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BACKGROUND: The comparisons of molecular characterization and antibiotic resistance of Klebsiella pneumoniae (KP) isolates from humans and other animal hosts are not well studied. Our goal was to compare the molecular epidemiology of KP strains that were isolated from urban rodents, shrews, and healthy people. RESULTS: K. pneumoniae (KP) isolates were isolated from fecal samples of rodents, shrews and healthy adults in 2015 in southern China. In total, 465 fecal samples were collected, of which 85 from rodents, 105 from shrews, and 275 from healthy adults. Antimicrobial susceptibility and production of extended-spectrum ß-lactamases (ESBL) of the isolates were tested. PCR-based methods were used to detect specific genes, including ESBL genes (blaTEM, blaSHV, and blaCTX-M) in ESBL-producing isolates, capsular serotypes (K1, K2, K5, K20, K54, and K57) in hypervirulent KPs (hvKPs), and virulence genes (magA, wcaG, rmpA, uge, kfu, and aerobactin) in hvKP isolates. Multilocus sequence type (MLST) and pulsed-field gel electrophoresis (PFGE) were performed to exclude the homology of these isolates. The carriage rate of KP in urban rodents and shrews (78.42%) was higher than that in healthy adults (66.18%) (χ2 = 8.206, P = 0.004). The prevalence rates of ESBL-producing isolates among rodents, shrews, and humans were 7.94, 12.79, and 17.03%, respectively. The positive rates of CTX-M, TEM and SHV types in ESBL-producing isolates were 29.79, 27.66, and 17.02%, respectively. Serotype K1, K5, K20, and K57 were detected in both small mammals and humans. PFGE typing revealed thirty-six clusters. PFGE cluster A was clustered by samples of shrews and healthy adult, with a similarity of 88.4%. MLST typing revealed thirty-eight types. ST23 and ST35 were detected in samples of shrews and healthy adults. ST37 was detected in samples of 2 rodents and a healthy adult. CONCLUSIONS: Overlapping serotypes of hvKP were observed in both the animals and humans. The same PFGE or MLST types were also found in isolates derived humans, rodents and shrews. Therefore, urban rodents and shrews might play a certain role in the transmission of drug-resistant and hypervirulent KP.
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Antibacterianos/farmacologia , Klebsiella pneumoniae/classificação , Musaranhos/microbiologia , Fatores de Virulência/genética , Animais , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Fezes/microbiologia , Voluntários Saudáveis , Humanos , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/patogenicidade , Camundongos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Filogenia , RatosRESUMO
BACKGROUND: Rattus norvegicus and Suncus murinus are important reservoirs of zoonotic bacterial diseases. An understanding of the composition of gut and oropharynx bacteria in these animals is important for monitoring and preventing such diseases. We therefore examined gut and oropharynx bacterial composition in these animals in China. RESULTS: Proteobacteria, Firmicutes and Bacteroidetes were the most abundant phyla in faecal and throat swab samples of both animals. However, the composition of the bacterial community differed significantly between sample types and animal species. Firmicutes exhibited the highest relative abundance in throat swab samples of R. norvegicus, followed by Proteobacteria and Bacteroidetes. In throat swab specimens of S. murinus, Proteobacteria was the predominant phylum, followed by Firmicutes and Bacteroidetes. Firmicutes showed the highest relative abundance in faecal specimens of R. norvegicus, followed by Bacteroidetes and Proteobacteria. Firmicutes and Proteobacteria had almost equal abundance in faecal specimens of S. murinus, with Bacteroidetes accounting for only 3.07%. The family Streptococcaceae was most common in throat swab samples of R. norvegicus, while Prevotellaceae was most common in its faecal samples. Pseudomonadaceae was the predominant family in throat swab samples of S. murinus, while Enterobacteriaceae was most common in faecal samples. We annotated 33.28% sequences from faecal samples of S. murinus as potential human pathogenic bacteria, approximately 3.06-fold those in R. norvegicus. Potential pathogenic bacteria annotated in throat swab samples of S. murinus were 1.35-fold those in R. norvegicus. CONCLUSIONS: Bacterial composition of throat swabs and faecal samples from R. norvegicus differed from those of S. murinus. Both species carried various pathogenic bacteria, therefore both should be closely monitored in the future, especially for S. murinus.
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Bactérias/classificação , RNA Ribossômico 16S/análise , Ratos/microbiologia , Musaranhos/microbiologia , Animais , Bactérias/genética , China , Fezes/microbiologia , Microbiota , Orofaringe/microbiologiaRESUMO
BACKGROUND: The transmission of methicillin-resistant Staphylococcus aureus (MRSA) between humans and animals has been identified in a number of countries. In this study, MRSA in urban rodents and shrews in a community was investigated. Further, comparisons of MRSA isolates from rodents, shrews, and humans were conducted to evaluate the relationships of these isolates from different origins. RESULTS: Between 2015 and 2016, 397 oropharynx samples from 212 rodents and 185 shrews, and 8 MRSA isolates from hospital patients were collected. Twelve MRSA were isolated from the small mammals (3.0, 95%CI: 1.3-4.7%), including 11 isolates from rodents and one from a shrew. Three MRSA isolates from Rattus norvegicus were PVL-positive, and seven isolates were IEC-negative (one from Suncus murinus, five from Rattus norvegicus, and one from a patient). The spa type, MLST, and antimicrobial resistance patterns showed that the MRSA retrieved from rodents and shrews are likely related to human strains. CONCLUSION: MRSA derived from rodent shares similar antimicrobial resistance and molecular characteristics to those from humans, suggesting that urban rodents may play as maintenance host or vectors for MRSA which is important to human health.
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Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Roedores/microbiologia , Musaranhos/microbiologia , Infecções Estafilocócicas/microbiologia , Animais , China/epidemiologia , Cidades , Farmacorresistência Bacteriana , Humanos , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Infecções Estafilocócicas/epidemiologia , Fatores de Virulência/genéticaRESUMO
BACKGROUND: To assess whether the peri-conceptional or pregnancy exposure of human papillomavirus (HPV) vaccination would increase the risk of spontaneous abortion. METHODS: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for clinical trials and observational studies that investigated the association between exposure of HPV vaccines (2vHPV, 4vHPV or 9vHPV) during peri-conceptional period or pregnancy and spontaneous abortion before 28 gestational weeks. We pooled data from 2vHPV, 4vHPV and 9vHPV separately. Subgroup analyses were conducted according to data sources, and raw data or adjusted data. RESULTS: Seven observational studies were eligible and all studies were low risk of bias. Meta-analyses suggested that 2vHPV vaccination did not increase the risk of spontaneous abortion regardless of exposure period during 90 days before last menstrual period (LMP) or pregnancy: risk ratio, 95% confidence intervals (RR, 95% CI), 1.15 (0.95-1.39), and 45 days before LMP or pregnancy: 1.28 (0.96-1.70). However, 2vHPV vaccination during Pre-45 days to LMP seemed to increase the risk of spontaneous abortion: 1.59 (1.04-2.45). The current evidence did not support the association between 4vHPV vaccination and spontaneous abortion regardless of exposure period during 45 days before LMP or pregnancy: 0.88 (0.73-1.06); and 45 days before LMP: 1.00 (0.80-1.24). Additionally, 9vHPV during within 30 days of conception also seemed to increase the risk: 2.04 (1.28-3.24). CONCLUSIONS: The association between peri-conceptional or pregnancy exposure of HPV vaccine and spontaneous abortion is still uncertain, and additional research is warranted to assess the impact of exposure of HPV vaccination on spontaneous abortion.
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Aborto Espontâneo/induzido quimicamente , Exposição Materna/efeitos adversos , Vacinas contra Papillomavirus/efeitos adversos , Cuidado Pré-Concepcional/métodos , Feminino , Humanos , Vacinas contra Papillomavirus/administração & dosagem , Gravidez , Fatores de Risco , Fatores de TempoRESUMO
OBJECTIVE: To investigate the prevalence of the adeno-associated virus (AAV) in murine rodents and house shrews in 4 provinces of China. METHODS: A total of 469 murine rodents and 19 house shrews were captured between May 2015 and May 2017. Cap gene of AAV sequences was obtained to evaluate the genetic characteristics of rat AAV. RESULTS: Rat AAVs were found in 54.7% (267/488) of throat swabs, 14.3% (70/488) of fecal samples, and 18.4% (41/223) of serum samples. Rat AAVs were detected in 3 species of murine rodents including Rattus norvegicus (34.8%), R. tanezumi (43.0%), and R. losea (2.3%), and house shrews (Suncus murinus) (26.1%) from the selected sampling sites. Fourteen near-full-length Cap gene sequences, ranging in length from 2,156 to 2,169 nt, were isolated from the fecal samples of R. norvegicus and R. tanezumi. These 14 sequences shared a high identity of 97.4% at the nucleotide level and 99.1% at the amino acid level. Phylogenetic analysis showed that the rat AAV formed a distinct clade, distinguishable from the AAV discovered in humans and in other animals. CONCLUSIONS: A high prevalence of rat AAV that was highly conserved within the Cap gene was found in 3 common murine rodents and house shrews in China.
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Portador Sadio/veterinária , Portador Sadio/virologia , Dependovirus , Infecções por Parvoviridae/veterinária , Ratos/virologia , Musaranhos/virologia , Animais , China/epidemiologia , DNA Viral/genética , Fezes/virologia , Infecções por Parvoviridae/sangue , Faringe/virologia , Filogenia , Prevalência , Roedores/virologiaRESUMO
In this study, we detected and genetically characterized rat bocavirus (RBoV) carried in 496 murine rodents that were captured in four provinces in China between May 2015 and May 2017. RBoV-positive samples were found in all four provinces, with a total positive rate of 24.8% (123/496) in throat swabs and 58.1% (286/492) in fecal samples. Twelve nearly full-length genome sequences of RBoV were determined, and the average sequence identity was 96.2%. Phylogenetic analysis showed that RBoVs formed a distinct clade that was distinguishable from the bocaviruses discovered in humans and other animals.
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Bocavirus/isolamento & purificação , Fezes/virologia , Orofaringe/virologia , Infecções por Parvoviridae/veterinária , Doenças dos Roedores/virologia , Animais , Bocavirus/classificação , Bocavirus/genética , Genoma Viral , Infecções por Parvoviridae/virologia , Filogenia , Ratos , RoedoresRESUMO
AIMS: To estimate the impact of human papillomavirus (HPV) infection on spontaneous abortion, spontaneous preterm birth (sPTB), pregnancy rate of females undergoing assisted reproductive technologies (ART), and spontaneous abortion of ART pregnancy. METHODS: PubMed, Medline, Embase, and the Cochrane Library were searched until December 16, 2016. The OR or relative risk (RR) with its corresponding 95% CI were selected as effect size. Subgroup analysis of HPV genotype infection (high-risk HPV [HR-HPV] or indiscriminate genotype) was performed. Statistical analysis was conducted using STATA 12.0. RESULTS: Eighteen studies were included. Eight studies revealed no significant association between HPV infection and spontaneous abortion (OR 1.40, 95% CI 0.56-3.50). However, subgroup analysis showed indiscriminate genotype HPV infection increased the ratio of spontaneous abortion with OR of 2.24 (95% CI 1.37-3.65), while HR-HPV infection had no significant effect (OR 0.65, 95% CI 0.21-1.98). The results indicated that HR-HPV infection was a risk for sPTB with a pooled OR of 2.84 (95% CI 1.95-4.14). HPV infection was found to be independent of the ART-based clinical pregnancy rate (RR 1.04, 95% CI 0.64-1.70) and spontaneous abortion of ART pregnancy (RR 1.47, 95% CI 0.86-2.50). CONCLUSIONS: Indiscriminate HPV genotype infection can increase the risk of spontaneous abortion and HR-HPV infection was a risk factor for sPTB. However, there was not enough evidence to indicate the association between HPV infection and pregnancy rate of ART, and spontaneous abortion of ART pregnancy. Different genotypes of HPV infection may play a discrepant role in adverse pregnancy outcomes.
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Aborto Espontâneo/etiologia , Infecções por Papillomavirus/complicações , Taxa de Gravidez , Nascimento Prematuro/etiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Técnicas de Reprodução Assistida/estatística & dados numéricos , Medição de RiscoRESUMO
Several studies have reported the detection of herpesviruses (HVs) in bats. However, the prevalence and phylogenetic characteristics of HVs in bats are still poorly understood. To elucidate the epidemiological characteristics of bat HVs in southern China, 520 fecal samples from eight bat species were collected in four geographic regions of southern China. Of these samples, 73 (14.0 %) tested positive for HVs using nested polymerase chain reaction assay. Phylogenetic analysis revealed a high degree of molecular diversity of HVs in bats of different species from different geographic regions. Our study provides evidence for co-evolution of bats and HVs.
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Quirópteros/virologia , Fezes/virologia , Gammaherpesvirinae/isolamento & purificação , Infecções por Herpesviridae/veterinária , Animais , Biodiversidade , China/epidemiologia , Quirópteros/classificação , Gammaherpesvirinae/classificação , Gammaherpesvirinae/genética , Variação Genética , Infecções por Herpesviridae/epidemiologia , Infecções por Herpesviridae/virologia , Dados de Sequência Molecular , Filogenia , PrevalênciaRESUMO
The prevalence and phylogenetic characteristics of AdVs in rodents and shrews in China are still unknown. To explore the epidemiological characteristics of rodent and shrew AdVs in southern China, 255 fecal samples derived from four rodent species and 90 from shrews were collected in Xiamen and Guangzhou city of southern China. Amplification of a 314-324-bp fragment from the DNA polymerase gene of AdVs was attempted by using a nested PCR. Twenty-nine (11.4 %) specimens from rodents and one (1.1 %) specimen from shrews were tested positive for AdVs. Phylogenetic analysis revealed that nine samples from Rattus norvegicus in Guangzhou city between 2012 and 2013 might be the genuine AdV of R. norvegicus. The same putative AdV sequences were derived from samples of different host species from different/same places. A novel adenovirus was detected in Suncus murinus Linnaeus (SML/14GDGZ72) for the first time. Our findings provide new data on the prevalence and diversity of AdVs in rodents and shrews.
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Infecções por Adenoviridae/veterinária , Adenoviridae/classificação , Adenoviridae/isolamento & purificação , Roedores/virologia , Musaranhos/virologia , Adenoviridae/genética , Infecções por Adenoviridae/transmissão , Infecções por Adenoviridae/virologia , Animais , Animais Selvagens/virologia , China/epidemiologia , DNA Viral/genética , DNA Polimerase Dirigida por DNA/genética , Fezes/virologia , Camundongos , Filogenia , Prevalência , RatosRESUMO
BACKGROUND AND AIMS: Barrett's esophagus (BE) is considered the most important risk factor for development of esophageal adenocarcinoma. Confocal laser endomicroscopy (CLE) is a recently developed technique used to diagnose neoplasia in BE. This meta-analysis was performed to assess the accuracy of CLE for diagnosis of neoplasia in BE. METHODS: We searched EMBASE, PubMed, Cochrane Library, and Web of Science to identify relevant studies for all articles published up to June 27, 2015 in English. The quality of included studies was assessed using QUADAS-2. Per-patient and per-lesion pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio with 95% confidence intervals (CIs) were calculated. RESULTS: In total, 14 studies were included in the final analysis, covering 789 patients with 4047 lesions. Seven studies were included in the per-patient analysis. Pooled sensitivity and specificity were 89% (95% CI: 0.82-0.94) and 83% (95% CI: 0.78-0.86), respectively. Ten studies were included in the per-lesion analysis. Compared with the PP analysis, the corresponding pooled sensitivity declined to 77% (95% CI: 0.73-0.81) and specificity increased to 89% (95% CI: 0.87-0.90). Subgroup analysis showed that probe-based CLE (pCLE) was superior to endoscope-based CLE (eCLE) in pooled specificity [91.4% (95% CI: 89.7-92.9) vs 86.1% (95% CI: 84.3-87.8)] and AUC for the sROC (0.885 vs 0.762). CONCLUSION: Confocal laser endomicroscopy is a valid method to accurately differentiate neoplasms from non-neoplasms in BE. It can be applied to BE surveillance and early diagnosis of esophageal adenocarcinoma.
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Adenocarcinoma/diagnóstico , Esôfago de Barrett/diagnóstico , Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas/diagnóstico , Esôfago/patologia , Microscopia Confocal/métodos , Adenocarcinoma/patologia , Idoso , Área Sob a Curva , Esôfago de Barrett/patologia , Distribuição de Qui-Quadrado , Diagnóstico Diferencial , Neoplasias Esofágicas/patologia , Feminino , Humanos , Funções Verossimilhança , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos TestesRESUMO
Purpose: Specific nutrients found in food, such as minerals, antioxidants, and macronutrients, have a significant impact on immune function and human health. However, there is currently limited research exploring the relationship between specific nutrients, immune system function, and thyroid dysfunction commonly observed in autoimmune thyroid diseases, which manifest predominantly as hyperthyroidism or hypothyroidism. Therefore, the objective of this study was to investigate the connections between dietary traits and thyroid dysfunction, as well as the potential mediating role of immune cells, using Mendelian randomization (MR) analysis. Methods: The two-step MR analysis used single-nucleotide polymorphisms as instruments, with a threshold of p < 5e-08 for nutrients and thyroid dysfunction, and p < 5e-06 for immune cells. Data from different GWAS databases and UK Biobank were combined to analyze 8 antioxidants and 7 minerals, while the data for 4 macronutrients came from a cohort of 235,000 individuals of European. The outcome data (hypothyroidism, N = 3340; hyperthyroidism, N = 1840; free thyroxin [FT4], N = 49,269; thyroid-stimulating hormone [TSH], N = 54,288) were source from the ThyroidOmics consortium. Immune trait data, including 731 immune phenotypes, were collected from the GWAS catalog. Results: The results revealed that nutrient changes, such as lycopene, toenail and blood selenium, and α-tocopherol, impacted the immune system. Immune cells also affected thyroid function, with cDC cells promoting hypothyroidism and median fluorescence intensity (MFI) phenotypes correlating strongly with FT4 levels. Toenail and blood selenium reduce the relative cell counts (RCC) phenotypes of immune cells (CD62L- plasmacytoid DC %DC and transitional B cells %Lymphocyte), thereby diminishing its promoting effect on hypothyroidis. Furthermore, toenail and blood selenium mainly impacted phenotypes in three types of T cells (CD25 + ⣠+ CD8br, CD3 on CD45RA- CD4+, and CD45RA on Terminally Differentiated CD8br), reinforcing the negative regulation of FT4 levels. Conclusion: The role of immune cells as mediators in the relationship between nutrients and thyroid dysfunction highlights their potential as diagnostic or therapeutic markers. Toenail and blood selenium levels can indirectly impact hypothyroidism by influencing the RCC levels of two types of immune cells, and can indirectly affect FT4 levels by influencing three types of T cells.
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AIM OF THE STUDY: The treatment for papillary thyroid microcarcinoma (PTMC), which is a tumor measuring less than 1 cm, is still a subject of controversy. The aim of this study is to retrospectively evaluate the patients diagnosed with PTMC in terms of their clinical and histopathological features. MATERIAL AND METHODS: A total of 153 consecutive patients with PTMC were treated, and their clinical and histopathological characteristics were reviewed. The tumor diameter was observed to range from 1.0 mm to 10 mm (mean of 5.8 mm). Histologically, 138 (90.2%) cases of classical papillary carcinoma and 15 (9.8%) cases of the follicular variant were noted. Multicentric tumors were found in 37 (24.2%) patients, of whom 12 (7.8%) had more than one PTMC on the same side and 25 (16.3%) displayed bilateral PTMC. RESULTS: The proportions of capsular invasion and lymph node metastasis were 11.8% (18/153) and 48.1% (39/81), respectively. One patient showed distant metastasis during follow-up and died fifteen months after the operation. PTMC showed a high incidence of multifocality and lymph node metastasis in the level VI central compartment. The optimal surgical strategy for PTMC was total thyroidectomy and central compartment node dissection. CONCLUSIONS: Frozen tissue sections should be made for the prompt diagnosis of PTMC in all the thyroid nodules, except when the malignant diagnosis was already confirmed by cytology.
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OBJECTIVES: To evaluate the effectiveness of cervical pessary in preventing preterm birth (PTB) and improving perinatal outcomes among singleton and twin pregnancies. METHODS: Electronic databases were systematically searched from their inception until 14 March 2019. Randomized clinical trials comparing the effectiveness of cervical pessary placement with expectant management were included. The primary outcome was the incidence of PTB <34 weeks. RESULTS: Thirteen studies were included, involving eight studies about singleton and six studies about twin pregnancies. For singleton pregnancies with short cervical length, cervical pessary, comparing with expectant treatment, seemed have no effectiveness in preventing PTB <34 weeks (relative risk, 95% confidence interval, 0.73, 0.42-1.28), <37 weeks (0.69, 0.43-1.09), and <28 weeks (0.79, 0.42-1.48); while for twin pregnancies with short cervical length, cervical pessary also did not reduce the risk of PTB <34 weeks (0.81, 0.49-1.35), <37 weeks (0.93, 0.83-1.05), and <28 weeks (0.72, 0.38-1.38). However, cervical pessary seemed have the effectiveness of reducing the risk of spontaneous PTB <28 weeks (0.50, 0.25-0.99) and low birth weight (<1500 g) (0.68, 0.50-0.94) among twin pregnancies with short cervical length. In addition, cervical pessary increased the rate of vaginal discharge and did not improve perinatal outcomes among both singleton and twin pregnancies. CONCLUSIONS: Comparing with the expectant treatment, the effectiveness of cervical pessary for reducing the risk of PTB remains uncertain. Additional trials are warranted to further evaluate the effectiveness of cervical pessary.
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Pessários , Nascimento Prematuro , Colo do Útero , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Gravidez de Gêmeos , Nascimento Prematuro/prevenção & controleRESUMO
Objectives: Subject to ethical constraints, real-world data are an important resource for evaluating treatment effects of medication use during pregnancy and the postpartum period. This study investigated whether motherwort injection, a traditional Chinese medicine preparation, was more effective than intramuscular (IM) oxytocin for preventing postpartum hemorrhage (PPH) in a real-world setting when intravenous (IV) oxytocin is administered. Methods: We conducted an active-controlled, propensity-score matched cohort study using an established pregnancy registry database. Women who underwent cesarean section and received IV oxytocin at the third stage of labor were included. We used an active-comparator design to minimize indication bias, in which we compared IM motherwort injection in the uterus versus IM oxytocin, both on top of IV oxytocin use. We applied 1:1 propensity-score matching (PSM) to balance patient baseline characteristics and used a logistic regression model to estimate treatment effect (i.e., risk difference (RD) and odds ratio (OR)) by using the counterfactual framework. The outcomes of interest were blood loss over 500 ml within 2 h after delivery (PPH, primary) and blood loss over 1,000 ml (severe PPH, secondary). We conducted four sensitivity analyses to examine the robustness of the results. Results: A total of 22,519 pregnant women underwent cesarean sections, among which 4,081 (18.12%) PPH and 480 (2.13%) severe PPH occurred. Among included women, 586 (2.60%) were administrated with IM motherwort injection, and 21,933 (97.40%) used IM oxytocin. After PSM, patient baseline characteristics were well balanced. Compared with IM oxytocin, the use of IM motherwort injection was associated with significantly lower risk of PPH (RD -25.26%, 95% CI -30.04% to -20.47%, p < 0.001; OR 0.25, 95% CI 0.18 to 0.32, p < 0.001) and severe PPH (RD -3.58%, 95% CI -5.87% to -1.30%, p < 0.001; OR 0.39, 95% CI 0.20 to 0.71, p < 0.002). Sensitivity analyses showed that the results were similar. Conclusion: With the use of data from a real-world setting, the findings consistently showed that among women undergoing cesarean section who had received IV oxytocin, the additional use of IM motherwort injection could achieve a lower risk of PPH as compared to the additional use of IM oxytocin. Our study suggested a paradigm for investigating the treatment effect of Chinese herbal medicine in the real-world practice setting.
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BACKGROUND: Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19. METHODS: Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders. RESULTS: The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by -54.81% (interquartile range, -65.50% to -43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%-0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities. CONCLUSIONS: Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.
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COVID-19 , China/epidemiologia , Cidades , Humanos , SARS-CoV-2RESUMO
OBJECTIVE: To study the association between prepregnancy subnormal body weight and obstetrical outcomes after autologous in vitro fertilization (IVF) cycles. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women with prepregnancy subnormal body weight (body mass index <18.5 kg/m2) and normal body weight (body mass index 18.5-25 kg/m2) after assisted reproductive treatment. INTERVENTIONS(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate. CPR and LBR were calculated at per-woman and per-cycle levels. RESULT(S): A total of 38 cohort studies with low risk of bias were included. Meta-analyses showed that, compared with normal-weight women, those underweight before pregnancy had a lower CPR at per-woman and per-cycle levels. Compared with normal weight, underweight before pregnancy had little impact on LBR at both per-woman and per-cycle levels, nor on miscarriage rate. CONCLUSION(S): Compared with women of normal weight, women who were underweight before pregnancy had modest association with a lower CPR, but underweight did not seem to affect LBR or miscarriage after IVF.
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Peso Corporal , Fertilidade , Fertilização in vitro , Infertilidade/terapia , Saúde Materna , Magreza/fisiopatologia , Aborto Espontâneo/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Fertilização in vitro/efeitos adversos , Humanos , Infertilidade/diagnóstico , Infertilidade/epidemiologia , Infertilidade/fisiopatologia , Nascido Vivo , Pessoa de Meia-Idade , Gravidez , Taxa de Gravidez , Medição de Risco , Fatores de Risco , Magreza/diagnóstico , Magreza/epidemiologia , Resultado do Tratamento , Adulto JovemRESUMO
Bocaparvovirus infections of humans and both wild and domestic animals have been widely reported around the world. In this study, we detected and genetically characterized porcine bocavirus (PBoV) carried by murine rodents (Rattus norvegicus, Rattus tanezumi, and Rattus losea) and house shrews (Suncus murinus) in China. Between May 2015 and May 2017, 496 murine rodents and 23 house shrews were captured in four Chinese provinces. Nested polymerase chain reaction was used to investigate the prevalence of PBoV in throat swab, faecal and serum samples. A total of 7.5% (39/519) throat swab samples, 60.5% (309/511) faecal samples, and 22.9% (52/227) serum samples were PBoV-positive. The prevalence among R. norvegicus and R. tanezumi was higher than that among R. losea and house shrews. PBoV-positive samples were found in all four provinces. Phylogenetic analysis based on partial viral capsid protein 1/2 (VP1/VP2) showed that sequences obtained in this study formed a novel group (PBoV G4). In addition, five near full-length PBoV genomes (4,715-4,798 nt) were acquired. These genomes encoded two non-structural proteins, NS1 (1,908 nt in four genomes and 1,923 nt in the remaining genome) and NP1 (600 nt), and the structural proteins, VP1/VP2 (1,851 nt). Phylogenetic analysis showed that PBoV G4 is distinct from rodent, human, and other bocaviruses. In conclusion, PBoV G4 prevalence was high among two common murine rodents in China, and the pathogenecity of PBoV G4 need to be further clarified.
Assuntos
Bocavirus/isolamento & purificação , Infecções por Parvoviridae/veterinária , Ratos , Doenças dos Roedores/epidemiologia , Musaranhos , Animais , China/epidemiologia , Fezes/virologia , Infecções por Parvoviridae/sangue , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Faringe/virologia , Filogenia , Reação em Cadeia da Polimerase/veterinária , Prevalência , Doenças dos Roedores/sangue , Doenças dos Roedores/virologiaRESUMO
BACKGROUND: Human parvovirus B19 (B19) is widespread infection in humans, yet the impact on adverse pregnancy outcomes is controversial. OBJECTIVE: to evaluate the impact of B19 infection during pregnancy on adverse pregnancy outcome, and investigated the incidence of fetal loss and fetal hydrops after maternal B19 infection during pregnancy. STUDY DESIGN: A systematic literature search was performed using Embase, Medline, PubMed, Web of science, and the Cochrane Library database for relevant publications up to 10th August 2018. Cohort studies and case-control studies were included in analyses. RESULTS: In total, 36 eligible studies were included. Of these, 18 studies reported the risk of maternal B19 infection during pregnancy on fetal loss and 20 studies reported the incidence of fetal loss or fetal hydrops after maternal B19 infection. Collectively, the results indicated that maternal B19 infection increased the risk of fetal loss, spontaneous abortion, and stillbirth with ORs of 2.68 (95% CI: 2.02-3.55), 2.42 (95% CI: 1.76-3.33), and 3.53 (95% CI: 1.91-6.54), respectively, when compared with uninfected pregnant women. In addition, the incidence of fetal loss and fetal hydrops in B19 infected pregnant women was 7.6% (95% CI: 5.5-9.5) and 9.3% (95% CI: 5.6-13.0), respectively. CONCLUSIONS: maternal parvovirus B19 infection during pregnancy increased the risk of fetal loss, spontaneous abortion, and stillbirth. A high incidence of fetal loss and fetal hydrops was observed in pregnant women with parvovirus B19 infection.
Assuntos
Morte Fetal/etiologia , Hidropisia Fetal/virologia , Infecções por Parvoviridae/complicações , Parvovirus B19 Humano/patogenicidade , Complicações Infecciosas na Gravidez/virologia , Aborto Espontâneo/virologia , Feminino , Humanos , Gravidez , Resultado da Gravidez , Fatores de Risco , NatimortoRESUMO
BACKGROUND: Bladder cancer is the fourth most common malignancy in men and a considerable disease burden globally. Multiple studies have focused on the accuracy of optical coherence tomography for bladder cancer diagnosis; however, the findings are inconsistent. Here, we assessed the accuracy of optical coherence tomography for bladder cancer diagnosis. METHODS: Embase, PubMed, Medline, Web of Science, and the Cochrane Library database were searched for relevant studies from the earliest date available through March 11, 2019. Studies evaluating the accuracy of optical coherence tomography bladder cancer diagnosis were included. Pooled sensitivity, specificity, and area under the curve values of weighted symmetric summary receiver operating curves, were calculated at the per-lesion level. RESULTS: Eleven studies, with a total of 1933 lesions, were included in the final analysis. The pooled results indicated that optical coherence tomography can differentiate bladder cancer from benign lesions: sensitivity, 94.9% (95% confidence interval: 92.7%-96.6%); specificity, 84.6% (95% confidence interval: 82.6%-86.4%); area under the curve, 0.97. Moreover, compared with optical coherence tomography alone, combined optical coherence tomography and fluorescence cystoscopy increased the diagnostic accuracy (sensitivity, 94.3% vs. 87.3%; specificity, 89.2% vs. 73.9%). Cross-polarization optical coherence tomography could also distinguish bladder cancer from normal tissue: sensitivity, 92.0% (95% confidence interval: 87.0%-95.6%); specificity, 84.4% (95% confidence interval: 81.7%-86.9%); area under the curve, 0.95. CONCLUSIONS: Optical coherence tomography can accurately differentiate malignant from benign bladder lesions, particularly when combined with fluorescence cystoscopy.
Assuntos
Tomografia de Coerência Óptica/métodos , Neoplasias da Bexiga Urinária/diagnóstico , Cistoscopia/métodos , Fluorescência , Humanos , Sensibilidade e Especificidade , Tomografia de Coerência Óptica/normas , Neoplasias da Bexiga Urinária/patologiaRESUMO
Optical coherence tomography (OCT) is an emergent imaging tool used for noninvasive diagnosis of skin diseases. The present meta-analysis was carried out to assess the accuracy of OCT for the diagnosis of skin cancer. We conducted a systematic literature search though EMBASE, Medline, PubMed, the Cochrane Library, and Web of Science database for relevant articles published up to June 6, 2017. The quality of the included studies was assessed using the QUADAS-2 tool and the Oxford Levels of Evidence Scale. Statistical analyses were conducted using the software Meta-Disc version 1.4 and STATA version 12.0. A total of 14 studies involving more than 813 patients with a total of 1958 lesions were included in our analyses. The pooled sensitivity and specificity of OCT for skin cancer diagnoses were 91.8% and 86.7%, respectively. Subgroup analysis showed that the pooled sensitivities of OCT for detecting basal cell carcinoma (BCC), squamous cell carcinoma (SCC), actinic keratosis, and malignant melanoma were 92.4%, 92.3%, 73.8%, and 81.0%, respectively. The pooled specificities were 86.9%, 99.5%, 91.5%, and 93.8%, respectively. OCT appears to be useful for the detection of BCC and SCC. It is a valuable diagnostic method when screening for early skin cancers.