Investigation of the cell composition and gene expression in the delayed-type hypersensitivity tuberculin skin test

Dear Editor,The tuberculin skin test(TST)reagents have continuously improved,with the ESAT6-CFP10(EC)test having recently been introduced,but are seldom based on the direction of the delayed-type hypersensitivity(DTH)mechanism.Previous studies only partially showed the infiltration and activation of immune cells and the production of cytokines of the skin induration[1,2],and lack the detailed measurements of cell proportions and gene expression in the DTH response.Therefore,in this study,we revealed the comprehensive characteristics of DTH by single-cell RNA sequencing(scRNA-seq)in the guinea pig tuberculosis(TB)model[Experimental Animal Welfare Ethics Committee,Beijing Tuberculosis and Thoracic Tumor Research Institute(2021-064)].

Performance and correlation of QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test in young children with or exposed to tuberculosis

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children.Methods:A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis.QuantiFERON-TB Gold,T-SPOT.TB and tuberculin skin test were performed in each patient.Results:Of the 60 children,median age 3.3 years,17 had tuberculosis and 43 had recent tuberculosis exposure.Overall,15(25.0%)children had tuberculin skin test reaction≥10 mm;8(13.3%)were positive by QuantiFERON-TB Gold In-Tube test,and 12(20.0%)by T-SPOT.TB.Nineteen(31.7%)children had at least one positive test.There was a moderate agreement between interferon gamma release assays and tuberculin skin test.Conclusions:The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis,supporting the management strategy of not testing children younger than 5 years.

Skin Sensitive Difference of Human Body Sections under Clothing— Smirnov Test of Skin Surface Temperatures' Dynamic Changing

Skin sensitive difference of human body sections under clothing is the theoretic foundation of thermal insulation clothing design. By a new method of researching on clothing comfort perception, the skin temperature live changing procedure of human body sections affected by the same cold stimulation is inspected. Furthermore with the Smirnov test the skin temperatures dynamic changing patterns of main human body sections are obtained.

Relationship between Serum Specific IgE and Allergen Skin Test in Allergic Patients of Wuhan Area

Summary: In order to study the relationship between serum specific IgE (sIgE) and allergen skin test, allergen skin tests and detections of sIgE in 220 allergic patients of Wuhan area were analyzed. The coherent rate of the two methods was beyond 70 % (P<0.01). It was concluded that the in vitro and in vivo detection methods of allergens have a high coherence and can be used as the effective ways to diagnose the allergic diseases in clinical practice.

Performance and correlation of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

瞄准：相关临床的特征对待并且有到皮肤的结果的急躁的肠症候群(IBS ) 的未经治疗的病人为食物和被吸入的东西变应原刺测试(SPT ) 。方法：我们招募了 105 个对象形成三个不同目标组：为 IBS 经历治疗的对待的组(n=44 ) ，没有治疗，为 IBS 满足罗马 II 标准的未经治疗的组(n=31 ) ，没有 IBS 症状的控制组(n=30 ) 。结果：SPT 结果在在哪个 SPT 是积极的在里面(38.6%) 17 对待病人的三个组之中是不同的，在 5 (16.1%) 未经治疗的病人并且在 1 (3.3%) 控制(P【0.01 ) 。积极 SPT 的数字比在控制组(P【0.001 ) 在 IBS 组是更大的。积极食物 SPT 的数字比在未经治疗的 IBS 组(P=0.03 ) 在对待的 IBS 组是更高的。结论：积极食物 SPT 比在控制在 IBS 病人是更高的。

Comparison and Evaluation of Several Dermatophagoides Pteronyssinus Allergen Extracts for Skin Prick Test

Objective To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test(SPT) in patients allergic to Dermatophagoides pteronyssinus.Methods Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen.Three kinds of house dust mite allergen extracts were used for SPT,including the Dermatophagoides pteronyssinus extract prepared by our laboratory(group A),standardized Dermatophagoides pteronyssinus extract(group B),and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae(group C).Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy.The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.Results SPT results showed that the median wheal diameter of group A,group B,and group C was 0.43,0.35,and 0.28 cm,respectively,with significant difference among three groups(P<0.05).The difference was significant between group A and B(P<0.01) as well as group A and C(P<0.01),but not between group B and C(P>0.05).There was no local urticaria or systemic allergic reactions following the procedure of SPT.Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A.As for group B and C,local reaction occurred in 3 cases and delayed reaction in 2 cases in each group.The area under ROC curve of SPT with extract in group A,group B,and group C was 0.765,0.801,and 0.782,respectively.Based on the detection results of serum specific IgE,the sensitivity of SPT in diagnosis of Dermato-phagoides pteronyssinus allergy with extract of group A,group B,and group C was 92.4%,87.0%,and 81.5%,and the specificity was 60.6%,73.2%,and 74.8%,respectively.Conclusion The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts,and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Discrepancies between the responses to skin prick test to food and respiratory antigens in two subtypes of patients with irritable bowel syndrome

AIM:To compare the response to skin prick tests (SPTs) to food antigens (FAs) and inhalant allergens (IAs) in patients with two subtypes of irritable bowel syndrome (IBS) and healthy controls. METHODS:We compared the results of SPTs for IAs and FAs in 87 volunteers divided into three groups:diarrhea predominant IBS (D-IBS) GroupⅠ(n = 19), constipation predominant IBS (C-IBS) Group Ⅱ (n = 17), and normal controls Group Ⅲ (n = 51). RESULTS:Of the 285 tests (171 for FAs and 114 for IAs) performed in GroupⅠwe obtained 45 (26.3%) positive responses for FA and 23 (20.1%) for IA. Of the 153 tests for FA in Group Ⅱ, we obtained 66 (20.1%) positive responses, and of the 102 tests for IA, we obtained 20 (19.6%) positive responses. Of the 459 tests for FA performed in Group Ⅲ, we obtained 39 (84%) positive responses, and of the 306 for IA, we obtained 52 (16.9%) positive responses. The numbers of positive responses were not significantly different between the three groups, but in the D-IBS group, the number of SPTFA responses differed significantly from those for the other two groups (P < 0.01). CONCLUSION:Despite the small number of cases studied, the higher reactivity to FAs in GroupⅠcompared to Groups Ⅱ and Ⅲ adds new information, and suggests the presence of a possible alteration in intestinal epithelial function.

Anaphylaxis to Skin Prick Testing in a 29-Year-Old Woman

Introduction: Skin prick testing (SPT) is a common test to diagnose IgE sensitization and the rate of adverse reactions is very low. Case Presentation: 29-year-old woman with anaphylactic reaction to routine SPT with 11 allergens (aero and food). Discussion: Allergy profile included multiple food and inhalant allergies, polysensitization, prior episode of anaphylaxis to mushrooms, active eczema and active hay fever but not active asthma. Conclusion: Anaphylaxis to SPT, although a rare event, is unpredictable necessitating availability of appropriate personnel and adequate resuscitation facilities for all testing.

Indications, Interpretation and Clinical Consequences of Tuberculin Skin Tests in Resource Limited Settings

Objective: to evaluate the policy of TST testing in Suriname. As there is no gold standard to diagnose latent tuberculosis infection (LTBI), the tuberculin skin test (TST) is used to diagnose LTBI. However, internationally, the cut-off values of the TST are not uniform and depend on local tuberculosis (TB) epidemiology and guidelines for test initiation. In Suriname, where currently several indications exist for TSTs, cut-off values are set at 5 mm or 10 mm, depending on the age and/or medical history of the patient. LTBI classification is performed by pulmonologists primarily based on the American Thoracic Society targeted TB testing guidelines. Method: retrospective analysis of outpatient TST data between 2011 and 2019 from Suriname’s sole pulmonary medicine clinic. Result: 1373 patients were evaluated. 590 patients were from the screening group of whom 253 had a positive TST result, 46 of whom were classified as LTBI. In the contact tracing group of 649 patients, 616 had a positive TST, 352 of whom were classified as LTBI. In the medical condition group of 134 patients, 96 had a positive TST, 38 of whom were classified as LTBI. Eventually, positive TST results were found for 965 tested patients: 436 patients were classified as LTBI and 529 non-LTBI patients were not prescribed chemoprophylaxis. None of the non-LTBI TST-positive patients were diagnosed with active TB, including 174 patients with a TST result of 15 mm or greater and in need of IPT, but not prescribed by judgement of the pulmonologist or because of loss to follow-up. Conclusion: the overrepresentation of positive TST results in Suriname is attributable to stringent cut-off values, especially among patients who do not disclose TB risk factors. In our opinion the TST cut-off value for such patients in Suriname and other similar settings could be set at 15 mm. We also promote that for all patients with a TST result of 15 mm or greater, offering IPT should be considered (after excluding active TB).

Comparison between Quanti-FERON-TB Gold In-Tube test and tuberculin skin test for diagnosis of latent tuberculosis in children: A cross-section study

Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.

Preliminary Observation and Significance of Changes on Rash of Skin Prick Test during SLIT

Objective: To observe the changes on skin wheal and erythema of skin prick test for the patients with allergic rhinitis during SLIT. Methods: Since March 2010 the 103 cases of SLIT attacked by allergic rhinitis patients, divided into four age groups, respectively measured the diameter of skin wheal and erythema before treatment, six months, one year and 2 years after SLIT. The data were analyzed by analysis of variance method;P Results: The results showed that the most changes of skin erythema diameter were statistically significant in N1, N2, N3 age group during test observation compare with the data before SLIT (p Conclusion: Although most of the skin test wheal did not change significantly during the treatment of SLIT, the erythema reaction decreased to a certain extent, indicating that the intensity of histamine release may be reduced during the treatment.

Effectiveness of Virtual Reality for Pediatric Pain and Anxiety Management during Skin Prick Testing

This study investigated the effectiveness of virtual reality (VR) distraction, compared to comic book distraction and no distraction, in reducing pain and anxiety during a medical procedure in a pediatric population: the skin prick test. Although this test has many advantages and is considered to be minimally invasive, it causes anxiety and painful discomfort in children. Ninety-two children aged 7 to 17 years consulting for an allergic test received VR distraction, comic book distraction, or no distraction. Outcome measures included pain score, level of anxiety, and VR measures. The results showed that there were no significant differences between the three groups regarding sex, age, and preprocedural anxiety level. In the distraction groups (VR and comic book), children reported significantly lower pain and procedural anxiety scores than children with no distraction;VR distraction had a more significant effect than comic book distraction. A decrease in anxiety before and during the skin prick test is significantly more significant in VR distraction. This study suggested the effectiveness and feasibility of VR to reduce pain and anxiety during the pediatric skin prick test.

我国医务人员头孢菌素类药物皮试知信行的调查研究

目的分析我国医疗机构医务人员对头孢菌素类药物皮试的知信行现状及其影响因素,为规范皮试相关医疗行为提供参考。方法采用自行设计的头孢菌素类药物皮试知信行问卷对我国医务人员进行调查。通过微信向全国医疗机构发放问卷二维码,被调查者采用匿名方式自愿参加。统计不同文化程度,工作岗位、职称医务人员的知识、态度、行为得分,应用Wilcoxon秩和检验、多元线性回归分析等方法分析其影响因素。结果30个省份205家医疗机构的873名医务人员参与调查。对头孢菌素类药物皮试知识(总分16分)、态度(总分20分)、行为(总分20分)得分分别为10(8,12)分,13(12,15)分和12(9,15)分。多元线性回归结果显示,文化程度、工作岗位和职称与知识、态度得分相关(P<0.05)。研究生比专科医务人员知识掌握情况好、态度积极;药师比医生、护士知识掌握情况好、态度积极;中级、高级比初级及以下职称医务人员知识掌握情况好、态度积极。知识水平与态度正相关(P<0.05)。性别、工作岗位和职称与行为得分相关(P<0.05)。女性比男性医务人员行为消极,护士比药师行为积极;高级比初级及以下职称医务人员行为积极。知识水平、态度与行为正相关(P<0.05),态度在知识对行为影响中的中介效应差异无统计学意义(P=0.085)。结论我国医疗机构医务人员头孢菌素类药物皮试知信行有待加强,应结合不同岗位、职称等方面的知信行差异,对医务人员开展培训,以提升知识水平、树立积极态度、规范皮试相关医疗行为。

心理性勃起功能障碍患者的阴茎交感皮肤反应表现分析

目的探讨心理性勃起功能障碍(ED)患者的阴茎交感皮肤反应(PSSR)的变化。方法选取因非创伤性ED收住院分别进行夜间阴茎胀大试验(NPT)及阴茎神经电生理检查的患者96例作为研究对象,将NPT结果显示有单次阴茎勃起头部硬度≥60%的时间≥10 min的有效勃起患者68例纳入心理性ED组,以至少连续两晚均未出现有效勃起患者28例纳入非创伤性器质性ED组。比较两组年龄、身高、体重、病程、检查天数、有效勃起总次数、第一天有效勃起次数、第二天有效勃起次数、第三天有效勃起次数、阴茎头部硬度≥60%的维持时间、阴茎根部硬度≥60%的维持时间、头部膨大周径、根部膨大周径、阴茎神经电生理检查结果PSSR潜伏期及波幅。结果两组身高、体重、病程、检查天数、PSSR波幅比较,差异均无统计学意义(P>0.05)。心理性ED组年龄小于非创伤性器质性ED组(P<0.01),而有效勃起总次数、第一天有效勃起次数、第二天有效勃起次数、第三天有效勃起次数、阴茎头部硬度≥60%的维持时间、阴茎根部硬度≥60%的维持时间、头部膨大周径、根部膨大周径均高于非创伤性器质性ED组(P<0.01),PSSR潜伏期短于非创伤性器质性ED组(P<0.01)。结论心理性ED患者PSSR潜伏期缩短,交感神经兴奋性可能偏高,PSSR检测可作为一种辅助方法用于心理性ED的评估。

基于改进YOLOv5的人体结核菌素试验后皮下硬块检测算法研究

针对传统皮下硬块检测方法精度低、计算速度慢等问题,提出了一种基于改进YOLOv5的皮下硬块目标检测算法。首先,将YOLOv5模型的主干网络CSPDarknet53进行改进,引入Faster模块来替换其中的C3模块。其次,利用模型剪枝在保证整个模型性能的同时减轻其计算复杂度。最后,引入Wise-IoU来进一步提升网络的回归性能。实验结果表明,基于改进YOLOv5的皮下硬块目标检测算法相比于原始的YOLOv5,准确率提升了1.2%,参数量减少了77.7%,整个算法更加轻量化,有效提高了算法对于皮下硬块的检测精度,减少了计算参数量,提升了算法的运行速度。

皮肤试验预测头孢菌素过敏反应的研究进展

头孢菌素是以7-氨基头孢烷酸(7-amino-cephalosporanic acid)为母核,通过连接不同侧链而形成的一类β-内酰胺类抗菌药物。通过不断迭代研发,头孢菌素在抗菌谱、抗菌作用和药物安全性等方面得到不断优化。然而,在临床使用过程中,头孢菌素仍会出现过敏反应等药物不良反应,国内一直以来都是通过皮肤试验进行预测,但相关研究对皮肤试验的预测和应用价值是存在质疑的。为此,笔者从β-内酰胺类药物致过敏反应的分子机制和影响因素、皮肤试验的经济学价值、国内外头孢菌素的皮肤试验开展现状等方面对相关研究进行了综述,为临床评估皮肤试验对头孢菌素过敏反应的预测价值和应用前景提供参考。

中空波纹夹层钢管混凝土柱抗震性能拟静力试验研究

为了研究中空波纹夹层钢管混凝土柱的抗震性能,以轴压比、空心率、长细比和截面形式为试验参数,开展了中空波纹夹层钢管混凝土柱的拟静力试验,分析了试件的破坏模式、承载能力、延性与耗能能力、刚度退化和强度退化等性能指标.结果表明:中空波纹夹层钢管混凝土柱的水平承载力较高,滞回曲线饱满,无明显捏缩现象,延性和耗能能力良好,同级循环荷载作用下性能稳定;试件的破坏模式为延性破坏,具体表现为柱底钢管鼓曲变形、混凝土压溃、局部缺陷处管壁撕裂;空心率较小的试件承载力较高,耗能能力较强;当长细比由20增至30时,试件位移延性系数降低了47.49%,承载力也明显下降;随着轴压比的增大,试件耗能能力逐渐降低.

南充地区变应性鼻炎人群皮肤点刺试验结果分析

目的探讨南充地区变应性鼻炎人群过敏原种类分布及流行特征,为临床诊断、治疗及预防提供依据。方法对2021年10月至2022年9月于川北医学院附属医院耳鼻咽喉科就诊的2015例具有变应性鼻炎典型症状的患者进行皮肤点刺试验,分析比较不同患者过敏原检测结果差异。结果2015例患者中,对单一过敏原过敏的有178例(8.83%),对两种过敏原过敏的有447例(22.18%),对3种过敏原过敏的有433例(21.49%),对4种过敏原过敏的有307例(15.24%),对5种过敏原过敏的有244例(12.11%),对5种以上过敏原过敏的有406例(20.15%)。单一过敏原中,过敏率最高的是圆柏花粉,最低的是豚草花粉;两种过敏原中,过敏率最高的是屋尘螨和粉尘螨;3种过敏原中,过敏率最高的是屋尘螨、粉尘螨和圆柏花粉;4种过敏原中,过敏率最高的是屋尘螨、粉尘螨、圆柏花粉和蟑螂。尘螨过敏率最高,为82.03%,其次是花粉,为72.21%,蟑螂过敏率为28.80%,宠物毛发过敏率为21.14%,真菌过敏率最低,为13.15%,差异有统计学意义(χ^(2)=3234.89,P<0.05)。尘螨是婴幼儿期、学龄前期、学龄期、青少年期的主要过敏原。在青年期,花粉与尘螨过敏率相同,至中年期,花粉过敏率高于尘螨,成为该年龄段主要的过敏原。圆柏花粉是各个年龄期的主要过敏原,银杏花粉在各年龄期的过敏率均较低。结论南充地区变应性鼻炎患者大多合并多重过敏,以屋尘螨、粉尘螨、圆柏花粉和蟑螂过敏常见。尘螨是婴幼儿期、学龄前期、学龄期、青少年期的主要过敏原,青年期尘螨与花粉过敏率相同,中年期花粉成为主要过敏原,且以圆柏花粉过敏率最高。

湖南地区变应性鼻炎皮肤点刺试验结果分析

目的 分析湖南地区拟诊变应性鼻炎(AR)患者皮肤点刺试验(SPT)结果,探讨近年来该地区常见吸入性变应原的演变及其在不同人群中的分布特征,针对性指导本地区AR防治工作。方法 回顾性分析2017年1月—2019年12月就诊的6 276例拟诊AR患者门诊资料,以及常见11种吸入性变应原的SPT结果,依据不同年度、性别和年龄进行分层描述特征。结果 共有5 178例AR患者对至少一种吸入性变应原SPT呈阳性反应。变应原阳性率由高到低的前3种依次为粉尘螨(96.81%)、屋尘螨(96.33%)和蟑螂(57.92%)。97.89%的阳性患者存在至少2种阳性变应原的共同致敏现象。变应原SPT总体阳性率在不同年度组和性别组之间差异均无统计学意义(P>0.05),而在不同年龄组之间差异显著(P<0.05),且随年龄增加呈逐渐下降趋势。进一步分析不同个体SPT阳性率在不同年度、性别和年龄之间的差异。研究期间,杂草SPT阳性率呈逐年下降趋势,而霉菌1 SPT阳性率呈逐年上升(P<0.05)。此外,男性患者的杂草和葎草的SPT阳性率显著高于女性患者(P<0.05),而动物毛发SPT阳性率显著低于女性患者(P<0.05)。11种变应原中有8种不同变应原SPT阳性率在不同年龄组间具有显著差异,且主要高发于≤20岁年龄段的患者(P<0.05)。结论 湖南地区6 276例疑诊AR患者SPT阳性率排在前3位的变应原是粉尘螨、屋尘螨和蟑螂。不同阳性变应原在不同年度、性别和年龄中分布特征不同。应根据本地区AR患者常见吸入性变应原的特点开展有效的防治工作。