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Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.
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Objective@#To investigate the effect of capillary electrophoresis-based multiplex PCR (CEMP) in detecting pathogens for children respiratory tract infection, and to provide scientific basis for clinical diagnosis and treatment rapidly and accurately.@*Methods@#The cases were defined according to the national monitoring program of febrile respiratory syndrome during the 12th Five-Year Plan, and the samples were collected from nasopharyngeal swabs, bronchoalveolar lavage fluid and sputum of children with respiratory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018.Multiplex PCR amplification was performed by one-step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by "Genemapper software" software.Detecting pathogens included Influenza A virus (InfA), Human Adenovirus (HADV), Boca virus (Boca), Human Rhinovirus (HRV), Novel InfA-09H1 (InfA-09H1) and Seasonal Influenza virus H3N2 (InfA-H3N2), Parainfluenza virus (HPIV), Human metapneumonia virus (HMPV), Influenza B virus (InfB), Mycoplasma pneumoniae (Mp), Chlamydia pneumoniae (CP), Human Coronavirus (HCOV), Human Respiratory Syncytial virus (HRSV).@*Results@#The effective detection rate of the CEMP assay was 95.71%.The positive detection rate of respiratory tract pathogens was 62.84% and the mixed infection rate was 9.61%.The mixed infection was mainly InfA and HRSV.The highest three positive rates were named InfA, HRSV and Mp.The positive rate of HRSV was significantly higher in the 0-3 age group than that in older group.Different pathogens were detected in different age groups, and the high-occurrence season of respiratory tract infection with virus was from December to March of the next year.InfA-09H1 was the main prevalent influenza virus in January, February and March 2017, InfA-H3N2 was the main prevalent influenza virus in November and December 2017, and the outbreak of InfB was happened in Changchun in late 2017 and early 2018.HRSV was detected only in the coldest season in Changchun from November to March of the next year.Different pathogens were detected in different respiratory infection.HRSV was the main pathogen detected in pneumonia; InfA-03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection.@*Conclusion@#CEMP is an efficient, rapid and accurate method for the detection of pathogens in patients with respiratory tract infections, and it will have a broad application prospect to develop reagents suitable for clinical diagnosis.
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Objective To investigate the effect of capillary electrophoresis﹣based multiplex PCR ( CEMP) in detecting pathogens for children respiratory tract infection,and to provide scientific basis for clin﹣ical diagnosis and treatment rapidly and accurately. Methods The cases were defined according to the na﹣tional monitoring program of febrile respiratory syndrome during the 12th Five﹣Year Plan,and the samples were collected from nasopharyngeal swabs,bronchoalveolar lavage fluid and sputum of children with respira﹣tory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018. Multi﹣plex PCR amplification was performed by one﹣step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by"Genemapper software" software. Detecting pathogens included Influenza A virus (InfA),Human Adenovirus (HADV),Boca virus ( Boca), Human Rhinovirus ( HRV), Novel InfA﹣09H1 ( InfA﹣09H1 ) and Seasonal Influenza virus H3N2 ( InfA﹣H3N2),Parainfluenza virus ( HPIV),Human metapneumonia virus ( HMPV), Influenza B virus ( InfB), Mycoplasma pneumoniae (Mp),Chlamydia pneumoniae ( CP),Human Coronavirus ( HCOV),Human Re﹣spiratory Syncytial virus (HRSV). Results The effective detection rate of the CEMP assay was 95. 71%. The positive detection rate of respiratory tract pathogens was 62. 84% and the mixed infection rate was 9. 61%. The mixed infection was mainly InfA and HRSV. The highest three positive rates were named InfA, HRSV and Mp. The positive rate of HRSV was significantly higher in the 0﹣3 age group than that in older group. Different pathogens were detected in different age groups,and the high﹣occurrence season of respiratory tract infection with virus was from December to March of the next year. InfA﹣09H1 was the main prevalent influenza virus in January,February and March 2017,InfA﹣H3N2 was the main prevalent influenza virus in November and December 2017,and the outbreak of InfB was happened in Changchun in late 2017 and early 2018. HRSV was detected only in the coldest season in Changchun from November to March of the next year. Different pathogens were detected in different respiratory infection. HRSV was the main pathogen detec﹣ted in pneumonia; InfA﹣03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection. Conclusion CEMP is an effi﹣cient,rapid and accurate method for the detection of pathogens in patients with respiratory tract infections,and it will have a broad application prospect to develop reagents suitable for clinical diagnosis.
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Objective To understand the clinical features and pathogenic spectrum of encephalitis and menin﹣gitis syndrome in children. Methods A total of 667 cases of children with encephalitis or meningitis diagnosed and documented at Changchun Children′s Hospital from May 2012 to July 2015 were enrolled. A variety of samples in diffe﹣rent types were collected and presented,including 335 cerebrospinal fluid specimens,530 blood samples,and 332 stool samples. All the samples were collected from the patients within 72 hours on admission. Moreover,these samples are analyzed and tested,including PCR for enterovirus(EV),herpesvirus(HSV),mycobacterium tuberculosis( TB)and My﹣coplasma pneumoniae(MP)nucleic acid in cerebrospinal fluid samples;fecal specimens were tested for EV,enterovirus 71(EV71),coxsackievirus A6(CA6),coxsackievirus A16(CVA16),coxsackievirus A10( CVA10)nucleic acids;degenerate primers to amplify Echovirus 30(Echo30). Clinical data of children were collected. Results The peak in﹣cidence of encephalitis and meningitis syndrome was from June to August,age distribution was from 0 to 15 years old, the proportion of children aged from 0－6 accounted for 81. 41﹪;the highest proportion was among 0－1 years old in﹣fants,occupying 32. 38﹪;408 males and 259 females;the main symptoms were fever(586 cases),apathy(337 ca﹣ses),vomiting(307 cases)and headache(203 cases). And clinical signs included drowsiness(103 cases),neck stiff﹣ness(71 cases),meningeal irritation(12 cases),and pathological reflex( 313 cases),etc. The clinical diagnosis included 272 cases of viral encephalitis,332 cases of severe hand,foot and mouth disease complicated by encephalitis, 30 cases of bacterial meningitis,and 33 other cases;the etiological detection included:the positive rates of EV,EBV and Echo30 in cerebrospinal fluid specimens were 59. 72﹪,3. 16﹪ and 70. 00﹪,respectively. And EV71,CVA16,CVA6, EV71+CA16 and EV71+CVA16+CVA6 nucleic acids were detected in fecal samples,in which the highest detection rate was EV71(98. 96﹪). Conclusions In Changchun Children′s Hospital,the children with encephalitis and menin﹣gitis are mainly viral encephalitis. The main symptoms were fever,apathetic,drowsiness,vomiting and headache. Signs included,neck stiffness,meningeal irritation,and pathological reflexes,etc. The main pathogen of the disease is EV71.
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Objective@#To understand the clinical features and pathogenic spectrum of encephalitis and meningitis syndrome in children.@*Methods@#A total of 667 cases of children with encephalitis or meningitis diagnosed and documented at Changchun Children′s Hospital from May 2012 to July 2015 were enrolled.A variety of samples in diffe-rent types were collected and presented, including 335 cerebrospinal fluid specimens, 530 blood samples, and 332 stool samples.All the samples were collected from the patients within 72 hours on admission.Moreover, these samples are analyzed and tested, including PCR for enterovirus(EV), herpesvirus(HSV), mycobacterium tuberculosis(TB) and Mycoplasma pneumoniae(MP) nucleic acid in cerebrospinal fluid samples; fecal specimens were tested for EV, enterovirus 71 (EV71), coxsackievirus A6 (CA6), coxsackievirus A16 (CVA16), coxsackievirus A10 (CVA10) nucleic acids; degenerate primers to amplify Echovirus 30 (Echo30). Clinical data of children were collected.@*Results@#The peak incidence of encephalitis and meningitis syndrome was from June to August, age distribution was from 0 to 15 years old, the proportion of children aged from 0-6 accounted for 81.41%; the highest proportion was among 0-1 years old infants, occupying 32.38%; 408 males and 259 females; the main symptoms were fever(586 cases), apathy(337 cases), vomiting (307 cases) and headache(203 cases). And clinical signs included drowsiness (103 cases), neck stiffness (71 cases), meningeal irritation (12 cases), and pathological reflex (313 cases), etc.The clinical diagnosis included 272 cases of viral encephalitis, 332 cases of severe hand, foot and mouth disease complicated by encephalitis, 30 cases of bacterial meningitis, and 33 other cases; the etiological detection included: the positive rates of EV, EBV and Echo30 in cerebrospinal fluid specimens were 59.72%, 3.16% and 70.00%, respectively.And EV71, CVA16, CVA6, EV71+ CA16 and EV71+ CVA16+ CVA6 nucleic acids were detected in fecal samples, in which the highest detection rate was EV71(98.96%).@*Conclusions@#In Changchun Children′s Hospital, the children with encephalitis and meningitis are mainly viral encephalitis.The main symptoms were fever, apathetic, drowsiness, vomiting and headache.Signs included, neck stiffness, meningeal irritation, and pathological reflexes, etc.The main pathogen of the disease is EV71.
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@#Objective To explore the theoretical framework and method of community-based rehabilitation assessment for children with cerebral palsy based International Classification of Functioning, Disability and Health (ICF). Methods The system of assessment of community-based rehabilitation was developed based on the theoretical framework ICF, combined with multi-tools and self-compiled work scales.The system was used for 50 rural children with cerebral palsy after 1-year of community-based rehabilitation. Results and Conclusion The system of assessment is applicable for rural community-based rehabilitation of children with cerebral palsy, with satisfactory efficacy and compliance.
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Objective To measure the level of interleukin-15(IL-15) in serum and its expression in lung tissues,and analyze the correlations between IL-15 and IL-4,IFN-?,eosinophil(Eos),and explore the effect of IL-15 on bronchial asthma.Methods Thirty femal BALB/C mice were randomly divided into three group(n=10),group A(asthma model),group B(corticosteroid treatment) and group C(normal control).All mice were killed 24 h after final OVA challenge.Blood were obtained for measurement of serum IgE,IL-4,IFN-? and IL-15 levels by enzyme-linked immunoabsorbent assay(ELISA).Bronchoalveolar lavage fluid(BLAF) was collected for Eos count.The left lungs were isolated for pathological examination.The lung sections were stained with hematoxylin and eosin(HE).The expressions of IL-15 in lung tissues were measured by immunohistochemical SP method.Results ①The mouse asthma model appeared ethological changes specific to asthma,the Eos count in BALF was increased,and IgE and IL-4 levels in serum were also increased compared with control group(P
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Objective To observe the therapeutic effect of reformed subhibernation therapy on status epilepticus in patients with severe viral encephalitis.Methods 96 children with severe viral encephalitis complicated by status epilepticus were randomly divied into control group and experimental group.Control group: routine treatment was given that includes anticonvulsivus,ice compress and conventional therapy.The anticonvulsivus was applied in five drugs: the same doses of wintermin and phenergan mixed up,10% chlorpromazine hydrochloride,luminal,valii,the drugs were delivered when convulsion occurred otherwise not.Experimental group: in addition to routine treatment reformed subhibernation therapy was given.The anticonvulsivus drug's was delivered in return each 4-6 h according to the drugs half life.And anticonvulsivus drugs were applied for 2 d then gotten off.The clinical manifestation,auxiliary examination and therapeutic efficacy of patients in two groups were observed.Results All of 96 cases were analyzed.The lotal effective rate in experimental group is higher than that in control group(?2=5.872,P