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Cytomegalovirus (CMV) infection is currently prevalent in populations throughout the world, and 56%-94% of the global population is seropositive for CMV. CMV infection mainly affects immunocompromised hosts. In these cases, it can cause significant symptoms, tissue-invasive disease, and many sequelae including death (Dioverti and Razonable, 2016). The vast majority of healthy adults with CMV infection experience an asymptomatic course; when symptomatic, it manifests as a mononucleosis-like syndrome in approximately 10% of patients (Sridhar et al., 2018). The gastrointestinal tract and central nervous system appear to be the most frequent sites of severe CMV infection in immunocompetent individuals (Rafailidis et al., 2008). However, CMV infection is relatively rarely recorded in immunocompetent hosts.
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Adult , Humans , Lymphohistiocytosis, Hemophagocytic/complications , Cytomegalovirus Infections/diagnosis , Gastrointestinal Tract , Disease ProgressionABSTRACT
Both immunosuppressants and antibiotics (ABX) are indispensable for transplant patients. However, the former increases the risk of new-onset diabetes, whereas the latter impacts intestinal microbiota (IM). It is still unclear whether and how the interaction between immunosuppressants and ABX alters the IM and thus leads to glucose metabolism disorders. This study examined the alterations of glucose and lipid metabolism and IM in mice exposed to tacrolimus (TAC) with or without ABX. We found that ABX further aggravated TAC-induced glucose tolerance and increased insulin secretion. Combined treatment resulted in exacerbated lipid accumulation in the liver. TAC-altered microbial community was further amplified by ABX administration, as characterized by reductions in phylum Firmicutes, family Lachnospiraceae, and genus Coprococcus. Analyses based on the metagenomic profiles revealed that ABX augmented the effect of TAC on microbial metabolic function mostly related to lipid metabolism. The altered components of gut microbiome and predicted microbial functional profiles showed significant correlation with hepatic lipid accumulation and glucose disorders. In conclusion, ABX aggravated the effect of TAC on the microbiome and its metabolic capacities, which might contribute to hepatic lipid accumulation and glucose disorders. These findings suggest that the ABX-altered microbiome can amplify the diabetogenic effect of TAC and could be a novel therapeutic target for patients.
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Objective To explore the effect of Lee Silverman voice treatment on the speech and life quality of Parkinson's disease patients.Methods A total of 98 patients with Parkinson's disease anddifferent degrees of speech disorder (Hoehn-Yahr clinical stages 1 to 3) were randomly divided into an intervention group and a control group,each of 49,according to a random number table.The control group was given routine speech therapy covering tongue and lip movement,rhythm,sound,volume,speed and respiratory control.The intervention group was provided with 12 weeks of Lee Silverman voice treatment aimed at abnormal voice and emphasizing pronunciation,4 times a week and 1 hour each time.During the treatment,all patients were required to practice once at home on treatment days and twice on days without treatment.The voice handicap index (VHI),the western aphasia battery (WAB),the speech function portion of UPDRS-Ⅲ and the speech articulation assesstnent were used to evaluate the 2 groups before and after the 12 weeks ofintervention.Results Beforethe intervention there was no significant differencebetween the two groups in any of the measurements.After the interventionsignificant improvement was ohserved in all of these indicesin bothgroups.After treatment the average total VHI score of the intervention group (60.39±9.84) had improved significantly more than that of the control group,as did the WAB score for spontaneous speech (14.64±1.98),listening comprehension (112.67± 19.43),repeating (65.31±7.98),Name (39.89±9.84) and the average AQ scores (69.19±10.78) and UPDRS-scores [(1.39±0.61)] [of the intervention group than the control group [(71.03±11.01),(13.67±1.06),(111.53±29.61),(63.75±7.41),(37.89± 9.29),(62.14±10.21) and (1.82±0.82)].After the intervention,the average speech articulation scores of the intervention and control group were (77.61± 11.72) and (59.67± 10.04),significantly higher than those before the intervention [(54.36±10.71) and (53.98±9.92)],with the improveinent of the intervention group significantly higher than the control group.Conclusion Lee Silverman voice treatment can effectively improve the speech and life quality of patients with Parkinson's disease.
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Objective To discuss the ability of nursing major undergraduate students in disaster response in order to construct undergraduate's disaster response ability evaluation system.Methods Delphi method was used to draw the evaluation system framework on the basis of consulting literature material and analyzing theories.35 related experts attended it.The choice was evaluated according to the 5 classification Likert evaluation method.Results Consensus was reached after two rounds inst.Questionnaire recovery rate was 100％.Construct undergraduate's disaster response ability evaluation system with 3 first-level indexes,12 second-level indexes,37 third-level indexes.Conclusions The undergraduate's disaster response ability evaluation system based on Delphi experts method is reliable.It can provide reference for the nursing major undergraduate student's disaster response training and research.
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Objective To investigate JC virus(JCV) infection in kidney transplant recipients and its influence on graft function and also initially explore JCV infection factors. Methods A total of 49 kidney transplant recipients and 24 health examination persons were enrolled in our study, JCV DNA was measured using nested qualitative polymerase chain reaction assays of urine, while CMV DNA was measured by common qualitative polymerase chain reaction assays of urine. JCV infection factors, such as age, male, immunosuppressive therapy, cytomegalovirus(CMV) infection were analyzed by Binary Logistic Regression, and glomerular filtration rate(GFR) was selected as a index of kidney function and the difference of GFR between JCV-infected and non-infected patients was compared using t test. Results JCV was detected in 42.9% of kidney transplant patients and 4.2% health examination persons. CMV infection and Pred + MMF + CsA triple immunosuppressive regimen were found to be the risk factors of JCV infection. No difference of GFR was observed between JCV infected and non-infected patients (86.470 ± 29.990 and 84.060 ± 33. 729 for each; t =0. 259, P =0.797). Conclusion JCV is frequently detected in kidney transplant recipients. CMV infection and using of Pred + MMF + CsA triple immunosuppressive regimen can significantly increase the risk of JCV infection. While, graft function was not influenced by JCV infection in kidney transplant patients.
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Objective To study the correlation of HBV infection pretransplantation and posttrans-plantation and HCMV recurrence after liver transplantation (LT). Methods We reviewed historical patient medical records of LT patients in recent two years in our hospital. All the patients were divided into HBV in-fection group and a control group based on a peripheral blood HB antigen assay before LT. The HBV infec-tion group was divided into HBV reactive infection group and HBV non-relapse group. HCMV antigen pp~65 was detected by immunohistochemical methods. HB antigens and antibodies were detected by time-resolved fluorescence immunoassay, and liver enzyme levels were detected by conventional methods. Results Com-paring two groups of patients, pp65-positive rates of LT patients with HBV infection and control group pa-tients were 84.3% and 57.9% respectively (P=0.024). While in HBV recurrence infection group and non-recurrence infection group, the incidences of HCMV recurrence were 90.9% and 83.3% (P=0.843). The changes in the liver transaminases level in both groups have no statistical significance (P>0.05). Conclusion Pretransplantation HBV infection may increase the incidence of HCMV recurrence. Posttrans-plantation HBV reactive infection, however, may not increase the incidence of HCMV reactive infection. Meanwhile, compare with either HBV infection or HCMV infection alone, co-infection may not serious in liv-er enzymes levels.
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A model of acute lung injury was reproduced by intravenous injection of endotoxin (700?g / kg) to rabbits. It had been found that the rabbits were in the state of shock, with leukopenia and thrombocytopenia, increased 6 -keto-PGF1? and TXB2, decreased serum ACE and increased permeability of the pulmonary capillaries. Granulocyte sequestration and disturbance in pulmonary microcirculation were found in lungs. A series of changes in epithelial and endothelial cells were also found in both lungs. It was obviously proved that PGE1 had some therapeutic effects in acute lung injury induced by E. coli endotoxin.