A family clustering of coronavirus disease 2019 caused by asymptomatic infection / 上海预防医学

Objective:To analyze a family clustering of coronavirus disease 2019 （COVID-19） associated with the exposure to an asymptomatic case， and to provide evidences of developing strategies for COVID-19 prevention. Methods:Epidemiological investigation was conducted on a COVID-19 family cluster （1 confirmed case and 2 asymptomatic cases）. The specimens of the cases were tested for 2019 novel coronavirus nucleic acid with real-time fluorescence quantitative polymerase chain reaction. Results:The clustering epidemic occurred in a family. Two asymptomatic cases B and C （B’s son） had Wuhan residential history. After arrival in Beijing on January 24， 2020， B stayed in his mother's house. One family member A （B’s mother） developed the disease on February 7， 2020， while the other two family members D and E （B’s wife and brother） did not develop the disease， and they were managed as close contacts. Conclusion:Thisfamily COVID-19 clustering is induced by the exposure to an asymptomatic case. Identification of asymptomatic cases is very important for the control of COVID-19 epidemic.

Comparison of three measurements of lower extremity length during total hip arthroplasthy / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the accuracy of three measurements of lower extremity length during total hip arthroplasty(THA),and explore the causes that influence the accuracy.</p><p><b>METHODS</b>From January 2010 to January 2013,145 patients underwent THA were retrospectively analyzed. There were 66 males and 79 females,ranging in age from 48 to 89 years with an average of 66.7 years. Their lower extremities were measured by three methods during operation,among them,31 cases with reference method of contralaterallegs (A method) ,63 cases with measurement method of Kirschner wire location (B method), and other 51 cases with measurement method of anatomical landmark (C method). The accuracy of the three measurements and the incidence rate of length inequality of lower extremity were analyzed.</p><p><b>RESULTS</b>All patients were followed up,there was no significant differences in the operation time and the intraoperative blood loss among three groups. The difference of lower extremity length with A,B,C method were respectively (8.7+/-5.7),(3.1+/-2.6), (5.6+/-5.3) mm after operation; there were significant difference between any two groups. The accuracy of three methods from high to low were respectively B,C,A method. The incidence rate of length inequality of lower extremity with A, B, C method were respectively 32.3%, 1.6%, 11.8%, the incidence rate with A method was higher than that other two methods ; and there was no significant difference between B method and C method.</p><p><b>CONCLUSION</b>The measurement method of Kirschner wire location has the best accuracy in the three methods and the measurement method of anatomical landmark is the second. The measurement method of Kirschner wire location is recommended in all THA except for the patients with femoral neck fracture. And the measurement method of anatomical landmark can be used in the patients with femoral neck fracture.</p>

A multicenter study of the effectiveness of interferon alpha-1b (Hapgen) in treating HBeAg positive chronic hepatitis B patients / 中华肝脏病杂志

To compare the efficacy and safety of interferon a-1b and interferon a-1b combined with lamivudine in the treatment of HBeAg positive chronic hepatitis B (CHB), to analyze the impact of variable factors on the efficacy, and to investigate the individualized anti-viral regimen for CHB patients. 111 CHB patients were enrolled and randomly divided into two groups. Group A: patients received interferon a-1b (49 patients, 50mug I. M. , qod. ) , Group B: interferon a-1b (idem) combined with lamivudine for 6-12 months or longer(62 patients, 100 mg, P.O. , q.d. ). (1) The HBeAg seroconversion rates of treatment by 12 and 18 months were 28.6% and 36.7% in group A, 29.0% and 38.7% in group B, respectively, no significant difference found between the two groups at the end of treatment (x2=0.003, P value is more than 0.05; x2=1.500, P value is more than 0.05). (2) The HBV DNA undetectable rates of treatment by 6 months, 12 months and 18 months were 8.2%, 53.1% and 57.1% in group A, 66.1%, 83.9% and 88.7% in group B, respectively, still no significant difference existed between the two groups (x2=38.150, P value is less than 0.05; x2=12.073, P value is less than 0.05, x2=14.459, P value is less than 0.05). (3) In group A, the HBeAg seroconversion rates for male and female patients were 34.5% and 40.0% respectively, no significant difference found between. As regard ages the rates were 34.9% and 50.0% for patients younger or more than 40 years of age, no significant difference existed between. The HBeAg seroconversion rate was higher in patients with lower baseline serum HBV DNA loads ( less than 6 log10 copies/ml) . (4) The rates of patients with fever and blood abnormality were 36.7% and 34.7% in group A, 32.3% and 27.4% in group B, respectively. The total incidences of adverse events were similar between group A and B (x2=0.244, P value is more than 0.05; x2=0.682, P value is more than 0.05). (5) The ratio of drug resistance in group B was only 1.6%. The adverse events of interferon a-1b treatment for CHB are low and mild. The HBeAg seroconversion rate persistently raises with the extension of interferon a-1b treatment course. The HBV DNA undetectable rate of interferon a-1b combined with lamivudine is significantly higher than that of interferon a-1b and the drug resistance of lamivudine can be reduced obviously by combination therapy.

Determination of Ephedrine Hydrochloride in Zhike Pingchuan Tangjiang by HPLC / 中国中医药信息杂志

Objective To establish the method for detemining the content of ephedrine hydrochloride in Zhike Pingchuan Tangjiang by HPLC. Methods Diamonsil ODS1 C_(18) Column was used with acetonitrile -0.1% phosphoric solution (with 0.1% triehylamine) (3 : 97) as the mobile phase, the detection wavelength as 205 nm, and flow rate was 1.0 mL/min. Results The calibration curve was linear at the range of 0.12～ 0.96 ?g for ephedrine hydrochloride and linear equation was Y= 109759X+3792.8, r=0.9998. The average recovery was 98.4% and RSD was 0.87% (n =5). Conclusion This method was simple, accurate and proper, with good reproducibility. It can be used for quantitative analysis of ephedrine hydrochloride in Zhike Pingchuan Tangjiang.

Study on association between vitamin D receptor gene polymorphisms and the outcomes of HBV infection / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore whether the vitamin D receptor gene (VDR) polymorphisms are associated with the outcomes of hepatitis B virus (HBV) infection in Chinese Han population.</p><p><b>METHODS</b>Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphisms of Fok I locus in exon 2 and Taq I locus in exon 9 of VDR gene. One hundred and eighty-four chronic hepatitis B patients and 205 asymptomatic HBV carriers were recruited to make the comparison of frequencies of genotype and haplotype of the VDR gene between the patients and the carriers.</p><p><b>RESULTS</b>The univariate analysis showed a significant difference in Fok I polymorphism between chronic hepatitis B patients group and asymptomatic HBV carriers group. The FF genotype frequency in chronic hepatitis B patients group was 44.6%,higher than 31.7% in asymptomatic HBV carriers group (P<0.05). After adjusting the confounders by multiple logistic regression analysis, the result still showed a significant difference in Fok I site polymorphism between chronic hepatitis B patients group and asymptomatic HBV carriers group (OR=1.95, P<0.05). The FT haplotype frequency in chronic hepatitis B patients group was higher than that in asymptomatic HBV carriers group (OR=1.45, P<0.05). The fT haplotype frequency in chronic hepatitis B patients group was lower than that in asymptomatic HBV carriers group (OR=0.72, P<0.05).</p><p><b>CONCLUSION</b>VDR gene polymorphism may be an influence factor of genetic susceptibility to HBV infection.</p>

Relationship between polymorphisms of vitamin D receptor gene and familial aggregation of HBsAg carriers / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine whether -Taq I T/C and -Fok I C/T polymorphisms of vitamin D receptor (VDR) gene are associated with the familial aggregation of hepatitis B virus (HBV) infection.</p><p><b>METHODS</b>Based on a population-based case-control family design, 288 family members from 27 case families and 230 family members from 27 control families were recruited. VDR gene polymorphisms were analyzed. VDR-Taq I T/C and VDR-Fok I C/T polymorphisms were examined by polymerase chain reaction-restriction fragment length polymorphism.</p><p><b>RESULTS</b>The frequency of VDR-Taq I TT genotype in the case families was significantly higher than that in the control families (P < 0.05) , however, the frequency of VDR-Fok I CC genotype in the case families was significantly higher than that in the control families (P < 0.05). The frequency of family members carriying Taq I T-Fok I C haplotype in the case families was significantly higher than that in the control families (OR = 1.67, P < 0.05), however, the frequency of family members carrying Taq I C-Fok I T haplotype in the case families was significantly lower than that in the control families (OR = 0. 24, P < 0.05). The similar results were found in the familial biological kinship relatives with any HBV-infected makers.</p><p><b>CONCLUSION</b>VDR-Taq I and -Fok I gene polymorphisms are likely to play a substantial role in HBsAg familial aggregation.</p>

Association of TNFA polymorphisms with the outcomes of HBV infection / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore whether the TNFA promoter single nucleotide polymorphisms (SNPs) are associated with the outcomes of hepatitis B virus(HBV) infection in Chinese Han population.</p><p><b>METHODS</b>One hundred and forty-eight self-limited HBV infection subjects and 207 chronic hepatitis B patients were recruited. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequence specific primer-PCR(PCR-SSP) were used to detect the SNPs of five sites in TNFA promoter (-238G/A, -308G/A, -857C/T, -863C/A, -1031T/C). The frequency distributions of genotypes and haplotypes in different groups were analyzed by EPI and EH programs.</p><p><b>RESULTS</b>The frequencies of -238GG genotype in chronic hepatitis B patients were significantly higher than that in self-limited infection subjects (P=0.02). The frequencies of -857TT genotype in chronic hepatitis B patients were clearly lower than that in self-limited infection subjects (P=0.02). Haplotypic frequencies of GGCCT (-238/-308/-857/-863/-1031) in chronic hepatitis B patients was significantly lower than that in self-limited infection subjects (P=0.03), and the frequencies of haplotype GGCAT or GGTAT in chronic hepatitis B patients were clearly higher than those in self-limited infection subjects (P=0.0001; P=0.004).</p><p><b>CONCLUSION</b>TNFA promoter polymorphisms are important host genetic factors affecting the outcomes of HBV infection.</p>

Liver histological changes after lamivudine treating in chronic hepatitis B patients with HBeAg positive / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the histological changes in liver biopsy tissues taken from chronic hepatitis B patients with HBsAg and HBeAg positive and ALT abnormal after lamivudine therapy for one year.</p><p><b>METHODS</b>Lamivudine was given orally at the dose of 100 mg once a day for one year. 101 patients were enrolled into this open-label study. Paired liver biopsies from patients with hepatitis B before and after therapy with lamivudine were studied. Blinded biopsies were evaluated by a histopathologist and scored according to Knodell's histology activity index(HAI).</p><p><b>RESULTS</b>53.5% (54/101), 51.5% (52/101) and 31.7% (32/101) patients had a reduction of their total hepatic HAI score, necroinflammation and fibrosis scores by >or=2 points or 1 points at the end of one year of lamivudine therapy, compared with their pretreatment values, respectively. There were significant reduction of HAI score, necroinflammation and fibrosis scores from 8.0+/-4.7 to 5.2+/-3.3 (t=7.358, P<0.01), from 5.9+/-3.8 to 3.6+/-2.5 (t=7.298, P<0.01), and from 2.1+/-1.2 to 1.6+/-1.2 (t=3.827, P<0.01), respectively. The histological improvement was independent on the HBeAg seroconvertion during the therapy.</p><p><b>CONCLUSION</b>Significant improvement in liver histology, both necroinflammation and fibrosis, can be obtained in the majority of patients treated with lamivudine for one year.</p>