Clinical features of liver function and coagulation function in patients with Alongshan virus infection / 临床肝胆病杂志

ObjectiveTo investigate the clinical features of liver function and coagulation function in patients with Alongshan virus (ALSV) infection. MethodsClinical data were collected from 27 patients with ALSV infection who were admitted to Inner Mongolia General Forestry Hospital from May 2018 to September 2019, among whom there were 18 male patients and 9 female patients. Related data were extracted, and a database of relevant case reports was established. The descriptive epidemiological method was used to analyze the clinical features of liver function and coagulation markers, and the features of liver injury caused by ALSV infection were analyzed. ResultsFor the 27 patients, the abnormal rates of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), cholinesterase, and total bile acid were 25.9%, 33.3%, 25.9%, 40.7%, 8%, and 8%, respectively; among the 27 patients, 4 (14.8%) had an ALT level of ＞2×upper limit of normal (ULN), 3 (11.1%) had an AST level of ＞2×ULN, 1 (3.7%) had an ALP level of ＞2×ULN, and 5 (18.5%) had a GGT level of ＞2×ULN. Among the 27 patients, 25 (17 male patients and 8 female patients) had the results of bilirubin test, among whom 1 had a reduction in total bilirubin (TBil) (3.30 μmol/L) and 3 had an increase in TBil (23.7 μmol/L, 26.2 μmol/L, and 32 μmol/L, respectively). The abnormal rates of the coagulation markers international normalized ratio, activated partial thromboplastin time, and fibrinogen were 3.7%, 11.1%, and 22.2%, respectively. ConclusionThere is a certain degree of liver injury in patients with ALSV infection, generally with mild symptoms.

Theclinicopathologicalfeaturesand MRImanifestationsofuterinespecialleiomyoma / 实用放射学杂志

Objective ToexploretheclinicopathologicalfeaturesandMRImanifestationsofseveralspecialtypesofuterineleiomyomato improvethediagnosticlevelofit.Methods TheclinicopathologicalfeaturesandMRImanifestationsof18caseswithuterineleiomyomathatwere verifiedbypathologicanalysiswereanalyzedretrospectively.Results Amongthe18cases,therewere11casesofcellularleiomyoma,5casesof fattyleiomyomaand2casesofintravenousleiomyoma.Thetumorswereroundorirregular,withaclearmarginandamaximumdiameterof3.2cm to12.5cm.CellularleiomyomashowedisointensityonT1WI,homogeneouslyorslightlyhyperintensityonT2WI,and mostofthem werehyperintenseonDWI,whileafewisointense.Thelesionshowedearlyobviousenhancementandcontinuedtostrengthen,higher thanthemyometriumofthesameperiod.Fattyleiomyomaconsistsofsmooth musclecellsandadipocytesindifferentproportions, smoothmuscletissueshowedisointensityonT1WI,andisointensityorslightlyhyperintensityonT2WI,whileadiposetissueshowed hyperintensityonT1WIandT2WI,hypointensityonfatsequence,lighttomoderateenhancementforsmooth muscletissueandadiposetissue ntravenousleiomyomashowedirregularcircuity,shuttlesolidlumpin myometriumorneartheuterus,whichshowedisointenseon T1WI,andunevenorhyperintensityonT2WI,moderateheterogeneousenhancement,multiplecircuityvesselswithinoraroundthelesions.Allthe threetypesofuterineleiomyomaabovehavecertainMRIfeaturesandareassociatedwithpathology.Conclusion TheMRIfindingsof thecell-richleiomyomashowthattheedgeofthetumorisclear,ofwhichshowhyperintensityonDWI,andearlyandcontinuousenhancement, whilethedegreeofenhancementishigherthanthatinthemyometriumofuterusatthesameperiod.MRIofuterineadiposeleiomyomashows"whirlpool"or "braided"distributionoffatsignalinthetumor,andnoenhancementinadiposetissue;MRIofvenousleiomyoma showsirregulartwistsandturnsbetweenthewallofuterusorbesidetheuterus,andmoderateorunevenintensificationafterenhancement. withoutI.

Distribution characteristics and drug resistance of carbapenem-resistant Enterobacteriaceae in chil-dren from 2016 to 2017 / 中华微生物学和免疫学杂志

Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7％ and among them, 13. 5％ were isolated in neonatal group and 5. 8％ in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7％ vs 5. 7％). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0％), 667 strains of Escherichia coli (22. 0％), 206 strains of Enterobacter cloacae (7. 0％), 56 strains of Klebsiella aerogenes (1. 8％) and 47 strains of Serratia marcescens (1. 5％). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8％ and 19. 7％, respectively. Respiratory tract (61. 8％), urine (19. 4％) and blood (5. 7％) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6％-100％), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7％) and fos-fomycin (11. 9％), fluoroquinolones such as levofloxacin (37. 7％) and ciprofloxacin (43. 3％), and tige-cycline (3. 8％). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.

Streptococcal toxic shock syndrome in children: one case report and literature review / 中国感染与化疗杂志

Objective To investigate the clinical manifestations, treatment and prognosis of streptococcal toxic shock syndrome (STSS) in children. Methods One case of STSS was reported in a child who was admitted to Children's Hospital of Fudan University. Search terms such as "streptococcal toxic shock syndrome", "children" and "case report" were used to identify relevant reports from PubMed database, as well as Chinese databases including Chongqing VIP, Wanfang, and China National Knowledge Infrastructure for further review. Results The patient in this report was a 11-year-old female. The main clinical manifestations were fever, red, swelling, and pain in the right lower extremity, associated with impaired walking and hypotension. Imaging examination suggested diffuse abnormal signals in the soft tissue of right thigh. Group A Streptococcus (namely Streptococcus pyogenes) was isolated from the puncture fluid. The patient was improved after active shock-correcting and anti-infective treatment. A total of 6 STSS cases were identified from Chinese databases between January 1, 1996 and May 1, 2017. All the 7 cases (including this one, 4 males and 3 females, 15 months to 13 years of age) reported fever and skin rashes, and rapidly progressed to shock. Respiratory failure was reported in 4 cases and supported with a ventilator. Three patients died, including 2 within 24 hours after hospitaladmission. A total of 38 STSS cases (40 days to 18 years of age) were identified from PubMed database. The main clinical manifestations of these cases were respiratory tract or digestive tract symptoms, and skin and soft tissue infection. In addition, chickenpox was found in 3 cases, Kawasaki disease in 2 cases, neonatal bullous impetigo, pancreatitis, infectious mononucleosis, and lymphohistiocytosis in one case each. Of the 38 patients, 22 survived and 16 died. Conclusions STSS is a rare and severe form of invasive streptococcal infection in children. The early manifestations are not specific, which may be mistaken for upper respiratory tract infection, gastrointestinal dysfunction symptoms, skin and soft tissue infection, or muscle and joint disorder, or even similar to or associated with Kawasaki disease. But rapid progression to shock and multiple organ failure of STSS pose a serious threat to children. Pediatricians should keep alert on STSS. Early identification, timely diagnosis, and adequate treatment are key to improving patient outcome.

Report of antimicrobial resistance surveillance program in Chinese children in 2016 / 中华儿科杂志

Objective@#To analyze the antimicrobial resistance profile in Chinese children.@*Methods@#This was a prevalence survey. From January 1 through December 31, 2016, the isolates were collected from 10 tertiary children hospitals in China. Antimicrobial susceptibility testing was carried out by routine laboratory methods. The penicillin susceptibility of streptococcus pneumonia and Meropenem susceptibility of gram-negative bacteria were detected by E-test and disk diffusion method respectively. Antimicrobial susceptibility results were interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) Guideline 2016. The data of antimicrobial susceptibility testing of isolates from either the different patients (neonatal group and non-neonatal group) or various sources were analyzed by WHONET 5.6 software.@*Results@#A total of 56 241 isolates were collected, of which 41.5% (23 328 isolates) were gram-positive organisms and 58.5% (32 886 isolates) gram-negative organisms. The five leading pathogens were Escherichia coli (7 995/56 214, 14.2%), Straphylococcus aureus (6 468/56 214, 11.5%), Streptococcus pneumonia (6 225/56 214, 11.1%), Haemophilus influenza (5 435/56 214, 9.7%) and Klebsiella pneumonia (4 523/56 214, 8.0%). The Meropenem resistance rates of Klebsiella pneumonia, Enterobacter cloacae, Escherichia coil, Pseudomonas aeruginosa, Acinetobacter baumonia isolates were 27.4% (326/1 189) , 8.1% (29/358) , 2.0% (27/1 362) , 19.5% (34/174) , 49.7% (230/463) in neonatal group and 15.4% (512/3 327) , 4.8% (40/841) , 2.3% (151/6 564) , 13.7% (252/1 840) , and 53.4% (860/1 611) in non-neonatal group. The Methicillin-resistant Staphylococcus aureus (MRSA) rates of neonatal group and non-neonatal group were 46.2% (649/1 404) and 33.3% (1 668/5 010) . The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 17.6% (6/34) and 18.2% (1 121/6 158) respectively. The β-lactamase positive rates of Haemophilus pneumonia isolates in the neonatal group and non-neonatal groups were 33.8% (47/139) and 44.4% (2 345/5 282) respectively.@*Conclusion@#This investigation highlights the worrisome trend of antimicrobial resistance in children, especially among neonatal patients in China.

No inhalation in combination with high frequency ventilation treatment in the treatment of neonatal severe respiratory failure

Objective: To discuss over NO inhalation [iNO] in combination with high frequency ventilation treatment in relieving clinical symptoms and respiratory state of patients with neonatal severe respiratory failure

Methods:Ninety newborns with severe respiratory failure who received treatment in our hospital were selected for this study. They were divided into research group and control group according to visiting time. Patients in the control group were given conventional treatment in combination with high-frequency oscillatory ventilation, while patients in the research group were given iNO for treatment additionally besides the treatment the same as the control group. Changes of respiratory function indexes and arterial blood gas indexes of patients in the two groups were compared. Mechanical ventilation time, time of oxygen therapy and the length of hospital stay were recorded. Besides, postoperative outcome and the incidence of complications were analyzed

Results:After treatment, the level of PaO[2] of both groups significantly improved, and respiratory function indexes such as partial pressure of carbon dioxide in artery [PaCO2], oxygenation index [OI], fraction of inspiration O[2] [FiO[2]] and mean arterial pressure [MAP] decreased [P<0.05]; the improvement of various indexes of the research group was more obvious than that of the control group [P<0.05]. Mechanical ventilation time, oxygen therapy time and the length of hospital stay of the research group was much shorter than those of the control group. The incidence of complications in the two groups had no statistically significant difference [P>0.05], but the clinical outcome of the research group was better than that of the control group

Conclusion:NO inhalation in combination with high frequency ventilation for treating neonatal severe respiratory failure is effective in improving blood gas index and respiratory function, enhance cure rate, and reduce the incidence of complications and mortality; hence it is safe and effective and worth clinical promotion

Analysis on clinical and epidemioloical characteristics of measles in hospitalized children in Shanghai in 2012 / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles.</p><p><b>METHOD</b>A retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR (RT-PCR) was adopted to detect sputum specimens from suspected patients with measles,who were selected randomly,the sequence of the part of the PCR products was analyzed.</p><p><b>RESULT</b>(1) Clinical and epidemiological data: Totally were 182 children with measles (125 males, 57 females) were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months (69. 8%). The prevalence season was from April to August, while the peak month was April and May (22. 5%, 23. 1%). Among 182 hospitalized children, only 11 cases underwent measles vaccination (6. 0%), and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases (91. 8%) had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population (8. 45%, 6/71) and the settled children (29.4%, 5/17, χ =8. 11 P =0. 004). In total, 24 cases (13. 2%) had definite measles exposure history, with 153 cases (84. 1%) of unknown origin,5 cases (2.7%) without any history of contact. (2) Clinical manifestations: All the 182 patients had fever (100%) and obvious rashes (100%), among them 145 cases had body temperature higher than 39 °C (79. 7%). The fever period ranged from 2 to 38 days. Among 182 hospitalized children,165 cases (90. 7%) had typical measles,17 cases had atypical measles. Among the 17 cases, two had severe measles, one had heterotypic measles. (3) The common complica tions: 96 cases had pneumonia (52. 8%), 80 had laryngitis (44. 0%), 38 had bronchitis (20. 9%),15 had hepatic dysfunction (8. 2%), 11 had myocardial damage (6. 0%), 3 had febrile seizures (1. 6%), and no patient had encephalitis. Of the 96 cases with pneumonia, 92 received sputum test; 38 were sputum culture positive (41%). The dominant pathogens were Streptococcus pneumoniae(11/38,29%), Haemophilus influenzae (6/ 38,16%), Moraxella catarrhalis (4/38, 11%), Escherichia coli (4/38, 11%), Candida albicans (4/38, 11%), Mycoplasma pneumoniae (4/38, 11%) and Staphylococcus aureus (3/38, 8%). (4) The H1a genotype was the only one genotype in the detected sequence of 54 measles virus strains.</p><p><b>CONCLUSION</b>Measles was more often seen in the children under the age of 9 months from the floating population. The morbidity peak month was from April to May in Shanghai. The H1a genotype was the only one genotype. We should try to improve vaccination coverage rate in the children who are at the age for vaccination, so as to prevent measles outbreak.</p>

The neuroprotective effect of Bax-inhibiting peptide on neonatal rats with hypoxic-ischemic brain damage / 临床儿科杂志

Objective To observe the expression of neuron specific enolase (NEC) to evaluate the neuroprotective effect of a cell-penetrating Bax-inhibiting peptide (BIP) on neonatal rats with hypoxic-ischemic brain damage (HIBD). Methods Wi-star rats (7-day old) were randomly divided into Sham group, BIP group and HIBD group. After modeling HIBD, the histologi-cal (HE staining) and immunohistochemistry methods were used to determine the apoptotic pathological changes and the NSE expression levels in the brain at different time points. Results Compared to the Sham group, the rats of HIBD group showed significant apoptotic pathological changes. The histological changes and the brain damages were improved significantly in BIP group at each sampling point. The number of NSE-positive cells was significantly decreased in HIBD and BIP groups over time (P<0.05). The number of NSE-positive cells had significant difference among different groups at 48 h, 96 h and 7 d after opera-tion (F=45.35-81.66, P<0.01). The number of NSE-positive cells in the HIBD group was smaller than that of the Sham group and BIP group 48 h after operation (P<0.05). The number of NSE-positive cells in the BIP group was smaller than that of the Sham group 96 h after operation (P<0. 05). Conclusions BIP can decrease the apoptosis of cortex nerve cells in 7-day old HIBD rat model, and may have neuroprotective effect on the early stage of HIBD.

Uterine artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function / 中国基层医药

Objective To discuss the uterus artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function.Methods Participants included 52 routine uterine artery embolization of uterine flesh tumour patients,all patients were followed up for one year,observed the curative effects of all subjects and the influence of the rightness of ovarian function.Results After treatment,the results showed that the curative effects,after 3 months,6 months,12 months compared with the preoperative,uterine tumor size,volume were significantly smaller,menstrual cycle extended,menstrual quantity increased,uterine fibroids oppression,anemia patients were significantly reduced,the difference was statistically significant (t =3.23,3.18,x2 =2.98,4.57,4.42,2.18,respectively,P ＜ 0.05) ; And after treatment with the extension of time,the symptoms and signs of patients were distinct improvement,the difference was statistically significant (t =2.66,2.57,x2 =3.45,5.12,6.54,3.67,respectively,P ＜ 0.05).After treatment of ovarian function results showed that the effects,after 3 months,6 months,12 months compared with the preoperative,serum levels of estradiol (E2),progesterone (P),follicle-stimulating hormone (FSH),corpus luteum erythropoietin (LH),prolactin (PRL) level had no change,there were no statistically significant differences (P ＞ 0.05).Conclusion Uterine artery embolization for treatment in patients with uterine fibroids has obvious curative effect,and the influence of ovarian function is not obvious.

The comparison of the effects of different doses of insulin in diabetic ketoacidosis in children / 中国基层医药

Objective To study the effects of different doses of insulin in diabetic ketoacidosisin children.Methods 44 patients with diabetic ketoacidosis in children who were treated with insulin in our hospital were selected as research object,and they were divided into group A(low dose group)22 cases and group B(high dose group)22 cases, and the blood glucose, blood calcium, serum potassium, acidosis corrected time and the levels of serum IL-6,IL-12,IL-18 and TNF-α and incidence of hypoglycemia of the two groups were compared and studied. Results The blood glucose, blood calcium,serum potassium, acidosis corrected time and the levels of serum IL-6, IL-12, IL-18 and TNF-α of the two groups had no differences, there were no significant difference(all P ＞ 0. 05), but the incidence of hypoglycemia of the group B was lower than that of group A,there was significant difference(P ＜0. 05). Conclusion The effects of low dose of insulin in diabetic ketoacidosis in children was better, blood glucose placidity decreases, and was worthy of further studying and popularization and application.

Anti-inflammatory Effect of Apigenin on Microglia after Oxygen Glucose Deprivation and Reperfusion / 中国中医药信息杂志

Objective To study the neuroprotective effect of apigenin on microglia which was exposed to oxygen glucose deprivation and reperfusion (OGD/R), which was characterized by its influence on IL-1? and TNF-? expression. Methods Primary microglial cultures were prepared from newborn rat brain. The purity of isolated cells were identified by GSA-IB4. The cells were randomized into 5 groups:normal group, DMSO group and apigenin-treated groups (10, 25, 50 ?mol/L). The cells of DMSO group and apigenin-treated group were exposed to 8 h of OGD and 24 h of reperfusion in the presence or absence of apigenin at a range of concentrations. Culture supernatants were collected and IL-1? and TNF-? were detected by ELISA assay. Results The expression of IL-1? and TNF-? were significantly higher in DMSO group (P

Formula Optimization of Aspirin Chitosan-Sodium Alginate Microcapsules and Drug Releasing Mechanism Study / 中国药房

OBJECTIVE:To prepare aspirin chitosan-sodium alginate microcapsules(ACSPM)and to investigate its optimal formula and releasing mechanism.METHODS:The formula of ACSPM was optimized by the orthogonal design with entrapment ratio as index,and then ACSPM was prepared,with its release rate determined as well.The releasing mechanism of aspirin from the microcapsules was established by equation fitting of releasing kinetic model.RESULTS:The prepared microcapsules were uniform in size and contents.The optimized formula was as follows:the concentration of sodium polymannuronate and chitosan were 3.0% and 1.0%,respectively,and the proportion of polymannuronate to aspirin was 1∶ 4.The in vitro drug release was in line with both Higuchi equation and Peppas equation.CONCLUSION:This preparation technology was simple and the drug releasing mechanism of the preparation was chiefly characterized by drug diffusion including bulk erosion non-Fickian process.