RESUMO
Objective:To analyze the clinical characteristics of brucellosis in Huzhou City, Zhejiang Province, so as to provide basis for clinicians to improve their understanding and diagnosis and treatment of brucellosis.Methods:The data of 10 cases of brucellosis in Huzhou Central Hospital from 2014 to 2019 were collected, and the epidemiological characteristics, clinical manifestations, laboratory examination results, imaging examination results, etiological examination results, diagnosis and treatment process and prognosis were summarized and analyzed by retrospective analysis method.Results:Among the 10 patients with brucellosis, 6 were males and 4 were females, aged from 32 to 71 years old, and 9 patients had a history of contact with goat, and one case was considered as food borne infection. The main clinical manifestations were fever (10 cases), sweating (2 cases), joint pain (7 cases). In imaging examination, 5 cases with splemomegaly, 1 cases with lymphadenopathy, 3 patients presented with spondylitis (including 1 case with paravertebral abscess) and 2 cases with prostatitis; Brucella was cultured in 2 patients and Brucella antibodies were positive in 10 patients. The treatment drugs included doxycycline, rifampicin and levofloxacin in two or three combinations. Eight patients were followed up for more than 1 month to more than 5 years, and the prognosis was good. Conclusions:Brucellosis lacks specificity in clinical features. Most patients with brucellosis are associated with osteoarthritis or urinary system diseases. Physicians should be vigilant, combine epidemiological features, conduct laboratory tests in time, and diagnose as soon as possible.
RESUMO
Objective To analyze the effect of single nucleotide polymorphism ( SNP) rs8099917 of interleukin-28B ( IL-28B) on spontaneous virus clearance and the efficacy of antiviral therapy in hepatitis C virus (HCV) infected patients in Huzhou area of Zhejiang Province.Methods A total of 268 HCV-infected patients were enrolled.The high sensitive HCV RNA quantification , HCV genotype and the IL-28B rs8099917 SNP were detected at baseline.One hundred and sixty-three patients received pegylated interferon α-2a ( Peg-IFNα-2a) and ribavirin (RBV) combined antiviral therapy (referred as PR treatment) for 48 weeks, who were followed up for 24 weeks.The remaining 44 patients were treated with sofosbuvir and daclatasvir for 12 weeks. The virological response of patients with different IL-28B rs8099917 genotypes was monitored.The count data was compared by χ2 test.Results The distributions of IL-28B rs8099917 SNP were 84.33%for TT genotype and 15.67%for GT genotype, while the GG genotype was not detected.Of the 135 patients with acute HCV infection, 61 cases had spontaneous viral clearance , 74 cases were converted to chronic infection.The spontaneous clearance rates were 47.11% for TT genotype and 28.57% for GT genotype.There was no significant difference of the spontaneous clearance rate between TT and GT genotype (χ2 ＝1.072, P＝0.30). In 163 chronic hepatitis C (CHC) patients with PR treatment, the rate of sustained virological response (SVR) after 24 weeks follow-up was 86.50%(141 cases).SVR rate in patients with TT genotype was significantly higher than those with GT genotype (91.67%vs 47.36%, χ2 ＝28.212, P＜0.05).There was no statistically significant difference of the SVR rates between genotype 1b and 2a (χ2 ＝1.525, P＞0.05).In 44 patients received sofosbuvir and daclatasvir treatment , both SVR rates of TT genotype and GT genotype were 100%. Conclusions In Huzhou area of Zhejiang Province , there is no significant correlation between IL-28B rs8099917 genotype and spontaneous clearance in patients with acute HCV infection , but the genotype of IL-28B rs8099917 is valuable for the prediction of PR treatment efficacy , the SVR rate of the TT genotype is superior to the GT genotype.The SVR rate can reach 100% in patients received combination therapy of sofosbuvir and daclatasvir independent of polymorphism of IL-28B.
RESUMO
Objective To investigate the characteristics of depression in the chronic hepatitis C (CHC) patients who received pegylated interferon therapy.Methods Clinical data of 218 CHC patients who were treated with pegylated interferon were collected in Huzhou Central Hospital,Zhengjiang from January 2008 to December 2013.The Hamilton Depression Rating Scale (HAMD) was used to assess the patient's depression symptoms during the treatment process.The sustained virological response (SVR) rate was assessed 24 weeks after the completion of treatment.Chi square test was used to compare the effects of treatment,gender,age,different types of interferon during the treatment process on depression,and to analyze the dynamic changes of depression and the effect of depression on SVR.Results Of the 218 CHC patients who completed pegylated interferon treatment,the proportion of patients with HAMD score ≥8 (n=73,33.19％) after treatment was significantly higher than that before treatment (n=20,9.17％;x2=40.321,P＜0.05).The female CHC patients were more prone to have depressive symptoms than the male patients (40.50％o [49/121] vs 24.74％ [24/97];x2 =6.097,P＜0.05).The incidence rate of depression in patients younger than 55 years old was lower than that of over 55 years (27.48％ [36/131] vs42.53％ [37/87];x2=5.271,P＜0.05).The incidence rate was not significant different between pegylated interferon α-2a group and pegylated interferon α-2b group after treatment (35.04％ [41/117] vs31.68％ [32/01];x2=0.275,P＞0.05).At week 8 of treatment,the number of depression patients increased most significantly.Totally 113 (51.83 ％) of 218 patients achieved SVR,including 57.53％ (42/73) of patients with depression and 48.97％ (71/145) of patients without depression,but there was no statistical significance (x2 =1.432,P＞0.05).Conclusion In CHC patients received pegylated interferon treatment,elderly and female patients are more susceptible to develop depression and the incidence of depression peaks at week 8 of treatment.
RESUMO
Fracture problem of orthodontic wires was discussed in this paper. The calculation formulae of bending stress and tensile stress were obtained. All main factors that affect bending stress and tensile stress of orthodontic wires were analyzed and discussed. It was concluded that the main causes of fracture of orthodontic wires were fatigue and static disruption. Some improving proposals for preventing fracture of orthodontic wires were put forward.