Advances in clinical diagnosis and treatment of drug-induced liver injury in children / 中华肝脏病杂志

Drug-induced liver injury (DILI) is one of the most common adverse drug reactions that may seriously threaten the health of children and is receiving increasing clinical attention day by day. There is still no independent diagnosis and treatment guideline for DILI in children, but its clinical features are not completely similar to those in adults. This article reviews the epidemiology, clinical features, diagnosis, and treatment progress in order to provide a reference for the management of DILI in children.

Application of ITO Method in Determination of Special Half-Sibling Relationship / 法医学杂志

OBJECTIVES@#To identify whether the relationship between Zhang A, Zhang B, Zhang C and Zhang X is the half-sibling relationship whose mother is sister (hereinafter referred to as the special half-sibling relationship) or the common first cousin relationship and discuss the application of ITO method in discriminating the special kinship.@*METHODS@#DNA was extracted from blood stain of four identified individuals, PowerPlex® 21 System and AGCU 21+1 STR kit were used to detect autosomal STR genetic markers. Investigator® Argus X-12 QS kit was used to detect the X chromosome STR genetic markers, the special half-sibling index (SHSI) and first cousin index (FCI) and their likelihood ratio (LR) were calculated by ITO method.@*RESULTS@#The LR results of SHSI to FCI, which were calculated based on autosomal STR genotyping and the analysis of X-STR genotyping results suggested that the relationship between Zhang A, Zhang B, Zhang C and Zhang X was inclined to be a special half-sibling relationship.@*CONCLUSIONS@#For the identification of special kinship, it is necessary to comprehensively apply various genetic markers according to the case. After the conclusion that shared alleles cannot be excluded from the analysis, ITO method can be further used to establish discriminant assumptions according to the specific case to obtain objective and reliable identification opinions.

Research advances in the treatment strategies for severe pertussis in children / 中国当代儿科杂志

At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.

Effect of pertussis vaccination on clinical manifestations of infants and young children with pertussis / 中国当代儿科杂志

OBJECTIVE@#To study the effect of pertussis vaccination on the clinical manifestations of infants and young children with pertussis.@*METHODS@#A retrospective analysis was performed to investigate the differences in clinical manifestations and peripheral blood cell levels between pertussis children with different pertussis vaccination status.@*RESULTS@#A total of 1 083 children with pertussisat at age of < 3 years were enrolled, with 551 children in the unvaccinated group and 532 in the vaccinated group. Of all the children, 392 had an age of onset of < 3 months (372 were unvaccinated and 20 were vaccinated) and 691 children had an age of onset of ≥ 3 months (179 were unvaccinated and 512 were vaccinated). Compared with the vaccinated group, the unvaccinated group had a longer length of hospital stay and a higher incidence rate of respiratory failure (@*CONCLUSIONS@#Pertussis vaccination can reduce the incidence of severe pneumonia and respiratory failure and alleviate the severity of respiratory complications in infants and young children with pertussis.

Selection of enteral nutrition regimens for children with abdominal Henoch-Schönlein purpura / 中国当代儿科杂志

OBJECTIVE@#To explore the reasonable and effective enteral nutrition regimen for children with abdominal Henoch-Schönlein purpura (HSP).@*METHODS@#A retrospective analysis was performed on the medical data of children with abdominal HSP who were hospitalized from August 2013 to August 2018. According to the starting time of enteral nutrition after abdominal pain relief, the children were divided into three groups: < 24 hours (@*RESULTS@#The retrospective analysis showed that the children who were given extensively hydrolyzed lactoprotein formula for enteral nutrition at 24-48 hours after abdominal pain relief had a lower recurrence rate of clinical symptoms and the highest degree of satisfaction among their family members (@*CONCLUSIONS@#It is reasonable and effective to start the feeding with extensively hydrolyzed lactoprotein formula at 24-48 hours after abdominal pain relief in children with abdominal HSP.

A molecular epidemiological study of pediatric norovirus gastroenteritis, 2017-2019 / 中国当代儿科杂志

OBJECTIVES@#To study the molecular epidemiological characteristics of norovirus in children with acute gastroenteritis from 2017 to 2019.@*METHODS@#A retrospective analysis was performed on the medical data of children with acute gastroenteritis who were admitted to Children's Hospital of Chongqing Medical University from January 2017 to December 2019. A total of 1 458 stool samples were collected from the children, and viral RNA was extracted. Reverse transcription polymerase chain reaction was used for gene amplification, sequencing, and genotype identification of the VP1 region of capsid protein in norovirus.@*RESULTS@#Among the 1 458 stool samples, 158 (10.8%) were positive for norovirus. There was no significant difference in the positive detection rate of norovirus between different years (@*CONCLUSIONS@#Norovirus GII.4 Sydney 2012 was the major epidemic strain in the children with norovirus gastroenteritis from 2017 to 2019. Although norovirus infection can exist throughout the year, August to October is the peak period. During this period, norovirus surveillance and key population protection are strengthened to help prevent and control norovirus diarrhea.

Clinical characteristics and drug sensitivity in children with invasive pneumococcal disease: a multicenter study / 中国当代儿科杂志

OBJECTIVE@#To study the clinical characteristics, drug sensitivity of isolated strains, and risk factors of drug resistance in children with invasive pneumococcal disease (IPD).@*METHODS@#The clinical characteristics and drug sensitivity of the isolated strains of 246 hospitalized children with IPD in nine grade A tertiary children's hospitals from January 2016 to June 2018 were analyzed.@*RESULTS@#Of the 246 children with IPD, there were 122 males and 124 females. Their ages ranged from 1 day to 14 years, and among them, 68 (27.6%) patients were less than 1 year old, 54 (22.0%) patients were 1 to 2 years old, 97 (39.4%) patients were 2 to 5 years old, and 27 (11.0%) patients were 5 to 14 years old. Pneumonia with sepsis was the most common infection type (58.5%, 144/246), followed by bloodstream infection without focus (19.9%, 49/246) and meningitis (15.0%, 37/246). Forty-nine (19.9%) patients had underlying diseases, and 160 (65.0%) had various risk factors for drug resistance. The isolated Streptococcus pneumoniae strains were 100% sensitive to vancomycin, linezolid, moxifloxacin, and levofloxacin, 90% sensitive to ertapenem, ofloxacin, and ceftriaxone, but had a low sensitivity to erythromycin (4.2%), clindamycin (7.9%), and tetracycline (6.3%).@*CONCLUSIONS@#IPD is more common in children under 5 years old, especially in those under 2 years old. Some children with IPD have underlying diseases, and most of the patients have various risk factors for drug resistance. Pneumonia with sepsis is the most common infection type. The isolated Streptococcus pneumoniae strains are highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone in children with IPD.

Proteomics and Its Application in Forensic Pathology / 法医学杂志

Proteomics has become one of the hot topics in modern life sciences. Its application prospects have been confirmed in clinical medical research, such as the discovery of new disease biomarkers, identification of disease-related proteins, and development of new drug targets. However, in the field of forensic science, especially in forensic pathology, it is still in the stage of exploration. This paper reviews the research techniques and the use of proteomics in forensic pathology in domestic and foreign scholars, in order to provide new ideas for the research and application of forensic pathology.

The analysis of allelic deletion in 4 cases of Amelogenin loci in paternity testing / 复旦学报（医学版）

Objective To apply PowerPlex(R) 21 System Kit and AGCU 21 + 1 STR Fluorescence Detection Kit as supplementary detection kit in some samples with Amelogenin locus X deletion.Methods While with the help of Investigator Argus X-12 Kit,MicroreaderTM 19X ID System kit and the application of capillary electrophoresis,the complete X pattern of these four samples can be identified.Results From Mar,2013 to Dec,2016,4 cases of male samples with Amelogenin locus X deletion have been found.Conclusions Sometimes Amelogenin locus X deletion may happen when using PowerPlex(R)21 System Kit and AGCU 21 + 1 STR Fluorescence Detection Kit,while validating with other forensic biology detection kit can assure the accuracy of genotyping.

Progress in Association between Genetic Correlation and Human Violent Behavior / 法医学杂志

Human violent behavior is a complex behavior which is influenced by genetic and environmental factors. There is a trend in investigating the mechanism of violent behavior by using the genetic methods. This article reviews several candidate genes and advances in epigenetics which are associated with violent behavior. The prospects and significance of violent behavior research from the view of gene polymorphism and epigenetics are also discussed.

Phosphoproteomics Analysis of Endometrium in Women with or without Endometriosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The molecular mechanisms underlying the endometriosis are still not completely understood. In order to test the hypothesis that the approaches in phosphoproteomics might contribute to the identification of key biomarkers to assess disease pathogenesis and drug targets, we carried out a phosphoproteomics analysis of human endometrium.</p><p><b>METHODS</b>A large-scale differential phosphoproteome analysis, using peptide enrichment of titanium dioxide purify and sequential elution from immobilized metal affinity chromatography with linear trap quadrupole-tandem mass spectrometry, was performed in endometrium tissues from 8 women with or without endometriosis.</p><p><b>RESULTS</b>The phosphorylation profiling of endometrium from endometriosis patients had been obtained, and found that identified 516 proteins were modified at phosphorylation level during endometriosis. Gene ontology annotation analysis showed that these proteins were enriched in cellular processes of binding and catalytic activity. Further pathway analysis showed that ribosome pathway and focal adhesion pathway were the top two pathways, which might be deregulated during the development of endometriosis.</p><p><b>CONCLUSIONS</b>That large-scale phosphoproteome quantification has been successfully identified in endometrium tissues of women with or without endometriosis will provide new insights to understand the molecular mechanisms of the development of endometriosis.</p>

Genotyping and parental related methylation of SNRPN gene rs220030 / 法医学杂志

OBJECTIVE@#To establish two methods by denaturing gradient gel electrophoresis (DGGE) and pyrosequencing for genotyping rs220030 (a SNP in the promoter region of small nuclear ribonucleoprotein polypeptide N, SNRPN). To establish an analytical technique for detecting CpG methylation status by pyrosequencing and to further investigate the feasibility of applying rs220030 to the determination of parental origin allele.@*METHODS@#The rs220030 of 97 blood samples from individuals of Shanghai Han population were genotyped by DGGE, meanwhile the rs220030 of 25 blood samples of them were genotyped by pyrosequencing to compare the two methods in genotyping SNP. Pyrosequencing united bisulfite conversion method was applied to detect CpG methylation status of region upstream rs220030 of two random blood genealogical samples and investigate whether the methylation status was parental related.@*RESULTS@#The rs220030 genotyping results of 97 blood samples detected by DGGE were 20 C homozygote, 29 T homozygote, and 48 C/T heterozygote. Twenty-five blood samples genotyped by pyrosequencing showed the same result with DGGE. The CpG methylation status of region upstream rs220030 of the child was similar to the mother.@*CONCLUSION@#Compared with DGGE, pyrosequencing is more accurate, convenient, and suitable for large samples and high throughput SNP genotyping. Pyrosequencing united bisulfite conversion can be used to detect CpG methylation status precisely. It is feasible to apply rs220030 to parental origin allele determination.

Cross-sectional investigation of visual impairing diseases in Shanghai blind children school / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School (SBCS) can provide useful information on childhood blindness in Shanghai.</p><p><b>METHODS</b>A cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness (WHO/PBL) eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS.</p><p><b>RESULTS</b>Of the 146 children observed, 80 children (54.8%) were blind (best corrected best visual acuity less than 0.05), 27 children (18.5%) had severe visual impairment (best corrected visual acuity less than 0.1 but better than or equal to 0.05), and 34 children (23.3%) had moderate visual impairment (best corrected visual acuity less than 0.3 but better than or equal to 0.1). The major affected anatomic sites in the 107 children with severe visual impairment and blindness (SVI/BL) were retina (47.7%), whole globe (16.8%), optic nerve (13.1%) and lens (9.3%). The leading causes of SVI/BL were retinopathy of prematurity (ROP, 25.2%), followed by retinal dystrophy (15.9%), optic nerve atrophy (9.3%) and microphthalmos (9.3%). The two leading etiologic categories of SVI/BL were perinatal/neonatal (36.4%) and congenital/hereditary groups (29.0%). The leading cause of moderate visual impairment was aphakia after cataract surgery (congenital cataract, 44.1%). Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens (cataract and aphakia) significantly decreased.</p><p><b>CONCLUSIONS</b>The leading cause of childhood blindness in SBCS nowadays is ROP. It is projected that without improvement in perinatal medical care that ROP will continue to be a major cause of childhood blindness.</p>

Polymorphism study of small nuclear ribonucleoprotein polypeptide N gene rs220030 by DGGE / 法医学杂志

OBJECTIVE@#To analyze the polymorphism of rs220030, a SNP which is located in the promoter region of small nuclear ribonucleoprotein polypeptide N (SNRPN) gene in the Chinese Han population and to obtain the data of population genetics.@*METHODS@#The denaturing gradient gel electrophoresis (DGGE) method was applied to detect the polymorphism of rs220030 in 100 unrelated and healthy individuals from the Shanghai Han population. The genotyping result of this SNP was confirmed by TaqMan assay in some typical samples.@*RESULTS@#DGGE results showed 4 bands for CT heterozygote, and 1 band for CC or TT homozygote, and those results were confirmed by The TaqMan SNP genotyping assays. Genotyping results showed 34 individuals with CC, 41 with CT and 25 with TT of rs220030. The allele frequencies for C and T were 0.545 and 0.455, respectively. H was 0.500, PIC was 0.373, DP was 0.654, and PE was 0.186. The distribution of genotype frequencies were in Hardy-Weinberg equilibrium.@*CONCLUSION@#DGGE is a quick and effective method in the analysis of SNP polymorphism in small population. Statistical parameters of rs220030 for forensic evaluation meet the requirements for forensic identification and paternity testing.

Estimation of early postmortem interval using beta-actin mRNA in rat's brain, heart and kidney / 法医学杂志

OBJECTIVE@#To explore the relationship between beta-actin mRNA degradation in SD rat's brain, heart and kidney and early postmortem interval (PMI) in order to find new markers for estimating early PMI.@*METHODS@#Rats were sacrificed and kept in the place at a temperature of 20 degrees C. The total RNA were extracted from the brain, heart and kidney at different PMI points. Real time RT-PCR was applied to determine beta-actin mRNA levels in total RNA and the results were given in the form of Ct values. Linear relationships between PMI and Ct values were obtained and the functions of linear regression were established.@*RESULTS@#The great decrease of beta-actin mRNA level were observed in the three organs. The degradation rate was obviously higher in 24 hours after death in the heart and kidney. However, there were no significant changes in the brain. The changes of Ct values and PMI showed a good linear relationship.@*CONCLUSION@#beta-actin mRNA in rat's brain, heart and kidney degrades obviously after death and can be used for estimating early PMI by its degradation rules.

Clinical significance of histopathologic and ultrastructural pathologic examination in etiological diagnosis of infantile cholestatic diseases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the features of histopathologic and ultrastructural pathologic changes of liver biopsy in patients with infantile cholestatic disease, and to investigate its diagnostic significance combining with the clinical data.</p><p><b>METHODS</b>Thirty-six children diagnosed as infantile cholestatic disease and received liver biopsy in Chongqing Medical University Children's Hospital from Jun 2007 to Oct 2008 were enrolled and the pathologic and ultrastructural pathologic changes of liver were analyzed.</p><p><b>RESULTS</b>Morphologic changes under light microscope in liver tissues included hepatocyte swelling, hepatocyte denaturation, hepatocyte necrosis, multinucleated giant cell formation, bile duct proliferation, fiber tissues proliferation and inflammatory cells infiltration in liver lobules and portal regions. The characteristics of cholestasis including intralobular cholestasis, acinus formation, feather-like cytoplasmic filaments and bile stasis in bile canaliculi were observed. The morphologic changes of biliary atresia were observed in 7 cases whose image investigations showed no obstruction of biliary tract. Nuclear changes, resolution of cytoplasm, inflammatory cell infiltration, collagen fiber proliferation and increased number of lysosomes were observed under electromicroscope. Two cases of glycogen storage disease, 1 case of Niemann-Pick disease and 1 case of lipid storage disease with unknown cause were confirmed by the combination of histological changes and clinical manifestations.</p><p><b>CONCLUSION</b>Common pathologic changes of liver tissues existed under light microscope or electroscope. The diagnosis of hereditary metabolic disorders could be made increasingly by application of these two technologies in clinical practice. It is difficult to diagnose biliary atresia in early childhood by image investigations and the pathological changes of liver tissues are helpful.</p>

Studies on chemical constituents of Astragalus dahuricus / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents in Astragalus dahuricus.</p><p><b>METHOD</b>The compounds were isolated and purified by column chromatography on silica gel and HPLC, and their structures were elucidated by their spectroscopic evidences.</p><p><b>RESULT</b>Six compounds were identified as: 7, 2'-dihydroxy-3', 4'-dimethoxyisoflavan (1), 2'-hydroxy-3', 4'-dimethoxyisoflavan-7-O-beta-D-glucopyranoside (2), 8, 2'-dihydroxy-7, 4'-dimethoxyisoflavan (3), 7-hydroxy-4'-methoxyisoflavone (4), 7, 3'-dihydroxy-4'-metho-xyisoflavone (5), 9, 10-dimethoxypterocarpan-3-O-beta-D-glucopyranoside (6).</p><p><b>CONCLUSION</b>Compounds 1-6 were obtained from this plant for the first time.</p>

Over-expression of the cellular repressor of E1A-stimulated genes inhibits the apoptosis of human vascular smooth muscle cells in vitro / 生理学报

To investigate the effects and molecular mechanisms of the cellular repressor of E1A-stimulated genes (CREG) on the apoptosis of vascular smooth muscle cells (VSMCs), the human internal thoracic artery-Shenyang (HITASY) cells were infected with sense-CREG [pLNCX(2)(+)/CREG] and antisense-CREG [pLXSN(-)/CREG] retrovirus respectively. The stably infected cells were obtained by screening the G418-resistant clones. DAPI nuclei staining and Annexin V/PI FASC assay indicated that over-expression of CREG in HITASY cells infected with pLNCX(2) (+)/CREG inhibited VSMC apoptosis induced by serum deprivation, accompanied with decreased expression of caspase-9 mRNA detected by RT-PCR. Furthermore, Western blot analysis showed that p38 mitogen activated protein kinase (p38 MAPK) expression and activation were significantly enhanced in HITASY cells infected with pLNCX(2) (+)/CREG. The inhibition of CREG protein expression in cells infected with pLXSN(-)/CREG promoted the VSMC spontaneous apoptosis, as well as down-regulated p38 MAPK expression and activation, when cells were cultured with 10% fetal bovine serum (FBS) mediums. These results implicate that the CREG protein has the ability to regulate VSMC apoptosis in which the activation of p38 MAPK is possibly involved. To further identify the role of p38 MAPK in VSMC apoptosis, SB203580, a specific inhibitor of p38 MAPK, was used to inhibit p38 MAPK activity. When p38 MAPK signaling pathway was blocked, the effects that over-expression of CREG protein inhibited VSMC apoptosis disappeared. Taken together, the present work indicates that over-expression of CREG protein inhibits VSMC apoptosis, and this inhibitory effect is partly mediated by p38 MAPK signaling pathway.

PreS/S gene mutations in HBV in children infected through mother-to-infant transmission and in their mothers / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the characteristics of mutations in PreS/S gene of HBV in children infected through mother-to-infant transmission and in their mothers with different degree of viremia.</p><p><b>METHODS</b>There were 15 pairs of child and mother in this study. Mothers of all children were chronic asymptomatic HBsAg carrier (ASC) before pregnancy and the children were not inoculated against HBV after birth. Anti-HBV medicine was never administrated to all subjects. The serological markers of hepatitis A, B, C, D and E virus were tested and the titers of serum HBV DNA were quantitated. PreS/S gene was amplified by PCR and cloned into pGEM-T vector with T-A cloning technique. The recombinant plasmid pGEM-PreS/S was confirmed by digestion with restriction enzyme ApaI and SacI. Two clones were selected to be sequenced from each patient.</p><p><b>RESULTS</b>According to the degree of viremia in every pair of mother and child, 15 pairs of child and mother were divided into three groups: group A (both children and mothers had high viremia with HBeAg-positive), group B (high in children and low in mothers with anti-HBe positive), and group C (low in children and high in mothers), and there were 5 pairs in each group. The subtype of each pair was the same. There were 4/5 pairs of HBV with B/adw2 and 1/5 pair of HBV with C/adrq+ in each group. It was shown that there were no difference among the four high viremia groups or between the two low viremia groups in the number of mutations and the number of mutational positions. However, there was significant difference between high viremia group and low viremia group. The mutation was not related to age. There were 56 mutational positions and there was no mutational hotspot in high viremia patients. In two low viremia groups (the mothers in group B and the children in group C), there were 113 mutational positions and 85 mutational positions were hotspots (owned by 5/8 clones in each) which could make 37 amino acids changed. Most of mutational amino acids were located within T and B cell epitopes of envelope protein or/and located in the surrounding regions.</p><p><b>CONCLUSIONS</b>There are many differences in HBV with different degree of viremia, even if it comes from the same strain. There are some regular patterns in the mutations of HBV after HBeAg seroconversion happened.</p>

Specific immune responses in Balb/c mice induced by plasmid coexpressing hepatitis B surface antigen and granulocyte-macrophage colony stimulating factor / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the improvement of specific immune responses induced by plasmid coexpressing hepatitis B surface antigen (HBsAg) and granulocyte-macrophage colony stimulating factor (GM-CSF).</p><p><b>METHODS</b>All Balb/c (H-2d) mice were immunized with pGM-CSF/S, pS/GM-CSF, pS or control plasmids. 4 weeks later, anti-HBs titer and the levels of IL-2, IL-4 and IFN-gamma in the supernatant of splenocytes were detected using enzyme- linked immunosorbent assay (ELISA), and HBsAg-specific cytotoxic T lymphocytes (CTL) activity was measured with a 51Cr release assay, using P815/S transfectants as target cells.</p><p><b>RESULTS</b>The anti-HBs antibody titers in the serum, the levels of IL-2 and IFN-gamma, and the CTL activity in pcDNA3.1-GM-CSF-S immuned mice were higher than those in PcDNA3.1-S immunized mice (F=4.176, P<0.01; F=31.188, P<0.01; F=31.796, P<0.01; F<or=26.891, P<0.01).</p><p><b>CONCLUSION</b>It will improve the specific immune responses induced by HBsAg DNA vaccine after it is binded to the gene of GM-CSF.</p>