Infections associated with CAR-T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies.

BACKGROUND: Chimeric antigen receptor T (CAR-T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment-related toxicities, particularly infections, pose a significant challenge to patient safety. METHODS: This review synthesizes current knowledge on the mechanisms underlying post-CAR-T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment-induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in infection characteristics and the confounding clinical presentation of cytokine release syndrome. RESULTS: The review identifies that patients receiving CAR-T cells are at increased risk of concurrent infections due to the heterogeneity in infection characteristics across different time periods, individuals, and patient groups. It highlights the diagnostic and therapeutic complexities introduced by the overlapping symptoms of infection and cytokine release syndrome. CONCLUSION: To enhance the infection control post-CAR-T therapy, this review proposes preventive strategies tailored to the early and long-term management of patients. It underscores the need for a nuanced understanding of infection mechanisms and the importance of personalized prevention plans to improve clinical outcomes in multiple myeloma treatment.

Effects of medical abortion assisted by traditional Chinese medicine: A network meta-analysis of randomized controlled trials.

BACKGROUND: To what extent traditional Chinese medicine (TCM) combined with mifepristone and misoprostol is beneficial for improving the complete abortion rate and duration of vaginal bleeding has been a subject of debate in the field of medical abortion. OBJECTIVE: To assess the evidence regarding the complete abortion rate and duration of vaginal bleeding of medical abortion assisted by different kinds of TCM. SEARCH STRATEGY: We searched electronic databases such as PubMed, Web of Science and Cochrane Library database, China National Knowledge Internet, Wan fang Database, VIP Database, and China Biology Medicine disc from 2000 to February 15, 2023. SELECTION CRITERIA: The control group was medical abortion with mifepristone and misoprostol, and the experimental group was medical abortion assisted by TCM. DATA COLLECTION AND ANALYSIS: Major data extraction included sample size, age, medicine used for abortion, outcome measures. RevMan 5.3 and Stata 15.1 software were used to assess the literature quality and perform network meta-analysis, respectively. MAIN RESULTS: A total of 73 randomized controlled trials (RCTs) with 11 683 patients and nine kinds of TCM were included in this study. Compared with mifepristone and misoprostol, eight kinds of TCM had statistical significance in improving the complete abortion rate. The effect value of Sancao decoction was 5.86 (95% confidence interval [CI] 2.53-13.58). Seven kinds of TCM shortened the duration of vaginal bleeding. The effect value of comfrey and trichosanthin decoction was -8.75 (95% CI -10.86 to -6.64). CONCLUSIONS: This network meta-analysis showed that Lenge Zhumo decoction and Sancao decoction could have a large beneficial effect on complete abortion rate in medical abortion during early pregnancy, and comfrey and trichosanthin decoction could be the best TCM for shortening the duration of vaginal bleeding.

Trigeminal Ganglion Electrical Stimulation for Trigeminal Nerve Postherpetic Neuralgia: A Retrospective Study.

Purpose: To investigate the clinical outcome of trigeminal ganglion electrical stimulation for the treatment of trigeminal postherpetic neuralgia (TPHN). Patients and Methods: A retrospective analysis of clinical data was performed on six patients who suffered from severe postherpetic neuralgia involving the trigeminal nerve maxillary and mandibular branch. They were admitted under the Pain Management Department of the First Hospital of Shanxi Medical University from July 2022 to February 2023 and underwent trigeminal ganglion electrical stimulation therapy. Visual analogue scale (VAS) scores, pregabalin dosage, pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were recorded before treatment, as well as after treatment at 1, 4, 8, 12, and 24-week. Adverse reactions related to the treatment were also documented. Results: After trigeminal ganglion electrical stimulation therapy, the VAS scores, PSQI scores, anxiety scores, depression scores, and pregabalin dosage of six patients showed significant reductions at 1, 4, 8, 12, and 24 weeks. (P < 0.05). No serious adverse reactions occurred in any of the patients. Conclusion: Trigeminal ganglion electrical stimulation effectively relieved postherpetic neuralgia in the distribution areas of the trigeminal nerve 2 and 3 branches, reduced the dosage of analgesics, improved the quality of sleep, and alleviated anxiety and depression symptoms in patients. Our data suggested that It was a safe and effective clinical.

[Clinical Characteristics and Risk Factors for 30-Day Mortality in Patients with Hematologic Diseases Infected by Carbapenem-Resistant Organisms].

OBJECTIVE: To explore the clinical characteristics of hospitalized patients with hematologic diseases complicated with carbapenem-resistant organisms (CRO) infection and analyze the risk factors of 30-day all-cause mortality. METHODS: The clinical data and laboratory test data of 77 hospitalized patients with hematologic diseases complicated with CRO infection in department of hematology of the Third Hospital of Shanxi Medical University from January 2015 to December 2020 were retrospectively analysed, the risk factors of 30-day all-cause mortality after CRO infection were analyzed by multivariate logistic regression. RESULTS: Among the total of 77 patients with hematologic diseases complicated with CRO infection, 29 died and 48 survived within 30 days of infection, with a case fatality rate of 37.66%. A total of 93 strains of CRO were isolated from these patients, of which Acinetobacter baumannii had the highest detection rate (25.81%, 24/93), followed by Pseudomonas aeruginosa (18.28%, 17/93). The lung was the most common site of CRO infection. The detected pathogens were highly resistant to carbapenems, and 64.52% (60/93) of the pathogens were resistant to imipenem with minimum inhibitory concentration (MIC)≥16 µg/ml. The results of the univariate analysis showed that albumin concentration <25 g/L (P =0.048), serum creatinine concentration≥120 µmol/L (P =0.023), age-adjusted Charlson comorbidity index (ACCI) (P =0.037) and primary treatments (supportive treatment, immunosuppressive therapy, chemotherapy, HSCT) (P =0.048) were significantly associated with 30-day all-cause mortality after infection. The results of multivariate logistic regression analysis showed that when CRO infection confirmed, albumin concentration <25 g/L (P =0.014, OR=6.171), serum creatinine concentration≥120 µmol/L (P =0.009, OR=10.867) were independent risk factors for 30-day mortality of patients with hematologic diseases complicated with CRO infection. CONCLUSION: The mortality rate of CRO-infected patients with hematologic diseases is high. The detected pathogenic bacteria are highly resistant to imipenem. The albumin concentration <25 g/L and the serum creatinine concentration≥ 120 µmol/L at diagnosis of CRO infection were independent risk factors for 30-day mortality of the patients with hematologic diseases.

Lack of surgical resection is associated with increased early mortality in hematological patients complicated with rhino-orbital-cerebral mucormycosis.

Rhino-orbital-cerebral mucormycosis (ROCM), which is an acute fatal infectious disease with a high mortality rate, is increasingly being diagnosed in patients with hematological diseases worldwide. We aimed to investigate the clinical characteristics, treatment, and prognosis of hematological diseases complicated by ROCM. Our sample comprised a total of 60 ROCM patients with hematological diseases. The most common primary disease was acute lymphoblastic leukemia (ALL) (n=27, 45.0%), while 36 patients (60.0%) were diagnosed with a clear type of pathogen, all belonging to the Mucorales, most commonly Rhizopus (41.7%). Of the 32 patients (53.3%) who died, 19 (59.3%) died of mucormycosis, and 84.2% (n=16) of those died within 1 month. Forty-eight cases (80.0%) received antifungal treatment combined with surgical therapy, 12 of whom (25.0%) died of mucormycosis, amounting to a mortality rate that was significantly lower than in patients who received antifungal therapy alone (n=7, 58.3%) (P=0.012). The median neutrophil value of patients who underwent surgery was 0.58 (0.11-2.80) 103/µL, the median platelet value was 58.00 (17.00-93.00) 103/µL, and no surgery-related deaths were reported. Multivariate analysis showed that patient's advanced age (P=0.012, OR=1.035 (1.008-1.064)) and lack of surgical treatment (P=0.030, OR=4.971 (1.173-21.074)) were independent prognostic factors.In this study, hematological diseases associated with ROCM have a high mortality rate. Lack of surgical treatment is an independent prognostic factor for death from mucormycosis. Surgery may therefore be considered in patients with hematological disease even if their neutrophil and platelet values are lower than normal.

Interactions between Benzo(a)pyrene exposure and genetic polymorphisms of AhR signaling pathway on missed abortion.

Benzo(a)pyrene (BaP) is an environmental pollutant widely exposed to human beings. While the relationship between BaP and missed abortion is few understood. To explore the association between missed abortion and BaP, genetic polymorphisms of AhR pathway, we recruited 112 cases women with missed abortion and 137 controls women with normal pregnancy from Shanxi, China. The BPDE-DNA adducts level in the case group was higher than that in the control group (P < 0.001). The subjects were categorized according to the tertiles of BPDE-DNA adduct concentrations: T1 (

FAPhigh α-SMAlow cancer-associated fibroblast-derived SLPI protein encapsulated in extracellular vesicles promotes ovarian cancer development via activation of PI3K/AKT and downstream signaling pathways.

Ovarian cancer is the most lethal gynecological malignancy worldwide with high metastasis and poor prognosis rates. Cancer-associated fibroblasts (CAFs), a heterogeneous population of cells that constitutes a major component of the tumor microenvironment, secrete extracellular vesicles (EVs) loading with proteins, lipids, and RNAs to promote tumorigenesis. However, the specific roles of CAF-derived proteins contained in EVs in ovarian cancer remain poorly understood at present. Using the gene expression microarray analysis, we identified a list of dysregulated genes between the α-SMA+ CAF and FAP+ CAF subpopulations, from which secretory leukocyte protease inhibitor (SLPI) was chosen for further validation. Quantitative PCR, western blot, immunohistochemistry, and enzyme-linked immunosorbent assays were used to assess SLPI expression in ovarian cancer cells, tissues, CAFs, and EVs. Additionally, we evaluated the effects of exogenous SLPI on proliferation, migration, invasion, and adhesion of ovarian cancer cells in vitro. Our results showed SLPI protein was upregulated in CAFs, particularly in the FAPhigh α-SMAlow CAF subpopulation, and associated with increased tumor grade and decreased overall survival (OS). Importantly, CAF-derived SLPI protein could be encapsulated in EVs for delivery to ovarian cancer cells, thus facilitating cell proliferation, migration, invasion, and adhesion via activating the PI3K/AKT and downstream signaling pathways. Moreover, high plasma expression of SLPI encapsulated in EVs was closely correlated with tumor stage in ovarian cancer patients. Our collective results highlight an oncogenic role of plasma EV-encapsulated SLPI secreted by CAFs in tumor progression for the first time, supporting its potential utility as a prognostic biomarker of ovarian cancer.

Comparison of the effect of skin closure materials on skin closure during cesarean delivery.

OBJECTIVE: To compare the effect of skin closure materials on skin closure during cesarean delivery. METHODS: We searched EMBASE、PubMed、Scopus、Cochrane CENTRAL for randomized controlled trials (RCTs) on the use of closure materials for skin closing effect during cesarean delivery. The outcomes were time to skin closure of dermal and epidermal layer, skin separation rate and wound complications(wound infection, hematoma,seroma, reclosure, readmission) reported as an odds ratio (OR) and surface under the cumulative ranking curve analysis (SUCRA) score. RESULTS: Twenty -six RCTs met the inclusion criteria. In the network meta-analysis (NMA) for time to skin closure of dermal and epidermal layer, pooled network OR values indicated that staple (network SMD, -337.50; 95% CrI: -416.99 to -263.18) was superior to absorbable suture. In the Skin separation NMA, pooled network OR values indicated that the absorbable suture (network OR, 0.37; 95% CrI: 0.19 to 0.70) were superior to staple. In the wound complications NMA, pooled network OR values indicated that the no interventions were superior to staple. CONCLUSION: In conclusion, our network meta-analysis showed that the risk of skin separation with absorbable suture after cesarean delivery was reduced compared with staple, and does not increase the risk of wound complications, but the wound closure time would slightly prolonged.

Phthalate levels in urine of pregnant women and their associated missed abortion risk.

Phthalates are one of the most common environmental endocrine disrupting chemicals (EDCs) in human contact. Prenatal phthalates exposure may adversely affect intrauterine growth, however, little is known about their association. This study aimed to explore the impact of phthalates on the risk of missed abortion. A total of 123 women with missed abortion (cases) and 148 normal pregnant women (controls) were simultaneously collected from Taiyuan, China. Four urinary phthalate metabolites were determined by high-performance liquid chromatography (HPLC). Logistic regression model was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CI) of missed abortion associated with phthalate metabolite levels. Four phthalate metabolites, including monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), were detected in at least 78.97 % of all participants, with the highest geometric mean concentration of 147.19 ng/mL for MEP of the urine samples. Both MMP (Z = -3.898, P < 0.001) and MBP (Z = -2.198, P = 0.028) concentrations were higher in cases than in controls. There were no significant differences for MEP (Z = -0.285, P = 0.076) and MBzP (Z = -0.878, P = 0.380) concentrations between cases and controls. Furthermore, Logistic analysis revealed that each one-unit increase in log-transformed MMP (OR = 1.49, 95 % CI = 1.14-1.95) was positively associated with missed abortion. Increasing risks of missed abortion were observed the third quartile (Q3) and the highest quartile (Q4) of MMP(OR = 2.21, 95 % CI = 1.06-4.60; OR = 2.85, 95 % CI = 1.34-6.05) compared to the lowest quartile (Q1) of MMP concentrations. We concluded that prenatal phthalates exposure may contribute to an increased risk of missed abortion.

[Effects of benzo[a]pyrene subacute administrate on the cardiovascular of male Wistar rats].

OBJECTIVE: To explore subacute toxic effects of benzo[a]pyrene on the cardiovascular system of male Wistar rats. METHODS: Forty SPF grade male Wistar rats were randomly divided into blank control group, solvent control group, low, medium and high dose group(B[a]P concentrations were 1. 0, 2. 5 and 6. 25 mg/kg, respectively), eight in each group. The solvent group was given the same amount of olive oil and the blank group was not treated at all for 28 consecutive days. After the end of the exposure, the left ventricular structural function and hemodynamic changes were observed with Prospect 3. 0 small animal ultrasound imager and BL-410 biological function test system. Pathological changes of rat thoracic aorta and left ventricle were observed by HE staining. RESULTS: The total difference in ejection fraction(EF), fractional shortening(FS) and left ventricular end diastolic pressure(LVEDP) between the groups was statistically significant(H=11. 497, P=0. 022; H=11. 422, P=0. 022; H=10. 104, P=0. 039). The EF and FS of the middle dose group were lower than the solvent group(adjusted P<0. 05), the LVEDP of the high dose group was higher than that of the solvent group(adjusted P<0. 05). The HE staining of thoracic aorta in the medium and high dose groups showed the loss of endothelial cells, the shedding of some endothelial cells, the exposure of subintimal collagen, the large gap of the middle layer. In the medium and high dose group, left ventricular transverse striations were blurred, muscle fibers reduced or disappeared, the myocardial space widened, inflammatory cells or the myocardial interspace bleeding phenomenon was occasionally observed. CONCLUSION: Benzo[a]pyrene can cause cardiovascular and endothelial damage in male Wistar rats.

Sei-1 promotes double minute chromosomes formation through activation of the PI3K/Akt/BRCA1-Abraxas pathway and induces double-strand breaks in NIH-3T3 fibroblasts.

Sei-1 is a potential oncogene that plays an important role in promoting genomic instability. Double minute chromosomes (DMs) are hallmarks of gene amplification and contribute to tumorigenesis. Defects in the DNA double-strand break (DSB) repairing pathways can lead to gene amplification. To date, the mechanisms governing the formation of DMs induced by Sei-1 are not fully understood. We established DMs induced by Sei-1 in the NIH-3T3 cell line. RNA-sequencing was used to identify key characteristics of differentially expressed genes. Metaphase spreads were used to calculate DM numbers. Immunofluorescence was employed to detect γH2AX foci. Western blot and Akt pathway inhibition experiments were performed to reveal the role of the PI3K/Akt/BRCA1-Abraxas pathway in Sei-1-induced DMs. Luciferase reporter assay was employed to explore the regulatory mechanisms between Sei-1 and BRCA1. DM formation was associated with a deficiency in DSB repair. Based on this finding, activation of the PI3K/Akt/BRCA1-Abraxas pathway was found to increase the DM population with passage in vivo, and inhibition resulted in a reduction of DMs. Apart from this, it was shown for the first time that Sei-1 could directly regulate the expression of BRCA1. Our results suggest that the PI3K/Akt/BRCA1-Abraxas pathway is responsible for the formation of DMs induced by Sei-1.

Prevalence of and risk factors for the occurrence of symptomatic osteoarthritis in rural regions of Shanxi Province, China.

AIM: To determine the prevalence of symptomatic osteoarthritis (OA) in rural regions of Shanxi Province, China, and to identify factors increasing the prevalence of OA. METHOD: Residents over 16 years of age of targeted towns and villages in rural regions of Shanxi Province were sampled using a stratified multi-stage cluster method. Those exhibiting symptoms of rheumatism were referred to rheumatologists and those in whom rheumatism was suspected were X-rayed within 10 days of interview. OA was diagnosed by consensus (two or three rheumatologists). Factors associated with the presence of OA were identified. RESULTS: A total of 7126 permanent residents were surveyed and 1734 (24.3%) had OA. Knee OA was the most prevalent form of OA (13.8%), followed by lumbar (7.4%), cervical (3.4%), hand (3.3%), shoulder (3.0%), elbow (2.9%), ankle (0.7%), hip (0.6%), wrist (0.5%), thoracic (0.5%) and foot OA (0.5%). All of knee, ankle, shoulder and hand OA exhibited a gender bias. Advanced age, a sweet tooth, poor home ventilation, poor home heating, separation, divorce, or death of a partner, low-grade occupation, low educational level, high body mass index and the presence of concomitant cardiovascular disease, were associated with the presence of OA. CONCLUSION: Symptomatic OA is very prevalent in rural regions of Shanxi Province. Many factors increase the prevalence of the condition. Primary and secondary prevention programs seeking to improve living conditions, to reduce obesity, and to effectively treat concomitant cardiovascular disease, are required.

The effect of meteorological variables on the transmission of hand, foot and mouth disease in four major cities of shanxi province, China: a time series data analysis (2009-2013).

Increased incidence of hand, foot and mouth disease (HFMD) has been recognized as a critical challenge to communicable disease control and public health response. This study aimed to quantify the association between climate variation and notified cases of HFMD in selected cities of Shanxi Province, and to provide evidence for disease control and prevention. Meteorological variables and HFMD cases data in 4 major cities (Datong, Taiyuan, Changzhi and Yuncheng) of Shanxi province, China, were obtained from the China Meteorology Administration and China CDC respectively over the period 1 January 2009 to 31 December 2013. Correlations analyses and Seasonal Autoregressive Integrated Moving Average (SARIMA) models were used to identify and quantify the relationship between the meteorological variables and HFMD. HFMD incidence varied seasonally with the majority of cases in the 4 cities occurring from May to July. Temperatures could play important roles in the incidence of HFMD in these regions. The SARIMA models indicate that a 1° C rise in average, maximum and minimum temperatures may lead to a similar relative increase in the number of cases in the 4 cities. The lag times for the effects of temperatures were identified in Taiyuan, Changzhi and Yuncheng. The numbers of cases were positively associated with average and minimum temperatures at a lag of 1 week in Taiyuan, Changzhi and Yuncheng, and with maximum temperature at a lag of 2 weeks in Yuncheng. Positive association between the temperature and HFMD has been identified from the 4 cities in Shanxi Province, although the role of weather variables on the transmission of HFMD varied in the 4 cities. Relevant prevention measures and public health action are required to reduce future risks of climate change with consideration of local climatic conditions.

Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen.

AIMS: A placenta with hepatitis B virus (HBV) is one of the main reasons for transplacental transmission during pregnancy. This study aims to explore the factors influencing the presence of hepatitis B surface antigen (HBsAg) in the placenta and the synergistic effect of these factors. METHODS: A total of 155 placentae and blood specimens were collected from HBsAg-positive mothers and their newborns. HBsAg in placenta was detected using the immunohistochemistry method. HBV serum markers were detected using enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) methods. RESULTS: The results showed that hepatitis B e antigen (HBeAg) positive, or HBV DNA positive status, is significantly associated with an HBsAg-positive placenta. A synergistic effect was present. The hazard ratio for a HBsAg-positive placenta in mothers with HBeAg and HBV DNA was 1.97 times higher than the sum of the independent relative risk of each separate effect (synergy index, S=1.97). There was a statistically significant association between HBsAg in newborns and HBsAg in placenta, and the risk of newborns with HBsAg was greater (odds ratio values 3.33 and 5.31, respectively) when placental cells close to the fetal side were HBsAg positive. CONCLUSIONS: Being positive for HBeAg and/or HBV DNA are significant risk factors for HBsAg in the placenta. HBsAg can pass through the placenta via cellular transfer, possibly contributing to transplacental transmission.

The impact of climate change on infectious disease transmission: perceptions of CDC health professionals in Shanxi Province, China.

There have been increasing concerns about the challenge of emerging and re-emerging infectious diseases due to climate change, especially in developing countries including China. Health professionals play a significant role in the battle to control and prevent infectious diseases. This study therefore aims to investigate the perceptions and attitudes of health professionals at the Centers for Disease Control and Prevention (CDC) in different levels in China, and to consider adaptation measures to deal with the challenge of climate change. In 2013, a cross-sectional questionnaire survey was undertaken among 314 staff in CDCs in Shanxi Province, China, whose routine work involves disease control and prevention. Data were analyzed using descriptive methods and logistic regression. A majority of the CDC staff were aware of the health risks from climate change, especially its impacts on infectious disease transmission in their jurisdictions, and believed climate change might bring about both temporal and spatial change in transmission patterns. It was thought that adaptation measures should be established including: strengthening/improving currently existing disease surveillance systems and vector monitoring; building CDC capacity in terms of infrastructure and in-house health professional training; development and refinement of relevant legislation, policies and guidelines; better coordination among various government departments; the involvement of the community in infectious disease interventions; and collaborative research with other institutions. This study provides a snapshot of the understanding of CDC staff regarding climate change risks relevant to infectious diseases and adaptation in China. Results may help inform future efforts to develop adaptation measures to minimize infectious disease risks due to climate change.

Perception, attitude and behavior in relation to climate change: a survey among CDC health professionals in Shanxi province, China.

BACKGROUND: A better understanding of public perceptions, attitude and behavior in relation to climate change will provide an important foundation for government׳s policy-making, service provider׳s guideline development and the engagement of local communities. The purpose of this study was to assess the perception towards climate change, behavior change, mitigation and adaptation measures issued by the central government among the health professionals in the Centres for Disease Control and Prevention (CDC) in China. METHODS: In 2013, a cross-sectional questionnaire survey was undertaken among 314 CDC health professionals in various levels of CDC in Shanxi Province, China. Descriptive analyses were performed. RESULTS: More than two thirds of the respondents believed that climate change has happened at both global and local levels, and climate change would lead to adverse impacts to human beings. Most respondents (74.8%) indicated the emission of greenhouse gases was the cause of climate change, however there was a lack of knowledge about greenhouse gases and their sources. Media was the main source from which respondents obtained the information about climate change. A majority of respondents showed that they were willing to change behavior, but their actions were limited. In terms of mitigation and adaptation measures issued by the Chinese Government, respondents׳ perception showed inconsistency between strategies and relevant actions. Moreover, although the majority of respondents believed some strategies and measures were extremely important to address climate change, they were still concerned about economic development, energy security, and local environmental protection. CONCLUSION: There are gaps between perceptions and actions towards climate change among these health professionals. Further efforts need to be made to raise the awareness of climate change among health professionals, and to promote relevant actions to address climate change in the context of the proposed policies with local sustainable development.

[Study on influence factors of HBV intrauterine infection in newborns of pregnant women with HBsAg].

OBJECTIVE: To explore the interrelated influence factors of HBV intrauterine infection in newborns of pregnant women with HBsAg. METHODS: HBsAg positive pregant women,who were prenatal diagnosis and partal, and their newborns were as subjects. Data of general situation of pregnant women and HBIG Jection history before delivery and HBV infection history in family and HBVM and HBVM in newborns at birth within 24h were collected. By if newborns occurred HBV intrauterine infection, 379 cases HBsAg-positive pregnant women are divided into two groups: 36 cases of HBV intrauterine infection, 343 cases of no HBV intrauterine infection. Then the relationship between the general situation of pregnant women, HBV infection history in family, the state of HBV replication, HBIG injection history, HBVM positive modes and HBV intrauterine infection in newborns were analyzed. RESULTS: Single factors analysis show: The difference of age, the state of HBV replication, HBVM positive modes of HBsAg positive pregant women between HBV intrauterine infection group and no HBV intrauterine infection group is significant (p < 0.05). But cultural levels,HBV infection history in family and HBIG injection history of HBsAg positive pregant women between the two groups isn't significant (p > 0.05). Multiariate Logistic regression analysis display: the age (OR = 0.398, 0.159-0.996) and both postitivity of HBeAg and HBV DNA (OR = 2.539,1.233- 5.227) go into regression equation. Meanwhile, the analysis of relation of HBV DNA load grade of HBsAg positive pregnant women and HBV intrauterine infection show: the different is significant (chi2 = 10.983, P = 0.004 < 0.05); and the analysis of trend chi-quare test show: when HBV DNA copy number is more than 10(6), the rate of HBV intrauterine infection obviously rise. CONCLUSIONS: The age (> 30 years) are the protected factors of HBV intrauterine infection in HBsAg positive pregant women. But when HBsAg positive pregant women is both postitivity of HBeAg and HBV DNA, the possibility is bigger to occur HBV intrauterine infection.

[Comprehensive study on the risk factors of hepatitis B virus intrauterine infection].

OBJECTIVE: To study the risk factors of hepatitis B virus (HBV) intrauterine infection. METHODS: Risk factors of HBV intrauterine infection were analyzed by nested case control study. RESULTS: Data from univariate analysis revealed that risk factors of HBV intrauterine infection were positive results on HLA-DR3 (OR = 4.71, 1.62-13.66), HBV DNA (OR = 6.59, 2.72-15.97) and HBeAg (OR = 4.53, 1.93-10.64) in pregnant women, HLA-DR3 (OR = 3.91, 1.18-12.94) in newborn, HLA-I) R3 (OR = 5.96, 1.14-31.15) both in pregnant women and her newborns and HBV infection in placentas (OR = 2.51,1.12-5.60). Results from Multivariate unconditional logistics regression analysis showed that the risk factors of HBV intrauterine infection were positive in both HLA-DR3 (OR = 4.65, 1.44-15.05) and HBV DNA (OR = 6.56, 2.65-16.23) in pregnant women. However, there was no interaction between the two factors. The exposure rate of other factors did not reveal the difference in the two groups. With the increase of HBV DNA in pregnant women, the risk of HBV intrauterine infection was rising (chi2 = 16.74, P < 0.05). CONCLUSION: Risk factors of HBV intrauterine infection were HLA-DR3 positive and HBV DNA positive in pregnant women but there was no interaction between the two factors. The risk of HBV intrauterine infection was increased along with the increase of HBV DNA in pregnant women.

[Study on hepatitis B virus intrauterine infection state and its correlation factors].

OBJECTIVE: To investigate the correlation factors of hepatitis B virus (HBV) intrauterine infection and the influence factors of HBV infection in peripheral blood mononuclear cells (PBMC) and placentas. METHODS: HBeAg and HBsAg in 151 pregnant women and their newborns were determined by enzyme linked immunoadsorbent assay (ELISA). HBV DNA in serum and PBMC of pregnant women and their newborns were determined by polymerase chain reaction. HBsAg in 151 placentas were detected by immunohistochemistry ABC. The correlation risk factors were analyzed by non-condition logistic regression model. RESULTS: HBV DNA positive in serum, HBV DNA positive in PBMC of pregnant women and HBsAg positive in placentas were the risk factors for HBV intrauterine infection. Their odds ratio (OR) and 95% confidence interval were 2.25 (1.08-4.72), 2.69 (1.26-5.73) and 4.63 (1.70-12.62), respectively. The influence factors of HBV infection in placenta included antepartum injection of hepatitis B immunoglobulin (HBIG) over thrice and HBV DNA positive in serum of pregnant women with OR 0.08 (0.01-0.69) and 4.24 (1.22-14.69). The risk factor for HBV DNA positive in PBMC of newborns was HBV DNA positive in PBMC of their mothers with OR 24.53 (7.92-76.01). CONCLUSIONS: HBV infection in placentas, HBV DNA positive in PBMC and serum of pregnant women are the risk factors for HBV intrauterine infection. Antepartum injection of HBIG over thrice can protect placentas from being infected by HBV to some extent. PBMC HBV DNA positive in pregnant women is probably the independent risk factor for PBMC HBV intrauterine infection in newborns.

[Role of the cell transportion from mother to baby in the mechanism of HBV intrauterine infection].

OBJECTIVE: To explore the route that the HBsAg positive pregnant women's cell entered fetal circulation, and to study the mechanism of HBV intrauterine transmission that the cell transported HBV to fetus and infected fetus. METHODS: 123 pregnant women and 123 newborns were collected from December, 2001 to October, 2003 in Taiyuan Infectious Hospital. The cell transportion from mother to baby were determined by allele-specific PCR (AS-PCR) and heminested PCR(hemi-nPCR). RESULTS: Regarding GSTM1, ACE as maternal specific alleles: 42 mother-baby pairs were recruited from hemocyte specimens as informative cases, then examining 26 (61.90%) newborns' blood cell out of 42 informative cases had maternal cell DNA. There was significantly association between the cell transportion and HBV intrauterine infection (chi2 = 8.58, P < 0.01). There was significantly association between the cell transportion and HBV DNA positive in the newborns' PBMC (chi2 = 10.10, P < 0.01) . CONCLUSION: One factor of HBV intrauterine infection is in the result of the cell transportion from mother to baby; PBMC carrying HBV probably passed through placent barrier into fetus and infected them.