Comparative analysis on clinical manifestations for gastroenteritis caused by norovirus and rotavirns in infants and young children / 中华流行病学杂志

Objective To compare the clinical manifestations of gastroenteritis caused by norovirus and rotavirus in infants and young children in Beijing. Methods Stool specimens were collected from infants and young children with acute diarrhea who visited the Affiliated Children's Hospital to Capital Institute of Pediatrics from January 2002 to December 2006. Registration form was designed for clinical data collection for each patient from whom specimen was collected. Poly-acrylamide gel electrophoresis (PAGE) and enzyme immunoassay (EIA) were used to detect rotavirus and Human norovirus, respectively. Results Among 779 stool specimens tested for rotavirus, 263 were positive (33.8 %), and norovirus positive specimens were 79 out of 318 (24.8%) specimens tested. Most of the clinical manifestations of gastroenteritis caused by these two viruses were quite similar with no significant difference, except for fever. The seasonal distribution of these two viruses were different with the peak of rotavirus infection was in cold weather between October and January, as indicated by the peak of the positive rates of the virus detection. The infection of norovirus seemed no obvious peak in the year.Conclusion Rotavirus is the most important pathogen for acute diarrhea among infants and young children while. Norovirus is also an important pathogen for acute gastroenteritis in infants and young children. No significant difference was found out for clinical manifestations for the gastroenteritis caused by these two viruses.

Forlax in the treatment of childhood constipation: a randomized, controlled, multicenter clinical study / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine the therapeutic effectiveness and safety of polyethylene glycol 4000 (forlax) in the treatment of constipation in children over 8 years old.</p><p><b>METHODS</b>This study was designed as a randomized, positive medicine (lactulose) controlled multicenter trial. A total of 216 children with constipation from 8-18 years old from 7 hospitals across China who were matched with a uniform entry criteria were enrolled in this study. The 216 patients were randomized to receive either oral forlax (20 g/d, n=105) or lactulose (15 mL/d, n=111) for 2 weeks. The therapeutic effects, including bowel movement frequency, stool consistency, clinical complete remission rate of constipation and abdominal symptoms, and the safety of forlax and lactulose were evaluated at 1 and 2 weeks of treatment.</p><p><b>RESULTS</b>The median weekly frequency of bowel movement in the forlax group increased by 4 and 5 times respectively after 1 and 2 weeks of treatment, and increased by 3 and 4 times in the lactulose group (P < 0.05). The stool consistency of the two groups was both improved significantly after treatment. The Bristol score of stool consistency of the forlax and lactulose groups were 3.41+/-1.11 and 3.64+/-1.33 respectively (P < 0.05) after 1 week of treatment, and were 4.26+/-0.89 and 3.63+/-1.33 respectively (P < 0.05) after 2 weeks of treatment. The clinical complete remission rate of constipation in the forlax and lactulose groups was 70% and 40% respectively (P < 0.05) by week 1 of treatment, and that was 72% and 41% respectively (P < 0.05) by week 2 of treatment. Abdominal pain disappeared in 75% of patients in the forlax group but in only 57% in the lactulose group by week 2 of treatment (P < 0.05). No serious adverse events happened and no abnormalities were found in laboratory tests and physical examinations in the two groups after medication.</p><p><b>CONCLUSIONS</b>Forlax is safe and effective in the treatment of constipation in children over 8 years old.</p>

Comparison of methods for Norovirus detection in stool specimens collected from hospitalized patients with hospital acquired diarrhea / 中华流行病学杂志

<p><b>OBJECTIVE</b>In order to find out a more convenient, rapid and efficient way in detecting human Norovirus infections in specimens collected from hospitalized patients with acute non-bacterial diarrhea in Beijing.</p><p><b>METHODS</b>Two kits for enzyme immunoassay (EIA) were used to detect human Noroviruses in stool specimens collected from 69 infants and young children as well as 15 adults who were all diagnosed as acute non-bacterial diarrhea in 4 different hospitals. Reverse transcription-polymerase chain reaction(RT-PCR) was performed to evaluate the data from two kits in this study. Data were statistically analyzed by SPSS 11.5 software. chi2 test was used to test categorical variables.</p><p><b>RESULTS</b>Out of 84 stool specimens collected from infants and young children or adults with acute non-bacterial diarrhea, 17 (20.2%) were Norovirus positive determined by EIA kit A and 31 (36.9%) were Norovirus positive determined by EIA kit B. chi2 test used to test categorical variables showed significant differences (P < 0.01), suggesting that the EIA kit B was superior to the EIA kit A. Among these 84 stool specimens, 20 were tested by RT-PCR simultaneously. Out of those 20 specimens, 11 (55.0%) were Norovirus positive as determined by RT-PCR, which was higher than that from 2 EIA kits.</p><p><b>RESULTS</b>from 10 (50.0%) samples detected by EIA kit A were consistent with those detected by RT-PCR. Through chi2 test, the categorical variables showed significant differences with P < 0.05, suggesting that RT-PCR was superior to the EIA kit A. Results from 14 (70.0%) samples detected by EIA kit B were consistent with those detected by RT-PCR while chi2 test showed that the differences were not significant (P > 0.05), among categorical variables suggesting that EIA kit B was as sensitive as RT-PCR in detecting Norovirus. The were hospital acquired diarrhea outbreaks in these three hospitals since at least 2 Norovirus positive specimens were detected in each of the hospitals.</p><p><b>CONCLUSION</b>To detect human Noroviruses infection, EIA seemed to be more convenient and time saving than RT-PCR which had been used worldwide. The EIA kit B in this study was comparable to RT-PCR for detecting Norovirus in stool specimens. Norovirus was a pathogen causing hospital acquired diarrhea outbreaks in these three hospitals.</p>

Clinical manifestations of norovirus gastroenteritis in infants and children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the clinical manifestations for norovirus gastroenteritis in infants and young children.</p><p><b>METHODS</b>Stool specimens were collected from infants and children with acute diarrhea who visited the affiliated Children's Hospital to Capital Institute of Pediatrics from January 2002 to December 2006. Enzyme-linked immunosorbent assay (ELISA) was used to detect human norovirus antigen in stool specimens and polyacrylamide gel electrophoresis (PAGE) was performed to detect rotavirus genome.</p><p><b>RESULTS</b>Out of the 318 specimens under testing, 79 showed positive for norovirus antigen, with a positive rate of 24.8% (79/318). Among those positive specimens, 48(48/79, 60.8%) were detected in October to December, suggesting the seasonal preference of the virus. Most of the positive specimens (91.2%) were from those under 2 years of age. Rotavirus genome were detected from 16 out of 79 norovirus positive specimens (16/79, 20.3%), indicating those patients were co-infected by these two viruses. There was significant difference found in the severity of fever but not in the frequencies of diarrhea between rotavirus and norovirus co-infection group and noroviral infection group. Fourteen out of 79 norovirus positive patients were admitted to hospitals under the diagnosis other than gastroenteritis but started to develop symptoms of diarrhea between 1 to 11 days after hospitalization.</p><p><b>CONCLUSION</b>Norovirus seemed one of the most important pathogens for acute diarrhea among infants and young children and could cause nosocomial infectious gastroenteritis.</p>

Therapeutic Effects of Interferon-? and Polyresistin on Measles in Children / 实用儿科临床杂志

10-15 years were 7 cases(6.3%),they were randomly divided into treatment group and contol group.The treatment group with 60 patients were given INF-? and polyresistin,age 3 years,given IFN-? 200 000 U per day;and polyresistin 5 mg per time,3 times every day,the course of therapy were 5 days.The control group was given traditional Chinese medicine at the same time.Results After therapy,in treatment group,53 cases(88.3%) of children′s cooling time were lower than 5 days,47 cases(78.3%) of children′s rash subsided time were lower than 6 days,48 cases(75%) of children′s Catarrhal symptoms disappeared time were lower than 5 days,and the rate of complications′ occurrence were 15 cases(18.3%).In control group,28 cases(53.8%) of children′s cooling time were lower than 5 days,14 cases(26.9%) of children′s rash subsided time were lower than 6 days,28 cases(53.8%) of children′s Catarrhal symptoms disappeared time were lower than 5 days,and the rate of complications′ occurrence were 37 cases(71.5%),there were significant differences between both groups(Pa

Evaluation of early and rapid etiological diagnosis of measles by detection of measles virus RNA using nested RT-PCR / 中华儿科杂志

<p><b>OBJECTIVES</b>To develop techniques which can be used to detect genetic material of measles virus from clinical samples to make diagnosis and differentiate atypical measles from other exanthematous infections early in clinical course.</p><p><b>METHODS</b>A nested reverse transcriptase-polymerase chain reaction (RT-PCR) was developed to amplify gene fragment with the size of 301 bps from N gene of measles virus in throat swabs and urine samples collected from infants and children who were suspected measles cases. Before the test was used for clinical samples, preliminary tests were performed to determine the sensitivity and specificity of the test. The sensitivity of the test was determined by plaque assay using measles virus strain Edmonton and the specificity of the test was determined by cross-reaction with rubella virus, respiratory syncytial virus, influenza A and B viruses, enterovirus, adenovirus, human cytomegalovirus (hCMV), EB virus, and herpes simplex virus I. Serum specific IgM antibody against measles virus was also tested by ELISA.</p><p><b>RESULTS</b>Measles virus with the titer of 0.53 pfu could be detected by using the nested RT-PCR developed in this study. No amplification was found with the nested RT-PCR when rubella virus, respiratory syncytial virus, influenza A and B virus, enterovirus, adenovirus, hCMV, EB virus, and herpes simplex virus I were used as templates. Out of 116 throat swabs collected from suspected measles cases, 70 (60.3%) were measles RNA positive. For urine samples, 48 out of 74 (64.9%) were positive. Both throat swab and urine samples were collected simultaneously from 73 patients. Among those, 71 (97.3%) showed consistent results. Serum specimens were collected from 110 suspected patients. Among those, 65 (59.1%) and 61 (55.5%) were measles virus specific IgM antibody positive detected with ELISA kits from two different sources, respectively. Out of 110 sera samples, 106 (96.4%) showed consistent results. The consistency of the gene amplification and specific IgM antibody detection was 80.8% as shown by 84 out of 104 patients from whom throat swab and sera were collected at the same time.</p><p><b>CONCLUSION</b>The data indicate that the nested RT-PCR developed in this study is sensitive and specific for detection of gene fragment of measles virus from clinical samples. The test is superior to the commonly used specific IgM antibody detection because of identifying gene material in early clinical stage, and even single clinical sample can be tested.</p>

Clinical Application for Detection of Helicobacter Pylori Infection in Children with Helicobacter Pylori Stool Antigen Test / 实用儿科临床杂志

Objective To evaluate the accuracy of the Helicobacter pylori stool antigen (HpSA) test for detection of Helicobacter pylori (Hp) infection before and after treatment in children.Methods stool specimens were collected from 62 consecutive patients (4-17 years) who received 13 C-urea breath test( 13C-UBT) and/or gastroscopy for gastrointestinal symptom and 31 patients after radical cure of Hp who received 13 C-UBT within 2 days.The evaluation of Hp status was defined as positive when 13 C-UBT were positive and gastroscopic biopsy were positive.Results The sensitivity of HpSA test for the diagnosis of Hp using a cutoff value of 0.121 was 92.30% and its specificity and accuracy was 91.30% and 91.94%,respectively.sensitivity was 83.33% and its specificity was 88.00% and accuracy was 87.10% after radical cure of Hp.Conclusions The precision ratio of HpSA test is higher to diagnose Hp infection before the radical cure in children.Sensitivity and specificity after the radical cure are lower than before.