The comparison of the three assays for determination of fecal calprotectin in inflammatory bowel disease

IntroductionFecal calprotectin is a biomarker for monitoring inflammatory bowel disease (IBD) activity. Our aim, therefore, was to evaluate two new assays, the point of care test Quantum Blue and the Liaison Calprotectin with respect to the Calprest, commonly used assay, and to determine their performance for IBD diagnosis.Materials and methodsWe included 73 prospective patients with IBD. Fecal calprotectin was measured and analysed with the routine Calprest assay and two recently introduced assays, the Quantum Blue and the Liaison Calprotectin. Furthermore, we compared the results by Bland and Altman analysis, and Passing-Bablok regression.ResultsWe observed no difference in median calprotectin values obtained by the Calprest (94.6 µg/g, 95%CI 66.5 to 166.1) and Liaison assay (101.0 µg/g, 95%CI 48.1 to 180.1) whereas significantly higher concentrations were obtained with the Quantum Blue assay (240.0 µg/g, 95%CI 119.9 to 353.2). The mean absolute and relative difference between the Calprest and Quantum Blue methods was statistically significant (- 162.3 µg/g and
- 143.1%). Mean absolute difference between the Calprest and Liaison calprotectin methods was positive (2.2 µg/g). The agreement between assays revealed that Quantum Blue and Calprest have fair agreement with Kappa coefficient of 0.38 (95%CI 0.26 to 0.51). Liaison Calprotectin and Calprest revealed moderate agreement with a weak Kappa coefficient of 0.47 (95%CI 0.32 to 0.62).ConclusionClinicians should be aware of these differences between the assays and avoid comparison of their respective results.     

Serological markers of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract with two main distinguishable entities, Crohn’s disease (CD) and ulcerative colitis (UC). IBD-unclassified (IBD-U) is a diagnosis that covers the “grey” zone of diagnostic uncertainty between UC and CD. Current diagnosis of IBD relies on the clinical, endoscopic, radiological, histological and biochemical features, but this approach has shortcomings especially in cases of overlapping symptoms of CD and UC. The need for a diagnostic tool that would improve the conventional methods in IBD diagnosis directed the search towards potential immunological markers, since an aberrant immune response against microbial or endogenous antigens in a genetically susceptible host seems to be implicated in IBD pathogenesis. The spectrum of antibodies to different microbial antigens and autoantibodies associated with IBD is rapidly expanding. Most of these antibodies are associated with CD like anti-glycan antibodies: anti-Saccharomices cerevisiae (ASCA) and the recently described anti-laminaribioside (ALCA), anti-chitobioside (ACCA), anti-mannobioside (AMCA), anti-laminarin (anti-L) and anti-chitin (anti-C) antibodies; in addition to other antibodies that target microbial antigens: anti-outer membrane porin C (anti-OmpC), anti-Cbir1 flagellin and anti-I2 antibody. Also, autoantibodies targeting the exocrine pancreas (PAB) were shown to be highly specific for CD. In contrast, UC has been associated with anti-neutrophil cytoplasmic autoantibodies (pANCA) and antibodies against goblet cells (GAB). Current evidence suggests that serologic panels of multiple antibodies are useful in differential diagnosis of CD versus UC and can be a valuable aid in stratifying patients according to disease phenotype and risk of complications.     

Biochemical diagnosis of liver disease

It is important that clinicians and laboratorians, including clinical chemists and pathologists, recognize and understand the clinical significance of abnormal liver function tests. The liver regulates many important metabolic functions. Hepatic injury is associated with distortion of these metabolic functions. Hepatic disease can be evaluated and diagnosed by determining serum concentrations of a number of serum analytes. Many serum analytes exist to assist in the biochemical diagnosis of liver disease. The focus of this paper is on the analytes which are associated with hepatic necrosis, cholestasis, defects in excretion and end stage hepatic disease which results in decreased synthetic function. The abnormalities of these serum analytes will be correlated with the important types of liver disease.     

Faecal fat content in healthy adults by the ‘acid steatocrit method’

Malabsorption syndromes causing steatorrhoea are quite common in India. Estimation of faecal fat is an important non-invasive investigation, which provides vital information regarding the occurrence of malabsorption. The aim of this study was to estimate the fat excretion per day in stools of apparently healthy adults on an unrestricted diet in random spot stool samples using the Acid Steatocrit Method, which provides an alternate, simpler and yet reliable method of stool fat estimation. Several studies have proved the correlation of the acid steatocrit method with the conventional methods. In India, however, there has been no published data regarding the normal levels of fat in the stools, by the acid steatocrit method. We follow the normal range values, as set by the United States and the European countries, not having a range for the Indian population. Hence, we took up a preliminary study, to estimate stool fat in a section of normal and healthy Indian population. The result obtained after screening 600 healthy and normal adults, showed the mean of stool fat to be 8.72 gms/24 hours, which is much higher than that, defined by Western literature (7 gms/24 hours). This can be accounted for, by the cultural and ethnic variations in dietary and food habits. Further studies are required in the same direction, involving larger population groups, and in different malabsorptive conditions.     

电针联合穴位注射治疗慢性盆腔炎的疗效观察

目的:观察电针联合穴位注射治疗慢性盆腔炎的临床疗效。方法:运用电针联合穴位注射方法治疗68例慢性盆腔炎患者,观察其疗效。结果:痊愈48例,显效12例,有效5例,无效3例,总有效率为95.59%。结论:电针联合穴位注射治疗慢性盆腔炎疗效肯定。     

浅谈静脉输液疗法在犬病诊治中的应用

根据多年从事宠物诊疗的临床经验,通过对犬静脉输液的适应症、静脉输液的部位和方法、静脉输液的原则及剂型选择、静脉输液的量及速度的确定的具体分析,总结出较为科学的静脉输液在犬病诊治中的应用方法及注意事项和其在临床诊疗中的重要意义。     

中药热奄包治疗慢性盆腔炎的护理体会

目的:总结中药热奄包治疗慢性盆腔炎的护理体会。方法:将加有跌打酊蒸热后的中药热奄包对慢性盆腔炎患者进行治疗,每次30分钟,每天一次,一个疗程10次,连续2个疗程后,观察疗效。结果:治疗组总有效率达83.4%,与对照组总有效率比较,P0.05。结论:中药热奄包治疗慢性盆腔炎,疗效确切,简单方便,患者无痛苦。     

血清透明质酸放射免疫测定在肝病诊断中的应用

血清透明质酸(HA),主要由肝内皮细胞摄取分解,小分子由肾小球滤过、排泄。当肝、肾功能受损时,血清HA升高,且与病变的严重程度有关。本文用放射免疫法检测了87例肝病患者血清HA及甲胎蛋白(AFP)的水平,通过对比分析发现,以血清HA水平判断肝脏疾病较AFP敏感。     

老年病科中西医结合辨病与辩证

针对老年病多病共存、起病缓慢、表现不典型、无症状(亚临床型)多、变化迅速的临床特点,分析中医辨商辩证诊治和西医辨病施治的各自局限性,指出在老年病科临床实践中,坚持中西医辨病辩证相结合,促进中西医诊治方法上的优势互补,避免误诊误治,漏诊漏治。     

中医护理干预对慢性盆腔炎患者生活质量影响的研究进展

以国内近几年发表的文献为依据,总结中医药传统特色护理对慢性盆腔炎患者生活质量的影响,提示中医特色护理干预技术有其独特性,不管是用五音疗法、辩证施膳,还是用中药灌肠、内服、针灸理疗等综合疗法同用,疗效显著,达到标本兼治,改善和提高患者生活质量的效果。     

Application of a single-chain fragment variable (scFv) antibody for the confirmatory diagnosis of hydatid disease in non-endemic areas

BackgroundHydatid disease is a serious parasitic disease threatening public health. Because of its rarity in non-endemic coastal areas, determining the nature and origin of a chronic, enlarged liver cystic mass is challenging in these regions. Under these circumstances, physicians need a confirmatory diagnostic tool beyond immunological and radiological examinations. This study investigated a novel human single-chain fragment variable (scFv) antibody for the confirmative diagnosis of 18 atypical hydatid disease cases in non-endemic coastal areas.ResultsA scFv antibody against cystic echinococcosis was produced by genetic engineering and then applied to the immunohistochemical diagnosis of 18 cases of cystic echinococcosis presented in non-endemic coastal areas. The diagnosis of these cases by ultrasound and serum-based examinations was inconclusive. The 750 bp scFv antibody gene was expressed in COS-7 cells, and the antibody localized in the cytoplasm. The scFv antibody can detect the germinal layer and protoscolices of actively growing cysts but not of the degenerating protoscolices and has a diagnostic efficiency higher than that of single serum or ultrasound testing (P < 0.05). The combined use of scFv antibodies with serology and ultrasound diagnostics results in a diagnostic efficiency comparable to that of surgery. The scFv antibody can be used as a confirmatory test for the diagnosis of hydatid disease in non-endemic areas, providing a beneficial supplementary diagnostic method that complements traditional immune testing and ultrasonic radiology and thus helping physicians to effectively differentiate hydatid disease.     

掌握与消除病人的心理障碍发挥和提高疾病的诊疗效果

本文针对人们生病后就医时的心理特点，医务人员应该如何观察、掌握、消除病员的心理障碍，才能提高疾病的诊疗效果作了较为详细的阐述。     

瑶医大钻麻堆方对慢性盆腔炎患者生活质量的影响

目的:观察瑶医大钻麻堆方治疗慢性盆腔炎后对患者生活质量的影响。方法:120例慢性盆腔炎患者,随机分为观察组和对照组各50例,空白组20例,观察组应用瑶医大钻麻堆方治疗,对照组采用中药银甲丸治疗,空白组予甘草煎液治疗,观察三组治疗前后生活质量积分的变化及生活质量的改善情况。结果:治疗后,观察组患者在BP、PF、SF、RP、MH、RE、GH、活力等方面积分均明显提高,治疗前后比较差异均有统计学意义(P0.05);观察组与对照组比较,患者在PF、SF、RP、RE、活力等差异均有统计学意义(P0.05);观察组与空白组比较,患者在BP、PF、SF、RP、MH、RE、GH、活力等差异均有统计学意义(P0.05)。结论:瑶医大钻麻堆方治疗后慢性盆腔炎患者的生活质量普遍提高,该方治疗可以改善患者的生活质量。     

运动应激肠屏障损伤机理与调节剂研究进展

1项目简介该项目是国家奥运科技攻关专项———“优秀运动员应激损伤机理与调控方法研究”的一项子课题。由科技部、国家体育总局、中国科学院联合组织并资助。项目承担单位:遗传与发育生物学研究所农业资源研究中心。我国体能类竞技项目明显落后,其中运动应激引起的功能性腹泄/腹痛(肠易激综合症)是造成我国运动员体能迅速下降的一个重要原因。因此,急需在奥运科技攻关中重点突破。项目组与国家体育总局运动医学研究所、中国人民解放军304医院等单位进行多学科联合攻关,研究在运动应激状态下肠道屏障损伤发生机理及规律,为研制运动应激肠道…     

Studies on homocysteine demonstrating its significance as a possible tool for differential diagnosis in occlusive vascular disease

Homocysteine (Hcy) is a non-protein forming amino-acid, whose metabolism is at the intersection of two metabolic pathways: remethylation and transsulfuration which are dependent on the vitamins folic acid, B₁₂ and B₆, and the enzymes methylenetetrahydrofolate reductase and cystathionine-β-synthetase. A deficiency of any of these vitamins or enzymes results in hyperhomocysteinemia. This causes oxidative and other damage to blood vessels, thus affecting various organ systems of the body. As part of our ongoing research on cardiovascular risk factors, we have studied the Hcy levels in the plasma of normal controls and those suffering from vascular diseases. It was observed that Hcy is significantly higher in patients of vascular diseases (21.59±1.28 μmol/L, mean±SEM), as compared to normal controls (11.33±0.18 μmol/L). This significance, was more pronounced in cases of venous thrombosis (26.77±2.43 μmol/L) as opposed to cases of arterial block (17.27±0.84 μmol/L). This signifies that Hcy estimation would be beneficial in obtaining a differential diagnosis in addition to being a modifiable vascular risk factor.     

盆腔炎症的物理治疗法

研究物理治疗学在女性生殖系统炎症治疗方面的应用技术,分析了物理治疗学的原理及其综合利用,论述了物理方法治疗女性生殖系统炎症的注意事项。重点研究了外阴炎、前庭大腺炎、阴道炎、子宫颈炎的物理治疗方法,通过临床治疗效果对比,得出了女性生殖系统理疗与化疗(药物疗法)的比较结果。     

盆腔炎性包块的研究进展

为了解临床治疗盆腔炎性包块的慨况,在临床中探求疗效好、无毒副作用、易于患者接受的治疗方法,对近年来有关盆腔炎性包块的资料和文献进行归纳总结,从中医中药、西医、中西医结合几方面进行论述,为今后的临床研究提供思路。     

Uncertainty and the inconvenient facts of diagnosis

One common contemporary usage of the term “diagnostic uncertainty” is to refer to cases for which a diagnosis is not, or cannot, be applied to the presenting case. This is a paradoxical usage, as the absence of diagnosis is often as close to a certainty as can be a human judgement. What makes this sociologically interesting is that it represents an “epistemic defence,” or a means of accounting for a failure of medicine’s explanatory system. This system is based on diagnosis, or the classification of individual complaints into recognizable diagnostic categories. Diagnosis is pivotal to medicine’s epistemic setting, for it purports to explain illness via diagnosis, and yet is not always able to do so. This essay reviews this paradoxical use, and juxtaposes it to historical explanations for non-diagnosable illnesses. It demonstrates how representing non-diagnosis as uncertainty protects the epistemic setting by positioning the failure to locate a diagnosis in the individual, rather than in the medical paradigm.     

西藏山南地区隆子县境内214例传染病皮肤病(疥疮)调查、临床分析及诊断治疗情况

本文报告214例传染性皮肤病（疥疮）的流行病学调查，统计处理、临床分析、鉴别诊断及治疗评估等的综合方法。结果：本次实际调查人数为1828人，发病人数214例，经214例患者初步诊断为疥疮。治疗和其他措施：第一所有患者暂时隔离以切断传播途径；第二患者的衣裤、被褥等爆晒以消灭疥虫；第三外用杀虫药等方法后较短时间内214例患者全部治愈，无一例复发。