Current Issue

2022 Vol.7 No.2 Published:31 May 2022

Special Topic on Prevention and Treatment of COVID-19

Expert advice on novel coronavirus vaccination in patients with malignant tumors Yuan Jing, Tan Xiaohua, Wang Fuxiang, Wang Lyuhua, Lu Hongzhou 2022, 7 (2):  1-5.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.001 Abstract ( 854)    PDF (902KB) ( 1087 )    Since SARS-CoV-2 infection remains to be a global pandemic, effective vaccination strategies were urgent to reduce the infection rate of SARS-CoV-2, attenuate the progress of the disease, and decrease the mortality after infection, which is particularly important for immunosuppressed patients. However, the efficacy and safety of SARS-CoV-2 vaccination in patients with malignant tumor are not well investigated in China, therefore, leading to a low SARS-CoV-2 vaccination coverage in patients with malignant tumor. According to the most recent researches and clinical treatment demands of SARS-CoV-2 vaccination for patients with malignant tumors, we summarized a detailed SARS-CoV-2 vaccination regimen for malignant tumors patients with different types of tumor, distinct anticancer treatment plan, as well as specialized the disease condition, so as to improve SARS-CoV-2 vaccines coverage, effectively protect patients, and reduce the susceptibility, severity and mortality of SARS-CoV-2 infection in patients with malignant tumors.

SARS-CoV-2 omicron variant strains infection: comparative analysis of clinical features in moderate group and mild/asymptomatic group and chest CT findings Liu Wenhao, Yang Jinrong, Chen Yixin, Zhou Yun, Li Yinfeng, Yun Yongxing, Yang Gendong, Huang Hua 2022, 7 (2):  6-10.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.002 Abstract ( 1237)    PDF (1919KB) ( 705 )    Objective To investigate the differences of clinical characteristics in patients with SARS-CoV-2 omicron variant strains infection in different group and Chest CT imaging. Method A retrospective analysis of the clinical data of 68 patients with SARS-CoV-2 omicron variant infection was conducted. According to whether the patients had pneumonia or not, they were divided into moderate group and asymptomatic/mild group, the clinical manifestation differences between the two groups were compared, and the moderate group chest CT imaging characteristics were analyzed. Result Among the 68 cases of SARS-CoV-2 omicron variant infection, the main clinical manifestations were cough in 49 cases, pharyngeal discomfort in 27 cases, fever in 24 cases, and fatigue in 12 cases. The proportion of fever in the moderate group was higher than that in the asymptomatic/mild group, and the difference was statistically significant (P<0.05), the proportion of pre-existing diseases in the moderate group was higher than that of the asymptomatic/mild group, the difference was statistically significant (P<0.05), the peak ESR in the moderate group was higher than that of the asymptomatic/mild group, the difference was statistically significant (P<0.05), the difference of the lowest Ct value of nucleic acid was not statistically significant between the moderate group and asymptomatic/mild group. The common chest CT of omicron variant pneumonia was subpleural ground-glass opacity and consolidation. The percentage of pneumonia lesions to the whole lung volume showed an average of 2.2% (0.1%~12.2%) by chest CT. The average time from onset of symptoms to pneumonia peak is 8.6 days by chest CT. Conclusion The clinical symptoms of SARS-CoV-2 omicron variant infected patients are mild;fever, pre-existing diseases and ESR can be used as observation indicators. The damage to the lung by the virus is mild, and the chest CT mainly showed ground-glass opacity and consolidation with subpleural distribution.

Clinical application of shelter CT in isolation area in the stage of regular COVID-19 prevention and control Liu Dong, Wang Shuaidi, Feng Mingnan, Huang Shunxing, Li Shuo, Du Xiaopeng, Liu Ya'ou, Ding Jinli 2022, 7 (2):  11-14.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.003 Abstract ( 530)    PDF (957KB) ( 660 )    Significant progress in COVID-19 prevention and control has been achieved in China, however, the global COVID-19 epidemic is still in the stage of continuous pandemic. Our country is still facing the pressure on preventing "COVID-19 epidemic from abroad" and "the resurgence of COVID-19 at home", and has been in the stage of regular epidemic prevention and control. Imaging examination, especially CT examination, is still one of the important clinical examinations for COVID-19 screening, diagnosis and efficacy evaluation. The emergency shelter CT has become the main special equipment for CT examination of confirmed patients in isolation areas. This paper aims to explore the clinical application of shelter CT in the isolation area of Beijing Ditan Hospital Capital Medical University in the stage of regular epidemic prevention and control, focusing on the layout of the shelter CT in isolation area, the effective application of intelligent system and the challenges to medical technologists, in order to summarize effective experience and guide clinical practice.

Prevention and control strategies of central sterile supply department under the normalization of the COVID-19 epidemic Jiang Xuemei, Song Yan, Chen Yan, He li, Shao Wei 2022, 7 (2):  15-18.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.004 Abstract ( 568)    PDF (896KB) ( 649 )    To complete the prevention and control strategies for the reprocessing of reusable medical devices in central sterile supply department (CSSD) under the normalization of the prevention and control of the coronavirus disease 2019 (COVID-19). Standardize and rationalize the process, prevent nosocomial infection, prevent and control the spread of infectious diseases, and ensure that the prevention and control of n COVID-19. The CSSD of Second Hospital of Nanjing (Jiangsu designated hospital for COVID-19) started from the requirements of epidemic prevention and control regulations, including overall prevention control strategies, personnel prevention and control strategies, reprocessing strategies for reused medical devices, and medical waste management. To carry out prevention and control management, formulate prevention and control procedures and systems, and strictly implement them. Through a series of prevention and control strategies, in the past two years of epidemic prevention and control, no nosocomial cross-infection occurred during the reprocessing of the reused equipment in CSSD. It provides a safety guarantee for the disinfection and supply of clinical reusable medical devices, and achieves good prevention and control results. This paper introduces the prevention and control strategy in detail for the reference of hospital CSSD.

Effects of age factor on susceptibility to SARS-CoV-2 Niu Yilin, Zhang Chun, Cao Wenyu, Liu Xuling, Wu Qinghua, Liu Yingfang, Zhang Bao, Zhao Wei 2022, 7 (2):  19-24.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.005 Abstract ( 712)    PDF (906KB) ( 928 )    SARS-CoV-2 is a type of human coronavirus that enters the body by binding to the ACE2 receptor. COVID-19 is now a global pandemic, and the prevention and control of the epidemic around the world is still not optimistic. The epidemiological investigation found that the susceptibility of different age groups to SARS-CoV-2 was significantly different. In this epidemiological discussion, COVID-19 was found to be highly transmissible in people aged 65 or above 65 years and 45~64 years, with relatively low susceptibility in people aged 15~44 years and the lowest susceptibility in children younger than 10 years. Compared with adults and the elderly, the pathological changes and clinical symptoms of children were slighter, and the fluctuation range of laboratory examination indicators was slight. Through the analysis of the differences in susceptibility to SARS-CoV-2, it is found that the main reasons for the differences in susceptibility to SARS-CoV-2 in different ages are the differences of host cell receptors, host immune responses, intestinal flora, underlying diseases and social factors.

Original Articles

Establishment of a universal endogenous internally controlled recombinase-aided amplification detection method for human papilloma virus types 6 and 11 He Anna, Zhang Mengyi, Li Fengyu, Ma Xuejun, Shen Xinxin, Rong Xiuge 2022, 7 (2):  25-29.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.006 Abstract ( 398)    PDF (1471KB) ( 722 )    Objective To establish a universal endogenous internally controlled recombinase-aided amplification (EIC-RAA) for the detection of HPV-6 and HPV-11 method, in order to achieve simple, accurate and rapid screening of HPV-6 and HPV-11. Method The EIC-RAA method for detecting HPV-6 and HPV-11 was established by designing universal primers and probes for L1 fragment of the conserved region of HPV-6 and HPV-11, and combining RNaseP gene primers and probes as internal reference. The sensitivity, repeatability and specificity of EIC-RAA method were tested by series of concentration diluted plasmids and nucleic acids from different subtypes of HPV sample. A total of 230 clinical samples were collected and compared for EIC-RAA and commercial HPV PCR-fluorescent probe method. Result The established EIC-RAA method can detect HPV-6 and HPV-11 within 30 minutes at 39℃, with a sensitivity of 10 copies/reaction, good repeatability and high specificity. The coincidence rate between EIC-RAA and commercial HPV PCR-fluorescent probe method was 100%. Conclusion The EIC-RAA showed the advantages of simplicity, accuracy and rapidity in detecting HPV-6 and HPV-11, and has great potential application value in the field screening of HPV-6 and HPV-11.

Clinical value of ultrasound elastography in the diagnosis of anti-tuberculosis drug-induced liver injury Huang Kun, Zeng Weimei, Li Zhiyan, Lai Yuting, Dong Changfeng, Zheng Baoqi, Zhang Ziteng 2022, 7 (2):  30-34.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.007 Abstract ( 702)    PDF (1235KB) ( 472 )    Objective To explore the clinical application value of ultrasound elastography in non-invasive evaluating anti-tuberculosis drug-induced liver injury and predicting the risk of it to avoid the aggravation of patients' condition. Method Fifty-six patients hospitalized at the Third People's Hospital of Shenzhen from January to December 2020 were selected and divided into two groups: anti-tuberculosis group with liver injury (n=26) and anti-tuberculosis group without liver injury (n=30). Thirty healthy volunteers were enrolled in this study as the normal control group (n=30). All subjects underwent two-dimensional ultrasound examination, ultrasound elastography and blood biochemical test. ROC curve were used to analyze the efficacy of ultrasound elastography in the diagnosis of anti-tuberculosis drug-induced liver injury. Logistic regression analysis was used to screen the independent risk predictors of anti-tuberculosis drug-induced liver injury. Result ① The values of spleen length, liver STE and liver STQ in the anti-tuberculosis group with liver injury were significantly higher than those in the control group and the anti-tuberculosis group without liver injury. ② The sensitivity of liver STE, liver STQ and splenic STE in the diagnosis of anti-tuberculosis drug-induced liver injury were 88.46%, 80.77% and 69.23% respectively, and the specificity was 96.77%, 86.89% and 73.68%. The areas under the curve were 0.978, 0.894 and 0.739. ③ Logistic multivariate regression analysis showed that liver STE was an independent predictor of anti-tuberculosis drug-induced liver injury. Conclusion Ultrasound elastography, especially liver STE, has clinical value for the risk prediction and diagnosis of anti-tuberculosis drug-induced liver injury.

Clinical features in adult patients with infection of Epstein-Barr virus and predictive factors for hemophagocytic lymphohistiocytosis Yang Zhi, Wu Weigang, Ou Pengcheng, Li Bin, Yang Guilin 2022, 7 (2):  35-40.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.008 Abstract ( 636)    PDF (915KB) ( 825 )    Objective To analyze the clinical features in adult patients admitted to our hospital with infection of Epstein-Barr virus (EBV) and explore the predictive factor of hemophagocytic Lymphohistiocytosis(HLH). Method The cli-nical data of adult patients with infection of EBV treated in the Shenzhen People's Hospital from September 2016 to September 2019 were collected and analyzed. The patients were divided into two groups, including 56 cases of infectious mononucleosis（IM）,12 cases of combined with HLH. Univariate analysis and logistic regression analysis were conducted to identify independent predictive factors for HLH in adults with infection of EBV. Result A total of 68 patients were analyzed, including 33 males [mean age (25.1±7.16) years] and 35 females [mean age (21.83±9.25) years]. Thirty-seven patients(30.6%) had typical triads (fever, sore throat, cervical lymphadenopathy).Increased WBC count was found in 26 cases (38.2%), lymphocyte ratio(LY%)≥50% in 52 cases (76.5%), abnormal lymphocyte ratio≥10% in 20 cases (46 cases accounted for analysis, 43.5%), liver injury in 61 cases (89.7%),spleen enlargement in 43 cases(63.2%), liver enlargement in 9 cases (13.2%). The median value of EBV-deoxyribonucleic acid(EBV DNA) was 5.59×103copies/ml. There was no statistically significant difference in sex, age, the proportion of fever and sore throat symptoms, the proportion of lymphadenectasis、splenomegaly or rash, the proportion of leukocytosis, the proportion of WBC in the normal range, the proportion of a decrease in hemoglobin(HGB), the proportion of abnormal lymphocyte ratio≥10%, the proportion of LDH≥1000U/L and the proportion of alanine ALT≥5 and 10 times the normal value between the two groups (P>0.05). There have statistically significant differences in the PLT decreased, the proportion of the (LY%≥50%, the proportion of serum ferritin increased(respectively greater than 500, 800, 1000, 1500μg/L accounted for analysis), the proportion of ALT/AST≤1, the proportion of EBV DNA≥1.0×105copies/ml between the two groups(P<0.05). Logistic regression analysis showed that patient age, WBC<4×109/L, PLT<10×109/L, LY%≥50%, ALT/AST≤1 and EBV DNA≥1.0×105copies/ml were independent predictive factor for HLH in adults with infection of EBV(OR=1.111, P=0.009; OR=0.033, P=0.027; OR=0.967,P<0.001;OR=0.890,P<0.001; OR=0.006,P=0.001; OR=1.000,P=0.019）. Conclusion Adult persons with infection of EBV had atypical symptoms. Patient age, WBC<4×109/L, PLT<10×109/L, LY%≥50%, ALT/AST≤1 and EBV DNA≥1.0×105copies/ml were independent predictive factor for HLH in adults with infection of EBV.

Efficacy and safety of switching to tenofovir alafenamide fumarate from poor response to prior nucleos(t)ide analogue treatment in chronic hepatitis B patients Chen Yu, Lyu Tao, Han Shaowei, Tan Aiming, Seto Wai-Kay 2022, 7 (2):  41-46.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.009 Abstract ( 690)    PDF (1190KB) ( 585 )    Objective We aimed to evaluate the early effectiveness and the renal safety after switching from long-term nucleos(t)ide anologues(NAs) treatment to tenofovir alafenamide fumarate(TAF) in patients with chronic HBV infection. Method We followed up consecutive chronic hepatitis B(CHB) virus infection patients with ≥12 months of prior NAs therapy who were switched to TAF 25 mg daily at the University of Hong Kong-Shenzhen Hospital from April 2019 to January 2020. Endpoints such as serum HBV DNA undetectability(HBV DNA<20U/ml), ALT normalization (upper limit of normal:male 35U/L, female 25U/L) and renal function safety were assessed at 12 weeks after switching. Renal function was evaluated by serum creatinine and estimated glomerular filtration rate (eGFR by CKD-EPI). Result Seventy-four CHB patients [(77% male, mean age (49.55±10.52)] were recruited. Serum HBV DNA undetectability rates increased from 40.54% at switching to 71.62% at 12 weeks (P<0.001). ALT normalization rates also increased from 56.76% to 74.32% after 12 weeks (P=0.038). Median serum ALT level decreased significantly from 28.90 (19.52, 42.70)U/L to 21.80 (15.20, 34.85)U/L (P=0.016). There was a small but not significant improvement in eGFR at week 12 compared to baseline. For the subgroup stage 2 chronic kidney disease (CKD) at TAF-switching, there was a significant improvement in mean eGFR after 12 weeks [(79.37±10.82)ml/(min·1.73m2) vs (72.23±9.11)ml/(min·1.73m2), P=0.017]. Conclusion Switching from prior NAs to TAF was effective for maintaining virological suppression and ALT normalization in CHB, and can lead to improvements in renal function in patients with mild chronic kidney disease.

Evaluation of GenoType Mycobacterium CM for the rapid identification of non-tuberculous mycobacteria Zhu Yumei, Zhong Yuquan, Li Jinli, Wu Likai, Wang Feng 2022, 7 (2):  47-51.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.010 Abstract ( 453)    PDF (903KB) ( 568 )    Objective To study and evaluate the GenoType Mycobacterium CM for rapid identification of NTM. Method A total of 3420 Mycobacterium positive cultures were collected from 2017 to 2018 in Shenzhen Center for Chronic Disease Control, Guangming District People's Hospital and Yantian District People's Hospital. After initial detection of GenoType MTBDRplus and elimination of the duplicate samples of patients, 127 cultures were screened out for further NTM identification through GenoType Mycobacterium CM and PCR sequencing (16S rRNA and ITS). The PCR sequencing results were used as the "gold standard" to evaluate the results of GenoType Mycobacterium CM. Result Among 127 NTM strains, there were 47 M.abscessus strains (37.0%), 20 M.fortuitum strains (15.8%), 18 M.intracellularstrains (14.2%), 11 M.gordonae strains (8.7%), 8 M.kansasii strains (6.3%), 7 M.avium strains (5.5%), 6 M.lentiflavum strains (4.7%), and 2 M.chimaera strains (1.6%), 1 M.xenopi strain (0.8%), 1 M.scrofulaceum strain (0.8%), 1 M.peregrinum strain (0.8%), 1 M.terraestrain (0.8%), 1 M.cosmeticum strain (0.8%), 1 M.kumamotonense strain (0.8%) and 1 M.dioxanotrophicus strain (0.8%). Compared with sequencing results, all 127 strains of NTM were detected by GenoType Mycobacterium CM, and 112 strains (112/127, 88.2%) could be accurately identified, 2 strains (2/127, 1.6%) could not be distinguished as M.intracellular or M.intracellular, 12 strains (12/127, 9.4%) were beyond the identification range of the kit, and 1 M.peregrinum strain (1/127, 0.8%) was incorrectly identified. Conclusion GenoType Mycobacterium CM can quickly and accurately identify common NTM, but its scope of strain identification is limited and can not fully meet the needs of clinical NTM identification.

Study of preoperative CT-based radiomics models for the prediction of prognosis of surgical treatment of spinal tuberculosis Song Min, Xie Zhien, Yang Hongzhi, Wu Huaqiang, Guan Quan, Zhong Peng, Fang Weijun 2022, 7 (2):  52-56.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.011 Abstract ( 595)    PDF (1440KB) ( 642 )    Objective Construct radiomics models based on preoperative CT features of patients with spinal tuberculosis to predict the prognosis of surgical treatment,so as to improve the accuracy of preoperative diagnosis and personalized treatment. Method The clinical and imaging data of 216 patients with spinal tuberculosis who received initial surgical treatment in Guangzhou Chest Hospital from January 2015 to May 2019 were analyzed retrospectively. According to the prognosis one year after operation, they were divided into Bad Group（39 cases）and Good Group（177 cases）. The patients in Bad Group and Good Group were randomly divided into training cohort and validation cohort with a ratio of 7:3 (training cohort: 27 cases in Bad Group and 124 cases in Good Group; validation cohort: 12 cases in Bad Group and 53 cases in Good Group). The preoperative plain CT images of all the patients were converted and outlined two kinds of region of interest (ROI), including the ROI of diseased vertebra and the ROI of diseased vertebra with peripheral abscess, which were saved as radiomics files and extracted radiomics features. The L1 regularized logistic regression model was used to identify the optimal radiomics features for construction of radiomics models。The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was used to evaluate the performance of the constructed radiomics model. Result In the training cohort, the AUC of vertebra model was 0.892（95%CI：0.826, 0.914）,the AUC of vertebra model in the validation cohort was 0.851（95%CI：0.761,0.887）. In the training cohort, the AUC of diseased vertebra with peripheral abscess model was 0.906（95%CI：0.809,0.920）. In validation cohort, AUC of diseased vertebra with peripheral abscess model was 0.868（95%CI：0.786,0.904）. There was no significant difference in the performance between the two models（P>0.05）. Conclusion The radiomics models based on preoperative CT images of spinal tuberculosis can effectively predict the postoperative prognosis, and are helpful for surgeons to choose the clinical treatment of spinal tuberculosis..

Effect of non-alcoholic fatty liver disease on pregnancy outcomes and antiviral therapy in pregnant women with hepatitis B: a retrospective cohort study Wang Chenxu, Li li, Han Guorong, Yuan Deping, Ye Xiajun 2022, 7 (2):  57-62.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.012 Abstract ( 359)    PDF (953KB) ( 565 )    Objective To study the effects of non-alcoholic fatty liver disease (NAFLD) on pregnancy outcome and the antiviral treatment during pregnancy of women with hepatitis B, so as to provide more reliable evidence for improving the management of pregnancy and perinatal period in this population. Method Pregnant women with hepatitis B who delivered in the Second Hospital of Nanjing from January 1, 2020 to December 31, 2021 were selected and divided into NAFLD group(35 cases) and non-NAFLD group(156 cases) according to whether NAFLD was present or not. Matches were made by propensity score matching. The statistical analysis of pregnancy outcomes（25 pairs of patients） and antiviral treatment effect（12 pairs of patients） were performed between the two groups. Result Compared with non-NAFLD group, NAFLD group had an increased risk of adverse maternal and off spring outcomes (both P<0.05). And there was statistically significant difference in the scores of adverse maternal and offspring outcomes between the two groups (P=0.01). It was found that platelet count in NAFLD group was higher than non-NAFLD group at different stage of gestation and postpartum 42 days, while mean platelet volume was lower than control group. There were no statistically significant differences in HBV DNA levels at baseline, 4 and 8 weeks of antiviral therapy between the two groups of pregnant women with high viral load who initiated antiviral therapy in the second trimester of pregnancy. Conclusion NAFLD increased the risk of maternal and fetal adverse outcomes in pregnant women with hepatitis B, but had no significant effect on antiviral therapy initiating in the second trimester of pregnancy in women with high viral load. The platelet-related indicators may be potential prognostic predictors of pregnant women with hepatitis B combined NAFLD.

Preliminary study of the value of Gd-EOB-DTPA enhanced MRI in evaluation of reserved liver function patients with hepatitis B Ren Meiji, LiLi, Zhao Jing, Li Hongjun 2022, 7 (2):  63-66.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.013 Abstract ( 427)    PDF (1161KB) ( 471 )    Objective To investigate the value of Gd-EOB-DTPA enhanced MRI in evaluation of reserved liver function patients with hepatitis B to establish a better method of liver reserve function to guide clinical diagnosis and treatment. Method The clinical and imaging data of 78 patients with hepatitis B who underwent Gd-EOB-DTPA enhanced MRI examination admitted to You'an Hospital from January 2018 to January 2020 were retrospectively analyzed. The enhancement ratios of SNR and CNR of whole liver and liver parenchyma were measured on the images from liver acquisition of hepatobiliary phase. Patients were divided into groups according to Child-Pugh grading standard and end-stage liver disease model (MELD) scoring standard respectively: Grade A (50 cases)/Grade B (28 cases), MELD≤10 (57 cases)/MELD >10 (21 cases), signal to noise ratio (SNR) enhancement rate and contrast to noise ratio (CNR) enhancement rate were compared between groups, and the correlation between enhancement rate and liver function score was analyzed. Result There were no significant differences in SNR and CNR enhancement rates in each lobe of liver parenchyma and whole liver (P>0.05). The SNR and CNR enhancement ratios of Class A were higher than those of Class B (both P<0.05). The SNR and CNR enhancement ratios of MELD≤10 were higher than those of MELD>10 (both P<0.05). There was a negative correlation between enhancement rate and MELD score (r=-0.29, -0.31, P=0.02, 0.01). Conclusion The Gd-EOB-DTPA enhanced MRI has good evaluation value for liver function reserve of patients with hepatitis B. Measurement of the degree of parenchymal enhancement of any lobe or the whole liver on the images of Gd-EOB-DTPA -enhancement MRI in the hepatobiliary phase might reflect the reserved liver function to a certain extent.

Clinical analysis of 100 patients with syphilis serofast Zheng Jinfen, Wang Qianqiu, Lai Yonghui, Wu Xiaobing, Li Xiangzi, Liu Hui, Zhang Dehua, Guan Yang, Yang Shaodie, Tian Yongzhen, Mo Qianying, Huang Shuhong, Li Chao 2022, 7 (2):  67-70.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.014 Abstract ( 761)    PDF (898KB) ( 1403 )    Objective To analyze the epidemiology, clinical data and laboratory results of patients with serofast of syphilis, and explore the related factors of serofast of syphilis. Method According to the standards formulated by the "Expert consensus on the clinical treatment of syphilis serofast" in 2015, a structured questionnaire survey was conducted on the patients who were diagnosed with syphilis serofast in the dermatology department of center for chronic disease prevention of Shenzhen from January 2018 to December 2021. The investigation items included ①The demographic characteristics, life behavior characteristics, history of sexually transmitted diseases and other clinical data were collected. ②Blood was collected for treponema pallidum particle agglutination test (TPPA), syphilis toluidine red unheated serum test (TRUST), and cerebrospinal fluid was collected for leukocyte count and other test indexes of cerebrospinal fluid. Epidata 3.1 was used for data double entry and consistency test. Result Among the 100 patients with serofast of syphilis, there were 37 males and 63 females. There were 4 patients with primary syphilis (4.0%), 19 patients with secondary syphilis (19.0%) and 77 patients with latent syphilis (77.0%). The patients aged from 31 to 40 years old were the most. The baseline titer of toluidine red unheated serum test (TRUST) in 88 patients was 1:256~1:1. The most patients with TRUST baseline titer ≤1:8, accounting for 51%. After treatment, 89 patients had TRUST titer maintained at 1:8~1:1, and 11 patients had TRUST titer above 1:8. There was significant difference between the baseline TRUST titer and the current titer of serofast sate (P<0.01). Of the 100 patients treated for the first time, 97 were treated with penicillin. 57 patients were retreated once due to serofast sate, of which 55 cases were still treated with penicillin and 2 cases were treated with doxycycline. The serum titer still did not turn negative after treatment. Among the 100 patients, 63 patients had cerebrospinal fluid laboratory examination, of which 3 patients were patients with neurosyphilis. Serofast sate occurred after treatment, and 60 patients had no abnormality in cerebrospinal fluid examination. Conclusion Women, latent syphilis and low baseline titer are more prone to serofast state. Benzathine penicillin can still cause serofast of syphilis in the treatment of syphilis. The curative effect of benzathine penicillin in the treatment of serofast is not ideal. New therapeutic drugs should be developed to reduce the occurrence of serofast and treat serofast of syphilis.

Case Report

A case report of phage therapy against lung infection caused by Carbapenem-resistant Acinetobacter baumannii and Carbapenem-resistant Pseudomonas aeruginosa Chen Peifen, Kong Yingjun, Wen Si, Gu Xiaowen, Zhou Yang, Tan Xin, Ma Yingfei, Lu Hongzhou 2022, 7 (2):  71-75.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.015 Abstract ( 1135)    PDF (1323KB) ( 916 )    One 82-year-old male patient suffering from Alzheimer's disease was admitted to the hospital due to repeated pulmonary infection in the past half-year. Carbapenem-resistant Acinetobacter baumannii (CRAB）and Carbapenem-resistant Pseudomonas aeruginosa(CRPA）were cultured in the sputum so he was treated with a variety of antibiotics including tigecycline before admission. However, Pulmonary infection and sputum culture of CRAB and CRPA did not show any sign of improvement. After admission, a single-phage preparation for CRAB and a two-phage cocktail preparation for CRPA was nebulized twice daily, combined with intravenous administration of tigecycline, piperacillin-tazobactam and amikacin. Phages for CRAB lasted for 10 days and phages for CRPA lasted for 19 days in total. The treatment was well tolerated and resulted in clearance of the CRAB and reduction of CRPA. Clinical signs and chest X-ray indicated that the pulmonary infection was improved gradually.

CT misdiagnosis of lung tuberculous abscess: case report Huang Yubin, Liu Yongxi, Guo Qinglu, Huang Huang 2022, 7 (2):  76-78.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.016 Abstract ( 543)    PDF (2080KB) ( 537 )    The immune system of infants is immature, it is easy to cause widespread infections via blood once they infected with mycobacterium tuberculosis. However, the clinical manifestations of infants are often atypical, which make clinical diagnosis and treatment challenging. CT scan is of great clinical significance to infant tuberculosis, although its CT findings are diverse, but still has certain characteristics. When lump sand cystic lesions showed in lung, accompanied by multiple patches and lymph nodes swelling, pulmonary abscesses should be considered. And further clinical evidence should be promptly sought to develop a better treatment program. This paper introduces the diagnosis and treatment of a child with tuberculous pulmonary abscess misdiagnosed as neuroblastoma with lymph nodes by CT in Guangdong Women and Children Hospital, in order to improve the clinical diagnosis and treatment level of child tuberculosis

Guidelines and Consensus

Consensus of experts on radiological examination, diagnosis, prevention and control rules for coronavirus disease 2019 in Jiangsu province (2nd Edition 2022) Infectious, Inflammatory Radiology Committee of Jiangsu Research Hospital Association, Quality Control Center of Jiangsu Diagnostic Radiology, Infectious Diseases Group of Radiology Branch of Jiangsu Medical Association 2022, 7 (2):  79-88.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.017 Abstract ( 578)    PDF (1890KB) ( 1039 )    Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). The pneumonia caused by SARS-CoV-2 was then named as coronavirus disease 2019 (COVID-19) on February 11th, 2020 by WHO. SARS-CoV-2 is a coronavirus, during recent 2 years, there were many variants of SARS-CoV-2, of which Delta and Omicron variant were the most common variants prevailing in China. The Omicron variant currently replaced Delta variant as the main epidemic strain in China, which was with strong infectivity, fast transmission speed and weak pathogenicity. In order to renew the knowledge of COVID-19 for radiologists, to standardize the procedure of radiological examination and diagnosis, to enhance the prevention and control of infection in the process of radiological examination, and to ensure the medical quality and safety, the second edition of consensus was compiled by the experts from Infectious and Inflammatory Radiology Committee of Jiangsu Research Hospital Association, Quality Control Center of Jiangsu Diagnostic Radiology and Infectious Diseases Group of Radiology Branch of Jiangsu Medical Association. There are five parts in the consensus, covering overview, radiological examination and diagnosis procedure,radiological diagnosis, radiological quality control and infection control in radiology department. The consensus is promising to provide the guidance for the clinical work of radiology department in the medical institutions.

Review

Progress on Talaromycosis in non-HIV-infected patients Huang Liping, Lu Aili, Peng Jie 2022, 7 (2):  89-94.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.018 Abstract ( 578)    PDF (991KB) ( 982 )    Talaromyces marneffei is an opportunistic pathogen, which mainly occurs in human immunodeficiency virus (HIV)-infected patients. Whereas, non-HIV Talaromycosis patients increased in recent years which was related to the compromised immune conditions of hosts. The most common underlying diseases in children were various primary immunodeficiency diseases. The most common underlying diseases in adults were anti-interferon-gamma autoantibody (AIGA) syndrome, autoimmune diseases, glucocorticoid and/or immunosuppressive therapy, malignancy, diabetes and so on. Most non-HIV Talaromycosis patients occurred disseminated infection, and might coinfected with other opportunity pathogens and had secondary hemophagocytic lymphohistiocytosis. The clinical manifestations and prognosis of non-HIV Talaromycosis patients were different from that of HIV-infected patients. Herein, we reviewed the epidemiology, immunodeficiency, clinical manifestations, diagnosis, treatment and prognosis of non-HIV Talaromycosis.

New progress in ultrasonic diagnosis of chronic hepatitis B complicated with non-alcoholic fatty liver diseas Huang Xiuling, Feng Cheng, Dong Changfeng 2022, 7 (2):  95-98.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.019 Abstract ( 373)    PDF (898KB) ( 667 )    Chronic hepatitis B（CHB） is the most common chronic liver disease in China, as well as the common cause of cirrhosis and liver cancer. In recent years, the incidence of non-alcoholic fatty liver disease (NAFLD) has increased rapidly, resulting in more and more common CHB combined with NAFLD. Patients with CHB combined with NAFLD have a significantly increased risk of liver fibrosis, cirrhosis and even liver cancer compared with patients with CHB alone or NAFLD alone. The combined action of hepatitis B virus and hepatocellular steatosis on the liver can accelerate the progression of liver fibrosis. Accurate diagnosis of liver fibrosis and steatosis in patients with CHB complicated with NAFLD is of great value in disease monitoring, guiding clinical intervention and improving the prognosis of patients. At present, liver biopsy is still the gold standard in the diagnosis of liver fibrosis and liver steatosis, but because of its many defects such as invasive and complications, difficult to promote in the clinical application and clinical needs to be a non-invasive diagnostic technology, ultrasonography as a noninvasive diagnosis technology is developing rapidly in recent years, such as real-time, visual advantage is becoming more and more widely applied in liver disease diagnosis. With the development of new technologies such as elastography and artificial intelligence, the integration of multiple new technologies and ultrasound imaging is deepening, enabling ultrasound to provide more Objective and rapid diagnosis. This paper introduces the application value of ultrasound elastography, ultrasonic attenuation imaging and ultrasonic artificial intelligence in the diagnosis of chronic hepatitis B complicated with NAFLD.

Education Fields

Progress in diagnosis and treatment of tsutsugamushi disease—a case report of tsutsugamushi disease with multiple organ dysfunction Huang Kaizhuang, Ran Yingqi, Li Ningjun, Du Dahao, Cheng Tao, Li Rong, Lou Shaofei 2022, 7 (2):  99-103.  DOI: 10.19871/j.cnki.xfcrbzz.2022.02.020 Abstract ( 576)    PDF (901KB) ( 879 )    Tsutsugamushi disease is an acute natural infectious disease caused by Orientia tsutsugamushi. The clinical manifestations are diverse and non-specific, resulting in easy to miss diagnosis and misdiagnosis. In this paper, the progress in the research of tsutsugamushi disease was reviewed, and a case of tsutsugamushi disease with multiple organ dysfunction was reported, aiming to improve the clinical diagnosis and treatment level of tsutsugamushi disease, especially severe cases. In terms of epidemiology, tsutsugamushi disease in China can be divided into summer type and autumn type. The cases have been reported all over the country and the incidence is increasing year by year. Cases have occurred in all ages and are mainly outdoor workers. Clinical manifestations include high fever, rash, eschar and multiple organ dysfunction. The traditional diagnostic methods are characterized by low positive rate and poor specificity. With the development of scientific research, the latest diagnostic techniques such as second-generation gene sequencing have been developed. In terms of treatment, general treatment, etiological treatment and supportive treatment are mostly adopted. Tetracycline drugs are effective antibiotics. When multiple organ function injury occurs, support technologies such as mechanical ventilation, blood purification and artificial liver can improve the efficacy.