[Discussions on Clinical Characteristics and Diagnostic Criteria of Pertussis in Children].

OBJECTIVE: To compare the clinical manifestations of pertussis in children of different ages and different immunization statuses in Wenzhou, and to explore the limitations of diagnostic criteria for pertussis. METHODS: The clinical data of 288 children diagnosed with pertussis at Yuying Children's Hospital & the Second Affiliated Hospital of Wenzhou Medical University from October 2017 to December 2019 were retrospectively analyzed. The clinical characteristics of children of different ages and different immunization statuses were analyzed. Their clinical data were compared to relevant diagnostic criteria of pertussis in children of different ages according to the Recommendations for Diagnosis and Treatment of Chinese Children with Pertussis and the diagnosis conformity rate was analyzed. RESULTS: Among the 288 children, 124 cases (43.06%) were 3 months old or younger, and 164 cases (288, 56.94%) were >3 months old. Among patients≤3 months of age, cyanosis, three-depression sign, face redness, dyspnea and peripheral blood lymphocyte ratio were significantly higher than those of patients >3 months of age. They also had higher incidence of pneumonia, higher proportion of developing severe pertussis, and longer stay at the hospital. All these findings showed statistically significant difference ( P<0.05). 83 children were fully immunized (receiving the full course of vaccination), and 205 were not fully immunized (not receiving the full course of vaccination or being unvaccinated). The proportion of children presenting cyanosis, shortness of breath, three depression sign and face redness in the incomplete immunization group was higher than that in the complete immunization group. In the incomplete immunization group, the proportion of lymphocytes was higher, the level of C-reactive protein (CRP) was lower, and the length of hospitalization was longer than those of the complete immunization group. All the differences were statistically significant ( P<0.05). Among patients aged ≤3 months, the conformity rate of diagnosis (112/114, 90.32%) upon admission was higher than that among patients aged >3 months (119/164, 72.56%). Among patients aged ≤3 months, 41.94% (52/124, while 54.03% (67/124) of the patients aged ≤3 months had WBC count <20×10 9 L -1. CONCLUSION: Pertussis in children ≤3 months of age in Wenzhou City were more serious, showing higher rate of diagnosis conforming to the recommended clinical diagnostic criteria than that in children >3 months old. The WBC threshold in routine blood test of ≤3 months old could be lowered appropriately and the current diagnostic criteria still needed improvement.

Gastroesophageal reflux in bronchiectasis and the effect of anti-reflux treatment.

BACKGROUND: Bronchiectasis is a progressive and fatal disease despite the available treatment regimens. Gastroesophageal reflux (GER) may play an important role in the progression of bronchiectasis. However, active anti-reflux intervention such as Stretta radiofrequency (SRF) and/or laparoscopic fundoplication (LF) have rarely been used to treat Bronchiectasis. CASE PRESENTATION: Seven patients' clinical outcomes for treating GER-related deteriorated bronchiectasis were retrospective reviewed. All patients were treated by SRF and/or LF, and had follow-up periods ranging from one to five years. Typical GER symptoms, respiratory symptoms, medication consumption and general health status were assessed during the follow-ups. At the latest follow-up all patients were alive. The typical GER symptoms disappeared in five people and were significantly improved in the other two. Two had complete remissions of both respiratory symptoms and bronchiectasis exacerbations; four had significantly improved respiratory symptoms to mild/moderate degrees as well as reduced or zero bronchiectasis exacerbations, which allowed them to resume the physical and social functions; one's respiratory symptoms and bronchiectasis exacerbations were not much improved, yet she was in stable condition and satisfied with the results. CONCLUSIONS: Potentially, GER plays an important role in some patients with bronchiectasis, and active anti-reflux treatments can be beneficial. Future clinical studies are suggested to clarify GER's role in bronchiectasis and to further determine whether anti-reflux interventions for GER can improve the outcomes of patients with bronchiectasis.

[The characteristics of gastroesophageal reflux disease overlapping with functional bowel diseases in gastrointestinal clinic].

UNLABELLED: OBJECTIVE To analyze the common symptoms in our gastrointestinal (GI) clinic of a general hospital and the prevalence of gastroesophageal reflux disease (GERD) combined with functional bowel diseases (FBD) was also investigated. METHODS: Data of out-patients who visited GI clinic from April to June, 2011 were collected, including demographic information and chief complaints. A validated Chinese Reflux Disease Questionnaire (RDQ) was used to assess the frequency and severity of typical gastroesophageal reflux (GER) symptoms. Reflux esophagitis (RE) and non-erosive gastroesophageal reflux disease (NERD) were differentiated according to RDQ scores, endoscopic diagnosis, and response to proton pump inhibitors (PPIs). FBD was diagnosed based on Rome III criteria. RESULTS: Totally 1074 patients(98.3%) had completed the questionnaires. A total of 107 patients(10%) were diagnosed as GERD among 351 patients(32.7%) who had GER symptoms. A total of 404 cases (37.6%) presented symptoms of chronic abdominal pain/bloating, chronic diarrhea/constipation. Totally 206 cases (19.2%) of FBD were diagnosed, including 63 irritable bowl disease (IBS), 40 functional constipation and others. RDQ scores were positively correlated with the prevalence of other atypical GER symptoms, as well as chronic bloating, constipation, the incidence of IBS and functional constipation (FC) (P < 0.05). Further, the incidences of chronic bloating [25.2% (27/107)], chronic constipation [14.0% (15/107)], IBS [10.3% (11/107)] and FC[7.5% (8/107)] in GERD patients were higher than those in non-GERD patients [16.6% (160/966), 7.1% (69/966), 5.4% (52/966), 3.3% (32/966), all P < 0.05]. Higher rate of NERD than RE overlapping with FBD was found, but without statistic significance. CONCLUSIONS: GERD frequently represents with chronic bloating and constipation, usually overlaps with IBS and FC. The severity of GERD symptoms is associated with higher rate of overlapping with FBDs.

Pretreatment with Sodium Phenylbutyrate Alleviates Cerebral Ischemia/Reperfusion Injury by Upregulating DJ-1 Protein.

Oxidative stress and mitochondrial dysfunction play critical roles in ischemia/reperfusion (I/R) injury. DJ-1 is an endogenous antioxidant that attenuates oxidative stress and maintains mitochondrial function, likely acting as a protector of I/R injury. In the present study, we explored the protective effect of a possible DJ-1 agonist, sodium phenylbutyrate (SPB), against I/R injury by protecting mitochondrial dysfunction via the upregulation of DJ-1 protein. Pretreatment with SPB upregulated the DJ-1 protein level and rescued the I/R injury-induced DJ-1 decrease about 50% both in vivo and in vitro. SPB also improved cellular viability and mitochondrial function and alleviated neuronal apoptosis both in cell and animal models; these effects of SPB were abolished by DJ-1 knockdown with siRNA. Furthermore, SPB improved the survival rate about 20% and neurological functions, as well as reduced about 50% of the infarct volume and brain edema, of middle cerebral artery occlusion mice 23 h after reperfusion. Therefore, our findings demonstrate that preconditioning of SPB possesses a neuroprotective effect against cerebral I/R injury by protecting mitochondrial function dependent on the DJ-1 upregulation, suggesting that DJ-1 is a potential therapeutic target for clinical ischemic stroke.

Fabrication of multifunctional cellulose nanocrystals/poly(lactic acid) nanocomposites with silver nanoparticles by spraying method.

The poly (lactic acid) (PLA)/functionalized cellulose nanocrystals formates (CNFs) were prepared by solution casting and then the binary films were sprayed with silver ammonia aqueous solution to fabricate PLA/CNF/Ag ternary nanocomposites. It was found that both deposited silver (Ag) nanoparticles and CNFs showed efficient reinforcing effect on the thermal, mechanical, barrier properties and antibacterial activity of PLA matrix. Especially, the maximum decomposition temperature (Tmax) and Young's modulus of PLA/CNF/Ag(6) nanocomposite film increased by 15.5°C and 48.7%, respectively. Meanwhile an obvious reduction in the water vapor permeability was detected. Furthermore, the migration levels of the ternary nanocomposite films were well below the permitted limits in both non-polar and polar food simulants (60mgkg(-1)), and they showed a significant antibacterial activity influenced by the Ag contents. This study reveals that the novel nanocomposite films will offer a good perspective for food packaging applications.

Neoadjuvant chemotherapy for Patients with advanced epithelial ovarian cancer: A Meta-Analysis.

The value of neoadjuvant chemotherapy (NAC) has not yet been fully defined. We aimed to systematically evaluate the influence of neoadjuvant chemotherapy (NAC) on survival and complete cytoreduction after debulking surgery in advanced epithelial ovarian cancer (AEOC) patients. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for the randomized controlled trials (RCTs) comparing NAC and primary debulking surgery (PDS) in AEOC patients. The last search date is February 25, 2016. Cochrane systematic evaluation was used to evaluate bias risk of included studies. RevMan 5.3 software was used for statistical analysis. A total of 4 RCTs involving 1922 patients were included. Compared with PDS, NAC may contribute to the completeness of debulking removal [no residual disease (RR: 2.37; 95%CI: 1.94-2.91; P<0.00001), residual disease ≤1 cm (RR: 1.28; 95%CI: 1.04-1.57; P = 0.02), optimal cytoreduction rate (RR: 1.76; 95%CI: 1.57-1.98; P<0.00001)], but there were no significant differences in both groups with regard to overall survival (HR: 0.94; 95%Cl: 0.81-1.08; P = 0.38) and progression-free survival (HR: 0.89; 95%Cl: 0.77-1.03; P = 0.12). This meta-analysis indicates that the higher rate of optimal debulking made NAC more favorable as a treatment option for AEOC patients with non-inferior survival compared with PDS.

[Efficacy and safety of cefditoren pivoxil in treatment of respiratory infections, a clinical study].

OBJECTIVE: To evaluate the efficacy and safety of cefditoren pivoxil in treatment of respiratory infections. METHODS: 199 cases of respiratory infection confirmed by etiological and clinical examinations were treated with cefditoren pivoxil tablets taken orally. Therapeutic evaluation was conducted among 196 cases and safety evaluation was conducted among 199 cases. RESULTS: The total effective rate was 94.9%, and the causative bacteria -elimination rate was 96.7%. Clinical adverse events, including moderate diarrhea, mild nausea and vomiting, and stomach discomfort, were seen in 9 cases with an incidence rate of 4.5%. Laboratory adverse events, including increase of with an incidence rate of 3.5%. CONCLUSION: Cefditoren pivoxil is effective and safe in treatment of mild and moderate respiratory infections. The resistance rate to cefditoren pivoxil of pathogens of respiratory infections and the efficacy of cefditoren pivoxil show no difference from those tested 7 years ago.

[Encoding genes and genotypes of gamma-lactamases produced by a multiple resistant Klebsiella pneumoniae]

OBJECTIVE: To determine the sequence of gene for encoding beta-lactamase produced by Klebsiella pneumoniae E3 isolated from Jiaxing Area in Zhejiang Province. METHODS The Klebsiella pneumoniae strain E3 was identified as an ESBLs-producing bacterium by inhibitor-potentiated broth dilution test. The gene encoding gamma-lactamase of the strain was amplified by PCR. The purified PCR product was cloned and sequenced by Sanger's dideoxy chain termination composition method. RESULTS The Klebsiella pneumoniae strain E3 produced both TEM and SHV gamma lactamases. The SHV encoding gene had 812 nucleotide residues responsible for encoding SHV-11 gamma-lactamase and the TEM encoding gene had 973 nucleotide residues responsible for encoding TEM-1 gamma-lactamase. CONCLUSION The Klebsiella pneumoniae strain E3 isolated from a patient in Jiaxing Area in Zhejiang Province is able to produce both TEM-1 and SHV-11 gamma-lactamases.