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Objective:To study the Epstein-Barr virus (EBV) activity and its clinical characteristics in patients with hemorrhagic fever with renal syndrome (HFRS). Methods:From January 2016 to August 2017, patients with HFRS who were hospitalized in the First Affiliated Hospital of Harbin Medical University were routinely tested by EBV serology, and were divided into two groups according to their presence or absence of EBV infection, namely EBV active group and non-EBV active group. The clinical data between the two groups were compared and analyzed by SPSS 18.0.Results:A total of 188 HFRS patients were enrolled, including 73 cases in EBV active group and 115 cases in non-EBV active group. The EBV active rate of HFRS patients was 38.83% (73/188). The incidences of lumbago [57.53% (42/73) vs 42.61% (49/115)], abdominal pain [42.47% (31/73) vs 20.00% (23/115)], skin and mucosa congestion [57.53% (42/73) vs 39.13% (45/115)], and conjunctiva edema [50.68% (37/73) vs 28.70% (33/115)] in EBV active group were significantly higher than those in non-EBV active group (χ 2 = 3.983, 11.008, 6.083, 9.239, P < 0.05). There were 10, 7 and 43 patients with acute kidney injury (AKI) stage 1, 2 and 3 in EBV active group and 5, 13 and 53 patients in non-EBV active group. Degree of AKI in EBV active group was higher than that in non-EBV active group, and the difference was statistically significant (χ 2 = 12.615, P < 0.05). In EBV active group, the proportion of patients whose renal function recovery over 15 days [23.29% (17/73)] and white blood cell count [11.26 (3.39 ~ 54.23) × 10 9/L] were significantly higher than those in non-EBV active group [6.96% (8/115), 10.03 (2.91 ~ 66.99) × 10 9/L], and the differences were statistically significant (χ 2 = 10.330, Z = - 2.003, P < 0.05). Conclusion:HFRS patients may cause latent EBV activity, complicate their clinical features, cause severe renal damage and prolong the recovery time of renal function.
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The infectious disease outpatient service as a frontier is an important fulcrum of public health service. Its standardized construction is an important support for ensuring medical safety, reducing nosocomial infections, and controlling the epidemic of infectious diseases. The sub-specialty outpatient service of infection diseases includes fever outpatient service, intestinal outpatient service, tuberculosis outpatient service, AIDS outpatient service, liver disease outpatient service, etc. According to the characteristics of each subspecialty outpatient service and combining with clinical practice, we elaborated the setting norms of subspecialty outpatient service for common infectious diseases from the perspective of planning and design, building layout, equipment and facilities configuration, staffing, daily management and demonstration.
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Objective To compare the efficacy and safety of simeprevir-based (SMV) or telaprevir-based (TVR) triple therapy [SMV + Pegylated interferon alfa (PegIFNα) and ribavirin (RBV) versus TVR + PegIFNαand RBV] in patients with hepatitis C virus (HCV) genotype 1 infection .Methods A systematic literature searching was conducted in multiple online databases to identify relevant studies .The sustained virologic response rate at 12 (SVR12) and 24 weeks (SVR24) after end of the treatment were used as the efficacy endpoints .The rate of treatment related adverse events (AEs) ,discontinuation due to AEs and overall treatment discontinuation were used as safety endpoints . Patients were divided into multiple subgroups according to the previous treatment history to further compare the efficacy of the two treatment regimen .Statistical analyses were performed using the RevMan 5 .3 software .The Jajad score scale and the Newcastle-Ottawa scale were employed to evaluate the quality of included studies .Results A total of 5 clinical studies including 1666 HCV genotype 1 patients were included in this study .The pooled results showed that SVR12 rates in SMV group and TVR group were 67 .6％ and 68 .3％ , respectively .There was no significant difference in overall SVR12 rate between SMV and TVR groups (OR=0 .95 ,95％ CI:0 .76 -1 .18 , P=0 .65) .There was no significant heterogeneity among studies (P=0 .84 ,I2 = 0％ ) .For SVR24 rate ,the average SVR24 rate in SMV group was 78％ ,which was lower than that in TVR group of 84％ .However ,there was no significant difference in overall SVR24 rate between SMV and TVR groups (OR=0 .71 ,95％ CI:0 .42-1 .20 ,P=0 .20) .Meanwhile ,there was no significant heterogeneity among studies (P= 0 .69 ,I2 = 0％ ) .The subgroup analysis also showed that there was no significant difference in efficacy between SMV and TVR-based triple therapy for treatment-native patients ,prior partial response ,relapse ,and prior null response patients (all P>0 .05) .However , the pooled analysis indicated that both SMV-based and TVR-based triple therapies were most effective for the treatment-naive patients(SMV :85 .7％ ,TVR :85 .6％ ) .For the safety endpoints ,the incidence rate of anemia was significant lower in SMV group compared to TVR group (OR=0 .30 ,P<0 .001) .For the rate of overall treatment discontinuation ,there was no statistically significant difference between SMV and TVR group (OR=0 .48 ,P=0 .12) .Conclusions This meta-analysis suggests that the efficacy of SMV-based triple therapy is non-inferior to TVR-based triple therapy .However ,the SMV-based triple therapy is more tolerable and has a lower incident rate of anemia and discontinuation due to AEs compared to TVR-based triple therapy .
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Objective To explore the effect of nucleos(t)ide analog (NA)antiviral treatment on the pathological differentiation of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)and the prognostic factors of HCC.Methods Totally 127 patients with HBV-related HCC who were hospitalized and received partial hepatectomy in First Affiliated Hospital of Harbin Medical University from March 2007 to November 2013 were included in this study.Sixteen cases received antiviral treatment before operation and the remaining 111 cases had no history of NA treatment.The differences of histopathological grading were compared between the two groups.Twenty-nine patients received antiviral treatment for the first time after surgery,and the rest 82 patients did not.All these patients were followed up for survival and recurrence.Multivariate analysis was used to explore the prognostic factors for HCC.The categorical variables were analyzed byχ2 test or Fisher exact test.Survival rate was compared with Log-rank test. Univariate or multivariate Cox regression analysis was used to explore the related factors of survival. Results The proportions of well-,moderately- or poorly-differentiated HCC in patients with antiviral treatment before surgery were 18.75 %,68.75 % and 12.5 %,respectively.Whereas the proportions in those without treatment were 16.22%,66.67% and 17.11 %,respectively.There was no significant difference in histopathological grading of HCC between the two groups (χ2=0.224,P =0.885 ).The overall median survival time was 39 months.The 6-month,1-and 2-year survival rates were 91 .7%, 77.5 % and 59.3%,respectively.The 6-month,1- and 2-year survival rate of postoperative antiviral treatment were 96.3%,92.4% and 78.5 %,respectively,which were significantly higher than those of no antiviral treatment group (85 .9%,70.0% and 48.5 %,respectively;χ2= 6.967,P = 0.008 ). Univariate analysis showed that tumor number,size,portal vein transfer,AFP level,postoperative antiviral treatment,histopathological grading,TNM staging,BCLC staging,γ-GT and PTA were prognostic factors for postoperative HCC survival.Multivariate analysis showed that AFP level (HR=1 , 95 %CI :1 .0004—1 .002,P =0.004),postoperative antiviral treatment (HR =0.38,95 %CI :0.38—0.15 ,P =0.04)and BCLC stage (B vs A:HR=1 .55 ,95 %CI :0.76—3.18;C vs A:HR=3.63,95 %CI :1 .31 —10.09,P =0.04)were independent prognostic factors.Conclusions Preoperative antiviral treatment has no impact on the histopathological grading of HCC. BCLC stage, AFP level and postoperative antiviral treatment are independent prognostic factors for HBV-related HCC.
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Objective To analyze and monitor the distribution of EBSLs-producing E.coli in our hospital and its resistance to commonly used antibacterial drugs.Methods The drug sensitivity test results of E.coli cultured in our hospital from 2008 to 2011 were continuously observed and performed the summary and the descriptive analysis.Results The detection rate of EBSLs-produ-cing E.coli during these 4 years was more than 50%.The generation rate of ESBLs-producing E.coli from the pharyngeal swab samples was the highest.The drug resistance of EBSLs-producing E.coli was mostly higher than that of non-EBSLs-producing E. coli,the difference was statistically significant(P <0.05).EBSLs-producing E.Coli showed the multi-drug resistant phenomenon. But the resistance rate of EBSLs-producing E.Coli to some antimicrobial drugs had the decreasing tendency year by year.Conclusion The drug-resistance situation of ESBLs-producing E.Coli is serious.The diceovered carbapenems-resistance ESBLs-producing E. Coli should cause the concern.The antibacterial drugs with increased drug-resistance rate should be replaced by the antibacterial drugs with the gradually decreased drug resistance rate.Strengthening the bacterial drug resistance minitoring can timely discover the change trend of clinically isolated bacteria and has the improtant significance to provide reference for clinically empirical medica-tion.
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Objective:To construct secreted chimeric vector of AFP-HSP70 and investigate transient expression of vectors in eukaryotic cells.Methods:Vectors were constructed by routine molecular technique.Fusion genes were linked with G-S-G-G-S linker.Vectors were transfected into COS-7 cells by Lipofectamine 2000. Proteins were assayed by immunocytochemistry and RT-PCR for its RNA.Results:Proteins expressed in COS-7 were comfirmed by immunocytochemistry 48 hours later and RNA was detected by RT-PCR.Conclusion:AFP-HSP70 chimeric vector is constructed successfully and could be expressed in eukaryotic cells.
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<p><b>OBJECTIVE</b>To study the HBsAg transient expression in HepG2 or COS-7 cells with eukaryotic expression plasmids inserting HBsAg gene (pCI-S and pcDNA3.1-S) and the efficacy of naked DNA immunization in mice.</p><p><b>METHODS</b>Firstly, the recombinant plasmids of pCI-S and pcDNA3.1-S were constructed by the cloning technique and the accuracy of these constructs was confirmed by restriction enzyme digestion and DNA sequencing. Secondly, plasmids of pCI-S and pcDNA3.1-S were transferred into HepG2 and COS-7 cells, respectively by means of cationic liposome. HBsAg transient expression was assayed by ELISA in cell culture supernatants and cell lysates. Thirdly, plasmids were injected into quadriceps muscles of BALB/C mice and serum samples were obtained from individual immunized or control mice 4 weeks after injection and boost injection, respectively. Anti-HBs were assayed in mice sera by ELISA. HBsAg-specific CTL responses of spleen cells from immunized mice were tested by the LDH method.</p><p><b>RESULTS</b>Plasmids of pCI-S and pcDNA3.1-S allowed HBsAg transient expression in cell culture supernatants and cell lysates of HepG2 or COS-7 cells. Intramuscular immunization of BALB/C mice with plasmids of pCI-S or pcDNA3.1-S elicited the antibody and cytotoxic T lymphocyte responses to HBsAg.</p><p><b>CONCLUSIONS</b>The vectors used in this study are effective to induce prime antibody and HBsAg-specific-cytotoxic T lymphocyte responses to HBsAg in mice after intramuscular immunization.</p>
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Animals , Female , Humans , Mice , COS Cells , Cloning, Molecular , DNA, Viral , Genetics , Eukaryotic Cells , Metabolism , Gene Expression , Hepatitis B , Allergy and Immunology , Hepatitis B Surface Antigens , Genetics , Allergy and Immunology , Hepatitis, Viral, Animal , Allergy and Immunology , Immunization , Mice, Inbred BALB C , Plasmids , Genetics , T-Lymphocytes, Cytotoxic , Allergy and Immunology , Transfection , Tumor Cells, Cultured , Vaccines, DNA , Genetics , Allergy and Immunology , Viral Vaccines , Genetics , Allergy and ImmunologyABSTRACT
Objective To study the HBsAg specific CTL activities activated by dendritic cells derived from human monocytes on the HepG2/S target cells, and further to probe into the anti HBV effect of HBsAg DC (dendritic cell) vaccine. Methods DCs are proliferated from human peripheral blood monocytes by adding GM CSF and IL 4 and then HBsAg specific CTL are activated by DCs pulsed by HBsAg; The target cell line (HepG2/S) expressing HBsAg was set up by transfecting recombinated plasmid with HBV/S gene (PLXSN/S) into HepG2/S cell line; HBsAg specific CTL and HepG2/S target cells were cocultured in 96 well flat bottomed microtiter plates for 48 hours at 37 ?C in 5% CO 2, and then HBsAg specific CTL activities activated by DCs pulsed by HBsAg were detected by counting the number of killed target cells. Results HBsAg specific CTL activated by dendritic cells derived from human monocytes could produce strong killing effect on the target cells HepG2/S cells. It's specific CTL activities were 3.8%, 69.5% and 85.1% in different concentration (0 ?g/L,50 ?g/L and 100 ?g/L) respectively. While, it had no killing effect on the HepG2 cells, so the HBsAg specific killing effect was specific. Conclusions The result shows that HBsAg specific CTL activated by dendritic cells derived from human monocytes has strong killing effect on the HBV.