Human encephalitis caused by pseudorabies virus infection: a case report

Pseudorabies virus (PRV) primarily infects swine but can infect cattle, dogs, and cats. Several studies have reported that PRV can cross the specie barrier and induce human encephalitis, but a definitive diagnosis of human PRV encephalitis is debatable due to the lack of PRV DNA detection. Here, we report a case of human PRV encephalitis diagnosed by the next-generation sequencing (NGS) of PRV sequences in the cerebrospinal fluid (CSF) of a patient. A male pork vendor developed fever and seizures for 6 days. NGS results showed PRV sequences in his CSF and blood. Sanger sequencing showed that PRV DNA in the CSF and PRV antibodies in both the CSF and blood were positive. MRI results revealed multiple inflammatory lesions in the bilateral hemisphere. Based on the clinical and laboratory data, we diagnosed the patient with PRV encephalitis. This case suggests that PRV can infect humans, causing severe viral encephalitis. People at risk of PRV infection should improve their self-protection awareness.

     

Analysis of Progression Patterns and Failure Sites of Patients With Metastatic Lung Adenocarcinoma With EGFR Mutations Receiving First-line Treatment of Tyrosine Kinase Inhibitors

BackgroundReliable prediction of progression patterns and failure sites for patients with stage IV lung adenocarcinoma is valuable for physicians to deliver personalized tyrosine kinase inhibitor (TKI) treatment.Patients and MethodsWe retrospectively enrolled 266 patients who had stage IV lung adenocarcinoma and received first-line TKI treatment from 2013 to 2017 in Shanghai Chest Hospital. The clinical characteristics at initial diagnosis, progression patterns, and failure sites were analyzed with the attempt to identify some predictive factors for progression patterns and failure sites.ResultsAmong all patients, 62.4% developed systemic progression, and 37.6% developed oligoprogression. Both cohorts had a median progression-free survival (PFS) of 9 months. The percentage of patients who developed original and distant failure was 39.1% and 60.9%, respectively. Patients with oligometastasis at initial diagnosis were more prone to develop oligoprogression (odds ratio [OR], 4.370; 95% confidence interval [CI], 1.881-10.151; P = .001), whereas pulmonary metastasis was negatively correlated with oligoprogression (OR, 0.567; 95% CI, 0.330-0.974; P = .04). Both oligometastasis diagnosis (OR, 2.959; 95% CI, 1.347-6.500; P = .007) and the maximum diameter of the primary lung lesion (threshold 3.25 cm: OR, 3.646; 95% CI, 2.041-6.515; P = .0001) were strong predictive factors for original failures. Osseous metastasis at initial diagnosis might be an indication for distant failure (OR, 0.536; 95% CI, 0.316-0.909; P = .021).ConclusionOver one-half of patients with stage IV lung adenocarcinoma receiving first-line TKI treatment developed systemic progression and distant failure. Metastasis patterns at initial diagnosis was the most important predictive factor for progression patterns and failure sites. The maximum diameter of the primary lung lesion and evidence of osseous metastasis were also found to be significant indicative factors for failure sites.     

电阻应变式传感器在下肢牵引手术中的应用

目的 研究电阻应变式传感器（RSS）在不同下肢骨折类型手术中的应用。方法 选择2020年10月—2022年8月中国科学技术大学附属第一医院收治的外伤性下肢骨折患者99例,按照骨折类型分为股骨粗隆间骨折组79例、股骨干骨折组15例、股骨颈骨折组5例。患者均在牵引床上行闭合复位内固定术,使用RSS测量3组不同骨折类型手术中的初始牵引力、牵引时长、松解牵引力。记录手术时间、术中出血量,术后评分及3组不同骨折类型手术前后血色素变化及输血情况;比较使用不同内固定方式（长髓内钉、短髓内钉、空心钉）的术中牵引力和手术出血量、手术时间;比较长髓内钉固定患者和短髓内钉固定患者时下肢旋转角度。结果 3组不同骨折类型初始牵引力、牵引时长、松解牵引力、手术时长、术中出血量、术后评分比较,差异均有统计学意义（P <0.05）。3组不同骨折类型术前、术后血红蛋白、红细胞压积比较,差异均有统计学意义（P <0.05）。3组术中输血情况比较,差异有统计学意义（P <0.05）,术后输血情况比较,差异无统计学意义（P>0.05）。使用不同内固定方式的患者牵引总时长、年龄、术中出血量、手术时间比较...     

GPR34-mediated sensing of lysophosphatidylserine released by apoptotic neutrophils activates type 3 innate lymphoid cells to mediate tissue repair

1. Download : Download high-res image (200KB)
2. Download : Download full-size image

     

强化护理在儿童急性白血病鞘内注射中的应用效果

目的探讨强化护理在儿童急性白血病鞘内注射治疗中的应用效果。方法选取2019年5月至2020年6月于中国科学技术大学附属第一医院西区行鞘内注射治疗的90例急性白血病患儿作为研究对象,按照入院时间将其分为A组(45例)与B组(45例)。A组采用常规护理方法,B组采用强化护理方法。比较两组的不良反应发生情况、家长满意度、护理质量。结果B组不良反应发生率低于A组,差异有统计学意义(P<0.05);B组家长总满意度高于A组,差异有统计学意义(P<0.05);B组护理质量高于A组,差异有统计学意义(P<0.05)。结论采用强化护理模式可缓解患儿鞘内注射治疗不良反应,减轻患儿痛苦,促进治疗顺利完成,提高家长满意度,改善护理质量,应用效果较好。     

预防性护理干预在女性垂体瘤切除术患者围手术期的应用效果

目的探讨预防性护理干预在女性垂体瘤切除术患者围手术期的应用效果。方法选取2019年11月至2020年12月中国科学技术大学附属第一医院南区收治的84例女性垂体瘤切除术患者作为研究对象,根据护理方法的不同分为观察组(42例)和对照组(42例),分别实施预防性护理干预和常规护理,比较两组患者术后并发症发生率、护理满意度及护理前后焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果观察组患者术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组护理后的SAS和SDS评分低于护理前,观察组护理后SAS和SDS评分低于对照组,差异有统计学意义(P<0.05)。观察组患者的护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论女性垂体瘤切除术患者实施预防性护理干预,可提高术后并发症的防治效果,促进患者快速、良好康复。     

优质护理在小儿喘息性支气管炎

目的观察优质护理在小儿喘息性支气管炎雾化吸入治疗中的应用效果。方法选取2019年10月至2020年12月于中国科学技术大学附属第一医院就诊的60例小儿喘息性支气管炎患儿,采用随机数字表法分为两组,每组各30例。对照组行常规护理,观察组行优质护理,比较两组护理效果、临床指标。结果观察组护理效果高于对照组,喘憋消除时间、咳嗽消除时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论为雾化吸入治疗小儿喘息性支气管炎患儿提供优质护理,能够在提升患儿护理效果的同时,改善临床指标。     

The role of bDMARDs in idiopathic inflammatory myopathies: A systematic literature review

Idiopathic inflammatory myopathies (IIM) are a group of different conditions typically affecting striate muscle, lung, joints, skin and gastrointestinal tract. Treatment typically relies on glucocorticoids and synthetic immunosuppressants, but the occurrence of refractory, difficult to treat, manifestations, may require more aggressive treatment, borrowed from other autoimmune diseases, including biologic disease modifying drugs (bDMARDs). In this regard, we conducted a systemic literature review in order to depict the current evidence about the use of bDMARDs in IIM. A total of 78 papers, published during the last 21 years, were retrieved. The majority of patients was treated with TNF-α inhibitors, whose effectiveness was assessed particularly in recalcitrant striate muscle, skin and joints involvement. Rituximab, whose evidence is supported by a large number of real-life studies and trials, seems to be an excellent option in case of ILD and anti-synthetase syndrome, while Tocilizumab, despite not meeting primary and secondary endpoints in a recently published clinical trial, proved its effectiveness in rapidly progressing ILD. Similarly, Abatacept, studied in a phase IIb clinical trial with conflicting evidence, was reported to be effective in some case reports of refractory dermatomyositis. Less data exist for anti-IL1 and anti-IL23 agents, which were employed particularly for inclusion body myositis and severe skin disease, respectively. This study provides an organ-focused assessment of bDMARDs in IIM, which display encouraging results in the treatment of refractory subsets of disease.     

Low-dose interleukin-2 treatment increases the proportion of regulatory T cells in patients with rheumatic diseases: A meta-analysis

BackgroundIt is now accepted that immune tolerance disorders caused by inadequate Treg cell function or number are important factors in the development and progression of rheumatic diseases. There is increasing evidence that ld IL-2 treatment increases the proportion of Treg cells in patients' peripheral blood, but this conclusion is still controversial. Here, we performed a meta-analysis of reports documenting the proportion of Treg cells and the rate of adverse events in patients with rheumatic disease before and after the administration of ld IL-2 to better understand its effect and safety on Treg cells in the field of rheumatic diseases.MethodsWe systematically searched PubMed, Embase, Scopus, Cochrane Library, and Web of science databases up to 15th November 2022 and identified studies that reported the proportion of peripheral blood Treg cells before and after ld IL-2 treatment in patients with rheumatic disease. Random-effects model was used to perform a meta-analysis of Treg cell proportions before and after ld IL-2 administration, and a meta-regression analysis was performed to explore heterogeneity. Inconsistency was evaluated using the I-squared index (I²), and publication bias was assessed by examining funnel plot asymmetry using the Egger tests.ResultsEighteen studies involving 1608 patients were included in the meta-analysis. The proportion of Treg cells in peripheral blood of these patients increased significantly after receiving ld IL-2 treatment [1.07 (95% CI 0.86,1.27), p < 0.001, I² = 67.3%]. Next, Meta-regression was performed for 5 variables including publish year, disease type, trail type and dosage and duration of the medication. The results suggest that these variables do not lead to high heterogeneity. (p = 0.698, 0.267, 0.502, 0.843, 0.560, respectively). And finally, statistical analysis showed no difference in adverse reactions between ld IL-2 group and control group in treatment [1.06 (95% CI 0.86,1.31), p = 0.586, I2 = 53.8%], which is unreliable because the data is so small.ConclusionsLd IL-2 does increase the proportion of peripheral blood Treg cells in patients with rheumatism, and single and cumulative doses must be considered when using ld IL-2. In addition, more studies on the safety of ld IL-2 are urgently needed.