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Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases.Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic.Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection.This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities.The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Cefpodoxime proxetil(CPDX-PR) is the third generation cephalosporin with high oral efficiency.It has strong anti-gram negative bacteria and-gram positive bacteria effects, with wide tissue distribution, long plasma half-time(T1/2), stable to lactamase, good tolerance, small therapeutic dose, few times of administration, definite cli-nical efficacy and other advantages.It is recommended for application in the treatment guidelines of foreign children with various infectious diseases.It is of great clinical significance to discuss the rational application of CPDX-PR oral preparation under the condition of severe bacterial drug resistance.This article reviews the pharmacological characteristics of CPDX-PR and the research progress in the treatment of common infectious diseases in pediatrics, so as to promote the research on the rational clinical application of CPDX-PR in China.
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Recombinant human interferon αl b (rhIFN-1 b) is the first internationally unique novel genetic engineering medicine in China.In the previous article,it has been summarized that it is a major interferon subtype that is naturally antiviral in human body,and has high safety and broad-spectrum antiviral effect.A number of pediatric consensus and guidelines of clinical experts have formed in China's national conditions.This article summarizes its innovative research and achievements in the clinical treatment of pediatric diseases,and further discusses the problems that need to be solved in the clinical application of rhIFN-α1b in pediatrics.
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Recombinant human interferonα1b (IFN-α1b) is the first internationally unique novel ge-netic engineering medicine in China. As a major interferon subtype with natural antiviral activity, IFN-α1b has high safety and broad-spectrum antiviral effect, so it has broad application prospects in the treatment of viral diseases. Chinese pediatric doctors have taken the lead globally in conducting clinical research of IFN-α1b in the treatment of respiratory syncytial virus ( RSV) pneumonia、 bronchiolitis、 hand-foot-mouth disease, her-petic angina、 viral diarrhea, etc. A series of clinical guidance and expert consensus have been published which are in line with China's national conditions. This article summarizes the innovative research of IFN-α1b and proposes common issues and potential application in pediatric clinical applications.
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As the first class Ⅰ novel genetic engineering medical product in China,recombinant human interferon alpha 1b (IFNα1b) shows unique biological significance and clinical value.Especially in the field of pediatrics,IFNα1 b has been used in the treatment of viral pneumonia,viral hepatitis,bronchiolitis,herpetic angina,hand-footmouth disease and some tumors in children and shown definite efficacy and good safety.It is also used in the prevention and treatment of virus-related wheezing and major infectious diseases,such as influenza.With a greater application prospect,IFNα1b plays an important role in promoting children's health in China.Now,IFNα1b's gene and molecular characteristics,new delivery methods,and the frontier clinical research will be discussed.
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Objective To systematically assess the safety of recombinant human interferon α1b(rhIFNα1b) as therapy for viral diseases in children,so as to provide on evidence-based medicine for the clinical treatment.Methods Randomized controlled trails (RCTs) of rhIFNα1b for viral diseases in children were investigated through PubMed literature retrieval service system,Science Citation Index,China National Knowledge Infrastructure,WanFang Database;RCTs were selected according to the inclusion and exclusion criteria.Related data were extracted and the Meta-analysis was performed.Results Nineteen RCTs were involved,including 2 731 patients.In the overall,59/1 437 cases (4.1％) in the rhIFNα1b treatment group and 79/1 294 cases (6.1％) in the control group had adverse reactions.The Meta-analysis revealed that in the overall and in atomization inhalation subgroup,the incidence of adverse reactions was significantly lower in the rhIFNα1b treatment group than that in the control group [Z =2.18 (P =0.03),RR =0.71(95％ CI:0.52-0.97);Z =2.44(P =0.01),RR =0.53 (95％ CI:0.32-0.88)].But,there was no significant difference in the incidence of adverse reactions between the rhIFNα1b treatment group and the control group in intramuscular injection subgroup,and the test for overall effect was Z =0.78 (P =0.43),RR =0.86 (95 ％ CI:0.58-1.26).The incidence of adverse reactions of the control group was significantly higher than that of the rhIFNα1b treatment group in gastrointestinal adverse reaction [Z =2.20 (P =0.03),RR =0.60 (95 ％ CI:0.39-0.95)],and the incidence of adverse reactions of the rhIFNα1b treatment group was significantly higher than that of the control group in nervous system symptoms [Z=2.09(P=0.04),RR =4.28(95％ CI:1.10-16.72)].Conclusion Compared with other antiviral drugs,the treatment of pediatric common viral diseases with rhIFNα1 b has good safety,low incidence of adverse reactions,and the incidence of adverse reactions through atomization inhalation can be lower than that of intramuscular injection.
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Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.
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In order to improve rational useage of inerferon in clinic,this article elaborate the background of this Specialists consensus on pediatric clinical application of recombinant human interferon-α1 b,the differences of various subtypes of interferon,the envidence and method of interferon-α1b clinical application,the satety and the adverse reaction monitoring issues in this article.
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Obgective To investigate the impact of different ways and doses of recombinant human interferon o1b(rhIFN-α1b) on antiviral effect on respiratory syncytial virus(RSV)-effected mice and signal pathway of JAK/ STAT.Methods Forty-eight mice were divided randomly into 6 groups,negative control group,RSV-infection model group,12.5,25.0,50.0 μg rhIFN-α1 b atomization inhalation of intervention group,and 12.5 μg rhIFN-α 1 b injection of intervention group.After continuous drug therapy for 5 days,the left lung tissues of mice were aseptically dissected in the sixth day.Then it were observed lung tissue pathology changes by optical microscope,and expression of STAT1 and STAT2 protein with laser scanning confocal microscopy.Results It was observed that RSV-infection model mice's lungs had significant inflammatory injury under light microscope.After treatments of rhIFN-α 1b,it showed that the mice lung tissue had recovery of inflammation on different degrees.The group of inhaled rhIFN-o1b 50.0 μg was damaged on lightest degree.There were statistically significant differences between each group (all P ＜ 0.05).The expression of STAT1 and STAT2 protein in RSV-infection model mice's lungs decreased remarkably under fluorescene microscopy.Treatments of rhIFN-α 1b increased the expression of STAT1 and STAT2 inhibited by RSV-infection.The expression of STAT1 and STAT2 protein of the inhaled rhIFN-α1b 50.0 μg group increased significantly.The differences between groups were statistically significant(all P ＜ 0.05).Conclusions rhIFN-α 1 b played an important role in anti-RSV effects,simultaneously,it could improve the activity of JAK/STAT signal pathway inhibited by RSV-infection.The treatment effect of rhIFN-α 1b deliveried by atomization inhalation was better than that of intraperitoneal injection.And curative effect is proportional to the atomization inhalation dose within a certain range.
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Objective To explore the effect of family rehabilitation on growth and development of children with hypoxic ischemic en-cephalopathy (HIE). Methods 80 children with moderate HIE were divided into control group (n=40) and observation group (n=40). The control group received routine intervention and nursing, and the observation group accepted family rehabilitation in addition. Mental devel-opment index (MDI) and psychomoter developmental index (PDI) were compared when they were 3 and 6 months old with intellectual de-velopment testing, and their development quotients (DQ) were compared at the age of 1 year. Results The MDI and PDI scores were higher (P<0.01) in the observation group than in the control group when they were 3 and 6 months old. The DQ were higher (P<0.05) in the obser-vation group than in the control group when they were 1 year old. Conclusion Family rehabilitation can promote the development of intelli-gence in children with HIE.
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Objective To optimize the concentration of a microRNA-21 (miR-21) inhibitor and a miR-494 mimic for the transfection of A375 human melanoma cells,and to estimate the effect of the miR-21 inbihitor and miR-494 mimic on the proliferation of A375 cells.Methods A miR-21 inbihitor and a miR-494 mimic were designed and constructed.To optimize the concentration of the miR-21 inbihitor and miR-494 mimic for transfection,six concentrations (70-250 nmol/L) of the inbihitor and mimic were transfected into A375 cells separately by using LipofectamineTM2000.Then,quantitative fluorescence-based PCR was performed to determine the expression of miR-21 and miR-494 in A375 cells.Some A375 cells were classified into five groups:Mock blank control group remaining untransfected,miR-21 inhibitor group transfected with the miR-21 inhibitor,miR-21 control group transfected with the miR-21 inhibitor negative control,miR-494 mimic group transfected with the miR-494 mimic,and miR-494 control group transfected with the miR-494 mimic negative control.Mter another 48-hour culture,the cells were collected for the analysis of cell apoptosis and cycle by using flow cytometry.Meanwhile,Cy5-labelled miR-494 mimic negative control was transfected into A375 cells for the evaluation of the transfection efficiency by using an inverted fluorescence microscope.Results miRNAs were successfully extracted from A375 cells.As quantitative PCR revealed,the A375 cells transfected with the miR-21 inhibitor at 120 nmol/L showed the lowest expression level (2-△△Ct) of miR-21 (average:0.80; range:0.65-0.92),and those transfected with the miR494 mimic at 250 nmol/L displayed the highest expression level of miR-494 (average:126.82; range:111.52-144.22).The transfection efficiency in A375 cells was higher than 90％.Compared with the corresponding negative control groups,the miR-21 inhibitor group and miR-494 mimic group showed increased apoptosis rate ((27.74 ± 1.39)％ vs.(12.93 ± 0.65)％,(34.30 ± 2.35)％ vs.(15.54 ± 1.02)％,both P ＜ 0.01),percentage of G1-phase cells ((61.61 ± 3.25)％ vs.(50.34 ± 5.62)％,(61.05 ± 3.17)％ vs.(49.95 ± 2.58)％,both P＜ 0.05),but decreased proliferation index ((38.39 ± 3.25)％ vs.(49.66 ± 5.62) ％,(38.95 ± 3.17)％ vs.(50.05 ± 2.58)％,both P ＜ 0.05).Conclusions Both the miR-21 inhibitor and miR-494 mimic can promote the G1-phase arrest and apoptosis in A375 cells,and miR-21 may act as a protooncogene accelerating the proliferation of A375 cells,while miR-494 may founction as a tumor suppressor inhibiting the proliferation of A375 cells.
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Objective To screen and identify effective small interfering RNA (siRNAs) targeting the conserved 5’ untrans-lated region (UTR) of the enterovirus 71 (EV71) genome. Methods Double-stranded siRNAs were designed to target the 5’UTR of the EV71 genome. The cytotoxicity effect of siRNAs on rhabdomyosarcoma (RD) cells was evaluated. The cytopathic effect on EV71-infected RD cells was observed under phase-contrast microscopy and the effective siRNAs were screened out by cell viability assay and real-time TaqMan RT-PCR assay. Results All the siRNAs did not exhibit any cytotoxic effects on the viability and growth of RD cells. Transfection of si-1 and si-2 targeting the 5’ UTR in EV71 genome into RD cells signiifcantly delayed and alleviated the cytopathic effects of EV71 infection, increased cell viability and reduced the EV71 RNA transcripts. And the inhibitory effect of si-1/si-2 on EV71 replication was sequence-speciifc. Conclusions The 2 siRNAs (si-1 and si-2) targeting the conserved 5’UTR of the EV71 genome may have broad spectrum antiviral effects on many epidemic EV71 strains.
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Objective To detect gene mutations associated with dapsone-,rifampicin-and ofloxacinresistance in lesions of patients with recurring or treatment-resistant leprosy collected from 2010 to 2011.Methods Clinical data and lesional specimens were collected during 2010-2011 from patients with recurring or treatment-resistant leprosy who were diagnosed and reported by provincial centers for leprosy control.Mycobacterium leprae DNA was extracted from the specimens and subjected to PCR for the amplification of folP1,rpoB and gyrA genes.The PCR products were directly sequenced and BLAST program was used to compare the sequence of isolated strains with the reference sequence in GenBank.Results Twenty-four patients were enrolled in this study,including 13 with recurring leprosy and 11 with treatment-resistant leprosy.Twenty-one patients showed positive PCR results in all the three regions.Of these PCR-positive specimens,3 from 1 patient with recurring and 2 patients with resistant leprosy harbored a point mutation,acc (threonine)→gcc (alanine),at codon 53 in the floP1 gene,1 from a patient with recurring leprosy harbored a missense mutation,gat (aspartic acid) → aac (asparagine),at codon 441 in the rpoB gene.Conclusions Mutations are detected in the folP1 and rpoB genes,which are associated with the resistance to dapsone and rifampicin respectively,but not in the ofloxacin resistance-associated gyrA gene,in Mycobacterium leprae isolates from patients with recurring or treatment-resistant leprosy.
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ObjectiveTo study the epidemiological characteristics of leprosy in China,2001-2010.MethodsData were collected from the database of the national system of leprosy surveillance.A descriptive and comparative analysis was performed.ResultsTotally,15 507 new leprosy cases were detected from 2001 to 2010 with an average case detection rate of 0.118 per 100 000 population.Among these cases,2.7％ were children under 15 years,86.5％ multibacillary,and 22.5％ suffered from grade 2 disability.From 2001 to 2010,a total of 1506 relapse cases were detected,and relapse occurred after multi-drug therapy(MDT) in 464 of these cases.There were significant differences between low and high endemic areas in the proportion of children under 15 years,females,immigrant patients among newly detected patients as well as the proportion of cases of relapse after MDT among all the relapse cases.By the end of 2010,the registered leprosy cases were 6032 with a prevalence rate of 0.450 per 100 000 population,among whom 2886 were under MDT.ConclusionsThe leprosy case detection rate continued to decrease in China from 2001 to 2010 with an unequal distribution.The pocket areas were in Yunnan province,Guizhou province,Sichuan province,Guangdong province,Hunan province and Tibet Autonomous Region.It is warranted to enhance the control of leprosy and reduce the prevalence of disability due to leprosy.
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Objective To select microRNAs (miRNA) associated with human cutaneous malignant melanoma (MM). Methods Total RNA was extracted from 6 tissue samples of MM and 9 human control samples of pigmented nevi, and small RNAs of less than 200 bp were enriched, miRNA microarray was used to select differentially expressed miRNAs between tissue samples of MM and pigmented nevi from 468 candi-dates. The expression of differentially expressed miRNAs was confirmed by fluorescence based real-time quan-titative PCR (qPCR) in all of these samples. Those miRNAs that were identified as differentially expressed with both miRNA microarray and qPCR were considered as significant miRNAs. Results Between the tissue samples of MM and pigmented nevi, 12.18% to 86.33% of miRNAs differentially expressed by more than 2 folds, 1.28% to 19.02% by more than 5 folds, and 0.43% to 5.34% by more than 10 folds. The expression of miRNA-21 was obviously up-regulated, while that of miRNA-320 and miRNA-494 was down-regulated in the MM samples. Conclusion There is an increase in the expression of homo sapiens miRNA-21 but a decrease in that of miRNA-320 and miRNA-494 in MM tissues.
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@#Objective To investigate the psychological status of leprosy people with disability and their expectation towards surgical outcomes before surgical operation.Methods 937 cases from nine provinces，which were covered by the China National Commonweal funded surgical camps, were surveyed by a structure questionnaire designed by the Department of Leprosy Control and Rehabilitation, Institute of Dermatology, the Chinese Academy of Medical Sciences (CAMS).Results Reasons for the patients to refuse the surgical operation included concerns in medical cost (79.19%), unawareness of the free medical surgery program (64.78%), scaring of surgery (48.88%), unwilling to expose their disabilities (46.43%), unwilling to expose their history of leprosy (45.57%), despairing with disability (43.86%), having no ideas on surgical Results (37.46%), believing that disability is an inevitable outcome of the disease (32.98%), and rejecting the operation becasue of age(30.63%). More than 90% of PALs who are willing to accept surgery expected that surgery can improve their physical ability and they may contribute more to their family or become less independent after surgery; however, they thought there was little opportunity to return to work after surgery.Conclusion It is helpful and necessary to understand the psychological status of the leprosy people with disability before surgery.
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@#Objective To observe the effect of stump ulcer repairing in people affected by leprosy (PALs). Methods Bone shortening and osteophyte removal were performed in 73 PALs amputees with stump ulcers. Results All the incisions were healed without any delay. During a follow-up period of 3～12 years, no relapse or new ulcers were found in 70 PALs. 3 PALs developed new ulcers, which were healed after debridement, resting, and prosthesis repairing. Conclusion Surgical revision of the bone in amputation stump can change the local distribution of pressure. Postoperative self-care teaching to the PALs and their sustaining daily self-care will finally prevent them from stump ulcer recurring.
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Objective To investigate the expression of microRNA-21(miRNA-21)in two human malignant melanoma cell lines,A375 and M14,and its effect on the viability of these cells.Methods The expression of human miRNA-21 was assessed by quantitative fluorescent PCR in A375 and M14 cells.Then,three concentrations(90,180,270 nmol/L)of miRNA-21 inhibitor and were transfected both cells and a negative control were transfected a mixture of LipofectamineTM 2000 reagent,respectively.After another 3-day culture,the proliferation of cells was detected by cell counting kit-8,and R value was calculated to denote the relative activity of cells.Statistical analysis was carried out by SPSS13.0.Results The expression of miRNA-21 was higher on A375 cells than that on M14 cells with the average value of 2-deltaCT being 1.2928±0.1509 vs 0.1894±0.1803.With miRNA-21 inhibitor at the concentration of 90,180,270 nmol/L,the activity of A375 cells was significantly lowered in comparison with that in the control group,with the R value being 0.7362±0.1662.0.7248±0.3204 and 0.6767±0.2998 respectively(all P＜0.01).However,in the case of M14 cells,cell activity was only suppressed by miRNA-21 inhibitor at 90 nmol/L with the R value being 0.7295±0.1478.and no significant inhibition was observed with the inhibitor at 180 or 270 nmol/L (both P＞0.05).Conclusions miRNA-21 is expressed on human melanoma cell lines,A375 and M14,at different levels,with a promoting effect on the proliferation of both cells.Moreover,miRNA-21 may act as an oncogene-like gene via down-regulating the expression of some tumor-inhibiting factors.