慢性乙型肝炎(chronic hepatitis B,CHB)患者乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)和乙型肝炎病毒表面抗体(hepatitis B surface antibody,HBsAb)共存的矛盾现象在临床并不少见,其产生机制一直以来都是研究热点.近年来研究发现HBsAg新增N-糖基化突变、HBV准种多样性、宿主遗传基因的突变和免疫组库表达的差异可能与HBsAg和HBsAb的共存有关.该文就CHB患者HBsAg和HBsAb共存机制的最新研究作一综述.

目的 评估流式荧光法(FFIA)、间接免疫荧光法(IIF)及酶联免疫吸附法(ELISA)检测抗双链DNA(dsDNA)抗体用于系统性红斑狼疮(SLE)诊断的临床价值,为临床实践寻找适宜的检测策略.方法 选取我院就诊的SLE患者92例,非SLE自身免疫性疾病患者127例及50例健康体检者,分别采用FFIA、IIF和ELISA检测血清中抗dsDNA抗体,计算各方法检测灵敏度和特异性,采用Kappa检验评估结果一致性,采用受试者工作特征曲线(ROC曲线)比较各方法用于区分SLE和非SLE自身免疫性疾病的效能.结果 用FFIA、IIF、ELISA检测抗dsDNA抗体,SLE组阳性率分别为44.6％、50.0％和62.0％,均高于疾病对照组和健康对照组(P<0.0001).IIF与FFIA、ELISA具有高度的一致性,Kappa值分别为0.64和0.72.FFIA与ELISA检测结果具有中等的一致性,Kappa值为0.56.以串联的方式FFIA-IIF或ELISA-IIF联合检测,可提高SLE诊断的灵敏度,分别达到59.8％和67.4％,其特异性分别为92.1％和89.3％,阴阳性与诊断符合率分别提高到81.0％和81.8％.ROC曲线分析显示,FFIA的AUC最大,达到0.768,ELISA和ⅡF的AUC分别为0.748和0.711.结论 FFIA、ELISA和IIF检测抗dsDNA抗体具有较好的一致性,用于SLE诊断的准确性高.ELISA-IIF或FFIA-IIF(串联)联合检测,可作为临床实践中适用于SLE诊断的抗dsDNA抗体检测模式.

Antibodies in response to antigens are related to the immune repertoire of T- and B-cell receptors. However, some patients with chronic hepatitis B (CHB) have coexisting HBsAg and anti-HBsAg antibodies (anti-HBs) that cannot neutralize HBV. We attempted to investigate the repertoires that produce this response in CHB patients. The T-cell receptor β chain (TRB) and B-cell receptor (BCR) repertoires of peripheral blood genomic DNA were analyzed using MiXCR. T-cell receptor (TCR) cluster analysis was carried out by clusTCR, and motifs prediction was selected by Multiple Em for Motif Elicitation (MEME). A total of 76 subjects were enrolled, including 26 HBsAg and anti-HBs coexisting patients with CHB (DP group), 25 anti-HBs single-positive healthy people (SP group), and 25 CHB patients (CHB group). The clone length of BCR in 39, 90 was significantly different among these groups (p = 0.005, 0.036). The motif "CASSLG" in the DP group was significantly higher than SP and CHB groups and may relate to coexistence, and the motif "GAGPLT" was only shown in the SP group and may relate to anti-HB expression. These provide important insights into vaccine development and CHB treatment.

Some patients with chronic hepatitis B virus (HBV) infection failed to clear HBV, even persistently continue to produce antibodies to HBV. Here we performed a two stage genome wide association study in a cohort of Chinese patients designed to discover single nucleotide variants that associate with HBV infection and clearance of HBV. The first stage involved genome wide exome sequencing of 101 cases (HBsAg plus anti-HBs positive) compared with 102 control patients (anti-HBs positive, HBsAg negative). Over 80% of individual sequences displayed 20 × sequence coverage. Adapters, uncertain bases > 10% or low-quality base calls (> 50%) were filtered and compared to the human reference genome hg19. In the second stage, 579 chronic HBV infected cases and 439 HBV clearance controls were sequenced with selected genes from the first stage. Although there were no significant associated gene variants in the first stage, two significant gene associations were discovered when the two stages were assessed in a combined analysis. One association showed rs506121-“T” allele [within the dedicator of cytokinesis 8 (DOCK8) gene] was higher in chronic HBV infection group than that in clearance group (P = 0.002, OR = 0.77, 95% CI [0.65, 0.91]). The second association involved rs2071676—A allele within the Carbonic anhydrase (CA9) gene that was significantly elevated in chronic HBV infection group compared to the clearance group (P = 0.0003, OR = 1.35, 95% CI [1.15, 1.58]). Upon replication these gene associations would suggest the influence of DOCK8 and CA9 as potential risk genetic factors in the persistence of HBV infection.

TORCH, the acronym of Toxoplasma gondii (TOX), others, rubella virus (RUV), cytomegalovirus (CMV) and herpes simplex virus (HSV), is a major contributor to congenital infection. National population-based study on the seroepidemiology of TORCH in women is yet lacking, and it is still obscure whether TORCH infection in the women was associated with adverse pregnancy outcomes. A total of 48,406 asymptomatic women from eight hospitals in China which covered the most areas of mainland China were enrolled in this study, and 26,400 were simultaneously subjected to 7 detection tests for TORCH specific antibodies. Chemiluminescent immunoassay was performed to detect TORCH Immunoglobulin M (IgM) and/or Immunoglobulin G (IgG) antibodies, and IgG avidities of TOX and CMV IgM and IgG positive serum samples. The overall IgG prevalence of TOX, RUV, CMV and HSV-(1 + 2) in the reproductive-aged women was 1.71 %, 81.97 %, 95.09 % and 90.15 % respectively. The corresponding IgM prevalence of TOX, RUV and CMV was 0.30 %, 0.89 % and 0.52 %. Moreover, the rates of primary TOX and CMV infections were at least 0.08 % (21/26,400) and 0.03 % (7/26,400) in the studied population. The distributions of TORCH positive women in various age, season and region groups were different (P < 0.05). The CMV IgM-positive rate was higher in the pregnant women than those in non-pregnant women (P < 0.05). The higher past infection rates of RUV, CMV and HSV in women with bad obstetric history (BOH) imply that TORCH infections are associated with BOH. These data suggest that TORCH infections in the prenatal women, especially with BOH, are worthwhile to be screened by detections of specific IgG and IgM antibodies, and even IgG avidities.

目的 分析HBsAg和HBsAb双阳性乙型肝炎患者与其他HBV感染者间T细胞受体(TCR)组库β链互补决定区3(CDR3)克隆型差异性.方法 以11例HBsAg和HBsAb双阳性乙型肝炎患者为病例组,10例自然痊愈(HBsAb+)者为对照组1,10例HBsAg阳性但HBsAb阴性乙型肝炎患者为对照组2.用Illumina HiseqX10测序仪对全血DNA的CDR3序列进行高通量测序,建立CDR3免疫组库,并进行CDR3克隆型及多样性分析.结果 病例组任意两样本CDR3克隆型重叠率为6.28％ (0.25％,13.10％);对照组1为10.49％(6.20％,17.30％);对照组2为2.60％(0.13％,13.69％),病例组与对照组1相比差异有统计学意义(P=0.008),对照组1与对照组2组相比差异有统计学意义(P=0.001),病例组与对照组2相比差异无统计学意义.经过病例组与2个对照组分别比较得到:克隆型TRBV7-2/TRBD1/TRBJ2-1频率病例组高于对照组1(P=0.029),克隆型TRBV7-3/TRBD1/TRBJ2-7频率病例组低于对照组1(P=0.031).病例组与对照组1相比,V基因型TRBV5-8频率差异有统计学意义(P=0.047);病例组与对照组2之间,有14种克隆型频率差异有统计学意义,V基因型TRBV28频率差异有统计学意义(P=0.028).3组样本的TCR β链CDR3多样性差异无统计学意义(P＞0.05).结论 克隆型TRBV7-2/TRBD1/TRBJ2-1和TRBV7-3/TRBD1/TRBJ2-7,V基因型TRBV5-8可能与HBsAg和HBsAb双阳性相关,而TCR β链CDR3多样性与HBsAg和HBsAb双阳性无明显关系.

Objectives In order to provide valuable information for the diagnosis and treatment of allergic diseases,the prevalence and trend changes of common allergens in Beijing were investigated and analyzed.Methods This study was a retrospective data collection study.A total of 11 641 patients with allergen examinations were collected from Peking University First Hospital from 2013 to 2017.The positive rate of each allergen was counted according to age,season and year.The epidemiological characteristics and trends were analyzed.Results In the past five years,20 636 total IgE and 45 620 allergen-specific IgE were collected,and the total positive rate of total IgE was 47.8％ (9 874/20 636).The top three positive rates of inhaled allergens were Dermatophagoides farina (28.1％,509/1 812),Dermatophagoides pteronyssinus (26.8％,503/1 876) and Mugwort (24.7％,240/971).The top three positive rates of food allergen were egg (17.3％,188/10 88),milk (16.7％,186/1 114) and wheat (15.3％,127/829).The positive rate of inhaled allergens (phad as an example) increased year by year.The positive rate of food allergens (fx5 as an example) reached its peak in 2015 (16.3％,511/3 139) and decreased slightly in the last two years (2016:13.0％,571/ 4 396;2017:7.4％,330/4 461).In inhaled allergens,the positive rate of weed pollen increased significantly in autumn.The positive rates of mx2 and dust mites were higher in summer.Food allergen did not change significantly with the seasons.Conclusions This study shown the distribution of allergens in patients with allergic diseases to a certain extent.It provided epidemiological data and clinical evidence for the prevention and treatment of allergic diseases.

外源性生物素对生物素-链霉亲合素免疫分析系统的干扰现象,近几年广受关注.使用该系统方法进行检测的常规项目,如激素、心肌标志物和肿瘤标志物,可受到生物素不同程度的干扰,导致结果异常,甚至造成疾病的误诊或误治.该文对生物素的应用及其干扰生物素-链霉亲合素免疫分析系统的情况进行概述,并分析消除干扰的对策.

Objective To investigate the connection between the avidity or level of anti-dsDNA antibody with the progression of systemic lupus erythematosus (SLE) ,and their influence on the performance of two widely used techniques (ELISA and IIF ) .Methods Using commercially available kits based on ELISA and IIF techniques simultaneously ,serum anti-dsDNA antibody was determined from 300 patients with SLE ,495 patients with non-SLE autoimmune disease ,and 300 health controls (HCs) .Positive samples by ELISA were further determined for anti-dsDNA antibody avidity index using urea based ELISA kits .Results (1)the level and avidity index of anti-dsDNA antibody were significantly and insignificantly higher in SLE than non-SLE patients[antibody level :285 .8(164 .5-463 .3) IU/mL vs .172 .9(135 .3-200 .1) IU/mL ,P=0 .038 ;antibody avidity index :32 .3(19 .2 -50 .7)vs .15 .5(9 .5-49 .8) ,P=0 .169] ,and significantly correlated with SLEDAI scores ,respectively (P=0 .000 ,0 .002) .(2)For samples whose anti-dsDNA antibody were positive by both ELISA and IIF ,their anti-dsDNA antibody levels and avidity indices were significantly higher than those sole-ly positive by ELSIA(P<0 .05).Conclusion The closely correlation of anti-dsDNA level and avidity index with SLE disease progression ,signifies that antibody amount and avidity might have been involved in disease development ,and could also be used to monitor disease progression .For the determination of anti-dsDNA anti-body ,IIF was more likely to detect antibodies of relatively higher avidity ,in comparison with ELISA .

BackgroundThe indirect immunofluorescence assay (IIFA) for the detection of antinuclear antibodies (ANA) was firstly described in 1958 and is still considered the reference method for ANA screening. Currently, an automated processing and recognition system for standardized and efficient ANA interpretation by human epithelial (HEp‐2) cell‐based immunofluorescence (IIF; EUROPattern Suite, Euroimmun) is available in China.MethodsIn this study, the performance of this novel system for positive/negative classification, pattern recognition (including homogenous, speckled, nucleolar, nuclear dots, cytoplasmic, and centromeres patterns) and titers evaluation was evaluated by comparing to visual interpretation.ResultsReferring to the total of 3681 collected samples, there was an agreement of 98.7% (κ = 0.973) between the visual and automated examination regarding positive/negative discrimination. In sera with single pattern, correct pattern recognition was observed in 94.6% of the samples. The efficiency of automated recognition for single pattern varied for the different patterns. The automatically determined patterns were correct and complete in 1071 of 1620 cases and correct and meaningful but not complete (“main pattern”) in another 405 cases, enabling main pattern recognition in 91.1% of all cases. Referring to the titers evaluation, the results within the next titer were considered to be consistent. In 1603 positive sera both by visual and automated evaluation, titers of 1514 sample were consistent, accounting for 94.4%.ConclusionAttributed to the performance characteristics, EUROPattern system is suitable for clinical use as its high degree of automation and result reliability, and may help clinical laboratories to standardize of IIF evaluation.

Objective To evaluate the value of serum pepsinogen for atrophic gastritis (AG)screening and determine the optimal cutoff values and screening protocol for Chinese population.Methods Participants who visited hospital because of digestive tract symptoms and received gastroscope examination were enrolled in this study.According to the results of endoscopic examination and gastric mucosa biopsy,the patients were divided into different groups.Adopting pathological results as gold standard for the screening of AG,receiver operating curve (ROC)was depicted to evaluate the screening efficiency of PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,CEA,CA72-4,CA19-9 and CA242 for AG.Results A total of 323 participants were divided into five groups:control group (148 cases),chronic non-atrophic gastritis (53 cases),AG (95 cases,including 48 cases of mild atrophy,34 cases of moderate atrophy and 12 cases of severe atrophy),gastric ulcer (17 cases)and gastric cancer group (10 cases).Due to the small number of cases of gastric cancer,no statistical analysis was performed in this group.There were no significant differences between control group and chronic non-atrophic gastritis,AG,and gastric ulcer group with respect to their sex,age,serum concentration of CA72-4,CA242,CA19-9 and CEA (P ＞0.05).PG Ⅰ and PG Ⅰ/PG Ⅱ ratios in AG group were significantly lower than control group and chronic non-atrophic gastritis group (P ＜ 0.05).With the increase of atrophy severity of gastric mucosal,PG Ⅰ and PG Ⅰ/PG Ⅱ ratio decreased gradually,but there was no statistically significant difference among these three groups (P =0.057 and P =0.200).PG Ⅰ and PG Ⅰ/PG Ⅱ ratio had higher screening accuracy for AG.The areas under curve (AUC) were 0.725 and 0.871,respectively,which were higher than the AUC of CA72-4 、CA242、CEA and CA19-9 (P ＜ 0.05).The optimal cutoff values of PG Ⅰ and PG Ⅰ/PG Ⅱ ratio for AG screening were ＜ 58.6 ng/mL and ＜ 5.72,respectively.The sensitivity and specificity of PG Ⅰ/PG 1Ⅱ ratio were 91.4％ and 65.1％ respectively,PG Ⅰ were 81％ and 52.8％ respectively.Considering the screening efficiency,PGⅠ/PG Ⅱ ratio ＜ 5.72 was recommended for screening of AG.The screening sensitivity and specificity were 91.4％ and 65.1％ respectively.Conclusion Compared with the traditional stomach tumor markers,serum PG Ⅰ and PG Ⅰ/PG Ⅱ ratio had higher sensitivity and specificity in the screening of AG,which not only helped early identification of high-risk individuals of gastric cancer,but also could reduce unnecessary invasive procedures on patients.

Objective To investigate the value of serum and feces myeloperoxidase(MPO)in assist diagnosis and dis-ease activity of ulcerative colitis (UC).Methods 45 patients with UC and 25 control subjects were enrolled in present study.UC patients were divide into active(n=27)and inactive (n=18)group according to Mayo score.MPO was de-tected by ELISA.Mann-whitney U test was used for comparison of different groups.Results serum MPO between UC group and controls were [113.78(71.31-174.53)vs.62.66(43.39-113.39)],Z =-2.488,P =0.013,respectively;ser-um MPO between active and inactive group were[102.67(70.52-176.70)vs.116.91(68.16-174.04)],Z =-0.255,P=0.799,respectively.Fecal MPO between UC group and controls were[926.47(495.34-1264.07)vs.557.86 (377.84-930.43)],Z =-2.507,P =0.012,respectively;fecal MPO between active and inactive group were[1231.24(725.42-1550.77)vs.692.58(285.98-886.17)],Z =-3.197,P =0.001,respectively.Conclusion Serum and feces MPO was useful for auxiliary diagnosis of UC,feces MPO was a promising biomarker in monitoring disease activity of UC.

Objective To analyze the correlation of anti - cross reactive carbohydrate determinants IgE(anti-CCDIgE level)with serum IgE level and skin prick test(SPT)of patients with allergic rhinitis. Methods From January 2012 to July 2013,we enrolled 161 patients who were definitely diagnosed as allergic rhinitis or non - allergic rhinitis and accorded with inclusion criteria in Peking University First Hospital. According to whether the patients had non - allergic rhinitis,they were divided into allergic rhinitis group(n = 121)and control group(n = 40). General data of patients were collected,including gender,age and history of hymenoptera stings. Dot immunobloting( dot-IBT)was used to detect the expression of sIgE and anti-CCDIgE. Phadiatop and tIgE expression was detected by FEIA,and SPT was conducted. The correlation of anti-CCDIgE expression with gender,age,history of hymenoptera stings,and the expression of sIgE,phadiatop,tIgE and SPT sensitization was analyzed,and the correlation of SPT results with gender,age,and the experession of phadiatop and tIgE was also analyzed. Results Allergic rhinitis group was higher than control group in the positive expression rate of sIgE,anti-CCDIgE,phadiatop and tIgE and SPT positive rate(P ﹤ 0. 05). The expression of anti - CCDIgE had no correlation with gender,age,expression of mixed trees,humulus,mugwort,household dust,mixed dust mites,mixed fungus,cockroaches,dog dander and cat dander of sIgE atopic allergens,expresion of phadiatop,expresion of trees 1,weeds,spruce,humulus,trees 2,gramineae/ grain, mugwort,robinia pseudoacacia, pine, dust mites, household dust mites, aspergillus fumigatus, candida albicans, cockroaches,gramineae,mould 1,mould 2 and animal dander of SPT inhaled allergens(P ﹥ 0. 05);the expression of anti -CCDIgE had correlation with history of hymenoptera stings,ragweed of sIgE atopic allergens,tIgE expression,quinoa and goosefoots of SPT inhaled allergens(P ﹤ 0. 05). SPT results had no correlation with gender and tIgE expression(P ﹥ 0. 05), and had correlation with age and phadiatop expression(P ﹤ 0. 05). SPT positive rate increased as age increased(χ2trend = 4. 264, P = 0. 039). Conclusion The anti-CCDIgE expression of patients with allergic rhinitis has correlation with serum IgE( sIgE and tIgE)level and SPT result. The expression of anti-CCDIgE disturbs the SPT and sIgE for the diagnosis of allergens.

Objective To investigate the prevalence of anti-dsDNA antibody in several autoimmune diseases ,and evaluate the di-agnostic efficacy of ELISA and indirect immunofluorescence (IIF) techniques for the detection of anti-dsDNA antibody in SLE pa-tients .Methods Using commercially available kits based on ELISA (ELISA1 ,ELISA2) and IIF techniques simultaneously ,serum anti-dsDNA antibody was determined in 300 SLE patients ,495 non-SLE autoimmune disease patients ,and 300 health controls .The efficacy of anti-dsDNA antibody determined by one method or combined methods for the diagnostic of SLE patients was further e-valuated .Results The positive rates of anti-dsDNA antibody in SLE patients detected by ELISA1 ,ELISA2 and IIF kit were 42 .3% ,35 .3% and 38 .0% respectively .An utmost prevalence in the non-SLE patients and health controls were 1 .2% and 0 .3%respectively .In SLE patients ,Kappa values of ELISA1 and ELISA2 ,ELISA1 and IIF ,ELISA2 and IIF were 0 .672 ,0 .398 ,0 .512 re-spectively(P< 0 .05) .A significant difference was only observed between ELISA1 and ELISA2(P= 0 .003) .The area under the re-ceiver operating curve (AUC)of ELISA1 ,ELISA2 and IIF were 0 .708 ,0 .672 and 0 .687 respectively ,based on the result obtained from individual method .when ELISA1 kit and IIF kit were used in combination ,the highest positive rate and AUC were 54 .7% and 0 .764 in SLE patients .When three kinds of kits were used in combination ,the highest positive rate and AUC were 57 .7% and 0 .781 .Conclusion Using ELISA and IIF in combination to detect anti-dsDNA antibody could greatly improve the efficacy for the diagnosis of SLE .

Background Colonoscopy can assess disease activity and severity of ulcerative colitis (UC) accurately, but it is invasive and costly. Role of noninvasive biomarkers of intestinal inflammation in evaluation of patients with UC is not well understood. In this study, we assessed fecal eosinophil cationic protein (FECP), fecal myeloperoxidase (FMPO), and fecal calprotectin (FC) as surrogate markers of disease activity and severity in patients with UC, and then evaluated effect of the combination of these markers. Methods Sixty‐three UC patients and 59 cases of age‐matched controls were investigated. All patients underwent clinical, endoscopic, and histological assessment for disease activity and severity. Fecal samples were analyzed for FECP, FC, and FMPO. Results All three fecal biomarkers were elevated in patients compared with controls ( P = 0.000). Significant differences were found between inactive UC and controls ( P = 0.000). Cases with severe UC had significantly higher FECP levels than those with mild UC ( p < 0.05), but there were no significant differences in FC and FMPO levels among disease severity groups. All three biomarkers showed positive correlation with Ulcerative Colitis Activity Index (UCAI). The areas under the ROC curve of FECP, FC, and FMPO were 0.939, 0.783, and 0.785, respectively. Sensitivity and specificity of fecal biomarkers in assessing disease activity were FECP—88.46%, 89.47%; FC—80.77%, 68.42%; and FMPO—84.62%, 63.16%. Conclusions All three fecal biomarkers could be used as surrogate markers for assessing disease activity of UC, and FECP provided superior discrimination than FMPO and FC. Moreover, FECP could distinguish between mild disease and severe disease group.

目的 评价化学发光微粒子免疫分析法(CMIA)用于梅毒螺旋体抗体(TP-Ab)筛查的价值,并制定合理的TP-Ab血清学筛查方案.方法 收集在我院进行TP-Ab筛查的患者标本,共计30,100例,对于CMIA为阴性者直接报告结果,CMIA阳性者采用梅毒螺旋体明胶凝集试验(TPPA)确认,并同时进行快速血浆反应素环状卡片试验(RPR),分析结果的一致性.结果 在30100例筛查标本中,CMIA阳性者402例(1.3％),样本吸光度与临界质控吸光度比值(S/CO)在1.05～40.56之间.CMIA结果＞10 S/CO的标本共178例,TPPA阳性比例为100％,RPR阳性63例;在6-10 S/CO之间的标本共计50例,RPR阳性8例,TPPA阳性比例92％;在3～6 S/CO之间的标本59例,RPR阳性者5例,TPPA阳性的比例66.1％;在1～3 S/CO之间的标本115例,RPR均为阴性,TPPA阳性的比例仅为20％.结论 CMIA筛查TP-Ab具有较高的灵敏度,但特异性相对较低,采用CMIA进行TP-Ab筛查,并根据其S/CO值确定是否需要进一步采用另外一种高特异性梅毒螺旋体抗体检测试验进行确认,是TP-Ab筛查理想的方案,确认方法可以选择TPPA等试验.确认阳性者,应报告RPR结果,辅助临床区分既往感染和现症感染.

Objective To evaluate whether erythrocyte sedimentation rate (ESR) could evaluate disease activity of patient with systemic lupus erythematosus (SLE) .Methods Totally 77 SLE patients From June 2012 to December 2012 were included in this study ,diagnosis of American Rheumatism Association requirements ,male 14 cases ,female 63 cases ,ESR ,complement (C3 ,C4) ,anti dsDNA antibody and other test items completed detection on the day of treatment ,and allocated patients into two subgroups accord‐ing to SLEDAI score ,active group (n=44 ,SLEDAI>4) and inactive group (n=33 ,SLEDAI=0-4) .The above indicators of two groups were compared ,the correlation between each index and the SLEDAI score was calculated .Results ESR was significantly in‐creased in active group than inactive group[21(10 ,37)mm/h vs .11(5 ,21)mm/h ,Z= -2 .787 ,P=0 .005] .On the ability to distin‐guish whether the activity of SLE ,there was no significant difference in between ESR and C3 ,C4 ,anti dsDNA antibody(P>0 .05) . Pearson correlation analysis showed that ESR was positively correlated with SLEDAI score (r=0 .293 ,P=0 .010) .Conclusion ESR can be considered as an useful marker for assessment of disease activity in patient with SLE .

BackgroudHerpes simplex virus types 1 and 2 (HSV‐1 and HSV‐2) are common infectious agents worldwide and the primary infection of HSV remains a major problem in the pregnant women in China nowadays. At present, typing detection of HSV is mainly based on ELISA in China.MethodsIn this study, we evaluated the performance of a newly introduced chemiluminescent immunoassay assay (CLIA) for the determination of serum HSV‐1 and HSV‐2 immunoglobulin G (IgG) antibodies.ResultsThe functional sensitivity of detecting HSV‐1 and HSV‐2 IgG were 0.7 Index and 0.6 Index, respectively. The repeatability and the total imprecision coefficient of variations were both below 10%, and the recoveries of these assays ranged from 90% to 110%. High concentration of hemoglobin, lipids, and bilirubin in samples did not affect the results. The infective rates of HSV‐1 and HSV‐2 were 919 (87.5%) and 169 (16.1%), respectively. HSV‐1 seroprevalence was significantly higher than that of HSV‐2 (P < 0.001).ConclusionCLIA is an excellent method for HSV‐1 and HSV‐2 IgG measurement and can be used as a routine screening test. The infective rate of HSV was pretty high among women before pregnancy or in the period of pregnancy in Beijing.

BACKGROUND:Traditionally, testing for syphilis has consisted of initial screening with a non-treponemal test, then retesting reactive specimens with a treponemal test. Recent availability of a chemiluminescent microparticle immunoassay for detecting antibodies against Treponema pallidum has led several laboratories in China to adopt chemiluminescent microparticle immunoassay for screening of syphilis, with subsequent testing of reactive serum samples with non-treponemal tests. We evaluated the utility of chemiluminescent microparticle immunoassay for routine screening of syphilis.METHODS:Antibodies against Treponema pallidum were screened in 20,550 serum samples using chemiluminescent microparticle immunoassay. Chemiluminescent microparticle immunoassay-positive samples were reflexively tested with rapid plasma reagin tests and Treponema pallidum particle agglutination assays. Dot-immunoblot assays were used to confirm results of chemiluminescent microparticle immunoassay-positive and Treponema pallidum particle agglutination-negative serum samples.RESULTS:Overall, 267 samples (1.3%) were chemiluminescent microparticle immunoassay-positive, and 185 (69.3%) of those chemiluminescent microparticle immunoassay-positive serum samples were also Treponema pallidum particle agglutination-positive. Samples' signal to cut-off ratio for chemiluminescent microparticle immunoassay correlated with diagnostic reliability, as greater samples' signal to cut-off ratio corresponded with greater concordance between chemiluminescent microparticle immunoassay and Treponema pallidum particle agglutination results. Dot-immunoblot testing of 82 chemiluminescent microparticle immunoassay-positive and Treponema pallidum particle agglutination-negative serum samples showed that 16 samples (19.5%) were Dot-immunoblot-positive, 28 (34.2%) were indeterminate and 38 (46.3%) were negative.CONCLUSIONS:Because there is a certain percentage of false-positive results using chemiluminescent microparticle immunoassay for routine screening of syphilis, further analysis by Treponema pallidum particle agglutination is recommended to confirm diagnostic results. While in screening populations discrepancies between chemiluminescent microparticle immunoassay and Treponema pallidum particle agglutination results are quite prevalent, confirmation by immunoblot assay may be useful.

SYSTEMIC lupus erythematosus（SLE）is a systemic autoimmune disease.Several mechanisms have been put forward as underlying the loss of self-tolerance and development of organ dysfunction,such as genetic,environmental,hormonal and immunoregulatory factors.1 In recent years,oxidative