[Clinical Characteristics and Risk Factors for 30-Day Mortality in Patients with Hematologic Diseases Infected by Carbapenem-Resistant Organisms].

OBJECTIVE: To explore the clinical characteristics of hospitalized patients with hematologic diseases complicated with carbapenem-resistant organisms (CRO) infection and analyze the risk factors of 30-day all-cause mortality. METHODS: The clinical data and laboratory test data of 77 hospitalized patients with hematologic diseases complicated with CRO infection in department of hematology of the Third Hospital of Shanxi Medical University from January 2015 to December 2020 were retrospectively analysed, the risk factors of 30-day all-cause mortality after CRO infection were analyzed by multivariate logistic regression. RESULTS: Among the total of 77 patients with hematologic diseases complicated with CRO infection, 29 died and 48 survived within 30 days of infection, with a case fatality rate of 37.66%. A total of 93 strains of CRO were isolated from these patients, of which Acinetobacter baumannii had the highest detection rate (25.81%, 24/93), followed by Pseudomonas aeruginosa (18.28%, 17/93). The lung was the most common site of CRO infection. The detected pathogens were highly resistant to carbapenems, and 64.52% (60/93) of the pathogens were resistant to imipenem with minimum inhibitory concentration (MIC)≥16 µg/ml. The results of the univariate analysis showed that albumin concentration <25 g/L (P =0.048), serum creatinine concentration≥120 µmol/L (P =0.023), age-adjusted Charlson comorbidity index (ACCI) (P =0.037) and primary treatments (supportive treatment, immunosuppressive therapy, chemotherapy, HSCT) (P =0.048) were significantly associated with 30-day all-cause mortality after infection. The results of multivariate logistic regression analysis showed that when CRO infection confirmed, albumin concentration <25 g/L (P =0.014, OR=6.171), serum creatinine concentration≥120 µmol/L (P =0.009, OR=10.867) were independent risk factors for 30-day mortality of patients with hematologic diseases complicated with CRO infection. CONCLUSION: The mortality rate of CRO-infected patients with hematologic diseases is high. The detected pathogenic bacteria are highly resistant to imipenem. The albumin concentration <25 g/L and the serum creatinine concentration≥ 120 µmol/L at diagnosis of CRO infection were independent risk factors for 30-day mortality of the patients with hematologic diseases.

Prevalence of and risk factors for the occurrence of symptomatic osteoarthritis in rural regions of Shanxi Province, China.

AIM: To determine the prevalence of symptomatic osteoarthritis (OA) in rural regions of Shanxi Province, China, and to identify factors increasing the prevalence of OA. METHOD: Residents over 16 years of age of targeted towns and villages in rural regions of Shanxi Province were sampled using a stratified multi-stage cluster method. Those exhibiting symptoms of rheumatism were referred to rheumatologists and those in whom rheumatism was suspected were X-rayed within 10 days of interview. OA was diagnosed by consensus (two or three rheumatologists). Factors associated with the presence of OA were identified. RESULTS: A total of 7126 permanent residents were surveyed and 1734 (24.3%) had OA. Knee OA was the most prevalent form of OA (13.8%), followed by lumbar (7.4%), cervical (3.4%), hand (3.3%), shoulder (3.0%), elbow (2.9%), ankle (0.7%), hip (0.6%), wrist (0.5%), thoracic (0.5%) and foot OA (0.5%). All of knee, ankle, shoulder and hand OA exhibited a gender bias. Advanced age, a sweet tooth, poor home ventilation, poor home heating, separation, divorce, or death of a partner, low-grade occupation, low educational level, high body mass index and the presence of concomitant cardiovascular disease, were associated with the presence of OA. CONCLUSION: Symptomatic OA is very prevalent in rural regions of Shanxi Province. Many factors increase the prevalence of the condition. Primary and secondary prevention programs seeking to improve living conditions, to reduce obesity, and to effectively treat concomitant cardiovascular disease, are required.

[Comprehensive study on the risk factors of hepatitis B virus intrauterine infection].

OBJECTIVE: To study the risk factors of hepatitis B virus (HBV) intrauterine infection. METHODS: Risk factors of HBV intrauterine infection were analyzed by nested case control study. RESULTS: Data from univariate analysis revealed that risk factors of HBV intrauterine infection were positive results on HLA-DR3 (OR = 4.71, 1.62-13.66), HBV DNA (OR = 6.59, 2.72-15.97) and HBeAg (OR = 4.53, 1.93-10.64) in pregnant women, HLA-DR3 (OR = 3.91, 1.18-12.94) in newborn, HLA-I) R3 (OR = 5.96, 1.14-31.15) both in pregnant women and her newborns and HBV infection in placentas (OR = 2.51,1.12-5.60). Results from Multivariate unconditional logistics regression analysis showed that the risk factors of HBV intrauterine infection were positive in both HLA-DR3 (OR = 4.65, 1.44-15.05) and HBV DNA (OR = 6.56, 2.65-16.23) in pregnant women. However, there was no interaction between the two factors. The exposure rate of other factors did not reveal the difference in the two groups. With the increase of HBV DNA in pregnant women, the risk of HBV intrauterine infection was rising (chi2 = 16.74, P < 0.05). CONCLUSION: Risk factors of HBV intrauterine infection were HLA-DR3 positive and HBV DNA positive in pregnant women but there was no interaction between the two factors. The risk of HBV intrauterine infection was increased along with the increase of HBV DNA in pregnant women.

[Study on hepatitis B virus intrauterine infection state and its correlation factors].

OBJECTIVE: To investigate the correlation factors of hepatitis B virus (HBV) intrauterine infection and the influence factors of HBV infection in peripheral blood mononuclear cells (PBMC) and placentas. METHODS: HBeAg and HBsAg in 151 pregnant women and their newborns were determined by enzyme linked immunoadsorbent assay (ELISA). HBV DNA in serum and PBMC of pregnant women and their newborns were determined by polymerase chain reaction. HBsAg in 151 placentas were detected by immunohistochemistry ABC. The correlation risk factors were analyzed by non-condition logistic regression model. RESULTS: HBV DNA positive in serum, HBV DNA positive in PBMC of pregnant women and HBsAg positive in placentas were the risk factors for HBV intrauterine infection. Their odds ratio (OR) and 95% confidence interval were 2.25 (1.08-4.72), 2.69 (1.26-5.73) and 4.63 (1.70-12.62), respectively. The influence factors of HBV infection in placenta included antepartum injection of hepatitis B immunoglobulin (HBIG) over thrice and HBV DNA positive in serum of pregnant women with OR 0.08 (0.01-0.69) and 4.24 (1.22-14.69). The risk factor for HBV DNA positive in PBMC of newborns was HBV DNA positive in PBMC of their mothers with OR 24.53 (7.92-76.01). CONCLUSIONS: HBV infection in placentas, HBV DNA positive in PBMC and serum of pregnant women are the risk factors for HBV intrauterine infection. Antepartum injection of HBIG over thrice can protect placentas from being infected by HBV to some extent. PBMC HBV DNA positive in pregnant women is probably the independent risk factor for PBMC HBV intrauterine infection in newborns.

[Role of the cell transportion from mother to baby in the mechanism of HBV intrauterine infection].

OBJECTIVE: To explore the route that the HBsAg positive pregnant women's cell entered fetal circulation, and to study the mechanism of HBV intrauterine transmission that the cell transported HBV to fetus and infected fetus. METHODS: 123 pregnant women and 123 newborns were collected from December, 2001 to October, 2003 in Taiyuan Infectious Hospital. The cell transportion from mother to baby were determined by allele-specific PCR (AS-PCR) and heminested PCR(hemi-nPCR). RESULTS: Regarding GSTM1, ACE as maternal specific alleles: 42 mother-baby pairs were recruited from hemocyte specimens as informative cases, then examining 26 (61.90%) newborns' blood cell out of 42 informative cases had maternal cell DNA. There was significantly association between the cell transportion and HBV intrauterine infection (chi2 = 8.58, P < 0.01). There was significantly association between the cell transportion and HBV DNA positive in the newborns' PBMC (chi2 = 10.10, P < 0.01) . CONCLUSION: One factor of HBV intrauterine infection is in the result of the cell transportion from mother to baby; PBMC carrying HBV probably passed through placent barrier into fetus and infected them.

[Study on the relationship between fetomaternal cellular traffic and hepatitis B virus intrauterine infection].

OBJECTIVE: To study the relationship between fetomaternal cellular traffic and hepatitis B virus (HBV) intrauterine infection. METHODS: Maternal DNA and fetal DNA were amplified by short tandem repeat (STR)-polymerase chain reaction (PCR), allele-specific PCR (As-PCR) and heminested PCR (hemi-nPCR). Cell transfer from mother-to-fetus or fetus-to-mother was determined by detecting the existence of TH01, GSTM1 and ACE. The relationship between cell transfer from mother-to-fetus and HBV intrauterine infection was analyzed by nested case-control study. RESULTS: 26 of the 42 informative mother-baby pairs indicated mother-to-fetus cell traffic, 32 of the 40 informative mother-baby pairs indicated fetus-to-mother cell traffic and two-way cell traffic occurred in 10 mother-baby pairs. Statistical analysis demonstrated that the mother-to-fetus instead of fetus-to-mother cell traffic presented the association with HBV intrauterine infection. There was no significant correlation between mother-to-fetus cell traffic or the fetus-to-mother cell traffic. Both mother-to-fetus cell traffic and PBMC HBV DNA positivity appeared in pregnant women were risk factors of HBV intrauterine infection but the two did not manifest the interaction. The positive risk factors of positivity PBMC HBV DNA in newborns would included mother-to-fetus cell traffic and PBMC HBV DNA in pregnant women, also did not display the interaction. CONCLUSION: The cell traffic from HBsAg positive mother to fetus had more contribution to HBV intrauterine infection, which was possibly one of the HBV routes of intrauterine infecting.