Disparities in the Levels of Whole-Blood Epstein-Barr Virus between the Cancer and Non-Cancer Populations in Zhejiang,China

Objective This study aimed to investigate the prevalence of Epstein-Barr virus(EBV)infection in patients with and without cancer.Methods A total of 26,648 participants who underwent whole-blood EBV DNA(WBEBV)assays between January 1,2020,and August 31,2023,were included.The chi-square test was used for categorical data analysis,and R software was used to analyze the differences in EBV DNA load levels and the diagnostic capabilities of WBEBV.Results Positive rates were 10.2%and 25.4%for healthy controls(HC)and patients,respectively.The positivity rate for EBV-associated neoplasms(EN)was the highest at 7.53%,followed by leukemia(Le)at 5.49%.The subgroup analysis showed that the positivity rate for abnormal proliferation or hyperplasia(APH)was 31.9%,followed by 30.5%for Le.The WBEBV of patients with transplants(TP),especially living-related transplants(LT),was the highest among all subgroups.WBEBV at diagnosis was used to differentiate between infectious mononucleosis(IM)and chronic active Epstein-Barr virus(CAEBV),with a sensitivity of 67.4%(95%confidence interval[CI]:57.6-75.8)and specificity of 72%(95%CI:63.3-79.3).We conclude that the prevalence of EBV infection is low in the healthy population in this region and that a high EBV load at baseline is more common in LT,IM,and Lymphocyte Leukemia(LL).Conclusion This study used a large-sample survey to characterize the prevalence of whole-blood EBV levels in various diseases,including the stages and subtypes.The EBV detection rate was higher in patients with malignant disease than in those with benign disease.Our study provides clinicians with baseline information regarding EBV-associated diseases.

30岁以上乙型肝炎病毒感染者肝组织病理学分级特点及与病毒载量和炎症因子的关系分析

目的分析30岁以上乙型肝炎病毒(HBV)感染者肝组织病理学分级特点及与病毒载量和炎症因子的关系。方法选取2020年1月至2022年1月于宜春市第二人民医院诊治的80例30岁以上HBV感染患者作为研究对象,所有患者均在B超定位下进行肝活检,采用Metavir评分对肝组织炎症和纤维化程度进行评价,同时检测患者HBV-DNA病毒载量和炎症因子,并采用Spearman相关进行病理学分级与病毒载量和炎症因子的相关性分析。结果80例30岁以上HBV感染患者的肝组织病理学结果中,肝组织炎症分级:G0级0例,G1级49例,G2级27例,G3级3例,G4级1例;肝组织纤维化分级:S0级4例,S1级44例,S2级17例,S3级10例,S4级5例,其中肝组织炎症分级<G2级患者49例,≥G2级患者31例,肝组织纤维化程度分级<S2级患者48例(60.00%),≥S2级患者32例(40.00%);肝组织炎症分级<G2级患者的HBV-DNA、白细胞介素-12(IL-12)、白细胞介素-21(IL-21)、壳多糖酶3样蛋白1(CHI3L1)水平均低于肝组织炎症分级≥G2级患者,差异有统计学意义(P<0.05);肝组织纤维化分级<S2级患者的HBV-DNA、IL-12、IL-21、CHI3L1水平均低于肝组织纤维化分级≥S2级患者,差异均有统计学意义(P<0.05);Spearman相关分析结果显示,肝组织炎症分级与HBV-DNA病毒载量、IL-12、IL-21、CHI3L1水平呈正相关(r>0,P<0.05),肝组织纤维化分级与HBV-DNA病毒载量、IL-12、IL-21、CHI3L1水平呈正相关(r>0,P<0.05)。结论30岁以上HBV感染者的病毒载量和炎症因子水平在一定程度上可以反映肝组织炎症反应和纤维化程度。

57例甲型流感病毒感染合并肺炎患者感染指标与病毒载量相关性

目的分析流感高峰期甲型流感病毒感染且合并肺炎患者的临床表现特点。方法将2018年12月—2019年4月某院呼吸内科甲型流感病毒感染合并肺炎住院患者列为甲流合并肺炎组,内科门诊就诊的甲型流感病毒感染患者列为甲流组,体检中心正常体检者列为体检组,回顾性分析患者临床表现和特征。结果甲流合并肺炎组57例,甲流组42例,体检组33例,三组年龄比较,差异有统计学意义(F=16.57,P<0.001),甲流合并肺炎组患者年龄最大,为(61.65±16.92)岁。甲流合并肺炎组患者白细胞(WBC)计数中性粒细胞百分比以及C反应蛋白(CRP)、降钙素原(PCT)、血清淀粉样蛋白(SAA)检测值均高于甲流组患者和体检组健康者(均P<0.05)。甲流合并肺炎组患者甲型流感病毒载量核酸检测CT值(16.18±2.53)低于甲流组患者(19.30±4.12),差异有统计学意义(t=2.100,P=0.039);甲流合并肺炎组患者检测结果CT值与其感染指标CRP、PCT相关系数(r)分别为-0.51、-0.55,均呈负相关。结论甲型流感病毒感染患者为老年人,甲型流感病毒载量高,感染指标CRP、PCT升高提示感染者存在合并肺炎的风险,可为临床诊疗提供依据。

基于ddPCR技术分析EB病毒载量特征及与qPCR技术的比较研究

目的解决临床工作中应用实时荧光定量PCR(qPCR)方法检测EB病毒(EBV)载量与临床诊断不符的问题,探讨微滴式数字PCR(ddPCR)和qPCR方法检测EBV载量的能力并为临床提供可能的解决方案。方法收集510例疑似EBV感染相关疾病患者血浆标本,采用ddPCR和qPCR两种方法测定同一血浆标本的EBV-DNA载量。结果 EBV感染人群中,EBV-DNA载量较其他地区低,载量中位数仅360copies/mL,其中初诊未治鼻咽癌患者中位病毒载量为4 590copies/mL,治疗后鼻咽癌患者中位病毒载量下降为430copies/mL,免疫力低下者中位病毒载量为130copies/mL,而淋巴瘤患者中位病毒载量为840copies/mL;qPCR检测EBV感染以400copies/mL为界值,高于400copies/mL时,ddPCR与qPCR的EBV-DNA测定水平值呈中度相关(r=0.533,P<0.05),低于400copies/mL时,ddPCR与qPCR的EBV-DNA测定水平值呈弱相关(r=0.299 5,P<0.05);以ddPCR为标准,qPCR检测EBV-DNA的灵敏度仅为0.317,以ddPCR检测结果为标准,构建qPCR的受试者工作特征曲线下面积为0.871,此时临界值(qPCR)为10copies/mL,灵敏度为0.824,特异度为0.780。结论采用ddPCR方法或优化qPCR的临界值去检测EBV-DNA载量更能为临床诊断EBV感染提供有利支持。

Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China:A nationwide retrospective study

Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.

Vulnerability and Resilience to Stress and Immune and Neuroendocrine Function in Portuguese Subjects with Psychic Anomaly (Anxiety and Depression)

The present study aimed to investigate the impact of chronic psychosocial stress and resilience, including at a biological level (immune and neuroendocrine function) in Portuguese citizens with psychic anomaly/mental disorder. The sample aggregated 69 participants. It has been used the following psychometric instruments: 21-item depression, anxiety and stress scales (DASS-21), in the Portuguese validated version;measuring state resilience (MSR), in the Portuguese validated version;the Portuguese scale of 23 questions on vulnerability to stress. Serum levels of cortisol, dehydroepiandrosterone sulfate, antibodies anti-viral capsid antigen of Epstein-Barr virus, triglycerides, high density lipoprotein-cholesterol and body mass index have been measured. It has been concluded that factors of vulnerability to stress and chronic stress, of social nature (lack of social support, adverse living conditions), correlate positively with depression, anxiety and stress, and, through alostatic load, are involved in a greater propensity for immune and neuroendocrine dysfunction in this population.

中国MSM人群HIV感染者病毒载量抽样调查数据分布特征及数据转换研究

目的 了解MSM人群的HIV感染者（MSM感染者）人群病毒载量（PVL）数据分布特征,拟合分布函数,探讨评价PVL的合适参数.方法 病毒载量（VL）检测限设定为≤50拷贝/ml.描述PVL的一般分布特征,结合Box-Cox转换和正态性检验,根据PVL数据转换后的分布特征,拟合稳定分布函数,并进行拟合优度检验.结果 PVL原始数据为偏态分布,变异系数（CV）为622.24%,经Box-Cox转换,转换参数（λ）最优值=-0.11,为多峰分布;VL原始值〉检测限的PVL经Box-Cox数据转换,λ最优值=0,为对数转换,偏态厚尾特征,不满足正态分布,拟合稳定分布函数（α=1.70,β=-1.00,γ=0.78,δ=4.03）,呈稳定分布.结论 PVL原始值存在截尾、非正态分布的特征,变异度较大;当VL原始值≤检测限的截尾数据占总体比例较大时,不宜用检测限的1/2代替;VL原始值〉检测限的PVL对数值为稳定分布,适合用M和IQR来描述集中趋势和离散趋势.

高新型布尼亚病毒载量发热伴血小板减少综合征患者141例的临床特征及预后影响因素分析

目的分析高新型布尼亚病毒载量发热伴血小板减少综合征患者的临床特征及其预后影响因素。方法收集2013年5月20日至2019年10月30日于威海市中心医院经实验室确诊的新型布尼亚病毒RNA≥1×104拷贝/mL的141例发热伴血小板减少综合征住院患者的临床资料,并进行回顾性分析。按照预后分为生存组和死亡组,对比分析其临床表现、实验室检查结果和病毒载量对病情的影响及其预后影响因素。统计学分析采用χ2检验、秩和检验和logistic回归分析。结果生存组76例,中位年龄为64岁;死亡组65例,中位年龄为71岁。生存组和死亡组在神经系统损伤、昏迷、出血、心房颤动伴快速心室率、肾损伤中的差异均有统计学意义(χ2=16.45、64.06、11.25、6.98、33.80,均P<0.01)。生存组和死亡组活化部分凝血活酶时间、天冬氨酸转氨酶、肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶、羟丁酸脱氢酶、肌酐、血小板计数差异均有统计学意义(Z=6.33、4.51、2.93、4.65、5.00、4.93、5.36、-4.34,均P<0.01)。138例新型布尼亚病毒RNA定量在1.06×104~6.53×107拷贝/mL,3例≥1.00×108拷贝/mL,生存组和死亡组病毒载量分别为4.63(4.32,5.22)和5.29(4.92,6.17)lg拷贝/mL,差异有统计学意义(Z=4.91,P<0.01)。病毒载量为1.00×104~<1.00×105拷贝/mL患者的病死率为29.33%(22/75);病毒载量为1.00×105~<1.00×106拷贝/mL患者的病死率为51.28%(20/39);病毒载量为1.00×106~<1×107拷贝/mL患者的病死率为80.95%(17/21),病毒载量≥1.00×107拷贝/mL的6例患者均死亡。logistic回归分析显示,患者年龄≥60岁,病毒载量>1.00×106拷贝/mL,血小板计数<30.00×109/L,乳酸脱氢酶≥5000.00 U/L,活化部分凝血活酶时间≥84.00 s时,患者的死亡风险增加。结论昏迷、出血、心房颤动伴快速心室率、肾损伤等并发症的发生提示患者病情较重,死亡风险更高。患者年龄、病毒载量、血小板计数、乳酸脱氢酶、活化部分凝血活酶时间可以作为评估患者死亡风险的指标。