Objective To investigate the incidence and potential risk factors of linezolid (LZD) related thrombocytopenia (TP) in patients with liver cirrhosis (LC). Methods Clinical data of LC patients treated with LZD for at least 1 dose (600 mg per 12 h) between January 2013 and May 2017 were retrospectively collected and analyzed to investigate the incidence and risk factors of LZD-related TP defined as platelet count during LZD therapy ≤ 50×109/L or a decline by ≥25％ of the baseline level. Results A total of 52 patients with LC were included in this study. The cumulative incidence of LZD-related TP was 51.9％ (27/52), of which 85.2％ (23/27) was severe TP (decline of platelet count by ≥50％ of the baseline level). Multivariate logistic regression analysis showed that the baseline platelet count ≤110 ×109/L (OR=6.989, 95％ CI: 1.192-40.971, P=0.031), LZD course ≥ 7 d (OR=9.478, 95％ CI: 1.349-66.587, P=0.024) and LZD dose ≥ 17 mg·kg-1·d-1 (OR=0.062, 95％ CI: 0.010-0.383, P=0.003) were independent risk factors of LZD-related TP in LC patients. Kaplan-Meier analysis revealed that the overall median time from the initiation of LZD therapy to in-hospital death was 18 days in TP patients and 13 days in non-TP patients without significant difference (P＞0.05). Cox proportional-hazards regression revealed no significant correlation between the in-hospital mortality and LZD-related TP in LC patients (P＞0.05). Conclusions Patients with LC are at high risk of LZD-related TP, but not associated with organ hemorrhage during LZD therapy and in-hospital mortality. Platelet count should be monitored more closely during LZD therapy for LC patients with lower baseline platelet count and longer LZD course.

Objective:To analyze the clinical features of an outbreak of extensive drug resistant typhoid fever, and to provide experience for the diagnosis and treatment of drug resistant typhoid fever.Methods:Seven patients with confirmed diagnosis of extensive drug resistant typhoid fever who visited Beijing You′an Hospital, Capital Medical University, from January 27 to February 15, 2022 were included. The clinical characteristics, drug sensitivity tests, consultation and treatment history and prognosis of the patients were analyzed through descriptive study.Results:Of the seven extensive drug resistant typhoid fever patients, three were male and four were female, one of whom was pregnant (at 32-week gestation), aged (29.8±6.8) years, with a range of 22 to 42 years. There were seven cases with fever, and the course of fever ranged from six to 20 days. There were five cases with diarrhea and lack of typhoid-specific manifestations such as rose spot, apathetic facial expression and relatively slow pulse. Four cases were complicated with intestinal bleeding and six cases developed liver function injury. Six cases had loss or decrease in eosinophil ratio and two cases had decreased white blood cell count. The results of drug susceptibility tests showed that seven strains of Salmonella typhi were resistant to chloramphenicol, ampicillin, sulfamethoxazole-trimethoprim, quinolones, ceftriaxone, cefepime, ceftazidime, cefuroxime, and sensitive to carbapenem antibiotics, tigecycline and piperacillin/tazobactam. All seven cases had a history of antimicrobial use before admission. One case was administered with intravenous ceftizoxime for seven days after admission. After discharge, cefixime was administered orally for seven days. Six patients were given intravenous piperacillin sodium/tazobactam sodium for 14 days. All blood/fecal cultures were negative and the patients were cured and discharged. During the follow-up, one patient developed splenic abscess. All the seven patients were residents of the same apartment in Beijing City, and there were water cuts and turbid odors in the incubation period, which were considered as typhoid fever outbreak caused by waterborne transmission. Conclusions:With the use of antimicrobial agents, the typical clinical manifestations of typhoid fever are absent, and the drug resistance rates to quinolone and third-generation cephalosporins increase. Appropriate antimicrobial agents should be selected and the anti-infection course should be prolonged.

Objective To study the factors that influence the ex vivo proliferation of human immunodeficiency virus (HIV) specific CD8 T cells.Methods Three methods to use HIV-specific antigen peptides stimulating the proliferation of virus specific CD8 T cells from HIV patients were compared,and the effect of adding exogenous IL-2 into co-culture on proliferation was evaluated.Results In comparison to directly adding MHC I matched HIV peptides into peripheral blood mononuclear cells (PBMCs) by presence during co-culture or incubating for 2 hours,the more efficient proliferation of HIV-specific CD8 T cells was stimulated by loading HIV peptides on the mixed antigen presenting cells (APCs) that harvested by removing CD8 T cells from PBMCs.Adding IL-2 into co-culture could largely enhance the number of proliferated HIV-specific CD8 T cells but also induced non-specific proliferation of CD8 T cells.Conclusions Stimulation of HIV-specific CD8 T cells by loading HIV-specific antigen peptides on mixed APCs and in absence of IL-2 can specifically induce the efficient proliferation of HIV-specific CD8 T cells by providing both antigen and co-stimulation signals.

Objective:To conduct a series case study on hospitalized anthrax cases in five hospitals in North China, to share clinical experiences in the diagnosis and treatment of cutaneous and pulmonary anthrax.Methods:A retrospective, multicenter cohort study was conducted on the anthrax patients admitted to five hospitals in North China from August 2018 to March 2022. Forty patients were divided into severe and mild groups. The clinical features, treatment and prognosis of the patients were collected and analysed. Statistical evaluations included independent sample t test, Mann-Whitney U test, and chi-square test. Results:Among the 40 patients with anthrax, 10(25.0%) were severely ill and 30(75.0%) were mildly ill. According to the sites of infection, 40 patients were classified as 39 cutaneous anthrax cases (one case had secondary pulmonary anthrax) and one pulmonary anthrax case. The rates of chills and fever, lymphadenopathy, liver dysfunction and hypoalbuminemia in the severe group were all higher than those in the mild group, with statistically significant differences ( χ2=5.71, 6.54, 4.68 and 9.22, respectively, all P<0.05). The peripheral white blood cell count, neutrophil count, neutrophil/lymphocyte ratio and C-reactive protein were (11.8±4.9)×10 9/L, (9.5±5.1)×10 9/L, 8.6±7.3, 27.9(8.6, 167.7) mg/L, respectively, which were all higher than those in mild disease group ((7.5±2.4)×10 9/L, (5.0±2.1)×10 9/L, 3.2±2.3, 3.5(1.2, 14.7) mg/L), with statistically significant differences ( t=2.66, t=2.71, t=2.32 and Z=-3.01, respectively, all P<0.05). The albumin level in the severe group was (35.5±8.1) g/L, which was lower than that of the mild group ((43.7±3.2) g/L), and the difference was statistically significant ( t=-3.13, P=0.011). The severe cases were more likely to have skin lesions greater than four centimetre in diameter, multiple, vesicular, or edematous, with a significant difference ( χ2=6.01, P=0.014). Among 39 patients with cutaneous anthrax, 28(71.8%) in the mild group were treated with penicillin alone, and nine (23.1%) in the severe group were treated with penicillin, ofloxacin, piperacillin/tazobactam combined with one of linezolid, doxycycline, or clindamycin for anti-infection treatment. The two patients with pulmonary anthrax were treated with closed thoracic drainage for pleural effusion and pneumothorax, and were treated with two bactericidal and one protein synthesis inhibitor antibiotics. All 40 anthrax patients were cured and discharged from hospital. Conclusions:Patients with mild cutaneous anthrax can generally be treated with single penicillin, and patients with severe cutaneous anthrax and pulmonary anthrax should be treated with combined antibiotics.

With the continuous development of gene therapy, more new technologies have been found and gradually applied in the basic research and clinical treatment of various diseases. In the field of AIDS treatment, gene therapy shows obvious advantages over traditional antiretroviral therapy. In recent years, short hairpin RNA (shRNA), clustered regulatory interspaced short palindrome repeat (CRISPR), transcription activator-like effector nucleases (TALEN), and zinc finger nucleases (ZFN) have been applied in AIDS treatment and have fruitful results. This paper reviews the major breakthroughs in this field since the emergence of gene therapy and the latest research achievements and their progress, with a view to providing a useful reference on a wider range of gene therapy application.