Invasive fungal infections in the pediatric intensive care unit: a clinical analysis of 38 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of invasive fungal infections (IFI) in the pediatric intensive care unit (PICU) and, to provide a basis for the effective prevention and treatment of IFI.</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical features and treatment outcomes of 38 children with IFI who were admitted to the PICU of Wuhan Children's Hospital between January 2009 and August 2012.</p><p><b>RESULTS</b>Pulmonary fungal infection (89%) was the most common among the 38 cases. Before diagnosis of IFI, all patients had severe underlying diseases and received several broad-spectrum antibiotics, including carbapenems, which were used in 95% of cases; 47% of all cases had been treated with corticosteroids systemically; all patients had received invasive operations, and 47% of them had undergone endotracheal intubation and mechanical ventilation. None of these cases had either typical clinical symptoms and signs or specific imaging findings. Fifty-six strains of fungi were isolated, with Candida albicans (41%), Aspergilli (25%), and Mucor (20%) being the most common ones. All patients received timely antifungal therapies, 15 cases were cured and 16 cases showed improvements, with a response rate of 82%, and the rate of adverse events was 16%.</p><p><b>CONCLUSIONS</b>In the PICU, the respiratory tract is the most common site of IFI infection, and Candida albicans is the leading pathogen. Severe underlying diseases, use of broad-spectrum antibiotics and corticosteroids, and invasive operations are the main risk factors for IFI in the PICU. Early diagnosis and timely treatment with high-performance antifungal drugs can improve the prognosis in children with IFI.</p>

Small hairpin RNA silencing Tim-3 affects peripheral blood Th1 and Th17 cells differentiation in asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of down-regulating Tim-3 gene in the peripheral blood mononuclear cells (PBMCs) of an asthmatic mouse model by short hairpin RNA (shRNA) and to explore the effect of Tim-3 on Th1 and Th17 cell differentiation.</p><p><b>METHODS</b>An asthmatic murine model was established by ovalbumin sensitization and challenge. PBMCs were isolated from asthmatic mice and transfected by shRNA targeting Tim-3 gene. The mRNA and protein expressions of Tim-3 were detected by quantitative PCR and Western blot. Flow cytometry analysis was performed to determine the levels of Th1 and Th17, and ELISA was performed to determine concentrations of IFN-γ, IL-4 and IL-17 in the supernatant.</p><p><b>RESULTS</b>Tim-3 mRNA expression in PBMCs was significantly increased in asthmatic mice. The mRNA and protein expression of Tim-3 decreased significantly in the shRNA group. Compared with the negative groups, Th1 cell levels increased and Th17 cell levels decreased significantly in the asthmatic groups after Tim-3 shRNA interference. In the Tim-3 shRNA interference groups concentrations of IFN-γ increased significantly while IL-17 decreased significantly.</p><p><b>CONCLUSIONS</b>Specific Tim-3 shRNA effectively silences the expression of Tim-3 and change in Tim-3 expression could affect T cell differentiation.</p>

Significance of Expression of Interferon ? Inducible Protein 10 in Peripheral Blood Mononuclear Cells in Children with Kawasaki Disease / 实用儿科临床杂志

0.05).Conclusions The expression of PBMC IP-10 mRNA increases in KD.IP-10 may participate in the pathogenesis of KD and CAL in KD.Perhaps the inhibition to the expression of PBMC IP-10 mRNA is one of the mechanisms of IVIG.

Treatment of chronic refractory idiopathic thrombocytopenic purpura in children with multiglycosidorum Tripterygii and prednisone / 中国实验血液学杂志

In order to determine the curative effect of multiglycosidorum Tripterygii and prednisone for treatment of children with chronic refractory idiopathic thrombocytopenic purpura (ITP), a total of 28 patients had been treated with multiglycosidorum Tripterygii and prednisone. Multiglycosidorum Tripterygii was given at a dose of 1 mg/kg body weight per day and the prednisone was given at a dose of 0.5 mg/kg body weight per day for two consecutive months. Bone marrow examination and blood platelet associated immunoglobin G (PAIgG) measurement were performed during the treatment. The results showed that in 21 patients acquired effectiveness, of whom, according the common criteria, 9 patients achieved curative effective, 7 achieved significant effectiveness and 5 effective. 7 patients did not achieve effectiveness. There were no serious side effects associated with therapy. The number of proplatelets on bone marrow smears was increased and the titers of IgG to platelet were restored to normal range in patients achieving remission. In conclusion, combination of multiglycosidorum triptergii with prednisone is effective and safe for treatment of chronic refractory idiopathic thrombocytopenic purpura in children.