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Objective:To analyze the pathogen of 3 pediatric cases of scrub typhus without the eschar using metagenomics next-generation sequencing (mNGS), and the clinical application value of mNGS.Methods:Clinical data of 3 pediatric cases of severe scrub typhus without the eschar in the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from June 2018 to October 2019 were analyzed retrospectively.Among them, 2 cases were 5-year-old males and 1 case was 6-year-old female.Peripheral blood samples of 3 children were detected via mNGS technology.Results:Through mNGS detection, all 3 children were diagnosed with Orientia tsutsugamushi infection and were not complicated with other pathogenic infections.Case 1 died, and case 2 and case 3 were cured.Conclusions:Early diagnosis of scrub typhus without the eschar is difficult.Clinical infectious diseases, especially complicated and critical infectious diseases are difficult to be diagnosed at an early stage, mNGS can provide fast and accurate pathogenic diagnosis support for precise treatment.
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Objective:To analyze the clinical manifestations, blood biochemistry indexes, imaging and genetic characteristics of mitochondrial encephalomyopathy with lactic academia and stroke 1ike episodes (MELAS) in children, so as to provide the basis for the diagnosis of MELAS and reduce the misdiagnosis rate.Methods:The clinical data of children with MELAS admitted to the Second Affiliated Hospital of Wenzhou Medical University from January 2000 to December 2020 were retrospectively analyzed, and healthy children undergoing physical examination during the same period were selected as control group.The clinical data were compared between two groups, and the clinical manifestations, blood biochemistry indexes, electrocardiogram, cardiac ultrasound, cranial imaging and genetic testing were analyzed.Results:A total of eight children in MELAS group were collected, including three males and five females.The average age of onset was(9.90±3.89)years.There were eight children in control group, including four boys and four girls, with an average age of(7.92±2.51)years.Among the eight children with MELAS, there were six cases of vomiting, eight cases of epilepsy, five cases of headache, two cases of growth retardation, one case of mental retardation, one case of diabetes, and one case of peripheral neuropathy.The levels of lactate, lactate dehydrogenase, creatine kinase, and pyruvate in MELAS group were higher than those in control group, and the differences were statistically significant( P<0.05). Brain MRI abnormalities were observed in all patients, among which five patients had lesions located in the cerebral cortex, mostly in the parietal occipital temporal lobe, one patient had lesions located in the basal ganglia, and two patients had lesions in both cortex and basal ganglia.MRS of five cases showed inverted lactate peak with bimodal change.The electroencephalogram of eight cases showed slow wave of background activity, and epileptic discharge was observed in two cases.Seven children with MELAS had mtDNA locus mutation M. 3243A>G, and one patient had M. 8344A>G mutation.Eight cases were treated with symptomatic and supportive therapy, and were followed up for 3-5 years, most of them were hospitalized repeatedly because of similar chief complaints.The course of disease was prolonged and repeated, and the symptoms were relieved and discharged after about one week of hospitalization. Conclusion:The clinical manifestations of MELAS in children are diverse, and early diagnosis is difficult.Blood biochemistry, imaging characteristics and genetic testing results are helpful for early diagnosis, early treatment and delaying the progression of the disease.
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Objective:To explore the application value of bacterial culture and antibody detection of pertussis in children.Methods:A total of 262 children diagnosed with pertussis at the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from January 2018 to January 2020 were collected as the research objects.Bacterial culture and serum antibody test for pertussis were performed in all cases.According to the gender, age, course of the disease, and whether the children were vaccinated with pertussis vaccine, the patients were divided into different groups and we compared the detection results of different groups.Results:The high incidence age of pertussis was less than 1 year old, mainly less than 6 months old(62.2%). The positive rate of bacterial culture was 82.4%, and the highest positive rate was found in the group of ≤6 months old (94.5%). The positive rate of bacterial culture decreased with the increase of age and course of disease, and the positive rate of children without pertussis vaccination was higher than children with pertussis vaccination( P<0.001). The positive rate of pertussis antibody test was 23.3%.The positive rate of antibody test increased with the increase of age and course of disease and the positive rate of children without pertussis vaccination was lower than children with pertussis vaccination( P<0.001). Conclusion:The high incidence age of pertussis is mainly less than 6 months old.Bacterial culture of pertussis has a good diagnostic value in the early stage of the course, and enzyme linked immunosorbent assay is more helpful in the late stage of the disease.
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OBJECTIVE： To establish a method for content determination of total polyphenols from Gastrodia elata， and to optimize the purification technology of macroporous resin. METHODS： The content of total polyphenols from G. elata was determined by Folin-ciocaileu colorimetry. Using the absorption and desorption performance as index， 4 kinds of macroporous adsorption resins were selected by static adsorption and desorption tests. The flow rate and mass concentration of the sampling solution， volume fraction of eluent， eluent flow rate and eluent volume were investigated by dynamic adsorption and desorption tests. The purification technology of macroporous resin was optimized. RESULTS： The linear range of gallic acid was 4-32 μg/mL （r＝0.999 9）. RSDs of precision， stability and repeatability tests were all less than 2％. The recovery rate of the sample was 95.51％-102.94％（RSD＝2.54％，n＝6）. D301 macroporous resin had strong static adsorption and desorption ability from G. elata polyphenols. The optimal purification technology included that the sample solution flow rate 2 BV/h； the sample solution mass concentration 4 mg/mL； the elution solvent 70％ ethanol； the elution flow rate was 3 BV/h， and the eluent volume 5 BV. The content of total polyphenols from G. elata optimized by the optimal purification technology was 0.381 mg/g. CONCLUSIONS： Established method is sensitive and stable. The optimized purification technology is stable and feasible.
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Objective To explore the clinical effect of neoadjuvant chemotherapy of endostar combined with docetaxel plus cisplatin(TP) on patients with advanced ovarian cancer.Methods 76 patients meeting the criterion were enrolled to the study,and they were randomly divided into study group and the control group.The control group were administered with TP,while the study group received endostar combined with TP.The clinical effects,conditions of surgery and long-term survival were observed.Results All patients finished 3 cycles of neoadjuvant chemotherapy.The incidence of adverse reactions (leucopenia,anorexia and fever) in the study group was higher than that in the control group,and the difference had statistical significance (P＜0.05).The level of CA125,tumor load and ascites volume decreased after chemotherapy (P＜0.05).The two groups had no significance difference in intraoperative ascites,blood loss,time of surgery or hospital stay (P＞0.05).The rate of residual lesion≤2 cm was 84.2％ in the study group,higher than that of the control group (60.5％),and the difference had statistical significance (P＜0.05).The overall 1-year and 3-year survival were 84.2％,and 63.1％ for the control group,86.8％ and 60.5％ for the study group,and the difference had no statistical significance (γ2=0.207,P=0.649).One-year and 3-year disease free survival were 89.4％ and 68.4％ for the control group,94.7％ and 76.3％ for the study group (γ2=4.042,P=0.040).Conclusion Endostar combined with TP (docetaxel plus cisplatin) for patients with advanced ovarian cancer is safe and effective,which can improve the success rate of cytoreductive surgery and local control rate of tumor.