Progress in the treatment of Kawasaki disease in acute phase / 国际儿科学杂志

Kawasaki disease is an acute systemic vasculitis and its etiology is still unknown.About 15%~25% of untreated children suffer from coronary artery damage, so it has attracted more and more attention around the world.Although high-dose intravenous immunoglobulin and oral aspirin are currently recognized as the most effective treatment.Immunoglobulin resistance and coronary artery damage are still big challenge for some patients.In recent years, new treatments(such as glucocorticoids, TNF-α antagonists, interleukin-1 antagonists, cyclosporin A, cytotoxic drugs, plasma exchange, et al)have been clinically affirmed, and some of them are still controversial.This article reviews the treatment progress of Kawasaki disease in the acute phase at home and abroad in recent years.

Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China / 中国当代儿科杂志

OBJECTIVES@#To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia.@*METHODS@#A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis.@*RESULTS@#Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, @*CONCLUSIONS@#Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.

Clinical significance of laparoscopic extraperitoneal abdominal para-aortic lymphadenectomy / 中国实用妇科与产科杂志

OBJECTIVE: To evaluate the clinical significance of laparoscopic extraperitoneal para-aortic lmphadenectomy(PAL)in high para-aortic lymphadenectomy.METHODS: A non-randomized controlled method was used to analyze the clinical data of laparoscopic extraperitoneal PAL in 35 patients(extraperitoneal group)and laparoscopic transabdominal PAL in 40 patients(transabdominal group)in the Gynecological Department of the First Affiliated Hospital of Xiamen University from March 2018 to April 2019.RESULTS: All the 35 cases of laparoscopic extraperitoneal PAL reached the level of renal vein.Endometrial cancer accounted for the largest proportion,with an average age of 47.57 years and an average body mass index of 23.77.The average operation time was 109 minutes in the first 6 cases and 74.73 minutes in the other 29 cases.The amount of hemorrhage was 15.19 mL,and the average number of para-aortic lymph nodes(PALN)resected was 17.87.There were 5 cases of positive PALN metastasis,and the average gastrointestinal recovery time was13.43 hours.The average postoperative pelvic drainage was 76.57 hours and the average postoperative hospital stay was8.24 days.Intraoperative and postoperative complications included 1 case of inferior vena cava rupture,1 case of chyle leakage,and 1 case of vulvar edema.None of the 40 cases of laparoscopic transabdominal PAL reached the level of renal vein,and endometrial cancer accounted for the largest proportion,with the average age of 46.78 years and the average body mass index of 24.03.The average operation time was 90.55 min;the average intraoperative blood loss was 67.40 mL The average number of para-aortic lymph nodes was 3.30.There was one case of PALN metastasis.The average gastrointestinal recovery time was 22.35 hours,and the average postoperative pelvic drainage time was 75.75 hours.The average length of hospital stay was 8.90 days.There were 2 cases of rupture of the inferior mesenteric artery,3 cases of chyle leakage,and 2 cases of vulvar edema.The number of PALN resection,intraoperative blood loss,and operation time in the extraperitoneal group were not related to the body mass index,but the number of PALN in obese patients in the laparoscopic transabdominal group was significantly reduced,the operation time was longer,the intraoperative blood loss was more,and postoperative gastrointestinal recovery time is longer(P<0.05).CONCLUSION: Laparoscopic extraperitoneal PAL can solve the problems of laparoscopic transabdominal PAL lymph node resection,which is difficult to reach the level of renal vein,intraoperative intestinal tube interference,and the number of lymph nodes resected.It is especially suitable for obese patients.Laparoscopic extra-peritoneal high-grade PAL is safe,feasible,and recommended.

Analysis of HIV infection status and factors among men who have sex with men in Guangzhou / 中华疾病控制杂志

Objective To understand infection status of human immunodeficiency virus (HIV) and analyze the influencing factors among men who have sex with men (MSM) in Guangzhou. Methods Men who have sex with men (MSM) were recruited from 2014 to 2017. Face-to-face questionnaire survey was conducted to collect information of characterisitc and behaviors. Blood samples were used to detect HIV antibodie. Data were analyzed using SPSS 19.0. Results Among 2 419 MSM, 200(8.27%) participants were confirmed positive for HIV. Multivariate Logistic regression analysis showed that with Guangzhou and monthly economic income >0.5 million as reference, non-Guangzhou (OR=1.712, 95% CI: 1.176-2.492，P=0.005) and monthly economic income ≤0.5 million (OR=1.998, 95% CI: 1.409-2.833，P<0.001) were associated with HIV infection among MSM. Diagnosed syphilis (OR=2.461, 95% CI: 1.375-4.405,P=0.002) , undetected syphilis (OR=2.333, 95% CI: 1.635-3.331,P<0.001), anal sex role passive (OR=2.015, 95% CI: 1.244-3.267,P=0.004), both active and passive (OR=2.115, 95% CI: 1.374-3.251,P=0.001), non-using condoms every time during anal sex (OR=1.955, 95% CI: 1.374-2.781,P<0.001), non-fixed anal sex objects (OR=2.150, 95% CI: 1.463-3.160,P<0.001) were major risk factors for HIV infection among MSM. Conclusions The prevalance of HIV infection and high-risk sexual behavior were high among MSM in Guangzhou. It is urgent to expand the scope of HIV testing and advocate safe sexual behaviors among MSM.

Therapeutic effect of fructose-1, 6-diphosphate combined antiviral treatment on pediatric patients with viral myocarditis / 心血管康复医学杂志

Objective: To explore therapeutic effect of fructose-1, 6-diphosphate (FDP) combined antiviral treatment on pediatric patients with viral myocarditis (VMC). Methods: A total of 118 VMC children were randomly and equally divided into routine treatment group and combined treatment group (received FDP therapy based on routine treatment), both groups were treated for two weeks. Therapeutic effect after treatment, levels of creatine kinase (CK), lactate dehydrogenase (LDH), CK isoenzyme MB (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH), heart rate (HR), stroke volume (SV), cardiac output (CO) and left ventricular ejection fraction (LVEF) before and after treatment were measured and compared between two groups. Results: Total effective rate of combined treatment group was significantly higher than that of routine treatment group (91. 53％ vs. 71. 19％, P=0. 005). Compared with before treatment after two-week treatment, there were significant reductions in levels of CK, LDH, CK-MB, HBDH and HR, and significant rise in SV, CO and LVEF in two groups, P＜0. 01 all. Compared with routine treatment group after two-week treatment, there were significant reductions in levels of CK [(168. 2±33. 7) U/L vs. (126. 4±30. 4) U/L], LDH [(199. 0±41. 3) U/L vs. (162. 7±47. 1) U/L], CK-MB [(18. 3±6. 4) U/ L vs. (12. 2±6. 6) U/L], and HR [(85. 4±12. 6) times/min vs. (80. 2±12. 3) times/min], and significant rise in SV [(82. 4±13. 4) ml vs. (89. 5±14. 0) ml]and LVEF [(50. 1±8. 5) ％ vs. (59. 7±8. 8) ％]in combined treatment group, P＜0. 05 or＜0. 01. Conclusion: Fructose-1, 6-diphosphate combined antiviral therapy could significantly improve myocardial enzyme levels, recover cardiac pump function with significant therapeutic effect in VMC pediatric patients.

Determination of seven components in flowers of Gentiana tibetica and Gentiana dendrologi by HPLC / 中草药

Objective: To establish an HPLC method for simultaneously determining seven components, such as loganic acid, 6′-O-β-D-glucopyranosyl gentiopicroside, swertiamarine, gentiopicroside, swertiamarin, isoorientin, and isovitexin, from the flowers of Gentiana tibetica and G. dendrology. Methods: Chromatographic analysis was achieved on an Agilent Zorbax ODS column (150 mm × 4.6 mm, 5 μm) by gradient elution of acetonitrile-0.4% acetic acid in water at 30℃. The flow rate was 0.4 mL/min and the detection wavelength was 254 nm. Results: The calibration curves of all the seven constituents showed good linearity in a relatively wide concentration range. The linear ranges of loganic acid, 6′-O-β-D-glucopyranosyl gentiopicroside, swertiamarine, gentiopicroside, gentiopicroside, isoorientin, and isovitexin were 0.228-2.280, 0.680-6.800, 0.220-2.20, 1.476-14.760, 0.200-2.000, 0.436-4.360, and 0.276-2.760 μg (R2 ≥ 0.999 2), respectively. The recoveries (n = 9) of loganic acid, 6′-O-β-D-glucopyranosyl gentiopicroside, swertiamarine, gentiopicroside, gentiopicroside, isoorientin, and isovitexin were 100.9%, 99.4%, 101.0%, 105.7%, 103.1%, 98.4%, 104.2%. Conclusion: This method is simple, accurate, and specific, and can be used for the determination of seven constituents in the flowers of G. tibetica and G. dendrologi.

Simultaneous Determination of Protocatechualdehyde, Rosmarinic Acid and Salvianolic Acid A in Salvia Miltiorrhiza Bunge by HPLC / 中国药师

Objective:To establish an HPLC method to simultaneously determine the content of protocatechualdehyde, rosmarinic acid and salvianolic acid A in Salvia miltiorrhiza Bunge. Methods: The chromatographic column was a Linksil-ODS ( 250 mm × 4. 6 mm,5 μm) column,the mobile phase was 1% acetic acid water solution-acetonitrile (7∶3) with the flow rate of 0. 8 ml·min-1 . The detection wavelength was 280nm , the column temperature was 30℃ and the injection volume was 20 μl. Results: The linear range of protocatechualdehyde, rosmarinicacid and salvianolic acid A was 3-300 μg·ml-1(r>0. 999 0), and the recovery was within the range of 95. 22%-99. 68% with RSD below 2% (n=5). Conclusion:The method is accurate, rapid and reproducible, and can be used to control the quality of Salvia miltiorrhiza Bunge.

Effects of stem cell therapy on dilated cardiomyopathy

To perform a meta-analysis of clinical trials and investigate the effect of stem cell therapy on dilated cardiomyopathy. A systematic literature search was carried out between May 2012 and July 2013 in PubMed, Medline, Cochrane Library, and Excerpta Medica Database [EMBASE]. The study took place in the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. The weighted mean difference [WMD] was calculated for left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD], mortality and heart transplantation, and the 6-minute walk test [6-MWT] distance using the RevMan 5.0 software. Seven trials with 599 participants evaluated the association between the stem cell therapy and control groups. Compared with the control group, stem cell therapy group improved the LVEF [WMD: 3.98%, 95% confidence interval [CI]: 0.55 - 7.41%, p=0.02] and the 6-MWT distance [WMD: 132.12 m, 95% CI: 88.15-176.09 m, p<0.00001], and reduced mortality and heart transplantation [odds ratio [OR]: 0.48, 95% CI: 0.29-0.80, p=0.005]. However, the LVEDD showed no significant difference between the 2 groups [WMD: -1.53 mm, 95% CI: -1.15-0.10 mm, p=0.10]. This meta-analysis demonstrated that stem cell therapy improves cardiac function and reduces mortality in dilated cardiomyopathy patients, which suggested that stem cell therapy may represent a new therapy option for dilated cardiomyopathy.

Application of next-generation sequencing in clinical oncology to advance personalized treatment of cancer / 癌症

With the development and improvement of new sequencing technology, next-generation sequencing (NGS) has been applied increasingly in cancer genomics research over the past decade. More recently, NGS has been adopted in clinical oncology to advance personalized treatment of cancer. NGS is used to identify novel and rare cancer mutations, detect familial cancer mutation carriers, and provide molecular rationale for appropriate targeted therapy. Compared to traditional sequencing, NGS holds many advantages, such as the ability to fully sequence all types of mutations for a large number of genes (hundreds to thousands) in a single test at a relatively low cost. However, significant challenges, particularly with respect to the requirement for simpler assays, more flexible throughput, shorter turnaround time, and most importantly, easier data analysis and interpretation, will have to be overcome to translate NGS to the bedside of cancer patients. Overall, continuous dedication to apply NGS in clinical oncology practice will enable us to be one step closer to personalized medicine.

Cloning and analysis of full-length genes of a H9N2 subtype avian influenza virus isolated from Guangdong / 病毒学报

Eight full-length genes of an avian influenza virus Chinese isolate of H9N2 subtype, A/Chicken/Guangdong/HL/2006 (H9N2) (abbreviated as Ck/GD/HL/06), were amplified by RT-PCR, including the 5' and 3' non-coding region. All the genes were cloned and sequenced. The phylogenetic analysis results showed the HA gene of Ck/GD/HL/06 was located in the same phylogenetic clade as Dk/HK/Y280/97 (H9N2), while the Dk/HK/Y280/97-like viruses had been predominately isolated from chickens in mainland China. After the analysis of glycosylation sites and receptor-binding sites in the HA, it was shown that the HA of Ck/GD/HL/06 exhibited the common feature of H9 subtype avian influenza virus isolated from China, but the leucine (Leu) residue at the amino acid position 226 indicated the potential of binding with SA alpha,2-6 receptor. The three internal genes of Ck/GD/HL/06 (PB1, PA and NP) had the highest nucleotide identity with A/Viet Nam/1203/2004 (abbreviated A/VN/1203/04) isolate, which was shown to be transmitted from chickens to human and caused lethal infection in human. No analogous H9N2 strains was reported in previous studies. Based on the high similarity of Ck/GD/HL/06 three genes to A/VN/1203/04, it was suggested that the possibility of generating new highly pathogenic H5N1 AIVs by recombination was worthy of our attention. Further studies should be needed for molecular epidemiologic surveillance of H9N2 AIV in the south China for a long time.

Molecular analysis of an avian influenza virus isolate of H5N2 subtype from parrot / 病毒学报

In 2005, an avian influenza virus stain was isolated from Parrot in Guangdong, which was then genotyped as H5N2 subtype and designated as A/Parrot/Guangdong/268/2005. According to the current OIE definition on the low-pathogenicity of avian influenza virus, the strain was recognized as a low pathogenic avian influenza virus due to the presence of one basic amino acid residue at the HA cleavage site. Some molecular characteristics of the virus, such as potential glycosylation sites in HA and NA, receptor binding sites of HA, and drug resistance site of NA, showed no variations. To analyze molecular evolution of this strain, we selected the sequences of H5N2 subtype AIVs from GenBank and established the phylogenetic trees. Our results indicated that this strain shared the highest homologies with the H5N2 LPAI isolate A/Pheasant/NJ/1355/1998-like. Phylogenic analysis revealed the isolate, together with A/Chicken/Pennsylvania/1/1983 (H5N2), belonged to America lineages and clustered with A/Pheasant/NJ/1355/1998-like.

A diabetic model for liver oxidant damage in mice / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the liver oxidant damage for diabetic model in mice.</p><p><b>METHODS</b>Male kunming mice were feed with high fat dietary for a week and then were randomly divided into two groups by weight, with 10 mice in each group. One group was induced by small dose streptozotocin (STZ) and obtained STZ-induced diabetic mice, and the other group was regarded as the control. Both of the two groups were feed with high fat dietary. After 6 weeks, the activities of enzymes, such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) and nitric oxide synthase (NOS) were measured. Glutathione (GSH), maleic dialdehyde (MDA), nitric oxide (NO) levels in the liver and the liver viscera quotient were also measured. Liver histological manifestations were observed.</p><p><b>RESULTS</b>In diabetes group, there was a significant decrease in body weight, and the activities of GSH, CAT, and NOS decreased significantly (t value were 5.370, 10.639, 5.235, 3.089, respectively, P < 0.01). While, the liver viscera quotient, the levels of MDA, GSH-PX and NO increased remarkably (t value were -6.246, -2.728, -2.660, -4.924, respectively, P < 0.01 or P < 0.05). The significant difference was not observed in SOD between the two groups (t value was -0.405, P > 0.05). The liver histological damages were observed in diabetes group, light microscope observation showed hepatocytes swelling, ballooned changing and fatty droplets clustering.</p><p><b>CONCLUSION</b>The oxidant damage might exist in the liver diabetic model in mice.</p>

Significance of Expression of Nerve Growth Factor and Slouble Fas in Children with Viral Myocarditis / 实用儿科临床杂志

Objective To investigate the expression of nerve growth factor(NGF) and slouble Fas(sFas) in children with viral myocarditis(VM),and the relationship with immunity,with the aim to provide evidence and basis for the diagnosis and treatment of VM.Methods The serum levels of NGF and sFas were detected by two-site enzyme-linked immunosorbent assy(ELISA) in 43 children with VM,and 20 normal heathy children as controls.Results The serum levels of both NGF and sFas in children with the acute stage(course in less than month and 1-2 months)and the procrastinate and chronic stages of VM were significantly higher than those of healthy children(P0.05).Conclusion The increased serum expression levels of NGF and sFas are related to the process of viral myocarditis,which confirms the relationship between the onset of VM and immune factors.