Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study / 中国当代儿科杂志

OBJECTIVES@#To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.@*RESULTS@#Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).@*CONCLUSIONS@#This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

Research progress on chemical constituents and biological activities of Arisaematis Rhizoma / 中国中药杂志

Arisaematis Rhizoma included in the Chinese Pharmacopoeia is the dried tuber of Arisaema erubescens, A. heterophyllum or A. amurense in the family Araceae. This paper mainly focuses on the classification and summary of the chemical components and structures reported in recent years in the above three varieties of this medicinal material included in the pharmacopoeia, including alkaloids, flavonoids, phenylpropanoids, lignans and benzene ring derivatives, steroids and terpenes, glycosides and esters, etc. Then we reviewed the reported biological activities of these chemical components, including cytotoxicity, antitumor activity, antibacterial activity, nematicidal activity, etc. Although there have been reports on the review of the chemical composition of the medicinal material, the structure and classification of the chemical composition in these reviews are not clear enough. This review provides a basis for the later study of the chemical composition of this medicinal material, especially the identification of the chemical structures. And most of the current reviews on the biological activity of this medicinal material are mainly for the crude extract. This paper mainly summarized the biological activity of related monomer compounds and expected to lay a foundation for the development of novel high-efficiency and low-toxicity active leading compounds from Arisaematis Rhizoma.

Short-term effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique / 中国骨伤

OBJECTIVE@#To explore the method and curative effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique.@*METHODS@#From October 2010 to June 2018, 50 patients with simple posterior cruciate ligament rupture were admitted, including 35 males and 15 females, ranging in age from 20 to 45 years old, 16 with acute injury and 34 with old injury. The posterior cruciate ligament (PCL) was reconstructed by double bundle technique with the whole internal short tendon. The two ends of the transplanted ligament were fixed by titanium plate suspended with adjustable loop. The Lysholm knee score and IKDC score were used to evaluate the clinical effects.@*RESULTS@#All the 50 patients were followed up, and the duration ranged from 6 to 60 months, with a mean of (28.84±9.52) months. At the latest follow up, the knee joint activity returned to normal range. The median value of Lysholm knee score was 54 before operation and 100 after operation. According to the IKDC score, there were 0 case of grade A, 0 case of grade B, 20 cases of grade C and 30 cases of grade D before operation;29 cases of grade A, 19 cases of grade B, 1 case of grade C and 1 case of grade D after operation;the difference was statistically significant (<0.01).@*CONCLUSION@#Arthroscopic double bundle reconstruction of posterior cruciate ligament with short internal tendon is safe and reliable, with less tendon transplantation, more stable fixation, and more bone reserve, which is beneficial for healing and renovation. The short term effect is positive.

The analysis of characteristic parameters based on the ultrasonic original radio-frequency signals of normal gastrocnemius / 中华超声影像学杂志

Objective:To analyze the influence of different factors on the entropy and grayscale values extracted from the ultrasonic original radio-frequency signals of normal human gastrocnemius.Methods:The ultrasonic original radio-frequency signals of 10 healthy men and 10 healthy women admitted to the Department of Ultrasound of First Affiliated Hospital of Nanjing Medical University from October to December 2019 in natural ankle joint position, maximum plantar flflexion and maximum dorsiflflexion position were collected, and the entropy and grayscale values were obtained by processing these signals with MATLAB software to analyze the differences of parameters in different positions and sections, and to discuss the influence of age, gender and BMI on them.Results:Comparison of the values between different sections: the differences between longitudinal extraction entropy values and transverse extraction entropy values at the maximum dorsiflexion position were statistically significant ( P<0.05), the differences between longitudinal extraction grayscale values and transverse extraction grayscale values at the natural position were statistically significant ( P<0.05) and both of values extracted in the longitudinal plane were higher than those extracted in the transverse plane. Comparison of the values among different positions of the ankle joints: the values of the maximal metatarsal flexion were statistically different from those of the natural position and the maximal dorsiflexion ( P<0.05), and the values of the maximal metatarsal flexion were the lowest, while the entropy and gray values of the natural position and the maximal dorsiflexion were not statistically different ( P>0.05). There was no significant difference in ultrasonic characteristic parameters between different genders and different age groups ( P>0.05). There was no correlation between BMI and characteristic parameters ( P>0.05). Conclusions:The entropy and grayscale values extracted from the original radio-frequency ultrasonic signals of healthy persons′ gastrocnemius can quantitatively reflect the difference in muscle structure from different positions and setions. As a result, this method can be considered in the quantitative evaluation of neuromuscular diseases.

Clinical features and precision medicine of the six most common types of monogenic diabetes / 中华内分泌代谢杂志

Monogenic diabetes is a special type of diabetes caused by a single gene mutation, and it is commonly misdiagnosed in clinical practice. The two major forms of monogenic diabetes are neonatal diabetes(NDM) and maturity onset diabetes of the young(MODY). The most common mutations in 6 genes, induding HNF1α, GCK, HNF4α, KCNJ11, ABCC8, and INS, account for more than 90% of all monogenic diabetic cases. This article is to review recent advances in clinical features, and precision medicine of monogenic diabetes, and to discuss the significance of insights gained from monogenic diabetes in better understanding the pathogenesis of type 1 and type 2 diabetes. The current models for screening of monogenic diabetes were also discussed.

Effect of transcutaneous electrical acupoint stimulation on recovery of gastrointestinal function after cesarean section / 中国针灸

OBJECTIVE@#To explore the effect on the recovery of gastrointestinal function after cesarean section treated with transcutaneous electrical acupoint stimulation at Zusanli (ST 36) on the basis of routine treatment.@*METHODS@#A total of 110 primiparas after cesarean section were randomized into an observation group and a control group, 55 cases in each one. The conventional treatment was applied in the two groups, after operation, transcutaneous electrical acupoint stimulation at Zusanli (ST 36) was used immediately in the observation group, the skin electrode of disposable anti-magnetic buckle was attached to Zusanli (ST 36) and the corresponding part of the inner lower leg, with disperse-dense wave, 30 Hz/60 Hz and 15-20 mA. The treatment was given for 30 min every time, once every 8 h, until the end of the first bowel movement. The recovery of gastrointestinal function after cesarean section (the restoring time of borborygmus, the time of first anal exsufflation and the first defecation time), the time of secretion of foremilk, complications (abdominal distension, abdominal pain, nausea etc.), hospital stays after operation and the satisfaction of primiparas after bowel movement were compared between the two groups.@*RESULTS@#The observation group was superior to the control group in the restoring time of borborygmus, the time of first anal exsufflation, the first defecation time and the time of secretion of foremilk (<0.01, <0.05). In the observation group, the incidence of postoperative complications such as abdominal pain, abdominal distension and nausea was 3.6% (2/55), which was lower than 16.4% (9/55) in the control group (<0.05). Compared with the control group, the observation group had shorter hospital stays (<0.01). The satisfaction of effect was 89.1% (49/55) in the observation group, which was superior to 72.7% (40/55) in the control group (<0.05).@*CONCLUSION@#Transcutaneous electrical acupoint stimulation at Zusanli (ST 36) can speed up the recovery of gastrointestinal function after cesarean section, reduce complications such as abdominal pain, abdominal distension, shorten hospital stays, promote patient nutrition intake and lactation, and improve comfort level and satisfaction of primiparas.

Clinical value of serum neuroglobin in evaluating hypoglycemic brain injury in neonates / 中国当代儿科杂志

OBJECTIVE@#To study the clinical value of serum neuroglobin in evaluating hypoglycemic brain injury in neonates.@*METHODS@#A total of 100 neonates with hypoglycemia were enrolled as subjects. According to amplitude-integrated EEG (aEEG) findings and/or clinical manifestations, they were divided into symptomatic hypoglycemic brain injury group (n=22), asymptomatic hypoglycemic brain injury group (n=37) and hypoglycemic non-brain injury group (n=41). The three groups were compared in terms of blood glucose, duration of hypoglycemia, levels of neuroglobin and neuron-specific enolase (NSE), and modified aEEG score. The correlation of neuroglobin with NSE and modified aEEG score was analyzed. The receiver operating characteristic (ROC) curve was plotted.@*RESULTS@#Compared with the asymptomatic hypoglycemic brain injury and hypoglycemic non-brain injury groups, the symptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Compared with the hypoglycemic non-brain injury group, the asymptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Neuroglobin was positively correlated with NSE and duration of hypoglycemia (r=0.922 and 0.929 respectively; P<0.05) and negatively correlated with blood glucose and modified aEEG score (r=-0.849 and -0.968 respectively; P<0.05). The areas under the ROC curve of neuroglobin, NSE and modified aEEG score were 0.894, 0.890 and 0.941 respectively, and neuroglobin had a sensitivity of 80.8% and a specificity of 95.8% at the optimal cut-off value of 108 mg/L.@*CONCLUSIONS@#Like NSE and modified aEEG score, serum neuroglobin can also be used as a specific indicator for the assessment of brain injury in neonates with hypoglycemia and has a certain value in clinical practice.

Determination of heavy metals in Coptidis Rhizoma of different habitats and risk assessment of heavy metals under different ways of administration / 药学学报

Inductively coupled plasma mass spectrometry (ICP-MS) was applied to this study to detect heavy metal contents in Coptidis Rhizoma from different habitats, for a comprehensive understanding of heavy metal residues in Coptidis Rhizoma. Decocting method and artificial gastrointestinal digestion model were used to determine transfer rates of heavy metals in assessment of health risk of heavy metals using the target hazard quotient (THQ) developed by the US EPA (1989). The results showed that excess rates of Cu, Pb, As, Cd and Hg of 17 batches of Coptidis Rhizoma were 0, 12%, 0, 0 and 0, respectively, under the ISO international standard of Chinese medicine-Chinese herbal medicine heavy metal. The transfer rates of Cu, Pb, As, Cd and Hg were 3.63%, 1.69%, 37.17%, 20.86% and 0 in decoction solution, respectively, and 59.15%, 29.98%, 67.55%, 104.59% and 0 in artificial gastrointestinal solution, respectively. The values of THQ under the two ways of administration in adults and children were 0.001 0, 0.005 3 and 0.000 7, 0.003 6, respectively, and the maximum residue limits (MRL) of heavy metals in Coptidis Rhizoma were higher than the contents of samples in this study. The research showed that the contents of heavy metals in Coptidis Rhizoma were in the safe ranges with no obvious risks to human body, indicating that the excessive of heavy metals in Coptidis Rhizoma might be attributed to the unduly strict standard. The contents of heavy metals in Coptidis Rhizoma of different habitats was estimated for health risks using international risk assessment model, which provides a reference for establishment of heavy metal standards in Coptidis Rhizoma.

Preparation of Melamine Molecularly Imprinted Surface Plasmon Resonance Sensor and Its Analytical Application / 分析化学

The melamine molecular imprinted polymer ( MIP ) membrane immobiliZed on the surface of the surface plasmon resonance ( SPR) chip was prepared with allylcyanurate and ethylene glycol dimethacrylate as a functional monomer and cross-linker, respectively.Based on the ratio of the intercept to the slope of Langmuir equation for imprinted polymer, the association constant ( Kass ) of imprinted sites in the imprinted film to melamine was calculated to be 1.40 × 108 L/mol.The SPR sensor showed high selectivity to the template molecule melamine, and the best response was obtained at pH=7.5.The method showed good linearity in the melamine concentration range of 0.1-10.0 nmol/L ( R=0.9991 ).Based on a signal to noise ratio of 3, the detection limits of melamine were 62.6 pmol/L and 56.4 pmol/L for the milk and milk powder, respectively.The recoveries were 91.5% for milk and 92.0% for milk powder.These results suggest that SPR sensing combined with MIP film is a promising alternative method for detection of melamine.

Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To provide a basis for early diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children by comparing the clinical characteristics of RMPP and general Mycoplasma pneumoniae pneumonia (MPP).</p><p><b>METHODS</b>Children with MPP hospitalized between October 2015 and December 2016 were selected as study subjects. According to the diagnostic criteria, children were divided into RMPP group (n=152) and MPP group (n=551). The differences between the two groups in the basic situation, clinical manifestations, infection parameters and myocardial enzymes were compared.</p><p><b>RESULTS</b>There were no significant differences in gender and age between the RMPP and MPP groups (P>0.05). The peak temperature in the RMPP group was significantly higher than that in the MPP group on the first day of admission (P<0.01). The percentage of children with augmentation in the RMPP group was lower than that in the MPP group (P=0.009). The percentage of neutrophils [Ne(%)] and serum procalcitonin (PCT) levels in the RMPP group were both higher than those in the MPP group (P<0.05), while the percentage of lymphocytes was significantly lower in the RMPP group (P<0.05). The serum levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in the RMPP group were also higher than those in the MPP group (P<0.05). Binary logistic regression analysis showed that the peak temperature and LDH were closely related to RMPP in children (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the peak temperature and LDH for the diagnosis of RMPP was 0.647 and 0.637 respectively. In children ≤2 years old, when the threshold value of LDH was 400 U/L, the diagnostic sensitivity was 52.63% and the specificity was 54.84%. In children above 2 years old, when the threshold value of LDH was 335 U/L, the diagnostic sensitivity was 69.92% and the specificity was 51.55%.</p><p><b>CONCLUSIONS</b>The children with RMPP have a high fever in the early stage. Meanwhile there are abnormal laboratory test results in these children. Elevated serum LDH levels have a high clinical value of early diagnosis of RMPP, especially in children above 2 years.</p>

Clinical efficacy of zoledronic acid in the treatment of osteoporotic unstable intertrochanteric fracture in the elderly / 中国生化药物杂志

Objective To study and analyze the clinical efficacy of zoledronic acid in the treatment of osteoporotic intertrochanteric fracture in elderly patients. Methods 100 elderly patients with osteoporotic unstable intertrochanteric fracture treated in our hospital from February 2014 to July 2016 were selected and randomly divided into the control group and the experimental group. There were 50 patients in each group. The control group received routine treatment (calcitonin), and the experimental group was treated with zoledronic acid.The clinical indicators of the two groups were compared and analyzed. Results After the corresponding treatment, the VAS scores of the experimental group and the control group were (0.36±0.42) and (0.34±0.40), and there was no statistical significance. The excellent rate of hip joint function was 82% in the control group, and the excellent and good rate of hip joint function in the experimental group was 80%, which was not statistically significant. In addition, there were no statistically significant differences in fracture healing time and complications between the two groups. After 1 years, the hip bone mineral density and the lumbar vertebral bone mineral density were (0.78±0.05) g/cm2, and (0.85±0.06) g/cm2 were significantly higher than those in the control group,with statistical significance (P<0.05). Conclusion Zoledronic acid in the treatment of senile osteoporotic unstable intertrochanteric fracture clinical effect is remarkable,can increase bone mineral density in a large extent, the joint recovery had no effect, has clinical significance.

Clinical efficacy of zoledronic acid in the treatment of osteoporotic unstable intertrochanteric fracture in the elderly / 中国生化药物杂志

Objective To study and analyze the clinical efficacy of zoledronic acid in the treatment of osteoporotic intertrochanteric fracture in elderly patients. Methods 100 elderly patients with osteoporotic unstable intertrochanteric fracture treated in our hospital from February 2014 to July 2016 were selected and randomly divided into the control group and the experimental group. There were 50 patients in each group. The control group received routine treatment (calcitonin), and the experimental group was treated with zoledronic acid.The clinical indicators of the two groups were compared and analyzed. Results After the corresponding treatment, the VAS scores of the experimental group and the control group were (0.36±0.42) and (0.34±0.40), and there was no statistical significance. The excellent rate of hip joint function was 82% in the control group, and the excellent and good rate of hip joint function in the experimental group was 80%, which was not statistically significant. In addition, there were no statistically significant differences in fracture healing time and complications between the two groups. After 1 years, the hip bone mineral density and the lumbar vertebral bone mineral density were (0.78±0.05) g/cm2, and (0.85±0.06) g/cm2 were significantly higher than those in the control group,with statistical significance (P<0.05). Conclusion Zoledronic acid in the treatment of senile osteoporotic unstable intertrochanteric fracture clinical effect is remarkable,can increase bone mineral density in a large extent, the joint recovery had no effect, has clinical significance.

Beclin1, LC3 and mTOR expression in esophageal squamous cell canceration and its clinical significance / 临床与实验病理学杂志

Purpose To investigate the difference of expression of autophagy-related gene (Beclin1,LC3,mTOR) in the development of esophageal squamous cell cancer.Methods Immunohistochemical EnVision method was adopted to detect the expression of autophagy-related gene Beclinl,LC3 and mTOR in 30 cases of normal esophageal mucosa,32 cases of low-grade intraepithelial neoplasia (LGIN),34 cases of highgrade intraepithelial neoplasia (HGIN),35 cases of early carcinoma and 126 cases of advanced esophageal carcinoma,respectively.The correlation between their expression with clinicopathologic factors was also analysed.Results The expression of Beclin1 in advanced esophageal carcinoma was obviously higher than that in another four groups (P ＜ 0.005).LC3 expression in advanced esophageal carcinoma was significantly higher than that in normal esophageal mucosa,LGIN and early carcinoma (P ＜ 0.005).The expression of mTOR in advanced esophageal carcinoma was significantly higher than that in normal esophageal mucosa,LGIN and HGIN (P ＜ 0.005).In advanced esophageal carcinoma group,the expression of Beclin1,LC3 and mTOR was related to tumor TNM stage and lymph node metastasis (P ＜ 0.05).Beclin1 expression was positively associated with LC3 and mTOR expression in advanced squamous cell carcinoma (P ＜ 0.05).Positive correlation was also observed between the expression of mTOR and LC3 in advanced esophageal carcinoma and HGIN (P ＜ 0.05).Conclusion In the carcinogenesis and development of esophageal cancer,Beclin1,as a tumor suppressor gene,activates autophagy and leads to excessive self consumption and death of tumor cells.mTOR promotes tumor growth by inhibiting autophagy and promoting angiogenesis.The combined detection of Beclinl,LC3 and mTOR may be beneficial to evaluate the progression and prognosis of esophageal squamous cell cancer.

Association between doctor selection habit and precision search on Internet medical platform / 中华医学图书情报杂志

The difference between doctor selection needs of the public and medical service at present was analyzed according to the questionnaire investigation of doctor selection habit of the public. The association between the focus on doctor personal information and the importance of different factors influencing doctor selection was analyzed ac-cording to the information searching methods used by the public when they selected their doctor. The effective pre-cision search approaches and methods on the Internet medical platform were proposed, including information searching methods on innovation platform, standardizing the weight of different kinds of information, and perfecting the pushing and recommending mechanisms for doctor selection searching results.

Effect of hypobaric hypoxia and cold exposure on formation of brown adipose tissue in mice / 中国比较医学杂志

Objective To investigate the effect of hypobaric hypoxia and cold exposure on brown adipose tissue in mice. Methods Twenty-four 6-week old SPF C57BL/6 male mice were randomly divided into 4 groups with 6 mice in each group: normal atmospheric pressure and temperature group ( 18~22℃, 20~60 m ) ( NTNP ) , low atmospheric pressure and normal temperature group ( 18~22℃, altitude of 5000 m ) ( NTLP ) , normal atmospheric pressure and cold exposure group(0~6℃, altitude of 20 ~60 m)(LTNP), low atmospheric pressure and cold exposure group(0 ~6℃, altitude of 5,000 m)(LTLP). The experimental period was 4 weeks. The body weight was measured at the beginning and end of the experiment. By the end of the four-week trial, the back and inguinal fat were dissected and observed by histology using HE staining. The expression of UCP-1 as the marker of brown adipose tissue in the back fat was detected by qPCR and western blot. Results The body weight gain of NTNP group was higher ( P< 0. 05 ) than the other three groups. Meanwhile, the color of the back and groin fat tissue of mice of LTNP and LTLP groups were darker, the blood supply in mice of these two groups was richer than the NTLP group. The volume of adipose tissue of NTNP group was higher than others. The histology showed that the back adipose cells of the mice were smaller and darker and full of multilocular lipid droplets, exhibiting a typical morphology of brown fat cells. Compared with the NTNP and NTLP groups, the mRNA and protein levels of UCP-1 were higher under cold exposure, while low atmospheric pressure had a tendency to reduce the mRNA expression of UCP-1. Conclusions The formation of brown fat is affected by the imitated conditions of low atmospheric pressure and cold exposure, and is more closely related to the decresed temperature.

Relationship between serum 25-hydroxyl-vitamin D3 levels and galectin-3 levels in serum and bronchoalveolar lavage fluid in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes of the levels of galectin-3 (Gal-3) in serum and bronchoalveolar lavage fluid (BALF) of children with asthma whose have different serum levels of 25-hydroxyl-vitamin D₃[25(OH)D₃].</p><p><b>METHODS</b>Fifty children with asthma between January 2013 and December 2014 were enrolled as the asthma group, and they were classified into 25(OH)D₃sufficient (n=7), insufficient (n=12) and deficient subgroups (n=31) according to the serum levels of 25(OH)D₃. Twenty children with abnormal airway or tracheal foreign bodies served as the control group. The levels of 25(OH)D₃, Gal-3 and total IgE in serum and Gal-3 levels in BALF were measured using ELISA.</p><p><b>RESULT</b>The serum levels of 25(OH)D₃in the asthma group were lower than in the control group (P<0.05). The 25(OH)D₃deficient subgroup displayed the highest percentages of neutrophils, eosinophils and epithelial cells in BALF, followed by the 25(OH)D₃insufficient subgroup and the 25(OH)D₃sufficient subgroup (P<0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF in the three subgroups were all higher than in the control group (P<0.05). In children with asthma, serum levels of 25(OH)D₃were negatively correlated with the percentages of neutrophils, eosinophils and epithelial cells in BALF (r=-0.683, -0.795 and -0.670 respectively; P<0.05); and a negative correlation was also seen between serum 25(OH)D₃levels and serum Gal-3 and total IgE levels (r=-0.759 and -0.875 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>The children with asthma have low serum levels of 25(OH)D₃. 25(OH)D₃and Gal-3 may be involved in the airway inflammation and the development of asthma.</p>

Distribution of pathogenic microorganisms and its relationship with clinical features in children with community-acquired pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the distribution of pathogenic microorganisms in different genders, age groups and seasons in children with community-acquired pneumonia (CAP) and the relationship between the distribution of pathogenic microorganisms and clinical features.</p><p><b>METHODS</b>A total of 1,155 children with CAP were enrolled, among whom there were 670 boys and 485 girls, with a mean age of 3.1±2.8 years (range: one month to 14 years). Indirect immunofluorescence assay, particle agglutination test, enzyme-linked immunosorbent assay, colloidal gold method. and bacterial culture were applied to determine common respiratory pathogenic microorganisms in sputum, throat swabs, blood samples, bronchoalveolar lavage fluid, and urine.</p><p><b>RESULTS</b>A total of 758 specimens (65.63%) were tested positive by pathogen detection. The top three dominant pathogens were Mycoplasma pneumoniae (MP, 43.64%), bacteria (15.12%), and respiratory syncytial virus (RSV, 9.26%), and the rate of mixed infection was 16.02%. The rates of MP infection between boys and girls with CAP were different (40.8% vs 47.6%; P<0.05). The MP detection rate was the highest in the age group of 6-14 years (77.4%) and the lowest in children younger than 1 year (11.2%), while the detection rates of bacteria and RSV were the highest in children younger than 1 year (21.2% and 17.2%, respectively). The MP detection rate was significantly higher in summer and autumn than in winter and spring, while the detection rates of bacteria and RSV in summer and autumn were significantly lower than those in winter and spring. Among children who were MP positive, fever, chills, cough, crackles were more likely to appear; children with RSV infection were more likely to have wheezes; children with bacterial infection were less likely to have cough. Serum levels of C-reactive protein and procalcitonin were associated with bacterial infection (OR=1.747 and 1.418, respectively; both P<0.05).</p><p><b>CONCLUSIONS</b>MP plays a more and more important role in the pathogenic microorganisms of CAP in children. Prevalence and outbreaks of MP infection among children should be alerted in summer and autumn. There are differences in the detection rate of various pathogenic microorganisms in CAP children with various age groups. The clinical features of children with CAP caused by different pathogenic microorganisms are different.</p>

Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture.</p><p><b>METHODS</b>Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm.</p><p><b>RESULTS</b>The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good.</p><p><b>CONCLUSION</b>The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.</p>

Clinical efficacy on vertebrobasilar insufficiency treated with auricular acupuncture / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy on vertebrobasilar insufficiency (VBI) between auricular acupuncture therapy and oral administration of medicine.</p><p><b>METHODS</b>Sixty patients of VBI were randomized into an auricular acupuncture therapy group and a medicine group, 30 cases in each one. In the auricular acupuncture group, acupuncture was applied bilaterally to gan (CO12) and jiejie (HX8) on the ears and needles were retained for 15 min. After needle withdrawal, the vaccariae semen were fixed with plaster at naogan (AT3, 4i), zhen (AT3), jing (AH12), shen (CO10) and pi (CO13) on the ears. In the medicine group, flunarizine hydrochloride capsules (Sibelium), 5mg were prescribed for oral administration, once every night. The treatment lasted continuously for 2 weeks (14 days) in the two groups. In 2 weeks, the clinical efficacy was assessed and the transcranial doppler (TCD) examination was performed.</p><p><b>RESULTS</b>After treatment, the symptom scores were all apparently reduced in the patients of the two groups (P < 0.01, P < 0.05). Compared with the medicine group, the reduced score was much more obvious in the auricular acupuncture group (P < 0.05), indicating the significant difference. After treatment, with TCD examination, the blood velocity was increased to different degrees in the patients of low velocity type in the auricular acupuncture group and the medicine group; that was reduced to different degrees in the patients of high velocity type in the auricular acupuncture group and the medicine group. All of them were different significantly as compared with those before treatment (all P < 0.05). But the difference was not significant between the two groups (both P > 0.05). In comparison of clinical efficacy between the two groups, the effective rate was 93.3% (28/30) in the acupuncture group and better than 76.7% (23/30) in the medicine group, indicating the significant difference in comparison (P < 0.05).</p><p><b>CONCLUSION</b>The auricular acupuncture therapy achieves the definite efficacy on VBI and the efficacy is better than flunarizine hydrochloride capsules.</p>

Alterations of SP-A, SP-D and KL-6 in serum and bronchoalveolar lavage fluid in children with Mycoplasma pneumoniae pneumonia / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the alterations and relationship of surfactant protein (SP)-A, SP-D and KL-6 in serum and bronchoalveolar lavage fluids (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP).</p><p><b>METHOD</b>Self-control method was used for the study on SP-A, SP-D and KL-6 in serum, infected and non-infected BALFs in 32 MMP children with only one side of MPP.</p><p><b>RESULT</b>The contents of SP-A, SP-D and KL-6 in infected BALF were [mg/L;M (IQR) ]: 243 (90-468) , 187 (43-333) , 148 (47-426) ;104 (37-257) , 56 (25-131) , 35 (12-147) in non-infected BALF; 35 (25-69) , 33 (9-149) and 24 (15-62) in serum. The correlation coefficient of KL-6 between serum and infected BALF were -0.534 and -0.378 (P < 0.05).</p><p><b>CONCLUSION</b>There were significant correlation between the alterations of SP-A, SP-D and KL-6 in serum and lung infection in children with CAP. KL-6 in serum may be more sensitive than SP-A and SP-D.</p>