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A 11-year old female patient with severe thalassemia, receipt a lentivirus-based cell and gene therapy (CGT) therapy in Shenzhen Children′s Hosptial on July 27th, 2021. At the two follow-up visits after discharge, patient were continuously tested positive for HIV screening through HIV Ag/Ab Combo assay (chemiluminescence Immunoassay), and the viral load results of HIV-1 nucleic acid testing (NAT) were both>5 000 copies/ml. The patient can be diagnosed with HIV infection according to the National Guideline for Detection of HIV/AIDS(2020 Revised Edition). The thorough investigation findings and supplementary experiment results indicated that the false-positive HIV-1 NAT results was caused by cross-reactivity between the target sites detected by conventional HIV-1 NAT reagents and the lentiviral vectors fragments integrated into the genome of patient′s hematopoietic stem/progenitor cells. In conclusion, it is important for laboratories to select appropriate HIV-1 NAT testing platforms which won′t cause cross-reactivity for the testing of samples from patients who have been treated with HIV-derived vectors. It is also recommended to design and develop NAT testing platforms with multiple target regions labeled by different fluorescents for HIV NAT supplementation experiment to reduce the risk of false-positive diagnoses of HIV infection.
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Objective To analyze the influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation. Methods Clinical data of 66 patients with airway stenosis requiring clinical interventions after lung transplantation were retrospectively analyzed. Univariate and multivariate Cox’s regression models were adopted to analyze the influencing factors of survival of all patients with airway stenosis and those with early airway stenosis. Kaplan-Meier method was used to calculate the overall survival and delineate the survival curve. Results For 66 patients with airway stenosis, the median airway stenosis-free time was 72 (52,102) d, 27% (18/66) for central airway stenosis and 73% (48/66) for distal airway stenosis. Postoperative mechanical ventilation time [hazard ratio (HR) 1.037, 95% confidence interval (CI) 1.005-1.070, P=0.024] and type of surgery (HR 0.400, 95%CI 0.177-0.903, P=0.027) were correlated with the survival of patients with airway stenosis after lung transplantation. The longer the postoperative mechanical ventilation time, the higher the risk of mortality of the recipients. The overall survival of airway stenosis recipients undergoing bilateral lung transplantation was better than that of their counterparts after single lung transplantation. Subgroup analysis showed that grade 3 primary graft dysfunction (PGD) (HR 4.577, 95%CI 1.439-14.555, P=0.010) and immunosuppressive drugs (HR 0.079, 95%CI 0.022-0.287, P<0.001) were associated with the survival of patients with early airway stenosis after lung transplantation. The overall survival of patients with early airway stenosis after lung transplantation without grade 3 PGD was better compared with that of those with grade 3 PGD. The overall survival of patients with early airway stenosis after lung transplantation treated with tacrolimus was superior to that of their counterparts treated with cyclosporine. Conclusions Long postoperative mechanical ventilation time, single lung transplantation, grade 3 PGD and use of cyclosporine may affect the survival of patients with airway stenosis after lung transplantation.
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ObjectiveTo analyze the polarized light microscopic characteristics, the composition of physical phases and their relative contents of Maifanitum from different origins, and to establish the Fourier characteristic fingerprint of Maifanitum powder crystals by X-ray diffraction(XRD). MethodA total of 26 batches of Maifanitum samples were selected, and the microscopic characteristics of the sample powders and grinding flakes were observed by polarized light microscopy under single polarized light and orthogonal polarized light, and the main phase compositions and their relative contents were analyzed by powder crystal XRD technique, and the XRD Fourier characteristic fingerprint of Maifanitum was established. The incident light source of XRD was Cu target Kβ radiation, the light tube voltage and light tube current were 40 kV and 40 mA, respectively, the divergence slit was 1°, the scattering slit was 1°, the receiving slit was 0.2 mm, the scanning speed was 5°·min-1 with continuous scanning and scanning range of 5-90°(2θ), and the step length was 0.02°. ResultThe polarized light micrographs of powders and grinding flakes of Maifanitum were obtained, and the main phases were plagioclase, potassium feldspar and quartz, and a few samples also contained illite, pyrite, iron dolomite, calcite, iron amphibole and chlorite, etc. The relative total content of feldspar phases was 61.9%-82.4%, and the relative content of quartz was 12.6%-33.6%. The XRD Fourier fingerprint analysis method of Maifanitum with 13 common peaks as the characteristic fingerprint information was established, and the similarity calculated by the mean correlation coefficient method was 0.920 9-0.997 7, the similarity calculated by the mean angle cosine method was 0.940 5-0.998 4, the similarity calculated by the median correlation coefficient method was 0.921 1-0.997 5, and the similarity calculated by the median angle cosine method was 0.947 5-0.998 2. ConclusionThe polarized light microscopic identification characteristics of Maifanitum are mainly plagioclase, quartz and potassium feldspar, and the technique of powder crystal XRD Fourier fingerprint analysis can be used for the identification of Maifanitum.
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ObjectiveTo evaluate the effect of the therapy of dispelling stasis, removing toxin, and promoting urination (modified Linggui Zhugantang combined with Xuebijing injection) on the prognosis of sepsis-induced cardiomyopathy (SICM). MethodA total of 96 patients were randomly assigned into an observation group and a control group, with 48 patients in each group. The patients in the control group received sepsis bundle, and those in the observation group additionally received the therapy of dispelling stasis, removing toxin, and promoting urination (intravenous drip of Xuebijing injection and oral administration of modified Linggui Zhugantang). The course of treatment in both groups was 7 days. The disease and prognosis indicators [28-day mortality, intensive care unit (ICU) length of stay, major adverse cardiac events (MACE), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA) score, and mortality in emergency department sepsis (MEDS) score], cardiac function indicators [left ventricular ejection fraction (LVEF), E/A ratio of peak velocity blood flow from left ventricular relaxation in early diastole (the E wave) to peak velocity flow in late diastole caused by atrial contraction (the A wave), E/e′ ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (e′), and afterload-corrected cardiac performance (ACP)], myocardial injury markers [high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), and high mobility group box-1 (HMGB-1)], hemodynamic indicators [extravascular lung water index (EVLWI), global end-diastolic volume index (GEDVI), cardiac index (CI), and systemic vascular resistance index (SVRI)], and TCM syndrome scores were assessed and compared between the two groups. ResultThe 28-day mortality and the incidence of MACE in the observation group were slightly lower than those in the control group. The ICU length of stay in the observation group was shorter than that in the control group (P<0.05). After treatment, APACHE Ⅱ, SOFA, MEDS, syndrome score of stasis-caused internal obstruction, E/e′ ratio, hs-cTnT, NT-proBNP, H-FABP, and HMGB1 decreased compared with those before treatment (P<0.05), while LVEF, E/A ratio, and ACP increased (P<0.05). Moreover, the changes were more significant in the observation group (P<0.05). On days 3, 5, and 7 after treatment, the EVLWI and SVRI in the observation group were lower than those in the control group (P<0.05), while CI showed an opposite trend (P<0.05). The observation group had higher GEDVI than the control group on days 3 and 5 after treatment (P<0.05). ConclusionOn the basis of conventional bundle therapy, modified Linggui Zhugantang combined with Xuebijing injection with the effect of dispelling stasis, removing toxin, and promoting urination can inhibit the generation of myocardial injury markers and improve hemodynamics to shorten the length of ICU stay, mitigate the TCM syndrome, and reduce the risk of death, thereby improving the prognosis of SICM.
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Objective: To explore the epidemiological characteristic of a COVID-19 outbreak caused by 2019-nCoV Omicron variant BF.7 and other provinces imported in Shenzhen and analyze transmission chains and characteristics. Methods: Field epidemiological survey was conducted to identify the transmission chain, analyze the generation relationship among the cases. The 2019-nCoV nucleic acid positive samples were used for gene sequencing. Results: From 8 to 23 October, 2022, a total of 196 cases of COVID-19 were reported in Shenzhen, all the cases had epidemiological links. In the cases, 100 were men and 96 were women, with a median of age, M (Q1, Q3) was 33(25, 46) years. The outbreak was caused by traverlers initial cases infected with 2019-nCoV who returned to Shenzhen after traveling outside of Guangdong Province.There were four transmission chains, including the transmission in place of residence and neighbourhood, affecting 8 persons, transmission in social activity in the evening on 7 October, affecting 65 persons, transmission in work place on 8 October, affecting 48 persons, and transmission in a building near the work place, affecting 74 persons. The median of the incubation period of the infection, M (Q1, Q3) was 1.44 (1.11, 2.17) days. The incubation period of indoor exposure less than that of the outdoor exposure, M (Q1, Q3) was 1.38 (1.06, 1.84) and 1.95 (1.22, 2.99) days, respcetively (Wald χ2=10.27, P=0.001). With the increase of case generation, the number and probability of gene mutation increased. In the same transmission chain, the proportion of having 1-3 mutation sites was high in the cases in the first generation. Conclusions: The transmission chains were clear in this epidemic. The incubation period of Omicron variant BF.7 infection was shorter, the transmission speed was faster, and the gene mutation rate was higher. It is necessary to conduct prompt response and strict disease control when epidemic occurs.
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Masculino , Humanos , Feminino , SARS-CoV-2 , COVID-19/epidemiologia , Surtos de Doenças , Epidemias , China/epidemiologiaRESUMO
As the final resolution for end-stage lung disease, lung transplantation can not only significantly prolong the survival, but also remarkably improve the quality of life of recipients. In recent decades, with the advancement of surgical techniques, immunosuppressants and post-transplantation management, the quantity of lung transplantation has been surged around the globe. However, the shortage of donor lung has severely restricted the development of lung transplantation. It is necessary to develop innovative approaches to expand the donor pool. The number of donors and effective preservation and functional maintenance of potential donor lungs play a key role in expanding the donor pool. The quality of donor lung is a critical precondition to ensure the long-term survival of lung transplant recipients. Preservation and functional maintenance of donor lung are of significance for guaranteeing the quality of lung allograft. In this article, research progresses on the management and maintenance of donor lung before procurement, the procurement of donor lung and the preservation and functional maintenance of lung allograft were reviewed, aiming to provide reference for the development of lung transplantation in clinical practice.
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The spectrum of biopsy-confirmed kidney disease varies with regions and periods. We describe the distribution of pathological types and epidemiological characteristics of kidney diseases in Northwest China due to regional differences in geographical environment, social economy, and dietary habits. Methods: Kidney biopsy cases from 2005 to 2020 in Xijing Hospital were retrospectively analyzed. Pathological characteristics of patients in different periods were analyzed using the t test or chi-square test. Joinpoint regression was used to analyze trends in pathological types and disease spectrum. Results: A total of 10,528 eligible patients were included. Primary glomerular disease (PGD) accounted for the majority of the cases and exhibited an obvious downward trend, whereas secondary glomerular disease (SGD) showed an obvious upward trend. Among PGD, immunoglobulin A nephropathy (IgAN) remained the most common pathological type, and the detection rate of membranous nephropathy (MN) was significantly increased. Among SGD, Henoch-Schönlein purpura nephritis (HSPN) was the most common pathological type and may present a significant characteristic of Northwest China. Diabetic nephropathy (DN) exhibited the most obvious upward trend in the whole process, whereas the fastest growth since 2012 was in hypertensive nephropathy. Conclusion: The proportion of SGD increased whereas PGD declined. IgAN remained the most common PGD, and HSPN was the most common SGD. MN and DN showed the most obvious upward trend among PGD and SGD, respectively. Changes in the spectrum of kidney disease, especially the constituent ratio of SGD, pose a great challenge to public health.
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OBJECTIVE To evaluate the effects of gene polymorphism on the efficacy and safety of citalopram/escitalopram, and to provide evidence-based reference for precision medication. METHODS Retrieved from PubMed, Embase, the Cochrane Library, CNKI, Wanfang data and SinoMed, clinical studies about the association of gene polymorphism with efficacy and safety of citalopram/escitalopram were collected. Meta-analysis was performed with RevMan 5.3 software after literature screening, data extraction and quality evaluation based on Newcastle-Ottawa scale. RESULTS Totally 35 pieces of literature were included, all of which were cohort studies, with a total of 9 836 patients. Meta-analysis showed that the SLC6A4 gene 5-serotonin transporter linked polymorphic region (HTTLPR) LL genotype was associated with high response rate of citalopram/escitalopram [LS/SS vs. LL: OR=0.47, 95%CI (0.22, 0.98), P=0.05]; results of subgroup analysis suggested a higher correlation in white people with LL genotype and escitalopram; there was no significant correlation of HTTLPR genotype with remission rate [LS/SS vs. LL: OR= 0.92,95%CI(0.77, 1.10), P>0.05; SS vs. LL/LS:OR=0.73, 95%CI(0.45, 1.19), P>0.05] or overall incidence of ADR in patients with gene SLC6A4; but high expression of rs25531 LA was significantly associated with reduced incidence of ADR(P< 0.05). CYP2C19*2/*3 allele was significantly associated with slowed metabolism, higher response rate and increased incidence of ADR. CONCLUSIONS HTTLPR LL genotype is associated with the increased response rate of citalopram/escitalopram, but no significant correlation with safety is found, while CYP2C19*2/*3 allele is significantly associated with higher response rate and reduced tolerability.
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Objective:To detect the expression of has_circ_0001459 in peripheral blood mononuclear cells (PBMCs) of Epstein-Barr virus (EBV)-infected individuals and evaluate its diagnostic value for EBV infection.Methods:The expression profiles of circRNAs in PBMCs of patients with EBV infection were obtained by whole-transcriptome sequencing. Differentially expressed circRNAs with statistical significance were selected based on the criteria of ∣log 2Fold Change∣≥1 and P<0.05. Based on the composition, length and primer specificity, hsa_circ_0001459 with high expression was selected for further research. The relative expression of hsa_circ_0001459 in PBMCs of 60 patients with EBV infection and 45 healthy people was detected by real-time fluorescent quantitative PCR. Receiver operating characteristic (ROC) curve and Kappa analysis were used to analyze the diagnostic value of hsa_circ_0001459 expression for EBV infection. Results:The expression of hsa_circ_0001459 showed an up-regulation trend in patients with EBV infection as compared with that in the healthy people, and the results were consistent with the sequencing results. The area under the ROC curve for screening EBV-infected individuals was 0.83(95%CI: 0.75-0.91) with the sensitivity of 0.80(95%CI: 0.66-0.89) and the specificity of 0.77(95%CI: 0.65-0.86). Kappa analysis indicated that hsa_circ_0001459 was moderately consistent with EBV DNA in the diagnosis of EBV infection (κ=0.51).Conclusions:Hsa_circ_0001459 tended to be highly expressed in PBMCs of EBV-infected individuals, which might be uses as a diagnostic marker for EBV infection.
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Autoimmune diseases refer to clinical diseases caused by the body′s autoimmune tolerance state being broken or autoimmune cells being abnormally regulated, and the immune system produces autoantibodies, causing self-tissue damage or abnormal function. Most of the causes are unknown and easy to repeat, causing a huge burden on the quality of life of patients. Infectious pathogens have a potential role in initiating autoimmune processes and exacerbating disease progression, and conversely, some pathogens can suppress autoimmune responses. This paper summarizes the relationship between different types of infection and autoimmune diseases. Possible mechanisms of action include molecular mimicry of pathogen antigens, activation of bystander T or B cells, modification of autoantigens, and epitope diffusion.
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Proteomic characterization of plasma is critical for the development of novel pharmacodynamic bio-markers.However,the vast dynamic range renders the profiling of proteomes extremely challenging.Here,we synthesized zeolite NaY and developed a simple and rapid method to achieve comprehensive and deep profiling of the plasma proteome using the plasma protein corona formed on zeolite NaY.Specifically,zeolite NaY and plasma were co-incubated to form plasma protein corona on zeolite NaY(NaY-PPC),followed by conventional protein identification using liquid chromatography-tandem mass spectrometry.NaY was able to significantly enhance the detection of low-abundance plasma proteins,minimizing the"masking"effect caused by high-abundance proteins.The relative abundance of middle-and low-abundance proteins increased substantially from 2.54%to 54.41%,and the top 20 high-abundance proteins decreased from 83.63%to 25.77%.Notably,our method can quantify approxi-mately 4000 plasma proteins with sensitivity up to pg/mL,compared to only about 600 proteins iden-tified from untreated plasma samples.A pilot study based on plasma samples from 30 lung adenocarcinoma patients and 15 healthy subjects demonstrated that our method could successfully distinguish between healthy and disease states.In summary,this work provides an advantageous tool for the exploration of plasma proteomics and its translational applications.
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Catheter-associated bloodstream infection(CRBSI) is one of the most common hospital-associated infections, and the incidence of central line-associated blood stream Infections (CLABSI) is the highest in CRBSI. This paper analyzes the current monitoring system of CLABSI in China, and compares the concept and method of National Healthcare Safety Network (NHSN) monitoring system, in order to make suggestions for the CLABSI monitoring system in China, and further improve the quality of medical safety.
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As the second largest vector of infectious diseases, ticks carry and transmit various pathogens that cause human infections and pose a serious public health hazard. In recent years, there has been an ongoing epidemic of tick-borne fever with thrombocytopenia syndrome virus (SFTSV), as well as the occurrence of human infections by brand-new viruses such as Jingmen tick virus (JMTV) and Alongshan virus (ALSV) in China. This paper will review the advancement of disease clinical characteristics, laboratory methods of virus isolation, immunology and molecular biology of these emerging tick-borne viral diseases in China.
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With the decline in hepatitis B virus (HBV) incidence and the increase in the life expectancy of infected individuals, the population infected with HBV is experiencing rapid aging, leading to an escalating risk of co-morbid chronic noncommunicable diseases (NCDs). This study summarizes research related to the comorbidity between HBV and NCDs, discussing the aging of the HBV-infected population, the mechanisms, prevalence, and management of this comorbidity. This study provides insights into potential directions for future research on the comorbidity between HBV and NCDs and aims to provide a basis for further research and the development of prevention and treatment strategies for the comorbidity of NCDs among HBV-infected individuals in China.
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Humanos , Vírus da Hepatite B , Doenças não Transmissíveis/epidemiologia , Hepatite B/epidemiologia , Comorbidade , China/epidemiologiaRESUMO
With the decline in hepatitis B virus (HBV) incidence and the increase in the life expectancy of infected individuals, the population infected with HBV is experiencing rapid aging, leading to an escalating risk of co-morbid chronic noncommunicable diseases (NCDs). This study summarizes research related to the comorbidity between HBV and NCDs, discussing the aging of the HBV-infected population, the mechanisms, prevalence, and management of this comorbidity. This study provides insights into potential directions for future research on the comorbidity between HBV and NCDs and aims to provide a basis for further research and the development of prevention and treatment strategies for the comorbidity of NCDs among HBV-infected individuals in China.
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Humanos , Vírus da Hepatite B , Doenças não Transmissíveis/epidemiologia , Hepatite B/epidemiologia , Comorbidade , China/epidemiologiaRESUMO
The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
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Humanos , Dentística Operatória , Consenso , Endodontia , Tratamento do Canal Radicular , Assistência OdontológicaRESUMO
Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
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Humanos , Consenso , Endodontia/métodos , Dente , Impressão Tridimensional , Assistência Odontológica , Tomografia Computadorizada de Feixe Cônico , Tratamento do Canal RadicularRESUMO
The main products and performance characteristics of non-portable and portable blood transfusion warmers in the world were introduced.The problems of the blood transfusion warmer were analyzed,and some suggestions were put forward accordingly.It's pointed out the intelligent and portable blood transfusion warmer with the functions of heating,pressurization and speed control would be the main direction of future development.
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To screen novel anti-dengue virus (DENV) NS5 RdRp enzyme inhibitors, a series of 5-cyano-2-thiacetoaryl pyrimidinone compounds were designed and synthesized by molecular hybridization method with HCV NS5B RdRp inhibitor 3jc and ZIKV NS5 RdRp inhibitor 4w as lead compounds. The anti-DENV activity of these compounds was evaluated by MTT assay and plaque assay and five compounds showed anti-DENV activity. The most active compound 7a'k showed better anti-DENV activity than that of the positive control ribavirin (EC50 = 7.86 μmol·L-1 vs EC50 = 18.07 μmol·L-1), and the other four compounds showed almost the same anti-DENV activity as ribavirin. Finally, the prediction and simulation of the binding mode through molecular provided new ideas for the further development of this new DENV NS5 RdRp inhibitor.
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Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.