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Infectious diarrhea is a gastrointestinal infectious disease caused by a wide range of pathogens and found throughout the world. It is one of the most important public health problems in the world and the second leading cause of death among children under five years of age. The pathogens of infectious diarrhea include viral diarrhea pathogens, bacterial diarrhea pathogens, and parasites. Viruses are the most frequent pathogens, mainly including norovirus, rotavirus, astrovirus and sapovirus. The most frequently identified organisms causing bacterial diarrhea are diarrheagenic Escherichia coli, Salmonella, Shigella, Vibrio parahaemolyticus and Campylobacter. This paper provides an overview of the epidemiological trends and changes in the pathogen spectrum of infectious diarrhea for better understanding the distribution and epidemiological features of infectious diarrhea in China, and hopes to provide reference for developing prevention and control strategies and reducing the disease burden.
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OBJECTIVE： To study the effects of simvastatin combined with rivaroxaban on pharmacokinetics of rivaroxaban in rats. METHODS： Thirty rats were randomly divided into rivaroxaban group （intragastric administration of normal saline+rivaroxaban 2.6 mg/kg）， simvastatin+rivaroxaban group （intragastric administration of simvastatin 5.3 mg/kg+rivaroxaban 2.6 mg/kg）， with 15 rats in each group. The rats were given normal saline/simvastatin intragastrically for 5 d， once a day， and then given intragastric administration of rivaroxaban+normal saline/simvastain once. The blood samples were collected from orbital cavity of rats before medication and 0.25， 0.5， 0.75， 1， 1.5， 2， 4， 8， 12， 24 h after medication. The plasma concentration of rivaroxaban was determined by LC-MS/MS. Plasma concentration-time curves were drawn， and the pharmacokinetic parameters were fitted by DAS 2.1.1 software. RESULTS： The pharmacokinetic parameters of rivaroxaban group and simvastatin+rivaroxaban group in rats included that AUC0-24 h were （2 599.86±791.82） and （2 777.74±989.25） ng·h/mL； AUC0-∞ were （3 053.28± 1 116.06） ng·h/mL and （3 396.78±1 409.80） ng·h/mL； t1/2 were （8.06±3.52） h and （9.25±4.18） h； tmax were（0.65±0.28） h and （0.60±0.13） h； CLZ were （0.95±0.32） L/（h·kg） and （0.88±0.34） L/（h·kg）； Vd were（10.37±4.43） L/kg and （11.07±4.48） L/kg； cmax were （424.93±145.30） ng/mL and （507.15±132.40） ng/mL. Compared with rivaroxaban group， AUC0-24 h， AUC0-∞， t1/2， Vd and cmax of simvastatin+rivaroxaban group increased by 6.40％， 10.11％， 12.86％， 6.32％， 16.21％； tmax and CLZ decreased by 8.33％ and 7.95％. There was no significant difference （P＞0.05）. CONCLUSIONS： There is no significant change in pharmacokinetic parameters of rivaroxaban in rats after combination of simvastatin （5.3 mg/kg） and rivaroxaban （2.6 mg/kg）.
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OBJECTIVE:To study therapeutic efficacy of total hip arthroplasty(THA)combined with Alendronate sodium tablets in the treatment of femoral neck fracture and its effects on bone mineral density(BMD). METHODS:A total of 98 patients with femoral neck fractures in our hospital during 2014-2016 were divided into observation group and control group by random digital table method,with 49 cases in each group. Both groups were treated with THA. 7 days after operation,control group was given routine anti-osteoporosis treatment [Gaierqi D tablets(containing 600 mg calcium/vitamin D3125 IU in each tablet),p.o., one tablet/time,once a day;Calcitriol soft capsules(25 μ g each pill,p.o.,2 pills/time,once a day)]. Observation group was additionally given Alendronate sodium tablets(10 mg/time,once a day)on the basis of control group. Both groups were treated for consecutive 3 months. The hip function excellent rate was evaluated by using Harris scoring system at 7 days,3 months and 6 months after operation. The periprosthetic 7 cases of egion interest(ROI1-7)BMD were detected and compared between 2 groups. RESULTS:The excellent rate of hip joint function in the control group were 16.33%,40.82%,69.39% 7 days,3 months,6 months after operation,respectively;those of observation group were 17.78%,73.33%,88.89% respectively. There was no statistical significance in the excellent rates of hip joint function between 2 groups 7 days after operation(P>0.05). The excellent rate of hip joint function in observation group was higher than control group 3 months and 6 months after operation(P<0.05). There was no significant difference in periprosthetic BMD between 2 groups 7 days after operation(P>0.05). Compared with 7 days after operation,BMD of ROI1,ROI6 and ROI7 in 2 groups were decreased gradually 3 months and 6 months after operation (P<0.05 or P<0.01). BMD of ROI2,ROI3 and ROI5 decreased first and then increased(P<0.05 or P<0.01). There was no significant change in BMD of ROI4(P>0.05). There was no significant difference in BMD of each area between 2 groups 3 months after operation(P>0.05). BMD of ROI1,ROI2,ROI3,ROI5,ROI6 and ROI7 in observation group were significantly higher than control group 6 months after operation(P<0.05 or P<0.01). CONCLUSIONS:THA combined with Alendronate sodium tablets and conventional anti-osteoporosis treatment can improve the excellent rate of hip joint function in patients with femoral neck fracture and the level of periprosthetic BMD.
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Objective To analyze the influential factors of the prognosis of neonatal cholestasis. Methods The data on 106 newborns with neonatal cholestasis collected from January 1, 2009 to June 30, 2016 was collected and analyzed retrospectively. All cases were divided into cure group (99 patients) and improvement group (7 patients) according to the effect of oral ursodeoxycholic acid therapy and comprehensive medical treatment. There was no cure for invalid case. The clinical features, course of disease and curative effect were observed. The levels of total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (γ-GT), total bile acid (TBA) were compared between two groups. The ratio of neonatal bacterial infection, cytomegalovirus (CMV) infection, sex, total intravenous nutrition (more than 7 d), perinatal hypoxia, premature birth, maternal complicated intrahepatic cholestasis of pregnancy (ICP) were compared between two groups. Multiple Logistic regression analysis was used to analyze the prognosis factors of neonatal cholestasis. Results The levels of serum ALT, AST, γ-GT, TB, DB and TBA in improvement group were significantly higher than those in cure group, the course of disease in improvement group was significantly longer than that in cure group, there were significant differences (P<0.05). A strong linear correlation was showed between course of disease and the levels of serum ALT, AST, TB, DB and TBA (tALT=13.050, tAST=14.696, tTB=12.771, tDB=13.776, tTBA=12.019, P < 0.05). Multiple Logistic regression analysis showed that the prognosis of neonatal cholestasis was associated with bacterial infection, CMV infection, total intravenous nutrition (more than 7 d) and premature ( OR=9.375, 7.909, 11.333, 11.333, P < 0.05). Conclusions The higher the level of serum TB, DB, TBA, ALT and AST, the longer the course of the disease. Bacterial infection, CMV infection, total venous nutrition( ≥ 7 d) and premature are the risk factors of the prognosis of neonatal cholestasis. Therefore, prevention of neonatal bacterial and CMV infection, reduction of the occurrence of preterm delivery and reduction of the total parenteral nutrition time are very important to improve the prognosis of neonatal cholestasis.
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Objective To investigate the diversity of gut microbiota and its dynamic changes in very low birth weight infants (VLBWIs) during the first six months after birth.Methods From January to December in 2015,53 VLBWIs admitted to the Neonatal Intensive Care Unit (NICU) were recruited.Stool samples were collected from each subject on day 1,7,14 and 28 after birth as well as on day 180 during a follow-up visit.High-throughput 16S rRNA gene sequencing and bioinformatics analysis of bacterial DNA extracted from stool samples were performed using Illumina MiSeq platform double-end sequencing.Results (1) Phyla level:At all five time points,the dominant phyla were all Proteobacteria,Firmicutes,Bacteroidetes and Actinobacteria.The median relative abundance of Proteobacteria was 0.598 5 (0.122 3～0.942 6) on day 1,then rose to 0.893 2 (0.478 1～0.987 0) after one week,maintained at 0.943 2～0.966 0 within 28 days,and later dropped back to the same level as day 1 on day 180 (all P＜0.05).In contrast,the median relative abundance of Actinobacteria on day 180 was significantly higher than that on days 1,7,14 and 28 (all P＜0.05).(2) Genus level:The relative abundance of Klebsiella increased significantly between days 7 and 28 as compared with the lower level on day 1 [0.326 5～0.368 2 vs 0.003 1(0.000 8～0.026 0),all P＜0.05],but significantly decreased to a lower level on day 180 [0.008 1 (0.000 5～0.067 1)].There was no significant difference in the relative abundance of Escherichia within 14 days after birth.However,it significantly increased since day 28 (P＜0.05) and reached a peak on day 180 (P＜0.05).Infants were born with a certain abundance of Bifidobacterium [0.000 5 (0.000 1～0.004 2)],which remained at a very low level for 28 days before reaching to a higher level of 0.045 1 (0.010 2～0.124 8) on day 180 (P＜0.05).(3)The Shannon index on day 14 and 28 were lower than that of day 1 and day 180 (1.81±0.71,1.89±1.270.56 vs 2.33±1.29,2.2±0.5,all P＜0.05),respectively.Conclusions The diversity of gut microbiota in VLBWIs decreases during NICU hospitalization as compared with that at birth when Proteobacteria and Klebsiella becoming the dominant bacteria.However,the diversity was regained after discharge with the increase of Bifidobacterium,Escherichia and other residential bacteria,which indicates that NICU hospitalization is a risk factor for dysbiosis in VLBWIs.
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Objective To study the effects of Vitamin D (VitD) supplementation on growth and immune function in neonatal mice.Methods A total of 120 mice were divided into four groups (30 mice in each group) according to dose of VitD.The high-dose group,medium-dose group and low-dose group was given 3.44,1.72,0.86 IU VitD drops,respectively.The control group was not treated with VitD drops.Rat body weight,level of peripheral blood 25-(OH)D3 were observed.The cellular immune function (determined by using delayed hypersensitivity reaction experiment),humoral immune function (assessed by antibody producing cells counts and HC50 determination) and mononuclear-macrophage phagocytic function (assessed by mouse peritoneal macrophage phagocytosis of chicken red blood cells test and carbon clearance test) were detected.The flow cytometry assay was carried out to differentiate T lymphocyte subsets.Results With the increase of dose of VitD,levels of peripheral blood 25-(OH)D3 and calcium ion were gradually increased,there were statistically significant differences when compared with the control group(P＜0.05);the body weight and body length were gradually increased,while no statistically significant difference was found among the groups treated with VitD(P＞0.05).Compared to the control group,the toes swelling,phagocytic percentage,number of antibody producing cells,serum soluble HC50 in the high-dose group and medium-dose group were increased significantly,while carbon clearance test phagocytic index were decreased significantly (P＜0.05).With the increase of dose of VitD,the number of CD4+,CD8+ T lymphocytes and the CD4+/CD8+ ratio were gradually increased.Conclusion VitD could promote the growth and development of offspring mice,and enhance the immune function of the body.
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Objective To explore the association between variation in genes related to lipid metabolism and the susceptibility of nonalcoholic fatty liver disease (NAFLD). Methods Obese children with fatty liver aged 6~18 years old were included. All of them got ultrasonic testing, routine examination and biochemical detection. In addition, the DNA of peripheral blood was extracted and the 36 target genes related to lipid metabolism were detected by next generation sequencing. Results In 368 obese children who met the inclusion criteria, 183 children (49.7%) were detected to have NAFL . 100 children with NAFLD and 100 children without NAFLD were randomly selected from obese children. The levels of body mass, waistline, alanine aminotransferase (ALT), triacylglycerol (TG), cholesterol, low density lipoprotein (LDL) and apolipoprotein B (ApoB) in NAFLD children were all higher than those in non-NAFLD children, and there were significant differences (P all0.05). The levels of bilirubine in the two groups were within normal range. Logistic regression analysis showed that the genes of MTTP rs2306986 (OR=2.70, 95%CI: 1.38~5.27) and MTTP rs3792683 (OR=7.34, 95%CI: 2.04~26.50) that encode microsomal triglyceride transfer protein (MTTP or MTP), and the mutation of rs738409 (OR=2.11, 95%CI:1.31~4.48) in gene PNPLA3 that encode patatin-like phospholipase domain-containing protein 3 are the independent risk factors for the occurrence of the disease. Conclusion Genovariation of MTTP rs2306986, MTTP rs3792683, and PNPLA3 rs738409 may increase susceptibility to NAFLD in children.
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<p><b>OBJECTIVE</b>To screen for mutations of NTRK1 gene in a Chinese family affected with congenital insensitivity to pain with anhidrosis (CIPA).</p><p><b>METHODS</b>Genomic DNA was extracted from the proband and her family members. All of the 17 exons and intron-exon boundaries of the NTRK1 gene were analyzed by direct Sanger sequencing. For the deletional mutation, the PCR products were subjected to T-A cloning and sequencing to verify the mutation.</p><p><b>RESULTS</b>NTRK1 gene analysis revealed that proband has carried a c.1786C>T (p.Arg596*) nonsense mutation inherited from her mother and a novel deletional mutation c.1928-2028+23del from her father. Her elder brother only carried the deletional mutation.</p><p><b>CONCLUSION</b>The diagnosis of CIPA relied on typical clinical symptoms of no pain, anhidrosis and intellectual disability and detection of the biallelic NTRK1 mutations. The novel deletional mutation has enriched the spectrum of NTRK1 mutations.</p>
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Child, Preschool , Female , Humans , DNA Mutational Analysis , Exons , Hereditary Sensory and Autonomic Neuropathies , Diagnosis , Genetics , Mutation , Receptor, trkA , GeneticsABSTRACT
Objective Application of PDCA method to improve the coincidence rate of emergency inspection report time.Methods 472 cases of emergency inspection report returns the fraction defective of the time from September to December 2014 (blood routine,blood biochemistry,blood coagulation,cerebrospinal fluid,urine analysis).Analyzing the reason and take measures to improve the emergency inspection report time coincidence rate.At the same time,counted 654 cases of emergency inspection report returns the fraction defective of the time after the improvement from July to November 2015,and compared and analyzed the coincidence rate before and after the improvement measures.Results Emergency inspection report of the total fraction defective return time decreased from 13.9 ％ to 4.9 ％ by taking measures.Blood coagulation,blood biochemistry,urine analysis,routine blood,cerebrospinal fluid and urine analysis of emergency return time unqualified rate decreased from 18.2 ％,16.2 ％,10.3 ％,6.75 ％ and 9.1％ to 5.2 ％,5.0 ％,6.4％,5.0 ％ and 3.9 ％ respectively.Conclusion The application of PDCA could improve the time coincidence rate of emergency department,and to finish the emergency detection and report detection results in the shortest possible time.
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Objective To explore the clinical characteristics,treatment and prognosis of neonatal group B streptococcus (GBS) sepsis.Methods According to the onset time and clinical features of the patients,30 cases of neonatal GBS sepsis in Department of Noonatology,Zhuhai People's Hospital and ICU of Newborn of Maternity and Child Care Health Hospital of Guangxi from January 2013 to February 2015 were divided into the early-onset group (onset day of the patients ≤7 days) and late-onset group (onset day of the patients ＞7 days).The clinical manifestations,the examination results of laboratory,imaging examination,treatment and prognosis were retrospectively analyzed.Results Among the newborns diagnosed as neonatal GBS sepsis,there were 19 cases of early-onset sepsis and 11 cases of late-onset sepsis,including 17 males and 13 females,consisting of 24 term infants and 6 premature infants.The early-onset newborns were mainly diagnosed with respiratory symptoms like anhelation,groaning (73.7％,14/19 cases),late-onset GBS sepsis with high fever (81.8％,9/11 cases),high frequency of early-onset intrauterine infection pneumonia (89.5％,17/19 cases) and late-onset intracranial infection (63.6％,7/11 cases).The differences between the 2 groups were statistically significant (all P ＜ 0.05).Laboratory tests of GBS sepsis showed that the early value of procalcitonin (PCT) increased,while the number of white blood cells,platelet decreased and C-reactive protein (CRP) increased relatively late.Chest X-ray examination showed 16 cases of pneumonia in children,1 case of pulmonary hemorrhage,1 case of bilateral pneumothorax.Head CT,B ultrasound,and magnetic resonance imaging discover 1 case of ventricular perivascular hemorrhnge,2 cases of intraventricular hemorrhage with ventricular dilatation and 1 case of subdural effusion.Drug sensitivity test showed that 30 cases of children were sensitive to Penicillin,Vanoomycin among which 17 cases (56.66％) were cured,4 cases (23.33％) were improved,9 cases died,6 cases died of abandoning treatment,and the total mortality was 30.00％ (9/30 cases).The 6-month follow-up of 9 cases of purulent meningitis newborns showed that there were 2 cases of mild mental retardation and motor dysfunction,1 case of mild ventricular dilatation with no progressive increase,and 6 cases with no significant sequelae.Conclusion The clinical manifestations of neonatal GBS sepsis are typical.Dynamically monitoring the changes of PCT,CRP,white blood cells and platelet helps to early identify GBS sepsis infection and use sensitive antibiotics to cure the newborns.