RESUMO
As one of the key stable crops to feed half of the world's population, how rice cropping system affects honey bee health regarding pesticide exposure and forage availability is under investigated. We predicted honey bees were stressed by high pesticide exposure and forage dearth in monoculture rice systems. Providing access to natural habitats is a typical approach to mitigate the negative impact of intensive agriculture on honey bees. We aimed to determine if bee colonies located in landscapes with more cover of forest habitat would collect more forage and be exposed to less pesticides. We selected beekeeping locations in rice dominated landscapes (as control), mosaic landscapes of rice and medium woodland (MW) cover, and landscapes of high woodland (HW) cover, respectively, in July when rice starts bloom and pesticides are commonly used. Colonies were inspected at a biweekly frequency from July to October with population growth and forage (nectar and pollen) availability estimated. Pollen and bees were collected in middle August for pesticide exposure analysis. We did not observe enhancement in forage availability and reduction in pesticide exposure in landscapes with increased forest habitat (i.e., MW or HW cover), and all colonies failed in the end. Other natural habitats that can supplement flower shortage periods in forest can be considered for supporting bee health. Our results suggest that forest should be carefully assessed for being incorporated into beekeeping management or pollinator conservation when forest phenology can be a factor to affect its impact as a natural habitat.
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Oryza , Praguicidas , Abelhas , Animais , Agricultura , Criação de Abelhas , Néctar de PlantasRESUMO
The newly identified Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has resulted in a global health emergency (COVID-19) because of its rapid spread and high mortality. Since the virus epidemic, many pathogenic mechanisms have been revealed, and virus-related vaccines have been successfully developed and applied in clinical practice. However, the pandemic is still developing, and new mutations are still emerging. Virus pathogenicity is closely related to the immune status of the host. As innate immunity is the body's first defense against viruses, understanding the inhibitory effect of SARS-CoV-2 on innate immunity is of great significance for determining the target of antiviral intervention. This review summarizes the molecular mechanism by which SARS-CoV-2 escapes the host immune system, including suppressing innate immune production and blocking adaptive immune priming. Here, on the one hand, we devoted ourselves to summarizing the combined action of innate immune cells, cytokines, and chemokines to fine-tune the outcome of SARS-CoV-2 infection and the related immunopathogenesis. On the other hand, we focused on the effects of the SARS-CoV-2 on innate immunity, including enhancing viral adhesion, increasing the rate of virus invasion, inhibiting the transcription and translation of immune-related mRNA, increasing cellular mRNA degradation, and inhibiting protein transmembrane transport. This review on the underlying mechanism should provide theoretical support for developing future molecular targeted drugs against SARS-CoV-2. Nevertheless, SARS-CoV-2 is a completely new virus, and people's understanding of it is in the process of rapid growth, and various new studies are also being carried out. Although we strive to make our review as inclusive as possible, there may still be incompleteness.
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COVID-19 , SARS-CoV-2 , Antivirais/farmacologia , Citocinas/metabolismo , Humanos , Imunidade InataRESUMO
OBJECTIVES: To investigate the epidemiological characteristics of respiratory Haemophilus influenzae (HI) infection in children in Suzhou, China and its association with climatic factors and air pollutants. METHODS: The data on air pollutants and climatic factors in Suzhou from January 2016 to December 2019 were collected. Respiratory secretions were collected from 7 940 children with acute respiratory infection who were hospitalized during this period, and bacterial culture results were analyzed for the detection of HI. A stepwise regression analysis was used to investigate the association of HI detection rate with air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and climatic factors (monthly mean temperature, monthly mean humidity, monthly total rainfall, monthly total sunshine duration, and monthly mean wind speed). RESULTS: In 2016-2019, the 4-year overall detection rate of HI was 9.26% (735/7 940) among the children in Suzhou. The children aged <1 year and 1-<3 years had a significantly higher HI detection rate than those aged ≥3 years (P<0.01). The detection rate of HI in spring was significantly higher than that in the other three seasons, and the detection rate of HI in autumn was significantly lower than that in the other three seasons (P<0.001). The multiple linear regression analysis showed that PM10 and monthly mean wind speed were independent risk factors for the detection rate of HI: the detection rate of HI was increased by 0.86% for every 10 µg/m3 increase in the concentration of PM10 and was increased by 5.64% for every 1 m/s increase in monthly mean wind speed. Air pollutants and climatic factors had a lag effect on the detection rate of HI. CONCLUSIONS: HI is an important pathogen for acute respiratory infection in children in Suzhou and is prevalent in spring. PM10 and monthly mean wind speed are independent risk factors for the detection rate of HI.
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Poluentes Atmosféricos , Poluição do Ar , Infecções por Haemophilus , Infecções Respiratórias , Criança , Humanos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Estações do Ano , China/epidemiologia , Infecções por Haemophilus/etiologia , Infecções por Haemophilus/induzido quimicamente , Poluição do Ar/efeitos adversos , Poluição do Ar/análiseRESUMO
BACKGROUND: Airway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. So the purpose of this study is to summarize the pathogenic bacteria and clinical manifestations of airway softening complicated with pneumonia in children. METHODS: Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results. RESULTS: A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3-10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05). CONCLUSION: The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.
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Pneumonia por Mycoplasma , Pneumonia , Infecções Respiratórias , Criança , Pré-Escolar , Tosse , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/epidemiologia , Sons RespiratóriosRESUMO
BACKGROUND: Bronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized children with bronchiolitis and study the clinical characteristics of bronchiolitis with or without coinfections. METHODS: We investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children's Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined to detect viruses by direct immunofluorescence assay or polymerase chain reaction (PCR). Mycoplasma pneumoniae (MP) was tested by PCR and enzyme-linked immunosorbent assay. RESULTS: Of the 1134 children less than 2 years with bronchiolitis, 122 were excluded by exclusion criteria. Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). Coinfection was identified in 13.5% (137 of 1012) of the patients. Coinfection included mixed virus infection and virus infection with MP infection. Children with single virus infection had a higher rate of oxygen therapy compared with single MP infection. CONCLUSIONS: The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia.
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Bronquiolite/virologia , Criança Hospitalizada , Coinfecção/epidemiologia , Viroses/epidemiologia , Pré-Escolar , China/epidemiologia , Enterovirus/isolamento & purificação , Feminino , Técnica Direta de Fluorescência para Anticorpo , Humanos , Lactente , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Reação em Cadeia da Polimerase , Prevalência , Vírus Sincicial Respiratório Humano/isolamento & purificação , Estudos Retrospectivos , Centros de Atenção TerciáriaRESUMO
OBJECTIVES: Exosomes are extracellular vesicles released from various inflammatory cells, such as T cells, B cells, dendritic cells (DCs), and mast cells, which have been implicated in the modulation of immune response in asthma. This study aimed to investigate whether exosomes from DCs activated by thymic stromal lymphopoietin (TSLP) play a role in T-helper cell differentiation through the OX40 ligand (OX40L). METHODS: Serum samples from patients with asthma were collected to measure the levels of OX40L, T-helper type 1 (Th1) cytokine interferon (IFN)-γ, and T-helper type 2 (Th2) cytokine interleukin (IL)-4 by enzyme-linked immunosorbent assay (ELISA). Exosomes were isolated from TSLP-activated DCs and co-cultured with CD4+ T cells. Western blot and ELISA assays were used to measure the levels of OX40L, IFN-γ, and IL-4 in DCs and CD4+ T cells. Flow cytometry was applied to detect Th1 and Th2 cells. RESULTS: OX40L and IL-4 were increased and IFN-γ was decreased in serum from asthmatic patients compared with healthy controls. TSLP induced DCs to express OX40L in released exosomes, which could promote proliferation of CD4+ T cells, elevate the level of IL-4, and promote Th2 differentiation. CONCLUSION: Blockade of OX40L in DC-derived exosomes could inhibit exosome-mediated CD4+ T proliferation and Th2 differentiation.
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Asma/imunologia , Citocinas/farmacologia , Células Dendríticas/efeitos dos fármacos , Exossomos/imunologia , Ligante OX40/imunologia , Células Th2/citologia , Asma/sangue , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD4-Positivos/imunologia , Diferenciação Celular , Humanos , Interferon gama/imunologia , Interleucina-4/imunologia , Células Th2/imunologia , Linfopoietina do Estroma do TimoRESUMO
BACKGROUND: MicroRNAs play roles in the pathogenesis of bronchial asthma. However, the mechanism of miR-29c in allergic asthma remains unclear. This study is to elucidate the regulation of Th cell differentiation by miR-29c in mononuclear macrophages. METHODS: A total of 52 children with asthma exacerbation and 26 children as controls were enrolled in the study. CD14+ monocytes were isolated from the peripheral blood. Differential expressions of microRNAs were evaluated using microarray analysis and miR-29c expression in monocytes was determined by qRT-PCR. The plasma B7-H3 was determined by ELISA. Transfection studies and luciferase reporter assay were performed to confirm target gene of miR-29c and its function. RESULTS: Compared to controls, 88 miRNAs in blood monocytes were up-regulated and 41 miRNAs down-regulated including miR-29c in asthma children. Children with asthma exacerbation had significantly lower level of miR-29c and higher level of plasma B7-H3 compared to controls (both P < 0.05). Functional studies based on luciferase reporter assay and immunofluorescence staining suggest that B7-H3 is the direct target of miR-29c and transfection anti-miR-29c into macrophages could enhance ROR-γt and GATA-3 expression in co-cultured CD4+ T cells and increase levels of IL-4 and IL-17 in supernatants. CONCLUSION: The axis of miR-29c/B7-H3 plays an important role in children with asthma through regulating Th2/Th17 cell differentiation and may provide new targets for treatment of asthma.
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Asma/genética , Antígenos B7/metabolismo , Hipersensibilidade/genética , MicroRNAs/metabolismo , Transdução de Sinais , Asma/sangue , Asma/complicações , Antígenos B7/sangue , Sequência de Bases , Estudos de Casos e Controles , Diferenciação Celular , Criança , Técnicas de Cocultura , Progressão da Doença , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Genes Reporter , Humanos , Hipersensibilidade/sangue , Hipersensibilidade/complicações , Luciferases/metabolismo , Macrófagos/metabolismo , Masculino , MicroRNAs/genética , Análise de Sequência com Séries de Oligonucleotídeos , Admissão do Paciente , Alta do Paciente , Linfócitos T Auxiliares-Indutores/metabolismo , Células THP-1RESUMO
BACKGROUND: Co-infections are common in childhood community acquired pneumonia (CAP). However, their etiological pattern and clinical impact remains inconclusive. METHODS: Eight hundred forty-six consecutive children with CAP were evaluated prospectively for the presence of viral and bacterial pathogens. Nasopharyngeal aspirates were examined by direct immunofluorescence assay or polymerase chain reaction (PCR) for viruses. PCR of nasopharyngeal aspirates and enzyme-linked immunosorbent assays were performed to detect M. pneumoniae. Bacteria was detected in blood, bronchoalveolar lavage specimen, or pleural fluid by culture. RESULTS: Causative pathogen was identified in 70.1% (593 of 846) of the patients. The most commonly detected pathogens were respiratory syncytial virus (RSV) (22.9%), human rhinovirus (HRV) (22.1%), M. pneumoniae (15.8%). Coinfection was identified in 34.6% (293 of 846) of the patients. The majority of these (209 [71.3%] of 293) were mixed viral-bacterial infections. Age < 6 months (odds ratio: 2.1; 95% confidence interval: 1.2-3.3) and admission of PICU (odds ratio: 12.5; 95% confidence interval: 1.6-97.4) were associated with mix infection. Patients with mix infection had a higher rate of PICU admission. CONCLUSIONS: The high mix infection burden in childhood CAP underscores a need for the enhancement of sensitive, inexpensive, and rapid diagnostics to accurately identify pneumonia pathogens.
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Coinfecção , Infecções Comunitárias Adquiridas , Pneumonia , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/virologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae , Pneumonia/epidemiologia , Pneumonia/microbiologia , Pneumonia/virologia , Vírus Sincicial Respiratório Humano , RhinovirusRESUMO
Background: We aimed to find the relationship between the clinical characteristics and mucus plug formation and developed models to predict mucus plug formation in refractory Mycoplasma pneumoniae pneumonia (RMPP) infection. Methods: RMPP patients treated with bronchoscopy were retrospectively enrolled in the study between November 2011 and November 2015. Multivariate logistic regression was performed to identify independent predictors of mucus plug formation. Results: Of the 173 RMPP patients enrolled, the mucus plug group accounted for 82 (47.4%) cases. Multivariate logistic regression analysis identified age, fever duration, C-reactive protein (CRP) and lactic dehydrogenase (LDH) as independent risk factors for mucus plug. We assigned one point for age, length of fever and CRP and two points for LDH. Using this predicted score, we identified patients with mucus plug with 71.8% sensitivity and 78.9% specificity. Conclusions: Our predictive models based on demographic and laboratory variables accurately predicted mucus plug formation in initial treatment of patients with RMPP.
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Lavagem Broncoalveolar/efeitos adversos , Broncoscopia , Febre/etiologia , Muco , Pneumonia por Mycoplasma/terapia , Antibacterianos/uso terapêutico , Proteína C-Reativa/análise , Criança , Pré-Escolar , Feminino , Humanos , Macrolídeos/uso terapêutico , Masculino , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/tratamento farmacológico , Valor Preditivo dos Testes , Estudos RetrospectivosRESUMO
BACKGROUND: The purpose of this study is to explore the correlations of interleukin 36 (IL-36) and Soluble B7-H3 (sB7-H3) levels in bronchoalveolar lavage fluid (BALF) with clinical characteristics and laboratory findings. METHODS: A total of 35 children with M. pneumnoiae pneumonia (MPP) and 15 control subjects were enrolled. BALF concentrations of sB7-H3 and IL-36 were detected using enzyme-linked immunosorbent assays and clinical profiles of children with MPP were obtained. RESULTS: Children with MPP had significantly higher levels of sB7-H3 and IL-36 compared to control subjects (both P < 0.05). Meanwhile, children with pleural effusion had significantly higher levels of sB7-H3 and IL-36 compared to children without pleural effusion (both P < 0.05). BALF concentration of sB7-H3 was strongly associated with concentration of IL-36 (r = 0.796, P < 0.0001) and sB7-H3 was correlated with duration of fever (r = 0.427, P = 0.11) and length of stay (r = 0.345, P = 0.043). Both concentrations of sB7-H3 and IL-36 were significantly decreased in convalescent phase after treatment (both P < 0.05). CONCLUSION: Both soluble B7-H3 and IL-36 may play an important role in pathogenesis of M. pneumoniae infection and sB7-H3 could be useful as a prognostic predictor or biomarker of MPP.
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Antígenos B7/sangue , Líquido da Lavagem Broncoalveolar/microbiologia , Interleucina-1/sangue , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/sangue , Adolescente , Biomarcadores/sangue , Líquido da Lavagem Broncoalveolar/química , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/líquido cefalorraquidiano , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/microbiologiaRESUMO
BACKGROUND: Wheezing is a common symptom in early childhood. However, refractory wheezing is difficult to treat, and it may thus account for extensive use of medical resources. It is therefore important to improve our understanding of the pathophysiology of refractory childhood wheezing. METHODS: In this descriptive study, we studied 156 children with refractory wheezing using fiberoptic bronchoscopy and bronchoalveolar lavage (BAL), and compared the results with a control group of 46 children with various pulmonary diseases but no wheezing. Etiology and cell classification were analyzed for each BAL sample. RESULTS: Overall, 21.8 % of children with refractory wheezing had airway malformations including tracheomalacia, airway stenosis, and tracheal bronchus. The incidence of airway malformations increased to 31 % in infants under 12 months of age. A significant increase in neutrophil ratio and decrease in macrophage ratio were observed in BAL from children with refractory wheezing compared with controls. Pathogen infection led to a higher ratio of neutrophils in the wheezing group compared with controls. However, there were no significant differences in neutrophil ratios among children with various pathogen infections. Furthermore, children with refractory wheezing had a high rate of Mycoplasma pneumoniae infection. CONCLUSIONS: Airway malformations might play an important role in children under 3 years of age with refractory wheezing, especially in infants under 12 months of age. Neutrophil-mediated airway inflammation was characteristic of refractory wheezing in children under 3 years of age. In addition, infections such as M. pneumoniae may aggravate airway inflammation and affect refractory wheezing.
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Obstrução das Vias Respiratórias/complicações , Bronquite/complicações , Sons Respiratórios/etiologia , Anormalidades do Sistema Respiratório/complicações , Traqueomalácia/complicações , Obstrução das Vias Respiratórias/diagnóstico por imagem , Biomarcadores/metabolismo , Bronquite/diagnóstico , Bronquite/imunologia , Lavagem Broncoalveolar , Líquido da Lavagem Broncoalveolar/imunologia , Broncoscopia , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Lactente , Macrófagos/metabolismo , Masculino , Neutrófilos/metabolismo , Sons Respiratórios/diagnóstico , Sons Respiratórios/fisiopatologia , Anormalidades do Sistema Respiratório/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco , Traqueomalácia/diagnóstico por imagemRESUMO
OBJECTIVE: To investigate the detection rates, epidemical characteristics, and clinical features of human rhinovirus C (HRV-C) in hospitalized children with respiratory tract infections (RTIs) in Suzhou, China. METHODS: A total of 1 702 hospitalized children with RTIs from January to December, 2014 were enrolled, and 1 702 nasopharyngeal aspirate samples were collected from all children. RT-PCR was used to measure HRV mRNA, and quantitative real-time PCR combined with high-resolution melting curve was used to measure HRV-C. RESULTS: Of all children, 244 (14.34%) were detected to have HRV infection, among whom 69 (69/244, 28.3%) had HRV-C infection. The rate of mixed infection of HRV-C with other viruses and bacteria was 61% (42/69). HRV-C was detected in each month of the year, and the detection rate of HRV-C in autumn was significantly higher than that in spring, summer, and winter (P<0.05). The children aged 2-5 years had a significantly higher detection rate of HRV-C than those in the other age groups (P<0.05). Compared with HRV-A/B infection, HRV-C infection led to significantly higher proportions of patients with lobar pneumonia and acute exacerbation of asthma (P<0.05), as well as patients with increased neutrophil count and CRP level (P<0.05). There were no significant differences in sex distribution or other clinical manifestations (P>0.05). CONCLUSIONS: HRV-C infection accounts for about 1/3 of HRV infection, with a high incidence rate in autumn. The rate of mixed infection of HRV-C with other viruses and bacteria is high, and children aged 2-5 years have the highest detection rate of HRV-C. Children with HRV-C infection have similar clinical manifestations as those with HRV-A/B infection.
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Infecções Respiratórias/virologia , Rhinovirus/isolamento & purificação , Criança , Criança Hospitalizada , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Rhinovirus/classificação , Estações do AnoRESUMO
OBJECTIVE: To investigate the percentage of T lymphocyte subsets and allergen screening results in infants and young children with Mycoplasma pneumoniae (MP) infection complicated by wheezing. METHODS: Flow cytometry was used to measure the percentage of peripheral blood T cell subsets in 354 infants and young children with MP infection complicated by wheezing (MP wheezing group), 336 infants and young children with MP infection but without wheezing (MP non-wheezing group), and 277 children with recurrent wheezing (recurrent wheezing group). Allergen screening was also performed for these children. RESULTS: Both the MP wheezing group and recurrent wheezing group had significantly lower percentages of CD3+ and CD3+CD8+ lymphocytes than the MP non-wheezing group (p<0.05). The MP groups with or without wheezing had a significantly higher percentage of CD3+CD4+ lymphocytes than the recurrent wheezing group (p<0.05). Both the MP wheezing group and recurrent wheezing group had significantly higher percentages of CD3-CD19+ and CD19+CD23+ lymphocytes than the MP non-wheezing group (p<0.05), and the recurrent wheezing group had the highest percentages (p<0.05). The overall positive rate of food allergens was significantly higher than that of inhaled allergens (30.3% vs 14.7%; p<0.05). The positive rates of food and inhaled allergens in the recurrent wheezing group and MP wheezing group were significantly higher than in the MP non-wheezing group (p<0.05), and the recurrent wheezing group had the highest rates. CONCLUSIONS: Imbalance of T lymphocyte subsets and allergic constitution play important roles in the pathogenesis of MP infection complicated by wheezing in infants and young children.
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Alérgenos/imunologia , Pneumonia por Mycoplasma/complicações , Sons Respiratórios/etiologia , Subpopulações de Linfócitos T/imunologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pneumonia por Mycoplasma/imunologiaRESUMO
BACKGROUND: The pathogenesis of Mycoplasma pneumoniae infection involves cytoadherence of M. pneumoniae to the ciliated respiratory epithelium (CRE), followed by CRE injury caused by the M. pneumoniae. However, whether CRE abnormalities are related to the severity of M. pneumoniae pneumonia (MP) remains to be determined. METHODS: Thirty-eight patients with MP and 8 controls who underwent fiber-optic bronchoscopy with bronchial biopsy were included in this study. Patients with MP were divided into 2 groups: a mild disease group (12 patients) and a severe disease group (26 patients). The clinical features, laboratory findings, chest radiographic findings, and CRE abnormalities were characterized. RESULTS: Patients with severe pneumonia had a higher epithelial integrity score than those with mild pneumonia (5.1 ± 0.76 vs 3.8 ± 0.75; p < 0.01). Patients with severe CRE abnormalities had a longer duration of fever (p < 0.01), higher C-reactive protein (p < 0.01), and lower proportion of blood lymphocytes (p < 0.05) compared to those with mild abnormalities. Patients with a positive bacteria culture had a higher epithelial integrity score compared to those with a negative culture (6.0 ± 0.44 vs 4.8 ± 0.71; p < 0.01). CONCLUSIONS: CRE abnormalities are closely related to the severity of MP. These findings extend our current knowledge of MP.
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Cílios/microbiologia , Mycoplasma pneumoniae/fisiologia , Pneumonia por Mycoplasma/patologia , Mucosa Respiratória/anormalidades , Adolescente , Aderência Bacteriana , Broncoscopia , Estudos de Casos e Controles , Criança , Pré-Escolar , Cílios/patologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pneumonia por Mycoplasma/imunologia , Pneumonia por Mycoplasma/microbiologia , Mucosa Respiratória/microbiologia , Mucosa Respiratória/patologia , Índice de Gravidade de DoençaRESUMO
UNLABELLED: This study was aimed to describe the epidemiology, clinical features, and prognosis of respiratory adenoviral infections among children in Suzhou, China. From 1 January 2006 to 31 December 2012, medical records of 474 hospitalized patients with respiratory adenovirus infection were reviewed retrospectively. From 2006 to 2012, the virus positive rate was 1.42, 0.82, 1.45, 1.54, 0.77, 1.63, and 0.78 %, respectively; there was no outbreak in Suzhou throughout the 7 years. Adenovirus was detected in almost every month of the year with a peak from March to August. The median age was 36 months (range, 2 days-13 years); 89 % of the infections were confined to children <7 years of age, positive rates in patients between 2 â¼ 7 years of age and patients >7 years of age were higher than that of patients <2 years of age (P < 0.002). Comparisons of the length of hospital stay using the log-rank test statistic demonstrated patients <2 years had a significantly longer length of hospital stay (P < 0.001). CONCLUSIONS: The study demonstrates that respiratory adenovirus infection is an important cause of hospitalization in young children. Patients less than 2 years old were associated with prolonged hospitalization.
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Adenoviridae/isolamento & purificação , Infecções por Adenovirus Humanos/epidemiologia , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Infecções Respiratórias/epidemiologia , Infecções por Adenovirus Humanos/diagnóstico , Infecções por Adenovirus Humanos/virologia , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Estudos RetrospectivosRESUMO
Lung cancer is one of the deadliest cancers globally, and early diagnosis is crucial for patient survival. Pulmonary nodules are the main manifestation of early lung cancer, usually assessed using CT scans. Nowadays, computer-aided diagnostic systems are widely used to assist physicians in disease diagnosis. The accurate segmentation of pulmonary nodules is affected by internal heterogeneity and external data factors. In order to overcome the segmentation challenges of subtle, mixed, adhesion-type, benign, and uncertain categories of nodules, a new mixed manual feature network that enhances sensitivity and accuracy is proposed. This method integrates feature information through a dual-branch network framework and multi-dimensional fusion module. By training and validating with multiple data sources and different data qualities, our method demonstrates leading performance on the LUNA16, Multi-thickness Slice Image dataset, LIDC, and UniToChest, with Dice similarity coefficients reaching 86.89%, 75.72%, 84.12%, and 80.74% respectively, surpassing most current methods for pulmonary nodule segmentation. Our method further improved the accuracy, reliability, and stability of lung nodule segmentation tasks even on challenging CT scans.
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Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Nódulo Pulmonar Solitário , Humanos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador , Nódulo Pulmonar Solitário/diagnóstico por imagemRESUMO
Objective: The objective of this study is to examine the risk factors associated with apnea in hospitalized patients diagnosed with bronchiolitis and to develop a nomogram prediction model for the early identification of patients who are at risk of developing apnea. Methods: The clinical data of patients diagnosed with acute bronchiolitis and hospitalized at the Children's Hospital of Nanjing Medical University between February 2018 and May 2021 were retrospectively analyzed. LASSO regression and logistic regression analysis were used to determine the risk factors for apnea in these patients. A nomogram was constructed based on variables selected through multivariable logistic regression analysis. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the accuracy and discriminative ability of the nomogram model, and decision curve analysis (DCA) was performed to evaluate the model's performance and clinical effectiveness. Results: A retrospective analysis was conducted on 613 children hospitalized with bronchiolitis, among whom 53 (8.6%) experienced apnea. The results of Lasso regression and Logistic regression analyses showed that underlying diseases, feeding difficulties, tachypnea, WBC count, and lung consolidation were independent risk factors for apnea. A nomogram prediction model was constructed based on the five predictors mentioned above. After internal validation, the nomogram model demonstrated an AUC of 0.969 (95% CI 0.951-0.987), indicating strong predictive performance for apnea in bronchiolitis. Calibration curve analysis confirmed that the nomogram prediction model had good calibration, and the clinical decision curve analysis (DCA) indicated that the nomogram was clinically useful in estimating the net benefit to patients. Conclusion: In this study, a nomogram model was developed to predict the risk of apnea in hospitalized children with bronchiolitis. The model showed good predictive performance and clinical applicability, allowing for timely identification and intensified monitoring and treatment of high-risk patients to improve overall clinical prognosis.
RESUMO
Background: The implementation of a zero-COVID policy for 3 years in China during the COVID-19 pandemic significantly impacted a broad spectrum of acute respiratory tract infections (ARTIs). The epidemiological characteristics of ARTI pathogens in children following the cessation of the zero-COVID policy remain unclear. Methods: Etiologically diagnostic data from 82,708 children with ARTIs at the Children's Hospital of Soochow University during 2016-2023 were analyzed for 8 pathogens (human respiratory syncytial virus [HRSV], influenza A [FluA], FluB, human parainfluenza virus [HPIV], adenovirus [ADV], human rhinovirus [HRV], bocavirus [BoV], and mycoplasma pneumoniae [MP]). The changes in respiratory infections in Suzhou, China during the first year (2020, Phase I) and the second and third years of the pandemic (2021-2022, Phase II) and the first year after the end of zero-COVID policy (2023, Phase III) versus that in the pre-pandemic years (2016-2019) were compared. Results: When compared with the average pre-pandemic levels, the pathogen-positive rate decreased by 19.27% in Phase I (OR: 0.70; 95% CI: 0.67-0.74), increased by 32.87% in Phase II (OR: 1.78; 95% CI: 1.72-1.84), and increased by 79.16% in Phase III (OR: 4.58; 95% CI: 4.37-4.79). In Phase I, the positive rates of HRSV, FluA, ADV, and MP decreased by 26.72, 58.97, 72.85, and 67.87%, respectively, and the positive rates of FluB, HPIV, HRV, and BoV increased by 86.84, 25, 32.37, and 16.94%, respectively. In Phase III, the positive rates of HRSV, FluA, FluB, HPIV, ADV, and HRV increased by 39.74, 1046.15, 118.42, 116.57, 131.13, and 146.40%, respectively, while the positive rate of BoV decreased by 56.12%. MP was inhibited during the epidemic, and MP showed a delayed outbreak after the ending of the zero-COVID policy. Compared with the average pre-pandemic levels, the MP-positive rate in Phase III increased by 116.7% (OR: 2.86; 95% CI: 2.74-2.99), with the highest increase in 0-1-year-old children. Conclusion: The strict and large-scale implementation of the zero-COVID policy in the early stages of the COVID-19 pandemic was the main driving factor for the sharp reduction in the rate of children's respiratory pathogenic infections. The termination of this policy can cause a resurgence or escalation of pathogenic infections.
Assuntos
COVID-19 , Infecções Respiratórias , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , China/epidemiologia , Infecções Respiratórias/epidemiologia , Criança , Pré-Escolar , Lactente , Pandemias , Feminino , Política de Saúde , Masculino , Adolescente , Influenza Humana/epidemiologiaRESUMO
Automatic and accurate segmentation of pulmonary nodules in CT images can help physicians perform more accurate quantitative analysis, diagnose diseases, and improve patient survival. In recent years, with the development of deep learning technology, pulmonary nodule segmentation methods based on deep neural networks have gradually replaced traditional segmentation methods. This paper reviews the recent pulmonary nodule segmentation algorithms based on deep neural networks. First, the heterogeneity of pulmonary nodules, the interpretability of segmentation results, and external environmental factors are discussed, and then the open-source 2D and 3D models in medical segmentation tasks in recent years are applied to the Lung Image Database Consortium and Image Database Resource Initiative (LIDC) and Lung Nodule Analysis 16 (Luna16) datasets for comparison, and the visual diagnostic features marked by radiologists are evaluated one by one. According to the analysis of the experimental data, the following conclusions are drawn: (1) In the pulmonary nodule segmentation task, the performance of the 2D segmentation models DSC is generally better than that of the 3D segmentation models. (2) 'Subtlety', 'Sphericity', 'Margin', 'Texture', and 'Size' have more influence on pulmonary nodule segmentation, while 'Lobulation', 'Spiculation', and 'Benign and Malignant' features have less influence on pulmonary nodule segmentation. (3) Higher accuracy in pulmonary nodule segmentation can be achieved based on better-quality CT images. (4) Good contextual information acquisition and attention mechanism design positively affect pulmonary nodule segmentation.
Assuntos
Algoritmos , Redes Neurais de Computação , Humanos , Bases de Dados Factuais , Radiologistas , Tomografia Computadorizada por Raios XRESUMO
Introduction: Hypomorphic mutations of DCLRE1C cause an atypical severe combined immunodeficiency (SCID), and Epstein-Barr virus (EBV)-related colon lymphoma is a rare complication. Case presentation: A teenage boy presented with colon EBV-related colon lymphoma, plantar warts, and a history of recurrent pneumonia. His peripheral blood lymphocyte count and serum level of immunoglobulin (Ig) G were normal, but he exhibited a T+B-NK+ immunophenotype. Genetic analysis by whole exome sequencing revealed compound heterozygous mutations of DCLRE1C (NM_001033855.3), including a novel paternal splicing donor mutation (c.109 + 2T>C) in intron 1, and a maternal c.1147C>T (p.R383X) nonsense mutation in exon 13. Based on his clinical features and genetic results, the diagnosis of atypical SCID with colon lymphoma was established. Our review shows that seven patients, including our patient, have been reported to develop lymphoma, all with hypomorphic DCLRE1C mutations. Among these cases, six had EBV-related B-cell lineage lymphoma, and one had Hodgkin lymphoma with EBV reactivation. Unfortunately, all of the patients died. Conclusion: Recognizing the radiosensitivity of the disease is critical for the prognosis. Hematopoietic stem cell transplantation before being infected with EBV is an optimal treatment.