Severe influenza A (H1N1) in late pregnancy: a case report / 中华危重病急救医学

Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30+2 weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO2 of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH2O (1 cmH2O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO2) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.

Severe influenza A (H1N1) in late pregnancy: a case report / 中华危重病急救医学

Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30+2 weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO2 of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH2O (1 cmH2O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO2) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.

Extrapulmonary complications of severe influenza virus infection / 中华实用儿科临床杂志

Nowadays severe influenza is still the main disease threatening the health of children.Influenza virus infection is mainly involved in the human respiratory system,the clinical manifestations are mainly respiratory symptoms,but the influenza virus can also cause systemic disease,especially in patients with severe influenza is often associated with multi system involvement.This paper will introduce influenza associated hemophagocytic syndrome,influenza associated encephalopathy,influenza associated viral myocarditis,influenza associated renal complications,influenza associated complications of digestive system,influenza associated rhabdomyolysis.

Extrapulmonary complications of severe influenza virus infection / 中华实用儿科临床杂志

Nowadays severe influenza is still the main disease threatening the health of children.Influenza virus infection is mainly involved in the human respiratory system,the clinical manifestations are mainly respiratory symptoms,but the influenza virus can also cause systemic disease,especially in patients with severe influenza is often associated with multi system involvement.This paper will introduce influenza associated hemophagocytic syndrome,influenza associated encephalopathy,influenza associated viral myocarditis,influenza associated renal complications,influenza associated complications of digestive system,influenza associated rhabdomyolysis.

Distribution of γδT17/Th17/Tc17 cells in lung of H1N1 infected mice and their relationship with immunologic injury of lung / 中国免疫学杂志

Objective:To investigate the distribution of γδT17,Th17 and Tc17 cells in the lung of mice severely infected by influenza A(H1N1)pdm09 virus and the relationship between these cells with lung immunopathalogical injury.Methods:Intranasal infection was used to establish mouse model of severe H1N1 infection.Flow cytometry assay was used to detect the proportion and number of γδT17 cells,Th17 cells and Tc17 cells in the lung.The concentrations of interleukin-17A(IL-17A),interleukin-1β(IL-1β)and interleukin-23(IL-23) in the bronchoalveolar lavage fluid and serum were assayed by enzyme-linked immunosorbent assay and Lu-minex assay.Results:①The model of mice severely infected by influenza A(H1N1)pdm09 virus was established successfully.②The ratio of γδT cells,but not CD4+T and CD8+T cells in total lymphocytes of the lung of infected mice significantly increased compared with uninfected control mice at the third day post infection(DPI)(P<0.01).③The proportion and number of γδT17 cells,Th17 cells and Tc17 cells in total γδT cells,Th cells and Tc cells in the lung of infected mice were significant higher than that in uninfected control mice at the first DPI,respectively.However,the absolute number of γδT17 cells was far more than Th17 and Tc17 cells(P<0.05);④The concentration of IL-17A in BALF increased significantly after infection(P<0.05),and the concentration of IL-17A in serum increased significantly at the third DPI(P<0.05).The concentrations of both IL-1β and IL-23 in BALF probably participating in the activation of γδT17 cells increased significantly after infection compared with uninfected control mice.Conclusion:The γδT17 cells could be activated and secreted IL-17A via γδTCR non-depended pathway and involved in inflammatory pathological injury of lung at the early stage of severe H1N1 infection.

Clinical analysis of eight pediatric severe influenza A(H1N1)cases / 中国小儿急救医学

Objective To analyze the clinical feature of pediatric severe influenza A(H1N1)cases.Methods To summarize the clinical manifestation,diagnostic and therapeutic process of eight pediatric severe influenza A(H1N1)cases.Results All eight cases couldn't provide contact history.Four cases had fundamental diseases,which were nephrotic syndrome,congenital hypothyroidism,bronchial asthma and moderate anemia.All cases had cough and fever,which was productive cough and hyperpyrexia(5 cases).All cases had tachypnea,which presented at the course of 0.5～6 days and progressively aggravated to respiratory failure 3～24 hours later.Chest x-ray showed localized exudation,which was similar to mycoplasma pneumonia.Seven cases had increased percentages of neutrophil.Six cases had increased CRP.All cases had respiratory failure;two cases were complicated with toxic encephacopathy.Treatment included anti-virus and support therapy.All cases received immunoglobulin and some cases received glucocorticoid.Six patients received mechanicai ventilation.Time of mechanical ventilation was 3～6 days.No patients died.Conclusion Pediatric severe influenza A(H1N1)case is severe pneumonia with characteristic of severe hypoxemia.Acute respiratory distress syndrome and death can be prevented through effective and in-time therapy.