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Objective:To analyze the anti-drug resistance, molecular epidemiology and virulence gene distribution of non-A-F group serotype isolates of Salmonella enterica enteric subspecis, so as to provide epidemiological basis for clinical diagnosis and treatment.Methods:Serotyping, antimicrobial susceptibility test and whole genome sequencing were performed on 11 isolates of non-A-F group serotype isolates of Salmonella enterica enteric subspecies that were isolated from The Children′s Hospital, Zhejiang University School of Medicine between 2017 and 2020. The serotype, multilocus sequence typing and virulence gene of the whole genome sequencing results were analyzed. Results:In our hospital, the detection rate of non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low (1.13%). Among the 11 strains, there were 3 strains belong to Jangwani serotype, 2 strains of Hvittingfoss serotype, and Wandsworth, Pomona, Kedougou, Urbana, Poona and Kumasi serotypes have 1 strain each. Except for the two multi-drug resistant strains, the other strains were sensitive to most antibiotics, and the MICs were at low levels. A total of 9 ST types were detected in the 11 strains, the 3 Jangwani serotype strains were ST3918, and the other isolates were of different ST types. The phylogenetic tree shown that the three strains of Jangwani serotype were closely related. A total of 103 virulence genes were detected in the 11 strains, including 78 genes related to secretion system, 21 genes related to adherence, 2 genes related to magnesium uptake, 1 gene related to resistance to antimicrobial peptides and 1 gene related to typhoid toxin. Conclusions:The detection rate of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low, and the sensitivity of the isolates to common antibiotics was high. The ST types and genetic relationship showed diversity. Clinical laboratory should pay attention to the detection of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies, and the changes in drug resistance and virulence genes of the isolates should be closely monitored.
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Objective To explore the common clinical features and mechanism of HenochSchonlein purpura (HSP) in children,and provide evidence and guidance for clinical diagnosis,therapy and prognosis of HSP.Methods Prospective study.Totally 1 232 HSP children blood samples were collected during January 2010 to December 2013 in the Children's Hospital of Zhejiang University School of Medicine,and the levels of immunoglobulin,complement,T lymphocyte subsets and CRP were detected in the acute phase of HSP.The clinical data were analyzed with these indexes to explore the function of cellular and/or humoral immunity in the pathogenesis of HSP.In addition,this study detected serum IgA levels in 200 cases of sepsis rash,200 cases of urticarial and 200 cases of thrombocytopenic purpura patients and 400 cases of healthy children over the same period to our hospital respectively,in order to find out whether IgA is capable of differentiating allergic purpura rash from other similar skin rashes.Results Compared with healthy children,the IgA level was significantly higher [IgA:2.0 (0.6-7.5) g/L vs 1.1(0.6-2.1) g/L,Z =5.928,P =0.03].When IgA ＞ 1.44 g/L,the diagnostic sensitivity and specificity to differentiate allergic purpura patients from sepsis patients were 77.43 ％ (954/1 232) and 80.00％ (160/200),respectively.When IgA ＞ 1.53 g/L,the diagnostic sensitivity and specificity to distinguish from allergic purpura with urticaria patients were 72.57％ (894/1 232) and 74.51％ (149/200).When IgA ＞0.91 g/L,it had a 95.14％ sensitivity (1 172/1 232) and a 79.45％ specificity (159/200) for the differential diagnosis of allergic purpura and thrombocytopenic purpura patients.When IgA ＞ 1.33 g/L,the sensitivity of distinguishing allergic purpura patients from healthy children was 81.25％ (1 001/1 232),while the specificity was 95.00％ (380/400).Conclusions HSP children show cellular immune dysfunction.Th1/Th2 imbalance and over-activation of Th2 cells result in the increased synthesis and release of immune globulin,causing abnormalities in humoral immune.An increase in serum IgA level of HSP patients can differentiate HSP from other similar rashes.
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Objective To study the relationship between the functional gastrointestinal disease of children and food allergies,and recent prognosis.Methods 108 children with functional gastrointestinal disease were selected as the observation group,at the same time 36 healthy cases were selected as control group.ELISA was used to detect IgG antibody concentration and total IgE level in ten kinds of allergy food.The different methods were used to guide the patients' diet,the improved quality were oberseved in the two groups after 3 ～6 months.Results In the observation group 108 cases of children with functional gastrointestinal disease,1 ～ 10 kinds of inequality of food allergen specific IgG children have increased in 90 cases,accounting for 83.3％,whereas the control group had 9 cases,only accounting for 25.0％ (x2 =20.87,P ＜ 0.05).In the observation group,the foods with highest sensitivity were milk,egg white/yellow,respectively for 84 patients (77.8％) and 60 cases (55.6％).Serum total IgE level between the observation group and control group had no significant difference (P ＞ 0.05).17 cases (15.7％) within one month,the symptoms were improved,13 cases (12.1％) in three months,the symptoms were improved,the symptoms of 21 cases (19.4％) were not improved after 3 months.The total effective rate was 80.6％.Conclusions Children with functional gastrointestinal decease is easily to occur allergy caused by different food,and IgG antibody level can correctly reflect the relationship between them,reasonable diet can improve the symptoms of functional gastrointestinal disease.
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Objective To explore the incidence of G-6-PD deficiency in Dongguan District,Dongguan,Guangdong province. Methods Cord blood was obtained in 9676 cases of live births. G6PD/6PGD ratio was measured. Results Two hundred and sixty-five cases were diagnosed as G-6-PD deficiency giving an incidence of 2.74%. The incidence in male (4.07%,230/5646) was significantly higher than that in female (0.875,35/4030) ( P