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2022年助理医师资格考试《临床助理医师》综合检测试卷(含答案)

2022年助理医师资格考试《临床助理医师》综合检测试卷（含答案）一、单项选择题（共130题，每题1分）。

1、申请个体行医的执业医师，须经注册后在医疗、预防、保健机构中执业满几年，方可按照国家规定办理审批手续A、满2年B、满3年C、满4年D、满5年E、满6年【参考答案】：D2、新生儿散发性甲状腺功能减低症最早出现的症状是A、腹泻B、贫血C、生理性黄疸消退延迟D、心率正常E、发热【参考答案】：C3、产程中，产妇子宫出现病理性缩复环提示A、子宫发育畸形B、子宫不协调收缩C、先兆子宫破裂D、子宫破裂E、软产道异常【参考答案】：C4、关于急性有机磷杀虫药中毒的中间型综合征不正确的说法A、指中毒后24～96小时突然死亡B、神经一肌肉接头处突触后功能障碍C、中枢神经系统灰质受抑制D、死亡前可先有颈、上肢、呼吸肌麻痹E、累及颅神经者、上睑下垂、眼外展障碍和面瘫【参考答案】：C5、判断胃酸缺乏的指标是A、有嗳气，无反酸B、呕吐物无酸C、进餐后明显腹胀D、基础胃酸分泌(BAO)为零E、最大胃酸分泌(MAO)为零【参考答案】：E6、正常成年人安静时的肺通气／血流比值为A、0．048B、0．084C、0．24D、0．48E、0．84【参考答案】：E7、豆类蛋白质含量较高的必需氨基酸是A、蛋氨酸B、赖氨酸C、含硫氨基酸D、亮氨酸E、苏氨酸【参考答案】：B8、在原发性肾小球肾炎的病理分型中，预后最好的是A、轻微病变B、硬化性病变C、系膜毛细血管性病变D、膜性肾病E、局灶节段性病变【参考答案】：A9、下列哪项不是卵巢恶性肿瘤的特点A、肿瘤生长迅速B、多为实性C、常为单侧性D、肿块界限不清E、常伴腹水【参考答案】：C10、心肌梗死最常发生的部位在A、室间隔后1／3B、左心室前壁C、左心室后壁D、右心室前壁E、左心室侧壁【参考答案】：B11、采用全胃肠外营养，哪项措施不对A、每6小时查血糖及尿糖B、每1～2天测定离子及肝、肾功能C、深静脉插管，可同时用于给药、输血、采血化验D、输液速度保持恒定E、隔日消毒插管处皮肤，并更换敷料【参考答案】：C12、关于系统性红斑狼疮的叙述，不正确的是A、青年女性多见B、属于自身免疫性疾病C、抗Sm抗体是其标记性抗体D、所有抗核抗体均为阳性E、主要的治疗手段是糖皮质激素【参考答案】：B13、关于上消化道出血的描述，下列哪一项不正确A、大量出血后可出现肠性氮质血症B、大量出血后，在1～2个小时内血红蛋白与红细胞比容不下降C、大量出血后，白细胞计数可有明显升高D、通过对呕血与黑粪的定量测定，可判断出血量E、消化道出血后的贫血属于正常细胞正色素性【参考答案】：D14、最能提示该病人并发慢性阻塞性肺气肿紫肿型的表现是A、慢性咳嗽、咳痰痰量多B、呼吸困难明显C、肺气肿体征明显D、肺功能检查残气量增加明显E、血气分析氧分压下降明显【参考答案】：D15、肝性脑病前期最突出的表现是A、表情欣快B、精神错乱C、行为异常D、昏睡E、意识错乱昼睡夜醒【参考答案】：E16、急性脊髓炎不应出现A、脊髓休克B、病变节段以下感觉消失C、大小便潴留D、眼肌麻痹E、病变节段以下无汗17、男，40岁。

安徽省六安二中2024届高三第二次模拟考试生物试卷含解析

安徽省六安二中2024届高三第二次模拟考试生物试卷注意事项1．考生要认真填写考场号和座位序号。

2．试题所有答案必须填涂或书写在答题卡上，在试卷上作答无效。

第一部分必须用2B 铅笔作答；第二部分必须用黑色字迹的签字笔作答。

3．考试结束后，考生须将试卷和答题卡放在桌面上，待监考员收回。

一、选择题(本大题共7小题,每小题6分,共42分。

)1．下列关于细胞结构与其功能相适应特征的叙述中，不正确．．．的是（）A．蛋白质合成旺盛的细胞中核糖体较多B．代谢强度不同的细胞中线粒体数目有差异C．合成胰蛋白酶的胰岛细胞中内质网发达D．携带氧气的哺乳动物成熟红细胞没有细胞核2．水孔蛋白是存在于某些细胞（如肾小管上皮细胞）膜上的一种通道蛋白，其作用是帮助水分子顺浓度梯度进行跨膜运输。

下列叙述正确的是（）A．水分子通过水孔蛋白进行跨膜运输属于自由扩散B．水分子通过水孔蛋白进行跨膜运输需要ATP提供能量C．破坏水孔蛋白的结构后，水分子不能进出细胞D．肾小管上皮细胞重吸收水分的速率受膜内外水分子的浓度和水孔蛋白的数量影响3．下列有关遗传基本规律的叙述，错误的是（）A．孟德尔通过测交实验，验证其假说是否正确B．孟德尔提出的“遗传因子”后来被命名为“基因”C．F1高茎豌豆自交所得F2中出现了高茎豌豆和矮茎豌豆，这是基因重组的结果D．通过单倍体育种的方法可以验证分离定律和自由组合定律4．科学家向小球藻培养液中通入14CO2，给予实验装置不同时间光照，结果如表所示。

根据上述实验结果分析，下列叙述错误的是（）A．碳反应最初形成的主要是3-磷酸甘油酸（三碳化合物）B．本实验利用小球藻研究的是光合作用的暗反应阶段C．3-磷酸甘油酸可直接转化成氨基酸、有机酸等D．实验结果说明小球藻光合作用产物是糖类和氨基酸、有机酸等5．结核分枝杆菌俗称结核杆菌，属胞内寄生菌，是引起结核病的病原菌，下列有关结核杆菌所引起的免疫调节的说法中不正确的是（）A．结核杆菌能够引发机体产生体液免疫和细胞免疫B．T细胞可增殖分化形成效应T细胞直接清除结核杆菌C．吞噬细胞可对结核杆菌的抗原进行非特异性识别和处理D．过量使用免疫抑制剂会使结核病的发病率出现上升趋势6．将蚕豆植株放在湿润的空气中光照一段时间后，用清水浸润蚕豆叶下表皮，在显微镜下观察，然后用1．3g/mL蔗糖溶液取代清水，继续观察，结果如图所示。

连续监测法测定酶活性浓度医学课件

（二）IFCC推荐的测定方法
以色素原GCNA为底物，甘氨酰甘氨酸为受体，GGT催化γ谷氨酰基团从GCNA转移至甘氨酰甘氨酸上，并游离出2-硝基 -5-氨基苯甲酸。后者的生成量与样品中的GGT活性成正比关系，故测定405nm处的吸光度增量可计算出GGT的活性。
GCNA 双甘氨酸 pGHG7T.72 硝基 5 氨基苯甲酸 L 谷氨酰甘氨酰甘氨酸
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第二十四章连续监测法测定酶活性浓度
（三）方法学评价
②2-硝基-5-氨基苯甲酸在410nm的摩尔消光系数为 7.96×103（pH为7.70），受pH和温度影响较大。若选择 401nm或405nm时需注意校正。
③由于产物摩尔消光系数较小，样品用量大，样品体积分数0.0909，为了样品和反应液在37℃平衡，故需要孵育时间180s和底物启动模式。
（一）测定方法概述
γ-L-谷氨酰对硝基苯胺为底物
L-γ-谷氨酰-α（β） -萘胺为底物
方法灵敏度低，底物溶解度差，受溶血干扰较大
可以连续监测，有较好的灵敏度和准确性，但底物溶解度差
L-γ-谷氨酰-3-羧基-4-硝基苯胺为
底物
IFCC推荐方法
第12页
第二十四章连续监测法测定酶活性浓度
CNPF AFU CNP(黄色) L - 岩藻糖
第22页
第二十四章连续监测法测定酶活性浓度
（三）方法学评价
CNPF法所采用CNP的解离常数(pKa)5.5与AFU的最适pH相近，缩短了反应时间，无需样本空白，实现了AFU的连续监测法测定。提高pH可提高CNP的离子化率，但过高的pH会影响酶活性；该方法操作简便，测定时间短，灵敏度及抗干扰性都有所提高。溶血仍有干扰。

荧光免疫生物素放大

Journal of Clinical Laboratory Analysis00:1–6(2014) Determination of Anticyclic Citrullinated Peptide Based on Biotin–Streptavidin-Ampliﬁed Time-ResolvedFluoroimmunoassayHuiming Sheng,1Zhi-Gang Hu,2,3∗Jie Liu,2Fenghong Yuan,2Mei Li,2Yaohong Zou,2and Yu Chen31Shanghai Tongren Hospital Afﬁliated to Shanghai Jiaotong University,School of Medicine,Shanghai,China2Afﬁliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi,China 3Department of Laboratory Medicine,The First Afﬁliated Hospital,College of Medicine,ZhejiangUniversity,Hangzhou,ChinaBackground:A rapid and sensitive time-resolvedﬂuoroimmunoassay(TRFIA) based on the biotin–streptavidin ampliﬁ-cation system was developed for the deter-mination of anticyclic citrullinated peptide (anti-CCP).Methods:Europium-labeled streptavidin derivatives combined with eu-ropium and anhydride of diethylene triamine pentaacetic acid were used to label strep-tavidin,biotin was coupled with rabbit anti-human IgG to form a biotin–anti-human IgG bridge between streptavidin–europium and the anti-CCP antibody in the immunoas-say.The anti-CCP assay was carried out by measuring theﬂuorescence of Eu3+–streptavidin at615nm.Results:The pre-sented method produced a wide linear range from0.58to9,463U/ml,while itwas only591.4–18.48U/ml when using anELISA kit,and featured a detection limit upto0.5U/ml for anti-CCP.The values deter-mined by the biotin–streptavidin–TRFIA andELISA correlated well(R2=0.8927).The method was applied to determine anti-CCPin serum samples with satisﬁed recoveriesof96.45–104.63%.Conclusion:The assayresults obtained by the present methodshowed that biotin–streptavidin-ampliﬁedTRFIA improve the traditional ELISA kit foranti-CCP detection.Therefore,it offers abetter alternative immunoassay in rheuma-toid arthritis b.Anal.00:1–6,2014.C 2014Wiley Periodi-cals,Inc.Key words:cyclic citrullinated peptide;rheumatoid arthritis;time-resolvedﬂuoroim-munoassayINTRODUCTIONRheumatoid arthritis(RA)is an inﬂammatory autoim-mune disease,with a prevalence of0.3–1%worldwide, which leads to progressive joint erosion and substantial disability if not treated early.A reliable and speciﬁc test for a marker present early in the disease would be use-ful for identifying RA patients prior to the occurrence of joint damage(1).Antibodies to citrullinated proteins(ACPA)are speciﬁc serological markers for RA(2).ACPA constitute a grow-ing family of autoantibodies,and the major breakthrough came with the realization of the crucial role of peptide epitopes,which were citrullinated posttranslationally,and the subsequent development of the anticyclic citrullinated peptide antibodies(anti-CCP)test(3).The anti-CCP an-tibodies can be detected in up to80%of patients with RA,which is highly speciﬁc for the disease,and may be of value for both the diagnosis and prognosis of RA, particularly implicated in more erosive disease course(4). Grant sponsor:Wuxi’s Hospital Administration Center Key Subject;Grant number:YGZ1101;Grant sponsor:Directive Planning Project of Wuxi Science and Technology Bureau,China;Grant number:CSE31N1302.∗Correspondence to:Zhigang Hu,Afﬁliated Wuxi People’s Hospital of Nanjing Medical University,214023,Wuxi,China.E-mail:jswx-hzg@Received24November2013;Accepted25June2014DOI10.1002/jcla.21796Published online in Wiley Online Library().C 2014Wiley Periodicals,Inc.2Sheng et al.Time-resolvedﬂuoroimmunoassay(TRFIA),a nonra-dioimmunoassay,offers better sensitivity than other tradi-tional FIA methods due to the uniqueﬂuorescence prop-erties of lanthanide chelates and the time-resolved mea-surement mode,which allows the speciﬁcﬂuorescence to be measured after the backgroundﬂuorescence has al-ready declined(5).Bioanalytical assays based on TRFIA have made a substantial impact on routine and research areas(6).Up to now,the use of Eu3+-labeled streptavidin(Eu3+–streptavidin)and time-resolvedﬂuorometry has been well suited as an indirect label for its relatively high afﬁnity to biotin and low nonspeciﬁc binding properties.As a tetrameric structure with four binding sites for biotin,it can be used for amplifying signal(7).Moreover,a univer-sal detection reagent,europium chelate,as aﬂuorescent marker has attracted much attention for high-throughput screening of large populations of biologically active sam-ples(8,9).In this study,the europium chelate of Eu3+–streptavidin was prepared and used as a signal generation reagent after its binding to the biotin moieties of the surface immuno-complex.A novel,rapid,biotin–streptavidin-ampliﬁed TRFIA for the determination of anti-CCP was developed and is described here.This method was applied to deter-mine anti-CCP in human serum samples with satisfactory results.MATERIALS AND METHODSChemicals and InstrumentationAuto DELFIA1235,Eu3+-labeled regent,and Eu3+-labeled enhancement solution were purchased from Wallac Oy(Turku,Finland).The96-well polystyrene microtiter plates and recombinant CCP antigen were ob-tained from AESKU(Dresden,Germany).Monoclonal rabbit anti-human IgM was purchased from Sigma(St. Louis,MO).N2-[p-isocyanate-benzyl]diethylenetriamine tetraacetic acid(DTTA)was purchased from Sigma Aldrich(St.Louis,MO).Bovine serum albumin(BSA) was purchased from Institute of Biological Products Min-istry of Health(Shanghai,China).Sephadex G25was pur-chased from Pharmacia(Piscataway,NJ).Concentrated wash buffer and enhancement solution were provided by Institute of Nuclear Medicine(Jiangsu,China).Other reagents used were of analytical reagent grade.ELISA Kit and Reference Standard of the Anti-CCP PreparationCommercial ELISA kits of the anti-CCP IgG were ob-tained from AESKU,Dr.Fenning(Kirchzarten,Ger-many),and ORGENTEC(Mainz,Germany),respec-tively.Reference standard of the anti-CCP was obtained from AESKU.Preparation of Solid AntigenEach well of polystyrene microtiter plates was coated with100μl of recombinant CCP antigen diluted with coating buffer(pH9.6,50mmol/l Na2CO3-NaHCO3) by incubating at4°C overnight.The coating buffer was discarded.After three times wash,some binding sites not occupied by the coating buffer were then blocked by250μl 3g/l BSA(Institute of Biological Products Department of Health,Shanghai,China)in phosphate buffer solu-tion(PBS;pH7.4)and the plates were incubated at4°C overnight.After the blocking buffer was discarded,the plates were vacuum-dried and stored at−20°C until anal-ysis.Biotin Labeling of Anti-Human IgGOne milligram of N-hydroxysuccinimidobitin (Promega,Madison,Wisconsin)was added to0.5mg of a1mg/ml solution of rabbit anti-human IgG(St. Louis,MO)in pH7.2,0.05M PBS.The reaction mixture was incubated at37°C for1h and then dialyzed overnight at4°C with PBS.The biotin-labeled antibody was stored at−20°C until use.Eu3+-Labeled Streptavidin PreparationEu3+labeling of streptavidin(Sigma)was performed us-ing a Eu3+-labeling Kit(EG&G-Wallac,Turku,Finland) strictly according to the manufacture’s instructions.One milligram of streptavidin was loaded on a PD10column and eluted using carbonate buffer(pH8.5,50mmol/l Na2CO3-NaHCO3)containing0.155mol/l NaCl.Then streptavidin was mixed with0.2mg Eu3+-DTPAA(di-ethylenetriamine pentaacetic acid;Sigma Aldrich)fol-lowed by vigorous stirring at30°C for20h.The resulting mixture was then fractionated on a Sepharose CL-6B(1×40cm;Pharmacia)with pH7.8,80mmol/l Tris-HCl buffer.The absorbance values of the elution were measured at280nm to obtain protein concentra-tions.After puriﬁcation,equal amount of AR glycerin was added before subpackaging and stored at−20°C until use.Anti-CCP Antibody AssayThe procedures for BAS-TRFIA of serum anti-CCP antibody were performed using an indirect ELISA tech-nique.Hundred microliters of serum diluted with assay buffer was pipetted into each coated microtiter well,and incubated for30min at25°C.The plates were washed fourb.Anal.Determination of Anticyclic Citrullinated Peptide3times with wash buffer,then100μl of rabbit anti-humanIgG was added to each well,and incubated with shakingfor30min at25°C.The plates were washed again fourtimes,then pipetted with100μl buffer,diluted with Eu3+-labeled streptavidin to each well,and incubated with shak-ing for15min.After washing six times with wash buffer,100μL of enhancement solution was pipetted into eachwell.The plates were shaken for5min.Eu3+ﬂuorescenceintensity(cps)was measured with auto DELFIA1235.The concentrations of anti-CCP antibody in respectivesamples were determined based on the calibration curvesusing Multicalc software program.Evaluation on the Kits(1)Precision testing.Three pools of mixed serum speci-mens with high,intermediate,and low concentrationof anti-CCP antibody were subpackaged and stored at −20°C.Mixed with the serum specimens and evaluat-ing their concentrations with samples,the coefﬁcientof variations(CVs)was calculated.(2)Linear range testing.Serum from patient with thehighest anti-CCP antibody concentration was dilutedin a twofold serial dilution manner,and the anti-CCPantibody concentrations of diluted specimens weredetected using the established BAS-TRFIA kit and acommercial ELISA one,respectively.The linear curveof dilution concentration was obtained with dilutionmultiple as the horizontal abscissa andﬂuorescentintensity as the vertical ordinate.(3)Sensitivity testing.The sensitivity of the assay wasback-calculated by the obtained meanﬂuorescentcounts(n=20)of the zero standard plus2SD inthe calibration curve.(4)Clinical applications.The speciﬁcity of anti-CCP an-tibody detection was evaluated by testing serum from52healthy blood donors,32systemic lupus erythe-matosus(SLE),27Sjogren’s syndrome(SS),10sclero-derma,20mixed connective tissue disease(MCTD),23multiple sclerosis(MS)patients.(5)Correlation test.The anti-CCP antibody concentra-tions of32serum specimens from patients with RAwere detected using the established BAS-TRFIA kitand a commercial ELISA kit,respectively,and thenthe values obtained were analyzed.(6)Stability testing.New BAS-TRFIA kit and threeELISA kits were put into the37°C water box for7days and then compared with the one stored in rou-tine conditions.(7)Coefﬁcient of recovery.Three sera with high antibodyconcentrations were diluted with sample buffer andassayed in the new TRFIAkit.Fig.1.Serial dilutions of a specimen with the highest anti-CCP IgG concentration were tested with TRFIA and ELISA,respectively.Double Y-axis curve was determined according to dilution strength(X-axis)as well as BAS-TRFIAﬂuorescence intensity and ELISA absorbance(the two Y-axes).Statistical AnalysesData were analyzed using the SPSS13.0software.Re-gression analysis and analysis of variance were used to calculate correlation and test linearity,respectively.In-terassay and intra-assay variation was calculated using the CV.The statistical signiﬁcance level was set at0.05. RESULTSLinearityA strong positive specimen from9,081to0.55U/ml was diluted and the serial dilutions with the established TRFIA as well as ELISA were detected.The curve of de-tectable range of the two methods is shown in Figure1,in which we observe that for the established TRFIA kit there was a good linear range within9,463–0.58U/ml,whereas it was within591.4–18.48U/ml when using an ELISA kit,indicating that the method of TRFIA we established has a wider detectable range than the commercial ELISA. Calibration Curve for Determination of Anti-CCP IgGAs shown in Figure2,the time-resolvedﬂuorescence intensities are directly proportional to the concentrations of anti-CCP IgG.The concentrations of anti-CCP IgG were2,365.8,591.44,147.86,36.96,9.24,0.58U/ml.The line equation for the calibration curve of anti-CCP IgG was Y=3.79071+0.79505X+0.01094X2,where X is the concentration of anti-CCP IgG(GPL U/ml)and Y is ﬂuorescence intensity.The sensitivity of the assay,deﬁned as the mean signal of the zero standard plus2SD,was 0.5U/ml.b.Anal.4Sheng et al.Y : A x i s T i t l eX:The concentration for anti-CCP IgG (U/ml)Fig.2.Standard curves for anti-CCP IgG by TRFIA at different concentrations (2,365.8,591.44,147.86,36.96,9.24,0.58U/ml).TABLE 1.Intrabatch and Interbatch Precision AnalysisBAS-TRFIA (U/ml)ELISA (U/ml)Mean ±SDCV (%)Mean ±SD CV (%)HighIntrabatch (n =20)241.5±7.63 3.16242.8±14.86 6.12Interbatch (n =10)240.9±10.33 4.29243.1±17.647.26IntermediateIntrabatch (n =20)72.7±2.78 3.8272.6±5.948.18Interbatch (n =10)72.3±3.38 4.6873.1±7.269.93LowIntrabatch (n =20)14.15±0.60 4.2414.32±1.389.61Interbatch (n =10)14.23±0.714.9714.37±1.5410.74Assay PrecisionThe precision of the assay was also analyzed by mea-suring three pools of mixed serum specimens with high,intermediate,and low concentration of anti-CCP IgG 20times in one series (intra-assay)and in duplicate in eight different series,and data were compared with those ob-tained by the ELISA kit.As shown in Table 1,the intra-assay CVs detected by TRFIA at mean anti-CCP IgG concentrations of 241.5,72.7,14.15U/ml were 3.16%,3.82%,and 4.24%,respectively,and the interassay CVs at mean concentrations of 240.9,72.7,14.23U/ml were 4.29%,4.68%,and 4.97%,respectively.In comparison,the intra-assay CVs detected by ELISA at mean concen-trations of 242.8,72.6,14.32U/ml were 6.12%,8.18%,and 9.61%,respectively,and the interassay CVs at mean concentrations of 243.1,73.1,14.37U/ml were 7.268%,9.93%,and 10.74%,respectively.Obviously,the TRFIA kit we established for anti-CCP IgG detection was better than the commercial ELISA kit in intra-and interassay precision with either rank of concentration.TABLE 2.Speciﬁcity of Anti-CCP Antibody in Different Types of PatientsCase and Negative control 15Positive ࣙSpeciﬁcity groupn U/ml U/ml(%)Healthy blood donors 5251198.1SLE 3231196.9SS2726196.3Scleroderma 10100100MCTD 2019195.0MS2322195.7Clinical ApplicationEach well of polystyrene microtiter plates was coated with recombinant CCP antigen.The speciﬁcity of anti-CCP antibody detection was evaluated by testing serum from 52healthy blood donors,32SLE,27SS,10sclero-derma,20MCTD,and 23MS patients.Cross-reactivities are shown in Table 2.Correlation With ELISAConcentration results of 32serum samples determined by TRFIA were compared with those obtained by an ELISA kit.The scatter plots showed that the two methods correlated well (Fig.3)and the correlation coefﬁcient of the results obtained from the two assays was 0.8927.Stability of the TRFIA KitsThe assay kits were stored at 4°C and water bathed at 37°C for 7days.Then,the difference of ﬂuores-cence intensity or absorbance—that is decline rate ofb.Anal.Determination of Anticyclic Citrullinated Peptide5Fig.3.Correlation between the BAS-TRFIA and ELISA. TABLE3.Stability of the BAS-TRFIA and ELISAGroups4°Cpreserve7days37°Cwater bath7daysThe declinedrate ofcombination(%)ELISA1(abs) 2.56 1.6336.3 ELISA2(abs) 2.39 1.6929.3 ELISA3(abs) 2.71 2.2317.7 BAS-TRFIA(cps)2,451,2362,153,41512.1 combination—was measured both by TRFIA and ELISA.We observed that it exhibited no visible change except for a decline by12.1%for TRFIA(17.7%,29.3%, 36.3%for the commercial ELISA)in the rate of combina-tion when compared with the one stored in routine con-ditions,suggesting that the established assay kit had good stability and could be stored at4°C for1year(Table3). Moreover,the accuracy decreased as time was extended by ELISA,but after enhancement solution was added the detection ofﬂuorescent results was not affected up to the next day.Thus,it can be seen that TRFIA is more stable.Coefﬁcient of RecoveryThe recoveries of theﬁrst sample were100.98%, 102.25%,and96.45%,respectively.The recoveries of the second sample were100.46%,98.18%,and101.59%, respectively.The recoveries of the third sample were 104.63%,97.18%,and98.17%,respectively.The average recovery rate calculated by the average of nine individ-ual values by the formula of observed concentrations×100/expected concentration in Table4)was99.98%.TABLE4.Coefﬁcient of Recovery:Three Sera With High Anti-body Concentrations Were Diluted With Sample Buffer and As-sayed in the New BAS-TRFIA KitObserved ExpectedSample Dilution(U/ml)(U/ml)O/E(%) 11:100266.41:200134.5133.2100.981:40068.166.6102.251:80032.133.396.40 21:100175.61:20088.287.8100.461:40043.143.998.181:80022.321.95101.59 31:10088.51:20046.344.25104.631:40021.522.12597.181:80010.8611.062598.17DISCUSSIONTo facilitate early diagnosis,a serological marker of RA that is detectable very early in the disease is needed.As mentioned above,several recent studies have shown that anti-CCP can be detected very early in the course of RA and may be helpful in early diagnosis.Herein,we developed a new sandwich TRFIA with biotin–streptavidin system as a quantitative and rapid immunological assay for measuring anti-CCP in clini-cal serum samples,since the new method combined the advantages of both high sensitivity of traditional TR-FIA and high afﬁnity of biotin to streptavidin tetrameric bond.Moreover,the detectable signal can be ampliﬁed because of the tetrameric structure with four binding sites of streptavidin for biotin.The experimental results indi-cated that the new TRFIA is a promising immunoﬂuoro-metric method with highly sensitive and speciﬁc,mean-while,the assay provided wider dynamic working ranges and better reproducibility.In Figure1,TRFIA demon-strated a good linear range within9,463–0.58U/ml,by contrast,within591.4–18.48U/ml of an ELISA kit.The expanded detection range will improve earlier detection and higher sensitivity in RA diagnosis(10,11).Further-more,the serologic-positive patients will be treated timely and effectively,subsequently,preventing irreversible joint damage(12).By comparison,the new assay has satisﬁed correlation with general commercial ELISA kit with the R2value 0.8927(Fig.3),moreover,its stability performance is bet-ter than the commercial ones,which will guarantee the more stable yield(Table3).In sum,the new TRFIA with biotin–streptavidin system as a quantitative and rapid im-munological assay for measuring anti-CCP is a promising alternative assay for RA diagnosis and monitor.b.Anal.6Sheng et al.CONFLICT OF INTERESTAll authors declare that they have no competing inter-ests.REFERENCES1.Raptopoulou A,Sidiropoulos P,Katsouraki M,Boumpas DT.Anti-citrulline antibodies in the diagnosis and prognosis of rheumatoid arthritis:Evolving concepts.Crit Rev Clin Lab Sci 2007;44(4):339–363.2.van Gaalen FA,Linn-Rasker SP,van Venrooij WJ,et al.Au-toantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis:A prospective cohort study.Arthritis Rheum2004;50(3):709–715. 3.van Venrooij WJ,van Beers JJ,Pruijn GJ.Anti-CCP antibod-ies:The past,the present and the future.Nat Rev Rheumatol 2011;7(7):391–398.4.Forslind K,Ahlm´e n M,Eberhardt K,Hafstr¨om I,Svensson B;BARFOT Study Group.Prediction of radiological outcome in early rheumatoid arthritis in clinical practice:Role of antibodies to cit-rullinated peptides(anti-CCP).Ann Rheum Dis2004;63(9):1090–1095.5.Du L,Cheng S,Wang S.Determination of diethylstilbe-strol based on biotin-streptavidin-ampliﬁed time-resolvedﬂuoro-immunoassay.Luminescence2012;27(1):28–33.6.Hu Z,Liu J,Y e Y,Zhou Y,Yu L.Detection of anticardiolipinantibody igm by sm(3+)-labeled time-resolvedﬂuoroimmunoassay.J Immunoassay Immunochem2013;34(3):255–265.7.Suonpaa M,Markela E,St˚a hlberg T,Hemmil¨a I.Europium-labelled streptavidin as a highly sensitive universal label.Indirect time-resolved immunoﬂuorometry of FSH and TSH.J Immunol Methods1992;149(2):247–253.8.Qin QP,Lovgren T,Pettersson K.Development of highlyﬂuores-cent detection reagents for the construction of ultrasensitive im-munoassays.Anal Chem2001;73(7):1521–1529.9.Huhtinen P,Soukka T,L¨ovgren T,H¨a rm¨a H.Immunoassayof total prostate-speciﬁc antigen using europium(III)nanoparti-cle labels and streptavidin-biotin technology.J Immunol Methods 2004;294(1–2):111–122.10.van Genderen FT,Gorus FK,Pipeleers DG,van Schravendijk CF.Sensitive and speciﬁc time-resolvedﬂuorescence immunoassay of rat C-peptide for measuring hormone secretory and storage capacity of beta-cells in vivo and in vitro.Endocrinology2013;154(5):1934–1939.11.Farid S,Azizi G,Mirshaﬁey A.Anti-citrullinated protein antibodiesand their clinical utility in rheumatoid arthritis.Int J Rheum Dis 2013;16(4):379–386.ndewe RB,Boers M,Verhoeven AC,et al.COBRA combina-tion therapy in patients with early rheumatoid arthritis:Long-term structural beneﬁts of a brief intervention.Arthritis Rheum 2002;46(2):347–356.b.Anal.。

黄酒中多肽的研究进展

doi:10.16736/41-1434/ts.2021.02.025黄酒中多肽的研究进展Research Progress of Peptides in Huangjiu◎ 罗浩怡1，曾　林1，张雅琦1，陈煜倩1，李慧玲1，白卫东1,2，刘晓艳1,2（1.仲恺农业工程学院轻工食品学院，广东　广州　510225；2.现代农业工程创新研究院，广东　广州　510225）LUO Haoyi1, ZENG Lin1, ZHANG Yaqi1, CHEN Yuqian1, LI Huiling1, BAI Weidong1,2, LIU Xiaoyan1,2(1.College of Light Industry and Food Science, Zhongkai University of Agriculture and Engineering, Guangzhou　510225, China;2.Academy of Contemporary Agricultural Engineering Innovations, Guangzhou　510225, China)摘　要：本文综述了黄酒中多肽的分离提纯和功效的研究进展情况，特别是黄酒的抗氧化、抗衰老，降血压血脂、降胆固醇，免疫调节以及代谢功能，抗疲劳作用等功效，旨在梳理黄酒多肽当前的研究现状，进一步推动黄酒产业的发展。

关键词：黄酒；多肽；功效Abstract：This article reviews the research progress on the separation, purification and efficacy of Huangjiu, especially its anti-oxidation and anti-aging, lowering blood pressure and blood lipids, lowering cholesterol, immune regulation, metabolic function, and anti-fatigue effects. It aims to sort out the current research status of Huangjiu peptides and further promote the development of Huangjiu industry.Keywords：Huangjiu; polypeptide; efficacy中图分类号：TS262.4黄酒是我国古老的酒种之一，与啤酒、葡萄酒并称世界三大古酒。

体外诊断研究报告

体外诊断研究报告体外诊断（In Vitro Diagnosis，简称 IVD）是指在人体之外，通过对人体样本（血液、体液、组织等）进行检测而获取临床诊断信息的产品和服务。

近年来，随着人们对健康的重视程度不断提高，以及医疗技术的飞速发展，体外诊断行业正经历着前所未有的变革和发展。

一、体外诊断的分类体外诊断产品种类繁多，按照检测方法可以分为生化诊断、免疫诊断、分子诊断、微生物诊断、血液诊断、尿液诊断等。

生化诊断是最早发展起来的体外诊断技术之一，主要通过测定生物化学物质的含量来判断人体的生理功能和代谢状态。

常见的生化检测项目包括肝功能、肾功能、血糖、血脂等。

免疫诊断则是利用抗原与抗体的特异性结合反应来检测样本中的目标物质。

免疫诊断技术包括酶联免疫吸附试验（ELISA）、化学发光免疫分析（CLIA）、胶体金免疫层析等。

化学发光免疫分析由于其灵敏度高、特异性强、自动化程度高等优点，已逐渐成为免疫诊断的主流技术。

分子诊断是通过检测生物大分子（如 DNA、RNA）的结构和表达水平来诊断疾病。

分子诊断技术包括聚合酶链反应（PCR）、荧光原位杂交（FISH）、基因芯片等。

分子诊断在传染病诊断、遗传病诊断、肿瘤诊断等领域具有重要的应用价值。

微生物诊断主要用于检测病原微生物，如细菌、病毒、真菌等。

常见的微生物诊断方法包括培养法、涂片镜检法、核酸检测法等。

血液诊断和尿液诊断则分别针对血液和尿液中的成分进行检测，以评估人体的健康状况。

二、体外诊断的市场现状近年来，全球体外诊断市场规模持续增长。

据市场研究机构的数据显示，2020 年全球体外诊断市场规模达到了约 834 亿美元，预计到2025 年将超过 1000 亿美元。

从地区分布来看，北美、欧洲和亚太地区是体外诊断市场的主要区域。

北美地区市场规模最大，技术水平最为先进；欧洲地区市场发展较为成熟；亚太地区市场增长迅速，尤其是中国、印度等新兴经济体，由于医疗需求的不断增加和医疗保障体系的逐步完善，体外诊断市场潜力巨大。

食品安全生物技术论文

食品安全生物技术论文随着科技发展和人们生活水平的提高，食品安全事件频发。

下面是店铺为大家整理的食品安全生物技术论文，希望你们喜欢。

食品安全生物技术论文篇一生物技术在食品安全检测中的应用[摘要]由于人们生活质量水平的提高，对食品安全问题的关注度越来越高，在一定程度上食品检测技术水平得到了不断提高，从而使各种新设备、新技术不断应用于食品检测中。

现如今，生物技术在食品检测中得到了广泛的应用，不仅提高了食品检测的精确度，而且拓展了食品检测的新方向，大大地提高了食品的安全性。

文章就生物技术在食品安全检测中的应用进行详细的分析，以此为相关从业人员提供参考依据。

[关键词]生物技术;食品安全;检测;应用目前，食品的安全性受到了人们的高度关注，不仅对人类的健康生存具有重要的影响，还关系着我国经济和社会的发展。

由此可见，食品安全检测的重要性。

作为食品生产企业和政府监管机构，必须严格控制食品的品质，检测人员应做好食品安全检测工作，以此实现现场无损检测和快速检测。

由于传统的食品检测方法已经不能满足现代社会的发展，基因探针法、PCR技术、免疫学检测技术、生物芯片和生物传感器技术等生物技术在食品安全检测中得到了广泛应用。

具体分析如下：一、基因探针技术基因探针技术即DNA探针技术，又称分子杂交技术，是利用DNA分子的变性、复性以及碱基互补配对的高度精确性，对某一特异性DNA序列进行探查的新技术。

目前，基因探针杂交方法总体上可以分为两种：一种是异相杂交;另外一种是同相杂交，其关键技术都在于DNA探针的构建。

例如，在食品微生物检测中，大肠杆菌具有葡糖苷酸酶的特性，利用大肠杆菌中编码该酶的基因序列作为目标DNA，并制成DNA探针，用以检测食品中的总大肠杆菌。

与传统微生物检测方法相比，基因探针技术不仅能克服传统食品微生物检验方法的不足，而且还具有特异性强、灵敏度高和操作简便、省时等优点。

与此同时，基因探针技术也存在其局限性，如检测成本高、速度慢、效率相对较低，这些都是在以后的科研中需要改进的地方。

教改题目

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孙景蔚桑永宣陈国金戚明钧黎常裘益政田师一余燕平楼伯坤林家莲陈文娟毛锡锋张艳孙卫红徐时清左冕范庆瑜赵伟春汪国建楼航芳许丽来平凡黄真郑园娜楼然苗丁天明宋秋前傅纪良郑基蔡慧萍
基于校企联动平台和工作室制的工业设计创新实践人才培养模式的研究《大学生体质健康测评管理系统》开发及应用于体育教学和锻炼干预的研究与实践课堂教学与实践教育融合互动机制研究和探索——以绿色制药基地班为例多元协同背景下拔尖创新人才培养模式研究与实践基于提升就业竞争力的“三商”协同发展人才培养体系的构建与实践高校思想政治理论课研究性学习与实践性教学改革的探索与实践着力提升教学创新能力的教师教学发展体系研究与实践科研反哺教学育人体系的探索环境科学创新性应用型人才培养实践教学模式改革基于大学生学习主动性和效能提高的“五个一” 班主任工作创新实践 “法律思维中心”论的教与学方式创新——法学课程“五步教学法”的理论与实践 “四会”反思型小学卓越教师培养模式研究走向卓越：体育教育专业人才培养模式创新与实践全国师范生教学技能竞赛评价与组织运行机制研究视频公开课与资源共享课教改研究探究式课堂教学中360°评价体系的构建面向学生创新实践能力培养的毕业实践环节综合改革研究基于国际化人才培养定位的会计教学模式创新研究体育师范生“学成”标准理论与实践探索高校教学方法改革评价指标与推进路径研究通识教育背景下“单件小批”专业素质个性化培养模式探索卓越服装设计创新性人才培养模式研究基于诺贝尔物理学奖系列实验，构建学生科学素养培养新模式信息类专业协同创新实践能力培养模式及机制研究教师教学能力发展的生态优化问题研究地方院校本科专业布局优化与调整的机制研究工业设计专业E-CO移动学习社区建设与应用地方本科院校国际化专业建设模式研究与实践大学生自主学习理论、模式及评价体系研究全人教育理念下的心理健康课程教学模式与实践基于FPGA技术的开放式计算机硬件系列课程实验改革研究

高中生物专题1 基因工程 3 基因工程的应用检测(含解析)新人教版选修3-新人教版高中选修3生物试

1.3 基因工程的应用一、选择题题型一植物基因工程的应用1．下列转基因植物与所选用的目的基因对应错误的是( )A．抗虫棉——Bt毒蛋白基因B．抗病毒转基因烟草——几丁质酶基因C．抗盐碱和抗旱植物——调节细胞渗透压的基因D．耐寒的番茄——抗冻基因答案 B解析抗病毒转基因植物常使用的是病毒外壳蛋白基因和病毒的复制酶基因，几丁质酶基因及抗毒素合成基因一般用作抗真菌转基因植物的目的基因，B错误。

2．我国转基因技术发展态势良好，下列关于转基因抗冻番茄和转基因水稻的叙述，不正确的是( )A．转基因抗冻番茄的目的基因来源于鱼B．转基因抗虫水稻减少了化学农药的使用，减轻了环境污染C．转基因抗虫水稻是否具有抗虫性，可通过饲养卷叶螟进行检测D．转基因抗虫水稻的外源基因是几丁质酶基因答案 D解析转基因抗冻番茄的目的基因来自于鱼的抗冻基因，转基因抗虫水稻的外源基因是Bt毒蛋白基因，而几丁质酶基因是抗真菌转基因植物常用的基因，A正确，D错误；转基因抗虫水稻减少了农药的使用，减轻了环境污染，同时降低了农业生产的成本，B正确；检测目的基因是否表达最简便的方法是进行个体水平的检测，故检测转基因抗虫水稻是否具有抗虫性，可通过饲养卷叶螟进行检测，C正确。

3．以下有关基因工程应用的说法正确的是( )A．用基因工程培育的抗虫植物也能抗病毒B．转基因矮牵牛只能变异为自然界已存在的颜色类型C．基因工程可用来培育高产、稳产、品质优良和抗逆性强的作物D．科学家将必需氨基酸含量多的蛋白质导入植物中，或者改变这些氨基酸的合成途径中某种关键酶的活性，以提高氨基酸的含量答案 C解析基因工程培育的抗虫棉只能抗某种虫害，不能抗病毒，A错误；转基因矮牵牛通过转入与花青素代谢有关的目的基因，可以使其呈现出自然界没有的颜色变异，B错误；想要提高植物的氨基酸含量，应将必需氨基酸含量多的蛋白质编码基因导入植物中，D错误。

题型二动物基因工程的应用4．下列有关乳腺生物反应器的说法中，不正确的是( )A．利用转基因哺乳动物乳腺的分泌功能生产产品B．构建的基因表达载体应该含有乳腺蛋白基因的启动子C．分泌的乳汁中含有目的基因D．乳腺生物反应器是将目的基因转入哺乳动物受精卵获得的答案 C解析利用转基因哺乳动物乳腺的分泌功能生产产品，获得高产量的外源蛋白质，A正确；表达载体含有乳腺蛋白基因的启动子才能保证目的基因只在乳腺细胞中表达，B正确；分泌的乳汁中含有目的基因控制合成的蛋白质，但不会含有目的基因，C错误；乳腺生物反应器是通过基因工程技术，将目的基因转入哺乳动物受精卵获得的，D正确。

2022年第19届亚运会组委会_企业报告(业主版)

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中国卫生检验杂志２０１５年８月第２５卷第１５期Ｃｈｉｎ　Ｊ　Ｈｅａｌｔｈ　Ｌａｂ　Ｔｅｃ，Ａｕｇ．２０１５，Ｖｏ１．２５，Ｎｏ．１５　・调查报告・　金华地区８　００７例自身抗体检测结果分析　

赵硕，马闪珊，单小云，陆晓东　金华市中心医院检验科，浙江金华３２１０００　

摘要：目的探讨自身抗体在临床就诊患者中的阳性分布趋势与自身免疫性疾病（ＡＩＤ）发生的相关性，对临床诊断的　价值。方法采用间接免疫荧光法（ＩＩＦ）和印迹法，对２０１２年４月一２０１３年４月在金华中心医院就诊的８　００７例患者　的血清标本进行ＡＮＡ、ＥＮＡ和ｄｓ—ＤＮＡ检测。结果　在８　００７份检测标本中，ＡＮＡ阳性率为１７．５％，其中男性为　９．１％，女性为２０．５％，二者差异有统计学意义（　＝１３７．３６，Ｐ＜０．０１）。不同年龄组间ＡＮＡ阳性患者的阳性率也有统　计学意义（≤２０岁组为１４．７％、２１岁～４９岁组为１９．２％、＞１５０岁组为１８．Ｏ％，Ｘ２＝１８．４７，Ｐ＜０．叭）。ＡＩＤ患者荧光模　型分析表明，单一荧光模型以颗粒型（３６．８％）和均质型（２６．４％）为主，混合荧光模型以颗粒型／浆细胞型（５．８％）为　主。ＡＮＡ阳性患者１　４０４例，其中符合ＡＩＤ诊断的患者８１５例。结论临床就诊患者中ＡＮＡ阳性率在不同性别、年龄　组间差异有统计学意义；不同ＡＩＤ患者均会出现特异或相对特异的自身抗体。ＡＮＡ与ＥＮＡ抗体谱联合检测对ＡＩＤ患　者诊断及鉴别诊断具有重要意义。　关键词：自身抗体；自身免疫性疾病；临床意义　・　中图分类号：Ｒ４４６．６　文献标识码：Ｂ　文章编号：１００４—８６８５（２０１５）１５—２６０２—０３　

Ａｎａｌｙｓｉｓ　０ｆ　８　００７　ｃａｓｅｓ　ａｕｔ０ａｎｔｉｂｏｄｉｅｓ　ｄｅｔｅｃｔｉｏｎ　ｒｅｓｕｌｔｓ　ｉｎ　Ｊｉｎｈｕａ　ＺＨＡＯ　Ｓｈｕｏ，ＭＡ　Ｓｈａｈ—ｓｈａｎ，ＳＨＡＮ　Ｘｉａｏ—ｙｕｎ，ＬＵ　Ｘｉａｏ—ｄｏｎｇ　Ｄｅｐａｒｔｍｅｎｔ　ｏｆ　Ｃｌｉｎｉｃａｌ　Ｌａｂｏｒａｔｏｒｙ，Ｊｉｎｈｕａ　Ｃｅｎｔｒａｌ　Ｈｏｓｐｉｔａｌ，Ｊｉｎｈｕａ，Ｚｈｅｊｉａｎｇ　３２１０００，Ｃｈｉｎａ　Ａｂｓｔｒａｃｔ：Ｏｂｊｅｃｔｉｖｅ　Ｔｏ　ｉｎｖｅｓｔｉｇａｔｅ　ｔｈｅ　ｃｏｒｒｅｌａｔｉｏｎ　ｂｅｔｗｅｅｎ　ｔｈｅ　ｐｏｓｉｔｉｖｅ　ｄｉｓｔｒｉｂｕｔｉｏｎ　ｏｆ　ａｕｔｏａｎｔｉｂｏｄｉｅｓ　ｉｎ　ｐａｔｉｅｎｔｓ　ｗｉｔｈ　ｃｌｉｎｉｃａｌ　ｄｉａｇｎｏｓｉｓ　ａｎｄ　ｔｈｅ　ｏｃｃｕｒｒｅｎｃｅ　ｏｆ　ａｕｔｏｉｍｍｕｎｅ　ｄｉｓｅａｓｅｓ（ＡＩＤ）ａｎｄ　ｔｈｅ　ｖａｌｕｅ　ｏｆ　ｃｌｉｎｉｃａｌ　ｄｉａｇｎｏｓｉｓ．Ｍｅｔｈｏｄｓ　Ｆｒｏｍ　２０１２　Ａｐｒｉｌ　ｔｏ　２０１３　０ｃｔｏｂｅｒ　ｉｎ　Ｊｉｎｈｕａ　ｃｅｎｔｅｒ　ｈｏｓｐｉｔａ１．８　００７　ｐａｔｉｅｎｔｓ’ｓｅｒｕｍ　ｓａｍｐｌｅｓ　ｏｆ　ＥＮＡ　ａｎｄ　ＡＮＡ　ａｎｄ　ｄｓ—ＤＮＡ　ｗａｓ　ｄｅｔｅｃｔｅｄ　ｂｙ　ｉｎｄｉｒｅｃｔ　ｉｍｍｕｎｏｆｌｕｏｒｅｓｃｅｎｃｅ（ＩＩＦ）ａｎｄ　Ｗｅｓｔｅｒｎ　ｂｌｏｔｔｉｎｇ．Ｒｅｓｕｌｔｓ　Ｏｆ　ｔｌｌｅ　８　００７　ｓｐｅｃｉｍｅｎｓ，ｔｈｅ　ｐｏｓｉｔｉｖｅ　ｒａｔｅ　ｏｆ　ＡＮＡ　ｗａｓ　１７．５％，ｔｈｅ　ｐｏｓｉｔｉｖｅ　ｒａｔｅ　ｆｏｒ　ｆｅｍａｌｅ　ｐａｔｉｅｎｔｓ　ａｎｄ　ｍａｔｅ　ｐａｔｉｅｎｔｓ　ｗｅｒｅ　２０．５％ａｎｄ　９．１％．ａｎｄ　ｔｈｅ　ｄｉｆｅｒｅｎｃｅ　ｂｅｔｗｅｅｎ　ｔｌｌｅｍ　ｗａｓ　ｓｔａｔｉｓｔｉｃａｌｌｙ　ｓｉｇ—　ｎｉｆｉｅａｎｔ（Ｘ　＝１３７．３６，Ｐ＜０．０１）．ＡＮＡ　ｐｏｓｉｔｉｖｅ　ｐａｔｉｅｎｔｓ　ｉｎ　ｄｉｆｆｅｒｅｎｔ　ａｇｅ　ｇｒｏｕｐｓ　ｗａｓ　ｓｔａｔｉｓｔｉｃａｌｌｙ　ｓｉｇｎｉｆｉｃａｎｔ（≤２０　ｙｅａｒｓ　ｏｌｄ，　１４．７％；２１—４９　ｙｅａｒｓ　ｏｌｄ，１９．２％；Ｉ＞５０　ｙｅａｒｓ　ｏｌｄ，１８．Ｏ％，Ｘ２＝１８．４７，Ｐ＜０．０１）．ＡＩＤ　ｐａｔｉｅｎｔｓ　ｆｌｕｏｒｅｓｃｅｎｃｅ　ｍｏｄｅ　ａｎａｌｙｓｉｓ　

ｓｈｏｗｅｄ　ｔｈａｔ　ｔｈｅ　ｍａｊｏｒ　ｓｉｎｇｌｅ　ｆｌｕｏｒｅｓｃｅｎｃｅ　ｍｏｄｅ　ｗｅｒｅ　ｐａｒｔｉｃｌｅ　ｔｙｐｅ（３６．８％）ａｎｄ　ｈｏｍｏｇｅｎｏｕｓ　ｔｙｐｅ（２６．４％），ｔｈｅ　ｍａｊｏｒ　ｍｉｘｅｄ　ｆｌｕｏｒｅｓｃｅｎｃｅ　ｍｏｄｅ　ｗａｓ　ｐａｒｔｉｃｌｅ　ｔｙｐｅ　ａｎｄ　ｐｌａｓｍａ　ｃｅｌｌ　ｔｙｐｅ（５．８％）．ＡＮＡ　ｐｏｓｉｔｉｖｅ　ｐａｔｉｅｎｔｓ　ｗｅｒｅ　ｌ　４０４　ｅａｓｅｓ，８１５　ｃａｓｅｓ　ｗｅｒｅ　ｄｉ—　ａｇｎｏｓｅｄ　ｂｙ　ＡＩＤ．Ｃｏｎｃｌｕｓｉｏｎ　Ｔｈｅ　ｐｏｓｉｔｉｖｅ　ｒａｔｅ　ｏｆ　ＡＮＡ　ｉｎ　ｃｌｉｎｉｃａｌ　ｔｒｅａｔｍｅｎｔ　ｗａｓ　ｓｔａｔｉｓｔｉｃａｌｌｙ　ｓｉｇｎｉｆｉｃａｎｔ　ｉｎ　ｄｉｆｅｒｅｎｔ　ｇｅｎｄｅｒ　ａｎｄ　ａｇｅ　ｇｒｏｕｐｓ．Ｉｎ　ｐａｔｉｅｎｔｓ　ｗｉｔｈ　ｄｉｆｆｅｒｅｎｔ　ＡＩＤ．ｔｈｅｒｅ　ｗｉｌｌ　ｂｅ　ｓｐｅｃｉｆｉｃ　ｏｒ　ｒｅｌａｔｉｖｅｌｙ　ｓｐｅｃｉｆｉｃ　ａｕｔｏａｎｔｉｂｏｄｉｅｓ．　ｅ　ｃｏｍｂｉｎｅｄ　ｄｅｔｅｃｔｉｏｎ　ｏｆ　ＡＮＡ　ａｎｄ　ＥＮＡ　ａｎｔｉｂｏｄｙ　ｓｐｅｃｔｒｕｍ　ｉｓ　ｏｆ　ｇｒｅａｔ　ｓｉｇｎｉｆｉｃａｎｃｅ　ｉｎ　ｔｈｅ　ｄｉａｇｎｏｓｉｓ　ａｎｄ　ｄｉｆｅｒｅｎｔｉａｌ　ｄｉａｇｎｏｓｉｓ　ｏｆ　ＡＩＤ　ｐａｔｉｅｎｔｓ．　Ｋｅｙ　Ｗｏｒｄｓ：Ａｕｔｏａｎｔｉｂｏｄｉｅｓ；Ａｕｔｏｉｍｍｕｎｅ　ｄｉｓｅａｓｅｓ；Ｃｌｉｎｉｃａｌ　ｓｉｇｎｉｆｉｃａｎｃｅ　．　

自身免疫性疾病（ＡＩＤ）是由自身免疫应答引起　的疾病，机体内产生针对自身成分的自身抗体或自身　反应性Ｔ淋巴细胞，最终导致自身组织器官损伤或功　能障碍所致的疾病。每种自身免疫性疾病都伴有特　征性的自身抗体谱，及时、准确地检测出患者体内产　生的自身抗体，对疾病的早期诊断、治疗和预后判断　均具有十分重要的意义。间接免疫荧光法检测抗核　抗体（ａｎｔｉｎｕｃｌｅａｒ　ａｎｔｉｂｏｄｙ，ＡＮＡ）及其荧光模型，在自　身免疫性疾病的临床诊断与鉴别诊断中十分重要，　ＡＮＡ阳性者进一步检测各亚类ＡＮＡ抗体对明确诊　断、临床分型、病情观察、预后及治疗评价都具有重要　意义。针对特异性抗体检测的抗可溶性抗原（ＥＮＡ）　作者简介：赵硕（１９７６一），女，本科，副主任技师，主要从事自身免　疫检验的工作。　抗体谱是自身免疫性疾病实验诊断的确诊试验。本　文收集２０１２年４月一２０１３年４月在本院就诊的门诊　和住院患者的血清标本共８　００７份，对ＡＮＡ、ＥＮＡ和　ｄｓ—ＤＮＡ的检测结果进行回顾性分析，以了解自身抗　体在临床就诊患者中的阳性分布趋势，旨在找到具有　较高敏感性和特异性的实验诊断方法，提高ＡＩＤ早期　诊断、治疗和预后判断的准确性。　

１资料与方法　１．１　资料２０１２年４月一２０１３年４月在本院就诊　的疑似或待排除ＡＩＤ患者８　００７例，其中女性５　９５３　例（７４％），年龄为１岁～９３岁，平均年龄为４２岁；男　性２　０５４例（２６％），年龄为１岁一９０岁，平均年龄为　４３岁。ＡＮＡ检测阳性患者１　４０４例，年龄为１２岁～　８２岁，平均年龄为４０岁，其中女性１　２１８例，男性１８６　中国卫生检验杂志２０１５年８月第２５卷第１５期Ｃｈｉｎ　Ｊ　Ｈｅａｌｔｈ　Ｌａｂ　Ｔｅｅ，Ａｕｇ．２０１５，Ｖｏ１．２５，Ｎｏ．１５　例。临床诊断符合美国风湿病学会诊断标准的ＡＩＤ　患者８１５例，其中系统性红斑狼疮（ＳＬＥ）２０５例，类风　湿性关节炎（ＲＡ）２８３例，干燥综合征（ｓｓ）９８例，混合　性结缔组织病（ＭＣＴＯ）１０９例，系统性硬皮病（ＳＳｅ）３３　例，强直性脊柱炎（ＡＳ）４５例，多发性肌炎／皮肌炎　（ＰＭ／ＤＭ）４２例。此外，血小板减少性紫癫（ＩＴＰ）７３　例，呼吸系统疾病５６例，肾脏系统疾病８９例，其他疾　病３７１例。　１．２方法抽取待检者清晨空腹静脉血３　ｍｌ，离心　分离血清后进行检测。　１．２．１　ＡＮＡ检测采用德国欧蒙公司生产的试剂盒　（批号：Ｆ１１１２０１＂，＇Ｈ）通过间接免疫荧光法对ＡＮＡ进行　检测。每个反应区同时有２种抗原基质：猴肝组织和　Ｈｅｐ一２细胞。实验操作由经验丰富的检验师严格按照　产品说明书进行。样本滴度≥１：１００判断为阳性。　１．２．２　ＥＮＡ检测采用德国欧蒙公司生产的试剂盒　（批号：Ｄ１２０１１６ＡＩ）通过欧蒙印迹法对ＥＮＡ进行检　测。可检测针对以下ｌ５种抗原的抗体：ｎＲＮＰ／Ｓｍ、　Ｓｍ、ＳＳ—Ａ、Ｒｏ一５２　ＳＳ—Ｂ　Ｓｅｌ一７０、ＰＭ—Ｓｅｌ　Ｊｏ一１　着丝点蛋白Ｂ、ＰＣＮＡ、ｄｓ—ＤＮＡ、核小体、组蛋白、核糖　体Ｐ蛋白、ＡＭＡ—Ｍ２。实验操作由经验丰富的检验　师严格按照产品说明书进行，肉眼判断结果。　１．２．３　ｄｓ—ＤＮＡ检测采用德国欧蒙公司生产的试　剂盒（批号：Ｆ１　１　１０２０ＹＡ）通过间接免疫荧光法对ｄｓ—　ＤＮＡ进行检测。用绿蝇短膜虫作为抗原基质。血清　起始稀释度为１：１０，使用ＦＩＴＣ标记的抗人ＩｇＧ抗体　作为二抗。实验操作由经验丰富的检验师严格按照　产品说明书进行。样本滴度≥１：１０判断为ｄｓ—　ＤＮＡ检测阳性。　１．３统计学处理用ＳＰＳＳ　１３．０软件进行统计学处　理。组问比较用　检验，以Ｐ＜０．０５为差异有统计　学意义。　

２结果　２．１　８　００７例患者ＡＮＡ总体阳性率及在不同年龄组　中的比较在８　００７例患者中，ＡＮＡ阳性者１　４０４例，　阳性率为１７．５％（１　４０４／８　Ｏ０７）。男性ＡＮＡ阳性者　１８６例，阳性率为９．１％（１８６／２　０５４）；女性ＡＮＡ阳性　者１　２１８例，阳性率为２０．５％（１　２１８／５　９５３）。２组比　较差异有统计学意义（　＝１３７．３６，Ｐ＜０．Ｏ１）。在　１　４０４例ＡＮＡ阳性患者中，２１岁一４９岁组的阳性率最　高，为１９．２％，≤２０岁组阳性率为１４．７％，Ｉ＞５０岁组　为１８．０％，３个年龄组ＡＮＡ阳性率差异具有统计学　意义（　＝１８．４７，Ｐ＜０．Ｏ１）（表１）。　

表１　１　４０４例ＡＮＡ阳性患者在不同年龄组中的阳性率比较（％）　

２．２　８１５例ＡＩＤ患者血清中自身抗体检测结果比较　抗ｄｓ—ＤＮＡ、ｎＲＮＰ／Ｓｍ、Ｓｍ、ＳＳＡ、ＳＳＢ、Ｓｃ］一７０、Ｊｏ一１、　ＡＨＡ、ＡｎｕＡ、ＡＲＰＡ抗体在各疾病中的阳性率比较，差　异有统计学意义（Ｐ＜０．Ｏ１）（表２）。抗Ｕ１一ＲＮＰ抗　体在ＭＣＴＤ中阳性率最高，达５７．８％，但在其他疾病　如ＳＬＥ、ＲＡ、ＳＳｃ等中也有不同程度的阳性。ＳＳ病人　的抗ＳＳＡ抗体阳性率为７９．６％，与其他疾病差异有　统计学意义（Ｐ＜０．Ｏ１）。抗ＳＳＢ抗体阳性率高达　