Detection of viral pathogens and allergens in infants and young children at high risk of asthma during a wheezing episode / 中国当代儿科杂志

OBJECTIVE@#To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode.@*METHODS@#A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration.@*RESULTS@#Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the <1 year group (P<0.05). The positive rate of allergen screening was 59.3%, with 44% for inhaled allergens and 89% for food allergens. Among the inhaled allergens, dust mites had the highest positive rate of 77%, followed by mould (37%), pollen (26%) and animal dander (9%). Among the food allergens, egg white had a positive rate of 73% and milk had a positive rate of 68%. The <1 year group had a significantly higher positive rate of inhaled allergens than the 1-3 years group (P<0.05). The 1-3 years age group had a significantly higher level of T-IgE than the <1 year group (P<0.05). The positive virus group had a significantly higher positive rate of inhaled allergens than the non-virus group (P<0.05). The children with the second wheezing episode had significantly higher positive rates of inhaled allergens and food allergens and level of T-IgE than those with the first wheezing episode (P<0.05). The children with the second wheezing episode also had significantly higher positive rates of dust mites and mould than those with the first wheezing episode (P<0.05).@*CONCLUSIONS@#Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.

Epidemiological analysis of 440 cases of respiratory adenovirus infections in children from the Suzhou area between 2006 and 2015 / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the epidemiological characteristics of respiratory adenovirus (ADV) infections in children from the Suzhou area, China.</p><p><b>METHODS</b>The clinical data of ADV-positive children out of 35 529 children with respiratory tract infections who were hospitalized in the Children's Hospital of Soochow University between January 2006 and December 2015 were retrospectively studied.</p><p><b>RESULTS</b>Of the 35 529 children with respiratory tract infections, 440 (1.24%) were ADV-positive. There was no significant difference in the rate of ADV infections between boys and girls (1.18% vs 1.34%). The ADV infection rates of children at the age of <1 year old, 1-3 years old, 3-7 years old and 7-14 years old were 0.39% (71/18 002), 1.12% (103/9 191), 3.14% (201/6 398), and 3.35%( 65/1 938) respectively and the rate increased with age (P<0.01). The ADV infection rates in spring [1.85%(60/8 658)] and summer [2.20%(189/8 606)] were significantly higher than in autumn [0.30%(27/8 952)] and winter [0.69%(64/9 313)] (P<0.01).</p><p><b>CONCLUSIONS</b>The ADV infection rate is increased with age in the children from the Suzhou area, but it is not associated with gender. ADV infections are more common in spring and summer.</p>

An epidemiological study on human rhinovirus C in hospitalized children with respiratory tract infections / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the detection rates, epidemical characteristics, and clinical features of human rhinovirus C (HRV-C) in hospitalized children with respiratory tract infections (RTIs) in Suzhou, China.</p><p><b>METHODS</b>A total of 1 702 hospitalized children with RTIs from January to December, 2014 were enrolled, and 1 702 nasopharyngeal aspirate samples were collected from all children. RT-PCR was used to measure HRV mRNA, and quantitative real-time PCR combined with high-resolution melting curve was used to measure HRV-C.</p><p><b>RESULTS</b>Of all children, 244 (14.34%) were detected to have HRV infection, among whom 69 (69/244, 28.3%) had HRV-C infection. The rate of mixed infection of HRV-C with other viruses and bacteria was 61% (42/69). HRV-C was detected in each month of the year, and the detection rate of HRV-C in autumn was significantly higher than that in spring, summer, and winter (P<0.05). The children aged 2-5 years had a significantly higher detection rate of HRV-C than those in the other age groups (P<0.05). Compared with HRV-A/B infection, HRV-C infection led to significantly higher proportions of patients with lobar pneumonia and acute exacerbation of asthma (P<0.05), as well as patients with increased neutrophil count and CRP level (P<0.05). There were no significant differences in sex distribution or other clinical manifestations (P>0.05).</p><p><b>CONCLUSIONS</b>HRV-C infection accounts for about 1/3 of HRV infection, with a high incidence rate in autumn. The rate of mixed infection of HRV-C with other viruses and bacteria is high, and children aged 2-5 years have the highest detection rate of HRV-C. Children with HRV-C infection have similar clinical manifestations as those with HRV-A/B infection.</p>

Clinical significance of MP-DNA from endotracheal aspirates in diagnosis of Mycoplasma pneumoniae pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the detection rates of Mycoplasma pneumoniae (MP) from nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in children with pneumonia.</p><p><b>METHODS</b>A total of 164 hospitalized children with pneumonia were enrolled. NPA and BALF of these children were collected within 24 hours of admission, and MP-DNA was detected by fluorescence quantitative PCR. Venous blood samples of all these children were collected within 24 hours of admission and on days 7-10 of treatment, and serum MP-IgM was detected using ELISA.</p><p><b>RESULTS</b>The positive rate of MP-DNA in NAP of the 164 cases was 51.8% , which was lower than 63.4% as the detection rate of MP-IgM in serum (P=0.044), and the two detection rates were moderately consistent with each other (Kappa=0.618, P<0.01). The positive rate of MP in BALF was 71.3%, which was not significantly different with that of MP-IgM in serum (P>0.05), and the detection rates were well consistent (Kappa=0.793, P<0.01). The detection rate of MP in NPA was lower than that in BALF (P<0.01), with moderate consistency between two of them (Kappa=0.529, P<0.01). The median MP copy number in BALF was significantly higher than that in NPA (P<0.01). The MP detection rates in NPA and BALF were significantly different among different courses of disease (P<0.05). As the course of disease extended, the MP detection rates in both NPA and BALF showed a declining trend; children with MP pneumonia of 1-2 weeks' duration and 2-4 weeks' duration had a higher MP-DNA detection rate in BALF than in NPA (P<0.05).</p><p><b>CONCLUSIONS</b>MP-DNA in BALF has a high sensitivity, with a great significance for early diagnosis of MP pneumonia, while NPA MP-DNA tests may lead to a missed diagnosis.</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>

Granulocyte-macrophage colony-stimulating factor and interleukin 4 induce the malignant transformation of the bone marrow-derived human adult mesenchymal stem cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The purpose of the study was to examine the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 4 (IL-4) on the bone-marrow-derived human adult mesenchymal stem cells (hMSCs).</p><p><b>METHODS</b>The hMSCs were isolated and cultured with GM-CSF and IL-4 for a period of one month. A single colony of transformed cells was then isolated and their phenotype was characterized by morphology, surface marker expression, and in vivo tumorigenesis.</p><p><b>RESULTS</b>After one month culture, the transformed mesenchymal cells exhibited the morphology and phenotype similar to those of tumor cells, and also caused multiple fast growing lung deposits when it was injected into immunodeficient mice.</p><p><b>CONCLUSION</b>Cytokines-driven malignant transformation of hMSCs may be a useful model for studying signaling pathways initiating malignant transformation of hMSC.</p>

Characteristics and the prevalence of respiratory viruses and the correlation with climatic factors of hospitalized children in Suzhou children's hospital / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the epidemiological characteristics of respiratory virus infection and its relations to climatic factors in Suzhou.</p><p><b>METHODS</b>From 2006 to 2009, viral etiology surveillance was conducted among 6655 children hospitalized with acute respiratory tract infections (ARIs). Direct immunofluorescence method was used to test respiratory secretion samples for respiratory syncytial virus (RSV), influenza viruses A and B (Inf-A, Inf-B), parainfluenza virus types I, II, and III (Pinf-I, Pinf-II, Pinf-III) and adenovirus. Samples were tested for human metapneumovirus (hMPV) with reverse transcription polymerase chain reaction (RT-PCR). Samples from Jan 2006 to Dec 2009 were also tested for human bocavirus (HBoV). Climatic factors, including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of each virus and climatic factors were analyzed by linear regression and stepwise regression analysis.</p><p><b>RESULTS</b>From 2006 to 2009, in the total virus detection rate was 32.2% (2142/6655) in Suzhou. RSV was the most common virus and the average detection rate was 15.7% (1048/6655), followed by hMPV 8.9% (596/6655), HBoV 7.8% (148/1883), Pinf-III 2.7% (183/6655), Inf-A 2.4% (161/6655), ADV 1.3% (89/6655), Pinf-I 0.4% (29/6655), Inf-B 0.37% (25/6655) and Pinf-II 0.16% (11/6655). The positive rates of RSV, hMPV and ADV were significantly different in four years (χ(2) = 17.71, 33.23, 8.42, all P values < 0.05). Different virus has different epidemiological characteristics and distinct seasonality. The detection rate of RSV, hMPV, Inf-A were higher in Winter as 37.2%, 13.2%, 4.4%, respectively. ADV and Pinf-III were higher in summer as 2.3% and 4.6% respectively. The peak of HBoV existed in Autumn as 3.3%. The total virus detection rate showed significant inverse correlation with month average temperature (r = -0.732, P < 0.001) and a weak inverse correlation with average wind velocity was also found (r = -0.36, 0.01 < P < 0.05). The highest month total virus detection rate was from 47.6% to 84.4% when average temperature was from 3.2°C to 9.4°C and mean wind velocity was from 1.2 - 1.9 m/s. The associations of average temperature, sum of sunshine and wind velocity with RSV activity were statistical significant (r = -0.88, P < 0.001; r = -0.43, P < 0.01; r = -0.47, P < 0.01). The highest rate was from 24.3% to 58.2%, when mean temperature was from 5.3°C to 19.9°C, mean wind velocity was from 1.3 - 2.4 m/s and sum of sunshine was 61.0 to 153.4 hours. hMPV detection rate was inversely correlated with mean temperature and rain account (r = -0.43, P < 0.01; r = -0.29, P < 0.05). The rate was highest from 11.7% to 31.6% when mean temperature was from 5.3°C to 21.9°C and rain account was from 27.5 millimeter to 150.9 millimeter. Only mean temperature was positively correlated with Pinf-III (r = 0.53, P < 0.001). The rate was from 2.8% to 7.2% when mean temperature was between 11.9°C and 30.4°C. ADV detection rate was positively correlated with mean temperature and sum of sunshine, but negatively correlated with wind velocity (r = 0.35, P < 0.05; r = 0.30, P < 0.05; r = -0.32, P < 0.05). The rate was from 2.2% to 6.6% when mean temperature was between 15.9°C and 30.4°C, and sum of sunshine between 93 hours to 240.7 hours and mean wind velocity was from 1.1 - 2.8 m/s. Average temperature and relative humidity showed interactions on the detection rate of ADV (r = 0.36, P = 0.0093; r = -0.34, P = 0.016), but temperature showed higher effect on ADV detection rate. ADV detection rate was high at higher temperature (15.9 - 30.4°C) and low humidity (56% - 71%).</p><p><b>CONCLUSION</b>RSV was one of the most common viruses among hospitalized children in Suzhou, and hMPV and HBoV also played an important role in respiratory tract infection of children. Different virus has different cycle and seasonality. Climatic factors, especially mean temperature, was the main factor affecting the virus prevalence.</p>

Characteristics of human metapneumovirus respiratory tract infection in children and the relationship between the infection and meteorological conditions / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the epidemiology of human metapneumovirus (hMPV) infection in children and its relations with meteorological conditions in Suzhou.</p><p><b>METHOD</b>Samples obtained from 6655 children hospitalized with acute respiratory tract infections (ARIs) during the period from 2006 to 2009, were tested for virus pathogens. Nasopharyngeal aspirates were obtained from the children according to a standard protocol and were tested for respiratory syncytial virus (RSV), influenza viruses (IFV) A and B, parainfluenza virus (PIV) types 1, 2, and 3 and adenovirus (ADV) with direct immunofluorescence assay. Samples were tested for hMPV with reverse transcription polymerase chain reaction (RT-PCR). Meteorological conditions including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of the virus and meteorological conditions was analyzed by linear regression and stepwise regression analysis.</p><p><b>RESULT</b>Viral pathogens were identified in 32.2% of 6655 specimens. The positive rate of hMPV was 8.9%, RSV was 15.7%, IFV, PIV and ADV detection rates were less than that of hMPV. The annual positive rate of hMPV from 2006 to 2009 was 8.2%, 8.1%, 12.7%, 7.4% respectively (χ(2) = 33.23, P < 0.05). The hMPV positive rate of the four seasons was 11.6%, 7.6%, 4.7% and 11.7%, respectively, detection rate in winter and spring was significantly higher than those in summer and autumn (χ(2) = 74.67, P < 0.001). The positive rate of hMPV and the monthly mean temperature was moderately correlated (r = -0.43), and the monthly average rainfall (r = -0.29), monthly mean relative humidity (r = -0.27), monthly average sunshine duration (r = -0.11), the monthly average wind speed (r = -0.13) had low correlations.</p><p><b>CONCLUSION</b>hMPV was the second most common viral pathogen of acute respiratory tract infection in children in Suzhou, which prevailed predominantly in the winter and spring. Climatic factors, especially temperature and rainfall may affect the prevalence of hMPV.</p>

Prevalence and clinical features of human metapneumovirus infection in hospitalized pediatric patients with respiratory tract infection in Suzhou area / 中华儿科杂志

<p><b>OBJECTIVE</b>To determine whether human metapneumovirus (hMPV) was circulating in Suzhou area and the epidemiology and clinical features associated with hMPV infection.</p><p><b>METHOD</b>Samples were collected from January 2006 to December 2007; respiratory specimens were tested for the presence of hMPV by reverse-transcription polymerase Chain reaction (RT-PCR). PCR products of hMPV N gene from some patients were randomly selected for sequencing analysis, and the sequences of the nucleotides and deduced amino acids were compared with those in the GenBank.</p><p><b>RESULT</b>Of the 4702 patients screened, 8% had evidence of hMPV infection. The positive rate in 2006 and 2007 was 8.4% and 7.6%, respectively. The positive rates detected during January to March, November and December were higher. The median age of patients was 22. 56 months. The infected children were diagnosed as having upper respiratory tract infection (3.2%), laryngitis (2.1%), bronchiolitis (27.1%), pneumonia (55.9%), and asthma exacerbation (11.7%). Sequence analysis of these hMPV N genes showed 99%-100% homology with the registered sequence in GenBank.</p><p><b>CONCLUSION</b>(1) hMPV accounted for a significant proportion of respiratory tract infection in infants and children. (2) hMPV prevailed predominantly in the winter and spring time. (3) Clinically, hMPV infection can not be discriminated from the infection with other respiratory tract viruses.</p>

Reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effective skills of reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus in order to avoid postoperative complications of joint instability and great tubercle displacement.</p><p><b>METHODS</b>From June 2002 to June 2006, 25 patients with Neer four-part fracture of the proximal humerus were adopted in the study which included 15 females and 10 males, with the mean age of 66 years (ranged from 56 years to 80 years). They were treated with humeral head replacement and should joint reparation simultaneously by modified operation approach and reconstruction and balance skills of soft tissue.</p><p><b>RESULTS</b>The mean duration of follow-up was 2.3 years (ranged from 1 to 4.5 years). No infection, nerve damage and prosthesis loosing were found in all cases. Two cases of infra-forward dislocation or subluxation occurred due to affected limb placed on abduction splint postoperatively. One case occurred prosthesis upward displacement due to early active abduction exercise but no complains. Neither joint instability nor displacement and malunion of great tubercle were found in other patients. According to Neer scoring system, 6 cases were rated as excellent, 15 as good and 5 as fair. The good and excellent rate was 84%.</p><p><b>CONCLUSION</b>In hemi-shoulder replacement for patients with Neer four-part fracture the modified operation approach and reconstruction and balance of soft tissue skills combined with rational rehabilitation exercise can prevent postoperative shoulder joint instability and displacement and malunion of great tubercle.</p>

Treatment of osteonecrosis of the femoral head by percutaneous decompression and autologous bone marrow mononuclear cell infusion / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of the treatment of osteonecrosis of the femoral head by percutaneous decompression and autologous bone marrow mononuclear cell (BMCs) infusion.</p><p><b>METHODS</b>44 hips in 28 patients with avascular necrosis at early stage were treated by percutaneous multiple holes decompression followed by autologous BMCs infusion. Autologous BMCs were concentrated from bone marrow that was taken from the posterior iliac crest of the patient. Patients were followed up at least 2 years. The results were determined by the changes in the Harris hip score and the progression in the radiograghic stages.</p><p><b>RESULTS</b>No complications were observed after the operation. Before operation, there were stage I of femoral head necrosis in 8 hips, stage II in 15 hips, stage III in 14 hips, stage IV in 7 hips, and the postoperative stages at the most recent follow-up were stage O in 1 hip, stage I in 6 hips, stage II in 13 hips, stage III in 13 hips, stage IV in 7 hips, stage V in 4 hips. The mean preoperative Harris hip score was 58 (46-89), and improved to 86 (70-94) postoperatively. All the femoral head collapsed preoperatively showed that the necrotic size was at least more than 30%.</p><p><b>CONCLUSIONS</b>Percutaneous multiple holes decompression combined with autologous BMCs is a new way to treat avascular necrosis of the femoral head. The earlier the stage, the better the result. A randomized prospective study needed to compare with routine core decompression in the future.</p>

Apoptosis-related gene expression and its clinical significance of human osteosarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the prognostic markers in osteosarcoma.</p><p><b>METHODS</b>Expressions of p53, c-myc, bcl-2 and apoptosis index (AI) in 28 osteosarcoma specimens were detected by ABC immunohistochemistry and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labelling (TUNEL). The relationship between gene expression and apoptosis, and their correlations with pathologic classification and prognostic factors were analyzed.</p><p><b>RESULTS</b>There was negative correlation between the expressions of p53, c-myc, bcl-2 protein and AI, which was closely related to the long term survival of patients but was not related to pathologic types of the tumor.</p><p><b>CONCLUSION</b>The expressions of p53, c-myc, bcl-2 protein and AI can be used as an index for predicting the progression and prognosis of osteosarcoma.</p>

Coculture of elongated neuron axon with poly (D,L-lactide-co-glycolide) biomembrane in vitro / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To elongate human nerve axon in culture and search for suitable support matrices for peripheral nervous system transplantation.</p><p><b>METHODS</b>Human embryo cortical neuronal cells, seeded on poly (D,L-lactide-co-glycolide) (PLGA) membrane scaffolds, were elongated with a self-made neuro-axon extending device. The growth and morphological changes of neuron axons were observed to measure axolemmal permeability after elongation. Neurofilament protein was stained by immunohistochemical technique.</p><p><b>RESULTS</b>Human embryo neuron axon could be elongated and cultured on the PLGA membrane and retain their normal form and function.</p><p><b>CONCLUSIONS</b>Three dimensional scaffolds with elongated neuron axon have the basic characteristics of artificial nerves, indicating a fundemental theory of nerve repair with elongated neuron axon.</p>

Knee replacement of the treatment of malignant tumor of the proximal tibia and early follow-up / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the clinical effects of using rotating hinge prosthesis in treating primary malignant tumor of the proximal tibia.</p><p><b>METHODS</b>After the malignant tumor of the proximal tibia was extensively resected or radically resected, rotating hinge prosthesis replacement was performed for reconstruction, while neoadjuvant chemotherapy was used in treating the osteosarcoma.</p><p><b>RESULTS</b>The average follow-up period was 4.2 years. There was no local recurrence and metastasis in 22 patients, though there was recurrence in 8 patients. The MSTS functional scores of all different items 4 years after the operations were above 3, which showed the clinical results were satisfactory.</p><p><b>CONCLUSIONS</b>It is an efficacious method for the treatment of malignant tumor of the proximal tibia by using rotating hinge prosthesis. It has the advantage of early recovery of joint function.</p>

Study on Etiology of Acute Pneumonia in Children in Suzhou Area / 实用儿科临床杂志

Objective To investigate etiology of acute pneumonia in children in order to provid basis for clinical diagnosis and treatment.Methods The children with acute pneumonia who were hospitalized in children's hospital affiliated to Suzhou university were selected.And the sputum of them were collected.Bacteria and virus were tested using sputum culture and direct immunofluoresence respectively.Antibodies against mycoplasma and chlamydia were detected by enzymelinked immunosorbent assay(ELISA) in paired sera. Results Microbial etiology was obtained in 360 cases (67.7%) of 532 patients.Viral infections were in 178 cases (33.5%).Bacterial infections were in 23 cases (4.3%),mycoplasma pneumoniae 50 cases (9.4%) and chlamydia pneumoniae 19 cases (3.6%),compound infections 90 cases (16.9%).Respiratory syncycial virus was the major viral pathogen,streptococcus pneumoniae were the prominent pathagens of bacterial pneumonia,followed by haemophilus influenza.Conclusions Viral infection is the most common cause of acute pneumonia in children in Suzhou area during winter and spring,followed by mycoplasma pneumoniae,bacteria and chlamydia pneumoniae.Mycoplasma pneumoniae infection is more common in children older than 3 years,chlamydia pneumoniae infection is more in infants less than 3 months,most of compound infection children were below the age of 3 years.