COL4A5 genotypes and clinical characteristics of children with Alport syndrome / 中国当代儿科杂志

OBJECTIVES@#To investigate the genotypes of the pathogenic gene COL4A5 and the characteristics of clinical phenotypes in children with Alport syndrome (AS).@*METHODS@#A retrospective analysis was performed for the genetic testing results and clinical data of 19 AS children with COL4A5 gene mutations.@*RESULTS@#Among the 19 children with AS caused by COL4A5 gene mutations, 1 (5%) carried a new mutation of the COL4A5 gene, i.e., c.3372A>G(p.P1124=) and presented with AS coexisting with IgA vasculitis nephritis; 3 children (16%) had large fragment deletion of the COL4A5 gene, among whom 2 children (case 7 had a new mutation site of loss51-53) had gross hematuria and albuminuria at the onset, and 1 child (case 13 had a new mutation site of loss3-53) only had microscopic hematuria, while the other 15 children (79%) had common clinical phenotypes of AS, among whom 7 carried new mutations of the COL4A5 gene. Among all 19 children, 3 children (16%) who carried COL4A5 gene mutations also had COL4A4 gene mutations, and 1 child (5%) had COL4A3 gene mutations. Among these children with double gene mutations, 2 had gross hematuria and proteinuria at the onset.@*CONCLUSIONS@#This study expands the genotype and phenotype spectrums of the pathogenic gene COL4A5 for AS. Children with large fragment deletion of the COL4A5 gene or double gene mutations of COL4A5 with COL4A3 or COL4A4 tend to have more serious clinical manifestations.

Clinicopathological and therapeutic analysis of Castleman's disease in children / 中华儿科杂志

Objective: To investigate the clinical features, pathological phenotype, treatment and prognosis of Castleman's disease in children. Methods: Clinical data of 15 children diagnosed with Castleman's disease in Henan Provincial People's Hospital and the First Affiliated Hospital of Zhengzhou University from May 2010 to October 2019 were analyzed retrospectively. The clinical characteristics, laboratory examination and histopathological data were analyzed. Results: Among the 15 Castleman's disease patients, 12 were males and 3 females. The age of first visit was 12 (10, 15) years. The time from mass discovery to pathologic diagnosis was 9.0 (2.0, 13.0) months. The majority of patients were unicentric (13 cases), and the histopathological type was hyaline vascular (11 cases). Unicentric lesions were most common in the neck (11 cases), all 13 patients received complete surgical resection of the lesions, the follow-up time was 20.0 (13.5, 50.5) months, and the prognosis was good. Two cases were multicentric type, the pathological types were mixed variant, meeting the criteria of idiopathic Castleman's disease, the two children underwent partial surgical resection, one was treated with rituximab and prednisone and the other was treated with thalidomide and prednisone. The follow-up time was 32 months and 10 month, both of them had good prognosis. Conclusions: Most cases of Castleman's disease in children are diagnosed late, and the unicentric type is dominant. The most common pathological type is hyaline vascular, which is characterized by painless lymphadenopathy, while multicentric type has systemic symptoms and both of them have a good overall prognosis.

Efficacy of pegylated-interferon alpha-2a treatment in patients with HBeAg-positive chronic hepatitis B and partial viral response to nucleoside analogue therapy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and related factors of pegylated-interferon alpha-2a (PEG-IFN-2a) treatment in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) who achieved partial viral response with nucleoside analogue (NA) therapy.</p><p><b>METHODS</b>Patients with HBeAg-positive CHB and partial viral response to NA treatment were administered a PEG-IFN-2a therapy regimen of 180 g subcutaneous injection once weekly for a personlized duration of time. The existing NA therapy was continued in combination with the new PEG-IFN-2a treatment for 12 weeks. Measurements of serum HBV DNA load, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HBeAg and hepatitis B e antibody (anti-HBe) were taken at baseline (prior to addition of the PEG-IFN-2a therapy) and every 3 months afterwards.For determining response to treatment, primary efficacy was defined as undetectable HBsAg and seroconversion, and secondary efficacy was defined as HBsAg less than 10 IU/mL and HBeAg seroconversion.Statistical analysis was carried out using SPSS statistical software.</p><p><b>RESULTS</b>A total of 81 consecutive patients with an average of 12.0 months (range: 6.0-24.0 months) of NA therapy were included in the study and received an average of 19.6 months (range: 15.5-33.3 months) of PEG-IFN-2a treatment. At the end of PEG-IFN-2a therapy, 7 (8.6%) of the patients achieved undetectable HBsAg and seroconversion, and 14 (17.3%) showed HBsAg less than 10IU/mL. In addition, 40.7% achieved undetectable HBeAg and seroconversion, a rate that was slightly higher than that (38.3%) seen in treatment-naive patients who received PEG-IFN-2a. Statistical analyses suggest that baseline level of HBsAg at less than 1500 IU/mL may predict end of PEG-IFN-2a treatment response for HBsAg less than 10 IU/mL, as evidenced by the area under the curve measure of 0.747, sensitivity measure of 87.3%, specificity measure of 33.3%, positive predictive value of 82.1% and negative predictive value of 42.8%.</p><p><b>CONCLUSION</b>Patients with HBeAg-positive CHB and partial viral response to NA therapy can achieve undetectable HBsAg and HBeAg seroconversion after switching to PEG-IFN-2a treatment. Baseline HBsAg level may be predictive of response to this therapeutic strategy.</p>

Finite element analysis of Tuina manipulation on three-dimensional displacement of lumbar intervertebral disc protrusion / 医用生物力学

Objective To study the mechanisms of vertebrae semi-dislocation of Tuina manipulation for treating patients with lumbar intervertebral disc protrusion (LIDP) by observing the three-dimensional (3D) displacement of lumbar before and after Tuina manipulation. Methods Ten LIDP patients were selected and evenly divided into two groups: Group 1 as tendon-smoothing manipulation group (relaxing group), Group 2 as tendon-smoothing plus adjusting manipulation group (adjusting group). Besides, Group 3 as control group was established by 5 healthy volunteers treated with tendon-smoothing manipulation. Before and after manipulation intervention, all subjects were scanned from L1 to L5 segment by using Philips 64 spiral CT under equal conditions for accessing the volume data. ITK reconstruction software was used to reconstruct each lumbar skeleton for finite element analysis. The 3D displacements and angular displacements among three groups were compared. Results 3D displacement from L1 to L5 segment all changed in three groups. For adjusting group, the angular displacements at X-axis in L3 segment was (1.77±0.46)°, and that in L4 segment at X-axis and Y-axis was (1.78±0.53)° and (1.89±0.75)°, respectively, which was significantly larger than relaxing group and control group (P<0.05); the angular displacements at X-axis from L1 to L5 segment were (1.50±0.47)°, (1.55±0.57)°, (1.77±0.46)°, (1.78±0.53)°, (1.61±0.39)°, respectively, which were significantly larger than control group (P<0.05); displacement at Y-axis in L3 segment was (2.87±0.74) mm, and that at X-axis in L4 segment was (1.68±0.64) mm, which were significantly larger than relaxing group and control group (P<0.05); displacement at X-axis in L1, L4 and L5 segment was (1.28±0.21),（1.68±0.64）, (1.30±0.51） mm, and that at Y-axis in L1 to L3 segment was (1.92±0.42), (2.25±0.61), (2.87±0.74) mm, which was significantly larger than control group (P<0.05). The angular displacements and displacements of L1 to L5 segment in relaxing group were larger than those in control group, but without any significant differences. Conclusions Compared with relaxing manipulation, adjusting manipulation played a more obvious adjusting role in instability and degenerative lumbar vertebra, especially for angular displacements in X-axis, and displacements in X-axis and Y-axis. Namely, the mechanisms of vertebrae semi-dislocation of adjusting manipulation were to make horizontal and rotational displacements at lumbar vertebra other than upper and lower displacement. The effect of relaxing manipulation was not so obvious on lumbar structure of LIDP patients.

The correlation study of HBV serological index in neonate's venus, cord blood and mother's venus blood / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>In this study, we discussed the consistency and correlation of HBV serological indexes between neonates' venous blood and cord blood whose mothers had chronical HBV infection, as well as the correlation of thoses indexes with the mothers'.</p><p><b>METHOD</b>Chronically HBV infected mothers who were postive of both HBsAg and HBeAg and also had a HBV DNA virus load above 10(5) copies/ ml and their infants were enrolled. The mothers' venous blood were collected before delivery. The neonates' cord blood were collected at birth after removal of contaminants and disinfected with alcohol on the cord's surface, and the venous blood were collected before hepatitis B virus immune globin(HBIG) and hepatitis B vaccine were given. The levels of HBsAg, anti-HBs, HBeAg and anti-HBeAg were tested with Abbott microparticle chemiluminescence method (Abbott Laboratories, Abbott Architac i2000). HBV DNA quantification were tested by COBAS TagMan real-time PCR Assay.</p><p><b>RESULTS</b>383 mothers and their infants were enrolled. The positive rates of HBsAg in cord blood and venous blood were 61.2% and 63.9%. The positive rates of HBeAg level in cord blood and venous blood were 83.2% and 83.5%. The positive rates of HBV DNA level in cord blood and venous blood were 56.0% and 59.4%. The state of HBsAg, HBeAg and HBV DNA in cord blood and venous blood were consistency, and significant correlation was observed in their levels with correlation coefficients of 0.766, 0.857, and 0.692, respectively (P < 0.000). Significant correlation of the HBeAg levels were observed between mothers' venous blood and neonates' venous blood, as well as neonates' cord blood with correlation coefficients of 0.362 and 0.352 (P < 0.000). However, there was no significant correlation of HBsAg levels between them (r = 0.023, P = 0.785; r = 0.04, P = 0.604).</p><p><b>CONCLUSIONS</b>The HBV serological index of neonate's cord blood could reflect the HBV serological indexes in venous blood because of the good correlation and consistency between them.</p>

Practice on the case-based teaching innovation of Science of Meridians, Collaterals and Acupoints / 中国针灸

The case-based teaching method which is applied to the teaching of Science of Meridians, Collaterals and Acupoints is discussed in this paper, in which the typical cases such as the growth of the acupuncture-moxibustion eminent physicians, the application of acupoints by the eminent physicians and the experiences in the acupoint combination are integrated. The students are instructed to launch the clinical practical activity through establishing the clinical base of Science of Meridians, Collaterals and Acupoints, in association with the true cases. It is proved that the case-based teaching method can promote the training of the manipulation techniques of the students and the inheritance of the experiences of eminent physicians in higher education.

The relationship of serum HBsAg, HBeAg concentration and HBV-DNA load in chronic hepatitis B during IFN treatment / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relation of serum HBsAg, HBeAg contents and HBV-DNA load changes in HBeAg-positive chronic hepatitis B during IFN-alpha treatment.</p><p><b>METHODS</b>After enrolled, the patients were treated with 3MU-5MU IFN subcutaneous injection every two days, and their serum was collected before treatment and every 3 months during the treatment course. The serum HBV-DNA load was determined by real-time fluorescence quantitative PCR method kit (lower detection limit 500 copies/ml, Piji company, Shenzhen city, China,) according to production instruction, and HBeAg and HBsAg contents were detected by ARCHITECH I 2000.chemiluminescent kit. The relation of serum HBV-DNA, HBeAg and HBsAg content was analyzed by SPSS statistic software.</p><p><b>RESULTS</b>There were 228 patients enrolled into this group, male 162 cases, female 66 cases, aged 14-60 years, average 30.94 years old. After IFN treatment the HBV-DNA, HBeAg and HBsAg levels were all gradually decreased. But there was no relation of HBsAg content to HBV DNA and HBeAg content before and during treatment course(P > 0.05). However the serum HBeAg content was related to HBV-DNA content significantly (P < 0.05) and their changes was correspondence.</p><p><b>CONCLUSION</b>Before and during treatment of interferon, HBeAg and HBV-DNA content changes are closely related, while there is no significant correlation between HBsAg and HBeAg and HBV-DNA content. During interferon therapy, HBsAg, HBeAg, HBV-DNA contents should be detected together.</p>

Influence of Operative Stress on Serum Levels of Adrenocorticotrophic Hormone,Cortisol,Atrial Natriuetic Peptide,and Interleukin-6 in Children with Abdominal Neoplasms after Operation / 实用儿科临床杂志

Objective To investigate the regularity and clinical significance of cortisol(Cor),adrenocorticotrophic hormone(ACTH),atrial natriuetic peptide(ANP) and interleukin-6(IL-6) changes before and after operation stress.Methods The ACTH,Cor,ANP and IL-6 levels in 18 children with abdominal neoplasms(12 male and 6 female,8 cases with sacrococcygeal teratoma,5 cases with hepatoblastoma,and 5 cases with nephroblastoma) were measured before and after operation(24 hours before operation;4,24,48,and 72 hours after operation).Eighteen children were divided into the study group and the control group.The children in the former group were accompanied with stress ulcer,intestinal obstruction and infection shock or even death after operations,while the children in the later group recovered without any complication.The ACTH,Cor,ANP in serum were measured by radioactive immune analysis(RIA) assay,and serum IL-6 level were measured by enzyme linked immunosorbent assay(ELISA).Results In 2 groups,serum levels of ACTH,Cor,ANP,IL-6 increased significantly 4 h after operation.The changes in ACTH and ANP were similar in 2 groups.Cor in the control group reached its peak 24 h after operation,and then decreased gradually to the pre-operation levels 72 h after operation;IL-6 reached its peak 4 h after operation,and then decreased slowly.It was still at a high level in 48 h after operation,and then decreased to pre-operation levels 72 h after operation.But serum Cor,IL-6 in the study group slightly increased 24 h after operation,and were apparently higher than those in the control group(Pa

Pathogenicity of fungi isolated from American ginseng seeds and bioassay of fungicides against the pathogenic fungi / 中国中药杂志

<p><b>OBJECTIVE</b>Detect the pathogenicity of fungi isolated from American ginseng seeds and select new fungicides against the pathogenic seed-born fungi.</p><p><b>METHOD</b>inoculate the isolates to American ginseng seedlings to detect the pathogenicity, and seeded the hyphae disk at the center of agar plate containing chemicals to do fungicide bioassay.</p><p><b>RESULT</b>Fusarium sp. isolate 5 and Alternara sp. isolate 13 had pathogenicity to American ginseng seedling. Sportak had the strongest inhibition to the two isolates, Carbendazim had better inhibition and Celest had weak inhibition.</p><p><b>CONCLUSION</b>Sportak and Celest could be used as efficacious candidate chemicals to treat or coat the American ginseng seeds, and substitute Carbendazim, which has been used for many years, to control the diseases occurring in seedling stage of American ginseng.</p>

Fungal detection of American ginseng seeds from Beijing and northeast area in China / 中国中药杂志

<p><b>OBJECTIVE</b>The quantity and genus of fungi on 13 samples of American ginseng seed from Beijing and Northeast area in China were detected.</p><p><b>METHOD</b>Washing and surface sterilization were used to isolate the fungi existed on seed surface and inside of the seed, respectively.</p><p><b>RESULT</b>The genera of the fungi in embryo and shell of the seeds mainly belonged to Fusarium spp., Alternaria spp., Penicilium spp., Cephalosporium sp., Rhizopus spp., and a small quantity of Mucor, Aspergillus, Tritroderma, Doratomyces and so on. The isolated fungal frequencies on the shell and in the embryo were 36%-100% and 40%-100% respectively.</p><p><b>CONCLUSION</b>The fungal frequency of American ginseng seed was higher. There were significant differences among different seed samples, the main fungal genera and isolation frequency in the seed embryo were identical with the results from the seed shell.</p>

Expression of Stromal Cell-Derived Factor-1,Chemokine Receptor 4 and Vascular Endotheliar Growth Factor in Children with Wilms Tumor / 实用儿科临床杂志

ObjectiveTo investigate the role of vascular endotheliar growth factor(VEGF),chemokine receptor 4(CXCR4) and stromal cell-derived factor-1(SDF-1) in Wilms tumor as well as their relationship with clinical features by examining the expressions of VEGF,CXCR4 and SDF-1.MethodsThirty cases of Wilms tumor samples and 12 cases of adjacent kidney tissue were collected from the First and the Third Affiliated Hospital of Zhengzhou University from May 2003 to May 2008.Thirteen boys and 17 girls aging from 4 months to 7 years old of whom were 22 favorable histologic types and 8 unfavorable histologic types.By means of cytoplasm to dye buffy for masculine cell,staining intensity and percentage of positive tumor cells serve as the judgment criteria for being positive or negative.All tissues would be tested by hematoxylin and eosin stain at the same time.ResultsThe positive expression rate of VEGF,CXCR4 and SDF-1 in Wilms tumor were 63.33%,70.0% and 53.33%.Those in adjacent normal kidney tissue were 25.0%,8.3% and 16.7%.The 2 groups were statistically significant(Pa