Adenovirus pneumonia with hemophagocytic lymphohistiocytosis in children: a clinical analysis of 7 children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with adenovirus pneumonia and hemophagocytic lymphohistiocytosis (HLH).@*METHODS@#A retrospective analysis was performed on the mediacal data of 7 children with adenovirus pneumonia and HLH from March to September, 2019.@*RESULTS@#The age of these children ranged from 11 months to 5 years, and among these children, 5 were aged <2 years and 5 were boys. None of these children had underlying diseases. All children were hospitalized due to persistent high fever and cough, and the peak temperature of fever was 39°C to 41°C. With disease progression, 7 children developed hepatomegaly and 6 developed splenomegaly. Routine blood test results showed reductions in two or three lineages of blood cells, with increases in serum ferritin (SF), C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH). Phagocytosis of blood cells was observed in 6 children. Radiological examination of lungs showed pneumonia changes. All 7 children were diagnosed with human adenovirus type 7 infection based on pathogenic metagenome detection. No abnormality was found by HLH gene detection and the children were diagnosed with secondary HLH. All children received intravenous immunoglobulin. Among these children, 4 received dexamethasone and etoposide chemotherapy, 3 received dexamethasone alone, and 4 received plasma exchange. Of the 7 children, 2 died and 5 were recovered. Compared with those who survived, the children who died had significantly greater reductions in the three lineages of blood cells and significantly greater increases in serum levels of CRP, PCT, SF, and LDH.@*CONCLUSIONS@#The children with adenovirus pneumonia and HLH have main clinical features of persistent high fever, progressive reductions in two or three lineages of peripheral blood cells, and involvement of other organ systems, including hepatosplenomegaly. Significant increases in serum levels of CRP, PCT, SF, and LDH may suggest a poor prognosis.

Mid-term outcome of endoscopic greater saphenous vein harvesting in coronary artery bypass grafting / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the mid-term clinical outcome of endoscopic greater saphenous vein harvesting (EVH) in coronary artery bypass grafting (CABG). Method A total of 205 patients receiving off-pump CABG between July, 2012 and April, 2013 at our department were enrolled in this study, including 66 patients (35 male and 31 female patients with a mean age of 60.3±7.92 years) undergoing EVH and 139 patients (109 male and 30 female patients with a mean age of 59.20±8.37 years) undergoing open greater saphenous vein harvesting (OVH).</p><p><b>RESULTS</b>The surgical procedures were completed smoothly in all the cases. The perioperative mortality rates was 3.03% (2/66) in EVH group, as compared with 3.60% (5/139) in OVH group (P=1.00). Acute myocardial infarction (AMI) occurred during the perioperative period in 3 (2.16%) patients in OVH group and in 1 (1.52%) patient in EVH group. Perioperative low cardiac output syndrome was diagnosed in 4 (2.88%) patients in OVH group and in 2 (3.03%) in EVH group (P>0.05). During the follow-up, 8 (8.80%) patients in OVH group and 5 (8.06%) in EVH group had recurrent angina (P=0.93). No patients experienced AMI during the follow-up. The 2-year patency rate of the venous grafts was 83.59% in OVH group and 82.22% in EVH group (P=0.73).</p><p><b>CONCLUSION</b>EVH has significant advantage in reducing the complications of the incision in the lower limbs. The mid-term patency rates of venous grafts are similar between OVH and EVH, but the long-term patency rate needs further evaluation.</p>

Effect and possible mechanism of hemoperfusion treatment for severe Henoch-Sch(o)nlein purpura / 中华实用儿科临床杂志

Objective To research the changes of clinical symptoms and serum free radical in children with severe Henoch-Sch(o)nlein purpura (HSP) between before and after accepted hemoperfusion.And evaluate the curative effect of hemoperfusion treatment for severe HSP and discuss the mechanism.Methods Twenty-three severe HSP patients in Children's Medical Center of the Second Xiangya Hospital of Central South University which were divided into 2 groups:13 cases were divided into traditional treatment group,10 cases were divided into hemoperfusion group; 11 healthy children were divided into healthy control group.The alleviate situation of clinical symptoms were observed and recorded such as purpura,abdominal pain,joint pain,hematuria,albuminuria,and the changes of urine RBC count,24 hour urine protein quantitative before and after hemoperfusion and traditional treatment.Collected the serum before and after the first time hemoperfusion treatment,after the second time hemoperfusion treatment,after the third time hemoperfusion treatment in hemoperfusion group;Collected the serum before and after conventional therapy in traditional treatment group; Collected only once serum in healthy control group.And then their superoxide anion(O2-·),hydroxy radical(· OH),hydrogen dioxide(H2O2),malonaldehyde(MDA) values were detected with spectrophotometry.The differences of each index among each group were compared respectively.Results After treatment,the clinical symptoms of 23 severe HSP children such as rash,abdominal pain,joint pain,hematuria,albuminuria which were reliefed compared to before treatment.The urine erythrocyte count,24 hour urine protein quantitative were reduced in 2 groups,but the symptoms of perfusion group children relieved faster,and the clinical index decreased more obviously.The serum O2-·,· OH,H2O2,MDA levels of 23 HSP children were significantly higher than those of the healthy control group (all P ＜ 0.01).In the traditional treatment group,compared between before and after treatment,the indexes were decreased (all P ＜ 0.05) ; After 3 times of hemoperfusion,all indexes were decreased in hemoperfusion group,but only after the third hemoperfusion the indexes were decreased statistically significant(all P ＜ 0.05).But compared with the hemoperfusion group,the index were decreased more apparently in after the third hemoperfusion,and it was statistically significant (P ＜ 0.05).Conclusions 1.The serum free radicals are increased in severe HSP children,they may play a role in vasculitis.2.For severe HSP,the recent therapeutic effect of hemoperfusion ally with traditional treatment is better than the alone traditional treatment.3.Hemoperfusion ally with traditional treatment can remove more effectly the serum free radicals,reduce lipid peroxide products,then mitigate the damage of the oxidate stress to the vascular endothelial.

Total liquid ventilation reduces oleic acid-induced lung injury in piglets / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pediatric patients are susceptible to lung injury that does not respond to traditional therapies. Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury. The aim of this study is to investigate the effect of total liquid ventilation on oleic acid (OA)-induced lung injury in piglets.</p><p><b>METHODS</b>Twelve Chinese immature piglets were induced acute lung injury by OA. Twelve piglets were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes. Samples for blood gas analysis were collected before, and at 60-minute intervals after OA-induced lung injury. The degree of lung injury was quantified by histologic examination. The inflammatory cells and the levels of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were analyzed.</p><p><b>RESULTS</b>Neutrophil and macrophage counts in bronchoalveolar lavage were significantly decreased in the study group (P < 0.05). The total lung injury score was also reduced in the study group (P < 0.05). The concentrations of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were significantly reduced in the study group (P < 0.05).</p><p><b>CONCLUSIONS</b>Total liquid ventilation reduces biochemical and histologic OA-induced lung injury in piglets.</p>

Atrial natriuretic peptide attenuates inflammatory responses on oleic acid-induced acute lung injury model in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An inflammatory response leading to organ dysfunction and failure continues to be a major problem after injury in many clinical conditions such as sepsis, severe burns, and trauma. It is increasingly recognized that atrial natriuretic peptide (ANP) possesses a broad range of biological activities, including effects on endothelial function and inflammation. A recent study has revealed that ANP exerts anti-inflammatory effects. In this study we tested the effects of human ANP (hANP) on lung injury in a model of oleic acid (OA)-induced acute lung injury (ALI) in rats.</p><p><b>METHODS</b>Rats were randomly assigned to three groups (n = 6 in each group). Rats in the control group received a 0.9% solution of NaCl (1 ml × kg(-1) × h(-1)) by continuous intravenous infusion, after 30 minutes a 0.9% solution of NaCl (1 ml/kg) was injected intravenously, and then the 0.9% NaCl infusion was restarted. Rats in the ALI group received a 0.9% NaCl solution (1 ml × kg(-1) × h(-1)) intravenous infusion, after 30 minutes OA was injected intravenously (0.1 ml/kg), and then the 0.9% NaCl infusion was restarted. Rats in the hANP-treated ALI group received a hANP (0.1 µg × kg(-1) × min(-1)) infusion, after 30 minutes OA was injected intravenously (0.1 ml/kg), and then the hANP infusion was restarted. The anti-inflammation effects of hANP were evaluated by histological examination and determination of serum cytokine levels.</p><p><b>RESULTS</b>Serum interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor (TNF) α were increased in the ALI group at six hours. The levels of all factors were significantly lower in the hANP treated rats (P < 0.005). Similarly, levels of IL-1β, IL-6, IL-10 and TNF-α were higher in the lung tissue in the ALI group at six hours. hANP treatment significantly reduced the levels of these factors in the lungs (P < 0.005). Histological examination revealed marked reduction in interstitial congestion, edema, and inflammation.</p><p><b>CONCLUSION</b>hANP can attenuate inflammation in an OA-induced lung injury in rat model.</p>

A novel, recovery, and reproducible minimally invasive cardiopulmonary bypass model with lung injury in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cardiopulmonary bypass (CPB) has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a good rat model of CPB to study the pathophysiology of potential complications.</p><p><b>METHODS</b>Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into a CPB group (n = 10) and a control group (n = 10). All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 8 ml of colloid. The surface of the hollow fiber oxygenator was 0.075 m(2). CPB was conducted for 60 minutes at a flow rate of 100-120 ml× kg(-1)×min(-1) in the CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Blood gas analysis, hemodynamic investigations, and lung histology were subsequently examined.</p><p><b>RESULTS</b>All CPB rats recovered from the operative process without incident. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. Mean arterial pressure remained stable. The results of blood gas analysis at different times were within the normal range. Levels of IL-1β and TNF-α were higher in the lung tissue in the CPB group (P < 0.005). Histological examination revealed marked increases in interstitial congestion, edema, and inflammation in the CPB group.</p><p><b>CONCLUSION</b>This novel, recovery, and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.</p>

Cannulated screw fixation through posteromedial approach screw for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effects of cannulated screw fixation through posteromedial approach for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament.</p><p><b>METHODS</b>From February 2007 to March 2012, 36 patients with tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament were reviewed. Among the patients, 28 patients were male and 8 patients were female, ranging in age from 16 to 57 years old,averaged 35 years old. All fractures were fresh closed fracture. The posterior drawer test and heavy sign were positive in all patients. AP X-ray of knee joints of all patients showed avulsion fracture flaps at the posterior tibia platform. All the patients were treated with cannulated screw fixation through posteromedial approach, and function exercise performed after operation. The Lysholm criterion was used to evaluate clinical effects.</p><p><b>RESULTS</b>All the patients had successful operation, and were followed up. The duration of follow-up ranged from 6 to 36 months, with an average of 12 months. The fractures healed at 3 months after operation. According to Lysholm knee joint evaluation criteria, 30 patients got an excellent result, 4 good and 2 poor,the average score was 92.2 +/- 3.8.</p><p><b>CONCLUSION</b>Cannulated screw fixation through posteromedial approach for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament is effective to recover joint function to large extent, which is a safe, simple and effective surgical method.</p>

Value of oral mucosa cast-off cells as samples in fluorescent in situ hybridization for the diagnosis of Down's syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>At present, blood and skin biopsy tissues are used in the fluorescent in situ hybridization (FISH) test for the diagnosis of Down's syndrome, however, the samples are usually obtained invasively. This study explores the value of oral mucosa cast-off cells in the FISH test, as samples obtained non-invasively, for the diagnosis of this disorder.</p><p><b>METHODS</b>Peripheral blood and oral mucosa cast-off cells were sampled for the FISH test in 16 children with suspected Down's syndrome between March 2010 and March 2011. Chromosomal karyotype analysis of peripheral blood lymphocytes ("gold standard" for the diagnosis of Down's syndrome) was also conducted.</p><p><b>RESULTS</b>The FISH test, in which both peripheral blood and oral mucosa cast-off cells were examined, showed that 14 children had 21-trosomy syndrome and the other 2 children had normal numbers of cromosome 21. The results of the FISH test were the same as the results of the chromosomal karyotype analysis.</p><p><b>CONCLUSIONS</b>Use of the FISH method to test samples of oral musoca cast-off cells is non-invasive and reliable for the diagnosis of Down's syndrome in children, and is hence worthy of recommendation.</p>

A novel, stable and reproducible acute lung injury model induced by oleic acid in immature piglet / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Young children are susceptible to pulmonary injury, and acute lung injury (ALI) often results in a high mortality and financial costs in pediatric patients. A good ALI model will help us to gain a better understanding of the real pathophysiological picture and to evaluate novel treatment approaches to acute respiratory distress syndrome (ARDS) more accurately and liberally. This study aimed to establish a hemodynamically stable and reproducible model with ALI in piglet induced by oleic acid.</p><p><b>METHODS</b>Six Chinese mini-piglets were used to establish ALI models by oleic acid. Hemodynamic and pulmonary function data were measured. Histopathological assessment was performed.</p><p><b>RESULTS</b>Mean blood pressure, heart rate (HR), cardiac output (CO), central venous pressure (CVP) and left atrial pressure (LAP) were sharply decreased after oleic acid given, while the mean pulmonary arterial pressure (MPAP) was increased in comparison with baseline (P < 0.05). pH, arterial partial pressure of O2 (PaO2), PaO2/inspired O2 fraction (FiO2) and lung compliance decreased, while PaCO2 and airway pressure increased in comparison with baseline (P < 0.05). The lung histology showed severe inflammation, hyaline membranes, intra-alveolar and interstitial hemorrhage.</p><p><b>CONCLUSION</b>This experiment established a stable model which allows for a diversity of studies on early lung injury.</p>

The mechanism of the increase of plasma bilirubin after hepatic ischemia-reperfusion in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of plasma bilirubin level increase after hepatic ischemia-reperfusion in rats.</p><p><b>METHODS</b>Rats were divided into a sham operation group (A group), a 20 min ischemia-reperfusion group (B group) and a 35 min ischemia-reperfusion group (C group). Study time points were 6 hours and 1, 3, and 5 days after the reperfusion. Pathological changes in the livers were studied with histological slides stained with hematoxilin and eosin. Routine biochemistry methods were used to detect the bilirubin level of blood plasma and the bile drained from the ischemic hepatic lobes. RT-PCR was used to analyze the expression of the multidrug resistance-associated protein 2 (MRP2) and mRNA. Immunohistochemistry was used to analyze the localization of MRP2 in the canalicular membrane.</p><p><b>RESULTS</b>B and C groups showed a mild inflammatory reaction without hepatocyte necrosis. At 6 h and 1 day after reperfusion, there was a significant increase of the plasma bilirubin level and a decrease of the bilirubin level of the drained bile in B group. These changes lasted to the day 3 and day 5 in C group. MRP2 mRNA down-regulation was found at 6 h only in the B and C groups. No localization of MRP2 in the canalicular membrane was found but it appeared in "esicules" under the canalicular membrane in C group.</p><p><b>CONCLUSIONS</b>Absence of MRP2 localization in the canalicular membrane could be the cause of the blood plasma bilirubin level increase after liver ischemia-reperfusion.</p>

Clinical observation and follow-up of 186 cases of Kawasaki disease with lesion of coronary artery / 中南大学学报(医学版)

OBJECTIVE@#To provide a reference for diagnosing and treating Kawasaki disease (KD).@*METHODS@#We retrospectively analyzed the clinical data of 186 cases of final diagnosed Kawasaki disease and observed the characteristics of incomplete KD.@*RESULTS@#There were 108 cases of KD with lesion of coronary artery in 186 cases through 2-dimensional echocardiography. The incidence rate was 58.1%; it was easier to complicate with lesion of coronary artery in incomplete KD. Of them, slight coronary artery aneurysm was 60 cases (55.6%), midrange coronary artery aneurysm was 36 cases (33.3%), and severe coronary artery aneurysm was 12 cases (11.1%). After 1 to 3 year's follow-up to all cases, the cases of slight coronary artery aneurysm all recovered in 6 months. The state of an illness in the cases of moderate and heavy coronary artery aneurysm was improved in 6 months except 3 huge aneurysm combining coronary artery thrombosis and coronary artery stenosis developed heart infarction and cardiomyopathy. The 30 cases of coronary artery aneurysm recovered in 1 year, 8 cases in 2 years, and 7 cases in 3 years. The patient that were not found with arterial coronary at the acute stage had no abnormality in 1 to 2 years after the treatment.@*CONCLUSION@#It is easier to complicate with lesion of coronary artery in incomplete KD and the prognosis of coronary aneurysm is worse. To improve early diagnose and treatment of incomplete KD, it is necessary to use 2-dimensional echocardiography to check the suspected cases.

Common SNPs of APM1 gene are not associated with hypertension or obesity in Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population.</p><p><b>METHODS</b>A case-control study design was applied. Common polymorphisms of 45T/G and 276G/T were genotyped by PCR product sequencing in 484 cases with HO and 502 controls with normal blood presure and BMI < 25.</p><p><b>RESULTS</b>The genotype and allele frequencies of 45T/G, 276G/T, and haplotype defined by the two variants in cases did not differ from those in controls. The means of blood pressure, BMI and waist-hip ratio did not differ among genotypes of the two polymorphisms and haplotypes. Among lipid profiles, only serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in T allele carriers than that in non-T carriers after adjusting possible confounding factors (1.21 vs 1.32 mmol/L, P=0.0001).</p><p><b>CONCLUSION</b>Polymorphisms of 45T/G and 276G/T in APM1 gene are not associated with hypertension or obesity, or their clinical features in Chinese Han population. Common polymorphism of 45T/G might be associated with serum HDL-C levels in Chinese.</p>

Prevalence, awareness, treatment and control of hypertension in Chinese adults / 中华预防医学杂志

<p><b>OBJECTIVE</b>To identify the prevalence, distribution, current status of awareness and control of hypertension in Chinese adult population.</p><p><b>METHODS</b>A cross-sectional survey was conducted in mainland of China in 2000 - 2001 as a part of work coordinated with InterASIA Program. A total of 15,838 nationally representative subjects aged 35 to 74 were selected with multistage cluster sampling. Measurement of blood pressure was taken for all of them with three readings in a mercuric-column sphygmomanometer after resting for five minutes. Standard structured questionnaire was used to collect their histories and treatment and prevention for hypertension. A case of hypertension was defined as any person with systolic blood pressure equal to or greater than 140 mmHg, or with diastolic blood pressure equal to or greater than 90 mmHg, or being administered with antihypertensive agents.</p><p><b>RESULTS</b>A total of 15,838 adults aged 35 - 74 years were included in this survey. Overall, the prevalence of hypertension was 27.2%, representing 130 million persons with hypertension nationwide as estimated. Age-specific prevalence of hypertension was 10.7%, 26.8%, 38.9% and 50.2% for women and 17.4%, 28.2%, 40.7% and 47.3% for men aged 35 - 44, 45 - 54, 55 - 64 and 65 - 74 years, respectively. Among hypertensive patients, 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved their blood pressure under control (< 140/90 mm Hg). All these data indicated that percentages of awareness, treatment and control of hypertension increased by 86.2%, 92.6% and 145.4%, respectively in the past ten years, as compared with the data in 1991.</p><p><b>CONCLUSIONS</b>In the past ten years, percentages of awareness, treatment and control of hypertension in Chinese adults increased significantly, who had a relatively high prevalence of hypertension, but lower awareness and much lower percentages of treatment and control of hypertension. It is urgently needed to improve prevention, detection and treatment for hypertension in adults.</p>

Correlation between Angiotensin Converting Enzyme Gene Polymorphism and Kawasaki Disease / 实用儿科临床杂志

Objective To investigate the correlation between angiotensin converting enzyme(ACE) gene polymorphism and kawasaki disease(KD).Methods A 287 bp Alu fragment in intron 16 of the ACE gene was used as insertion(I)/deletion(D) polymorphism marker. The ACE genotype of 28 children (10 children complicated coronary dilataltion) with KD and 35 healthy controls were detected by polymerase chain reaction (PCR), and ACE concentration in blood serum was measured by ultraviolet-spectrophotometer assay.Results 1.The ACE concentration was significantly higher in KD group than that in healthy control group(P