新发传染病诊断及鉴别诊断预警系统研究

目的建立我国尚未报道的新发传染病（EID）诊断及鉴别诊断预警系统。方法系统研究我国目前尚未报道的EID文献资料,综合分析并提取主要临床特征,采用信息化技术,建立其诊断和鉴别诊断预警系统。结果建立的诊断和鉴别诊断预警系统具有信息的完整录入、查询、统计、分析和网络预警等功能。应用该系统对49种感染性疾病、314份病例进行初步验证,结果显示第一诊断符合率61．9％;前3位提示率78．1％;前5位提示率86．6％。结论新发传染病的诊断及鉴别诊断预警系统功能强大,使用方便、灵活,扩充性强,对病例比较准确地提示可能的诊断及鉴别诊断,提供针对性的进一步检查内容及治疗原则,特殊病例可通过电子疫情报告系统及时上报,可以提前预警EID。     

传染病相关知识数据库的研究与建立

目的研究和建立传染病相关知识数据库,以利于国内突发公共卫生事件处置工作的开展.方法收集与整理有关传染病的文献、专著、专业数据库等信息和数据,采用SQL server 2005作为后台数据库,并基于JAVA语言开发具有友好用户查询界面的传染病数据库系统.结果构建了系统的传染病基础数据库,它包含了343种传染病症状和体征、传染病病理和媒介生物学数据、273种用于传染病治疗和预防的药物和67种疫苗、国家和地方各类突发疫情应急预案,以及监测方案、典型案例、标准和法规等.结论传染病相关知识数据库的建立可极大地增强传染病疫情判断的准确性和及时性,提高国家和军队的公共卫生事件防控能力.     

新发传染病现状与教学思考

新发传染病 (EID)在世界各国都是一个非常重要的公共卫生问题。世界卫生组织 (WHO)在 1999年传染病的分析报告中指出 ,全世界每小时有 15 0 0人死于传染病 ,其中大部分发生在发展中国家。目前我国传染病总的形势是少数传染病将被消灭 ,一些过去已经基本上控制了的传染病又卷土重来 ,危害日重。值得注意的是陆续发现了一些新的传染病 ,有的危害巨大、传染性极强、病死率很高 ,给人类生命、财产造成巨大损失。我国面临着新、老传染病的双重威胁 ,人类与传染病的较量进入了一个新的阶段。1　新发传染病简介1 1　新发传染病的定义　 (1)过去…     

2011～2012年新疆和田地区法定管理新发传染病疫情分析

目的了解2012年新疆和田地区法定管理新发传染病疫情和流行特点,为控制疫情提供科学依据。方法利用2012年新疆和田地区七县一市各类医疗卫生机构法定管理新发传染病的报告资料,用描述性流行病学方法进行统计分析。结果2012年新疆和田地区共报告法定管理新发传染病12673例,年发病率614．25／10万,较2011年发病率（57874／10万）上升6．14％,死亡77例,年死亡率3．73／10万,较2011年死亡率（2．53／10万）上升47．43％;每月均有新发传染病报告,无明显季节性;职业以农民为主占66．04％,男女性别比为1．01：1;肺结核仍占首位,梅毒病例数有大幅度升高,艾滋病较2011年上升7．8倍,疫苗相关疾病发病仍维持在较高水平。结论新疆和田地区肺结核流行严重、血源性及性传播疾病发病人数快速增长,已成为当今和田地区重大公共卫生问题,急需尽快积极应对并做好处理。     

26例IgG4相关性腹膜后纤维化的系统评价

目的 探讨IgG4相关性腹膜后纤维化的临床病理特点、治疗及预后情况.方法 联机检索中国期刊全文数据库、维普中文科技期刊数据库、Medlme/Pubmed及OVID全文数据库,检索截止至2013年11月,结合南京大学医学院附属鼓楼医院消化科诊治的1例患者,进行系统评价.结果 15篇文献进入本系统综述,共纳入26例诊断明确的病例.系统评价结果显示（1）该病好发于69岁左右男性,临床表现以腰背痛、腹痛及肾盂积水为主;（2）血清IgG4升高多见;CT或MRI提示腹膜后肿块;（3）组织病理学检查显示软组织纤维化和IgG4＋浆细胞聚集;（4）目前无标准化方案,糖皮质激素仍是治疗IgG4相关性腹膜后纤维化的首选方案.结论 IgG4相关性腹膜后纤维化是一新的疾病亚型,临床症状缺乏特异性,极易误诊,需进一步研究以提高对该病的认识.     

原发性胆汁性肝硬化中医证候分型文献分析

目的了解现有原发性胆汁性肝硬化临床研究文献中中医证候规律的特点。方法检索中国期刊全文数据库、万方数据库和维普数据库,收集并阅读全文,筛选出符合纳入标准的文献,提取证候类型和辨证依据等资料,进行描述性统计学分析。结果在检索出的78篇文献中,符合纳入条件的文献7篇,所涉及原发性胆汁性肝硬化中医证型共20种,排名在前6位的中医证型分别为：肝郁脾虚（34.85%）、肝肾阴虚（27.82%）、湿热瘀血（6.69%）、湿热蕴结（4.23%）、脾胃气虚（3.87%）和湿滞血瘀（3.52%）;证候分型要素共14个,排名前6位的分别为脾虚（40.49%）、肝郁（39.43%）、肝阴虚（31.34%）、肾阴虚（31.34%）、瘀血（25.70%）和湿热（17.25%）。结论中医研究原发性胆汁性肝硬化的论文水平较低,分型依据缺乏科学性。     

《传染病信息》稿约

1本刊宗旨 本刊是中华人民共和国新闻出版总署批准，解放军302医院主办的国家级传染病专业性杂志。已被中国核心期刊（遴选）数据库期刊、中国期刊全文数据库（CJFD）期刊、中国科技期刊数据库期刊、中文生物医学期刊数据库期刊（CMCC）、中国生物医学文献数据库期刊、万方数据一数字化期刊群期刊等多家知名数据库收录。目前为双月刊。主要报道内容为国内外传染病方面的新动态、新进展、新技术和新方法，其中包括传染病的诊断、治疗、预防、护理以及卫生防疫，流行病学相关的知识和各种感染病诊治经验等内容。主要读者对象为传染病防治人员、各种生物学科及相关医药和基础科研人员、临床各科特别是与感染病相关的医护人员、卫生防疫部门的管理人员、医学院校师生以及公共卫生疾病控制保障保险人员。     

稳心颗粒治疗室性早搏及安全性的Meta分析

目的 系统评价稳心颗粒治疗室性早搏的临床疗效及安全性.方法 计算机检索中国学术期刊全文数据库（CNKI）、万方数据库、读秀数据库、PubMed自建库以来至2014年6月公开发表的与稳心颗粒治疗室性早搏相关的随机对照试验,并手工检索相关杂志,经质量评价最终纳入文献后采用Review Manger 5.0软件进行Meta分析.结果 共纳入20个研究,全部为中文,Jadad评分均为1分.Meta分析结果显示,稳心颗粒组与西药常规治疗组比较：稳心颗粒可提高临床疗效[0R=3.72,95％CI（2.88,4.81）,p＜0.00001];改善心电图[0R=2.7,95％CI（1.88,3.89）,p＜0.00001];降低不良反应[0R=0.27,95％CI（0.19,0.39）,p＜0.00001].结论 稳心颗粒较西药常规治疗室性早搏可进一步提高临床疗效,改善心电图,降低不良反应.但由于纳入文章质量有限,其治疗室性早搏的疗效及安全性需要更多高质量大规模的RCT进一步验证.     

急性心肌梗死患者新发心房颤动相关影响因素探讨

目的 探讨急性心肌梗死患者新发心房颤动相关影响因素。方法 回顾性分析500例我院于2018年1月至2020年3月收治的急性心肌梗死患者的临床资料,根据所选患者是否新发心房颤动将其分为房颤组（56例）和非房颤组（444例）。回顾性统计急性心肌梗死患者新发心房颤动的发生情况,比较房颤组和非房颤组的临床资料,并采用多因素Logistic回归分析法分析急性心肌梗死患者新发心房颤动的危险因素。结果 急性心肌梗死患者500例中新发心房颤动56例,发生率11.20%。多因素Logistic回归分析发现,吸烟、左心房内径（Left atrial diameter,LAD）>40 mm、血清脑钠肽（Brain natriuretic peptide,BNP）水平高是急性心肌梗死新发心房颤动的危险因素（OR=4.545、4.464、5.073,P<0.05）。结论 急性心肌梗死患者新发房颤的危险因素与吸烟、LAD>40 mm、血清BNP水平高息息相关,可据此针对性制定临床治疗措施方案,以降低急性心肌梗死患者心房颤动的发生率。     

胰腺癌相关糖尿病的血清蛋白质组学分析

目的 检测胰腺癌相关糖尿病的血清蛋白标志物,并建立诊断模型.方法 应用表面增强激光解析电离飞行时间质谱( SELDI-TOF-MS)技术检测17例胰腺癌相关糖尿病与17例新发2型糖尿病、17例健康对照者血清的差异表达蛋白,用Biomarker Patterns Software 5.0软件建立胰腺癌相关糖尿病诊断模型并验证.结果 在胰腺癌相关糖尿病、新发2型糖尿病,健康者各10例的蛋白指纹图谱中筛选出12个差异表达蛋白峰,其中质荷比为6116、6695、8936 Da的蛋白峰被选为建立胰腺癌相关糖尿病诊断模型的蛋白峰.该诊断模型的诊断正确率为90％.盲法验证各组另7例样本,正确诊断胰腺癌相关糖尿病患者达100％,新发2型糖尿病患者为71％,健康人群为86％.经检索蛋白质数据库,与以上3种差异表达蛋白分子质量最为接近的蛋白分别为金属硫蛋白、胰腺干细胞增殖分化因子和成纤维细胞生长因子 1.结论 通过SELDI方法筛选出3种胰腺癌相关糖尿病的血清蛋白标志物,建立了可靠的胰腺癌相关糖尿病的诊断模型.     

Prevalence and prediction of exercise-induced oxygen desaturation in patients with chronic obstructive pulmonary disease

Background: Previous studies with small sample sizes reported contradicting findings as to whether pulmonary function tests can predict exercise-induced oxygen desaturation (EID). Objective: To evaluate whether forced expiratory volume in one second (FEV(1)), resting oxygen saturation (SpO(2)) and diffusion capacity for carbon monoxide (DLCO) are predictors of EID in chronic obstructive pulmonary disease (COPD). Methods: We measured FEV(1), DLCO, SpO(2) at rest and during a 6-min walking test as well as physical activity by an accelerometer. A drop in SpO(2) of >4 to <90% was defined as EID. To evaluate associations between measures of lung function and EID univariate and multivariate analyses were used and positive/negative predictive values were calculated. Receiver operating characteristic curve analysis was performed to determine the most useful threshold in order to predict/exclude EID. Results: We included 154 patients with COPD (87 females). The mean FEV(1) was 43.0% (19.2) predicted and the prevalence of EID was 61.7%. The only independent predictor of EID was FEV(1) and the optimal cutoff value of FEV(1) was at 50% predicted (area under ROC curve, 0.85; p < 0.001). The positive predictive value of a threshold of FEV(1) <50% was 0.83 with a likelihood ratio of 3.03 and the negative predicting value of a threshold of FEV(1) ≥80% was 1.0. The severity of EID was correlated with daily physical activity (r = -0.31, p = 0.008). Conclusions: EID is highly prevalent among patients with COPD and can be predicted by FEV(1). EID seems to be associated with impaired daily physical activity which supports its clinical importance.     

Oral sarpogrelate can improve endothelial dysfunction as effectively as oral cilostazol, with fewer headaches, in active young male smokers

Sarpogrelate and cilostazol are two commonly used adjunctive antiplatelet agents that also can be used to improve endothelial dysfunction. We compared the effects of sarpogrelate and cilostazol on endothelial dysfunction in active male smokers with flow-mediated dilatation (FMD). We enrolled and compared baseline and follow-up FMD in 20 young male smokers without any known cardiovascular diseases. Two participants who were initially medicated with cilostazol dropped out because of severe headache after taking medication. However, they continued the other experiment with sarpogrelate medication. Baseline endothelium-dependent dilatation (EDD) after reactive hyperemia was 7.5 % ± 1.9 % and endothelium-independent dilatation (EID) after sublingual administration of nitroglycerin was 13.3 % ± 3.4 %. After a 2-week treatment of cilostazol, follow-up EDD significantly increased (7.7 % ± 1.9 to 8.8 ± 2.0 %, P = 0.016), but follow-up EID changed insignificantly (13.2 % ± 3.5 to 12.5 % ± 3.9 %, P = 0.350). With the sarpogrelate treatment, follow-up EDD was significantly increased (7.4 % ± 1.9 % to 8.8 % ± 1.9 %, P = 0.021), but follow-up EID was similar (13.5 % ± 3.5 to 14.0 % ± 3.2 %, P = 0.427). There was no clinical significance between the two groups on follow-up EDD and EID (P = 0.984 and 0.212, respectively). However, the mean score of intensity of headache was significantly higher in the cilostazol group than in the sarpogrelate group (3.8 % ± 2.5 % vs 1.4 % ± 2.2 %, P = 0.005). EDD showed a similar significant increase with 2-week treatment of cilostazol and sarpogrelate. However, intensity of headaches was significantly higher in the cilostazol group.     

Dynamics and Constraints of Early Infant Diagnosis of HIV Infection in Rural Kenya

A cohort design was used to determine uptake and drop out of 213 HIV-exposed infants eligible for Early Infant Diagnosis (EID) of HIV. To explore service providers and care givers knowledge, attitudes and perceptions of the EID process, observations and in-depth interviews were conducted. 145 (68%) infants enrolled after 2 months of age. 139 (65%) dropped out before follow up to 18 months old. 60 (43%) drop outs occurred within 2 months of enrolment. Maternal factors associated with infant drop out were maternal loss to follow up (48 [68%] vs. 8 [20%], P < 0.001) and younger maternal age (27.2 vs. 30.1 years, P = 0.033). Service providers and caregivers had inadequate training, knowledge and understanding of EID. Poverty and lack of social support were challenges in accessing EID services. EID should be more closely aligned within PMTCT services, integrated with routine mother and child health (MCH) activities and its implementation more closely monitored.     

Application of electroimmunodiffusion and crossed electroimmunodiffusion tests for the diagnosis of visceral leishmaniasis (kala-azar)

Techniques of electroimmunodiffusion (EID) and crossed electroimmunodiffusion (CEID) were applied and compared with the indirect fluorescent antibody (IFA) test for the diagnosis of visceral leishmaniasis. Results obtained by EID on 28 serum samples of proven cases of kala-azar correlated well with IFA. False-positive reactions were encountered by IFA assay among healthy controls and non-kala-azar patients. Using EID technique, species-specific antibody to L. donovani was demonstrated in all sera of kala-azar patients. CEID was less sensitive than EID as a few false-negative results were obtained with this technique. It is concluded that the EID test which is specific, sensitive and more economical could be applied for diagnosis of systemic leishmaniasis.     

"They have already thrown away their chicken": barriers affecting participation by HIV-infected women in care and treatment programs for their infants in Blantyre, Malawi

HIV-infected infants and young children are at high risk of serious illness and death. Morbidity and mortality can be greatly reduced through early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy (ART). Despite global efforts to scale-up of EID and infant ART, uptake of these services in resource poor, high HIV burden countries remain low. We conducted a qualitative study of 59 HIV-infected women to identify and explore barriers women face in accessing HIV testing and care for their infants. To capture different perspectives, we included mothers whose infants were known positive (n=9) or known negative (n=14), mothers of infants with unknown HIV status (n=13), and pregnant HIV-infected women (n=20). Five important themes emerged: lack of knowledge regarding EID and infant ART, the perception of health care workers as authority figures, fear of disclosure of own and/or child's HIV status, lack of psychosocial support, and intent to shorten the life of the child. A complex array of cultural, economic, and psychosocial factors creates barriers for HIV-infected women to participate in early infant HIV testing and care programs. For optimal impact of EID and infant ART, reasons for poor uptake should be better understood and addressed in a culturally sensitive manner.     

老年冠心病合并糖尿病患者血管内皮功能的变化

目的探讨老年冠心病患者以及冠心病合并糖尿病患者肱动脉内皮依赖性舒张功能(EDD)、非内皮依赖性舒张功能(EID)、血浆一氧化氮(NO)、内皮素(ET)的水平,为临床防治提供依据。方法采用高分辨率超声诊断系统分别检测35例老年冠心病患者(冠心病组,年龄62~91岁)以及32例老年冠心病合并糖尿病患者(冠心病合并糖尿病组,年龄65~89岁)肱动脉的EDD及EID;同时采用还原、比色法测定NO水平;采用放射免疫法检测ET水平,并分别与40例健康老年人(健康对照组,年龄61~86岁)进行对比。结果老年冠心病合并糖尿病组肱动脉的EDD、EID以及血浆NO水平均显著低于老年冠心病组和健康对照组(P<0.05),而老年冠心病组的EDD、EID以及血浆NO水平亦显著低于健康对照组(P<0.05);老年冠心病合并糖尿病组的ET却显著高于老年冠心病组和健康对照组(P<0.05),老年冠心病组ET水平显著高于健康对照组(P<0.05)。结论(1)老年冠心病及冠心病合并糖尿病组肱动脉EDD及EID均受损;(2)老年冠心病及冠心病合并糖尿病组均存在血管内皮功能失调,且冠心病合并糖尿病组内皮功能紊乱更严重;(3)改善血管内皮功能、控制血糖是减少心血管事件的重要措施之一。     

Management strategies of the interaction between direct oral anticoagulant and drug-metabolizing enzyme inducers

Journal of Thrombosis and Thrombolysis - Little is known regarding the management of direct oral anticoagulants (DOACs) in patients with enzyme-inducing drugs (EID). The use of EID may lead to...     

Hub gene target of glioblastoma: LOX,SERPINH1 and TGFBI

Glioblastoma (GBM) is a malignant tumor. The long-term prognosis of the patients is poor. Therefore, it is of important clinical value to further explore the pathogenesis and look for molecular markers for early diagnosis and targeted treatment. Two expression profiling datasets [{"type":"entrez-geo","attrs":{"text":"GSE50161","term_id":"50161"}}GSE50161 ({"type":"entrez-geo","attrs":{"text":"GPL570","term_id":"570"}}GPL570 platform), {"type":"entrez-geo","attrs":{"text":"GSE116520","term_id":"116520"}}GSE116520 ({"type":"entrez-geo","attrs":{"text":"GPL10558","term_id":"10558"}}GPL10558 platform)] were respectively downloaded from the gene expression omnibus database. Volcano diagrams show the Differently expressed genes (DEGs) of {"type":"entrez-geo","attrs":{"text":"GSE50161","term_id":"50161"}}GSE50161 and {"type":"entrez-geo","attrs":{"text":"GSE116520","term_id":"116520"}}GSE116520. A Venn diagram revealed 467 common DEGs between the 2 datasets. Lysyl oxidase (LOX), serpin family H member 1 (SERPINH1) and transforming growth factor beta induced (TGFBI) were negatively correlated with the overall survival rate in patients with GBM. The hub genes are high in GBM tumor tissues. The relative expression levels of LOX, SERPINH1 and TGFBI were significantly higher in GBM samples, compared with the normal brain tissues groups. Bioinformatics technology could be a useful tool to predict progression of GBM and to explore the mechanism of GBM.LOX, SERPINH1 and TGFBI may be involved in the mechanism of the occurrence and development of GBM, and may be used as molecular targets for early diagnosis and specific treatment.DEGs identified using GEO2R. Functional annotation of DEGs using Kyoto Encyclopedia of Genes and Genomes and gene body pathway enrichment analysis. Construction of a protein-protein interaction network. The pathway and process enrichment analysis of the hub genes were performed by Metascape. Survival analysis was performed in gene expression profiling interactive analysis. Real-time fluorescent quantitative polymerase chain reaction assay was performed to verify. The animal model was established for western blot test analysis.     

Identification and verification of a 4-gene signature predicting the overall survival of cervical cancer

Cervical cancer (CC) is one of the most common gynecological malignancies, ranking fourth in both incidence and mortality in women worldwide. Early screening and treatment are of great significance in reducing the incidence and mortality of CC. Due to the complex molecular mechanisms of tumor progression, the predictive power of traditional clinical information is limited. In this study, an effective molecular model is established to assess prognosis of patients with CC and guide clinical treatment so as to improve their survival rate. Three high quality datasets ({"type":"entrez-geo","attrs":{"text":"GSE138080","term_id":"138080"}}GSE138080, {"type":"entrez-geo","attrs":{"text":"GSE52904","term_id":"52904"}}GSE52904, {"type":"entrez-geo","attrs":{"text":"GSE67522","term_id":"67522"}}GSE67522) of expression profiling were obtained from gene expression omnibus (GEO) database. Another mRNA expression and clinicopathological data of CC were obtained from The Cancer Genome Atlas (TCGA) dataset. The bioinformatic analyses such as univariate analysis, multivariate Cox proportional-hazards model (Cox) analysis and lasso regression analysis were conducted to select survival-related differentially expressed genes (DEGs) and further establish a prognostic gene signature. Moreover, the performance of prognostic gene signature was evaluated based on Kaplan–Meier curve and receiver operating characteristic (ROC) curve. Gene set enrichment analysis (GSEA) and tumor immunity analysis were carried out to elucidate the molecular mechanisms and immune relevance. A 4-gene signature comprising procollagen-lysine, 2-oxoglutarate 5-dioxygenase 2 (PLOD2), spondin1 (SPON1), secreted phosphoprotein 1 (SPP1), ribonuclease H2 subunit A (RNASEH2A) was established to predict overall survival (OS) of CC. The ROC curve indicated good performance of the 4-gene signature in predicting OS of CC based on the TCGA dataset. The 4-gene signature classified the patients into high-risk and low-risk groups with distinct OS rates of CC. Univariate analysis and multivariate Cox regression analysis revealed that the 4-gene signature was an independent factor affecting the prognosis of patients with CC. Our study developed a 4-gene signature capable of predicting the OS of CC. The findings may be beneficial to individualized clinical treatment and timely follow-up for patients with CC.