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1.
Article in Chinese | WPRIM | ID: wpr-934099

ABSTRACT

To investigate the efficacy and safety of modified endoscopic retrograde appendicitis therapy (ERAT) in children with acute uncomplicated appendicitis complicated with intussusception. Data of 6 patients with acute uncomplicated appendicitis complicated with intussusception who received modified ERAT were collected from October 2018 to February 2020 in Pediatrics Department of Tangdu Hospital. The reduction rate of intussusception, the success rate of ERAT appendiceal intubation and endoscopic treatment, the remission time of clinical symptoms, the time of white blood cells return to normal, the length of hospital stay, complications and recurrence were summarized. All the 6 patients were confirmed to be acute uncomplicated appendicitis combined with ileocecal intussusceptions under colonoscopy. Endoscopic intussusception reduction and ERAT were performed successfully. The mean time of disappearance of abdominal tenderness was 1.3 days after the therapy, and the time of white blood cells return to normal was 1 day after surgery. The endoscopic treatment were all successful and the length of hospital stay was 3-6 days. No complications or recurrence of intussusception and appendicitis occurred during the follow-up period of 6-12 months. Modified ERAT can effectively, safely and minimally invitingly treat acute uncomplicated appendicitis with intussusception in children on the basis of definite diagnosis.

2.
Article in Chinese | WPRIM | ID: wpr-930810

ABSTRACT

The functional gastrointestinal disorders(FGIDs)is a common digestive system disease in children.It is a group of diseases characterized by chronic and recurrent gastrointestinal symptoms.Based on the Rome Ⅳ functional gastrointestinal disorders published in 2016, this review introduced the classification, etiology and pathogenesis regarding FGIDs in children, as well as the diagnosis and treatment.The aim is to improve pediatricians′ awareness and knowledge regarding FGIDs.

3.
Article in Chinese | WPRIM | ID: wpr-907947

ABSTRACT

Objective:To establish a mice model of inflammatory bowel disease (IBD) induced by dextran sulfate sodium (DSS), and to analyze the changes in intestinal inflammation and macrophage subsets at different stages, so as to find a new target for the treatment of IBD.Methods:Thirty male C57BL/6 mice of 6-8 weeks were randomly divided into control group, activation stage group and resolution stage group.The latter 2 groups were given 25 g/L DSS for 5 consecutive days to establish the IBD model.After 5 days, the mice were given filtered and sterilized water and sacrificed on the 10 th and 15 th day, respectively.Colon inflammation in mice was evaluated, including body weight, disease activity index (DAI) score, changes in colon length, histopathology and histopathological score.Then the expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β in colon tissues were detected by quantitative real-time PCR(qPCR). Finally, the changes of intestinal macrophage subsets were detected by flow cytometry. Results:The colon inflammation of mice in the activation stage group was significantly more severe than that in the control group, while the colon inflammation of mice in the resolution stage group was reduced.The colon length of mice in the activation stage group was (5.94±0.40) cm, which was significantly shorter than that in the control group [(7.25±0.29) cm], and the situation was slightly improved in the resolution stage with the colon length of [(6.87±0.95) cm], and the differences were statistically significant (all P<0.05). The mRNA expression levels of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α in the activation stage were 53.40±6.58, 117.69±30.78 and 2.52±0.25, respectively, which were significantly higher than those in the control group (1.00±0.13, 1.00±0.39, 1.00±0.10); the mRNA expression levels of IL-1β, IL-6 and TNF-α in the resolution stage were 2.51±0.13, 5.43±0.51 and 1.73±0.14, respectively, which were significantly lower than those in the activation stages(all P<0.05). The expression level of anti-inflammatory cytokine TGF-β in the resolution stage was 2.41±0.17, which was significantly higher than that in the activation stage (0.94±0.12), and the diffe-rence was statistically significant ( P<0.05). During the progression of IBD, there were 3 groups of macrophages in the lamina propria of intestinal mucosa of mice, of which the number of F4/80 lowCD 64-MHCⅡ - macrophage subset with the lowest maturity increased significantly in the activation stage of IBD, accounting for (10.68±4.62)%, and it decreased and returned to the normal level in the resolution stage, accounting for (4.63±1.06)%, and the difference was statistically significant ( P<0.05). Conclusions:Macrophages play an important role in the progression of IBD, the hindrance of maturation and development may be the main cause of inflammatory injury in the activation stage of IBD, and the transformation of macrophage subsets may become a new target for the treatment of IBD.

4.
Article in Chinese | WPRIM | ID: wpr-882915

ABSTRACT

Objective:To study the value of ultrasound-guided endoscopic retrograde appendicitis therapy in children with uncomplicated appendicitis.Methods:This study was a single center, retrospective study, including all electronic cases of appendicitis diagnosed clinically in Department of Pediatrics, the Second Affiliated Hospital of Air Force Military Medical University from October 2018 to October 2020 and received ultrasound-guided endoscopic retrograde appendicitis therapy.The clinical features, treatment and prognosis of the children were retrospectively analyzed.Results:A total of 152 electronic cases were included, there were 77 males and 75 females, aged(6.84±3.09) years.All the 152 children were treated with ultrasound-guided endoscopic retrograde appendicitis therapy.Intubation success rate and clinical success rate was 98.03%(149/152 cases)and 97.99%(146/149 cases), respectively.The median time of endoscopic therapy was 42.50 (31.00, 56.00) minutes.Mean postoperative hospital stay was (2.81 ±1.41) days, and the mean total hospital stay was (4.19 ±1.71) days.A total of 139 patients were followed up with a median follow-up time of 5 (1, 26) months.During the follow-up, the recurrence rate was 7.19%(10/139 cases), and the median time of recurrence was 2 (1, 3) months.Conclusions:Ultrasound-guided endoscopic retrograde appendicitis therapy had high effective rate and low recurrence rate in children with uncomplicated appendicitis, preserved the physiological function of appendix and avoided radiation damage.It can be used as a safe and effective treatment for acute and chronic uncomplicated appendicitis in children.

5.
Chinese Journal of Dermatology ; (12): 704-709, 2020.
Article in Chinese | WPRIM | ID: wpr-870350

ABSTRACT

Objective:To evaluate the proliferative activity of and changes in the expression of related differentiation proteins in a stably NCSTN gene-silenced human immortalized keratinocyte cell line HaCaT, and to preliminarily explore the possible mechanism underlying the occurrence of acne inversa.Methods:By lentivirus-mediated short hairpin RNA (shRNA) , a NCSTN gene-silenced HaCaT cell model was established (shRNA group) , and other HaCaT cells transfected with empty lentivirus served as a negative control group. Real-time quantitative PCR and Western blot analysis were performed to determine the NCSTN gene-silencing efficiency. Cell counting kit-8 (CCK8) assay was conducted to evaluate the proliferative activity of HaCaT cells, and real-time quantitative PCR and Western blot analysis were performed to determine the mRNA and protein expression of cytokeratins (CK1, CK5, CK7, CK10, CK14, CK16, CK17, CK18, CK19 and CK20) and other differentiation molecules (involucrin and loricrin) respectively in HaCaT cells. Two-independent-sample t test was used to compare the measurement data between two groups. Results:NCSTN mRNA and protein expression were significantly lower in the shRNA group (0.42 ± 0.19, 0.30 ± 0.07 respectively) than in the negative control group (1.00 ± 0.34, 1.00 ± 0.26; t = 5.196, 2.637, P < 0.001, < 0.05, respectively) , and the gene-silencing efficiency was 70%. Compared with the negative control group, the shRNA group showed higher cellular proliferative activity, but decreased protein expression of CK16, CK19 and terminal differentiation molecule involucrin ( t = 3.787, 3.817, 2.904, P < 0.01, < 0.05, < 0.05, respectively) . Conclusion:Stable silencing of NCSTN gene can lead to abnormal proliferation and differentiation of HaCaT cells, which provides new ideas for subsequent exploration of acne inversa caused by NCSTN gene mutation.

6.
Chinese Journal of Dermatology ; (12): 445-451, 2020.
Article in Chinese | WPRIM | ID: wpr-870308

ABSTRACT

Objective:To investigate changes of nicastrin (NCSTN) downstream molecules in signaling pathways related to cell proliferation and differentiation after silencing the expression of the NCSTN gene in the human immortalized keratinocyte cell line HaCaT.Methods:HaCaT cells were divided into 3 groups: interference group transfected with a specific small interfering RNA (siRNA) targeting NCSTN (NCSTN-siRNA) , negative control group transfected with a negative control siRNA, and blank control group transfected with the equal amount of transfection reagent. Real-time PCR and Western blot analysis were performed to measure the NCSTN mRNA and protein expression in groups, in order to verify the transfection efficiency. Differences in gene expression profiles in HaCaT cells were detected between the interference group and negative control group by using Agilent whole-genome microarray, and differentially expressed genes were identified based on a fold change ≥ 2.0 with a P value ≤ 0.05. Gene ontology (GO) enrichment analysis was employed to identify the roles of the differentially expressed genes, and then to screen out significantly differentially expressed genes associated with proliferation and differentiation of keratinocytes, some of which were verified by real-time PCR. Results:The interference group showed significantly decreased mRNA and protein expression of NCSTN (0.287 ± 0.090, 0.443 ± 0.085, respectively) compared with the negative control group (0.969 ± 0.127, 1.047 ± 0.114, respectively) and blank control group (1.000 ± 0.151, 1.000 ± 0.111, F = 30.787, 31.139, respectively, both P = 0.001) . Whole genome-expression analysis using an Agilent microarray platform revealed 605 downregulated genes and 444 upregulated genes in HaCaT cells in the interference group compared with the negative control group. GO analysis showed that differentially expressed genes were enriched into 4 biological processes, including epithelial development, epithelial cell differentiation, keratinocyte differentiation and keratinization. The significantly differentially expressed genes associated with proliferation and differentiation of keratinocytes, including the Sprouty-related protein with EVH1 domain 2, fibroblast growth factor 7, insulin-like growth factor-binding protein 5, Rho-associated coiled-coil kinase 2 and bone morphogenetic protein 6 genes, were verified by real-time PCR, and the verification results were consistent with the difference trend shown by the microarray results. Conclusion:The loss of NCSTN gene function may affect the normal proliferation and differentiation of keratinocytes by regulating the expression of its downstream molecules in signaling pathways associated with cell proliferation and differentiation.

7.
Article in Chinese | WPRIM | ID: wpr-864252

ABSTRACT

Objective:To observe the variation of glutamate(AMPA) receptor interacting protein(GRIPs)and apoptosis of oligodendrocyte precursor cells (OPCs)under oxygen glucose deprivation (OGD) condition, so as to explore the role of GRIPs in AMPA receptor-induced excitotoxic injury.Methods:OPCs were divided into control group, 60 min OGD group and 120 min OGD group.Real-time polymerase chain reaction (PCR) and Western blot were used to detect the mRNA and protein expressions of GRIP1 and GRIP2 under OGD conditions.OPCs were divided into blank control group, OPCs+ OGD group, OPCs+ cyclic adenosine monophosphate(cAMP)+ OGD group, OPCs+ cAMP+ OGD+ GRIP1 small interfering RNA(siRNA) group, OPCs+ cAMP+ OGD+ GRIP1 siRNA negative control group, OPCs+ cAMP+ OGD+ GRIP2 siRNA group, OPCs+ cAMP+ OGD+ GRIP2 siRNA negative control group again, and terminal-deoxynucleoitidyl transferase mediated nick end labeling(TUNEL) kit was used to detect the apoptosis of each group.Fluo-4 fluorescent probe was used to measure the changes of intracellular free calcium.Results:OGD caused damage to OPCs, and the light microscope showed that the cell contour was not clear and the cell body retracts.The expressions of GRIP1 (1.233±0.060 vs.1.003±0.079, P<0.05) and GRIP2 (1.396±0.069 vs.1.001±0.037, P<0.05) were significantly higher than those in control group after 60 min of OGD was, and the longer the period of OGD, the higher the expression levels of GRIP1 (1.416±0.064 vs.1.233±0.060, P<0.01) and GRIP2 (1.680±0.018 vs.1.396±0.069, P<0.01) were.When GRIP1 and GRIP2 were down-regulated, the level of intracellular free calcium ion decreased(0.054±0.003 vs.0.074±0.003, P<0.01; 0.060±0.003 vs. 0.074±0.003, P<0.01), and the apoptosis rate decreased as well [(20.703±3.882)% vs.(11.470±1.679)%, P<0.05; (19.070±1.106)% vs.(14.448±0.849)%, P<0.01]. Conclusions:GRIP1 and GRIP2 are involved in the damage of OPCs that are caused by OGD, which may trigger AMPA receptor-mediated excitotoxicity by regulating Ca 2+ permeability.

8.
Article in Chinese | WPRIM | ID: wpr-864210

ABSTRACT

Functional constipation(FC) in children is a kind of common gastrointestinal disease caused by a variety of factors.At present, basic therapy and drug therapy are main treatments of FC in children.The drug therapy has a good curative effect, but it is prone to cause symptom recurrence after drug withdrawal.Moreover, the long-term medication costs much.In recent years, research has indicated that intestinal flora disturbance may be a vital mechanism of FC, In this article means that regulating the gut microbiota can provide a theoretical support for microbial treatment in FC.In this article, the research progress of the correlation between intestinal flora and FC in children and its mechanism were reviewed.

9.
Chinese Journal of Dermatology ; (12): 656-659, 2019.
Article in Chinese | WPRIM | ID: wpr-755825

ABSTRACT

Acne inversa is a chronic inflammatory skin disease of the folliculo-sebaceous-apocrine unit.Currently,genetic and immunological factors are hot topics in the study of its pathogenesis.Genetic factors are mainly related to γ-secretase mutations,and abnormal expression of the γ-secretase-Notch axis leads to increased keratinization of hair follicles and inflammation in some patients with haploinsufficiency of the y-secretase gene.Mutations in the γ-secretase gene are not necessary for acne inversa,and the risk of Alzheimer's disease in familial acne inversa patients still remains unclear.Some progress has been made in researches on the association of genotype with phenotype in acne inversa patients,but further studies with large sample size are needed for verification.

10.
Chinese Journal of Dermatology ; (12): 656-659, 2019.
Article in Chinese | WPRIM | ID: wpr-797852

ABSTRACT

Acne inversa is a chronic inflammatory skin disease of the folliculo-sebaceous-apocrine unit. Currently, genetic and immunological factors are hot topics in the study of its pathogenesis. Genetic factors are mainly related to γ-secretase mutations, and abnormal expression of the γ-secretase-Notch axis leads to increased keratinization of hair follicles and inflammation in some patients with haploinsufficiency of the γ-secretase gene. Mutations in the γ-secretase gene are not necessary for acne inversa, and the risk of Alzheimer′s disease in familial acne inversa patients still remains unclear. Some progress has been made in researches on the association of genotype with phenotype in acne inversa patients, but further studies with large sample size are needed for verification.

11.
Article in Chinese | WPRIM | ID: wpr-734748

ABSTRACT

Objective To evaluate the value of indirect immunofluorescence (IIF) on three different substrates including normal human skin (NS),monkey esophagus (ME) and salt-split human skin (SS) in the diagnosis of autoimmune subepidermal bullous diseases.Methods A total of 56 patients with autoimmune subepidermal bullous diseases,including 47 with bullous pemphigoid (BP),6 with epidermolysis bullosa acquisita (EBA),2 with linear IgA bullous dermatosis,and 1 with anti-P200 pemphigoid,were diagnosed in and enrolled from Department of Dermatology,Institute of Dermatology,Chinese Academy of Medical Sciences between January 2015 and December 2016.Seventy patients with pemphigus,15 patients with chronic eczema and 15 healthy adults served as controls.Blood samples collected from these patients and controls were subjected to IIF on three different substrates including NS,ME and SS,and the fluorescence deposition was observed.The sensitivities and specificities of IIF in the diagnosis of different subepidermal bullous diseases were compared.Statistical analysis was carried out with SPSS 13.0 software by using chi-square test for the comparison of enumeration data.Results IIF on NS or ME in the serum of patients with BP showed linear deposition of fluorescent material along the basement membrane zone.IIF on SS showed linear deposition of fluorescent material in the epidermis in the patients with BP,but in the dermis in the patients with EBA and anti-P200 pemphigoid.The sensitivities of IIF on NS,ME or SS in the diagnosis of subepidermal bullous diseases were 73.2%,60.7% and 94.6% respectively,and the specificities were 98.0%,100% and 97.1% respectively.There were significant differences among the sensitivities (x2 =18.2,P < 0.05),but no significant difference was observed among the specificities (P > 0.05).The diagnostic sensitivity of IIF on SS was significantly higher than that of IIF on NS or ME(x2 =8.0,16.7,both P < 0.05).Conclusion In the diagnosis of autoimmune subepidermal bullous diseases,IIF on SS is superior to IIF on ME or NS.

12.
Article in Chinese | WPRIM | ID: wpr-743500

ABSTRACT

Objective To investigate the effect of antibiotic-induced microbiota dysbiosis on colonic barrier and immune response in juvenile mice.Methods Twenty Balb/c mice were randomly divided into experimental group and control group.Broad spectrum antibiotic mixture were administered by means of gavage to the experimental group every 12 hours for 14 days to induce intestinal microbiota dysbiosis.The mice of control group were given an equal amount of physiological saline.On the 15th day,all mice were intraperitoneally injected with lipopolysaccharide(LPS) to induce intestinal inflammatory reaction.The structure of intestinal flora was analyzed by way of 16SrRNA sequencing,and the morphology of colonic mucosa was observed by means of HE staining.The infiltration of colonic mucosa was observed through toluidine blue staining and immunohistochemistry.The levels of inflammatory cytokines in colon tissue were measured by real-time PCR and intestinal permeability-related parameters were measured by enzyme-linked immunosorbent assay.Results The intestinal microbial composition of the experimental group was significantly changed,and the expression levels of inflammatory cytokines interleukin (IL)-1β,IL-6,IL-8,IL-10,tumor necrosis factor (TNF)-α mRNA in the antibiotic group (0.765 ± 0.062,0.082 ± 0.040,0.442 ± 0.059,0.469 ±0.079,0.736 ± 0.063) were all lower than those in the control group (1.738 ± 0.243,1.090 ± 0.104,1.151 ±0.136,1.066 ± 0.102,1.539 ± 0.218),and the differences were statistically significant (all P < 0.05).The expressions of intestinal barrier related gene of mice ZO-1 and Occludin decreased (0.639 ± 0.071 vs.1.347 ± 0.224,0.770 ±0.067 vs.1.487 ± 0.148) but the level of fecal albumin increased [(6.419 ± 0.552) mg/L vs.(6.079 ± 0.011) mg/L] after antibiotic exposure,and the differences were statistically significant (all P < 0.05).Conclusions Antibiotic exposure leads to changes of enteric microbiota,which adversely affects local mucosal immunity and intestinal barrier function of colon in juvenile mice.

13.
Article in Chinese | WPRIM | ID: wpr-801523

ABSTRACT

Objective@#To analyze and discuss the social factors and clinical characteristics of oral poisoning in children, so as to provide reference for preventing and treating children poisoning.@*Methods@#The clinical data of 173 pediatric patients with oral poisoning diagnosed and treated in Department of Pediatrics, the Fourth Military Medical University in Tangdu Hospital from January to December 2017 were retrospectively analyzed.@*Results@#Pesticide and insecticide poisoning topped the list(68 cases, 39.31%)and the clinical manifestations of different poisons were varied.Geographically, the urban and rural distribution was mainly rural(118 cases, 68.21%), among which 103 cases(87.29%)were left-behind children in rural areas.Within one year, the number of urban children fluctuated slightly, with a small peak in March and the number of rural children fluctuated greatly, with a large peak in July.In addition, urban children were mainly poisoned by oral internal medicine(34 cases, 61.82%), while rural children were mainly poisoned by oral pesticide and insecticide(64 cases, 54.24%). The gender distribution was mainly male(101 cases, 58.38%), with the highest incidence in early childhood(97 cases, 56.07%). The main reasons for taking poison included children′s misadministration(123 cases, 71.10%), parents′ accidental feeding(24 cases, 13.87%), and elder children′s self-administration due to emotional factors(26 cases, 15.03%). The treatment methods were gastric lavage, emetic stimulation and enema according to the type and time of poisoning of administration, and timely use of specific antidote and symptomatic treatment was also the key to treatment.@*Conclusion@#The situation is more serious in rural areas of oral poisoning in children, especially for left-behind children in rural areas, who are at the highest incidence in early childhood.Oral pesticides, insecticides and oral drugs are the most prominent, and misadministration is the main reason.Family poison management should be strengthened for prevention, and treatment should vary according to the type and time of taking poison.

14.
Chinese Journal of Dermatology ; (12): 742-744, 2017.
Article in Chinese | WPRIM | ID: wpr-660524

ABSTRACT

A 59-year-old male patient presented with recurrent erythema and wheals all over the body for 6 years,complicated by irregular fever (the highest body temperature < 39 ℃)and arthralgia for 2 months.He experienced a weight loss of 5 kg during two years prior to the presentation.Physical examination showed anemic comlexion,and there was no palpable enlargement of superficial lymph nodes,liver and spleen.Generalized erythema and wheals occurred all over the body,involving about 50% of the body surface area.Histopathological examination of skin lesions showed infiltration of multiple neutrophilic granulocytes around blood vessels in the superficial dermis,and no vasculopathy was observed.Laboratory examinations revealed increased white blood cell (WBC) counts(13.97 × 109/L),erythrocyte sedimentation rate (ESR,136 mm/1 h) and C-reactive protein (CRP) level (75 mg/L),decreased hemoglobin level (96 g/L),and high serum levels of IgE (1 596 kU/L),IgG(20.4 g/L)and IgM(6 310 mg/L).Serum immunoelectrophoresis demonstrated that the IgM was a κ-type monoclonal immunoglobulin.Bone marrow examination showed active bone marrow hyperplasia.DNA sequencing analysis of 10 pairs of exons of the NLRP3 gene revealed 3 synonymous mutations,including c.663:C > T:p.T221,c.732:G > A:p.A244A and c.786:A > G:p.R262R.Finally,the patient was diagnosed with Schnitzler's syndrome.There was no improvement of symptoms after the treatment with multiple oral antihistamines at increased dose levels.Then,the treatment protocol was adjusted to oral ciclosporin at a dosage of 200 mg/d for consecutive 18 days,but the patient still showed no response.After the treatment with oral prednisone (30 mg/d) and Tripterygium wilfordii tablets (66 μg thrice a day) for 2 weeks,the skin rashes subsided gradually,and arthralgia was relieved.Moreover,the WBC count,ESR and CRP level were decreased to 9.01 × 109/L,50 mm/1 h and 6 mg/L respectively,while the hemoglobin level was increased to 109.7 g/L.After 1-year follow-up,the dosage of glucocorticoids was gradually decreased to 8 mg/d.In addition,his condition was controlled well with no skin lesions and fever,except for occasional arthralgia in the knees and hip.

15.
Article in Chinese | WPRIM | ID: wpr-658963

ABSTRACT

Objective To investigate the effects of lysine and gluconic acid zinc granules combined with cimetidine on serum creatine kinase isoenzyme (CK-MB), aspartate aminotransferase (AST) and interleukin-6 (IL-6) levels and prognosis in children with rotavirus enteritis. Methods Eighty-one children with rotavirus enteritis were randomly divided into control group (40 patients) and observation group (41 patients).The patients in control group were treated with cimetidine, and those in the observation group were treated with cimetidine combined with lysine and gluconic acid zinc granules. Clinical treatment, dehydration correction time, diarrhea time, fever time and serum CK-MB, AST and IL-6 levels were observed and compared between two groups. The occurrence of toxic side effects and vitality, physiological function, mental status scores were statistically analyzed. Results The total effective rate in observation group was 95.12%(39/41), in control group was 75.00%(30/40), and there was significant difference (P < 0.05). The dehydration correction time, diarrhea time, fever time after treatment in observation group was less than that in control group (P<0.05). The serum CK-MB, AST and IL-6 levels after treatment in observation group were significantly lower than those in control group (P<0.01). There was no significant difference in the incidence of side effects between observation group 17.07%(7/41) and control group 10.00%(4/40) (P>0.05). The scores of physiological function, vitality and mental status scores in observation group were higher those in control group, and there were significant differences(P < 0.01). Conclusions The lysine and gluconic acid zinc granules combined with cimetidine in the treatment of rotavirus enteritis gets has a significant effect and high safety, which can alleviate the inflammatory reaction and improve the myocardial enzymes levels and the quality of life.

16.
Chinese Journal of Dermatology ; (12): 742-744, 2017.
Article in Chinese | WPRIM | ID: wpr-657945

ABSTRACT

A 59-year-old male patient presented with recurrent erythema and wheals all over the body for 6 years,complicated by irregular fever (the highest body temperature < 39 ℃)and arthralgia for 2 months.He experienced a weight loss of 5 kg during two years prior to the presentation.Physical examination showed anemic comlexion,and there was no palpable enlargement of superficial lymph nodes,liver and spleen.Generalized erythema and wheals occurred all over the body,involving about 50% of the body surface area.Histopathological examination of skin lesions showed infiltration of multiple neutrophilic granulocytes around blood vessels in the superficial dermis,and no vasculopathy was observed.Laboratory examinations revealed increased white blood cell (WBC) counts(13.97 × 109/L),erythrocyte sedimentation rate (ESR,136 mm/1 h) and C-reactive protein (CRP) level (75 mg/L),decreased hemoglobin level (96 g/L),and high serum levels of IgE (1 596 kU/L),IgG(20.4 g/L)and IgM(6 310 mg/L).Serum immunoelectrophoresis demonstrated that the IgM was a κ-type monoclonal immunoglobulin.Bone marrow examination showed active bone marrow hyperplasia.DNA sequencing analysis of 10 pairs of exons of the NLRP3 gene revealed 3 synonymous mutations,including c.663:C > T:p.T221,c.732:G > A:p.A244A and c.786:A > G:p.R262R.Finally,the patient was diagnosed with Schnitzler's syndrome.There was no improvement of symptoms after the treatment with multiple oral antihistamines at increased dose levels.Then,the treatment protocol was adjusted to oral ciclosporin at a dosage of 200 mg/d for consecutive 18 days,but the patient still showed no response.After the treatment with oral prednisone (30 mg/d) and Tripterygium wilfordii tablets (66 μg thrice a day) for 2 weeks,the skin rashes subsided gradually,and arthralgia was relieved.Moreover,the WBC count,ESR and CRP level were decreased to 9.01 × 109/L,50 mm/1 h and 6 mg/L respectively,while the hemoglobin level was increased to 109.7 g/L.After 1-year follow-up,the dosage of glucocorticoids was gradually decreased to 8 mg/d.In addition,his condition was controlled well with no skin lesions and fever,except for occasional arthralgia in the knees and hip.

17.
Article in Chinese | WPRIM | ID: wpr-608490

ABSTRACT

Objective To investigate the relationship between cow's milk protein allergy(CMPA)and gastroesophageal reflux disease(GERD)and the prognosis of GERD combined with CMPA.Methods Fifty patients(24 boys and 26 girls)with GERD were enrolled in this study from January 2015 to June 2016 at Department of Pediatrics,Tangdu Hospital of the Fourth Military Medical University.All children were treated with serum milk protein soluble IgE(sIgE)and milk protein avoidance test,and those with positive results of children's milk protein by provocation test and those with milk serum protein sIgE negative by milk protein provocation tests were diagnosed as CMPA children with GERD according to the CMPA diagnostic criteria and received diet therapy for 1 month and then their blood eosinophil ratio and 24-hour esophageal pH were monitored.Results Twenty-three cases(46%)of 50 children with GERD were diagnosed as CMPA.There was significant difference in clinical symptoms between GERD group and GERD combined with CMPA group(x2=22.78,P0.05).For children with GERD combined with CMPA,the patients received dietary treatment for 1 month.There was significant improvement in vomiting,runny nose/wheezing/cough and diarrhea(P0.05).The proportions of blood eosinophils were decreased after treatment compared with those before treatment [(2.7±1.8)%vs.(8.2±2.7)%,t=10.006,P<0.01].The results of 5 children's 24-hour esophageal pH monitoring showed that the reflux index and the number of acid GERD episodes were lower than before,and the difference was all statistically significant before and after(all P<0.05).Conclusions The occurrence of GERD in infants is partly related to CMPA,and the treatment of CMPA can relieve the clinical symptoms of GERD.

18.
Chinese Journal of Pediatrics ; (12): 200-204, 2017.
Article in Chinese | WPRIM | ID: wpr-808252

ABSTRACT

Objective@#To explore the composition of the gastrointestinal bacterial flora of mouse embryos and the placenta tissue bacterial flora.@*Method@#Twenty-four specimens were collected from pregnant Kunming mouse including 8 mice of early embryonic (12-13 days) gastrointestinal tissues, 8 cases of late embryonic (19-20 days)gastrointestinal tissues, 8 of late pregnancy placental tissues.The 24 samples were extracted by DNeasy Blood & Tissue kit for high-throughput DNA sequencing.@*Result@#The level of Proteobacteria, Bacteroidetes, Actino-bacteria and Firmicutes were predominantin all specimens.The relative content of predominant bacterial phyla in each group: Proteobacteria (95.00%, 88.14%, 87.26%), Bacteroidetes(1.71%, 2.15%, 2.63%), Actino-Bacteria(1.16%, 4.10%, 3.38%), Firmicutes(0.75%, 2.62%, 2.01%). At the level of family, there were nine predominant bacterial families in which Enterobacteriaeae, Shewanel laceae and Moraxellaceae were dominant.The relative content of dominant bacterial family in eachgroup: Enterobacteriaeae (46.99%, 44.34%, 41.08%), Shewanellaceae (21.99%, 21.10%, 19.05%), Moraxellaceae(9.18%, 7.09%, 5.64%). From the species of flora, the flora from fetal gastrointestinal in early pregnancy and late pregnancy (65.44% and 62.73%) were the same as that from placenta tissue in the late pregnancy.From the abundance of bacteria, at the level of family, the same content of bacteria in three groups accounted for 78.16%, 72.53% and 65.78% respectively.@*Conclusion@#It was proved that the gastrointestinal bacterial flora of mouse embryos and the placenta tissue bacterial flora were colonized. At the same time the bacteria are classified.

19.
Chinese Journal of Dermatology ; (12): 268-272, 2017.
Article in Chinese | WPRIM | ID: wpr-511360

ABSTRACT

Objective To construct a lentiviral vector delivering the Nicastrin (NCT) gene-targeted short hairpin RNA (shRNA) and determine gene-silencing efficiency of the vector in the human immortalized keratinocyte cell line HaCaT,and to construct a NCT gene-silenced HaCaT cell model to lay an experimental foundation for subsequently studying effects of NCT gene silencing on biological behavior of keratinocytes.Methods Three NCT gene-targeted shRNAs were designed and inserted into the pGLV3/ H1/GFP + Puro vector to construct three recombinant plasmids,which were then confirmed by sequencing.Recombinant plasmids combined with lentivirus packaging plasmids were co-transfected into 293T cells to obtain lentivirus particles,and the virus titer was determined.Cultured HaCaT cells were divided into 3 groups:blank group receiving no treatment,negative control group infected with the empty vector LV3-shNC,interference groups infected with lentivirus NCT-shRNA1,-shRNA2,-shRNA3,respectively.Flow cytometry was performed to determine transfection efficiency,and real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were conducted to determine efficiency of target gene silencing in HaCaT cells,so as to select the most efficient interference sequence.Results Sequencing analysis indicated that recombinant lentiviral vector NCT-shRNA was constructed successfully.After co-transfection of recombinant plasmids and lentivirus packaging plasmids into 293T cells,the titer of recombinant lentivirus particles was about 109 TU/ml.Flow cytometry showed that the transfection efficiency was greater than 95%.qRT-PCR revealed that the NCT mRNA expression was obviously down-regulated in the interference group compared with the negative control group,and NCT-shRNA1 was the most efficient sequence with interference efficiency being 75%.Western blot analysis showed that the inhibition rate of NCT protein expression was 71.7% in the shRNA1 group compared with the negative control group.Conclusion The most efficient NCT-shRNA interference sequence is screened out,and the recombinant lentiviral vector NCT-shRNA and an NCT gene-silenced HaCaT cell model are both constructed successfully.

20.
Article in Chinese | WPRIM | ID: wpr-661882

ABSTRACT

Objective To investigate the effects of lysine and gluconic acid zinc granules combined with cimetidine on serum creatine kinase isoenzyme (CK-MB), aspartate aminotransferase (AST) and interleukin-6 (IL-6) levels and prognosis in children with rotavirus enteritis. Methods Eighty-one children with rotavirus enteritis were randomly divided into control group (40 patients) and observation group (41 patients).The patients in control group were treated with cimetidine, and those in the observation group were treated with cimetidine combined with lysine and gluconic acid zinc granules. Clinical treatment, dehydration correction time, diarrhea time, fever time and serum CK-MB, AST and IL-6 levels were observed and compared between two groups. The occurrence of toxic side effects and vitality, physiological function, mental status scores were statistically analyzed. Results The total effective rate in observation group was 95.12%(39/41), in control group was 75.00%(30/40), and there was significant difference (P < 0.05). The dehydration correction time, diarrhea time, fever time after treatment in observation group was less than that in control group (P<0.05). The serum CK-MB, AST and IL-6 levels after treatment in observation group were significantly lower than those in control group (P<0.01). There was no significant difference in the incidence of side effects between observation group 17.07%(7/41) and control group 10.00%(4/40) (P>0.05). The scores of physiological function, vitality and mental status scores in observation group were higher those in control group, and there were significant differences(P < 0.01). Conclusions The lysine and gluconic acid zinc granules combined with cimetidine in the treatment of rotavirus enteritis gets has a significant effect and high safety, which can alleviate the inflammatory reaction and improve the myocardial enzymes levels and the quality of life.

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