Coronavirus Disease 2019 versus Influenza A in Children: An Observational Control Study in China

正This study aimed to understand the differences in clinical, epidemiological, and laboratory features between the new coronavirus disease 2019 (COVID-2019) and influenza A in children. Data of 23 hospitalized children with COVID-19 (9 boys, 5.7±3.8 years old) were compared with age-and sexmatched 69 hospitalized and 69 outpatient children     

借力医院文化环境探索传染病专科医院研究生医德培养的方法及途径

新医改环境下，临床医学人才的医德培养愈发重要，也越来越引起管理层重视。而医院文化环境对研究生医德培养可以起着潜移默化的引领作用，优秀的医院文化，能塑造并铸就研究生良好信念，强化研究生医德养成。结合传染病专科医院自身文化环境特点，探索传染病学研究生医德培养方式，对于传染病专科医院研究生医德培养具有一定理论指导意义。     

男男性行为者对HIV非职业暴露后预防的认知及相关因素分析

目的 了解MSM对HIV非职业暴露后预防（nPEP）的认知情况,以及使用nPEP的相关因素。方法 2019年3月15日至4月14日,采用滚雪球抽样方法,分别在北京市、深圳市和昆明市MSM社会组织招募年龄≥18岁男性、最近3个月发生过男男性行为、听说过HIV nPEP等符合条件的研究对象,通过“i卫士”收集人口学、行为学特征、nPEP基本知识及其咨询和使用情况。采用logistic回归模型对是否使用nPEP的相关因素进行分析。结果 共调查1 809人,nPEP基本知识知晓率为39.8%（720/1 809）,33.4%（605/1 809）咨询过nPEP,15.0%（271/1 809）使用过nPEP。多因素logistic回归分析结果显示,研究对象使用nPEP的相关因素包括最近3个月与男性HIV感染者发生过性行为（OR=2.58,95%CI：1.64~4.07）、最近1年HIV检测次数≥2次（OR=2.47,95%CI：1.28~5.11）、nPEP基本知识知晓（OR=0.70,95%CI：0.49~0.99）、咨询过nPEP（OR=70.98,95%CI：40.51~136.83）。结论 MSM对nPEP认知不足,应加强MSM的nPEP相关宣传教育,促进MSM发生HIV暴露后尽快使用nPEP。     

NF-κB和RBP-Jκ在大鼠肝再生过程中的作用及苦参碱的调节机制

目的:探讨肝再生过程中NF-κB、RBP-JK的作用及苦参碱对其调节机制,揭示苦参碱参与肝再生启动的分子机制.方法:60只SD大鼠随机分为2组,每组30只.肝大部分切除组:建立2/3肝切除模型;苦参碱/肝大部分切除组:建立2/3肝切除模型,同时以苦参碱灌胃.观察点为术后1、3、7、14、21 d,通过苏木精-伊红染色、...     

脂质蓄积指数和内脏脂肪指数对成年人代谢综合征的预测价值研究

背景　脂质蓄积指数（LAP）和内脏脂肪指数（VAI）是反映个体脂肪分布及内脏脂肪蓄积程度的重要指标，与肥胖相关的慢性代谢性疾病关系密切。目的　探讨LAP和VAI与成年人代谢综合征（MS）的相关性，并评估LAP、VAI对MS的预测价值。方法　纳入2018年9月至2019年5月在中日友好医院体检中心进行体检的708例受试者，其中MS患者249例（MS组），非MS患者459例（非MS组），比较两组患者LAP、VAI及相关生化指标。根据LAP、VAI四分位数将受试者进行分组（L1组、L2组、L3组、L4组各177例；V1组、V2组、V3组、V4组各177例），比较各组MS及其组分发生率。采用多因素Logistic回归分析计算不同LAP、VAI受试者MS的发生风险，并分别绘制不同性别LAP、VAI、腰围（WC）、体质指数（BMI）预测MS发生风险的受试者工作特征（ROC）曲线。结果　LAP和VAI与成年人MS发生率呈高强度正相关（Cramer's V=0.585、0.577）。多因素Logistic回归分析结果显示，在调整各危险因素后，L3组、L4组MS发生风险仍高于L1组，V3组、V4组MS发生风险仍高于V1组（P<0.001）。ROC曲线分析结果显示，男性LAP、VAI预测MS发生风险的ROC曲线下面积（AUC）分别为0.831〔95%CI（0.795，0.867）〕、0.825〔95%CI（0.788，0.863）〕，临界值分别为52.03、1.99；女性LAP、VAI预测MS发生风险的AUC分别为0.887〔95%CI（0.834，0.940）〕、0.886〔95%CI（0.827，0.945）〕，临界值分别为54.84、2.54。结论　LAP、VAI与成年人MS发生率呈高强度正相关，随着LAP、VAI增高，MS发生风险亦增高；LAP、VAI对MS有良好的预测价值，联合WC和BMI能有效预测MS。     

Molecular genetic analysis of Plasmodium vivax isolates from Eastern and Central Sudan using pvcsp and pvmsp-3α genes as molecular markers

In Sudan, Plasmodium vivax accounts for approximately 5–10% of malaria cases. This study was carried out to determine the genetic diversity of P. vivax population from Sudan by analyzing the polymorphism of P. vivax csp (pvcsp) and pvmsp-3α genes. Blood samples (n = 76) were taken from suspected malaria cases from 2012–2013 in three health centers of Eastern and Central Sudan. Parasite detection was performed by microscopy and molecular techniques, and genotyping of both genes was performed by PCR-RFLP followed by DNA sequence for only pvcsp gene (n = 30). Based on microscopy analysis, 76 (%100) patients were infected with P. vivax, whereas nested-PCR results showed that 86.8% (n = 66), 3.9% (n = 3), and 3.9% (n = 3) of tested samples had P. vivax as well as Plasmodium falciparum mono- and mixed infections, respectively. Four out of 76 samples had no results in molecular diagnosis. All sequenced samples were found to be of VK210 (100%) genotype with six distinct amino acid haplotypes, and 210A (66.7%) was the most prevalent haplotype. The Sudanese isolates displayed variations in the peptide repeat motifs (PRMs) ranging from 17 to 19 with GDRADGQPA (PRM1), GDRAAGQPA (PRM2) and DDRAAGQPA (PRM3). Also, 54 polymorphic sites with 56 mutations were found in repeat and post-repeat regions of the pvcsp and the overall nucleotide diversity (π) was 0.02149 ± 0.00539. A negative value of dN − dS (−0.0344) was found that suggested a significant purifying selection of Sudanese pvcsp, (Z test, P < 0.05). Regarding pvmsp-3α, three types were detected: types A (94.6%, 52/55), type C (3.6%, 2/55), and type B (1.8%, 1/55). No multiclonal infections were detected, and RFLP analysis identified 13 (Hha I, A1-A11, B1, and C1) and 16 (Alu I, A1-A14, B1, and C1) distinct allelic forms. In conclusion, genetic investigation among Sudanese P. vivax isolates indicated that this antigen showed limited antigenic diversity.     

索拉非尼联合国产PD-1抑制剂治疗不可手术切除的肝细胞癌的疗效及不良反应

目的研究索拉非尼联合国产程序性细胞死亡受体-1(programmed cell death receptor-1,PD-1)抑制剂在不可手术切除的肝细胞癌(hepatocellular carcinoma, HCC)中的疗效及不良反应。方法回顾性分析2019年6月至2021年1月于北京地坛医院肿瘤内科使用国产PD-1抑制剂联合索拉非尼治疗的不可手术切除的HCC患者的临床资料,资料完整且符合入组条件者共22例,其中卡瑞利珠单抗联合索拉非尼组9例,信迪利单抗联合索拉非尼组13例,随访患者,主要研究终点为统计客观缓解率(objective response rate, ORR)、疾病控制率(disease control rate, DCR)和无进展生存期(progression-free survival, PFS),次要研究终点为总生存期(overall survival, OS)和安全性。结果在可评价疗效的22例患者中,7例患者疗效评价为部分缓解(partial remission, PR),10例患者疗效评价为疾病稳定(stable disease, SD),5例患者疗效评价为疾病进展(progressive disease, PD),ORR为31.8%,DCR为77.3%。中位无进展生存期(median progression-free survival, mPFS)为8.0个月(5.4~10.6个月)。不良反应发生率为77.3%,最常见的不良反应为腹泻(27.3%)、手足综合征(22.7%)、转氨酶升高(22.7%)、疲乏(18.2%)。结论索拉非尼联合国产PD-1抑制剂治疗不可手术切除的HCC临床效果显著,不良反应可控,是一种安全、有效的治疗方案。     

AIDS患者肝功能异常的原因及预后分析

目的探讨AIDS患者发生肝功能异常的原因及预后情况。方法收集2008年4月—2013年3月北京地坛医院感染一科确诊为AIDS并在住院期间诊断肝功能异常的165例患者的临床资料,分析患者的一般情况、合并症、用药情况、CD4+T淋巴细胞计数、HIV载量、肝脏生化指标、肝损伤持续时间及处理措施、预后转归等。结果AIDS合并肝功异常患者中以男性、性传播病例居多;主要临床表现为食欲不振、恶心、皮疹、乏力、呕吐、腹泻等;肝功能转氨酶峰值为ALT 93.20(60.05~135.55)U/L,AST 65.10(43.60~113.80)U/L,肝功能异常程度多为轻度肝损伤;以磺胺类、抗HIV药、抗结核药及抗真菌药为主诱发的药物性肝损伤(141例,85.45%)为主要病因。132例(80.00%)患者肝功能恢复,平均恢复时间为8(5~13)d。结论AIDS患者用药复杂,药物性肝损伤多发,临床须全面了解AIDS患者的用药情况,定期监测肝功变化,评估肝毒性的发生风险,保证用药安全。     

Verteporfin synergizes the efficacy of anti-PD-1 in cholangiocarcinoma

BackgroundCholangiocarcinoma (CCA) is one of the primary hepatobiliary malignant neoplasms with only 10% of 5-year survival rate. Promising immunotherapy with the blockade of immune checkpoints has no clear benefit in CCA. The inhibition of YAP1 signaling by verteporfin has shown encouraging results by inhibiting cell proliferation and inducing apoptosis. This study aimed to evaluate the potential benefit of the combination of verteporfin and anti-programmed cell death 1 (PD-1) in CCA mouse model.MethodsWe assessed the cytotoxicity of verteporfin in human CCA cell lines in vitro, including both intrahepatic CCA and extrahepatic CCA cells. We examined the in vitro effect of verteporfin on cell proliferation, apoptosis, and stemness. We evaluated the in vivo efficacy of verteporfin, anti-PD-1, and a combination of both in subcutaneous CCA mouse model.ResultsOur study showed that verteporfin reduced tumor cell growth and enhanced apoptosis of human CCA tumor cells in vitro in a dose-dependent fashion. Nevertheless, verteporfin impaired stemness evidenced by reduced spheroid formation and colony formation, decreased numbers of cells with aldehyde dehydrogenase activity and positive cancer stem cell markers (all P < 0.05). The combination of verteporfin and anti-PD-1 reduced tumor burden in CCA subcutaneous SB1 tumor model compared to either agent alone.ConclusionsVerteporfin exhibits antitumor effects in both intrahepatic and extrahepatic CCA cell lines and the combination with anti-PD-1 inhibited tumor growth.     

抗病毒口服液治疗小儿手足口病肺脾湿热证的随机对照、多中心临床研究

目的 评价抗病毒口服液治疗普通型小儿手足口病肺脾湿热证的有效性及安全性。方法 采用随机、双盲、安慰剂平行对照、多中心临床试验方法,计划纳入288例患儿,按1：1的比例随机分为试验组和对照组。试验组服用抗病毒口服液,对照组服用安慰剂,剂量均为1~2岁5 mL/次、3~6岁10 mL/次,3次/d,疗程5 d。以完全退热时间为主要有效性指标。结果 实际入组287例,其中试验组144例、对照组143例。试验组完全退热中位时间为24 h （PPS数据集,下同）,对照组为48 h,两组比较差异有显著性（P<0.05）;试验组皮疹/疱疹开始消退中位时间为24 h、对照组为40 h,试验组皮疹/疱疹完全消退中位时间为96 h、对照组为112 h,试验组中医证候疗效总愈显率为92.62%、对照组为72.32%,两组比较,差异均有统计学意义（P<0.05）。试验组与对照组不良事件发生率分别为4.35%和2.99%,组间比较,差异无统计学意义。结论 抗病毒口服液治疗小儿手足口病普通型肺脾湿热证,可以缩短退热时间、皮疹/疱疹消退时间,促进口腔黏膜疱疹/溃疡愈合,改善中医证候,临床使用有效、安全。