Monitoring of viral pathogens in pediatric intensive care unit and analysis of clinical significance / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the characteristics of viral spectrum and clinical features of children in pediatric intensive care unit (PICU).</p><p><b>METHOD</b>Nasopharyngeal aspirate specimens (NPA) from 349 patients(1 from each) and 130 cerebrospinal fluids (CSF) specimens were collected from children who were admitted to the PICU of Second Affiliated Hospital of Shantou University Medical College. Additional 87 NPA specimens were collected from healthy children for routine examination on the physical examination center, and the clinical data were collected. Multiplex PCR was applied to detect 16 kinds of viruses from NPA and CSF. Fluorescence quantitative PCR was applied to detect 13 viruses from CSF and to analyze the clinical data of positive cases.</p><p><b>RESULT</b>There were 209 samples (59.9%) of the 349 NPA specimens were positive for viruses, which included 117 cases positive for human rhinovirus (HRV), 60 for respiratory syncytial virus (RSV), 20 for influenza virus A (Inf A), 10 for adenovirus (ADV), 6 for parainfluenza virus type 3(PIV-3), 6 for human Boca virus (HBoV), 5 for influenza virus C(Inf C), 4 for parainfluenza virus type 4(PIV-4), 4 for human coronavirus-HKU1/OC43, 3 for influenza virus B (Inf B), 3 for WU Polyomavirus (WUPyV), 2 parainfluenza virus type 1(PIV-1), 2 human metapneumovirus (HMPV) and 1 human coronavirus-NL63/229E. But none from 87 healthy controls were positive for any respiratory virus. Among the 130 CSF specimens, in 58 cases the diagnosis was viral encephalitis. There were 22 samples (37.9%) among the 58 CSF specimens positive for viruses, which included 14 enterovirus (EV), 3 human cytomegalovirus (HCMV), 2 mumps virus, 1 coxsackie virus A16 (Cox-A16), 1 herpes simplex virus (HSV) and 1 human rhinovirus (HRV). The total positive rate was 63.3% (221/349) . Co-infection by at least 2 viral pathogens under study was observed in 45 of the 349 patients (12.9% of the total number of cases, 20.4% of the positives cases). The commonest pathogens in co-infected samples were WUPyV (100%) and HMPV(100%). The positive rate of virus peaked in the first 6 months of life, the rate in boys were higher than in girls and the peak season was summer. The numbers of none serious cases in the virus positive group were less than those in the virus negative group while the numbers of extremely serious cases in the virus positive group were higher than in the virus negative group.</p><p><b>CONCLUSION</b>Viral pathogen is a major cause of infectious disease in pediatric critical illnesses and virus infection may lead to severe illness.</p>

Detection and clinical features of human rhinovirus in hospitalized children with acute respiratory tract infection in eastern areas of Guangdong province / 中华流行病学杂志

Objective To investigate the prevalence and clinical features of human rhinovirus (HRV) infection in hospitalized children with acute respiratory (ARI) in eastern areas of Guangdong province from 2008 to 2010.Methods From Oct.2008 through Sep.2010,nasopharyngeal aspirates were collected prospectively,from hospitalized children with acute lower respiratory tract infection at the Second Hospital,affiliated to the Shantou University Medical College.Multiplex PCR was applied to detect ten kinds of viruses including HRV,RSV in the hospitalized children with respiratory tract infection.Clinical data on HRV-positive cases or RSV-positive cases were collected and analyzed.Results Among all the 1335 specimens,124 were confirmed as HRV-positive cases (9.3％),with IVA-positive rate as the highest (25.1％),followed by RSV-positive rate (15.1％).HRV infection occurred sporadically around the year,with the highest HRV-positive rate seen in spring 2009 and autumn in 2010.Symptoms,signs,chest X-ray,leukocyte count and CRP count did not differ between patients with co-infection or single HRV infection.Clinical symptoms or signs were similar between those with single HRV infection or single RSV infection in children,but the single RSV infected children were more frequently seen with wheeze and cough.28.4％ of the single RSV infected children had bronchiolitis while 10.7％ of single HRV infected children were seen (x2=0.281,P=0.596).Conclusion HRV was a relatively common cause for acute respiratory infections in the eastern areas of Guangdong province.The highest HRV-positive rate was slightly different in different years.Infants and young children were generally susceptible to rhinovirus infection.Bronchiolitis,wheeze and cough associated with HRV infection happened less than those caused by RSV.

Detection and clinical characterization of WU polyomavirus in acute respiratory tract infection in children / 中华儿科杂志

<p><b>OBJECTIVE</b>WU polyomavirus (WUPyV), a new member of the genus Polyomavirus in the family Polyomaviridae, has been found to be associated with respiratory tract infections recently. But the role of the WUPyV as agents of human disease remains uncertain. We sought to describe the detection and clinical characterization of WUPyV in acute respiratory tract infection in children.</p><p><b>METHOD</b>From July 2008 through June 2009, nasopharyngeal aspirates were collected from 771 children who were hospitalized with acute respiratory tract infection in Second Affiliated Hospital of Shantou University Medical College, and from 82 asymptomatic children who visited the health checkup clinic. WUPyV was detected by using PCR technology and was identified by using DNA sequencing. All WUPyV-positive specimens were screened for 9 common viruses [influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus (PIV) 1 and 3, human metapneumovirus, human bocavirus, adenovirus and rhinovirus] by using PCR or RT-PCR. The clinical data of WUPyV infection were collected and analyzed.</p><p><b>RESULT</b>In this study, fifteen of the 771 tested specimens with acute respiratory tract infection were positive for WUPyV, the positive rate was 1.95% and all of the asymptomatic children who visited the health checkup clinic were negative. Of the 15 cases who were positive for the virus, the age range was 2 to 48 (mean 18.8) months, 9 (60%) were male and 6 (40%) were female. WUPyV was the sole virus detected in 9 specimens (60%) from patients with acute respiratory tract infection. WUPyV was associated with the co-infection with another respiratory virus in 6 of 15 (40%) cases, most frequently with RSV (n = 4), followed by adenovirus (n = 1) and rhinovirus (n = 1). The most common clinical findings in the patients with WUPyV were cough, fever and wheezing. The most frequent diagnoses were pneumonia (n = 8), bronchiolitis (n = 4), upper respiratory tract infections (n = 2) and bronchitis (n = 1). A severe case was complicated with viral encephalitis.</p><p><b>CONCLUSION</b>WUPyV may be a respiratory pathogen because it was the sole virus detected in 9 specimens from patients with respiratory illness and all of the asymptomatic controls were negative. The most common clinical findings are cough and wheezing. Young children may be susceptible to infection with this virus and occasionally the infection with this virus may cause severe disease. More comprehensive and in-depth studies are required to prove the pathogenicity of these viruses.</p>

Viral pathogens of acute lower respiratory tract infection in hospitalized children from East Guangdong of China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the viral pathogens of acute lower respiratory tract infection (ALRTI) in hospitalized children from East Guangdong Province of China and the relationship of the pathogens with age and seasons.</p><p><b>METHODS</b>The nasopharyngeal aspirates samples obtained from 345 hospitalized children with ALRTI were investigated for respiratory syncytial virus (RSV), human bocavirus (HBoV), human metapneumovirus (hMPV), influenza virus types A and B, rhinovirus, parainfluenza virus types 1 and 3 and adenovirus by PCR.</p><p><b>RESULTS</b>Viral pathogens were detected in 178 patients (51.6%). RSV was the most frequent (19.3%). Novel viruses hMPV (3.2%) and HBoV (3.2%) were found. A highest detection rate (61.9%) of virus was found between January to March. The infants aged 1 to 6 months showed a higher detection rate (71.3%) of virus than the other age groups. The detection rate of viral pathogens was 72.6% in children with bronchiolitis, followed by asthmatic bronchitis (70.0%) and bronchial pneumonia (44.6%).</p><p><b>CONCLUSIONS</b>RSV remained the leading viral pathogens in children with ALRTI in East Guangdong of China. Novel viruses HBoV and hMPV were also important pathogens. The detection rate of viral pathogens was associated with seasonal changes and age. Different respiratory infectious diseases had different viral detection rates, with highest detection rate in bronchiolitis cases.</p>

Low-Dose Erythromycin Treatment on Intractable Allergic Rhinitis Associated with Bronchus Asthma / 实用儿科临床杂志

Objective To explore the therapeutic effect and medication safety of low-dose erythromycin treatment on intractable allergic rhinitis(AR) associated with bronchus asthma.Methods Totally 173 cases of children received outpatient treatment because of AR associated with asthma,their ages ranging from 3 to 14 years.Among them,78 cases developed intractable AR with symptoms of asthma having been controlled or satisfactorily controlled after 2 courses of conventional treatment.Seventy-six children with intractable AR received full follow-up and were randomly divided into observation group and control group.The control group was given different second-generation antihistamines,when necessary,supplemented by nasal glucocorticoids.In the observation group,the same treatment as it was done in control group was continued,plus oral treatment with erythromycin enteric-coated capsules(10 mg?kg-1?d-1,which were taken 3 times a day for 1 month) to the observation group.Both observation group and control group were in accordance with the norms of the treatment of asthma.Results The improvement rate,inefficiency and the total efficiency were different between observation group and control group,and the diffe-rence was statistically significant(?2=12.629,8.412,8.412,Pa0.05).Their liver function was also monitored and was found normal before treatment and after the replacement of drugs for 1 month,including alanine ami-notransferase,aspartate aminotransferase,albumin,globulin,and were found normal.Conclusions On the basis of conventional treatment,low-dose erythromycin treatment of intractable AR is effective and safe.However,the treatment must be limited to the refractory cases,and the appropriate indications must be strictly observed.

Study on Transplantation of Human Umbilical Cord Mesenchymal Stem Cells into Infertile Mouse Testis / 实用儿科临床杂志

Objective To observe clone ability of human umbilical cord mesenchymal stem cells (MSCs) into infertile mouse seminife-rous tubules and the effects of MSCs on reproductive function.Methods Busulfan was used to destroy endogenous spermatogenesis of the recipient mice.To isolate,culture and purify MSCs with adherent method before marked with Brdu and Hoechst 33258 respectively,and then transplanted into the seminiferous tubules by microinjection.The survival of MSCs in recipient testes were evaluated by immunohistochemistry stained for Brdu and Fluorescent microscopy for Hoechst 33258 observation at different times.The diameter of seminiferous tubules was detected with HMIAS-2000 high-definition colored analyzing system for medical pictures.SPSS 13.0 software was used to analyze the data.Results The dosage of Busulfan resulted in 15% death in the mice,the testis of survived mice showed only basilar membrane in seminiferous tubules after 4 weeks.A lot of purified MSCs were obtained at the third generation and transplantation them into mouse seminiferous tubules survive for at least 4 months and appear to migration.The average diameter in experimental groups were higher than those in controls not only on 26 days but also on 120 days(P

Therapeutic Effects of Low-Dose Topiramate on Children with Tourette Syndrome / 实用儿科临床杂志

Objective To explore the therapeutic effects and dose of Topiramate(TPM)in children with Tourette syndrome(TS).Me-thods Seventy-nine children with TS were given oral TPM,which were treated with Topiramate [0.5-3.0 mg/(kg?d),twice a day].The therapeutic effects were assessed using Yale Global Tic Severity Scale(YGTSS)before and 3 months after treatment and the side-effects of the drugs were observed.Results The differences of YGTSS scores before and after treatment,motertic score(19.63?3.09 vs 5.05?1.74),vocaltic score[(18.95?2.56)vs(4.82?1.94)],global scole score[(24.21?5.89)vs(10.42?3.69)],severity score[(62.21?5.81)vs(22.26?4.81)],there were significant differences of every score of YGTSS between before and after treatment(Pa

Biological Characteristics of Mesenchymal Stem Cells Cultured in Conditions for Spermatogonia in Vitro / 实用儿科临床杂志

Objective To investigate the possibility of inducing mesenchymal stem cells(MSCs)from human umbilical cord Wharton's Jelly to differentiate into spermatogonia.Methods To isolate,culture and purify MSCs with adherent method,the growth and proliferation of human umbilical cord-derived MSCs were observed,and their immunophenotypes were determined by flow cytometry;MSCs of the third generation were divided into 2 groups to be induced and cultured,MSCs of the control group were cultured in basal medium,while those of the experimental group with conditional medium.The morphologic and ultrastructure changes of control group and experimental group cells were compared with phase contrast microscopy,electron microscopy(EM)and transmission electron microscope(TEM)respectively ;the spermatogonial cells differentiated were then evaluated by immunohistochemistry stained for CD117and CD49f ;the method of Western-blot was used to test if the cells induced could express CD49f.Results A population of MSCs were isolated from human umbilical Wharton's Jelly;they were processed to obtain a fibroblast-like population of cells and could be maintained in vitro for extended periods with stable population doubling;After induction,the shape of MSCs changed greatly from the fibroblast to the round,even familiar to the tadpole;expressed the known molecular markers of spermatogonial cells,such as CD49f,CD117.Conclusion The induced MSCs not only undergo spfermatogonial-cell like morphologic changes,ultramicrostructure mature with increasing cell organs,but also express the spermatogonial cell markers,which show that human umbilical cord derived MSCs are capable of differentiating into spermatogonial cell.