Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unpr...Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.展开更多
Objective: To discuss some key points about nursing in the use of DDG-3300K liver reserve function analyzer in patients at the department of infectious diseases. Method: DDG-3300K liver reserve function analyzer was a...Objective: To discuss some key points about nursing in the use of DDG-3300K liver reserve function analyzer in patients at the department of infectious diseases. Method: DDG-3300K liver reserve function analyzer was applied to 5464 patients at the department of infectious diseases. The reasons for failed detection and complications related to the detection were analyzed, and the measures for improving the nursing procedures were proposed. Result: Among the 5464 patients, the detections were successful at the first attempt in 5458 patients;2 patients had leakage of liquid;2 patients were poorly prepared, and 1 case failed because of mistaken selection of CO mode, which led to adverse drug reactions;1 case did not finish the detection due to anaphylactic shock;8 patients had nausea and 6 patients had skin rash on the four limbs and torso during the detection. Conclusion: It is necessary to formulate the nursing procedures for the use of DDG-3300K liver reserve function analyzer. Moreover, preparatory work, health education, refined nursing procedures and skillful operations are closely related to the success rate and accuracy of the detection.展开更多
Introduction: Parasitic diseases remain a public health problem in Burkina Faso, as they are in other developing countries. Objective: To describe the epidemiological, clinical and evolutionary characteristics of para...Introduction: Parasitic diseases remain a public health problem in Burkina Faso, as they are in other developing countries. Objective: To describe the epidemiological, clinical and evolutionary characteristics of parasitosis diagnosed in the infectious diseases department of the Yalgado Ouédraogo University Hospital. Patients and Method: This is a descriptive cross-sectional study with retrospective data collection during the period from January 1, 2010 to August 31, 2022. Results: From January 1, 2010 to August 31, 2022, a total of 2829 patients were admitted to the infectious diseases department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Among them, 624 patients suffered from parasitic pathologies, representing a hospital prevalence of 22%. The patients were predominantly male with a sex ratio of 1.1. The average age was 34 years ± 11. Most patients (74.7%) lived in the capital city of Ouagadougou. Ten percent (10%) of the patients with parasitosis were infected with HIV (PLHIV). Out of a total of 624 cases of parasitosis, protozoosis represented 97%, of which 80% were malaria cases. Clinical signs were dominated by neurological signs, digestive signs and dehydration. Comorbidities were dominated by HIV infection, tuberculosis and digestive candidiasis. Under treatment, the evolution was marked by a lethality of 10%. Conclusion: Protozoosis were the most frequently diagnosed. They were dominated by malaria and opportunistic parasitosis during AIDS. These results argue for a revitalization of voluntary HIV testing and careful management of PLHIV.展开更多
Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to deter...Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.展开更多
The present study aimed to establish a list of parameters indicative of pathogen invasion and develop a predictive model to distinguish the etiologies of fever of unknown origin (FUO) into infectious and non-infectiou...The present study aimed to establish a list of parameters indicative of pathogen invasion and develop a predictive model to distinguish the etiologies of fever of unknown origin (FUO) into infectious and non-infectious causes.From January 2014 to September 2017,431 patients with FUO were prospectively enrolled in the study population.This study established a list of 26 variables from the following 4aspects:host factors,epidemiological factors,behavioral factors,and iatrogenic factors.Predefined predicted variables were included in a multivariate logistic regression analysis to develop a predictive model.The predictive model and the corresponding scoring system were developed using data from the confirmed diagnoses and 9 variables were eventually identified.These factors were incorporated into the predictive model.This model discriminated between infectious and non-infectious causes of FUO with an AUC of 0.72,sensitivity of 0.71, and specificity of 0.63.The predictive model and corresponding scoring system based on factors concerning pathogen invasion appear to be reliable screening tools to discriminate between infectious and non-infectious causes of FUO.展开更多
Nervous system infections are among the most important diseases in travellers.Healthy travellers might be exposed to infectious agents of central nervous system,which may require in-patient care.Progressive course is ...Nervous system infections are among the most important diseases in travellers.Healthy travellers might be exposed to infectious agents of central nervous system,which may require in-patient care.Progressive course is not uncommon in this family of disorders and requires swift diagnosis.An overview of the available evidence in the field is.therefore,Urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research.In November 2013,data were collected from PubMed,Scopus,and Web of knowledge(1980 to2013) including books,reviews,and peer-reviewed literature,Works pertained to pre-travel care,interventions,vaccinations related neurological infections were retrieved.Here we provide information on pre-travel care,vaccination,chronic nervous system disorders,and post-travel complications.Recommendations with regard to knowledge gaps,and state-of-the-art research are made.Given an increasing number of international travellers,novel dynamic ways are available for physicians to monitor spread of central nervous system infections.Newer research has made great progresses in developing newer medications,detecting the spread of infections and the public awareness.Despite an ongoing scientific discussion in the field of travel medicine,further research is required for vaccine development,state-of-the-art laboratory tests,and genetic engineering of vectors.展开更多
Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies...Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.展开更多
Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape ...Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious diseases.Whether in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases.All factors closely related to these three conditions can affect the prevalence of infectious diseases.China is one of the cradles of world civilization.The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases.In the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease.The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.展开更多
The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 p...The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 participants from the UK Biobank,with 75209 participants diagnosed with infectious diseases.Participants reporting the highest intake frequency of processed meat(odds ratio[OR]=1.0964,95%confidence interval[CI]:1.0622–1.1318)and red meat(OR=1.0895,95%CI:1.0563–1.1239)had a higher risk of infectious diseases,compared with those with the lowest intake frequency.Consuming fish 2.0–2.9 times(OR=0.8221,95%CI:0.7955–0.8496),cheese≥5.0 times(OR=0.8822,95%CI:0.8559–0.9092),fruit 3.0–3.9 servings(OR=0.8867,95%CI:0.8661–0.9078),and vegetables 2.0–2.9 servings(OR=0.9372,95%CI:0.9189–0.9559)per week were associated with a lower risk of infection.Low meat-eaters(OR=0.9404,95%CI:0.9243–0.9567),fish-eaters(OR=0.8391,95%CI:0.7887–0.8919),and vegetarians(OR=0.9154,95%CI:0.8561–0.9778)had a lower risk of infectious diseases,compared with regular meat-eaters.The mediation analysis revealed that glycosylated hemoglobin,white blood cell count,and body mass index served as the mediators in the associations between diet and infectious diseases.The current study indicates that the intake frequency of food groups is a risk factor for infectious diseases,and fish-eaters have a lower risk of infection.展开更多
Infectious diseases result from the interactions of host, pathogens, and, in the case of vector-borne diseases, also vec- tors. The interactions involve physiological and ecological mechanisms and they have evolved un...Infectious diseases result from the interactions of host, pathogens, and, in the case of vector-borne diseases, also vec- tors. The interactions involve physiological and ecological mechanisms and they have evolved under a given set of environmental conditions. Environmental change, therefore, will alter host-pathogen-vector interactions and, consequently, the distribution, in- tensity, and dynamics of infectious diseases. Here, we review how climate change may impact infectious diseases of aquatic and terrestrial wildlife. Climate change can have direct impacts on distribution, life cycle, and physiological status of hosts, pathogens and vectors. While a change in either host, pathogen or vector does not necessarily translate into an alteration of the disease, it is the impact of climate change on the interactions between the disease components which is particularly critical for altered disease risks. Finally, climate factors can modulate disease through modifying the ecological networks host-pathogen-vector systems are belonging to, and climate change can combine with other environmental stressors to induce cumulative effects on infectious dis- eases. Overall, the influence of climate change on infectious diseases involves different mechanisms, it can be modulated by phenotypic acclimation and/or genotypic adaptation, it depends on the ecological context of the host-pathogen-vector interactions, and it can be modulated by impacts of other stressors. As a consequence of this complexity, non-linear responses of disease sys- tems under climate change are to be expected. To improve predictions on climate change impacts on infectious disease, we sug- gest that more emphasis should be given to the integration of biomedical and ecological research for studying both the physio- logical and ecological mechanisms which mediate climate change impacts on disease, and to the development of harmonized methods and approaches to obtain more comparable results, as this would support the discrimination of case-specific versus gen- eral mechanisms .展开更多
Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the vi...Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the viewpoints of ancient Iranian scholars for using these opinions in treating ID. In this regard returning to TPM options and modalities can be useful at least as complementary method in treating ID. For understanding the concepts of ID in TPM first of all it is needed to trace ID in TPM and translate them into western medicine language which is the goal of this report. Methodology: This research includes 80 ID mentioned in TIBBE-AKBARI (one of Persian Medicine textbook) for rewriting and comparing with conventional medicine findings. Findings: The majority of clinical signs, symptoms and physical examinations of ID are comparable with modern medicine except the viewpoint of TPM about aetiology which is based on Akhlat and Mezaj theory. By considering no option for antibiotic therapy in ancients time so there is a completely different opinion in treating ID with modern medicine. Conclusion: IDs have different names in TPM and conventional medicine. In contrast to modern medicine in which micro-organism are as etiologic agents, Akhlat and Mezaj theory of TPM has main role for description of ID, the subject which must to be decoded. Although they have completely different opinions in treatment, but with regard to the increasing of antibiotic resistance issue, TPM treatment comments may be useful in future in ID as complementary method beside antibiotics.展开更多
Objective A diagnostic model was established to discriminate infectious diseases from non-infectious diseases. Methods The clinical data of patients with fever of unknown origin(FUO) hospitalized in Xiangya Hospital C...Objective A diagnostic model was established to discriminate infectious diseases from non-infectious diseases. Methods The clinical data of patients with fever of unknown origin(FUO) hospitalized in Xiangya Hospital Central South University, from January, 2006 to April, 2011 were retrospectively analyzed. Patients enrolled were divided into two groups. The first group was used to develop a diagnostic model: independent variables were recorded and considered in a logistic regression analysis to identify infectious and non-infectious diseases(αin = 0.05, αout = 0.10). The second group was used to evaluate the diagnostic model and make ROC analysis.Results The diagnostic rate of 143 patients in the first group was 87.4%, the diagnosis included infectious disease(52.4%), connective tissue diseases(16.8%), neoplastic disease(16.1%) and miscellaneous(2.1%). The diagnostic rate of 168 patients in the second group was 88.4%, and the diagnosis was similar to the first group. Logistic regression analysis showed that decreased white blood cell count(WBC < 4.0×109/L), higher lactate dehydrogenase level(LDH > 320 U/L) and lymphadenectasis were independent risk factors associated with non-infectious diseases. The odds ratios were 14.74, 5.84 and 5.11(P ≤ 0.01), respectively. In ROC analysis, the sensitivity and specificity of the positive predictive values was 62.1% and 89.1%, respectively, while that of negative predicting values were 75% and 81.7%, respectively(AUC = 0.76, P = 0.00).Conclusions The combination of WBC < 4.0×109/L, LDH > 320 U/L and lymphadenectasis may be useful in discriminating infectious diseases from non-infectious diseases in patients hospitalized as FUO.展开更多
To the Editor: Wilson's disease is an autosomal recessive genetic disease caused by ATP7B gene mutations and characterized by a copper metabolism disorder. Liver transplantation(LT) is a treatment option for the m...To the Editor: Wilson's disease is an autosomal recessive genetic disease caused by ATP7B gene mutations and characterized by a copper metabolism disorder. Liver transplantation(LT) is a treatment option for the most severe(life-threatening) cases of Wilson's disease. Because of donor shortages and high costs, pursuing simple, safe, and effective therapies has become a medical hotspot [1]. Numerous studies [1–6] have shown that stem cell transplantation in liver diseases can attenuate liver fibrosis, improve liver function, and alleviate clinical symptoms. Here, we reported a case of Wilson's disease with decompensated cirrhosis who was treated with menstrual blood derived-mesenchymal stem cells(Men-MSCs) transplantation.展开更多
Background:Whether chronic hepatitis B or C virus infection is a risk factor for autoimmune liver diseases(AILDs)remains unclear.This study aimed to investigate the causal relationship between the two disease entities...Background:Whether chronic hepatitis B or C virus infection is a risk factor for autoimmune liver diseases(AILDs)remains unclear.This study aimed to investigate the causal relationship between the two disease entities and underlying mechanisms.Methods:Bidirectional Mendelian randomization analysis was performed using genome-wide association study summary statistics for hepatitis B or C virus infection and AILDs in individuals of European ancestry.Statistically significant findings underwent meta-analysis for validation and single-cell RNA-seq were conducted to explore the potential mechanisms.Results:A causal relationship was observed between chronic hepatitis B virus(HBV)infection and an elevated risk of primary biliary cholangitis(PBC).Meta-analysis of all PBC-outcome findings confirmed the association(Odds ratio:1.32,95%confidence interval:1.23–1.42)without a reverse causal effect.Chronic HBV infection was also potentially associated with an increased risk of autoimmune hepatitis,but not with primary sclerosing cholangitis.No causal relationship was found between hepatitis C virus infection and AILDs.Single-cell RNA-seq revealed HLA gene activated in liver and impaired innate immune suppressive function in chronic hepatitis B patients.Conclusion:This study demonstrates a one-way causal association between chronic HBV infection and certain AILDs(PBC and autoimmune hepatitis),but not chronic hepatitis C virus infection.Single-cell transcriptome analysis revealed immune dysfunction caused by chronic HBV infection persists and is difficult to resolve even after HBV clearance,potentially leading to autoimmune hepatic diseases.展开更多
In this letter,we comment on the article by Xuan Yuan et al,published in the recent issue of the World Journal of Gastroenterology.Mixed lineage kinase domainlike protein(MLKL)exhibits cell-type-specific functions in ...In this letter,we comment on the article by Xuan Yuan et al,published in the recent issue of the World Journal of Gastroenterology.Mixed lineage kinase domainlike protein(MLKL)exhibits cell-type-specific functions in liver parenchymal and non-parenchymal cells,playing dual roles in the pathogenesis of liver diseases.In hepatocytes,MLKL primarily mediates necroptosis and inhibits autophagy,thereby exacerbating liver injury.Conversely,in non-parenchymal liver cells,MLKL modulates inflammatory responses and promotes fibrotic processes,thereby driving disease progression.Notably,MLKL also demonstrates protective functions under specific conditions.For instance,MLKL can inhibit intracellular bacterial replication,promote endosomal trafficking,and facilitate the generation and release of extracellular vesicles,potentially exerting hepatoprotective effects.Understanding these cell-type-specific mechanisms of MLKL action,including its dual roles in promoting injury and providing protection,is crucial for elucidating the complex pathogenesis of liver diseases and developing targeted therapeutic strategies.展开更多
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions ...BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions are relatively rare,and some may be misdiagnosed as pulmonary tuberculosis.CASE SUMMARY In this report,we present an uncommon instance of IgG4-related lung disease,which was diagnosed through lung tissue biopsy conducted via puncture.A 67-year-old male was hospitalized with a two-month history of cough and sputum production.Chest computed tomography(CT)revealed infiltrative pulmonary tuberculosis in both upper lungs.However,the initial diagnosis was unclear,and the patient received HZRE quadruple therapy for tuberculosis at a local hospital.After 45 days of anti-tuberculosis treatment,the patient's cough and sputum worsened,and he began coughing up blood,prompting transfer to our hospital.Serum tests revealed elevated IgG4 levels.A biopsy of a right lung showed localized fibrous and extensive plasma cell infiltration,with 30-40 IgG4-positive cells per high-power field,and an IgG4/IgG ratio of 40%.These findings led to a diagnosis of IgG4-related lung disease.Following treatment with prednisone and mycophenolate mofetil,follow-up lung CT scans showed significant lesion improvement.CONCLUSION The chest CT findings of IgG4-RD are diverse and nonspecific,often leading to misdiagnosis as pulmonary tuberculosis,especially in primary care settings with limited diagnostic resources.We confirmed the diagnosis of IgG4-related lung disease through histological examination.展开更多
Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient ...Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.展开更多
Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively aff...Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively affect prognosis.COPD and tuberculosis share a number of common risk factors and pathogenetic mechanisms involving various immune and non-immune cells.Inflammation,hypoxia,oxidative stress,and lung tissue remodeling play an important role in the comorbid course of COPD and respiratory tuberculosis.These mechanisms are of diagnostic interest and are promising therapeutic targets.Thus,the aim of the current review is to discuss the mechanisms of the comorbid course of chronic obstructive pulmonary disease and respiratory tuberculosis.展开更多
Background:In recent years,the rising prevalence of obesity and metabolic syndrome has led to an increased number of individuals developing metabolic dysfunction-associated steatotic liver disease(MASLD).Furthermore,g...Background:In recent years,the rising prevalence of obesity and metabolic syndrome has led to an increased number of individuals developing metabolic dysfunction-associated steatotic liver disease(MASLD).Furthermore,given the substantial global prevalence of chronic hepatitis B(CHB),instances of MASLD coexisting with CHB are becoming increasingly commonplace in clinical scenarios.Both conditions can lead to liver fibrosis,cirrhosis,and potentially hepatocellular carcinoma(HCC).However,the intrica-cies of the dual etiology,consequential outcomes,and associated risks of CHB concurrent with MASLD are still not fully understood.Data sources:A literature search was conducted on PubMed for articles published up to March 2024.The search keywords included nonalcoholic fatty liver disease,nonalcoholic steatohepatitis,chronic hepatitis B,liver fibrosis,hepatocellular carcinoma,nuclear factor erythroid 2-related factor 2,and oxidative stress.Results:This review examined recent studies on the interplay between MASLD and CHB.The coexis-tence of these conditions may facilitate the clearance of hepatitis B surface antigen from the serum and impede hepatitis B virus(HBV)replication.Conversely,individuals with coexisting CHB tend to exhibit a lower rate of hypertriglyceridemia and reduced serum triglyceride levels compared with those only having NAFLD.Nevertheless,these observations do not necessarily indicate universally positive outcomes.Indeed,MASLD and CHB may synergistically act as“co-conspirators”to exacerbate clinical manifestations,particularly liver fibrosis and HCC.Conclusions:As our understanding of the interaction between steatosis and HBV infection becomes clearer,we can better assess the risk of advanced liver disease in patients with concurrent CHB and MASLD.These insights will support the exploration of potential underlying mechanisms and may provide recommendations for improving patient outcomes.展开更多
基金the Natural Science Basic Research Program of Shaanxi Province,China[2023-JC-QN-0858]the Free Exploration Program of the Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University[2020YJ(ZYTS)605]the National Natural Science Foundation of China[81900620].
文摘Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.
文摘Objective: To discuss some key points about nursing in the use of DDG-3300K liver reserve function analyzer in patients at the department of infectious diseases. Method: DDG-3300K liver reserve function analyzer was applied to 5464 patients at the department of infectious diseases. The reasons for failed detection and complications related to the detection were analyzed, and the measures for improving the nursing procedures were proposed. Result: Among the 5464 patients, the detections were successful at the first attempt in 5458 patients;2 patients had leakage of liquid;2 patients were poorly prepared, and 1 case failed because of mistaken selection of CO mode, which led to adverse drug reactions;1 case did not finish the detection due to anaphylactic shock;8 patients had nausea and 6 patients had skin rash on the four limbs and torso during the detection. Conclusion: It is necessary to formulate the nursing procedures for the use of DDG-3300K liver reserve function analyzer. Moreover, preparatory work, health education, refined nursing procedures and skillful operations are closely related to the success rate and accuracy of the detection.
文摘Introduction: Parasitic diseases remain a public health problem in Burkina Faso, as they are in other developing countries. Objective: To describe the epidemiological, clinical and evolutionary characteristics of parasitosis diagnosed in the infectious diseases department of the Yalgado Ouédraogo University Hospital. Patients and Method: This is a descriptive cross-sectional study with retrospective data collection during the period from January 1, 2010 to August 31, 2022. Results: From January 1, 2010 to August 31, 2022, a total of 2829 patients were admitted to the infectious diseases department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Among them, 624 patients suffered from parasitic pathologies, representing a hospital prevalence of 22%. The patients were predominantly male with a sex ratio of 1.1. The average age was 34 years ± 11. Most patients (74.7%) lived in the capital city of Ouagadougou. Ten percent (10%) of the patients with parasitosis were infected with HIV (PLHIV). Out of a total of 624 cases of parasitosis, protozoosis represented 97%, of which 80% were malaria cases. Clinical signs were dominated by neurological signs, digestive signs and dehydration. Comorbidities were dominated by HIV infection, tuberculosis and digestive candidiasis. Under treatment, the evolution was marked by a lethality of 10%. Conclusion: Protozoosis were the most frequently diagnosed. They were dominated by malaria and opportunistic parasitosis during AIDS. These results argue for a revitalization of voluntary HIV testing and careful management of PLHIV.
文摘Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.
文摘The present study aimed to establish a list of parameters indicative of pathogen invasion and develop a predictive model to distinguish the etiologies of fever of unknown origin (FUO) into infectious and non-infectious causes.From January 2014 to September 2017,431 patients with FUO were prospectively enrolled in the study population.This study established a list of 26 variables from the following 4aspects:host factors,epidemiological factors,behavioral factors,and iatrogenic factors.Predefined predicted variables were included in a multivariate logistic regression analysis to develop a predictive model.The predictive model and the corresponding scoring system were developed using data from the confirmed diagnoses and 9 variables were eventually identified.These factors were incorporated into the predictive model.This model discriminated between infectious and non-infectious causes of FUO with an AUC of 0.72,sensitivity of 0.71, and specificity of 0.63.The predictive model and corresponding scoring system based on factors concerning pathogen invasion appear to be reliable screening tools to discriminate between infectious and non-infectious causes of FUO.
基金Supported by the Baqiyatallah University of Medical Sciences Chancellor of Research(grant number 45387)
文摘Nervous system infections are among the most important diseases in travellers.Healthy travellers might be exposed to infectious agents of central nervous system,which may require in-patient care.Progressive course is not uncommon in this family of disorders and requires swift diagnosis.An overview of the available evidence in the field is.therefore,Urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research.In November 2013,data were collected from PubMed,Scopus,and Web of knowledge(1980 to2013) including books,reviews,and peer-reviewed literature,Works pertained to pre-travel care,interventions,vaccinations related neurological infections were retrieved.Here we provide information on pre-travel care,vaccination,chronic nervous system disorders,and post-travel complications.Recommendations with regard to knowledge gaps,and state-of-the-art research are made.Given an increasing number of international travellers,novel dynamic ways are available for physicians to monitor spread of central nervous system infections.Newer research has made great progresses in developing newer medications,detecting the spread of infections and the public awareness.Despite an ongoing scientific discussion in the field of travel medicine,further research is required for vaccine development,state-of-the-art laboratory tests,and genetic engineering of vectors.
基金Zhejiang Medical Science and Technology Plan Project(2019RC167).
文摘Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.
文摘Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious diseases.Whether in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases.All factors closely related to these three conditions can affect the prevalence of infectious diseases.China is one of the cradles of world civilization.The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases.In the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease.The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.
基金supported by the National Natural Science Foundation of China(Grant Nos.82173585 and 82273741)the Natural Science Foundation of Jiangsu Higher Education Institutions of China(Grant Nos.21KJB330005 and 22KJB330007)+1 种基金the Nanjing Major Science and Technology Project(Grant No.2021-11005)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘The current study used multivariable logistic regression analysis to investigate associations between the intake frequencies of 13 food groups(or four diet groups)and infectious diseases.The analysis included 487849 participants from the UK Biobank,with 75209 participants diagnosed with infectious diseases.Participants reporting the highest intake frequency of processed meat(odds ratio[OR]=1.0964,95%confidence interval[CI]:1.0622–1.1318)and red meat(OR=1.0895,95%CI:1.0563–1.1239)had a higher risk of infectious diseases,compared with those with the lowest intake frequency.Consuming fish 2.0–2.9 times(OR=0.8221,95%CI:0.7955–0.8496),cheese≥5.0 times(OR=0.8822,95%CI:0.8559–0.9092),fruit 3.0–3.9 servings(OR=0.8867,95%CI:0.8661–0.9078),and vegetables 2.0–2.9 servings(OR=0.9372,95%CI:0.9189–0.9559)per week were associated with a lower risk of infection.Low meat-eaters(OR=0.9404,95%CI:0.9243–0.9567),fish-eaters(OR=0.8391,95%CI:0.7887–0.8919),and vegetarians(OR=0.9154,95%CI:0.8561–0.9778)had a lower risk of infectious diseases,compared with regular meat-eaters.The mediation analysis revealed that glycosylated hemoglobin,white blood cell count,and body mass index served as the mediators in the associations between diet and infectious diseases.The current study indicates that the intake frequency of food groups is a risk factor for infectious diseases,and fish-eaters have a lower risk of infection.
文摘Infectious diseases result from the interactions of host, pathogens, and, in the case of vector-borne diseases, also vec- tors. The interactions involve physiological and ecological mechanisms and they have evolved under a given set of environmental conditions. Environmental change, therefore, will alter host-pathogen-vector interactions and, consequently, the distribution, in- tensity, and dynamics of infectious diseases. Here, we review how climate change may impact infectious diseases of aquatic and terrestrial wildlife. Climate change can have direct impacts on distribution, life cycle, and physiological status of hosts, pathogens and vectors. While a change in either host, pathogen or vector does not necessarily translate into an alteration of the disease, it is the impact of climate change on the interactions between the disease components which is particularly critical for altered disease risks. Finally, climate factors can modulate disease through modifying the ecological networks host-pathogen-vector systems are belonging to, and climate change can combine with other environmental stressors to induce cumulative effects on infectious dis- eases. Overall, the influence of climate change on infectious diseases involves different mechanisms, it can be modulated by phenotypic acclimation and/or genotypic adaptation, it depends on the ecological context of the host-pathogen-vector interactions, and it can be modulated by impacts of other stressors. As a consequence of this complexity, non-linear responses of disease sys- tems under climate change are to be expected. To improve predictions on climate change impacts on infectious disease, we sug- gest that more emphasis should be given to the integration of biomedical and ecological research for studying both the physio- logical and ecological mechanisms which mediate climate change impacts on disease, and to the development of harmonized methods and approaches to obtain more comparable results, as this would support the discrimination of case-specific versus gen- eral mechanisms .
文摘Background: Treating infectious diseases (ID) is the priority of health systems. Traditional Persian medicine (TPM) has diagnostic and preventive comments in most diseases. Readout TPM gives opportunity to know the viewpoints of ancient Iranian scholars for using these opinions in treating ID. In this regard returning to TPM options and modalities can be useful at least as complementary method in treating ID. For understanding the concepts of ID in TPM first of all it is needed to trace ID in TPM and translate them into western medicine language which is the goal of this report. Methodology: This research includes 80 ID mentioned in TIBBE-AKBARI (one of Persian Medicine textbook) for rewriting and comparing with conventional medicine findings. Findings: The majority of clinical signs, symptoms and physical examinations of ID are comparable with modern medicine except the viewpoint of TPM about aetiology which is based on Akhlat and Mezaj theory. By considering no option for antibiotic therapy in ancients time so there is a completely different opinion in treating ID with modern medicine. Conclusion: IDs have different names in TPM and conventional medicine. In contrast to modern medicine in which micro-organism are as etiologic agents, Akhlat and Mezaj theory of TPM has main role for description of ID, the subject which must to be decoded. Although they have completely different opinions in treatment, but with regard to the increasing of antibiotic resistance issue, TPM treatment comments may be useful in future in ID as complementary method beside antibiotics.
文摘Objective A diagnostic model was established to discriminate infectious diseases from non-infectious diseases. Methods The clinical data of patients with fever of unknown origin(FUO) hospitalized in Xiangya Hospital Central South University, from January, 2006 to April, 2011 were retrospectively analyzed. Patients enrolled were divided into two groups. The first group was used to develop a diagnostic model: independent variables were recorded and considered in a logistic regression analysis to identify infectious and non-infectious diseases(αin = 0.05, αout = 0.10). The second group was used to evaluate the diagnostic model and make ROC analysis.Results The diagnostic rate of 143 patients in the first group was 87.4%, the diagnosis included infectious disease(52.4%), connective tissue diseases(16.8%), neoplastic disease(16.1%) and miscellaneous(2.1%). The diagnostic rate of 168 patients in the second group was 88.4%, and the diagnosis was similar to the first group. Logistic regression analysis showed that decreased white blood cell count(WBC < 4.0×109/L), higher lactate dehydrogenase level(LDH > 320 U/L) and lymphadenectasis were independent risk factors associated with non-infectious diseases. The odds ratios were 14.74, 5.84 and 5.11(P ≤ 0.01), respectively. In ROC analysis, the sensitivity and specificity of the positive predictive values was 62.1% and 89.1%, respectively, while that of negative predicting values were 75% and 81.7%, respectively(AUC = 0.76, P = 0.00).Conclusions The combination of WBC < 4.0×109/L, LDH > 320 U/L and lymphadenectasis may be useful in discriminating infectious diseases from non-infectious diseases in patients hospitalized as FUO.
基金supported by a grant from the National Key Re-search and Development Program of China (2018YFC20 0 050 0)。
文摘To the Editor: Wilson's disease is an autosomal recessive genetic disease caused by ATP7B gene mutations and characterized by a copper metabolism disorder. Liver transplantation(LT) is a treatment option for the most severe(life-threatening) cases of Wilson's disease. Because of donor shortages and high costs, pursuing simple, safe, and effective therapies has become a medical hotspot [1]. Numerous studies [1–6] have shown that stem cell transplantation in liver diseases can attenuate liver fibrosis, improve liver function, and alleviate clinical symptoms. Here, we reported a case of Wilson's disease with decompensated cirrhosis who was treated with menstrual blood derived-mesenchymal stem cells(Men-MSCs) transplantation.
基金supported by the National Natural Science Foundation of China(82270626)China Mega-Project for Infectious Diseases(2017ZX10203202,2013ZX10002005)the Project of Beijing Science and Technology Committee(Z191100007619037).
文摘Background:Whether chronic hepatitis B or C virus infection is a risk factor for autoimmune liver diseases(AILDs)remains unclear.This study aimed to investigate the causal relationship between the two disease entities and underlying mechanisms.Methods:Bidirectional Mendelian randomization analysis was performed using genome-wide association study summary statistics for hepatitis B or C virus infection and AILDs in individuals of European ancestry.Statistically significant findings underwent meta-analysis for validation and single-cell RNA-seq were conducted to explore the potential mechanisms.Results:A causal relationship was observed between chronic hepatitis B virus(HBV)infection and an elevated risk of primary biliary cholangitis(PBC).Meta-analysis of all PBC-outcome findings confirmed the association(Odds ratio:1.32,95%confidence interval:1.23–1.42)without a reverse causal effect.Chronic HBV infection was also potentially associated with an increased risk of autoimmune hepatitis,but not with primary sclerosing cholangitis.No causal relationship was found between hepatitis C virus infection and AILDs.Single-cell RNA-seq revealed HLA gene activated in liver and impaired innate immune suppressive function in chronic hepatitis B patients.Conclusion:This study demonstrates a one-way causal association between chronic HBV infection and certain AILDs(PBC and autoimmune hepatitis),but not chronic hepatitis C virus infection.Single-cell transcriptome analysis revealed immune dysfunction caused by chronic HBV infection persists and is difficult to resolve even after HBV clearance,potentially leading to autoimmune hepatic diseases.
基金Supported by the Science and Technology Planning Projects of Guizhou Province,No.QKHJC-ZK[2022]YB642Health Research Project of Guizhou Province,No.gzwkj2024-324,and No.gzwkj2024-103+2 种基金WBE Liver Fibrosis Foundation,No.CFHPC2025028Beijing Liver and Gallbladder Mutual Aid Public Welfare Foundation Artificial Liver Special Fund,No.iGandanF-1082024-Rgg018Student Innovation and Entrepreneurship Training Program of Zunyi Medical University,No.S2024106612360.
文摘In this letter,we comment on the article by Xuan Yuan et al,published in the recent issue of the World Journal of Gastroenterology.Mixed lineage kinase domainlike protein(MLKL)exhibits cell-type-specific functions in liver parenchymal and non-parenchymal cells,playing dual roles in the pathogenesis of liver diseases.In hepatocytes,MLKL primarily mediates necroptosis and inhibits autophagy,thereby exacerbating liver injury.Conversely,in non-parenchymal liver cells,MLKL modulates inflammatory responses and promotes fibrotic processes,thereby driving disease progression.Notably,MLKL also demonstrates protective functions under specific conditions.For instance,MLKL can inhibit intracellular bacterial replication,promote endosomal trafficking,and facilitate the generation and release of extracellular vesicles,potentially exerting hepatoprotective effects.Understanding these cell-type-specific mechanisms of MLKL action,including its dual roles in promoting injury and providing protection,is crucial for elucidating the complex pathogenesis of liver diseases and developing targeted therapeutic strategies.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
文摘BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a persistent and progressive autoimmune condition marked by inflammation and fibrotic changes in the affected tissues.Cases of IgG4-RD causing pulmonary lesions are relatively rare,and some may be misdiagnosed as pulmonary tuberculosis.CASE SUMMARY In this report,we present an uncommon instance of IgG4-related lung disease,which was diagnosed through lung tissue biopsy conducted via puncture.A 67-year-old male was hospitalized with a two-month history of cough and sputum production.Chest computed tomography(CT)revealed infiltrative pulmonary tuberculosis in both upper lungs.However,the initial diagnosis was unclear,and the patient received HZRE quadruple therapy for tuberculosis at a local hospital.After 45 days of anti-tuberculosis treatment,the patient's cough and sputum worsened,and he began coughing up blood,prompting transfer to our hospital.Serum tests revealed elevated IgG4 levels.A biopsy of a right lung showed localized fibrous and extensive plasma cell infiltration,with 30-40 IgG4-positive cells per high-power field,and an IgG4/IgG ratio of 40%.These findings led to a diagnosis of IgG4-related lung disease.Following treatment with prednisone and mycophenolate mofetil,follow-up lung CT scans showed significant lesion improvement.CONCLUSION The chest CT findings of IgG4-RD are diverse and nonspecific,often leading to misdiagnosis as pulmonary tuberculosis,especially in primary care settings with limited diagnostic resources.We confirmed the diagnosis of IgG4-related lung disease through histological examination.
文摘Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.
文摘Chronic obstructive pulmonary disease(COPD)and respiratory tuberculosis are important respiratory problems.Meeting together,these diseases can mutually worsen the severity of clinical manifestations and negatively affect prognosis.COPD and tuberculosis share a number of common risk factors and pathogenetic mechanisms involving various immune and non-immune cells.Inflammation,hypoxia,oxidative stress,and lung tissue remodeling play an important role in the comorbid course of COPD and respiratory tuberculosis.These mechanisms are of diagnostic interest and are promising therapeutic targets.Thus,the aim of the current review is to discuss the mechanisms of the comorbid course of chronic obstructive pulmonary disease and respiratory tuberculosis.
基金supported by a grant from the Scientific Re-search Program of Furong Laboratory(No.2023SK2108).
文摘Background:In recent years,the rising prevalence of obesity and metabolic syndrome has led to an increased number of individuals developing metabolic dysfunction-associated steatotic liver disease(MASLD).Furthermore,given the substantial global prevalence of chronic hepatitis B(CHB),instances of MASLD coexisting with CHB are becoming increasingly commonplace in clinical scenarios.Both conditions can lead to liver fibrosis,cirrhosis,and potentially hepatocellular carcinoma(HCC).However,the intrica-cies of the dual etiology,consequential outcomes,and associated risks of CHB concurrent with MASLD are still not fully understood.Data sources:A literature search was conducted on PubMed for articles published up to March 2024.The search keywords included nonalcoholic fatty liver disease,nonalcoholic steatohepatitis,chronic hepatitis B,liver fibrosis,hepatocellular carcinoma,nuclear factor erythroid 2-related factor 2,and oxidative stress.Results:This review examined recent studies on the interplay between MASLD and CHB.The coexis-tence of these conditions may facilitate the clearance of hepatitis B surface antigen from the serum and impede hepatitis B virus(HBV)replication.Conversely,individuals with coexisting CHB tend to exhibit a lower rate of hypertriglyceridemia and reduced serum triglyceride levels compared with those only having NAFLD.Nevertheless,these observations do not necessarily indicate universally positive outcomes.Indeed,MASLD and CHB may synergistically act as“co-conspirators”to exacerbate clinical manifestations,particularly liver fibrosis and HCC.Conclusions:As our understanding of the interaction between steatosis and HBV infection becomes clearer,we can better assess the risk of advanced liver disease in patients with concurrent CHB and MASLD.These insights will support the exploration of potential underlying mechanisms and may provide recommendations for improving patient outcomes.
