Research on syndrome distribution features, etiologies, and pathogeneses of Japanese encephalitis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore Chinese medical syndrome distribution features of Japanese encephalitis (JE), and to analyze its correlation between syndromes and features of etiologies and pathogeneses.</p><p><b>METHODS</b>Recruited were 277 patients with confirmative diagnosis of JE from Wuhan Medical Treatment Center, Children's Hospital Affiliated to Chongqing Medical University, Fifth People's Hospital of Guiyang City, Hangzhou Sixth People's Hospital, and Chengdu Hospital of Infectious Diseases between July to September 2012. Chinese medical syndrome distribution features were summarized from their general materials and detailed records of clinical data, including medical history, symptoms and signs, tongue fur, and pulse figures.The frequency of symptoms and signs was calculated according to mild, ordinary, severe, extreme severe degrees. The distribution of Chinese medical syndromes was summarized. And its correlation between syndromes and features of etiologies and pathogeneses were analyzed.</p><p><b>RESULTS</b>After clustering analysis, Chinese medical syndromes of JE could be categorized as four groups: toxicity accumulation in Fei and Wei syndrome (TAFWS), brain collateral impaired by poison syndrome (BCIPS), depression of toxicity in the pericardium syndrome (DTPS), exhaustion of yin and yang syndrome (EYYS). BCIPS and DTPS were dominated, accounting for 74.0% (205 cases). The main causes covered evil of summer heat [accounting for 92.42% (256/277 cases)], heat [accounting for 87.73% (243/277 cases)], and toxin [accounting for 99.64% (276/277 cases)].</p><p><b>CONCLUSIONS</b>The four Chinese medical syndrome types of JE met Chinese medical clinical features of encephalitis. It is induced by infestation of dampness-heat, resulting in toxicity accumulation in Fei and Wei, brain collateral impaired by poison, depression of toxicity in the pericardium. Yin fluid and blood is exhausted as time goes by. Qi and yin are impaired to form intermingled deficiency and excess, and finally causing exhaustion of yin and yang.</p>

Genotyping of 210 Mycobacterium tuberculosis strains with Spoligotyping and MIRU-VNTR among pediatric tuberculosis patients in Chongqing / 中华流行病学杂志

Objective To evaluate the application of spacer oligonucleotide typing (Spoligotyping) and mycobaeterial interspersed repetitive unit-variable-number tandem repeat (MIRU-VNTR) analysis in the molecular-epidemiological study of tuberculosis and to discuss the characteristics of pediatric Mycobacterium (M.) tuberculosis strains in Chongqing. Methods M. tuberculosis strains isolated and typed by Spoligotyping and MIRU-VNTR respectively, from the children patients in Chongqing and to compare the results from both methods, epidemiologically. Results By means of Spoligotyping, 210 clinical isolates were divided into 2 gene groups, displaying 44 genotypes. Among them, the biggest group was M. tuberculosis Beijing family, including 130 strains (61.90%) ,using the Spoligotyping. From the results of MIRU-VNTR, 24 loci showed different polymorphism and the HGI of different loci set (12 old loci, 15 basic loci and 24-loci set) increased accordingly. The subtle difference in HGI was originated from one locus ETR-B, which was included in the 24-locus system. The diversity of each loci and MIRU-VNTR set for non-Beijing genotype strains was higher than that of the Beijing genotype strains. Conclusion In this study, it was preliminarily confirmed the existence of high polymorphism of M. tuberculosis while the Beijing Family was the main genotype and main prevalent strain in children of Chongqing area. Spoligotyping prior to 15-locus with ETR-B combination seemed more suitable for the massive epidemiological investigation of pediatric tuberculosis patients.

Epidemiological surveillance of norovirus and rotavirus diarrhea among outpatient children in five metropolitan cities / 中华儿科杂志

<p><b>OBJECTIVE</b>To survey the clinical epidemiological features of norovirus and rotavirus diarrhea among children living in 5 cities.</p><p><b>METHOD</b>A prospective epidemiological investigation was conducted among outpatient children with acute diarrhea between August 2008 and July 2009 in Shanghai, Hangzhou, Guangzhou, Chongqing and Tianjin. The stool samples were randomly collected from children with non-dysentery diarrhea. Group A rotavirus antigen was tested by the kit that applies colloidal gold method in all specimens. GI and GII genogroups of norovirus were detected by one-step real-time reverse-transcription polymerase chain reaction (RT-PCR). The detection rates, seasonality and susceptible age of both viruses-associated diarrhea were analyzed.</p><p><b>RESULT</b>During the one-year period, 5091 fecal samples were obtained, of which 1563 (30.7%) were rotavirus-positive. The detection rates of rotavirus were 29.5% (268/916) in Shanghai, 36.1% (334/926) in Hangzhou, 26.3% (254/968) in Guangzhou, 34.1% (359/1054) in Chongqing and 28.2% (348/1233) in Tianjin, respectively. Among the remaining 3528 rotavirus-negative samples, 1049 (29.7%) were identified to be norovirus-positive. The detection rates of norovirus were 21.2%(136/642) in Shanghai, 31.3% (185/592) in Hangzhou, 24.2% (173/714) in Guangzhou, 31.8% (221/695) in Chongqing and 37.7% (334/885) in Tianjin, respectively. It is estimated that the infection rate of norovirus among outpatients with acute diarrhea is at least more than 20.6% (1049/5092). Of 1049 norovirus strains, 1036 (98.7%) were GII genogroup and 16 (1.5%) were GI genogroup, 3 were mixed with GI and GII genogroups. The 1049 children with norovirus diarrhea aged between 1 month and 14 years with the median age of 10 months (mean: 13.9 ± 16.9 months) and 91.8% were 2 years old or younger. The 1563 children with rotavirus diarrhea aged between 1 month and 11.3 years with the median age of 10 months (mean: 12.9 ± 13.7 months) and 92.5% were 2 years old or younger. The median ages between norovirus-infected children and rotavirus-infected children were significantly different (P < 0.05). The peak seasons of rotavirus diarrhea spanned autumn and winter (from October to February). The peak seasons of norovirus diarrhea presented in the winter and spring (from November to April) in Tianjin. Norovirus became active in April and usually predominantly prevalent in the summer and autumn (from July to October) in Shanghai, Hangzhou and Chongqing. However, norovirus was sporadically prevalent in the spring and detected more commonly in the other seasons in Guangzhou.</p><p><b>CONCLUSION</b>Both rotavirus and norovirus are the major causative agents for childhood diarrhea. The seasonality of rotavirus diarrhea was similar among the 5 cities. Nevertheless, the seasonality of norovirus diarrhea was diverse in the different areas. In Tianjin located in the north of China, norovirus was quite prevalent in the cold season. In the east (Shanghai and Hangzhou) and south-west (Chongqing), norovirus prevailed dominantly in the summer and autumn. In the south (Guangzhou), the activity of norovirus was more obvious in the summer, autumn and winter.</p>

Monocyte chemotactic protein-1 gene polymorphism and monocyte chemotactic protein-1 expression in Chongqing Han children with tuberculosis / 中华儿科杂志

<p><b>OBJECTIVE</b>The aims of this study were to evaluate whether the presence of -2518A/G polymorphism in the distal regulatory region of the monocyte chemotactic protein-1 (MCP-1) was associated with tuberculosis (TB) in Chongqing Han population and to find whether it has a significant impact on the pediatric patient.</p><p><b>METHOD</b>One hundred children [ < or = 15 years old, mean age (7.3+/-4.6) years, 53 male, 47 female] and one hundred adults [51 male, 49 female, age (44.6+/-13.5) years with TB] and 200 healthy controls of comparable age were screened for genotype by PCR-sequence-specific primer (SSP) method. MCP-1 levels in the sera were detected by ELISA.</p><p><b>RESULT</b>(1) TB patients and controls showed different single nucleotide polymorphism (SNP) distribution patterns (58%, 36%). MCP-1 alleles -2518G was associated with increased TB susceptibility (P<0.01). (2) The -2518 GG genotypes was associated with increased TB susceptibility (32% in TB patients and 13% in non-TB controls respectively, P<0.01). (3) The odds of developing TB in genotypes GG were higher than those in homozygous AA, and the risk was higher in children than in adult (7.0-fold in children and 5.1-fold in adults, respectively). (4) Cases of homozygous GG had the highest plasma levels of MCP-1, which increased the likelihood of developing TB. Furthermore, higher levels were observed in children than in adults.</p><p><b>CONCLUSION</b>These findings suggest that persons bearing the MCP-1 genotype GG produce high concentrations of MCP-1, which increases the risk of active TB infection in Chongqing Han people. These findings are more significant in child patients than in adult patients with TB.</p>

Primary immunodeficiency complicated with Bacillus Calmette-Guerin infection: identification and clinical phenotype of a case of novel interleukin-12Rbeta1 gene mutation / 中华儿科杂志

<p><b>OBJECTIVE</b>Interleukin-12 receptor beta1 (IL-12 Rbeta1) deficiency is a rare primary immunodeficiency (PID) characterized by selective susceptibility to weakly virulent organisms, including Mycobacterium bovis, BCG, non-tuberculous environmental mycobacteria and non-typhoidal salmonellosis. The present study was conducted to identify the mutation type and to analyze clinical phenotype.</p><p><b>METHODS</b>Based on the typical clinical manifestations and immunologic tests in this case, a varieties of PIDs were excluded and IL-12Rbeta1 deficiency was suspected. IL-12Rbeta1 chain expressed on Epstein-Barr virus-transformed lymphoblastoid B cell lines were detected by flow cytometric assay. The IL-12Rbeta1 gene sequences of the patient and her parents were analyzed by PCR-directed sequencing. The IL-12Rbeta1 gene sequences of the patient's younger brother also had been analyzed prenatally and after birth.</p><p><b>RESULTS</b>After inoculating BCG, the patient suffered from multiple BCG infectious lymphadenitis. There was no detectable IL-12Rbeta1 on the Epstein-Barr virus-transformed lymphoblastoid B cell lines from the patient, while only mild expression on the cell line from her mother. Sequencing analysis by using sense and antisense primers separately, a novel IL-12Rbeta1 gene mutation was found in the patient which was homozygous single nucleotide substitution, a nonsense mutation with nucleotide substitution of C to T at position 853 (853C-->T) in exon 9 leading the glutamate at position 285 to the stop codon mutation (Q285X). The parents were carriers of the mutated IL-12Rbeta1 gene. But her younger brother has normal IL-12Rbeta1 gene.</p><p><b>CONCLUSION</b>The novel IL-12Rbeta1 gene mutation is responsible for BCG infection in this case and genetic analysis is useful in carrier detection and prenatal diagnosis is feasible when the mother had a baby with identified IL-12Rbeta1 gene mutation before.</p>

Mechanism of Action of Rhubarb on Intrahepatic Cholestasis in Infantile Rats / 实用儿科临床杂志

Objective To explore mechanism of action of rhubarb on intrahepatic cholestasis in infantile rats.Methods Ninety Sprague-Dawley(SD)infantile rats were randomly divided into 5 groups:treatment group of rhubarb,untreated group,treatment control group 1 of ursodeoxychlic acid(UDCA),treatment control group 2 of UDCA and deltasone,and control group not treated with ?-naphthyl isothiocyanate(ANIT)and any other treatments.Jaundice model of intrahepatic cholestasis was established in infantile rats by ANIT.At the time of the 2nd,3rd,and 4th week,the concentrations of serum total bilirubin(TB),direct bilirubin(DB),ALT,alkaline phosphatase(ALP),total bile acid(TBA)and TBA were assessed by automatic biochemical analyzer.The concentrations of nitrogen monoxide(NO),maleic dialdehyde(MDA)and the ability of total antioxidation(T-AOC)in liver tissues were measured.Results It was demonstrated that the animal model of hepatic jaundice with cholestasis was successfully established.The levels of serum DB,TB,ALP,ALT and TBA were significantly lower in the treatment group of rhubarb compared with those in the untreated group(Pa

Progress of Diangosis and Treatment in Children with Irritable Bowel Syndrome / 实用儿科临床杂志

Irritable bowel syndrome(IBS) is a quite common disease,and it is a functional enteropathy that characterized by abdomen discomfort or pain,diarrhea,constipation or the mix of both.At present the clinical diagnosis refers to the Roman Ⅱ standard,but it is easy to create leaks examines.In 2006,the new Roman Ⅲ standard let clinician have a more objective basis regarding diagnosis of children with IBS.Its treatment is a complex therapy based on the symptom and serious degree of the symptom.The author will introduce children with IBS with emphasis on the diagnosis and treatment progress.

Relative Analysis between Drug Sensitivity and Escherichia Coli Induced Enzymes in Childhood Diarrhea / 实用儿科临床杂志

Objective To investigate the distribution of pathogenic bacteria,drug sensitivity,and the relationship between drug sensitivity and Escherichia coli(E.coli) induced enzymes in childhood diarrhea in the last 2 years in Chongqing area,so as to provide important evidence for pediatric clinical therapy.Methods Thirty-one E.coli induced enzymes,extended spectrum ?-laetamases(ESBLs),cephalosporinase(AmpC)detected in different phenotype methods,and drug sensitivity was measured in paper strip method,and the specimens were collected from children′s hospital affiliated to chongqing university of medical sciences from Jan.2005 to Dec.2006 were determined.Among the total,there were 18 enteropathogeic E.coli(EPEC) strains,8 enterotoxigenic E.coli(ETEC) strains and 5 enteroinvasive E.coli(EIEC) strains.In addition,drug resistance tests by paper strip included chloramphenicol(CHL),amikacin(AMK),gentamicin(GEN),norfloxacin(NOF),ciproflocacin(CIP),cefazolin(CEZ),cefoperazone(CPZ),ceftriaxone(CRO),ceftazidime(CAZ),cefotacime(CTX),cefepime(FEP),imipenem(IPM).SPSS 12.0 software was used to analyze the data.Results Three point two percent of the 31 E.coli were drug resistant to IPM,and 35.5%,38.7% to NOF,CIP individually,but more than 60% to AMK,GEN,even more than 67.7% towards cephalosporin(except ceftazidime and cefepime);the gross enzyme-produced rate was 87.1%,rate of single ESBLs,AmpC,and induction of both enzymes simultaneously presented 64.5%,6.5%,16.1% respectively;and there was marked difference in drug resistance when bacteria that produced single AmpC versus bacteria that produced single ESBLs or that produced both ESBLs and AmpC(Pa﹤0.05).Conclusions The relationships among enzyme′s quantity,sort and bacterial resistance are different.These data show E.coli infected by bacterial diarrhea children in Chongqing due to a high rate of induced enzymes,and their drug resistance vary according to the state of induced enzymes.

Study on Effect of Omeprazole on Therapy and Prophylaxis for Stress Ulcer in Children with Epidemic Type B Encephalitis / 实用儿科临床杂志

Objective To investigate the safety,therapy and prophylactic effect of Omeprazole on stress ulcer in children with epidemic type B encephalitis.Methods Before and after medication,chest X-ray examination was performed.The result of occult blood(OB) was confirm by Colloidal gold assay in stool and/or gastric juice.Based on the result of OB,the patients were divided into therapy group[besides conventional therapy for encephalitis,Cimitidine group and Omeprazole group with positive result OB,was administered with 0.9% normal sodium 100 mL+Cimitidine 20-40 mg/(kg?d),iv,q12 h and normal sodium 100 mL+Omeprazol 0.5-0.8 mg/(kg?d),iv,qd,respectively] and prophylaxis group(Cimitidine group,Omeprazole group and control group,with negative result OB,were administered with same medicines as therapy group,respectively.Except control group being administered only 0.9%NS 100 mL,iv,(q12 h)).The effects of drugs on hemostasis,preventing hemorrhage,and the potential risk of acquired pneumonia result from drugs used were observed.Results In therapy group,the average time of hemostasis in Omeprazole group was obviously shorter than that of in Cimitidine group,there was significant difference between two groups(P0.05).Conclusions Both of the drugs is safety and effect to therapy or prophylaxis for the latent stress ulcer in short term.The effect of Omeprazole is better than those of Cimitidine.Using Cimitidine and Omeprazole,neither therapy nor prophylaxis for stress ulcer increaseds the potential risk of acquired pneumonia in children with epidemic type B encephalitis in this study.