Poisonous substances and geographical distribution of poisoning in hospitalized children based on data from 25 hospitals in China from 2016 to 2020 / 中华儿科杂志

Objective: To investigate the poisonous substances and geographical distribution of poisoning in children in China. Methods: A cross-sectional study. The clinical data of 8 385 hospitalized children from January 2016 to December 2020 were extracted from the FUTang Updating Medical Records database. These children aged 0 to 18 years and were admitted due to poisoning. They were grouped according to age (newborns and infants, toddlers, preschoolers, school-age children, adolescents), place of residence (Northeast China, North China, Central China, East China, South China, Southwest China, Northwest China), and mode of discharge (discharge under medical advice, transfer to another hospital under medical advice, discharge without medical advice, death, other). The poisonous substance and causes of poisoning in different groups were analyzed. Results: Among these 8 385 children, 4 734 (56.5%) were male and 3 651 (43.5%) female, with a male-to-female ratio of 1.3∶1. The age was 3 (2, 7) years. The prevalence of poisoning was 51.8% (4 343/8 385) in toddlers, 16.5% (1 380/8 385) in adolescents, 14.8% (1 242/8 385) in preschoolers, 14.4% (1 206/8 385) in school-age children, and 2.5% (214/8 385) in newborns and infants. Drug poisoning accounted for 43.5% (3 649/8 385) and pesticide accounted for 26.8% (2 249/8 385). Drug poisoning was more common in adolescents (684/1 380, 49.6%) and toddlers (2 041/4 343, 47.0%); non-drug poisoning was more common in school-age children (891/1 206, 73.9%), of which carbon monoxide was mainly in newborns and infants (41/214, 19.2%) and food poisoning in children of school age (241/1 206, 20.0%). Regarding regional characteristics, drug poisoning was more frequent in South China (188/246, 64.2%) and non-drug poisoning was more frequent in Southwest China (815/1 123, 72.5%). For drugs, anti-epileptic drugs, sedative-hypnotic drugs and anti-Parkinson's disease drugs had a higher proportion of poisoning in North China (138/1 034, 13.0%) than that in other regions. For non-drug poisoning, pesticides (375/1 123, 33.3%), food poisoning (209/1 123, 18.6%) and contact with poisonous animals (86/1 123, 7.7%) were more common in Southwest China than in other regions; carbon monoxide poisoning was more common in North China (81/1 034, 7.6%) and Northwest China (65/1 064, 6.3%). In Central China, poisoning happened more in toddlers (792/1 295, 61.2%) and less in adolescents (115/1 295, 8.8%) than in other regions. Regarding different age groups, poisoning in adolescent happened more in Northeast China (121/457, 26.5%), North China (240/1 034, 23.2%), and Northwest China (245/1 064, 23.0%). The rate of discharge under medical advice, discharge without medical advice, and mortality rate within the 5 years were 77.0% (6 458/8 385), 20.8% (1 743/8 385), 0.5% (40/8 385), respectively. Conclusions: Poisoning is more common in male and toddlers. Poisonous substances show a regional characteristic and vary in different age groups, with drugs and insecticides as the most common substances.

Diagnosis and treatment of pediatric septic shock in pediatric intensive care units from hospitals of different levels / 中华儿科杂志

Objective: To investigate the differences in clinical characteristics, diagnosis, and treatment of pediatric septic shock in pediatric intensive care unit (PICU) among hospitals of different levels. Methods: This retrospective study enrolled 368 children with septic shock treated in the PICU of Beijing Children's Hospital, Henan Children's Hospital, and Baoding Children's Hospital from January 2018 to December 2021. Their clinical data were collected, including the general information, location of onset (community or hospital-acquired), severity, pathogen positivity, consistence of guideline (the rate of standard attainment at 6 h after resuscitation and the rate of anti-infective drug administration within 1 h after diagnosis), treatment, and in-hospital mortality. The 3 hospitals were national, provincial, and municipal, respectively. Furthermore, the patients were divided into the tumor group and the non-tumor group, and into the in-hospital referral group and the outpatient or emergency admission group. Chi-square test and Mann-Whitney U test were used to analyze the data. Results: The 368 patients aged 32 (11, 98) months, of whom 223 were males and 145 females. There were 215, 107, and 46 patients with septic shock, with males of 141, 51, and 31 cases, from the national, provincial, and municipal hospitals, respectively. The difference in pediatric risk of mortality Ⅲ (PRISM Ⅲ) scores among the national,provincial and municipal group was statistically significant (26(19, 32) vs.19(12, 26) vs. 12(6, 19), Z=60.25,P<0.001). The difference in community acquired septic shock among the national,provincial and municipal group was statistically significant (31.6%(68/215) vs. 84.1%(90/107) vs. 91.3%(42/46), χ2=108.26,P<0.001). There were no significant differences in compliance with guidelines among the 3 groups (P>0.05). The main bacteria detected in the national group were Klebsiella pneumoniae (15.4% (12/78)) and Staphylococcus aureus (15.4% (12/78)); in the provincial group were Staphylococcus aureus (19.0% (12/63)) and Pseudomonas aeruginosa (12.7% (8/63)), and in the municipal group were Streptococcus pneumoniae (40.0% (10/25)) and Enteric bacilli (16.0% (4/25)). The difference in the proportion of virus and the proportion of 3 or more initial antimicrobials used among the national,provincial and municipal group was statistically significant (27.7% (43/155) vs. 14.9% (13/87) vs. 9.1% (3/33), 22.8%(49/215) vs. 11.2%(12/107) vs. 6.5%(3/46), χ2=8.82, 10.99, both P<0.05). There was no difference in the in-hospital mortality among the 3 groups (P>0.05). Regarding the subgroups of tumor and non-tumor, the national group had higher PRISM Ⅲ (31(24, 38) vs. 22 (21, 28) vs.16 (9, 22), 24 (18, 30) vs. 17(8, 24) vs. 10 (5, 16), Z=30.34, 10.45, both P<0.001), and it was the same for the subgroups of in-hospital referral and out-patient or emergency admission (29 (21, 39) vs. 23 (17, 30) vs. 15 (10, 29), 23 (17, 29) vs. 18 (10, 24) vs. 11 (5, 16), Z=20.33, 14.25, both P<0.001) as compared to the provincial and municipal group. There was no significant difference in the in-hospital mortality among the 2 pairs of subgroups (all P>0.05). Conclusion: There are differences in the severity, location of onset, pathogen composition, and initial antibiotics of pediatric septic shock in children's hospitals of different levels, but no differences in compliance with guidelines and in-hospital survival rate.

Clinical analysis of 6 critically ill children with acute chlorine poisoning / 中华儿科杂志

Objective: To analyze the clinical characteristics and treatment of critically ill children with acute chlorine poisoning and explore the risk factors and effective strategies. Methods: This retrospective study collected the clinical data, including general state, clinical characteristics, treatment and follow-up(till 1 year and 6 months after discharge), of 6 critically ill children who were hospitalized in the Pediatric Intensive Care Unit of Beijing Children's Hospital due to acute chlorine poisoning in August 2019. Results: There were 6 children characterized by severe dyspnea in this accident, among whom 4 were boys and two girls, aged 4-12 years. When the accident occurred, they were within 5 m of the chlorine source. These patients underwent tracheal intubation and mechanical ventilation in 3.5-7.0 h after poisoning. The child who was the closest to the chlorine source (1.5 m) and took the longest time (5 min) to evacuate was the most severe one. He suffered hypoxia which could not be corrected by conventional mechanical ventilation and severe shock, then had veno-arterial extracorporeal membrane oxygenation(ECMO) treatment started 10 h after the accident. All the 6 children in this study survived. Following-up found no growth and developmental abnormality. The pulmonary function tests were normal except for one case with increased small airway resistance due to previous suspected asthma, and the lung CT, electhoencephalogram, and brain magnetic resonance imaging were all normal. Conclusions: Severe chlorine poisoning is mainly characterized by respiratory failure. Mechanical ventilation is often required within a few hours after poisoning. When conventional mechanical ventilation is ineffective, ECMO could save live. Timely treatment could improve prognosis.

A study on the psychological security and quality of life of the women in poverty-stricken family / 中国实用护理杂志

Objective:To investigate the status of women′s psychological security and quality of life in poverty-stricken areas, and analyze their interrelation and influencing factors.Methods:With the method of convenient sampling, 368 women from poor families who participated in the poverty alleviation vocational training course were investigated with self-designed questionnaire, Psychological Safety Scale (SQ) and World Health Organization Quality of Life-Brief (WHOQOL-BREF).Results:The average total score of women's psychological security in poverty-stricken families was 48.66 ± 12.75, which was in the middle level. Multivariate linear regression analysis showed that family income and religious beliefs had an impact on interpersonal security ( F value was 16.509, P<0.05); ethnicity and religious beliefs had an impact on the certainty of control ( F value was 17.546, p<0.05); religious beliefs had an impact on the total value of security ( F value was 20.911, P<0.05). The overall quality of life and health status scores of females from poor families (13.38±2.91) were significantly lower than the norm ( t value was -3.27, P<0.05). Multiple linear regression analysis showed that personal annual income and religious beliefs had an impact on physiological domain( F value was 2.694, P<0.05); marital status and religious beliefs had an impact on the psychological domain ( F value was 3.305, P<0.05); family annual income and religious beliefs had an impact on the environmental domain ( F value was 2.866, P<0.05) while they had no impact on the social domain. There was a significant positive correlation between psychological security and quality of life. Conclusions:There is a significant positive correlation between the level of psychological security and the quality of life of poor family women. Improving the quality of life of poverty-stricken family women can improve their psychological security.

Blood purification therapy for sepsis / 中国实用儿科杂志

Sepsis is a life-threatening organ dysfunction caused by the body's dysfunctional response to infection. There is currently no definitive symptomatic treatment for sepsis inflammatory response in the clinic. Blood purification treatment exerts immunomodulatory effects by non-specifically eliminating endotoxin and/or inflammatory mediators and shows a good prospect of application in sepsis. However,most studies on the treatment of sepsis with blood purification have not shown significant improvement in patients' prognosis. This article reviews the research progress of immunoregulation mechanism of blood purification therapy for sepsis,as well as the advantages and disadvantages of different blood purification methods.

Effects of Living with Hope Program on family caregivers of patients with advanced lung cancer / 中华护理杂志

Objective To explore the effects of Living with Hope Program(LWHP) on family caregivers of patients with advanced lung cancer.Methods Totally 60 family caregivers of patients with advanced lung cancer were randomly divided into the experimental group and the control group.The experimental group received LWHP intervention and routine care knowledge education,the control group only received routine care knowledge education.Hope,self-efficacy,anxiety and depression,and quality of life were evaluated at the first week,the second week,the first month,and the third month.Differences between two groups were compared using variance analysis of repeated measurements.Results The self-evaluation of the intervention was 76.6％,and the main effects of hope level,selfefficacy,anxiety and depression,and mental health were statistically significant (P＜0.05);the time effect on hope level and self-efficacy were statistically significant (P＜0.05);there were interaction effects between intervention and time on hope level,self-efficacy,anxiety and depression,and mental health (P＜0.05).Conclusion LWHP can effectively improve hope level,self-efficacy and mental health status,and alleviate anxiety and depression of family caregivers of patients with advanced lung cancer.

Association study between -765G > C and -1195G > A functional polymorphisms in the cyclooxygenase 2 gene and risk of preeclampsia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between two polymorphisms immediately upstream of the cyclooxygenase 2 (COX2) gene and preeclampsia in a South West Han Chinese population.</p><p><b>METHODS</b>Blood samples from 205 patients with preeclampsia and 276 normal pregnant women as controls from Han Chinese in Chengdu area were analyzed by polymerase chain reaction-restriction fragment length polymorphisms.</p><p><b>RESULTS</b>G and A allele frequencies for -1195G>A site were 48.54% and 51.46% in the patient group, respectively, and 40.40% and 59.60% in the control group, respectively. G and C allele frequencies for -765G>C site were 94.15% and 5.85% in the case group, respectively, and 94.38% and 5.62% in the control group, respectively. The AA genotype and variant A allelic frequencies of the -1195G>A SNP were significantly lower in patients with preeclampsia than in the control group (P<0.05), and the odds ratio for the risk of preeclampsia was 0.665 (95% CI: 0.444-0.982) in women homozygous for the variant COX2 A allele ( x²=4.233, P=0.047). The genotype and allele frequencies of the -765G>C polymorphism in patients with preeclampsia and controls showed no significant differences (P>0.05). Additional subgroup analyses (mild vs severe preeclampsia) of the two polymorphisms failed to reveal significant correlation for either genotypic or allelic frequencies. Furthermore, there was no significant association between the polymorphisms and blood pressure levels in the patient or control groups.</p><p><b>CONCLUSION</b>COX2 -1195A homozygosity is associated with a decreased risk for preeclampsia in a South West Han Chinese population. On the other hand, the -765G>C polymorphism has no effect.</p>

Trillin can enhance the anti-cancer effect of fluorouracil on cervical cancer cells / 肿瘤

Objective: To investigate the enhancement effect of trillin on anti-cancer function of fluorouracil in cervical cancer cells. Methods: HeLa cells were treated with trillin (300 |xg/mL), fluorouracil (10 μg/mL), and fluorouracil (10 μg/mL) plus trillin (30, 100 and 300 |xg/mL), respectively. The inhibitory effects of trillin and fluorouracil on proliferation of HeLa cells were assayed by MTT method. Flow cytometry was applied to test the apoptosis of HeLa cells treated with trillin and fluorouracil. The expression levels of mitogen-activated protein kinase (MEK)/extracellular signal-regulated kinase (ERK), Akt and other proteins in apoptosis-related signaling pathways in Hela cells were determined by Western blotting. The xenograft tumor model of human HeLa cells in nude mice was established, and the anti-tumor effect of trillin in vivo was tested after intraperitoneal injection of trillin (300 mg/kg), fluorouracil (10 mg/kg), and fluorouracil (10 mg/kg) plus trillin (300 mg/kg), respectively. Results: As compared with treatment with fluorouracil alone, the combination of trillin and fluorouracil could improve the inhibitory effect on proliferation and apoptosis of HeLa cells (both P < 0.05). The tumor formation in nude mice administrated with trillin plus fluorouracil was inhibited, and this inhibitory effect was more significant than that in nude mice treated with fluorouracil alone (P < 0.05). The combination of trillin and fluorouracil inhibited the expressions of phosphorylated MEK/ERK and Akt proteins in HeLa cells, increased the activation of caspase-3 protein, down-regulated Bcl-2 expression, and up-regulated Bax expression. Conclusion: Trillin can enhance the anti-cancer function of fluorouracil on cervical cancer. It is suggested that trillin may be used as a potential chemosensitizer.

Effect of Loratadine combined with de-escalation therapy for wheeze in infants / 中华实用儿科临床杂志

Objeetive To evaluate the efficacy of loratadine combined with de-escalation therapy for infant wheeze.Methods One hundred out-patients from Dec.2011 to Apr.2012 were randomly divided into 2 groups:Loratadine combined with de-escalation therapy was adopted in Loratadine group,while no Loratadine was taken in control group.The dose of Loratadine was 0.3 mL/(kg · d),14 days ; oral Prednisone 0.5 mg/(kg · d),3 days; Azithromycin 10 mg/(kg · d),3 days; Tulobuterol patch 0.5 mg/d,7 days; Montelukast 4 mg/d,14 days.Control group abolished Loratadine,but the rest of drugs were same as Loratadine group.Results The respiratory symptoms (gasp,wheeze sound,phlegm removal difficulty) and the nasal symptoms (including nasal congestion,sneeze,runny nose)in the acute phase of infant wheeze all had therapeutic effect,and there were significant differences in scoring symptoms (all P ＜ 0.05).The Loratadine group had certain treatment effect on eczema.The cough symptoms in 3 days,7days,14 days of the treatment had statistically significant differences between the both groups (all P ＜ 0.05).And there were statistical differences in eczema symptom of the Loratadine group in 7 days and 14 days of treatment (all P ＜ 0.05).Control group still had no statistical differences (all P ＞ 0.05).Days of improvement in symptoms,wheeze recurrence rate and frequency of respiratory infections in I month between 2 groups had no significant differences.Conclusions Loratadine can obviously improve the patients' breathing cough symptoms,and play a certain role in the treatment combined with de-escalation therapy in infant wheezing,and has high safety and eczema therapy effect.Loratadine can be used in clinic personally according to the patient's condition.

The anti-proliferation effect of gypenosides on cervical cancer HeLa cells and its molecular mechanism / 肿瘤

Objective: To investigate the inhibitory effect of gypenosides on proliferation of human uterine cervical cancer HeLa cells in vitro, and to explore its possible mechanism. Methods: The HeLa cells were treated with different concentrations of gypenosides (low-dose group, 4.5 μg/mL; middle-dose group, 45 μg/mL; high-dose group, 450 μg/mL). The cells treated with 0.9% sodium chloride solution was designed as a control group. The inhibitory effect of gypenosides on the proliferation of HeLa cells was detected by MTT assay and BrdU (5-bromo-2-deoxyuridine) incorporation experiment. The effect of gypenosides on apoptosis of HeLa cells was detected by FCM (flow cytometry). The expression levels of Bcl-2, Bax, ERK1/2 (extracellular regulated protein kinase 1/2), p-ERK1/2 (phospho-ERK1/2), MEK1/2 (mitogen-activated protein kinase kinase) and p-MEK1/2 were detected by Western blotting. Results: The survival rate of HeLa cells was decreased significantly after treatment with gypenosides (45 μg/mL) at 24 h (P < 0.01). The survival rate of HeLa cells was decreased significantly after treatment with gypenosides (4.5 μg/mL) at 48 h (P < 0.01). The inhibitory effect of gypenosides (450 μg/mL) on the cell proliferation was confirmed by BrdU incorporation experiment. The apoptotic rate of HeLa cells was increased significantly after treatment with different concentrations of gypenosides. Gypenosides could down-regulate the expression levels of Bcl-2 and p-ERK1/2 and up-regulate the expression level of Bax. Conclusion: Gypenosides can significantly inhibit the proliferation of cervical cancer HeLa cells and also markedly induce the apoptosis. This effect may related to the up-regulation of Bax expression and down-regulation of Bcl-2 and p-ERK1/2 expressions. Copyright © 2013 by TUMOR.

Inhibitory effect of PTD-OD-HA fusion protein on Bcr-Abl in K562 cells / 解放军医学杂志

Objective To study the transduction dynamics, location of PTD-OD-HA fusion protein and its interaction with Bcr-Abl oncoprotein in K562 cell lines, and explore the influence of PTD-OD-HA fusion protein on oligomerization and tyrosine kinase activity of Bcr-Abl. Methods PTD-OD-HA fusion protein was labeled with FITC and co-cultured with K562 cells. The transduction efficiency of labeled PTD-OD-HA at different doses and time intervals was observed under fluorescence microscope. The location of labeled PTD-OD-HA fusion protein in K562 cells was detected by confocal microscopy. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was confirmed by coimmunoprecipitation. The phosphorylation of Bcr-Abl oncoprotein was detected by Western blotting. Results PTD-OD-HA fusion protein labeled with FITC was transduced into K562 cells in a dose- and time-dependent manner. PTD-OD-HA fusion protein was located in the cytoplasm of K562 cells and was consistent with the location of Bcr-Abl oncoprotein. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was proved in K562 cells. This interaction could interrupt the homologous oligomerization of Bcr-Abl oncoprotein and reduce the phosphorylation of Bcr-Abl oncoprotein. Conclusion PTD-OD-HA fusion protein could be transduced into K562 cells efficiently, inhibit the oligomerization and reduce the phosphorylation of Bcr-Abl oncoprotein.

Inhibitory effect of PTD-OD-HA fusion protein on Bcr-Abl in K562 cells / 解放军医学杂志

Objective To study the transduction dynamics, location of PTD-OD-HA fusion protein and its interaction with Bcr-Abl oncoprotein in K562 cell lines, and explore the influence of PTD-OD-HA fusion protein on oligomerization and tyrosine kinase activity of Bcr-Abl. Methods PTD-OD-HA fusion protein was labeled with FITC and co-cultured with K562 cells. The transduction efficiency of labeled PTD-OD-HA at different doses and time intervals was observed under fluorescence microscope. The location of labeled PTD-OD-HA fusion protein in K562 cells was detected by confocal microscopy. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was confirmed by coimmunoprecipitation. The phosphorylation of Bcr-Abl oncoprotein was detected by Western blotting. Results PTD-OD-HA fusion protein labeled with FITC was transduced into K562 cells in a dose- and time-dependent manner. PTD-OD-HA fusion protein was located in the cytoplasm of K562 cells and was consistent with the location of Bcr-Abl oncoprotein. The interaction of PTD-OD-HA fusion protein with Bcr-Abl oncoprotein was proved in K562 cells. This interaction could interrupt the homologous oligomerization of Bcr-Abl oncoprotein and reduce the phosphorylation of Bcr-Abl oncoprotein. Conclusion PTD-OD-HA fusion protein could be transduced into K562 cells efficiently, inhibit the oligomerization and reduce the phosphorylation of Bcr-Abl oncoprotein.

Comorbid presentation of severe novel influenza A (H1N1) and Evans syndrome: a case report / 中华医学杂志(英文版)

One 22-month-old boy who was admitted for a fever lasting 6 days as well as a cough and wheezing lasting 2 days was reported. He was diagnosed with influenza A (H1N1, severe type), severe pneumonia, acute respiratory distress syndrome (ARDS), Evans syndrome and multiple organ failure. This is the first case of novel influenza A (H1N1) and Evans syndrome. The pathogenesis is still unknown.