Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pre...Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software. Results The immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% （32/556）. High sequence homology （99.8%-100%） was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype Cl strains. Three serotypes were detected： adr （19/30）, adw （9/30）, and ayw （2/30）. The frequency of amino acid mutation of the ＇a＇ determinant region was 16.67% （5/30）, including that of Q129H, F134Y,S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome. Conclusion The immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the ＇a＇ determinant region could not account for immunoprophylactic failure for all infants.展开更多
BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate...BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate the clinical and pathological characteristics of inferior mesenteric artery(IMA)root lymph node metastases in patients with rectal cancer.The findings of this study provided us with fresh medical information that assisted us in determining the appropriate treatment for these patients.METHODS Our study searched PubMed,Google Scholar,and other databases and searched the relevant studies and reports on the risk factors of IMA root lymph node metastasis of rectal cancer published in the self-built database until December 31,2023.After data extraction,the Newcastle-Ottawa scale was used to evaluate the quality of the included literature,and RevMan5.3 software was used for meta-analysis and heterogeneity testing.The fixed effect modules without heterogeneity were selected to combine the effect size,and the random effect modules with heterogeneity were selected to combine the effect size.The cause of heterogeneity was found through sensitivity analysis,and the data of various risk factors were combined to obtain the final effect size,odds ratio(OR)value,and 95%confidence interval(CI).Publication bias was tested by drawing funnel plots.RESULTS A total of seven literature were included in this study.By combining the OR value of logistic multivariate regression and the 95%CI of various risk factors,we concluded that the risk factors for lymph node metastasis in the IMA region of rectal cancer were as follows:Preoperative carcinoembryonic antigen(CEA)>5 ng/mL(OR=0.32,95%CI:0.18-0.55,P<0.05),tumor located above peritoneal reflexive(OR=3.10,95%CI:1.78-5.42,P<0.05),tumor size≥5 cm(OR=0.36,95%CI:0.22-0.57,P<0.05),pathological type(mucinous adenocarcinoma/sig-ring cell carcinoma)(OR=0.23,95%CI:0.13-0.41,P<0.05),degree of tumor differentiation(low differentiation)(OR=0.17,95%CI:0.10-0.31,P<0.05),tumor stage(T3-4 stage)(OR=0.11,95%CI:0.04-0.26,P<0.05),gender and age were not risk factors for IMA root lymph node metastasis in rectal cancer(P>0.05).CONCLUSION Preoperative CEA level,tumor location,tumor size,tumor pathologic type,tumor differentiation,and T stage were correlated with IMA root lymph node metastasis.展开更多
BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking ...BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.展开更多
Pertussis(whooping cough)is an acute and contagious respiratory disease caused by the pathogen Bordetella pertussis(B.pertussis).B.pertussis can infect individuals of all ages.Children with pertussis may experience se...Pertussis(whooping cough)is an acute and contagious respiratory disease caused by the pathogen Bordetella pertussis(B.pertussis).B.pertussis can infect individuals of all ages.Children with pertussis may experience severe and persistent coughing and paroxysms;for newborns and infants,pertussis may be life-threatening.The development and widespread administration of the pertussis vaccine had once successfully brought pertussis under control,maintaining it at a low level for many years.However,resurgence of pertussis has been reported in many countries even with high vaccination coverage recently.The resurgence of pertussis was first reported in the United States(USA)in 1993[1].During 2000–2016,the baseline incidence increased and the age distribution of pertussis changed in the USA[2].Other countries including Canada[3],Australia[4],European Union countries,and South Korea have also reported a rise in pertussis outbreaks[2,5].展开更多
Background Pertussis resurgence has been reported worldwide in the past two decades. Pertussis is still endemic and diffcult to control though with universal vaccination in children. The resurgence may be related to m...Background Pertussis resurgence has been reported worldwide in the past two decades. Pertussis is still endemic and diffcult to control though with universal vaccination in children. The resurgence may be related to multiple variables, such as increased disease awareness and laboratory tests, waning of immunity following vaccination, and/or genetic mutations of Bordetella pertussis. For better pertussis prevention, diagnosis, and management, we called up an expert panel to develop this expert consensus to provide new concepts in diagnosis and treatment for clinical practice.Data sources The expert groups collected clinical evidence, summarized their clinical experiences, evaluated preliminary recommendations or guidelines, and then organized open-ended discussions to form the recommendations. This consensus was developed by reviewing the literature and studies in databases, including PubMed, Cochrane, EMBASE, the China Biomedical Database, and the Chinese Journal Full-text Database up to May 2024. The search terms included “pertussis” or “whooping cough”, “children”, “diagnosis”, and “treatment”.Results The burden of pertussis has also changed from infants to school children and adults, and these age groups have consequently become the main source of infection for vulnerable population including infants and newborns. In China, a high prevalence of erythromycin-resistant Bordetella pertussis (ERBP) has been reported in the past decade. ERBP may lead to failed clinical empirical treatment with macrolides, which poses a great challenge for pertussis management and control. For better management of pertussis, a fow diagram for diagnosis and treatment of pertussis was presented in this consensus. This consensus also described the diagnostic criteria for pertussis, high-risk cases, and severe pertussis. Macrolides can still be used to treat confrmed erythromycin-sensitive B. pertussis (ESBP) infections, whereas oral trimethoprim–sulfamethoxazole therapy is the initial treatment option for children older than two months. For infants younger than two months, severe patients, or those exhibiting a high degree of sulfonamide allergy, intravenous administration of piperacillin or cefoperazone–sulbactam is advised.Conclusions This expert consensus provides a comprehensive guidance and a reference for the diagnosis and treatment of pertussis in children.展开更多
基金supported by the Chinese Twelfth Five-Year Plan,a major science and technology program for hepatitis(Grant Number:2012ZX10002001)
文摘Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software. Results The immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% （32/556）. High sequence homology （99.8%-100%） was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype Cl strains. Three serotypes were detected： adr （19/30）, adw （9/30）, and ayw （2/30）. The frequency of amino acid mutation of the ＇a＇ determinant region was 16.67% （5/30）, including that of Q129H, F134Y,S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome. Conclusion The immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the ＇a＇ determinant region could not account for immunoprophylactic failure for all infants.
文摘BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate the clinical and pathological characteristics of inferior mesenteric artery(IMA)root lymph node metastases in patients with rectal cancer.The findings of this study provided us with fresh medical information that assisted us in determining the appropriate treatment for these patients.METHODS Our study searched PubMed,Google Scholar,and other databases and searched the relevant studies and reports on the risk factors of IMA root lymph node metastasis of rectal cancer published in the self-built database until December 31,2023.After data extraction,the Newcastle-Ottawa scale was used to evaluate the quality of the included literature,and RevMan5.3 software was used for meta-analysis and heterogeneity testing.The fixed effect modules without heterogeneity were selected to combine the effect size,and the random effect modules with heterogeneity were selected to combine the effect size.The cause of heterogeneity was found through sensitivity analysis,and the data of various risk factors were combined to obtain the final effect size,odds ratio(OR)value,and 95%confidence interval(CI).Publication bias was tested by drawing funnel plots.RESULTS A total of seven literature were included in this study.By combining the OR value of logistic multivariate regression and the 95%CI of various risk factors,we concluded that the risk factors for lymph node metastasis in the IMA region of rectal cancer were as follows:Preoperative carcinoembryonic antigen(CEA)>5 ng/mL(OR=0.32,95%CI:0.18-0.55,P<0.05),tumor located above peritoneal reflexive(OR=3.10,95%CI:1.78-5.42,P<0.05),tumor size≥5 cm(OR=0.36,95%CI:0.22-0.57,P<0.05),pathological type(mucinous adenocarcinoma/sig-ring cell carcinoma)(OR=0.23,95%CI:0.13-0.41,P<0.05),degree of tumor differentiation(low differentiation)(OR=0.17,95%CI:0.10-0.31,P<0.05),tumor stage(T3-4 stage)(OR=0.11,95%CI:0.04-0.26,P<0.05),gender and age were not risk factors for IMA root lymph node metastasis in rectal cancer(P>0.05).CONCLUSION Preoperative CEA level,tumor location,tumor size,tumor pathologic type,tumor differentiation,and T stage were correlated with IMA root lymph node metastasis.
基金Supported by the Academic Leaders Training Program of Pudong Health Bureau of Shanghai,No.PWRd2023-03Clinical Research Fund of Shanghai Municipal Commission of Health,No.202040136+1 种基金National Natural Science Foundation of China,No.82070842Jiangxi Health Commission Science and Technology Plan Project,No.202212838 and No.202212852.
文摘BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.
文摘Pertussis(whooping cough)is an acute and contagious respiratory disease caused by the pathogen Bordetella pertussis(B.pertussis).B.pertussis can infect individuals of all ages.Children with pertussis may experience severe and persistent coughing and paroxysms;for newborns and infants,pertussis may be life-threatening.The development and widespread administration of the pertussis vaccine had once successfully brought pertussis under control,maintaining it at a low level for many years.However,resurgence of pertussis has been reported in many countries even with high vaccination coverage recently.The resurgence of pertussis was first reported in the United States(USA)in 1993[1].During 2000–2016,the baseline incidence increased and the age distribution of pertussis changed in the USA[2].Other countries including Canada[3],Australia[4],European Union countries,and South Korea have also reported a rise in pertussis outbreaks[2,5].
基金supported by the National Natural Science Foundation of China(92169113)the CAS Project for Young Scientists in Basic Research(YSBR-010)+1 种基金the National Key R&D Program of China(2022YFC2302900)the Key Research Program of Frontier Sciences of CAS(ZDBS-LY-SM025)。
基金supported by the Natural Science Foundation of Zhejiang Province,China[LGF18H010001].
文摘Background Pertussis resurgence has been reported worldwide in the past two decades. Pertussis is still endemic and diffcult to control though with universal vaccination in children. The resurgence may be related to multiple variables, such as increased disease awareness and laboratory tests, waning of immunity following vaccination, and/or genetic mutations of Bordetella pertussis. For better pertussis prevention, diagnosis, and management, we called up an expert panel to develop this expert consensus to provide new concepts in diagnosis and treatment for clinical practice.Data sources The expert groups collected clinical evidence, summarized their clinical experiences, evaluated preliminary recommendations or guidelines, and then organized open-ended discussions to form the recommendations. This consensus was developed by reviewing the literature and studies in databases, including PubMed, Cochrane, EMBASE, the China Biomedical Database, and the Chinese Journal Full-text Database up to May 2024. The search terms included “pertussis” or “whooping cough”, “children”, “diagnosis”, and “treatment”.Results The burden of pertussis has also changed from infants to school children and adults, and these age groups have consequently become the main source of infection for vulnerable population including infants and newborns. In China, a high prevalence of erythromycin-resistant Bordetella pertussis (ERBP) has been reported in the past decade. ERBP may lead to failed clinical empirical treatment with macrolides, which poses a great challenge for pertussis management and control. For better management of pertussis, a fow diagram for diagnosis and treatment of pertussis was presented in this consensus. This consensus also described the diagnostic criteria for pertussis, high-risk cases, and severe pertussis. Macrolides can still be used to treat confrmed erythromycin-sensitive B. pertussis (ESBP) infections, whereas oral trimethoprim–sulfamethoxazole therapy is the initial treatment option for children older than two months. For infants younger than two months, severe patients, or those exhibiting a high degree of sulfonamide allergy, intravenous administration of piperacillin or cefoperazone–sulbactam is advised.Conclusions This expert consensus provides a comprehensive guidance and a reference for the diagnosis and treatment of pertussis in children.
