Logistic regression analysis of risk factors for hemorrhagic fever with renal syndrome complicated with acute pancreatitis.

BACKGROUND: Hantavirus infection is the main cause of hemorrhagic fever with renal syndrome (HFRS), which is common in Asia and Europe. There is a considerable risk of morbidity and mortality from the uncommon Hantavirus complication known as acute pancreatitis (AP). METHODS: Retrospective analysis of the medical records of individuals with HFRS was performed. Relevant variables were assessed by univariate analyses and the variables with a p value <.05 were entered into the multivariable regression analysis. RESULTS: In this study, 114 individuals with HFRS in total were included, and 30 of them (26.32%) had AP. The univariate analyses showed that living in Xuancheng city (Anhui Province); an alcohol consumption history; white blood cell (WBC) count; lymphocyte (lym%) and eosinophil percentages (EO%); neutrophil (neut), eosinophil (EO), and red blood cell (RBC) counts; hemoglobin (Hb); hematocrit (HCT); proteinuria; hematuria; albumin (ALB), blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), cystatin-C (Cys-C) levels; carbon dioxide-combining power (CO2CP); fibrinogen degradation products (FDPs); and D-dimer level were significantly associated with HFRS complicated with AP (p < .05). In the multivariable regression analysis, an alcohol consumption history, lym%, proteinuria, FDPs and D-dimer level were found to be risk factors for HFRS complicated with AP (p < .05). CONCLUSION: Our findings indicate that HFRS patients with a history of consuming alcohol, a high lym%, intense proteinuria, high levels of FDPs, and a low level of D-dimer might be more prone to the development of AP.KEY MESSAGESThis is the first report employing Logistic regression analysis methods for exploring the risk factors for HFRS complicated with AP in China.Many factors (most are laboratory parameters) were significantly associated with HFRS complicated with AP.We found that HFRS patients with a history of consuming alcohol, a high lym%, intense proteinuria, high levels of FDPs, and a low level of D-dimer might be more prone to the development of AP.

Epidemiological and Clinical Characteristics of Severe Fever with Thrombocytopenia Syndrome in Southern Anhui Province, China, 2011-2020.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever, and the causative pathogen, the SFTS virus (SFTSV), was first discovered in China in 2010. In this study, a retrospective analysis of 86 patients that were diagnosed with SFTS from two 5-year periods (2011-2015 and 2016-2020) was performed to explore the changes in epidemiology, clinical characteristics, laboratory parameters, and prognosis between both periods. The results showed that there were significant differences in age, the proportion of farmers, geographical distribution, the incidence of multiple organ dysfunction, the decrease in thrombocyte count, and the elevations of serum AST and lipase levels between the two groups (P < 0.05). Additionally, the case-fatality rate in the 2016-2020 group (16.7%) was higher than that in the 2011-2015 group (6.25%), although the difference was not significant. Our study shows that SFTS is broadly distributed across Anhui Province and the mortality rate is high. May to July was the peak of the epidemic, and farmers constituted a high-risk group. In recent years, thrombocytopenia has become more serious, and multiple organ dysfunction is more common. Clinicians need to strengthen their knowledge of the changing epidemiological and clinical characteristics of this disease.

The Psychological Effect of Forming WeChat Groups Between Medical Staff and Patients With COVID-19.

Background: This study was conducted in order to explore the effect of psychological intervention based on the use of WeChat with coronavirus disease 2019 (COVID-19) patients. Methods: A total of 65 patients with COVID-19, from two wards, were divided into an experimental group and a control group with the ward as the basic unit. Communication concerning routine treatment and nursing was established between the medical staff and patients in the experimental group via WeChat groups. Within 48 h of admission, at 7 days, and on discharge, all 65 patients completed two self-evaluation questionnaires: the Positive and Negative Affect Schedule (PANAS) and the Hospital Anxiety and Depression Scale (HADS). Hospital stay statistics and a satisfaction survey on discharge were also collated for both groups of patients. Results: The PANAS scores of the experimental group were 26.61 ± 7.99 points on admission, 20.81 ± 5.48 points at 7 days, and 19.58 ± 6.61 points on discharge (P < 0.05). The scores of HADS in the experimental group were 27.74 ± 9.35 points on admission, 12.19 ± 1.92 points at 7 days, and 11.71 ± 3.64 points on discharge (P < 0.05). The differences in the PANS and HADS scores between the experimental and control groups at 7 days and on discharge were statistically significant. The discharge satisfaction ratings of the two groups of patients were 99.87 ± 0.34 and 98.68 ± 1.09 points, the difference being statistically significant (t = 5.827, P < 0.05). Conclusion: Establishing WeChat groups between medical staff and patients with COVID-19 and building a bridge for better communication improved patients' positive mentality and their compliance with doctors, shortened their hospital stay, and promoted their recovery.

Autophagy inhibition by reversine and its suppressive effects on human hepatocellular carcinoma cells.

INTRODUCTION: Therapy for human hepatocellular carcinoma (HCC) remains a great challenge for physicians and patients worldwide. The anti-tumor effects of reversine have attracted much more concerns. MATERIALS AND METHODS: This study evaluated the growth regulatory effects of reversine on HCC cells lines. Meanwhile, the underlying mechanism including autophagy modulation was also identified. RESULTS: reversine markedly inhibited the proliferation of both HCC cells and induced cell apoptosis and multinuclear in a dose-dependent manner. In addition, the decreased ratio of LC3II/LC3I as well as elevated p62 expression were observed under reversine treatment, indicating the autophagy inhibition by reversine in HepG2 cell line. Moreover, modulation of autophagy with rapamycin and chloroquine significantly attenuated and enhanced the cytostatic effects of reversine, respectively. CONCLUSIONS: reversine could reduce the cell viability of HCC cells via inducing cell apoptosis and polyploidy. In addition, cell autophagy was involved and might play a protective role in HCC cells, the joint use of autophagy inhibitor enhanced reversine-mediating antitumor effects. Our data offered novel ideas for comprehensive therapeutic regimes on human hepatocellular carcinoma.

Clinical analysis of patients with acute pancreatitis complicated with hemorrhagic fever with renal syndrome and acute biliary pancreatitis.

Acute pancreatitis (AP) is a rare complication of hemorrhagic fever with renal syndrome (HFRS), and is difficult to diagnose. In this study, we retrospectively analyzed the clinical characteristics of 7 cases of HFRS complicated with AP and 105 cases of acute biliary pancreatitis (ABP).Medical records of 83 hospitalized patients with HFRS and 105 hospitalized patients with ABP in the affiliated Yijishan Hospital of Wannan Medical College were reviewed. The comparative analysis of patients between the 2 groups was conducted in terms of sex, age, duration of hospital stay, fever, hemorrhage, proteinuria, oliguria, laboratory results, radiologic examinations, and prognosis.A total of 83 patients were diagnosed with HFRS during study period. Only 8.43% (7/83) of the total HFRS patients were diagnosed with AP. The differences in the gender, age, and duration of hospital stay between the 2 investigated groups of patients were not statistically significant. The major symptoms for all 7 patients with HFRS complicated with AP and 105 patients with ABP were fever and upper abdominal pain. During the disease course of HFRS complicated with AP, 6 patients experienced hemorrhaging, and 7 patients underwent an oliguric stage, but none of the ABP patients experienced hemorrhaging and oliguria. Among the laboratory results of all patients, the differences in alanine aminotransferase and glycemia were not statistically significant. The other laboratory results (leucocyte count, platelet count, amylase, lipase, total bilirubin, direct bilirubin, creatinine, blood urea nitrogen, prothrombin time, activated partial thromboplastin time, and serum calcium level) were significantly different during hospitalization. All 7 patients with HFRS complicated with AP received conservative medical treatment and hemodialysis. In the patients with ABP, 21 patients were discharged from the hospital after conservative treatment, 53 patients were treated by endoscopic invasive treatment after stabilization, and 31 patients were treated by surgery after stabilization.AP is not a frequent complication in patients with HFRS. There are differences in clinical manifestations and laboratory findings between the HFRS complicated with AP group and the ABP group; these differences may help in the differential diagnosis and treatment of these 2 types of pancreatitis.

Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis.

INTRODUCTION: The aim of this study was to investigate the basis for a differential diagnosis of lymph node tuberculosis and histiocytic necrotizing lymphadenitis. METHODOLOGY: This study selected 85 cases of lymph node tuberculosis (Group A patients) and 26 cases of histiocytic necrotizing lymphadenitis (Group B patients). The clinical and pathology features on both groups were analysed. RESULTS: The Group A patients were older than the Group B patients (t = 5.233, P < 0.01); The Group B patients had less tuberculosis exposure history (x2 = 4.279, P < 0.01), and a higher frequency of tenderness (χ2 = 8.109, P < 0.01) and fever (x2 = 31.923, P < 0.01). The Group A patient group had a higher WBC level (t = 2.980, P < 0.01) and lower serum ALB (t = 5.508, P < 0.01); As seen through ultrasound imaging, Group B patients had more clear boundaries (70.59%), higher low-echo rates (82.36%) and low calcification rates (0%), Group A patients for whom these rates was 25.76%, 40.91% and 25.76% respectively. In terms of pathology data, the main manifestations of Group A patients were granulomatous inflammation with caseous necrosis, multinuclear giant cell reaction, and in some cases, acid-fast bacilli smears (+). In Group B patients, there were instances of coagulative necrosis surrounded by foam-like tissue cells without neutrophil infiltration. CONCLUSION: We found that the epidemiological history, clinical symptoms, laboratory examinations, ultrasound imaging and changes in pathology are very important for the identification of lymph node tuberculosis and histiocytic necrotizing lymphadenitis.

[Expression of Tim-3 on peripheral blood CD4+ T cells and its correlation with liver function damage parameters in advanced schistosomiasis patients].

OBJECTIVE: To explore the expression levels of T cell immunoglobulin and mucin domain protein 3 (Tim-3) on peripheral blood CD4+ T cells and its correlation with liver function damage parameters in advanced schistosomiasis patients. METHOD: Totally 28 advanced schistosomiasis patients were selected as study subjects, and 20 chronic schistosomiasis patients and 30 healthy persons were selected as controls. The expression levels of Tim-3 on CD4+ T cell were detected by flow cytometry, and the serum IFN-γ and IL-4 levels were detected by ELISA. Hitachi 7600 biochemical analyzer was used to analyze the liver function parameters (ALT, γ-GT and TBIL). RESULTS: There was a significant difference in Tim-3 expression among the three groups (F = 4.578,P < 0.05). Tim-3 expression level in advanced schistosomiasis patients was (8.33 ± 2.28)%, which was significantly higher than that of the healthy control group (6.57 ± 1.99)% (t = 3.015, P < 0.01). The Spearman nonparametric correlation analysis showed that the Tim-3 expression level on CD4+ T cells in advanced schistosomiasis patients was positively correlated with the serum ALT(r, = 0.746, P < 0.01), γ-GT(r, = 0.656, P < 0.01) and IL-4(r, = 0.672, P < 0.01) levels, but negatively correlated with the serum IFN-γ levels (r(s) = -0.404, P < 0.05). CONCLUSION: The expression of Tim-3 on peripheral CD4' T cells is increased in advanced schistosomiasis patients, which may regulate the function of CD4' T cells and then be involved in the liver damage process of advanced schistosomiasis.

[Expression of Tim-3 on Peripheral CD56(+) NK Cells and ItsCorrelation with Liver Fibrosis in Patients withAdvanced Schistosomiasis].

OBJECTIVE: To explore the expression of T cell immunoglobulin and mucin domain protein 3 (Tim-3) on CD56(+) NK cells in peripheral blood and its correlation with liver fibrosis indicators in patients with advanced schistosomiasis. METHODS: Tim-3 expression on CD6(+) NK cells from 28 patients with advanced schistosomiasis and 30 healthy controls was determined by flow cytometry. The serum levels of IFN-y and IL-4 were detected by enzyme-linked immunosorbent assay (ELISA). Fibroscan analyzer was used for liver stiffness measurement (LSM) to determine the extent of liver fibrosis. Four serological indicators of liver fibrosis, collagen type III N-peptide (PIIP N-P), Laminin (LN), collagen IV (CIV) and hyaluronic acid (HA) were measured by the Automated Chemiluminescence Immunoassay Analyzer. RESULTS: Flow cytometry analysis showed that Tim-3 expression on CD56(+) NK cells in advanced schistosomiasis patients was (62.3±11.4)%, significantly higher than that (52.1±6.5)% (P< 0.01). In patients with advanced schistosomiasis and the healthy controls, the levels of PIIIP N-P were (86.5±29.5) ng/mL and (22.0±7.8) ng/mL, LN (49.3±21.5) ng/mL and (20.4±6.3) ng/mL, CIV (67.5±22.3) ng/mL and (22.0±3.9) ng/mL, HA (645.9±483.1) ng/mL and (54.7±27.7) ng/mL, respectively. There were significant differences in all these indicators between the two groups (P<0.05). The levels of IFN-y were (93.9?20.1) ng/L and (107.7?24.6) ng/L, and those of IL-4 were (46.6±11.8) ng/L and (28.9±8.9) ng/L respectively in patients with advanced schistosomiasis and the healthy controls, both with significant differences (P<0.05). Spearman nonparametric correlation analysis showed that Tim-3 expression on CD56(+) NK cells in patients was positively correlated with the levels of LSM, PIIIP N-P, LN, CIV and IL-4 (r=0.528-0.834, P<0.01), but negatively with serum IFN-y (r=-0.501, P<0.01). No correlation was found with the HA level (r=0.352, P>0.05). CONCLUSION: The expression of Tim-3 on peripheral CD56(+) NK cells increases in patients with advanced schistosomiasis compared with the healthy controls, and it positively correlates with the levels of LSM, PIIIP N-P, LN, CIV and IL-4, four indicators of liver fibrosis.

[Seasonal changes of glycogen level in Oncomelania hupensis].

Oncomelania hupensis snails were collected from Qingyi River of Wuhu City from August 2012 to July 2013. Livers and pedal muscles of snails were dissected. Anthrone colorimetric method was used to evaluate the glycogen concentrations of whole-body, liver and muscle. The concentration of whole-body and liver glycogen decreased from September to next June. The whole body glycogen content in female (0.55 microg/mg) and male (0.88 microg/mg) snails was the lowest in June and April, respectively. The mean whole-body glycogen concentration in females and males was 2.99 and 3.39 microg/mg, respectively. Liver glycogen concentration was lowest in May (female = 0.29 microg/mg, male = 0.22 microg/mg), and reached peak level in August (female = 2.49 microg/mg, male = 2.78 microg/mg). The average liver glycogen concentration in female and male snails was 1.09 and 0.89 microg/mg, respectively. The muscle glycogen concentration gradually decreased from February to June, the lowest was found in June (female = 0.25 microg/mg, male = 0.41 microg/mg), and reached peak level in December (female =16.59 microg/mg, male = 10.06 microg/mg). The average muscle glycogen concentration in female and male snails was 799 and 605 microg/mg, respectively. There was a positive linear correlation between whole-body and liver glycogen concentrations (P < 0.05), and both of them had the similar trend in their monthly change. A positive linear correlation was found among whole-body, liver and muscle glycogen concentrations (P < 0.05).

[Seasonal changes of glucose levels in Oncomelania hupensis].

OBJECTIVE: To study the seasonal changes of glucose levels per unit soft tissue of Oncomelania hupensis. METHODS: O. hupensis snails were collected from the beach of the Qingyi River in Wuhu City, Anhui Province from August 2012 to July 2013. They were kept in minus 80 degrees C refrigerator immediately. The male snails were distinguished from female, and their soft tissues were collected separately after crushing their shells. The hexokinase method was used to measure the glucose concentrations, and the results were analyzed statistically. RESULTS: The contents of glucose decreased from March to July. The lowest glucose content in the female was 1.87 µg/mg in March, and that in male was 3.70 µg/mg in July. Both of them increased from August and reached peak levels in September (Female = 57.38 µg/mg, male = 44.39 µg/mg), and then gradually decreased from October to next January and increased in February. CONCLUSION: The contents of glucose have seasonal changes regularly in O. hupensis.