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20 October 2024, Volume 22 Issue 5 Previous Issue    Next Issue

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SPECIAL TOPICS ON SEVERE FEVER WITH THROMBOCYTOPENIA SYNDROME

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Epidemic characteristics of fatal cases of severe fever with thrombocytopenia syndrome in China from 2010 to 2023 YUE Yujuan, REN Dongsheng, LUN Xinchang 2024, 22 (5):  257-261.  doi: 10.20199/j.issn.1672-2302.2024.05.001 Abstract ( 301 )   HTML ( 22 )   PDF (1818KB) ( 243 )   Objective To analyze the epidemiological characteristics of fatal cases from severe fever with thrombocytopenia syndrome (SFTS) in China from 2010 to 2023 for reference in formulating scientific prevention and control of this infection. Mvethods The fatal cases of SFTS reported in the Information System for Disease Prevention and Control in China were collected from 2010 to 2023. Descriptive epidemiological methods were used to analyze the temporal, spatial, and demographic characteristics of SFTS deaths, as well as the time interval characteristics from onset to diagnosis and onset to death. Results From 2010 to 2023, a total of 1 326 SFTS deaths were reported in 736 townships in 219 counties (cities/districts) of 62 cities in the 12 provinces (autonomous regions, municipalities). The average annual case fatality rate was 4.83%. The annual numbers of deaths increased, whereas the annual case fatality rate decreased in wave fashion. The case fatality rate was decreased year after year from 2019 to 2023. The number of deaths in 2023 was 191, with case fatality rate of 3.77%. The deaths represented seasonal distribution, which peaked between May and July, accounting for 61.84% (820/1 326) of the total deaths. From 2010 to 2023, the number of regions with deaths from SFTS was gradually increased, and 51.43% (682/1 326) of the deaths were reported in Shandong Province. The gender ratio was 1.15∶1. The deaths occurred in 96.15% (1 275/1 326) of population aged 50 years and over, the case fatality rate was increased with age, and 84.46% (1 120/1 326) were farmers. The annual median interval between onset and diagnosis was 89.00 days in 2010, and ranged from 6.54 days to 9.71 days from 2011 to 2023. A total of 578 deaths were confirmed after death, accounting for 43.59% (578/1 326) of the total reported deaths, in which 60.90% (352/578) occurred in Shandong Province. Conclusion The number of SFTS deaths was generally increased in the past 13 years in China, yet the annual case fatality rate was declined. In response to the continuous expansion of the number of regions and the increasing number of deaths, strengthening case monitoring, diagnosis and treatment of SFTS is recommended. In addition, it is necessary to enhance education of prevention and control knowledge related to SFTS in the key population. Figures and Tables | References | Related Articles | Metrics

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Analysis on the seasonal characteristics of sever fever with thrombocytopenia syndrome in Anhui Province from 2010 to 2023 GENG Haoxiang, CHU Na, LI Ming, CHU Xiujie, SUN Yong, CHEN Qingqing, GONG Lei 2024, 22 (5):  262-266.  doi: 10.20199/j.issn.1672-2302.2024.05.002 Abstract ( 211 )   HTML ( 19 )   PDF (979KB) ( 219 )   Objective To investigate the seasonal patterns of severe fever with thrombocytopenia syndrome (SFTS) in population in Anhui Province for evidence to prevent and control this infection. Methods Monthly reported cases of SFTS, including deaths in Anhui Province were collected from 2010 to 2023 through the Infectious Disease Monitoring Information System under the China Information System for Disease Control and Prevention. The concentration method was used to analyze the seasonal intensity of SFTS, and circular distribution method was used to analyze the peak days and epidemic peaks of SFTS. Results In total, 5 715 cases of SFTS and 184 deaths were reported in Anhui Province from 2010 to 2023. The average annual incidence was 0.661 6 per 100 000 population, and the case fatality rate was 3.22%. The incidence rate showed an overall upward trend (χ2trend=3 518.04, P<0.01), with the lowest morbidity increasing from 0.001 6/100 000 in 2010 to the highest 2.310 9/100 000 in 2023. The total M-value of monthly incidence concentration of SFTS was 0.538 in Anhui Province from 2010 through 2023, which indicated strong seasonality. The circular distribution analysis demonstrated that the peak incidence date of SFTS in Anhui Province was on June 2 in spring and summer seasons (March-August), and the peak epidemiological period was between April 20 and July 15. The peak incidence date was found on October 9 in autumn and winter seasons (September-February), and the peak epidemiological period was between September 16 and November 1. Conclusion The incidence of SFTS in Anhui Province has strong seasonal characteristics, showing a double-peak distribution by primary and secondary peak. Our findings suggest that effective prevention and control measures should be taken before arrival of the peak epidemic in order to reduce the occurrence of SFTS. Figures and Tables | References | Related Articles | Metrics

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Epidemiological characteristics analysis of severe fever with thrombocytopenia syndrome in Hunan Province from 2014 to 2023 YANG Hao, ZHANG Siyu, ZHAO Shanlu, DAI Zhihui, BU Zheni, CHEN Shengbao, LIU Rongjiao, ZHAN Zhifei, LUO Kaiwei 2024, 22 (5):  267-270.  doi: 10.20199/j.issn.1672-2302.2024.05.003 Abstract ( 171 )   HTML ( 8 )   PDF (1338KB) ( 174 )   Objective To understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in population in Hunan Province for scientific basis in formulating prevention and control strategies. Method The cases of SFTS reported in Hunan Province between 2014 and 2023 were retrieved from the China Information System for Disease Control and Prevention, and descriptively analyzed regarding the temporal, population and regional distribution, the patients′ visits, death cases and clusters. In addition, between 2014 and 2019, 2015 and 2023, and 2020 and 2023, we conducted serological surveillance on the Bandavirus dabieense in healthy population in Yongxing County of Chenzhou City, Xinhua County of Loudi City and Cili County of Zhangjiajie City, respectively. The serum-specific total antibody was detected by double antigen sandwich ELISA. Finally, the positive rate of DBV antibody in healthy population was calculated. Results A total of 59 cases of SFTS were reported in Hunan Province from 2014 to 2023, and only one death occurred. The average annual incidence was 0.006 6/100 000. Of the 14 cities in Hunan Province, SFTS cases were reported in 7 cities, in which the top three cities were Huaihua (39 cases), Yueyang (8 cases) and Zhangjiajie (6 cases). SFTS was prevalent in typical seasonal fashion in Hunan Province from 2014 to 2023, and dominated in between June and November, during which a total of 48 cases were reported and accounted for 81.35% of the total reported cases. Among the reported cases, 32 were males and 27 females. The age was mainly in 50-79 years old, in whom 50 cases were reported, accounting for 84.75% of the total reported cases. The occupation was mainly associated with farmers (89.83%, 53/59). A total of 2 clusters of epidemics were reported, one of which was caused by human-to-human transmission, and the other was caused by tick bites. A total of 7 055 people underwent serological detection, which revealed positive DBV antibody in 158 (2.24%). Conclusion The incidence of SFTS in Hunan Province shows an increasing trend from 2014 to 2023. The findings suggest that it is necessary to strengthen the training of medical personnel, improve the diagnostic level of grassroots medical institutions, avoid delaying patient treatment and causing outbreaks due to missed diagnosis and misdiagnosis. At the same time, health education and awareness of personal protection should be improved in order to reduce the risk of infection. Figures and Tables | References | Related Articles | Metrics

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Clinical observation of faveravir for severe fever with thrombocytopenia syndrome PENG Junxia, WANG Xin, YANG Jiayue, SU Qian 2024, 22 (5):  271-276.  doi: 10.20199/j.issn.1672-2302.2024.05.004 Abstract ( 204 )   HTML ( 11 )   PDF (1006KB) ( 126 )   Objective To clarify the clinical efficacy and adverse reactions of faveravir in the treatment of patients with severe fever with thrombocytopenia syndrome (SFTS). Methods The clinical data were collected from March 2023 to August 2024 in SFTS cases confirmed by laboratory studies and treated in the Department of Infectious Diseases and the Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University. The cases were divided into faveravir treatment group (treatment group) and non-faveravir treatment group (control group) based on whether they received faveravir medication during their hospitalization. The propensity score matching method (PSM) was used to conduct cluster matching of other factors except whether-they-received-faveravir-treatment between the two groups at a ratio of 1∶1. Comparative analysis was performed on the 28-day survival rate of the two groups after successful matching and the average survival time of deceased patients. Then the influencing factors of the 28-day survival period were analyzed using Cox regression. Results Among the 272 laboratory-confirmed cases collected, 111 were in the treatment group and 161 were in the control group. Of these cases, there were 65 deaths, with a case fatality rate of 23.90%. Five indicators, including the age, C-reaction protein (CRP), D-dimer, fibrin degradation products (FDP), and the nucleic acid load of Bandavirus dabieense, were identified as covariates for PSM. After matching, 108 patients from each group were included in the study. The 28-day survival rates of the treatment group and the control group after matching were 85.19% (92/108) and 78.70% (85/108), respectively. Log-rank test revealed no significant difference (χ2=1.900, P>0.05). There were 16 and 23 deaths respectively in the treatment group and control group, and the average survival time was 6.5 (3.0，9.0) and 2.0 (1.0, 5.0) days. The difference was statistically significant (Z=2.824, P<0.01). The results of Cox regression analysis indicated that the use of faveravir was a protective factor for patient survival [HR=0.534, 95%CI: (0.267, 1.068)], while increased age [HR=1.044, 95%CI: (1.004, 1.085)], elevated serum amylase [HR=1.003, 95%CI: (1.001, 1.005)], the use of glucocorticoids [HR=2.243, 95%CI: (1.093, 4.602)], and the presence of consciousness disturbance were risk factors for patient survival [HR=11.548, 95%CI: (4.786, 27.861)]. The tolerance was overall acceptable in the 111 patients who received faveravir, and the adverse reactions were relatively fewer. Cvonclusion Faveravir for the treatment of SFTS can prolong the survival period of patients and has few adverse reactions, which is an effective antiviral therapy. Figures and Tables | References | Related Articles | Metrics

CONTROL STUDIES

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Distribution characteristics and spatio-temporal analysis of soil-transmitted nematode in the hilly areas of Sichuan Province from 2016 to 2023 WU Xiaohong, TIAN Hongchun, LUO Jingwen, TIE Lei, DENG Xiu, ZHANG Suping, LIU Yang 2024, 22 (5):  277-283.  doi: 10.20199/j.issn.1672-2302.2024.05.005 Abstract ( 187 )   HTML ( 14 )   PDF (6387KB) ( 208 )   Objective To analyze the prevalence of soil-transmitted nematode in the hilly areas of Sichuan Province for evidences to scientifically develop the prevention and control measures. Methods From 2016 to 2023, we carried out surveillance in accordance with the requirements of Sichuan Provincial Surveillance Program for Hepatic Flukes and Soil-transmitted Nematode Diseases (for Trial implementation) by setting a certain number of monitoring sites yearly in the counties (cities/districts). The modified Kato-Katz thick smear method (one sample for two smears) was used to detect hookworm eggs, roundworm eggs and whipworm eggs in the fecal samples, and the infection rate was calculated. The differences of infection rates in the hilly areas were analyzed among different genders, ages, education levels and occupational groups. Software ArcGIS 10.7 was used to establish a spatial database for analyzing whether the infection rate of soil-transmitted nematode (hookworm, roundworm and whipworm) in the hilly areas of Sichuan Province was spatially clustered by using global spatial autocorrelation and local spatial autocorrelation. Results A total of 89 226 people in 70 hilly counties (cities/districts) in Sichuan Province were surveyed between 2016 and 2023, and soil-transmitted nematode infections were found in 8 075 people, with an infection rate of 9.05%. The infection rate of hookworm, roundworm and whipworm was 8.52% (7 602/89 226), 0.52% (465/89 226) and 0.17% (149/89 226), respectively. The co-infection rate was 0.15% (130/89 226). The infection rate of soil-transmitted nematode was different between males (8.68%, 3 725/42 912) and females (9.39%, 4 350/46 314), with significant difference (χ2=13.71, P<0.01). In population in different age group and educational level group, the infection rate climbed up generally with added ages and lower educations (χ2trend=1 675.73, 883.37, both P<0.01). By occupations, the infection rate was relatively higher in farmers and herdsmen (10.54%, 7 376/69 990), with significant difference (χ2=890.86, P<0.01). The infection rates of soil-transmitted nematodes >20.00%, 10.01%-20.00%, 5.01%-10.00%, 1.01%-5.00% and 0.01%-1.00% were associated with 8, 21, 19, 20 and 2 counties (districts/cities), respectively. Global spatial autocorrelation analysis showed that there was spatial aggregation in the distribution of soil-transmitted nematodes and hookworm infections (Moran′s I>0, Z>2.58, P<0.01). Local spatial autocorrelation analysis revealed that the number of counties (cities/districts) with "high-high", "high-low", "low-high" and "low-low" concentrations of soil-transmitted nematode infection rates accounted for 7, 2, 1 and 2, and the number of counties (cities/districts) with "high-high", "high-low", "low-high" and "low-low" hookworm infection rates were 7, 3, 1 and 2, respectively. Conclusion The infection rate of soil-transmitted nematode in the hilly areas of Sichuan Province is relatively high, and presents spatial aggregation, therefore comprehensive prevention and control should be strengthened in the key areas. Figures and Tables | References | Related Articles | Metrics

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Monitoring and analysis of food-borne parasites in freshwater products in Yunnan Province from 2017 to 2022 ZHANG Juan, ZHOU Xiaomei, TAO Hong, LI Yanzhong, YANG Jingjing, WANG Tingting, CHEN Yishan, XIANG Yibin 2024, 22 (5):  284-288.  doi: 10.20199/j.issn.1672-2302.2024.05.006 Abstract ( 180 )   HTML ( 8 )   PDF (895KB) ( 184 )   Objective To investigate the statuses of foodborne parasites infection in freshwater products and raw meat in Yunnan Province for evidence in formulating prevention and control strategies for foodborne parasitic diseases. Methods From 2017 to 2022, the surveillance of food-borne parasitic infections in commercially available freshwater products was carried out in 16 prefectures (cities) of Yunnan Province. The freshwater fish detection project was the metacercaria of Metorchis orientali, the stage Ⅲ larvae of Gnathostoma, Clonorchis sinensis, the freshwater snail detection project was the stage Ⅲ larvae of Angiostrongylodes cantonensis, and the freshwater crab and freshwater shrimp detection project was the metacercaria of Paragonimus. The samples were collected from intermediate links, catering services and aquaculture. Digestion method was used for the detection. Results From 2017 to 2022, a total of 2 803 freshwater product samples were detected, in which parasites were detected in 158 (5.64%), yet no parasites were found in the 328 samples of 8 species of freshwater fish and 57 samples of 1 species of freshwater shrimp. The larvae were detected in 2 215 of 3 species of freshwater snails. The total detection rate of Angiostrongylus cantonensis stage Ⅲ was 5.82%. A total of 203 samples from 4 species of freshwater crab were detected, and the detection rate of Paragonimus cysticercus was 14.29%. The annual parasite detection rates of freshwater products in Yunnan Province from 2017 to 2022 were 7.69% (15/195), 8.85% (56/633), 6.01% (27/449), 2.95% (19/645), 2.78% (9/324) and 5.75% (32/557), respectively. Apart from Nujiang Prefecture, all the fresh water products sent for inspection were found to be infected with parasites. The parasite detection rates were 6.02% (144/2 394), 4.03% (11/273) and 2.21% (3/136) in circulation, catering and aquaculture, respectively. Conclusion Fresh water products were infected with parasites in some areas of Yunnan Province. The findings suggest that food hygiene supervision and education should be strengthened, and self-prevention awareness should be raised in mass to reduce the incidence of food-borne parasitic diseases. Figures and Tables | References | Related Articles | Metrics

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Investigation and analysis of Clonorchis sinensis infection and related KAP status in population in Nanning City from 2021 to 2023 WEI Shulin, QU Zhiqiang, DIAO Shuqin, LI Xue, LUO Mifang, HUANG Yancui, LUO Yuanyuan 2024, 22 (5):  289-293.  doi: 10.20199/j.issn.1672-2302.2024.05.007 Abstract ( 245 )   HTML ( 4 )   PDF (943KB) ( 136 )   Objective To investigate the Clonorchis sinensis infection and related knowledge, attitudes, and practice (KAP) in the population in Nanning City for evidences to plan targeted prevention and control measures. Methods Two to three counties (districts) in Nanning area were annually selected as surveillance sites for clonorchiasis from 2021 to 2023. Then 1 000 people were respectively included from each monitoring site every year by stratified cluster sampling method to undergo detection of clonorchiasis eggs with modified Kato-Katz thick smears (one stool and two tests). Finally, 150 subjects were randomly selected for questionnaire survey. Results A total of 8 058 people were investigated from 2021 to 2023, in whom 1 534 were positive for Clonorchis sinensis. The total infection rate was 19.04% and classification of infection degree is mainly mild infection (85.46%, 1 311/1 534). The difference of infection rate in each counties (districts) was statistically significant (χ2=757.968, P<0.05). The top 3 infection rates were in Jiangnan District (41.16%, 417/1 013), Qingxiu District (36.97%, 373/1 009) and Xixiangtang District (15.30%, 153/1 000). The infection rate was 28.07% (1 101/3 922) for males and 10.47% (433/4 136) for females, and the highest in population aged 50-59 years (28.33%, 440/1 553). By educational background and occupation, the highest infection rate was seen in population of junior middle school (28.15%, 908/3 226) and farmers (26.02%, 1 368/5 258). There were significant differences in infection rate among different genders, age groups, education levels and occupations (χ2=404.732, 691.044, 352.794, 695.679, all P<0.05). The overall knowledge awareness rate, attitude accuracy rate and behavior accuracy rate were 80.08% (961/1 200), 72.75% (873/1 200) and 69.42% (833/1 200), respectively. The KAP was negatively correlated with Clonorchis sinensis infection [OR=0.51, 95% CI: (0.35, 0.74); OR=0.42, 95% CI: (0.29, 0.62) ; OR=0.27, 95% CI: (0.18, 0.40), respectively]. Conclusion The overall infection level of Clonorchis sinensis in Nanning city remains relatively higher, yet the infection is in mild degree, and the level of KAP towards Clonorchis sinensis infection needs improving. It is recommended to carry out comprehensive control measures combining health education and drug treatment to reduce the infection rate of the population. Figures and Tables | References | Related Articles | Metrics

EXPERIMENTAL STUDY

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Upregulation of TET1 contributes to the activation of lncRNA HULC in LO2 cells treated with silver nanoparticles JIAO Qunfang, LI Huifang, ZHENG Dongyan, HUANG Hao, ZHONG Qinghua, CAI Xiaonan, LING Xiaoxuan, LIU Linhua 2024, 22 (5):  294-300.  doi: 10.20199/j.issn.1672-2302.2024.05.008 Abstract ( 173 )   HTML ( 4 )   PDF (1088KB) ( 166 )   Objective To explore the impact of silver nanoparticles (AgNPs) on the expression of DNA demethylation enzyme, specifically ten-eleven-translocation proteins (TETs) family and the molecular mechanism underlying the regulation of long non-coding RNA HULC. Methods Human normal liver cells (LO2) were treated with silver nanoparticles (AgNPs) at concentrations of 0 (blank control group), 5, 10 and 20 μg/mL. Additionally, LO2 cells were treated with 10 μg/mL AgNPs in combination with the DNA methyltransferase inhibitor 5-azacitidine (5-azaC) and the histone deacetylase inhibitor trichostatin A (TSA) for 24 hours. qRT-PCR was employed to assess the mRNA expression levels of long non-coding RNAs (lncRNAs) HULC, HOTAIRM1, H19 and MALAT1, as well as the expression of the DNA methyltransferases (DNMTs) and TETs families. Western blot (WB) was utilized to evaluate the protein expression levels of the DNMTs and TETs families. Furthermore, RNA interference (siRNA) technology was employed to silence the expression of TET1 in order to further investigate the regulatory relationship between TET1 and lncRNA HULC. Results qRT-PCR results showed that compared to the blank control group, the mRNA expression of H19 was downregulated in all concentration groups (t=7.250, 6.876, 5.077, all P<0.05). In the 20 μg/mL AgNPs group, the mRNA expression of lncRNA HULC was upregulated, while HOTAIRM1 expression was downregulated (t=12.250, 12.850, both P<0.05). After TSA intervention, the expression of lncRNA HULC was upregulated, and H19 expression was downregulated (t=12.970, 12.950, both P<0.05). Compared with the control group, the expression of TET1 and TET3 in the 20 μg/mL AgNPs group was up-regulated (t=6.909, 15.551, both P<0.05). After TSA intervention, TET1 expression was upregulated and TET3 was down-regulated (t=17.224, 3.602, both P<0.05). WB analysis revealed that compared to the blank control group, the protein expression of DNMT1 and DNMT3a was upregulated in all concentration groups, while DNMT3b protein expression was downregulated (t=5.968, 2.518, 4.010; t=8.983, 16.230, 14.260; t=23.000, 41.630, 49.300, all P<0.05). After 5-azaC and TSA intervention, DNMT1 protein expression was downregulated, and DNMT3a protein expression was upregulated (t=3.111, 3.695; t=30.740, 62.790, all P<0.05), while DNMT3b expression showed a downregulation and upregulation trend respectively (t=7.024, 3.372, both P<0.05). The protein expression of TET1 was upregulated in all concentration groups (t=5.869, 7.519, 10.470, all P<0.05). Successful construction of TET1-silenced cell model, the expression of TET1 protein and lncRNA HULC mRNA in si-TET1-3 group (TET1 gene silenced group) was lower than that in si-NC group (silencing control group) (t=3.297, 4.708, both P<0.05). Conclusion With the increase in AgNPs concentration, the expression of lncRNA HULC and DNA demethylase TET1 in cells is significantly upregulated. The addition of 5-azaC and TSA can effectively alter their expression levels, indicating that lncRNA HULC is likely influenced by DNA methylation. Figures and Tables | References | Related Articles | Metrics

CLINICAL STUDIES

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Evaluation of the effectiveness of different laboratory testing technologies in diagnosing pulmonary tuberculosis at non-tuberculosis designated hospitals WANG Tiantian, WANG Xiaojun, WU Gang, ZHOU Meilan, ZHANG Zhengbin, LU Zhouqin, LI Yuehua 2024, 22 (5):  301-305.  doi: 10.20199/j.issn.1672-2302.2024.05.009 Abstract ( 151 )   HTML ( 7 )   PDF (932KB) ( 123 )   Objective To investigate the application and effectiveness of different laboratory testing technologies in the tuberculosis patients at first visit in the non-designated tuberculosis hospitals for evidences in optimizing the testing procedures for diagnosis of tuberculosis in these hospitals. Methods The pulmonary tuberculosis patients who were initially registered and admitted in six non-designated hospitals in Wuhan City and subsequently confirmed as tuberculosis in the designated hospital, reported in the Infectious Disease Reporting and Management System under the China Information System for Disease Control and Prevention from January 2021 to June 2022, were included as study subjects. Individual patient data were collected from the Infectious Disease Reporting System, and tuberculosis-related test results, diagnostic information, and other data during the patients′ visits were gathered from the information systems of the non-designated hospitals. Then the detection rate was compared among the patients underwent single or combined tests in the non-designated hospitals by different laboratory testing technologies. Finally, the days of diagnosis, cost of diagnosis, and detection of rifampicin resistance were analyzed between patients who received GeneXpert MTB/RIF (GeneXpert) system test and those who did not. Results A total of 386 confirmed tuberculosis patients were finally included, in whom 8 were rifampicin resistant. When a single laboratory testing technology was used in non-designated hospitals, the detection rate by GeneXpert system, mycobacterial culture, tuberculosis deoxyribonucleic acid test (TB-DNA) and smear acid-fast staining was 86.79% (138/159), 79.37% (50/63), 75.00% (45/60) and 48.25% (138/286), respectively. When two laboratory testing technologies were applied in combination, the detection rate by GeneXpert system + mycobacterial culture, GeneXpert + smear acid-fast staining, and smear acid-fast staining + mycobacterial culture arrived at 90.00% (45/50), 84.75% (100/118) and 79.66% (47/59), respectively. The average days to tuberculosis diagnosis and the average diagnostic cost for patients who underwent GeneXpert system testing were 1 (1, 1) day and (2 039 ± 2 075) yuan, respectively, compared to 4 (2, 9) days and (3 140 ± 4 557) yuan for those who did not undergo GeneXpert system testing. The difference was significant (H=110.975, t=-3.198, both P<0.01). In both the GeneXpert group and the non-GeneXpert group, there were 4 patients resistant to rifampin. The GeneXpert group detected 3 cases, while the non-GeneXpert group did not detect any. Conclusion The average cost of diagnosis is relatively lower by application of GeneXpert test for detection of tuberculosis in non-tuberculosis designated hospitals, and combined GeneXpert system with other detection technology and routine sputum examination can be conductive to diagnosis of common tuberculosis and rifampicin-resistant tuberculosis, which is of great significance for rapid sourcing of the infection and control of tuberculosis spreading. Figures and Tables | References | Related Articles | Metrics

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The application value of different laboratory detection technologies in the diagnosis of lung tuberculosis YANG Jing, CHEN Yexin, XIA Guangxiu, LIN Yuhong, LI Jun, XU Dongfang, LI Yue, DING Yunsheng, BAO Xundi 2024, 22 (5):  306-310.  doi: 10.20199/j.issn.1672-2302.2024.05.010 Abstract ( 156 )   HTML ( 6 )   PDF (1025KB) ( 118 )   Objective To analyze the value of different laboratory test technologies in the diagnosis of pulmonary tuberculosis so as to provide a basis for application of different detection technologies in clinical diagnosis and treatment of this infection. Methods Suspected tuberculosis patients who received treatment at Anhui Provincial Chest Hospital from January to August 2023 were selected, sputum specimens were collected for acid-fast bacilli smear, isolation culture, Mycobacterium tuberculosis DNA (TB-DNA), RNA (TB-RNA) and GeneXpert MTB/RIF detection. Blood specimens were harvested for TSPOT-TB and TB-Ab detection. The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of the seven technologies were compared, and receiver operating characteristic curve (ROC) was drawn to calculate the area under the curve (AUC). Results A total of 191 suspected tuberculosis patients were included in this study. The sensitivity (74.17%), negative predictive value (63.95%) and Youden index (0.516 3) of TSPOT-TB were the highest when the seven technologies were separately used, and the GeneXpert MTB/RIF assay had the highest specificity (100.00%) and positive predictive value (100.00%). Combined use of TSPOT-TB and TB-Ab led the highest sensitivity (91.67%), and the specificity (94.37%), positive predictive value (94.44%), negative predictive value (94.37%) and Youden index (0.510 4) were the highest when TB-DNA, TB-RNA and GeneXpert MTB/RIF were jointly detected. TSPOT-TB had the highest AUC (0.758) when used alone, TB-DNA, TB-RNA and GeneXpert MTB/RIF assays had the highest AUC (0.755) when used in combination. Conclusion All the 7 laboratory technologies are effective in the diagnosis of pulmonary tuberculosis, yet TSPOT-TB produces the highest specificity, sensitivity and Youden index. In clinical settings, either of the single test or combined tests can be optional to achieve the best detection effect. Figures and Tables | References | Related Articles | Metrics

CASE REPORT

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Clinical diagnosis and treatment of an elderly patient with confirmed Norwegian scabies WANG Bibai, LIU Pengxin, ZHANG Yuchao, XU Li, ZHANG Zhongqiong, WU Jianhua, ZHOU Zhi 2024, 22 (5):  311-314.  doi: 10.20199/j.issn.1672-2302.2024.05.011 Abstract ( 185 )   HTML ( 5 )   PDF (1314KB) ( 230 )   This article reports the diagnosis and treatment process of a case of Alzheimer′s disease complicated with pemphigus vulgaris and infected with Norwegian scabies (also known as scabies scabies). The patient was admitted to the hospital due to pulmonary infection, and after anti-inflammatory treatment, peripheral blood eosinophils, C-reactive protein and procalcitonin rised repeatedly. Afterwards, multiple papules and skin crusts appeared throughout the body, and multiple tests were negative for pemphigus vulgaris and bullous pemphigus vulgaris. Scabies mites and eggs were found on the bacterial smear of the skin flakes, which confirmed the diagnosis of Norwegian scabies. After sequential application of 10% sulfur ointment, Jinglian Fukang antibacterial solution (5% permethrin solution) and oral administration of ivermectin tablets, the patient was cured via pathogen confirmation, and the close contacts were also cured after one course of topical application of 10% sulfur ointment. The purpose of report of this case is to analyze the clinical key points and experience in Norwegian scabies in elderly patients. Figures and Tables | References | Related Articles | Metrics

REVIEW

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Role and mechanism of melatonin in the treatment of infectious diseases GAO Yang, GUAN Fei, LEI Jiahui 2024, 22 (5):  315-320.  doi: 10.20199/j.issn.1672-2302.2024.05.012 Abstract ( 169 )   HTML ( 1 )   PDF (935KB) ( 1696 )   Melatonin (MT) is an endogenous hormone that acts as a safe and effective sleep aid for regulating the circadian cycle. In addition to its traditional functions, more researches suggest that MT can play an important role in the treatment of infectious diseases. The therapeutic mechanism of MT in infectious diseases mainly involves the effect of reducing tissue damage caused by infection via regulating oxidative stress and enhancing immune function induced by regulating circadian rhythm to recruit immune cells. Moreover, MT can exert an anti-inflammatory effect by regulating Th1/Th2 development and differentiation, NF-κB phosphorylation and so on, and affect the apoptosis pathway to play a certain anti-infective effect. Based on the above functions of MT, this article summarizes the research status and mechanism of MT in the treatment of infectious diseases in order to provide a theoretical basis for the application of MT against infection in clinical settings. References | Related Articles | Metrics