Cytokines Expression in Pregnant Women With Primary and Non-primary Cytomegalovirus (CMV) Infection

@#Introduction: Cytomegalovirus (CMV) infection in pregnancy is the commonest cause of congenital infection worldwide. Primary CMV infection in pregnancy carries a higher risk of fetal transmission compared to non-primary infection. This study aims to determine the cytokines expression in pregnant women with primary and non-primary CMV infections in both types of infection. Methods: This prospective cohort study was conducted at Microbiology Laboratory, Universiti Sains Malaysia (USM) from January 2019 until June 2020. Seventy-four pregnant women with abnormal pregnancy outcomes with positive CMV IgG with or without IgM by electrochemiluminescence assay (ECLIA) were subjected to IgG avidity assay by ECLIA method to discriminate primary and non-primary CMV infection. Later, the sera were subjected to magnetic Luminex multiplex enzyme-linked immunosorbent assay for cytokine analysis to determine their concentrations in both primary and non-primary CMV infection. Cytokines and chemokines tested were IL-12, IL-2, IFN- γ, TNF-α, IL-1β, IL-6, IL-10, IFN- γ, TNF-α, MCP-1 (CCL-2), and IP-10 (CXCL-10). Results: Concentrations of IL-1β, IL-6, and MCP-1 (CCL-2) were significantly elevated in pregnant women with primary CMV infection with the p-values of (0.001, 0.035, and 0.002) respectively. The intensity of IFN-γ, IL-12, and IL-2 were higher in primary CMV infection with the p-values of (0.018, 0.004, and 0.007). Conclusion: The pro-inflammatory cytokines were expressed significantly in pregnant women with primary CMV infection together with MCP-1 (CCL2), showing predominant Th1 response. The low level of cytokines in non-primary CMV infection might be due to the latent state of CMV in a host.

Comparative study of fungal culture and in vivo confocal microscopy in the diagnosis of non-primary fungal keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare fungal culture and in vivo confocal microscopy ( IVCM ) in the diagnosis of non- primary fungal keratitis.?METHODS:The clinical data of 31 cases (31 eyes) with non- primary fungaI keratitis from September 2016 to February 2017 in our HospitaI were retrospectiveIy reviewed. The positive rate of the two methods was compared by chi-square test.?RESULTS: The positive rate by fungal culture was 58％(18/31 ) and IVCM was 19％ ( 6/31 ); the positive rate comparison difference was statistically significant between fungal culture and IVCM (x2=7. 56,P<0. 01). In the 13 eyes with positive culture results, 2 eyes were positive by IVCM;in the 25 positive IVCM eyes, 14 eyes were positive in culture.?CONCLUSION: The positive rate of fungal culture in non-primary fungal keratitis is higher than that of IVCM. Fungal culture is an essential auxiliary examination in the diagnosis of non - primary fungal keratitis. With the characteristics of fast, noninvasive and repeatable, IVCM also plays an important role in the diagnosis of non-primary fungal keratitis. The combination of the two methods can improve the positive rate of diagnosis.

Clinical characteristics and outcomes of patients with atrial fibrillation: impact of an alternative primary diagnosis / 中华急诊医学杂志

Objective To explore the impact of atrial fibrillation (AF) recognized at primary diagnosis on clinical features and outcomes of patients with AF in emergency service.Methods Data were collected from consecutive patients admitted in resuscitation room in the Department of Emergency (ED) of a major comprehensive teaching hospital,from January 1,2011 through December 31,2015.Patients were checked by electrocardiogram examination and / or monitored in resuscitation room after admission,and were divided into patients with AF recognized at a primary diagnosis and those with AF judged by alternative primary diagnoses in ED.The main criteria of prognosis were the length of resuscitation room stay,number of repeated ED visits,and outcome scale (such as death,transferred to intensive units,transferred to general wards,or direct discharge).Non-paired student t test,x2,and circular distribution analysis were performed using SPSS 10.0 and EXCEL 2007 software.Results A total of 929 patients with mean age of (70.3 ± 12.7) years,and 502 (54.0％) female were enrolled.There were 122 cases with AF not recognized at primary diagnosis but by an alternative primary diagnosis (non-primary group,NPG),and 807 cases with AF recognized at primary diagnosis (primary group,PG).Compared with the PG,the patients were older [(76.9 ±9.3) vs.(68.7 ± 14.4),P ＜0.01],had more comorbidities [(1.75 ± 1.26) vs.(0.08±0.39),P＜0.01],higher APACHE Ⅱ scores [(17.89±8.19) vs.(8.64±4.15),P＜ 0.01],longer resuscitation room stay (P ＜ 0.01),higher mortality (11.5％ vs.0.2％,OR =52.176,95％ CI:11.698-232.710,x2 =78.928,P ＜ 0.01) and a higher percentage of transferring to intensive careunit (14.8％ vs.5.1％,OR=3.234,95％CI:1.791-5.838,x2 =16.674,P＜0.01) in NPG.There were no significant difference in number of repeated-visits in ED between the PG and the NPG.Conclusion Patients with AF in the ED judged by alternative primary diagnosis are older and have more comorbidities,higher mortality and higher probability to be transferred to intensive care unit than patients with AF directly recognized by a primary diagnosis.This cohort of patients with special characteristics should be meticulously cared for and be distinguished from the patients with AF crystal clear at a primary diagnosis.Future studies are needed to examine the specific impact of AF on outcomes in the setting of primarydiagnoses in ED.

Analysis of the effect of the basic drug system in 12 non-primary health care institutions of Lu Zhou / 中国生化药物杂志

Objective To analyze the usage of basic drugs in non-primary health care institutions in Luzhou,Sichuan,to comment on the performance of the basic drug system,and to provide reference data for relevant ministries and departments.Methods To collect and to statistically analyze the data of the categories and sales amount of the basic drugs used by three level-3A health care institutions and nine level-2 health care institutions from Jan 1,2010 to Dec 31,2012. Results The purchasing proportion of the basic drugs in the level-3A institutions for 2010,2011,and 2012 are respectively 15.62%,17.84%,20.01%;similarly,the data for the level-2A institutions are respectively 29.35%,32.16%,35.07%;the data for the level-2B institutions are respectively 34.73%,37.05%,40.02%.The sales proportion ofthe basic drugs for the years of2010,2011,and 2012 are respectively 10.43%,12.38%,15.04% for the level-3A institutions,25.08%,27.24%,30.12% for the level-2A institutions,and 29.24%,32.08%,35.03%for the level-2B institutions.Conclusion Non-primary health care institutions should firmly execute the basic drug system, enhance the propaganda of this policy,try to increase the purchasing proportion of the basic drugs,supervise the prescription behavior of the doctors, and optimize the basic drug index in order to use drugs more appropriately and efficiently.