Study on the related factors of antiviral treatment in previously reported hepatitis C patients based on the Andersen model / 中华肝脏病杂志

Objective: To understand the basic characteristics of previously reported patients with hepatitis C and analyze the related factors affecting their antiviral treatment. Methods: A convenient sampling method was adopted. Patients who had been previously diagnosed with hepatitis C in the Wenshan Prefecture of Yunnan Province and Xuzhou City of Jiangsu Province were contacted by telephone for an interview study. The Andersen health service utilization behavior model and related literature were used to design the research framework for antiviral treatment in previously reported hepatitis C patients. A step-by-step multivariate regression analysis was used in previously reported hepatitis C patients treated with antiviral therapy. Results: A total of 483 hepatitis C patients, aged 51.73 ± 12.06 years, were investigated. The proportion of male, agricultural occupants who were registered permanent residents, farmers and migrant workers was 65.24%, 67.49%, and 58.18%, respectively. Han ethnicity (70.81%), married (77.02%), and junior high school and below educational level (82.61%) were the main ones. Multivariate logistic regression analysis results showed that married patients with hepatitis C (OR = 3.19, 95% CI: 1.93-5.25, compared with unmarried, divorced, and widowed patients) with high school education or above (OR = 2.54, 95% CI: 1.54-4.20, compared with patients with junior high school education or below) were more likely to receive antiviral treatment in the predisposition module. Patients with severe self-perceived hepatitis C in the need factor module (compared with patients with mild self-perceived disease, OR = 3.36, 95% CI: 2.09-5.40) were more likely to receive treatment. In the competency module, the family's per capita monthly income was more than 1,000 yuan (compared with patients with per capita monthly income below 1,000 yuan, OR = 1.59, 95% CI: 1.02-2.47), and the patients had a high level of awareness of hepatitis C knowledge (compared with patients with a low level of knowledge, OR = 1.54, 95% CI: 1.01-2.35), and the family members who knew the patient's infection status (compared with patients with an unknown infection status, OR = 4.59, 95% CI: 2.24-9.39) were more likely to receive antiviral treatment. Conclusion: Different income, educational, and marital statuses are related to antiviral treatment behavior in hepatitis C patients. Family support of hepatitis C patients receiving hepatitis C-related knowledge and their families knowing the infection status is more important in promoting the antiviral treatment of patients, suggesting that in the future, we should further strengthen the hepatitis C knowledge of hepatitis C patients, especially the family support of hepatitis C patients' families in treatment.

Neutralizing Antibody Responses against Five SARS-CoV-2 Variants and T Lymphocyte Change after Vaccine Breakthrough Infections from the SARS-CoV-2 Omicron BA.1 Variant in Tianjin, China: A Prospective Study / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate whether Omicron BA.1 breakthrough infection after receiving the SARS-CoV-2 vaccine could create a strong immunity barrier.@*METHODS@#Blood samples were collected at two different time points from 124 Omicron BA.1 breakthrough infected patients and 124 controls matched for age, gender, and vaccination profile. Live virus-neutralizing antibodies against five SARS-CoV-2 variants, including WT, Gamma, Beta, Delta, and Omicron BA.1, and T-lymphocyte lymphocyte counts in both groups were measured and statistically analyzed.@*RESULTS@#The neutralizing antibody titers against five different variants of SARS-CoV-2 were significantly increased in the vaccinated population infected with the Omicron BA.1 variant at 3 months after infection, but mainly increased the antibody level against the WT strain, and the antibody against the Omicron strain was the lowest. The neutralizing antibody level decreased rapidly 6 months after infection. The T-lymphocyte cell counts of patients with mild and moderate disease recovered at 3 months and completely returned to the normal state at 6 months.@*CONCLUSION@#Omicron BA.1 breakthrough infection mainly evoked humoral immune memory in the original strain after vaccination and hardly produced neutralizing antibodies specific to Omicron BA.1. Neutralizing antibodies against the different strains declined rapidly and showed features similar to those of influenza. Thus, T-lymphocytes may play an important role in recovery.

Prevalence of HCV Antibody and its Associated Factors: A Study from Sentinel Hospitals in China / 生物医学与环境科学（英文）

OBJECTIVE@#The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies.@*METHODS@#Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations.@*RESULTS@#HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%-6.93%. Patients who were admitted to the liver disease-related departments (a OR = 10.76; 95% CI, 10.27-11.28), Internal Medicine (a OR = 2.87; 95% CI, 2.75-3.00), and Department of Surgery (a OR = 1.95; 95% CI, 1.87-2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older (a OR = 2.74; 95% CI, 2.69-2.80), testing in infetious disease hospitals (a OR = 2.33; 95% CI, 2.26-2.40) and secondary hospitals (a OR = 1.72; 95% CI, 1.69-1.75). Patients in sentinel hospitals of the Northeast (a OR = 12.75; 95% CI, 12.40-13.11), the Central (a OR = 1.65; 95% CI, 1.61-1.70), and the West (a OR = 1.78; 95% CI, 1.73-1.83) China had higher HCV prevalence than those who were in the Eastern coastal area.@*CONCLUSION@#Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.

Clinical and Angiographic Characteristics Derived From Coronary Artery Computed Tomography in Patients With Ankylosing Spondylitis / 中国循环杂志

Objectives:To observe the clinical and coronary artery computed tomography(CT) characteristics of patients with ankylosing spondylitis. Methods:Data from 33 consecutive patients with ankylosing spondylitis admitted due to chest discomfort in Fuwai Hospital from January 2014 to June 2017 were analyzed, 33 age and sex matched patients with no ankylosing spondylitis were selected as the control group. Coronary artery CT features was compared between the two groups. Results:Incidence of hypertension, smoking, diabetes and hyperlipidemia, BMI values were similar between the two groups. Blood lipid level (high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and, total cholesterol), creatinine and uric acid values were also similar between the two groups. Erythrocyte sedimentation rate (ESR) ([14.15±12.81]m/s vs [7.79±6.26]m/s, P=0.013) and high C-reactive protein (hs-CRP) ([6.88±5.65]ng/L vs [3.16±3.13]ng/L, P=0.002) values were significantly higher in ankylosing spondylitis group than in the control group. Percent of coronary artery stenosis (＞50%) was significantly higher in ankylosing spondylitis group than in the control group (23[69.7%] vs 14[42.4%], P=0.026). Coronary artery calcification was significantly higher in ankylosing spondylitis group than in the control group (22 [66.7%] vs 9[27.3%], P=0.001). Conclusions:Degree of coronary artery stenosis and calcification as well as inflammatory index (ESR and hs-CRP) are significantly higher in ankylosing spondylitis patients compared to control patients.

Risk factors of long term mortality in elderly patients age over 75 years old with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To investigate the risk factors of short-term and long-term mortality in elderly patients with ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PPCI).Methods From Sept. 2011 to Jan. 2014, there were 27397 PCI cases performedin the Fuwai Hospital. 108 consecutive patients(0.39％) who aged over 75 diagnosed as acute myocardial infarction and underwent PCI were enrolled into this study. Cox proportional hazards model was used to analysis the risk factors of mortality during follow up.Results In the study population, 5 patients (4.63％) died during in-hospital stay, 7 patients(6.5％) died within 30 days after PPCI and 17 patients (15.7％)died during follow up[averaged follow up duration was (51.17±17.75) months] . Independent risk factors of 1-year mortality included female(HR 5.482, 95％CI1.099-27.333,P=0.038) and cardiac shock(HR 11.283, 95％CI 2.841-44.805,P=0.001). Stent implantation was found to be a protective factor(HR 0.173, 95％CI 0.032-0.943,P=0.043). Independent risk factors of long-term mortality included age(HR 1.146,95％CI 1.010-1.300,P=0.034)and cardiac shock(HR 4.928, 95％ CI1.718-14.130, P=0.003).Conclusions Old age, female, low LVEF, cardic shock and not having stent implantation were independent risk factors for mortality in elderly STEMI patients(≥75 years) who underwent primary PCI.

Short-term prognosis and risk factors of ventricular septal rupture following acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the short-term prognosis and risk factors of ventricular septal rupture (VSR) following acute myocardial infarction (AMI).</p><p><b>METHODS</b>A total of 70 consecutive VSR patients following AMI hospitalized in our hospital from January 2002 to October 2010 were enrolled in this study. We compared the clinical characteristics of patients with VSR who survived ≤ 30 days (n = 39) and survived > 30 days (n = 31) post AMI. A short-term prognosis index of VSR (SPIV) was established based on the logistic regression analysis.</p><p><b>RESULTS</b>The single factor analysis showed that the risk factors of death within 30 days of VSR patients were female, anterior AMI, Killip class 3 or 4, apical VSR and non-aneurysm (all P < 0.05). Logistic regression analysis revealed that female (P = 0.013), anterior AMI (P = 0.023), non-aneurysm (P = 0.023), non-diabetes (P = 0.009), Killip class 3 or 4 (P = 0.022) and time from AMI to VSR less than 4 days (P = 0.027) were independent risk determinants for death within 30 days post VSR. Patients with SPIV ≥ 9 were associated with high risk [77.4% (24/31)] of dying within 30 days post AMI. SPIV ≤ 8 were associated with low risk as the 30 days mortality is 28.6% (8/28).</p><p><b>CONCLUSION</b>Female gender, anterior AMI, non-aneurysm, non-diabetes, Killip class 3 or 4 and time from AMI to VSR less than 4 days are independent risk factors of short-term mortality of VSR.</p>

Clinical features of unexpected sudden death clustered in 7 families in Yunnan Province / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.</p><p><b>METHODS</b>This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.</p><p><b>RESULTS</b>All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/GPT, CK/CKMB, LDH/LDH1 etc.). In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor. There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.</p><p><b>CONCLUSION</b>The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear. Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases. Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.</p>

Electrocardiogram analysis in high risk population of unexplained sudden death in Yunnan province / 中华心血管病杂志

<p><b>OBJECTIVE</b>The purpose of this study was to analyze the electrocardiographic features of the people living in the area with high incidence of unexplained sudden deaths in Yunnan province.</p><p><b>METHOD</b>The electrocardiograms of 338 residents from three villages (Dayao, Ninglang, Heqing) with high incidence of unexplained sudden deaths and one control village (Dali) were analyzed [averaged age was (33.4 +/- 11.7) years, 175 men and 163 women].</p><p><b>RESULTS</b>The incidence of cardiac arrhythmias was similar low in all groups. The left ventricular hypertrophy was observed in 34.6% of residents from Dayao. QTc significantly prolonged in the residents from all 3 high incidence areas compare the control area of Dali [control (386.8 +/- 27.22) ms, Ninglang (428.92 +/- 25.71) ms, Heqing (440.67 +/- 28.03) ms, Dayao (417.7 +/- 24.00) ms, P < 0.05 vs. control]. Incidence of U wave was significantly higher in Heqing village than that in control village (P < 0.05). The QUc of these 3 villages was: (613.67 +/- 37.34) ms, (597.19 +/- 46.47) ms, (608.59 +/- 39.59) ms respectively, and also significantly longer than the control village of Dali (589.33 +/- 41.27) ms (P < 0.05). The typical pattern of U wave presents as enlarged U wave and apparent T-U complex. In the 7 residents who have the family history of unexplained sudden death, 6 residents have U wave, and 4 of them present typical U wave pattern.</p><p><b>CONCLUSION</b>The significant ECG changes in villages with high incidence of unexplained sudden death in Yunnan province were prolonged QTc, enlarged U wave and apparent T-U complex and these ECG features suggested the repolarization abnormalities of the heart in these subjects.</p>

Retrospective study on 116 unexpected sudden cardiac deaths in Yunnan, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify the epidemiological and clinical features of unexpected sudden cardiac deaths (SUD) in Yunnan.</p><p><b>METHODS</b>Choosing the old SUD cases from Xiangyun, Heqing, Nanjian and Dayao counties and using the standardized verbal autopsy Form, we interviewed the family members of the cases, witnesses and doctors as well as reviewing their medical files to get relative information.</p><p><b>RESULTS</b>We identified 116 SUDs in 21 villages from 1984 to 2004. The village-specific annually standardized incidence rates were ranged from 0.2/1000 to 8.9/1000 (median = 0.8/1000). 66% and 29% of the SUDs occurred in July and August respectively. The incidence rates of SUD were higher (1.6/1000, chi(2) = 16, P < 0.01) in 10 - 39 year-olds, and higher in females than in males (RR = 1.6, 95% CI: 1.1 - 2.3). Seventy percent of SUD occurred in families having clustering nature and 60% of the additional cases in the family were occurred within 24 hours (median = 20 hours) after the first SUD identified in the family. SUD occurred in 23 families followed the first affected family in a village during the same season. In these 23 families, 61% of the first SUD occurred within 8 days after the first SUD in the first affected family. 68% and 66% of the SUDs did not have any complaints or signs during the last 3 weeks or from 3 weeks to 2 days prior to the onset of the disease. 63% of the SUDs had cardiac symptoms within the last 2 days prior to the onset with major symptoms as dizziness, nausea, faintness, unconsciousness, weakness and palpitation. The median duration from acute onset to death was 2 hours.</p><p><b>CONCLUSIONS</b>The extreme time-space clustering of SUD in families and in villages suggested that the risk factors occurred in specific time and location. Familial clustered SUD cases had common exposure pattern. Sudden onset of acute cardiac symptoms often followed by sudden death. Epidemiological study on new cases was necessary to identify risk factors and to develop hypothesis for causation. In July 2005, we instituted a special SUD surveillance system for all the affected counties together with 10 counties which had no reported cases.</p>