Comparison of a monoclonal antigen stool test (Hp StAR) with the ^(13)C-urea breath test in monitoring Helicobacter pylori eradication therapy

AIM： To evaluate the agreement between a mAb-based stool test （HP STAR） and the urea breath test （UBT） in monitoring （H pylon） infection after eradication therapy. METHODS： Patients with discordant results on UBT and Hp STAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status. RESULTS： Among 250 patients （50±14 years）, 240 （96.0%） had concordant UBT and Hp STAR tests with a significant correlation between DOB and A values （R = 0.87; P〈0.0001）. The remaining 10 （4.0%） patients had discordant tests （positive Hp STAR and negative UBT） with the Hp STAR inaccurate in five cases （false positive） and UBT inaccurate in the other five cases （false negative）. The “maximal expected” sensitivity, specificity, ＋PV, -PV, ＋LR, and -LR were 91%, 100%, 100%, 97.4%, ∞, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp STAR. Overall accuracy for both tests was 98%. CONCLUSION： Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the “best” non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.

Comparative Study of the Widal Test against Stool Culture in the Diagnosis of Suspected Cases of Typhoid Fever in Some Low Income Communities in the Adamawa Region of Cameroon

Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.

Fecal microbial biomarkers combined with multi-target stool DNA test improve diagnostic accuracy for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a major global health burden.The current diagnostic tests have shortcomings of being invasive and low accuracy.AIM To explore the combination of intestinal microbiome composition and multi-target stool DNA(MT-sDNA)test in the diagnosis of CRC.METHODS We assessed the performance of the MT-sDNA test based on a hospital clinical trial.The intestinal microbiota was tested using 16S rRNA gene sequencing.This case-control study enrolled 54 CRC patients and 51 healthy controls.We identified biomarkers of bacterial structure,analyzed the relationship between different tumor markers and the relative abundance of related flora components,and distinguished CRC patients from healthy subjects by the linear discriminant analysis effect size,redundancy analysis,and random forest analysis.RESULTS MT-sDNA was associated with Bacteroides.MT-sDNA and carcinoembryonic antigen(CEA)were positively correlated with the existence of Parabacteroides,and alpha-fetoprotein(AFP)was positively associated with Faecalibacterium and Megamonas.In the random forest model,the existence of Streptococcus,Escherichia,Chitinophaga,Parasutterella,Lachnospira,and Romboutsia can distinguish CRC from health controls.The diagnostic accuracy of MT-sDNA combined with the six genera and CEA in the diagnosis of CRC was 97.1%,with a sensitivity and specificity of 98.1%and 92.3%,respectively.CONCLUSION There is a positive correlation of MT-sDNA,CEA,and AFP with intestinal microbiome.Eight biomarkers including six genera of gut microbiota,MT-sDNA,and CEA showed a prominent sensitivity and specificity for CRC prediction,which could be used as a non-invasive method for improving the diagnostic accuracy for this malignancy.

Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection

BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for H.pylori,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and specific.Typically,the results of histology and other tests align with each other.However,on rare occasions,discrepancy between histopathology and other H.pylori diagnostic tests occurs.AIM To investigate the discordance between histology and other H.pylori tests,the underlying causes,and the impact on clinical management.METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018.Reports were included in the study only if there were other H.pylori tests within seven days of the biopsy.These additional tests include CLO test,SA,and H.pylori culture.Concordance between histopathology and other tests was determined based on the consistency of results.In instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was reviewed.RESULTS Of 1396 pathology reports were identified,each accompanied by one additional H.pylori test.The concordance rates in detecting H.pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were identified.Only 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other tests.Four cases initially stained with Warthin-Starry turned out to be positive for H.pylori with subsequent IHC staining.Among the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other tests.Most patients underwent treatment,except for two who were untreated,and two patients who were lost to follow-up.CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test.Various factors may contribute to this inconsistency.Most patients in such cases had undergone treatment.

Stool antigen tests for the management of Helicobacter pylori infection

Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.

Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test

AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).

Patient perceptions of stool DNA testing for pan-digestive cancer screening:A survey questionnaire

AIM: To explore patient interest in a potential multi-organ stool-DNA test (MUST) for pan-digestive cancer screening.

Sample preference for colorectal cancer screening tests: Blood or stool?

Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, including faecal aversion. Emerging test technologies suggest blood-based molecular markers might provide an alternative, more acceptable option, for CRC screening tests. We aim to determine preference for blood compared to faeces as the sample for the screening test. Methods: A survey was mailed to 956 South Australians aged 50 to 74 years. Data were collected on sample preference, demographic variables, and ratings of screening test convenience and comfort. Results: The survey yielded a 43% response rate. The majority of participants preferred to provide a blood sample (78% v 22%, p < 0.001). Women were more likely to prefer blood than men (82% vs 74%, p = 0.05). Sample experience influenced preferences, with a significantly higher preference for faeces among participants with experience in faecal sampling (27% vs 17% with no experience, p < 0.05). Participants who preferred to provide a faecal sample rated it significantly more convenient (p < 0.001), more comfortable (p < 0.001), and more acceptable (p < 0.001) than those who preferred blood sampling. Conclusions: Survey participants overwhelmingly indicate a preference for the idea of a blood sample over a faecal sample for CRC screening. Preference was influenced by gender, experience with sampling method and the individual’s perception of sampling convenience, sampling comfort and sample acceptability. Our results suggest population participation rates are likely to improve with blood-based screening tests.

Comparison of invasive methods and two different stool antigen tests for diagnosis of H pylori infection in patients with gastric bleeding

AIM： To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS： The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test （UBT）, rapid urease test （RUT） and histopathological examination were applied to all patients. Stool specimens from these patients were examined by rapid STPIP!HpSA and one step simple H pylori antigen cassette test for the detection of Hpylori antigens. RESULTS： For these 22 patients, 15 （68.2%） were diagnosed as positive and seven （31.8%） were diagnosed negative for H pylori infection by the gold standard methods. Whereas 10 （45.5%） were positive and 12 （54.5%） were diagnosed negative by the rapid STPIP!HpSA test. The sensitivity, specificity, positive and negative predictive values were 60%, 86%, 90% and 50%, respectively. When compared to the gold standard methods, these differences were not significant. However, six patients （27.3%） were positive, and 16 （72.7%） were negative by the simple H pylori stool antigen cassette test. The sensitivity, specificity, positive and negative predictive values were 33%, 86%, 83% and 38%, respectively. Compared to the gold standard methods, the simple H pylori stool antigen cassette test results were significantly different （P = 0.012）. CONCLUSION： Rapid STRIP!HpSA test could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H pylori in upper gastrointestinal system bleeding patients.

自动粪便分析仪与人工复核法检测粪便结果的比较分析

目的比较自动粪便分析仪与人工复核法两种粪便检测方法的检验效果。方法收集2022年9月—2023年8月三明市第二医院就诊患者的9402份新鲜粪便标本,分别使用FA160自动粪便分析仪和人工复核法检测粪便有形成分(白细胞、红细胞、脂肪球、真菌)和隐血,记录两种方法的检测结果并进行统计学分析。结果自动粪便分析仪检测白细胞、红细胞、脂肪球、真菌和隐血的阳性检出率分别为4.90%、2.67%、6.31%、4.54%、25.34%,人工复核法阳性检出率分别为4.17%、2.22%、5.55%、5.29%、25.23%,自动粪便分析仪对粪便有形成分的阳性检出率除真菌略低于人工复核外,其他各项指标均高于人工复核,且差异均有统计学意义(均P<0.05),而粪便隐血试验的阳性检出率比较差异无统计学意义(P>0.05)。以人工复核法为标准,自动粪便分析仪检测白细胞、红细胞、脂肪球、真菌、隐血的阳性符合率分别为91.07%、96.17%、94.83%、78.07%、98.19%;阴性符合率分别为98.85%、99.46%、98.90%、99.56%、99.25%;阳性预测值分别为77.44%、80.08%、83.47%、90.87%、97.77%;阴性预测值分别为99.61%、99.91%、99.69%、98.79%、99.39%。结论自动粪便分析仪与人工复核法的检测结果虽然符合率较高,但还存在漏检和误检。因此对自动分析结果必须进行人工复核,提高检测结果的准确性,为临床提供可靠的参考依据。

体检人群幽门螺杆菌感染检测意愿调查

目的探讨体检人群对H.pylori感染检测的主动性及其对检测方式的倾向性。方法于2022年9月至2022年12月在国内两家综合性三甲医院的体检人员中发放电子调查问卷,问卷内容包括受访者对H.pylori感染及检测方式的了解情况,主动给自己及家中老人、儿童(<14岁)检测的意愿,及其对尿素呼气试验(urea breath test,UBT)和H.pylori粪便抗原试验(H.pylori stool antigen test,HpSAT)的比较与选择等。结果共回收488份有效问卷。消化道症状或疾病在体检人群(57.0%)及其家庭成员(35.5%)中普遍存在。体检人群对H.pylori感染的熟悉率仅为11.9%。43.0%受访者会在体检时主动检测,36.9%的受访者在医师建议下才会进行检测,而20.1%不会主动检测。影响检测主动性的因素主要是对H.pylori感染的了解程度。对于家中老人和儿童的检测,大部分体检人员需要医师建议才会进行检测。体检人员选择检测方式时,主要看其重准确性、方便性、安全性,超过80%体检人员会选择UBT。结论体检人群对H.pylori感染的认知水平较低,但检测意愿性较强,在检测时倾向于选择传统的UBT,对新兴的快速HpSAT缺乏了解。

Gastrointestinal insights during the COVID-19 epidemic

Coronavirus disease-2019(COVID-19)has so far caused hundreds of mortalities worldwide.Although respiratory symptoms are the main complication in COVID-19 patients,the disease is also associated with gastrointestinal problems,with diarrhea,nausea,and vomiting being primary COVID-19 symptoms.Thus,cancer and inflammatory bowel disease(IBD)management,stool viral tests,and virus exposure are major concerns in the context of COVID-19 epidemic.In patients with colorectal cancer and IBD,the colonic mucosa exhibits elevated angiotensin-converting enzyme 2 receptor levels,enhancing COVID-19 susceptibility.In some cases,positive viral stool tests may be the only indicator of infection at admission or after leaving quarantine.Without supplemental stool tests,the risk of undetected COVID-19 transmission is high.Moreover,viral exposure during the regular or emergency endoscopic examination should be avoided.We carefully discuss key gastrointestinal concerns with regard to COVID-19 and call for more attention to such problems.

基于粪便样本检测幽门螺杆菌感染及耐药情况的研究进展

幽门螺杆菌(Helicobacter pylori,H.pylori)是一种革兰氏阴性细菌,特异性定植于人类的胃上皮,特别是胃窦上皮中。它是慢性胃炎、消化性溃疡、胃癌、胃黏膜相关淋巴组织淋巴瘤及一些胃外疾病的主要病因。由于H.pylori抗生素耐药菌株的迅速出现,其根治率正逐年下降。对抗生素耐药性进行检测,指导临床医师选择治疗方案是目前提高H.pylori根治率的重要手段。目前,H.pylori抗生素耐药性的检测主要是患者基于接受内镜检查的侵入性检测。而针对非侵入性手段获得粪便样本的检测相比于侵入性检测具有无创便捷、高效、依从性好等优点。近年来针对粪便样本进行抗原检测、分子检测等多种方式的研究均有报道。本文就基于粪便样本诊断H.pylori感染及检测其耐药情况的研究进展进行综述和分析,为探索更为便捷、高效的诊断方式和指导治疗手段提供思考。

便捷式高低凳型绝缘平台的研制

针对高低凳型绝缘平台在使用过程中存在的问题,提出设计一种具备折叠功能和重量检测报警功能的便捷式高低凳型绝缘平台。通过折叠式设计和凳面重量检测报警,解决了高低凳型绝缘平台存放和运输时占地面积大、不便于运输、重量不均衡等问题,保障了使用过程的安全性和灵活性。

New fecal test for non-invasive Helicobacter pylori detection:A diagnostic accuracy study

AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H. pylori), using ^(13)Curea breath test as the reference standard, and explore bacterial antibiotic resistance. METHODS We conducted a prospective two-center diagnostic test accuracy study. We enrolled consecutive people≥ 18 years without previous diagnosis of H. pylori infection, referred for dyspepsia between February and October 2017. At enrollment, all participants underwent 13 C-urea breath test. Participants aged over 50 years were scheduled to undergo upper endoscopy with histology. Participants collected stool samples 1-3 d after enrollment for a new fecal investigation(THD fecal test). The detection of bacterial 23 S rRNA subunit gene indicated H. pylori infection. We also used the index diagnostic test to examine mutations conferring resistance to clarithromycin and levofloxacin. Independent investigators analyzed index test and reference test standard results blinded to the other test findings. We estimated sensitivity, specificity, positive(PPV) and negative(NPV) predictive value, diagnostic accuracy, positive and negative likelihood ratio(LR), together with 95% confidence intervals(CI).RESULTS We enrolled 294 consecutive participants(age: Median 37.0 years, IQR: 29.0-46.0 years; men: 39.8%). Ninetyfive(32.3%) participants had a positive ^(13)C-urea breath test. Twenty-three(7.8%) participants underwent upper endoscopy with histology, with a full concordance between ^(13)C-urea breath test and histology in detecting H. pylori infection. Four(1.4%) out of the 294 participants withdrew from the study after the enrollment visit and did not undergo THD fecal testing. In the 290 participants who completed the study, the THD fecal test sensitivity was 90.2%(CI: 84.2%-96.3%), specificity 98.5%(CI:96.8%-100%), PPV 96.5%(CI: 92.6%-100%), NPV 95.6%(CI: 92.8%-98.4%), accuracy 95.9%(CI: 93.6%-98.2%), positive LR 59.5(CI: 19.3-183.4), negative LR 0.10(CI: 0.05-0.18). Out of 83 infected participants identified with the THD fecal test, 34(41.0%) had bacterial genotypic changes consistent with antibiotic-resistant H. pylori infection. Of these, 27(32.5%) had bacterial strains resistant to clarithromycin, 3(3.6%) to levofloxacin, and 4(4.8%) to both antibiotics. CONCLUSION The THD fecal test has high performance for the non-invasive diagnosis of H. pylori infection while additionally enabling the assessment of bacterial antibiotic resistances.

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i>Infection in Children

Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H. pylori) and prevent gastric cancer. Our aim was to assess the performance of non-invasive tests to diagnose H. pylori infection in pediatric patients. A retrospective analysis was performed on 141 pediatric patients requiring endoscopic evaluation and diagnostic tests for H. pylori infection to define the cause of abdominal symptoms. Non-invasive tests included the 13C-urea breath test (UBT), a monoclonal stool antigen test using enzyme-linked immuno-sorbent assay (mSAT), and a serum immunoglobulin G antibody test using antigens derived from Japanese individuals (S-Ab). This study investigated sensitivity, specificity, likelihood ratios for a positive and a negative test (LR+ and LR-), and accuracy of non-invasive tests, in comparison with invasive tests. Eighty two of 141 patients (58%) were recognized as H. pylori positive by invasive methods. When UBT, mSAT or S-Ab were analyzed, all were found to be effective over 94% accurate. Specificity ranged between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When subjects were stratified into three distinct age groups, the best performance was achieved for 1-6 years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab yielded the best results for children 7-12 years old and the UBT test performed best for 13-18 years old. These results demonstrate the utility of UBT, mSAT, and S-Ab non-invasive tests in diagnosing H. pylori but suggest that certain tests may be optimal for children of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining with a histological test and a culture test in children.

幽门螺杆菌粪便抗原检测法在胃肠疾病中的临床诊断价值研究

目的研究幽门螺杆菌粪便抗原(HpSA)检测法在胃肠疾病中的临床诊断价值。方法196例胃肠疾病患者,采集患者的粪便样本以及胃窦区黏膜样本,分别开展HpSA检测法、快速尿素酶试验(RUT)联合组织学检测法。以RUT联合组织学检测结果为金标准,分析HpSA检测法的诊断效能。结果196例患者经RUT联合组织学检测法确诊123例患者感染幽门螺杆菌(Hp),73例未感染Hp,阳性率为62.76%(123/196)。以RUT联合组织学检测法为金标准,HpSA检测法检出阳性患者123例,阳性检出率为62.76%(123/196),灵敏度为97.56%(120/123)、特异度为95.89%(70/73)、阳性预测值为97.56%(120/123)、阴性预测值为95.89%(70/73)、诊断准确率为96.94%(190/196)。结论HpSA检测法在胃肠疾病中的诊断准确率、灵敏度和特异度均较高,可以将该诊断方法应用于儿童、老年人、胃癌家属的筛查中,同时对于不能进行13C-尿素呼气试验(UBT)或14C-UBT、组织学诊断的患者或地区也可以使用该方法。

肠道门诊急性腹泻患者检验指标与治疗的临床分析

目的分析在肠道门诊就诊的急性腹泻患者血常规、粪常规检验结果与治疗方案的关系,为急性腹泻的临床诊疗提供参考依据。方法选择2023年5—9月天津医院肠道门诊收治的486例急性腹泻患者作为研究对象,采集其静脉血和粪便样本进行白细胞计数(WBC)、中性粒细胞比例(NEU%)、淋巴细胞比例(LYM%)及血细胞比容(HCT)等血常规检验和粪常规检验,分析检验结果与治疗方案的关系。结果486例急性腹泻患者的粪便样本中检出细菌性痢疾56例,感染性腹泻66例,普通腹泻364例。血常规检验结果可见,细菌性和感染性腹泻患者的WBC、NEU%、LYM%、HCT异常者占比均明显高于普通腹泻患者[WBC>10×10^(9)/L:80.32%(98/122)比28.85%(105/364),NEU%>75.00%:86.06%(105/122)比26.65%(97/364),LYM%<20.00%:46.72%(57/122)比4.40%(16/364),HCT>49.00%:9.02%(11/122)比1.92%(7/364),均P<0.05]。进行粪常规检验结果可见,普通腹泻患者发生水样便的比例明显高于细菌性和感染性腹泻患者[91.21%(332/364)比13.11%(16/112),P<0.05],而发生黏液便的比例明显低于细菌性和感染性腹泻患者[1.92%(11/364)比72.95%(89/112),P<0.05]。细菌性和感染性腹泻患者的抗菌药物处方率明显高于普通腹泻患者[74.59%(91/122)比3.57%(13/364),P<0.05]。结论常规检验对急性腹泻的诊疗有一定参考价值,但应进行更准确、全面的临床检测,以便为临床诊疗提供更精准的参考依据,联合中成药治疗对绝大多数普通腹泻患者和部分感染性腹泻患者有相当高的应用价值。

血清癌胚抗原、糖类抗原199、糖类抗原125配合粪便隐血试验在结直肠癌早期筛查中的应用

目的:探讨血清癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)联合粪便隐血试验检测对早期诊断结直肠癌的价值。方法:选取100例结直肠癌患者为观察组,另选取100例同期健康体检者为对照组,检测两组各指标水平;比较三种肿瘤标志物与粪便隐血试验联合检测阳性率与单项检测阳性率;对比观察组不同TNM分期者的各项检测指标水平,并对患者经6个月治疗后复发转移与无复发转移者的检测结果比较。结果:观察组各项检测结果均显著高于对照组,差异有统计学意义(P<0.05);联合检测的阳性检出率明显高于单项检测,差异有统计学意义(P<0.05);观察组患者随着TNM分期的升高在各项检测结果上也有所升高,观察组患者经6个月的治疗后,复发转移患者在各项检测结果上均高于无复发转移患者,差异有统计学意义(P<0.05)。结论:血清CEA、CA199、CA125与粪便隐血试验结直肠癌的早期筛查及诊断有重要意义,联合检测有利于疾病的早诊断,评估治疗效果,并且判断预后。

儿童细菌性肠炎病原学分布特点及及耐药性分析

目的分析儿童细菌性肠炎的病原学分布特点及耐药性分析。方法回顾性分析2020年1月至2021年12月嘉兴市妇幼保健院细菌性肠炎患者的临床资料。结果大便培养总送检数567例,培养阳性标本102例,检出阳性率17.99%。其中沙门菌属肠炎66例(64.71%),鼠伤寒沙门菌51例,非鼠伤寒沙门菌15例;金黄色葡萄球菌26例(25.49%);铜绿假单胞菌10例(9.80%)。鼠伤寒沙门菌药敏实验结果显示:阿莫西林/克拉维酸钾、哌拉西林/他唑巴坦、头孢他定、头孢噻肟、头孢吡肟、氨曲南、亚胺培南、美罗培南、阿米卡星、庆大霉素、四环素敏感性均>80%,其中亚胺培南和美罗培南敏感性均为100%。氨苄西林、哌拉西林、头孢唑啉、莫西沙星、复方新诺明耐药率均>50%。金黄色葡萄球菌药敏实验结果显示:环丙沙星、庆大霉素、利福平、复方新诺明、呋喃妥因、利奈唑胺、万古霉素、替考拉宁敏感性均>90%,苯唑西林、阿莫西林克拉维酸钾敏感性>70%,青霉素、氨苄西林、克林霉素、红霉素耐药率均>50%。结论≤3岁是儿童细菌性肠炎的高发年龄段,尤其是<1岁婴幼儿,夏季是细菌性肠炎高发季节,鼠伤寒沙门菌是细菌性肠炎主要感染源。