Bacterial pathogenic characteristics of respiratory tract infection in children in Suzhou, China: an analysis of 14,994 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the bacterial pathogenic characteristics of respiratory tract infection in children.</p><p><b>METHODS</b>The medical data from 14,994 children with respiratory tract infection who were hospitalized in Children's Hospital Affiliated to Soochow University between November 2005 and October 2014 were retrospectively reviewed.</p><p><b>RESULTS</b>Among the 14,994 sputum samples from the children with respiratory tract infection, 3,947 (26.32%) had a positive bacterial culture. The most common bacterial pathogen was Streptococcus pneumonia (12.79%), followed by Haemophilus influenzae (5.02%) and Moraxella catarrhalis (2.91%). The bacterial detection rates differed significantly in different years and seasons and children of different ages (P<0.01). The children who had not taken antibacterial agents before admission had a significantly higher positive bacterial culture rate than those who had taken antibacterial agents (P<0.01). There were significant differences in the bacterial detection rate among the children with different course of disease (<1 month, 1-3 months and >3 months) (P<0.05). The detection rates of Streptococcus pneumonia, Moraxella catarrhalis and Acinetobacter baumannii showed an increased trend with a prolonged disease course (P<0.05).</p><p><b>CONCLUSIONS</b>Streptococcus pneumonia is the most common bacterial pathogen causing respiratory tract infection in children, followed by Haemophilus influenzae and Moraxella catarrhalis. The detection rate of bacterial pathogens varies in different years and seasons and children of different ages. The course of the disease and application of antibacterial agents outside hospital can affect the detection rate of bacterial pathogens in children with respiratory tract infection.</p>

Etiology of acute respiratory tract infection in hospitalized children in Suzhou from 2005 to 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To elucidate the etiology of acute respiratory tract infection (ARI) in hospitalized children in Suzhou from 2005 to 2011.</p><p><b>METHODS</b>A total of 10 243 hospitalized children with ARI in Children's Hospital Affiliated to Soochow University from September 2005 to October 2011 were enrolled in the study. The clinical information was collected; and the nasopharyngeal aspiration fluid and serum samples were sent for multi-pathogen detection. Respiratory syncytial virus (RSV), influenza virus type A and B (IV-A, IV-B), parainfluenza virus type 1-3 (PIV-1-PIV-3) and adenovirus (ADV) were detected by direct immunofluorescence assay. Human bocavirus (HBoV), mycoplasma pneumoniae (MP) and chlamydia pneumoniae (CP) were detected by fluorescent quantitative PCR while human metapneumovirus (hMPV) was detected by reverse transcription PCR (RT-PCR). Sputum culture was applied to detect bacterial infection and quantitative ELISA was adopted to detect the specific antibodies of MP and CP. The results of the above detections were analyzed, and thereby to explore the prevalent pathogens among different aging children and the seasonal distribution and characteristics of the disease.</p><p><b>RESULTS</b>At least one type of pathogen was detected in 5871 out of 10 243 hospitalized children and the overall positive rate was 57.32%; including 3326 virus samples with positive rate at 32.47% (3326/10 243), 2870 bacteria samples with positive rate at 28.02% (2870/10 243) and 2759 atypical pathogen samples,with positive rate at 26.94% (2759/10 243). MP was the most common pathogen,whose detected rate was 25.74% (2637/10 243). The median age of children with RSV (6 months) or PIV-3(8 months) infection was younger than the median age of all hospitalized children (12 months) (χ(2) = 380.992, 34.826, P < 0.05). While the median age of children with ADV (42 months), HBoV (14 months) or IV-A (24 months) infection was older than it of all hospitalized children (χ(2) = 83.583, 13.169, 18.012, P < 0.05). The median age of children with MP (30 months),streptococcus pneumoniae (17 months) or haemophilus parainfluenzae (21 months) infection was older than it of all hospitalized children (χ(2) = 728.299, 60.463, 8.803, P < 0.05). The detected rate of RSV in the groups of children aging less than 6 months, 7-12 months, 2-3 years, 4-5 years and over 6 years was separately 25.59% (840/3283), 17.05% (333/1953), 11.85% (310/2615), 6.68% (90/1347), and 2.87% (30/1045); which decreased while the age grew (χ(2) = 178.46, P < 0.01). Conversely, the positive rate of MP increased with the age growing (χ(2) = 379.21, P < 0.01). The rate in the above groups was 8.25% (271/3283), 19.46% (380/1953), 33.00% (863/2615), 41.43% (558/1347), 54.07% (565/1045), respectively. RSV and IV-A were prevalent in winter, whose detected rates were 35.73% (941/2634) and 4.44% (117/2634) respectively.hMPV infection was common in spring, with the detected rate at 10.55% (278/2634); while HBoV infection was common in summer and autumn, with the positive rate at 9.99% (149/1491) and 9.71% (98/1009). MP and CP were frequently detected in summer, up to 31.27% (819/2619) and 10.07% (43/427) respectively. RSV was the most common pathogen in bronchiolitis (33.27% (866/2603)) and MP was the most common pathogen in bronchopneumonia (26.05% (1152/4422)) and lober pneumonia (52.25% (267/511)).</p><p><b>CONCLUSION</b>MP and RSV were the most common pathogens in respiratory tract infection in hospitalized children. The novel virus included hMPV and HBoV, which also played an important role in ARI. Different pathogens were prevalent in different ages; with respective seasonal distribution and characteristics.</p>

Effects of costimulatory pathway OX40/OX40L on the pathogenesis of allergic asthma in mice / 中华儿科杂志

<p><b>OBJECTIVE</b>Allergic asthma is thought to be mediated by CD4+ T lymphocytes producing the Th2-associated cytokines, which play a critical role in the development of the airway hyper-responsiveness and the eosinophilic inflammatory response. The costimulatory pathway CD28/B7 has been shown to play an important role in CD4+ T cell activation in allergic asthma. This study was conducted to evaluate the role of another costimulatory pathway OX40/OX40 ligand (L) in the pathogenesis of allergic asthma in BALB/c mice.</p><p><b>METHODS</b>An allergic asthma model in BALB/c mice was established. Thirty-six BALB/c mice were randomly divided into three groups with 12 in each. Mice in treatment group (group B) were treated with neutralizing anti-OX40L monoclonal antibody (mAb, 300 microg per mouse) during the sensitization period. Mice in two control groups, asthma model group (group A) and IgG antibody group (group C) were treated with normal saline (NS) and control IgG respectively instead of anti-OX40L mAb. Bronchoalveolar lavage fluid (BALF) was collected from the mice of each group for counting the total number of white blood cells (including neutrophil granulocyte, lymphocyte, monocyte and eosinophil granulocyte) and the proportions of these cells. The levels of IL-4 and INF-gamma in BALF were measured by ELISA. Lungs were removed for morphological examination after HE and PAS staining, and expression of OX40 in lungs was evaluated by immunohistochemical method.</p><p><b>RESULTS</b>(1) The count of total number of white blood cells in BALF (x10(6)/ml) was lower in group B than that of group A and group C (26.6 +/- 4.6 vs. 36.8 +/- 5.2 and 34.3 +/- 6.9, respectively), the difference between the treatment group (group B) and two control groups (groups A and C) was significant; The proportions of eosinophils and lymphocytes in the BALF (%) were lower in group B than those in group A and group C (eosinophils 15.1 +/- 2.6 vs. 20.0 +/- 4.1 and 19.9 +/- 3.9, respectively; lymphocytes 7.0 +/- 0.9 vs. 8.9 +/- 1.6 and 8.6 +/- 1.8, respectively), the difference between the treatment group and two control groups was significant. (2) The IL-4 level in BALF (pg/ml) was lower in group B than that in group A and group C (672 +/- 58 vs. 809.57 +/- 106.00 and 784 +/- 58, respectively), but the INF-gamma levels in BALF (pg/ml) were higher than those in group A and group C (0.86 +/- 0.09 vs. 0.69 +/- 0.15 and 0.67 +/- 0.13 respectively), and all the differences were statistically significant. (3) The expression of OX40 in the lungs of mice in group B were at a lower level than that of group A and group C, and the morphological changes of asthma were ameliorated in the mice of the treatment group. The signs of mice in treatment group were obviously ameliorated as compared to the two control groups.</p><p><b>CONCLUSION</b>Blocking the costimulatory pathway by administering the neutralizing anti-OX40L mAb during the sensitization period of allergic asthma model could balance the Th1/Th2 responses, inhibit lung inflammation and ameliorate the signs of mice model of asthma.</p>

Influence of Inhaled Corticosteroids on Airway Transforming Growth Factor - ?1 Expression of Asthmatic Remodeling Model / 实用儿科临床杂志

Objective To investigate the role of inhaled corticosteroids (ICS) on transforming growth factor - ?1 (TGF - ?1 )of asthmatic remodeling model Methods One hundred and eight guinea pigs were divided into 3 groups randomly and equally: asthmatic group( A), therapeutic group(B), control group(C) Three groups were treated by ovalbumin, budesonide, normal saline respectively The lung tissue specimens were collected after the guinea pigs were killed; the expression of TGF- ?1 was determined Results The expressions of TGF-?1 in A, K and C groups were(41 83 ? 10. 45) %, (27. 22 ? 8. 09)% , (15. 36 ? 2. 64)% respectively at 12 weeks. It was statistically significant( P

1 alpha, 25-dihydroxyvitamin D3 and its analogues modulate the phagocytosis of human monocyte-derived dendritic cells / 药学学报

<p><b>AIM</b>To investigate the role of 1 alpha, 25-dihydroxyvitamin D3 (calcitriol) and its analogues tacalcitol and 24, 25(OH)2D3 on the phagocytosis of human monocyte-derived dendritic cells (MoDC).</p><p><b>METHODS</b>MoDC were generated in vitro by differentiating monocytes in the presence of GM-CSF and IL-4 for 5 days. Expression of mannose receptor (MR) and Fc gamma receptors (Fc gamma Rs) by MoDC was analysed by flow cytometry. Zymosan ingestion was measured to assess the phagocytosis of MoDC.</p><p><b>RESULTS</b>MoDC expressed high level of MR and Fc gamma Rs and showed the capacity of zymosan ingestion. Calcitriol and tacalcitol but no 24, 25(OH)2D3 not only upregulated the expression of MR and Fc gamma Rs on MoDC but also correspondingly enhanced their phagocytosis by increasing zymoasan ingestion. Furthermore, the upregulatory role occurred in the early stage of MoDC differentiation and was irreversible. The upregulatory role of calcitriol was dose dependent.</p><p><b>CONCLUSION</b>Calcitriol and its analogue tacalcitol may play an important role in dendritic cell binding and capturing foreign antigens at the initiation of immune response.</p>

Effects of fumaric acid esters on differentiation of dendritic cells in vitro / 浙江大学学报·医学版

OBJECTIVE: To investigate the effect of anti-psoriatic drug fumaric acid esters (FAE) on the differentiation of dendritic cells (DC). METHODS: Dendritic cells were obtained by differentiating human monocytes in vitro. Flow cytometry was used to analyse the effect of FAE on cell surface expression of CD1a, CD14, CD40, CD80, CD86 and HLA-DR by monocyte-derived dendritic cells (MoDC). Mixed lymphocyte reaction (MLR) was made to demonstrate the influence of FAE on T cell stimulatory activity of MoDC. RESULTS: Dimethylfumarate and methylhydrogenfumarate-calcium-salt (0.01 approximate, equals 100 mg/L) inhibited MoDC differentiation as well as reducing the capacity of MoDC to stimulate lymphocytic proliferation in MLR. CONCLUSION: The mode of action of FAE in pso riasis may be mediated by inhibition of DC differentiation.

Differences in Clinical Characteristics and Etiology of Bronchopneumonia and Lobar Pneumonia / 实用儿科临床杂志

Objective To study the differences in clinical characteristics and etiology in bronchopneumonia and lobar pneumonia,and provide the basis for the clinical diagnosis and treatment.Methods A retrospective study was performed on 100 children with lobar pneumonia and 200 children with bronchopneumonia from Dec.2005 to Dec.2007.Antibodies of mycoplasma(MP) and chlamydia(CP) were detected with quantitative enzyme linked immunosorbent assay of serum samples which were collected on addmission.On the second day morning,axenic sputum samples of laryngeapharyngis at pars were collected with onetime asepsis aspiration sputum tube by negative pressure for bacterial culture,and the common seven viruses were detected with direct immunofluorescence,and MP DNA,CP DNA were detected.The results and the clinical data and the characters of sternum were analyzed.Results Lobar pneumonia was more in the elder children,and the features were fever and cough in clinic,absence in physical sign of bellow,and inflammation of one pulmonary lobe in X-ray.Sixty-one percent of childhood lobar pneumonia had MP infection in laboratory examination.But bronchopneumonia was found more in infants and young children,whose features were cough,dyspnea and catarrhus in clinics,wheezy phlegm and stridor in physical sign of bellow,pulmonic shadow of spot and lamellar in X-ray.Bacteria were the most common pathogen in bronchopneumonia.Conclusions Lobar pneumonia was different from bronchopneumonia in age and clinic features and sternum characters of patients,and much more different in etiology.Bacterial infection was important in bronchopneumonia.But in lobar pneumonia,MP infection occupied 61.0%,which was different from traditionaletiology.Moreover,the MP infection rate in infant and young children tend to increase obviously.