Review: Helicobacter pylori infection in children

Helicobacter pylori infection in children and adolescents differs in comparison to adults with respect to epidemiology, host responses, and disease manifestations. Furthermore, treatment options are limited in this population and antibiotic resistance rates continue to increase. Therefore, ongoing research is vital to understand disease pathogenesis and provide optimal management of children with infection. This review summarizes relevant publications from April 2019 to March 2020. Similar to adults, recent studies show a decreasing prevalence of infection in the pediatric population. Studies of pathogenesis investigated serum immune responses and the potential inverse association of infection and allergy. Several studies investigated the effect of H pylori and related inflammation on the gut microbiome. The recommendation of endoscopy‐based testing to identify the cause of symptoms and not just H pylori, reserving noninvasive UBT or stool antigen tests for post‐eradication follow‐up, was supported by the current literature.     

结核分枝杆菌小RNA及其作用的研究进展

细菌小RNA是一类长度在50～500个核苷酸之间的不具有编码蛋白质功能,但具有转录后调控作用的RNA,在细菌中参与调控细菌多种生理和病理活动,如调节细菌代谢和毒力作用等过程。近年来,在结核分枝杆菌已经鉴定出近200种小RNA,并证明这些小RNA参与结核分枝杆菌的生理和病理过程。本文对结核分枝杆菌小RNA在细菌生长繁殖、毒力因子调控、细菌耐药和巨噬细胞内应激环境的适应等方面的作用进行综述。     

Why genetic selection to reduce the prevalence of infectious diseases is way more promising than currently believed

Genetic selection for improved disease resistance is an important part of strategies to combat infectious diseases in agriculture. Quantitative genetic analyses of binary disease status, however, indicate low heritability for most diseases, which restricts the rate of genetic reduction in disease prevalence. Moreover, the common liability threshold model suggests that eradication of an infectious disease via genetic selection is impossible because the observed-scale heritability goes to zero when the prevalence approaches zero. From infectious disease epidemiology, however, we know that eradication of infectious diseases is possible, both in theory and practice, because of positive feedback mechanisms leading to the phenomenon known as herd immunity. The common quantitative genetic models, however, ignore these feedback mechanisms. Here, we integrate quantitative genetic analysis of binary disease status with epidemiological models of transmission, aiming to identify the potential response to selection for reducing the prevalence of endemic infectious diseases. The results show that typical heritability values of binary disease status correspond to a very substantial genetic variation in disease susceptibility among individuals. Moreover, our results show that eradication of infectious diseases by genetic selection is possible in principle. These findings strongly disagree with predictions based on common quantitative genetic models, which ignore the positive feedback effects that occur when reducing the transmission of infectious diseases. Those feedback effects are a specific kind of Indirect Genetic Effects; they contribute substantially to the response to selection and the development of herd immunity (i.e., an effective reproduction ratio less than one).     

环丝氨酸联合莫西沙星治疗耐多药肺结核的疗效及对免疫功能和生活质量的影响

摘要 目的：探讨环丝氨酸联合莫西沙星治疗耐多药肺结核（MDR-TB）的疗效及对免疫功能和生活质量的影响。方法：选取2016年7月到2018年10月期间我院收治的MDR-TB患者86例作为研究对象,根据奇偶排序法将患者分为对照组（n=43,基础治疗联合莫西沙星治疗）和研究组（n=43,对照组基础上联合环丝氨酸治疗）,均治疗20个月。对比两组疗效、痰结核菌转阴率、病灶吸收率、空洞缩小率情况、免疫功能、生活质量及不良反应。结果：研究组治疗20个月后的总有效率高于对照组（P<0.05）。研究组治疗12个月后、治疗20个月后痰结核菌转阴率、病灶吸收率、空洞缩小率均高于对照组（P<0.05）。两组治疗20个月后心理功能、躯体功能、社会功能、物质生活评分均升高,且研究组高于对照组（P<0.05）。两组治疗20个月后CD8⁺较治疗前降低,且研究组低于对照组（P<0.05）,CD3⁺、CD4⁺/CD8⁺、CD4⁺较治疗前升高,且研究组高于对照组（P<0.05）。对比两组不良反应发生率无差异（P>0.05）。结论：环丝氨酸联合莫西沙星治疗MDR-TB,能够有效的促进患者机体免疫功能和生活质量的改善,并能够有效的促进临床转归,且用药安全性较高。     

莫西沙星联合纤维支气管镜药物灌注对耐多药肺结核患者T细胞亚群、肺功能和肝功能的影响

摘要 目的：探讨莫西沙星联合纤维支气管镜药物灌注对耐多药肺结核患者T细胞亚群、肺功能和肝功能的影响。方法：选取2017年2月~2018年12月期间我院收治的90例耐多药肺结核患者,根据随机数字表法分为对照组（n=45,常规基础治疗）和研究组（n=45,莫西沙星联合纤维支气管镜药物灌注）,比较两组患者痰菌转阴率、病灶吸收率、T细胞亚群、肺功能和肝功能。结果：研究组治疗6个月后的痰菌转阴率为88.89%（40/45）,高于对照组的68.89%（31/45）（P<0.05）。研究组治疗6个月后的病灶吸收率为84.44%（38/45）,高于对照组的64.44%（29/45）（P<0.05）。两组治疗6个月后第1 s用力呼气容积（FEV₁）、用力肺活量（FVC）、每分钟最大通气量（MVV）占预计值百分比、总蛋白(TP)、CD4⁺、CD4⁺/CD8⁺均升高,且研究组高于对照组（P<0.05）;丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、CD8⁺均降低,且研究组低于对照组（P<0.05）。结论：莫西沙星联合纤维支气管镜药物灌注治疗耐多药肺结核,可有效阻止疾病进展,同时在改善患者T细胞亚群、肺功能和肝功能方面效果显著。     

6MWT在评价老年肺结核应用及与血气分析相关性

摘要 目的：探究6分钟步行试验（6-minute walk test,6MWT）在评价老年肺结核患者病情中的应用,并分析6MWT同肺结核患者血气指标的相关性。方法：选择2019年1月至2019年12月于我院接受治疗的200例高龄肺结核患者为实验组,另选取同期于我院接受体格检查的50例健康个体为对照组,分别对两组患者实施6MWT实验,测量两组个体的步行距离、实验前后血氧饱和度（SpO₂）,计算SpO₂下降率,并对所有实验组患者实施肺功能实验,评估肺功能相关指标同6MWT相关性。结果：（1）对比显示实验组患者的6MWT、SpO₂、PaO₂明显低于对照组,PaCO₂高于对照组（P<0.05）;（2）实验前后比较显示实验组患者试验后的SpO₂、PaO₂低于实验前,PaCO₂高于实验前（P<0.05）;（3）相关性分析显示,实验组患者的6MWT同FEV1、FEV1/FVC呈正相关（P<0.05）;（4）相关性分析显示实验组患者的6MWT同SpO₂、PaO₂呈正相关,同PaCO₂呈负相关（P<0.05）。结论：6MWT同高龄肺结核患者肺功能及血气相关指标存在明显的相关性,可将6MWT作为老年肺结核患者病情评估指标之一。     

Wolbachia host shifts: routes,mechanisms, constraints and evolutionary consequences

Wolbachia is one of the most abundant endosymbionts on earth, with a wide distribution especially in arthropods. Effective maternal transmission and the induction of various phenotypes in their hosts are two key features of this bacterium. Here, we review our current understanding of another central aspect of Wolbachia's success: their ability to switch from one host species to another. We build on the proposal that Wolbachia host shifts occur in four main steps: (i) physical transfer to a new species; (ii) proliferation within that host; (iii) successful maternal transmission; and (iv) spread within the host species. Host shift can fail at each of these steps, and the likelihood of ultimate success is influenced by many factors. Some stem from traits of Wolbachia (different strains have different abilities for host switching), others on host features such as genetic resemblance (e.g. host shifting is likely to be easier between closely related species), ecological connections (the donor and recipient host need to interact), or the resident microbiota. Host shifts have enabled Wolbachia to reach its enormous current incidence and global distribution among arthropods in an epidemiological process shaped by loss and acquisition events across host species. The ability of Wolbachia to transfer between species also forms the basis of ongoing endeavours to control pests and disease vectors, following artificial introduction into uninfected hosts such as mosquitoes. Throughout, we emphasise the many knowledge gaps in our understanding of Wolbachia host shifts, and question the effectiveness of current methodology to detect these events. We conclude by discussing an apparent paradox: how can Wolbachia maintain its ability to undergo host shifts given that its biology seems dominated by vertical transmission?     

应用GeneXpert MTB/RIF对肺外结核的快速检测及评估

目的评估GeneXpert MTB/RIF检测肺外结核分枝杆菌的准确性,并与传统方法进行比较。方法选取2016年6月至2017年6月在本院就诊的144例疑似肺外结核病患者,对所有标本分别进行金胺“O”荧光染色镜检、液体培养及药敏试验、固体培养及比例法体外药敏试验和Xpert法检测。结果收集的144例疑似肺外结核标本中,确诊108例,以胸水、淋巴结活检和脓液感染较多,另36例阴性患者中,10例为非结核分枝杆菌感染。Xpert试验的敏感性为28.73%,特异性为96.00%,其阳性预测值和阴性预测值均高于其他3种检测方法。在阳性检出率方面,Xpert试验高于涂片镜检(χ~2=17.39,P0.05)、低于液体培养(χ~2=8.64,P0.05),而与固体培养之间差异无统计学意义(χ~2=2.56,P0.05)。固体培养、液体培养和Xpert试验3种方法对结核分枝杆菌利福平耐药率检测差异无统计学意义(P0.05),耐药率分别为8.33%、9.68%和11.11%,且Xpert试验方法检测出2株耐多药结核分枝杆菌,平均耗时2.5 h。结论 GeneXpert MTB/RIF可以作为一种筛选及快速检测工具应用于肺外结核的诊断,同时可作为检测MDR-TB的一种指标。     

Structural insights of PA-824 derivatives: ligand-based 3D-QSAR study and design of novel PA824 derivatives as anti-tubercular agents

Abstract

With the purpose of designing novel chemical entities with improved inhibitory potencies against drug-resistant Mycobacterium tuberculosis, the 3D- quantitative structure–activity relationship (QSAR) studies were carried out on biphenyl analogs of the tuberculosis (TB) drug, PA-824. Anti-mycobacterial activity (MABA) was considered for the 3D-QSAR studies using the comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) approaches. The best CoMFA and CoMSIA models were found statistically significant with cross-validated coefficients (q²) of 0.784 and 0.768, respectively, and conventional coefficients (r²) of 0.823 and 0.981, respectively. The cross-validated and the external validation results revealed that both the CoMFA and CoMSIA models possesses high accommodating capacities and they would be reliable for predicting the pMIC values of new PA-824 derivatives. Based on the models and structural insights, a series of new PA-824 derivatives were designed and the anti-mycobacterial activities of the designed compounds were predicted based on the best 3D-QSAR model. The predicted data results suggest the designed compounds are more potent than existed ones.