Comparison RNA with DNA detection assay in diagnosis of Mycoplasma pneumoniae infection / 中华实用儿科临床杂志

Objective:To evaluate the rapid nucleic acid amplification detection of Mycoplasma pneumoniae (MP)-DNA and MP-RNA in the diagnosis of MP infection and therapeutic values in children. Methods:Patients who were diagnosed with pneumonia were enrolled from the Department of Respiration, Children′s Hospital of Capital Institute of Pediatrics from January 2018 to December 2018.Specimens were detected using the MP and Macrolide-Resistant isolates Diagnostic Kit (PCR Fluorescence Probing, Jiangsu Mole Bioscience Co., Ltd.) and MP Diagnostic Kit (Isothermal RNA amplification, Shanghai Rendu Biotechnology Co., Ltd.).Results:Among them, 42.1%(840 cases) of the 1 994 cases were positive for MP-DNA, and the macrolide associated gene mutations were detected in 96.0% (806/840 cases) of them, while 33.9% (551 cases) of 1 624 cases were positive for MP-RNA.Seven hundred and fifty-eight specimens were simultaneously detected by adopting MP-DNA and MP-RNA, and the positive rate was 43.1% (327/758 cases) and 36.7% (278/758 cases), accordingly, which were inconsistent (Kappa=0.604) in 613 (80.9%, 613/758 cases) cases, with significant differences ( χ2=6.60, P=0.01). Part of the specimens were rechecked with the interval of 7 days: MP-RNA was negative in 70.1% (47/67 cases) specimens and MP-DNA was negative in 36.1% (22/91 cases) specimens ( χ2=33.20, P<0.01). Conclusions:The positive detection rate of MP was at a high level in 2018, in Beijing, China.The results of MP-DNA and MP-RNA are consistant.But RNA detection can help to diagnose MP in the early stage, and monitor the survival of MP and its efficiency.

The impact of lymph node dissection on survival in patients with clinical early-stage ovarian cancer / 부인종양

Objective@#To estimate the impact of lymph node dissection on survival in patients with apparent early-stage epithelial ovarian cancer (EOC). @*Methods@#We conducted a retrospective review of patients with clinical stage I–II EOC. All patients underwent primary surgery at Sun Yat-sen University Cancer Center between January 2003 and December 2015. Demographic features and clinicopathological information as well as perioperative adverse events were investigated, and survival analyses were performed. @*Results@#A total of 400 ovarian cancer patients were enrolled, and patients were divided into 2 groups: 81 patients did not undergo lymph node resection (group A), and 319 patients underwent lymph node dissection (group B). In group B, the median number of removed nodes per patient was 25 (21 pelvic and 4 para-aortic nodes). In groups A and B, respectively, the 5-year progression-free survival (PFS) rates were 83.3% and 82.1% (p=0.305), and the 5-year overall survival (OS) rates were 93.1% and 90.9% (p=0.645). The recurrence rate in the retroperitoneal lymph nodes was not associated with lymph node dissection (p=0.121).The median operating time was markedly longer in group B than in group A (220 minutes vs. 155 minutes, p<0.001), and group B had a significantly higher incidence of lymph cysts at discharge (32.9% vs. 0.0%, p<0.001). @*Conclusion@#In patients with early-stage ovarian cancer, lymph node dissection was not associated with a gain in OS or PFS and was associated with an increased incidence of perioperative adverse events.

Study of upfront surgery versus neoadjuvant chemotherapy followed by interval debulking surgery for patients with stage IIIC and IV ovarian cancer, SGOG SUNNY (SOC-2) trial concept / 부인종양

Background@#Two randomized phase III trials (EORTC55971 and CHORUS) showed similar progression-free and overall survival in primary or interval debulking surgery in ovarian cancer, however both studies had limitations with lower rate of complete resection and lack of surgical qualifications for participating centers. There is no consensus on whether neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) could be a preferred approach in the management of advanced epithelial ovarian cancer (EOC) in the clinical practice. @*Methods@#The Asian SUNNY study is an open-label, multicenter, randomized controlled, phase III trial to compare the effect of primary debulking surgery (PDS) to NACT-IDS in stages IIIC and IV EOC, fallopian tube cancer (FTC) or primary peritoneal carcinoma (PPC).The hypothesis is that PDS enhances the survivorship when compared with NACT-IDS in advanced ovarian cancer. The primary objective is to clarify the role of PDS and NACT-IDS in the treatment of advanced ovarian cancer. Surgical quality assures include at least 50% of no gross residual (NGR) in PDS group in all centers and participating centers should be national cancer centers or designed ovarian cancer section or those with the experience participating surgical trials of ovarian cancer. Any participating center should be monitored evaluating the proportions of NGR by a training set. The aim of the surgery in both arms is maximal cytoreduction. Tumor burden of the disease is evaluated by diagnostic laparoscopy or positron emission tomography/computed tomography scan. Patients assigned to PDS group will undergo upfront maximal cytoreductive surgery within 3 weeks after biopsy, followed by 6 cycles of standard adjuvant chemotherapy. Patients assigned to NACT group will undergo 3 cycles of NACT-IDS, and subsequently 3 cycles of adjuvant chemotherapy. The maximal time interval between IDS and the initiation of adjuvant chemotherapy is 8 weeks. Major inclusion criteria are pathologic confirmed stage IIIC and IV EOC, FTC or PPC; ECOG performance status of 0 to 2; ASA score of 1 to 2. Major exclusion criteria are non-epithelial tumors as well as borderline tumors; low-grade carcinoma; mucinous ovarian cancer. The sample size is 456 subjects. Primary endpoint is overall survival.

A phase II trial of cytoreductive surgery combined with niraparib maintenance in platinum-sensitive, secondary recurrent ovarian cancer: SGOG SOC-3 study / 부인종양

Background@#In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. @*Methods@#SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.

Study of upfront surgery versus neoadjuvant chemotherapy followed by interval debulking surgery for patients with stage IIIC and IV ovarian cancer, SGOG SUNNY (SOC-2) trial concept / 부인종양

Background@#Two randomized phase III trials (EORTC55971 and CHORUS) showed similar progression-free and overall survival in primary or interval debulking surgery in ovarian cancer, however both studies had limitations with lower rate of complete resection and lack of surgical qualifications for participating centers. There is no consensus on whether neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) could be a preferred approach in the management of advanced epithelial ovarian cancer (EOC) in the clinical practice. @*Methods@#The Asian SUNNY study is an open-label, multicenter, randomized controlled, phase III trial to compare the effect of primary debulking surgery (PDS) to NACT-IDS in stages IIIC and IV EOC, fallopian tube cancer (FTC) or primary peritoneal carcinoma (PPC).The hypothesis is that PDS enhances the survivorship when compared with NACT-IDS in advanced ovarian cancer. The primary objective is to clarify the role of PDS and NACT-IDS in the treatment of advanced ovarian cancer. Surgical quality assures include at least 50% of no gross residual (NGR) in PDS group in all centers and participating centers should be national cancer centers or designed ovarian cancer section or those with the experience participating surgical trials of ovarian cancer. Any participating center should be monitored evaluating the proportions of NGR by a training set. The aim of the surgery in both arms is maximal cytoreduction. Tumor burden of the disease is evaluated by diagnostic laparoscopy or positron emission tomography/computed tomography scan. Patients assigned to PDS group will undergo upfront maximal cytoreductive surgery within 3 weeks after biopsy, followed by 6 cycles of standard adjuvant chemotherapy. Patients assigned to NACT group will undergo 3 cycles of NACT-IDS, and subsequently 3 cycles of adjuvant chemotherapy. The maximal time interval between IDS and the initiation of adjuvant chemotherapy is 8 weeks. Major inclusion criteria are pathologic confirmed stage IIIC and IV EOC, FTC or PPC; ECOG performance status of 0 to 2; ASA score of 1 to 2. Major exclusion criteria are non-epithelial tumors as well as borderline tumors; low-grade carcinoma; mucinous ovarian cancer. The sample size is 456 subjects. Primary endpoint is overall survival.

Prevalence and prediction of pre-hospital medical trauma in Urumqi / 中华急诊医学杂志

Objective@#To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years, so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.@*Methods@#A total of 427 754 pre-hospital emergency patients were collected from January 1, 2011 to December 31, 2008 in Urumqi. Epidemiological methods were performed for statistical description and analysis. The single-factor gray model [GM (1,1)], multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year. The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.@*Results@#The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (χ2=7 659.707, P<0.01), and the incidence rate of male patients was 1.95 times higher than that of female patients. The trauma patients aged 35-59 years accounted for the largest proportion (42%), and the incidence of the disease was the highest among those aged≥ 60 years old (644.23/100 000). The incidence of pre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017), with a high incidence in summer (27 123, 31.03%), especially in August (9 535, 10.91%), most of which occurred in the new urban area (high-tech zone) (23 157, 26.50%). The single-factor gray model [GM (1,1)] , multi-factor gray model, and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118, 11 715 and 13 305, respectively, and the MAE were 451.125 0, 607.428 6, and 205.125 0, respectively. The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999, respectively, and the MAE were 47.129 0 and 110.370 4, respectively.@*Conclusions@#The pre-hospital trauma in Urumqi is mainly male and young work-age adults, the incidence of the elderly is the highest, summer is the season of high incidence, and the new urban area (high-tech zone) is the primary district. The moving average model (MA1) model has a more accurate annual prediction, and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction. The pre-hospital trauma emergency medical care demand will continue to increase in the next five years. The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.

Prevalence and prediction of pre-hospital medical trauma in Urumqi / 中华急诊医学杂志

Objective To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years,so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.Methods A total of 427 754 pre-hospital emergency patients were collected from January 1,2011 to December 31,2008 in Urumqi.Epidemiological methods were performed for statistical description and analysis.The single-factor gray model [GM (1,1)],multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year.The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.Results The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (x2=7 659.707,P＜0.01),and the incidence rate of male patients was 1.95 times higher than that of female patients.The trauma patients aged 35-59 years accounted for the largest proportion (42％),and the incidence of the disease was the highest among those aged ≥ 60 years old (644.23/100 000).The incidence ofpre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017),with a high incidence in summer (27 123,31.03％),especially in August (9 535,10.91％),most of which occurred in the new urban area (high-tech zone) (23 157,26.50％).The single-factor gray model [GM (1,1)],multi-factor gray model,and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118,11 715 and 13 305,respectively,and the MAE were 451.125 0,607.428 6,and 205.125 0,respectively.The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999,respectively,and the MAE were 47.129 0 and 110.370 4,respectively.Conclusions The pre-hospital trauma in Urumqi is mainly male and young work-age adults,the incidence of the elderly is the highest,summer is the season of high incidence,and the new urban area (high-tech zone) is the primary district.The moving average model (MA1) model has a more accurate annual prediction,and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction.The pre-hospital trauma emergency medical care demand will continue to increase in the next five years.The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.

Epidemiological characteristics of Mycoplasma pneumoniae infection in hospitalized children in Beijing: 10-year retrospective analysis / 中华实用儿科临床杂志

Objective@#To investigate the season, age and gender distribution of Mycoplasma pneumoniae (MP) infection in children in Beijing, and to analyze the epidemiological characteristics of MP infection.@*Methods@#A total of 4 271 children with community acquired pneumonia hospitalized at the Respiratory Department of Children′s Hospital Affiliated to Capital Institute of Pediatrics were collected between January 2006 and December 2015.MP 16S rRNA and tandem repeat locus-Mpn16 were amplified by nested polymerase chain reaction(PCR).@*Results@#Among 4 271 specimens, 1 042 were positive for MP by PCR, and the positive rate was 24.4% (1 042/4 271 cases). There were 3 MP outbreaks (2006-2007, 2012-2013 and 2015, respectively). The positive rate was up to 44.6% in the epidemic year, but as low as 13.0% in the non-epidemic year.The positive rates of MP in spring, summer, autumn and winter were 21.2% (217/1 022 cases), 22.0% (230/1 044 cases), 28.9% (320/1 108 cases) and 25.1% (275/1 097 cases), respectively.There were mild epidemic peaks in April to May and August to September every year.The infection rates of MP in autumn were significantly higher than those in other 3 seasons(χ2=16.50, 13.30, 4.07, all P<0.05). The positive rates of children in each age group were 10.6% (69/651 cases) in < 1 year old group, 17.5% (216/1 233 cases) in 1- 2 years old group, 28.5% (369/1 294 cases) in 3-6 years old group, and 35.5% (388/1 093 cases) in > 7 years old group, respectively.The positive rate of preschool and school-age children was 31.7% (757/2 387 cases), which was higher than that of the infants (15.1%, 285/1 884 cases), and there was a statistical significance (χ2=157.0, P<0.05). The positive rate of MP in girls was 28.3% (481/1 699 cases), which was significantly higher than that in boys [21.8% (561/2 572 cases)], and there was a statistical significance (χ2=23.4, P<0.05), especially during the epidemic years.@*Conclusions@#The detection rate of MP infection in children in Beijing is high in autumn and winter, and low in summer.The positive rate of MP increases with age.The high incidence of MP infection is in preschool and school-age children, especially girls.There is a significant difference between the prevalence of MP infection and the prevalence intervals.The prevalence of MP infection may be closely related to the long-term closed and semi-closed living habits.

Screening of differential microRNA and prediction of target genes between human immunodeficiency virus-Burkitt lymphoma and diffuse large B cell lymphoma / 中华传染病杂志

Objective To screen the differential microRNA (miRNA ) in human immunodeficiency virus (HIV) related Burkitt lymphoma (BL) and diffuse large B cell lymphoma (DLBCL).Methods Five freshly frozen tissue samples of BL and 3 freshly frozen tissu samples of DLBCL ,19 paraffin specimens of BL and 15 paraffin specimens of DLBCL were collected from Shanghai Public Health Clinical Center . Agilent human miRNA microarrays were employed to detect the miRNA expressions in fresh frozen BL tissues and fresh frozen DLBCL tissues ,and to find out differential miRNA .SmartRNAplexTMmiRNA was employed to verify the expressions of crucial miRNA in BL formalin fixed and paraffin-embedded tissues and DLBCL FFPET .Bioinformatics methods were used to predict the target genes of the crucial miRNA .Results Compared with DLBCL group ,42 differential miRNA were detected in BL group . Among them ,28 miRNA were up-regulated and 14 miRNA were down-regulated in BL group .According to positive control in eukaryote and high-expression molecular contributing to the emergence of tumor ,5 crucial miRNA were selected from 28 up-regulated miRNA in BL group for validation .The result was consistent with that of Agilent human miRNA microarrays .Compared with the DLBCL group ,5 crucial miRNA were all up-regulated in BL ,which were miRNA-16-2-3p ,miRNA-20a-3p ,miRNA-130b-3p , miRNA-185-5p and miRNA-423-5p (t＝2 .7151 ,2 .539 ,2 .750 ,4 .004 ,and 3 .625 ,respectively ,all P＜0 .05).The corresponding target genes of miRNA-16-2-3p might be CTNND2 and RAD21 .The target genes of miRNA-20a-3p might mainly be DYRK1A and GPAM .The target genes of miRNA-130b-3p might mainly be IRF1 , DICER1 and PTEN .The target genes of miRNA-185-5p might mainly be VEGFA ,NFATC3 and SEC24C .The target genes of miRNA-423-5p might mainly be PA2G4 and PNKD . Conclusions There are significantly differentially expressed miRNA between BL and DLBCL tissues . These miRNA are expected to provide new molecular markers for diagnosis and differential diagnosis of BL and DLBCL .Potential target genes of crucial miRNA are related with cell survival , proliferation , differentiation ,apoptosis and carcinogenesis ,etc ,which may play important roles in the origination and progress of BL.

Relationship between macrolide resistance mutations in Mycoplasma pneumoniae and its genotype / 中华微生物学和免疫学杂志

Objective To analyze the relationship between macrolide resistance mutations in My-coplasma pneumoniae (Mp) and its genotype by multiple-locus variable-number tandem-repeat analysis (MLVA). Methods One hundred and forty-three Mp-positive specimens were collected in Beijing(54 col-lected at the Affiliated Children′s Hospital of the Capital Institute of Pediatrics),the United States(59 col-lected at four different geographical locations:Kansas City,Missouri;Seattle,Washington;New York,New York;Chicago,Illinois) and Australia(30 provided by the diagnostic laboratory at the Centre for Infectious Diseases and Microbiology Laboratory Services,Institute of Clinical Pathology and Medical Research,West-mead Hospital,Sydney). Nested PCR was used to detect mutations in 23S rRNA. A capillary electrophore-sis-based single tube multiplex PCR (mPCR-CE) was used to analyze the MLVA types of Mp in those sam-ples. Results A2063G mutation was identified in 57 specimens including 49 from Beijing,seven from the United States and one from Australia. The 143 Mp-positive specimens were typed into 10 distinct MLVA types. Fifty-four specimens collected in Beijing belonged to four MLVA types, which were M4-5-7-2 (44/54,81.5%),M3-5-6-2 (7/54,13.0%), M4-5-6-2 (2/54,3.70%) and M4-5-5-2 (1/54,1.85%). Fifty-nine specimens collected in the United States belonged to six MLVA types including M4-5-7-2(27/59, 45.8%),M3-5-6-2 (18/59,30.5%),M3-6-6-2 (11/59,18.6%),M3-5-6-1 (1/59,1.69%),M4-5-7-3 (1/59,1.69%) and M5-5-7-2 (1/59,1.69%). Thirty specimens of Mp from Australia were grouped to five types with M3-5-6-2 (12/30, 40.0%) and M4-5-7-2 (10/30, 33.3%) and M3-5-7-2 (5/30, 16.7%) being the predominant types. Macrolide resistance mutations were detected in 57 out of 143 speci-mens (49 from Beijing,seven from the United States and one from Sydney) and 50 of them were MLVA type of M4-5-7-2. Conclusion The MLVA type of M4-5-7-2 is associated with macrolide resistance in Mp.

Comparison of culture method, polymerase chain reaction and serological test for the detection of Mycoplasma pneumoniae infection in children with pneumoniae / 中华微生物学和免疫学杂志

Objective To compare the capabilities of culture method, polymerase chain reaction ( PCR) and serological test in identifying Mycoplasma pneumoniae infection in children with confirmed com-munity acquired pneumonia. Methods Bronchoalveolar lavage fluid and serum samples were collected from hospitalized children with community acquired pneumonia in Capital Institute of Pediatrics from March to May in 2016. Three methods, traditional culture method, PCR and serological test, were respectively used to de-tect Mycoplasma pneumoniae infection in those children. Statistical analysis was performed by using SPSS18. 0 software and chi-square test. Results Seventy-nine children with community acquired pneumonia were enrolled in this study. Eight (10. 13%) patients were diagnosed with Mycoplasma pneumoniae infec-tions by the traditional culture method with an average positive culture period of 21 days. Twenty-three (29. 11%) patients showed positive results by using PCR analysis, including the 8 patients identified by the culture method. Forty-one (51. 90%) patients were found to be positive for Mycoplasma pneumoniae infec-tions by the serological test. However, four negative samples identified by the serological test were confirmed to be positive by PCR analysis, including two positive samples confirmed by the culture method. Statistical analysis showed that the differences in positive rates detected by using the three methods were statistically significant. Conclusion It is recommended that both serological test and PCR analysis should be used in combination with clinical symptoms for a comprehensive assessment of Mycoplasma pneumonia infection in children.

Dynamic change of activated cytotoxic T cells percentage during perioperative period in patients with breast cancer and its clinical significance / 国际检验医学杂志

Objective To observe the dynamic change of activated cytotoxic T lymphocyte (CTL) percentage during periopera-tive period in the patients with breast cancer and to explore the value of detecting the peripheral blood activated CTL in monitoring the perioperative condition of breast cancer patients .Methods The lymphocytes in whole blood were defined by forward scatter and side scatter (FSC/SSC) signal parameters by adopting flow cytometry (FCM ) ,the CD3 ,CD8 and CD38 antigens on lymphocyte surface were detected by CD3-FITC ,CD8-APC and CD38-PE monoclonal antibody ,respectively .The CD3+CD8+CD38+ percentage in 20 healthy people were detected with the established method to determine the reference ranges ,and the dynamic changes of CD3+CD8+ CD38+ cells percentage in total T cells and cytotoxic T cells of 33 patients with breast cancer during perioperative period were observed .Results The percentages of CD3+ CD8+ CD38+ /CD3+ and CD3+ CD8+ CD38+ /CD3+ CD8+ in healthy group were (13 .46 ± 4 .08)% and (29 .98 ± 9 .1)% ,respectively .Both the CD3+ CD8+ CD38+ /CD3+ [(10 .44 ± 6 .61)% ] and CD3+ CD8+CD38+ /CD3+CD8+ [(22 .34 ± 10 .68)% ] before operation in 33 patients with breast cancer were significantly lower than those in healthy group (P0 .05) .Conclusion Observing the dynamic change of CD3+CD8+CD38+ cells percentage has an impor-tant significance for monitoring the perioperative condition of the patients with breast cancer ,contributing to get the activated CTL recovery situation of the patients and to choose the correct chemotherapy occasion for the patients .

Prevalence and molecular characteristics of Mycoplasma pneumoniae in Beijing in the first half of 2015 and 2016 / 中华微生物学和免疫学杂志

Objective To investigate the prevalence and molecular characteristics of Mycoplasma pneumoniae (M.pneumoniae) in Beijing in the first half of 2015 and 2016. Methods Respiratory tract specimens were collected from children with respiratory infection who were admitted to Affiliated Children′s Hospital of Capital Institute of Pediatrics in the first half of 2015 and 2016. DNA molecules were extracted from these specimens and then analyzed by real-time PCR to detect M.pneumoniae repMp1 genes. Speci-mens that were positive for M.pneumoniae were genotyped by modified MLVA[multiple-locus variable-num-ber tandem-repeat (VNTR) analysis] and P1-RFLP (restriction fragment length polymorphism analysis). Moreover, macrolide resistance was evaluated through detecting mutations in 23S rRNA genes. Results The prevalence of M.pneumoniae from January to June in 2015 and 2016 was 18.5% (50/271) and 35% (99/283),respectively. Of the 50 strains isolated in 2015,48 were M4-5-7-2/P1 genotype and only two were M3-5-6-2/P2 genotype. The 99 strains isolated in 2016 belonged to three genotypes, including 82 of M4-5-7-2/P1,two of M4-5-7-3/P1 and 15 of M3-5-6-2/P2. Macrolide resistance rate was 92% in 2015 and 83.8% in 2016. Conclusion More cases of M.pneumoniae infection were detected in the first half of 2016 than in the corresponding period of 2015. Compared with the 2015,the proportion of M4-5-7-2/P1 genotype strains decreased,while that of M3-5-6-2/P2 genotype strains increased in 2016. Moreover, a decline in macrolide resistance rate was found in 2016.

Prevalence of plasmid-mediated quinolone resistance genes in Klebsiella pneumoniae strains in pediatrics in China / 中华微生物学和免疫学杂志

Objective To investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes among clinical isolates of Klebsiella pneumoniae (K.pneumoniae) in pediatrics.MethodsA total of 131 non-duplicate clinical isolates of K.pneumoniae were collected in the Affiliated Children′s Hospital of Capital Institute of Pediatrics from 2010 to 2012.PMQR genes [qnrA, qnrB, qnrS, aac(6′)-Ⅰb-cr and qepA], mutations in the quinolone resistance-determining region (QRDR) and extended spectrum β-lactamases (ESBLs) genes in those strains were analyzed by PCR.Minimum inhibitory concentrations (MIC) of different antibiotics against those K.pneumoniae strains were determined by broth microdilution method and E-test according to the guidelines issued by the Clinical and Laboratory Standards Institute (CLSI).Transferability of the PMQR genes was examined by conjugation test with the sodiumazide-resistant Escherichia coli J53.Results Among the 131 isolates, 9.92% were resistant to quinolone and 30.5% were positive for PMQR genes, including 6.87% harboring qnrB gene, 22.9% harboring qnrS gene and 4.58% harboring aac(6′)-Ⅰb-cr gene.Neither qnrA-positive nor qepA-positive strain was detected.Among these PMQR genes-positive isolates, 90% were ESBLs-producing strains and two presented mutations in gyrA and parC genes.Conjugation test showed that these PMQR genes could be transferred horizontally and the ciprofloxacin resistance increased 2 to 32 folds in transconjugants.Conclusion This study indicates that the PMQR gene-carrying rate is high in K.pneumoniae strains isolated in paediatrics in China.Most of the PMQR gene-positive strains are also ESBLs-producing strains.The PMQR genes could be transferred horizontally in bacteria.

Research progress of HIV/AIDS related lymphoma / 国际肿瘤学杂志

HIV /AIDS related lymphoma (ARL)are a group of heterogeneity of neoplasms,and they have poor prognosis.The factors of pathogenesis elucidated in recent years include immune injury caused by HIV,EB virus infection and genetic changes.There are four pathological types of ARL,including diffuse large B cell lymphoma,Burkitt lymphoma,plasmablastic lymphoma and primary effusion lymphoma.Morphological characteristics,immunophenotype markers and clinical data should be combined to make diagnosis and differen-tial diagnosis,which will facilitate timely treatment and improve prognosis.

Low initial human papillomavirus viral load may indicate worse prognosis in patients with cervical carcinoma treated with surgery / 부인종양

OBJECTIVE: To evaluate the prognostic implication of human papillomavirus (HPV) viral load in cervical cancer patients who underwent radical hysterectomy. METHODS: We conducted a retrospective review of patients with stage IA2 through stage IIIA cervical carcinoma who underwent radical hysterectomy at Sun Yat-sen University Cancer Center between January 2005 and December 2009. Patients who had undergone preoperative hybrid capture 2 testing to detect HPV DNA were included. A total of 346 patients positive for HPV DNA were enrolled and stratified into two groups according to the median HPV viral load. RESULTS: HPV viral load was significantly correlated with lymphovascular space invasion (p=0.026) and deep stromal invasion (p=0.024). However, other factors, such as age, stage, histologic grade, histologic type, lymph node metastasis, and tumor size, were not significantly associated with viral load. Low HPV viral load was correlated with poor disease-free survival in univariate analysis (p=0.037) and multivariate analysis (p=0.027). There was no significant difference in overall survival with regard to initial HPV viral load. CONCLUSION: Low initial HPV viral load may be a poor prognostic factor for cervical cancer patients who have undergone radical hysterectomy.

Investigation of individualized treatment based on sentinel lymph node biopsy for early-stage vulvar ;cancer / 中华妇产科杂志

Objective To evaluate the feasibility and outcomes of different surgical approaches on the basis of sentinel lymph node biopsy (SLNB) in treating early-stage vulvar cancer, and discuss the proper strategy for individualized treatment. Methods The medical charts of patients with early-stage vulvar cancer treated in Sun Yat-sen University between January 2004 and December 2013 were retrospectively collected. A total of 74 patients who received sentinel lymph node(SLN)detection in primary surgery were enrolled (average age 55). The surgical approaches contained SLNB, inguinal lymphadenectomy (IL), and extensive vulvectomy. The SLN were examed on intraoperative frozen sections. The treatment protocols, lymphatic metastasis, postoperative recovery condition, recurrence and survival data were collected and analyzed. Results At least one SLN was successfully detected in 68 (92%,68/74) patients. SLN were positive in 21 patients, of whom 12 (group A) underwent bilateral IL, and 9 (group B) received radiotherapy without performed IL. SLN were negative in 47 patients, of whom 26 (group C) underwent bilateral IL and one of them had a non-SLN metastasis, and 21 (group D) were advised to follow-up. The coincidence of pathological results between frozen and paraffin sections was 100%. The sensitivity and specificity of SLNB for diagnosis of lymph node metastasis were 95% and 100%, respectively. A total of 44 complications happened in patients underwent SLNB and IL (group A and C), including 16 poor wound healing, 14 lymphedema, 8 lymphatic fistulas, 3 phlebothrombosis and 3 infections. There were no complications happened in patients underwent SLNB alone (group B and D), among whom the operation time, bleeding amount, and hospital stay were also significantly less than those in patients underwent SLNB and IL. The median follow-up time was 41 months and the 3-year overall survival rate was 85% in the whole series. Recurrences were observed in 11 patients and 9 of them died of the tumor with the median survival time of 15 months. In patients with positive SLN (group A and B), the 3-year overall survival rate was 58% with 8 patients died of the disease, including 4 in group A and 4 in group B. In patients with negative SLN (group C and D), the 3-years overall survival rate was 97% with one patient in group D died of the tumor, and significantly higher than that of patients with positive SLN (P=0.003). The 3-year overall survival rate was significantly difference. In univariate analysis by log-rank test showed that, neither in patients with nor without SLN metastasis the prognosis differed with respect to surgical approaches (group A vs B, P=0.709;group C vs D, P=0.253). Univariate analysis by log-rank test showed that, lymph node metastasis, pathological grade, depth of invasion, and tumor location could significantly affected survival (P0.05). Multivariate analysis showed that lymph node metastasis (RR=21.57, 95%CI:2.68-173.10, P=0.002) and tumor location (RR=7.85, 95%CI:1.79-34.50, P=0.024) were the independent factors for overall survival. Conclusions Lymph node metastasis is an independent prognosis factor for patients with early-stage vulvar cancer. SLNB could accurately diagnose the status of lymph nodes and help to decide subsequent treatment. The omissions of IL in patients with negative SLN avoid surgical morbidity and shorten postoperative recovery period without an increased risk of recurrence.

Surveillance of Mycoplasma pneumoniae infection among children in Beijing from 2007 to 2012 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mycoplasma pneumonia (M. pneumoniae) is one of the key pathogens of community-acquired pneumonia. A global pandemic of M. pneumoniae has occurred since 2010. The aim of this study was to survey the prevalence of M. pneumoniae in children in Beijing from 2007-2012.</p><p><b>METHODS</b>A total of 3 073 clinical specimens were obtained from pediatric patients with respiratory tract infections from January 2007 to December 2012, and examined by nested polymerase chain reaction. PCR products were visualized by 2% agarose gel electrophoresis, positive products sequenced, and compared with reference sequences in GenBank. Macrolide resistance-associated mutations were also detected for some positive samples.</p><p><b>RESULTS</b>Of the 3 073 specimens, 588 (19.13%) were positive for M. pneumoniae, 12.4% of which were accompanied by viral infections. Positive rates for M. pneumoniae were highest in 2007 and 2012, showing a significant difference when compared with other years. Infections tended to occur in autumn and winter and positive rates were significantly higher for children aged 3-16. The rate of macrolide resistance-associated mutations was 90.7%, and the predominant mutation was an A→G transition (89.92%) at position 2063 in domain V of the 23S rRNA gene.</p><p><b>CONCLUSIONS</b>M. pneumoniae outbreaks occurred in 2007 and 2012 in pediatric patients in Beijing, which is consistent with the global prevalence of M. pneumoniae. M. pneumoniae can cause multi-system infections in children, and may be accompanied with viral infections. We determined that school-age children are more susceptible to this disease, particularly in autumn and winter. Gene mutations associated with macrolide resistance were very common in M. pneumoniae-positive specimens during this period in Beijing.</p>

Application of special staining techniques in pathological diagnosis of fungi infections in HIV/AIDS patients / 中华临床感染病杂志

Objective To apply special staining techniques in pathological diagnosis of fungal infections in HIV/AIDS patients.Methods Pathological data of 20 HIV/AIDS patients complicated with fungi infections in Shanghai Public Health Clinical Center during February 2010 and November 2013 were retrospectively analyzed.Tissue specimens were stained with hematoxylin and eosin (HE),Periodic acidSchiff (PAS) and methenamine silver nitrate (MSN),and the sections were observed under optical microscope.Results Among 20 HIV/AIDS patients complicated with fungi infections,2 were infected with pulmonary cryptococcosis; 3 were penicillium marneffei infections in skin,lung and abdominal mesenteric lymph nodes; 5 were histoplasma capsulatum infections in epiglottis,neck lymph nodes,oral cavity,abdominal cavity and skin; 4 were aspergillus infections in maxillary sinus,lung and vocal cords,and 3 of them were combined with tuberculous lesions; 6 were candida albicans infections in liver,pharynx,esophagus and stomach.In tissues stained with HE the infiltration of inflammatory cells,granuloma formation and coagulative necrosis were observed,and the shape of fungi needed careful observation to avoid missed diagnosis and misdiagnosis.In tissues stained with PAS,fungal spores and pseudohypha were presented in bright amaranth,and cell nucleus was in purple-blue.In tissues stained with MSN,fungal spores and pseudohypha were identified clearly in brown-black.Conclusion HE plus PAS and MSN staining will help pathological diagnosis of fungi infection.

Application of nested PCR in P1-RFLP for genotyping Mycoplasma pneumoniae strains / 中华微生物学和免疫学杂志

Objective To evaluate the efficiency of using nested PCR in restriction fragment length polymorphism analysis (P1-RFLP) for genotyping Mycoplasma pneumonia (M.pneumonia) in clinical specimens.Methods Based on the gene sequence of RepMp4 and RepMp2/3 in P1 gene of reference strains M129 (type 1) and FH (type 2),two sets of inner primers were designed with a HaeⅢ restriction enzyme site (GGCC).The nested PCR was set up to detect the target DNA in clinical specimens.The amplification products were mixed and digested with Hae Ⅲ enzyme.The genotypes were analyzed by comparing with various restriction maps and the results were verified by sequencing analysis.The concentration of DNA extracted from standard and clinical strains were detected by ten-fold dilution to evaluate the sensitivity of nested PCR-P1-RFLP and P1-RFLP.M.pneumonia-positive specimens isolated from Beijing in 2012 were analyzed by the nested PCR-P1-RFLP and the results were compared with those by P1-RFLP analysis.Results The nested PCR-P1-RFLP could effectively genotype M.pneumonia in clinical specimens and the results were consistent with those by sequencing analysis.The sensitivity of new assay was 103 times higher than that of the original P1-RFLP.Of the 115 M.pneumoniae positive clinical specimens,97.4％ (112/115) were type 1 and the rest were type 2.Conclusion The nested PCR-P1-RFLP shows high efficiency for genotyping of M.pneumonia in clinical specimens.It might be useful for the surveillance of M.pneumoniae infection.