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Probabilistic Antibiotic Therapy in the infectious diseases department of the Yalgado Ouédraogo University Hospital (CHU-YO) in Ouagadougou, Burkina Faso

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Advances in infectious diseases 2022年第4期12卷 639-645页

作者： Savadogo Mamoudou Bonané Faïz department of infectious diseases CHU Yalgado Ouédraogo Ouagadougou Burkina Faso

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

关键词： Probabilistic Antibiotic Therapy Beta-lactam infectious diseases department of the Yalgado Ouédraogo University Hospital

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New role and molecular mechanism of Gadd45a in hepatic fibrosis

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World Journal of Gastroenterology 2016年第9期22卷 2779-2788页

作者： Liang Hong Qing-Feng Sun Ting-Yan Xu Yang-He Wu Hui Zhang Rong-Quan Fu Fu-Jing Cai Qing-Qing Zhou Ke Zhou Qing-Wei Du Dong Zhang Shuang Xu Ji-Guang Ding department of infectious diseases the Third Affiliated Hospital to Wenzhou Medical University department of infectious diseases The First Peoples Hospital of Xiaoshan Disrict department of infectious diseases Tianjin Baodi Hospital

AIM: To investigate the role of Gadd45a in hepatic fibrosis and the transforming growth factor (TGF)-beta/ Smad signaling pathway. METHODS: Wild-type male BALB/c mice were treated with CCl4 to induce a model of chronic liver injury. Hepatic stellate cells (HSCs) were isolated from the liver of BALB/c mice and were treated with small interfering RNAs (siRNAs) targeting Gadd45a or the pcDNA3.1-Gadd45a recombinant plasmid. Cellular alpha-smooth muscle actin (alpha-SMA), beta-actin, type I collagen, phospho-Smad2, phospho-Smad3, Smad2, Smad3, and Smad4 were detected by Western blots. The mRNA levels of alpha-SMA, beta-actin, and type I collagen were determined by quantitative real-time (qRT)-PCR analyses. Reactive oxygen species production was monitored by flow cytometry using 2,7-dichlorodihydrofluorescein diacetate. Gadd45a, Gadd45b, anti-Gadd45g, type I collagen, and SMA local expression in liver tissue were measured by histologic and immunohistochemical analyses. RESULTS: Significant downregulation of Gadd45a, but not Gadd45b or Gadd45g, accompanied by activation of the TGF-beta/Smad signaling pathways was detected in fibrotic liver tissues of mice and isolated HSCs with chronic liver injury induced by CCl4 treatment. Overexpression of Gadd45a reduced the expression of extracellular matrix proteins and alpha-SMA in HSCs, whereas transient knockdown of Gadd45a with siRNA reversed this process. Gadd45a inhibited the activity of a plasminogen activator inhibitor-1 promoter construct and (CAGA)(9) MLP-Luc, an artificial Smad3/4-specific reporter, as well as reduced the phosphorylation and nuclear translocation of Smad3. Gadd45a showed protective effects by scavenging reactive oxygen species and upregulating antioxidant enzymes. CONCLUSION: Gadd45a may counteract hepatic fibrosis by regulating the activation of HSCs via the inhibition of TGF-beta/Smad signaling.

关键词： Antioxidant Gadd45a Hepatic fibrosis Hepatic stellate cells Transforming growth factor-beta/Smad signaling

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Is liver biopsy still needed in children with chronic viral hepatitis?

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World Journal of Gastroenterology 2015年第42期21卷 12141-12149页

作者： Maria Pokorska-?piewak Barbara Kowalik-Miko?ajewska Ma?gorzata Aniszewska Magdalena Pluta Magdalena Marczyńska department of Children’s infectious diseases Medical University of Warsaw Warsaw Hospital for infectious diseases

Liver biopsy is a standard method used for obtaining liver tissue for histopathological evaluation. Since reliable serological and virological tests are currently available, liver biopsy is no longer needed for the etiological diagnosis of chronic hepatitis B and C. However, liver histology remains the gold standard as a prognostic tool, providing information about the liver disease progression(grading of necroinflammatory activity and staging of fibrosis) and serving clinicians in the management and therapeutic decisions. In general, histopathological evaluation is indicated before starting the antiviral treatment. Main limitations of the liver biopsy include its invasive and painful procedure, sampling errors and the inter- and intra-observer variability. In addition, indications for the liver biopsy in pediatric patients with chronic viral hepatitis were questioned recently, and efforts have been made toward the development of non-invasive methods as an alternative to the liver biopsy. The most commonly used methods are novel imaging studies(elastography) and combinations of biomarkers. However, to date, none of these tests was validated in children with chronic viral hepatitis. In this review, we present the current status of the liver biopsy in the management of chronic viral hepatitis B and C in pediatric population, including specific indications, complications, contraindications, problems, limitations, and alternative non-invasive methods.

关键词： Liver biopsy Hepatitis B Hepatitis C Pathology Ela

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Parasitosis Diagnosed in the infectious diseases department of the Yalgado Ouédraogo University Hospital from 2010 to 2022: Epidemiological, Clinical and Evolutionary Aspects

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Advances in infectious diseases 2022年第4期12卷 633-638页

作者： Savadogo Mamoudou Traore Zoumbahan Marie Thérèse department of infectious diseases CHU Yalgado Ouédraogo Ouagadougou Burkina Faso

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.

关键词： Parasitosis Protozoosis Helminthosis HIV/AIDS

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Prostaglandin E1 protects hepatocytes against endoplasmic reticulum stress-induced apoptosis via protein kinase A-dependent induction of glucose-regulated protein 78 expression

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World Journal of Gastroenterology 2017年第40期23卷 7253-7264页

作者： Fang-Wan Yang Yu Fu Ying Li Yi-Huai He Mao-Yuan Mu Qi-Chuan Liu Jun Long Shi-De Lin department of infectious diseases Affiliated Hospital of Zunyi Medical College department of infectious diseases Heze Municipal Hospital

AIM To investigate the protective effect of prostaglandin E1(PGE1) against endoplasmic reticulum(ER) stressinduced hepatocyte apoptosis, and to explore its underlying *** Thapsigargin(TG) was used to induce ER stress in the human hepatic cell line L02 and hepatocarcinomaderived cell line Hep G2. To evaluate the effects of PGE1 on TG-induced apoptosis, PGE1 was used an hour prior to TG treatment. Activation of unfolded protein response signaling pathways were detected by western blotting and quantitative real-time RTPCR. Apoptotic index and cell viability of L02 cells and Hep G2 cells were determined with flow cytometry and MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2 H-tetrazolium] assay. RESULTS Pretreatment with 1 μmol/L PGE1 protected against TG-induced apoptosis in both L02 cells and Hep G2 cells. PGE1 enhanced the TG-induced expression of C/EBP homologous protein(CHOP), glucose-regulated protein(GRP) 78 and spliced X box-binding protein 1 at 6 h. However, it attenuated their expressions after 24 h. PGE1 alone induced protein and m RNA expressions of GRP78; PGE1 also induced protein expression of DNA damage-inducible gene 34 and inhibited the expressions of phospho-PKR-like ER kinase, phosphoeukaryotic initiation factor 2α and CHOP. Treatment with protein kinase A(PKA)-inhibitor H89 or KT5720 blocked PGE1-induced up-regulation of GRP78. Further, the cytoprotective effect of PGE1 on hepatocytes was not observed after blockade of GRP78 expression by H89 or small interfering RNA specifically targeted against human *** Our study demonstrates that PGE1 protects against ER stress-induced hepatocyte apoptosis via PKA pathwaydependent induction of GRP78 expression.

关键词： Hepatocytes Endoplasmic reticulum stress Thapsigargin Glucose-regulated protein 78 Protein kinase A Apoptosis

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Sodium butyrate protects against toxin-induced acute liver failure in rats

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Hepatobiliary & Pancreatic diseases International 2014年第3期13卷 309-315页

作者： Fan Yang Li-Kun Wang Xun Li Lu-Wen Wang Xiao-Qun Han Zuo-Jiong Gong department of infectious diseases Renmin Hospital of Wuhan University department of infectious diseases Linyi People's Hospital

BACKGROUND: Acute liver failure(ALF) is a serious clinical syndrome with high mortality. Sodium butyrate has been shown to alleviate organ injury in a wide variety of preclinical models of critical diseases. The aim of this study was to investigate the protective effect of sodium butyrate on ALF in ***: All rats were randomly divided into control,model and sodium butyrate treatment groups. Except the control group, the rats were induced ALF animal model by subcutaneous injection of human serum albumin+D- galactosamine+lipopolysaccharide. After induction of ALF,the rats in the treatment group received sodium butyrate(500mg/kg) at 12-hour or 24-hour time point. Fourty-eight hours after ALF induction, the animals were sacrificed and samples were harvested. Serum endotoxin, high mobility group box-1(HMGB1), liver function parameters, tumor necrosis factoralpha(TNF-α) and interferon-gamma(IFN-γ) were *** expression of HMGB1 and nuclear factor-kappa B(NF-κB)p65 protein in liver tissue was detected by Western blotting. The histological changes of liver and intestine were examined. The survival duration was also ***: Serum endotoxin, alanine aminotransferase, HMGB1,TNF-α and IFN-γ were significantly increased and the liver histology showed more severe histopathological injury in the model group compared with the control group(P<0.05).Compared to the model group, sodium butyrate treatment significantly improved the histopathological changes in the liver and intestine, reduced serum endotoxin and inflammatory cytokines, suppressed HMGB1 and NF-кB p65 proteins in liver tissue, and prolonged the survival duration regardless of treatment at 12 hours or 24 hours after induction of ALF(P<0.05).CONCLUSIONS: Sodium butyrate protected the liver from toxin-induced ALF in rats. The mechanisms may be due to direct hepatoprotection and decreased intestinal permeability.

关键词： acute liver failure high mobility group box-1 nuclear factor-kappa B p65 animal model sodium butyrate

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The frst avian infuenza A (H7N9) viral infection in humans in Zhejiang Province, China: a death report

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Frontiers of Medicine 2013年第3期7卷 333-344页

作者： Enfu Chen Fenjuan Wang Huakun Lv Yanjun Zhang Hua Ding Shelan Liu Jian Cai Li Xie Xiaoping Xu Chengliang Chai Haiyan Mao Jimin Sun Junfen Lin Zhao Yu Lianhong Li Zhiping Chen Shichang Xia department of infectious diseases Zhejiang Center for Disease Control and Prevention department of infectious diseases Xiaoshan District Center for Disease Control and Prevention department of infectious diseases Hangzhou Center for Disease Control and Prevention department of infectious diseases Jiande Center for Disease Control and Prevention

This study reports the frst death caused by a novel avian infuenza A(H7N9)virus in Zhejiang Province,*** patient had chronic hepatitis B and history of exposure to *** patient initially complained of diarrhea and infuenza-like symptoms on March 7 and 14 *** disease progressed to severe pneumonia,sustained hypoxia,and coagulation *** patient died on March 27 because of respiratory failure,multiple organ failure,and disseminated intravascular coagulation without oseltamivir *** H7N9 virus from Zhejiang is highly similar to isolates obtained from Shanghai,Jiangsu,Anhui,*** of hemagglutinin,neuramidinase,and matrix genes indicated that the isolates share the same avian origin,have low virulence,and are sensitive to oseltamivir,but are resistant to *** the isolate that caused the fatality exhibited substitution of Q226I in the HA gene,which indicates a potentially enhanced human *** secondary transmission rate was 1.6%(2/125).Only two health workers presented with infuenza-like symptoms,and they subsequently tested negative for H7N9 *** conclusion,underlying disease,late diagnosis,and untimely antiviral treatment are possible high-risk factors for infections and death caused by the lowpathogenicity avian infuenza A(H7N9).Person-to-person transmission of the H7N9 virus was not detected among close contacts,but such transmission should be investigated in the *** and enhancing surveillance will help in the early discovery and diagnosis of suspected cases,which will reduce the number of severe cases and deaths.

关键词： avian influenza A (H7N9) virus epidemiology contacts person-to-person transmission

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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 *** the efficacy comparison of hybrid minimally invasive esophagectomy(HMIE)and open esophagectomy(OE)is still *** To compare the perioperative and postoperative outcomes of HMIE and OE in patients with esophageal *** PubMed,EMBASE,and Cochrane Library databases were searched for related *** odds ratio(OR)or standard mean difference(SMD)with a 95%confidence interval(CI)was used to evaluate the effectiveness of HMIE and *** Seventeen studies including a total of 2397 patients were *** 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 *** Compared with the OE,HMIE shows less blood loss and pulmonary ***,further studies are necessary to evaluate the long-term oncologic outcomes of HMIE.

关键词： Hybrid minimally invasive esophagectomy Open esophagectomy Esophageal cancer

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High frequency of thrombocytopenia in patients with acute-on-chronic liver failure treated with linezolid

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Hepatobiliary & Pancreatic diseases International 2015年第3期14卷 287-292页

作者： Yi-Min Zhang Wei Yu Ning Zhou Jian-Zhou Li Li-Chen Xu Zhong-Yang Xie Ying-Feng Lu Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of infectious diseases Department of Infectious Diseases the First Affiliated Hospital Zhejiang University School of Medicine Collaborative Innovation Center for Diagnosis and Treatment of infectious diseases

BACKGROUND： Linezolid is an effective antibiotic reagent for Gram-positive bacterial infection; its most common side effect is thrombocytopenia. However, the incidence of throm- bocytopenia in patients with acute-on-chronic liver failure （ACLF） who underwent linezolid therapy was unclear. The present study was to evaluate the incidence of thrombocyto- penia in ACLF and non-ACLF patients treated with linezolid and the risk factors of thrombocytopenia in these patients.

关键词： acute-on-chronic liver failure linezolid thrombocytopenia

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Novel HBV mutations and their value in predicting efficacy of conventional interferon

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Hepatobiliary & Pancreatic diseases International 2017年第2期16卷 189-196页

作者： Da-Xian Wu Xiao-Yu Fu Guo-Zhong Gong Ke-Wei Sun Huan-Yu Gong Ling Wang Juan Wu De-Ming Tan department of infectious diseases Xiangya Hospital Central South University Key Laboratory of Viral Hepatitis of Hunan Province department of infectious diseases The Second Xiangya Hospital Central South University department of infectious diseases The First Affiliated Hospital Hunan University of Chinese Medicine department of infectious diseases The Third Xiangya Hospital Central South University

BACKGROUND： Accumulating studies assessing the impacts of hot spot mutations on conventional interferon（IFN） efficacy come to discrepant conclusions; studies regarding the mutations in S and RT regions are also unclear. The present study aimed to evaluate the impacts of HBV mutations on the efficacy of conventional IFN. METHODS： A total of 126 patients who received conventional IFN treatment for 48 weeks were enrolled. Biochemical and serological parameters were routinely tested. The sequences of HBV from 78 serum samples were amplified by nested-PCR; mutations were identified with sequence scanner V1.0 after ABI 3730 xl direct sequencing, HBV genotypes were determined according to RT gene sequences utilizing NCBI Genotyping Tool which was based on phylogenetic ***： The baseline DNA levels of virological response（VR） group were significantly lower than those of no VR group [7.13±0.76 vs 7.69±0.56 lg（copies/m L）, P=0.001]. The baseline ALT levels were significantly higher in the HBe Ag clearance group（204.72±88.65 vs 162.80±85.81 IU/L, P〈0.05） andHBe Ag seroconversion group（204.89 ±95.68 vs 166.75±84.43 IU/L, P〈0.05）. Females and lower BMI levels（20.01±2.33 vs 21.65±3.66 kg/m^2, P〈0.05） were prone to acquired biochemical response（BR）. PC-W28STOP（ntG 1896A） was significantly higher in the combined response（CR） group than that in the no CR group（91.7% vs 39.7%, P=0.001）. Multivariate logistic regression analysis showed that baseline DNA, PC-P159T（ntC2288A）, BCP-N118T（ntA 1726C） and BCP-L134L（ntA 1775C/G/T） influenced VR independently. PC-G182C（nt G2357T）, PC-S64A/T（nt T2003G/A） and BMI were independent influence factors for HBe Ag clearance, HBe Ag seroconversion and BR, respectively. The new predicting model concluded that baseline DNA and new mutations for VR were established successfully, and ROC analysis showed that AUC was 0.842（P〈0.001） with a sensitivity of 0.652 and a specificity of ***： PC-P159T（ntC 2288A）, BCP-N118T（ntA 1726C）, BCP-

关键词： hepatitis B virus interferon mutation treatment efficacy

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