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Typical hemophagocytic syndrome associated with cytomegalovirus infection in an immunocompetent patient: a case report and literature review

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第12期24卷 1159-1164页

作者： Fangfang GENG Meifang YANG Xuan ZHANG Hong ZHAO De ZHOU Jianhua HU State Key Laboratory for Diagnosis and Treatment of infectious diseases National Clinical Research Center for Infectious DiseasesNational Medical Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesDepartment of Infectious Diseasesthe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China department of Hematology the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Cytomegalovirus(CMV)infection is currently prevalent in populations throughout the world,and 56%-94%of the global population is seropositive for CMV.CMV infection mainly affects immunocompromised hosts.In these cases,it can cause significant symptoms,tissue-invasive disease,and many sequelae including death(Dioverti and Razonable,2016).The vast majority of healthy adults with CMV infection experience an asymptomatic course;when symptomatic,it manifests as a mononucleosis-like syndrome in approximately 10%of patients(Sridhar et al.,2018).

关键词： infection immuno

Hypertension and NAFLD risk:Insights from the NHANES 2017-2018 and Mendelian randomization analyses

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Chinese Medical Journal 2024年第4期137卷 457-464页

作者： Mengqin Yuan Jian He Xue Hu Lichao Yao Ping Chen Zheng Wang Pingji Liu Zhiyu Xiong Yingan Jiang Lanjuan Li Department of Infectious Diseases Renmin Hospital of Wuhan UniversityWuhanHubei 430000China department of Gastroenterology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510010China State Key Laboratory for Diagnosis and Treatment of infectious diseases National Clinical Research Centre for Infectious DiseasesCollaborative Innovation Centre for Diagnosis and Treatment of Infectious DiseasesDepartment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310000China

Background:Hypertension and non-alcoholic fatty liver disease(NAFLD)share several pathophysiologic risk factors,and the exact relationship between the two remains unclear.Our study aims to provide evidence concerning the relationship between hypertension and NAFLD by analyzing data from the National Health and Nutrition Examination Survey(NHANES)2017-2018 and Mendelian randomization(MR)analyses.Methods:Weighted multivariable-adjusted logistic regression was applied to assess the relationship between hypertension and NAFLD risk by using data from the NHANES 2017-2018.Subsequently,a two-sample MR study was performed using the genome-wide association study(GWAS)summary statistics to identify the causal association between hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),and NAFLD.The primary inverse variance weighted(IVW)and other supplementary MR approaches were conducted to verify the causal association between hypertension and NAFLD.Sensitivity analyses were adopted to confirm the robustness of the results.Results:A total of 3144 participants were enrolled for our observational study in NHANES.Weighted multivariable-adjusted logistic regression analysis suggested that hypertension was positively related to NAFLD risk(odds ratio[OR]=1.677;95%confidence interval[CI],1.159-2.423).SBP≥130 mmHg and DBP≥80 mmHg were also significantly positively correlated with NAFLD.Moreover,hypertension was independently connected with liver steatosis(β=7.836[95%CI,2.334-13.338]).The results of MR analysis also supported a causal association between hypertension(OR=7.203[95%CI,2.297-22.587])and NAFLD.Similar results were observed for the causal exploration between SBP(OR=1.024[95%CI,1.003-1.046]),DBP(OR=1.047[95%CI,1.005-1.090]),and NAFLD.The sensitive analysis further confirmed the robustness and reliability of these findings(all P>0.05).Conclusion:Hypertension was associated with an increased risk of NAFLD.

关键词： Hypertension Non-alcoholic fatty liver disease National Health and Nutrition Examination Survey Mendelian randomization analysis Causality

Development and validation of a nomogram to predict failure of 14-day negative nucleic acid conversion in adults with non-severe COVID-19 during the Omicron surge: a retrospective multicenter study

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infectious diseases of Poverty 2023年第1期12卷 36-46页

作者： Honglian Gui Zhenglan Zhang Bin Chen Yaoxing Chen Yue Wang Zhuo Long Chuanwu Zhu Yinling Wang Zhujun Cao Qing Xie Department of Infectious Diseases Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Infectious Diseases Shanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina department of Hepatology Wuwei People’s HospitalGansuChina Department of Infectious Diseases The Affiliated Infectious Diseases Hospital of Soochow UniversitySuzhouChina department of Endocrine and Metabolic diseases Fengcheng Hospital of Fengxian DistrictShanghaiChina

Background With the variability in emerging data,guidance on the isolation duration for patients with coronavirus disease 2019(COVID-19)due to the Omicron variant is controversial.This study aimed to determine the predictors of prolonged viral RNA shedding in patients with non-severe COVID-19 and construct a nomogram to predict patients at risk of 14-day PCR conversion failure.Methods Adult patients with non-severe COVID-19 were enrolled from three hospitals of eastern China in Spring 2022.Viral shedding time(VST)was defined as either the day of the first positive test or the day of symptom onset,whichever was earlier,to the date of the first of two consecutively negative PCR tests.Patients from one hospital(Cohort I,n=2033)were randomly grouped into training and internal validation sets.Predictors of 14-day PCR conversion failure were identified and a nomogram was developed by multivariable logistic regression using the training dataset.Two hospitals(Cohort II,n=1596)were used as an external validation set to measure the performance of this nomogram.Results Of the 2033 patients from Cohort I,the median VST was 13.0(interquartile range:10.0-16.0)days;716(35.2%)lasted>14 days.In the training set,increased age[per 10 years,odds ratio(OR)=1.29,95%confidence interval(CI):1.15-1.45,P14 days,whereas full or boosted vaccination(OR=0.63,95%CI:0.42-0.95,P=0.028)and antiviral therapy(OR=0.56,95%CI:0.31-0.96,P=0.040)were protective factors.These predictors were used to develop a nomogram to predict VST>14 days,with an area under the ROC curve(AUC)of 0.73 in the training set(AUC,0.74 in internal validation set;0.76 in external validation set).Conclusions Older age,increasing comorbidities,incomplete vaccinations,and lack of antiviral therapy are risk factors for persistent infection with Omicron variant for>14 days.A nomogram based on these predictors could be used as a prediction tool to guide treatment and isola

关键词： Nomogram Viral shedding time Prediction Omicron variant COVID-19

Safety and efficacy of PD-1 inhibitors in HIV-infected patients with severe comorbidities:a prospective observational cohort study

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Chinese Medical Journal 2023年第22期136卷 2750-2752页

作者： Xueling Zhu Xiang Liu Zhikai Wan Jiangjin Hui Ran Tao Xiaorong Peng Junwei Su Ying Huang Biao Zhu Department of Infectious Diseases State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesNational Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310003China

To the Editor:People living with the human immunodeficiency virus(PLWH)are more likely to develop cancers,have a more severe clinical course of cancers,and have a higher mortality than healthy population.Standard treatments and immunotherapy like immunecheckpoint inhibitors(ICIs)used for cancer are being employed increasingly to treat non-acquired immune deficiency syndrome-defining cancers in PLWH because of an improvement in combined antiretroviral therapy(cART)efficacy and life expectancy.[1]Malignant tumor cells provoke suppression of immune checkpoints and promote immunosuppressive states,which favors evasion of the immune system and tumor growth.ICIs act by blocking inhibitory pathways through invigorating T cells and other innate cells and adaptive cells,thereby resulting in productive antitumor immune responses.

关键词： mortality thereby likely

Mitochondrial dysfunction: A promising therapeutic target for liver diseases

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Genes & diseases 2024年第3期11卷 324-337页

作者： Ping Chen Lichao Yao Mengqin Yuan Zheng Wang Qiuling Zhang Yingan Jiang Lanjuan Li Department of Infectious Diseases Renmin Hospital of Wuhan UniversityWuhanHubei 430060China State Key Laboratory for Diagnosis and Treatment of infectious diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310003China

The liver is an important metabolic and detoxification organ and hence demands a large amount of energy,which is mainly produced by the mitochondria.Liver tissues of pa-tients with alcohol-related or non-alcohol-related liver diseases contain ultrastructural mito-chondrial lesions,mitochondrial DNA damage,disturbed mitochondrial dynamics,and compromised ATP production.Overproduction of mitochondrial reactive oxygen species in-duces oxidative damage to mitochondrial proteins and mitochondrial DNA,decreases mito-chondrial membrane potential,triggers hepatocyte inflammation,and promotes programmed cell death,all of which impair liver function.Mitochondrial DNA may be a poten-tial novel non-invasive biomarker of the risk of progression to liver cirrhosis and hepatocellular carcinoma in patients infected with the hepatitis B virus.We herein present a review of the mechanisms of mitochondrial dysfunction in the development of acute liver injury and chronic liver diseases,such as hepatocellular carcinoma,viral hepatitis,drug-induced liver injury,alcoholic liver disease,and non-alcoholic fatty liver disease.This review also discusses mito-chondrion-centric therapies for treating liver diseases.

关键词： Chronic diseases Liverdamage Mesenchymalstem cell Mitochondrial dysfunction Oxidativestress

Prevalence of transmitted drug resistance mutations among patients infected with human immunodeficiency virus type 1 (HIV-1) in Henan Province, China

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Chinese Medical Journal 2022年第22期135卷 2750-2752页

作者： Jinjin Liu Xiaohua Zhang Mingjie Hou Shuguang Wei Jie Ma Lixia Xu Xuan Yang Yan Sun Chunli Liu Qingxia Zhao Yuqi Huo Tanslational Medicine Research Center Henan Infectious Diseases HospitalZhengzhouHenan 450000China Clinic of Infection and Immunology Henan Infectious Diseases HospitalZhengzhouHenan 450000China Department of Infectious Diseases Henan Infectious Diseases HospitalZhengzhouHenan 450000China

To the Editor:Even with the emergence of highly active antiretroviral therapy,human immunodeficiency virus type 1(HIV-1)remains a serious public health problem worldwide.The widespread use of antiretroviral therapy(ART)has,on the one hand,significantly improved life expectancy in patients infected with HIV-1;on the other hand,it has inevitably brought along with it a difficult problem—viral resistance.Viral resistance is a common phenomenon evolutionarily,particularly in patients with poor adherence and suboptimal drug levels.

关键词： patients immunodeficiency Henan

Frequency and safety of COVID-19 vaccination in children with multisystem inflammatory syndrome:a telephonic interview-based analysis

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World Journal of Pediatrics 2022年第10期18卷 700-705页

作者： Kubra Aykac Kubra Ozturk Osman Oguz Demir Dilan Demir Gumus Sevgi Aslan Ela Cem Miray Yilmaz Celebi Mustafa Dogan Karabacak Gulsum Alkan Fatma Dilsad Aksoy Burcu Ceylan Cura Yayla Eda Kepenekli Solmaz Celebi Melike Emiroglu Ilker Devrim Ali Bulent Cengiz Mehmet Ceyhan Yasemin Ozsurekci Faculty of Medicine Department of Pediatric Infectious DiseasesHacettepe UniversityAnkaraTurkey Goztepe Prof.Dr.Suleyman Department of Pediatric RheumatologyYalcın City HospitalIstanbulTurkey Faculty of Medicine Department of Pediatric DiseasesHacettepe UniversityAnkaraTurkey department of Pediatric infectious diseases Marmara University School of MedicineIstanbulTurkey department of Pediatric infectious diseases Dr.Behçet Uz Children’s HospitalízmirTurkey Faculty of Medicine Department of Pediatric Infectious DiseasesSelcuk UniversityKonyaTurkey Faculty of Medicine Department of Pediatric Infectious DiseasesUludag UniversityBursaTurkey department of Pediatric infectious diseases University of Health Science Ankara Training and Research HospitalAnkaraTurkey

Coronavirus disease 2019(COVID-19)vaccines are currently approved or authorized to prevent serious outcomes,such as severe disease,hospitalization,and death.The Pfizer-BioNTech vaccine is recommended for everyone aged five and older in the United States(US)to prevent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection[1,2].However,it is unclear whether children with a history of multisystem,inflammatory syndrome in children(MIS-C)may be at risk for a MIS-like response following COVID-19 vaccination or SARS-CoV-2 reinfection[2].Therefore,physicians remain uncertain about vaccinating children with a history of MIS-C.This study investigates the occurrence of severe,systemic side effects of COVID-19 vaccines and the recurrence of the MIS-C symptoms in children with a history of MIS-C to overcome vaccine hesitancy.

关键词： vaccination vaccine Pfizer

Pronostic Factors of Cerebral Toxoplasmosis in department of infectious and Tropical diseases at Donka National Hospital

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Advances in infectious diseases 2019年第3期9卷 243-251页

作者： Mamadou Saliou Sow Karamba Sylla Diao Cissé Fodé Abass Cissé Ibrahima Bah Kadiatou Cissé Kadio Jean Jaques Olivier Kadio department of infectious and Tropical diseases at Donka National Hospital Conakry Guinea Chair of Public Health Conakry Guinea Neurology department of Ignace Deen National Hospital Conakry Guinea

Objectives: To identify predictive factors for poor prognosis during cerebral toxoplasmosis at Donka Hospital. Methods: It was a retrospective study of descriptive and analytic type lasting one year six months (18 months) from January 1st, 2016 to June 30th, 2017 which involved patients admitted and hospitalized for cerebral toxoplasmosis in HIV field. Data enter was performed by Epi data 3.1 software and SPSS 21 software for statistical analysis. The threshold of significance was p Results: We observed 87 cases of cerebral toxoplasmosis (CT). The mean age was 38.53 ± 12.16. The clinical signs were mainly infectious syndrome (100%), headache (69.0%), confusion (46.0%) and meningeal syndrome (41.4%). The lethality was 37.9%. Living with a partner (p = 0.007), CD4 at initiation of antiretroviral therapy 3 (p = 0.009), and coma (p = 0.02) were the factors associated with death. Conclusion: This study showed that cerebral toxoplasmosis is associated with very high morbidity and mortality in the infectious diseases department of Donka National Hospital. Living in a relationship, CD4 counts at baseline 3 and coma were independently associated with death. Special attention to these factors associated with infectious resuscitation and primary prevention in patients with a CD4 T lymphocyte count below 200 cells/mm may improve the prognosis of this pathology.

关键词： Cerebral Toxoplasmosis HIV/AIDS Donka

Efficacy of hybrid minimally invasive esophagectomy vs open esophagectomy for esophageal cancer: A meta-analysis

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World Journal of Gastrointestinal Oncology 2019年第11期11卷 1081-1091页

作者： Jiao Yang Ling Chen Ke Ge Jian-Le Yang Department of Infectious Diseases Zhejiang Hospital

BACKGROUND The first line treatment regimen for esophageal cancer is still surgical resection and the choice of surgical scheme depends on surgeon.Now the efficacy comparison of hybrid minimally invasive esophagectomy(HMIE)and open esophagectomy(OE)is still controversial.AIM To compare the perioperative and postoperative outcomes of HMIE and OE in patients with esophageal cancer.METHODS PubMed,EMBASE,and Cochrane Library databases were searched for related articles.The odds ratio(OR)or standard mean difference(SMD)with a 95%confidence interval(CI)was used to evaluate the effectiveness of HMIE and OE.RESULTS Seventeen studies including a total of 2397 patients were selected.HMIE was significantly associated with less blood loss(SMD=-0.43,95%CI:-0.66,-0.20;P=0.0002)and lower incidence of pulmonary complications(OR=0.72,95%CI:0.57,0.90;P=0.004).No significant differences were seen in the lymph node yield(SMD=0.11,95%CI:-0.08,0.30;P=0.26),operation time(SMD=0.24,95%CI:-0.14,0.61;P=0.22),total complications rate(OR=0.68,95%CI:0.46,0.99;P=0.05),cardiac complication rate(OR=0.91,95%CI:0.62,1.34;P=0.64),anastomotic leak rate(OR=0.95,95%CI:0.67,1.35;P=0.78),duration of intensive care unit stay(SMD=-0.01,95%CI:-0.21,0.19;P=0.93),duration of hospital stay(SMD=-0.13,95%CI:-0.28,0.01;P=0.08),and total mortality rates(OR=0.70,95%CI:0.47,1.06;P=0.09)between the two treatment groups.CONCLUSION Compared with the OE,HMIE shows less blood loss and pulmonary complications.However,further studies are necessary to evaluate the long-term oncologic outcomes of HMIE.

关键词： Hybrid minimally invasive esophagectomy Open esophagectomy Esophageal cancer