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Collaborative development among medical practice, education and research is a strategic decision of the country in disciplinary development guided by the innovation-driven strategy. In October 2017, Beijing Hospitals Authority organized 18 tertiary hospitals with pediatrics discipline and founded a collaborative development center for pediatrics. This center operated in a model featuring both leadership of due authorities and autonomous administration. Two of the specialized pediatrics hospitals work as leading units, and existing high quality pediatrics resources of the member hospitals were pooled to establish an academics committee and an executive committee. A development system was established with disciplinary construction as the focus, collaborative development as the goal and horizontal collaboration as the means. It was designed to explore a new model featuring overall planning and standardized management of the discipline, building of a shared platform for clinical capacity development, joint development of continued medical education and talent cultivation, as well as diversified and multi-centered research and platform resources sharing. This model can effectively promote the overall development level of pediatrics in Beijing municipal hospitals.
RÉSUMÉ
Objective:To investigate the proportion of helper T lymphocytes 22(Th22) and levels of interleukin(IL)-22 in peripheral blood of children with juvenile idiopathic arthritis (JIA), and analyze their relevance with JIA-related inflammatory cytokines.Methods:A total of 30 children with JIA who received treatment at the Department of Rheumatology, the Affiliated Children′s of Capital Institute of Pediatrics from November 2018 to December 2019 were enrolled as JIA group, and 12 healthy children at the same age were selected as healthy control group.The percen-tage of Th22 cells in peripheral blood was detected using flow cytometry.Concentrations of IL-22, IL-6, tumor necrosis factor(TNF-α), IL-17 and IL-10 were measured by enzyme-linked immunosorbent assay.Statistical analysis of the relevance of Th22 cells, IL-22 levels and inflammatory cytokines levels of IL-6, TNF-α, IL-17 and IL-10 in JIA were performed by Pearson test. Results:The proportion of Th22 cells in peripheral blood of patients in JIA group[(0.94±0.26)%] was higher than that of the healthy control group [(0.46±0.29)%], and the difference was statistically significant ( t=2.227, P<0.05). Plasma level of IL-22 of patients in JIA group[(185.2±11.93) ng/L] was significantly higher than that of healthy control group[(114.7±6.29) ng/L], and the difference was statistically significant ( t=3.632, P<0.001). The proportion of Th22 cells and the levels of plasma IL-22 in JIA patients were positively correlated with plasma levels of IL-6 (Th22: r=0.501, IL-22: r=0.573, all P<0.01), IL-17 (Th22: r=0.686, P<0.001; IL-22: r=0.445, P<0.01) and IL-10 (Th22: r=0.609, IL-22: r=0.284, all P<0.001). There was no relationship for Th22 cells and plasma levels of IL-22 with TNF-α. Conclusions:The proportion of Th22 cells and plasma levels of IL-22 significantly increase in peripheral blood of JIA patients and correlated with JIA-related inflammatory cytokines, which may play a potential role in the pathogenesis of JIA disease.
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Objective:To study the role of serum E-selectin and P-selectin in pathogenesis of severe Mycoplasma pneumonia pneumonia(MPP), and to evaluate their value in early clinical recognition of severe MPP.Methods:The clinical data of 87 MPP patients in the Respiratory Ward of Capital Institute of Pediatrics Children′s Hospital between December 2017 and October 2018 were collected.Children were divided into the mild group(37 cases)and the severe group (50 cases) according to the severity of the disease.There were 20 males and 17 females in the mild group, with the age of (7.62±2.02) years.There were 17 males and 33 females in the severe group, with the of (6.97±2.41) years.Serum E-selectin, P-selectin and related inflammatory indicators were measured and compared between the two groups, and their correlation with severe MPP was analyzed.The receiver operating characteristic curve (ROC) analysis was also conducted.Results:The length of stay [(8.46±2.53) d vs.(5.19±1.20) d, P<0.001], C-reactive protein(CRP)[(23.05±37.05) mg/L vs.(15.06±13.79) mg/L, P=0.001], lactate dehydrogenase(LDH)[(342.50±186.00) U/L vs.(284.44±64.82) U/L, P<0.001], procalcitonin(PCT)[(0.19±0.26) μg/L vs.(0.15±0.14) μg/L, P=0.012], serum ferritin(SF)[(197.33±429.43) μg/L vs.(124.60±66.30) μg/L, P<0.001], D-Dimer [(539.00±576.00) μg/L vs.(226.00±170.50) μg/L, P<0.001], E-selectin [(2.36±4.22) μg/L vs.(0.86±0.20) μg/L, P<0.001] and P-selectin [(4.15±4.40)μg/L vs.(1.72±1.22) μg/L, P<0.001] in the severe group were significantly higher than those in the mild group.There was no statistical difference in the white blood cell (WBC) and erythrocyte sedimentation rate(ESR). CRP, LDH, SF, D-Dimer, E-selectin and P-selectin were statistically correlated with severe MPP(all P<0.05), while WBC, PCT and ESR were not statistically correlated with severe MPP.The areas under ROC of CRP, LDH, SF, D-Dimer, E-selectin and P-selectin were all greater than 0.5, and the area under ROC of E-selectin was the largest, followed by that of P-selectin(both>0.8). Conclusions:Severe MPP may lead to excessive inflammatory reactions in the body.E-selectin and P-selectin possibly play an important role in this process, and can act as good indicators for early recognition of severe MPP.
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Objective To discuss the expression and clinical significance of microRNA(miR)- 766 in chil-dren with polyarticular juvenile idiopathic arthritis (poly - JIA). Methods A total of 23 children with poly - JIA who received treatment at the Department of Rheumatology,the Affiliated Children′s Hospital of Capital Institute of Pediat-rics,from November 2014 to September 2016,were enrolled as research group,and 24 healthy children at the same age were selected as healthy control group,while 24 children with oligoarticular juvenile idiopathic arthritis (oligo - JIA) and 19 children with juvenile ankylosing spondylitis (JAS)were selected as case - control groups. The expression lev-els of miR - 766 in plasmas were detected by real - time quantitative polymerase chain reaction (qPCR). The clinical diagnostic values were analyzed by operating characteristic curve (ROC). Correlations between the expression levels of miR - 766 and clinical,laboratory results were analyzed by conducting Pearson correlation coefficient analysis. Results Compared with the healthy control group and case - control group,the expression levels of miR - 766 in poly - JIA group decreased,and the differences were statistically significant (t = 6. 897,6. 446,6. 218,all P < 0. 001). There was no statistical difference of miR - 766 levels in plasma between case - control groups and healthy control group (P >0. 05). Compared with the healthy control group,the area under ROC curve of miR - 766 was 0. 938 (95％ CI:0. 872 -1. 000),and when the cutoff value of miR - 766 was 6. 083 pmol/ L,the sensitivity was 87. 0％ and the specificity was 91. 7％ . Compared with oligo - JIA and JAS,the area under ROC curves of miR - 766 was 0. 908 (95％ CI:0. 819 -0. 996)and 0. 927 (95％ CI:0. 865 - 1. 000),respectively. Correlation analysis indicated that the level of miR - 766 in plasma of poly - JIA children was positively associated with hemoglobin (r = 0. 651,P < 0. 001),but negatively asso-ciated with the 28 - joint Disease Activity Score (DAS28)and the percentage of type 1 helper T cells(Th1％)(r =- 0. 434,P = 0. 038;r = - 0. 417,P = 0. 008). Conclusions The expression levels of plasma miR - 766 in poly - JIA are significantly decreasing. miR -766 may serve as an evaluation indicator for the diagnosis and prognosis of poly - JIA.