Clinical characteristics of patients suffered from nervous system involved severe fever with thrombocytopenia syndrome / 中国感染控制杂志

Objective To analyze clinical characteristics of patients suffered from nervous system involved severe fever with thrombocytopenia syndrome (SFTS).Methods Clinical data of SFTS patients who were admitted to Qingdao Sixth People’s Hospital between January 2016 and December 2017 were retrospectively analyzed.Accor-ding to whether there was nervous system involvement,they were divided into two groups,clinical data of two groups of patients were compared and analyzed;SFTS patients with nervous system involvement were subdivided in-to death group and survival group according to the final outcome,clinical data of two groups were compared and ana-lyzed.Results The median date of occurrence of neurological symptoms in SFTS patients was at day 6 of disease process. There were statistical differences in age,skin ecchymosis/severe bleeding tendency,C-reactive protein,procalcitonin,Ca2+on admission,CD4+cell count,myocardial enzymes (LDH,CK,CKMB,HBDH),pulmonary inflammation,liver func-tion (ALT,Alb,AST),and activated partial thromboplastin time (APTT)between nervous system involvement group and non-nervous system involvement group(all P＜0.05).Among patients with nervous system involvement,there were statistical differences in skin ecchymosis,the lowest value of PLT,positive rate of SFTSV-IgM antibody,CD3+cell count, CD4+cell count,LDH,Alb,and APTT between death group and survival group (all P＜0.05).Conclusion Most SFTS patients with nervous system involvement are elderly patients with seriously damaged coagulation function, liver function,myocardial enzymes and immune system,proportion of pulmonary infection is high.Among SFTS patients with nervous system involvement,impairment of coagulation function,immune function,liver function, and myocardial enzymes in deceased patients are more serious than those in survivors.

Randomized controlled study of integrated treatment of traditional Chinese medicine and western medicine on AIDS with pulmonary inflammation patients / 中国中药杂志

<p><b>OBJECTIVE</b>To compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation.</p><p><b>METHOD</b>A multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed.</p><p><b>RESULT</b>Twenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group.</p><p><b>CONCLUSION</b>The integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.</p>

Association of haplotype formed on HLA-DRB1 and HLA-DQA1 alleles with outcomes of hepatitis B virus infection / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of haplotype of HLA-DRB1 and HLA-DQA1 alleles with outcomes of hepatitis B virus infection in Han population of north China.</p><p><b>METHODS</b>Two hundred and seven chronic hepatitis B (HB) patients, two hundred and twelve chronic asymptomatic hepatitis B virus (HBV) carriers (HBV carrier) and one hundred and forty-eight self-limited HBV infection were investigated for HLA-DRB1 and HLA-DQA1 alleles by sequence specific-polymerase chain reaction (PCR-SSP).</p><p><b>RESULTS</b>The frequency of DRB1*04-DQA1*0301 haplotype was 10.03% in self-limited HBV infection subjects, significantly higher than that in chronic HB patients (3.66%) (P=0.0005)ûthe frequency of DRB1*15/*16-DQA1*0102 haplotype was 6.80% in self-limited HBV infection subjects, significantly higher than 1.94% in chronic HB patients (P=0.0012) and 1.65% in asymptomatic HBV carriers (P=0.0004)ûwhile the frequency of DRB1*04-DQA1*0302 haplotype was 3.10% in chronic HB patients, higher than that in self-limited HBV infection subjects (0.39%) (P=0.0077).</p><p><b>CONCLUSION</b>Individuals with different haplotypes composed of HLA-DRB1 and HLA-DQA1 might have different outcomes of HBV infection.</p>

An outbreak of human Streptococcus suis serotype 2 infections presenting with toxic shock syndrome in Sichuan, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>In mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.</p><p><b>METHODS</b>An enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.</p><p><b>RESULTS</b>From June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.</p><p><b>CONCLUSION</b>An outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.</p>

Anlysis on features of dead cases with human Streptococcus suis infections / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators.</p><p><b>METHODS</b>Epidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done.</p><p><b>RESULTS</b>The population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found.</p><p><b>CONCLUSION</b>Preventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.</p>

Dynamics of peripheral blood B lymphocytes and natural killer cells in patients with severe acute respiratory syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the dynamics of peripheral blood B lymphocytes and natural killer (NK) cells in patients with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>The absolute numbers of peripheral blood B lymphocytes and NK cells in 602 serial samples from 240 patients with SARS were counted, using flow cytometry, and compared with that of normal population.</p><p><b>RESULTS</b>The absolute numbers of peripheral blood B lymphocytes and NK cells in SARS patients were significantly lower than that of the normal population (P < 0.001) and were much lower in SARS patients with severe or extremely severe types, as compared with that of moderate or mild type cases (P < 0.001). The amount of B lymphocytes in recovery SARS patients increased at the 2nd week after onset, and gradually becoming normal at the 5th week of the disease onset. The number of NK cells was in the low level at onset, and keep decreasing at the 2nd week. However, it was increasing with the recovery of the disease, but did not reach to normal level at the 5th week after onset.</p><p><b>CONCLUSION</b>The absolute numbers of peripheral blood B lymphocytes and NK cells were associated with the severity of the disease, and detection of these two kinds of cells was useful for predicting the prognosis of SARS.</p>