Community-based Survey of Prevalence and Risk Factors of Syphilis among Injection Drug Users in Sichuan Province, China

Objectives: To investigate prevalence and risk fac-tors of syphilis infection among injection drug users(IDUs) in Lianshan Yizu Autonomous Region ofSichuan province, China.Methods: From November 8th 2002 to November29th 2002, a community-based cross-sectional surveywas conducted to investigate the demographic charac-teristics and sexual behaviors of a population of IDUs.Blood samples were collected to test for syphilisinfection. A total of 379 subjects were recruitedfor the study through community outreach and peerrecruiting methods.Results: Of 379 IDUs, the syphilis prevalence amongIDUs was 15.3% (58/379). Gender, years of education,history of unprotected sex with non-steady sex part-ner in the last month, number of sex partners in thelast 6 months, frequency of sex with non-steady sexpartner in the last 6 months, and number of any newsex partner(s) in the last 6 months were associatedwith syphilis infection after univariate analysis usingthe chi-squared test. Multivariate logistic regressionanalysis showed that ethnicity (OR, 2.85; 95% CI,1.55-5.25), marriage (OR, 1.94; 95% CI, 1.04-3.62)and receiving money for sex in the last 6 months (OR, ,5.60; 95% CI, 2.65-11.85) were significantly associ-ated with syphilis infection among IDUs.Conclusions: This study found that receiving moneyfor sex in the last 6 months was significantly associ-ated with syphilis prevalence among IDUs. It isrecommended that further health education andintervention campaigns be focused on IDUs to promotesafe sexual practices.

Clinical features and risk factors of acute hepatitis E with severe jaundice

AIM:To compares the clinical features of patients infected with hepatitis E virus(HEV) with or without severe jaundice.In addition,the risk factors for HEV infection with severe jaundice were investigated.METHODS:We enrolled 235 patients with HEV into a cross-sectional study using multi-stage sampling to select the study group.Patients with possible acute hepatitis E showing elevated liver enzyme levels were screened for HEV infection using serologic and molecular tools.HEV infection was documented by HEV antibodies and by the detection of HEV-RNA in serum.We used χ2 analysis,Fisher's exact test,and Student's t test where appropriate in this study.Significant predictors in the univariate analysis were then included in a forward,stepwise multiple logistic regression model.RESULTS:No significant differences in symptoms,alanine aminotransferase,aspartate aminotransferase,al-kaline phosphatase,or hepatitis B virus surface antigen between the two groups were observed.HEV infected patients with severe jaundice had significantly lower peak serum levels of γ-glutamyl-transpeptidase(GGT)(median:170.31 U/L vs 237.96 U/L,P = 0.007),significantly lower ALB levels(33.84 g/L vs 36.89 g/L,P = 0.000),significantly lower acetylcholine esterase(CHE) levels(4500.93 U/L vs 5815.28 U/L,P = 0.000) and significantly higher total bile acid(TBA) levels(275.56 μmol/L vs 147.03 μmol/L,P = 0.000) than those without severe jaundice.The median of the lowest point time tended to be lower in patients with severe jaundice(81.64% vs 96.12%,P = 0.000).HEV infected patients with severe jaundice had a significantly higher viral load(median:134 vs 112,P = 0.025) than those without severe jaundice.HEV infected patients with severe jaundice showed a trend toward longer median hospital stay(38.17 d vs 18.36 d,P = 0.073).Multivariate logistic regression indicated that there were significant differences in age,sex,viral load,GGT,albumin,TBA,CHE,prothrombin index,alcohol overconsumption,and duration of admission between patients infected with acute hepatitis E with and without severe jaundice.CONCLUSION:Acute hepatitis E patients may naturally present with severe jaundice.

Viral Genotypes and Associated Risk Factors of Hepatocellular Carcinoma in India

Objective This study aims to investigate the etiological relationship among hepatitis B virus （HBV）, hepatitis C virus （HCV）, and alcohol as risk factors in a cohort of hepatocellular carcinoma （HCC） patients from India. The clinical and biochemical profiles and tumor characteristics in the HCC cases were also evaluated. Methods A total of 357 consecutive cases of HCC fulfilling the diagnostic criteria from the Barcelona-2000 EASL conference were included in the study. The blood samples were evaluated for serological evidence of HBV and HCV infection, viral load, and genotypes using serological tests, reverse transcription-polymerase chain reaction, and restriction fragment length polymorphism. Results The male/female ratio for the HCC cases was 5.87：1. Majority of the HCC patients （33.9%） were 50 to 59 years of age, with a mean age of 4±13.23 years. More than half the cases （60.8%） had underlying cirrhosis at presentation. Among the HCC patients, 68.9% were HBV related, 21.3% were HCV related, 18.8%, were alcoholic, and 18.2% were of cryptogenic origin. The presence of any marker positive for HBV increased the risk for developing HCC by almost 27 times [OR： 27.33; （12.87-60.0）]. An increased risk of 10.6 times was observed for HCC development for cases positive for ally HCV marker [OR： 10.55; （3.13-42.73）]. Heavy alcohol consumption along with HCV RNA positivity in cirrhotic patients was found to be a risk for developing HCC by 3 folds ]OR： 3.17; （0.37-70.71）]. Conclusions Patients of chronic HBV infection followed by chronic HCV infection were at higher risk of developing HCC in India. Chronic alcohol consumption was found to be a risk factor in cirrhotic cases only when it was associated with HCV RNA positivity. Most of the patients had a large tumor size （〉5 cm） with multiple liver nodules, indicating an advanced stage of the disease thus making curative therapies difficult.

Prevalence and risk factors of asymptomatic hepatitis C virus infection in Egyptian children

AIM: To identify the prevalence, risk factors and manifestations of asymptomatic hepatitis C virus (HCV) infection in Egyptian children. METHODS: Children at the age of 1-9 years were screened for HCV antibodies and alanine aminotransferase (ALT) levels. Every child with elevated ALT and/or detectable HCV antibodies was tested for HCV RNA by RT-PCR and compared with two negative controls for risk factors and signs and symptoms of liver disease.RESULTS: We screened 1042 children, six of them had elevated ALT, negative HCV antibody and positive RNA, likely representing acute hepatitis C cases. Fifteen children were HCV seropositive, 5 of them were HCV RNA positive. Asymptomatic HCV infection was present in 2.02% (positive results for either HCV antibodies or HCV-RNA or both). Symptoms such as diarrhea, abdominal pain, history of fatigue and school absence because of illness and risk factors such as dental care were significantly more common among HCV positive cases than among controls. None of the HCV positive children was diagnosed as having signs of advanced liver disease upon clinical or ultrasonographic examination. CONCLUSION: Asymptomatic HCV infection is detectable in 2.02% Egyptian children.

Re-searching nasopharyngeal carcinoma

Nasopharyngeal carcinoma(NPC)has been a focus of medical research for more than 100 years,with significant interest emerging over the last 58 years following the identification of the link between the disease and Epstein-Barr virus(EBV)infection.NPC possesses several distinctive characteristics among human cancers,notably its well-documented global epidemiology,which reveals localized high-incidence regions primarily in Southeast Asia,particularly in the Southern provinces of China near the Pearl river,as well as in Greenland and North Africa.Epidemiological data indicate a marked male predominance,early disease onset,and a nearly 100%prevalence of latent EBV infection in the tumors.Due to lack of consistent pattern of cancer-related mutations in NPC genomes and excessive DNA-methylation in the tumor cells,NPC can be considered"an epigenetic cancer".Despite extensive researches,convincing biological explanations for these unique characteristics remain elusive.Recently,suggestive evidence has been published that specific local variants of EBV may represent major high risk factors.In spite of tumor and virus specific immunity,it has not been possible to use this for improved treatment.Ongoing studies on the role of the local microflora and tumor microenvironment are essential for a comprehensive understanding of host-EBV-tumor interactions.Ultimately,this knowledge aims to enhance diagnosis,disease fractionation,treatment strategies,and potentially prevention of NPC.

202例药物性肝病临床分析

目的:分析致药物性肝病的药物种类、临床表现,探讨预防措施。方法:采取回顾性分析的方法,对本院2000年1月至2006年6月临床各科诊断药物性肝病的202例患者资料进行统计分析。结果:202例药物性肝病中男128例,女74例,年龄最小8岁,最大82岁,平均(46．96±16．67)岁;涉及药物37种,抗结核药物居首位占35．1%(71/202),中草药及其成药占第二位,为24．3%(49/202),抗肿瘤药居第三位,均占14．3%(29/202);临床分型:肝细胞型肝损伤40例(36．04%),淤胆型肝损伤43例(38．74%),混合型肝损伤28例(25．22%)。结论:致药物性肝病的药物品种较多,要掌握导致药物性肝病的相关危险因素,定期检查肝功能,早期发现、及时停药、早期诊断、及时治疗是预后良好的关键。

Factors associated with a SARS-CoV-2 recurrence after hospital discharge among patients with COVID-19:systematic review and meta-analysis

Background:The proportion of recurrences after discharge among patients with coronavirus disease 2019(COVID-19)was reported to be between 9.1%and 31.0%.Little is known about this issue,however,so we performed a meta-analysis to summarize the demographical,clinical,and laboratorial characteristics of non-recurrence and recurrence groups.Methods:Comprehensive searches were conducted using eight electronic databases.Data re-garding the demographic,clinical,and laboratorial characteristics of both recurrence and non-recurrence groups were extracted,and quantitative and qualitative analyses were conducted.Results:Ten studies involving 2071 COVID-19 cases were included in this analysis.The proportion of recurrence cases involving patients with COVID-19 was 17.65%(between 12.38%and 25.16%)while older patients were more likely to experience recurrence(weighted mean difference(WMD)=1.67,range between 0.08 and 3.26).The time from discharge to recurrence was 13.38 d(between 12.08 and 14.69 d).Patients were categorized as having moderate severity(odds ratio(OR)=2.69,range between 1.30 and 5.58),while those with clinical symptoms including cough(OR=5.52,range between 3.18 and 9.60),sputum production(OR=5.10,range between 2.60 and 9.97),headache(OR=3.57,range between 1.36 and 9.35),and diz-ziness(OR=3.17,range between 1.12 and 8.96)were more likely to be associated with recurrence.Patients pre-senting with bilateral pulmonary infiltration and decreased leucocyte,platelet,and CD4+T counts were at risk of COVID-19 recurrence(OR=1.71,range between 1.07 and 2.75;WMD=?1.06,range between?1.55 and?0.57,WMD=?40.39,range between?80.20 and?0.48,and WMD=?55.26,range between?105.92 and?4.60,respectively).Conclusions:The main factors associated with the recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)after hospital discharge were older age,moderate severity,bilateral pulmonary infiltration,laboratory findings including decreased leucocytes,platelets,and CD4+T counts,and clinical symptoms including cough,sputum production,headache,and dizziness.These factors can be considered warning indicators for the recurrence of SARS-CoV-2 and might help the development of specific management strategies.