Objective The aim of the study was to evaluate the characteristics of HIV drug-genotypic resistance among patients taking ifrst-line ARV regimens using polymerase chain reaction and sequencing, and guide to design optimal ARV regimens for these patients.Methods HIV reverse transcriptase-encoded gene was ampliifed with RT-PCR and ampliifed PCR products were aligned and comparatively analyzed with HIV resistance database to ifnd drug-resistance mutations.Results Twenty-eight PCR products were amplified and sequenced successfully in 30 serum samples of recruited HIV-infected patients with virologic failure. The resistance rate was 96%, mutations in NRT region were found in 26 patients (93%), while mutations in NNRT region were found in 27 patients (96%). M184V was the most common mutation (86%), K65R was selected in 14%of recruited individuals and TAMs occurred in 50%of patients, which resulted in resistance to NRTIs. Y181C and V179D were the most common mutations in NNRTIs and prevalence was 43%(12/28) and 36%(10/28), respectively, which resulted in cross-resistance to NNRTIs due to low-genetic barrier.Conclusions Virologic failure may occur in long-term administration of ifrst-line ARV regimens, and drug-resistance mutations can be found in these patients, which resulted in resistance to ifrst-line ARV regimens. We emphasized that HIV viral load assay and resistance assay were important tools to guide healthcare workers to design an optimal second-line ARV regimens for HAART-experienced individuals with virologic failure.

作者： 刊期： 2013年第04期

Objective To investigate the infection rate of hepatitis C virus among the ambulatory patients and in-patients of a tertiary teaching hospital, and study the demographic factors related to the prevalence of hepatitis C virus infection.Methods All patients tested for hepatitis C virus antibody from July 2008 to July 2009 in Peking Union Medical College Hospital were enrolled in this cross-sectional analysis. The prevalence of hepatitis C virus infection was compared according to age, gender, and departments, respectively. Among patients with positive serology hepatitis C virus marker, the positivity of hepatitis C virus RNA was analysed.Results Among 29 896 subjects included, the hepatitis C virus antibody of 494 patients were positive (1.7%). When patients were divided into 9 age groups, the age speciifc prevalence of hepatitis C virus antibody were 0.2%, 1.7%, 1.2%, 1.1%, 1.5%, 1.9%,2.6%, 2.4%and 2%, respectively. The prevalence of hepatitis C virus antibody in non-surgical department and surgical department was 3%and 1%, respectively. The prevalence of hepatitis C virus antibody of males was higher than that of the females. Total of 194 patients with positive hepatitis C virus antibody were tested for hepatitis C virus RNA, the RNA level of 113 patients (58.2%) were higher than the low detection limit.Conclusions The prevalence of hepatitis C virus antibody was relatively high among patients of general tertiary hospital. Age group of 60-69, males and patients in non-surgical departments were factors associated with high rate of hepatitis C virus infection.

作者： 刊期： 2013年第04期

The association of gene polymorphism and susceptibility to hepatocellular carcinoma (HCC) has been widely studied in recent years. Gene mutations are closely related to HCC. Understanding and measuring the gene mutations are useful to reduce the incidence of HCC and improve its prognosis.

作者： 刊期： 2013年第04期

Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward, the nursing log and the hospitalization medical record of correlative patients were consulted. SARS-CoV in serum specimen from SARS patient was detected by PCR. Results The room where SARS outbreak occurred was on the 13th lfoor of the 16-story main ward building. There were 6 beds in the room, living with 6 female patients (aged 45-67) who were all hospitalized due to type 2 diabetes. On March 24, 2003, Patient 1 began to have a fever and cough, chest X-ray showed pneumonia. Five and six days later, Patient 2 and Patient 3 began to have a fever, respectively. Finally, all of these 3 patients died. Their beds were all at the same side of the room, and the other 3 patients at the opposite side were not infected. Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR. The daughter-in-law of Patient 1 who accompanied Patient 1 by the bedside several days, mainly near the window, upwind of Patient 1, was not infected. Medical staff, family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol. The distance droplets travels could be up to 3.43 meters. Droplet spread has direction, and the droplets direction of propagation is closely related with the wind direction and speed. Those at the downwind position of SARS patients were susceptible to be infected. Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.

作者： 刊期： 2013年第04期

This article revealed two valuable case reports about two young females suffered tuberculous meningitis after cesarean section. After antituberculous therapy, the condition of one patient improved and the other one became deteriorated.

作者： 刊期： 2013年第04期

Psoriasis is a chronic recurrent inlfammatory dermatosis, which is characterized by epidermal proliferation and erythema scales. Its etiology and pathogenesis are still unknown and treatment is dififcult. The concentration of tacrolimus for the treatment of psoriasis has not been reported at home and abroad. In this report, we detected the tacrolimus plasma concentration and hope to provide a certain reference value for the clinical treatment of psoriasis.

作者： 刊期： 2013年第04期

Objective Nucleos(t)ide analogues (NAs) na?ve chronic hepatitis B(CHB) patients were given rescue combination therapy after drug resistance to lamivudine or adefovir. Evolution of HBV mutation patterns and its impact on antiviral effects were studied.Methods Total of 142 na?ve CHB patients treated with lamivudine were randomly divided into two groups when lamivudine resistance occurred. One group was added with adefovir, the other was switched to entecavir and adefovir. Seventy-two na?ve CHB patients treated with adefovir were randomly divided into two groups when adefovir resistance occurred. One group was added with lamivudine, the other was added with entecavir. HBV polymerase reverse transcriptase mutations associated with resistance were analyed before and after 48 weeks of rescue therapy, respectively.Results The mutation patterns of M204V/I, M204V+L180M were predominantly found in CHB patients after lamivudine resistance. Meanwhile, the entecavir resistance mutation patterns were also detected. Therefore, patients with lamivudine resistance could develop more diverse drug resistance mutations if they were switched to entecavir and adefovir. The mutation patterns of rtA181 were predominantly found in CHB patients after adefovir resistance and rescure therapy with add-on entecavir was more effective than with add-on lamivudine Conclusions Resistance mutation analysis chould help to choose NAs, reduce resistance and ehance antiviral effects.

作者： 刊期： 2013年第04期

Objective To investigate the prevalence and levels of anti-HEV IgG in the population of Jiangsu Province.Methods Total of 2 656 samples from Qindong and 11 463 samples from Anfeng were colleted. The anti-HEV antibody was qualitatively and quantitatively detected using ELISA kits and the references had been established.Results The positive rates of anti-HEV IgG in male and female were 55.6% and 40.1%, respectively. The positive rate of anti-HEV IgM in male and female were both 3.4%. In opposite to anti-HEV IgG, the positive rate of anti-HEV IgM in Anfeng was signiifcant higher than that in Qindong. The mean anti-HEV IgG titers for 6 age groups were 0.94, 0.92, 1.07, 1.46, 1.27, 1.19 and 0.68, 1.31, 1.08, 1.14, 1.31, 1.68 IU/ml, in Qindong and Anfeng region, respectively. The positive rate of anti-HEV IgG tended to increase with age and the titer of anti-HEV IgG was associated with age (R>0.90).Conclusions The results in this study showed that HEV was widely prevalent in both Qindong and Anfeng of Jiansu Province and the prevalence and the anti-HEV IgG titer were associated with gender and age.

作者： 刊期： 2013年第04期