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Efficacy and Safety of Flos Abelmoschus Manihot(Malvaceae) on Type 2 Diabetic Nephropathy:A Systematic Review

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Chinese Journal of Integrative Medicine 2015年第6期21卷 464-472页

作者：陈意志龚智翔蔡广研高清陈香美汤力魏日胞周建辉 Department of Nephrology Chinese PLA General HospitalChinese PLA Institute of NephrologyState Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney Diseases division of infectious diseases Chinese PLA 532 HospitalHuangshan Department of Nephrology Zhongshan HospitalXiamen University

Objective： To evaluate the efficacy and safety of Flos Abelmoschus manihot （Malvaceae） on type 2 diabetic nephropathy （DN）. Methods： The Cochrane Library, PubMed/MEDLINE, Excerpta Medical Database, Chinese electronic literature databases, and the references of relevant articles were searched in March 2012 for randomized controlled trials （RCTs） that reported the effects of Flos A. manihot on type 2 DN patients with overt but subnephrotic-range proteinuria （500-3,500 mg/24 h）. The quality of trials was evaluated using the Cochrane-recommended method. The results were summarized as risk ratios （RRs） for dichotomous outcomes or mean differences （MDs） for continuous outcomes. Results： Seven trials （531 patients） were included. F/os A. manihot significantly decreased proteinuria [MD -317.32 mg/24 h, 95% confidence interval （CI） [-470.48, -164.17], P〈0.01]. After excluding a trial that only included patients with well-preserved renal function, F/os A. manihot was associated with a significant decrease in serum creatinine （MD -11.99 i~ mol/L, 95% CI [-16.95, -7.04], P〈0.01）. Serious adverse events were not observed. The most common adverse event was mild to moderate gastrointestinal discomfort; however, patients receiving this herb did not have an increased risk for tolerated gastrointestinal discomfort （RR 1.48, 95% CI [0.39, 5.68], P=0.57）. Conclusions： F/os A. manihot may be considered as an important adjunctive therapy with the first-line and indispensable therapeutic strategies for type 2 DN. High-quality RCTs are urgently needed to confirm the effect of Flos A. manihot on definite endpoints such as end-stage renal disease.

关键词： Flos Abelmoschus manihot Huangkui Capsule Chinese medicine type 2 diabetic nephropathy systematic review meta-analysis randomized controlled trial

Premature Stop Codon at Residue 101 within HIV-1 Rev Does Not Influence Viral Replication of Clade BC but Severely Reduces Viral Fitness of Clade B

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Virologica Sinica 2020年第2期35卷 181-190页

作者： Zheng Wang Xiaolin Ji Yanling Hao Kunxue Hong Liying Ma Dan Li Yiming Shao State Key Laboratory of infectious diseases Prevention and Control Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesChinese Center for Disease Control and PreventionBeijing 102206China division of Research of Virology and Immunology National Center for AIDS/STD Control and PreventionChinese Center for Disease Control and PreventionBeijing 102206China

HIV-1 Rev is an accessory protein that plays a key role in nuclear exportation,stabilization,and translation of the viral *** of HIV-1 clade BC often shows a truncation of 16 AAs due to a premature stop codon at residue *** stop codon presents the highest frequency in clade BC and the lowest frequency in clade *** order to discover the potential biological effect of this truncation on Rev activity and virus replication of clade BC,we constructed Rev expression vectors of clade BC with or without 16 AAs within C-terminal separately,and replaced the stop codon by Q in a CRF07_BC infectious *** found that 16 AAs truncation had no effect on expression and activity of Rev in clade ***,the mutation from the stop codon to Q had no effect on virus replication of clade ***,to investigate the effect of this truncation on Rev activity and replication capacity of clade B,Rev expression vectors of clade B carrying or lacking 16 AAs in C-terminal were constructed respectively,and residue Q at position 101 within Rev was substituted by the stop codon in a clade B infectious *** was found that 16 AAs truncation significantly down-regulated Rev expression and impaired clade B Rev ***,a Q-to-stop codon substitution within Rev significantly reduced viral replication fitness of clade *** results indicate that the premature stop codon at residue 101 within Rev exerts diverse impact on viral replication among different HIV-1 clades.

关键词： HIV-1 CRF_BC Rev Premature stop codon Replication

Management of cytomegalovirus infection and disease in liver transplant recipients

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World Journal of Hepatology 2014年第6期6卷 370-383页

作者： Jackrapong Bruminhent Raymund R Razonable division of infectious diseases College of MedicineMayo ClinicRochesterMN 55905United States division of infectious diseases and the William J von Liebig Center for Transplantation and Clinical Regeneration College of MedicineMayo ClinicRochesterMN 55905United States

Cytomegalovirus(CMV) is one of the most common viral pathogens causing clinical disease in liver transplant recipients, and contributing to substantial morbidity and occasional mortality. CMV causes febrile illness often accompanied by bone marrow suppression, and in some cases, invades tissues including the transplanted liver allograft. In addition, CMV has been significantly associated with an increased predisposition to acute and chronic allograft rejection, accelerated hepatitis C recurrence, and other opportunistic infections, as well as reduced overall patient and allograft survival. To negate the adverse effects of CMV infection on transplant outcome, its prevention, whether through antiviral prophylaxis or preemptive therapy, is an essential component to the management of liver transplant recipients. Two recently updated guidelines have suggested that antiviral prophylaxis or preemptive therapy are similarly effective in preventing CMV disease in modest-risk CMV-seropositive liver transplant recipients, while antiviral prophylaxis is the preferredstrategy over preemptive therapy for the prevention of CMV disease in high-risk recipients [CMV-seronegative recipients of liver allografts from CMV-seropositive donors(D+/R-)]. However, antiviral prophylaxis has only delayed the onset of CMV disease in many CMV D+/Rliver transplant recipients, and such occurrence of lateonset CMV disease was significantly associated with increased all-cause and infection-related mortality after liver transplantation. Therefore, a search for better strategies for prevention, such as prolonged duration of antiviral prophylaxis, a hybrid approach(antiviral prophylaxis followed by preemptive therapy), or the use of immunologic measures to guide antiviral prophylaxis has been suggested to prevent late-onset CMV disease. The standard treatment of CMV disease consists of intravenous ganciclovir or oral valganciclovir, and if feasible, reduction in pharmacologic immunosuppression. In one c

关键词： Cytomegalovirus Outcome Hepatitis Transplantation Valganciclovir Prophylaxis Treatment

Correlation between invasive microbiota in margin-surrounding mucosa and anastomotic healing in patients with colorectal cancer

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 717-728页

作者： Yan-Dong Li Kang-Xin He Wei-Fang Zhu division of Colon and Rectal Surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina 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 UniversityHangzhou 310003Zhejiang ProvinceChina division of Dermatology First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Impaired anastomotic healing is one of the major complications resulting from radical resection in colorectal cancer(CRC).Accumulating evidence suggests that intestinal microbiota is correlated with anastomotic *** To explore the microbiota structural shift in margin-surrounding mucosa and evaluate the predictive ability of selected bacterial taxa for impaired anastomotic *** Margin-surrounding mucosa samples derived from 37 patients were collected to characterize the microbial community structure by 16 s r RNA gene *** patients were divided into two groups according to the healing status of anastomoses:well-healing group(n=30)and impaired-healing group(n=7).Statistic differences in bacteria taxa were compared by Wilcoxon test and chisquared *** predictive ability of the selected bacterial taxa for the healing status of anastomoses was evaluated by the area under the receiver operator characteristic *** Community structure shifts were observed in the impaired-healing group andwell-healing *** bacterial species were found to be significantly correlated with anastomotic healing,and among these species,Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis were considered as the predictive *** the known risk factor age into consideration,Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis improved predictive ability for the healing status of *** These data show that Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis could be considered as supplementary factors in the prediction of anastomosis healing status in patients after CRC radical resection.

关键词： Intestinal microbiota 16s rRNA gene sequencing Anastomotic healing Predictive ability Colorectal cancer Radical resection

Single amino acid substitution of VP1 N17D or VP2 H145Y confers acid-resistant phenotype of type Asia1 foot-and-mouth disease virus

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Virologica Sinica 2014年第2期29卷 103-111页

作者： Haiwei Wang Shanshan Song Jianxiong Zeng Guohui Zhou Decheng Yang Te Liang Li Yu division of Livestock infectious diseases State Key Laboratory of Veterinary BiotechnologyHarbin Veterinary Research Institute Chinese Academy of Agricultural Sciences

Infection by foot-and-mouth disease virus(FMDV) is triggered by the acidic pH in endosomes after virus uptake by receptor-mediated endocytosis. However, dissociation of the FMDV 146S particle in mildly acidic conditions renders inactivated foot-and-mouth disease(FMD) vaccines much less effective. Type Asia1 FMDV mutants with increased resistance to acid inactivation were selected to study the molecular basis of viral resistance to acid-induced disassembly and improve the acid stability of FMDV. Sequencing of capsid-coding regions revealed four amino acid replacements(VP1 N17D, VP2 H145Y, VP2 G192D, and VP3 K153E) in the viral population of the acid-selected 10th passage. We performed single or combined mutagenesis using a reverse genetic system, and our results provide direct experimental evidence that VP2 H145Y or VP1 N17D substitution confers an acid-resistant phenotype to type Asia1 FMDV.

关键词： foot-and-mouth disease virus acid-resistant phenotype virus fitness

Role of occult hepatitis B virus infection in chronic hepatitis C

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World Journal of Gastroenterology 2015年第42期21卷 11931-11940页

作者： Nicola Coppola Lorenzo Onorato Mariantonietta Pisaturo Margherita Macera Caterina Sagnelli Salvatore Martini Evangelista Sagnelli Department of Mental Health and Public Medicine Section of Infectious Diseases Second University of Naples division of infectious diseases AORN Sant’Anna e San Sebastiano di Caserta Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A. Lanzara" Second University of Naples

The development of sensitive assays to detect small amounts of hepatitis B virus(HBV) DNA has favored the identification of occult hepatitis B infection(OBI), a virological condition characterized by a low level of HBV replication with detectable levels of HBV DNA in liver tissue but an absence of detectable surface antigen of HBV(HBs Ag) in serum. The gold standard to diagnose OBI is the detection of HBV DNA in the hepatocytes by highly sensitive and specific techniques, a diagnostic procedure requiring liver tissue to be tested and the use of non-standardized non-commercially available techniques. Consequently, in everyday clinical practice, the detection of anti-hepatitis B core antibody(antiHBc) in serum of HBs Ag-negative subjects is used as a surrogate marker to identify patients with OBI. In patients with chronic hepatitis C(CHC), OBI has been identified in nearly one-third of these cases. Considerable data suggest that OBI favors the increase of liver damage and the development of hepatocellular carcinoma(HCC) in patients with CHC. The data from other studies, however, indicate no influence of OBI on the natural history of CHC, particularly regarding the risk of developing HCC.

关键词： Occult hepatitis B virus infection Silent hepatiti

Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis

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World Journal of Hepatology 2017年第30期9卷 1166-1175页

作者： Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti Caterina Aurilio Maria Caterina Pace Department of Anesth-esiological Surgical and Emergency SciencesUniversity of Campania 'Luigi Vanvitelli' Department of Clinical Medicine and Surgery Section of Infectious DiseasesUniversity of Naples Federico Ⅱ division of infectious diseases 'San Giuseppe Moscati' Hospital

Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease *** is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable *** mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune ***,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic ***,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been ***,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of ***,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor *** of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic *** appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development.

关键词： Spontaneous bacterial peritonitis Multi-drug resistant bacteria End-stage liver disease Cirrhosis Critically ill patient

Clinical characteristics of critical patients with pandemic influenza A(H1N1) virus infection in Chengdu,China

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第1期13卷 49-55页

作者： Li-hui DENG1,2,Yi-lan ZENG3,Ping FENG1,Ya-ling LIU3,Li-chun WANG1,2,Yun BAI3,Hong TANG1,2(1Center of infectious diseases,West China Hospital of Sichuan University,Chengdu 610041,China)(2division of infectious diseases,State Key Laboratory of Biotherapy,Sichuan University,Chengdu 610041,China)(3Chengdu infectious Disease Hospital,Chengdu 610041,China) Center of infectious diseases West China Hospital of Sichuan University Chengdu 610041 China.

Objective： The critical illness of pandemic influenza A （H1N1） virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated with the deaths of critical patients. Methods： Medical records of 26 critical patients with H1N1 infection admitted from Sept. 1 to Dec. 31, 2009, were retrospectively reviewed. Diagnosis was established by real-time reverse transcdptase- polymerase chain reaction （RT-PCR） assay. Results： The mean age of the patients was （40.4＋18.4） years and 73.1% of them were male. Clinical manifestations included fever, cough, and sputum production. The laboratory findings included leukocytosis, lymphopenia, C-reaction protein, and lactic dehydrogenase elevation. In this series, 17 subjects survived and 9 died. The parameters between the deaths and survivors were compared, which included acute physiology and chronic health evaluation II （APACHE II） scores （23.8＋10.1 vs. 14.3_＋6.6, P〈0.05）, sequential organ failure assessment （SOFA） scores （13.3_＋3.0 vs. 6.6_＋3.3, P〈0.05）, and multiple organ dysfunction syndrome （MODS） scores （7.4＋2.5 vs. 3.3＋1.7, P〈0.05）. The cases of deaths had higher incidences of cardiovascular failure （100% vs. 41.2%, P〈0.05）, renal failure （55.6% vs. 11.7%, P〈0.05）, encephalopathy （44.4% vs. 5.9%, P〈0.05）, hepatic failure （33.3% vs. 5.9%, P〈0.05）, and septic shock （33.3% vs. 17.6%, P〈0.05）. Conclusions： The critical patients with H1 N1 infection have high APACHE II, SOFA, and MODS scores, which may be associated with an increased risk of death and complex clinical courses.

关键词： Critical illness H1N1 Infection Influenza A virus Mortality

Diagnostic accuracy of tests for Helicobacter pylori in an Alaska Native population

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World Journal of Gastroenterology 2011年第42期17卷 4682-4688页

作者： Dana L Bruden Michael G Bruce Karen M Miernyk Julie Morris Debby Hurlburt Thomas W Hennessy Helen Peters Frank Sacco Alan J Parkinson Brian J McMahon Arctic Investigations Program Division of Preparedness and Emerging InfectionsNational Center for Emerging Zoonoses and Infectious DiseasesCenters for Disease Control and Prevention Alaska Native Tribal Health Consortium Anchorage

AIM： TO evaluate the accuracy of two non-invasive tests in a population of Alaska Native persons. High rates of Helicobacter pylori （H. pylon] infection, H. pyIori treatment failure, and gastric cancer in this population necessitate documentation of infection status at multiple time points over a patient＇s *** test, 13C urea breath test （UBT）, and immunoglobulin G antibodies to H. pylori in serum. The performances of 13C-UBT and antibody test were compared to a gold standard defined by a positive H. pylori test by culture or, in case of a negative culture result, by positive histology and a positive rapid urease test.RESULTS： The sensitivity and specificity of the 13C- UBT were 93% and 88%, respectively, relative to the gold standard. The antibody test had an equivalent sensitivity of 93% with a reduced specificity of 68%. The false positive results for the antibody test were associated with previous treatment for an H. pylorlinfection [relative risk （RR） = 2.8]. High levels of antibodies to H. py/or/were associated with chronic gastritis and male gender, while high scores in the 13C-UBT test were associated with older age and with theH. pylori bacteria load on histological examination （RR = 4.4）. CONCLUSION： The 13C-UBT outperformed the antibody test for H. pylori and could be used when a noninvasive test is clinically necessary to document treatment outcome or when monitoring for reinfection.

关键词： Urea breath test Antibody test Sensitivity Specificity