High prevalence of Chlamydia trachomatis,Neisseria gonorrhoeae and particularly Trichomonas vaginalis diagnosed using US FDA‐approved Aptima molecular tests and evaluation of conventional routine diagnostic tests in Ternopil,Ukraine

Sexually transmitted infections (STIs) remain major public health problems globally. Appropriate laboratory diagnosis of STIs is rare in Ukraine. We investigated the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) using the US FDA‐approved Aptima Combo 2 and Aptima TV assays and compared the results with the conventional routine diagnostic tests (CDTs) in Ukraine. Urogenital swabs from consecutive mostly symptomatic females (n = 296) and males (n = 159) were examined. The prevalences were as follows: 10% (n = 47) of TV, 5.3% (n = 24) of CT and 1.5% (n = 7) of NG. The specificity of some CDTs was high, for example, 100% for NG culture, TV IgG ELISA, CT IgM ELISA and CT microscopy, but lower for other CDTs, that is, from 44% to 99.8%. The sensitivity of all CDTs was suboptimal, that is, 71% (n = 5) for NG microscopy, 57% (n = 4) for NG culture, 53% (n = 8) for CT IgG ELISA, 33% (n = 1) for TV IgG ELISA, 28% (n = 13) for TV microscopy, 25% (n = 1) for CT IgA ELISA, 20% (n = 3) for CT IgM ELISA and 0% (n = 0) for CT microscopy. The prevalences of particularly TV and CT were high, but substantial also for NG, in Ternopil, Ukraine. The sensitivities of all CDTs were low, and widespread implementation of validated, quality‐assured and cost‐effective molecular diagnostic STI tests in Ukraine is imperative.     

Immunotherapy combinations and chemotherapy sparing schemes in first line non-small cell lung cancer

In recent years, studies have explored different combinations of immunotherapy and chemotherapy. The rationale behind these is the improved survival outcomes of new immunologic therapies used in first-line-treatment of advanced non-small cell lung cancer. Moreover, for the most-studied combinations of anti-programed death-1 (PD-1)/programed death ligand-1 (PD-L1) with the addition of platinum- based chemotherapy, recent research is investigating whether combining different immunologic antitumoral mechanisms of action, such as anti-PD-1/PD-L1 and anti-CTLA-4, or anti-PD-L1 and anti-TIGIT, with or without chemotherapy, can improve efficacy outcomes compared with more classical combinations, or compared with standard chemotherapy alone. Here, we present the data of the main randomized studies that have evaluated these combinations, focusing on the basic rationale behind the different combinations, and the efficacy and tolerability data available to date.     

磨牙区人工种植牙修复技术的临床应用研究

目的探讨牙种植术对磨牙缺失修复的疗效.方法采用埋置式种植术对部分磨牙区缺失患者行牙种植修复.结果本组21例患者经过连续临床观察,治疗效果好,没有明显的手术发症.结论采用埋置的方法可对后牙缺失的患者进行牙种植修复,临床效果满意.     

五子衍宗丸对GnRHa控制性超促排卵小鼠着床期S100A11基因的调控

目的:研究中药五子衍宗丸对GnRHa长方案控制性超促排卵(COH)小鼠着床期S100A11表达的影响,探讨COH影响胚胎着床的机制,寻求有效改善COH低妊娠率的中药方剂。方法:将60只小鼠随机分成3组:模型组(GnRHa+HMG+HCG),中药组(五子衍宗丸+GnRHa+HMG+HCG),对照组(生理盐水)。观察小鼠阴栓率和着床期子宫胚胎着床数及着床率;应用免疫组化法、RT-PCR和Western blot方法分别检测小鼠着床期子宫内膜S100A11 mRNA及蛋白的表达。结果:模型组胚胎着床数高于对照组和中药组(P0.01),但胚胎着床率和妊娠率均明显降低(P0.05)。模型组着床期子宫内膜S100A11mRNA及蛋白表达下降,与对照组和中药组比较均有明显差异(P0.05)。结论:中药五子衍宗丸可上调因GnRHa长方案COH所致下降的S100A11基因的表达,提高子宫内膜容受性,改善小鼠妊娠率和胚胎着床率。     

A Chlamydia trachomatis 23S rRNA G1523A variant escaping detection in the Aptima Combo 2 assay (Hologic) was widespread across Denmark in July–September 2019

Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection globally, and nucleic acid amplification tests (NAATs) are recommended for highly sensitive and specific diagnosis. In early 2019, the Finnish new variant of Chlamydia trachomatis (FI-nvCT) was identified. The FI-nvCT has a C1515T mutation in the 23S rRNA gene, making it escaping detection in the Aptima Combo 2 (AC2; Hologic) NAAT, and the FI-nvCT has been subsequently reported in Sweden and Norway. In the present study, we investigated the presence of the FI-nvCT and other AC2 diagnostic-escape CT mutants in July–September 2019 in Denmark. The FI-nvCT was present but rare in Denmark. However, another AC2 diagnostic-escape CT mutant (with a 23S rRNA G1523A mutation) was found to be widespread across Denmark, accounting for 95% (76/80) of AC2 diagnostic-escape nvCT samples from five Danish CT-diagnostic laboratories. This nvCT-G1523A has previously only been detected in one single sample in the United Kingdom and Norway, respectively. It is vital to monitor the continued stability of the NAAT targets in local, national and international settings and monitor as well as appropriately analyse incidence, unexplained shifts in diagnostics rates and/or annual collections of samples diagnosed as negative/equivocal using NAATs with different target(s). Furthermore, diagnostic CT NAATs with dual target sequences are crucial, and fortunately, an updated Hologic AC2 assay including one additional target sequence is in advanced development.     

D‐chiro‐inositol as a treatment in plaque psoriasis: A randomized placebo‐controlled clinical trial

Cyclitols are widely available natural sugars which do not exert toxic effects. Their anti‐inflammatory and antioxidant properties may be used in the treatment of psoriasis. The aim of this placebo‐controlled, double‐blind study was to evaluate the clinical effects of D‐chiro‐inositol (DCI) in mild plaque psoriasis (46 psoriatic patients and 10 healthy volunteers). Three stable psoriatic plaques were selected for evaluation in every patient. Different samples were applied on each lesion twice a day: vehiculum without an active agent, containing 1% DCI and 0.25% DCI. The lesions were assessed using the PSI, VAS scale, and the objective measurement of hydration, transepidermal water loss (TEWL), elasticity, and thickness (DermaLab Combo) at 0, 3, and 6 weeks. PSI and VAS were improved in all groups without significant statistical differences. 1% DCI sample presented the highest statistically significant increase in the hydration of 50%, but it was still significantly lower than in healthy controls. TEWL increased for 1% DCI, which was a statistically significant difference compared to 0.25% DCI and still higher than in controls. An improvement in elasticity was observed in all lesions—it was statistically significant for 1% DCI. The thickness of the lesion decreased for 1% DCI, but the change was not statistically significant. Subepidermal low‐echogenic band showed a decreasing tendency in all groups, but it was not statistically significant. Favorable 1% DCI sample results indicate that it may be used as an adjuvant to the local treatment of psoriasis.     

Association of ABO blood group and Plasmodium falciparum malaria in Dore Bafeno Area,Southern Ethiopia

Objective

To assess the distribution of ABO blood group and their relationship with Plasmodium falciparum (P. falciparum) malaria among febrile outpatients who sought medical attention at Dore Bafeno Health Center, Southern Ethiopia.

Methods

A total of 269 febrile outpatients who visited Dore Bafeno Health Center, Southern Ethiopia, were examined for malaria and also tested for ABO blood groups in January 2010. The blood specimens were collected by finger pricking, stained with Geimsa, and examined microscopically. Positive cases of the parasitemia were counted. CareStart™ Malaria Pf/Pv Combo was also used to test the blood specimens for malaria. ABO blood groups were determined by agglutination test using ERYCLONE^® antisera. Data on socio-demographic characteristics and treatment status of the participants were also collected. Chi-square and ANOVA tests were used to assess the difference between frequencies and means, respectively.

Results

Out of a total of 269 participants, 178 (66.2%) febrile patients were found to be infected with Plasmodium parasites, among which 146 (54.3%), 28 (10.4%), and 4 (1.5%) belonged to P. falciparum, P. vivax, and mixed infections, respectively. All febrile patients were also tested for ABO blood groups and 51.3%, 23.5%, 21.9% and 3.3% were found to be blood types of O, A, B and AB, respectively. Both total malaria infection and P. falciparum infection showed significant association with blood types (P<0.05). The proportion of A or B but not O phenotypes was higher (P<0.05) in individuals with P. falciparum as compared with non-infected individuals. The chance of having P. falciparum infection in patients with blood groups A, B and AB was 2.5, 2.5 and 3.3 times more than individuals showing blood O phenotypes, respectively. The mean P. falciparum malaria parasitaemia for blood groups A, B, AB, and O were 3 744/µL, 1 805/µL, 5 331/µL, and 1 515/µL, respectively (P<0.01).

Conclusions

The present findings indicate that individuals of blood groups A, B and AB are more susceptible to P. falciparum infection as compared with individuals of blood group O. Nevertheless, further in depth studies are required to clearly establish the role that ABO blood group plays in P. falciparum malaria.     

依托医联体分层管理模式在社区糖尿病护理管理中的探讨

目的：评价依托普陀区西部医联体,在社区内对糖尿病患者进行分层的社区护理,研究其在血糖水平控制、减少并发症、改善预后等方面的作用,探讨适合中国国情的糖尿病社区护理分层管理模式。方法：于2014年1月~2015年1月 入选医联体范围内包括真如、桃浦、曹杨、长征社区卫生服务中心登记在册372例糖尿病患者进行分层管理。比较实施分层管理模式与实施一般糖尿病护理干预的社区患者一年内空腹血糖、糖化血红蛋白、住院率、严重并发症发生率等的差异。结果：分层管理组一年空腹血糖(6.8 ± 2.3 vs. 8.2 ± 2.8),糖化血红蛋白(6.0 ± 0.8 vs. 7.3 ± 2.0)低于对照组(p<0.05);且通过分层管理高危亚组患者服药遵从、饮食控制、合理运动、血糖监测、足部护理的依从性都优于普通亚组患者(p<0.05);一年肾脏病变、眼部病变、足部病变、总并发症发生率及入院率都少于对照组患者(P<0.05)。结论：依托医联体的糖尿病社区护理分层管理模式能够充分利用有限的医疗资源,做好社区管理,从而提高患者的生活质量,也能在控制糖尿病进程中起到积极作用。