ABSTRACT
Objective:To construct a clinical predictive model of severe adenovirus pneumonia(SAP)in children using random forest and verify it.Methods:The clinical, laboratory and imaging data of 542 children with adenovirus pneumonia treated in Tianjin Children′s Hospital from January 2019 to January 2021 were analyzed retrospectively.The research object was randomly divided into training dataset and validation dataset(8∶2).The training dataset screened the predictors of SAP of pneumonia through random forest and established a prediction model, and the prediction model was expressed visually by the nomogram.In the validation dataset, the receiver operating characteristic curve(ROC)and sensitivity, specificity, error rate and confusion matrix were used to validate it.Results:A total of 439 children were in the training dataset, and 187 cases(42.60%)of the training data was divided as severe type.A total of 103 children were in validation dataset, and 44 cases(42.71%)of the validation dataset was divided as severe type.The percentage of monocytes(M%), PLT, AST, IL-6, the peak of body temperature, pulmonary inflammation of the consolidation and patchy shadowing were independent predictors of SAP in children.The area under the ROC curve of the training dataset and the validation dataset was 0.95(95% CI: 0.92~0.98)and 0.92(95% CI: 0.82~0.99), respectively.The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the training dataset were 0.994, 1.000, 0.987, 0.998, 1.000 and in validation dataset were 0.752, 0.990, 0.514, 0.945 and 0.857, respectively. Conclusion:The predictive model has good discriminant ability, and the early clinical and hematological indexes are helpful to improve the identification and screening of SAP in children.
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Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) in diagnosis and treatment of rectal carcinoid tumom, and the safety and efficacy of endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. Methods All the submucous tumor considered rectal carcinoid tumor received EUS examination and according to the result to select appropriate therapeutic regimen. Results All the 45 lesions were verified rectal carcinoid tumors by pathological examination. 42 patients received endoscopic submucosal dissection. Two tumors invaded into the muscularis propria and one tumor invaded beyond serosa and with lymph node metastasis received surgical strategy. Conclusion EUS can be used to determine surgical strategy for rectal carcinoid tumor for it provides precise information of the size, depth, border, muscularis propria or vessel infiltration of the tumor. For rectal carcinoid tumors smaller than 20 mm in diameter, ESD is safe and effective.
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Objective: To investigate the role of the recombinant S protein of SARS-CoV in the induction of chemokine IP-10 and other cytokines in airway epithelial cells and immunocytes. Methods: Using insect-baculovirus expression system and Nickel affinity Magnet Beads, S protein of SARS-CoV was produced and then used to stimulate cultured human bronchial epithelial cells (16HBE), human peripheral blood mononuclear cells(PBMC), human peripheral blood monocytes and alveolar macrophages. The levels of IP-10 and the cytokines involved in immunoreaction in response to virus infection were detected in the supernatants of those cells cultured with the S protein by liquid chip system. Results: Under normal condition, no detectable IP-10 was found in 16HBE. A high level of IP-10(79.97? 13.81) pg/ml was detected in the 16HBE 12 hrs after being treated with the S protein, and the induction of IP-10 by S protein displayed at a significant quantity-effect reaction, but not in PBMC, monocytes and alveolar macrophages. In contrast, IFN-? was able to induce the production of IP-10 in either 16HBE or the immunocytes. Conclusion: 1.S protein of SARS-CoV can induce a high level of IP-10 in lung epithelial cells at early stage after the virus infection, which may initiate the process of the immune damage in the lung. 2. S protein of SARS-CoV induces the production of IP-10 by a way of IFN-? independent.
ABSTRACT
AIM: To investigate the molecular mechanism by which the SARS-CoV S protein induces chemokine IP-10 in airway epithelial cells.METHODS: cDNA microarrays were used to screen the gene expression profiles of human bronchial epithelial cells(16HBEs) stimulated by SARS-CoV S protein.In addition,RT-PCR,EMSA,and Western blotting were performed to analyze the phosphorylation of JAK/STAT signal pathway.The changes of IRF-1 and IP10 gene expression and the influence by the corresponding inhibitors were analyzed.RESULTS: IRF-1,a key transcription factor of the JAK/STAT signal pathway,was activated in human bronchial epithelial cells after stimulation by the S protein of SARS-CoV.The IP-10 gene expression was detected 2 h following the phosphorylation of STAT1 after 15 min,which was blocked by STAT1or JAK2 inhibitors.Electrophoretic mobility shift assay(EMSA) demonstrated that the nuclear proteins bound to ISRE and GAS but not NF-?B DNA motif.CONCLUSION: The SARS-CoV S protein induces IP-10 gene expression in human bronchial epithelial cells through activation of the JAK/STAT signal pathway,suggesting that the JAK/STAT signal pathway activated by virus plays key roles in virus infection related acute lung injury.