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China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
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Novel coronavirus infection(COVID-19)has spread rapidly around the world since its emergence in 2019, with universal susceptibility of the population, causing hundreds of millions of infections and millions of deaths worldwide. Recently, the World Health Organization reconfirmed that COVID-19 is still a public health emergency of international concern. In order to ensure the early detection, identification and intervention of severe COVID-19 cases, reduce the disease severity and mortality, and further standardize the application of antiviral drugs for treatment, the National Center for Infectious Diseases (NCID) has invited experts to develop the Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( Trial version 10) in January 2023. The expert consensus is an important document that systematically reviews, summarizes and analyzes the application of antiviral drugs for COVID-19 from a multidisciplinary perspective for the first time, and can provide guidance and reference for medical institutions at all levels in the selection of antiviral drugs for COVID-19. This article aims to interpret the main points of the expert consensus, including the current epidemiological situation and pathogenic characters of novel coronavirus, clinical characteristics and classification of COVID-19, focusing on the antiviral therapy, guidance for home treatment and post-discharge management of patients with COVID-19.
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COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
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Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.
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The coronavirus disease 2019 (COVID-19) pandemic has lasted for more than 2 years in the world.At present, Omicron has become the dominant strain.Omicron is highly contagious, has a stronger ability of antibody evasion and reinfection, which brings great challenges to COVID-19 pandemic prevention and control.This article reviewed the latest evidence on COVID-19 in children, such as pandemic status, clinical manifestations, vaccine protection effect, antiviral medicines and non-pharmaceutical interventions, revealing some challenges in prevention and treatment efforts currently.
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Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
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Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.
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At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.
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2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.
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The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.
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Adult , Humans , Anti-Bacterial Agents/therapeutic use , Biomarkers , Calcitonin , Community-Acquired Infections/drug therapy , Pneumonia/drug therapy , Protein PrecursorsABSTRACT
Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.
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<p><b>OBJECTIVE</b>To investigate the feasibility and application value of improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion.</p><p><b>METHODS</b>A retrospective study was performed on 17 patients who were operated by improved extracorporeal anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion at Huaihe Hospital of Henan University during June 2015 and June 2017.</p><p><b>INCLUSION CRITERIA</b>(1) distance from tumor low margin to anal edge was 4 to 6 cm; (2) protrusive type tumor with a circumferential diameter of less than 3 cm; (3) ulcer type tumor with circumferential bowel infiltration of less than 1/2; (4) no distant metastasis(M0) and preoperative MRI of pelvic floor indicating T1-3N0. Patients with BMI>35 kg/m, or insufficient length of sigmoid and mesentery, or thickening sigmoid and mesentery were excluded. According to total mesorectal excision(TME) principle, rectum and its mesentery was resected completely; the sigmoid colon was cut off at the superior margin of tumor; the oval forceps was placed through anus to clamp and evert the rectum out of the anus; the rectum was transected at 1-2 cm from the lower edge of the tumor; the distal sigmoid colon was pulled out through anus; purse string suture was made after insertion of anvil and was restored to the abdominal cavity; end-to-end anastomosis of the rectum and sigmoid colon was performed after closing rectal stump.</p><p><b>RESULTS</b>Of 17 low rectal cancer patients, 10 were male and 7 were female with age of 42 to 71 (median 58) years old and BMI of 20.6 to 33.5(median 26) kg/m. Preoperative staging indicated 2 cases of stage I, 15 cases of stage II. Distance from tumor low margin to anal edge was 4 to 6(median 5.0) cm and diameter of tumor was 3.4 to 4.8 (median 4.2) cm. All the patients completed operations successfully without conversion to laparotomy. The operation time was 124 to 182 (median 136) minutes. Distal sigmoid colon was difficult to pull out in 1 patient due to the insufficient free of the mesosigmoid, which was then successful after the mesosigmoid was dissociated with laparoscopy thoroughly again. The intraoperative blood loss was 10 to 50 (median 20) ml. Postoperative pathology reveled 2 cases of stage I, 12 cases of stageII and 3 cases of stage III; 1 case of poorly differentiated adenocarcinoma, 15 cases of moderately differentiated adenocarcinoma and 1 case of highly differentiated adenocarcinoma. The postoperative exhaust time was 24 to 128 (median 36) hours and hospital stay was 5 to 15 (median 8) days. No anastomotic leakage and intra-abdominal infection was found. Fifteen patients were followed up for 5 to 24 months without local recurrence or distant metastasis.</p><p><b>CONCLUSION</b>The improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion without abdominal incision is safe and feasible.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Anal Canal , General Surgery , Laparoscopy , Methods , Neoplasm Recurrence, Local , Rectal Neoplasms , General Surgery , Rectum , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To evaluate the curative effect of recombinant human Interferon α2b (rhIFN α2b) spray in hand,foot and mouth disease (HMFD).Methods In total,313 HMFD children were enrolled from Beijing Ditan Hospital affiliated to Capital Medical University,Tianjing Second People's Hospital,Hebei Children's Hospital,the Second Hospital affiliated to Wenzhou Medical College,Kunming Maternal and Child Health Hospital and Guiyang Public Health Treatment Center from March,2015 to February,2017.They were divided into rhIFN α2b group (148 cases) and ribavirin group (165 cases).The children in rhIFN α2b group were given with the rhIFN α2b spray,and those in ribavirin group were given with the ribavirin spray.Meanwhile,the children were given unified standard interventions for basic treatment.The curative effect and safety between two groups was compared.The t test was used for intergroup comparison and the Wilcoxon rank test was used for non-normal quantitative data.Results At the end of the follow-up period,all kids reached the recovery level,with 144 cases in the rhIFN α2b group and 164 cases in the ribavirin group.Fever,herpes and rashes all disappeared with 7-day follow-up.The total efficiency of the rhIFN α2b group measured at the 72h after treatment was 74.15％,which showed significant differences compared with the ribavirin group with 49.09 ％ efficiency (Z=4.44,P＜0.01).As the secondary outcome measures,the complete disappearance time of fever and the immediate disappearance time of fever in the rhIFN α2b group were significantly shorter than those in the ribavirin group ([27.03±21.99] vs [33.21±26.71],t=-2.13;[23.56±13.96] vs [28.51±18.84],t=-2.07,both P＜0.05).The appetite improvement and the disappearance times of oral herpes and rashes in the rhIFN α2b group were shorter than those in the ribavirin group,with significant differences (x2 =4.94,3.17 and 3.55,respectively,all P=0.000).No adverse event in both groups.Conclusions rhIFN α2b spray treatment in HMFD is proved significantly effective,particularly,it can evidently relieve fever symptoms and promote the disappearance of oral herpes symptoms,and no adverse event is observed throughout the study,which indicates a good safety of the rhIFN α2b spray.Clinical trial registration Chinese Clinical Trial Registry,ChiCTR-OIN-17013182.
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Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease.As a dengue non-endemic country,China has experienced several dengue outbreaks in recent years.However,dengue patients in China displayed distinct clinical characteristics compared to patients in endemic countries.To standardize the diagnosis and treatment of dengue fever,the experts of the Society of Infectious Diseases,Society of Tropical Medicine and Parasitology of Chinese Medical Association,and the Society of Emergency Medicine,China Association of Chinese Medicine have reached this guideline based on guidelines for diagnosis,treatment,prevention and control of dengue (World Health Organization,2009);guidelines for diagnosis and treatment of dengue (National Health and Family Planning Commission of the People's Republic of China,2014,Edition 2),health industry standard of the People's Republic of China "diagnosis for dengue fever (WS216-2018)" and systemic reports on dengue.The guideline includes 8 aspects:introduction,terminology,epidemiology and prevention,etiology and pathogenesis,clinical features,diagnosis,treatment and problems to be solved.
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Objective To study curative efficacy of granisetron in treatment of postoperative severe vomiting after posterior scleral reinforcement . Methods 84 patients of posterior scleral reinforcement who received therapy from January 2012 to December 2014 in our hospital were selected as research objects.According to random number table,those patients were divided into the control group (n=100) and the observation group (n=100), the control group were treated with ondansetron hydrochloride at the end of surgery, while the observation group were treated with granisetron at the end of surgery.Then postoperative sedation, analgesia, nausea, vomiting and so on.were compared.Results There were no significant differences in anesthesia time, operation time and remifentanil dosage between the two groups.The Ramsay scores of the observation group were (2.49 ±0.31), (2.23 ±0.34) and (2.10 ±0.28) points at 30 min, 1h and 2h after operation, respectively.In the control group, Ramsay scores were (3.02 ±0.42), (2.84 ±0.37), (2.45 ±0.34) at 30 min, 1h and 2h after operation, lower than the control group.The incidence of nausea and vomiting in the observation group were 9.52% ( 4/32 ) , 11.90% ( 5/42 ) respectively, and there was no significant difference between the two groups in the postoperative analgesia The total incidence of postoperative nausea and vomiting was 30.95% (13/42) and 30.95% (13/42) respectively, which were lower than the control group (P <0.05).Conclusion Granisetron is well for postoperative posterior scleral reinforcement, which can reduce the incidence of postoperative severe vomiting, it’s worthy of application and promotion.
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Objective To compare the prevalence and genotype distribution of human papillomavirus (HPV) between human immunodeficiency virus (HIV)-positive and-negative populations.Methods Patients with condyloma acuminatum or persons who recently had sexual contact with patients with condyloma acuminatum were enrolled into this study,and classified into HIV-positive group (n =62) and HIV-negative group (n =2 716).GeneChip analysis was performed to detect HPV and determine HPV genotypes in mucocutaneous samples collected from the external genitalia of these subjects.Statistical analysis was carried out by chi-square test using the SPSS software version 19.0.Results The prevalence rates of HPV infection,high-risk HPV types and low-risk HPV types were significantly higher in HIV-positive persons than in HIV-negative persons (74.19％ (46/62) vs.42.30％ (1 149/2 716),67.74％ (42/62) vs.29.57％ (803/2 716),58.06％ (36/62) vs.24.71％ (671/2 716),respectively,all P＜ 0.01).The detection rate of HPV was also increased in HIV-positive men compared with HIV-negative men (92.11％ (35/38) vs.37.38％ (382/1 022),x2 =45.98,P ＜ 0.01).Although the top three genotypes of low-risk HPV were types 6,43 and 11 in both HIV-positive and-negative groups,the prevalence rate of HPV 6 was 37.10％ (23/62) in HIV-positive group,but only 11.12％ (302/2 716) in HIV-negative group.The top five genotypes of high-risk HPV were types 16 (22.58％,14/62),52,66,58 and 18 in HIV-positive group,and types 16 (7.77％,211/2716),58,56,66 and 52 in HIV-negative group.Coinfections with multiple HPV subtypes were common in both groups,and the number of concurrent HPV genotypes was as high as 8 in HIV-positive group,and 9 in HIV-negative group.The prevalence rate of coinfections with three or more HPV genotypes in HIV-positive group was significantly higher than that in HIV-negative group (65.21％ (30/46) vs.16.71％ (192/1 149)).Conclusions Compared with HIV-negative populations,HIV-positive populations show elevated prevalence of HPV infection,high-risk HPV genotypes and low-risk HPV genotypes.Moreover,the prevalence of HPV is higher in HIV-positive men than in HIV-negative men.These findings are worthy of further attention in clinic.
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Objective To investigate the clinical features of varicella and the prognosis in pregnant women and their newborns .Methods Clinical data of pregnant women with varicella zoster virus (VZV) infection (n= 25) and their newborns hospitalized in Beijing Ditan Hospital from 1st Jan .2008 to 31st Dec .2014 were retrospectively analyzed and randomly compared to non‐pregnant women with VZV infection (n=50) .Clinical features and prognosis of varicella in pregnant women and their infants were analyzed .Chi‐square test was used for categorical data and t test was used for quantitative data .Results Time to rash scab of varicella in pregnant women was longer than non‐pregnant women ([10 .1 ± 2 .1] d vs [5 .6 ± 1 .4] d ,t=10 .941 ,P<0 .05) .The rate of bacterial infection in pregnant women was higher than non‐pregnant varicella women (72 .0% [18/25] vs 32 .0% [16/50] ,χ2 = 10 .761 , P < 0 .05) , with statistical significance .Among 25 cases of varicella pregnant women ,the pregnancy complications were observed in 3 cases of diabetes ,2 cases of premature rupture of membranes ,5 cases of anemia and 1 case of oligoamnios .Seven cases out of 25 pregnant women underwent parturition during fever and varicella period ,and 3 cases (12 .0% ) were complicated with intrapartum hemorrhage . Twenty five varicella pregnant women were all cured after antiviral and supportive treatment and gave birth to their babies ,with no abortion ,stillbirth or birth defects .No congenital varicella was observed in newborns .Of the 25 infants ,4 developed (16 .0% ) varicella within 2 weeks after birth and they were all born from mothers who developed varicella around delivery time .The clinical features of neonatal varicella presented with classic rash with no fever .The time to rash scab was longer (11 .0 ± 2 .1) d and antibody test for VZV was negative .All neonates were cured after antiviral and immunoglobulin treatment .Conclusions Longer duration of skin rash scab and higher rate of bacterial infections are the features of varicella in pregnant women .Intrapartum hemorrhage occurrs more commonly in pregnant women with varicella onset around delivery time .Varicella occurring during mid‐pregnancy may not increase the risk of neonatal birth defects after treatment .The newborns whose mothers with varicella onset during perinatal time especially around delivery time may suffer from varicella .The prognosis of neonatal period varicella is good after treatment .
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<p><b>OBJECTIVE</b>To investigate the etiology of hand, foot and mouth disease (HFMD) in Beijing during 2013, and study the clinical characteristics of HFMD caused by the main serotypes of enterovirus in the study.</p><p><b>METHOD</b>Clinical data and 128 stool samples were collected from 128 hospitalized children with HFMD in Beijing Ditan Hospital during 2013. One step RT-PCR method was used for enterovirus genotyping to investigate the etiology of HFMD. Clinical characteristics of HFMD caused by the main serotypes of enterovirus were analyzed. And VP1 segments of the main virus were amplified to construct phylogenetic tree for the phylogenetic analysis.</p><p><b>RESULT</b>A total of 128 hospitalized children with HFMD were included. HFMD was more likely developed in children under 2 years of age (81.6%, 102/125); 11 different enteroviruses were genotyped, with a total enterovirus positive rate of 76.6% (98/128); the positive rate of coxsackievirus A6 (CA6), 43.0% ( 55/128), was the highest, followed by enterovirus 71 (EV71), accounting for 14.8% (19/128). HFMD caused by CA6 was atypical, the rashes of which involved the perioral, trunk, limbs, face and neck (47%, 26/55), besides the common parts. Of the 55 cases caused by CA6, 6 children had clinical manifestations of nervous system involvement, one of whom even displayed type 2 respiratory failure. Mental status change more likely to occur in EV71-infected children than in CA6-infected ones (42% (8/19) vs. 11% (6/55) (χ(2)=7.041, P=0.008)); 13 children displayed onychomadesis, including 12 CA6 cases (23%, 12/53) and 1 CA10 cases (17%, 1/6), in the convalescence of hand, foot and mouth disease, and the correlation between onychomadesis and CA6 infection was significant (χ(2)=9.297, P=0.002). Phylogenetic analysis of 33 CA6 VP1 showed that the CA6 isolates of this study were highly similar to that of Taiwan and the nucleotide similarity was 95.91%-98.89%.</p><p><b>CONCLUSION</b>CA6 was the major pathogen of hospitalized children with hand, foot and mouth disease in Beijing during 2013, followed by EV71. The rashes caused by CA6 involved a wide range of skin sites and patients with CA6 infection displayed manifestations of neurological involvement or pulmonary edema similar to EV71 infection. Mental status change more likely occurred in EV71-infected children when neurological system was involved..</p>
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Child, Preschool , Humans , Infant , Child, Hospitalized , Enterovirus , Classification , Enterovirus Infections , Diagnosis , Virology , Exanthema , Pathology , Genotype , Hand, Foot and Mouth Disease , Diagnosis , Virology , Hospitals , Phylogeny , Pulmonary Edema , Pathology , Skin , Pathology , TaiwanABSTRACT
<p><b>BACKGROUND</b>Protectin D1 (PD1), derived from docosahexaenoic acid, has been shown to control and resolve inflammation in some experimental models of inflammatory disorders. We investigated the protective roles of protectin D1 in pulmonary inflammation and lung injury induced by lipopolysaccharide (LPS).</p><p><b>METHODS</b>Mice were randomly assigned to six groups (n = 6 per group): sham-vehicle group, sham-PD1 group, sham-zVAD-fmk group, LPS-vehicle group, LPS-PD1 group, and LPS-PD1-zVAD-fmk group. Mice were injected intratracheally with 3 mg/kg LPS or saline, followed 24 hours later by intravenous injection of 200 µg/mouse PD1 or vehicle. At the same time, some mice were also injected intraperitoneally with the pan-caspase inhibitor zVAD-fmk. Seventy-two hours after LPS challenge, samples of pulmonary tissue and bronchoalveolar lavage fluid were collected. Optical microscopy was used to examine pathological changes in lungs. Cellularity and protein concentration in bronchoalveolar lavage fluid were analyzed. Lung wet/dry ratios and myeloperoxidase activity were measured. Apoptosis of neutrophils in bronchoalveolar lavage fluid (BALF) was also evaluated by flow cytometry.</p><p><b>RESULTS</b>Intratracheal instillation of LPS increased neutrophil counts, protein concentration in bronchoalveolar lavage fluid and myeloperoxidase activity, it induced lung histological injury and edema, and also suppressed apoptosis of neutrophils in BALF. Posttreatment with PD1 inhibited LPS-evoked changes in BALF neutrophil counts and protein concentration and lung myeloperoxidase activity, with the outcome of decreased pulmonary edema and histological injury. In addition, PD1 promoted apoptosis of neutrophils in BALF. The beneficial effects of PD1 were blocked by zVAD-fmk.</p><p><b>CONCLUSION</b>Posttreatment with PD1 enhances resolution of lung inflammation during LPS-induced acute lung injury by enhancing apoptosis in emigrated neutrophils, which is, at least in part, caspase-dependent.</p>
Subject(s)
Animals , Male , Mice , Acute Lung Injury , Drug Therapy , Allergy and Immunology , Apoptosis , Docosahexaenoic Acids , Therapeutic Uses , Inflammation , Drug Therapy , Lipopolysaccharides , Toxicity , Mice, Inbred BALB C , Neutrophils , Cell Biology , Peroxidase , MetabolismABSTRACT
Objective To analyze the imaging features of mycobacterium in AIDSpatients.Methods Twenty-three cases of mycobacterium tuberculosis and 13 patients of non-tuberculous mycobacteria were proved etiologically and included in this study.All patients underwent X-ray and CT examinations,imaging data were analyzed and compared.Results The imaging findings of mycobacterium tuberculosis in AIDS patients included consolidation (n =11),pleural effusion (n =11),mediastinal lymphadenopathy (n =11).Pulmonary lesions were always diffuse distribution,and 14 patients of extrapulmonary tuberculosis were found.Pulmonary lesions in non-tuberculous mycobacteria tend to be circumscribed.Conclusions Non-tuberculous mycobacterial infection in AIDS patients is more common and usually combined with other infections.Imaging features are atypical.