中华传染病杂志最新文献

{"title":"Direct-acting antiviral agents in the management of chronic hepatitis C virus in China: factors and considerations","authors":"Lai Wei","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.001","url":null,"abstract":"","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48821607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population","authors":"Ying-hui Gao, H. Rao, Rui‐feng Yang, J. Shang, Hong Chen, Jun Li, Q. Xie, Zhiliang Gao, Lei Wang, Jia Wei, Jianning Jiang, Yongtao Sun, R. Fei, Haiying Zhang, X. Kong, Q. Jin, Jian Wang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.10.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.10.005","url":null,"abstract":"Objective \u0000To evaluate the prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population. \u0000 \u0000 \u0000Methods \u0000This was a multicenter, cross-sectional study. A total of 997 Chinese Han patients with hepatitis C virus (HCV) infection were enrolled. Demographic data, anthropometric data and clinical parameters related to metabolic syndrome were collected. Statistical analysis was performed by t-test (normal distribution) or Mann-Whitney U two-sample test (non-normal distribution) and χ2 test. Binary logistic regression analyses were used to determine the parameters significantly related to metabolic syndrome. \u0000 \u0000 \u0000Results \u0000Among the 997 patients, 170 (17.1%) patients were diagnosed with metabolic syndrome. Binary logistic regression showed that genotype 2 (OR=1.594; 95%CI: 1.045-2.431, P=0.030), older age (OR=1.040; 95%CI: 1.022-1.058, P<0.01), overweight (OR=3.876; 95%CI: 2.593-5.792, P<0.01), fatty liver history (OR=2.106; 95%CI: 1.384-3.204, P=0.001), homeostasis model assessment insulin (HOMA-IR) (OR=1.263; 95%CI: 1.118-1.427, P<0.01), fasting insulin (OR=0.949; 95%CI: 0.915-0.985, P=0.006), lower serum albumin level (OR=0.957; 95%CI: 0.915-1.000, P=0.049) and higher γ-GT level (OR=1.004; 95%CI: 1.000-1.008, P=0.0041) were all significantly associated with the presence of metabolic syndrome. \u0000 \u0000 \u0000Conclusions \u0000Hepatitis C patients with genotype 2, older age, overweight, fatty liver history, higher HOMA-IR, lower fasting insulin level, lower serum albumin level or higher γ-GT level should be screened for metabolic syndrome. \u0000 \u0000 \u0000Key words: \u0000Hepatitis C chronic; Genotype; Metabolic syndrome","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49026146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between liver steatosis and serum virological markers during immune clearance phase of chronic hepatitis B","authors":"Jiaofeng Huang, Su Lin, Yueyong Zhu","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.003","url":null,"abstract":"Objective \u0000To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB) during immune clearance (IC) phase. \u0000 \u0000 \u0000Methods \u0000Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016. Patients were divided into non-to mild fatty liver (F0-F1) group and moderate to severe fatty liver (F2-F4) group according to the liver steatosis degree. The relationship between liver steatosis and virological markers in serum was compared. The measurement data were analyzed using independent sample t test, and the count data were analyzed by chi-square test. \u0000 \u0000 \u0000Results \u0000A total of 298 patients were included, including 237 males (79.5%) and 61(20.5%) females, and the average age was (32.4±10.3) years old. The 23.5% (70/298) of these patients had liver steatosis. A total of 273 (91.6%) cases were in F0-F1 group, and the remaining 25 (8.4%) cases were in F2-F4 group. The patients in F2-F4 group had higher body mass index ([25.90±2.70] vs [21.68±2.90] kg/m2), serum triglyceride ([1.52±0.77] vs [1.11±0.55] mmol/L) and cholesterol ([4.88±1.15] vs [4.33±0.92] mmol/L) than F0-F1 group, and the differences were all statistically significant (t=-7.007, -2.667, and -2.751, respectively, all P<0.05). In addition, the serum levels of HBsAg and HBV DNA in F2-F4 group were also significantly higher than F0-F1 group (t=-3.291 and -2.831, respectivelt, both P<0.01). According to the grading of inflammation and fibrosis, the differences of HBsAg and HBV DNA levels between F0-F1 group and F2-F4 group were statistically significant only in patients with more severe inflammation (t=-2.738 and -2.135, respectively, both P<0.05) or less severe fibrosis (t=-2.258 and -2.333, respectively, both P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Among CHB patients experiencing immune clearance, serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis, and this phenomenon is closely related to the degree of liver inflammation. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B, chronic; Hepatitis B surface antigens; Fatty liver; Immune clearance","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46301523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 levels in evaluation of severe hand, foot, and mouth disease complicated with neurogenic pulmonary edema","authors":"Shu-qin Fu, Chunlan Song, Yajie Cui, Peng Li, Fangzhou Chen, Lin Zhu","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.007","url":null,"abstract":"Objective \u0000To investigate the significance of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in serum and cerebrospinal fluid for evaluation of severe hand, foot, and mouth disease (HFMD) complicated with neurogenic pulmonary edema (NPE). \u0000 \u0000 \u0000Methods \u0000A total of 140 patients diagnosed with HFMD in Henan Children′s Hospital were enrolled and divided into three groups including mild group, severe HFMD group without NPE , severe HFMD group with NPE .These severe HFMD patients were also divided into survival group and death group according to the 28-day prognosis. Meanwhile, 50 age-matched healthy children were selected as controls. Serum MMP-9 and TIMP-1 levels were measured in all enrolled children. At the same time, MMP-9, TIMP-1 and ratio of MMP-9/TIMP-1 in cerebrospinal fluid were measured in the severe HFMD group with and without NPE. Quantitative data were compared using one-way analysis of variance, and means comparisons between samples were conducted using LSD- t test. \u0000 \u0000 \u0000Results \u0000Among 140 children with HFMD, 66 were in mild group, 42 in severe HFMD without NPE group, and 32 in severe HFMD with NPE group. And 50 healthy children were in control group. After 28 days, 14 cases died in severe HFMD groups. MMP-9, TIMP-1 and MMP-9/TIMP-1 in serum of severe HFMD group with NPE increased significantly greater than those in the other three groups (F=269.356, 121.301 and 101.502, respectively, all P <0.05). MMP-9, TIMP-1 and MMP-9/TIMP-1 in cerebrospinal fluid of severe HFMD group with NPE were (57.24±8.92) μg/L, (35.26±8.14) μg/L and (1.66±0.23) μg/L, respectively, while those in cerebrospinal fluid of severe HFMD group without NPE were (30.57±3.89) μg/L, (26.25±0.32) μg/L and (1.17±0.61) μg/L, respectively. The differences between the two groups were all statistically significant (t=62.485, 37.680 and 169.387, respectively, all P<0.01). MMP-9, TIMP-1 and MMP-9/TIMP-1 in serum and cerebrospinal fluid of death group increased significantly greater than those in survival group, the difference were statistically significant (all P<0.01). The maximum area under curve (AUC) was reached when the MMP9/TIMP-1 ratio in cerebrospinal fluid was 0.890 (95% CI: 0.801-0.978). \u0000 \u0000 \u0000Conclusions \u0000MMP-9 and TIMP-1 may be involved in the pathogenesis of HFMD complicated with NPE. The detection of MMP-9 and TIMP-1 levels may be beneficial for the early diagnosis of severe HFMD with NPE. The imbalance of MMP-9/TIMP-1 ratio can be used as one of the predictors of severe HFMD combined with NPE. \u0000 \u0000 \u0000Key words: \u0000Matrix metalloproteinase 9; Hand, foot and mouth disease; Pulmonary edema; TIMP-1","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47936903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and clinical significance of serum microRNA-122 in liver fibrosis of patients with chronic hepatitis B","authors":"Yan Wang, Xiangyu Chen, Ya Li, Yu Wang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.004","url":null,"abstract":"Objective \u0000To evaluate the expression of serum microRNA (miRNA)-122 in patients with chronic hepatitis B (CHB) with different stages of liver fibrosis, and to investigate its relevance with the clinical parameters. \u0000 \u0000 \u0000Methods \u0000Totally 138 CHB patients and 30 healthy controls were enrolled. Real-time polymerase chain reaction was used to measure the relative expression of miRNA-122 in serum. Serum levels of ALT, AST, γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), total bilirubin (TBil), albumin, prothrombin time (PT) and HBV DNA were measured, and their correlations with serum miRNA-122 were analyzed. Receiver operating characteristic (ROC)curev analysis was performed for miRNA-122 to compare healthy controls and CHB patients with fibrosis. Non-parametric t-test was used for comparison between groups. \u0000 \u0000 \u0000Results \u0000The relative expressions of serum miRNA-122 in patients with CHB and healthy controls were 4.41±1.32 and 1.47±0.58, respectively, with significantly statistical difference (t=3.16, P 0.05). The area under curve (AUC) value for miRNA-122 in the differentiation between CHB patients and control group was 0.92, and the AUC for predicting significant fibrosis and cirrhosis were 0.78 and 0.81, respectively. \u0000 \u0000 \u0000Conclusion \u0000Serum miRNA-122 is closely related to the replication of HBV, liver damage and liver fibrosis stage. It may play a suppressive role on the HBV replication and the development of liver fibrosis. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Hepatitis B virus; microRNA-122","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43165598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening of differential microRNA and prediction of target genes between human immunodeficiency virus-Burkitt lymphoma and diffuse large B cell lymphoma","authors":"Di Wang, Dong Zeng, Ye Zheng, Peng Zhang, Yan-ling Feng","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.005","url":null,"abstract":"Objective \u0000To screen the differential microRNA (miRNA) in human immunodeficiency virus (HIV) related Burkitt lymphoma (BL) and diffuse large B cell lymphoma (DLBCL). \u0000 \u0000 \u0000Methods \u0000Five freshly frozen tissue samples of BL and 3 freshly frozen tissu samples of DLBCL, 19 paraffin specimens of BL and 15 paraffin specimens of DLBCL were collected from Shanghai Public Health Clinical Center. Agilent human miRNA microarrays were employed to detect the miRNA expressions in fresh frozen BL tissues and fresh frozen DLBCL tissues, and to find out differential miRNA. SmartRNAplex™ miRNA was employed to verify the expressions of crucial miRNA in BL formalin fixed and paraffin-embedded tissues and DLBCL FFPET. Bioinformatics methods were used to predict the target genes of the crucial miRNA. \u0000 \u0000 \u0000Results \u0000Compared with DLBCL group, 42 differential miRNA were detected in BL group. Among them, 28 miRNA were up-regulated and 14 miRNA were down-regulated in BL group. According to positive control in eukaryote and high-expression molecular contributing to the emergence of tumor, 5 crucial miRNA were selected from 28 up-regulated miRNA in BL group for validation. The result was consistent with that of Agilent human miRNA microarrays. Compared with the DLBCL group, 5 crucial miRNA were all up-regulated in BL, which were miRNA-16-2-3p, miRNA-20a-3p, miRNA-130b-3p, miRNA-185-5p and miRNA-423-5p (t=2.7151, 2.539, 2.750, 4.004, and 3.625, respectively, all P<0.05). The corresponding target genes of miRNA-16-2-3p might be CTNND2 and RAD21.The target genes of miRNA-20a-3p might mainly be DYRK1A and GPAM. The target genes of miRNA-130b-3p might mainly be IRF1, DICER1 and PTEN. The target genes of miRNA-185-5p might mainly be VEGFA, NFATC3 and SEC24C.The target genes of miRNA-423-5p might mainly be PA2G4 and PNKD. \u0000 \u0000 \u0000Conclusions \u0000There are significantly differentially expressed miRNA between BL and DLBCL tissues. These miRNA are expected to provide new molecular markers for diagnosis and differential diagnosis of BL and DLBCL. Potential target genes of crucial miRNA are related with cell survival, proliferation, differentiation, apoptosis and carcinogenesis, etc, which may play important roles in the origination and progress of BL. \u0000 \u0000 \u0000Key words: \u0000Human immunodeficiency virus; Burkitt lymphoma; Lymphoma, large B-cell, diffuse; MicroRNA; Clinical pathology","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42634430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changes and significance of the soluble B cell-activating factor in the peripheral blood of patients with chronic human immunodeficiency virus infection","authors":"Xingzhong Hu, W. Kong, Guiqing He, Jichan Shi, Xiaoya Cui","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.006","url":null,"abstract":"Objective \u0000To elaborate the changes of the soluble B cell-activating factor of the tumor necrosis factor family (BAFF) in the peripheral blood of chronic human immunodeficiency virus (HIV)-infected patients, and to study the correlation between the soluble BAFF in HIV-infected patients and the progressions of acquired immune deficiency syndrome (AIDS). \u0000 \u0000 \u0000Methods \u0000Fifty untreated HIV outpatients and 30 healthy controls were recruited. According to the counts of CD4+ T lymphocytes, HIV-infected patients were divided into three groups, 350 cells/μL group. B cell counts and the BAFF levels were compared among the three groups and the healthy controls. The correlation analysis was conducted for the levels of BAFF, the counts of CD4+ T lymphocytes and B cells, and viral load in HIV-infected patients. The value of BAFF in staging of HIV disease was identified by receiver operating characteristic (ROC) curve. \u0000 \u0000 \u0000Results \u0000The B cell counts were (90.3±43.1) cells/μL in 350 cells/μL group and (307.1±97.0) cells/μL in healthy controls, which was significantly different among the four groups (F=47.92, P<0.05). The concentrations of BAFF in the four groups were (1 737.5±719.7), (962.8±341.1), (859.8±270.4), and (456.9±163.7) ng/L, with significant difference among the groups (F=36.72, P<0.05). The level of BAFF was negatively correlated with both B cell counts and CD4+ T lymphocyte counts (r=-0.722 and -0.568, respectively; both P<0.05), and positively correlated with viral load (r=0.607, P<0.05). The area under the ROC curve was 0.881. If the level of BAFF was 1 281.5 ng/L, the sensitivity and specificity to predict the period of AIDS were 74.1% and 87.0%, respectively. \u0000 \u0000 \u0000Conclusion \u0000The levels of soluble BAFF in HIV-infected patients are significantly increased and related with the reduction of B cell counts and disease progression. \u0000 \u0000 \u0000Key words: \u0000HIV-1; B-lymphocytes; BAFF","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43979537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the construction and virulence observation of Rv2346c gene knockout strains of Mycobacterium tuberculosis mediated by bacteriophage","authors":"Xiaolin Chen, Sixia Chen, Jing Yao, Lei Shu, Kaili Deng","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.08.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.08.007","url":null,"abstract":"Objective \u0000To investigate the Rv2346c gene function through constructing Rv2346c gene knockout strains of Mycobacterium tuberculosis (M. tuberculosis) mediated by bacteriophage and observing its virulence after infecting mice lung tissue in vivo. \u0000 \u0000 \u0000Methods \u0000The affinal exchange sites (AES) of the target gene was built, and then integrated into the phage genomes of M. tuberculosis for harvesting the phagemids. The phagemids was imparted into Mycobacterium smegmatis to get recombinant phages with the same AES. A high titer of the recombinant phages was harvested through amplification in vitro. The M. tuberculosis was transfected and coated on solid medium with hygromycin resistance and cultured for 4 weeks at 37℃. Single clone was picked out and gene knock-out was confirmed by PCR. Then C57BL/6J mice were infected with either wild type strain (WT) or knockout strain (KO) of M. tuberculosis. Mice mortality, lung tissue inflammation and colony-forming units (CFU) counts in vitro were observed 6 to 8weeks post infection with different strains. Paired-samples t test was used for comparison between groups, chi-square test was used for comparison of rates. \u0000 \u0000 \u0000Results \u0000The products of PCR and inserted fragment sizes were consisted with the expectation and confirmed to be the target gene. The target fragment of Rv2346c was removed successfully and the mice were infected for 6-8 weeks. The mice infected with Rv2346c KO strain had reduced mortality (53% vs 20%, χ2=6.1112, P<0.05), lung tissue inflammation (1 040±89 vs 1 960±56, t=7.101 6, P<0.05) and CFU count in vitro (15.0±0.8 vs 90.0±1.5, t=23.036 1, P<0.05) compared with WT strain 6-8 weeks post infection. \u0000 \u0000 \u0000Conclusion \u0000Rv2346c gene knockout strains of M. tuberculosis mediated by bacteriophageis are successfully constructed, which establishes the foundation for the future gene function study of Rv2346c. \u0000 \u0000 \u0000Key words: \u0000Bacteriophages; Mycobacterium tuberculosis; Gene knockout strains; Rv2346c gene","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43987439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for cryptococcal antigenemia and analyzsis of the related cryptococcal lesions in hospitalized human immunodeficiency virus infected patients","authors":"Zhiliang Hu, Wei Chen, Yaling Chen, Yuan Liu, Yun Chi, Cong Cheng, Yongfeng Yang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.08.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.08.005","url":null,"abstract":"Objective \u0000To evaluate the prevalence of cryptococcal antigenemia and explore the related cryptococcal lesions in hospitalized human immunodeficiency virus (HIV)-infected patients. \u0000 \u0000 \u0000Methods \u0000Medical records of 517 HIV-infected patients, including patients' age, sex, clinical features, previous medical history, laboratory tests, chest CT, treatment and the response to treatment, in the Second Hospital of the Nanjing between January 2016 and February 2018 were retrospectively analyzed. The serum cryptococcal antigen (sCrAg) was detected by lateral flow immunoassay. The χ2 test or Fisher exact test was used to perform the statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 517 HIV-infected cases, 51 were sCrAg positive, of whom 96.1% (49 cases) were men. The cases with CD4+ T lymphocyte count <100×106 cells/L accounted for 66.2% (342 cases), while 90.2% (46 cases) in sCrAg-positive patients showed CD4+ T lymphocyte count <100×106 cells/L with statistical significance (χ2=14.6, P<0.01). Multivariable analysis revealed that CD4+ T lymphocyte count <100 ×106 cells/L was independent risk factor for cryptococcal antigenemia (OR=4.7; 95%CI: 1.8-12.5, P<0.01). Clinical cryptococcal diseases were found in 76.4% (39/51) of patients with cryptococcal antigenemia, and cryptococcal meningitis (CM), pulmonary cyptococcosis (PC) and cryptococcal septicemia were found in 56% (28/50), 52.9% (27/51) and 44.4% (16/36) of the patients, respectively. Cryptoccal disease was not identified in 21.6% (11/51) of the patients with cryptococcal antigenemia (isolated cryptococcal antigenemia). The median (range) sCrAg titers of the patients with and without CM were 1∶1 280 (1∶10-1∶2 560) and 1: 15 (1∶2-1∶2 560), respectively (P<0.01). The proportion of CM in patients with sCrAg titers ≤1∶5, 1∶10-1∶320 and ≥1∶640 were 0 (0/10), 50% (10/20) and 90% (18/20), respectively. When cryptococcal infection was restricted to the lung, 87.5% (7/8) of the patients had sCrAg titers ≤1∶20. 30% (3/10) of the patients with sCrAg titers ≤1∶5 had PC. The median (range) sCrAg titers of the patients with cryptococcal septicemia and with isolated cryptococcal antigenemia were 1∶1 280 (1∶10-1∶2 560) and 1∶5 (1∶2-1∶320), respectively. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of cryptococcal antigenmia is high in hospitalized HIV-infected patients. Most patients with cryptococcal antigenemia have developed cryptococcal diseases. The sCrAg titer in HIV patients may, in some extend, predicts the condition of cryptococcal infection. sCrAg titers ≥1∶640 are strongly suggestive of CM. Patients with sCrAg titers ≤1∶5 seems unlikely to have CM or cryptococcal septicemia, however, clinician should still be alarmed of possible PC. \u0000 \u0000 \u0000Key words: \u0000HIV; Meningitis, cryptococcal; Cryptococcal antigenemia; Pulmonary cryptococcosis; Cryptococcal septicemia","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69753508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dynamics of serum vascular endothelial cadherin levels and its relationship with prognosis in patients with acute respiratory distress syndrome induced by sepsis","authors":"Zhenyu Li, Wei Li, Xiaolong Zong, Huiqing Hu","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.08.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.08.002","url":null,"abstract":"Objective \u0000To investigate the prognostic significance of serum vascular endothelial cadherine (VE-Cad) in patients with acute respiratory distress syndrome (ARDS) induced by sepsis. \u0000 \u0000 \u0000Methods \u0000A prospective observational study was performed between June 2015 and Dec 2017, and 48 ARDS patients induced by sepsis from intensive care unit (ICU) were enrolled. And 30 healthy volunteers were enrolled as control. ARDS group was divided into mild group (n=17), moderate group (n=18) and severe group (n=13). The dynamic levels of serum VE-Cad, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were monitored at day 1, 3 and 7 of admission. Clinical data including extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI), lung injury score (LIS), APACHEⅡand SOFA were also collected. The t-test or chi square test were used in the comparison between the two groups. One-way ANOVA was used for comparison among multiple groups. \u0000 \u0000 \u0000Results \u0000The serum VE-Cad level of septic group was higher than control group at day 1 of admission ([5.67±0.29] vs [0.28±0.03] g/L, t=101.2, P<0.01). The serum VE-Cad levels in the mild group, moderate group and severe group were (1.52±0.59), (3.45±0.68), and (4.68±0.53) g/L, respectively (F=15.45, P<0.01). There were positive correlation between VE-Cad levels and EVLWI, PVPI, LIS, TNF-α and IL-6 (r=0.640, 0.601, 0.507, 0.584, and 0.456, respectively, all P<0.01). The PaO2/FiO2and serum albumin level in death group (n=17) were lower than survival group (n=31) ([146.74±16.45] vs [245.42±12.13] mmHg [1 mmHg=0.133 kPa], t=23.72, P<0.01; [23.18±3.24] vs [29.16±3.45] g/L, t=5.865, P<0.01, respectively), and EVLWI , PVPI, LIS, serum lactate, mechanical ventilation time, 7 d fluid balance, APACHEⅡand SOFA in death group were all higher than survival group. The serum VE-Cad levels at day 1, 3 and 7 in death group were all higher than survival group ([4.72±0.96] vs [3.36±0.47] g/L, t=8.801; [3.87±0.28] vs [1.95±0.42] g/L, t=16.86; [3.92±0.53] vs [0.96±0.28] g/L, t=25.42, respectively, all P<0.01). The area under curve (AUC) of VE-Cad for ARDS outcome prediction was 0.878 with sensitivity of 100.00% and specificity of 58.06% with a cutoff of 3.035 g/L. \u0000 \u0000 \u0000Conclusion \u0000Serum VE-Cad level increases in patients with ARDS induced by sepsis, and positively correlates with disease severity, which could be a potential predictor for prognosis. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Acute respiratory distress syndrome; VE-cadherin; Tumor necrosis factor-alpha; Prognosis","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48631809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}