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Background@#and Purpose Most of the knowledge of Mycoplasma pneumonia (M. pneumoniae) encephalitis (MPE) in children is based on case reports or small case series. This study aimed to describe the clinical features and prognostic factors of MPE, and the efficacy of azithromycin with or without immunomodulatory therapy. @*Methods@#The medical data of 87 patients with MPE from 3 medical centers in southwestern China over a 7-year period were reviewed. @*Results@#MPE was found in children of all ages except for neonates. The most common neurological manifestations included consciousness disturbance (90%) and headache (87.4%), the most common extraneurological manifestations included fever (96.5%) and respiratory system involvement (94.3%); multisystem involvement (98.2%) and elevated C-reactive protein (CRP) (90.8%) were also prominent. M. pneumoniae was detected in cerebrospinal fluid (CSF) less often than in blood and respiratory tract secretions. Azithromycin with intravenous immunoglobulin or/and corticosteroid treatment can shorten the hospitalization duration and the clinical improvement process. Most patients (82.8%) received a favorable prognosis; serum lactate dehydrogenase (LDH) and CSF protein levels were higher in the poor-outcome group than in the good-outcome group (p<0.05). Neurological sequelae are likely to continue when the onset of this condition occurs during teenage years. @*Conclusions@#MPE generally presented with nonspecific clinical manifestations. In children with acute encephalitis accompanied by multi-system involvement and prominently elevated CRP, M. pneumoniae should be considered as a possible pathogen. Immunomodulating therapies should be recommended regardless of the duration of the prodromal period. High CSF protein
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Objective:To investigate the trends of changes in oxidative stress and inflammatory factor levels in intestine tissues of mice during aging, and to explore their significance in the aging process.Methods:Four-month-old and 20-month-old male C57BL6 mice were used, with 3 mice in each group.The mice were sacrificed under anesthesia, and serum, liver, spleen, kidney, intestine and lung tissues were collected.Age-related changes in expression levels of inflammation-related proteins in serum, intestine, liver, spleen, kidney and lung were detected and analyzed by cytokine antibody arrays.Immunohistochemistry was used to examine aging-related changes of adiponectin in tissues and 8-oxoguanine (8-oxoG) levels in intestinal tissues.Results:Cytokine microarrays revealed that levels of adiponectin in the intestine and serum were significantly higher in 20-month-old mice than those in 4-month-old mice ( t=5.370, 23.490, both P<0.05). Immunohistochemistry results showed that expression levels of 8-oxoG in 20-month-old mice were significantly higher than those in 4-month-old mice ( t=8.785, P<0.05). Furthermore, in intestine tissue, expression levels of adiponectin were significantly higher in 20-month-old mice, compared with 4-month-old mice ( t=24.530, P<0.05). However, there was no significant difference in adiponectin levels in spleen, kidney, lung and liver tissues between young and aged mice. Conclusions:Adiponectin levels in serum and intestine tissue increase with age and have the potential to be used as a specific intestinal tissue biomarker of aging.
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Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.
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Objective To investigate the changes and clinical significance of plasma N‐terminal pro‐brain natriuretic peptide (Nt‐proBNP) in patients with asphyxia of newborns combined with myocardial injury .Methods Fifty‐eight term neonates with neonatal asphyxia born within 24 h were included in our study ,18 of the 25 severe asphyxia cases were combined with myocardial injury ,15 of 33 mild asphyxia cases were with myocardial injury ,there were 25 subjects were not cardiac injured after asphyxia to‐tally .Patients of the same age without asphyxia or any cardiovascular disease were recruited into the control group .Levels of plasma Nt‐proBNP and creatine kinase isoenzyme (CK‐MB) were detected on the first ,third and the fifth days after birth for statistical a‐nalysis .Results On the first and third days after birth ,levels of plasma Nt‐proBNP in severe and mild asphyxia combined with my‐ocardial injury group were significantly higher than the groups without myocardial injury and the control (P0 .05) .On the first day after birth ,levels of Nt‐proBNP ,CK‐MB were positively corre‐lated in the mild asphyxia group (r=0 .58 ,P<0 .05) and severe asphyxia group (r=0 .47 ,P<0 .05) .On the first day after birth , the cutoff value for myocardial injury was 695 .87 fmol/mL ,the area under the ROC curve was 0 .763 ,with the sensitivity of 71 .9%and specificity of 65 .4% ,the positive predictive value was 73 .3% and negative predictive value was 63 .8% .Conclusion The Nt‐proBNP level has important clinical value for early evaluation of the severity of myocardial injury after asphyxia .
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Maple syrup urine disease (MSUD) is a rare inherited disorder of branched-chain amino acid metabolism presenting with life threatening encephalopathy and maple syrup odor in urine in affected individuals.Blood levels of branched-chain amino acids(BCAA) significantly increase.It is classified into 5 forms according to the clinical course,and classified 4 molecular phenotypes based on the affected locus of the branched chain αr-ketoacid dehydrogenase complex.Treatment of MSUD is divided into acute decompensation stage treatment and life-long dietary restriction treatment.