Liver failure progresses rapidly and has a high mortality rate. Since its development in 1986, Li's artificial liver has gradually formed a unique and highly effective treatment system, which is widely used in the treatment of liver failure. The Li's artificial liver system (Li ALS) integrates various purification methods such as plasma exchange, plasma perfusion, and hemofiltration, providing a homogeneous treatment plan for liver failure. Choosing the timing of artificial liver treatment, screening biomarkers related to artificial liver, and combining them with new treatment methods for liver failure are potential development directions for Li's artificial liver.
{"title":"Development and clinical application of Li's Artificial Liver System","authors":"Xiao-wei Xu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.09.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.09.002","url":null,"abstract":"肝衰竭病情进展快，病死率高。李氏人工肝自1986年起发展至今，逐步形成了独特且疗效显著的治疗体系，被广泛应用于肝衰竭的救治。李氏人工肝治疗模式各有特点，新型李氏人工肝系统(Li′s artificial liver system, Li-ALS)集成血浆置换、血浆灌流和血液滤过等各种净化手段，提供了肝衰竭同质化治疗方案。选择人工肝治疗时机，筛选人工肝相关生物标志物及联合新的肝衰竭治疗手段是李氏人工肝潜在的发展方向。","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"518-522"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45710349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.09.008
Luwen Wang, Hui Chen, F. Jiao, Fan Yang, Xun Li, Haiyue Zhang
Objective To investigate the inhibitory effect of small interference RNA (siRNA) targeted against transforming growth factor β1 (TGFβ1) in mice with hepatic fibrosis infected with Schistosoma japonicum. Methods Three short hairpin RNAs (shRNA) targeting different positions of TGFβ1 and one unrelated control sequence (HK) were designed and cloned to a plasmid pGenesil-1 respectively to obtain four recombinant expression vectors. Thirty male BALB/c mice were randomly divided into six groups, including normal group, model group, control group (pGenesil-HK) and three treatment groups (pGenesil-TGFβ1-m1, pGenesil-TGFβ1-m2 and pGenesil-TGFβ1-m3) and each group had five mice. The hepatic fibrosis animal models infected with Schistosoma japonicum were constructed. The levels of hydroxyproline (HYP) in liver tissue were examined by biochemistry. Liver histopathology was examined by hematoxylin-eosin and Masson staining. The mRNA expression and protein expression levels of TGFβ1, mothers against decapentaplegic homolog (Smad) 3, Smad 7 and α-smooth muscle actin (α-SMA) in the livers were detected by quantitative real time polymerase chain reaction (RT-qPCR) and Western blot. Two independent samples t test was used to compare the measurement data between groups. Results The liver fibrogenesis was obviously improved in all treatment groups compared with model group.The levels of HYP of liver tissue in all treatment groups were significantly lower than that in model group (t=14.870, 7.097 and 10.741, respectively, all P<0.01). The mRNA expression levels of TGFβ1, Smad 3 and α-SMA(model group vs pGenesil-TGFβ1-m1 group, t=3.235, 5.141 and 10.026, respectively; model group vs pGenesil-TGFβ1-m2 group, t=3.396, 5.145 and 4.951, respectively; model group vs pGenesil-TGFβ1-m3 group, t=3.511, 5.429 and 6.485, respectively)and protein (model group vs pGenesil-TGFβ1-m1 group, t=8.847, 8.044 and 10.746, respectively; model group vs pGenesil-TGFβ1-m2 group, t=9.709, 7.484 and 10.847, respectively; model group vs pGenesil-TGFβ1-m3 group, t=9.672, 8.766 and 11.508, respectively) were significantly decreased in all treatment groups compared with model group (all P< 0.01), while the levels of Smad 7 mRNA and protein were significantly increased in all treatment groups compared with model group(t=11.742 and 11.211, respectively in pGenesil-TGFβ1-m1 group; t=14.446 and 13.736, respectively in pGenesil-TGFβ1-m2 group; t=10.892 and 10.908, respectively in pGenesil-TGFβ1-m3 group, all P< 0.01). Conclusions Specific siRNA targeting TGFβ1 could significantly inhibit the liver fibrogenesis in mice infected with Schistosoma japonicum. The anti-fibrosis mechanisms of the siRNA maybe associated with the down-regulation of TGFβ1, Smad 3 and α-SMA expressions and up-regulation of Smad 7 expression in liver tissue, which results in suppressing the activation of hepatic stellate cells. Key words: Transforming growth factor beta 1; RNA, small interfering; Schistoso
{"title":"Inhibitory effect of specific small interference RNA targeted against transforming growth factor β1 in mice with hepatic fibrosis infected with Schistosoma japonicum","authors":"Luwen Wang, Hui Chen, F. Jiao, Fan Yang, Xun Li, Haiyue Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.09.008","url":null,"abstract":"Objective \u0000To investigate the inhibitory effect of small interference RNA (siRNA) targeted against transforming growth factor β1 (TGFβ1) in mice with hepatic fibrosis infected with Schistosoma japonicum. \u0000 \u0000 \u0000Methods \u0000Three short hairpin RNAs (shRNA) targeting different positions of TGFβ1 and one unrelated control sequence (HK) were designed and cloned to a plasmid pGenesil-1 respectively to obtain four recombinant expression vectors. Thirty male BALB/c mice were randomly divided into six groups, including normal group, model group, control group (pGenesil-HK) and three treatment groups (pGenesil-TGFβ1-m1, pGenesil-TGFβ1-m2 and pGenesil-TGFβ1-m3) and each group had five mice. The hepatic fibrosis animal models infected with Schistosoma japonicum were constructed. The levels of hydroxyproline (HYP) in liver tissue were examined by biochemistry. Liver histopathology was examined by hematoxylin-eosin and Masson staining. The mRNA expression and protein expression levels of TGFβ1, mothers against decapentaplegic homolog (Smad) 3, Smad 7 and α-smooth muscle actin (α-SMA) in the livers were detected by quantitative real time polymerase chain reaction (RT-qPCR) and Western blot. Two independent samples t test was used to compare the measurement data between groups. \u0000 \u0000 \u0000Results \u0000The liver fibrogenesis was obviously improved in all treatment groups compared with model group.The levels of HYP of liver tissue in all treatment groups were significantly lower than that in model group (t=14.870, 7.097 and 10.741, respectively, all P<0.01). The mRNA expression levels of TGFβ1, Smad 3 and α-SMA(model group vs pGenesil-TGFβ1-m1 group, t=3.235, 5.141 and 10.026, respectively; model group vs pGenesil-TGFβ1-m2 group, t=3.396, 5.145 and 4.951, respectively; model group vs pGenesil-TGFβ1-m3 group, t=3.511, 5.429 and 6.485, respectively)and protein (model group vs pGenesil-TGFβ1-m1 group, t=8.847, 8.044 and 10.746, respectively; model group vs pGenesil-TGFβ1-m2 group, t=9.709, 7.484 and 10.847, respectively; model group vs pGenesil-TGFβ1-m3 group, t=9.672, 8.766 and 11.508, respectively) were significantly decreased in all treatment groups compared with model group (all P< 0.01), while the levels of Smad 7 mRNA and protein were significantly increased in all treatment groups compared with model group(t=11.742 and 11.211, respectively in pGenesil-TGFβ1-m1 group; t=14.446 and 13.736, respectively in pGenesil-TGFβ1-m2 group; t=10.892 and 10.908, respectively in pGenesil-TGFβ1-m3 group, all P< 0.01). \u0000 \u0000 \u0000Conclusions \u0000Specific siRNA targeting TGFβ1 could significantly inhibit the liver fibrogenesis in mice infected with Schistosoma japonicum. The anti-fibrosis mechanisms of the siRNA maybe associated with the down-regulation of TGFβ1, Smad 3 and α-SMA expressions and up-regulation of Smad 7 expression in liver tissue, which results in suppressing the activation of hepatic stellate cells. \u0000 \u0000 \u0000Key words: \u0000Transforming growth factor beta 1; RNA, small interfering; Schistoso","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"545-551"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44559208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.09.006
Tingting Yu, Lunli Zhang, S. Ge, Xiaopeng Li
Objective To explore the efficacy of glucocorticoid (GC) therapy on hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), and the effectiveness and safety of voriconazole (VCZ) in preventing pulmonary Aspergillus infection in HBV-ACLF patients treated with GC. Methods Two hundred and thirty-two patients with HBV-ACLF were enrolled from January 2016 to December 2018 in the First Affiliated Hospital of Nanchang University. They were divided into non-GC group (104 cases), GC group (74 cases), and GC+ VCZ group (54 cases). The observation period was four months. The baseline liver function, the incidence of pulmonary Aspergillus infection, the survival rate during observation period, and the incidence of complications were compared among the three groups. The adverse reactions of VCZ were observed to identify the best dose for prevention. Quantitative data were analyzed by analysis of variance or rank sum test. Count data were analyzed by chi-square test or Fisher exact test. Results The baseline liver functions were not significantly different among the three groups (all P>0.05). The incidence of pulmonary Aspergillus infection in the GC group (22.97%(17/74)) was both higher than that in the non-GC group (5.77%(6/104)) and GC+ VCZ group (1.85%(1/54)), the differences were both statistically signifrcant (χ2=11.373 and 9.843, respectively, both P<0.01). The overall mortality rate of HBV-ACLF patients with pulmonary Aspergillus infection was 79.2%(19/24). The survival rate in non-GC group (37.5%(39/104)) showed no statistical difference with that in GC group (39.19%(29/74), χ2=0.052, P=0.819). The survival rate of GC+ VCZ group (66.67%(36/54)) was significantly higher than that in GC group and non-GC group (χ2 =12.126 and 9.431, respectively, both P<0.01). The blood concentrations of VCZ were randomly measured in 16 patients from the GC+ VCZ group, and the range was 0.82-5.38 mg/L, with no evident adverse reactions. Conclusions The GC treatment is effective in HBV-ACLF patients in early stage. The VCZ treatment effectively reduces the incidence of pulmonary Aspergillus infection in HBV-ACLF patients receiving GC treatment and increases the survival rate. Oral VCZ (200 mg/d) treatment has a stable blood concentration in HBV-ACLF patients, with rare adverse reactions and good safety. Key words: Hepatitis B virus; Glucocorticoid; Acute-on-chronic liver failure; Voriconazole
{"title":"Preventive effects of antifungal drugs in patients with acute-on-chronic liver failure treated with glucocorticoid","authors":"Tingting Yu, Lunli Zhang, S. Ge, Xiaopeng Li","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.09.006","url":null,"abstract":"Objective \u0000To explore the efficacy of glucocorticoid (GC) therapy on hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), and the effectiveness and safety of voriconazole (VCZ) in preventing pulmonary Aspergillus infection in HBV-ACLF patients treated with GC. \u0000 \u0000 \u0000Methods \u0000Two hundred and thirty-two patients with HBV-ACLF were enrolled from January 2016 to December 2018 in the First Affiliated Hospital of Nanchang University. They were divided into non-GC group (104 cases), GC group (74 cases), and GC+ VCZ group (54 cases). The observation period was four months. The baseline liver function, the incidence of pulmonary Aspergillus infection, the survival rate during observation period, and the incidence of complications were compared among the three groups. The adverse reactions of VCZ were observed to identify the best dose for prevention. Quantitative data were analyzed by analysis of variance or rank sum test. Count data were analyzed by chi-square test or Fisher exact test. \u0000 \u0000 \u0000Results \u0000The baseline liver functions were not significantly different among the three groups (all P>0.05). The incidence of pulmonary Aspergillus infection in the GC group (22.97%(17/74)) was both higher than that in the non-GC group (5.77%(6/104)) and GC+ VCZ group (1.85%(1/54)), the differences were both statistically signifrcant (χ2=11.373 and 9.843, respectively, both P<0.01). The overall mortality rate of HBV-ACLF patients with pulmonary Aspergillus infection was 79.2%(19/24). The survival rate in non-GC group (37.5%(39/104)) showed no statistical difference with that in GC group (39.19%(29/74), χ2=0.052, P=0.819). The survival rate of GC+ VCZ group (66.67%(36/54)) was significantly higher than that in GC group and non-GC group (χ2 =12.126 and 9.431, respectively, both P<0.01). The blood concentrations of VCZ were randomly measured in 16 patients from the GC+ VCZ group, and the range was 0.82-5.38 mg/L, with no evident adverse reactions. \u0000 \u0000 \u0000Conclusions \u0000The GC treatment is effective in HBV-ACLF patients in early stage. The VCZ treatment effectively reduces the incidence of pulmonary Aspergillus infection in HBV-ACLF patients receiving GC treatment and increases the survival rate. Oral VCZ (200 mg/d) treatment has a stable blood concentration in HBV-ACLF patients, with rare adverse reactions and good safety. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B virus; Glucocorticoid; Acute-on-chronic liver failure; Voriconazole","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"534-539"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43160072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effect of hepatitis B virus (HBV) X gene integration on expression of zinc finger protein ZBTB20 in chronic hepatitis B (CHB) patients complicated with hepatocellular carcinoma (HCC). Methods Eighteen CHB patients complicated with HCC who underwent surgical treatment in Taizhou Enze Medical Center Enze Hospital and Taizhou Central Hospital from July 2015 to June 2017 were enrolled. Samples of carcinoma tissue, para-carcinoma tissue and corresponding normal liver tissue were collected from each case. DNA was extracted from three kinds of tissue samples. HBV-Alu-polymerase chain reaction (PCR) was used to amplify the integrated HBVX fragments and their bilateral flanking sequences in human genomic DNA. The integrated HBV fragments were determined by PCR products sequencing. Protein was extracted from three kinds of tissue samples.The level of expression of ZBTB20 was detected by protein imprinting. Statistical analysis was performed using t test, analysis of variance, and χ2 test. Results Among the 18 CHB patients complicated with HCC, integration of HBVX gene was found in 13 carcinoma tissue samples, 16 para-carcinoma tissue samples and 9 corresponding normal liver tissue samples. The difference was statistically significant (χ2=6.353, P=0.037). Of the 18 patients, the protein expressions of ZBTB20 in carcinoma tissue, para-carcinoma tissue and corresponding normal tissue were (50.14±11.25)%, (40.71±7.17)% and (39.06±5.17)%, respectively, which was statistically different (F=9.420, P<0.01). HBVX gene integration was detected at ZBTB20 locus in five patients. The expression levels of ZBTB20 in patients with HBVX gene integration at this locus in carcinoma tissue, para-carcinoma tissue and corresponding, normal liver tissue were all significantly lower than those in patients without HBVX gene integration (carcinoma tissue (37.37±10.30)% vs (55.06±7.06)%, para-carcinoma tissue (32.06±2.61)% vs (44.04±5.24)%, corresponding normal tissue (34.66±5.59)% vs (40.76±4.04)%, t=4.205, 4.821 and 2.589, respectively, all P<0.05). Conclusions Incidence of HBVX integration in para-carcinoma tissue is higher than that in carcinoma tissue in CHB patients complicated with HCC.The expression level of ZBTB20 in carcinoma tissue is higher than that in para-carcinoma tissue. Integration of HBVX gene at ZBTB20 locus may decreases the expression of ZBTB20. Key words: Hepatitis B virus; Carcinoma, hepatocellular; Gene integration; Zinc finger protein ZBTB20
{"title":"Effect of hepatitis B virus X gene integration on expression of zinc finger protein ZBTB20 in chronic hepatitis B patients complicated with hepatocellular carcinoma","authors":"Zebao He, Qiuyue Chen, Jiansheng Zhu, Yang Lu, Hai-hong Zhao, Zheping Fang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.09.007","url":null,"abstract":"Objective \u0000To investigate the effect of hepatitis B virus (HBV) X gene integration on expression of zinc finger protein ZBTB20 in chronic hepatitis B (CHB) patients complicated with hepatocellular carcinoma (HCC). \u0000 \u0000 \u0000Methods \u0000Eighteen CHB patients complicated with HCC who underwent surgical treatment in Taizhou Enze Medical Center Enze Hospital and Taizhou Central Hospital from July 2015 to June 2017 were enrolled. Samples of carcinoma tissue, para-carcinoma tissue and corresponding normal liver tissue were collected from each case. DNA was extracted from three kinds of tissue samples. HBV-Alu-polymerase chain reaction (PCR) was used to amplify the integrated HBVX fragments and their bilateral flanking sequences in human genomic DNA. The integrated HBV fragments were determined by PCR products sequencing. Protein was extracted from three kinds of tissue samples.The level of expression of ZBTB20 was detected by protein imprinting. Statistical analysis was performed using t test, analysis of variance, and χ2 test. \u0000 \u0000 \u0000Results \u0000Among the 18 CHB patients complicated with HCC, integration of HBVX gene was found in 13 carcinoma tissue samples, 16 para-carcinoma tissue samples and 9 corresponding normal liver tissue samples. The difference was statistically significant (χ2=6.353, P=0.037). Of the 18 patients, the protein expressions of ZBTB20 in carcinoma tissue, para-carcinoma tissue and corresponding normal tissue were (50.14±11.25)%, (40.71±7.17)% and (39.06±5.17)%, respectively, which was statistically different (F=9.420, P<0.01). HBVX gene integration was detected at ZBTB20 locus in five patients. The expression levels of ZBTB20 in patients with HBVX gene integration at this locus in carcinoma tissue, para-carcinoma tissue and corresponding, normal liver tissue were all significantly lower than those in patients without HBVX gene integration (carcinoma tissue (37.37±10.30)% vs (55.06±7.06)%, para-carcinoma tissue (32.06±2.61)% vs (44.04±5.24)%, corresponding normal tissue (34.66±5.59)% vs (40.76±4.04)%, t=4.205, 4.821 and 2.589, respectively, all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Incidence of HBVX integration in para-carcinoma tissue is higher than that in carcinoma tissue in CHB patients complicated with HCC.The expression level of ZBTB20 in carcinoma tissue is higher than that in para-carcinoma tissue. Integration of HBVX gene at ZBTB20 locus may decreases the expression of ZBTB20. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B virus; Carcinoma, hepatocellular; Gene integration; Zinc finger protein ZBTB20","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"540-544"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44411884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.08.004
Jin Li, Zhenyu Xu, Yan He, Pei Pi, Jie-min Li, Zhu-ren Zhou
Objective To investigate the effect of high active antiretroviral therapy (HAART) on growth and development of infants born to pregnant women infected with human immunodeficiency virus (HIV) and the effect on blocking mother to children transmission. Methods Totally 165 pregnant women diagnosed with HIV infection from May 2006 to May 2017 and their 169 infants, including four pairs of twins were enrolled, and 82 infants born to HIV negative pregnant women in the same period were enrolled as control. All of the pregnant women in the experimental group were administrated with HAART when HIV antibody test was positive. The delivery intervention and artificial feeding were carried out as well. The weight, height, hemoglobin (Hb), serum iron and serum calcium level of infants at birth, 12 months and six years old were monitored and compared between the two groups. Apgar scores of newborns and intelligence tests at six-year-old were also recorded. Statistical analysis was performed by t test. Results Pregnant women were generally in good conditions and well tolerated to the drugs. There were no significant differences in neonatal Apgar scores, body weight, body length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between HIV positive experimental group and control group (t =-1.27, -1.12, -3.41, -5.62, -0.89, -3.02 and-0.74, respectively, all P>0.05). At the age of 12 months, there were no significant differences in body weight, length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between the two groups (t = 1.02, 1.41, 1.32, 1.03, 0.89 and 1.06, respectively, all P > 0.05). At the age of six years, there were no significant differences in all indexes between the two groups (t= 1.02, 0.87, 1.58, 1.03, 0.92 and 2.07, respectively, all P > 0.05). Intelligence assessment was performed in 78 children of the experimental group and 45 children of the control group at the age of six years, and there was no significant difference between the two groups ((89.7±12.5) score vs (91.2±13.7) score, t=1.67, P=0.43). All the children in the experimental group were positive for HIV antibody at birth, and six cases were positive for HIV RNA who were diagnosed with neonatal HIV infection. HAART was initiated for the six cases, while HIV antibody tests were still positive until the age of 18 months after HAART. The rest of the children′s HIV antibody tests became negative with the mother to children tramsission rate of 3.55% (6/169). Conclusion HAART could not only block mother to children tramsission of HIV, but also has no effect on growth and intellectual development of children during the observation period. Key words: Antiretroviral therapy, highly active; Human immunodeficiency virus; Child; Growth and development
{"title":"Effect of highly active antiretroviral therapy on growth and development of infants and children","authors":"Jin Li, Zhenyu Xu, Yan He, Pei Pi, Jie-min Li, Zhu-ren Zhou","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.08.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.08.004","url":null,"abstract":"Objective \u0000To investigate the effect of high active antiretroviral therapy (HAART) on growth and development of infants born to pregnant women infected with human immunodeficiency virus (HIV) and the effect on blocking mother to children transmission. \u0000 \u0000 \u0000Methods \u0000Totally 165 pregnant women diagnosed with HIV infection from May 2006 to May 2017 and their 169 infants, including four pairs of twins were enrolled, and 82 infants born to HIV negative pregnant women in the same period were enrolled as control. All of the pregnant women in the experimental group were administrated with HAART when HIV antibody test was positive. The delivery intervention and artificial feeding were carried out as well. The weight, height, hemoglobin (Hb), serum iron and serum calcium level of infants at birth, 12 months and six years old were monitored and compared between the two groups. Apgar scores of newborns and intelligence tests at six-year-old were also recorded. Statistical analysis was performed by t test. \u0000 \u0000 \u0000Results \u0000Pregnant women were generally in good conditions and well tolerated to the drugs. There were no significant differences in neonatal Apgar scores, body weight, body length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between HIV positive experimental group and control group (t =-1.27, -1.12, -3.41, -5.62, -0.89, -3.02 and-0.74, respectively, all P>0.05). At the age of 12 months, there were no significant differences in body weight, length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between the two groups (t = 1.02, 1.41, 1.32, 1.03, 0.89 and 1.06, respectively, all P > 0.05). At the age of six years, there were no significant differences in all indexes between the two groups (t= 1.02, 0.87, 1.58, 1.03, 0.92 and 2.07, respectively, all P > 0.05). Intelligence assessment was performed in 78 children of the experimental group and 45 children of the control group at the age of six years, and there was no significant difference between the two groups ((89.7±12.5) score vs (91.2±13.7) score, t=1.67, P=0.43). All the children in the experimental group were positive for HIV antibody at birth, and six cases were positive for HIV RNA who were diagnosed with neonatal HIV infection. HAART was initiated for the six cases, while HIV antibody tests were still positive until the age of 18 months after HAART. The rest of the children′s HIV antibody tests became negative with the mother to children tramsission rate of 3.55% (6/169). \u0000 \u0000 \u0000Conclusion \u0000HAART could not only block mother to children tramsission of HIV, but also has no effect on growth and intellectual development of children during the observation period. \u0000 \u0000 \u0000Key words: \u0000Antiretroviral therapy, highly active; Human immunodeficiency virus; Child; Growth and development","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"473-477"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48533696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.08.005
Shitian Yang, Wei Wang, Ya-dong Wang
Objective To validate the predictive value of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) risk score model D2AS in chronic HBV infection patients without antiviral therapy. Methods A total of 93 patients with chronic HBV infection were selected between January 2015 and July 2017 in the Third Affiliated Hospital of Hebei Medical University. Clinical data including age, gender, medical history, ultrasonography, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), HBV DNA and alanine aminotransferase levels were collected by information center. REACH-B score and D2AS score were used to predict the risk of HCC. Receiver operating characteristic curve (ROC) was used to evaluate the discrimination, and Hosmer-Lemeshow (H-L) goodness-of-fit test was used to evaluate the calibration of the model. Results REACH-B score and D2AS score for the 95 chronic HBV infection patients were 9 (8, 12) and 0.95 (0.57, 2.08), respectively. The area under the curve (AUC) for REACH-B score and D2AS score were 0.916 (95% confidence interval [CI] 0.834-0.998) and 0.784 (95%CI 0.587-0.981), respectively. The difference was not statistically significant (P=0.195). However, for HBeAg-negative patients with chronic HBV infection, the AUC for D2AS score and REACH-B score were 0.952 (95%CI 0.876-1.000) and 0.913 (95%CI 0.821-1.000), respectively (P=0.458). The H-L goodness-of-fit test was P>0.05. Conclusions The D2AS score can be used for HCC prediction among patients who do not meet antiviral criteria. The predictive value of the D2AS score for HCC is comparable to the REACH-B score in HBeAg-negative patients with chronic HBV infection. Key words: Carcinoma, hepatocellular; Hepatitis B; Prediction model
{"title":"Validation of D2AS model for prediction of early hepatitis B virus-related hepatocellular carcinoma","authors":"Shitian Yang, Wei Wang, Ya-dong Wang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.08.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.08.005","url":null,"abstract":"Objective \u0000To validate the predictive value of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) risk score model D2AS in chronic HBV infection patients without antiviral therapy. \u0000 \u0000 \u0000Methods \u0000A total of 93 patients with chronic HBV infection were selected between January 2015 and July 2017 in the Third Affiliated Hospital of Hebei Medical University. Clinical data including age, gender, medical history, ultrasonography, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), HBV DNA and alanine aminotransferase levels were collected by information center. REACH-B score and D2AS score were used to predict the risk of HCC. Receiver operating characteristic curve (ROC) was used to evaluate the discrimination, and Hosmer-Lemeshow (H-L) goodness-of-fit test was used to evaluate the calibration of the model. \u0000 \u0000 \u0000Results \u0000REACH-B score and D2AS score for the 95 chronic HBV infection patients were 9 (8, 12) and 0.95 (0.57, 2.08), respectively. The area under the curve (AUC) for REACH-B score and D2AS score were 0.916 (95% confidence interval [CI] 0.834-0.998) and 0.784 (95%CI 0.587-0.981), respectively. The difference was not statistically significant (P=0.195). However, for HBeAg-negative patients with chronic HBV infection, the AUC for D2AS score and REACH-B score were 0.952 (95%CI 0.876-1.000) and 0.913 (95%CI 0.821-1.000), respectively (P=0.458). The H-L goodness-of-fit test was P>0.05. \u0000 \u0000 \u0000Conclusions \u0000The D2AS score can be used for HCC prediction among patients who do not meet antiviral criteria. The predictive value of the D2AS score for HCC is comparable to the REACH-B score in HBeAg-negative patients with chronic HBV infection. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, hepatocellular; Hepatitis B; Prediction model","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"478-482"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47945477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the distribution and transmission characteristics of vancomycin-resistant Enterococcus faecium (VREF) carrying both vanA and vanM in the intensive care unit. Methods VREF strains were isolated from patients in the intensive care unit of Jinshan Hospital, Fudan University in Shanghai from 2013 to 2017. Antimicrobial susceptibilities of the VREF strains to nine antibiotics, including vancomycin, teicoplanin, linezolid and chloromycetin, were tested by broth microdilution method. Multiple polymerase chain reaction (PCR) was used for van genotyping and pulsed field gel electrophoresis (PFGE) was used for homology analysis. Results Thirty-five strains were mainly isolated from urine (16 strains), blood (11 strains), feces (five strains), bile (two strains) and pleural effusion (one strain). All the strains (100.00%) were resistant to vancomycin, ampicillin and levofloxacin, but only 40.00% were resistant to teicoplanin. All the strains were sensitive to linezolid. The results of van genotyping showed that 33 (94.3%) strains belonged to vanA and vanM dual genotype VREF, and the other two were vanA type VREF. PFGE results showed that 35 strains could be divided into 14 PFGE patterns, and seven out of 10 strains isolated in 2014 were identical and the other three belonged to three different PFGE patterns. Conclusions A dual genotype VREF carrying both vanA and vanM has been emerging and spreading in the intensive care unit of Jinshan Hospital, Fudan University in Shanghai. Key words: Enterococcus faecium; Vancomycin; Drug resistance; Genes; Genotype
{"title":"Distribution and transmission characteristics of thirty-five dual genotype vancomycin-resistant Enterococcus faecium carrying both vanA and vanM in an intensive care unit","authors":"Yiqun Yuan, Li Ding, Ying Zhou, Pei Li, Dongfang Lin, Liumei Ding, Xiaogang Xu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.08.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.08.006","url":null,"abstract":"Objective \u0000To investigate the distribution and transmission characteristics of vancomycin-resistant Enterococcus faecium (VREF) carrying both vanA and vanM in the intensive care unit. \u0000 \u0000 \u0000Methods \u0000VREF strains were isolated from patients in the intensive care unit of Jinshan Hospital, Fudan University in Shanghai from 2013 to 2017. Antimicrobial susceptibilities of the VREF strains to nine antibiotics, including vancomycin, teicoplanin, linezolid and chloromycetin, were tested by broth microdilution method. Multiple polymerase chain reaction (PCR) was used for van genotyping and pulsed field gel electrophoresis (PFGE) was used for homology analysis. \u0000 \u0000 \u0000Results \u0000Thirty-five strains were mainly isolated from urine (16 strains), blood (11 strains), feces (five strains), bile (two strains) and pleural effusion (one strain). All the strains (100.00%) were resistant to vancomycin, ampicillin and levofloxacin, but only 40.00% were resistant to teicoplanin. All the strains were sensitive to linezolid. The results of van genotyping showed that 33 (94.3%) strains belonged to vanA and vanM dual genotype VREF, and the other two were vanA type VREF. PFGE results showed that 35 strains could be divided into 14 PFGE patterns, and seven out of 10 strains isolated in 2014 were identical and the other three belonged to three different PFGE patterns. \u0000 \u0000 \u0000Conclusions \u0000A dual genotype VREF carrying both vanA and vanM has been emerging and spreading in the intensive care unit of Jinshan Hospital, Fudan University in Shanghai. \u0000 \u0000 \u0000Key words: \u0000Enterococcus faecium; Vancomycin; Drug resistance; Genes; Genotype","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"483-487"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48950833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.07.006
H. Meng, Ailing Zhang, Jingli Lu, Xiaoli Guo, Xiaojian Zhang
Objective To study the safety and efficacy of colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection. Methods CNKI, Wanfang database, PubMed, Embase and Cochrane library were systematically searched. Randomized controlled trials about colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection were enrolled. The Cochrane Reviewers′ Handbook 5.2 was employed to evaluate the quality of the enrolled studies.The primary outcome was all-cause mortality.The secondary outcomes included infection-related mortality, clinical response, bacterial clearance, nephrotoxicity and hepatotoxicity.Meta-analysis was conducted by RevMan 5.3 software. Results Seven articles containing 859 patients were finally included.There were no significantly statistical differences in all-cause mortality rate (relative risk [RR]=1.07, 95%CI: 0.93-1.24, P>0.05), infection-related mortality rate (RR=1.35, 95%CI: 0.98-1.87, P>0.05), bacterial clearance rate (RR=0.85, 95%CI: 0.71-1.02, P=0.08), hepatotoxicity development rate (RR=0.68, 95%CI: 0.41-1.13, P=0.14), and nephrotoxicity development rate (RR=1.01, 95%CI: 0.85-1.22, P>0.05) between colistin monotherapy and combination therapy. The clinical response rate was higher in combination therapy than that in colistin monotherapy (RR=0.81, 95%CI: 0.66-0.98, P=0.03). In the subgroup analysis, no statistical differences were found in all-cause mortality rate between colistin monotherapy and combination therapy for carbapenem-resistant Acinetobacter baumannii infection (RR=1.00, 95%CI: 0.86-1.12, P>0.05). The dosage of colistin with or without loading dose was not associated with the treatment response. Conclusions Although colistin-based combination therapy has a better clinical response against carbapenem-resistant bacteria infection, especially for Acinetobacter baumannii infection, the mortality rate dose not decline compared to colistin monotherapy.Large-scale randomized controlled trials are needed to evaluate the effect in the future. Key words: Colistin; Meta-analysis; Carbapenem-resistant gram-negative bacteria; Systematic review
{"title":"Safety and efficacy of colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection: a systematic review and meta-analysis","authors":"H. Meng, Ailing Zhang, Jingli Lu, Xiaoli Guo, Xiaojian Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.07.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.07.006","url":null,"abstract":"Objective \u0000To study the safety and efficacy of colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection. \u0000 \u0000 \u0000Methods \u0000CNKI, Wanfang database, PubMed, Embase and Cochrane library were systematically searched. Randomized controlled trials about colistin monotherapy versus combination therapy against carbapenem-resistant gram-negative bacteria infection were enrolled. The Cochrane Reviewers′ Handbook 5.2 was employed to evaluate the quality of the enrolled studies.The primary outcome was all-cause mortality.The secondary outcomes included infection-related mortality, clinical response, bacterial clearance, nephrotoxicity and hepatotoxicity.Meta-analysis was conducted by RevMan 5.3 software. \u0000 \u0000 \u0000Results \u0000Seven articles containing 859 patients were finally included.There were no significantly statistical differences in all-cause mortality rate (relative risk [RR]=1.07, 95%CI: 0.93-1.24, P>0.05), infection-related mortality rate (RR=1.35, 95%CI: 0.98-1.87, P>0.05), bacterial clearance rate (RR=0.85, 95%CI: 0.71-1.02, P=0.08), hepatotoxicity development rate (RR=0.68, 95%CI: 0.41-1.13, P=0.14), and nephrotoxicity development rate (RR=1.01, 95%CI: 0.85-1.22, P>0.05) between colistin monotherapy and combination therapy. The clinical response rate was higher in combination therapy than that in colistin monotherapy (RR=0.81, 95%CI: 0.66-0.98, P=0.03). In the subgroup analysis, no statistical differences were found in all-cause mortality rate between colistin monotherapy and combination therapy for carbapenem-resistant Acinetobacter baumannii infection (RR=1.00, 95%CI: 0.86-1.12, P>0.05). The dosage of colistin with or without loading dose was not associated with the treatment response. \u0000 \u0000 \u0000Conclusions \u0000Although colistin-based combination therapy has a better clinical response against carbapenem-resistant bacteria infection, especially for Acinetobacter baumannii infection, the mortality rate dose not decline compared to colistin monotherapy.Large-scale randomized controlled trials are needed to evaluate the effect in the future. \u0000 \u0000 \u0000Key words: \u0000Colistin; Meta-analysis; Carbapenem-resistant gram-negative bacteria; Systematic review","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"414-419"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42105438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.07.007
B. Luo, Jinglan Jin, H. Rao, Q. Ning, J. Hou, L. Bai, Yongfeng Yang, S. Zheng, X. Mao, Jun Quan, Dongliang Yang, Lunli Zhang, Caiyan Zhao, Z. Jia, Fuchun Zhang, Z. Gong, F. Lin, Guiqiang Wang, L. Luo, Liping Deng, Hongming Xie, Jing Li, Yingjun Zhang, Lai Wei
Objective To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus (HCV) genotype 1 infection who were treatment-naive or had a virologic failure to prior interferon-based treatment. Methods A multicenter, randomized, open-label, phase 2 clinical trial was conducted. The patients were randomly assigned to yimitasvir phosphate 100 mg+ sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+ sofosbuvir 400 mg group (Group 200 mg) in a 1∶1 ratio with the stratified factors of "treatment-naive" or "treatment-experienced" for 12 weeks and followed up for 24 weeks after the end of treatment. During the clinical trial, HCV RNA was tested in all patients. Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored. Safety and tolerability were assessed by monitoring adverse events, physical examination, laboratory examination, electrocardiogram, and vital signs during the study. The primary end point was SVR12 after the end of therapy. Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables. Descriptive statistics were used and summarized according to HCV genotypes and treatment groups. Safety data were presented using descriptive statistics and summarized according to treatment groups. Results A total of 174 subjects were screened from July 31, 2017 to September 26, 2018. One hundred and twenty-nine patients were successfully enrolled and received treatment, and 127 completed the study. There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively. Among the 129 patients who underwent randomization and were treated, 18.6% were treatment-experienced and: 100% were HCV genotype 1b infection. The total SVR rate was 98.4% (127/129), with 98.4% (63/64, 95% confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50% (64/65, 95%CI: 91.72%-99.96%) in the Group 200 mg. There was no significant difference between the two groups (χ2=0.000 2, P=0.989 2). The SVR rates in treatment-naive group and treatment-experienced group were 98.10% (95%CI: 93.29%-99.77%) and 100.00% (24/24, 95%CI: 85.75%-100.00%), respectively. Virological failure during treatment (including breakthrough, rebound and poor efficacy) and relapse after treatment did not occur during the trial. By Sanger sequencing, 11.6% (15/129) patients had baseline NS5A Y93H/Y or Y93H resistance-associated substitutions (RAS), 1.6% (2/129) patients had baseline NS5A L31M RAS. No mutation was observed in NS5B S282 at baseline. There was no S282 mutation in HCV NS5B. A total of 100 (77.5%) subjects had adverse events. No adverse events ≥Grade 3 or severe adverse events related to the study treatment. No patient prematurely discontinued study treatment owing to an adverse event. No life-threatening adverse event was reported.
{"title":"Efficacy and safety of yimitasvir phospha combined with sofosbuvir in patients with chronic hepatitis C virus infection","authors":"B. Luo, Jinglan Jin, H. Rao, Q. Ning, J. Hou, L. Bai, Yongfeng Yang, S. Zheng, X. Mao, Jun Quan, Dongliang Yang, Lunli Zhang, Caiyan Zhao, Z. Jia, Fuchun Zhang, Z. Gong, F. Lin, Guiqiang Wang, L. Luo, Liping Deng, Hongming Xie, Jing Li, Yingjun Zhang, Lai Wei","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.07.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.07.007","url":null,"abstract":"Objective \u0000To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus (HCV) genotype 1 infection who were treatment-naive or had a virologic failure to prior interferon-based treatment. \u0000 \u0000 \u0000Methods \u0000A multicenter, randomized, open-label, phase 2 clinical trial was conducted. The patients were randomly assigned to yimitasvir phosphate 100 mg+ sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+ sofosbuvir 400 mg group (Group 200 mg) in a 1∶1 ratio with the stratified factors of \"treatment-naive\" or \"treatment-experienced\" for 12 weeks and followed up for 24 weeks after the end of treatment. During the clinical trial, HCV RNA was tested in all patients. Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored. Safety and tolerability were assessed by monitoring adverse events, physical examination, laboratory examination, electrocardiogram, and vital signs during the study. The primary end point was SVR12 after the end of therapy. Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables. Descriptive statistics were used and summarized according to HCV genotypes and treatment groups. Safety data were presented using descriptive statistics and summarized according to treatment groups. \u0000 \u0000 \u0000Results \u0000A total of 174 subjects were screened from July 31, 2017 to September 26, 2018. One hundred and twenty-nine patients were successfully enrolled and received treatment, and 127 completed the study. There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively. Among the 129 patients who underwent randomization and were treated, 18.6% were treatment-experienced and: 100% were HCV genotype 1b infection. The total SVR rate was 98.4% (127/129), with 98.4% (63/64, 95% confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50% (64/65, 95%CI: 91.72%-99.96%) in the Group 200 mg. There was no significant difference between the two groups (χ2=0.000 2, P=0.989 2). The SVR rates in treatment-naive group and treatment-experienced group were 98.10% (95%CI: 93.29%-99.77%) and 100.00% (24/24, 95%CI: 85.75%-100.00%), respectively. Virological failure during treatment (including breakthrough, rebound and poor efficacy) and relapse after treatment did not occur during the trial. By Sanger sequencing, 11.6% (15/129) patients had baseline NS5A Y93H/Y or Y93H resistance-associated substitutions (RAS), 1.6% (2/129) patients had baseline NS5A L31M RAS. No mutation was observed in NS5B S282 at baseline. There was no S282 mutation in HCV NS5B. A total of 100 (77.5%) subjects had adverse events. No adverse events ≥Grade 3 or severe adverse events related to the study treatment. No patient prematurely discontinued study treatment owing to an adverse event. No life-threatening adverse event was reported. \u0000 \u0000 \u0000","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"420-429"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48861280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.07.005
Kaili Sun, Zhou Liu, Haoran Chen, Dongmei Zhao, Yi Gu, Yanyan Liu, Yalong Zhang, Jiabin Li
Objective To investigate the resistance genotype, capsular serotype and virulence gene of hypermucoviscous Klebsiella pneumoniae (HMVKP). Methods A total of 698 strains of Klebsiella pneumoniae (non-repetitive strains) were collected from 35 hospitals of Anhui in September 2017. A total of 78 HMVKP strains were isolated and screened, and the phenotypes of hypermucoviscosity were identified by slime test. The minimum inhibitory concentrations (MIC) of 17 antibiotics drugs were determined by agar dilution method. The resistance related genes, serotype and virulence gene were determined by polymerase chain reaction (PCR). Molecular typing was performed with multi-locus sequence typing (MLST). The homology of major ST-sequence strains was analyzed by pulsed-field gel electrophoresis (PFGE). The carrying rate between HMVKP virulence gene rmpA positive group and the negative group were compared and analyzed. Chi-square test was used for rates comparison between two groups. Results The results showed that 66 strains among 78 strains of HMVKP were isolated from sputum samples. The HMVKP strains were sensitive to 17 antibiotics drugs but had slightly high resistance rates to chloramphenicol, ceftriaxone and ceftizoxime. Four strains produced extended-spectrum beta lactamase carried drug resistance genes including TEM (one strain), CTX-M1 (one strain) and CTX-M2 (two strains), and one strain was resistant to carbapenems, which carries the IMP resistance gene. K2 (30/78, 38.46%) and K1 (13/78, 16.67%) were the major capsular serotypes in 78 HMVKP. IroNB (71/78, 91.03%) and aerobactin (67/78, 85.90%) were the major virulence genes among the five tested virulence genes, and the highest detection rates of virulence gene were found in K2 serotype. A total of 28 ST-sequences were found in 78 strains of HMVKP, and the PFGE results indicated that the four major clones (ST23, ST65, ST86 and ST412) were divided into 16 types, and some of them had homology. In addition, statistical analysis found that the HMVKP virulence gene rmpA positive group (27/52, 51.92%) was more likely to carry the virulence gene kfu than the negative group (7/26, 26.92%). Conclusions The detection rate of drug resistance genotypes in HMVKP stains is not high. K2 and K1 are the major capsular serotypes in 78 HMVKP; iroNB and aerobactin have the highest carrying rate, and the highest detection rates of virulence genes are found in K2 serotype. Key words: Klebsiella pneumoniae; Drug resistance; Electrophoresis, gel, pulsed-field; Virulent gene; Hyper mucoviscous
{"title":"Resistance genotype, capsular serotype and virulence gene of hypermucoviscous Klebsiella pneumoniae in Anhui Province","authors":"Kaili Sun, Zhou Liu, Haoran Chen, Dongmei Zhao, Yi Gu, Yanyan Liu, Yalong Zhang, Jiabin Li","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.07.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.07.005","url":null,"abstract":"Objective \u0000To investigate the resistance genotype, capsular serotype and virulence gene of hypermucoviscous Klebsiella pneumoniae (HMVKP). \u0000 \u0000 \u0000Methods \u0000A total of 698 strains of Klebsiella pneumoniae (non-repetitive strains) were collected from 35 hospitals of Anhui in September 2017. A total of 78 HMVKP strains were isolated and screened, and the phenotypes of hypermucoviscosity were identified by slime test. The minimum inhibitory concentrations (MIC) of 17 antibiotics drugs were determined by agar dilution method. The resistance related genes, serotype and virulence gene were determined by polymerase chain reaction (PCR). Molecular typing was performed with multi-locus sequence typing (MLST). The homology of major ST-sequence strains was analyzed by pulsed-field gel electrophoresis (PFGE). The carrying rate between HMVKP virulence gene rmpA positive group and the negative group were compared and analyzed. Chi-square test was used for rates comparison between two groups. \u0000 \u0000 \u0000Results \u0000The results showed that 66 strains among 78 strains of HMVKP were isolated from sputum samples. The HMVKP strains were sensitive to 17 antibiotics drugs but had slightly high resistance rates to chloramphenicol, ceftriaxone and ceftizoxime. Four strains produced extended-spectrum beta lactamase carried drug resistance genes including TEM (one strain), CTX-M1 (one strain) and CTX-M2 (two strains), and one strain was resistant to carbapenems, which carries the IMP resistance gene. K2 (30/78, 38.46%) and K1 (13/78, 16.67%) were the major capsular serotypes in 78 HMVKP. IroNB (71/78, 91.03%) and aerobactin (67/78, 85.90%) were the major virulence genes among the five tested virulence genes, and the highest detection rates of virulence gene were found in K2 serotype. A total of 28 ST-sequences were found in 78 strains of HMVKP, and the PFGE results indicated that the four major clones (ST23, ST65, ST86 and ST412) were divided into 16 types, and some of them had homology. In addition, statistical analysis found that the HMVKP virulence gene rmpA positive group (27/52, 51.92%) was more likely to carry the virulence gene kfu than the negative group (7/26, 26.92%). \u0000 \u0000 \u0000Conclusions \u0000The detection rate of drug resistance genotypes in HMVKP stains is not high. K2 and K1 are the major capsular serotypes in 78 HMVKP; iroNB and aerobactin have the highest carrying rate, and the highest detection rates of virulence genes are found in K2 serotype. \u0000 \u0000 \u0000Key words: \u0000Klebsiella pneumoniae; Drug resistance; Electrophoresis, gel, pulsed-field; Virulent gene; Hyper mucoviscous","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":"37 1","pages":"408-413"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41463279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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