Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.

This article reviews the research advances in mother-to-child vertical transmission of hepatitis B virus (HBV), cause of standard immunoprophylaxis failure against HBV, and use of tenofovir disoproxil fumarate (TDF) during pregnancy to prevent mother-to-child vertical transmission of HBV, in order to provide guidance for future clinical studies. Our purpose is to perform scientific clinical management and completely prevent the mother-to-child transmission of HBV.

Objective:To investigate the epidemiological characteristics, treatment and prognosis of pediatric severe sepsis in PICU in Shandong Province from 2018 to 2021, in order to provide a scientific basis for the prevention and treatment of severe sepsis in children.Methods:A multicenter retrospective observational study was conducted at PICUs from 19 hospitals in Shandong Province.Patients aged>28 days and ≤18 years, diagnosed with severe sepsis or septic shock who admitted to these PICUs during January 1, 2018 and December 31, 2021 were enrolled.Results:(1)From 2018 to 2021, the total number of hospitalized children and the number of children with severe sepsis admitted to the PICU showed an overall downward trend, with the most significant decrease in 2020.(2)During the study period, among the hospitalized children in PICU, the prevalence rate of children with severe sepsis fluctuated from 1.95% to 2.37%, and the median age fluctuated from 1.29 to 2.00 years old, more males than females.(3)Median pediatric sequential organ failure assessment score fluctuated between 5 and 6 at 24 hours after admission.(4)The most common primary infection site was the respiratory system, followed by the digestive system.(5)Since 2020, the propotion of children receiving fluid resuscitation, blood purification, mechanical ventilation, and glucocorticoid therapy has decreased significantly.(6)The median length of PICU stay was 9.22 to 11.51 days.(7)The median PICU costs decreased significantly from 41 075 yuan in 2018 to 30 972 yuan in 2021.(8)In-hospital mortality showed an overall decreased trend, reaching a maximum of 17.61% in 2019 and a minimum of 12.77% in 2020.Conclusion:From 2018 to 2021, there was no significant change in the incidence of pediatric severe sepsis in PICUs in Shandong province while the overall in-hospital mortality rate and the PICU costs showed a reduced trend.

Objective To investigate the epidemiologic and clinical features of human immunodeficiency virus (HIV)/hepatitis B virus (HBV)co-infected patients.Methods Patients who confirmed with HIV infection and received highly active anti-retroviral therapy (HAART)at Guangzhou Eighth People′s Hospital were enrolled.HIV/HBV co-infected patients and HIV mono-infected patients were screened and their epidemiological and clinical features were analyzed before HAART.Comparison of the levels of alanine transaminase (ALT),aspartate transaminase (AST),CD4 + T lymphocyte and HIV RNA between the two groups were conducted.The data were statistically analyzed by chi-square test and nonparametric test.Results One hundred and sixty-five out of 1 218 (13.5 %)patients were hepatitis B surface antigen positive.The median ALT and AST levels of HIV mono-infected patients were 29 U/L and 34 U/L respectively,which were both higher than HIV/HBV co-infected patients (22 U/L and 25 U/L, respectively)(Z = - 4.270 and Z = - 5 .780,respectively,both P = 0.000 ).The median CD4 + T lymphocyte count of HIV/HBV co-infected patients was significantly lower than that of HIV mono-infected patients (Z = -2.980,P =0.003 ).The CD4 + T lymphocyte count was lower in hepatitis B e antigen (HBeAg)positive patients than HBeAg negative patients (Z =-2.660,P =0.008).The median CD4 + T lymphocyte count in patients with HBV DNA≥5 lg copy/mL was significantly lower than those with HBV DNA<5 lg copy/mL (Z = -2.311 ,P =0.021 ).The proportions of positive HBV DNA, HBV DNA≥5 lg copy/mL,abnormal ALT and AST in 54 patiens with CD4 + T lymphocyte counts <50/μL were 81 .5 %,66.7%,44.4% and 53.7%,respectively.All were significantly higher than patients with CD4 + T lymphocyte count≥50/μL(χ2 =6.159,P =0.046 ;χ2 =6.618,P =0.037 ;χ2 =7.144,P =0.028 andχ2 =9.586,P =0.008,respectively).Conclusions The prevalence of HBV/HIV co-infection is high in this study.The CD4 + T lymphocyte counts in HIV/HBV co-infected patients are lower,especially in patients with HBeAg positive and high HBV DNA level.The CD4 + T lymphocyte counts are associated with HBV DNA replication levels.

Adefovir dipivoxil (ADV) is an acyclic nucleotide phosphate analogue, currently used for anti-HBV therapy. A few cases of hypophosphatemia related to ADV were reviewed. We report two cases of chronic hepatitis B patients with the chief complaints of chest pain due to hypophosphatemia associated with ADV treatment.
Adenine ; adverse effects ; analogs & derivatives ; Chest Pain ; chemically induced ; Female ; Humans ; Hypophosphatemia ; chemically induced ; Male ; Middle Aged ; Organophosphonates ; adverse effects ; Young Adult

Adefovir dipivoxil (ADV) is an acyclic nucleotide phosphate analogue, currently used for anti-HBV therapy. A few cases of hypophosphatemia related to ADV were reviewed. We report two cases of chronic hepatitis B patients with the chief complaints of chest pain due to hypophosphatemia associated with ADV treatment.

Adefovir dipivoxil (ADV) is an acyclic nucleotide phosphate analogue, currently used for anti-HBV therapy. A few cases of hypophosphatemia related to ADV were reviewed. We report two cases of chronic hepatitis B patients with the chief complaints of chest pain due to hypophosphatemia associated with ADV treatment.

Objective To investigate the prevalence and patterns of lamivudine (3TC) resistance mutations in acquired immune deficiency syndrome (AIDS)/chronic hepatitis B (CHB) co-infected patients receiving 3TC as a part of antiretroviral therapy.Methods Data of patients with AIDS/CHB co-infection from 2005 to 2010 were collected.HBV DNA was tested at the time of highly active antiretroviral therapy (HAART) and after 12,24,36,48 and 60 months therapy.HBV reverse transcriptase (RT) was amplified in detectable samples.3TC resistance mutations were identified.Results 185 co-infected patients were enrolled.3TC resistance mutations were negative at the time of HAART.3TC resistance mutations occurred in 29 co-infected patients after treatment,of these,7 patients were detected resistance mutations in two different points.9 patients were HBV non-viraemia at the time of antiviral therapy.Resistance mutations were detected after 12 months therapy in 3 patients.Patients with 3TC resistance mutations were more frequently HBeAg positive (65.5％ vs.33.3％,P =0.001),had higher HBV viral load (7.49 copies/ml vs.6.59 copies/ml,P =0.017) and longer duration of 3TC (40 months vs.26.5 months,P ＜ 0.001) than patients without 3TC resistance mutations.Four patterns of 3TC resistance mutations were detected:rtM204I (n=7),rtL180M (n=2),rtL180M + rtM204V/I (n =23) and rtL80V +rtM204I (n=4).Conclusions The prevalence of 3TC resistance mutations is low among AIDS/CHB co-infected patients in Guangzhou.Patients with HBV DNA negative before HAART are likely to develop resistance early during therapy.

OBJECTIVETo explore the relationship between HSD11B2 polymorphisms and fetal growth during normal pregnancy.

METHODSThe HSD11B2 promoter/G-209A, G-194C, G-151A and G-126A genotypes were examined in 33 samples from Chinese Han subjects by gene sequencing. HSD11B2 (CA)n microsatellite polymorphism in the first intron was detected in blood samples from 187 maternal and newborn pairs by PCR-capillary electrophoresis.

RESULTSAll the HSD11B2 promoter/G-209A, G-194C, G-151A and G-126A genotypes were wild-type GG. The offspring birth weight and any ultrasound parameters describing late gestational fetal body shape were not significantly different between maternal or fetal SS, SL and LL groups or combined SS+SL and LL groups. When considering the relevant confounding factors (gestational age at delivery, newborn's gender, maternal body mass index before pregnancy, maternal weight at delivery and maternal age), the offspring birth weight and late pregnancy ultrasound parameters were still not associated with the maternal or fetal HSD11B2 (CA) n microsatellite polymorphisms.

CONCLUSIONSFetal and maternal HSD11B2 polymorphism is not related to fetal growth during normal pregnancy.

11-beta-Hydroxysteroid Dehydrogenase Type 2 ; genetics ; Birth Weight ; Body Mass Index ; Female ; Fetal Development ; genetics ; Genotype ; Gestational Age ; Humans ; Infant, Newborn ; Polymorphism, Genetic ; Pregnancy ; Promoter Regions, Genetic

OBJECTIVETo explore the impact of maternal hepatitis B surface antigen (HBsAg) carrier status on the occurrence of preterm birth.

METHODSWe analyzed pregnancy-related complications, outcomes and fetal growth index in 188 HBsAg positive singleton pregnant women during the period of May 2009 to July 2011, with 265 HBsAg-negative women with singleton pregnancies in the same period serving as controls.

RESULTSThe HBsAg-positive pregnant women showed a significantly higher incidence of placenta praevia than the control group (2.66% vs 0%, P=0.03), and the incidence of preterm delivery (<37 weeks) was also significantly higher in HBsAg-positive group (12.23% vs 6.04%, P=0.02). The incidences of gestational hypertension, preeclampsia, gestational diabetes mellitus, abnormal glucose tolerance, premature rupture of membranes, cesarean delivery, and postpartum hemorrhage showed no significant differences between the two groups (P>0.05), nor did the fetal birth weight, height, head circumference or Apgar scores at 1, 5, and 10 min (P>0.05). Logistic regression identified HBsAg positivity, abnormal ALT, placenta praevia, and severe preeclampsia as the risk factors for preterm delivery.

CONCLUSIONHBsAg carrier status can increase the risk of preterm delivery in pregnancy, but it does not seem to affect the fetal growth.

Adult ; Carrier State ; Case-Control Studies ; Female ; Hepatitis B Surface Antigens ; blood ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; Premature Birth ; etiology ; Risk Factors ; Young Adult