A molecular epidemiological study of respiratory syncytial virus circulating in southern Zhejiang Province, China, from 2009 to 2014 / 中国当代儿科杂志

OBJECTIVE@#To find out the prevalence of respiratory syncytial virus (RSV) genotypes in southern Zhejiang Province, China, and to study the genetic characteristics of G protein from subtype A of RSV.@*METHODS@#The lower respiratory tract secretions of children under 5 years of age who were hospitalized for pneumonia and bronchiolitis in three hospitals in southern Zhejiang Province from July 2009 to June 2014 were collected. Direct immunofluorescence assay was used to detect RSV antigens from the collected secretions. A total of 200 samples were randomly selected from RSV-positive specimens in each prevailing year (from July of a specific year to June of the next year). RT-PCR was used to determine RSV subtypes, and the near-full length gene sequence of G protein from subtype A was amplified and sequenced to identify the genotype.@*RESULTS@#A total of 25 449 samples of lower respiratory tract secretions were collected from 2009 to 2014, among which 6 416 (25.21%) samples were RSV-positive. Among the 1 000 RSV-positive specimens randomly sampled, 462 strains (46.2%) were subtype A, and 538 strains (53.8%) were subtype B. Subtype A accounted for 22.5%, 74.5%, 84.5%, 19.0%, and 30.5% of the total strains in each year from 2009 to 2014. A total of 25 RSV subtype A strains were randomly sampled and sent out for bidirectional sequencing in each year, which confirmed 52 positive subtype A strains. Four genotypes of subtype A strains were obtained from the above strains, including NA1 (39 strains), NA4 (1 strain), ON1 (10 strains), and GA2 (2 strains). NA1 was the dominant genotype between 2009 and 2012, and ON1 was the only genotype of subtype A during 2013-2014. The nucleotide homology and amino acid homology between the G protein of subtype A and the prototype strain A2 were 80.7%-89.3% and 74.4%-82.6%, respectively. The nucleotide homology and amino acid homology between the isolates of subtype A were 81.5%-100% and 80.2%-100%, respectively.@*CONCLUSIONS@#In southern Zhejiang Province from 2009 to 2014, there was a co-circulation of RSV subtypes A and B, as well as a co-circulation of several different genotypes of RSV subtype A, which had highly variable G protein genes.

Control study on antimicrobial resistance of invasive and non-invasive Streptococcus pneumoniae in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the antimicrobial resistance of invasive and non-invasive Streptococcus pneumoniae (SP) strains in children and to provide a basis for proper use of antimicrobial drugs in the treatment of SP infection.</p><p><b>METHODS</b>Seventy children who were diagnosed with invasive pneumococcal diseases (IPD) between January 2009 and December 2013 were enrolled, and 164 children with lower respiratory tract infection caused by SP were randomly selected as the control group. The samples from sterile sites (blood, cerebrospinal fluid, etc) of children with IPD, as well as the sputum samples of children in the control group, were collected for bacterial culture, and the drug susceptibility tests for isolated SP strains were conducted.</p><p><b>RESULTS</b>A total of 82 invasive strains of SP were isolated from sterile sites of 70 children with IPD; 49 strains (60%) were isolated from blood, and 19 strains (23%) from cerebrospinal fluid. The detection rate of invasive SP strains decreased from 2009 to 2013 (P<0.01). The total detection rates of penicillin-nonsusceptible SP from the invasive and non-invasive strains were 27% and 17% respectively (P>0.05). Among invasive strains, the penicillin-nonsusceptible SP strains had significantly higher rates of insusceptibility to cefotaxime, ceftriaxone, and cefepime than the penicillin-susceptible SP (P<0.01). There were significant differences in the rates of insusceptibility to cefotaxime, ceftriaxone, and meropenem between the sensitive and non-sensitive SP strains (P<0.05). The multidrug resistance rates of the invasive and non-invasive SP strains were 89% and 93% respectively (P>0.05).</p><p><b>CONCLUSIONS</b>Invasive SP can easily invade the blood in children, but the total detection rate has decreased year by year. The results of drug sensitivity tests have guiding significance for proper use of antimicrobial drugs for different SP infections.</p>

New concept and clinical application of colorectal intraepithelial neoplasia and carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To introduce the WHO 2000 diagnostic criteria of biopsy of colorectal intraepithelial neoplasia and carcinoma and to enhance diagnostic accuracy and avoid overdiagnosis and underdiagnosis.</p><p><b>METHOD</b>The postoperative pathological examination and preoperative biopsy in 56 patients diagnosed as colorectal intraepithelial neoplasia and carcinoma before operation from January 2001 to October 2005 were compared retrospectively.</p><p><b>RESULTS</b>Among the 56 cases, 16 patients were diagnosed by preoperative biopsy as carcinoma in situ, intramucosal carcinoma and adenocarcinoma, but according to the new standard, of them 14 cases should be revised to be higher grade colorectal intraepithelial neoplasia.</p><p><b>CONCLUSIONS</b>Strictly adhere to the new WHO criteria, colorectal intraepithelial neoplasia and carcinoma can be diagnosed properly, but for the cases that submucosal muscular layer would not presented in biopsy, the diagnosis should be made by combining clinical findings and various examination results so as to avoid underdiagnosis and delay of treatment.</p>