1.Efficacy and safety of levofloxacin and rifapentine for elderly initial treatment pulmonary tuberculosis
Hongye NING ; Xiangao JIANG ; Jichan SHI ; Guiqing HE ; Zhengxing WU
Chinese Journal of Biochemical Pharmaceutics 2017;37(4):238-240
Objective To investigate the efficacy and safety of levofloxacin and rifapentine for elderly initial treatment pulmonary tuberculosis.Methods 120 cases of elderly initial treatment pulmonary tuberculosis patients January 2015 to January 2016 in our hospital were randomly divided into A,B,C three groups,with 40 cases in each group.Treatment regimen of group A: 2HRZE/4HR; treatment regimen of group B: 2Rft(rifapentine capsules)HZE/4HRft; treatment regimen of group C: 2Rft(rifapentine capsules)HELfx/4HRft.The clinical symptoms,signs and adverse drug reactions were compared between the three groups of patients,observation the changes of blood,urine,liver and kidney function,perform imaging and bacteriological examination to determine the treatment effect.Results Five cases in group A and one case in group B abandoned treatment because of liver damage and severe gastrointestinal reaction,but no one in the 40 cases of group C abandoned treatment.There was no statistically significant difference among three groups in sputum negative conversion rate and focus absorption.The number of cases presenting gastrointestinal reaction and liver damage in group C was significantly smaller than that in group A and group B(P<0.05).Rifampicin was replaced by levofloxacin in two cases of group A as a result of allergy,and no allergy occurred in the other two groups.Conclusion Levofloxacin and rifapentine have good efficacy and few side effects for elderly initial treatment pulmonary tuberculosis,initial treatment regimen for elderly pulmonary tuberculosis patients should be individualized,drugs with few side effects can be used to guarantee smooth proceeding of treatment.
2.Analysis of the complete genome sequence of a Shenzhen coxsackievirus A2 strain SHZH13-01
Chunlin CAI ; Xiangjie YAO ; Fei ZHUO ; Yaqing HE ; Guiqing YANG
Chinese Journal of Microbiology and Immunology 2014;(10):770-773
Objective To analyze the complete genome sequence of a Shenzhen coxsackievirus A2 strain CVA2-SHZH13-01 and its evolution.Methods RT-PCR was used to amplify the complete genome of CVA2-SHZH13-01 strain.The PCR products were purified and sequenced to analyze their genetic character-istics.Results The complete genome of CVA2-SHZH13-01 strain was 7400 bp in length, encoding 2191 amino acids.CVA2-SHZH13-01 strain was highly similar with the novel recombinant CVA2-HK (431306) strain isolated from Hong Kong sharing the nucleotide homology of 98.3%, 98.8%, 99.0%, 99.2%, 98.8%and 98.9%in 5′UTR, P1 ( VP1 to VP4) , P2, P3, 3′UTR regions and complete genome, respec-tively.CVA2-SHZH13-01 strain was highly identical to the international standard strain CVA2-Fleetwood showing the homology of 81.6% in nucleotide sequences in P1 region, but closely associated with EV71-SHZH03 and EV71-GD2009 strains (82.8%-88.7%) in P2 and P3 regions.The phylogenetic analysis in-dicated that CVA2-SHZH13-01 strain belonged to the CVA2-HK (431306) variant.Data from analysis of amino acid in P1 region showed that there were three amino acid mutations in CVA2-SHZH13-01 strain including aa5L→F, aa666S→G and aa671T→I as compared with CVA2-HK (431306) strain.Conclusion CVA2-SHZH13-01 strain belonged to CVA2-HK (431306) variant.
3.Prevalence of nontuberculous mycobacteria isolated from pulmonary specimens in Wenzhou during 2014 to 2016
Guiqing HE ; Ke XU ; Zhili SHAN ; Jichan SHI ; Lianpeng WU ; Hongye NING ; Xiaoya CUI ; Zhengxing WU ; Qingyong ZHENG ; Xiangao JIANG
Chinese Journal of Clinical Infectious Diseases 2017;10(4):262-267
Objective To investigate the isolation rate, distribution and trend of nontuberculous mycobacteria (NTM) in Wenzhou during 2014 to 2016.Methods Sputum or alveolar lavage specimens of patients with suspected pulmonary tuberculosis were collected for mycobacteria culture from January 2014 to December 2016.Mycobacterium culture positive strains were further identified by gene chip, 16S rRNA and hsp65 gene sequencing.SPSS 19.0 software was used to analyze the data.Results After excluding repetitive strains, 3 295 mycobacteria strains (MTB) were isolated from respiratory specimens, included 3 032 mycobacterium tuberculosis complex strains, 238 NTM strains, 20 Gordon genera strains, 3 Nocardia genera strains and 2 Tsukamurella genera strains.The proportion of NTM among confirmed mycobacteria was 8.5% (86/1 006), 6.7% (72/1 079) and 6.8% (80/1 185) in 2014, 2015 and 2016, respectively (x2 =2.459,P > 0.05).The overall prevalence of NTM was 7.3 % (238/3 270).There were 15 species of NTM, and the most common NTM strain was Mycobacterium intracellulare (52.5%,125/238), followed by Mycobacterium abscessus (22.7%, 54/238) and Mycobacterium avium (10.1%, 24/238), other species were only accounted for 14.7% (35/238).The ranking of Mycobacterium avium went up rapidly from the fifth in 2014 to the second in 2016 (x2 =18.259, P < 0.01), while proportion of Mycobacterium abscess, dropped from 34.9% (30/86) in 2014 to 17.5% (14/80) in 2016 (x2 =7.335, P<0.01).Among patients from whom the NTM strains were isolated, 56.7% (135/238) were male and most of them were aged 45 years or above (79.8%, 190/238).Conclusions In the past three years, the trend of NTM isolation rate in Wenzhou is steady.The most prevalent NTM species is Mycobacterium intracellulare, followed by Mycobacterium abscessus and Mycobacterium avium.Mycobacterium avium shows a continuously upward trend, while the separation of Mycobacterium abscessus shows a downward trend.
4.The changes and significance of the soluble B cell-activating factor in the peripheral blood of patients with chronic human immunodeficiency virus infection
Xingzhong HU ; Wanzhong KONG ; Guiqing HE ; Jichan SHI ; Xiaoya CUI ; Xiangao JIANG
Chinese Journal of Infectious Diseases 2018;36(9):543-546
Objective To elaborate the changes of the soluble B cell-activating factor of the tumor necrosis factor family (BAFF) in the peripheral blood of chronic human immunodeficiency virus (HIV)-infected patients ,and to study the correlation between the soluble BAFF in HIV-infected patients and the progressions of acquired immune deficiency syndrome (AIDS).Methods Fifty untreated HIV outpatients and 30 healthy controls were recruited .According to the counts of CD4+T lymphocytes ,HIV-infected patients were divided into three groups ,< 200 cells/μL group , (200 - 350 ) cells/μL group and >350 cells/μL group .B cell counts and the BAFF levels were compared among the three groups and the healthy controls .The correlation analysis was conducted for the levels of BAFF ,the counts of CD4+T lymphocytes and B cells ,and viral load in HIV-infected patients .The value of BAFF in staging of HIV disease was identified by receiver operating characteristic (ROC) curve.Results The B cell counts were (90.3 ± 43.1)cells/μL in <200 cells/μL group ,(114 .4 ± 28 .8) cells/μL in (200 -350) cells/μL group ,and (162 .1 ± 29 .5) cells/μL in >350 cells/μL group and (307.1 ± 97 .0) cells/μL in healthy controls ,which was significantly different among the four groups (F=47.92 ,P<0.05).The concentrations of BAFF in the four groups were (1 737.5 ± 719.7) ,(962.8 ± 341.1) ,(859.8 ± 270.4) ,and (456.9 ± 163.7) ng/L ,with significant difference among the groups (F=36.72 ,P<0.05).The level of BAFF was negatively correlated with both B cell counts and CD4+T lymphocyte counts (r= -0.722 and -0.568 ,respectively ;both P<0.05) ,and positively correlated with viral load (r=0.607 ,P<0 .05).The area under the ROC curve was 0 .881.If the level of BAFF was 1 281.5 ng/L ,the sensitivity and specificity to predict the period of AIDS were 74 .1% and 87.0%,respectively .Conclusion The levels of soluble BAFF in HIV-infected patients are significantly increased and related with the reduction of B cell counts and disease progression.
5.Analysis of drug resistance of second-line anti-TBdrugs to baseline strain in patients with multidrug-resistant pulmonary tuberculosis
Guiqing HE ; Jichan SHI ; Lianpeng WU ; Xiangao JIANG
China Modern Doctor 2018;56(15):84-87
Objective To investigate the resistance of second-line anti-TBdrugs to baseline strain in patients with multidrug-resistant pulmonary tuberculosis. Methods Atotal of 52 baseline strains in patients with multidrug-resistant pulmonary tuberculosis collected from March 2016 to May 2017 in our hospital were randomly selected. The sensitivity of the nine kinds of second-line anti-TBdrugs was tested, to analyze the proportion of different drug resistance and cross-resistance of similar drugs. Results Among the 9 second-line anti-TBdrugs, the ratio of drug resistance was ofloxacin =levofloxacin(59. 6%, 31/52)>moxifloxacin(30. 8%, 16/52)> amikacin=kanamycin(both 9. 6%,5/52)>paminosalicylic acid=cycloserine(both 7. 7%, 4/52)> capreomycin =prothionamide(both 9. 6%, 3/52). Ofloxacin was completely cross-resistant with levofloxacin, and its cross-resistant rate with moxifloxacin accounted for 51. 6% (15/31). Amikacin was completely cross-resistant with kanamycin, and its cross-resistant rate with capreomycin accounted for 60%. Conclusion The baseline strains of patients with multi-drug resistant pulmonary tuberculosis are seriously resistant to fluoroquinolones. There is resistance to some extent for other second-line anti-tuberculosis drugs. Therefore, second-line drug susceptibility testing should be completed prior to establishing an effective MDR-TBtreatment regimen.
6.Correlation between CD169 expression of peripheral blood monocytes and disease progression in human immunodeficiency virus-infected patients
Xingzhong HU ; Ying LIN ; Huaguo WANG ; Wanzhong KONG ; Xiangao JIANG ; Guiqing HE ; Jichan SHI ; Xiaoya CUI ; Qiyu BAO
Chinese Journal of Infectious Diseases 2017;35(11):666-669
Objective To study the correlation between CD169 expression of monocytes and disease progression in human immunodeficiency virus (HIV )-infected patients .Methods Sixty HIV-infected patients and 30 healthy controls were recruited .According to the CD4 + T lymphocyte counts ,HIV-infected patients were divided into three groups including < 200 cells/μL ,200 — 350 cells/μL and > 350 cells/μL groups . The differences in monocytes counts ,the proportions of CD16 + and CD169 + monocytes were analyzed among the three groups and healthy controls .The correlations between proportion of CD169 + monocytes and CD4 + T lymphocyte counts ,viral load ,and proportion of CD16 + monocytes were analyzed .Results The monocyte counts in CD4 + T lymphocytes < 200 cells/μL group , (200 — 350 ) cells/μL group , >350 cells/μL group and healthy control group were (342 ± 99) ,(396 ± 145) ,(365 ± 80) ,and (404 ± 106)/μL ,respectively ,which were not significantly different (F= 2 .55 , P > 0 .05) .The proportions of CD16 + monocytes in the four groups were (19 .8 ± 8 .8)% ,(14 .3 ± 2 .8)% ,(9 .7 ± 2 .0)% and (4 .0 ± 0 .8)% ,respectively ,which were significantly different ( F = 30 .90 , P < 0 .05 ) . The proportions of CD169 + monocytes in the four groups were (72 .6 ± 11 .4)% ,(59 .4 ± 14 .7)% ,(33 .3 ± 14 .5)% and (2 .6 ± 0 .8)% ,respectively ,which were significantly different (F = 152 .40 , P< 0 .05) .The proportion of CD169 + monocytes was negatively correlated with CD4 + T lymphocyte counts (r = 0 .792 , P< 0 .05) , while positively correlated with both viral load (r= 0 .485 ,P< 0 .05) and proportion of CD16 + monocytes (r= 0 .395 , P< 0 .05) .Conclusions The CD169 expressions of monocytes in HIV-infected patients are significantly increased and correlated with both monocyte activation and disease progression .
7. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens
Guiqing HE ; Jialin JIN ; Huaping SUN ; Jichan SHI ; Lianpeng WU ; Hongye NING ; Xiaoya CUI ; Xiangao JIANG
Chinese Journal of Infectious Diseases 2018;36(4):206-212
Objective:
To determine the clinical significance of nontuberculous mycobacteria (NTM) isolated from respiratory specimens.
Methods:
Clinical data of patients with NTM strains isolated from the respiratory tract between January 2014 and February 2017 were retrospectively analyzed. Clinical significance of NTM isolated strains was evaluated based on diagnostic criteria of NTM pulmonary diseases from American Thoracic Society (ATS). Quantitative data of two groups were analyzed by independent
8.Implementation status and thinking of multidisciplinary diagnosis and treatment model:practice of a heart specialists team
Ling YANG ; Mengjie WANG ; DeBelder ADAM ; Liu GUIQING ; Ruijue ZHOU ; Xiaozhou HE ; Yan ZHANG ; Huiyin WANG ; Yutong WU ; Jun ZHOU ; Xiaoying ZHANG
Chinese Journal of Hospital Administration 2018;34(2):128-132
Heart specialists team has become one of the core concepts of diagnosis and treatment mode for cardiovascular diseases.Multidisciplinary collaboration has proved its beneficial effects on the diagnosis and treatment strategies, patient selection, follow-up and management of some cardiovascular diseases.At present,it is chiefly seen in the diagnosis and treatment of coronary artery revascularization and transcatheter aortic valve replacement.During implementation there still exist such problems as lack of awareness,attention and effective operation of the medical staff,and lack of an incentive mechanism, thus incurring controversies over such a model.Therefore further follow-up and improvements are expected in combination with the characteristics of China′s medical institutions.
9.Expression of cMPO in 502 cases of acute myeloid leukemia (AML) and its diagnosis significance in AML subtypes.
Lei SHANG ; Xuejing CHEN ; Yuanyuan LI ; Guiqing GUO ; Dashui HE ; Xiaojin CAI ; Bin ZHENG ; Yingchang MI ; Jianxiang WANG ; Kun RU ; Huijun WANG
Chinese Journal of Hematology 2015;36(11):906-911
OBJECTIVETo investigate the myeloperoxidase (cMPO) expression pattern by flow cytometry (FCM) in patients with acute myeloid leukemia (AML) and its role in classifying AML.
METHODSEight- color multiparametric FCM with CD45/SSC gating was used to determine the cMPO expression in 502 AML patients.
RESULTSThe positive rate of cMPO in all patients was 58.0%, in which the proportion of normal positivity, dim positivity and partial positivity was 21.5%, 34.1% and 2.4%, respectively. The remaining case (42.0%) were all negative. In AML with t (15;17)(q22;q12)/PMLRARα, the positive rate was the highest (100%) and the intensity was similar to that of the normal granular leukocytes, followed by AML with t (8;21(q22;q22/RUNX1-RUNX1T1, the positive rate was 91.4% and the intensity was mostly dim. AML with minimal differentiation and acute megakaryoblastic leukemia were all cMPO negative. The positive rates of cMPO in the remaining subtypes were between 22.7% and 76.2%.
CONCLUSIONThe positive rate and intensity of cMPO were significantly different among different subtypes of AML.
Cell Differentiation ; Flow Cytometry ; Granulocytes ; Humans ; Leukemia, Myeloid, Acute ; classification ; genetics ; Peroxidase ; genetics
10.Expert consensus on the evaluation and management of dysphagia after oral and maxillofacial tumor surgery
Xiaoying LI ; Moyi SUN ; Wei GUO ; Guiqing LIAO ; Zhangui TANG ; Longjiang LI ; Wei RAN ; Guoxin REN ; Zhijun SUN ; Jian MENG ; Shaoyan LIU ; Wei SHANG ; Jie ZHANG ; Yue HE ; Chunjie LI ; Kai YANG ; Zhongcheng GONG ; Jichen LI ; Qing XI ; Gang LI ; Bing HAN ; Yanping CHEN ; Qun'an CHANG ; Yadong WU ; Huaming MAI ; Jie ZHANG ; Weidong LENG ; Lingyun XIA ; Wei WU ; Xiangming YANG ; Chunyi ZHANG ; Fan YANG ; Yanping WANG ; Tiantian CAO
Journal of Practical Stomatology 2024;40(1):5-14
Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.