Current Issue

2023 Vol.8 No.3 Published:30 June 2023

Original Articles

SIVgor has the capacity of zoonotic transmission and subsequent spread between humans Zou Wei, Wu Xiaoping, Chen Xinping, Liu Li, Zou Shijie, John Foster, J. Victor Garcia 2023, 8 (3):  1-6.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.001 Abstract ( 214)    PDF (4720KB) ( 415 )    Objective Western gorillas (Gorilla gorilla gorilla) are the natural hosts of simian immunodeficiency virusgorilla (SIVgor). The primary objective of our study is to determine whether SIVgor is capable of being transmitted to and replicating in humans. Method Human hematopoietic stem cells were transplanted into immune-deficient mice via tail veil dose to make the humanized mice reconstituted with a complete human hematopoietic system. Through determining HIV viral loads and CD4+T cell levels in humanized mice, the capacity of SIVgor to be transmitted after intravenous and mucosal exposure, to replicate in vivo and to kill CD4+T cells were evaluated. Result After intravenous exposure, SIVgor replicated very efficiently in humanized mice reaching viral loads comparable to HIV infected humans. In addition, humanized mice were susceptible to SIVgor infection after mucosal exposure. Both rectal and vaginal inoculation led to disseminated infection. However, despite high levels of virus replication these infections resulted in only a modest reduction in the levels of human CD4+T cells in the peripheral blood of humanized mice. However, effects of SIVgor infection on human CD4+T cells in other tissues except blood via three exposure routes were slightly different: CD4+T cells in the vagina decreased significantly after vaginal exposure while those in other tissues were preserved; after venous and rectal exposure human CD4+T cells in all the studied tissues were rarely affected. Conclusion SIVgor was able to infect humanized mice via both intravenous and mucosal routes and then replicate efficiently in the infected animals. Selective cytotoxicity for CD4+T cells in mucosal associated lymphoid tissues recapitulated HIV-1 infection of humans. Since humans are still exposed to SIVs from bushmeat, new zoonoses are likely to occur. Therefore, it is critical to establish model systems that can evaluate present and future dangers.

CRISPR/Cas9 silencing Fas inhibits autophagy formation and mitochondrial damage in acute liver failure cells Wu Zhijing, Zhang Wenyuan, Xu Zhiqi, Zhuang Peng 2023, 8 (3):  7-11.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.002 Abstract ( 247)    PDF (3014KB) ( 306 )    Objective In order to explore the role and mechanism of the death receptor Fas/CD95 in the progression of acute liver failure. Method We first established, a mouse animal model of ALF induced by concanavalin A (Con A). The formation of mitophagy in hepatocyte with ALF was detected by Western blot and transmission electron microscopy. Then, Knocking out Fas by administering CRISPR/Cas9 plasmid through the tail vein of mice,and then acute liver failure of mouse was induced by Con A, liver tissue injury, the formation of mitophagy and mitochondrial damage were detected. We treated HepG2 that knocked out Fas with Con A in vitro to detect the expression of mitochondrial autophagy related proteins and mitochondrial damage. Result The results show that after acute liver failure induced by concanavalin A in mice, transmission electron microscopy observation revealed mitochondrial autophagy in liver cells, a decrease in p62 protein levels, upregulation of PINK1/Parkin protein, and upregulation of Fas expression. After transfection with PX330Fas plasmid, the expression ratio of LC3II/LC3I in mouse liver tissue and in vitro liver cells decreased, the expression of p62 protein was restored, the levels of mitochondrial protein COX4I1 and mitochondrial DNA content decreased, and Fas expression was downregulated, with significant statistical significance. Conclusion In this study, we found that CRISPR/Cas9 silencing Fas inhibits the progression of ALF, the formation of mitochondrial autophagy and mitochondrial damage in hepatocytes.

Effect of antituberculosis drug pyrazinamide on neuronal activity Shao Honghua, Zhu Qingdong, Long Qian, Luo Xiaolu, Nong Jianhong, Li Sijun, Wu Fengyao 2023, 8 (3):  12-18.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.003 Abstract ( 191)    PDF (5394KB) ( 392 )    Objective Previous study suggests that pyrazinamide (PZA), a common anti-tuberculosis drug, may lead to neuronal damage. The mechanism of neuronal damage caused by PZA remains unclear. To further investigate the potential mechanism of neuronal damage caused by PZA , We constructed an in vitro model to study the effect of PZA on neurons. Method The in-vitro neuron model were constructed, which were incubated with different concentrations of PZA for 6h. Optimal concentration of PZA was selected. Based on optimal concentration, the neurons were then incubated with PZA (10µmol/L) for 12h (10-PZA-12h), and the neurons were incubated with PZA(10µmol/L) for 6h and then replaced with normal medium for another 6h (10-PZA-normal-6h). We observed the structure and morphology of neurons and detected the ATP content, survival rate, expression of Na+/K+-ATPase α1 subunit(ATP1A1), electrophysiology—resting potential (RP) and action potential (AP) in neurons. Result After the neurons were incubated in PZA (10µmol/L) for 6h, the neuronal structure, morphology and survival rate were not significantly changed, but the ATP content, the expression of ATP1A1 and amplitude of AP were decreased. Inversely, the RP was increased. In 10-PZA-12h group, the morphology and structure of neurons were changed; the ATP content, neuronal survival rate, the expression of ATP1A1 and amplitude of AP were significantly decreased; the RP was increased. In 10-PZA-normal-6h group,the neuronal morphology and structure, ATP content, survival rate, the expression of ATP1A1 and amplitude of AP and RP were not significantly changed. Conclusion PZA inhibits the activity of neurons. With the extension of drug action time, the neurons appear damage,and timely removal of inducement can save neurons.

Predictive value of MELD-ICGR15 score for complications in patients with liver cirrhosis Yang Zhi, Wu Weigang, Ou Pengcheng, Chen Hongtao, Zeng Furong, Xie Dongyuan, Yang Lin, Yang Guilin 2023, 8 (3):  19-24.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.004 Abstract ( 220)    PDF (1220KB) ( 349 )    Objective To analyze the relationship between MELD score and ICGR15 score in patients with liver cirrhosis, and to compare the predictive efficacy of complications about ICGR15, MELD and MELD-ICGR15 score in patients with liver cirrhosis within six months and forward, so as to provide clinical basis for the choice of prevention and treatment timing of complications. Method A total of 112 patients admitted to the Department of Infectious Diseases, Shenzhen People's Hospital from April 2017 to April 2018 were enrolled. The ICGR15, MELD and MELD-ICGR15 scores of each patient were calculated. Complications within a period of time (six months,one year,two years, three years respectively)were observed. The relationship between ICGR15, MELD, MELD-ICGR15 score and complications was analyzed,to evaluate the predictive value of ICGR15, MELD and MELD-ICGR15 scores for complications in patients with cirrhosis. Sensitivity, specificity,and area under the receiver operating characteristic (ROC) curve (AUC) were used. Result The complication rate of were 48.2% (54/112)、50.0%（56/112）、50.9%（57/112）、50.9%（57/112）during six month, one year, two years, three years respectively. There was no statistically significant difference in age(t=-0.929, P=0.357), sex (χ2=0.429, P=0.521), serum creatinine (Cr) (t=-1.229, P=0.224) and INR (t=-1.825, P=0.069) between the group with and without complication. There have statistically significant differences in total bilirubin (TBil) (t=-2.869, P=0.006), serum albumin (ALB) (t=4.998, P<0.001), ICGR15(t=-5.264, P<0.001), MELD score (t=-4.678, P<0.001) and MELD-ICGR15 score(t=-6.041, P<0.001) between the two groups (P<0.05). The area under the ROC curve (AUC) of the MELD-ICGR15 score was 0.866, the 95% confidence interval was 0.799 to 0.933, the cut-off value was 47.5, the corresponding sensitivity was 0.870, and the specificity was 0.759. Incorporated in the observations among the metrics, the ROC curve of the MELD-ICGR15 score was the largest area, better than the ICGR15 (AUC: 0.824), MELD Score (AUC: 0.830),the area under the ROC curve of the MELD-ICGR15 score was the largest, better than the ICGR15 (AUC: 0.824) and MELD score(AUC: 0.830). Conclusion The ICGR15, MELD score and MELD-ICGR15 score can predict the complications in patients with cirrhosis within 6 months and forward, but the MELD-ICGR15 score is the best.

Clinical effect of tenofovir taken every other day in patients with HIV combined with chronic kidney disease Ou Ruzhi, Li Xueqin, Qin Yingmei, Dong Wenyi, Huang Xinxin 2023, 8 (3):  25-28.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.005 Abstract ( 336)    PDF (852KB) ( 411 )    Objective To analyze the effect of tenofovir (TDF) 300mg every other day on viral load and renal function in patients with HIV combined with chronic kidney disease, and to evaluate its clinical efficacy. Method patients with AIDS who treated with lamivudine (3TC) +TDF+ efevirenz/nevirapine (EFV/NVP) in the Department of Infectious Diseases of the Fourth People's Hospital of Nanning from January 2016 to December 2018 were retrospectively analyzed. Patients with AIDS combined with chronic kidney disease treated with TDF 300mg once every other day were included in the experimental group. Patients with AIDS without TDF dose adjustment were included in the control group. CKD-EPI Scr formula was used to calculate the estimated glomerular filtration rate (eGFR), and the virological outcome and renal function changes of patients after 96 weeks of treatment were analyzed. Result After 96 weeks of treatment, the virological suppression rates of the experimental group and the control group were 84% and 82%, respectively, with no significant difference between the two groups. The eGFR of the experimental group at 96 weeks was 90.4 (73.0, 101.0) ml/min, which was significantly improved from 83.3 (72.1, 93.6) ml/min at baseline (P<0.001). In the control group, the eGFR at 96 weeks was 110.7 (94.3, 118.1) ml/min, which was not significantly different from the baseline 110.6 (88.6, 115.9) ml/min (P=0.154). At 96 weeks, serum phosphorus decreased compared with baseline in both groups. Conclusion TDF 300mg once every other day can improve the renal function of patients with AIDS combined with CKD and maintain a good effect of antiviral therapy. It may be a new optimized treatment regimen.

Effect of lactobacillus and enterococcus powder besides combined with enteral nutrition in the prevention of VAP in patients with sepsis and mechanical ventilation Zhang Aihua, Lai Weihua, Wang Min, Qing Ming 2023, 8 (3):  29-33.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.006 Abstract ( 226)    PDF (1415KB) ( 422 )    Objective To observe the effect of bifidobacterium triple viable capsule combined with enteral nutrition via nasogastric tube in the prevention of ventilator-associated pneumonia (VAP) in patients with sepsis and mechanical ventilation, and its impact on nutritional status and immune function of patients. Method A total of 102 patients with septic mechanical ventilation admitted to the intensive care unit (ICU) of our hospital from September 2019 to January 2021 were randomly divided into C group (n=50) and L group (n=52). The patients in both groups were treated with enteral nutrition with nasogastric tube within 24-72h after admission. The L group was treated with lactobacillus and enterococcus powder besides on the basis of the C group, The nutritional indexes [serum total protein (TP), albumin (ALB), prealbumin (PA), hemoglobin (HB)] and immune indexes [CD3+, CD4+, CD4+/CD8+, secretory immunoglobulin A (SIgA)] of the two groups before and 14 days after treatment were statistically compared with VAP, bacteremia, disease death rate, mechanical ventilation time and ICU hospitalization time 28 days after treatment. Result 14 days after treatment, the levels of serum TP, ALB, PA and Hb in the L group were higher than those in the C group (P< 0.01). On the 14th day after treatment, the levels of serum CD3+, CD4+, CD4+/CD8+ and SIgA in the L group were higher than those in the C group ( P<0.05). The incidence rate of VAP in the L group was lower than that in the C group (χ2=3.922, P=0.048). The ventilation time and ICU stay in the L group were shorter than those in the C group (t=2.264, 2.054, P=0.013, 0.021). The incidence rate and mortality rate of the L group were lower than those of the C group, but the difference was not statistically significant (χ2=1.230, 0.631, P=0.267, 0.427). The incidence of gastric retention, abdominal distension, diarrhea and constipation in group L was lower than that in group C (χ2=5.480, 15.291, 15.653, 7.233,P=0.019, <0.001, <0.001, 0.007). Conclusion lactobacillus and enterococcus powder besides combined with enteral nutrition can improve the status of septic patients with mechanical ventilation, enhance immune function, reduce the incidence rate of VAP and shorten the length of stay in ICU patients with sepsis.

Effect of novel coronavirus spike protein on the secretion of inflammatory factors by mononuclear macrophages Ding Fang, Jiang Ping, Li Li, Zhang Xin, Dai Erhei, Yan Huimin 2023, 8 (3):  34-38.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.007 Abstract ( 266)    PDF (1507KB) ( 504 )    Objective The aim of this study was to investigate the role and mechanism of SARS-CoV-2 virus on the secretion of inflammatory factors by mononuclear macrophages. Method Fifty-three patients with confirmed COVID-19 hospitalized from January 21 to February 10, 2020 and January 3 to January 7, 2021 were selected from Shijiazhuang Fifth Hospital, fifty-three healthy controls each were included, and the results of medical records and routine blood test were collected. Mononuclear macrophages were stimulated with SARS-CoV-2 virus spiked protein, cell viability was detected by CCK-8 assay. The level of pro-inflammatory cytokines IL-6, IL-1β and CCL2 and the expression of signaling pathway molecules JAK1, STAT1 and NF-κB were detected by quantitative RT-PCR. Result The monocyte ratio and neutrophil ratio were higher, while the lymphocyte ratio, lymphocyte count, eosinophil ratio, and eosinophil count, and hematocrit were lower in COVID-19 patients than those in controls. After stimulation of mononuclear macrophages by SARS-CoV-2 virus spiked protein, cell viability was higher at concentrations of 100ng/ml and 300ng/ml (P=0.046). The highest mRNA expression levels of IL-6, IL-1β and CCL2 at a concentration of 500ng/ml (P<0.01, P=0.036, P<0.001). The expression of JAK1 and STAT1 at a concentration of 100ng/ml (P<0.001), the expression of NF-κB expression was increased at 300 and 500ng/ml stimulation (P<0.001). Conclusion SARS-CoV-2 viral spike protein may promote inflammatory cytokine secretion by mononuclear macrophages through the JAK1/STAT1 signaling pathway, which play a role in the cytokine storm.

A real-world study of the immunogenicity of inactivated SARS-CoV-2 vaccine Peng Xuping, Zhang Zhicheng, Zhang Dan, Rao Jianfeng, Wang Li, Li Xue, Ju Weihua, Tu Xianglin, Wang Shumei, Luo Daya, Liu Zhuoqi, Huang Yanxia, Ao Qinfang, Zhou Yalan, Chen Hongyi 2023, 8 (3):  39-43.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.008 Abstract ( 261)    PDF (1142KB) ( 559 )    Objective To study the immunogenicity and related factors of the 3 doses inactivated SARS-CoV-2 vaccine. Method People who received 3 doses of inactivated SARS-CoV-2 vaccine in Nanchang Ninth Hospital from December 2020 to October 2021 were selected, At 3 weeks after the first dose, 4 weeks,16 weeks and 32 weeks after the second dose, and 4 weeks after the third dose, the blood neutralizing antibody, IgG and IgM antibody were detected respectively. Result A total of 874 participants were enrolled, including 316 males and 558 females. The positive rates of neutralizing antibody were 26.2%, 86.6%, 74.2%, 78.2% and 98.1% respectively at 3 weeks after the first dose, 4 weeks, 16 weeks, 32 weeks after the second dose and 4 weeks after the third dose;The positive rates of IgG antibody were 25.1%, 93.2%, 59.3%, 45.7% and 96.8% respectively. The quantitation of neutralizing antibody and IgG antibody at 4,16,32 weeks after the second dose and 4 weeks after the third dose were significantly higher than those at 3 weeks after the first dose (P<0.0001); 16,32 weeks after the second dose were significantly lower than 4 weeks after the second dose (P<0.0001); 4 weeks after the third dose were significantly higher than 4 weeks after the second dose (P<0.0001). Conclusion Two doses of the inactivated SARS-CoV-2 vaccine can produce a large number of neutralizing and IgG antibodies to play the immune effect, and the addition of the third dose of booster can significantly increase the peak value of both.

The value of magnetic resonance imaging in the differential diagnosis of brucellosis spondylitis and spinal tuberculosis Li Huiru, Fang Weijun, Gao Zhenhua, Liu Zengwei, Xie Zhien 2023, 8 (3):  44-48.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.009 Abstract ( 232)    PDF (2460KB) ( 346 )    Objective To investigate the value of magnetic resonance imaging (MRI) in the differential diagnosis of brucellosis spondylitis and spinal tuberculosis,and to provide reference for the differential diagnosis of brucellosis spondylitis and spinal tuberculosis. Method To select the records of 87 patients with spinal tuberculosis in the Guangzhou Chest Hospital as spinal tuberculosis group, 23 patients with brucellosis spondylitis as spondylitis group （Guangzhou Chest Hospital 5 cases, Huiya Hospital of The First Affiliated Hospital, Sun Yat-sen University 18 cases）from January 2019 to December 2021, all patients were performed MRI, according to the comparison of two groups of parts image information, the number of vertebral involvement, the affected vertebral signal morphological characteristics, destruction of vertebral bodies and intervertebral disc narrow and abscess. Result There was no significant difference in the incidence site and number of vertebral body involvement between the two groups (P>0.05). There was a significant difference in the signal morphology characteristics of the affected vertebral bodies between the two groups (P<0.05),among which the proportion of diffuse signals in the spondylitis group (50.00%) was lower than that in the spinal tuberculosis group (88.89%), the proportion of focal signals (30.43%) was higher than that in the spinal tuberculosis group (11.11%), and the proportion of fan-shaped signals (23.08%) was higher than that in the spinal tuberculosis group (0).There was a significant difference between the two groups in terms of vertebral body destruction and intervertebral disc stenosis (P<0.05). Among them, the proportion of vertebral collapse (0) in the spondylitis group was lower than that in the spinal tuberculosis group (43.52%), the proportion of kyphosis deformity (3.85%) was lower than that in the spinal tuberculosis group (24.07%), and the proportion of bone destruction around the intervertebral disc (46.15%) was higher than that in the spinal tuberculosis group (10.19%). Comparison of abscess signals between two groups: the proportion of paravertebral abscesses in the spinal tuberculosis group (54.02%) was higher than that in the spinal tuberculosis group (30.43%), the proportion of abnormal signals in the paravertebral soft tissue in the spinal tuberculosis group (91.95%) was higher than that in the spinal tuberculosis group (52.17%), and the proportion of abscesses under the ligament in the spinal tuberculosis group ≥ 3 vertebral levels (6.67%) was lower than that in the spinal tuberculosis group (57.75%), with statistically significant differences (P<0.05); There was no significant difference in the proportion of epidural abscess (47.83%), epidural abscess with neurological symptoms (34.78%), and abscess under anterior longitudinal ligament (65.22%) between the spondylitis group and the spinal tuberculosis group (P>0.05). Conclusion The degree of bone destruction, vertebral signal shape, paravertebral abscess, paravertebral soft tissue abnormal signal, and abscess diffusion in MRI examination of patients with Brucella spondylitis and spinal tuberculosis are significantly different, which can provide an important reference for clinicians to identify the two diseases.

Analysis on distribution characteristics of pathogens, nutritional status and changes of serum inflammatory factors in elderly patients with acute respiratory failure and pulmonary infection Hao Yuhua, Zhang Xiaoqing, Jiang Bin, Xu Lulu 2023, 8 (3):  49-52.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.010 Abstract ( 212)    PDF (962KB) ( 348 )    Objective To explore the distribution characteristics of pathogens, nutritional status, changes and clinical significance of serum procalcitonin (PCT) and interleukin-17 (IL-17) levels in elderly patients with acute respiratory failure and pulmonary infection. Method A total of 70 elderly patients with acute respiratory failure and pulmonary infection admitted to Zhongshan Hospital Affiliated to Dalian University were enrolled as observation group between June 2017 and June 2021, while other 50 elderly patients only with pulmonary infection during the same period were enrolled as control group. After admission, all were scored by short-form mini-nutritional assessment (MNA-SF). The fasting venous blood was collected to detect serum PCT and IL-17. The application value of serum PCT and IL-17 in evaluating prognosis of elderly patients with acute respiratory failure and pulmonary infection was evaluated by ROC curves. Result In the 70 elderly patients with acute respiratory failure and pulmonary infection, there were 83 strains of pathogens, including 20 strains of Gram-positive bacteria (24.10%), 62 strains of Gram-negative bacteria (74.70%) and 1 strain of fungus (1.20%). No significant difference was found in mortality rate between the two groups (P>0.05). MNA-SF score, malnutrition rate and serum PCT and IL-17 levels were significantly higher in observation group (P<0.05). The mortality rate in the elderly patients with acute respiratory failure and pulmonary infection was 14.29% (10/70). Serum PCT and IL-17 levels in dead patients were significantly higher than those in survived patients (P<0.05). AUC of serum PCT combined with IL-17 for assessing the prognosis was greater than that of PCT alone (P<0.05), and there was no significant difference between combined detection and IL-17 alone (P>0.05). Conclusion In elderly patients with acute respiratory failure and pulmonary infection, main pathogen is Gram-negative bacteria, incidence of malnutrition is higher, and levels of serum PCT and IL-17 significantly up-regulate. Combined detection of serum PCT and IL-17 is of good application value for prognosis assessment.

The epidemiological and clinical characteristics of severe pneumonia in children（2020-2021） Li Yaowen, Lin Jieqiong, Xiong Hairui, Fan Qimeng, Zeng Hongwu 2023, 8 (3):  53-58.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.011 Abstract ( 297)    PDF (858KB) ( 504 )    Objective To analyze and summarize the epidemiological and clinical characteristics of severe pneumonia in children, and to improve the diagnosis and treatment of this disease. Method Retrospectively analyzed the clinical and radiology data of 148 children with severe pneumonia, which were hospitalized in the pediatric intensive care unit (PICU) at Shenzhen Children's Hospital from January 2020 to December 2021. The epidemiological information was collected, and the demographic characteristics, clinical symptoms, laboratory results, imaging features, complications, treatment, and prognosis data were analyzed. Result There were 148 children, 79 (53.4%) males and 69 (46.6%) females. The onset age ranged from 1 month to 17 years old (the median age was 12 months). Fifty-seven (38.5%) cases occurred in winter. One hundred and five cases (70.9%) were infected with a single pathogen, and 43 cases (29.1%) were infected with mixed pathogens. The top three pathogens were respiratory syncytial, rhinovirus, and pseudomonas aeruginosa. Respiratory syncytial virus and rhinovirus infections were mainly found in the infant group. Pseudomonas aeruginosa has the highest detection rate among school-age children. One hundred and eight cases (73.0%) had underlying diseases. The most common respiratory symptoms were cough (73.0%) and wheezing (65.5%). Hypotension was found in 133 cases (89.9%), and hypoxemia in 68 cases (45.9%). Hypersensitive C-reactive protein, procalcitonin, and lactate dehydrogenase increased. Variety extent segmental or lobular pneumonia were the common radiology findings, particularly in the lower lobe of the lungs. Atelectasis was found in eighty-eight cases (59.5%), pleural effusion was found in 30 cases (20.3%), empyema was found in 4 cases (2.7%), lung abscess was found in 2 cases (1.4%), and necrotizing pneumonia was found in 4 cases (2.7%). Severe complications included septic shock (11.5%), acute respiratory distress syndrome (7.4%), and multiple organ dysfunction syndrome (MODS) (6.1%). Seventy-eight cases (52.7%) required ventilator-assisted ventilation, 4 cases were treated with extracorporeal membrane oxygenation (ECMO), and 11 cases (7.4%) died eventually. The proportion of deaths with severe pneumonia combined with septic shock, acute respiratory distress syndrome, and MODS was significantly higher than those who survived (P<0.05). Conclusion Severe pneumonia in children is more common in infants, and the epidemiology of the infant group is "double peaks" in summer and winter; the pathogens are mainly respiratory syncytial virus, rhinovirus and Pseudomonas aeruginosa infection. Chest imaging showed multiple lobes/segment involvement, with the most common changes in the density of the lower lobe of the lungs. Combined underlying diseases and septic shock suggest a poor prognosis.

Expression of inflammatory markers in hospitalized patients with COVID-19 and its short-term prognostic value Li Tao, Xie Liqiu, He Jianglin, Feng Xianbiao, Ma Yao, Luo Chunqiang, Yang Faqing, Li Huilin, Zhang Na, Hou Keke 2023, 8 (3):  59-63.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.012 Abstract ( 242)    PDF (1127KB) ( 444 )    Objective The predictive value of inflammatory indexes on disease staging and adverse outcomes during short-term hospitalization（within 30 days） for COVID-19. Method A total of 168 patients admitted to the Chengdu Public Health Clinical Medical Center from December 1, 2022 to December 31, 2022 were retrospectively analyzed, and 142 patients who improved and were discharged as the good prognosis group and 26 patients who were transferred to the ICU or died as the poor prognosis group according to the patients, prognosis survival, and the two groups were compared for white blood cell count (WBC), lymphocyte count (LYM), interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT); logistic regression model was used to analyze the factors affecting the prognosis of hospitalization in patients with novel coronavirus infection, and the subject operating characteristic curve (ROC) was drawn. Result ①WBC [(7.60±4.66)×109/L vs (4.99±2.41)×109/L)], IL-6 [38.20(17.03, 68.50)pg/ml vs 8.60(4.78,16.03)pg/ml], CRP[34.21(12.43,93.19)mg/L vs 2.98(2.98,16.45)mg/L], PCT[0.40(0.10,1.70)ng/ml vs 0.06(0.04,0.10)ng/ml] were higher than those in the good prognosis group (P<0.05), and LYM [(0.77±0.38)×109/L vs (1.13±0.54)×109/L)] were lower than those in the good prognosis group (P<0.05)．The results of multi-factorial logistic regression model analysis showed that elevated CRP was an independent risk factor for the development of novel coronavirus infection associated with poor prognosis, while the uncomplicated underlying disease and mild disease groups were independent protective factors for novel coronavirus infection. The ROC curve analysis showed that high CRP, combined underlying disease, and the severe disease group had a better predictive value for risk assessment of patients with novel coronavirus infection developing to poor prognosis compared with other risk factors. When CRP was higher than 13.765mg/L, the sensitivity for determining poor prognosis was 76.90%, the specificity was 73.90%, and the area under the curve (AUC) was 0.757 (95% CI 0.638-0.876, P<0.001); AUC for combined underlying disease was 0.654 (95% CI: 0.552-0.756, P=0.013); and AUC in the severe disease group was 0.716 (95% CI: 0.605-0.827, P<0.001). When the three were combined for diagnosis, the sensitivity was 84.60%, the specificity 70.40%, and AUC was 0.850 (95% CI: 0.772-0.929, P<0.001). Conclusion Elevated inflammatory indicators, especially high levels of CRP, combined underlying disease and severe disease groups can be used as early warning indicators of deterioration during hospitalization in patients with the novel coronavirus infection, and the combined diagnostic efficacy of the three is higher.

Case Report

A case report of acute kidney injury caused by antituberculosis fixed-dose combination formulations Li Jian, Yang Liangzi, Liu Zhi, Wu Pengyao, Qiu Lulu, Fu Jiapeng, Ke Xue, Gao Wenying, Li Guobao 2023, 8 (3):  64-67.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.013 Abstract ( 198)    PDF (1583KB) ( 557 )    A middle-aged male patient was admitted to hospital with cough, edema of both lower extremities and oliguria. The patient had a history of pulmonary tuberculosis and diabetes. The onset was diagnosed with pulmonary tuberculosis and re-treatment. After taking oral fixed-dose combination formulations for anti-tuberculosis treatment. Increased urea and creatinine. The clinical diagnosis was Acute kidney injury caused by rifampicin. After drug withdrawal and hemodialysis, the patient recovered and was discharged from the hospital. This case was used to explore the possible drugs and the mechanism of acute kidney injury by the use of antituberculosis fixed-dose combination formulations, and to analyze the relevant literature, so as to provide a reference for clinical rational drug use.

A case of Mycobacterium smegmatis infection confirmed by next-generation sequencing technology Xu Qinglang, Che Yuanmei, Zhong Yuanbin, He Ying, Yang Lixia, Zhu Ying, Wu Xiaoping 2023, 8 (3):  68-70.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.014 Abstract ( 221)    PDF (1381KB) ( 507 )    Mycobacterium smegmatis belongs to type IV (rapid growth) non-tuberculous mycobacteria. It is widely distributed in the natural environment and can exist normally in the skin and mucous membranes. When the immunity of the body is weakened or the normal skin and mucous membranes are damaged. It can become an opportunistic pathogen. There are few cases of Mycobacterium smegmatis infection reported, the incidence is low, and it is easy to be missed clinically. Pathogenic microorganism high-throughput sequencing technology (next-generation sequencing technology, NGS) can extract hundreds of thousands to millions of DNA and RNA molecules at a time. The application of this technology enables clinicians to identify pathogens of infectious diseases. Screening can detect pathogens earlier, achieve the purpose of early diagnosis and early treatment, and greatly improve the diagnosis rate of difficult infectious diseases. In this paper, a case of Mycobacterium smegmatis infection was diagnosed by blood NGS detection to report and review the literature, in order to improve the ability of diagnosis and treatment of Mycobacterium smegmatis infection.

Leprosy complicated with bacterial and fungal pneumonia: a case report Zhang Xiaoping, Xiao Xuehong, Wang Jinping, Liao Jia 2023, 8 (3):  71-73.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.015 Abstract ( 225)    PDF (2460KB) ( 462 )    A case of leprosy misdiagnosed and mistreated was reported, and the clinical and pathological data collected were analyzed retrospectively to improve the understanding of leprosy among clinicians. A leper with symptoms such as red papules, pustules and nodules on the lower limbs without obvious inducement was admitted to the Second People's Hospital of Zhongshan City, and the pathology confirmed the type Ⅱ leper reaction. Leprosy is a chronic infectious disease, with diverse clinical manifestations and involving many disciplines. In addition, clinicians lack knowledge about it and are prone to misdiagnosis. This paper discusses the clinical characteristics of the leprosy patient, the imaging manifestations of pulmonary infection, the basis of clinical diagnosis, and the active and effective comprehensive treatment methods. Strengthen the vigilance of clinicians, report suspected cases in time and reduce the incidence of misdiagnosis and therapeutic error.

Review

Progress in diagnosis and treatment of congenital tuberculosis Xie Dongsheng, Deng Guofang, Han Tingting 2023, 8 (3):  74-78.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.016 Abstract ( 230)    PDF (851KB) ( 564 )    Congenital tuberculosis is a rare type of tuberculosis caused by Mycobacterium tuberculosis infection during the intrauterine or normal parturition. It is caused by severe forms of tuberculosis in pregnancy such as extrapulmonary tuberculosis and meningeal tuberculosis,which infect the fetus through the placenta, amniotic fluid or maternal genital tract. The onset of congenital tuberculosis varies in age.There is easy to be misdiagnosed because congenital tuberculosis is lacking specificity and is similar to infectious diseases such as bacterial pneumonia for clinical symptoms and laboratory examination. We should combine diagnosis with clinical symptoms, imaging examination, etiological evidence, tuberculosis specific examination such as T-SPOT, and maternal history of tuberculosis during pregnancy. The disease progresses is quick and the fatality rate is high.So anti-tuberculosis treatment can be started after general clinical diagnosis. At present, Many literatures had been reported that diagnosis of congenital tuberculosis was considered only after the treatment with multiple antibiotics failed, which caused serious consequences in infants. So it is necessary to early diagnosis and appropriate treatment for reducing the fatality rate of infants. To providing further understanding for clinic reference, we have briefly summarized the definition, infection passway, clinical manifestations,accessory examination,diagnosis,treatment and prevention of congenital tuberculosis.

Research progress on adverse drug reactions of AIDS antiviral therapy Wei Yusu, Dong Wenyi, Xie Zhiman, Wei Lijuan 2023, 8 (3):  79-83.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.017 Abstract ( 327)    PDF (857KB) ( 964 )    Since the first drug,Azidothymidine (AZT) was used in treatment of acquired immune deficiency syndrome (AIDS), many reverse transcriptases, proteases and integrases, acting on a number of different targets of HIV replication, have been included into the antiretroviral therapy treatment (ART) system. AIDS is incurable, because none of the current available drugs can effectively eliminate the viral reservoir for HIV. AIDS has emerged as a chronic illness that is manageable with ART. However, HIV-infected individuals need to receive life-long therapy for AIDS prevention. Drug-induced adverse reactions have brought great trouble to people living with HIV, including drug-induced rash, adverse reaction of digestive system, drug-induced liver injury, nephrotoxicity, bone marrow suppression, diarrhea, metabolic disorders and so on, which are the main associated factors with the interruption of ART. It seriously affects the physical, mental and quality of life of people living with HIV. In order to comprehensively understand the associated factors and clinical manifestations of adverse drug reactions in AIDS treatment, this article reviews the adverse drug reactions and their mechanisms in people living with HIV, aiming to improve the awareness and the treatment capacity of adverse drug reactions for healthcare worker.

Progress in studying the epidemic characteristics of diseases associated with human enterovirus Qiu Fangzhou, Shen Yongming 2023, 8 (3):  84-89.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.018 Abstract ( 295)    PDF (859KB) ( 1099 )    Human enterovirus (HEV) can infect people and outbreak all over the world. At the same time, it can induce a variety of clinical symptoms, including fever, headache, respiratory tract infection, sore throat, and occasionally vomiting and diarrhea. Some specific serotypes can cause serious diseases, but most of the HEV infection symptoms are mild or even asymptomatic. In this review, we will summarize the research progress and current situation of reported diseases related to HEV infection (including hand foot mouth disease, acute flaccid paralysis, encephalitis/meningitis, diabetes, diarrhea, respiratory diseases, acute hemorrhagic conjunctivitis and acute otitis media. Further summarize the molecular epidemic characteristics and pathogenesis of HEV in different infectious diseases, and elaborate the relationship between HEV and human infectious diseases.

Guidelines and Consensus

Interpretation of Consensus on imaging techniques and diagnostic criteria for hepatitis B virus related early hepatocellular carcinoma Mou Bin, Xiong Jingtong, Li Yuna, Bian Jie, Luo Jiawen 2023, 8 (3):  90-96.  DOI: 10.19871/j.cnki.xfcrbzz.2023.03.019 Abstract ( 195)    PDF (3022KB) ( 680 )    Hepatocellular carcinoma is one of the most common malignant tumors in the human body. The early diagnosis of liver cancer, especially the diagnosis and timely treatment of early hepatocellular carcinoma (eHCC) is the key to prolong the survival of patients. In recent years, with the continuous progress of imaging technology, the detection rate of eHCC has been increasing year by year, but there is no unified standard for the imaging diagnosis of eHCC at home and abroad. In order to improve the early clinical recognition and compliance of imaging with pathological diagnosis, Radiology of Infection Sub-branch, Radiology Branch, Chinese Medical Association and Radiology Committee on Infectious and Inflammatory Disease, Chinese Research Hospital Association and other academic groups organized more than 40 relevant experts from all over the country to jointly issue the Consensus on imaging techniques and diagnostic criteria for hepatitis B virus related early hepatocellular carcinoma(here in after referred to as "the Consensus"). This paper reviews the Consensus based on relevant research progress, covering imaging examination methods, imaging manifestations, imaging diagnostic criteria for eHCC, consensus on relevant hot issues and differential diagnosis, with the aim of improving the understanding of relevant professional physicians about this disease.