1.Efficacy of direct-acting antiviral agents combined regimens for hepatitis C virus with different genotypes in Dehong Prefecture, Yunnan Province from 2022 to 2024
Renhai TANG ; Yidan ZHAO ; Yuecheng YANG ; Runhua YE ; Lifen XIANG ; Xingmei FENG ; Qunbo ZHOU ; Yanfen CAO ; Na HE ; Yingying DING ; Song DUAN
Shanghai Journal of Preventive Medicine 2025;37(8):676-681
ObjectiveTo investigate the therapeutic effects of direct-acting antiviral agents (DAAs) combined regimens for hepatitis C virus (HCV) patients in Dehong Prefecture, Yunnan Province from 2022 to 2024, to analyze the characteristics of treatment failure patients, so as to provide a basis for discovering more effective treatment regimens in the future. MethodsData on HCV prevention and treatment in Dehong Prefecture was extracted from the China Disease Control and Prevention Information System. A total of 617 patients with HCV antiviral therapy were included, and the differences in variable characteristics among patients with different genotypes were analyzed using comparative statistical tests, including basic socio-demographic characteristics, biochemical testing indicators, and information on previous treatment and current treatment. In addition, the cure rate of HCV patients with diverse characteristics was compared, and the potential causes of treatment failure were explored simultaneously. ResultsThe cure rate of HCV was 96.8%, and statistically significant differences were observed in aspartate transaminase (AST) and alanine transaminase (ALT) levels, previous antiviral therapy history and initial treatment regimens among patients with different HCV genotypes (all P<0.05). Among the multi-type combination regimens, the cure rate of sofosbuvir (SOF)-containing regimens was 97.00%, that of velpatasvir (VEL)-containing regimens was 95.45%, and the cure rate of other treatment regimens, including the regimens with ribavirin (RIB) intervention, was 93.10%. Among the patients with treatment failure, 45.00% had genotype 3, 40.00% had abnormal abdominal ultrasound results, and all presented with elevated baseline AST test levels. ConclusionThe clinical treatment of HCV patients should consider the differences in genotype and biochemical test results. DAAs combined regimens for HCV have achieved a high cure rate in Dehong Prefecture and are applicable to HCV patients with diverse clinical characteristics, providing research evidence for wider application.
2.HuiNet report of 2023: The distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui
Yanyan LIU ; Yasheng LI ; Liang YU ; Yi YANG ; Ting WU ; Jun YIN ; Lifen HU ; Ying YE ; Jiabin LI
Chinese Journal of Clinical Infectious Diseases 2024;17(2):113-125
Objective:To analyse the distribution and antimicrobial resistance profile of clinical bacterial isolates in Anhui province.Methods:Surveillance data was collected from 83 members of the Anhui Antimicrobial Resistance Surveillance Network(HuiNet)during October 2022 to September 2023,to analyze the resistance of major bacteria to commonly used antibiotics and the detection of clinically common drug-resistant bacteria. The data was analyzed using WHONET 5.6 and SPSS 25.0 software.Results:A total of 201 647 clinical bacteria isolates were collected,with Gram-negative bacteria accounting for 74.8%(150 847/201 647). The most prevalent Gram-positive bacterial strains were Staphylococus aureus(32.8%,16 648/50 800),followed by Staphylococcus epidermidis(14.0%,7 098/50 800), Enterococcus faecalis(10.7%,5 458/50 800), Enterococcus faecium(9.1%,4 613/50 800)and Staphylococcus hominis(7.4%,3 778/50 800);the most prevalent Gram-negative bacterial strains were Escherichia coli(28.9%,43 577/150 847),followed by Klebsiella pneumoniae(22.5%,34 006/150 847), Pseudomonas aeruginosa(14.7%,22 171/150 847), Acinetobacter baumannii complex(9.4%,14 194/150 847)and Enterobacter cloacae(3.5%,5 235/150 847). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus aureus(MRCNS)were 39.5%(6 442/16 325)and 75.7%(12 343/16 312),respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were 0.5% and 0.6%,respectively. The prevalence of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae(CR-KPN)were 1.9%(805/42 956)and 11.7%(3 950/33 761),respectively. The resistance rate of CR-KPN to tigecycline was 3.9%. The prevalence of carbapenem-resistant Pseudomonas aeruginosa(CR-PAE)and Acinetobacter baumannii(CR-ABA)complex were 18.4%(3 936/21 447)and 62.9%(8 649/13 744),respectively,with low resistance rate to polycolistin B(6.9% and 1.7%,respectively). The detection rates of MRSA,CR-ABA complex,third-generation cephalosporin-resistant Escherichia coli(CTX/CRO-R-ECO)and quinolone-resistant Escherichia coli(QNR-ECO)in northern Anhui were the highest(50.3%,72.9%,59.2% and 55.6%,respectively),which were higher than those in central and southern Anhui( χ2=112.734 and 575.069,132.747 and 233.885,93.986 and 471.209,60.062 and 230.669,all P<0.001),and the detection rate in central Anhui was higher than that in southern Anhui( χ2=278.671,29.219,207.395 and 80.267,all P<0.001). The detection rates of CR-KPN and thirdgeneration cephalosporinresistant Klebsiella pneumoniae(CTX/CRO-R-KPN)in central Anhui were the highest(15.5% and 33.3%,respectively),which were higher than those in northern and southern Anhui( χ2=156.237 and 325.533,76.928 and 180.686,all P<0.001),and the detection rate in northern Anhui was higher than that in southern Anhui( χ2=32.202 and 25.539, P<0.001). The detection rates of CTX/CRO-R-ECO and QNR-ECO were the highest in the elderly(55.2% and 55.8%,respectively),which were higher than those in children,and young and middle aged adults( χ2=23.906 and 120.575,376.404 and 196.612, P<0.001). The detection rate of CTX/CRO-R-KPN in neonates was the highest(57.1%),which was significantly higher than that in children,adults and the elderly( χ2=46.141,38.843 and 32.093, P<0.001),and the detection rate in the elderly was higher than that in children and adults( χ2=13.604 and 13.471, P<0.001). The detection rates of MRSA and MRCNS were the highest in children(42.8% and 77.8%,respectively),which were higher than those in adults( χ2=21.766 and 10.704, P<0.001). Except MRSA and vancomycin-resistant Enterococcus faecium and faecalis,the detection rates of major drug-resistant bacteria in tertiary hospitals were higher than those in secondary hospitals( P<0.05 or <0.01). Conclusion:In 2023,the situation of antimicrobial resistance in Anhui province was serious,especially in northern and central Anhui,and targeted drug resistance control measures should be taken according to the monitoring results. At the same time,it is necessary to pay attention to the bacterial resistance in the elderly,newborns and children,and strengthen the rational use of antibiotics by clinicians to curb the spread of drug-resistant bacteria.
3.Analysis of the iodine nutritional status of pregnant women in Jilin Province and its correlation with the distribution of water iodine in external environment
Lifen YANG ; Jingshen ZHAO ; Xinrui ZHAO ; Nan SHI ; Baoxiang FENG ; Hui SUN ; Huixin CHEN
Chinese Journal of Endemiology 2024;43(8):657-660
Objective:To investigate the iodine nutritional status of pregnant women in Jilin Province and its correlation with the distribution characteristics of water iodine in external environment, providing a basis for scientific iodine supplementation and prevention of iodine deficiency disorders.Methods:A retrospective analysis was conducted on the iodine survey data of drinking water for residents in Jilin Province in 2017 and the monitoring data of iodine deficiency disorders in 2021. The water iodine, salt iodine, and urinary iodine level of pregnant women were analyzed.Results:In 8 866 water samples from 873 townships (streets, hereinafter referred to as townships) of 60 counties (cities, districts) in 9 cities (autonomous prefectures) throughout the province, the median of water iodine was 4.60 μg/L, ranging from 0.00 to 81.30 μg/L. Among them, there were 758 townships with a median water iodine < 10 μg/L, accounting for 86.83% (758/873); 107 townships with a water iodine of 10 - < 40 μg/L, accounting for 12.26% (107/873). The median salt iodine was 23.50 mg/kg in 6 000 household consumption salt samples. The iodized salt coverage rate, iodized salt qualified rate, and qualified iodized salt consumption rate were 99.50% (5 970/6 000), 97.30% (5 809/5 970), and 96.82% (5 809/6 000), respectively. The iodized salt coverage rate in 9 cities (autonomous prefectures) were > 95%, the iodized salt qualified rate and qualified iodized salt consumption rate were > 90%. The median urinary iodine in 6 000 pregnant women's urine samples was 169.05 μg/L. Except for Bayshan City, which was iodine-deficient, the other 8 cities (autonomous prefectures) were iodine-suitable. The results of correlation analysis showed that there was no correlation between the urinary iodine level of pregnant women and the distribution of water iodine in the external environmental at the municipal (autonomous prefecture) level ( r = 0.60, P = 0.089). Conclusions:Most townships in Jilin Province are iodine-deficient in the external environment, and there are no water-borne high iodine area. The iodized salt coverage rate, iodized salt qualified rate, and qualified iodized salt consumption rate all meet the national standards. The iodine nutrition of pregnant women is generally at a suitable level, but there are still some areas where pregnant women are iodine-deficient, and there is no correlation with the distribution of water iodine.
4.Study on the Relationship between Serum LncRNA SNHG11 and HIF-1α Level Expression and Vasculogenic Mimicry of Cancer Tissues in Ovarian Cancer
Lifen YANG ; Jianqing HE ; Lixin YIN
Journal of Modern Laboratory Medicine 2024;39(2):28-33
Objective To investigate the relationship between the expression of long non-coding RNA(LncRNA)small nucleolar RNA host gene 11(SNHG11)and hypoxia inducible factor(HIF)-1α and angiogenesis mimicry(VM)in ovarian cancer.Methods A total of 116 ovarian cancer patients admitted to Tangshan Maternal and Child Health Care Hospital from October 2019 to January 2023 were regarded as the research subjects.Based on whether VM had formed,ovarian cancer patients were grouped into VM group(n=51)and non VM group(n=65).Another 50 partients who underwent health examinations during the same period were regarded as the control group.Real-time fluorescence quantitative PCR(qPCR)was applied to detect the expression levels of LncRNA SNHG11 and HIF-1α in serum of ovarian cancer patients and control groups.Spearman correlation was applied to detect the relationship between LncRNA SNHG11,HIF-1α,and VM formation.The diagnostic value of LncRNA SNHG11,HIF-1α,and their combined detection in the formation of VM in ovarian cancer patients was analyzed using the receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum LncRNA SNHG11(3.01±0.88,2.21±0.68 vs 1.12±0.35)and HIF-1α(2.16±0.67,1.60±0.44 vs 1.01±0.31)in ovarian cancer patients with VM group and non VM group were increased(t=12.136,9.006;19.890,16.591,all P>0.05),the levels of serum LncRNA SNHG11 and HIF-1αin the VM group were obviously higher than those in the non VM group(t=8.957,8.595),and the differences were statistically significant(all P<0.05).The expression of LncRNA SNHG11,HIF-1α,and the formation of VM were not related to age and tissue type(t=1.036,0.976,0.218;1.254,1.390,0.368,all P>0.05),but were related to tumor size,FIGO staging,lymph node metastasis,and pathological grading(t=5.351,5.186,13.264;5.465,5.227,10.898;6.063,6.016,5.374;4.030,5.871,5.509,all P<0.05).Spearman correlation analysis showed that there were obvious positive correlations between LncRNA SNHG11,HIF-1α,and VM generation(r=0.560,0.494,all P<0.05).ROC curve results showed that the areas under the curve(AUCs)of serum LncRNA SNHG11 and HIF-1α for diagnosing VM formation in ovarian cancer patients were 0.860 and 0.824,respectively,with sensitivity of 80.4%and 75.6%,specificity of 58.9%and 51.9%,respectively.The AUC of VM formation in ovarian cancer patients diagnosed by the combination of the two was 0.941,with sensitivity and specificity were 92.2%and 79.9%,respectively.Conclusion The abnormal expressions of LncRNA SNHG11 and HIF-1α were closely related to the formation of VM in ovarian cancer patients,and both may serve as potential biological indicators for judging VM.
5.Epidemic characteristics of HIV-infected people among Chinese and Burmese in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province, 2000-2023
Renhai TANG ; Yuecheng YANG ; Runhua YE ; Lifen XIANG ; Yurong GONG ; Shijiang YANG ; Qunbo ZHOU ; Xing DUAN ; Song DUAN ; Duo SHAN
Chinese Journal of Epidemiology 2024;45(12):1633-1638
Objective:To analyze the epidemic characteristics and trends of newly reported HIV-infected people among Chinese and Burmese in Dehong Dai and Jingpo Autonomous Prefecture (Dehong Prefecture) of Yunnan Province, China, from 2000 to 2023, and provide evidence for formμlating AIDS prevention and control measures for the Burmese living in Dehong.Methods:The data were obtained from the Chinese Disease Control and Prevention Information System. The distribution of HIV-infected people with different population characteristics was analyzed, and the Joinpoint regression model was used to analyze the temporal trend of crude detection rate in different genders, ethnicities, and ages.Results:From 2000 to 2023, 24 989 newly HIV infections were reported in Dehong Prefecture, of which 14 594 (58.4%) were Chinese and 10 395 (41.6%) were Burmese. Compared with Chinese, Burmese women (32.9%, 3 416/10 395), those aged 20-29 (40.9%, 4 248/10 395), and Jingpo people (26.7%, 2 773/10 395) accounted for a higher proportion. The new diagnosis rate of Chinese nationals increased from 1.0/10 000 in 2000 to 15.4/10 000 in 2004, and then showed a downward trend, falling to 1.2/10 000 in 2023. Among them, compared with other age groups, Dai and other ethnic groups and women, the new diagnosis rate among 20-49 age group, Jingpo and men were relatively higher, at 1.7/10 000, 2.3/10 000 and 1.3/10 000 respectively. Regarding the method of detection, the Chinese HIV-infected people were mainly detected by key population testing (35.7%), while the Burmese HIV-infected people by key population testing (28.9%) and physical examination for entry-exit personnel (25.3%). The transmission routes of both nationalities were mainly heterosexual transmission, but compared with Chinese HIV-infected persons, the proportion of Burmese infected persons through non-marital non-commercial transmission was relatively higher (66.4% vs. 60.6%). The proportion of Chinese nationals with a first CD4 +T lymphocyte (CD4) counts of <200 cells/μl (28.9%) was higher than that of Burmese nationals (19.8%). Conclusions:The rising trend of HIV infection among Chinese and Burmese people in Dehong Prefecture from 2000 to 2023 slowed down. The new diagnosis rate was higher in the 20-49 age group, Jingpo and men. Compared with Burmese HIV-infected people, the proportion of Chinese HIV-infected people with first CD4 counts <200 cells/μl was relatively higher. Comprehensive interventions should be further carried out for Myanmar nationals, and efforts should be made to expand testing for Chinese nationals.
6.Efficacy and safety study of standardized mite allergen specific immunotherapy with no reduction during maintenance in children with respiratory allergic disease
Ying LIANG ; Yi ZHONG ; Yunyan LI ; Lingping ZHU ; Lifen YANG ; Shuxian OU ; Zhuanggui CHEN ; Pingping ZHANG
Chinese Journal of Preventive Medicine 2024;58(6):768-777
Objective:To explore the optimal regimen of standardized mite allergen immunotherapy for airway allergic diseases in children, and to observe the clinical efficacy, safety and compliance.Method:Use a retrospective real-world study, clinical data from 156 children aged 5-16 years who received subcutaneous immunotherapy (SCIT) with double mite allergen preparation in the pediatrics department of the Third Affiliated Hospital of Sun Yat sen University from June 2019 to September 2020 were selected for allergic rhinitis (AR) and/or allergic asthma (bronchial asthma, BA), including gender, age, total VAS(visual analogue scale) score and CSMS(combined symptom and medication scores) score at different time points (before treatment, 4-6 months, 1 year, and 2 years after initiation of desensitization), peripheral blood eosinophil counts (EOS), serum total IgE (tIgE), specific IgE (tIgE), and serum IgE (tIgE), specific IgE (sIgE), tIgG4, and incidence of local and systemic adverse reactions. All patients had a consistent regimen during the initial treatment phase (dose-escalation phase), which was performed as directed. Among them, 81 cases (observation group) continued to continue subcutaneous injection of 1 ml of vial No. 3 every 4-6 weeks during the dose maintenance phase, while 75 cases (control group) followed the old traditional regimen during the maintenance phase (i.e., change to a new vial to halve the amount of vial No. 3 by 0.5 ml, and then 0.75 ml after 1-2 weeks, and 1 ml in a further interval of 1-2 weeks). The clinical efficacy, safety and adherence to the treatment were compared between the two groups.Results:A total of 81 cases of 156 children were included in the observation group, of which 58 children with AR, 15 children with BA, and 8 children with AR combined with BA; 75 cases were included in the conventional control group, of which 52 children with AR, 16 children with BA, and 7 children with AR combined with BA. In terms of safety, the difference in the incidence of local and systemic adverse reactions between the two groups was not statistically significant ( χ2=1.541 for local adverse reactions in the control group, χ2=0.718 for the observation group; χ2=0.483 for systemic adverse reactions in the control group, χ2=0.179 for the observation group, P value >0.05 for all of these), and there were no grade Ⅱ or higher systemic adverse reactions in any of them. In the control group, there were 15 cases of dropout at 2 years of follow-up, with a dropout rate of 20.0%; in the observation group, there were 7 cases of dropout at 2 years of follow-up, with a dropout rate of 8.6%, and there was a statistically significant difference in the dropout rates of the patients in the two groups ( χ2=4.147, P<0.05). Comparison of serological indexes and efficacy (compared with baseline at 3 different time points after treatment, i.e., 4-6 months, 1 year and 2 years after treatment), CSMS scores of the observation group and the conventional control group at 4-6 months, 1 year and 2 years after treatment were significantly decreased compared with the baseline status ( t-values of the conventional group were 13.783, 20.086 and 20.384, respectively, all P-values <0.001, and t-values of the observation group were 15.480, 27.087, 28.938, all P-values <0.001), and VAS scores also decreased significantly from baseline status in both groups at 4-6 months, 1 year, and 2 years of treatment ( t-values of 14.008, 17.963, and 27.512 in the conventional control group, respectively, with all P-values <0.001, and t-values of 9.436, 13.184, and 22.377 in the observation group, respectively; all P-values <0.001). Intergroup comparisons showed no statistically significant differences in CSMS at baseline status, 4-6 months, 1 year and 2 years ( t-values 0.621, 0.473, 1.825, and 0.342, respectively, and P-values 0.536, 0.637, 0.070, and 0.733, respectively), and VAS was no statistically significant difference in comparison between groups at different time points ( t-values of 1.663, 0.095, 0.305, 0.951, P-values of 0.099, 0.925, 0.761, 0.343, respectively); suggesting that the treatment regimens of the observation group and the conventional control group were clinically effective, and that the two regimens were comparable in terms of efficacy. The peripheral blood eosinophil counts of the observation group and the conventional control group decreased significantly from the baseline status at 4-6 months, 1 year and 2 years of treatment ( t-values of the conventional group were 3.453, 5.469, 6.273, P-values <0.05, and the t-values of the observation group were 2.900, 4.575, 5.988, P-values <0.05, respectively). 4-6 months, 1 year and 2 years compared with the baseline status tIgE showed a trend of increasing and then decreasing ( t-value in the conventional group was -5.328, -4.254, -0.690, P-value was 0.000, 0.000, 0.492, respectively, and t-value in the observation group was -6.087, -5.087, -0.324, P-value was 0.000, 0.000, 0.745, respectively). However, the results of intergroup comparisons showed no statistically significant differences in serological indices and efficacy between the two groups in terms of peripheral blood eosinophil counts at baseline status, 4-6 months, 1 year and 2 years ( t-values of 0.723, 1.553, 0.766, and 0.234, respectively; P-values of 0.471, 0.122, 0.445, and 0.815, respectively), tIgE ( t-values of 0.170, -0.166, -0.449, 0.839, P-values 0.865, 0.868, 0.654, 0.403, respectively), tIgG4 ( t-values 1.507, 1.467, -0.337, 0.804, P-values 0.134, 0.145, 0.737, 0.422, respectively). Conclusion:Both immunotherapy regimens for airway allergic diseases with double mite allergen subcutaneous immunotherapy have significant clinical efficacy, low incidence of adverse reactions, and the observation group has better patient compliance than the control group.
7.Efficacy and safety study of standardized mite allergen specific immunotherapy with no reduction during maintenance in children with respiratory allergic disease
Ying LIANG ; Yi ZHONG ; Yunyan LI ; Lingping ZHU ; Lifen YANG ; Shuxian OU ; Zhuanggui CHEN ; Pingping ZHANG
Chinese Journal of Preventive Medicine 2024;58(6):768-777
Objective:To explore the optimal regimen of standardized mite allergen immunotherapy for airway allergic diseases in children, and to observe the clinical efficacy, safety and compliance.Method:Use a retrospective real-world study, clinical data from 156 children aged 5-16 years who received subcutaneous immunotherapy (SCIT) with double mite allergen preparation in the pediatrics department of the Third Affiliated Hospital of Sun Yat sen University from June 2019 to September 2020 were selected for allergic rhinitis (AR) and/or allergic asthma (bronchial asthma, BA), including gender, age, total VAS(visual analogue scale) score and CSMS(combined symptom and medication scores) score at different time points (before treatment, 4-6 months, 1 year, and 2 years after initiation of desensitization), peripheral blood eosinophil counts (EOS), serum total IgE (tIgE), specific IgE (tIgE), and serum IgE (tIgE), specific IgE (sIgE), tIgG4, and incidence of local and systemic adverse reactions. All patients had a consistent regimen during the initial treatment phase (dose-escalation phase), which was performed as directed. Among them, 81 cases (observation group) continued to continue subcutaneous injection of 1 ml of vial No. 3 every 4-6 weeks during the dose maintenance phase, while 75 cases (control group) followed the old traditional regimen during the maintenance phase (i.e., change to a new vial to halve the amount of vial No. 3 by 0.5 ml, and then 0.75 ml after 1-2 weeks, and 1 ml in a further interval of 1-2 weeks). The clinical efficacy, safety and adherence to the treatment were compared between the two groups.Results:A total of 81 cases of 156 children were included in the observation group, of which 58 children with AR, 15 children with BA, and 8 children with AR combined with BA; 75 cases were included in the conventional control group, of which 52 children with AR, 16 children with BA, and 7 children with AR combined with BA. In terms of safety, the difference in the incidence of local and systemic adverse reactions between the two groups was not statistically significant ( χ2=1.541 for local adverse reactions in the control group, χ2=0.718 for the observation group; χ2=0.483 for systemic adverse reactions in the control group, χ2=0.179 for the observation group, P value >0.05 for all of these), and there were no grade Ⅱ or higher systemic adverse reactions in any of them. In the control group, there were 15 cases of dropout at 2 years of follow-up, with a dropout rate of 20.0%; in the observation group, there were 7 cases of dropout at 2 years of follow-up, with a dropout rate of 8.6%, and there was a statistically significant difference in the dropout rates of the patients in the two groups ( χ2=4.147, P<0.05). Comparison of serological indexes and efficacy (compared with baseline at 3 different time points after treatment, i.e., 4-6 months, 1 year and 2 years after treatment), CSMS scores of the observation group and the conventional control group at 4-6 months, 1 year and 2 years after treatment were significantly decreased compared with the baseline status ( t-values of the conventional group were 13.783, 20.086 and 20.384, respectively, all P-values <0.001, and t-values of the observation group were 15.480, 27.087, 28.938, all P-values <0.001), and VAS scores also decreased significantly from baseline status in both groups at 4-6 months, 1 year, and 2 years of treatment ( t-values of 14.008, 17.963, and 27.512 in the conventional control group, respectively, with all P-values <0.001, and t-values of 9.436, 13.184, and 22.377 in the observation group, respectively; all P-values <0.001). Intergroup comparisons showed no statistically significant differences in CSMS at baseline status, 4-6 months, 1 year and 2 years ( t-values 0.621, 0.473, 1.825, and 0.342, respectively, and P-values 0.536, 0.637, 0.070, and 0.733, respectively), and VAS was no statistically significant difference in comparison between groups at different time points ( t-values of 1.663, 0.095, 0.305, 0.951, P-values of 0.099, 0.925, 0.761, 0.343, respectively); suggesting that the treatment regimens of the observation group and the conventional control group were clinically effective, and that the two regimens were comparable in terms of efficacy. The peripheral blood eosinophil counts of the observation group and the conventional control group decreased significantly from the baseline status at 4-6 months, 1 year and 2 years of treatment ( t-values of the conventional group were 3.453, 5.469, 6.273, P-values <0.05, and the t-values of the observation group were 2.900, 4.575, 5.988, P-values <0.05, respectively). 4-6 months, 1 year and 2 years compared with the baseline status tIgE showed a trend of increasing and then decreasing ( t-value in the conventional group was -5.328, -4.254, -0.690, P-value was 0.000, 0.000, 0.492, respectively, and t-value in the observation group was -6.087, -5.087, -0.324, P-value was 0.000, 0.000, 0.745, respectively). However, the results of intergroup comparisons showed no statistically significant differences in serological indices and efficacy between the two groups in terms of peripheral blood eosinophil counts at baseline status, 4-6 months, 1 year and 2 years ( t-values of 0.723, 1.553, 0.766, and 0.234, respectively; P-values of 0.471, 0.122, 0.445, and 0.815, respectively), tIgE ( t-values of 0.170, -0.166, -0.449, 0.839, P-values 0.865, 0.868, 0.654, 0.403, respectively), tIgG4 ( t-values 1.507, 1.467, -0.337, 0.804, P-values 0.134, 0.145, 0.737, 0.422, respectively). Conclusion:Both immunotherapy regimens for airway allergic diseases with double mite allergen subcutaneous immunotherapy have significant clinical efficacy, low incidence of adverse reactions, and the observation group has better patient compliance than the control group.
8.Clinical analysis of 9 children with refractory N-methyl-D-aspartate receptor antibody encephalitis children treated with tocilizumab
Yang HAN ; Jing PENG ; Fang HE ; Ciliu ZHANG ; Lifen YANG ; Leilei MAO
Chinese Journal of Pediatrics 2024;62(6):559-564
Objective:To analyze the clinical features of children with refractory N-methyl-D-aspartate (NMDA) receptor antibody encephalitis treated with tocilizumab.Methods:Demographic and clinical manifeatations, immunotherapy and prognosis data of 9 children with refractory NMDA receptor antibody encephalitis who received tocilizumab in the Department of Pediatrics Neurology, XiangYa Hospital of Central South University from August 2021 to September 2023 were collected retrospectively. Prognosis was evaluated using the modified Rankin scale at initial diagnosis, at the initiation of tocilizumab treatment, and at the last follow-up. Treatment related complications, neuroimaging, and electroencephalography data were analyzed.Results:Among the 9 children, 6 were male and 3 were female, with an onset age of 4.2 (2.8, 8.7) years. At the onset of the disease, 9 children had a modified Rankin scale score of 5. When tocilizumab treatment was initiated, 7 children had a score of 5, and 2 children had a score of 4. The interval between the onset and initiation of tocilizumab treatment was 12 (5, 27) months, and the treatment frequency was 8 (5, 13) times. The follow-up time was 2.8 (1.5, 3.7) years. At the last follow-up, the symptoms of 9 children, including movement disorder, sleep disorder, consciousness disorder, silence and autonomic dysfunction, were improved to varying degrees, and none of them had seizures. At the last follow-up, 4 cases with a modified Rankin scale score of 0, 1 case with a score of 1, 2 cases with a score of 3, 1 case with a score of 4 and 1 case with a score of 5. The modified Rankin scale at the last follow-up was significantly different from that at the start of tocilizumab ( Z=-2.56, P=0.014). All children had no serious adverse reactions during the treatment. Conclusions:After treatment with tocilizumab, the symptoms in patients with refractory NMDA receptor antibody encephalitis, including movement disorder, sleep disorder, consciousness disorder, silence and autonomic dysfunction were improved, and none of them had seizures. The modified Rankin scale were improved, and the safety was good.
9.Evaluation of the effect of health education on iodine deficiency disorders in Jilin Province from 2015 to 2019
Xinrui ZHAO ; Jingshen ZHAO ; Haifeng LI ; Lifen YANG ; Baoxiang FENG ; Hui SUN ; Jiaxiang DONG
Chinese Journal of Endemiology 2023;42(3):234-237
Objective:To learn about the cognition of iodine deficiency disorders (IDD) prevention knowledge among key population in the IDD area of Jilin Province, and to evaluate the effect of health education.Methods:From 2015 to 2019, 10 counties (cities, districts, hereinafter referred to as counties) in Jilin Province were selected as project counties every year. Public health education covered the entire project county. In each project county, 3 project townships were selected, and students of grades 4-6 were selected from the central primary schools of each project township for school health education. In each project township, 3 project villages were selected to carry out community health education. Before and after health education, 30 fifth-grade students were selected from the central primary school of each project township, and 15 housewives were selected from the vicinity of each primary school to conduct a questionnaire survey on IDD prevention knowledge.Results:After health education, the overall awareness rate of IDD prevention knowledge among primary school students and housewives in Jilin Province was 96.26% (13 324/13 842) and 96.40% (6 819/7 074), which was significantly higher than that before the intervention [65.36% (9 032/13 818) and 71.26% (5 039/7 071)], and the differences were statistically significant (χ 2 = 4 258.34, 1 647.92, P < 0.001), and the awareness rates of primary school students and housewives increased by 30.90% and 25.14%, respectively. Conclusion:Health education has significantly increased the awareness rate of IDD prevention knowledge among key populations in Jilin Province, and is an important measure to ensure the continuous elimination of IDD.
10.Evidence-based practice in the prevention of surgical site infections in pediatric patients undergoing orthopedic implant surgery
Lifen YANG ; Ning WANG ; Meixue ZHANG ; Xiran LI ; Jianping WU
Chinese Journal of Modern Nursing 2023;29(31):4289-4297
Objective:To construct and implement an evidence-based practice protocol for the prevention of surgical site infections (SSI) in pediatric patients undergoing orthopedic implant surgery based on the best available evidence, and to evaluate its effectiveness in a clinical setting.Methods:Adhering to the standard procedures of a continuous quality improvement model based on evidence, evidence was transformed into clinical practice through four stages: evidence acquisition, current status review, evidence introduction, and effect evaluation. Totally 301 pediatric patients who underwent orthopedic implant surgery from March to December 2021 at Guangzhou Women and Children's Medical Center, along with 79 medical staff involved in the project implementation were selected by convenience sampling. Patients were divided into three groups according to the time of admission for baseline review (from March to May, n=106), first-round review post-implementation of the evidence-based protocol (from June to August, n=110), and second-round review (from September to December, n=85). Comparisons were made regarding the incidence of SSI in pediatric patients before and after the application of the evidence-based protocol, the knowledge level of medical staff concerning SSI associated with orthopedic implant surgeries in pediatric patients, and the execution of review indicators before and after the application of evidence. Results:Following the implementation of the evidence-based protocol, the incidence of SSI in pediatric patients undergoing orthopedic implant surgery reduced significantly from 8.49% in the baseline review to 0 in the second-round review ( P<0.05). Furthermore, there was a statistically significant increase ( P<0.01) in the scores denoting the knowledge level of medical staff on SSI associated with such surgeries, from (75.91±11.19) to (96.42±7.13). Comparison of the execution of review standards before and after evidence application revealed statistically significant differences ( P<0.05 in all cases) . Conclusions:The initiation of this evidence-based practice project can standardize perioperative diagnostic and nursing behaviors of orthopedic implant surgery in medical and nursing staff, effectively safeguard the safety of pediatric patients, and reduce the occurrence of SSI.

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