ABSTRACT
Objective:To observe the therapeutic timing and dosage of intravenous immunoglobulin (IVIG) in children with severe adenovirus pneumonia.Methods:Clinical data of children with severe adenovirus pneumonia treated with IVIG at the Department of Respiratory, Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from January 2019 to January 2020 were retrospectively analyzed.Participants were classified as early presenters (5-10 days of illness course) and later presenters (11-15 days of illness course) according to the timing of IVIG treatment.They were further subdivided into plan 1 group[1 g/(kg·d) IVIG for 2 days] and plan 2 group [0.4-0.5 g/(kg·d) IVIG for 3-5 days]. Continuous variables and categorical variables between groups were analyzed by the nonparametric Mann- Whitney U test and the Fisher′ s exact test, respectively. Results:A total of 202 patients with the median age of 12 (12, 36) months were recruited, involving 128 early presenters (63.37%) and 74 later presen-ters (36.63%). Later presenters had a longer duration of fever [18.00(14.00, 23.25) days vs.11.00(9.00, 14.00) days], more demands for mechanical ventilation (33.78% vs.20.31%), and higher incidence of bronchiectasis (9.46% vs.1.56%) than those of early presenters (all P<0.05). For early presenters, no significant differences were detected in the demand for advanced life support, outcomes and sequelae between plan 1 group and plan 2 group (all P>0.05). For later presenters, a shorter duration of fever [18.00(14.00, 21.00) days vs.21.00(15.50, 30.75) days] and lower usage of extracorporeal membrane oxygenation (ECMO, 2.13% vs.18.52%) were observed in the plan 1 group than that of plan 2 group (all P<0.05). The incidence of post-infectious bronchiolitis obliterans and bronchiectasis as pulmonary sequelae was comparable between plan 1 group and plan 2 group ( P>0.05). The incidence of adverse events was 5.77% during IVIG infusion, showing no significant difference between plan 1 group and plan 2 group ( P>0.05). Conclusions:Early treatment of IVIG are very important to improve the prognosis of children with severe adenovirus pneumonia.For later presenters, a high dosage of IVIG is effective in reducing the ECMO use and shortening the duration of fever, thus providing clinical benefits.
ABSTRACT
Penicillium marneffei (PM) is the only thermally dimorphic species as a Penicillium that causes the transmitted penicilliosis marneffei (PSM). PM infection is more common in immunodeficient children.Due to the lack of specific clinical manifestations, PSM is easily misdiagnosed as pulmonary plasmacycosis, tuberculosis or pulmonary aspergillosis.Because of the rapid progress and multiple complications of transmitted PSM, its mortality remains high without timely and effective treatment.Therefore, early diagnosis and treatment are of great significance, and the diagnosis of PSM mainly relies on the immune function examination, measurement of serum markers, pathogen detection and imaging examinations.There is no standard antifungal regimen, and Amphoterus B and Itraconazole are used as the first-line treatment.This study aims to review the progress of diagnosis and treatment of PM infection in children.
ABSTRACT
Human adenovirus(HAdV)is a double-stranded DNA virus with multiple serotypes.Owing to their genetic heterogeneity, HAdVs display broad tissue tropism and can infect several organs or tissues.Besides the most common respiratory system, different types of HAdV can enter into multi-tissue and cells of the whole body through different receptors and mechanisms, directly destroy the host cells and also trigger immune response that course further damages.Then a variety of extrapulmonary manifestations would appear, such as gastroenteritis, encephalitis, myocarditis, hemorrhagic cystitis, hemophagocytosis and conjunctivitis, which seriously threaten the health of children.
ABSTRACT
Human adenoviruses (HAdVs) are the common infectious pathogens in children, which mainly infect the respiratory tract, digestive tract and eyes.Severe HAdVs may even be life-threatening.HAdVs enter the host and cause infection by binding to the host epithelial cells.At the same time, they are recognized by various immune cells and then activate the immune defense response.This study aims to review the interaction between HAdVs and the host, and the immune defense mechanism, thus improving the understanding of the immune response to HAdVs.
ABSTRACT
Objective:To explore the structure of maternal verbal scaffolding features and develop a questionnaire on Mother's language scaffolding characteristics, so as to provide a quantitative, convenient and economical self-assessment tool for describing maternal verbal scaffolding features.Methods:On the basis of qualitative research and literature research, a questionnaire survey was conducted among 704 mothers of preschool children. After item analysis and exploratory factor analysis, a formal questionnaire was formed. Two weeks later, 106 mothers were retested to collect test-retest reliability data. Preschool children's expressive vocabulary checklist was used as external criterion.Data were analyzed by SPSS 18.0 and Amos 21.0.Results:(1)The formal questionnaire includes 28 items with two factors-detailed support factor and control rejection factor, the internal consistency coefficients of the two factors were 0.849 and 0.811, the project load was from 0 .482 to 0 .701, and the variance contribution rate was 40.36%.(2) AMOS 21.0 was used for confirmatory factor analysis, indicating that the two-factor structure met the requirements of psychometrics.( χ 2/ df=1.96, RMSEA=0.05, NFI=0.86, CFI=0.90, IFI=0.89). (3)The results of two-factor text-retest reliability were 0.840 and 0.871 as well as the results of split-half reliability was 0.801.The internal consistency reliability was 0.740.The external validity analysis showed that the mother's education level was positively correlated with factor Ⅰ( r=0.288, P=0.000), but not with factor Ⅱ( r=-0.091, P=0.052). There was significant difference in factorⅠbetween mothers with expressive vocabulary development delay children (52.22±10.56) and non delayed children (57.71±7.51) ( t=-5.07, P=0.000). There also was a significant difference in factor Ⅱ between mothers with expressive vocabulary development delay children (37.12±10.09) and non delayed children (31.53±8.59) ( t=4.61, P=0.000). (4)There was no significant difference in the characteristics of language scaffolding between boys(factorⅠ(58.08±8.14), factorⅡ(32.86±9.51)) and girls' mothers(factorⅠ(56.93±8.20), factorⅡ(31.42±8.48)). Analysis of the sample groups showed that age did not affect the verbal scaffolding features of preschool children's mothers( F1=1.633, P1=0.181; F2=0.758, P2=0.518). Conclusion:There are two factors in the questionnaire of the verbal scaffolding features questionnaire, which meet the criteria of psychometrics.The questionnaire of the verbal scaffolding features questionnaire is suitable for evaluating the characteristics of language scaffolding of mothers of preschool children aged 3-6.
ABSTRACT
Human adenovirus is a DNA virus and a common pathogen of respiratory tract infection in children of China.Adenovirus can trigger a variety of mechanisms, thereby dissolving and killing lung cells.Consequently, it leads to such acute lung injury as acute respiratory distress and lung consolidation, and such pulmonary sequelae as bronchiolitis obliterates, unilateral transparent lung, bronchiectasis, and interstitial fibrosis.In this article, the mechanism underlying children lung injury caused by adenovirus was reviewed.
ABSTRACT
Objective@#To understand the infection status, characteristics and drug resistance of non-O157 Shiga toxin-producing E. coli (STEC) in animal feces in Shandong Province.@*Methods@#From 2015 to 2016, convient sampling method was used to collect 1 022 fresh feces of animals in Weishan county and Laizhou city, and 24 non-O157 STEC were isolated. The serotypes of non-O157 STEC strains were confirmed through serum agglutination test. The susceptibility was explored through the antimicrobial sensitivity experiments. ESBLs activity was confirmed by double-disc diffusion. PCR method was used to detect the resistance genes. PFGE typing was operated to assess the relatedness and variability of the strains. The multi-locus sequence typing (MLST) was adopted to get the allelic profile and ST sequence of strains. Analysis was made on the evolutionary relationship between different ST groups was made through CLC Sequence Viewer and Counting Express.@*Results@#A total of 24 non-O157 STEC were isolated from animal feces. 23 strains were from pig feces, and 1 strain was from cow feces, and the serotypes were more dispersed. All of the 24 strains carried stx2 genes. The highest resistance rate was sulfamethoxazole(22 strains), the mount of cotrimoxazole and nalidixic acid was 18 strains, chloramphenicol was 13 strains, tetracycline was 19, and there was a phenomenon of multiple drug resistance. The drug resistance spectrum was sulfamethoxazole tetracycline-compound novammin-naphthidine-chloramphenicol. All strains were sensitive to cefepime and imipenem. The ESBLs confirmatory test showed that 4 strains of non O157 STEC produced beta lactamase. PCR detected 7 resistance genes, and 4 tetracycline resistance genes (Tet A, Tet B, tetC and tetD) were detected. The beta lactamase resistance genes (blaSHV-1, bla CTX-M, bla TEM) were all negative. 24 strains were divided into 15 PFGE types, and their clustering results were more dispersed and no dominant PFGE type. There were 11 kinds of MLST types, most of them are ST540 and ST5133 types, each of which was 4 strains, and clustered into 1 MLST genomes.@*Conclusion@#The serotypes of non-O157 STEC in animal feces O157 STEC were dispersed, and the resistant rate to common antibiotic was high. MLST typing results presents obvious polymorphism. Surveillance and manage ment of these strains should be strengthened.
ABSTRACT
Objective To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome Methods 57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled According to the length from the time diagnoses confirmed to the time of delivery,patients were divided into 3 groups; group Ⅰ,within 24 hours, group Ⅱ,24 to 48 hours and group Ⅲ,over 48 hours Complications,maternal and perinatal mortality were analyzed retrospectively between different groups Results Maternal and perinatal mortality were 7% and 11% in group Ⅰ, 16% and 21% in group Ⅱ, 64% and 73% in group Ⅲ with significant differences between group Ⅲ and group Ⅰ or group Ⅲ and group Ⅱ ( P