate the linear switching and weaken the nonlinear switching,which have been proved by comparing the domain evolutions under different spot sizes.

Detour for the inexperienced? Migration count data suggest mostly juvenile Greater Spotted Eagles appear in coastal peninsulas in China

Soaring bird migration often relies on suitable terrain and airflow;therefore,route selection is vital for successful migration.While age and experience have been identified as key factor influencing migration route selection among soaring raptors in the African-Eurasian Flyway,how they shape the migration route of soaring raptors in East Asia is still largely unknown.In this study,we investigated potential variations in the routes and timing in autumn migration of juvenile and older soaring birds,using count data of Greater Spotted Eagles(Clanga clanga)from two coastal sites and two inland sites in China.From 2020 to 2023,we recorded a total of 340 individuals,with the highest site averaging over 90 individuals per autumn,making it one of the world’s top single-season counts and thus a globally important site for this species.We found that 82% and 61% records from coastal sites were juveniles,significantly higher than inland sites(15% and 24%).Juveniles at all four sites exhibited markedly earlier median passage time than non-juveniles,with brief overlapping in their main migration periods.Both coastal sites are located on the tip of peninsulas stretching southwest,requiring long overwater flights if crossing the Bohai Bay or Beibu Gulf,which would be energetically demanding and increase mortality risk.Experienced individuals may have learned to avoid such terrain and subsequent detour,while juveniles are more prone to enter these peninsulas due to lack of experience and opportunities for social learning,or following other raptor species that are more capable of powered flight.Our findings highlight the importance of age and experience in migration route selection of large soaring birds.

Variations of phyllosphere microorganisms in asymptomatic and tobacco brown spot leaves before and after spraying 12% difenoconazole + fluxapyroxad SC

12%difenoconazole+fluxapyroxad SC(commercial name:Jiangong)was first released by BASF in China in 2016.It has been registered to control many diseases,including pear scab,apple Alternaria leaf spot,tomato early blight,cucumber powdery mildew,etc.This study evaluated the bioactivity of Jiangong against Alternaria alternata and explored variations of phyllosphere microorganisms in both asymptomatic and tobacco brown spot leaves at different persistence periods(0,5,10,and 15 days post-fungicide application)using high-throughput sequencing technology.The results indicated that Jiangong effectively inhibited mycelial growth(average EC_(50) value of 0.51μg/mL),conidia germination(average EC_(50) value of 3.47μg/mL),and the carbon metabolism of A.alternata.Both asymptomatic and symptomatic leaves presented complex microbial communities.Higher fungal diversity was noted in asymptomatic leaves,while higher bacterial diversity was found in symptomatic leaves.After application,the diversity and abundance of microbial community structures in both types of leaves changed over time.Fungal microbiome communities showed greater sensitivity than bacterial groups,with the microbiome communities of asymptomatic leaves being more affected than those of symptomatic leaves.Fungal community diversity decreased for both symptomatic and asymptomatic leaves after 5 days of application,while the diversity of fungal community in symptomatic leaves showed an upward trend after 10 days of application.Meanwhile,bacterial community diversity increased in both symptomatic and asymptomatic leaves after 5 days of application but then declined in asymptomatic leaves after 15 days.The abundance of the dominant function group of phyllosphere bacteria(metabolism,genetic information processing,environmental information processing)was not affected by the application of Jiangong.However,the abundance of the dominant function group of phyllosphere fungi(animal pathogen-endophyte-wood saprotroph,endophyte-plant pathogen,plant pathogen-undefined saprotroph)was significantly affected by the application of Jiangong,and high variation was found in symptomatic leaves than that of asymptomatic leaves.The application of Jiangong-induced alterations in the community structure of the tobacco phyllosphere microbiome provides a basis for future tobacco brown spot control strategies based on phyllospheric microecology.

Overexpression of auxin/indole-3-acetic acid gene MdIAA24 enhances Glomerella leaf spot resistance in apple(Malus domestica)

Auxin is throughout the entire life process of plants and is involved in the crosstalk with other hormones,yet its role in apple disease resistance remains unclear.In this study,we investigated the function of auxin/indole-3-acetic acid(IAA)gene Md IAA24 overexpression in enhancing apple resistance to Glomerella leaf spot(GLS)caused by Colletotrichum fructicola(Cf).Analysis revealed that,upon Cf infection,35S::Md IAA24 plants exhibited enhanced superoxide dismutase(SOD)and peroxidase(POD)activity,as well as a greater amount of glutathione(reduced form)and ascorbic acid accumulation,resulting in less H_(2)O_(2)and superoxide anion(O_(2)^(-))in apple leaves.Furthermore,35S::Md IAA24 plants produced more protocatechuic acid,proanthocyanidins B1,proanthocyanidins B2 and chlorogenic acid when infected with Cf.Following Cf infection,35S::Md IAA24 plants presented lower levels of IAA and jasmonic acid(JA),but higher levels of salicylic acid(SA),along with the expression of related genes.The overexpression of Md IAA24 was observed to enhance the activity of chitinase andβ-1,3-glucanase in Cfinfected leaves.The results indicated the ability of Md IAA24 to regulate the crosstalk between IAA,JA and SA,and to improve reactive oxygen species(ROS)scavenging and defense-related enzymes activity.This jointly contributed to GLS resistance in apple.

Research status and hotspots of tight junctions and colorectal cancer:A bibliometric and visualization analysis

BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related death.Over the past two decades,numerous researchers have provided important evidence regarding the role of tight junction(TJ)proteins in the occurrence and progression of CRC.The causal relationship between the presence of specific TJ proteins and the development of CRC has also been confirmed.Despite the large number of publications in this field,a bibliometric study to review the current state of research and highlight the research trends and hotspots in this field has not yet been performed.AIM To analyze research on TJs and CRC,summarize the field’s history and current status,and predict future research directions.METHODS We searched the Science Citation Index Expanded database for all literature on CRC and TJs from 2001-2023.We used bibliometrics to analyze the data of these papers,such as the authors,countries,institutions,and references.Co-authorship,co-citation,and co-occurrence analyses were the main methods of analysis.CiteSpace and VOSviewer were used to visualize the results.RESULTS A total of 205 studies were ultimately identified.The number of publications on this topic has steadily increased since 2007.China and the United States have made the largest contributions to this field.Anticancer Research was the most prolific journal,publishing 8 articles,while the journal Oncogene had the highest average citation rate(68.33).Professor Dhawan P was the most prolific and cited author in this field.Co-occurrence analysis of keywords revealed that“tight junction protein expression”,“colorectal cancer”,“intestinal microbiota”,and“inflammatory bowel disease”had the highest frequency of occurrence,revealing the research hotspots and trends in this field.CONCLUSION This bibliometric analysis evaluated the scope and trends of TJ proteins in CRC,providing valuable research perspectives and future directions for studying the connection between the two.It is recommended to focus on emerging research hotspots,such as the correlations among intestinal microbiota,inflammatory bowel disease,TJ protein expression,and CRC.

Evaluation of Resistance of Different Kiwifruit Varieties (Lines) to Canker Disease and Brown Spot Disease

Kiwifruit canker and brown spot are significant diseases affecting kiwis,caused by Pseudomonas syringae patho-genic variations(Pseudomonas syringae pv.Actinidiae(Psa))and Corynesporapolytica(Corynespora cassiicola).At present,the research on canker disease and brown spot disease mainly focuses on the isolation and identification of pathogenic bacteria,drug control,resistance gene mining and functional verification.Practice has proved that breeding disease resistant varieties are an effective method to control canker disease and brown spot disease.However,most existing cultivars lack genes for canker and brown spot resistance.Wild kiwifruit resources in nat-ure exhibit extensive genetic diversity due to prolonged natural selection,containing numerous resistance genes.But,due to insufficient understanding of the resistance of most kiwifruit varieties(lines)to canker disease and brown spot disease,some high-quality resources have not been fully utilized.The incidence of canker and brown spot of 18 kiwifruit cultivars(lines)was measured by inoculating isolated branches and leaves,and their resistance to canker and brown spot was analyzed according to the length,disease index,mean diameter,and systematic clustering.The results were as follows:Among 18 different kiwifruit varieties(lines)for canker disease,there were two highly resistant materials,eight disease-resistant materials,four disease-susceptible materials,and two highly susceptible materials.Moreover,regarding brown spot disease,there were one highly resistant material,five dis-ease-resistant materials,four susceptible materials,and three highly susceptible materials.Furthermore,four resources were resistant to both diseases.The outcomes provided a theoretical basis for breeding kiwifruit against canker and brown spot.

Investigation and improvement of tiny spot defects on hot-dip galvanized automotive steel sheets

The causes of tiny spot defects on the surface of hot-dip galvanized automotive steel sheets were studied using scanning electron microscopy(SEM)and energy dispersive spectrometer(EDS),and effective control measures were introduced.The results show that rubbing against the top roller after galvanizing is easy due to the local thickness of tiny spot defect location coating;therefore,the surface morphology is different from the normal part.Three kinds of defects,namely zinc slag,small slivers,and pitting,are likely to cause local thickening of the coating after galvanizing,leading to the formation of tiny spots.Therefore,resolving the three types of defects can effectively control the generation of tiny spot defects.Among them,due to the hereditary nature of the small sliver defect,focusing on its control and supervision is necessary.

ToF-SIMS characterization of a bare-spot defect in a hot-dip galvanized boron-added steel sheet

To determine the root cause of a bare-spot defect in a hot-dip galvanized boron-added steel sheet,we performed metallurgical characterizations using time-of-flight secondary ion mass spectrometry(ToF-SIMS)in addition to glow discharge optical emission spectrometry,field-emission scanning electron microscopy(FE-SEM),and energy dispersive spectroscopy.Mn and B enrichments on the steel surface in the bare-spot area were detected through various methods.FE-SEM revealed external oxide nodules and zinc droplets,which indicated poor wettability.ToF-SIMS further revealed considerably more detailed lateral and depth distributions of Mn,B,and Al.The formation of external Mn-B compound oxides on the steel surface prior to hot dipping,which substantially deteriorated the wettability and prevented the formation of a Fe_(2)Al_(5)inhibition layer,resulted in the formation of a bare-spot defect.ToF-SIMS mapping of Al ion proved that a slight reaction still occurred between the dissolved Al in the molten zinc bath and steel substrate,although no evident Fe_(2)Al_(5)inhibition layer formed in the bare-spot area.

Analysis of spot defects on the surface of a cold-rolled Fe-36%Ni alloy strip

Many spot defects were found on the surface of a cold-rolled Fe-36%Ni alloy strip produced in a factory,which seriously affected the surface quality of the product.Through metallographic microscopy and scanning electron microscopy analyses,it was found that the spot defects were caused by the residual oxide layer on the surface of the cold-rolled Fe-36%Ni alloy strip after hydrogen annealing.By properly increasing the grinding amount of the blank before cold rolling to remove the oxide layer,the spot defects on the surface of the cold-rolled strip were effectively eliminated,and the surface quality of the product was ensured.

Genomic Selection for Frogeye Leaf Spot Resistance in Soybean

Soybean frogeye leaf spot(FLS) disease is a global disease affecting soybean yield, especially in the soybean growing area of Heilongjiang Province. In order to realize genomic selection breeding for FLS resistance of soybean, least absolute shrinkage and selection operator(LASSO) regression and stepwise regression were combined, and a genomic selection model was established for 40 002 SNP markers covering soybean genome and relative lesion area of soybean FLS. As a result, 68 molecular markers controlling soybean FLS were detected accurately, and the phenotypic contribution rate of these markers reached 82.45%. In this study, a model was established, which could be used directly to evaluate the resistance of soybean FLS and to select excellent offspring. This research method could also provide ideas and methods for other plants to breeding in disease resistance.

Development and Quality Improvement of Lianqingshan Scenic Spot in Tengzhou City

Since the 21st century,China’s overall national strength has increased continuously.With the rapid development of the tourism industry,people have an increasingly strong demand for travel.Firstly,tourists’satisfaction to Lianqingshan Scenic Spot was surveyed,and then the types of tourism resources,current development situation and problems in the scenic spot were analyzed.Finally,some countermeasures and suggestions for its development and quality improvement were put forward.It is found that based on the environmental quality,safety and service quality of Lianqingshan Scenic Spot,the basic situation of the development of the scenic spot was investigated,and the comprehensive satisfaction of each item is 3.30,3.24 and 3.32.The tourists of the scenic spot is mainly from Tengzhou City and its surrounding cities,and the popularity of the scenic spot is relatively low.The management personnel of the scenic spot needs to increase the tourist flow by improving its exposure.The problems of the scenic spot include low popularity,poor environmental quality,low safety of tourists,poor operating condition of catering industry and service quality of service personnel.

基于SPOT4和Landsat5 TM的不同影像融合方法质量对比研究

【目的】探究不同影像融合方法对SPOT4全色影像和Landsat5 TM多光谱影像融合效果的影响。【方法】采用13种不同的影像融合算法开展融合试验,并通过定性和定量分析的方式,对融合结果进行综合评价分析。【结果】结果表明,融合影像的信息熵相比原影像有所增强,RGB三通道的熵值分布更为均匀,主要集中在50~200之间。此外,不同地物类型对融合方法的效果产生了显著影响。对于水体和植被,Brovey、HSV、IHS和EF方法展现出了良好的光谱保真性和细节增强能力,因此更适用于目视解译。NND法在这些区域出现了轻微的光谱失真现象,导致其分类精度偏低。【结论】针对不同传感器的影像选择适当的融合方法,对于提高遥感影像的解译精度和应用价值具有重要意义。

胸腔积液ADA联合外周血T-SPOT.TB、D-二聚体对结核性胸膜炎的早期诊断价值

目的:探讨胸腔积液腺苷脱氨酶(adenosine deaminase,ADA)、结核感染T细胞斑点实验(tuberculosis infection T-cell spot test,T-SPOT.TB)、D-二聚体(D-dimer,D-D)联合检测对结核性胸膜炎(tuberculosis pleurisy,TPE)的早期诊断价值。方法:选取2021年1月—2023年12月南通市第六人民医院收治住院患者118例,其中TPE患者62例为TPE组,非结核性胸膜炎患者56例为非结核性胸膜炎(non-tuberculous pleurisy,NTPE)组。分别检测和比较两组胸腔积液中ADA含量、外周血T-SPOT.TB试验中ESAT6、CFP10斑点孔数及D-D水平,比较不同指标之间的差异性及相关性。应用ROC曲线分析上述指标对TPE的早期诊断价值。结果:TPE组胸腔积液ADA含量、外周血ESAT6、CFP10斑点孔数以及D-D水平分别为[38.95(24.92,49.17)U·L^(-1)、20.00(12.75,40.00)孔、20.00(8.50,40.00)孔、3.52(1.99,5.95)mg·L^(-1)],与NTPE组[10.55(7.35,16.57)U·L^(-1)、1.00(0.00,4.00)孔、0.00(0.00,4.00)孔、1.17(0.74,2.29)mg·L^(-1)]相比均明显升高(Z=-6.405、-5.411、-6.517、-6.468,均P<0.001)。TPE组外周血ESAT6、CFP10斑点孔数与胸腔积液ADA含量均呈中度正相关(r=0.596、0.581,均P<0.001),而外周血ESAT6、CFP10斑点孔数与D-D水平则呈低度正相关(r=0.398、0.443,均P<0.001)。胸腔积液ADA、外周血ESAT6、CFP10及D-D早期诊断TPE的ROC曲线的AUC分别为0.842、0.845、0.840、0.789。上述4种指标联合检测的AUC为0.960,敏感度和特异度分别为87.1%和96.43%,均高于单个指标。结论:TPE患者胸腔积液ADA含量、外周血ESAT6、CFP10斑点孔数及D-D水平均升高,联合诊断可提高TPE的诊断效果,有助于临床早期诊断TPE。

单核细胞与淋巴细胞比值联合T-SPOT.TB检测在涂阴肺结核诊断中的应用价值

目的:探讨单核细胞与淋巴细胞比值(MLR)联合结核感染T细胞斑点试验(T-SPOT.TB)检测在涂阴肺结核诊断中的应用价值。方法:选取2021年9月—2023年9月孝感市中心医院收治的疑似肺结核患者329例作为研究对象,均行MLR、T-SPOT.TB检测。统计涂阴肺结核的检出情况,以综合诊断结果为“金标准”,将受试者分为结核组与非结核组,比较两组单核细胞、淋巴细胞、MLR;绘制受试者操作特征(ROC)曲线,计算MLR诊断涂阴肺结核的最佳临界值;分析MLR、T-SPOT.TB检测及两者联合检测的诊断效能。结果:329例受试者综合诊断结果显示,涂阴肺结核患者157例。结核组单核细胞、MLR高于非结核组,淋巴细胞低于非结核组,差异有统计学意义(P<0.001)。ROC曲线分析显示,MLR诊断涂阴肺结核的ROC曲线下总面积为0.78,最佳临界值为0.30。MLR检测诊断涂阴肺结核的准确度、特异度、阳性预测值高于T-SPOT.TB检测、联合检测,联合检测诊断涂阴肺结核的灵敏度高于MLR检测、T-SPOT.TB检测,差异有统计学意义(P<0.05);不同检测方式诊断涂阴肺结核的阴性预测值比较,差异无统计学意义(P>0.05)。结论:MLR联合T-SPOT.TB检测对涂阴肺结核具有良好的辅助诊断作用,其中MLR检测的诊断准确度、特异度、阳性预测值较高,联合检测能够提高诊断灵敏度。

Study on Problems and Countermeasures in the Management of Spot Check of Chinese Herbal Pieces

Objective To provide suggestions for optimizing the sampling management of Chinese herbal pieces and improving the quality Chinese herbal pieces.Methods Logical reasoning method was used to analyze the problems in the drug spot check of Chinese herbal pieces based on the data of drug quality published by the National Medical Products Administration from 2013 to 2021,combined with the current provisions and implementation of drug spot check management in China.Results and Conclusion At present,there are some problems in the drug spot check of Chinese herbal pieces,such as fewer varieties of Chinese herbal pieces in the national drug spot check,the unreasonable sampling links,the insufficient territorial management in some areas,and error-prone sample extraction.It is suggested that the actual quantity and overall quality of Chinese herbal pieces should be fully considered in the formulation of sampling plan.Besides,the variety coverage of drug spot check of traditional Chinese medicine should be strengthened.In the planning,the sampling links shall be made as a whole,and the credit rating and distribution of drug production,operation and use units within the jurisdiction shall be fully combined.While strengthening the sampling management at the production end in areas with concentrated industries,regional special drug spot check should be carried out or the administrative forces at the provincial,municipal and county levels should be fully mobilized to avoid local protection.In the assigned tasks,the name of Chinese herbal pieces should be accurately expressed to avoid the sampling errors of Chinese herbal pieces with the same original medicinal materials and different processing methods.

结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合诊断活动性肺结核的实践价值

文章探讨了结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合应用在活动性肺结核诊断中的临床实践价值。以2023年1月—12月期间甘肃医学院附属医院检验室接收的120例疑似肺结核患者样本为研究对象,对其血液和痰液样本进行检测,并评估单一检测结果与联合检测结果的诊断效能。研究结果显示,结核抗体、T-SPOT.TB、四种方法联合检测与临床检出结果无显著差异(P>0.05),痰涂片、痰培养检出阳性率显著低于临床检查结果(P<0.05)。四种方法联合检测的灵敏度和特异度分别为97.96%和95.45%,显著高于单一方法(P<0.05)。结核抗体、T-SPOT.TB及痰涂片、痰培养联合应用有助于提高活动性肺结核的诊断灵敏度,值得进一步推广应用。