HCVF蛋白和负性共刺激分子2B4与慢性HCV感染的关联研究

目的 探讨丙型肝炎病毒（hepatitis C virus,HCV）F蛋白的产生与负性共刺激分子2B4在慢性HCV感染中的关联性。方法 收集慢性HCV患者（chronic hepatitis patient,CHP）的血液样本,检测F抗体（F antibody,F-Ab）的阳性率并依据结果分成（HCV-F（+）组、HCV-F（-）组）两组,收集健康者的血液样本作为对照组;分离并培养外周血单核细胞（peripheral blood mononuclear cells,PBMCs）,收集各孔细胞,酶联免疫吸附试验检测2B4抗体阻断前后白细胞介素4（interleukin 4,IL-4）、干扰素γ（interferon γ,IFN-γ）的表达水平。结果 2B4抗体阻断前,HCV患者PBMCs中IFN-γ和IL-4分泌水平均较健康组高（均有P<0.05）,且HCV-F（-）组分泌IFN-γ水平高于HCV-F（+）组（F=1.908,P=0.020）,而IL-4分泌水平低于HCV-F（+）组（F=1.342,P=0.009）。2B4抗体阻断后,健康组中IFN-γ和IL-4水平较阻断前均无统计学意义（均有P>0.05）,CHP IFN-γ分泌水平较阻断前升高（F=1.214,P=0.003）,且HCV-F（-）组升高程度高于HCV-F（+）组（F=1.434,P=0.009）;而IL-4分泌水平较阻断前明显降低（F=1.505,P=0.015）,且HCV-F（-）组降低程度低于HCV-F（+）组（F=1.444,P=0.032）。结论 在慢性HCV感染中,F蛋白的信号调控机制与负性共刺激分子2B4具有相关性。     

关节置换术后手术部位及假体周围感染与营养不良相关性的Meta分析

目的系统评价关节置换术后手术部位感染(SSI)和假体周围感染(PJI)与营养不良的相关性,为预防术后感染提供循证依据。方法对PubMed、Embase、中国知网(CNKI)、万方等7个中英文数据库进行无语言限制的文献检索,检索从建库至2020年6月公开发表的文献,查找关节置换术后SSI和PJI与营养不良相关性的队列研究,采用RevMan 5.4软件对符合条件的研究进行Meta分析,合并其比值比(OR)和95%置信区间(CIs),并对发表偏倚进行漏斗图分析。结果通过最初的搜索词,总共识别出文献2525篇,全文审查了248篇文章,其中有10篇文章符合入选标准。最终共纳入11项回顾性队列研究,共计262640例患者。方法学质量评价结果显示纳入研究总体质量较高(NOS≥6)。Meta分析结果显示,营养不良和非营养不良组SSI与PJI发生率差异有统计学意义,与非营养不良人群相比,营养不良人群关节置换术后SSI与PJI的发生率升高,其效应值分别为[OR=2.69,95%CI(2.58~2.82)]与[OR=3.32,95%CI(2.53~4.36)]。结论营养不良与全关节置换术后SSI和PJI有关,建议术前对营养不良的患者实施一定的优化策略。     

Association between IL12B polymorphisms and tuberculosis risk: A meta-analysis

The interleukin (IL) 12B gene encodes p40, the subunit of both IL-12 and IL-23, which are important regulators of the type I T helper cell (TH1) immune response. IL12B 3′ UTR and promoter polymorphisms have been reported to be correlated with IL-12 p40 production and have been suggested to be associated with TB (tuberculosis) susceptibility. Studies that have investigated the associations between these polymorphisms and TB risk have reported conflicting results. In this study, we performed a meta-analysis with 11 case-control studies (2897 cases/2653 controls) for the IL12B 3′ UTR polymorphism and four case-control studies (1037 cases/1126 controls) for the IL12B promoter polymorphism to explore a more precise estimate of these associations. Crude odds ratios with 95% confidence intervals were assessed for the association using fixed- and random-effects models. For the IL12B 3′ UTR variant, no significant associations were observed in genotypic and allelic tests in the overall analysis. A stratified analysis by ethnicity showed a significant association in Caucasians in dominant model models AC + CC vs. AA (OR = 0.69, 95% CI: 0.51–0.93, p = 0.015, P_{heterogeneity} = 0.818). The allelic contrast indicated significant effects of the C allele on TB risk in Caucasians (OR = 0.74, 95% CI: 0.58–0.95, p = 0.019, P_{heterogeneity} = 0.377), whereas such effects were not observed in Asians or in Africans. For the IL12B promoter variant, no significant associations were observed in either genotypic or allelic tests with the limited data that were available. This meta-analysis suggests that the C allele of the IL12B 3′ UTR may act as a TB risk factor in Caucasians but not in Asians or in Africans. The effect of IL12B polymorphisms on TB risk might be influenced by ethnicity. To further confirm our findings, well-designed studies with large sample sizes and representing different ethnicities are required.     

Effects of the ketogenic diet on components of the metabolic syndrome: A systematic review and meta-analysis

Dietary interventions have been one of the major effective lifestyle interventions utilized to treat metabolic syndrome (MetS) among various lifestyle interventions for the treatment for MetS. The effect of ketogenic diet (KD) intake on MetS has received increasing attention since KD is a dietary intervention that may have the potential to improve risk factors of MetS. A meta-analysis of 24 studies identified by searching seven electronic databases was conducted to investigate the relation between KD intake and risk factors of MetS. The random effects standardized mean difference ± 95% confidence interval was calculated as the effect size. Results indicated that body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), diastolic blood pressure (DBP), systolic blood pressure (SBP), blood glucose, glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and insulin (d = 1.250, d = ?0.482 d = 0.802, d = 1.325, d = 1.232, d = 1.606, d = 0.999, d = 1.664, d = 1.347, respectively) were significantly affected by the intake of KD. In addition, subgroup analysis was carried out. The results indicated that different length of KD intake period (16 w, 20 w, 22 w, 24 w) could affect MetS risk factors and the effect size of short-term KD is larger. The results of the review and meta-analysis revealed the effectiveness of KD and its potential to improve MetS and MetS risk factors.     

Prevalence and correlates of hepatitis C infection among users of North America's first medically supervised safer injection facility

BACKGROUND: North America's first medically supervised safer injection facility (SIF) for illicit drug users was opened in Vancouver, Canada on 22 September 2003. We examined the prevalence and correlates of hepatitis C (HCV) infection among a representative cohort of SIF users. METHODS: Users of the Vancouver SIF were selected at random and asked to enrol in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort. At baseline, venous blood samples were collected and an interviewer-administered questionnaire was performed. Participants who were HCV-positive were compared with HCV-negative subjects using bivariate and logistic regression analyses. RESULTS: Between 1 December 2003 and 30 July 2004, 691 participants were enrolled into the SEOSI cohort, among whom 605 (87.6%) were HCV-positive at baseline. Factors independently associated with HCV infection in logistic regression analyses included: involvement with the sex trade [adjusted odds ratio (AOR) 3.7, 95% confidence interval (CI) 2.1-6.1], history of borrowing syringes (AOR 1.8, 95%CI 1.1-2.9), and history of incarceration (AOR 2.6, 95%CI 1.5-4.4). Daily heroin use was protective against HCV infection (AOR 0.6, 95%CI 0.3-0.9). CONCLUSION: The SIF has attracted injection drug users with a high burden of HCV infection and a substantial proportion of uninfected individuals. Although cross-sectional, this study provides some insight into historical risks for HCV infection among this population, and prospective follow-up of this cohort will be useful to determine if use of the SIF is associated with reduced risk behaviour and HCV incidence.     

Association between fruit and vegetable intake and risk for glioma: A meta-analysis

ObjectiveEpidemiologic studies evaluating the association between the intake of vegetables and fruit and the risk for glioma have produced inconsistent results. Therefore, the aim of this study was to test the hypothesis that higher vegetable and fruit intake may have a protective effect on risk for glioma.MethodsPertinent studies were identified by a search in PubMed, Web of Knowledge, and Wan Fang Med Online up to January 2014. Random-effect model was used to combine study-specific results. Publication bias was estimated using Begg's funnel plot and Egger's regression asymmetry test.ResultsFifteen studies involving 5562 cases focusing on vegetable intake and 17 studies involving 3994 cases of fruit intake compared with the risk for glioma were included in this meta-analysis. The combined relative risk (RR) of glioma associated with vegetable intake was 0.775 (95% confidence interval [CI], 0.688–0.872) overall, and the association for subgroup analysis by study design, sources of control, ethnicity, and number of cases was consistent with overall data. For fruit intake and glioma risk, significant protective associations were found in an Asian population (RR, 0.573; 95% CI, 0.346–0.947), but not in a white population. No publication bias was found.ConclusionsThis analysis indicated that intake of vegetables might have a protective effect on glioma. The intake of fruit might have a protective effect on glioma in the Asian population; however, the results need to be confirmed.     

A meta-analysis of the hepatitis C virus distribution in diverse racial/ethnic drug injector groups

Hepatitis C virus (HCV) is mostly transmitted through blood-to-blood contact during injection drug use via shared contaminated syringes/needles or injection paraphernalia. This paper used meta-analytic methods to assess whether HCV prevalence and incidence varied across different racial/ethnic groups of injection drug users (IDUs) sampled internationally. The 29 prevalence and 11 incidence studies identified as part of the HCV Synthesis Project were categorized into subgroups based on similar racial/ethnic comparisons. The effect estimate used was the odds or risk ratio comparing HCV prevalence or incidence rates in racial/ethnic minority groups versus those of majority status. For prevalence studies, the clearest disparity in HCV status was observed in the Canadian and Australian Aboriginal versus White comparison, followed by the US non-White versus White categories. Overall, Hispanic IDUs had greater HCV prevalence, and HCV prevalence in African-Americans was not significantly greater than that of Whites in the US. Aboriginal groups showed higher HCV seroconversion rates when compared to others, and African-Americans had lower seroconversion rates compared to other IDUs in the US. The findings suggest that certain minority groups have elevated HCV rates in comparison to other IDUs, which may be a consequence of stigma, discrimination, different risk behaviors or decreased access to health care, services and preventive education. Future research should seek to explicitly explore and explain racial/ethnic variations in HCV prevalence and incidence, and define the groups more precisely to allow for more accurate detection of possible racial/ethnic differences in HCV rates.     

Association between preventive measures against workplace infection and preventive behavior against personal infection

To prevent the spread of infection, it is necessary for each individual to adopt infection prevention behavior. We investigated the effect of infection control measures implemented in the workplace on personal infection prevention behavior. We conducted a self-administered questionnaire survey through the Internet from December 22 to 25, 2020, during which period coronavirus disease 2019 (COVID-19) was spreading. Among respondents aged 20 to 65 years (n=27,036), 21,915 workers were included in the analysis. The results showed that as the number of infection control measures in the workplace increased, implementation of infection prevention behavior by individuals also significantly increased. However, the relationship differed depending on the type of personal infection prevention behavior. Specifically, infection control measures against COVID-19 in the workplace may affect personal infection prevention behavior. Implementation of infection control measures in the workplace increases awareness of the importance of individual infection prevention behavior and its implementation by all individuals. These findings may be applicable not only to COVID-19 measures but also to responses to other emerging infections and seasonal influenza.     

CKD-EPI equation: A suitable Glomerular Filtration Rate estimate for drug dosing in HIV-infected patients

Objectives

To evaluate concordance between glomerular filtration rate (GFR) estimates (Cockcroft and Gault, modification of diet in renal diseases, chronic kidney disease epidemiology study group equations) for drug dosing in HIV-infected patients.

Burkholderia cenocepacia vaginal infection in patient with smoldering myeloma and chronic hepatitis C

We report a case of a vaginal infection caused by a strain of Burkholderia cenocepacia. The strain was isolated from vaginal swab specimens from a 68-year-old woman with smoldering myeloma and chronic hepatitis C virus infection who was hospitalized for abdominal abscess. Treatment with piperacillin/tazobactam eliminated B. cenocepacia infection and vaginal symptoms.     

Intradermal hepatitis B vaccination: A systematic review and meta-analysis

To compare seroprotection achieved by intradermal versus intramuscular hepatitis B vaccine, we conducted a systematic review of observational studies and a meta-analysis of randomized trials. Meta-analysis of data from 757 adults demonstrated that intradermal hepatitis B vaccination was slightly (14%) less likely to achieve seroprotection than intramuscular vaccination (risk ratio_pooled 0.86; 95% confidence interval: 0.77–0.95). Diverse study methodologies detracted from our ability to synthesize data from these studies; standardized approaches would enhance comparability of future studies. Seroprotection from intradermal vaccination was higher among females and children, suggesting that these populations may be most appropriate for future intradermal vaccine development efforts.     

社区人群中乙型肝炎病毒感染和代谢综合征的相关研究

目的:研究社区人群中乙型肝炎病毒(HBV)感染和代谢综合征(MS)的关系。方法:对参加2007-2009年间上海市普陀区各级医院的健康体检的常住人口进行调查,除了收集年龄、性别、腰围等数据外,还采集血清标本,检测其HBV携带情况以及空腹血糖、甘油三酯、高密度脂蛋白等MS相关指标,使用lo-gistic回归分析HBV感染和MS间的关系。结果:本次调查总数是9 414,乙型肝炎表面抗原阳性率是17.1%。乙型肝炎表面抗原在MS患病组中的阳性率为21.9%,明显比非MS患病组中的16.4%要高(P<0.000 1)。HBV感染和MS的联系粗的OR是1.561,95%可信区间是1.276～1.908,调整年龄和性别后,其调整OR为1.397,95%可信区间是1.139～1.714。结论:HBV感染和代谢综合征间存在一定的联系,研究结果表明HBV感染可能会增加研究人群代谢综合征的患病风险。     

螺杆菌感染与肝癌发生发展关系的Meta分析

目的通过Meta分析的方法探讨螺杆菌感染与肝癌发生发展的相关性。方法检索Medline、EMBASE、CNKI、万方和维普数据库中探讨螺杆菌感染与肝癌关系的研究,提取数据计算合并比值比(OR)以及95%置信区间(95%CI)。结果符合纳入排除标准的研究共有19项,均为病例对照研究,其中肝癌组785例,螺杆菌的感染率为66.50%(522/785),对照组1 298例,螺杆菌的感染率为37.75%(490/1 298)。各项研究之间具有明显异质性,选取随机效应模型进行分析,OR值为9.55(95%CI:5.78～15.77,P<0.05)。结论螺杆菌参与肝细胞癌的发生发展,但结果仍需进一步证实。     

我国大气PM_(10)污染对人群死亡率影响的meta分析

目的综合相关文献,建立我国PM_(10)与居民死亡率之间的暴露-反应关系。方法通过各数据库和文献检索平台收集2005—2015年发表的符合纳入标准的我国大气PM_(10)污染与居民每日总死亡率、呼吸系统及心脑血管疾病死亡率关系的文献,共纳入20篇共37组相关数据。采用Stata 12.0软件进行meta分析,提取PM_(10)与人群死亡的暴露-反应系数,利用随机或固定效应模型合并效应值,对结果进行敏感性分析、发表偏倚检验及校正。结果建立了我国大气PM_(10)与居民每日死亡之间的暴露-反应关系,我国大气PM_(10)每上升10μg/m3,人群每日总死亡率、呼吸系统疾病和心脑血管疾病死亡率的相对危险度(RR)及95%CI分别为1.001 4(95%CI:1.000 8~1.002 0),1.001 6(95%CI:0.999 9~1.003 3),1.002 5(95%CI:1.001 4~1.003 6)。结论大气PM_(10)浓度上升可导致我国居民总死亡率、呼吸系统疾病和心脑血管疾病死亡率增加。     

酒精摄入与女性乳腺癌发病风险的Meta分析

目的 探讨酒精摄入与女性乳腺癌发病风险的关联性。方法 通过Stata 12.0软件对国内外发表的有关酒精摄入与女性乳腺癌发病风险的队列研究和病例对照研究进行Meta分析。结果 共纳入16项病例对照研究和15项队列研究,包括50 519例患者和973 216例对照者。病例对照研究Meta分析提示,酒精暴露可明显增加女性个体发生乳腺癌的风险,合并OR值为1.18,95％置信区间为1.05～1.32;以绝经状态为亚组的Meta分析提示,酒精暴露可增加绝经后女性个体发生乳腺癌的风险,合并OR值为1.26,95％置信区间为1.08～1.46。队列研究Meta分析提示,有酒精暴露者女性乳腺癌的发生率是非饮酒者的1.1倍,合并RR值为1.10,95％置信区间为1.06～1.15;以绝经状态为亚组的Meta分析提示,有酒精暴露的绝经后女性乳腺癌的发生率是非饮酒者的1.1倍,合并RR值为1.14,95％置信区间为1.10～1.19。结论 酒精摄入可显著提高女性尤其绝经后乳腺癌的发病风险。     

Global prevalence of occult hepatitis C virus: A systematic review and meta-analysis

BACKGROUNDOccult hepatitis C infection (OCI) is characterized by the presence of hepatitis C virus (HCV) RNA in the liver, peripheral blood mononuclear cells (PBMC) and/or ultracentrifuged serum in the absence of detectable HCV-RNA in serum. OCI has been described in several categories of populations including hemodialysis patients, patients with a sustained virological response, immunocompromised individuals, patients with abnormal hepatic function, and apparently healthy subjects.AIMTo highlight the global prevalence of OCI.METHODSWe performed a systematic and comprehensive literature search in the following 4 electronic databases PubMed, EMBASE, Global Index Medicus, and Web of Science up to 6th May 2021 to retrieve relevant studies published in the field. Included studies were unrestricted population categories with known RNA status in serum, PBMC, liver tissue and/or ultracentrifuged serum. Data were extracted independently by each author and the Hoy et al tool was used to assess the quality of the included studies. We used the random-effect meta-analysis model to estimate the proportions of OCI and their 95% confidence intervals (95%CI). The Cochran''s Q-test and the I² test statistics were used to assess heterogeneity between studies. Funnel plot and Egger test were used to examine publication bias. R software version 4.1.0 was used for all analyses.RESULTSThe electronic search resulted in 3950 articles. We obtained 102 prevalence data from 85 included studies. The pooled prevalence of seronegative OCI was estimated to be 9.61% (95%CI: 6.84-12.73) with substantial heterogeneity [I² = 94.7% (95%CI: 93.8%-95.4%), P < 0.0001]. Seropositive OCI prevalence was estimated to be 13.39% (95%CI: 7.85-19.99) with substantial heterogeneity [I² = 93.0% (90.8%-94.7%)]. Higher seronegative OCI prevalence was found in Southern Europe and Northern Africa, and in patients with abnormal liver function, hematological disorders, and kidney diseases. Higher seropositive OCI prevalence was found in Southern Europe, Northern America, and Northern Africa.CONCLUSIONIn conclusion, in the present study, it appears that the burden of OCI is high and variable across the different regions and population categories. Further studies on OCI are needed to assess the transmissibility, clinical significance, long-term outcome, and need for treatment.