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1.
Med Oncol ; 37(3): 20, 2020 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-32146584

RESUMO

Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is an extremely rare subtype of non-small-cell lung cancer (NSCLC) but differs from other NSCLC types. Most patients with PPLELC have almost no obvious clinical manifestations, and are often diagnosed in the advanced stage. Complete resection is the standard treatment for cases with early stage disease, while chemotherapy and radiotherapy are effective to some extent in late stage disease. High expression of PD-L1 in PPLELC tumor cells confers immunotherapy an important role in the treatment of PPLELC, and programmed death-1 (PD-1) inhibitors such as nivolumab and pembrolizumab may be optimal options for PPLELC patients. This review focuses on the clinical and pathologic features, treatment, and prognosis of PPLELC.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32200421

RESUMO

With dichotomous etiology and pathogenesis, intestinal type and diffuse type gastric cancers vary in their clinical and molecular features to the point of representing distinct entities. However, the differences of tumor-infiltrating immune cells within the two types of gastric cancer have not been well researched. This study was aimed to evaluate the functional impact of Lauren classification on immune contexture in gastric cancer patients. Tumor tissues of gastric cancer patients from Zhongshan Hospital and gastric cancer data from The Cancer Genome Atlas (TCGA) cohort were analyzed. By immunohistochemistry and flow cytometry, we found that intratumoral CD8+ T cells were more abundant but less functional in diffuse type as compared with those in intestinal type tumor tissues. Survival analysis indicated that CD8+ T cells yielded favorable prognosis only in intestinal type patients other than diffuse type cancer patients. Moreover, such diffuse type-associated CD8+ T cell dysfunction was featured by elevated expression of immunosuppressive factors including interleukin-10 (IL-10), transforming growth factor-ß1 (TGF-ß1) and indoleamine 2,3-dioxygenase 1 (IDO1). In summary, we found that the density, prognostic significance and functional status of intratumoral CD8+ T cells varied with Lauren subtypes in gastric cancer. These results further indicated Lauren classification might be a potential therapeutic marker, and should be considered in therapeutic decisions, especially immunotherapeutic eligibility.

3.
Br J Cancer ; 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32205862

RESUMO

BACKGROUND: Intratumoural CD103+CD8+ T cells have been linked to prolonged survival in several malignancies. However, the clinical significance of CD103+CD8+ T cells in gastric cancer remains unexplored. METHODS: Gastric cancer tissues from Zhongshan Hospital and data from Gene Expression Omnibus were obtained and analysed. Immunohistochemistry and flow cytometry were performed to detect the number and phenotypical characteristics of CD103+CD8+ T cells. The effect of programmed cell death protein-1 (PD-1) blockade on CD103+CD8+ T cells was evaluated with the use of an in vitro study based on fresh tumour tissues. RESULTS: CD103+CD8+ T cells predicted superior overall survival and provided better prognostic power than total CD8+ T cells in gastric cancer. Patients with high CD103+CD8+ T cell infiltration also gained more benefit from adjuvant chemotherapy. Flow cytometry analysis showed that CD103+CD8+ T cells exerted superior anti-tumour effects with stronger retention capacity and cytotoxicity. Moreover, an in vitro study showed that CD103+CD8+ T cells were more functionally restored after PD-1 blockade than CD103-CD8+ T cells. CONCLUSIONS: CD103+CD8+ T cells might be a useful marker to predict prognosis and therapeutic efficacy for gastric cancer patients. Efforts to increase intratumoural CD103+CD8+ T cell frequency might be a novel therapeutic strategy in gastric cancer.

4.
Thyroid ; 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32204685

RESUMO

BACKGROUND: MicroRNAs (miRNAs) are a class of critical epigenetic regulators involved in several autoimmune diseases. Our previous study reported an miR-326-induced increase in T helper (Th) 17 cells in a mouse model of Hashimoto's thyroiditis (HT), but the pathogenic effect of miR-326 in HT patients has not been verified. The goal of the present study was to explore the pathogenic role of miR-326 and its underlying molecular mechanism in HT patients. METHODS: A total of 58 HT patients and 55 normal controls were enrolled in this study. We examined whether Th17 cells and miR-326 were aberrantly altered in the peripheral blood mononuclear cells (PBMCs) of HT patients with flow cytometry and real-time PCR. Levels of membrane IL-23R (mIL-23R) were determined by flow cytometry and western blot to explore the critical role of mIL-23R in the development of Th17 cells. Isolated CD3+ T cells were employed to further investigate the ectodomain shedding of mIL-23R by a disintegrin and metalloprotease (ADAM17). Furthermore, miR-326 inhibitor and mimics were transfected into PBMCs derived from HT patients and healthy controls to verify the regulation of ADAM17 by miR-326. RESULTS: We observed elevated miR-326 levels in the PBMCs of HT patients compared with those in the PBMCs of healthy controls. Consistent with IL-23-induced STAT3 overactivation, substantially more HT patient-derived PBMCs differentiated into Th17 cells under polarization culture conditions, which may, at least in part, have resulted from enhanced membrane IL-23R (mIL-23R) levels. Furthermore, ADAM17, an ectodomain sheddase of mIL-23R, was targeted and negatively regulated by miR-326. Inhibiting ADAM17 might attenuate the ectodomain shedding of mIL-23R. CONCLUSIONS: Our findings suggest that the effect of miR-326 on the IL-23/IL-23R/Th17 cell axis in HT patients might be partially due to the targeting of ADAM17.

5.
Nanoscale ; 12(10): 6096-6103, 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32129393

RESUMO

Integration of diagnostic and therapeutic components into a single coordination polymer nanoparticle is desirable for theranostic applications, but still challenging. Herein, we report the synthesis of bimetal-phenolic coordination polymer nanoparticles using gadolinium nitrate and ferrous sulphate as a metal source, and plant polyphenols (i.e., tannic acid) as an organic ligand via a metal-catechol coordination assembly process. Such coordination polymers show a tunable molar ratio of Gd/Fe and high dispersibility and stability in aqueous solution. The coordination polymers reveal composition-dependent performance for longitudinal relaxivity and photothermal conversion. The longitudinal relaxivity is positively related to the molar ratio of Gd/Fe, while the photothermal performance is negatively related to the molar ratio of Gd/Fe in the coordination polymers. The coordination polymers with an optimized molar ratio of Gd/Fe exhibit an ultra-small hydrodynamic diameter (∼23 nm), a high r1 value (9.3 mM-1 s-1) with low r2/r1 (1.26) and high photothermal conversion efficiency (η = 37%). They can be used as a contrast agent for T1-weighted magnetic resonance imaging of EMT-6 tumor bearing mice, which can effectively enhance the signals of tumors. They can also effectively suppress tumor growth via photothermal therapy. This work brings new insights for the synthesis of multifunctional coordination polymer nanoparticles and extending their potential applications in theranostics.

6.
Chaos ; 30(2): 023135, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32113252

RESUMO

Accurate and timely short-term traffic flow forecasting plays a key role in intelligent transportation systems, especially for prospective traffic control. For the past decade, a series of methods have been developed for short-term traffic flow forecasting. However, due to the intrinsic stochastic and evolutionary trend, accurate forecasting remains challenging. In this paper, we propose a noise-immune long short-term memory (NiLSTM) network for short-term traffic flow forecasting, which embeds a noise-immune loss function deduced by maximum correntropy into the long short-term memory (LSTM) network. Different from the conventional LSTM network equipped with the mean square error loss, the maximum correntropy induced loss is a local similar metric, which is immunized to non-Gaussian noises. Extensive experiments on four benchmark datasets demonstrate the superior performance of our NiLSTM network by comparing it with the frequently used models and state-of-the-art models.

7.
Endocrinology ; 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32152630

RESUMO

IL-10 is a highly important anti-inflammatory cytokine in the immune system. CD1dhi and CD5+ B cells are both traditionally defined IL-10-secreting B cells. In recent years, a B cell group with combined markers of CD1dhi and CD5+ has been widely studied as reported to suppress autoimmunity in mouse models of autoimmune diseases through IL-10 mechanisms. From the perspective of origination, CD1dhi and CD5+ B cells are developed from different B cell lineages. Whether the regulatory capacity of these two B cell groups is consistent with their ability to secrete IL-10 has not been determined. In this study, we generated IL-10 knockout NOD.H-2h4 mice to investigate the function of endogenous IL-10 in autoimmune thyroiditis and conducted adoptive transfer experiments to explore the respective roles of CD5+ and CD1dhi B cells. In our results, the IL-10-/- NOD.H-2h4 mice developed thyroiditis, similar to wild-type NOD.H-2h4 mice. The CD5+ B cells were more capable of secreting IL-10 than CD1dhi B cells in flow cytometric analysis, but the CD1dhi B cells showed more suppressive effects on thyroiditis development and autoantibody production, as well as Th17 cell response. In conclusion, endogenous IL-10 plays no important role in autoimmune thyroiditis. CD1dhi B cells may play regulatory roles through mechanisms other than secreting IL-10.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32037721

RESUMO

BACKGROUND: Early intervention for psychosis is recommended because the first 5 years beyond the first episode is considered the critical period within which individuals have the most potential to maximize their response to treatment and recovery. Mindfulness-based interventions (MBIs) have been studied extensively in diverse disease groups, but research in people with recent-onset psychosis is still immature. AIM: This review aims to explore the feasibility, acceptability and summarize any effectiveness data on of the MBIs for people with recent-onset psychosis reported by the study authors. METHODS: A systematic search of original intervention research studies relevant to the topic published between January 2000 and August 2019 was conducted with 10 databases. Articles published in English with accessible full text were included. RESULTS: A total of eight studies were included, which reported recruitment rates of between 62.5% and 100%, withdrawal rates between 0% and 37.5% and attendance rates of between 56% and 100%. Participants' qualitative feedback indicated high levels of satisfaction with the MBIs. The intervention approaches adopted in the reviewed studies include mindfulness-based interventions, acceptance and commitment therapy and compassion-based interventions. MBIs have produced promising positive effects on participants' psychiatric and psychosocial outcomes. CONCLUSION: This review confirms that MBIs are generally feasible and acceptable for people with recent-onset psychosis. The preliminary results suggested the potential effects of MBIs in this area. Fully powered randomized controlled trials are suggested to confirm the effectiveness and exploratory studies to gain greater insight into the active components and mechanism of actions of MBIs for recent-onset psychosis.

9.
Artigo em Inglês | MEDLINE | ID: mdl-32054572

RESUMO

Unsupervised domain adaptation has increasingly gained interest in medical image computing, aiming to tackle the performance degradation of deep neural networks when being deployed to unseen data with heterogeneous characteristics. In this work, we present a novel unsupervised domain adaptation framework, named as Synergistic Image and Feature Alignment (SIFA), to effectively adapt a segmentation network to an unlabeled target domain. Our proposed SIFA conducts synergistic alignment of domains from both image and feature perspectives. In particular, we simultaneously transform the appearance of images across domains and enhance domain-invariance of the extracted features by leveraging adversarial learning in multiple aspects and with a deeply supervised mechanism. The feature encoder is shared between both adaptive perspectives to leverage their mutual benefits via end-to-end learning. We have extensively evaluated our method with cardiac substructure segmentation and abdominal multi-organ segmentation for bidirectional cross-modality adaptation between MRI and CT images. Experimental results on two different tasks demonstrate that our SIFA method is effective in improving segmentation performance on unlabeled target images, and outperforms the state-of-the-art domain adaptation approaches by a large margin.

10.
Med Image Anal ; 61: 101632, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32028212

RESUMO

Neurodegenerative diseases are excessively affecting millions of patients, especially elderly people. Early detection and management of these diseases are crucial as the clinical symptoms take years to appear after the onset of neuro-degeneration. This paper proposes an adaptive feature learning framework using multiple templates for early diagnosis. A multi-classification scheme is developed based on multiple brain parcellation atlases with various regions of interest. Different sets of features are extracted and then fused, and a feature selection is applied with an adaptively chosen sparse degree. In addition, both linear discriminative analysis and locally preserving projections are integrated to construct a least square regression model. Finally, we propose a feature space to predict the severity of the disease by the guidance of clinical scores. Our proposed method is validated on both Alzheimer's disease neuroimaging initiative and Parkinson's progression markers initiative databases. Extensive experimental results suggest that the proposed method outperforms the state-of-the-art methods, such as the multi-modal multi-task learning or joint sparse learning. Our method demonstrates that accurate feature learning facilitates the identification of the highly relevant brain regions with significant contribution in the prediction of disease progression. This may pave the way for further medical analysis and diagnosis in practical applications.

11.
Med Image Anal ; 61: 101654, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32066065

RESUMO

Objective and quantitative assessment of fundus image quality is essential for the diagnosis of retinal diseases. The major factors in fundus image quality assessment are image artifact, clarity, and field definition. Unfortunately, most of existing quality assessment methods focus on the quality of overall image, without interpretable quality feedback for real-time adjustment. Furthermore, these models are often sensitive to the specific imaging devices, and cannot generalize well under different imaging conditions. This paper presents a new multi-task domain adaptation framework to automatically assess fundus image quality. The proposed framework provides interpretable quality assessment with both quantitative scores and quality visualization for potential real-time image recapture with proper adjustment. In particular, the present approach can detect optic disc and fovea structures as landmarks, to assist the assessment through coarse-to-fine feature encoding. The framework also exploit semi-tied adversarial discriminative domain adaptation to make the model generalizable across different data sources. Experimental results demonstrated that the proposed algorithm outperforms different state-of-the-art approaches and achieves an area under the ROC curve of 0.9455 for the overall quality classification.

12.
Artigo em Inglês | MEDLINE | ID: mdl-32091996

RESUMO

Sub-cortical brain structure segmentation is of great importance for diagnosing neuropsychiatric disorders. However, developing an automatic approach to segmenting sub-cortical brain structures remains very challenging due to the ambiguous boundaries, complex anatomical structures, and large variance of shapes. This paper presents a novel deep network architecture, namely ψ-Net, for sub-cortical brain structure segmentation, aiming at selectively aggregating features and boosting the information propagation in a deep convolutional neural network (CNN). To achieve this, we first formulate a densely convolutional LSTM module (DC-LSTM) to selectively aggregate the convolutional features with the same spatial resolution at the same stage of a CNN. This helps to promote the discriminativeness of features at each CNN stage. Second, we stack multiple DCLSTMs from the deepest stage to the shallowest stage to progressively enrich low-level feature maps with high-level context. We employ two benchmark datasets on sub-cortical brain structure segmentation, and perform various experiments to evaluate the proposed ψ-Net. The experimental results show that our network performs favorably against the state-of-the-art methods on both benchmark datasets.

13.
Eur J Cancer ; 128: 27-37, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32109848

RESUMO

AIM: Tumour-associated macrophages (TAMs) are prominent immune cells infiltrating in solid tumours with phenotypic and functional heterogeneity. However, the clinical significance of heterogeneous subtypes of TAMs in gastric cancer still remains obscure. Here, we aimed to explore the clinical significance of TAMs expressing dendritic cell-specific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN) and its relevance with immune contexture in gastric cancer. METHODS: We selected 453 formalin-fixed and paraffin-embedded samples and 51 fresh tissue specimens of patients with gastric cancer from Zhongshan Hospital. The association of DC-SIGN+ macrophages with clinicopathological parameters, overall survival (OS) and responsiveness to fluorouracil-based adjuvant chemotherapy (ACT) was inspected. Immunohistochemistry (IHC) and flow cytometry (FCM) were applied to characterize immune cells in gastric cancer. RESULTS: We demonstrated that high intratumoral DC-SIGN+ macrophages infiltration predicted poor OS and inferior therapeutic responsiveness to fluorouracil-based ACT in patients with gastric cancer. Furthermore, higher infiltration of DC-SIGN+ macrophages indicated an increased number of Foxp3+ regulatory T cells (Tregs), CD8+ T cells and a higher ratio of Foxp3+/CD8+ within the tumour microenvironment (TME). In addition, CD8+ T cells in DC-SIGN+ macrophages high subgroup were functionally impaired, showing decreased interferon-γ (IFN-γ), granzyme B (GZMB) and perforin production yet elevated programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) expression. CONCLUSIONS: DC-SIGN+ macrophages were associated with immunoinvasive TME and indicated poor prognosis and inferior therapeutic responsiveness to fluorouracil-based ACT. DC-SIGN+ macrophages might be an independent prognosticator and a potential immunotherapeutic target for gastric cancer.

14.
Biometrics ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32012220

RESUMO

We consider a two-sample problem where data come from symmetric distributions. Usual two-sample data with only magnitudes recorded, arising from case-control studies or logistic discriminant analyses, may constitute a symmetric two-sample problem. We propose a semiparametric model such that, in addition to symmetry, the log ratio of two unknown density functions is modeled in a known parametric form. The new semiparametric model, tailor-made for symmetric two-sample data, can also be viewed as a biased sampling model subject to symmetric constraint. A maximum empirical likelihood estimation approach is adopted to estimate the unknown model parameters, and the corresponding profile empirical likelihood ratio test is utilized to perform hypothesis testing regarding the two population distributions. Symmetry, however, comes with irregularity. It is shown that, under the null hypothesis of equal symmetric distributions, the maximum empirical likelihood estimator has degenerate Fisher information, and the test statistic has a mixture of χ2 -type asymptotic distribution. Extensive simulation studies have been conducted to demonstrate promising statistical powers under correct and misspecified models. We apply the proposed methods to two real examples.

15.
Infect Dis (Lond) ; 52(4): 284-290, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32013645

RESUMO

Background: Globally, a resurgence of measles during the last decade may be attributed to many factors. An unexpected measles outbreak occurred in Hong Kong, and infected 29 airport staff between March and April 2019. The authority updated public on new cases daily, a public enquiry telephone/online platform was set up on March 23, and an emergent vaccination programme was launched targeting unvaccinated airport staff. We aimed to study this measles outbreak and its related factors.Methods: We quantified the transmissibility of the outbreak by the time-varying effective reproduction number, Reff(t), and inferred the time-varying basic reproduction number, R0(t). We examined the statistical associations between local public awareness or reporting delay and the R0(t).Results: Our estimated average R0 is 10.7 with 95% CI of 6.0-29.2. We found that R0(t) was negatively associated with the level of public awareness and the level of promptness of situation updates on new cases.Conclusion: Public awareness via situation updates helped to control the outbreak. The medical effects of the vaccination programme was not soon enough to cause the immediate shutting down of the outbreak, but it boosted herd immunity to prevent future airport outbreaks in the next few years.

16.
Stat Med ; 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32073677

RESUMO

There has been a growing interest in developing methodologies to combine information from public domains to improve efficiency in the analysis of relatively small-scale studies that collect more detailed patient-level information. The auxiliary information is usually given in the form of summary statistics or regression coefficients. Thus, the question arises as to how to incorporate the summary information in the model estimation procedure. In this article, we consider statistical analysis of right-censored survival data when additional information about the covariate effects evaluated in a reduced Cox model is available. Recognizing that such external information can be summarized using population moments, we present a unified framework by employing the generalized method of moments to combine information from different sources for the analysis of survival data. The proposed estimator can be shown to be consistent and asymptotically normal; moreover, it is more efficient than the maximum partial likelihood estimator. We also consider incorporating uncertainty of the external information in the inference procedure. Simulation studies show that, by incorporating the additional summary information, the proposed estimators enjoy a substantial gain in efficiency over the conventional approach. A data analysis of a pancreatic cancer cohort study is presented to illustrate the methods and theory.

17.
Mol Cell Endocrinol ; 506: 110756, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32045626

RESUMO

Exosomes have been intensively studied in autoimmune diseases, and circulating exosomes and microvesicles have also been explored in autoimmune thyroiditis (AITD). However, the role of thyroid cell-derived exosomes in immune responses is unclear. We showed that IFN-γ-treated Nthy-ori 3-1 cell-derived exosomes (IFN-γ-Exo) harbored TPO, HSP60 and MHC-II and activated dendritic cells (DCs) in vitro. Compared with Exo-targeted DCs (DCExo), IFN-γ-Exo-targeted DCs (DCIFN-γ-Exo) promoted the expression and release of proinflammatory cytokines, such as IFN-γ, IL-17A and IL-22, from CD4+ T lymphocytes and inhibited the expression and release of anti-inflammatory cytokines, such as IL-4, IL-10 and TGF-ß1; however, IFN-γ-Exo did not have this effect compared with Nthy-ori 3-1 cell-derived exosomes (Exo). DCIFN-γ-Exo stimulates the expression and release of cytokines from CD4+ T lymphocytes more efficiently than IFN-γ-Exo. Thus, DCIFN-γ-Exo may effectively induce CD4+ T lymphocyte-mediated immune responses and play a role in the occurrence and development of AITD.

18.
Anal Bioanal Chem ; 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076790

RESUMO

A series of Ru(II)-containing metallopolymers with different polypyridyl complexes, namely [Ru(N^N)2(L)](PF6)2 (L = bipyridine-branched polymer; N^N = bpy: 2,2'-bipyridine (Ru 1); phen: 1,10-phenanthroline (Ru 2); dpp: 4,7-diphenyl-1,10-phenanthroline (Ru 3)), were synthesized with the motive that adjusting π-conjugation length of ligands might produce competent luminescent oxygen probes. The three hydrophobic metallopolymers were studied with 1H NMR, UV-Vis absorption, and emission spectroscopy, and then were utilized to prepare biocompatible nanoparticles (NPs) via a nanoprecipitation method. Luminescent properties of the NPs were investigated against dissolved oxygen by steady-state and time-resolved spectroscopy respectively. Luminescence quenching of the three NPs all followed a linear behavior in the range of 0-43 ppm (oxygen concentration), but Ru 3-NPs exhibited the highest oxygen sensitivity (82%) and longest emission wavelength (λex = 460 nm; λem = 617 nm). In addition, external interferons from cellular environments (e.g., pH, temperature, and proteins) had been studied on Ru 3-NPs. Finally, dissolved oxygen in monolayer cells under normoxic/hypoxic conditions was clearly differentiated by using Ru 3-NPs as the luminescent sensor, and, more importantly, hypoxia within multicellular tumor spheroids was vividly imaged. These results suggest that such Ru(II)-containing metallopolymers are strong candidates for luminescent nanosensors towards hypoxia. Graphical abstract.

20.
Medicine (Baltimore) ; 99(2): e18714, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914082

RESUMO

To investigate the situation of antibiotic consumption and to assess the inappropriate use on pediatric inpatients of different types hospitals in Sichuan, China.A cross-sectional survey of antibiotic prescriptions among hospitalized children aged 1month -14years were conducted from April 2018 to June 2018 in southwestern China. Antibiotic prescriptions were extracted from electronic records during hospitalization of each inpatient in five different types hospitals.In this study, the antibiotic prescription rate of hospitalized children was 66.9% (1176/1758). Compared with tertiary children hospital (TC) (46.1%), general hospitals and non-tertiary children hospitals has higher rate of antibiotic prescription (almost 85%) (P < .001). 93.4% of inpatients received parenteral antibiotic. Overall, the most common antibiotics were Cefoperazone and enzyme inhibitor, Cefixime and Azithromycin. Lower respiratory tract infection (LRTI) was the leading reason for antibiotic consumption in pediatric wards (56.8%), followed by upper respiratory tract infection (URTI) (22.2%). For children with LRTI, Cephalosporins were heavy prescribed, especially broad-spectrum third-generation Cephalosporins (60.3%). The antibiotic prescription proportion of URTI in general hospitals and non-tertiary children hospitals (more than 18%) was higher than TC (8.1%) (P < .001).There was inappropriate use of antibiotic in hospitalized children including overuse of parenteral administration, overprescribing of antibiotic on URTI and misuse of third-generation Cephalosporins in pediatric inpatients with LRTI. Compared with tertiary freestanding children hospital, the irrational antibiotic prescription of general hospitals and non-tertiary children hospitals were more serious. Management strategy should be implementer on quality improvement of antibiotic use.


Assuntos
Antibacterianos/uso terapêutico , Uso de Medicamentos/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Antibacterianos/administração & dosagem , Criança , Criança Hospitalizada , Pré-Escolar , China , Estudos Transversais , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Masculino , Infecções Respiratórias/tratamento farmacológico
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