An Extrapulmonary Manifestation of Coronavirus Disease 2019:Olfactory Dysfunction / 中国医学科学院学报

In addition to acute respiratory symptoms,coronavirus disease 2019(COVID-19)could cause olfactory dysfunction,which becomes the only clinical manifestation of COVID-19 in some cases.We review the epidemiological characteristics,pathological mechanism,screening value,treatment and prognosis of olfactory dysfunction in patients with COVID-19,aiming to achieve an in-depth understanding of the early diagnosis,quarantine,scientific treatment and prognosis of COVID-19.

Resistant hypertension during antituberculosis treatment: how is rifampicin implicated?

@#smear-positive pulmonary tuberculosis. His backgroundhistory included chronic essential hypertension which waswell-controlled with amlodipine 10mg daily. However, hisblood pressure became suboptimal one week intoantitubercular treatment, necessitating escalation ofantihypertensive therapy up to six medications. Followingcompletion of antitubercular treatment, his blood pressureimproved markedly. The number of antihypertensives wasable to be reduced to only two after a month. We postulatethat rifampicin has attenuated the therapeutic effect ofamlodipine via potent induction of hepatic CYP3A4 but thefailure to control the blood pressure even with medicationsunrelated to cytochrome P450 pathways raises the spectreof an additional interaction.

Bilateral Genu valgum in an adolescent with primary hyperparathyroidism / Journal of the ASEAN Federation of Endocrine Societies

@#Primary hyperparathyroidism in children and adolescents is rare and often symptomatic at presentation. A 15-year-old boy presented with bilateral genu valgum for two years. Biochemical results were consistent with primary hyperparathyroidism. Calcium levels normalized two months after removal of a left inferior parathyroid adenoma.

Observation on intestinal viral shedding time of hand, foot and mouth disease induced by coxsackievirus A6 / 中华儿科杂志

Objective@#To observe the intestinal viral shedding time in patients with hand, food and mouth disease (HFMD) induced by coxsackievirus A6 (CA6).@*Method@#Throat swab specimens and stool specimens of HFMD children were collected from those admitted to Hangzhou Children′s Hospital between May and October 2015, while fluorescence quantitative PCR was used to detect the viral load.Eeighteen cases of HFMD children were followed up, who were confirmed as CA6 infection via laboratory tests.Stool specimen was collected every 4-7 days, and fluorescence PCR was used for virus nucleic acid detection until the stool viral nucleic acids of infected children turned to be negative.The intestinal virus shedding time of CA6-infected HFMD was compared with the intestinal virus shedding time of 65 children with enterovirus 71 (EV71) infection and 44 children with coxsackievirus A16 (CA16) infection of the previous studies (from May to September 2012).@*Result@#The median stool viral load was 25×105 copies/ml (55×104 copies/mL, 9×106 copies/ml) in CA6-infected children.The numbers of stool virus nucleic acid turning negative were 0 case, 4 cases, 9 cases, 3 cases and 2 cases in 18 children at 1st, 2nd, 3rd, 4th, 5th weeks. At 5th week, the stool virus nucleic acid of children in CA6 group all turned to be negative.The positive rates of stool virus nucleic acid in EV71 group and CA16 group at the 5th week, however, were 31% and 27% respectively.There were statistically significant differences in distribution of positive rate of stool virus nucleic acid between CA6 infected children with EV71 and CA16 infected children (χ2=13.894, 10.698, P<0.05).@*Conclusion@#The longest intestinal virus shedding time for CA6-infected HFMD children was 5 weeks, which is obviously shorter than that of EV71- infected children and CA16-infected children.

Roles of microRNAs in allergic airway diseases / 中国医学科学院学报

The microRNAs (miRNAs/miRs) are a class of short non-coding RNAs regulating protein translation via mRNAs silencing. Studies have shown that microRNAs play critical roles in allergic diseases, tumors, and infections. The allergic airway diseases are characterized by inflammation and hyperresponsiveness of the respiratory tract. Several miRNAs are found to be involved in a series of pathophysiologic processes in allergic airway diseases including inflammatory cells infiltration, cytokines' expressions, airway hyperresponsiveness, and proliferation and change in phenotype of smooth muscle cells. Therefore, miRNAs may be new therapeutic targets for these allgeric diseases. This article reviews the roles of miRNAs in asthma and allergic rhinitis and their molecular biological mechanisms.

Observation on virus shedding periods of enterovirus-71 and coxsackievirus A 16 monitored by nucleic acids determination in stool samples of children with hand, foot and mouth disease / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the duration of enterovirus-71 (EV71) and coxsackievirus A 16 (CoxA16) viral shedding in stool samples of children with hand, foot and mouth disease (HFMD) infected with EV71 and CoxA16 and to explore the relationship between the duration of intestinal virus shedding and the severity of illness of children with HFMD.</p><p><b>METHOD</b>Totally 113 laboratory-confirmed cases of children with HFMD infected with EV71 and CoxA16 were followed up. The stool samples were collected with the interval of 4 to7 days and the viral nucleic acids were detected by fluorescent PCR until the stool viral nucleic acids of infected children turned to be negative. The cases in EV71 group were further divided into "ordinary EV71 group" and "severe EV71 group" according to the severity of the illness. The positive rates of viral nucleic acid and the differences of distribution among different groups were analyzed by Kaplan-Meier survival analysis during the follow-up period.</p><p><b>RESULT</b>The 113 cases of infected children were grouped as follows: 65 cases of EV71 positive children, 44 cases of CoxA16 positive children, 4 cases of EV71/CoxA16 mixed infection. The median duration of the stool viral nucleic acids turning to negative was 26 (18.25-32.50) days in EV71 group and 27 (14.50-33.75) days in CoxA16 group (Z = 1.51, P > 0.05). At 1, 4, 6 and 10 weeks, the positive rates of stool viral nucleic acid of children with HFMD in EV71 group were 100%, 48.1%, 17.2% and 0 respectively. At 1, 4 and 6 weeks, the positive rates of stool viral nucleic acid of children with HFMD in CoxA16 group were 95.5%, 53.8% and 0 respectively (χ(2) = 0.18, P > 0.05). At 1, 4 and 6 weeks, the positive rates of stool viral nucleic acid of children with HFMD in ordinary EV71 group were 100%, 23.5% and 0 respectively, while at 1, 4, 6 and 10 weeks, the positive rates of stool viral nucleic acid of children with HFMD in severe EV71 group were 100%, 62.4%, 26.0% and 0 respectively (χ(2) = 5.689, P < 0.05).</p><p><b>CONCLUSION</b>The duration of enterovirus shedding in stool samples of children with HFMD lasted for a long period. The maximum duration of EV71 and CoxA16 in stool of children with HFMD was 10 weeks and 6 weeks, respectively. The duration of intestinal virus shedding of children with HFMD infected with EV71 was related with the severity of the illness.</p>

Etiology of inspiratory laryngeal stridor in children / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Retrospective analysis was performed on the etiology of inspiratory laryngeal stridor in children. The purpose is to raise the diagnosis and cure rate of the disease.</p><p><b>METHODS</b>All patients were hospitalized in Children's Hospital from Jan, 2005 to Jan, 2007. Among of them, 245 cases were male and 133 cases were female. The median age was 4 months (range from 12 hours to 30 months). All the patients had chest X-ray examination. Two hundred and eighteen cases received chest CT scan, video laryngoscope, direct laryngoscope and bronchofibroscopy.</p><p><b>RESULTS</b>The diagnosis were as follows: acute laryngitis (140 cases), laryngomalacia (117 cases), acute laryngotracheal bronchitis (54 cases), vocal cord paralysis (18 cases), congenital tracheomalacia (9 cases), congenital laryngeal webs (8 cases), congenital cleft of larynx (6 cases), laryngeal cyst (6 cases), laryngeal papilloma (6 cases), acute epiglottitis (4 cases), congenital infraglottic stenosis (3 cases), tracheobronchial foreign body (3 cases), cysts thyrolinguals (1 case). All cases were cured except congenital tracheomalacia (9 cases), congenital cleft of larynx (6 cases), laryngeal papilloma (6 cases), congenital infraglottic (3 cases).</p><p><b>CONCLUSIONS</b>The etiology of inspiratory laryngeal stridor in children are very complicated. Video laryngoscope is recommended for all cases except for the acute inflammation disease. Chest CT scan and bronchofibroscopy may be necessary for some cases.</p>

Endoscopic surgery for nasopharyngeal angiofibroma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).</p><p><b>METHODS</b>Twenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.</p><p><b>RESULTS</b>Group A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.</p><p><b>CONCLUSIONS</b>The data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.</p>

Analysis of Clinical and Pathological Characteristics and Prognosis in 21 Children with Primary Focal Segmental Glomerulosclerosis / 实用儿科临床杂志

0.05).Two cases were lost to follow up,19 out of 21 cases were followed up.The follow-up duration was from 4 to 51 months[mean follow-up duration was(22.84?12.13) months].At last follow-up,10 cases(53%) had complete remission,4 cases(21%) had significant remission,4 cases(21%) had partial remission and 1 case(5%) had no remission.Tubulointerstitial lesions were related with prognosis(P1).Conclusions 1.The predominant clinical manifestation of primary FSGS is nephrotic syndrome in children.The not otherwise specified variant is the commonest pathological variant in primary FSGS.There is no relationship between patholo-gical types and clinical manifestations of FSGS.2.Most of the children with primary FSGS have a good short-term prognosis,but their long-term prognosis must be followed up.3.Tubulointerstitial lesions are risk factors for prognosis.