Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112150-20240826-00684
Respiratory syncytial virus (RSV) infection, which has the very heavy disease burdens, is the most common viral pathogen that seriously threatens the health of infants and young children. In order to better guide and standardize the clinical diagnosis, treatment, monitoring and immunization prevention and control of RSV infection in China, the Chinese Preventive Medicine Association jointly organized multidisciplinary experts to form a special working group, drawing on the implementation experience of foreign passive immunization prevention of RSV, integrating the existing evidence and the latest progress as a problem oriented, and putting forward the expert consensus on the passive immunization prevention of infant RSV infection in China in the future. The aim is to answer some professional questions about RSV infection and its immunoprophylaxis, especially passive immunoprophylaxis, in order to provide reference for the practice of immunoprophylaxis for professionals in medical institutions, disease prevention and control institutions and community health service centers at all levels.
{"title":"[Expert consensus on the passive immunization prevention of infant respiratory syncytial virus infection in China].","authors":"","doi":"10.3760/cma.j.cn112150-20240826-00684","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240826-00684","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) infection, which has the very heavy disease burdens, is the most common viral pathogen that seriously threatens the health of infants and young children. In order to better guide and standardize the clinical diagnosis, treatment, monitoring and immunization prevention and control of RSV infection in China, the Chinese Preventive Medicine Association jointly organized multidisciplinary experts to form a special working group, drawing on the implementation experience of foreign passive immunization prevention of RSV, integrating the existing evidence and the latest progress as a problem oriented, and putting forward the expert consensus on the passive immunization prevention of infant RSV infection in China in the future. The aim is to answer some professional questions about RSV infection and its immunoprophylaxis, especially passive immunoprophylaxis, in order to provide reference for the practice of immunoprophylaxis for professionals in medical institutions, disease prevention and control institutions and community health service centers at all levels.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393841","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 : 2024-09-27DOI: 10.3760/cma.j.cn112150-20240422-00332
W Luo, Q H Ma, L Y He, H C Wang, F L Wu, J W Hu, Y Wu, T Tao
<p><p>To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age (<i>Q<sub>1</sub>, Q<sub>3</sub></i>) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ<sup>2</sup>=3.844, <i>P</i>=0.043) and overall survival rate (χ<sup>2</sup>=4.662, <i>P</i>=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male (<i>HR</i>=2.70, 95%<i>CI</i>:1.10-6.80), EB viral load≥1 000 copies/ml (<i>HR</i>=1.75, 95%<i>CI</i>:1.12-2.84), HIV-RNA≥200 copies/ml (<i>HR</i>=4.64, 95%<i>CI</i>: 1.73-12.15), ECOG PS score of 2 to 4 points (<i>HR</i>=3.54, 95%<i>CI</i>:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points (<i>HR</i>=5.21, 95%<i>CI</i>:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.07, 95%<i>CI</i>:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males (<i>HR</i>=2.87, 95%<i>CI</i>:1.65-9.17), EB viral load≥1 000 copies/ml (<i>HR</i>=1.61, 95%<i>CI</i>:4.02-9.36), HIV-RNA≥200 copies/ml (<i>HR</i>=1.19, 95%<i>CI</i>:1.58-2.74), ECOG PS score of 2 to 4 (<i>HR</i>=6.42, 95%<i>CI</i>:2.55-14.33), IPI score of 3 to 5 points (<i>HR</i>=2.78, 95%<i>CI</i>:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.24, 95%<i>CI</i>:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml
{"title":"[Clinical features and prognostic factors of AIDS-associated diffuse large B-cell lymphoma].","authors":"W Luo, Q H Ma, L Y He, H C Wang, F L Wu, J W Hu, Y Wu, T Tao","doi":"10.3760/cma.j.cn112150-20240422-00332","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240422-00332","url":null,"abstract":"<p><p>To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age (<i>Q<sub>1</sub>, Q<sub>3</sub></i>) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ<sup>2</sup>=3.844, <i>P</i>=0.043) and overall survival rate (χ<sup>2</sup>=4.662, <i>P</i>=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male (<i>HR</i>=2.70, 95%<i>CI</i>:1.10-6.80), EB viral load≥1 000 copies/ml (<i>HR</i>=1.75, 95%<i>CI</i>:1.12-2.84), HIV-RNA≥200 copies/ml (<i>HR</i>=4.64, 95%<i>CI</i>: 1.73-12.15), ECOG PS score of 2 to 4 points (<i>HR</i>=3.54, 95%<i>CI</i>:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points (<i>HR</i>=5.21, 95%<i>CI</i>:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.07, 95%<i>CI</i>:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males (<i>HR</i>=2.87, 95%<i>CI</i>:1.65-9.17), EB viral load≥1 000 copies/ml (<i>HR</i>=1.61, 95%<i>CI</i>:4.02-9.36), HIV-RNA≥200 copies/ml (<i>HR</i>=1.19, 95%<i>CI</i>:1.58-2.74), ECOG PS score of 2 to 4 (<i>HR</i>=6.42, 95%<i>CI</i>:2.55-14.33), IPI score of 3 to 5 points (<i>HR</i>=2.78, 95%<i>CI</i>:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml (<i>HR</i>=0.24, 95%<i>CI</i>:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355458","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20231105-00313
B S Li, Y Shi, M J Geng, Y Q Guo, F Lin, Y P Zhang, Z J Li, L P Wang
Objective: To analyze the epidemiological characteristics of human respiratory syncytial virus (HRSV) in cases of febrile respiratory syndrome in China from 2010 to 2020. Methods: Based on the sub-project of the National Science and Technology Major Project for Infectious Disease Prevention and Control "Infectious Disease Monitoring Technology Platform", active monitoring of febrile respiratory syndrome cases was conducted in sentinel hospitals in 31 provinces across China (excluding Hong Kong, Macau, and Chinese Taiwan) from January 2010 to December 2020, resulting in the inclusion of 191 441 cases. Clinical specimens of monitored cases were screened for HRSV nucleic acid, and the differences in HRSV detection rates among different age groups, regions, and time periods were analyzed using the χ2 test/Fisher exact probability method. Results: Among the 191 441 cases of febrile respiratory syndrome in China from 2010 to 2020, the age group M (Q1, Q3) was 9 (2, 40) years old, with 83 773 cases (43.8%) in the <5 years old group. There were 113 660 males, with a male-to-female ratio of 1.5∶1.0. There were as many as 105 508 cases (55.2%) of scattered children and preschool children. About 70 565 cases (36.9%) lived in the northern region. There were 13 858 HRSV positive cases, with a total positive rate of 7.2%. The positive rate of HRSV detection in the northern population was 5.7% (4 004/70 565), which was lower than that in the southern population (8.2%, 9 854/120 876), and the difference was statistically significant (χ2=407.4, P<0.001). HRSV was detected in all age groups, with the highest positive rate of 23.9% in the <6 months age group. The month with the highest positive rate was December, and autumn and winter were the main epidemic seasons. Both northern and southern HRSV subtypes were mainly infected with type A, with a low proportion of mixed infections of type A and type B. Conclusion: HRSV is a common pathogen causing respiratory infections in children from 2010 to 2020. It can be detected throughout the year and shows the main peak of prevalence in autumn and winter. The HRSV strain is mainly classified as a type A infection.
{"title":"[Epidemiological characteristics of human respiratory syncytial virus infection in febrile respiratory syndrome cases in China from 2010 to 2020].","authors":"B S Li, Y Shi, M J Geng, Y Q Guo, F Lin, Y P Zhang, Z J Li, L P Wang","doi":"10.3760/cma.j.cn112150-20231105-00313","DOIUrl":"10.3760/cma.j.cn112150-20231105-00313","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the epidemiological characteristics of human respiratory syncytial virus (HRSV) in cases of febrile respiratory syndrome in China from 2010 to 2020. <b>Methods:</b> Based on the sub-project of the National Science and Technology Major Project for Infectious Disease Prevention and Control \"Infectious Disease Monitoring Technology Platform\", active monitoring of febrile respiratory syndrome cases was conducted in sentinel hospitals in 31 provinces across China (excluding Hong Kong, Macau, and Chinese Taiwan) from January 2010 to December 2020, resulting in the inclusion of 191 441 cases. Clinical specimens of monitored cases were screened for HRSV nucleic acid, and the differences in HRSV detection rates among different age groups, regions, and time periods were analyzed using the χ<sup>2</sup> test/Fisher exact probability method. <b>Results:</b> Among the 191 441 cases of febrile respiratory syndrome in China from 2010 to 2020, the age group <i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>) was 9 (2, 40) years old, with 83 773 cases (43.8%) in the <5 years old group. There were 113 660 males, with a male-to-female ratio of 1.5∶1.0. There were as many as 105 508 cases (55.2%) of scattered children and preschool children. About 70 565 cases (36.9%) lived in the northern region. There were 13 858 HRSV positive cases, with a total positive rate of 7.2%. The positive rate of HRSV detection in the northern population was 5.7% (4 004/70 565), which was lower than that in the southern population (8.2%, 9 854/120 876), and the difference was statistically significant (χ<sup>2</sup>=407.4, <i>P</i><0.001). HRSV was detected in all age groups, with the highest positive rate of 23.9% in the <6 months age group. The month with the highest positive rate was December, and autumn and winter were the main epidemic seasons. Both northern and southern HRSV subtypes were mainly infected with type A, with a low proportion of mixed infections of type A and type B. <b>Conclusion:</b> HRSV is a common pathogen causing respiratory infections in children from 2010 to 2020. It can be detected throughout the year and shows the main peak of prevalence in autumn and winter. The HRSV strain is mainly classified as a type A infection.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989071","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20240110-00042
X Li, L J Wang, G J Zhang
Demyelinating disorders of the nervous system constitute a broad spectrum of neurological conditions characterized by the depletion of myelin sheaths accompanied by inflammatory cell infiltration, manifesting in either the central or peripheral nervous system. The former primarily encompasses conditions such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), while the latter is exemplified predominantly by Guillain-Barre syndrome (GBS). Recent investigations have revealed that dyslipidemia may be related to the occurrence and development of neurological demyelination, but there are fewer analyses and summaries of related advances in China. Consequently, this review aims to comprehensively outline advancements in research concerning the correlation between dyslipidemia and neurological demyelinating disordersand discusses in depth the interrelationship between dyslipidemia and neurological demyelinating diseases, so as to provide reference for the prevention and treatment of neurological demyelinating diseases.
{"title":"[Progress in the study of the correlation between dyslipidemia and demyelinating diseases of the nervous system].","authors":"X Li, L J Wang, G J Zhang","doi":"10.3760/cma.j.cn112150-20240110-00042","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240110-00042","url":null,"abstract":"<p><p>Demyelinating disorders of the nervous system constitute a broad spectrum of neurological conditions characterized by the depletion of myelin sheaths accompanied by inflammatory cell infiltration, manifesting in either the central or peripheral nervous system. The former primarily encompasses conditions such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), while the latter is exemplified predominantly by Guillain-Barre syndrome (GBS). Recent investigations have revealed that dyslipidemia may be related to the occurrence and development of neurological demyelination, but there are fewer analyses and summaries of related advances in China. Consequently, this review aims to comprehensively outline advancements in research concerning the correlation between dyslipidemia and neurological demyelinating disordersand discusses in depth the interrelationship between dyslipidemia and neurological demyelinating diseases, so as to provide reference for the prevention and treatment of neurological demyelinating diseases.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296959","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20240408-00284
Y H Mao, T R Cao, L H Chen, J W Hu, L Y Zhou, Q H Ma, X Y Song, K Yuan
Clinical trials are an important method for evaluating the safety and efficacy of in vitro diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of in vitro diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of in vitro diagnostic reagents. Medical laboratory is the main department and implementer of in vitro diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the in vitro diagnostic industry, the clinical trial projects of in vitro diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of in vitro diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of in vitro diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of in vitro diagnostic reagents in current medical laboratories, and introduces the laboratory's experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of in vitro diagnostic reagents, in order to improve the quality and efficiency of clinical trials.
{"title":"[Analysis of problems and management of <i>in vitro</i> diagnostic reagent clinical trials in medical laboratory].","authors":"Y H Mao, T R Cao, L H Chen, J W Hu, L Y Zhou, Q H Ma, X Y Song, K Yuan","doi":"10.3760/cma.j.cn112150-20240408-00284","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240408-00284","url":null,"abstract":"<p><p>Clinical trials are an important method for evaluating the safety and efficacy of <i>in vitro</i> diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of <i>in vitro</i> diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of <i>in vitro</i> diagnostic reagents. Medical laboratory is the main department and implementer of <i>in vitro</i> diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the <i>in vitro</i> diagnostic industry, the clinical trial projects of <i>in vitro</i> diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of <i>in vitro</i> diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of <i>in vitro</i> diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of <i>in vitro</i> diagnostic reagents in current medical laboratories, and introduces the laboratory's experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of <i>in vitro</i> diagnostic reagents, in order to improve the quality and efficiency of clinical trials.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296971","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20240407-00280
L J Li, Z Y Yuan, L Zhang, R T Deng, L S Lai, W C Huang, W J Fu
To investigate the genomic features and perform cluster analysis of Carbapenem-resistant Klebsiella pneumoniae (CRKP) to provide an experimental basis for guiding the prevention and treatment of CRKP infections.A retrospective case-cohort study was conducted on 19 non-redundant CRKP strains isolated from the Tenth Affiliated Hospital of Southern Medical University between January and June 2023. Whole genome sequencing (WGS) and multilocus sequence typing (MLST) were performed to compare genomic features and analyze the resistance genes and homology of the strains.The results showed that the 19 CRKP strains were isolated from 8 different clinical departments, mainly from respiratory specimens. The whole genome sequencing revealed that the genomic lengths of CRKP ranged from 4.90 to 5.85 Mbp, with contigs N50 values>20 kb for each genome. The median overall GC content was 57.0% (50.4%-57.1%). Comparative genomic analysis identified three regions with high genomic variability. WGS detected 32 resistance genes across 11 categories. All 19 strains carried carbapenem resistance genes (blaKPC-2 and blaOXA-48), blaTEM-1B extended-spectrum β-lactamase resistance genes, qnrS1 quinolone resistance gene, and fosA fosfomycin resistance gene, with each strain carrying only one carbapenemase gene. The detection rate of blaKPC-2 was 94.7% (18/19). MLST identified three sequence types: ST11, ST437 and ST147, with ST11 being predominant (89.5%, 17/19). Clustering analysis based on acquired resistance genes revealed three clonal transmission patterns among strains 72 and 90, and strains 88, 84, 66 and 79.In conclusion, CRKP strains carry multiple resistance genes, and clustering analysis indicating that nosocomial clonal transmission is closely related to acquired resistance genes. The ST11-blaKPC-2 type strain is the predominant clone. Strengthened surveillance and effective control strategies are necessary to reduce nosocomial transmission of CRKP.
{"title":"[Genomic characterization and cluster analysis of Carbapenem-resistant <i>Klebsiella pneumoniae</i>].","authors":"L J Li, Z Y Yuan, L Zhang, R T Deng, L S Lai, W C Huang, W J Fu","doi":"10.3760/cma.j.cn112150-20240407-00280","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240407-00280","url":null,"abstract":"<p><p>To investigate the genomic features and perform cluster analysis of Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) to provide an experimental basis for guiding the prevention and treatment of CRKP infections.A retrospective case-cohort study was conducted on 19 non-redundant CRKP strains isolated from the Tenth Affiliated Hospital of Southern Medical University between January and June 2023. Whole genome sequencing (WGS) and multilocus sequence typing (MLST) were performed to compare genomic features and analyze the resistance genes and homology of the strains.The results showed that the 19 CRKP strains were isolated from 8 different clinical departments, mainly from respiratory specimens. The whole genome sequencing revealed that the genomic lengths of CRKP ranged from 4.90 to 5.85 Mbp, with contigs N50 values>20 kb for each genome. The median overall GC content was 57.0% (50.4%-57.1%). Comparative genomic analysis identified three regions with high genomic variability. WGS detected 32 resistance genes across 11 categories. All 19 strains carried carbapenem resistance genes (<i>bla</i><sub>KPC-2</sub> and <i>bla</i><sub>OXA-48</sub>), <i>bla</i><sub>TEM-1B</sub> extended-spectrum β-lactamase resistance genes, <i>qnrS1</i> quinolone resistance gene, and <i>fosA</i> fosfomycin resistance gene, with each strain carrying only one carbapenemase gene. The detection rate of <i>bla</i><sub>KPC-2</sub> was 94.7% (18/19). MLST identified three sequence types: ST11, ST437 and ST147, with ST11 being predominant (89.5%, 17/19). Clustering analysis based on acquired resistance genes revealed three clonal transmission patterns among strains 72 and 90, and strains 88, 84, 66 and 79.In conclusion, CRKP strains carry multiple resistance genes, and clustering analysis indicating that nosocomial clonal transmission is closely related to acquired resistance genes. The ST11-<i>bla</i><sub>KPC-2</sub> type strain is the predominant clone. Strengthened surveillance and effective control strategies are necessary to reduce nosocomial transmission of CRKP.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296953","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20240304-00183
S Z Huang, M Y Yu
Dyslipidemia stands as an autonomous peril in the realm of atherosclerotic cardiovascular maladies. Prompt identification and timely intervention in the case of dyslipidemia hold promise for substantially curbing the onset and fatality rates associated with coronary heart disease. Traditional lipid surveillance metrics employed in clinical settings, such as low-density lipoprotein cholesterol, exhibit notable limitations. Conversely, lipid-derived parameters emerge as formidable contenders, demonstrating a capacity to amalgamate and quantify disparate risk factors and multifactorial etiologies inherent in a given disease. By encompassing a broader spectrum of information than singular indices, these parameters offer a more profound insight into disease progression by virtue of their grounding in the physiological intricacies of lipid metabolism. Drawing upon extant domestic and international guidelines and research, this discourse delineates and synthesizes four lipid-derived parameters with promising clinical applications: atherogenic index of plasma, non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio, apolipoprotein B/A1 ratio, and lipoprotein combine index, and forwards a perspective grounded in current strides in clinical research.
{"title":"[Research progress of lipid-derived parameters in atherosclerotic cardiovascular disease].","authors":"S Z Huang, M Y Yu","doi":"10.3760/cma.j.cn112150-20240304-00183","DOIUrl":"10.3760/cma.j.cn112150-20240304-00183","url":null,"abstract":"<p><p>Dyslipidemia stands as an autonomous peril in the realm of atherosclerotic cardiovascular maladies. Prompt identification and timely intervention in the case of dyslipidemia hold promise for substantially curbing the onset and fatality rates associated with coronary heart disease. Traditional lipid surveillance metrics employed in clinical settings, such as low-density lipoprotein cholesterol, exhibit notable limitations. Conversely, lipid-derived parameters emerge as formidable contenders, demonstrating a capacity to amalgamate and quantify disparate risk factors and multifactorial etiologies inherent in a given disease. By encompassing a broader spectrum of information than singular indices, these parameters offer a more profound insight into disease progression by virtue of their grounding in the physiological intricacies of lipid metabolism. Drawing upon extant domestic and international guidelines and research, this discourse delineates and synthesizes four lipid-derived parameters with promising clinical applications: atherogenic index of plasma, non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio, apolipoprotein B/A1 ratio, and lipoprotein combine index, and forwards a perspective grounded in current strides in clinical research.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296980","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20240417-00316
T L Zhang, Z L Hu, H Q Wang, F X Zhao, Q Y Pan, Q Q Zhan, Q Y An, F Y Zhang, T Liu, Y D Hu
Objective: To study the influence of the severity of diabetic retinopathy (DR) on the visual function of patients with type 2 diabetes, to provide scientific basis for the early prevention and control of DR. Methods: This study was designed as a cross-sectional study, recruiting already-diagnosed type 2 diabetes patients in four community health service centers in Guizhou Province between February and September 2022. Employing the Chinese version of the Visual Function Index-14 (VF-14), assess the participants' near vision, visual adaptation, subjective visual perception, and stereo vision, with higher scores indicating poorer visual function. Categorize the severity of each eye's damage into no diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, and proliferative diabetic retinopathy (PDR), and use a 5-level DR grading system to evaluate the overall severity of diabetic retinopathy in both eyes. Employing linear regression analysis to investigate the linear relationship between DR and visual function index. Local weighted regression evaluates the nonlinear relationship between the DR composite score and the scores of visual function, with a steeper slope indicating poorer visual function for that level. Results: A total of 542 patients with type 2 diabetes were investigated, including 244 (45.02%) males, 298 (54.98%) females, and 162 (29.89%) patients with DR. After adjusting for confounders, compared with those without DR, patients with binocular DR Had overall scores (β=0.136, P=0.003), near vision (β=0.163, P<0.001), visual adaptation (β=0.092, P=0.042), subjective vision (β=0.120, P=0.009) and stereo vision (β=0.094, P=0.044) were higher than those without DR. There were no differences in visual functions between DR And monocular DR. The local weighted regression curve showed that near vision (slope: 23.78) and overall score (slope: 58.37) increased sharply from mild to moderate NPDR in both eyes. Visual adaptation (slope: 5.37, 7.72), subjective vision (slope: 6.53, 7.93), stereovision (slope: 0.74, 0.91) increased slowly in mild to moderate NPDR in both eyes and in moderate to severe NPDR/PDR in both eyes. Conclusion: Binocular DR is associated with impaired visual function, but there is no difference between monocular DR And non-DR visual function. The early damage of DR To visual function is mainly manifested in near vision. In the prevention and control of DR, more attention should be paid to visual function, especially the change of near vision, and retinal damage should not be assessed solely by visual status.
研究目的研究糖尿病视网膜病变(DR)的严重程度对 2 型糖尿病患者视功能的影响,为早期预防和控制 DR 提供科学依据。研究方法本研究为横断面研究,于2022年2月至9月在贵州省4个社区卫生服务中心招募已确诊的2型糖尿病患者。采用中文版视功能指数-14(VF-14),评估参与者的近视力、视适应、主观视知觉和立体视觉,得分越高表示视功能越差。将每只眼睛的损伤程度分为无糖尿病视网膜病变(DR)、轻度非增殖性糖尿病视网膜病变(NPDR)、中度非增殖性糖尿病视网膜病变(NPDR)、重度非增殖性糖尿病视网膜病变(NPDR)和增殖性糖尿病视网膜病变(PDR),并使用五级DR分级系统评估双眼糖尿病视网膜病变的总体严重程度。采用线性回归分析研究 DR 与视觉功能指数之间的线性关系。局部加权回归评估 DR 综合评分与视觉功能评分之间的非线性关系,斜率越陡,表明该级别的视觉功能越差。研究结果共调查了 542 名 2 型糖尿病患者,其中男性 244 人(45.02%),女性 298 人(54.98%),DR 患者 162 人(29.89%)。在对混杂因素进行调整后,与非 DR 患者相比,双眼 DR 患者的总分(β=0.136,P=0.003)、近视力(β=0.163,Pβ=0.092,P=0.042)、主观视力(β=0.120,P=0.009)和立体视力(β=0.094,P=0.044)均高于非 DR 患者。DR和单眼DR在视觉功能上没有差异。局部加权回归曲线显示,双眼的近视力(斜率:23.78)和总分(斜率:58.37)从轻度NPDR急剧上升到中度NPDR。双眼视适应(斜率:5.37,7.72)、主观视力(斜率:6.53,7.93)和立体视觉(斜率:0.74,0.91)在轻度至中度 NPDR 和中度至重度 NPDR/PDR 中增长缓慢。结论双眼 DR 与视功能受损有关,但单眼 DR 和非 DR 的视功能没有差异。DR 对视功能的早期损害主要表现在近距离视力上。在预防和控制 DR 的过程中,应更多地关注视功能,尤其是近视力的变化,而不应仅仅通过视力状况来评估视网膜损伤。
{"title":"[Effects of retinopathy on visual function in type 2 diabetes mellitus].","authors":"T L Zhang, Z L Hu, H Q Wang, F X Zhao, Q Y Pan, Q Q Zhan, Q Y An, F Y Zhang, T Liu, Y D Hu","doi":"10.3760/cma.j.cn112150-20240417-00316","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20240417-00316","url":null,"abstract":"<p><p><b>Objective:</b> To study the influence of the severity of diabetic retinopathy (DR) on the visual function of patients with type 2 diabetes, to provide scientific basis for the early prevention and control of DR. <b>Methods:</b> This study was designed as a cross-sectional study, recruiting already-diagnosed type 2 diabetes patients in four community health service centers in Guizhou Province between February and September 2022. Employing the Chinese version of the Visual Function Index-14 (VF-14), assess the participants' near vision, visual adaptation, subjective visual perception, and stereo vision, with higher scores indicating poorer visual function. Categorize the severity of each eye's damage into no diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, and proliferative diabetic retinopathy (PDR), and use a 5-level DR grading system to evaluate the overall severity of diabetic retinopathy in both eyes. Employing linear regression analysis to investigate the linear relationship between DR and visual function index. Local weighted regression evaluates the nonlinear relationship between the DR composite score and the scores of visual function, with a steeper slope indicating poorer visual function for that level. <b>Results:</b> A total of 542 patients with type 2 diabetes were investigated, including 244 (45.02%) males, 298 (54.98%) females, and 162 (29.89%) patients with DR. After adjusting for confounders, compared with those without DR, patients with binocular DR Had overall scores (<i>β</i>=0.136, <i>P=</i>0.003), near vision (<i>β</i>=0.163, <i>P</i><0.001), visual adaptation (<i>β</i>=0.092, <i>P=</i>0.042), subjective vision (<i>β</i>=0.120, <i>P=</i>0.009) and stereo vision (<i>β</i>=0.094, <i>P=</i>0.044) were higher than those without DR. There were no differences in visual functions between DR And monocular DR. The local weighted regression curve showed that near vision (slope: 23.78) and overall score (slope: 58.37) increased sharply from mild to moderate NPDR in both eyes. Visual adaptation (slope: 5.37, 7.72), subjective vision (slope: 6.53, 7.93), stereovision (slope: 0.74, 0.91) increased slowly in mild to moderate NPDR in both eyes and in moderate to severe NPDR/PDR in both eyes. <b>Conclusion:</b> Binocular DR is associated with impaired visual function, but there is no difference between monocular DR And non-DR visual function. The early damage of DR To visual function is mainly manifested in near vision. In the prevention and control of DR, more attention should be paid to visual function, especially the change of near vision, and retinal damage should not be assessed solely by visual status.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296950","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20231123-00366
L Zhang, Y F Yang, X Ma, Y F Zhang, Y Wang
Virus-like particles (VLPs) are self-assembled protein nanoparticles with repetitive antigen epitopes, which can stimulate immune response and do not contain viral genetic materials. VLPs has important research value and application potential in vaccine development, targeted drug delivery and bioengineering materials. In this review, the mechanism of VLPs vaccine induced immune responses is discussed. The existing VLPs expression systems are summarized. The research progress of VLPs vaccine in prevention and treatment of virus infection are summarized. This review provides general reference and guidance for the design and development of antiviral VLPs vaccine.
{"title":"[Current research status of virus-like particle vaccine].","authors":"L Zhang, Y F Yang, X Ma, Y F Zhang, Y Wang","doi":"10.3760/cma.j.cn112150-20231123-00366","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20231123-00366","url":null,"abstract":"<p><p>Virus-like particles (VLPs) are self-assembled protein nanoparticles with repetitive antigen epitopes, which can stimulate immune response and do not contain viral genetic materials. VLPs has important research value and application potential in vaccine development, targeted drug delivery and bioengineering materials. In this review, the mechanism of VLPs vaccine induced immune responses is discussed. The existing VLPs expression systems are summarized. The research progress of VLPs vaccine in prevention and treatment of virus infection are summarized. This review provides general reference and guidance for the design and development of antiviral VLPs vaccine.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296978","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 : 2024-09-06DOI: 10.3760/cma.j.cn112150-20231130-00388
B Qiao, K B Zhu, Z G Wu, J W Wang, H Y Zheng, Y Q Tong
Congenital defects and genetic diseases in the fetus are the focus of prenatal screening and prenatal diagnosis. Obstetrics and gynecology, pediatrics, medical imaging (ultrasound and magnetic resonance imaging), clinical laboratory, pathology, and other disciplines are mostly involved in this multidisciplinary work on maternal and infant health care, which aims to prevent birth defects in strict accordance with laws, regulations, and pertinent industry standards, such as the Notice of the National Health Commission on Issuing the Basic Standards for Prenatal Screening Technical Medical Institutions and the Basic Standards for Prenatal Diagnosis Technical Medical Institutions (Guowei Maternal and Child Letter [2019] No. 297). To further support the implementation of prenatal screening and diagnosis work and streamline workflow, this study has compiled the timing, inspection, and testing procedures of various projects in each link from the standpoint of the disease clinical laboratory diagnostic pathway. This approach improves communication amongst various disciplines in prenatal screening and diagnosis work and offers clinical service quality, and it also helps improve the standard of the birth population and prevent and controll severe birth defects.
{"title":"[Prenatal screening and prenatal diagnosis clinical laboratory diagnostic pathway].","authors":"B Qiao, K B Zhu, Z G Wu, J W Wang, H Y Zheng, Y Q Tong","doi":"10.3760/cma.j.cn112150-20231130-00388","DOIUrl":"https://doi.org/10.3760/cma.j.cn112150-20231130-00388","url":null,"abstract":"<p><p>Congenital defects and genetic diseases in the fetus are the focus of prenatal screening and prenatal diagnosis. Obstetrics and gynecology, pediatrics, medical imaging (ultrasound and magnetic resonance imaging), clinical laboratory, pathology, and other disciplines are mostly involved in this multidisciplinary work on maternal and infant health care, which aims to prevent birth defects in strict accordance with laws, regulations, and pertinent industry standards, such as the Notice of the National Health Commission on Issuing the Basic Standards for Prenatal Screening Technical Medical Institutions and the Basic Standards for Prenatal Diagnosis Technical Medical Institutions (Guowei Maternal and Child Letter [2019] No. 297). To further support the implementation of prenatal screening and diagnosis work and streamline workflow, this study has compiled the timing, inspection, and testing procedures of various projects in each link from the standpoint of the disease clinical laboratory diagnostic pathway. This approach improves communication amongst various disciplines in prenatal screening and diagnosis work and offers clinical service quality, and it also helps improve the standard of the birth population and prevent and controll severe birth defects.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296956","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}