Analysis of the change of tear film and the occurrence of dry eye after strabismus surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of strabismus surgery on tear film and the incidence of dry eye.<p>METHODS: A total of 66 eyes of 58 patients admitted and underwent surgery in our hospital between September 2018 to September 2019 with concomitant strabismus were enrolled. The patients were divided into two groups based on surgical methods: Group 1 included 25 cases(33 eyes)who underwent a single horizontal rectus cut; Group 2 included 33 cases(33 eyes)who underwent both horizontal rectus cut in. The noninvasive tear film break-up time(NIBUT)was examined with sirius anterior analysis system at the time of 1d preoperatively and 3d, 1wk, 2wk and 3wk after operation. In addition, the tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein examination were tested. The patients were diagnosed with dry eye in both groups according to the consensus of clinical experts specialized in the diagnosis and treatment of dry eye. <p>RESULTS: There were no statistically significant differences when compared to SⅠt between the two groups before and after surgery(<i>P</i>>0.05). The BUT of group 1 was higher than group 2 at postoperative 3d, 1wk and 2wk(<i>P</i><0.05), while there was no difference between the two groups at 3wk postoperative(<i>P</i>>0.05); BUT returned to baseline by 2wk after surgery in group 1 and by 3wk after surgery in group 2. There were no differences between the NIBUT measured by sirius anterior segment analysis system and the BUT measured by traditional method before and after operation(<i>P</i>>0.05). The lowest incidence of dry eye was found at postoperative 2wk and 3wk in group 1(24%, 18%). The lowest incidence of dry eye was found at postoperative 3wk in group 2(15%). Besides, the incidence of dry eye in group 2 was higher than that in group 1 at postoperative 2wk(52% <i>vs</i> 24%, <i>P</i><0.05). <p>CONCLUSION: There was no obvious influence on the SⅠt after strabismus surgery; the surgical effect on tear film was mainly reflected in BUT. The fewer muscles operated, the lesser tear film was affected and the tear film was recovered faster. The incidence of dry eye decreased as time went by.

Clinical value of cranial MRI in the diagnosis and treatment of central nervous system candidiasis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical value of cranial magnetic resonance imaging (MRI) in the diagnosis and treatment of central nervous system candidiasis (CNSC), which has no specific clinical manifestations and has no rapid and specific diagnostic tools.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 10 children who were diagnosed with CNSC in Beijing Children's Hospital Affiliated to Capital Medical University between 2009 and 2013.</p><p><b>RESULTS</b>Nine of the 10 children underwent cranial MRI within 8 days after admission, and 5 of the 9 children underwent contrast-enhanced MRI at the same time. Eight of the 9 children showed the features of meningoencephalitis, and 6 cases were accompanied by varying degrees of brain atrophy; one case showed hydrocephalus and cerebral abscess, and another case showed leukoencephalopathy. Six cases were found to have the features of cerebral vasculitis after infection in the first MRI after admission, including cerebral infarction (2 cases), venous sinus thrombosis (3 cases), and Moyamoya disease (1 case). Infectious granulomatous lesions were confirmed by contrast-enhanced MRI in 3 cases. Given the clinical manifestations, 8 of the 9 cases were diagnosed as suspected CNSC after MRI, and 7 of these cases received antifungal therapy before the pathogen test results were returned. The lesions on MRI were improved in 6 cases after 3-4 weeks of antifungal treatment. All the 10 children were diagnosed with CNSC by positive cerebrospinal fluid culture results.</p><p><b>CONCLUSIONS</b>Cranial MRI, especially contrast-enhanced MRI, is of great significance for the diagnosis and treatment of CNSC. To confirm the guidance of MRI in the diagnosis and treatment of CNSC, further case-control studies are needed.</p>

Clinical features and gene mutation analysis of 4 Chinese children with X-linked lymphoproliferative disease / 中华实用儿科临床杂志

Objective To summarize clinical,gene mutation and their families of 4 Chinese children with X-linked lymphoproliferative (XLP) disease.Methods The clinical records and 6 genes of immunodeficiency associated with Epstein-Barr(EBV) infection were summarized and the literatures were reviewed.Results The four cases were all boys younger than 3 years old,who had onset with fever.They were all treated with ganciclovir,plasma,intravenous immunoglobulin and methylprednisolone after hospitalization,but 3 cases had the features of fulminant or fatal infectious mononucleosis (FIM),whose progression of disease was getting worse and died of second hemophagocytic lymphohistiocytosis (HLH) in the end.The survival time after onset was about 20 days.One boy had the complications of HLH associated with EBV infection and drug-induced hypersensitivity syndrome,who was improved and discharged from hospital.Two cases had adverse family history in which brothers or cousins died at younger ages.EBV-CAIgM and EBV-DNA of the 4 cases were all positive,with the copy of EBV DNA ＞ 108 copies/L.The results of the 6 genes of immunodeficiency associated with EBV infection of the 4 boys showed SH2D1A mutation.Mothers of 3 cases separately had the same SH2D1A mutation as her boy,while 1 mother refused to have the genes detected.Conclusions Patients who had the XLP were all male.Infants and young children under 5 years old usually had the features of FIM,with the complication of EBV associated HLH.Patients with XLP showed SH2D1A mutation.For male patients with FIM,especially those under 5 years,it is important to perform genetic detection early and to receive therapy as early as possible.

Detection of group B streptococcus in the cases died of neonatal pneumonia / 中华儿科杂志

<p><b>OBJECTIVE</b>From the 1970s, group B streptococci (GBS) have been widely recognized as an important pathogen in neonatal infectious disease, and it emerged as the leading cause of neonatal morbidity and mortality in the Western world. However, there are few data on the prevalence of neonatal GBS infections in China. The aim of this retrospective study was to estimate whether GBS is an important pathogen in severe neonatal pneumonia, and to develop a method for detection of GBS infections in fatal neonatal pneumonia.</p><p><b>METHODS</b>A total of 234 neonatal cases (0 - 28 days) died in Beijing Children's Hospital from 1953 to 2004 were enrolled in this study. They were divided into two groups. Two hundred cases diagnosed as neonatal pneumonia were assigned to study group and the remaining 34 cases died of neonatal hemolysis or surgical operation without any confirmed infectious diseases were designated as control group. Formalin-fixed, paraffin-embedded lung tissues were used as source for total genomic DNA extraction. PCR and Southern blot analyses were applied to detect GBS specific cfb gene target sequence. And the clinical data of these cases were reviewed as well.</p><p><b>RESULTS</b>In the study group, 52 cases were detected positive for GBS DNA by PCR (26%), 130 cases were positive by Southern blot (65%). In the control group, 1 case was detected positive GBS DNA by PCR (3%), and 6 cases were positive by Southern blot (18%). The positive rate was significantly lower in the control group than that in the study group (PCR, chi(2) = 8.82, P < 0.01; Southern blot, chi(2) = 26.77, P < 0.01). The positive rate in the neonates younger than 7 days (early-onset) was significantly higher than that in neonates older than 7 days (late-onset) (PCR: 37% vs. 13%, chi(2) = 15.537, P < 0.01; Southern blot: 72% vs. 52%, chi(2) = 4.37, P < 0.05). In the positive early-onset cases, 39% of whom were born prematurely (29/74). Out of the 200 cases, 75 had complete clinical data. Neither blood nor lung culture for GBS was performed in any of these cases. But risk factors were identified for 35 cases, such as premature delivery, low birth weight, premature rupture of the membrane and abnormal amniotic fluid. GBS was positive in all these cases. Severe apnea appeared to be a common symptom and was present in most of the early-onset GBS-positive cases, while cough and wheezing were found in most of the late-onset GBS-positive cases. In the control group, one PCR positive case was suffered from malignant teratoma. The other 5 positive cases confirmed by Southern blot were diagnosed as kernicterus, hepatoma, aproctia complicating with cysti-urethral fistula, neonatal physio logical bleeding and aproctia complicated with archo-perineal fistula.</p><p><b>CONCLUSION</b>Group B Streptococcus is an important pathogen in fatal neonatal pneumonia, especially in early-onset cases. southern blot may be a sensitive method to detect GBS infection in archival tissues. In the clinical work, more attention should be paid to the neonates with GBS risk factors. And GBS detection and prevention in neonates should be put into clinical practice.</p>

Study on Haemophilus influenzae type b: data from autopsy of community acquired pneumonia among children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the status of Haemophilus influenza type b(Hib) on death cases of children from community-acquired pneumonia (CAP) and to estimate the value of direct in-situ polymerase chain reaction (ISPCR) on diagnosis of children CAP, pathogenically.</p><p><b>METHODS</b>Ordinary PCR, Southern blot and direct ISPCR were applied and compared in detecting Hib in 100 paraffin-embedded lung tissues of autopsy children died of CAP.</p><p><b>RESULTS</b>No major difference on the detection rate of Hib between 50-60s and 80s-2002 was found. The detection rate of Hib by direct ISPCR was higher than the other two methods. By Southern blot, Hib was identified from 8 out of 100 samples (8%), including 4 out of 56 in 1950-60s (7.1%) and 4 out of 44 (9.1%) (chi2 = 0.084, P>0.05) in 1980s-2002. By ISPCR, Hib was identified from 17 out of 100 samples (17%), including 8 out of 56 in 1950-60s (14.3%) and 9 out of 44 (20.5%) with chi2 = 0.665, P > 0.05, in 1980s-2002. Positive cases diagnosed by both Southern blot and ISPCR were 7%.</p><p><b>CONCLUSION</b>Hib was one of the main bacterial pathogens causing CAP and deaths among children. Direct ISPCR was prefertable to be used in pathogenic diagnosis on children pneumonia, in terms of its sensitivity, specificity and localization.</p>

Study on MYCN gene amplification and CD44 expression in neuroblastoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To assess the relationship between MYCN amplification in neuroblastoma (NB), tumor stage and prognosis; and to evaluate the usefulness of CD44 in predicting prognosis of NB.</p><p><b>METHODS</b>Differential polymerase chain reaction (D-PCR) with serial dilution assay was used to quantify the MYCN gene copy number in 33 paraffin-embedded tissue samples of NB. All the samples were also studied by immunohistochemistry for CD44. The results were correlated with various prognostic factors of NB, including patient age, tumor stage, pathologic type and MYCN gene amplification.</p><p><b>RESULTS</b>MYCN amplification was identified in 10 of the 33 samples studied (30.3%), which all were in high clinical stage (stage III or IV) and occurred in patients older than 1 year of age. MYCN amplification also significantly correlated with poor clinical outcome (P < 0.01). CD44 was positive in 21 cases and often occurred in patients below 1 year of age, in low clinical stage, with favorable histology and without MYCN gene amplification. The two-year survival rate of CD44-positive group (57.1%) was higher than that of CD44-negative group (8.3%, P < 0.01). Stronger CD44 expression was also associated with better prognosis (P < 0.01).</p><p><b>CONCLUSIONS</b>MYCN gene amplification is significantly associated with advanced tumor stage and poor prognosis in patients with NB. CD44 expression is a reliable marker for better prognosis and is complementary to MYCN amplification assay. D-PCR with serial dilution assay is also suitable for clinical use in quantifying MYCN copy number in NB.</p>