Comparison of different types of macular edema secondary to BRVO treated by intravitreal injection of Conbercept / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the changes of microvascular structure of different patterns of macular edema(ME)secondary to branch retinal vein occlusion(BRVO)after intravitreal injection of conbercept.<p>METHODS: A total of 70 patients(70 eyes)with ME secondary to BRVO were classified as cystoid macular edema(CME group, 24 eyes), diffuse retinal thickening(DRT group, 22 eyes)and serous retinal detachment(SRD group, 24 eyes)according to features under OCT examination. After an initial intravitreal injection of 0.5mg(0.05mL)conbercept(IVIC). The changes of best corrected visual acuity(BCVA), central macular thickness(CMT), foveal avascular zone(FAZ), vascular density of superficial capillary plexus(SCP), vascular density of deep retinal capillary plexus(DCP)and the injection times were compared among three groups after 1, 6mo treatment.<p>RESULTS: After 6mo follow up, the BCVA(0.24±0.13、0.11±0.07、0.33±0.13)and the CMT(268.75±19.01、245.64±23.20、277.00±21.21μm)of the three groups showed a significant downward trend; The FAZ(0.37±0.09、0.30±0.08、0.36±0.03mm2)of the three groups showed a significant decreased trend; The SCP(46.18%±3.21%、47.49%±3.48%、42.76%±3.66%)and the DCP(43.50%±4.34%、47.69%±2.76%、43.88%±3.54%)of the three groups showed a significant increased trend(<i>P</i><0.01). After 6mo treatment, DRT group was better than CME group and SRD group in improving BCVA, reducing CMT and FAZ area, increasing the density of SCP and DCP. The DRT group had the least injection numbers(2.55±0.69)(<i>F</i>=5.584, <i>P</i><0.05).<p>CONCLUSION: The intravitreal injection of conbercept significantly improved the BCVA, reduced the CMT and the FAZ, increased the vascular density of SCP and DCP of different patterns of ME. Best outcomes were achieved in DRT group.

Age-dependent changes of total and differential white blood cell counts in children / 中华医学杂志(英文版)

BACKGROUND@#Total and differential white blood cell counts are important for the diagnostic evaluation of suspected diseases. To facilitate the interpretation of total and differential white blood cell counts in pediatric patients, the present study investigated age-dependent changes in total and differential white blood cell counts in healthy reference children.@*METHODS@#Data were obtained from the Pediatric Reference Intervals in China study (PRINCE), which aims to establish and verify pediatric reference intervals for Chinese children based on a nationwide multicenter cross-sectional study from January 2017 to December 2018. Quantile curves were calculated using the generalized additive models for location, shape, and scale method. The 2.5th, 50th, and 97.5th quantile curves were calculated for both total and differential white blood counts. Percents of stacked area charts were used to demonstrate the proportions of differential white blood cells. All statistical analyses were performed using R software.@*RESULTS@#Both 50th and 97.5th quantiles of total white blood cell count and monocyte count were highest at birth, then rapidly decreased in the first 6 months of life; relatively slow reduction continued until 2 years of age. The lymphocyte count was low during infancy and increased to its highest level at 6 months of age; it then exhibited moderate and continuous reduction until approximately 9 years of age. The pattern of neutrophil count changed with age in a manner opposite to that of lymphocyte count. Besides, there were two inter-sections of lymphocyte count and neutrophil count during infancy and at approximately 5 years of age, based on locally weighted regression (LOESS) analysis. There were no apparent age-related changes in eosinophil or basophil counts.@*CONCLUSION@#These data regarding age-related changes in total and differential white blood cell counts can be used to assess the health of pediatric patients and guide clinical decisions.

Analysis of the Results of MP-Ab-IgM Detection of Serum,Bronchial Lavage Fluid,Pleural Effusion and Cerebrospinal Fluid in Children Suspected of Mycoplasma Pneumoniae Infection / 现代检验医学杂志

Objective To study the infection of MP-Ab IgM (MP) in serum,bronchial lavage fluid,pleural effusion and cere brospinal from pediatric patients with Mycoplasma Pneumoniae Pneumonia (MPP).Methods From March to June 2013,278 cases of patients suspected MP infection in Children's Hospital Affiliated to Capital Medical University were selected and the MP-Ab IgM of thcire serum,bronchial lavage fluid,pleural effusion and ccrebrospinal fluid specimens were detected with the method of particle agglutination test.Results 181 cases (104 cases of boys,77 cases of girls) of different specimens in (MP) were positive.All the serum samples,278 cases were detected positive serum specimen of 170 cases,the overall detection rate was 61.2％ (170/278),144 cases of bronchial lavage fluid was investigated at the same time,check out the posi rive 62 cases,and the detection rate was 43.1％ (62/144).19 cases for pleural effusion samples at the same time,checked out the positive 13 cases,and detection rate was 68.4％ (13/19).15 cases of cerebrospinal fluid specimens was investigated at the same time,checked out the positive in 1 case,and the detection rate was 6.7％ (1/ 15).Positive rate between different age groups was respectively:6 months～1 year group 29.0％ (9/31),～3 year group 51.0％ (25/49),～5 year group 56.1％ (23/41),～16 year group 79.0％ (124/157),6 months～1 year witb other age groups was statistically significant difference (P＜0.05).In 0.5～1 year,～3 year,～5 year,16 year～four age groups,different types of MP-Ab IgM positive specimens of the same patients,the corresponding results for A:serum type (111 cases) 7,21,13,70.B:serum and bronchoalveolar lavage fluid type (45 cases) 0,2,5,38.C:Serum pleural effusion (7 cases) 0,1,2,4.D:serum and cerebrospinal fluid (1 cases) 0,0,0,1;E:serum and bronchoalveolar lavage fluid and pleural effusion type (6 cases):0,0,2,4.F:bronchoalveolar lavage fluid type (11) 2,1,1,7.Conclusion MP infection varied,have atrend of younger age,and has a tendency to increase year by year,and the patient's infection rates have different characteristics.Positive serum of different age groups was gradually increased with age,infants and young children positive detection rate increased significantlychildren with severe multiple in older children.

A Five-year Surveillance of Carbapenemase-producing Klebsiella pneumoniae in a Pediatric Hospital in China Reveals Increased Predominance of NDM-1 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To characterize carbapenem (CPM)-non-susceptible Klebsiella pneumoniae (K. pneumoniae) and carbape-nemase produced by these strains isolated from Beijing Children's Hospital based on a five-year surveillance.</p><p><b>METHODS</b>The Minimal Inhibition Concentration values for 15 antibiotics were assessed using the Phonix100 compact system. PCR amplification and DNA sequencing were used to detect genes encoding carbapenemases. WHONET 5.6 was finally used for resistance analysis.</p><p><b>RESULTS</b>In total, 179 strains of CPM-non-susceptible K. pneumoniae were isolated from January, 2010 to December, 2014. The rates of non-susceptible to imipenem and meropenem were 95.0% and 95.6%, respectively. In the 179 strains, 95 (53.1%) strains carried the blaIMP gene, and IMP-4 and IMP-8 were detected in 92 (96.8%) and 3 (3.2%) IMP-producing isolates, respectively. 65 (36.3%) strains carried the blaNDM-1 gene. 6 (3.4%) strains carried the blaKPC gene, and KPC-2 were detected in 6 KPC-producing isolates. In addition, New Delhi-Metallo-1 (NDM-1) producing isolates increased from 7.1% to 63.0% in five years and IMP-4 producing isolates decreased from 75.0% to 28.3%.</p><p><b>CONCLUSION</b>High frequencies of multiple resistances to antibiotics were observed in the CPM-non-susceptible K. pneumoniae strains isolated from Beijing Children's Hospital. The production of IMP-4 and NDM-1 metallo-β-lactamases appears to be an important mechanism for CPM-non- susceptible in K. pneumoniae.</p>

Effect of three different fixation techniques on stability of greater tuberosity fractures of humerus / 医用生物力学

Objective To compare the stability of greater tuberosity fractures of humerus treated by three different fixation techniques (screws, tension band, locking plate, respectively) through biomechanical testing, so as to provide the biomechanics basis for choosing a better fixation in the clinical treatment for greater tuberosity fractures of humerus. Methods Standardized fracture models of the greater tuberosity from 18 fresh-frozen proximal humeri with intact rotator cuffs were created. The specimens were randomly assigned to 3 groups and treated by screws, tension band and locking plates, respectively. An increasing force was applied to the supraspinatus tendon. The force displacement curve and two parameters: LtYP(Load to 5 mm yield point) and Ltf(load to failure) were recorded. Results LtYP from the screw group, tension band group and locking plate group was (377±86), (499±90), (793±52) N, respectively, with significant differences among the three groups (P0.05). Conclusions Locking plates show more obvious biomechanical stability than screws and tension band, which provides a new and better choice for treatment of isolated greater tuberosity fractures of humerus.

Finite element analysis on titanium elastic nail and reconstruction plate fixation for midshaft clavicular fractures / 医用生物力学

Objective To analyze the stress distribution and peak stress on midshaft clavicular fractures fixed by titanium elastic nail (TEN) or reconstruction plate, respectively. Methods CT data of the clavicle was adopted to reconstruct the intact clavicle model and the midshaft clavicular fracture models with the TEN and reconstruction plate fixation by using Mimics software. All the three dimensional finite element models were analyzed using Abaqus 6.9 software. The distal displacement, the peak stress and stress distribution on the distal clavicle under the axial load (250 N) and vertical load (250 N) were calculated for the three models. Results The axial displacement of the distal clavicle under the axial load showed TEN (0.23 mm)>intact clavicle (0.14 mm)>reconstruction plate (0.11 mm), respectively. While the vertical displacement of the distal clavicle under the vertical load was 5.12 mm for TEN, 3.71 mm for intact clavicle and 2.25 mm for reconstruction plate, respectively. But the peak stress of the clavicle under the axial load was 33.1 MPa for TEN, 18.7 MPa for reconstruction plate, and 15.5 MPa for intact clavicle model, respectively. And the peak stress under the vertical load was 146.3, 64.1, 56.1 MPa in the TEN, intact clavicle model, and reconstruction plate model, respectively. The stress distribution in TEN model under both kinds of loads was similar to that in intact clavicle model, while under the vertical load, the stress distribution in reconstruction plate model was clearly different with that in intact clavicle model. For the implants under the axial load, the peak stresses were 191.5, 52.3 MPa in the TEN model and reconstruction plate model, respectively, and the peak stress on implants under the vertical load was 1 248.0, 421.7 MPa in the TEN model and reconstruction plate model, respectively. Conclusions The TEN for treating midshaft clavicular fractures showed a stress distribution similar to the intact clavicle, with a higher peak stress and a higher peak implant stress at the fracture site. The reconstruction plate fixation for midshaft clavicular fractures was shown to be more stable, but with obvious stress shielding. Therefore, TEN is generally preferable for treating the simple displaced fractures of midshaft clavicle. However, the ipsilateral shoulder should avoid excessive exercise and weight bearing in the early postoperative period.

Biomechanical advantages of medial support screws in locking plate for treating proximal humerus fractures / 医用生物力学

Objective To evaluate the biomechanical advantages of medial support screws (MSSs) in locking proximal humeral plate for treating proximal humerus fractures. Methods Thirty synthetic left humeri were randomly divided into 3 groups to establish the fracture models. Group A was fixed with a locking proximal humerus plate with medial cortical support, but without MSSs; group B was fixed with 3 MSSs, but without medial cortical support; group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsion, shear stiffness and failure tests were applied on the specimens of the three groups. Results For axial compression tests, the maximum load of group A, B, C was (240.88±19.13), (169.04±19.26), (128.58±17.53) N, respectively; the axial stiffness of group A, B, C was (424.4±101.2), (230.7±40.54), (147.0±29.2) N/mm, respectively, showing significant differences (P0.05). For shear stiffness tests, the maximum load of group A, B, C was (444.71±20.87), (228.79±28.95), (188.73±26.15) N, respectively; the shear stiffness of group A, B, C was (70.0± 54.4), (183.89±29.64), (140.2±32.1) N/mm, respectively, showing significant differences (P0.05). Conclusions Using three MSSs in locking plate for proximal humerus fractures shows optimal biomechanical properties, as compared to the situation without restoration of the medial column support. The reconstruction of the medial cortical support or MSSs for proximal humerus fractures helps to enhance the mechanical stability of the humeral head and prevent failure after internal fixation.

Frequency of ABO type IgM antibody in 276 infants younger than six months / 中国实验血液学杂志

The aim of study was to explore the frequency of ABO type IgM antibody in infants younger than six months. 309 hospitalized infants younger than six months were selected at first and their EDTA K(3) anticoagulant blood samples were taken. All the infants were divided into five groups: neonates within 1 week as group I; neonates aged 8 to 14 days as group II; neonates aged 15 days to 1 month as group III; infants aged two to 3 months as group IV and infants aged 4 to 6 months as group V. The monocolonal anti-A, anti-B serums, A cells, B cells and O cells were utilized to carried out the blood typing with tube test. The results indicated that from 309 samples tested 33 AB type sample were excluded. Out of the remains of 276 samples, 29 of 46 samples in group I were positive and with the ABO type consistent rate 63% (29/46); 41 of 64 samples in group II were positive and with the ABO type consistent rate 64% (41/64); 47 of 74 samples in group III were positive and with the ABO type consistent rate 63% (47/74); 28 of 45 samples in group IV were positive and with the ABO type consistent rate 62% (28/45); 40 of 47 samples in group V were positive and with the ABO type consistent rate 85%. It is concluded that the ABO type IgM antibody appear in most infants younger than six months and these IgM antibodies may be regarded as the important evidence for ABO typing in infants.

Characterization of multidrug-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa isolates from a paediatric clinic in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In the present study, we characterized multidrug-resistant Pseudomonas aeruginosa (MDRP) clinical isolates from a paediatric facility and investigated the types and features of the metallo-beta-lactamases (MBLs) produced by carbapenem-resistant strains.</p><p><b>METHODS</b>Four hundred and ninety-eight strains of Pseudomonas aeruginosa were isolated from patients at Beijing Children's Hospital between January 2005 and December 2006. The minimal inhibition concentrations (MICs) of the strains for 13 antibiotics were measured. A combination of the E test and PCR amplification/DNA sequencing was used to define the carbapenem-resistant strains.</p><p><b>RESULTS</b>We found that 24.1% (120/498) of the isolates were MDRP. The frequencies of resistance to imipenem and meropenem were 34.2% and 35.8%, respectively, and the MIC50 and MIC90 values for the two antibiotics were identical at 4 microg/ml and 32 microg/ml, respectively. The detection rate for carbapenem resistance was 49.2% (59/120). Among the 59 carbapenem-resistant Pseudomonas aeruginosa strains, 39 (66.1%) were positive for the MBL genotype; 35 (89.7%) strains carried the bla(IMP) gene and 4 (10.3%) strains carried the bla(VIM) gene. Neither bla(SPM) nor bla(GIM) was amplified from any of the 59 isolates. DNA sequencing revealed that IMP-1 was present in 35 IMP-producing isolates and VIM-2 was detected in four VIM-producing isolates.</p><p><b>CONCLUSIONS</b>These MDRP isolates exhibited high frequencies of resistance to carbapenems among clinical isolates from a paediatric facility in Beijing, China. The production of MBL appears to be an important mechanism for carbapenem resistance in Pseudomonas aeruginosa.</p>

Establishment of method collecting peripheral blood hematopoietic stem/progenitor cells from infants / 中国实验血液学杂志

The aim of this study was to explore a safe method collecting peripheral blood stem/progenitor cell (PBSPC) from the infants of body weight less than 20 kg by using the COBE Spectra Blood Cell Separator through Auto-PBSC procedure. After washing tube by normal saline, one unit of irradiated RBC was infused into the apheresis set. When the collection terminated, only the concentrated RBC in the apheresis set was returned to the infant. The peripheral mononuclear cells (PBMNCs) and CD34+ cells were counted, the cell viability was determined. The results showed that 13 PBSPC collections were carried out successfully from 7 infants of body weight<20 kg. The average count of MNCs was 4.44x10(8)/kg [(3.46-6.45)x10(8)/kg], the CD34+ count was 2.20x10(6)/kg [(1.34-3.79)x10(6)/kg] and the cell viability was 98.45% (97%-100%) respectively. The vital signs of all the infants went smoothly during collection of PBSPCs. In conclusion, with the aid of COBE Spectra blood cell separator and other measures, the collection of PBSPCs from infants of body weight<20 kg is safe and effective, the PBMNCs containing enough PBSPC can be harvested for transplantation.

Study on the distribution and correlation of trace elements in whole blood of children in Beijing / 中华流行病学杂志

Objective To study the distribution and correlation of trace elements in peripheral blood of children in Beijing so as to offer scientific evidence for the supplementation of trace elements and to prevent lead intoxication. Methods Contents of trace elements in whole blood of 13 929 children in Beijing region were detected by Atomic Absorption Spectrometer. According to developmental condition, children were divided into young infancy group, infancy group, toddler's age group, preschool age group, school age group and adolescence group. Every group was divided into males and females. Distribution and correlation of trace elements in different age groups and in different sex sets were then analyzed and compared. Results The level of copper, calcium and magnesium were stable in different age groups and in different sex sets.There were no obvious significant differences in age groups and sex sets and there were no deficiency of copper, calcium and magnesium discovered. The level of zinc increased gradually following the growth of age and the level of zinc was (81.71±15.91)μmol/L. There were significant differences in different age groups noticed as well in sex sets of infancy group, toddler's age group and preschool age group. The rate of deficiency of zinc decreased gradually following the growth of age. The rate of zinc deficiency was 13.7% and there were obvious differences noticed in sex sets of toddler, preschool and school age groups. The level of iron increased gradually following the growth of age with the level of iron as (8.28±0.78)mmol/L.There were significant differences noticed in different age groups, after infancy stage. There was significant difference noticed also in sex sets after school age group. The rate of iron deficiency decreased obviously following the growth of age. The iron deficiency rate was 12.9%, and significantly different in sex sets of young infancy, school age and adolescence groups. The level of lead increased gradually following the growth of age, with the overall level as (59.97±26.52)μg/L; There was an obvious significant differences noticed in different age groups with significant differences noticed in sex sets after toddler's age group. The rate of lead intoxication increased gradually following the growth of age. The rate of lead intoxication was 8.2%. There were significant differences noticed in sex sets after toddler's age group.However, there were negative correlations noticed among the levels of lead and copper, zinc, calcium,magnesium and iron. There were no correlations between the level of calcium and iron found but showed positive correlation among other trace elements. Conclusion The deficiency of calcium was basically corrected but the deficiency of zinc and iron were still obvious. There was a high level of lead noticed in these children. It is important to advocate on healthy feeding program, on culture good hygienic habit and on away from the lead pollution sites.

Relationships between Serum Lipid,Apolipoproteins and Angiocardiopathy in Obese Children / 实用儿科临床杂志

Objective To analyze obese children serum lipid level in order to understand the relationship between serum lipid and cardiovascular disease in obese children.Methods One hundred and fifty-three children(109 male and 44 female)aged 4-16 years old with obesity who attended the outpatient clinic of Beijing Children′s Hospital were collected.Percentage body fat (%BF),body fat (BF),fat-free mass (FFM) was estimated by using bioelectrical impedance analysis (BIA) and calculate.Waist and hip circumference,waist-to-hip ratio (WHR) was estimated by soft tape measure and calculate.Skinfold thickness of scapular bone below (S) and triceps muscle (T),S/T rate was estimated by skin fold meter and calculate.Serum total cholesterol (TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),apolipoprotein(Apo) AI and Apo B levels were also measured.SPSS 11.0 software was used to analyzed the data.Results The cardiovascular disease related was the prevalence of high TC levels(3.3%)or high LDL-C level(6.0%) and high TG level(24.7%) was rather low.HDL-C level was reduced in 31.3% of obese children.In children over 10 years old,%BW and %BF showed a weak correlation with HDL-C(r=-0.202,-0.211).Conclusions In obese children,serum lipid as well as Apo level should be exa-mined in order to evaluate angiocardiopathy.

Analysis of genotype of metallo-?-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in pediatric patients / 中华检验医学杂志

Objective To investigate the genotype of metallo-?-lactamases (MBL) produced by carbapenem resistant Pseudomonas aeruginosa in pediatric patients.Methods 59 strains of resistance to imipenem or meropenem were collected from December 2003 to November 2005 in Beijing children's hospital.Isolates were further evaluated for MBL production by two screening methods.MBL Etest strips were used to screen the phenotype of MBL production.Molecular screening for blaVIM,blaIMP,blaSPM and blaGIM was carried out using primers targeting the conserved regions of the MBL genes.The PCR fragments obtained with integron primers were sequenced on both strands.The nucleotide sequences were compared with sequences available over the Internet.Results Of the 59 carbapenem resistant Pseudomonas aeruginosa included in this study,29 (49.2%)were MBL positive using Etest methods,and 39 (66.1%) of these tested positive for MBL genes by PCR.35 (89.7%) were positive for blaIMP genes and 4 (10.3%) were positive for blaVIM genes.All isolates were negative for SPM and GIM DNA sequencing revealed that the IMP-1 was detected in 35 IMP-producing isolates,and VIM-2 was detected in 4 VIM-producing isolates.Conclusions This study has demonstrated that MBL-producing strains in pediatric are more common than in adult.IMP-1-producing strains are the main in pediatric,and VIM-2-producing strains concurred.The production of MBL is one of the important reasons of carbapenem resistant Pseudomonas aeruginosa in pediatric.It is very important to monitor the production of MBL.