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Objective:To explore more clinical characteristics and outcomes of children with severe pneumonia induced by adenovirus type 7(Adv-7).Methods:Seventy children with severe pneumonia induced by Adv-7 admitted to the pediatric intensive care unit of Guangzhou Women and Children′s Medical Center from January 2016 to October 2019 were enrolled.The clinical features, treatments and outcomes of these children were recorded.Results:(1)There were 43 males(61.4%)and 27 females(38.6%). Thirty(42.9%)patients were 0-12 months old, 28(40.0%)patients were 13-36 months old, and 12(17.1%)patients were over 36 months old.(2)The average onset time of severe pneumonia induced by Adv-7 was(11.87±7.10)days before being admitted to PICU.The average sequential organ failure assessment score was 6.80±3.13.The average Murray lung injury score was 2.49±1.15.The average P/F value was(150.57±86.25)mmHg(1 mmHg=0.133 kPa). Sixty-four cases(91.4%)were involved in two or more area of lung on X-rays.All cases were diagnosed with sepsis.(3)Laboratory examination: white blood cell count was(7.6±5.5) ×10 9/L, platelet count was(238.8±164.2)×10 9/L, and C-reactive protein was(39.4±37.2)mg/L.(4)Treatments: intravenous gamma globulin was used in 65 cases(92.9%). Intravenous glucocorticoid was used in 45 cases(64.3%). Fiberoptic bronchoscopy was performed in 43 cases(61.4%). Blood purification treatment was performed in 21 cases(30%). Sixty-three patients(90.0%)were treated with non-invasive or invasive ventilator, high frequency ventilator-assisted ventilation was used in 20 cases(28.6%). Surfactant was used in six cases(8.6%). Extracorporeal membrane oxygenation was used in 19 cases(27.1%). (5)The average treatment time for ventilation was(13.10±11.58)days.The average time for temperature recover was(4.69±4.01)days in PICU.The average PICU stay time was(15.76±12.20)days.The average length of stay was(27.04±13.10)days.There were 16 patients died and the mortality was 22.9%. Conclusion:The children with severe pneumonia induced by Adv-7 were critical and had significant lung injuries.Suffering from active clinical treatment such as extracorporeal membrane oxygenation, some of these patients still had poor prognosis.
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Objective To determine the viral etiology and its epidemic features of community-acquired pneumonia ( CAP) among pediatric inpatients in Guangzhou.Methods A total of 1 539 children with CAP admitted in Guangzhou Women and Children’ s Medical Center during June 2012 and June 2013 were enrolled in the study.Throat swab specimens were collected, and fluorescence quantitative polymerase chain reaction ( FQ-PCR) was performed to detect 11 respiratory pathogens.SPSS 17.0 was used for data processing, and χ2 test was performed to compare the infection rates among different groups.Results Among 1 539 patients, 550 cases (35.7%) were infected with at least one pathogen, and 101 (6.6%) were infected with two or more pathogens.The most popular viral etiologies were respiratory syncytial virus (RSV) (102, 6.6%), rhinovirus (RHV)(101, 6.6%), adenovirus (ADV) (78, 5.1%), influenza virus A (IVA) (78, 5.1%) and bocavirus (HBOV) (74, 4.8%).RSV infection often occurred in children with age≤3 years, while ADV or IVA infection often occurred in those with age >3 years.RSV infection rate peaked in winter and spring, IVA infection rate peaked in spring and summer, while ADV and HBOV infection rates peaked in summer.The rate of multiple infections in critically ill children (22/135, 16.3%) was significantly higher than that in other CAP patients (79/1 404,5.6%,χ2 =116.049, P<0.01).Conclusions Viral infection is common in pediatric inpatients with CAP, and RSV infection is the most popular.Multiple infections are more often to cause critical conditions.
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Objective To investigate the association with death for serum parameters at the time of diagnosis and its value in predicting the death in infants with hemophagocytic syndrome (HPS).Methods A retrospective case-control study was conducted on 108 children with HPS who were admitted to our center between July 2005 and July 2012.For each patient,demographic,laboratory data and outcome information were collected.The patients were divided into death and surviving groups based on the follow-up results.The relation between serum markers and death was examined using the COX proportional hazards model and decision tree.Results Of 108 infants with HPS,33 died corresponding to a fatality rate of 30.6％ and 90.3％ of deaths occurred within 8 weeks after diagnosis.Following features were significantly associated with death:white blood cells (WBC) ＜5 x 109/L (HR =9.08,95％ CI 3.07 ～ 26.87),hemoglobin ＜80 g/L (HR =6.15,95％ CI 1.68 ～ 22.49),albumin ＜ 28 g/L (HR =4.63,95％ CI 1.12 ～ 7.39),serum ferritin ＞ 1 100 μg/L (HR =3.05,95％ CI 1.28 ～ 16.75),trigeminal ganglion ≥4 mmol/L (HR =2.88,95％ CI 1.51 ～ 8.60),and prothromin time ≥ 16 s (HR =3.60,95 ％ CI 1.28 ～ 7.24),and fever for more than 2 weeks (HR =5.39,95％ CI 1.97 ～ 14.66).Decision tree demonstrated that the probability of death was as high as 100％ for infants with WBC ＜5 x 109/L and hemoglobin ＜ 80 g/L.The odds of dying was still 66.7％ for infants who had WBC≥5 × 109/L but reported trigeminal ganglion ≥4 mmol/L after having fever for more than 2 weeks.Conclusion The first 8 weeks after the onset of HPS is the critical period of treatment.There are several easily available serum predictors of early mortality in HPS infants,particularly the WBC and hemoglobin level,which may help guide treatment decisions.
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AIM: To investigate the changes of cardiac function, oxidative stress and apoptosis in myocardium of rat model of heart failure induced by adriamycin (ADR). METHODS: At the end of the study, we observed content of malondialdehyde (MDA), activity of superoxide dismutase (SOD) and apoptosis. Expression of P53 protein and p53 mRNA were measured with immunohistochemical method and RT-PCR, respectively. RESULTS: Our data showed that content of MDA increased, activity of SOD decreased and apoptosis in myocardium happened while cardiac function decreased after ADR treatment. p53 gene expression and P53 protein obviously increased in heart failure group. CONCLUSION: There were oxidative stress and apoptosis occurred significantly in a model of heart failure induced by ADR. p53 gene might play an important role in the apoptosis. Correlation analyses suggested that apoptosis in myocardium is related to oxidative stress in ADR-induced heart failure.
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AIM: The work was designed to explore protective effects of a traditional Chinese medicine-sini decoction (SD) on liver in hemorrhagic shock and its mechanism relating to oxygen free radical and nitric oxide. METHODS: Anesthetized Wistar rats were subjected to a hemorrhagic shock protocol for 60 min followed by intravenous injection with normal sodium chloride solution or SD solution. Superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) in liver were examined. The inducible nitric oxide synthase (iNOS) was determined immunohistochemically. RT-polymerase chain reaction (RT-PCR)was used to assay the mRNA, which were corresponding to eNOS (endothelial nitric oxide synthase) and iNOS. RESULTS: The activity of SOD decreased, while the concentration of MDA increased in liver during hemorrhagic shock. SD enhanced SOD activity and inhibited a increase in MDA level in liver ( P
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AIM: To screen the differentially expressed genes among normal, ischemic and Sini decoction-treated myocardium using DNA microarray.METHODS: Kunming mice were randomly divided into control group, ischemic group and Sini decoction group. Total RNA was extracted from myocardium of each group. cDNA microarray chips containing 2 304 cDNAs were used to investigate the gene expression pattern of each group. RESULTS: Up-and down-regulated genes were 33 and 70 in ischemic group vs control group, respectively. Up-and down-regulated genes were 23 and 52 respectively in Sini decoction group vs ischemic group. CONCLUSIONS: The analysis of gene expression pattern of ischemic myocardium based on cDNA microarray can realize high-throughput screening of the genes. Further analysis of those obtained genes information will be helpful to understand the molecular mechanism of myocardial ischemia and the therapeutic mechanism of Sini decoction.
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AIM: To detect the effect of Sini decoction on glutathione S-transferase (GST) mRNA expression in the ischemic myocardium. METHODS: Kunming mice were randomly divided into control group, ischemic group and Sini decoction group. Total RNA was extracted from the myocardium of mice in each group. The effect of Sini decoction on the expression of GST gene was detected by RT-PCR. RESULTS: The expression of GST mRNA in Sini decoction group was significantly up-regulated compared with the ischemic group and control group. CONCLUSION: Sini decoction can promote the expression of GST gene, which may be related to its protective effect on ischemic myocardium.
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AIM: To investigate the effect of Sini decoction (SND)on the ultrastructure of small intestinal epithelial cells in rats with intestinal ischemia-reperfusion. METHODS: Thirty-two Sprague-Dawley rats of both sexes were randomly divided into 4 groups: (1) Control group in which sham operation was performed; (2) Model group in which intestinal I/R was produced by clamping super mesenteric artery(SMA) for 1 hour and declamping SMA for 3 hours; (3) SND1 group in which SD (0.6 g/200 g rat) was given via stomach tube 3 d before intestinal I/R; (4) SND2 group in which SD (1.2 g/200 g rat)was given via stomach tube 3 d before intestinal I/R. A strip of small intestine was taken from distal end of ileum for electron microscopic examination. The two-dimensional structural parameters and three-dimensional structural parameters of mitochondria were calculated. RESULTS: (1)Morphological changes of small intestine: In control group, epithelial cells were orderly arranged, with normal mitochondria and intestinal villi. In model group, the gaps between epithelial cells widened. There were a lot of apoptotic cells. Microvilli were short and swelled. Mitochondria were swelled obviously with broken ridges. Endoplasmatic reticulum was severely dilated. In SND1 and SND2 groups, microvilli and epithelial cells were orderly arranged relatively, mitochondria was slightly swelled. (2) Structural parameters of mitochondria: In model group, there were the least mitochondria and the swelling of mitochondria was severe. In SND1 and SND2 groups, the mitochondria was more than that of model group and the swelling were slight. CONCLUSION: Sini decoction can protect small intestine from ischemia-reperfusion injury without dose-dependent effect.