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OBJECTIVES@#To investigate the incidence and mortality of gastrointestinal dysfunction in children with sepsis, the application of near-infrared spectroscopy (NIRS) in monitoring mesenteric regional tissue oxygen saturation (rSO2), and the association between rSO2 and gastrointestinal dysfunction.@*METHODS@#In this prospective study, 79 children with sepsis in the pediatric intensive care unit (sepsis group) and 40 children who underwent physical examination in the Department of Child Healthcare (healthy control group) from January to December, 2021 were enrolled as subjects. The related medical data were collected, including general information on admission and at discharge, treatment during hospitalization, and laboratory examination results. NIRS was used to measure mesenteric rSO2. Clinical characteristics were compared between the patients with and without gastrointestinal dysfunction.@*RESULTS@#For the 79 children with sepsis, the incidence rate of gastrointestinal dysfunction was 49% (39/79), and the mortality rate of the children with gastrointestinal dysfunction was 26% (10/39). The children with gastrointestinal dysfunction had a longer duration of mechanical ventilation and a higher 28-day mortality rate (P<0.05). The children with gastrointestinal dysfunction had a significantly lower median rSO2 (64%) than the children without gastrointestinal dysfunction (72%) and the healthy control group (78%) (P<0.05).@*CONCLUSIONS@#There are high incidence and mortality rates of gastrointestinal dysfunction in children with sepsis, and the reduction in rSO2 may be associated with the development of gastrointestinal dysfunction.
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Criança , Humanos , Gastroenteropatias/etiologia , Unidades de Terapia Intensiva Pediátrica , Oxigênio , Estudos Prospectivos , Sepse/complicações , Espectroscopia de Luz Próxima ao Infravermelho/métodosRESUMO
OBJECTIVE@#To study the features of new-onset organ dysfunction in children with sepsis in the pediatric intensive care unit (PICU).@*METHODS@#A retrospective analysis was performed for the clinical data of children with sepsis who were admitted to the PICU from 2015 to 2016. There were 34 children with severe sepsis and 69 with non-severe sepsis, and the two groups were compared in terms of the incidence rate of new-onset organ dysfunction and the functional status on admission and at discharge.@*RESULTS@#The severe sepsis group had a significantly higher incidence rate of new-onset organ dysfunction than the non-severe sepsis group (38% vs 6%; P<0.05). The children in the non-severe sepsis group had a relatively good functional status on admission, with marked improvement in the overall functional status at discharge. The children in the severe sepsis group had a poor functional status on admission, with mild/moderate abnormalities in consciousness, sensation, communication and respiratory function at discharge.@*CONCLUSIONS@#Children with non-severe sepsis have a low incidence rate of new-onset organ dysfunction and a good prognosis, and those with severe sepsis often have a high incidence rate of new-onset organ dysfunction and a poor prognosis.
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Criança , Humanos , Unidades de Terapia Intensiva Pediátrica , Insuficiência de Múltiplos Órgãos , Alta do Paciente , Prognóstico , Estudos Retrospectivos , SepseRESUMO
OBJECTIVE: To improve the understanding of the IFI,and to help the early diagnosis and treatment and positive improvement of prognosis. METHODS: A total of 21 children were chosen as the research subjects,who were diagnosed with the IFI bloodstream infection and were hospitalized in Shengjing Hospital affiliated to China Medical University from January2012 to January 2018,and the clinical characteristics,high risk factors and prognosis of them were retrospectively analyzed.RESULTS: Therewasnosignificantcorrelationbetweentheincidenceoffungalinfectionandageorsexin 21 children with IFI bloodstream infection. Candida albicans and Candida parapsilosis were the leading pathogen,and the mortality rate of Candida parapsilosis was high(80%).For the 21 children with IFI bloodstream infection,the mortality rate was as high as 61.9%(13 cases)with 28 days' following research. The protopathy was mainly respiratory system disease(14.29%)and digestive system disease(23.81%). Among them,there were 4 cases of severe pneumonia and 4 cases of gastrointestinal perforation. The high risk factors were mainly the combined use of broad-spectrumantibiotics,invasive operation(tracheal intubation,central venous catheterization,catheterization and indwelling stomach tube,etc.),long-term hospitalization in ICU and so on,all above 85%.Fungal infection was characterized by atypical fever(80.95%),abnormal increase or decrease of white blood cells(47.62%)andCRPincrease(80.95%);thepositiverateof Gtest couldreach 42.86%. Inthesurvival groupincluding 8 casesof children,75% were treated with antifungal treatment before diagnosed with fungal infection;the rate of preventive drug use was 53.85%for the death group. CONCLUSION: Long-termhospitalization in ICU,long-termand combined use of a large amount of broadspectrum antibiotics,invasive operation,autoimmune deficiency and other factors increase the risk of fungal infection. If there is atypical refractory infection after clinical primary diseases,fungal infection should be paid attention to and the related microbiological examination should be performed.
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In2O3nanoparticles-modified multiwalled carbon nanotubes (In2O3-MWCNTs) were successfully prepared as solid phase extraciton (SPE) adsorbent for the determination of three food preservatives(benzoic acid,sorbic acid,and methylparaben) in beverage samples coupled with high performance liquid chromatography (HPLC).Because of the large surface area and amount of hydroxyl groups on the surface of In2O3nanoparticles,In2O3nanoparticles could interact with specific functional groups.In2O3-MWCNTs adsorbent was prepared based on the large surface area of In2O3and superior thermal and chemical stability of MWCNTs.The obtained adsorbent was characterized via transmission electron microscope (TEM),thermogravimetric analysis (TGA),and Fourier transform-infrared (FT-IR) spectroscopy.Several experimental parameters affecting the extraction efficiency were investigated by single-factor experiments,such as adsorbents amount,sample volume,eluent volume,sample pH,and eluent type.The first four factors were then further evaluated by means of a Taguchi's L16(44) orthogonal array experimental design.According to the results of orthogonal array experiment,the optimal conditions were chosen as follows: 0.15 g of adsorbent amount,5.0 mL of sample volume,0.6 mL of ACN-H2O (60:40,0.1% formic acid,V/V) as eluent,and sample pH 4.0.Under the optimum conditions,the LODs (S/N=3) and LOQs (S/N=10) for three preservatives were in the range of 0.004-0.012 μg/mL and 0.012-0.038 μg/mL,respectively.The recoveries ranged from 70.2% to 109.4%.The method is rapid,sensitive,and suitable for the determination of preservatives in food samples.
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To analyze and summarize the surveillance results and epidemic situation of influenza in mainland China during 2016-2017 surveillance season,we collected ILI monitoring data and influenza outbreak data download from"China Influenza Surveillance Information System"and"Public Health Emergency Information Management System"in mainland China during 2016-2017 surveillance season.The results showed that influenza activity did not appear obvious summer peak in southern provinces,and the autumn and winter flu seasons were earlier than that during last season in both southern and northern prov-inces,while the epidemic peak level was lower than 2015-2016 surveillance season.Throughout the year,influenza predomi-nant viruses throughout the country underwent the alternation of type B,A (H3N2)and H1N1,respectively.The total num-ber of outbreaks of ILI reported in the country was less than that in 2015-2016.According the surveillance,we suggested that all regions continue to attach great importance to recent influenza virus activity,pay attention to the global epidemic situation and that of our country,strengthen the analysis and use of surveillance data,trace the activity levels,mutation and resistance change of influenza virus,carry out the flu outbreak investigation and disposal work timely.
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Dexamethasone is a synthetic glucocorticoid that is widely used in clinical due to its multiple pharmacological effects. Recently, dexamethasone is increasingly utilized in anti-cancer therapy. It is frequently used to prevent side effects of chemotherapy such as nausea, vomiting and pain, as well as to increase the anti-tumor activity of the cancer chemotherapeutic agents as a chemosensitizer and to inhibit tumor growth as an anti-cancer agent in some certain cancers. Dexamethasone produces the effects in anti-inflammation, anti-angiogenesis, control of estrogen activity and so on, by binding to glucocorticoid receptor to regulate gene expression of some important bio-signal molecules. Those signal pathways could interfere with the transcription of various factors which can regulate proliferation, invasion and metastasis of tumors.
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Humanos , Antieméticos , Antineoplásicos , Usos Terapêuticos , Dexametasona , Usos Terapêuticos , Náusea , Neoplasias , Tratamento Farmacológico , Transdução de Sinais , VômitoRESUMO
<p><b>OBJECTIVE</b>To investigate the factors that influence the short-term (6 months) prognosis in children with acute liver failure.</p><p><b>METHODS</b>The clinical information of 53 children with acute liver failure treated between June 2008 and September 2013 was retrospectively analyzed. The patients were divided into survival group (n=21) and death group (n=32) according to their outcomes. The liver function parameters and incidence of complications were compared between the two groups, and multivariate logistic regression analysis was used to identify major factors affecting the short-term prognosis in these patients.</p><p><b>RESULTS</b>There were significant differences between the death and survival groups in the indices of international normalized ratio (INR), blood ammonia and serum albumin (Alb), and complications such as hepatic encephalopathy, gastrointestinal hemorrhage, and multiple organ failure (P<0.05). Multivariate logistic regression analysis demonstrated that serum Alb, INR, and hepatic encephalopathy were the major factors affecting the short-term prognosis of acute liver failure (OR=0.616, 75.493 and 1210.727 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>INR, hepatic encephalopathy and serum Alb are the major factors that influence the short-term prognosis in children with acute liver failure.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Coeficiente Internacional Normatizado , Falência Hepática Aguda , Sangue , Mortalidade , Modelos Logísticos , Prognóstico , Estudos Retrospectivos , Albumina SéricaRESUMO
Five H9N2 avian influenza virus strains were isolated from the environmental samples in live poultry market in Qinghai Lake region from July to September, 2012. To evaluate the phylogenetic characteristics of these H9N2 isolates, the eight gene segments were amplified by RT-PCR and sequenced. The phylogenetic and molecular characteristics of the five strains were analyzed. The results showed that the HA genes of five strains shared 93. 2%-99. 1% nucleotide identities with each other, and the NA genes shared 94. 5%-99. 8% nucleotide identities. The HA cleavage site sequence of the A/environment/qinghai/ 017/2012 isolate was PSKSSRGLF, and the HA cleavage site sequences of the other four strains were all PSRSSRGLF. The HA receptor-binding site had the Q226L mutation. The M1 gene segment had the N30D and T215A mutations. The phylogenetic analysis showed that the five strains were similar to the virus A/chicken/Hunan/5260/2005 (H9N2) isolated in Hunan Province, China and were reassortant genotype viruses; the HA, NA, and NS genes belonged to the Y280-like lineage; the MP gene belonged to the G1-like lineage; the NP, PB1, PB2, and PA genes belonged to the F98-like lineage.
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Animais , China , Genoma Viral , Genótipo , Vírus da Influenza A Subtipo H9N2 , Classificação , Genética , Influenza Aviária , Virologia , Dados de Sequência Molecular , Filogenia , Aves Domésticas , Doenças das Aves Domésticas , Virologia , Proteínas Virais , GenéticaRESUMO
We retrospectively investigated germline polymorphisms in angiogenesis pathway genes (14 SNPs) and their correlation to clinical outcome (progression free survival and overall survival) in 128 patients with unresectable-advanced gastric carcinoma (AGC) treated with first-line chemotherapy. Our analysis revealed that Endostatin +4349 G>A polymorphism exhibited a worse progression free survival (PFS) and overall survival (OS) compared with the GG genotype. Significant OS difference was also observed in the endothelial nitric oxide synthase (eNOS)-786 T>C polymorphism. Hence, common germline variants in Endostatin and eNOS genes have predictive significance for clinical outcome and survivality in AGC patients treated with first-line chemotherapy.
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Adenocarcinoma/genética , Endostatinas/genética , Neovascularização Patológica/genética , Óxido Nítrico Sintase Tipo III/genética , Polimorfismo de Nucleotídeo Único , Neoplasias Gástricas/genética , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Frequência do Gene , Estudos de Associação Genética , Humanos , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologiaRESUMO
Objective To explore the polymorphism of-592C/A of IL-10 gene promoter region in children with bronchial asthma and its relationship with serum concentration of IL-10.Methods Ninety-two children with bronchial asthma and 92 healthy children were selected for study,polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used for the analysis of-592C/A of IL-10 promoter region polymorphism.The frequencies of genotypes of IL-10 gene-592 locus (CC,CA and AA) and alleles were accounted respectively,and x2 test was used to analyze the difference between the groups.Enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of the serum IL-10,and F test and q test were used for statistical analysis.Results Compared with the healthy control group,there were significant differences in-592C/A polymorphism of IL-10 gene in asthma group.The frequencies of AA genotypes (56.5%) and A allele (73.9%) in asthma group were higher than those (34.8%,58.7%)in the control group,there were significant differences(x2 =9.32,P < 0.01 ;x2 =8.87,P < 0.005,respectively).The individuals with AA genotype and A allele were 3.25 (95 % CI:1.28-8.28,P < 0.05) and 1.99 (95 % CI:1.28-3.08,P <0.01) times susceptible to asthma compared with CC genotype and C allele.The serum concentration of IL-10 in asthma group was significantly lower than that in healthy control group,whether in attacking-stage or remission-stage,and there were significant differences (all P < 0.01).The individuals with AA genotypes had lower serum IL-10 concentration than those with CC genotypes (P < 0.05) . Conclusions The IL-10 gene-592C/A polymorphism is different significantly between children with bronchial asthma and healthy ones,and this polymorphism influences the concentration of IL-10.The individuals with AA genotype have relatively lower IL-10 concentration,and A allele may be one of genetic susceptibility factor of bronchial asthma in children.
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<p><b>OBJECTIVE</b>To study the clinical characteristics of Pseudomonas aeruginosa (PA)-positive children in the pediatric intensive care unit, and to provide a basis for early diagnosis and reasonable treatment of PA infection.</p><p><b>METHODS</b>The clinical data of 62 children infected with PA in the pediatric intensive care unit were retrospectively reviewed,including age, affected organs, fever duration, hospital stay duration, mechanical ventilation duration, prognosis, underlying diseases, mortality, culture results and drug sensitivity test results.</p><p><b>RESULTS</b>Of the 62 PA-positive children, 25 (40%) were aged under 6 months and 47 (76%) under 2 years, with a median age of 28.8 months. Twenty-seven showed one positive result for sputum culture or endotracheal tube aspirates culture, 3 showed one positive result for blood culture, and 32 showed more than two positive results for blood, sputum or endotracheal tube aspirates cultures. On average, 2.8 organs were affected in each patient, with the respiratory system involved most frequently (58 patients, 94%). The mean fever duration was 7.3 days and the mean hospital stay duration was 34.2 days. In the 62 patients, 35 (57%) were cured and 17 (27%) died. Mechanical ventilation was administered to 51 patients (82%) for a mean duration of 13.4 days. Fifty-one patients (82%) had underlying diseases. The 17 (27%) children who died had a mean age of 17.4 months and a mean CRP level of 52.6 mg/L; 14 of them had increased or normal white blood cell count, and 3 had a decreased white blood cell count.The antibiotic sensitivity of PA was 72.6% for cefoperazone/sulbactam, 70.8% for meropenem, 49.1% for imipenem, 65.1% for ceftazidime, and 44.3% for piperacillin/tazobactam. There was complete resistance to cephazolin, cefuroxime and cefotaxime.</p><p><b>CONCLUSIONS</b>The children under 2 years are prone to PA infection. Respiratory system involvements are common. Most of children infected with PA suffer from underlying diseases.The sensitivity of PA to common antibiotics is not high.</p>
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Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Farmacorresistência Bacteriana , Unidades de Terapia Intensiva Pediátrica , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas , Sangue , Tratamento Farmacológico , Pseudomonas aeruginosa , Estudos RetrospectivosRESUMO
ObjectiveTo study the relationship between expression of a3 chain of collagen Ⅸ (COLIXA3)mRNA in the population exposed to fluorine and fluorosis,in order to reveal the role of COLIXA3 gene in the pathogenesis of endemic fluorosis.MethodsTwelve cases of mild drinking water-born skeletal fluorosis were selected as case groups in Regiment 123 and 128 of Xinjiang Production and Construction Corps Seven Division,6cases of healthy people living in fluorosis areas for more than 10 years as a internal control group and 6 heathly cases living in non-fluorosis areas for more than 10 years as a external control group.The expression of COLIXA3mRNA of peripheral blood lymphocyte of skeletal fluorosis patients and control groups were determined by using SYBR Green Ⅰ chimeric fluorescent method for real-time quantitative PCR.ResultsThe results of the relative expression of COLIXA3 mRNA of case group,internal control group and external control group were 2.16 ± 0.62,1.06 ± 0.09 and 1.05 ± 0.12,respectively.The COLIXA3 expression in case group was significantly higher than that of the internal control group and the external control group (all P < 0.05),while the difference of COLIXA3expression between the internal control group and the external control group was not significantly different (P >0.05).ConclusionsFluorine contributes to the expression of COLIXA3 mRNA in peripheral blood lymphocyte,and the expression is up to 2 times higher than that of the control groups,meaning potential biomarkers.
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Objective To describe the epidemiological and clinical features of hospitalized people less than 18 years old with influenza A (H1N1)-associated pneumonia and associated risk factors.Methods Through Chinese Reporting System of Influenza A (H 1 N1 ),children aged under 18 years who were hospitalized with laboratory confirmed influenza A (H1N1),case report forms and related information on pneumonia were collected between 1 September 2009 and 4 July 2010.Epidemiological and clinical characteristics including demographics,underlying chronic diseases,treatment,complications and clinical outcome etc.were described.Hospitalized children with pneumonia were compared with those without the above mentioned features,through the univariate and multivariate analysis.Results There were 4240 influenza A (H1N1)-associated hospitalized children with case report forms identified.Of the 4107 influenza A (H1N1) -associated hospitalized children with related information on pneumonia shown in the case report forms,2289 (55.7%) of them had pneumonia.Hospitalized children with influenza A (H1N 1 ) -associated pneumonia had a younger median age (4.9year old),when compared with those without pneumonia (13.1 year old,P< 0.0001 ).When compared with the hospitalized children without pneumonia,those hospitalized children with pneumonia were more likely to require intensive care unit care,using mechanical ventilation epuipmentto develop ARDS,respiratory failure or leading to death.Data from multivariate analysis showed that children aged <6months(OR=7.08,95%CI:4.15-12.06) between 6 and 23 months(aOR=8.26,95%CI:6.10-11.20) or between 2 to 4 year old (aOR=9.53,95%CI:7.39-12.29) were more likely to develop pneumonia than children aged 5 to 17.Factors as having asthma (OR=12.19,95% CI:5.18-28.72),cardiovascular disease (OR=5.19,95% CI:1.94-13.90),chronic renal diseases (OR=2.14,95% CI:1.02-4.53),chronic hepatic diseases ( OR =5.26,95% CI:1.40-19.81 ) and allergy (OR=2.54,95% CI:1.64-3.93 )were significantly associated with influenza A (H1N1) -associated pneumonia.Risk of complication with pneumonia had an increase when oseltamivir treatment was initiated >2 days after the onset of illness.Conclusion Pneumonia was a common complication among children hospitalized with influenza A (H1N1).Hospitalized children with influenza A (H1N1)-associated pneumonia were more likely to develop either severe clinical courses or outcomes than those without pneumonia.
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Objective To study the epidemiological characteristics on the clustering nature of pandemic (H1N1) 2009 in China.Methods Time and place distribution of pandemic (H1N1) 2009on the nature of clustering through data from Public Health Emergency Management Information System were described.Results As of August 10,2010,2773 pandemic (H1N1) 2009 clusters,a total of 77363 cases (including 20 deaths) were reported in the mainland of China.The most reported number of clusters was from schools and kindergartens with the total number of 2498 (accounted for 90.08% of the total number).Middle schools appeared the have the most clusters (1223,accounting for 48.96% ).The number of clusters reported in the southern provinces (cities) accounted for 77.03% of the total,and was more than that in the northern provinces (cities).Two reported peaks in the southern provinces (cities) were in June and November,2009,respectively.There was only one reported peakin the northern provinces in September,2009.Conclusion Time and place distribution characteristics on the clusters of pandemic (H1N1) 2009 were similar to the seasonal influenza,but the beginning of winter peak was much earlier and intensity of reporting was much higher on the clusters of pandemic (H1N1 ) 2009 than that of seasonal influenza.
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<p><b>OBJECTIVE</b>Pseudomonas aeruginosa is an important cause of nosocomial infection, severe sepsis and death which associated with a trends of rising rates of resistance to a broad array of antimicrobial agents. To explore a feasible treatment protocol for such patients, we analyzed the susceptibility patterns of Pseudomonas aeruginosa in pediatric intensive care unit (PICU).</p><p><b>METHOD</b>The age distribution, outcome of patients, sources of strains and susceptibility patterns of Pseudomonas aeruginosa in PICU from Jan 1, 2007 to Dec 31, 2011 were analyzed. Susceptibility to amikacin, piperacillin/tazobactam, aztreonam, ampicillin, ciprofloxacin, imipenem, meropenem, cefepime, cefoperazone, cefotaxime, ceftriaxone, ceftazidime, cefoperazone/sulbactam, cephazolin, cefuroxime, and polymyxin were determined by the disk-diffusion technique (K-B test method) and broth microdilution. P. aeruginosa ATCC 27853 was used as reference strain.</p><p><b>RESULT</b>Seventy-five patients were Pseudomonas aeruginosa positive. 26(34.7%) were < 6 m, 49 (65.4%) were < 2 y. The percentages of cases who were Pseudomonas aeruginosa positive in different age groups in the same time was basically similar; 18 (24.0%) cases died. Pseudomonas aeruginosa accounted for 10.9% of G(-) germs, 6.5% of all pathogens in 2010 - 2011. Of the 126 strains, 83 (65.9%) were from sputum sample, 31 (24.6%) were from catheter sample of tracheal cannula, 10 (7.9%) were from blood sample and 2 (1.6%) were from secretion sample. The sensitivity to antibiotics of Pseudomonas aeruginosa in pediatric common treatments was 72.4% to cefoperazone/sulbactam, 71.5% to meropenem, 48.4% to imipenem, 66.7% to ceftazidime, 49.2% to piperacillin/tazobactam. Absolute resistance to ampicillin, cephazolin, cefuroxime and cefotaxime. Multiple-drug resistance was still severe, but a decreasing tendency was observed, 90.5% in 2007, 81.3% in 2008, 51.1% in 2009, 53.8% in 2010, 33.3% in 2011. Pan-drug resistance in different years was similar, 12.5% in 2008, 2.2% in 2009, 7.7% in 2010, 6.7% in 2011.</p><p><b>CONCLUSION</b>The condition of drug resistance of Pseudomonas aeruginosa was still rigorous, we should conduct surveillance and prevent abusing antibiotics in order to avoid exacerbating drug resistance. We should improve testing technique, early and appropriate empirical antibiotics therapy is crucial according to clinical experience and antibiotic sensitivity. The effective treatment of P. aeruginosa is paramount to prevent multidrug resistance. The use of combination therapies for P. aeruginosa infection has been a long-advocated practice. To prevent hospital acquired cross infection, health care workers must pay close attention to hand sanitation and sterile operation strictly.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Ampicilina , Farmacologia , Antibacterianos , Farmacologia , Cefazolina , Farmacologia , Infecção Hospitalar , Microbiologia , Farmacorresistência Bacteriana Múltipla , Imipenem , Farmacologia , Unidades de Terapia Intensiva Pediátrica , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas , Tratamento Farmacológico , Microbiologia , Pseudomonas aeruginosaRESUMO
<p><b>OBJECTIVE</b>To investigate the characteristics of circulatory disturbance and treatment of severe hand-foot-and-mouth disease (HFMD).</p><p><b>METHOD</b>The clinical characteristics, laboratory findings, therapy and outcome of 22 severe HFMD patients were retrospectively analyzed.</p><p><b>RESULT</b>All the 22 severe HFMD patients came from the countryside. All these patients had encephalitis. Fifteen cases had myocardial injury. All had symptoms of sympathetic excitation and 17 cases had hypertension [(128 ± 16)/(81 ± 14) mm Hg (1 mm Hg = 0.133 kPa)]. Fourteen cases had exacerbation with rapid decline of blood pressure [(61 ± 12)/(33 ± 12) mm Hg]. In cardiorespiratory failure stage, 13 patients had neurogenic pulmonary edema accompanied by circulatory failure and 12 cases had a lower glasgow scores (less than 7). Myocardial injury and ECG change were found in some cases. Inotropic and pressor drugs were given in patients with circulatory collapse. Five cases received fluid resuscitation due to refractoriness to inotropic drugs. Nine patients received blood purification. Seventeen survived and 5 cases died due to circulatory failure.</p><p><b>CONCLUSION</b>Circulation failure of severe HFMD is the main cause of death. Early and appropriate circulation support is very important to reduce mortality.</p>
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Pré-Escolar , Feminino , Humanos , Lactente , Masculino , China , Epidemiologia , Terapia Combinada , Doença de Mão, Pé e Boca , Mortalidade , Terapêutica , Imunoglobulinas Intravenosas , Usos Terapêuticos , Unidades de Terapia Intensiva Pediátrica , Milrinona , Usos Terapêuticos , Insuficiência de Múltiplos Órgãos , Mortalidade , Edema Pulmonar , Mortalidade , Respiração Artificial , Estudos Retrospectivos , Choque , Mortalidade , Resultado do TratamentoRESUMO
Objective To investigate the possible origin of ovarian epithelial inclusions and its relationship with the low-grade ovarian serous carcinoma.Methods By comparatively evaluating the morphologic (secretory and ciliated cell distribution ) and immunophenotypic [using paired box gene 8 (PAX8),tubulin,calretinin,and Ki-67 as first antibodies] attributes of ovarian epithelial inclusions,the normal tubal epithelium,and the ovarian tumors,all adnexal tissues from a total of 198 patients were studied,including 116 adnexae removed for non-neoplastic indications,53 serous cystadenomas,44 serous borderline tumors,and 41 low-grade serous carcinomas,which were collected from Qilu Hospital of Shandong University and University of Arizona in USA.Immunohistochemical single staining was used to detect the expressions of PAX8,tubulin,calretinin,and Ki-67 in the two groups,while immunohistochemical double staining of PAX8/calretinin was used to figure out the immunophenotype of various ovarian epithelial inclusions in a more intuitive way.Results With immunohistochemical single staining of PAX8 and calretinin,the vast majority (90%,54/60) of ovarian surface epithelia displayed a mesothelial phenotype [calretinin(+),PAX8 (-)],whereas 10% (6/60)of the cases displayed foci with tubal phenotype [calretinin(-),PAX8 (+)].In contrast,most (79%,728/921 ) of the ovarian epithelial inclusions displayed a tubal phenotype,though 21% (193/921) of the ovarian epithelial inclusions showed a mesothelial phenotype.It was further proved by immunohistochemical double staining of PAX8/ calretinin.Secretory and ciliated cells were found in the ovarian epithelial inclusions with tubal phenotype.There was a progressive increase in the secretory/ciliated cells ratio and proliferative index,from ovarian epithelial inclusions/cystadenomas to borderline tumors to low-grade serous carcinoma,according to the expression of tubulin and Ki-67.Conclusions The findings make a strong argument that the ovarian epithelial inclusions displaying a tubal phenotype with PAX8 (+),calretinin (-) is likely derived from fallopian tube rather than through Mullerian metaplasia from ovarian surface epithelium.The increasing trend of secretory/ciliated cells ratio and proliferative index from ovarian epithelial inclusions/cystadenomas to borderline tumors to low-grade serous carcinoma indicates that the latter is a clonal expansion of secretory cells.Genetic and molecular studies are needed to further confirm these findings.
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<p><b>OBJECTIVE</b>To screen the gene GATA4 for novel mutations associated with congenital atrial septal defect (ASD).</p><p><b>METHODS</b>The clinical data and peripheral venous blood specimen from 85 unrelated subjects with congenital ASD were collected and analyzed in contrast to 200 healthy individuals. The coding exons and the exon/intron boundaries of GATA4 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination procedure. The obtained sequences were aligned with those publicized in GenBank with the help of programme BLAST to identify the sequence variations. The software Clustal W was applied to analysis of the conservation of altered amino acids.</p><p><b>RESULTS</b>Three novel heterozygous missense GATA4 mutations were identified in 3 of 85 ASD patients, respectively. Namely, the triplet substitutions of ATG for GTG at codon 267, GCC for ACC at codon 354, and CAA for CCA at codon 407, predicting the conversions of valine into methionine at amino acid residue 267 (V267M), threonine into alanine at amino acid residue 354 (T354A), and proline into glutamine at amino acid residue 407 (P407Q), were identified. No mutation was detected in 200 healthy controls. A cross-species alignment of GATA4 encoded protein sequences showed that the valine at amino acid residue 267 and proline at amino acid residue 407 were completely conserved evolutionarily.</p><p><b>CONCLUSION</b>Three novel heterozygous missense GATA4 mutations were identified in patients with congenital ASD, which reveals new molecular etiology responsible for ASD, and contributes to the early prophylaxis and therapy for ASD.</p>
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Humanos , Sequência de Bases , Estudos de Casos e Controles , Análise Mutacional de DNA , Fator de Transcrição GATA4 , Genética , Testes Genéticos , Comunicação Interatrial , Genética , Mutação de Sentido IncorretoRESUMO
<p><b>OBJECTIVE</b>To evaluate the effect of long-term Shexiang Baoxin Pill (SXBXP) administration on cardiovascular events in patients with stable angina pectoris (SAP).</p><p><b>METHODS</b>A prospective randomized non-blind parallel controlled study was conducted in the early stage (the first 6 months) of the trial, then a cohort study was succeeded in the later stage. Two hundred patients with SAP, who visited the hospital between May 2005 and June 2006, were selected and randomly assigned to the trial group and the control group, 100 patients in each group. Both were treated with conventional therapy, including treatment for anti-platelet, blood lipid regulating, anti-ischemia, etc, and to patients in the trial group, SXBXP was administered additionally for 2 pills, three times a day by oral intake. The therapeutic course lasted for at least 6 months. All patients were followed up until January 2008, the clinical events and conditions of treatment were recorded. The composite terminal of various cardiovascular events was regarded as the primary endpoint.</p><p><b>RESULTS</b>The median follow-up time of the study was 2.25 years (ranging from 0.5 to 2.75 years). In the trial group, the occurrence (cases) was 23 for all-clinical event, 20 for primary-clinical event and 9 for angina pectoris event, which were lesser than those in the control group, 33, 29 and 19 cases respectively, showing a significant difference between groups (P < 0.05). The dosage of nitrates used in the trial was decreased more than that before treatment. Besides, all the incidences (cases), in terms of all-cause death (2 vs 5), cardiovascular death (1 vs 2), congestive heart failure (3 vs 4), stroke (2 vs 4), and other clinical (5 vs 6) events, as well as in the need for percutaneous coronary intervention or coronary artery bypass graft (2 vs 4), showed somewhat lowering in the trial group as compared with the corresponding items in the control group, but statistical analysis showed an insignificant difference between them (P > 0.05).</p><p><b>CONCLUSION</b>Long-term SXBXP administration could reduce the occurrence of angina pectoris events and some other clinical events, and cut down the dosage of nitrates used in patients with SAP.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença das Coronárias , Tratamento Farmacológico , Medicamentos de Ervas Chinesas , Usos Terapêuticos , Fitoterapia , Estudos Prospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To explore the regulatory mechanism of immune response of guinea pigs sensitized by trichloroethylene (TCE), and the expression level of 3-arrestin, and the activity of NF-kappaB and AP-1 in peripheral blood mononuclear cells (PBMC) of guinea pigs sensitized by TCE.</p><p><b>METHODS</b>Guinea pigs were treated with TCE based on the guinea pig maximum response test (GPMT); Blank control group and DNCB positive control group were established. Scores of skin reaction were evaluated and used to determine whether or not allergy in guinea pig. Then TCE treated group was divided into sensitized group or un-sensitized group. The expression levels of beta-arrestin protein, activity of NF-kappaB and AP-1 in PBMC were detected by Western Blotting and EMSA, respectively. TNF-alpha level in serum was detected by ELISA kits.</p><p><b>RESULTS</b>No erythema or edema was found in the control group; part of guinea pigs treated with TCE developed erythema and edema, while obvious erythema and edema could be found in DNCB group. The sensitization rates were 71.4% and 100% in TCE and DNCB group, respectively. Compared with TCE un-sensitized group, expression of beta-arrestin and AP-1 activity were not significantly different in TCE sensitized group (P > 0.05). While the NF-kappaB activity was elevated obviously (P < 0.05). Compared with blank control groups [(32.118 +/- 12.550) pg/ml], serum TNF-alpha levels in TCE sensitized groups [(55.485 +/- 8.732) pg/ml] significantly elevated (P < 0.05);</p><p><b>CONCLUSION</b>In guinea pigs, beta-arrestin and AP-1 may not be activated, while the NF-kappaB activation is significant, and plays a immune regulatory role in the immune reaction of allergy induced by TCE.</p>