A comparative study of the clinical characteristics of spotted fever and severe fever with thrombocytopenia syndrome / 中国热带医学

@#Abstract: Objective To investigate the differences in epidemiological and clinical characteristics of patients with spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS). Methods A total of 86 patients with SF and 113 patients with SFTS who were laboratory-confirmed in the second-level and above hospitals in Lu'an City from January 2017 to January 2022 were selected. The basic data, epidemiological history, clinical data and laboratory test results of the two diseases were retrospectively analyzed for comparison. Results The proportion of male in SF group was 32.56% (28/86), and the proportion of male in SFTS group was 53.98% (61/113), the difference was statistically significant (χ2=9.067, P<0.01). The proportions of abdominal pain and diarrhea in the SF group were (3.49%, 3/83) and (21.24%, 24/113), which were significantly lower than corresponding (6.98%, 6/86) and (46.90%, 53/113) in the SFTS group (χ2=13.121, 37.322, P<0.01). The incidences of rash and eschar in SF group were 95.35% (82/86) and 20.93% (18/86), which were significantly higher than corresponding 1.77% (2/113) and 0.88% (1/113) in SFTS group (χ2=175.311, 22.721, P<0.01). The levels of leukocytes, platelets and C-reactive protein in the SF group were significantly higher than those in the SFTS group, and the levels of transaminase, lactate dehydrogenase and D-dimer were significantly lower than those in the SFTS group, and the differences were statistically significant (all P<0.05). Conclusions The rash and inflammatory reaction are more obvious in SF patients, while the liver function, myocardial function and coagulation function are significantly impaired in SFTS patients.

Hydrogen/oxygen therapy for the treatment of an acute exacerbation of chronic obstructive pulmonary disease: results of a multicenter, randomized, double-blind, parallel-group controlled trial.

BACKGROUND: To investigate whether the administration of hydrogen/oxygen mixture was superior to oxygen in improving symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: This prospective, randomized, double-blind, controlled clinical trial in 10 centres enrolled patient with AECOPD and a Breathlessness, Cough, and Sputum Scale (BCSS) score of at least 6 points. Eligible patients were randomly assigned (in a 1:1 ratio) to receive either hydrogen/oxygen mixture or oxygen therapy. Primary endpoint was the change from baseline in BCSS score at day 7. Adverse events (AEs) were recorded to evaluate safety. RESULTS: Change of BCSS score in Hydrogen/oxygen group was larger than that in Oxygen group (- 5.3 vs. - 2.4 point; difference: - 2.75 [95% CI - 3.27 to - 2.22], meeting criteria for superiority). Similar results were observed in other time points from day 2 through day 6. There was a significant reduction of Cough Assessment Test score in Hydrogen/oxygen group compared to control (- 11.00 vs. - 6.00, p < 0.001). Changes in pulmonary function, arterial blood gas and noninvasive oxygen saturation did not differ significantly between groups as well as other endpoints. AEs were reported in 34 (63.0%) patients in Hydrogen/oxygen group and 42 (77.8%) in Oxygen group. No death and equipment defects were reported during study period. CONCLUSIONS: The trial demonstrated that hydrogen/oxygen therapy is superior to oxygen therapy in patient with AECOPD with acceptable safety and tolerability profile. TRIAL REGISTRATION: Name of the registry: U.S National Library of Medicine Clinical Trials; Trial registration number: NCT04000451; Date of registration: June 27, 2019-Retrospectively registered; URL of trial registry record: https://www.clinicaltrials.gov/ct2/show/study/NCT04000451?term=04000451&draw=2&rank=1 .

Conjugated crosslinks boost the conductivity and stability of a single crystalline metal-organic framework.

A linker molecule with four pendant thiophene functions was crystallized with Zr(iv) ions to form a semiconductive porous coordination solid (1.1 × 10-5 S cm-1). Oxidative treatment with FeCl3 guests then coupled the thiophene units to form conjugated bridges as covalent crosslinks. The resulting hybrid of a metal-organic framework and conjugated polymer featured robust crystalline order that withstood long-term air exposure and broad pH (from 0 to 12) conditions. Moreover, the homocoupled thiophene units, conjugated through sulfide links (-S-) with the linker backbone, afforded higher electronic conductivity (e.g., >2.2 × 10-3 S cm-1), which is characteristic of conductive polymer prototypes of polythiophene and polyphenylene sulfide. The crosslinked solid also exhibited proton conductivity that could be increased broadly upon H2SO4 treatment (e.g., from 5.0 × 10-7 to 1.6 × 10-3 S cm-1).

Conductive Metal-Organic Frameworks: Mechanisms, Design Strategies and Recent Advances.

Metal-organic frameworks (MOFs), constructed from metal ions and organic ligands through coordination assembly, exhibit considerable conductivity, which originates from the ionic or electronic transport pathway between the host architecture and guest species. In recent decades, the study of conductive MOFs has accelerated deservedly due to their importance in the electronic information industry. In this review, we first briefly describe the different mechanisms of ionic and electronic conduction. The design strategies of constructing intrinsic and doping MOFs are then summarized and generalized into three major categories (host-based-, guest-based- and host-guest-related systems) in terms of promoting conductive performance. In the next section we provide an overview of recent progress in research on conductive MOFs, providing details according to the various carriers of transporting electrons, protons and other ions. We conclude with a discussion on the practicability and emerging applications of conductive MOFs and a section on the existing challenges and development prospects. Conduction mechanisms, design strategies, recent progresses and emerging applications of conductive MOFs.

The effectiveness, safety and compliance of Zheng's supine rehabilitation exercise as a rehabilitation programme among elderly patients with AECOPD.

PURPOSE: We investigated the effectiveness, safety and compliance of Zheng's Supine Rehabilitation Exercise (ZSRE) as a rehabilitation programme among elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). PATIENTS AND METHODS: About 82 elderly patients with AECOPD were divided into a rehabilitation group and control group on their admission day, and both groups received routine medical treatment. Patients in the rehabilitation group started ZSRE on the second day of admission and continued until 8 weeks after discharge. RESULTS: At the 9th week after discharge, the COPD Assessment Test (CAT), 6-minute walking distance (6MWD) and Modified Medical Research Council Dyspnea Scale (mMRC) in the rehabilitation group were all significantly better than those in the control group (P < 0.01; P < 0.01; and P < 0.05, respectively). In the rehabilitation group, the CAT and 6MWD were significantly improved in the 9th week after discharge as compared with those at admission or discharge, and mMRC was significantly improved at the 9th week after discharge as compared with that at admission (all P < 0.01). CONCLUSION: ZSRE can be performed by elderly patients with the acute exacerbation of severe or extremely severe COPD with high safety and compliance and was helpful for their recovery.

Symmetrically backfolded molecules emulating the self-similar features of a Sierpinski triangle.

We synthesized self-similar molecules (G3 and G2; based on phenylalkynyl backbones) with symmetrically backfolded shapes inspired by the famous fractal of a Sierpinski triangle. Unlike the more traditional, starburst dendrimers, the centripetal-shaped Sierpinski molecules feature side branches symmetrically bent away from the growth direction of the main branch, thus contrasting the natural-tree shape. Molecule G3 exhibits three distinct levels of the structural hierarchy comprising the primary, secondary and tertiary branches, while the smaller G2 contains only features of the 1st and 2nd orders. In spite of the much larger conjugated backbone of G3, its solution UV-vis absorption and fluorescence exhibit no red shift relative to G2. In a test of nitrobenzene sensing, a thin film of G3 deposited from THF was more sensitively quenched in fluorescence than the smaller G2.

Seroprevalence and risk factors of severe fever with thrombocytopenia syndrome virus infection in endemic areas.

BACKGROUND: To determine the seroprevalence, latent infection rate and risk factors for severe fever with thrombocytopenia syndrome virus (SFTSV) infection, a cross-sectional study was conducted in the general population of the Western region of Anhui Province of China from 1 September to 31 December 2014. METHODS: Twelve villages with the highest rates of endemic SFTS infection were selected from six towns in two counties in the western region of Anhui Province. Blood samples were collected and tested for the presence of SFTSV-IgG antibodies by ELISA. Each participant was interviewed using a structured questionnaire before blood collection. Participants with seropositive specimens were further investigated using another structured questionnaire. RESULTS: Of 2126 blood specimens collected, 99 (4.66%) were seropositive for SFTSV. None of the participants had been diagnosed with SFTS before the blood collection or were accompanied by fever, thrombocytopenia and leukocytopenia after blood collection. Multivariate logistic regression model analysis revealed living in areas of uncontrolled vegetation growth, long-term residents of the locality and tick bites as high risk factors for SFTSV infection. CONCLUSIONS: The overall seroprevalence of SFTSV is higher in the western region of Anhui, possibly due to latent infection, with the main risk factors being living in areas of uncontrolled vegetation growth, long-term residents of the locality and tick bites. Further investigations are warranted to clarify the modes of SFTS virus transmission, while vector management, education on tick bite prevention and personal hygiene management should be implemented for high risk groups in endemic areas.

[Detection of NPM1, FLT3 and C-KIT mutations in acute myeloid leukemia and their prognostic analysis].

This study was aimed to evaluate the frequencies and prognostic significance of the nucleophosmin 1 (NPM1) mutation, the fms-like tyrosine kinase 3 (FLT3) mutation and c-KIT mutation in acute myeloid leukemia (AML) and to explore their relevance to clinical characteristics, cytogenetics and survival. Genomic DNA from 78 newly diagnosed AML from August 2010 to October 2012 was screened by PCR and sequencing or capillary electrophoresis (CE) for NPM1, FLT3 and c-KIT mutations. The results showed that the incidence of NPM1 mutation was 14.1% in AML patients and 26.7% in normal karyotype AML patients. NPM1 mutant cases were significantly associated with old age (P < 0.05), high peripheral white cell count and platelet counts (P < 0.05) and low expression of CD34 (P < 0.05), but no statistic difference was found in sex, percentage of bone marrow blasts, Hb, expression of CD117 and HLA-DR, complete remission rate, overall survival and relapse rate (P > 0.05). The prevalences of FLT3-ITD and FLT3-TKD mutations were 11.5% (9/78) and 3.8% (3/78) respectively, and no one patient has both of the two mutations. Patients with FLT3-ITD mutation had higher white blood cell counts and percentage of in bone marrow blasts (P < 0.05), and lower overall survival (P < 0.05), more relative to normal karyotype (P < 0.05), while no statistic difference was found in sex, age, platelet count, Hb level, complete remission rate and relapse rate (P > 0.05). No statistic analysis was performed due to the cases of less FLT3-TKD mutation. C-KIT mutation accounts for 7.7% (6/78). Patients with C-KIT mutation had a higher percentage in abnormal karyotype (P < 0.05), and higher relapse rate (P < 0.05), and lower overall survival, whereas no statistic difference was found in sex, age, percentage of bone marrow blasts, peripheral blood cell count, complete remission rate (P > 0.05). It is concluded that the detection of NPM1, FLT3 and C-KIT mutations may contribute to guiding treatment and evaluating prognosis of patients with AML.

[Clinical significance of IDH1 and IDH2 mutations in patients with acute myeloid leukemia].

OBJECTIVE: To assess the frequencies and prognostic significance of the isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) mutations in acute myeloid leukemia (AML) and to explore their relevance to clinical, cytogenetic and molecular feature. METHODS: Genomic DNA from 96 newly diagnosed AML patients from Sep. 2009 to Jan. 2011 was screened by RT-PCR and sequencing for IDH1 and 1DH2 mutation. RESULTS: The prevalence of IDH1 (p. P127 and p. I130) and IDH2 mutations (p. R140) was 14.6% (14/ 96) and 2.17% (2/96) respectively. The IDH1 mutations of p. P127 and p. I130 were not reported so far in literature. Of 14 IDH1 mutation patients, 10 were with normal karyotype and the differences had statistical significance (P=0.021). Two patients with IDH2 mutation were also with normal karyotype. IDH2 mutations were in older patients at diagnosis. Patients with IDH mutation had higher white blood cell counts, lower platelet counts, expression of HLA-DR, CD34, CD33 and CD13, lower remission rate and higher relapse rate. CONCLUSION: IDH mutation is recurring genetic change in AML and indicates poor prognosis.

[Study of trisomy 22 and inversion 16 in acute myeloid leukemia].

OBJECTIVE: To explore the value of trisomy 22 ( +22) in the diagnosis of inv(16) acute myeloid leukemia (AML). METHODS: Interphase fluorescence in situ hybridization (FISH) was performed in 18 AML patients with +22. The probe was two-color break apart probe for CBFbeta with SpectrumRed on the centromeric side and SpectrumGreen on the telomeric side. The FISH results were compared with that of R-banding conventional cytogenetics (CC). Multiplex FISH (M-FISH) was used to analyze the relationship of +22 and inv(16). RESULTS: CC revealed inv(16) in none of the 18 AML, with +22, but FISH revealed inv (16) in 11 of them and del( 16) (q22) in one. As CC results, 9 of the 11 cases were sole +22, one complicated with trisomy 8, and one del(16) (q22). Four patients with +22 and inv(16) were analyzed by M-FISH and revealed +22 only. CONCLUSION: +22 can be regarded as an important marker for the diagnosis of inv(16) AML.

[Application of all-trans retinoic acid combining chemotherapy and As4S4 in the maintenance treatment of patients with acute promyelocytic leukemia].

OBJECTIVE: To compare the efficacy of all-trans retinoic acid (ATRA) combining chemotherapy and As4S4 with ATRA combining chemotherapy for the maintenance treatment of patients with acute promyelocytic leukemia (APL). METHODS: Sixty patients with APL induced to complete remission by ATRA and consolidated by chemotherapy were randomly divided into two groups. Thirty patients as As4S4 group received ATRA + As4S4 + chemotherapy, and another thirty patients as non-As4S4 group were treated only with ATRA + chemotherapy as maintenance therapy. The therapeutic effects, side effects and PML-RARalpha gene expression were analyzed. RESULTS: The three-year continuous complete remission (CCR) rate was 90.0% for As4S4 group and 61.1% for non-As4S4 group, the difference being statistically significant. Significant difference was also found in the positive rate of PML-RARalpha fusion gene between the two groups. The side effects were mild. CONCLUSION: APL patients in maintenance therapy with ATRA + 6-MP + MTX + As4S4 can obtain a higher CCR.

[Detection and screening for human cytomegalovirus infection in allogeneic hematopoietic stem cell transplantation recipients by different methods].

The aim of study was to explore the better detection method for cytomegalovirus (CMV) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients and to compare the efficiency of fluorogenic quantitative PCR (FQ-PCR), flow cytometry (FCM) and ELISA. The plasma DNA loading and serum level of IgM antibody against CMV in 214 clinical specimens from 19 allo-HSCT patients were detected by real-time FQ-PCR and ELISA respectively, the pp65 antigen in 118 peripheral blood leukocyte samples were measured by FCM. The results showed that the positive rates of pp65 antigen, IgM antibody and DNA load were 30.85% (58/188), 13.08% (28/214) and 35.51% (76/214) respectively, the coincidence between their sequential detection positive rates and clinical diagnosis were 7/8, 7/8 and 3/8 respectively. There was no statistical significant difference between the positive rate of pp65 antigen and of DNA amount (P > 0.05), and they have manifested relationships (P < 0.05). The positive rate of IgM antibody detected by ELISA was obvious lower than that of DNA quantitated by FQ-PCR and pp65 antigen detected by FCM, but the difference between them showed statistical significance (P < 0.05), Smaller relativity was found between IgM antibody detection and the other two methods (P > 0.05). It is concluded that FQ-PCR and FCM are sensitive, rapid, suitable and reliable methods for monitoring recipient reactive CMV infection of allo-HSCT recipients and are worthy to extensively use for guiding antiviral therapy.