围产新生儿SARS-CoV-2感染临床观察研究方案专家建议

严重急性呼吸综合征冠状病毒2(Severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染流行,但因目前新生儿病例报道较少,证据资料欠完善,对新生儿SARS-CoV-2感染的途径、临床特征、治疗及预后甚至诊断标准等认识尚不清楚和统一,故围产界应积极对围产儿SARS-CoV-2感染进行系统全面研究,因为这些临床资料、统计数据和研究结果将对于此次乃至今后冠状病毒感染在这些最脆弱特殊人群防治具有十分重要的意义。为此,中国医师协会新生儿科医师分会循证学组、中华医学会围产医学分会重症学组联合组织专家组研制本建议,供围产学界同行拟定该方面具体项目计划参考。     

Evaluation of SARS-CoV-2 prototype serologic test in hospitalized patients

ObjectivesHumoral immune response to SARS-CoV-2 infection has been reported in several patient cohorts with results that vary by method and population studied due to the lack of reliable commercial assays available as the pandemic initially spread. We sought to clinically assess commercial prototype SARS-CoV-2 IgG and IgA assays for use in screening for prior infection and convalescent plasma donation.Design and Methods: Prototype SARS-CoV-2 IgG and IgA assays from Euroimmun were assessed utilizing remnant specimens. Specificity testing used specimens in their convalescent window for the common coronaviruses and other infectious diseases known to be associated with increased non-specificity in serologic assays. Sensitivity testing utilized serial specimens from molecularly confirmed SARS-CoV-2 critically ill patients to assess seroconversion. Utilizing recombinant spike protein we also developed a competitive confirmation procedure to increase assay specificity.ResultsWe determined specificity to be 97% and 81%, respectively, when indeterminate samples were considered positive and 99% and 86% when indeterminate samples were considered negative. We developed a new confirmation methodology to enhance the specificity of the assays with an anticipated specificity of 98% for IgA. Valuation of hospitalized COVID-19 patients determined median IgA seroconversion to be 8 days and IgG 10 days. Neither level nor timing of antibody response correlated with days on ventilation. End titer measurements indicate that validated improved assays may be capable of semi-quantitative measurement.ConclusionsWe found these assays to be clinically acceptable for the high prevalence population tested, for instance, for convalescent plasma donation.     

The rs5743708 gene polymorphism in the TLR2 gene contributes to the risk of tuberculosis disease

Background: It has been reported that one single nucleotide polymorphisms (SNPs) rs5743708 in TLR2 gene might be associated with the susceptibility to tuberculosis disease. Owing to mixed and inconclusive results, we conducted a meta-analysis to systematically summarize and clarify the association between the rs5743708 gene polymorphism in the TLR2 gene and the risk of tuberculosis disease. Methods: A systematic search of studies on the association of the rs5743708 gene polymorphism in the TLR2 gene with susceptibility to tuberculosis disease was conducted in PubMed. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to pool the effect size. Results: A total of nineteen case-control studies from 13 articles on rs2910164 and 3 studies on the rs5743708 gene polymorphism in the TLR2 gene and the risk of tuberculosis disease were included. A significant relationship between the rs5743708 gene polymorphism in the TLR2 gene and tuberculosis disease was discovered in an allelic genetic model (OR: 2.801, 95% CI: 2.130-3.683, P=0.000), a homozygote model (OR: 5.795, 95% CI: 1.982-16.941, P=0.001), a heterozygote model (OR: 2.628, 95% CI: 1.888-3.569, P=0.000), a dominant genetic model (OR: 2.786, 95% CI: 2.003-3.877, P=0.000) and a recessive genetic model OR: (5.568, 95% CI: 1.907-16.255, P=0.002). In sub-group analysis base on ethnicity, significance was observed between the Caucasian group and the Asian group. Conclusions: The rs5743708 gene polymorphism in the TLR2 gene contributes to the risk of tuberculosis disease. Individuals with the rs5743708 gene polymorphism in the TLR2 gene are under a higher risk for tuberculosis disease.     

动吃两平衡换算工具对2型糖尿病患者教育效果的影响

目的探讨动吃两平衡换算工具对2型糖尿病患者教育效果的影响。方法将我院辖区内的128例2型糖尿病患者,按随机数字表法分为观察组65例和对照组63例。两组均进行糖尿病健康教育,观察组采用动吃两平衡换算工具加以指导。对照组采用常规方式进行健康教育。3个月后,观察两组各项指标及其教育依从性。结果干预后两组生化指标比较,观察组明显优于对照组,有显著性差异(P0.05),观察组依从性(除戒烟戒酒外)明显高于对照组,有显著性差异(P0.05)。结论采用动吃两平衡换算工具进行糖尿病健康教育指导,有利于糖尿病患者进行自我管理。     

Inborn errors of immunity with eosinophilia

Monogenic diseases of the immune system, also known as inborn errors of immunity (IEIs), are caused by single-gene mutations and result in immune deficiency and dysregulation. More than 400 monogenic diseases have been described to date, and this number is rapidly expanding. The increasing availability of next-generation sequencing is now facilitating the diagnosis of IEIs. It is known that IEIs can predispose a person to not only infectious diseases but also cancer and immune disorders, such as inflammatory, autoimmune, and atopic diseases. IEIs with eosinophilia and atopic diseases can occur in several disorders. IEIs with eosinophilia have provided insights into human immunity and the pathogenesis of allergic diseases. Eosinophilia is not a rare finding in clinical practice, and it often poses problems in terms of etiologic research and differential diagnoses. Secondary eosinophilia is the most common form. The main underlying conditions are infectious diseases such as parasitic infections, allergic disorders, drug reactions, and of course IEIs. In clinical settings, the recognition of IEIs in the context of an allergic phenotype with eosinophilia is critical for prompt diagnosis and appropriate treatment aimed at modulating pathophysiological mechanisms and improving clinical symptoms.