复方倍他米松注射液联合泛昔洛韦胶囊、普瑞巴林胶囊治疗带状疱疹的临床疗效观察

目的 对复方倍他米松注射液联合泛昔洛韦胶囊、普瑞巴林胶囊治疗带状疱疹的临床疗效进行观察并探讨。方法 选取2018 年1 月～2019 年12 月我院收治的118 例带状疱疹患者为研究对象，采用随机抽签的方式将患者分为对照组（泛昔洛韦胶囊+普瑞巴林胶囊+甲钴胺片+维生素B1 片）与观察组（联合复方倍他米松注射液），比较两组治疗总有效率、VAS 评分、QS 评分、C 反应蛋白、无新发皮疹时间、结痂时间及疼痛停止时间、随访2 个月后带状疱疹后遗神经痛发生率以及不良反应发生率。结果 观察组与对照组治疗总有效率分别为94.92%及76.27%，组间对比差异有统计学意义（P＜0.05）；治疗后，观察组VAS 评分显著低于对照组；观察组QS 评分低于对照组（P＜0.05）；治疗后，观察组C 反应蛋白显著低于对照组（P＜0.05）；观察组无新发皮疹时间、结痂时间及疼痛停止时间分别显著短于对照组（P＜0.05）；随访2 个月后，发现观察组带状疱疹后遗神经痛发生率显著低于对照组（P＜0.05）；观察组不良反应发生与对照组比较，差异无统计学意义（P＞0.05）。结论 复方倍他米松注射液联合泛昔洛韦胶囊、普瑞巴林胶囊治疗带状疱疹不仅效果好且安全性高，值得使用。     

经方治疗水痘-带状疱疹病毒感染探讨

介绍运用经方辨治水痘和带状疱疹的异同。认为两者均为水痘-带状疱疹病毒感染引起的常见皮肤病。治疗水痘应以祛邪为主,辨证以六经中的太阳、阳明、少阳三阳经为重点,可运用石膏类方等;而对于带状疱疹,应重视扶正,辨证宜兼顾六经、衡量虚实,可予柴胡类方等。     

Insurance reimbursements for recombinant zoster vaccine in the private sector

A two-dose series of the recombinant zoster vaccine (RZV, Shingrix) was licensed by the Food and Drug Administration in 2017 and recommended by the Advisory Committee on Immunization Practices in 2018 for adults in the United States age 50 years and older. Despite the health benefits of shingles vaccination, coverage has remained low, with financial barriers among healthcare providers identified as one potential factor. This study estimates the reimbursement levels for RZV among a large sample of privately insured individuals in the US from the 2018 IBM® MarketScan® Commercial Claims and Encounters database. Of 198,534 claims for an RZV dose, the mean reimbursement was $149. Most claims (83%) exceeded $140, which was the private sector vaccine price reported on the CDC vaccine price list in April 2018. These results can be useful for providers considering procuring RZV and for state immunization programs considering ways to improve vaccination coverage.     

Development of herpes zoster during infliximab treatment for pediatric generalized pustular psoriasis: A case report

The present authors report a 12‐year‐old Chinese child with generalized pustular psoriasis who was responded well to infliximab, but an adverse effect of herpes zoster occurred after the first infusion soon. The antiviral treatment was effective and no recurrence or flaring was observed after half‐year of follow‐up. This case reminds us to highlight the risk of viral infection during biological treatment on patients with psoriasis or autoimmune disease.     

β-TrCP1和HAUSP影响胶质母细胞瘤细胞增殖和侵袭并调控UHRF1蛋白水平

目的分析β-转导重复相容蛋白（β-TrCP1）和疱疹病毒相关性泛素特异性蛋白酶（HAUSP）对胶质母细胞瘤增殖和侵袭能力以及表观遗传调控因子UHRF1表达的影响。 方法胶质母细胞瘤U87细胞内分别转染N1空质粒（NC组）和β-TrCP1-N1过表达质粒（β-TrCP1组），以及分别转染无意义siRNA序列（siRNA阴性对照，si-NC组）和靶向HAUSP mRNA的siRNA（si-HAUSP组）。RT-qPCR法和Western blot法分别检测各组细胞中β-TRCP1、HAUSP和UHRF1的mRNA以及蛋白水平。CCK8法和基质胶-transwell侵袭实验分别检测各组细胞的增殖和侵袭能力。 结果质粒转染后第4天和第5天，β-TrCP1组细胞的增殖能力显著低于同时期的NC组细胞（均P<0.05）；转染第4天，β-TrCP1组穿过基质胶的细胞数显著低于NC组细胞（P<0.05）。转染siRNA后第4天和第5天，si-HAUSP组细胞的增殖能力显著低于同时期si-NC组细胞（P<0.05）；转染si-HAUSP 4 d，si-HAUSP组穿过基质胶的细胞数显著低于si-NC组（P<0.05）。此外，过表达β-TrCP1和敲低HAUSP均不影响UHRF1的mRNA水平（均P>0.05），但均可降低UHRF1蛋白水平（均P<0.05）。 结论过表达β-TrCP1和敲低HAUSP均可抑制胶质母细胞瘤U87细胞的增殖和侵袭能力，同时降低UHRF1蛋白水平。UHRF1蛋白水平改变可能是β-TrCP1和HAUSP影响胶质母细胞瘤增殖和侵袭能力的机制之一。     

Persistent skewing of the T-cell profile in adolescents adopted internationally from institutional care

The developing immune system is an adaptive system, primed by antigens, responsive to infectious pathogens, and can be affected by other aspects of the early rearing environment, including deviations from the normal provision of parental care. We investigated whether early rearing in an institutional setting, even when followed by years living in supportive and well-resourced families, would be associated with a persistent shift in T cell profiles. Immunophenotyping was used to enumerate CD4+ CD57+ and CD8+ CD57+ subsets, with gating strategies employed to differentiate naïve, central-memory, effector-memory, and terminally differentiated EM cells expressing CD45RA (TEMRA). Blood samples were collected from 96 adolescents, and PBMC isolated via Ficol gradient, followed by an optimized immunophenotypic characterization. CMV antibody titers were determined via ELISA. Adopted adolescents had lower CD4/CD8 ratios than did the control adolescents. Early rearing had a significant effect on the T cells, especially the CD8+ CD57+ CM, EM, and TEMRA cells and the CD4+ CD57+ EM cells. Adolescents who had spent their infancy in institutions before adoption were more likely to be seropositive for CMV, with higher antibody titers. CMV antibody titers were significantly correlated with the percentages of all CD8+ CD57+ cell subsets. In the statistical modeling, CMV antibody titer also completely mediated the relationship between institutional exposure and the ratio of CD4-to-CD8 cells, as well as the percentages of CD4+ CD57+ and CD8+ CD57+ subsets. These findings demonstrate that persistent immune differences are still evident even years after adoption by supportive American families. The shift in the T cells was associated with being a latent carrier of CMV and may reflect the role of specific T cell subsets in Herpes virus containment. In older adults, sustained CMV antigen persistence and immunoregulatory containment ultimately contributes to an accumulation of differentiated T cells with a decreased proliferative capacity and to immune senescence.     

双重围刺配合刺络拔罐治疗频次对急性带状疱疹疗效的影响

目的观察双重围刺配合刺络拔罐治疗急性期带状疱疹中治疗频次对临床疗效的影响。方法采用随机数字表法将100例急性期带状疱疹患者分为两组,每组50例。两组患者均口服盐酸伐昔洛韦和甲钴胺,联合双重围刺配合刺络拔罐治疗。试验组双重围刺法配合刺络拔罐的治疗频次为每日2次,对照组双重围刺法配合刺络拔罐的治疗频次为每日1次。对比观察两组患者治疗的临床疗效,止疱、结痂、脱痂时间,治疗前后疼痛视觉模拟量表(VAS)评分,疼痛缓解程度,每疗程末疼痛持续时间以及带状疱疹后遗神经痛发生率。结果试验组总有效率为98.0%,对照组总有效率为94.0%;两组治疗后VAS评分均较治疗前降低(P<0.05),且试验组低于对照组(P<0.05);试验组止疱、结痂、脱痂时间短于对照组(P<0.05);试验组疼痛缓解程度大于对照组(P<0.05);试验组前3个疗程末日疼痛持续时间均短于对照组(P<0.05);试验组后遗神经痛发生率为10.0%,对照组为18.0%。结论西药口服联合每日2次的双重围刺配合刺络拔罐对急性期带状疱疹患者可提高临床疗效,减轻患者疼痛持续时间及疼痛程度,缩短病程,疗效肯定。     

Oropharyngeal shedding of herpesviruses before and after BNT162b2 mRNA vaccination against COVID-19

IntroductionConcerns were raised over an increase in Bell's palsy, herpes simplex and herpes zoster after BNT162b2 vaccination, all are manifestations of herpesviruses reactivation. As herpesviruses commonly reactivate in the oropharynx, we have hypothesized that oropharyngeal shedding of herpesviruses will increase after vaccination.MethodsImmune-competent Adults, excluding those using topical steroids or manifesting symptomatic herpesvirus infection, were sampled before BNT162b2 vaccination and one week after. Herpesviruses 1–7 shedding was tested with a multiplexed PCR.ResultsIn 103 paired samples the prevalence of herpesviruses was similar before and after vaccination: HSV1, 3.9% vs. 5.8% (p = 0.75); HSV2, 0% vs. 1% (p = not applicable, NA); VZV, 0% vs. 0% (p = NA); EBV, 14.6% vs. 17.5% (p = 0.63); CMV, 0% vs. 0% (p = NA); HHV6, 4.9% vs. 7.8% (p = 0.55); HHV7, 71.8% vs. 72.8% (p = 1); any herpesvirus, 73.8% vs. 74.8% (p = 1).DiscussionWe did not find evidence for increased oropharyngeal reactivation of herpesviruses one week after BNT162b2.     

A truncated glycoprotein G vaccine formulated with Advax-CpG adjuvant provides protection of mice against genital herpes simplex virus 2 infection

Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted disease that affects approximately 500 million individuals globally. There is currently no approved vaccine to prevent HSV-2 infection. EXCT4 is a truncated form of the mature glycoprotein G-2 (mgG-2) that unlike full mature form is secreted by expressing cells enabling it to be rapidly scaled up for production. The current study examined whether EXCT4 immunity in mice could be further enhanced through use of adjuvants. EXCT4 formulated with Advax-CpG adjuvant induced a strong Th1-type immune response characterized by interferon gamma (IFN-γ) and protected animals against a lethal genital challenge with HSV-2. This response was associated with reduced viral load in vaginal washes, spinal cord, and dorsal root ganglia. Together the results provide proof of concept that EXCT4 formulated with Advax-CpG adjuvant is a promising HSV-2 vaccine candidate warranting further investigation.