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Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.
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Objective To investigate the clinical phenotype and molecular diagnosis of Noonan syndrome (NS) caused by mutations in SHOC2 gene. Methods The clinical data and gene testing results of one child with NS were analyzed retrospectively. Results This is an 8-month-old infant. Since birth, the boy had feeding and sleeping difficulties, irritability, and growth retardation. The boy had large head circumference, sparse, thin and yellow hair, broad and prominent forehead, flat nose, slightly wide eye distance, and slightly bilateral eye fissure outward tilt, no eyelid ptosis. Echocardiography showed patent foramen ovale,ventricular septum and left ventricular hypertrophy.A novel mutation(De novo)was found in the SHOC2 gene, heterozygous missense mutation c.4A>G, p.Ser2Gly His parents were normal genotypes. According to the clinical characteristics, relevant literature was reviewed. The clinical manifestation of sleep difficulty has not been reported in the NS patients with SHOC2 mutation.Conclusions This is the first domestic reported NS case with SHOC2 mutation.The phenotype is consistent with the foreign reports.Sleep difficulty may be a new phenotype of NS with SHOC2 mutation.
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Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.
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Objective ToevaluatetherelationshipbetweentypeIIdiabetes,hyperlipidlevelandcarotidartery arthrosclerosisbyultrasonography.Methods Atotalof150retiredofficerswereselected,ofwhich63diabeticpatients were divided into case group while 87 subjects free of diabetes were divided into control group.Blood laboratory examination wasconductedandthemanifestationofcarotidarterywasexaminedbyultrasonography.Results TCH,TG,LDLand ApoB of case group were significantly higher than those in control group (P<0.05 ).The intimamedia thickness (IMT)of carotid artery in case group was increased significantly (P<0.05 ).Moreover,arteries narrowing and plaque were more than those in control group (both P <0.05 ).T peak velocity in carotid artery and internal carotid were of statistical significance between two groups (P<0.01 ).Furthermore,multiple linear regression analysis considering the degree of carotid artery arthrosclerosis and serum lipid showed that multiple correlation coefficient of case group was 0.870 (P<0.01)and0.902(P<0.01)ofcontrolgroup.Conclusion Hyperlipidemiamayhavethepromoteeffectontheformation of arteriosclerosis plaque and ultrasonography could be one of the effective methods to detect early vessel lesion of diabetic patients.
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<p><b>OBJECTIVE</b>To compare the differences in the complete genome sequence between mumps epidemic strain and mumps vaccine strain S79 isolated in Zhejiang province.</p><p><b>METHODS</b>A total of 4 mumps epidemic strains, which were separated from Zhejiang province during 2005 to 2010, named as ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 were selected in the study. The complete genome sequences were amplified using RT-PCR. The genetic differences between vaccine strain S79 and other genotype strains were compared; while the genetic-distance was calculated and the evolution was analyzed.</p><p><b>RESULTS</b>The biggest difference between the 4 epidemic strains and the vaccine strain S79 was found on the membrane associated protein gene; whose average nucleotide differential number was 42.5 +/- 3.0 and the average variant ratio was 13.6%; while the mean amino acid differential number was 12.8 +/- 1.5 and the average variant ratio was 22.4%. The smallest difference among the 4 epidemic strains and the vaccine strain was found in stromatin genes, whose average nucleotide differential number was 73.8 +/- 2.5 and the average variant ratio was 5.9%; while the mean amino acid differential number was 3.0 +/- 0.8 and the average variant ratio was 0.8%. The dn/ds value of the stromatin genes of the 4 epidemic strains reached the highest, as 0.6526; but without any positive pressure (dn/ds < 1, chi2 = 0.87, P > 0.05). There were mutations happened on the known antigen epitope, as 8th amino acid of membrane associated protein genes and on the 336th and 356th amino acid of hemagglutinin/neuraminidase proteins. Compared with the vaccine strain, the glycosylation sites of ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 increased 1, 1, 2 and 2 respectively. The complete amino acid sequence of all strains showed that there were 17 characteristic sites found on the genotype-F mumps strain. Within the complete genome, the genetic-distance between epidemic strains and vaccine strains in Zhejiang province (0.071) was significantly larger than the genetic-distance between strains in Yunnan province (0.013); the difference showing statistical significance (t = 4.14, P < 0.05). Except nucleocapsid protein genes, all the genes shared similar evolution tree.</p><p><b>CONCLUSION</b>There were significant differences found in the genes between mumps epidemic strain and mumps vaccine in Zhejiang province.</p>
Subject(s)
Humans , Amino Acid Sequence , China , Epidemiology , Genome, Viral , Genotype , Molecular Sequence Data , Mumps , Epidemiology , Genetics , Virology , Mumps Vaccine , Mumps virus , Classification , Genetics , Viral Proteins , GeneticsABSTRACT
Objective To evaluate the long-term immunogencity and effectiveness of live attenuated hepatitis A (HA) vaccine (H2 strain) after one dose injection, through a 15 years' follow up observation. Methods A total of 220 children with negative anti-HAV antibody (aged 1-3 y)were involved and followed up in Jiaojiang district, Taizhou city, Zhejiang province. Indicators would include seroconversion and geometric meantiter(GMT) levels after inoculation the vaccine with single dose at 2 m, 12 m, 6 years, 10 years and 15 years. Epidemiological observation was carried out within the 15 years to evaluate the relationship between vaccine coverage, the incidence of HA and the overall effectiveness. In the studied population, serum was tested by ELISA(calibrated by WHO international reference) and ABBOTT Axsym HAVAB mEIA. Results Seroconversion rates were found to be 98.6% and 81.3% after 2 months and 15 years of inoculation and slowly decreased. GMT level was 128 mIU/ml after 15 years, significantly higher than the required protective level of 20 mIU/ml,recommended by WHO experts. Effectiveness through the 15-year follow up program showed a significant correlation between vaccine coverage and incidence of HA in 1-15 years aged group (Kendall-Rank test, t =-0.931, P＜0.01). There was no HA case seen among the observed accumulated 236 413 person-year vaccines, compared to 4 HA cases discovered in the 27 206 personyear of the non-vaccinees. The overall protective rate reached 100%. Through a mass vaccination program on children, the whole population established an immune-defence to enable the incidence of HA decreased by 96.7%. Conclusion The long-term immunogencity and effectiveness of live attenuated hepatitis A vaccine (H2 strain) after one dose injection could last as long as 15 years.
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<p><b>BACKGROUND</b>Live attenuated hepatitis A vaccine (H2 strain) is widely applied in prevention of hepatitis A epidemic in China and other countries now. It is essential to observe and confirm the vaccine immune efficacy, population antibody level and its persistent efficacy after mass immunization.</p><p><b>METHODS</b>A total of 220 children with negative anti-HAV antibody (aged 1 - 3 years) were taken for follow-up assay to observe seroconversion and geometric mean titre (GMT) level 2 months, 12 months, 6 years, and 10 years after inoculation. Another survey sampled from subjects of different age groups (3, 6, 9, 15, 18, 25 and 35 years) to compare anti-HA antibody positive rate before and after inoculation performed 10 years previously. Epidemiological observations were taken for 10 years to evaluate the relationship between vaccine coverage and hepatitis A morbidity. Serum antibody to HAV was detected by enzyme linked immunoassay (ELISA, calibrated by WHO international reference) and ABBOTT Axsym HAVAB microparticle enzyme immunoassay.</p><p><b>RESULTS</b>Seroconversion in follow-up assay 2 months and 10 years after inoculation was 98.6% and 80.2% respectively. For children, the vaccination anti-HA antibody positive rates were significantly different before and after 10 years, 7.69% cf 70.45% (aged 3 years) and 52.58% cf 71.78% (aged 18 years). When vaccine coverage rose from 57% to 74%, there were no any HA epidemics. When vaccine coverage reached 85%, there were no any HA cases. With vaccine coverage between 85% and 91%, there were no any HA cases in cohorts from the age of 1 year to 15 years during the 10 years.</p><p><b>CONCLUSIONS</b>Live attenuated hepatitis A vaccine has an obvious long-term effectiveness in prevention and control of HA epidemics through mass vaccination.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Enzyme-Linked Immunosorbent Assay , Follow-Up Studies , Hepatitis A , Hepatitis A Vaccines , Allergy and Immunology , Hepatitis Antibodies , Blood , Immunoglobulin G , Blood , Mass Vaccination , Vaccines, Attenuated , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the RT-PCR-ELISA method applied for testing live attenuated hepatitis A vaccine titer.</p><p><b>METHODS</b>A solid phase hybridization-enzyme colorimetric detection method was used for detecting specific nucleic acid. Primer labeled with biotin was used to amplify viral gene fragment, then the product was quickly hybridized with the specific probe covalently coupled on DNA-binding microplate wells. Finally, peroxidase-labeled streptavidin was used in colorimetric detection. The results were judged by reading A value. Eleven batches of live attenuated hepatitis A vaccine titer were tested by this method. The results were compared with that of routine cell culture method (CCID50).</p><p><b>RESULTS</b>The sensitivity was similar to routine cell culture method (P>0.05). This method was convenient, fast and specific.</p><p><b>CONCLUSION</b>CCID50 method may be replaced by the RT-PCR-ELISA method in evaluating the titer of live attenuated hepatitis A vaccine.</p>