Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children / 中国当代儿科杂志

OBJECTIVES@#To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP.@*METHODS@#Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment.@*RESULTS@#Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05).@*CONCLUSIONS@#The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.

Preparative isolation of graphislactone A from the fruits of Sinopodophyllum hexandrum and its antitumor action mechanism / 中草药

Objective To establish the preparative isolation technique of grahislactone A from the fruits of Sinopodophyllum hexandrum, and to investigate the action mechanism for apoptosis induction of graphislactone A in MCF-7/ADR cell line (human breast adencarcinoma cell line). Methods The fruits of S. hexandrum were extracted under ultrasound by EtOAc. Graphislactone A was enriched by silica gel column chromatography, and then purified by recrystallization. The cytotoxic activities of graphislactone A were tested against MCF-7 and MCF-7/ADR cell lines by MTT. The apoptosis of MCF-7/ADR cell line was evaluated by flow cytometry. RT-PCR was used to detect the expression of apoptosis-related genes in MCF-7/ADR cell line. Expression of P-gp in MCF-7/ADR cell line was investigated by western blotting. Results Graphislactone A was isolated from the fruits of S. hexandrum, which showed the potent cytotoxic activities against MCF-7 and MCF-7/ADR cell lines, with IC50 values of 2.38 and 9.35 μmol/L, respectively. With the increased dose of graphislactone A, the expression levels of p53, bax, caspase-3 genes were up-regulated, while bcl-2 and P-gp down-regulated in MCF-7/ADR cell line. Conclusion Graphislactone A as phenolic compoundswas firstly found in higher plants. The preparative isolation has the advantages of high-efficiency, high sample recovery, and high-purity compared with etoposide. Graphislactone A showed strong cytotoxic activities and apoptosis induction action in MCF-7 and MCF-7/ADR cell line.

Effect of Corticosteroid and Long-Acting ?_2-Agonist Seretide in Treatment of Children with Asthma / 实用儿科临床杂志

Objective To observe effect of corticosteroid and long-acting ?2-agonist seretide to treat patients with moderate asthma who were uncontrolled on existing corticosteroid therapy.Methods From Oct.2005 to Feb.2007,85 asthmatic patients were randomly divided into two groups,treatment group were treated with seretide twice daily and the control group were treated with pulmicort(budesonide)twice daily.The clinical effect index and peak expiratory flow(PEF)were analyzed statistically.Results There were 61 cases in seretide group and 24 cases in pulmicort group who were follow-up examined and evaluated effectively the clinical effect.The treatment period was 1 year,the efficacy were 100% and 75% respectively,there was significant difference between two groups(P