1.Investigation and analysis of prophylactic anti-infective drugs of liver transplantation in 13 liver transplantation centers in China
Yi LIU ; Donghua LIU ; Yan YAN ; Mingxing GUO ; Deli WANG ; Xiangli CUI
Chinese Journal of Organ Transplantation 2025;46(1):63-68
Objective:To investigate the current application status of prophylactic anti-infective drugs during the perioperative period in liver transplantation centers and provide data references for further standardizing prophylactic regimens.Methods:A questionnaire comprising 53 questions across 5 dimensions was designed and released using the WJX platform. The dimensions included basic information about medical institutions, perioperative pathogenic microorganisms, current status of empirical antibacterial prophylaxis, adjustments to prophylactic anti-infective strategies, and an overview of prophylactic measures against other pathogens. Based on the survey results, the types of common perioperative pathogens in liver transplantation, types of prophylactic antibacterial drugs, timing and duration of administration, upgraded prophylaxis strategies (such as escalation of antibiotic classes or extension of drug application duration), and prevention strategies for other pathogens were summarized.Results:A total of 13 completed questionnaires from pharmacists at liver transplantation centers were collected. The most common pathogens during the perioperative period were Gram-negative bacilli, including Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. The most frequently used prophylactic antibacterial drugs were cefoperazone/sulbactam and piperacillin/tazobactam. Regarding the timing of administration, 9 centers administered drugs 0.5 to 1.0 hour before surgery, 3 within 0.5 hour, and 1 within 1 hour preoperatively. The prophylactic duration was within 7 days postoperatively for living donor liver transplantation in 10 centers, while for cadaveric donor liver transplantation, only 6 centers adhered to the 7-day duration. When donors had infections with sensitive bacteria, 9 centers upgraded prevention strategies: 2 centers escalated the antibiotic class or adjusted regimens, 5 centers extended the duration of prophylaxis, 2 centers implemented donor-specific susceptibility-guided antibacterial treatments regardless of colonization or infection, and 5 centers administered prophylaxis only in cases of colonization based on donor susceptibility results. When donors had multi-drug resistance bacterial infections, 11 centers upgraded prevention strategies: 7 escalated the antibiotic class or adjusted regimens, 4 extended prophylaxis duration, 6 implemented susceptibility-guided treatments irrespective of colonization or infection, 1 administered prophylaxis only for colonization based on donor susceptibility results, and 2 abandoned transplantations. 7 centers routinely applied antifungal prophylactic measures, including 1 for preoperative prophylaxis and 6 for postoperative prophylaxis, using caspofungin (4 centers), fluconazole (2 centers), posaconazole (1 center), and micafungin (1 center). 6 centers initiated antifungal prophylaxis in cases with donor or recipient fungal infection history or active fungal infections detected during liver procurement. Most antifungal prophylaxis was administered within 72 hours postoperative (11 centers), with durations mostly within 14 days (12 centers). For viral infections, 6 centers adopted routine postoperative prophylactic measures. Conclusions:Currently, the perioperative prophylactic anti-infective strategies in 13 liver transplantation centers are not standardized. High-quality multicenter clinical studies are needed to compare the effectiveness of different prophylactic regimens, aiming to further standardize the types and durations of prophylactic drug use.
2.Survey on self-compassion levels in hematologic malignant tumor patients and analysis of its influencing factors
Xiaofei LIN ; Qiong JIANG ; Chunxue ZHOU ; Deli GUO ; Qixia ZHANG
Chinese Journal of Modern Nursing 2025;31(6):818-823
Objective:To investigate the current self-compassion levels in hematologic malignant tumor patients and analyze the influencing factors, providing a basis for clinical interventions.Methods:A convenience sampling method was used to select 120 patients with hematologic malignant tumors treated at the First Affiliated Hospital of Wenzhou Medical University from January to December 2022. Clinical data, self-compassion levels, social support, and adult attachment status were assessed using general data questionnaires, the Self-Compassion Scale (SCS) , the Perceived Social Support Scale (PSSS) , and the Experiences in Close Relationship Scale-Short Form (ECR-S) . Pearson correlation analysis was performed to analyze the correlation between SCS scores and PSSS, ECR-S scores. Multiple linear regression analysis was conducted to explore the influencing factors of self-compassion levels.Results:A total of 120 questionnaires were distributed, and 114 valid questionnaires were returned, resulting in an effective response rate of 95.00%. The average SCS score of hematologic malignant tumor patients was (80.54±5.80) . Univariate analysis showed that self-compassion levels differed significantly among patients of different ages, education levels, per capita family monthly income, disease duration, and the first diagnosis or not of hematologic malignant tumors ( P<0.01) . Pearson correlation analysis revealed a positive correlation between SCS scores and PSSS scores ( r=0.659, P<0.001) , and a negative correlation with the attachment anxiety and avoidance dimensions of the ECR-S ( r=-0.152, -0.588, P<0.001) . Multiple linear regression analysis showed that education level, the first diagnosis or not, PSSS score, ECR-S attachment anxiety dimension, and ECR-S attachment avoidance dimension scores entered the regression equation. Conclusions:The influencing factors of self-compassion levels in hematologic malignant tumor patients include education level, the first diagnosis or not, social support level, and adult attachment status. Healthcare providers should strengthen psychological support for patients with low education, disease recurrence/treatment failure, and insecure attachment types, while also improving patients' social support levels to enhance their self-compassion status.
3.Survey on self-compassion levels in hematologic malignant tumor patients and analysis of its influencing factors
Xiaofei LIN ; Qiong JIANG ; Chunxue ZHOU ; Deli GUO ; Qixia ZHANG
Chinese Journal of Modern Nursing 2025;31(6):818-823
Objective:To investigate the current self-compassion levels in hematologic malignant tumor patients and analyze the influencing factors, providing a basis for clinical interventions.Methods:A convenience sampling method was used to select 120 patients with hematologic malignant tumors treated at the First Affiliated Hospital of Wenzhou Medical University from January to December 2022. Clinical data, self-compassion levels, social support, and adult attachment status were assessed using general data questionnaires, the Self-Compassion Scale (SCS) , the Perceived Social Support Scale (PSSS) , and the Experiences in Close Relationship Scale-Short Form (ECR-S) . Pearson correlation analysis was performed to analyze the correlation between SCS scores and PSSS, ECR-S scores. Multiple linear regression analysis was conducted to explore the influencing factors of self-compassion levels.Results:A total of 120 questionnaires were distributed, and 114 valid questionnaires were returned, resulting in an effective response rate of 95.00%. The average SCS score of hematologic malignant tumor patients was (80.54±5.80) . Univariate analysis showed that self-compassion levels differed significantly among patients of different ages, education levels, per capita family monthly income, disease duration, and the first diagnosis or not of hematologic malignant tumors ( P<0.01) . Pearson correlation analysis revealed a positive correlation between SCS scores and PSSS scores ( r=0.659, P<0.001) , and a negative correlation with the attachment anxiety and avoidance dimensions of the ECR-S ( r=-0.152, -0.588, P<0.001) . Multiple linear regression analysis showed that education level, the first diagnosis or not, PSSS score, ECR-S attachment anxiety dimension, and ECR-S attachment avoidance dimension scores entered the regression equation. Conclusions:The influencing factors of self-compassion levels in hematologic malignant tumor patients include education level, the first diagnosis or not, social support level, and adult attachment status. Healthcare providers should strengthen psychological support for patients with low education, disease recurrence/treatment failure, and insecure attachment types, while also improving patients' social support levels to enhance their self-compassion status.
4.Investigation and analysis of prophylactic anti-infective drugs of liver transplantation in 13 liver transplantation centers in China
Yi LIU ; Donghua LIU ; Yan YAN ; Mingxing GUO ; Deli WANG ; Xiangli CUI
Chinese Journal of Organ Transplantation 2025;46(1):63-68
Objective:To investigate the current application status of prophylactic anti-infective drugs during the perioperative period in liver transplantation centers and provide data references for further standardizing prophylactic regimens.Methods:A questionnaire comprising 53 questions across 5 dimensions was designed and released using the WJX platform. The dimensions included basic information about medical institutions, perioperative pathogenic microorganisms, current status of empirical antibacterial prophylaxis, adjustments to prophylactic anti-infective strategies, and an overview of prophylactic measures against other pathogens. Based on the survey results, the types of common perioperative pathogens in liver transplantation, types of prophylactic antibacterial drugs, timing and duration of administration, upgraded prophylaxis strategies (such as escalation of antibiotic classes or extension of drug application duration), and prevention strategies for other pathogens were summarized.Results:A total of 13 completed questionnaires from pharmacists at liver transplantation centers were collected. The most common pathogens during the perioperative period were Gram-negative bacilli, including Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. The most frequently used prophylactic antibacterial drugs were cefoperazone/sulbactam and piperacillin/tazobactam. Regarding the timing of administration, 9 centers administered drugs 0.5 to 1.0 hour before surgery, 3 within 0.5 hour, and 1 within 1 hour preoperatively. The prophylactic duration was within 7 days postoperatively for living donor liver transplantation in 10 centers, while for cadaveric donor liver transplantation, only 6 centers adhered to the 7-day duration. When donors had infections with sensitive bacteria, 9 centers upgraded prevention strategies: 2 centers escalated the antibiotic class or adjusted regimens, 5 centers extended the duration of prophylaxis, 2 centers implemented donor-specific susceptibility-guided antibacterial treatments regardless of colonization or infection, and 5 centers administered prophylaxis only in cases of colonization based on donor susceptibility results. When donors had multi-drug resistance bacterial infections, 11 centers upgraded prevention strategies: 7 escalated the antibiotic class or adjusted regimens, 4 extended prophylaxis duration, 6 implemented susceptibility-guided treatments irrespective of colonization or infection, 1 administered prophylaxis only for colonization based on donor susceptibility results, and 2 abandoned transplantations. 7 centers routinely applied antifungal prophylactic measures, including 1 for preoperative prophylaxis and 6 for postoperative prophylaxis, using caspofungin (4 centers), fluconazole (2 centers), posaconazole (1 center), and micafungin (1 center). 6 centers initiated antifungal prophylaxis in cases with donor or recipient fungal infection history or active fungal infections detected during liver procurement. Most antifungal prophylaxis was administered within 72 hours postoperative (11 centers), with durations mostly within 14 days (12 centers). For viral infections, 6 centers adopted routine postoperative prophylactic measures. Conclusions:Currently, the perioperative prophylactic anti-infective strategies in 13 liver transplantation centers are not standardized. High-quality multicenter clinical studies are needed to compare the effectiveness of different prophylactic regimens, aiming to further standardize the types and durations of prophylactic drug use.
5.Efficacy of entecavir versus tenofovir disoproxil fumarate in treatment of chronic hepatitis B patients with high viral load
Huikun ZHOU ; Jianning JIANG ; Minghua SU ; Rongming WANG ; Bobin HU ; Deli DENG ; Huilan WEI ; Xianshuai LIANG ; Wenming HE ; Rongsheng GUO
Journal of Clinical Hepatology 2022;38(3):532-536
Objective To investigate the efficacy of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) and the treatment measures for poor response in previously untreated chronic hepatitis B (CHB) patients with high viral load. Methods A total of 165 CHB patients who received antiviral therapy and met the inclusion criteria in Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, from June 2016 to July 2021 were enrolled. The patients enrolled had a baseline HBV DNA level of > 6lg copies/ml and were previously untreated CHB patients who had used ETV or TDF for 48 weeks, and quantitative real-time PCR was used to measure HBV DNA. Virologic response rate was calculated after 48 weeks of treatment; a logistic regression analysis was used to investigate the influencing factors for the response of HBV DNA < 500 copies/mL and HBV DNA < 100 copies /mL at 48 weeks; a stratified analysis was performed to compare the virologic response rate of HBV DNA < 500 copies /ml and HBV DNA < 100 copies/ml after 48 weeks between the patients with different ages, sexes, baseline HBV DNA levels, baseline alanine aminotransferase (ALT) levels, types of first-line medication, and HBeAg statuses. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the binary logistic regression model was used for multivariate analysis. Results After 48 weeks of treatment, 85.5% (141/165) of the patients achieved an HBV DNA load of < 500 copies/mL, and 66.1% (109/165) of the patients achieved an HBV DNA load of < 100 copies /mL, with no significant difference in treatment outcome between the ETV group and the TDF group. The multivariate logistic regression analysis showed that sex( OR =2.793, 95% CI : 1.197-6.517), baseline HBV DNA( OR =0.369, 95% CI : 0.142-0.959), baseline ALT( OR =4.556, 95% CI : 1.770-11.732), and baseline HBeAg( OR =0.120, 95% CI : 0.033-0.429) were influencing factors for complete virologic response(all P < 0.05). For the patients with normal ALT (≤40 U/L) at baseline, 75.6% (34/45) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and 53.3% (24/45) achieved an HBV DNA load of < 100 copies/mL, with no significant difference in treatment outcome between the ETV group and the TDF group. For the patients with abnormal ALT (> 40 U/L) at baseline, 89.2% (107/120) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and the proportion of such patients in the TDF group was significantly higher than that in the ETV group (96.1% vs 84.1%, χ 2 =4.386, P =0.036); 70.8% (85/120) achieved an HBV DNA load of < 100 copies/mL, the proportion of such patients was no significant difference between the TDF group and the ETV group (78.4% vs 65.2%). The response of HBV DNA < 100 copies/ml of the normal baseline ALT group and the abnormal baseline ALT group, there were no significant differences between the patients aged≤30 years and aged > 30 years (77.8% vs 47.2%, 85.2% vs 66.7%). For the patients who did not achieve complete virologic response (HBV DNA ≥100 copies/mL) after 48 weeks of treatment, 87.9% (29/33) achieved complete virologic response after the original treatment regimen was prolonged for 48 weeks, and 100% (9/9) of the patients achieved complete virologic response after switching to or adding the first-line nucleos(t)ide analogues (NUCs) without cross-resistance sites with the original regimen for another 48 weeks. Conclusion The patients aged > 30 years should receive antiviral therapy as early as possible, regardless of viral load and ALT level, especially those with a family history of liver cirrhosis or hepatocellular carcinoma; the patients aged ≤30 years who have a normal ALT level and a high viral load should consider initiating antiviral therapy after providing informed consent. For the patients with poor response after 48 weeks of treatment, first-line NUCs without cross-resistance sites with the original regimen should be switched to or added in time.
6.Analysis of drug resistance gene in Mycoplasma pneumoniae and 13 pathogens in bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia
Dawei SHI ; Ling LIU ; Mengmeng ZHAO ; Leping YE ; Wei ZHOU ; Dongxing GUO ; Dan LI ; Haiwei DOU ; Peng TU ; Ruijie WAN ; Deli XIN
Chinese Journal of Applied Clinical Pediatrics 2022;37(12):893-896
Objective:To investigate drug resistance gene in Mycoplasma pneumoniae(MP) and the distribution of 13 respiratory pathogens in bronchoalveolar lavage fluid(BALF) of children with Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 100 BALF of children with MPP in Peking University Third Hospital and Peking University First Hospital from January 2018 to January 2019 were collected.Fluorogenic quantitative PCR was used to detect nucleic acid and it′s drug resistance gene of MP and multiple PCR method was adopted to detect influenza A virus, influenza A virus-H 1N 1, influenza A virus-H 3N 2, influenza B, human parainfluenza virus, adenovirus, human bocavirus, human rhinovirus, Chlamydia pneumoniae, human metapneumovirus, MP, human coronavirus, and respi-ratory syncytial virus gene, and the results were compared by using Chi square test. Results:In 100 BALF samples, MP and drug resistance gene were detected by fluorogenic quantitative PCR.Totally, 83 cases (83.00%) were MP positive and 78 cases (93.98%) were drug resistant.All of them had the point mutations A2063G in V region of 23S rRNA domain.A total of 13 kinds of respiratory pathogens were detected by multiplex PCR method, and 89 cases (89.00%) were positive.Totally, 79 cases (79.00%) were MP positive, of which 74 cases (74.00%) detected only MP, and 5 cases (5.00%) detected MP combined with other pathogens.Other pathogens were detected in 10 cases (10.00%). The virus detection rate of 0-4 years old group was higher than that of >4-6 years old group ( P=0.042) and >6 years old group ( P=0.002), and the differences were statistically significant. Conclusions:MP can be detected in most BALF samples of MPP children, the drug resistance phenomenon is serious, and the main point mutation is A2063G.There were other respiratory pathogens and 2 or 3 pathogens were detected in a small number of BALF samples.
7.Common bacteria in oropharynx of children with Mycoplasma pneumoniae pneumonia and its clinical significance
Lina HAN ; Dongxue ZHU ; Huisheng YAO ; Dongxing GUO ; Liangyu WANG ; Ran WEI ; Deli XIN ; Xiaohua HAN
Chinese Journal of Applied Clinical Pediatrics 2022;37(12):903-908
Objective:To investigate the common bacteria in the oropharynx of children with Mycoplasma pneumoniae pneumonia (MPP) and its clinical significance.Methods:A total of 134 children with MPP who were hospitalized in the Department of Pediatric Respiratory, Shengjing Hospital of China Medical University from December 2016 to June 2017 were selected as the research subjects, and 42 healthy children in the same hospital were selected retrospectively as the healthy control group during the same period.Fluorescent quantitative polymerase chain reaction Taqman probe was used to detect common oropharyngeal bacteria[ Streptococcus pneumoniae(SP), Moraxella catarrhalis(CTA), Haemophilus influenza(HI)] for the enrolled children.Firstly, the bacterial detection rate of MPP children and healthy children was compared.Then, according to age(<1 years old, 1-<3 years old, 3-<6 years old and 6-14 years old), bacterial detection[Mycoplasma pneumoniae(MP), MP+ bacteria]and bacterial species(MP+ SP, MP+ CTA, MP+ HI), 134 children with MPP were divided into groups to compare.Moreover, the relevant clinical datas were retrospectively analyzed by rank sum test and chi- square test. Results:Among 134 children with MPP, 79 (58.96%) children were detected bacteria, and 17 (40.48%) children were detected bacteria among 42 healthy children, with statistically significant differences( χ2=4.404, P<0.05). Compared with the MP group, the level of white blood cell (WBC)[8.5(6.7, 12.0)×10 9/L vs.7.8(5.8, 9.3)×10 9/L, Z=-2.232], C reactive protein(CRP)[19.2(7.2, 35.0) mg/L vs.8.4(3.4, 24.6) mg/L, Z=-2.810], lactate dehydrogenase(LDH)[286(244, 365) U/L vs.250(210, 302) U/L, Z=-2.474] and the incidence of lobar pneumonia[40.51%(32/79 cases) vs.18.18%(10/55 cases), χ2=7.510], pleural effusion[13.92%(11/79 cases) vs.3.64%(2/55 cases), χ2=3.917], refractory Mycoplasma pneumoniae pneumonia (RMPP)[34.18%(27/79 cases) vs.18.18%(10/55 cases), χ2=4.151] in MP+ bacteria group were higher; the course of fever[10(7, 12) d vs.8(6, 10) d, Z=-2.706] and duration of antibiotic use[16(13, 19) d vs.12(9, 16) d, Z=-3.747] in MP+ bacteria group were longer (all P<0.05). The level of WBC in MP+ SP group[12.20(7.80, 17.30)×10 9/L] was higher than that in MP+ HI group [6.75(5.37, 9.44)×10 9/L], and the differences were statistically significant( Z=11.574, P<0.05), and the incidence of lobar pneumonia in MP+ SP group [56.67%(17/30 cases)]was higher than that in MP+ CTA group [0(0/3 cases)]and MP+ HI group[18.75%(3/16 cases)], and the differences were statistically significant( χ2=9.770, P<0.05). Conclusions:Bacterial colonization or infection is more likely to occur in the oropharynx of children with MPP.When WBC, CRP, and LDH are significantly increased and the image shows a large consolidation or pleural effusion, it may indicate mixed bacterial infection, longer course of fever and higher incidence of RMPP, and the common mixed bacteria is SP.
8.Enlightenment from pathogen analysis and comparison of detection methods in 580 cases of influenza-like cases
Haiwei DOU ; Siyuan HU ; Peng TU ; Ruijie WAN ; Sihan LI ; Dongxing GUO ; Rong MA ; Deli XIN
Chinese Journal of Applied Clinical Pediatrics 2020;35(8):613-616
Objective:To understand the pathogen distribution of children with influenza in North China in the past 2018-2019 years, and compare the accuracy of influenza virus antigen test results with that of influenza virus nucleic acid test results, provide reference data for clinical use good influenza virus pathogen detection methods.Methods:Five hundred and eighty throat swab samples of influenza-like children in 10 hospitals, northern China, were collected from December 2018 to January 2019.Each sample was tested by rapid influenza diagnostic test and reverse-transcription polymerase chain reaction(RT-PCR).Results:Of all 580 clinical samples, 256 positive samples (256/580 cases, 44.14%)were detected by the influenza rapid influenza diagnostic test, of which 235 were pure influenza A(235/256 cases, 91.8%), 21 cases were pave influenza B(21/256 cases, 8.2%), and 324 case were negative samples(324/580 cases, 55.86%). No cases were detected positive A and B at the same time.Of all 580 samples were detected using the A /B influenza virus RT-PCR, and a total of 353 cases(353/580 cases, 60.9%) were positive (of which 242 cases were influenza virus antigen-positive), of which 311 were pure A influenza(311/353 cases, 88.1%) and 41 were pure B influenza(41/353 cases, 11.6%), 1 case of mixed infection of A and B(1/353 cases, 0.3%), and 227 cases were negative(227/580 cases, 39.1%). In 324 cases of influenza virus antigen negative samples, 111 cases(111/324 cases, 34.3%) were positive for influenza virus nucleic acid.The detection rate of influenza A in Taiyuan was 23.2% (22/95 cases), and the detection rate of influenza B was 43.2% (41/95 cases), which was significantly different from other regions.With reverse-transcription polymerase chain reaction detection as the standard, the diagnostic value of influenza pathogen detection reagents was evaluated.The sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index and area under the receiver operating characteristic curve were 68.56%, 93.83%, 31.44%, 6.17%, 94.53%, 65.74%, 11.12, 0.335, 0.624 and 0.812.Conclusions:From December 2018 to January 2019, the majority of children′s influenza in northern China is influenza A virus.Except Taiyuan which is dominated by influenza B. Influenza virus nucleic acid detection has high sensitivity and specificity for diagnosing influenza, and also has the ability to distinguish virus subtypes.Influenza virus antigen detection has a certain diagnostic value, a good specificity (93.83%), sensitivity (68.56%) which needs to be further improved, and a certain rate of missed diagnosis (31.44%) needs to be paid attention to possible missed diagnosis.Detecting positive cases of influenza virus antigens should be given a fast and effective anti-viral treatment, while the negative cases, especially those at high risk for influenza complications, should be confirmed influenza virus RT-PCR as soon as practical.
9.Liver histological status and clinic outcome in HBeAg-negative chronic hepatitis B with low viral load
Deli DENG ; Jianning JIANG ; Minghua SU ; Rongming WANG ; Weiwei ZANG ; Xiaozhang LING ; Huilan WEI ; Xianshuai LIANG ; Huikun ZHOU ; Wenming HE ; Rongsheng GUO
Chinese Journal of Hepatology 2020;28(12):1013-1017
Objective:To retrospectively analyze the serological, virological, biochemical, liver histological status and clinical outcomes in HBeAg-negative chronic hepatitis B (CHB) patients with low HBV viral load, and to explore the necessity of antiviral therapy for these patients.Methods:A total of 99 HBeAg-negative CHB patients with HBV DNA level < 4 lg copies/ml who performed liver biopsy at the baseline were enrolled from the follow-up cohort. Among them, 23 cases received the second liver biopsy during follow-up. The relationships among the degree of inflammation and fibrosis of liver tissues, the status of HBsAg and HBcAg, age, gender, family history, HBV DNA load, serological markers and other indicators were analyzed. The pathological differences between two liver biopsy examinations were compared. The effect of nucleos(t)ide analogues (NAs) treatment on patient’s clinical outcomes were analyzed. For multivariate analysis, a binary logistic regression model was performed. Log-rank test was used to compare the cumulative incidence of hepatocellular carcinoma (HCC) in NAs-treated and non-NA streated patients.Results:Baseline liver histology status showed that 58.6% (58/99) patients had obvious liver tissue damage in their baseline liver tissue pathology (G≥2 and /or S≥2). Univariate logistic regression analysis showed that a liver cirrhosis (LC) family history, a HBsAg-positive family history, baseline alanine aminotransferase and aspartate aminotransferase levels were positively correlated factors for liver tissue damage. Multivariate logistic regression analysis showed that a LC family history was the main risk factor for liver tissue damage. Twenty-three cases had received a second liver biopsy after an interval of 4.5 years. In 10 untreated cases, the second liver biopsy results showed the rate of obvious liver tissue damage (G≥2 and/ or S≥2) increased from 50.0% to 90.0%. In the other 13 cases who received NAs treatment, the second liver biopsy showed improvement in liver histology, and the rate of obvious liver tissue damage decreased from 61.5% to 46.2%. The 5-year HCC cumulative incidence in non-NAs-treated patients was significantly higher than that of in NAs-treated patients (17.7% vs. 3.8%, P = 0.046). Conclusion:For most HBeAg-negative CHB patients with low viral load, liver tissue pathology result suggests that it meets the indications for antiviral therapy, especially in patients with a LC familial history. Without antiviral therapy, liver tissue damage for these patients will progressively worse with the high incidence of HCC. Therefore, it is suggested that antiviral therapy should be started as soon as possible for the HBeAg-negative CHB patients with low viral load regardless of the alanine aminotransferase level, especially in patients over 30 years-old with a LC or HCC family history.
10.The antibacterial effect of Fusidic acid on Mycoplasma pneumoniae and antibiotic resistant Mycoplasma pneumoniae in vitro
Ran WEI ; Dawei SHI ; Haiwei DOU ; Shaogang LI ; Zhaoyong WU ; Dongxing GUO ; Liangyu WANG ; Deli XIN
Chinese Journal of Applied Clinical Pediatrics 2018;33(10):787-790
Objective To investigate the antibacterial effect of Fusidic acid on Mycoplasma pneumoniae and antibiotic resistant Mycoplasma pneumoniae in vitro.Methods Twenty-eight clinical strains of Mycoplasma pneumoniae isolated from patients with respiratory tract infection at Beijing Friendship Hospital Affiliated to the Capital University of Medical Sciences from January to December 2016 and 2 Mycoplasma pneumoniae reference strains were enrolled.The minimum inhibitory concentration (MIC) of Fusidic acid and Azithromycin were determined by using micro-dilution ration method.The chessboard method was used to check the antibacterial effect of combination between Fusidic acid and Azithromycin.The antibacterial activity of the Fusidic acid was evaluated by measuring the antibacterial rate of different concentrations.Results One isolate showed no mutation in 23SrRNA,26 isolates had one point mutation in loci 2063 and 1 isolate had one point mutation in loci 2064 among the 28 clinical isolates.The findings by micro-dilution method results showed that the MIC values of all the clinical isolates with mutations associated with macrolide resistance to Azithromycin were > 1.000 0 mg/L,and the MIC values of all the clinical isolates with no mutations to azithromycin were < 0.500 0 mg/L.The findings by micro-dilution method results showed that the MIC value of Fusidic acid for Mycoplasma pneumonia and drug resistance Mycoplasma pneumoniae was 1.000 0 mg/L.The Fractional Inhibitory Concentration index of Fusidic acid and Azithromycin combination was ≤0.500 0 mg/L.When the concentration of the Fusidic acid was lower than or equal to 32 MIC,the antibacterial effect of Fusidic acid against Mycoplasma pneumoniae increased with its higher concentration.When the concentration of the Fusidic acid was lower than or equal to 8 MIC,the longer the strain was exposed to the drug,the stronger antibacterial effect was against Mycoplasma pneumoniae.Conclusion If the treatment of Mycoplasma pneumoniae infection is not effective or the infection of patient is combined with bacteria,the application or combination of Fusidic acid may inhibit pathogenic bacteria effectively.Of course,how to use Fusidic acid in clinical treatment needs further study and discussion.

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