Current Issue

2022 Vol.7 No.1 Published:28 February 2022

Forum of Specialist

Current studies in 2019-nCoV Omicron variant: implications for scientific prevention and control strategies Liao Kangsheng, Lu Hongzhou 2022, 7 (1):  1-5.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.001 Abstract ( 628)    PDF (1245KB) ( 601 )    Coronavirus disease 2019 (COVID-19) pandemic is still a great threat to global public health, with a daily increase of 1 738 701 cases and 5150 deaths in 11 January, 2022. Recently, multiple variants of 2019-nCoV have emerged around the world, especially the newly 2019-nCoV variant B.1.1.529 (Omicron), a variant of concern (VOC), which are harboring up large number of mutations in its spike protein, the target of multi-faceted immune response generated by both prior infection or vaccination, leading to the immune evasion of neutralization. Optimistically, Omicron infection produces milder disease than previous strains, such as increased proportion of asymptomatic or mild cases and fewer hospital admissions. However, global health systems could still come under huge pressure considering the super spread rate of Omicron variant, which has outcompeted Delta and other variants within weeks in some countries and regions. Therefore, here we reviewed the molecular mechanism underlying the immune evasion, milder pathogenicity and enhanced transmissibility of Omicron, and further provided scientific suggestions to prevent and control the Omicron variant.

Original Articles

Expression and significance of zinc-finger antiviral protein in enterovirus 71 infected mice Xie Li, Wang Feng, Zhong Yuquan, Yang Hui 2022, 7 (1):  6-11.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.002 Abstract ( 293)    PDF (1925KB) ( 409 )    Objective To explore the expression level of host protein ZAP in enterovirus 71 (EV71) infected mice and its regulatory effect, and to provide data basis for antiviral treatment of EV71. Method The C57BL/6 mice were randomly divided into 4 groups, blank control group (Control group), infection group (EV71 group), infection + ZAP plasmid group (ZAP group) and infection + empty plasmid group (Mock group). In the latter three groups, EV71 was injected intraperitoneally to establish the infection model, and the mice in the plasmid injection group were injected with plasmids into the retro-orbital venous plexus to construct a ZAP overexpression mouse model. Hematoxylin-eosin (HE) staining, Western blot and quantitative real time polymerase chain reaction (Q-PCR) were used to detect mice. Viral load, pathological changes and expression levels of ZAP and VP1 in different tissues were detected. Conclusion ZAP plays an important role in the immune response to EV71 infection, suggesting that ZAP overexpression can improve the sensitivity of mice to EV71 virus and the resistance to viral inflammation. This finding provides new insights into the role of ZAP in virus-induced inflammatory disease.

Kaempferol inhibits NLRP3 inflammasome activation and pyroptosis to improve survival of sepsis mouse Wu Senquan, Fang Xinnian, Mo Weiliang, Zhang Ping 2022, 7 (1):  12-16.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.003 Abstract ( 346)    PDF (1811KB) ( 355 )    Objective To explore effects of kaempferol on ATP-induced NLRP3 inflammasome activation and pyroptosis in lipopolysaccharide(LPS)-primed murine bone marrow-derived macrophages and the underlying mechanism, and regulation of survival of sepsis mouse. Method The primary bone marrow cells of 6-7 week old C57BL/6 female mice were extracted and induced to differentiate into bone marrow-derived macrophages. According to the experimental design, they were divided into blank control group, LPS treatment group, drug treatment group, LPS+ATP group (positive model group), positive model dosing group (three drug concentrations). The NLRP3 inflammasome was activated by treating with LPS plus ATP. The protein levels of caspase-1p20, IL-1β and GSDMD were detected by Western blotting. Soluble IL-1β in the culture supernatants was measured by CBA assay. Cell death/pyroptosis was analyzed by propidium iodide (PI) staining. After adding protein kinase A (PKA) inhibitor H89, the above indicators of inflammasome activation and pyroptosis were detected again. Cecal ligation puncture (CLP) was used to establish septicemia mouse model. Result Kaempferol inhibited caspase-1p20 activation and mature IL-1β secretion in the LPS-primed BMDMs upon ATP treatment. Kaempferol also suppressed GSDMD-NT formation and pyroptosis in macrophages. In addition, H89 significantly reversed kaempferol-mediated suppression of ATP-induced caspase-1p20 activation, mature IL-1β secretion and pyroptosis. We also observed that Intragastric administration of kaempferol can effectively improve the survival rate of sepsis model mice. Conclusion Kaempferol probably suppressed NLRP3 inflammasome activation and pyroptosis through promoting PKA signaling in macrophages to improve the survival rate of sepsis mice.

IL-6 gene-572C/G polymorphism regulates the binding activity of nuclear extract with the promoter Fu Jiapeng, Liu Shuyan, Li Fang, Ou Min, Liang Zhihang, Wu Jilin 2022, 7 (1):  17-20.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.004 Abstract ( 401)    PDF (916KB) ( 347 )    Objective To investigate the effect of -572C/G polymorphism on the binding activity of IL-6 gene promoter and nuclear extract, it provides a reference for predicting the occurrence and development of diseases. Method A sequence of the IL-6 promoter region, from -1029 to 52 obtained from a subject with C allelotype at position -572 was cloned into the pGL3-Basic vector. The pGL3/-572C vector was mutated to pGL3/-572G, using Site-DirectedMutagenesis Kit.The IL-6 promoter luciferase vectors were transfected into HeLa cells, and the effects of -572C/G gene polymorphism on promoter activity was determined using Dual-Glo luciferase assay system.The single-stranded complementary oligonucleotides covering the IL-6 promoter region -572 site were designed and synthesized, and biotin-labeled at the 3' end. Then annealed to form a double-stranded oligonucleotide, which is then incubated with HeLa cell nuclear extracts, and the effects of IL-6 allele-572C/G on the binding activity of nuclear extract was analyzed by electrophoretic mobility-shift assay (EMSA). Result The transcription activity of pGL3/-572C in HeLa cells was significantly higher than that of pGL3/-572G, and the difference was statistically significant (P<0.01); EMSA Resultshowed that one strong band (complex 1) and one super shift band was shifted when the nuclear extracts were incubated with biotin-labeled C probe, In contrast, there was much less complex 1 formation on the G probe. Furthermore, complex 1 formation was specifically blocked by unlabeled C or G competitor. These result indicated that -572 C alleles variant increased the binding activity of more nuclear protein to an IL-6 promoter region, to form the transcription initiation complex. Conclusion The -572C/G polymorphism can affect the transcriptional activity of the IL-6 promoter and regulate the binding activity of nuclear extracts of IL-6 promoters.

Application of metagenomic next generation sequencing of cerebrospinal fluid in central nervous system infectious diseases suspected of AIDS Zeng Qin, He Kun, Yang Honghong, Wu Yushan, Li Mingjun, Shi Feng, Liu Qian, Liu Min 2022, 7 (1):  21-25.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.005 Abstract ( 547)    PDF (928KB) ( 469 )    Objective To evaluate the application value of metagenomic next generation sequencing (mNGS) in AIDS suspected central nervous system (CNS) infection, provide reference for diagnosis of AIDS complicated with CNS infection. Method In our hospital between July 2019 and July 2020, 73 cases of suspected AIDS CNS infections in patients with cerebrospinal fluid mNGS parallel data were retrospectively analyzed, collect clinical manifestations, imaging data, cerebrospinal fluid examination Result,calculate infections, a positive analysis of infection type, etiology.The pathogens detected by routine etiology examination and mNGS were compared, which was consistent with the clinical diagnosis Finally, the application value of mNGS in these patients was evaluated. Result Among 73 patients, Headache, dyskinesia and fever were the main clinical manifestations, and the incidence rates were 69.9% (51/73), 54.8%（40/73）and 49.3% (36/73), respectively. Immune function was severely impaired, and CD4+T lymphocyte count was <200 cells/μl in 67 patients (91.8%). Finally, 46 (63.0%)patients were clinically diagnosed as CNS infection, and 46 patients received a total of 57 times of etiological diagnosis. The overall positive rate of mNGS combined with conventional examination was 82.5% (47/57), and the positive rate of mNGS was 64.9% (37/57) higher than that of conventional examination 42.1%(24/57), the difference was statistically significant (P=0.015). In 23 cases of virus infection, the positive rate of mNGS diagnosis was 87.0% (20/23), which was higher than that of conventional examination 34.8%(8/23), and the difference was statistically significant (P=0.007). Conclusion AIDS patients have impaired immune function,high rate of central nervous system infection and low positive rate of routine etiological examination,mNGS has better diagnostic value,combined with conventional examination method, mNGS has complementary advantages and can significantly improve the positive rate of etiological diagnosis, which is worthy of clinical promotion.

Comparison of clinical features and prognosis of severe fever with thrombocytopenia syndrome transmitted from tick-to-person versus person-to-person Zhang Aiping, Liang Manman, Wang Zijian, Wang Wenjie, Yang Jianghua 2022, 7 (1):  26-29.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.006 Abstract ( 436)    PDF (888KB) ( 388 )    Objective By analyzing the clinical features and prognostic indicators of novel phlebovirus infection in different ways induced severe fever with thrombocytopenia syndrome(SFTS), it provides a reference for the prevention and control of the disease and early prognosis. Method Retrospective analysis of the confirmed cases of SFTS from January 2015 to June 2020 in Yijishan Hospital, Wannan Medical College, according to the different transmission routes, they were divided into tick-to-persontransmission infection group (37 cases) and person-to-person transmission infection group (12 cases). The epidemiological characteristics, clinical manifestations, blood biochemical examination and prognosis were analyzed retrospectively. Result The incidence of SFTS mainly occurred in April to June, and the infection route of the person-to-person transmission infection group was contact with the blood/body fluids of the confirmed patients. The tick-to-person transmission infection group was infected by tick bites during outdoor activities.The median time from onset to treatment was 2.5 days in person-to-person transmission infection group and 5.0 days in tick-to-person transmission infection group,the difference between the two groups was statistically significant(P<0.05).The proportion of consciousness disorder in tick-to-person transmission infection group was 43.24% (16/37) higher than that in person-to-person transmission infection group.The number of critical patients in person-to-person transmission group was 16.67%(2/12), which was significantly lower than 91.89% (34/37) in tick-to-person transmission infection group. The number of deaths in ticks-to-person transmission infection group was 29.73% (11/37), but none in person-to-person transmission infection group. Conclusion The tick-to-person transmission infection group is more serious and the risk of poor prognosis is higher, so we should scientifically formulate prevention and control strategies and treatment plans for ticks infection patients.

Comparison the efficacy of tenofovir disoproxil fumarate vs telbivudine during the third trimester in pregnant women with high viral load of hepatitis B virus in maternal-infant blocking and infant vaccine immune responses Shi Jinmei, Yang Lixin, Bai Shufen 2022, 7 (1):  30-33.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.007 Abstract ( 395)    PDF (860KB) ( 436 )    Objective To observe the efficacy of tenofovir disoproxil fumarate (TDF) and telbivudine (LdT) treatment during the third trimester in preventing mother-to-child transmission of hepatitis B virus (HBV) and the immune response to hepatitis B vaccine in infants aged 12 months and 24 months,provide reference for mother to child interruption of hepatitis B. Method 189 mothers with both hepatitis B surface antigen (HBsAg)and Hepatitis B e-antigen (HBeAg) positive and high viral load (HBV DNA≥1.0×106copies/ml) who delivered at the Second Hospital of Nanjing from January 2016 to December 2018 were enrolled in this study. Pregnant women were divided into three groups according to therapy strategy: A group, TDF treatment group (61 pregnancies); B group, LdT treatment group (97 pregnancies); C group, non-antiviral treatment group (31 pregnancies). The viral load and HBeAg titer of pregnant women before medication and delivery were observed HBsAb titer of 150 infants aged 12 months and 24 months were followed up. Statistical analysis was performed using SPSS 25.0 software. Result The viral load and HBeAg titer of A and B group were both decreased. There were statistical difference before medication and before delivery within group A and B (P<0.05), while no statistical difference existed between the two groups (P>0.05). The level of HBV DNA and HBeAg of group C before delivery was not statistically different from that before medication (P>0.05). No infant in A or B group was infected with HBV with a 100% blocking rate. There was one infant in C group infected with HBV through intrauterine infection,therefore the success rate of mother-to-child transmission blocking in C group was 96.8%. We compared HBeAb titer of infants aged 12 months who had responded actively to hepatitis B vaccine among three groups and found no statistical difference (P>0.05). HBeAb titer of infants aged 24 months in group A was higher than other groups with statistical differences(P<0.05). There was no obvious adverse reaction to either drug. Conclusion TDF and LdT used at third trimester for mothers is safe and effective in blocking mother-to-child transmission with a high blocking rate. Infants in all groups responded actively to the combined immunoprophylaxis.

Levels of TGF-β, IL-10, IL-17 and IL-21 in peripheral blood of AIDS patients and its relationship with overlapping HBV infection Si Guo, Yang Jing, He Hong 2022, 7 (1):  34-38.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.008 Abstract ( 281)    PDF (865KB) ( 441 )    Objective To investigate the change of the levels of transforming growth factor-β (TGF-β), interleukin-10 (IL-10), interleukin-17 (IL-17) and interleukin-21 (IL-21) in peripheral blood of acquired immune deficiency syndrome (AIDS) patients and its relationships with overlapping hepatitis B virus (HBV) infection, to provide reference for clinical treatment and prevention and control. Method AIDS patients (research group) and healthy people (control group) were selected, and the levels of TGF-β, IL-10, IL-17 and IL-21 in peripheral blood of all subjects were detected. Followed up for 1 year, the patients of the research group were divided into overlapping infection group and non-overlapping infection group according to the overlapping HBV infection, and the levels of the above factors in the two groups were compared, and the relationships between the levels of each factors and the overlapping HBV infection in AIDS patients were analyzed by multivariate Logistic regression analysis method. Result The levels of TGF-β and IL-10 in peripheral blood of the research group [(13.62±2.48)ng/ml and (6.61±1.29)pg/ml] were higher than those of the control group[(5.24±0.93）ng/ml and（1.96±0.38）pg/ml], while the levels of IL-17 and IL-21 [(26.41±5.07)pg/ml and (86.35±16.48)pg/ml] were lower than those of the control group[(58.23±10.16）ng/ml and（257.19±41.35）pg/ml], and the differences were statistically significant (t=40.588, 44.231, 37.671, 51.827, all P<0.001). Followed up for 1 years, the rate of overlapping HBV infection of AIDS patients was 13.44% (25/186). The levels of TGF-β and IL-10 in peripheral blood of the overlapping infection group [(16.75±3.22)ng/ml and (7.28±1.41)pg/ml] were higher than those of the non-over lapping infection group[(13.13±2.54）ng/ml and（6.51±1.26）pg/ml], while the levels of IL-17 and IL-21 [(23.06±4.48) pg/ml and (75.42±14.63) pg/ml] were lower than those of non-over lapping infection group[(26.93±5.04）pg/ml and（88.05±16.59）pg/ml], and the differences were statistically significant (t=6.382, 2.797, 3.622, 3.594, all P<0.05). Multivariate Logistic regression analysis showed that family history of HBV infection, poor coordination of AIDS treatment and the high TGF-β level and high IL-10 level in peripheral blood were all risk factors for overlapping HBV infection in AIDS patients (OR=3.842, 2.588, 3.615, 3.111, P<0.05), but hepatitis B vaccination history and IL-17 level and IL-21 level in peripheral blood were protective factors (OR=0.427, 0.520, 0.534, P<0.05). Conclusion The levels of TGF-β and IL-10 in peripheral blood of AIDS patients are abnormally increased, but the levels of IL-17 and IL-21 are abnormally decreased, and high levels of TGF-β and IL-10 can increases the risk of overlapping HBV infection in AIDS patients, while high levels of IL-17 and IL-21 can reduce the risk of overlapping HBV infection in AIDS patients.

Spectrum analysis of malignant tumor diseases in hospitalized AIDS patients Qin Yaqin, Luo Feng, Li YanJun, Wei Zheng 2022, 7 (1):  39-42.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.009 Abstract ( 389)    PDF (840KB) ( 478 )    Objective To explore the spectrum of malignant tumor in AIDS patients in our hospital, and to provide scientific data for epidemiological study and treatment of AIDS in Guangxi. Method the clinical data of 12711 AIDS patients admitted to Nanning Fourth People's Hospital from January 2014 to December 2019 were collected and analyzed. The types and distribution, age distribution and incidence rate of six cases of AIDS in hospital were analyzed. Result among the 12 711 AIDS patients, 755 cases developed malignant tumors, accounting for 5.94% of the total number, including 236 cases (1.86%) AIDS related tumors (ADCs) and 519 cases (4.08%) non-HIV defined tumors (NADCs), with 64 tumor types. The top five NADCs are malignant tumors of digestive tract, respiratory tract, female reproductive tract, urinary system and skin system. The incidence rate of malignant tumor in male patients with AIDS was significantly higher than that in female patients (χ2=11.891, P<0.01). The proportion of lymphoma and liver cancer in male AIDS patients was significantly higher than that in females (χ2= 13.594, 11.160, P<0.01), and the incidence of colorectal cancer in female patients was significantly higher than that in male patients (χ2=7.951, P<0.01). The incidence rate of malignant tumor in AIDS patients was six years, and was similar to that of lymphoma, Posey's sarcoma, respiratory tract malignant tumor and digestive tract malignant tumor. Conclusion The incidence rate of malignant tumor is higher in AIDS patients, the disease spectrum is different. Non-HIV defined cancer is the most common. The most common malignant tumor is digestive system. Men are more likely to have lymphoma and liver cancer and women are more likely to have colorectal cancer. There was a little change in the tumor spectrum over the6 year period.

Analysis of risk factors of decompensated hepatitis B liver cirrhosis with bacterial infection Chen Shangjun, Zhang Ji, Xie Husheng, Liang Xuesong 2022, 7 (1):  43-46.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.010 Abstract ( 497)    PDF (842KB) ( 361 )    Objective To explore the risk factors of bacterial infection associated with decompensated hepatitis B liver cirrhosis, and provide a reference for the formulation of prevention and treatment measures for bacterial infection associated with decompensated hepatitis B liver cirrhosis. Method A retrospective analysis of 316 patients with hepatitis B and liver cirrhosis who were admitted to Naval Hospital, Eastern theater of PLA from March 2019 to December 2020 in the decompensated period. Collect relevant indicators that may cause decompensation of hepatitis B liver cirrhosis accompanied by bacterial infection and cultivate pathogenic bacteria by professionals in accordance with the National Clinical Laboratory Practice Code (3rd Edition). According to the culture result, the patients were divided into positive group and negative group. The above indicators were compared between the two groups. Multivariate Logistic regression analysis was used to determine the comprehensive influence of each indicator on decompensated hepatitis B liver cirrhosis with bacterial infection. Result Among the 316 patients with hepatitis B liver cirrhosis in the decompensated stage of this investigation, a total of 73 cases (23.10%) were infected, 243 were negative (76.90%) . The result of multivariate logistic regression analysis showed that age>60 years old, child Pugh C, invasive operation, ascites, gastrointestinal bleeding, serum albumin level decreased as risk factors of bacterial infection in patients with decompensated hepatitis B cirrhosis (P<0.05). Conclusion The incidence of decompensated hepatitis B liver cirrhosis accompanied by bacterial infection is relatively high, which is mainly affected by the patient's age, Child-Pugh classification, invasive operation and other factors, and clinically targeted interventions can be developed to reduce the incidence of bacterial infections among these patients based on the these factors.

Application of autoregressive integrated moving average model in the forecasting of tuberculosis epidemic situation in Bao'an District, Shenzhen Zhang Juanjuan, Wang Yunxia, Hu Fangxiang, Huang Peipei, Liu Zhenyang, Mei Jinzhou, Yuan Qing 2022, 7 (1):  47-51.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.011 Abstract ( 297)    PDF (1099KB) ( 469 )    Objective To establish an autoregressive integrated moving average (ARIMA) model to predict the monthly incidence of tuberculosis in Bao'an District, Shenzhen, and to provide a scientific reference for the formulation of tuberculosis prevention and control measures. Method The number of patients reported monthly in Bao'an District, Shenzhen from 2006 to 2020 was derived from the tuberculosis information management system of the China Disease Control and Prevention System. Use IBM SPSS 20.0 statistical software to establish a time series based on the number of patients reported monthly from January 2006 to December 2019, construct an ARIMA model, and screen out the optimal model through identification, ranking, and diagnosis of the model. The model is used to predict the monthly incidence of tuberculosis from 1 to 12 in 2020, and the prediction effect of the fitted model is evaluated by comparing the predicted value with the actual value. Result The parameters of the ARIMA(1,0,0)(0,1,1)12 model passed the statistical test (P<0.05), and the residual sequence was a white noise sequence (P>0.05, R2=0.561, RMSE=22.632, NBIC=6.336), the goodness of fit is relatively good. The predicted value from January to December 2020 is basically consistent with the actual value, and the actual value falls within the 95% CI, and the prediction effect is good. Conclusion The ARIMA(1,0,0)(0,1,1)12 model can be used for short-term prediction of tuberculosis epidemic in Bao'an District, Shenzhen, and the prediction effect is good.

Analysis on the epidemic characteristics and trend of AIDS in Shiyan City, Hubei Province Chen Hongxia, Hu Yueyi, Deng Xiao 2022, 7 (1):  52-55.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.012 Abstract ( 1210)    PDF (894KB) ( 701 )    Objective To analyze the characteristics and changing trends of the AIDS epidemic from 1998 to 2020 in Shiyan City, providing a scientific basis for formulating precise AIDS prevention and control measures. Method To collect the AIDS epidemic data reported in Shiyan City from 1998 to 2020 for retrospective epidemiological analysis. Result Totally, 1496 cases of AIDS were reported in Shiyan City from 1998 to 2020, according to statistics based on current address and final review date, including 1093 males and 403 females, with a sex ratio of 2.71:1. 1094 AIDS cases survived in the city by the end of 2020. Based on the 2020 Shiyan City Census Data of 3.21 million, the prevalence of AIDS in Shiyan City was 33.25 per 100 000. The number of reported cases from 1998 to 2020 was increasing, as well as the fatality rate.The age of people living with AIDS varied from 20 to 49 years old, accounting for 63.37%; the farmers were the main occupation, accounting for 46.39%; the transmission route was mainly sexual transmission, accounting for 86.83%, followed by blood transmission, accounting for 10.63%. Conclusion The majority of HIV-infected person in Shiyan City were young and middle-aged males, and sexual contact was the main route of transmission. In recent years, the infection rate of the elderly and young students has grown rapidly, suggesting that the city should take comprehensive prevention and control measures according to the epidemic characteristics.

Analysis of risk factors for death of AIDS patients complicated with cryptococcus neoformans meningitis Huang Lixue, Li Sha, Li Qian, Teng Xiaoyan, Li Jieying, Wei Caiyun, Wu Fengyao 2022, 7 (1):  56-59.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.013 Abstract ( 390)    PDF (839KB) ( 398 )    Objective To explore the risk factors of acquired immune deficiency syndrome (AIDS) complicated with cryptococcal meningitis (CNM) death, and combined exploring nursing countermeasures in the process of clinical diagnosis and treatment, for the optimization of clinical diagnosis and treatment and nursing intervention measures to improve the reference to reduce the mortality. Method From January 2012 to December 2020, 57 AIDS patients with CNM deaths were admitted, and their clinical and nursing-related data were retrospectively analyzed, including HIV infection pathways, clinical manifestations, complications, and laboratory test result. Result Among 57 AIDS patients, 24 cases (42.1%) died within 1 month of hospitalization, and the median death time was 14 days. There were 49 cases of headache (86.0%), 40 cases of fever (70.2%), 36 cases (63.2%) of vomiting, 20 cases (35.1%) of consciousness disorder and 13 cases (22.8%) of vision loss. Fifty-three cases (93.0%) complicated with lung infection. There was increased cerebrospinal fluid pressure (≥180mmH2O) in 48 cases (84.2%), decreased hemoglobin content (<90g/L) in 31 cases (54.4%), and decreased blood potassium concentration (<3.5mmol/L) in 53 cases (93.0%). Decreased count of CD4+T lymphocytes (<100cells/μl) was detected in 56 cases (98.2%). Conclusion The clinical manifestations of AIDS patients with CNM are complex, and the disturbance of consciousness, pulmonary infection, cerebrospinal fluid pressure, low blood potassium and low CD4+T lymphocyte count are important clinical manifestations for death of AIDS patients with CNM. Medical staff should improve the understanding of this disease, strengthen monitoring and care, and detect and deal with various complications in time, so as to reduce the mortality rate.

Investigation and analysis on knowledge and practice of nosocomial infection prevention and control of supporting nurses in non-infectious department Yu Qi, Song Yan, Liu Sicong, Wang Mengmeng, Zhang Ailing 2022, 7 (1):  60-65.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.014 Abstract ( 378)    PDF (947KB) ( 336 )    Objective Investigate the current situation and related influences of factors of knowledge, belief and practice of nosocomial infection prevention and control among nurses in non-infectious departments in the isolation ward of novel coronavirus pneumonia. In the context of public health emergencies, nursing managers can formulate and improve the knowledge and information of nosocomial infection prevention and control for non-infectious department anti-epidemic support nurses. It provides a theoretical basis for the intervention strategy at the overall level. Method The self-designed Questionnaire on Knowledge, Confidence and Practice of Nosocomial Infection Prevention and Control of Supporting Nurses in Non-infectious Department was used to investigate the non-infectious department nurses of medical teams in 18 tertiary general hospitals from July 2021, who fought against COVID-19 in the isolation ward of Nanjing Public Health Medical Center. Result 438 questionnaires were sent out and 435 valid questionnaires were recovered, with an effective response rate of 99.32%. The score rates of knowledge, attitude, behavior and knowledge of nosocomial infection prevention and control among 435 anti-epidemic support nurses in non-infection department were 72.82%, 97.39%, 97.36% and 95.15%, respectively. The result of multivariate analysis showed that gender was the influencing factor of knowledge level of nosocomial infection prevention and control, age and the degree of attention of leaders were the influencing factors of attitude level of nosocomial infection prevention and control, and the degree of leadership attention was the influencing factor of behavior level of nosocomial infection prevention and control. Gender, age and leadership attention were the influencing factors of knowledge, belief and practice in nosocomial infection prevention and control (P<0.05). Conclusion The overall level of knowledge, attitude, behavior, knowledge, belief and practice of nosocomial infection prevention and control of anti-epidemic support nurses in non-infection department is high, but the knowledge dimension is still insufficient. Nursing managers can try to start with the factors that affect the level of knowledge, belief and practice of nosocomial infection prevention and control, and take targeted intervention strategies for supporting nurses to ensure that measures for nosocomial infection prevention and control are in place.

The application effect of internet + video medication APP supervision in the treatment and management of tuberculosis patients Zhang Xiaoqi, Li Minlu, Liu Jingyuan 2022, 7 (1):  66-69.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.015 Abstract ( 299)    PDF (839KB) ( 365 )    Objective To evaluate the application effect of Internet technology plus video medication APP in the management of tuberculosis patients, so as to provide reference for tuberculosis prevention and treatment. Method Smear positive pulmonary tuberculosis patients registered in Longgang District of Shenzhen in from January 2018 to December 2019 were selected as the research objects. According to the two different supervision Methodselected by the patients, the observation group and the control group were randomly selected according to the random table method, each group of 108 patients. The observation group was supervised by Internet plus video therapy APP. The control group was managed by routine supervision. The treatment compliance, treatment total effectiveness and patient health management quality indexes of the two groups were compared and analyzed. Result There was no significant difference in gender, age and occupation between the two groups. The treatment compliance and treatment total effectiveness of the observation group were higher than those of the control group (90.74% vs 73.15%, 92.59% vs 81.48%). The family visit rate (79.63% vs 38.89%) and patient management rate (95.37% vs 85.20%) of the two groups There were significant differences in standardized management rate (87.96% vs 74.07%) and regular medication rate (96.30% vs 85.19%) (P<0.05). Conclusion The use of internet plus video APP supervision and management can effectively improve the treatment compliance, treatment total effectiveness and quality of patient health management of pulmonary tuberculosis patients, and it has a good role in promoting TB prevention and control.

Case Report

Imaging features and literature analysis of a case of ileal tuberculosis with cold abscess of the right inguinal Deng Li, Zhang Guichuan, Ge Hai, You Lianbo, Bao Zihua, Wang Junda 2022, 7 (1):  70-72.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.016 Abstract ( 509)    PDF (1740KB) ( 489 )    Objective To explore the imaging manifestations of cold abscess in the groin area and analyze it in combination with the literature to provide favorable support for the diagnosis of intestinal tuberculosis abscess in the future. Method A case of Intestinal tuberculosis with abscess to the right groin area was analyzed retrospectively. Result The characteristic manifestation of cold abscess in the groin area is spreading to the periphery and descending in a stream-like manner, with no upward spreading trend. The abscess in enhanced CT scans is enhanced in a ring shape,MRI manifestations are mostly confounding signals with low T1WI and high or slightly higher T2WI.Conclusion Intestinal tuberculosis complicated by cold abscess in the inguinal area is very rare. It can be differentiated by CT, MRI and other imaging findings to improve the preoperative diagnosis rate, provide an effective basis for clinicians to formulate treatment plans, and reduce the chance of misdiagnosis and missed diagnosis.

Guidelines and Consensus

Expert consensus on diagnosis and treatment of Mycobacterium tuberculosis infection in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome Professional Committee of HIV Combined with TB, Chinese Association of STD, AIDS Prevention, Control 2022, 7 (1):  73-87.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.017 Abstract ( 606)    PDF (833KB) ( 899 )    In 2017, the AIDS Group of Infectious Diseases Branch of the Chinese Medical Association and the AIDS Group of tropical Diseases and Parasitology of the Chinese Medical Association jointly formulated and issued the first edition of the expert consensus on the diagnosis and treatment of HIV combined with Mycobacterium tuberculosis infection. In 2021, Professional Committee of HIV Combined with TB, Chinese Association of STD and AIDS Prevention and Control revised and updated the first version of the consensus. The new consensus has updated the tuberculosis prophylaxis treatment in HIV/AIDS patients, the molecular diagnosis of tuberculosis, the treatment of drug-resistant tuberculosis, the timing and regimen of antiretroviral therapy, the diagnosis and treatment of tuberculosis-related immune reconstitution inflammatory syndrome, and management of side effects. This consensus will be updated regularly based on the latest clinical research evidence.

Review

Analysis of virological characteristics of 2019-nCoV mutant strain concerned by WHO Lu Hongxi, Liu Gang, Chen Xin 2022, 7 (1):  88-91.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.018 Abstract ( 482)    PDF (840KB) ( 534 )    The outbreak of coronavirus disease 2019 poses a serious threat to human life and safety. At present, there is no clear and effective antiviral therapy for large-scale clinical use, so there are great difficulties in antiviral therapy. After the advent of the 2019-nCoV vaccine, it has shown good protective effect on the population. However, the virus is highly susceptible to mutation and the emergence of mutated strains that reduce the protection of existing vaccines against human infection and increase the risk of 2019-nCoV infection. In this paper, the virology characteristics of seven 2019-nCoV mutant strains concerned by the World Health Organization are briefly described, and the virology characteristics of seven mutant strains are summarized and analyzed, providing ideas for clinical diagnosis, treatment and drug research of this virus, with important clinical significance.

Research progress in hepatocellular carcinoma associated with hepatitis B virus and hepatitis C virus Li Xiaoyue, Li Shujie, Yi Yongxiang 2022, 7 (1):  92-99.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.019 Abstract ( 319)    PDF (867KB) ( 586 )    Hepatitis B virus (HBV) and hepatitis C virus (HCV) related primary hepatocellular carcinoma (HCC) is caused by complex mechanisms, which led to the host's immune dysfunction with chronic inflammation and to produce inflammatory factors that regulate multiple cancer signaling pathways. DNA fragment of HBV can insert into host genome to cause occurrence of HCC. Genome of HCV cannot be integrated into host genome, but it can induce the occurrence and progression of HCC by viral proteins and regulation of specific oncogenic pathways to induce reactive oxygen species(ROS) that damage host DNA and lead to gene mutation. Currently, in addition to the classic antiviral therapy, therapy of traditional Chinese medicine HBX targeted therapy, platelet therapy and engineered T cell therapy also show great prospects and advantages for the treatment of virus-associated HCC. In the review, we will summarize the research progress on the mechanism and treatment of HBV/HCV-associated HCC, and confer clues for future research directions.

Education Fields

The clinical value of diagnosis and treatment guidelines timely updated for prevention and control of COVID-19 Wu Weigang, Yang Zhi, Ou Pengcheng, Zeng Furong, Lyu Xiaoqing, Wang Jialu, Guo Jianwei, Wu Shipin, Yang Guilin 2022, 7 (1):  100-103.  DOI: 10.19871/j.cnki.xfcrbzz.2022.01.020 Abstract ( 347)    PDF (910KB) ( 345 )    Analyzed the diagnosis process of a patient infected with coronavirus disease 2019(COVID-19) who visited relatives in Shenzhen, to clarified the clinical value of the diagnosis and treatment guideline for prevention and control of COVID-19. On January 21, 2020, the patient was absence of fever and no pneumonia imaging findings by CT scanning，it did not meet the diagnostic criteria for suspected cases,so the patient just be required for home quarantine and observation. However, according to the new version of guideline issued by the National Health Commission of the People’s Republic of China on January 27, 2020, the patient must be required for home quarantine and observation which clinical feature was met the diagnostic criteria for suspected cases, so the missing diagnosis and community transmission were avoided. Therefore, during the outbreak of COVID-19, the diagnosis and treatment guidelines timely updated and published by the National Health Commission of the People's Republic of China were very practical which effectively controlled the epidemic of COVID-19.