Comparison of clinical features between chronic active Epstein-Barr virus infection and infectious mononucleosis in adult patients / 中华临床感染病杂志

Objective:To compare the clinical features between chronic active Epstein-Barr virus infection(CAEBV) and infectious mononucleosis(IM)in adult patients.Methods:Clinical data from 56 adult IM patients and 14 adult CAEBV patients admitted in the First Affiliated Hospital of Nanjing Medical University during January 2011 to December 2019 were enrolled. Clinical manifestations, laboratory indicators, treatment and outcomes were compared between two groups. Chi-square test and Mann-whitney U test were used to analyze data. Results:The average age of CAEBV patients was higher than that of IM patients [36.0(23.8, 50.5)years vs. 19.0(17.3, 22.8) years; U=90.0, P<0.05]. The symptoms of sore throat, throat congestion, tonsilla enlargement and lymphadenopathy in IM group were more common than those in CAEBV group( χ2=14.088, 16.875, 31.855 and 10.938, all P<0.01). However, the incidence of pulmonary infection, sleepiness/dysphoria and splenomegaly in CAEBV group were significantly higher than those in IM group( χ2=17.217, 5.809 and 6.254, P<0.05 or <0.01). The white blood cell counts, hemoglobin levels, platelet counts, alanine aminotransferase(ALT) and albumin in CAEBV group were significantly lower than those in IM group( U=47.0, 49.5, 158.5, 173.0 and 263.5, all P<0.01). The levels of neutrophil ratio, C-reactive protein, serum ferritin and EBV DNA load in CAEBV group were significantly higher than those in IM group( U=145.0, 140.0, 128.5 and 115.0, P<0.05 or <0.01). The proportions of CD3 + T cell counts and CD8 + T cell counts in CAEBV group were significantly lower compared to those in IM group( U=42.0 and 24.5, P<0.01); the proportions of CD4 + T cell counts, the CD4 + T/CD8 + T cell counts ratio and B lymphocytes in CAEBV group were significantly higher compared to those in IM group( U=29.0, 23.5 and 34.5, P<0.01). Fifty-six IM patients were all cured and discharged from hospital. In CAEBV group, 8 cases died, 3 cases were improved and 3 cases lost follow-up. Conclusions:Patients with IM represent a favorable prognosis, while the prognosis of CAEBV is relatively poor and complication with HLH may occur. For older patients with EBV infection complicated with pulmonary infection, lethargy/irritability, attention should be paid to monitor blood routine, liver function, serum EBV DNA load and peripheral blood lymphocyte subsets.

Qualitative study on post-traumatic experience of inpatients with simple maxillofacial trauma / 中国实用护理杂志

Objective:To investigate the post-traumatic experience of inpatients with simple maxillofacial trauma, and to provide a theoretical basis for the construction of post-traumatic intervention programs.Methods:A qualitative approach was used to conduct semi-structured interviews with 17 inpatients with simple maxillofacial trauma in Affiliated Hospital of Nantong University from January to April, 2020, and Colaizzi phenomenological analysis was used to analyze the interview data.Results:The post-traumatic experience of inpatients with simple maxillofacial trauma mainly included five themes: acute impairment of maxillofacial function, change of comfort, disorder of self-image, transformation from negative psychological experience to positive psychological experience, and lack of coping resources.Conclusions:Medical staff should pay attention to the functional recovery, body image and psychological intervention of inpatients with simple maxillofacial trauma, provide more professional support, and promote the physical and mental recovery of patients.

Effects of ShenGuiBaoXin Decoction on Matrix Metalloproteinase-2, the Tissue Inhibitor of Matrix Metalloproteinase-1, Brain Natriuretic Peptide, and Ventricular Remodeling in Rats with Chronic Heart Failure / 中国医科大学学报

Objective To observe the effects of ShenGuiBaoXin decoction on matrix metalloproteinases-2 (MMP-2), the tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), brain natriuretic peptide (BNP) levels, and cardiac histopathology in rats with heart failure, and to investigate the mechanism of the inhibition effect on ventricular remodeling in rats with heart failure. Methods Ninety male SD rats were randomly divided into two groups, with 15 rats in the control group and 75 rats in the model group. Normal saline was injected in the normal control group. The model group was given an intraperitoneal injection of isoprenaline 3 mg/ (kg·d). After 4 weeks, an ejection fraction of ≤50％ on echocardiography was considered a successful model. Seventy-five rats were randomly divided into the model, Qiliqiangxin, and ShenGuiBaoXin groups (high, medium, and low doses), with 15 rats in each group. Eight weeks later, the cardiothoracic ratio and BNP level were measured, hematoxylin-eosin staining was performed, and the MMP-2 and TIMP-1 protein expressions in the myocardium was detected. Results In terms of cardiothoracic ratio and BNP level, all the groups showed decreases after treatment, especially the Qiliqiangxin and high-dose groups. The MMP-2 protein expression level was decreased in all the groups after the treatment, and the high-dose group was superior to the Qiliqiangxin group. Conclusion ShenGuiBaoXin decoction functions by reducing the MMP-2 expression level, regulating MMP-2/TIMP-1 dynamic balance, maintaining the balance of synthesis and degradation of the extracellular matrix, inhibiting ventricular remodeling, and improving cardiac function.

Enhanced anti-tuberculosis immunity by a TAT-Ag85B protein vaccine in a murine tuberculosis model.

BACKGROUND: The development of more effective anti-tuberculosis vaccines would contribute to the control of the global problem of infection with Mycobacterium tuberculosis (MTB). Recently, increasing evidences showed that HIV-Tat protein transduction domain is implicated in promotion of vaccines by inducing cellular immuno-response. However, it is rare known about the role of TAT in vaccines against MTB. METHODS: In this study, we expressed recombinant protein-fused Ag85B with TAT (TAT-Ag85B) which was used as a vaccine to inoculate mice infected with MTB. RESULTS: As s result, both IgG2a in serum and IFN-γ or TNFα produced by spleen cells were all increased significantly in the mice inoculated by TAT-Ag85B. Furthermore, consistently, TAT-Ag85B inoculation significantly reduced MTB loads both in lung and spleen. CONCLUSIONS: These findings demonstrate that a novel protein vaccine of TAT-Ag85B enhances immune response both in humoral and cellular immunity, and contributes to protective efficacy against MTB.

Formulation optimization of metoprolol succinate sustained release pellets using central composite design-response surface methodology / 军事医学

Objective To optimize the formulation of metoprolol succinate ( MS) controlled release pellets by central composite design-response surface methodology .Methods MS sustained-release pellets were prepared using sugar pellet cores as starter beads , ethyl cellulose as coating materials and MS itself as a pore former .The formulation of MS sustained-release pellets was optimized by a central composite design with two factors at five levels .These two factors ( two independ-ent variables) were the pore former level and coating level , and the evaluated indexes ( namely dependent variables ) included the in vitro cumulative release percentages of MS at 1, 4, 8, 12 and 16 h, respectively.Results and Conclusion The results of mathematical equation fitting suggested that the second-order quadratic model was the optimal fitting equa-tion.According to the response surfaces , the optimum values at the pore former level and coating level weve ranged from 16%to 18%and 20% to 25%, respectively .The in vitro cumulative release percentage of MS from the pellets at 1 h reached 9.15%,which consequently eliminated the lag phase in the initial release period and exhibited a good sustained-release effect.Central composite design-response surface methodology can be applied to optimizing the coating formulation for MS sustained release pellets .