Abstract Objective Preeclampsia (PE) is a disorder that occurs during the pregnancy and could affect the maternal and perinatal mortality as well as morbidity. The aim of our study is to investigate the associations between the hypertension susceptibility genes ITGA9, MOV10 and CACNB2 with PE in Chinese Han population. Methods A case–control study including 178 PE patients and 202 healthy controls was conducted to assess the associations between three loci (ITGA9 rs155524, MOV10 rs2932538 and CACNB2 rs4373814) and PE. The TaqMan probe assay was applied for genotyping in our study. Quantitative real-time PCR was performed to detect the mRNA expression levels of ITGA9, MOV10 and CACNB2. ELISA was carried out to detect the concentration of serum sFlt-1 or PLGF. Results Our study detected no significant differences in allelic frequencies of three SNPs between PE patients and healthy controls. In the genetic model, the results showed that the patients with ITGA9 rs155524 GA or AA genotypes had a higher risk of PE development compared to those with GG genotype in codominant model. And PE patients had a higher frequency of GA + AA genotypes based on the dominant model. Subgroup analysis showed ITGA9 rs155524 was associated with early-onset PE but not with late-onset PE. No association was observed between MOV10 and CACNB2 with PE in any genetic model and subgroup analysis. Quantitative real-time PCR results showed that ITGA9 mRNA expression level was apparently increased in the placental tissues of PE patients. In addition, ITGA9 expression levels of GA + AA subjects were apparently higher than that in the genotype GG of placental tissues. sFlt-1/PLGF ratio was higher in GA + AA subjects than that in GG subjects. Regression analysis revealed that ratio of sFlt-1/PLGF was positively correlated with ITGA9 mRNA expression level. Conclusion This study has identified ITGA9 is a promising candidate susceptibility gene for early-onset PE. Our findings demonstrated that the high expression of ITGA9 might be associated with an increased risk of PE.
Objective: The present study aims to explore potential infection and death risk factors in patients infected with carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods: A retrospective case-control study was performed at Beijing Shijitan Hospital, China. The clinical and microbiological data of patients infected with K. pneumoniae (K.pn) were collected; the clinical characteristics of patients infected with carbapenem-susceptible K.pn and CRKP were analyzed using logistic regression analysis. Results: CRKP infection was significantly associated with prior carbapenem use (odds ratio [OR] and 95% credibility interval [CI]: 5.161 [1.840– 32.233], P < 0.001), the use of more than three types of antibiotics for seven or more days (OR and 95% CI: 9.681 [2.662– 18.122], P < 0.001), tracheotomy (OR and 95% CI: 5.015 [2.343– 11.724], P < 0.001), and intensive care unit (ICU) stay (OR and 95% CI: 6.322 [2.02– 12.231], P < 0.001). The risk of death in patients with CRKP infection was significantly associated with older age (OR and 95% CI of 70– 80 years: 8.894 [1.972– 67.346], P < 0.001; ≥ 80 years: 15.234 [2.072– 93.452], P < 0.001), renal dysfunction (OR and 95% CI: 1.672 [1.104– 7.451], P = 0.016), tracheotomy (OR and 95% CI: 2.051 [1.217– 11.235], P = 0.002), and ICU stay (OR and 95% CI: 3.043 [2.174– 18.453], P < 0.001). Conclusion: Prior to carbapenem use, older age, renal dysfunction, tracheotomy, and ICU stay were independent risk factors for death in patients infected with CRKP. Keywords: Klebsiella pneumoniae , carbapenems, drug resistance, risk factors, antibiotics, Beijing
Abstract The data of 35 246 patients with intestinal diseases were retrospectively analyzed, 28 cases of cholera patients were screened in 17 years, of which 23 cases had suspicious unclean food history, 10 cases were migrant workers, 8 cases had history of coastal city tour in one week. All of the 28 patients were positive for Vibrio cholerae culture, 19 cases were identified as O1 serotype Ogawa and 6 were identified as O1 serotype Inaba, 3 were identified as O139. Twenty-three patients were mild, five cases were moderate, patients with severe diseases were not found. It was found in this study that O1 serotype Vibrio cholerae was still dominant, 82% of cholera patients were mild cases. Tourists who had a incompletely heated seafood intake history and migrant people are susceptible to cholera.
Adiponectin is a protein hormone that modulates glucose metabolism and fatty acid oxidation. We explored the clinical implication of serum adiponectin in hepatogenic diabetes. Serum adiponectin levels were determined using enzyme–linked immunochemistry assay in 78 individuals including 19 hepatogenic diabetes, 20 type 2 diabetes (T2D), 20 chronic liver disease and 19 healthy controls. Cases and controls were matched by gender and body mass index (BMI). There is no difference in serum adiponectin levels among hepatogenic diabetic, T2D and healthy control groups. The levels of adiponectin are highest in chronic liver disease and lowest in T2D. Insulin levels are highest in hepatic diabetics and lowest in T2D. Hepatic diabetics have the lowest insulin sensitivity index (ISI). Serum adiponectin levels were negatively correlated with triglycerides and total cholesterol in T2D. Serum adiponectin is significantly increased in chronic liver disease, but lacks association with hepatogenic diabetes.
Rubinstein-Taybi syndrome (RSTS) is an autosomal dominant genetic disease characterized by growth retardation, psychomotor retardation, and distinctive facial features. It is primarily caused by mutations in CREBBP or EP300. In this study, we aimed to describe the clinical manifestations and genetic analyses of two cases with RSTS. Clinical analysis was performed on two cases with RSTS. Molecular diagnoses were made via whole exome sequencing, and potential pathogenic variants were filtered and selected. PCR followed by Sanger sequencing was used to verify candidate variants in the family members. Case 1 involved a 7-year-old boy (patient 1) who exhibited delayed language development, growth retardation, and intellectual disability. We did not find any other characteristics of RSTS, such as thumb or hallux abnormalities. Case 2 involved a fetus who had severe congenital heart disease, low conus medullaris, and a large gallbladder. Whole exome and Sanger sequencing results revealed that a missense mutation c.5120G>A (p. Cys1707Tyr) was present in patient 1 and that the fetus carried a heterozygous nonsense mutation c.1984C>T (p. Gln662Ter). In conclusion, whole exome sequencing combined with Sanger sequencing revealed that c.5120G>A (p. Cys1707Tyr) and c.1984C>T (p. Gln662Ter) are two new mutation sites that cause RSTS. This study expands the clinical phenotypes and is helpful in identifying gene-phenotype correlations in RSTS.
Objectives To study the pathogenic bacterial profile and drug resistance in older patients with community-acquired pneumonia (CAP) in outpatients with fever, and provide evidence to diagnose and treat CAP timely and accurately. Methods We studied older (>60 years) patients with CAP in Beijing Shijitan Hospital from 2016 to 2017. Pathogenic bacteria from sputum of patients were isolated and identified and their resistance to antibiotics was tested. Risk factors for multidrug-resistant CAP (MDR-CAP) and clinical outcomes were analyzed. Results A total of 5563 outpatients with fever were recruited and 391 had CAP. A total of 117 isolates of pathogenic bacteria were obtained from 176 CAP cases. The main pathogenic bacteria were Klebsiella pneumoniae (27.4%), Escherichia coli (17.9%), Staphylococcus aureus (12.0%), Pseudomonas aeruginosa (10.3%), and Streptococcus pneumoniae (9.4%). A drug sensitivity test (DST) showed that K. pneumoniae, E. coli, and P. aeruginosa had good sensitivity to imipenem, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin. Staphylococcus aureus and Streptococcus pneumoniae had strong sensitivity to vancomycin, linezolid, and levofloxacin. Previous multiple antibiotic treatment was an independent risk factor for MDR-CAP. Conclusions Gram-negative bacteria are the main pathogenic bacteria in older patients with CAP. Identification and DSTs of pathogens could enable accurate diagnosis and treatment of CAP.
To explore clinical efficacy of Yiguanjian Decoction (YD) combined Adefovir Dipivoxil Tablet (ADT) in treating HBeAg negative chronic viral hepatitis B (CVHB) active compensated liver cirrhosis (LC) patients.Totally 68 HBeAg negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group using random digit table, 34 in each group. Patients in the control group took ADT alone, 10 mg each time, once per day. Those in the treatment group additionally took YD, one dose per day. The therapeutic course for all was 48 weeks. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) were detected once in every two weeks. Hepatitis B virus (HBV)-DNA and four items of serum liver fibrosis [procollagen type I (PCN), hyaluronidase (HA), procollagen III peptide (PCIII), laminin (LN)] were detected once per every 4 weeks. Abdominal ultrasound B was performed before and after treatment. The inner diameter of the portal vein and the size of spleen were recorded. The fibrosis degree of liver was evaluated using Fibroscan. Efficacy of Chinese medicine (CM) was evaluated between the two groups before and after treatment using CM syndrome integrals. Efficacy of Western medicine (WM) was also evaluated between the two groups using Child-Pugh grading. Results Compared with before treatment in the same group, ALT and AST levels restored to normal levels, HBV-DNA turned negative (HBV-DNA < or = 1 x 10(2)) in the two groups after 48-week treatment. Besides, levels of TBil, ALB, PCIV, HA, PCIII, and LN obviously decreased (P < 0.05, P < 0.01). Results of ultrasound B showed the inner diameter of the portal vein and the size of spleen decreased. Fibroscan results showed that the elasticity value of the liver obviously decreased (P < 0.05). Besides, post-treatment levels of PCIV, HA, PCEJ, and LN, and the elasticity value of the liver decreased more obviously in the treatment group than in the control group (P < 0.01). There was no statistical difference in post-treatment levels of ALT, AST, TBil, ALB, inner diameter of the portal vein, or the size of spleen between the two groups (P > 0.05). Compared with before treatment in the same group, scores of Chinese medical syndrome and Child-Pugh scores decreased in the two groups after treatment (P < 0.05, P < 0.01). Besides, scores of Chinese medical syndrome decreased more obviously in the treatment group than in the control group (P < 0.05). The effective rate was 8824% (30/34) in the treatment group, higher than that of the control group [67.65% (23/34)] with statistical difference (P <0.05). Conclusion Combined treatment of YD and ADT could significantly improve symptoms of CM and fibrosis degree of liver of HBeAg negative CVHB active compensated LC patients.
Objective: To observe continuous and intermittent application of lamivudine or entecavir resistance mutations in patients with chronic hepatitis B. Methods: Data of patients with active stage of chronic hepatitis B over the past 6 years were collected and analyzed retrospectively. The incidence of drug resistance mutation and related factors between patients taking LAM or ETV continuously and intermittently were compared with those taking LAM or ETV. Data comparison was performed using χ(2) test. Results: Patients with HBV DNA≥10(5) copies / ml at the time of initial treatment had higher resistance mutation rates than those with HBV DNA < 10(5) copies / ml at either continuous or intermittent treatment, and patients with intermittent treatment had higher resistance mutation rates than those with continuous treatment. Simultaneously, the incidence of drug resistance mutation in LAM and ETV in the first, second and third years were significantly higher in intermittent treatment than that of continuous treatment (P < 0.05). There was a positive correlation between the frequency of drug withdrawal and the rate of drug resistance mutation. There were no individual difference and drug difference between LAM and ETV. Conclusion: In the treatment of chronic hepatitis B with oral nucleoside analogues, drug resistance may occur in either continuous or intermittent treatment. When comparing continuous with intermittent treatment, it suggests that intermittent is more likely to cause viral resistance mutation.目的： 观察慢性乙型肝炎患者服用拉米夫定（LAM ）或恩替卡韦（ETV）抗病毒治疗过程中，持续服药与间断服药（抗病毒治疗12周后,肝脏生物化学指标及HBV DNA转阴,患者自动停药，12周或24周后因HBV DNA > 10(4)拷贝/ml，排除耐药后再服原药治疗）出现病毒耐药变异概率的情况。 方法： 收集近6年的慢性乙型肝炎患者资料,回顾性分析在治疗过程中患者单药持续服用LAM或ETV与间断服用LAM或ETV发生病毒耐药变异的概率及相关因素的差异，计数资料比较采用χ(2)检验。 结果： 初治时HBV DNA≥10(5)拷贝/ml的患者，无论是持续服药或间断治疗，病毒耐药变异比例均大于HBV DNA < 10(5)拷贝/ml的患者；持续与间断治疗的患者比较，间断治疗患者的病毒耐药变异率高于持续治疗的患者。同时，间断治疗的患者，第1年、第2年LAM的病毒耐药变异率以及第1、2、3年ETV的病毒耐药变异发生率远远高于持续治疗的患者（P < 0.05)。间断治疗患者的停药次数与病毒耐药变异发生比呈正相关。LAM及ETV在患者中的应用无个体差异及药品差异性。 结论： 核苷类似物治疗慢性乙型肝炎过程中，无论是持续或间断口服核苷类似物进行抗病毒治疗均有可能发生耐药。两者相比，间断性用药更易导致病毒耐药变异发生。.
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