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Objective To analyze the epidemiological characteristics and risk factors of antibiotic-associated diarrhea (AAD) in children with pneumonia in Chongzhou, Sichuan Province, and to provide a theoretical basis for the diagnosis and treatment of AAD in children with pneumonia. Methods A total of 394 children with pneumonia admitted to our hospital from June 2018 to June 2021 were selected and divided into control group and AAD group according to whether the children had AAD. Univariate analysis and logistic regression were used to analyze the risk factors of pediatric pneumonia complicated with AAD. Results There were 79 cases of children with pneumonia complicated with AAD (20.05%). The average age of the ADD group was significantly lower than that of the control group (P<0.05). There were significant differences between the two groups in age of onset, length of hospital stay, type of antibiotics combined use, duration of antibiotics application, proportion of bacterial use of probiotics, and type of antibiotics (P<0.05). The age of onset <3 years old, duration of antibiotics application ≥5 days, combined use of three kinds of antibiotics, use of cephalosporin antibiotics, and no use of probiotics are independent risk factors for AAD in children with pneumonia. Conclusion The risk of AAD in children with pneumonia in Chongzhou is high, and the main pathogens are Candida and Escherichia coli. For children with cephalosporin antibiotics use, long application time of antibiotics, and onset age <3 years old, early application of probiotics should be done to reduce the risk of pediatric pneumonia complicated with AAD.
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OBJECTIVE@#To observe the effect of electroacupuncture (EA) at "Zusanli" (ST 36) on duodenal mast cells, nerve growth factor (NGF) and neurotrophic tyrosine kinase receptor type 1 (NTRK1), and to explore the mechanism of electroacupuncture at Zusanli (ST 36) on functional dyspepsia (FD).@*METHODS@#Sixty SPF-grade 10-day-old SD rats were randomly divided into a normal group, a model group, a ketotifen group and an EA group, 15 rats in each group. The FD model was prepared by iodoacetamide combined with rat tail clamping method in the model group, the ketotifen group and the EA group. The rats in the ketotifen group were injected intraperitoneally with ketotifen (1 mg•kg-1•d-1) for 7 days; the rats in the EA group were treated with EA at bilateral "Zusanli" (ST 36), with disperse-dense wave, frequency of 2 Hz/50 Hz and intensity of 0.5 mA, 20 min each time, once a day for 14 days. The gastric emptying rate and small intestinal propulsion rate in each group were observed; the morphology of duodenal mucosa was observed by HE staining; the toluidine blue staining was used to observe the number and degranulation of mast cells in duodenal mucosa; the protein and mRNA expressions of NGF, NTRK1 in duodenum were detected by Western blot and real-time PCR; the level of interleukin-1β (IL-1β) in duodenum was measured by ELISA.@*RESULTS@#Compared with the normal group, the gastric emptying rate and small intestinal propulsion rate in the model group were decreased (P<0.01); compared with the model group, the gastric emptying rate and small intestinal propulsion rate in the ketotifen group and the EA group were increased (P<0.01); the small intestinal propulsion rate in the EA group was higher than that in the ketotifen group (P<0.01). In the model group, local defects in duodenal mucosa were observed with a small amount of inflammatory cell infiltration; no obvious abnormality was found in duodenal mucosa of the other groups. Compared with the normal group, the mast cells of duodenal mucosa in the model group were increased significantly with significant degranulation; compared with the model group, the mast cells of duodenal mucosa in the ketotifen group and the EA group were decreased significantly, and the degranulation was not obvious. Compared with the normal group, the protein and mRNA expressions of NGF, NTRK1 as well as the level of IL-1β in duodenum in the model group were increased (P<0.01); compared with the model group, the protein and mRNA expressions of NGF, NTRK1 as well as the levels of IL-1β in duodenum in the ketotifen group and the EA group were decreased (P<0.01, P<0.05); compared with the ketotifen group, the mRNA expression of NGF, as well as the protein and mRNA expressions of NTRK1 in duodenum in the EA group were decreased (P<0.05, P<0.01).@*CONCLUSION@#EA at "Zusanli" (ST 36) could inhibit the activation of duodenal mast cells and regulate the expressions of NGF and its receptor to improve the low-grade inflammatory response of duodenum, resulting in treatment effect on FD.
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Animals , Rats , Acupuncture Points , Duodenum/metabolism , Dyspepsia/therapy , Electroacupuncture , Ketotifen , Mast Cells/metabolism , Nerve Growth Factor/metabolism , RNA, Messenger , Rats, Sprague-Dawley , Receptor, trkA/geneticsABSTRACT
Objective@#To investigate whether γ-aminobutyric acid (GABA) receptor signaling pathway is involved in the regulation of thalamic undefined (ZI)-nucleus accumbens (NAc) neural pathways on gastric distraction (GD)-sensitive neuronal firing activity and the impact on food intake, the number of times and the frequency in rats.@*Methods@#Six rats were randomly selected and the neural pathway between ZI and NAc in rat thalamus was observed by fluorescent gold (FG) retrograde tracing method.Eighty-two rats were randomly selected, and the gastric balloon was placed in gastric cavity, the microelectrode was placed in the NAc, and the stimulating electrode was placed in the ZI. The single-cell discharge recording method was used to observe the effect of electrical stimulation ZI on the excitability of GD-sensitive neurons in rat NAc.Eighteen rats were randomly selected and were divided into three groups according to the random number table. They were NS group, GABA group, GABA + GABA receptor antagonist bicuculline (BIC) group with 6 in each group, and the rat NAc was used to embed the cannula. The method of GABA and BIC was injected to observe the changes of cumulative food intake in rats for 4 h. Eighteen rats were randomly selected and randomly divided into three groups: sham stimulation (SS) group, 50 μA electrical stimulation group, 50 μA electrical stimulation + BIC group with 6 in each group. The 4 h cumulative food intake of rats was observed by electro-stimulation of rat ZI and rat NAc injection of BIC.@*Results@#Fluorescent gold retrograde tracking combined with fluorescent immunohistochemical staining showed that there were visible GABA and fluorescent gold double labeled neurons in ZI. Electrical stimulation of ZI, the frequency of GABA-sensitive GD neurons in rat NAc increased significantly (GD-E increase: (78.8±8.4)%, GD-I increase: (89.3±9.2)%, P<0.01), but the inhibitory effect was antagonized by BIC (GD-E increase: (113.8±13.6)%, GD-I increase: (121.8±14.2)%, P<0.01). Microinjection of GABA in rat NAc significantly increased the cumulative food intake for 4 h ((155.72±18.84) kcal, t=3.41, P<0.05), which was antagonized by partial BIC (123.43±15.11) kcal, t=3.28, P<0.05). Electrical stimulation of ZI significantly increased the food intake in rats ((39.07±11.27) kcal, t=2.96, P<0.05), and this effect can be partially antagonized by BIC ((34.17±10.85)kcal, t=2.33, P<0.05).@*Conclusion@#The ZI-NAc neural pathway regulates the discharge activity of rat gastric distension (GD)-sensitive neurons and the feeding status of rats, and the GABA receptor signaling pathway may be involved in mediating the process.
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Objective To investigate whether γ-aminobutyric acid (GABA) receptor signaling pathway is involved in the regulation of thalamic undefined (ZI)-nucleus accumbens (NAc) neural pathways on gastric distraction (GD)-sensitive neuronal firing activity and the impact on food intake,the number of times and the frequency in rats.Methods Six rats were randomly selected and the neural pathway between Zl and NAc in rat thalamus was observed by fluorescent gold (FG) retrograde tracing method.Eighty-two rats were randomly selected,and the gastric balloon was placed in gastric cavity,the microelectrode was placed in the NAc,and the stimulating electrode was placed in the ZI.The single-cell discharge recording method was used to observe the effect of electrical stimulation ZI on the excitability of GD-sensitive neurons in rat NAc.Eighteen rats were randomly selected and were divided into three groups according to the random number table.They were NS group,GABA group,GABA + GABA receptor antagonist bicuculline (BIC) group with 6 in each group,and the rat NAc was used to embed the cannula.The method of GABA and BIC was injected to observe the changes of cumulative food intake in rats for 4 h.Eighteen rats were randomly selected and randomly divided into three groups:sham stimulation (SS) group,50 μA electrical stimulation group,50 μA electrical stimulation + BIC group with 6 in each group.The 4 h cumulative food intake of rats was observed by electro-stimulation of rat ZI and rat NAc injection of BIC.Results Fluorescent gold retrograde tracking combined with fluorescent immunohistochemical staining showed that there were visible GABA and fluorescent gold double labeled neurons in ZI.Electrical stimulation of ZI,the frequency of GABA-sensitive GD neurons in rat NAc increased significantly (GD-E increase:(78.8±8.4) ％,GD-I increase:(89.3±9.2) ％,P＜0.01),but the inhibitory effect was antagonized by BIC (GD-E increase:(113.8 ± 13.6)％,GD-I increase:(121.8± 14.2)％,P＜0.01).Microinjection of GABA in rat NAc significantly increased the cumulative food intake for 4 h ((155.72± 18.84) kcal,t=3.41,P＜0.05),which was antagonized by partial BIC (123.43± 15.11) kcal,t =3.28,P＜ 0.05).Electrical stimulation of ZI significantly increased the food intake in rats ((39.07± 11.27) kcal,t =2.96,P＜0.05),and this effect can be partially antagonized by BIC ((34.17 ± 10.85) kcal,t =2.33,P＜ 0.05).Conclusion The ZI-NAc neural pathway regulates the discharge activity of rat gastric distension (GD)-sensitive neurons and the feeding status of rats,and the GABA receptor signaling pathway may be involved in mediating the process.
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Objective@#To investigate the clinicopathologic features of Rasmussen syndrome (RS) and to raise awareness of this rare disease.@*Methods@#Clinicopathologic data of 4 cases of RS were retrospectively analyzed at Beijing Haidian Hospital from 2008 to 2016.@*Results@#The clinical manifestations included epilepsia partialis continua and progressive neurologic deficits in all patients.MRI demonstrated unihemispheric focal cortical atrophy in all cases. The histopathologic changes included variable degrees of lymphocytic infiltrate within the cortex, subarachnoid space and perivascular cuffing.Microglial nodules and neuronophagia were seen. Mild to severe neuronal loss was noted with variable degrees of reactive gliosis. Spongy edema and cavitation were observed in focal cortex. Inflammation involving hippocampus was seen in one case. Three cases were accompanied by focal cortical dysplasia (FCD) Ⅲd. Immunohistochemical staining showed that the infiltrative lymphocytes were positive for CD3, CD8, granzyme B and TIA1 and the proliferating microglial cells were positive for CD68. NeuN positive neurons decreased significantly and reactive astrocytes were GFAP positive.@*Conclusions@#Pathologic changes of RS are similar to viral encephalitis and the inflammation is progressive and multifocal involving the hemisphere. The diagnosis of RS relies on pathologic features combined with clinical findings and neuroradiological examinations.
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OBJECTIVE To observe the clinical characteristics and curative effect inpatients with benign paroxysmal positional vertigo(BPPV). METHODS The data of 1000 BPPV patients were retrospectively analyzed. RESULTS 1. There was no significant difference in age between men and women; There was significant difference in incidence between men and women; 2. The single semicircular canal was involved in 993 cases, 2 semicircular canals were involved in 7 cases, canalolithiasis in 818 cases, cupulolithiasis in 175 cases; 3. The posterior semicircular canalwas involved in 587 cases, horizontal semicircular canal in 402 cases, anterior semicircular canal in four cases. The incidence of the right side was significantly higher than that of the left side; 4. The average treatment times of canalolithiasis and cupulolithiasiswere statistically different; 5. BPPV canalolithiasis and cupulolithiasisonetimerepositi on cure rate is 62.5％ and 42.3％ respectively; 6. There was no correlation between nystagmus velocity,affected sideand reposition times in horizontal BPPV. CONCLUSION BPPV has the following characteristicscs. First of all, popularin the middle-aged, elderly population and more common in women, single semicircular canal involve predominantly. Second, most of BPPV involve posterior semicircular canal, horizontal semicircular canal lesion take the second place and anterior semicircular canal lesion was least. Most of BPPV occur in the right side andiscanalolithias type. Thirdly, the average treatment times of BPPV of cupulolithiasis type is more than that of canalolithiasistype.
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Purpose To study the clinicopathologic features of ganglioglioma. Methods The clinicopathologic data of the cases pathologically diagnosed as ganglioglioma that underwent resection of epileptic focus were retrospectively analyzed. Results In the 19 cases studied, the mean onset age was 9.1 years, and the duration of disease was 9.3 years. MRI images showed abnormal signals. The majority of the site was temporal lobe (14/19, 73.7％). The tumors showed heterogeneity and often accompanied by focal cortical dysplasias (13/19, 68.4％). Immunohistochemical staining showed CD34 positive in 18 cases, Nestin positive in 16 cases, and BRAF-V600E positive in 6 case. The positive expression rate of CD34 and Nestin did not have significant differences. Conclusion The diagnosis of ganglioglioma relies on pathological observations combined with clinical features and neuroradiological examinations. Differential diagnosis should be done from other tumors or cortical dysplasia. Immunohistochemical staining of CD34 and Nestin can help diagnosis.
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Objective To investigate the effects of vitamin D on synthesis and secretion of lubricin in chondrocytes at the cellular level. Methods Rat articular chondrocytes were stimulated by TNF-α. Normal and inflammatory chondrocytes were treated by different doses of vitamin D respectively. ELISA and Western Blot were used to detect the secretion of lubricin in the supernatant and the synthesis level in the cells. Results TNF-α significantly reduced the activity of both normal chondrocytes and chondrocytes in inflammatory state. TNF-α also significantly reduced the expression of lubricin in the cells and supernatant. 1α,25(OH)2D3 increased the activity of both normal chondrocytes and chondrocytes in inflammatory state. 1α,25(OH)2D3 significantly elevated the secretion and expression of supernatant and intracellular lubricin only in chondrocytes stimulated by TNF-α in a dose-dependent manner, but not in normal chondrocytes. Conclusions Vitamin D can promote the secretion and expression of lubricin in inflammatory state chondrocytes, which may act as one of the mechanisms of vitamin D protecting the cartilage surface in osteoarthritis.
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Objective To investigate the effects of vitamin D on synthesis and secretion of lubricin in chondrocytes at the cellular level. Methods Rat articular chondrocytes were stimulated by TNF-α. Normal and inflammatory chondrocytes were treated by different doses of vitamin D respectively. ELISA and Western Blot were used to detect the secretion of lubricin in the supernatant and the synthesis level in the cells. Results TNF-α significantly reduced the activity of both normal chondrocytes and chondrocytes in inflammatory state. TNF-α also significantly reduced the expression of lubricin in the cells and supernatant. 1α,25(OH)2D3 increased the activity of both normal chondrocytes and chondrocytes in inflammatory state. 1α,25(OH)2D3 significantly elevated the secretion and expression of supernatant and intracellular lubricin only in chondrocytes stimulated by TNF-α in a dose-dependent manner, but not in normal chondrocytes. Conclusions Vitamin D can promote the secretion and expression of lubricin in inflammatory state chondrocytes, which may act as one of the mechanisms of vitamin D protecting the cartilage surface in osteoarthritis.
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Objective To study the clinicopathologic features of brain tumors in patients with medically intractable epilepsy. Methods The clinical, radiologic and pathologic features of brain tumors in thirty-six patients with intractable epilepsy encountered during the period from 2008 to 2014 in the Epilepsy Center of Haidian Hospital were retrospectively reviewed. Results There were 18 males and 18 females in thirty-six patients. The mean age of seizure onset and disease duration were (14.05 ± 1.67) years and (10.04 ± 1.19) years respectively. The histological types of brain tumors included ganglioglioma (12/36, WHO gradeⅠ,1/36, WHO gradeⅡ), dysembryeplastic neuroepithelial tumor (2/36, WHO gradeⅠ), pleomorphic xanthoastrocytoma (1/36, WHO gradeⅡ), angiocentric glioma (1/36, WHO gradeⅠ), astrocytoma (4/36, WHO gradeⅡ), oligoastrocytoma (1/36, WHO gradeⅡ, 2/36, WHO gradeⅠ-Ⅱ), oligodendroglioma (1/36, WHO gradeⅠ-Ⅱ,1/36, WHO grade Ⅱ), cavernous hemangioma (4/36) and Sturge-Weber syndrome (1/36). Most of these tumors were located in temporal lobe (25/36, 69.4%). Patients were followed up for 0.5-7 years after operation. One patient was lost for follow up. Seizure outcome after the epilepsy operation revealed that 28 patients (77.8%) had Engel gradeⅠ, 4 patients (11.1%) had Engel gradeⅡ,2 patients (5.6%) had Engel gradeⅢ,1 patient (2.8%) had Engel gradeⅣ. Conclusion Brain tumors in patients with medically intractable epilepsy are almost low grade tumors of the nervous system. Focal cortical dysplasia is existed in most brain tissues from the epilepsy operation. Low grade tumors of the nervous system have close relation with focal cortical dysplasia in patients with medically intractable epilepsy. It is possible that the classifications of pathology diagnosis has connection with prognosis.
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BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especial y to avoid the corresponding spinal nerve injury. OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine. METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. Al patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in al patients. X-ray films or CT films showed the bone graft fusion during fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final fol ow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final fol ow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.
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<p><b>OBJECTIVE</b>To study the clinicopathologic features of tuberous sclerosis complex (TSC).</p><p><b>METHODS</b>The clinicopathologic data of the patients diagnosed as TSC with refractory epilepsy and resection of epileptic focus were retrospectively analyzed.</p><p><b>RESULTS</b>Fourteen cases were included, the mean age was (15.8±12.9) years, with a male predominance (male to female ratio=10:4). Frontal lobe was the most common (13/14) site of involvement. MRI showed multiple patchy long T1 and long T2 signals. CT images showed multiple subependymal high density calcified nodules in nine cases. Histology showed mild to severe disruption of the cortical lamination, cortical and subcortical tubers with giant cells and/or dysmorphic neurons. The giant cells showed strong immunoreactivity for vimentin and nestin, while the dysmorphic neurons partially expressed MAP2 and NF. Vimentin also stained strongly the "reactive" astrocytes. Thirteen cases had follow-up information: Engel class I in six cases, Engel class II in six cases, and Engel class III in one case.</p><p><b>CONCLUSIONS</b>Diagnosis of TSC relies on combined pathologic, clinical and neuroradiological features. Immunohistochemical staining can be helpful. Resection of epileptic focus is an effective method to treat refractory epilepsy in TSC.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Astrocytes , Chemistry , Pathology , Drug Resistant Epilepsy , General Surgery , Epilepsy , Metabolism , Pathology , Epilepsy, Frontal Lobe , Metabolism , Pathology , Giant Cells , Chemistry , Pathology , Magnetic Resonance Imaging , Nestin , Neurons , Metabolism , Pathology , Retrospective Studies , Tuberous Sclerosis , Metabolism , Pathology , VimentinABSTRACT
OBJECTIVE@#To summary the clinical therapy experience of thyroid carcinoma invading cervical esophagus and trachea full thickness and reconstruction of them to improve the survival rate and quality of life of these patients.@*METHOD@#In 33 patients with thyroid carcinoma inviding cervical esophagus and trachea, 7 patients were operated with total thyroid resection, 22 patients were operated with one lobectomy and the other side subtotal thyroid resection,and 4 patients were operated with partial lobectomy. Trachea local recection and intubation were performed on 19 patients, partial laryngectomy and pyriform sinus resection with trachea local recection and intubation were performed on 4 patients,and 10 cases were operated with tracheal sleeve resection and end to end anastomos.@*RESULT@#All patients were primary healing without tracheal anastomosis fistula, tracheal wall necrosis, esophageal fistula and pharyngeal fistula. One case had hypoparathyroidism after the operation and took a favorable turn a month later. Seven cases were dead (21. 21%). 1-year, 3-year, 5-year survival rates of the thyroid papillary carcinoma inviding cervical esophagus and trachea were 100.0%, 93.8% and 70.3%; 1-year, 3-year, 5-year survival rates of the thyroid carcinoma inviding cervical esophagus and trachea were 96.6%, 79.0% and 61.4%.@*CONCLUSION@#Thyroid carcinoma invading cervical esophagus and trachea full-thickness can be treated with surgical methods, and tracheal sleeve resection and end to end anastomos are the suitable methods.