Tight junction protein expression of gastric mucosa and its significance in children with Helicobacter pylori infection / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the junction protein expression of gastric mucosa including occlusal proteins (occludin), closed protein-4 (claudin-4), zonula occluden-1(ZO-1), epithelial cadherin (E-cadherin), and β ring protein (β-catenin) and the clinical significance in children with Helicobacter pylori (Hp) infection.</p><p><b>METHOD</b>Seventy patients in whom gastric endoscopy was performed because of nausea, vomiting, abdominal pain, bloating, acid reflux, melena, and other gastrointestinal symptoms were enrolled in this study from Dec. 2010 to Apr. 2013 in our hospital. Informed consent was signed by their parents, and the study was in accordance with the principles of medical ethics. Hp positivity was confirmed if both respiratory urea test (RUT) and Hp were positive by gastric mucosal pathology. Gastric mucosal samples from 70 patients were enrolled in this study, 23 of them were Hp negative, 47 of them were Hp positive (24 cases without peptic ulcer, 23 cases with peptic ulcer). The mRNA levels and protein expression of tight junction protein of gastric mucosa were measured by RT-PCR and Western blot respectively. The location and semi quantitative content of E-cadherin and β-catenin in gastric mucosa were detected by immunohistochemical staining method.</p><p><b>RESULT</b>The mRNA level of E-cadherin, β-catenin, ZO-1 in the Hp positive group regardless of peptic ulcer was significantly lower than that in the Hp negative group. Hp positive without peptic ulcer group were 0.0008, 0.0040, 0.0014, respectively; Hp positive with peptic ulcer group were 0.0010, 0.0090, 0.0013, respectively; Hp negative group were 0.0137, 0.0423, 0.0198, respectively (F values were 36.956, 39.893, 38.962, respectively, all P<0.05). The expression of claudin-4 mRNA in Hp positive group with peptic ulcer increased significantly, the difference among Hp positive group with peptic ulcer, Hp positive group without peptic ulcer and Hp negative group was statistically significant (0.1438 vs. 0.0926 vs. 0.0789) (F value was 11.964, P<0.05), while the difference of occludin mRNA levels among the three groups was not statistically significant.Immunohistochemistry results showed that the score of E-cadherin, β-catenin positive cell in the Hp positive patients were also significantly lower than that in the Hp negative group (t values were 3.981 and 2.340, all P<0.05, respectively). Western blot results showed that the protein levels of β-catenin in Hp positive group with peptic ulcer were significantly lower than that in Hp negative group, while the protein levels of E-cadherin in Hp positive patients regardless of peptic ulcer were decreased significantly in Hp negative group.</p><p><b>CONCLUSION</b>Our results revealed that the tight junction protein E-cadherin, β-catenin, ZO-1 expression of gastric mucosa were decreased in children with Hp infection, while claudin-4 expression was increased in Hp positive patients with peptic ulcer, suggesting that damage to gastric epithelial barrier function may be the main pathogenesis of Hp associated gastric diseases in children.</p>

Application of combined detection of sputum and serum procalcitonin in infants with community acquired pneumonia / 中国小儿急救医学

Objective To evaluate the effects of combined detection of sputum and serum procalcitonin (PCT) to identify the etiology of community acquired pneumonia(CAP) in infants.Methods Retrospective analysis from August 2010 to September 2012 enrolled 435 patients with definitely etiological diagnosis of CAP.The all cases were divided into three groups according to the etiological diagnosis:243 cases of bacterial infection group(including mixed bacterial infection),106 cases of viral infection group,and 86 cases of mycoplasma infection group.Sputum and serum PCT levels in all cases were detected,with simultaneous detection of blood leukocytes,C-reactive protein levels.Results Sputum PCT level of bacterial infection group [(8.44 ± 1.08) ng/ml] was significantly higher than viral infection group [(0.32 ±0.12) ng/ml] and mycoplasma infection group [(0.24 ± 0.17) ng/ml],which showed statistically significant difference (F =765.03,P ＜0.01).Serum PCT level of bacterial infection group [(6.69 ± 1.36) ng/ml] was also higher than viral infection group [(0.37 ± 0.22) ng/ml] and mycoplasma infection group [(0.42 ± 0.28) ng/ml],the difference of which was statistically significant (F =240.46,P ＜ 0.01).Meanwhile between the viral infection group and mycoplasma infection group,sputum PCT and serum PCT showed no significant difference (P ＞ 0.05).The levels of blood leukocytes and C-reactive protein among 3 groups showed no statistically significant difference(P ＞ 0.05).As the critical value of the PCT ＞ 0.5ng/ml,the positive rates of sputum and serum PCT were significant difference in bacterial infection group (86.83％ vs 73.66％,x2 =13.92,P ＜0.05).The sensitivity of diagnosing bacterial CAP by sputum and serum PCT levels were 86.83％ and 73.66％,the specificity were 86.98％ and 88.54％,respectively.The sensitivity and specificity of combined detection sputum and serum PCT were 72.02％ and 94.27％.Conclusion Combined detection of sputum and serum PCT has clinical value and efficiency in pathogen identification of CAP.

Analysis on clinical manifestations and drug resistance of Escherichia coli pneumonia in infants / 临床儿科杂志

Objective To investigate the clinical features of Escherichia coli pneumonia, the positive rate of extend-spectrumβ-lactamase (ESBLs) produced by Escherichia coli and antimicrobial resistance of Escherichia coli. Methods Three hundred and thirty-six infants with Escherichia coli pneumonia were divided into community acquired infection group and hos-pital acquired infection group from Jun 2003 to Jun 2013. The clinical data of those patients were collected and analyzed. The ESBLs were examined, and drug susceptibility results were analyzed. Results Infants under 6 months had higher infective rate of Escherichia coli. The Escherichia coli pneumonia had similar clinical manifestations as Gram negative bacterial pneumonia. ESBLs were found in most strains (58.3%, 196/336), positive rate of ESBLs of hospital acquired infection group (84.00%) was higher than that of community acquired infection group (50.96%) (χ2=26.17, P0.05). The ESBLs positive rate of hospital acquired infection group was significantly increased from 76.74%(Jun 2003-May 2008) to 93.75% (Jun 2008-Jun 2013) (χ2=3.95, P<0.05). The most sensitive antibiotic was carbapenem. Conclusions Escherichia coli pneumonia mainly occurs in infants, usually with severe clinical situations and more persistent. The hospital acquired infection is the high risk factor of acquiring ESBLs. Antibiotics should be prescribed depending on community acquired infection or hospital acquired infection.

Correlation between Helicobacter pylori infection in oral cavity and Helicobacter pylori infection in stomach in children / 国际儿科学杂志

Helicobacter Pylori (Hp) is closely related to gastrointestinal diseases.Some scholars have proposed that Hp resides in the oral cavity and oral Hp is related to stomach Hp.The oral cavity has been implicated as a potential Hp reservoir and therefore may be involved in the reinfection or replapse of the stomach Hp after treatment of Hp infection.