Current Issue

2019 Vol.4 No.3 Published:30 September 2019

Guidelines and Consensus

Strategies and effects of prevention of major emerging infectious diseases HOU Yun-de 2019, 4 (3):  129-132.  Abstract ( 342)    PDF (902KB) ( 1372 )    In 70 years since the founding of New China, with the great attention of the CPC Central Committee and the State Council and the joint efforts of all parties concerned, remarkable achievements have been made in China's public health and infectious disease prevention and control, especially in the field of emerging infectious disease prevention. Those efforts effectively enhance population’shealth and social stability and make important contributions to economic development. From the SARS outbreak in 2003 to human infection of H7N9 avian influenza in 2013, the emerging infectious diseases have become a major public health problem, increasingly capturing China and other countries’attention and concern.In order to effectively prevent emerging infectious diseases, the Chinese government has formulated and established a series of strategies, programs and guidelines and constructed a network system for disease surveillance. Through the establishment of the "four early" prevention and treatment Methods , early detection, early reporting, early isolation and early treatment, the haze of major new infectious diseases such as SARS and human avian influenza has been dispelled, leaving a significant record in the history of international epidemiology. This has pushed forward the goal of "healthy China".

Epidemic situation of Nipah Virus in the world JIN Ning-yi, XU Wang, DU Shou-wen, LI Chang, LI Ti-yuan, WU Shi-pin 2019, 4 (3):  133-136.  Abstract ( 451)    PDF (907KB) ( 1087 )    Nipah virus (NiV), a zoonotic pathogen, has become a great threat to humans and domestic animals health. It can be transmitted through direct contact or aerosols, causing infection or even death in humans or animals. This article summarizes the countries and regions where NiV outbreaks and epidemics have occurred since the first patient in Malaysia in 1998 and analyzed the main transmission ways of NiV. The Results show that the Nipah virus infection had spread from the Western Pacific Region to Southeast Asia in a rising trend. Guangxi, Yunnan and other southern regions in China are high-risk areas of NiV. Increasing surveillance and preventative measures for the viral infectious disease are urgently needed.

Progress in research and practice of molecular epidemiology of HIV-1 ZHONG Ping 2019, 4 (3):  137-144.  Abstract ( 559)    PDF (938KB) ( 1291 )    This article reviews the progress in global HIV-1 molecular epidemiology research and practice in recent years. The current diversity, characteristics and trends of the evolution of HIV-1 subtypes, as well as the emerging recombinant viruses in the world and China are described. The novel national strategy of molecular transmission network that can help to accurately intervene the AIDS epidemics is emphasized. This article will provides relatively new literatures for public health professionals, medical doctors and laboratory workers engaged in AIDS prevention and control. A large number of literatures and conference news cited in this article can be used for further reference by readers.

Original Articles

Association between CD4+T cell counts and chest CT scan parameters in severely immunocompromised patients coinfected with human immunodeficiency virus and tuberculosis YUAN Jing, LI Chun-hua, LI Qi-sui, YU Qing, LV Sheng-xiu, CHEN Yao-kai 2019, 4 (3):  145-148.  Abstract ( 283)    PDF (891KB) ( 840 )    Objective To investigate whether chest CT scan parameters have any association with CD4+T cell counts in severely immunocompromised patients coinfected with human immunodeficiency virus (HIV) and tuberculosis (TB). Methods This was a retrospective study and we collected and analyzed the clinical data and chest CT scan Results of HIV/TB coinfected patients admitted between January 2017 and December 2017. Results 118 patients coinfected with HIV and TB were included, and 116 patients had CD4+T cell counts less than 200 cells/μl. There are multiple lobar lesions in HIV/TB patients, and the average numbers of mediastinal lymph nodes、the maximum diameter of lymph nodes were larger in patients ofHIV/TB (P < 0.05). Exudation, nodules and miliary lesion were more common in patients of HIV/TB (P < 0.05). No significant differences ware observed in chest CT of patients with severe immunodeficiency (CD4+T cells < 200/μL), except that the maximum diameter of mediastinal lymph node in patients with CD4+T cell count less than 100/uL is larger than that in patients with CD4+T cell count more than 100/μL, (P < 0.005). Conclusion There are no significantly noticeable differences in chest CT scan parameters between patients with lower and higher CD4+T cell counts when their CD4+T cell counts are less than 200 cells/μl, except that the enlargement of mediastinal and hilar lymph nodes is more recognizable in patient with CD4+T cell counts less than 100 cells/μl.

Expression of absent in melanoma 2 mRNA in peripheral blood mononuclears and its significance in primary hepatocellular carcinoma CHEN Hong-tao, Yang Zhi, WU Shi-pin 2019, 4 (3):  149-151.  Abstract ( 223)    PDF (929KB) ( 808 )    Objective To analyze the expression level of absent in melanoma 2(AIM2) in peripheral blood mononuclears(PBMCs) and its significance in primary hepatocellular carcinoma(HCC). Methods The mRNA expression levels of AIM2 in PBMCs in 41 patients with HCC were detected by reverse transcription PCR and real-time fluorescence quantitative PCR, and the relationship between the liver tumor diameters, extrahepatic metastasis and liver function reserve scores were analyzed. Results Patients with the diameter of the intrahepatic tumor less than 5cm had higher AIM2 mRNA expression levels than those with the diameter of the intrahepatic tumor greater than 5cm (P = 0.006). The AIM2 mRNA expression levels were higher in patients without extrahepatic metastasis than in those with extrahepatic metastasis(P = 0.025). Patients with grade A and B liver function reserve had higher AIM2 mRNA expression levels than patients with grade C (P < 0.001). Conclusion The expression level of AIM2 mRNA in PBMCs is negatively associated with the progression of HCC. AIM2 is a potential biomarker for the prognostic evaluation of HCC and a potential target for therapeutic intervention.

Clinical-imaging-pathological analysis of 48 cases of AIDS patients and HIV infected persons LIU De-Chun, LI Hong-Jun 2019, 4 (3):  152-155.  Abstract ( 412)    PDF (1249KB) ( 932 )    Objective To explore the relationship between the clinical, imaging and pathological appearance. Methods 48 cases of AIDS patients and HIV infected person from the high-incidente area of AIDS were detected radiologically in all cases and pathologically in 33 cases. The examination Results were analyzed retrospectively. Results All cases, including 30 men and 18 women, were confirmed to be infected by HIV, and 33 cases were infected by blood including 19 cases by blood transfusion and 14 by illegal blood collection. 4 cases were infected by sexual transmission, 1 child might be infected by his mother, while other transmitted ways in others were unknown. There are 30 patients admitted to hospital for surgical diseases. Among them, more than 40 kinds of diseases were diagnosed by clinician combined with imaging examinations including fracture in 6 cases, trauma in 2 cases, pulmonary diseases in 2 cases, liver diseases in 3 cases, gastrointestinal diseases in 6 cases, malignancies in 6 cases and benign tumors in 5 cases. 14 cases of AIDS related diseases were confirmed by pathologists including lymphoma in 2 patients, lymphadenopathy related to AIDS in 3 patients, tuberculosis in 6 patients, and 1 case of cryptococcosis in lymph node, 1 case of toxoplasma pneumonitis, and 1 case of pulmonary mixed infection with cytomegalovirus(CMV) and aspergillus, respectively. The other diseases are non- indicated diseases to AIDS consisted of 4 patients suffered from malignant tumors, and 5 from benign tumors, all of which were found no relationship to the CD4+ cells counts. Conclusions The reliable diagnosis of AIDS must relay on the combination of the 5 items including epidemiologic history, clinical presentations, laboratory examination to confirm the HIV infection and immune state, imaging inspection to make sure the location and bound of the lesions, and pathological detection to determine the properties and kinds of the lesions especially for the tumors.

Efficacy and safety of balloon dilatation compared with cryotherapy combined with balloon dilatation in the management of airway stenosis caused by scar stenosis type of tracheobronchial tuberculosis YE Tao-sheng, ZENG Xuan, XU Yu-xiang, LI Min, ZHANG Jiao-hong, WANG Zhao-qin 2019, 4 (3):  156-159.  Abstract ( 545)    PDF (869KB) ( 775 )    Objective To investigate the efficacy and safety of balloon dilatation compared with cryotherapy combined with balloon dilatation in the management of airway stenosis caused by scar stenosis type of tracheobronchial tuberculosis. Methods A total of 60 patients who were diagnosed as airway stenosis caused by scar stenosis type of tracheobronchial tuberculosis from February 2010 to April 2015 in the partment of Tuberculosis of the Third people's hospital of Shenzhen were enrolled. All patients were divided into 2 groups according to seal the envelope method. Simple balloon expansion treatment method was implemeted in the control group (n=30), and cryotherapy combined with balloon expansion through bronchoscopewas implemented in the experimental group (n=30). The effective rate of postoperative treatment, the incidence of complications with andtracheal restenosis at the third month after treatment were compared between the two groups and the ratio of forced expiratory volume to forced vital capacity and airway inner diameter were measured before treatment and 1 second after treatment. Results The effective rates of treatment in the control group and the experimental group were 66.67% (20/30) and 93.33% (28/30), respectively, with statistically significant differences between the two groups(P < 0.05). Compared with the control group, patients in the experimental group had higher 1 month of the first second forced expiratory volume and the ratio of the forced vital capacity, airway diameter measured values, and there was also a difference in the two group of patients(all P < 0.05).Patients in the experimental group had lower incidence of chest pain, hemoptysis, aerothorax (43.33%, 6.67%, 6.67%) compared with in control group patients (50.00%, 10.00%, 10.00%), However, the difference was not statistically significant (P > 0.05).In the experimental group and control group , the incidence of tracheal restenosis in the third month after treatment was 6.67%、26.67%, indicating that index comparison test of statistical significance(P < 0.05). Conclusion Cryotherapy combined with balloon dilatation through electronic bronchoscope was a very effective and safe method in the management of airway stenosis caused by scar stenosis of tracheobronchial, and it deserves to be applied and spreaded in the clinic.

Value of magnetic resonance imaging in the diagnosis and evaluation of inflammatory bowel disease QIN Xing-ru, LI Hui, TANG Hao-jie, Jiang Shan, REN Ying 2019, 4 (3):  160-164.  Abstract ( 505)    PDF (1410KB) ( 767 )    Objective To investigate the diagnostic efficiency of MRI combined with diffusion-weighted imaging (DWI) in diagnosis and quantitative evaluation of inflammatory bowel disease (IBD) Methods 20 patients with pathologically diagnosed IBD and 10 patients with normal enteroscopy examination were collected. The MR-score-S of each intestinal segment was analyzed, and the ADC value and intestinal wall thickness was also measured (rectum, sigmoid colon, descending colon, transverse colon, ascending colon and ileum). Using endoscopy as the golden standard, diagnosis efficiency of IBD by quantitative parameters including MR-score-S, ADC value and intestinal wall thickness was analyzed by ROC curve and their correlation with endoscopy scores was also analyzed. Results 162 intestinal segments were analyzed. The area under the ROC curve of MR-score-S, ADC value and the thickness of the bowel wall in diagnosis of IBD was 0.8126, 0.7654 and 0.74, respectively. That of MR-score-S (Without enhancement), MR-score-S (Without DWI) and MR-score-S (Without enhancement or DWI) was 0.785, 0.7988 and 0.7377, respectively. In IBD patients, MR score, ADC value and bowel wall thickness showed statistical correlation with endoscopic grading (P<0.05), and the correlation coefficients were 0.724, -0.43 and 0.519 in UC patients, while those in CD patients were 0.484, -0.392 and 0.331. Conclusion Combined with DWI and ADC value, MRI provides a reliable diagnostic method for IBD, especially in patients with ulcerative colitis. And quantitative assessment of bowel inflammation helps to guide clinical individualized treatment and improve the prognosis of IBD.

Epidemiological characteristics of foreign HIV/AIDS cases live in Shenzhen during 2004-2017 ZHANG Yan, LIU Dan, YANG Zheng-rong, LIU Shao-chu, LIAO Qing-hua, LUO Yi-juan, FENG Tie-jian 2019, 4 (3):  165-168.  Abstract ( 474)    PDF (928KB) ( 681 )    Objective Describe and analyze the epidemiological characteristics of foreign HIV (AIDS) and AIDS patients (HIV/AIDS cases) in Shenzhen from 2004 to 2017 and the differences in case characteristics between different time periods. Methods Basic information on foreign HIV/AIDS cases during 2004-2017 were analyzed by descriptive epidemiological method. Results A total of 111 cases of foreign HIV/AIDS cases were reported in Shenzhen from 2004 to 2017, including 100 HIV infected person and 11 AIDS patients. The average age was 33.0±8.8 years old, the male-female ratio was 3.8:1, the illiterate and primary school education was 34.23%, the unmarried cases accounted for 48.65%, the sexually transmitted infections accounted for 44.14%. Among the sample source distributions, 60.36% were diagnosed in prisons. Comparing the epidemiological characteristics of foreign cases in different time periods, the Results showed that the differences in nationality, education level, infection route, sample source, disease stage and follow-up were statistically significant (P<0.05). During 2011-2017, the detection rate of the first CD4+T lymphocytesin foreign cases was 76.74% (33/43)inShenzhen, and 60.61%(20/33)Results were lower than 350cells/μL. Two cases were treated with antiviral therapy. Conclusion The epidemiological characteristics of foreign HIV/AIDS caseslived in Shenzhen were significantly changed recently. Multisectoral cooperation andpolicy research should be strengthened to improve their follow-up and antiviral therapy level.

Talaromyces marneffei infection complications in an HIV-negative patient with lung cancer: a case report and review of literature YANG Peng#, LIU Ping#, LI Qiu-wen, LU Yue-mei, WANG Ling-wei 2019, 4 (3):  169-172.  Abstract ( 630)    PDF (1030KB) ( 958 )    Objective To analyze the clinical recognition of talaromyces marneffei infection complications in an HIV-negative patient with lung cancer in clinical manifestations, diagnosis and treatment. Methods The clinical manifestations, pathological characteristic, imaging manifestations, diagnosis, the therapy and review of literature of a patient with talaromyces marneffei infection complications in an HIV-negative patient with lung cancer were presented. Results The HIV-negative patient was a 52-year-old male, with cough, expectoration, dyspnea and wasting as the main symptom. Themicrobes of sputum culture were Talaromyces marneffei. The pulmonary nodule in the right upper lobe was pathologically confirmed as lung adenocarcinoma.Combined with the clinical symptoms, the patient was diagnosed as lung adenocarcinoma with Talaromycosis marneffei. Conclusion Patients with non-HIV immunocompromised are high-risk groups of Marneffeinosis, which are clinically lack of characteristics. It can cause multiple organ damages and is easy to be misdiagnosed. For patients with life history in epidemic areas or immunocompromised patients, they should be alert to whether it is Talaromyces marneffei infection and make diagnosis and treatment as soon as possible.

Review

Research progress of Anti-tuberculosis drug-induced liver injury ZHANG Jin-xin, CHEN Juan-juan, PENG Jie 2019, 4 (3):  173-176.  Abstract ( 640)    PDF (917KB) ( 928 )    Anti-tuberculosis drug-induced liver injury (AT-DILI) is the leading adverse drug reaction during tuberculosis treatment. This review summarizes the latest information of incidence, risk factors, mechanism and prediction associated with AT-DILI. Better understanding of the mechanisms of AT-DILI may help to the individualized treatment and effective management of tuberculosis in the future.

Status in the prevention and control of neglected tropical diseases HUANG Da-na, ZHANG Ren-li, TANG Yi-jun, ZHANG Qin, HUANG Ya-lan, WU Wei-hua 2019, 4 (3):  177-180.  Abstract ( 255)    PDF (867KB) ( 979 )    With the growth of the global economy and the improvement of public health status, neglected tropical diseases have attracted the attention of the world health organization and non-governmental organizations in recent years. The elimination of neglected tropical diseases will have important implications for the achievement of the United Nations millennium development goals and social and health undertakings. This paper focuses on the prevention and control strategies of neglected tropical diseases in the world and the current situation and challenges neglected tropical diseases in China, to further improve the awareness and prevention ability of such diseases.

CurrentStatus of HIV drug resistance in China WU Ya-song, MA Ye 2019, 4 (3):  181-184.  Abstract ( 255)    PDF (868KB) ( 1414 )    The emergence and spread of drug resistant HIV strains can compromise the strategy of using antiretroviral drugs for treating and preventing HIV infection. HIV drug resistance surveillance and monitoring program have been gradually conducted since 2003. The HIV drug resitance operational framework was developed which including HIV drug resistance. Currently, China is mainly engaged in the surveilance of transmitted HIV drug resistance (TDR), pretreatment drug resistance (PDR) in naïve patients and acquired drug resistance (ADR) in individuals on ART. In most areas of China, the prevalence of TDR is relatively low, and the prevalence of non-nucleoside reverse transcriptase inhibitors (NNRTI) PDR is lower than 10%. The prevalence of HIV-1 DR in participants experiencing treatment failure is about 50%.The prevalence of HIV drug resistance is relatively low in China. However, with the increasing number of people receiving antiviral treatment, drug resistance rate increased in some regions. It is important to standardize surveillance and monitoring HIV drug resistance.

Application and development of artificial intelligence in detection and diagnosis of pulmonary nodules LI xin-ling, WANG Ying 2019, 4 (3):  185-189.  Abstract ( 329)    PDF (873KB) ( 1161 )    The mortality rate of lung cancer is very high. The detection of lung nodules by chest CT is of great significance for the early diagnosis and treatment of lung cancer. Computer-aided detection and diagnostic systems can help radiologists reduce workload and improve diagnostic accuracy. With the development of deep learning, computer-aided detection and diagnosis systems based on deep learning are also growing. This article reviews the application and development of artificial intelligence in the detection and diagnosis of pulmonary nodules.

Education Fields（Video）

Interpretation of "Chinese expert consensus on prevention and treatment of Zika virus disease (2019)" HONG Wen-xin, ZHANG Fu-chun 2019, 4 (3):  190-192.  Abstract ( 414)    PDF (902KB) ( 954 )    “Chinese expert consensus on prevention and treatment of Zika virus(ZIKV) disease(2019)”is formulated based on the latest domestic and international clinical practice and research Results . The consensus focuses on the epidemiological characteristics, pathogenesis, clinical and laboratory characteristics, diagnosis, treatment and prevention of ZIKV infection in order to improve the management of ZIKV infection in China.