广州市儿童和青年新型冠状病毒Delta变异株感染患者临床特征

 目的 探讨儿童和青年新型冠状病毒（SARS-CoV-2） Delta变异株患者的临床特征。方法 选取广州医科大学附属市八医院2021年5月21日—6月18日收治的SARS-CoV-2 Delta突变株感染者,根据年龄分为儿童组（2~14岁）和青年组（15~35岁）,比较两组患者临床、实验室指标及影像学的差异。结果 儿童组21例,青年组24例,两组均无重症患者。儿童以家庭聚集性发病为特征,青年组普通型比儿童组更常见（66.7% VS 33.3%,P<0.05）。与青年组临床表现比较,儿童组咳嗽（33.3% VS 87.5%）、咳痰（33.3% VS 66.7%）和咽喉不适（28.6% VS 70.8%）少见（均P<0.05）,儿童发热时间更短（2.5 d VS 4 d,P<0.05）,但两组患者发热（76.2% VS 83.3%）差异无统计学意义。与青年组生化学指标比较,基线时儿童组C-反应蛋白（CRP）、血清淀粉样蛋白A （SAA）和白介素-6（IL-6）更低（均P<0.05）,但淋巴细胞（LYM）、嗜酸性粒细胞（EOS）、乳酸脱氢酶（LDH）和肌酸激酶同工酶（CK-MB）更高;第1周儿童组CRP和SAA更低,但LYM、EOS、LDH和CK-MB更高（均P<0.05）。儿童基线CK-MB和LDH升高更常见（均P<0.05）。儿童组基线时LYM减少5例（23.8%）,EOS减少3例（14.3%）,第1周LYM和EOS均恢复正常。胸部CT显示儿童组7例（33.3%）肺部感染,单侧受累为主;青年组16例（66.7%）肺部感染,双肺受累为主。儿童组SARS-CoV-2核酸转阴时间中位日数为17（12,25） d,青年组核酸转阴时间中位日数为19（15,21） d,两组患者均预后良好。结论 儿童SARS-CoV-2 Delta变异株感染以家庭聚集性发病为主要特征。与青年患者比较,儿童患者呼吸道症状、炎症反应、免疫细胞和肺损伤更轻,免疫细胞恢复更快。儿童患者基线CK-MB和LDH升高更常见,需关注急性心肌损伤的可能性。青年和儿童患者SARS-CoV-2核酸转阴时间长,需延长监测上呼吸道核酸的时间。     

Effectiveness of Preventive Therapy for Persons Exposed at Home to Drug-Resistant Tuberculosis,Karachi, Pakistan

In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patients began a 6-month course of preventive therapy with a fluoroquinolone-based, 2-drug regimen. We assessed effectiveness in this cohort by comparing the rate and risk for TB disease over 2 years to the rates and risks reported in the literature. Of 172 participants, TB occurred in 2 persons over 336 person-years of observation. TB disease incidence rate observed in the cohort was 6.0/1,000 person-years. The incidence rate ratio ranged from 0.29 (95% CI 0.04–1.3) to 0.50 (95% CI 0.06–2.8), with a pooled estimate of 0.35 (95% CI 0.14–0.87). Overall, fluoroquinolone-based preventive therapy for DR TB exposure reduced risk for TB disease by 65%.     

Extraintestinal Seeding of Salmonella enterica Serotype Typhi,Pakistan

We evaluated Salmonella enterica serotype Typhi strains isolated from all body sites in Pakistan during 2013–2018. Despite an increase in overall number of localized, extensively drug-resistant Salmonella Typhi in organ infections during 2018, there was no increase in the proportion of such isolates in comparison with non–extensively drug-resistant isolates.     

Expression of cyclooxygenase-2 mRNA in drug-sensitive cell and drugresistant strains of ovarian cancer cell lines

Objective： To investigate the expression of cyclooxygenase-2 （COX-2） mRNA in drug-sensitive cell and drugresistant clones of ovarian cancer cell lines. Methods： RT-PCR and immunocytochemistry were used to investigate the expression of cyclooxygenase-2 in 3 clones drug-sensitive and 5 clones drug-resistant ovarian cancer cell. Results： Strong COX-2 mRNA expressions were detected in 3 clones of drug-sensitive cell and weak expressions were detected in 5 clones of drug-resistant cell. The protein expression of COX-2 in drug-sensitive cell was strongly positive reaction in immunocytochemistry stain and there was a weak positive reaction in 5 clones of drug-resistant cell. Conclusion： The expression of COX-2 mRNA in drug-sensitive cell strains is much higher than that in drugresistant strains of ovarian cancer cell lines, providing a basis of the chemoprevention for ovarian cancer.     

基因芯片技术检测方法对耐多药肺结核治疗的指导价值研究

目的探讨基因芯片技术在肺结核耐药检测中的应用及指导临床治疗的价值。方法河北省胸科医院结核科住院的83位复治菌阳肺结核患者为选例对象,根据既往药敏试验结果,择符合条件的56例耐多药肺结核患者作为研究对象,随机分为基因芯片组24例根据基因芯片检测结果制定抗结核化疗方案,常规药敏组32例根据常规药敏试验结果制定抗结核化疗方案,观察评价两组在治疗后痰菌阴转情况及肺部病灶吸收情况。结果痰菌阴转情况基因芯片组58.3%(14/24),常规药敏组53.2%(17/32),基因芯片组略高于常规药敏组,组间相比无显著性差异(P0.05);X线肺部病灶吸收情况基因芯片组45.9%(11/24),常规药敏组43.8%(14/32),组间相比无显著性差异(P0.05)。结论基因芯片技术快速准确,可用于肺结核的耐药检测,指导临床用药。     

表没食子儿茶素没食子酸酯的抗感染作用研究进展

表没食子儿茶素没食子酸酯（epigallocatechin gallate，EGCG）是茶多酚的主要组成成分。EGCG具有多种生物学功能，包括抗细菌、抗真菌、抗病毒、抗肿瘤、抗炎症、抗衰老、抗肥胖、抗糖尿病、心血管疾病的预防和保护、免疫调节、神经保护等生物学功能。本文主要归纳了EGCG在治疗新型冠状病毒（SARS-CoV-2）感染中的潜在作用，在耐药细菌感染中的预防和治疗作用，以期为EGCG在抗感染药物开发方面提供一定的理论依据。     

Drug-resistant tuberculosis control in South Africa: scientific advances and health system strengthening are complementary

We examine some aspects of the South African health system that have contributed to the current multi- and extensively drug-resistant tuberculosis (M(X)DR-TB) epidemic and identify opportunities for change and improvement. Implementation of several recent major scientific advances have the potential to accelerate the control of M(X)DR-TB, but health systems strengthening will be essential.     

Nanocarrier-based interventions for the management of MDR/XDR-TB

Emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB over the past decade presents an unprecedented public health challenge to which countries of concern are responding far too slowly. Global Tuberculosis Report 2014 marks the 20th anniversary of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance, indicating the highest global level of drug-resistance ever recorded detection of 97?000 patients with MDR-TB resulting in 170?000 deaths in 2013. Treatment of MDR-TB is expensive, complex, prolonged (18–24 months) and associated with a higher incidence of adverse events. In this context, nanocarrier delivery systems (NDSs) efficiently encapsulating considerable amounts of second-line anti tubercular drugs (^sATDs), eliciting controlled, sustained and more profound effect to trounce the need to administer ^sATDs at high and frequent doses, would assist in improving patient compliance and avoid hepatotoxicity and/or nephrotoxicity/ocular toxicity/ototoxicity associated with the prevalent ^sATDs. Besides, NDSs are also known to inhibit the P-glycoprotein efflux, reduce metabolism by gut cytochrome P-450 enzymes and circumnavigate the hepatic first-pass effect, facilitating absorption of drugs via intestinal lymphatic pathways. This review first provides a holistic account on MDR-TB and discusses the molecular basis of Mycobacterium tuberculosis resistance to anti-tubercular drugs. It also provides an updated bird’s eye view on current treatment strategies and laboratory diagnostic test for MDR-TB. Furthermore, a relatively pithy view on patent studies on second-line chemotherapy using NDSs will be discussed.