Clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis and its effect on T lymphocyte subsets.</p><p><b>METHODS</b>A total of 76 children with infectious mononucleosis, who were admitted to the hospital between July 2016 and June 2017, were enrolled and randomly divided into two groups: conventional treatment and pidotimod treatment (n=38 each). The children in the conventional treatment group were given antiviral therapy with ganciclovir for injection and symptomatic treatment. Those in the pidotimod treatment group were given pidotimod oral liquid in addition to the treatment in the conventional treatment group. The course of treatment was two weeks for both groups. The two groups were compared in terms of the recovery of clinical indices and the changes in peripheral blood T lymphocyte subsets.</p><p><b>RESULTS</b>Compared with the conventional treatment group, the pidotimod treatment group had significantly shorter fever clearance time, time to the disappearance of isthmopyra, time to the relief of lymph node enlargement, time to the relief of hepatosplenomegaly, and length of hospital stay (P<0.05). After treatment, the pidotimod treatment group had significant reductions in the percentages of CD3 and CD8 T cells and had significantly lower percentages of CD3 and CD8 T cells than the conventional treatment group (P<0.001). The pidotimod treatment group had significant increases in the percentage of CD4 T cells and CD4/CD8 ratio after treatment, which was significantly higher than those in the conventional treatment group (P<0.001). The conventional treatment group had no significant changes in T lymphocyte subsets after treatment (P>0.05).</p><p><b>CONCLUSIONS</b>Pidotimod oral liquid has a good clinical effect as the adjuvant therapy for infectious mononucleosis and can improve cellular immune function, so it holds promise for clinical application.</p>

Thirty-six cases of paragonimiasis in children,Ningbo,China / 中国人兽共患病学报

We analyzed the clinical characteristics of paragonimiasis in children in Ningbo City,in order to provide a basis for diagnosis and treatment of this disease,and to reduce the misdiagnosis.Thirty-six children seen in ningbo women and chil-dren's hospital from January 2010 to December 2016 with a diagnosis of paragonimiasis were studied,and the medical history, conditions of diagnosis and treatment were retrospectively analyzed.A total of 36 cases were included,and there were 20 boys and 16 girls with a mean ages of 6.6 (3.4-12)years.Among these patients,22 lived in urban area and 14 in rural area.There were 29 cases with the history of eating raw or baked crabs,freshwater shrimp and 7 cases with the history of catching the crab or drinking raw stream water before the disease onset.The clinical symptoms varied,mainly for cough and expectoration,fe-ver,chest tightness or pain and abdominal pain.All children had the elevated eosinophilia in peripheral blood,and the blood IgE were significantly increased in 3 1 cases.Paragonimiasis serum antibody detection were all positive.The chest CT showed abnormal performance in 32 cases which mainly for the pulmonary lesions and pleural effusion.And 2 cases showed the imaging findings of paragonimiasis encephalopathy in their head MRI.All patients were given praziquantel treatment after the definite diagnosis,and all were not found significant adverse reactions.The clinical manifestations of children paragonimiasis in Ningbo City were complex and diverse,the children's diet and lifestyle history should be asked in detail,at the same time,combined with peripheral blood eosinophils,IgE test results and the imaging data,made a comprehensive analysis,so as to make a early diagnosis and treatment as soon as possible,and reduce the misdiagnosis rate.

The correlational study of viral load of human bocavirus and clinical features in children with acute respiratory tract infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the correlations between clinical features in paediatric patients with acute respiratory tract infection (ARTI) and viral load of human bocavirus.</p><p><b>METHODS</b>A prospective study was conducted on 956 children < 5 years admitted with an acute respiratory tract infection from November 2009 to December 2010, and 251 healthy children conclused as control group in the corresponding period. Human bocavirus was investigated in nasopharyngeal aspirates (NPA) and throat swab by PCR, and viral load was detected by real-time polymerase chain reaction (RT-PCR) in HBoV positive sample. Clinical data were also prospectively recorded.</p><p><b>RESULTS</b>A significant difference was found in HBoV positive rate between children with ARTI and control group at enrollment. There was a significant difference in HBoV viral load between children with upper respiratory tract infection and lower respiratory tract infection. HBoV viral load did not differ significantly between children with upper respiratory tract infection and control group. Among children with lower respiratory tract infection, no significant difference were detected between common and severe cases in HBoV viral load. HBoV viral load did not differ significantly whether the children were with or without co-infection.</p><p><b>CONCLUSIONS</b>HBoV could be detected perennial and considered as a major pathogen associated with acute respiratory tract infection in children. However, HBoV may not be a independent factor in children with ARTI and the HBoV viral load was not associated with the severity of respiratory illness.</p>

Regulative mechanism of dexamethasone on Toll-like receptor 4 signal transduction of infant asthma rat / 中华儿科杂志

<p><b>OBJECTIVE</b>Eosinophilic airway inflammation is one of the basic characteristics of allergic asthma. Toll-like receptor is one of the most important innate immunity pattern recognition receptors. Glucocorticoids (GCS) are still the most effective treatment for asthma. However, few reports of studies on regulatory mechanism of GCS on the innate immunity system are available. The mechanism of effects of GCS on TLR4 is unclear. The present study aimed at understanding the effect of dexamethasone (DXM) on change of TLR4 and mechanism of regulatory effect of TLR4 on eosinophil (EOS) apoptosis.</p><p><b>METHODS</b>Twenty-seven Sprague-Dawley (SD) rats (age 28 to 42 days, body weight 120 to 180 gram) were randomly divided into the control group, asthma group and DXM group with 9 in each. Asthma model rats were sensitized with the mixture of ovalbumin (OVA, 1 mg) and Al (OH)(3), 100 mg on day 1 and day 8, repeatedly exposed to aerosolized OVA after day 15, once a day for three days and continued for 30 minutes at every time. During the sensitization stage, 100 microg/ml DXM were prepared with DXM group for every other day, and the same doses DXM were prepared for every day on the stage of challenge. The histopathological changes of lung tissues were observed with light microscope (LM). EOS and other inflammatory cells in bronchoalveolar lavage fluid (BALF) were counted; the concentrations of OVA-sIgE in serum were measured by using "sandwich" ELISA; The expressions of TLR4 mRNA were determined by in situ hybridization, the apoptosis of EOS was detected by TUNEL.</p><p><b>RESULTS</b>(1) LM showed many inflammatory cells infiltration around the bronchi and blood vessels, bronchus mucus increased, airway epithelium damage and desquamation, and airway mucous plugs in asthma group, whereas DXM group showed significantly milder changes. (2) Inflammationary cells count in BALF of asthma group was significantly higher as compared to control group (P < 0.01); compared with asthma group, the total cell count, EOS absolute count and EOS% were all significantly decreased in DXM group [(2.14 +/- 0.10) x 10(9)/L, (4.78 +/- 1.23) x 10(7)/L, (2.17 +/- 0.25)%]. (3) Levels of OVA-sIgE in serum of asthma group [(83.40 +/- 6.80) microg/ml] were significantly higher than those of the control group [(14.38 +/- 4.25) microg/ml] (P < 0.01), while those of DXM group [(45.02 +/- 7.47) microg/ml] were significantly lower than asthma group (P < 0.0 1). (4) There were no significant differences in TLR4 mRNA detected by in situ hybridization between control group (24.71 +/- 0.85) and asthma group (25.81 +/- 3.56) (P > 0.05); but it significantly increased in DXM group (29.86 +/- 3.92) as compared to asthma group. (5) The percentages of apoptotic EOS in asthma group [(7.39 +/- 1.93)%] were significantly lower than those in control group [(9.06 +/- 1.52)%] (P < 0.01); and significantly higher in DXM group [(13.33 +/- 1.09)%] than in asthma group (P < 0.01). There were significantly positive correlations between TLR4 mRNA and the percentage of apoptotic EOS (r = 0.612, P < 0.01).</p><p><b>CONCLUSION</b>DXM can decrease OVA-sIgE level, induce EOS apoptosis, which may correlate with the activation of TLR4 signal transduction.</p>