Observation of tear film stability in dry eye patients with different lipid layer thickness / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the difference of tear film stability among different lipid layer thickness.METHOD: A total of 194 dry eye patients(384 eyes)admitted to our hospital from June 2020 to December 2021 were enrolled in this study. The tear meniscus height, the first tear film break-up time and lipid layer thickness were measured by corneal topographer. The tear meniscus height and the first tear film break-up time among different lipid layer thickness were compared and the correlation between them was analyzed.RESULTS: The included patients(384 eyes)were divided into lipid rich group(49 eyes), lipid balance group(27 eyes), slight lipid deficiency group(266 eyes)and significant lipid deficiency group(42 eyes)according to the lipid layer thickness. The differences of the tear meniscus height were statistically different(P=0.022), while the differences of the first tear film break-up time were not statistically different(P=0.322). The lipid layer thickness was positively correlated with tear meniscus height(rs=0.143, P=0.006). There was no correlation between lipid layer thickness and the first tear film break-up time(rs=-0.090, P=0.083), nor was there correlation between tear meniscus height and the first tear film break-up time(rs=0.038, P=0.460).CONCLUSION: There was no significant difference in tear film stability in dry eye patients with different lipid layer thickness.

Clinical and gene mutation features of cystic fibrosis: an analysis of 8 cases / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features and gene mutation sites of children with cystic fibrosis (CF), in order to improve the understanding of CF to reduce misdiagnosis and missed diagnosis.@*METHODS@#A retrospective analysis was performed on the medical records of 8 children with CF who were diagnosed in Hebei Children's Hospital from 2018 to 2021.@*RESULTS@#Among the 8 children with CF, there were 5 boys and 3 girls, with an age of 3-48 months (median 8 months) at diagnosis, and the age of onset ranged from 0 to 24 months (median 2.5 months). Clinical manifestations included recurrent respiratory infection in 7 children, sinusitis in 3 children, bronchiectasis in 4 children, diarrhea in 8 children, fatty diarrhea in 3 children, suspected pancreatic insufficiency in 6 children, pancreatic cystic fibrosis in 1 child, malnutrition in 5 children, and pseudo-Bartter syndrome in 4 children. The most common respiratory pathogens were Pseudomonas aeruginosa (4 children). A total of 16 mutation sites were identified by high-throughput sequencing, multiplex ligation-dependent probe amplification, and Sanger sequencing, including 5 frameshift mutations, 4 nonsense mutations, 4 missense mutations, 2 exon deletions, and 1 splice mutation. CFTR mutations were found in all 8 children. p.G970D was the most common mutation (3 children), and F508del mutation was observed in one child. Four novel mutations were noted: deletion exon15, c.3796_3797dupGA(p.I1267Kfs*12), c.2328dupA(p.V777Sfs*2), and c.2950G>A(p.D984N).@*CONCLUSIONS@#p.G970D is the most common mutation type in children with CF. CF should be considered for children who have recurrent respiratory infection or test positive for Pseudomonas aeruginosa, with or without digestive manifestations or pseudo-Bartter syndrome.

Progress of discovery of molecular glues from natural products and their derivatives / 药学学报

Molecular glues are a class of small molecules that induce the formation of protein-protein interactions to confer new biological function or therapeutic effects. As a unique pharmacological modality, molecular glues could target proteins without druggable binding pockets. It exhibits a variety of functions, including regulating signal transduction, stabilization or degradation of targeted proteins, through sticking different proteins together. This review will summarize the development and current status of molecular glues derived from natural products and analogs by illustrating the discovery and interaction mechanism. We hope to present a systematic view, provide valuable clues for researchers and encourage them to explore more efficient and rational molecular glue discovery strategies.

Status of antibiotic use in hospitalized children with community-acquired pneumonia in multiple regions of China / 中国当代儿科杂志

OBJECTIVE@#To investigate the use of antibiotics in children with community-acquired pneumonia (CAP) in multiple regions of China, and to provide a reference for CAP standard treatment and rational antibiotic use in children.@*METHODS@#The medical data of 1 383 children with CAP who were hospitalized in the department of pediatrics in 10 grade A tertiary hospitals from 9 cities between April 14, 2014 and January 1, 2016 were reviewed, to analyze the status of antibiotic use in hospitalized children in North China, Northeast China, East China, and South China.@*RESULTS@#The overall rate of antibiotic use in children with CAP was 89.08%, with 88.7% in North China, 95.5% in Northeast China, 83.3% in East China, and 86.6% in South China. The main types of antibiotics used were cephalosporins, macrolides, compound preparations of β-lactam antibiotics, polyphosphoric broad-spectrum antibiotics and other β-lactam antibiotics. The selection of antibiotics was generally rational, but antibiotics were still used in some patients with viral infection alone or a combined use of ≥2 kinds of antibiotics were noted in some patients with infection caused by one kind of pathogen. Irrational antibiotic use was observed in 131 children (10.63%).@*CONCLUSIONS@#There are high rates of antibiotic use and irrational use of antibiotics among children with CAP. Standard management of antibiotic use in children with CAP should be strengthened.

Prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features / 中国当代儿科杂志

OBJECTIVE@#To investigate the prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features.@*METHODS@#A total of 106 children who were treated at the outpatient service or hospitalized from January 1, 2016 to May 31, 2017 were enrolled. Their nasopharyngeal swabs and venous blood samples were collected for Bordetella pertussis culture, multiple PCR and serum anti-pertussis toxin antibody detection. According to these results, the children were divided into pertussis group with 26 children and control group with 80 children, and clinical features were analyzed for both groups. E-test stripes were used to determine the sensitivity of Bordetella pertussis strains to erythromycin, azithromycin, doxycycline, levofloxacin, sulfamethoxazole/trimethoprim and amoxicillin.@*RESULTS@#Of the 106 children with chronic cough, 26 (24.5%) were found to have Bordetella pertussis infection. There were no significant differences in the incidence rates of typical symptoms of pertussis between the pertussis and control groups (P>0.05). E-test showed that erythromycin and azithromycin had a minimal inhibitory concentration (MIC) of >256 mg/L against five Bordetella pertussis strains, while amoxicillin had an MIC of 0.5-1 mg/L.@*CONCLUSIONS@#The presence of Bordetella pertussis infection in children with chronic cough should be taken seriously by clinicians, and children with chronic cough and Bordetella pertussis infection may not have the typical symptoms of pertussis and are mainly manifested as chronic cough. Amoxicillin may be an alternative drug for macrolide-resistant Bordetella pertussis infection.

A multicenter,randomised,controlled clinical study on efficacy and safety of recombinant human interferon α 2b spray (P.putida) in treatment of acute upper respiratory tract infection in children / 中国实用儿科杂志

OBJECTIVE: To evaluate the efficacy,safety and tolerability of recombinanat human interferon α2 b(rhIFNα2b)spray in treatment of acute upper respiratory tract infection(except the flu)in children. METHODS: In total,575 children who met the inclusion criteria were enrolled from January,2019 to July,2019. They were divided into rhIFNα2b spray group(291 cases)and ribavirin group(284 cases). The children in rhIFNα2b spray group were given the rhIFNα2b spray(P.putida),and those in ribavirin groups were treated with the ribavirin spray. The curative effect and safety between the two groups were compared. RESULTS: The per-protocol set(PPS) comprised 448 patients(233 in the rhIFNα2b spray group,215 in the ribavirin group). The primary efficacy endpoint was antipyretic time which in rhIFNα2b spray group(25.0 h)was significantly shorter than that in the ribavirin group(33.6 h)(P=0.0001). In the comparison of symptomatic relief time,the relief time of nasal congestion,runny nose,sore throat and cough in rhIFNα2b spray group was shorter than that in ribavirin group(P<0.05). The recovery time in the rhIFNα2b spray group was 92 h,which showed significant decrease compared with the ribavirin group(112 h)(P<0.0001). The incidence of adverse events had no statistical differences between the two groups(P=0.2461). CONCLUSION: The rhIFNα2b spray treatment for acute upper respiratory tract infection in children is proved to be significantly effective;particularly,it can evidently relieve fever symptoms and promote the disappearance of nasal and pharyngeal symptoms. It has good safety and tolerability,so the rhIFNα2b spray is worthy to be promoted in clinical application.

Efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia complicated by airway mucus obstruction / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by airway mucus obstruction.</p><p><b>METHODS</b>According to the time from admission to the treatment via fiber bronchoscope, the children with MPP who were found to have airway mucus obstruction under a fiber bronchoscope were randomly divided into early intervention group (≤3 days; n=40) and late intervention group (>3 days; n=56). The two groups were compared in terms of clinical data and imaging recovery.The children were followed for 1-3 months.</p><p><b>RESULTS</b>Of the 96 children, 38 were found to have the formation of plastic bronchial tree, among whom 10 were in the early intervention group and 28 were in the late intervention group (P=0.01). Compared with the late intervention group, the early intervention group had a shorter duration of fever, length of hospital stay, and time to the recovery of white blood cell count and C-reactive protein (P<0.05), as well as a higher atelectasis resolution rate (P<0.05). Compared with the late intervention group, the early intervention group had a higher percentage of children with a ≥ 60% absorbed area of pulmonary consolidation at discharge. After 3 months of follow-up, the early intervention group had a higher percentage of children with a ≥ 90% absorbed area of pulmonary consolidation than the late intervention group (80% vs 55%; P=0.01), and the early intervention group had a lower incidence rate of atelectasis than the late intervention group (P<0.05).</p><p><b>CONCLUSIONS</b>Early treatment via fiber bronchoscope can shorten the course of the disease and reduce complications and sequelae in MPP children with airway mucus obstruction.</p>

Study on expression of long non-coding RNA in colon cancer tissues and adjacent tissues / 中国病理生理杂志

AIM:To screen the differentially expressed long non-coding RNA(lncRNA)in colon cancer,and to explore its expression in colon cancer tissues and adjacent tissues.METHODS:The "Colon adenocarcinoma:Person neoplasm cancer status" which consisted of 36 cases of colon cancer tissues and 29 cases of normal colonic tissues was downloaded from the lncRNAtor database.The candidate genes were selected from these differentially expressed lncRNAs based on artificial criterion(P<0.01;fold change ≥2 or<0.5)and then validated by real-time PCR in 60 pairs of colon cancer tissues and adjacent tissues.RESULTS:A total of 50 lncRNAs were differentially expressed in colon cancer tis-sues,including 28 up-regulated and 22 down-regulated(P<0.01).The verifying results displayed that HNF1A-AS1 and ZDHHC8P1 were up-regulated(P<0.01),and SUZ12P expression was down-regulated(P<0.05),but the expression of AC069513.3 was not statistically significant between colon cancer tissues and adjacent tissues.The abilities of HNF1A-AS1,ZDHHC8P1,SUZ12P and AC069513.3 to discriminate the colon cancer from normal adjacent tissue by the ROC curve with an AUC of 0.729(sensitivity 78％,specificity 67％),0.617(sensitivity 68％,specificity 55％),0.689(sensitivity 66％,specificity 55％)and 0.518(sensitivity 52％,specificity 48％)were observed.CONCLUSION:Long non-coding RNA HNF1A-AS1 and ZDHHC8P1 are up-regulated and SUZ12P is down-regulated in colon cancer tis-sues,suggesting that they may be involved in the pathogenesis of colon cancer.

Bacterial Co-infection in Hospitalized Children with Mycoplasma pneumoniae Pneumonia.

Objective: To describe the frequency and impact of bacterial co-infections in children hospitalized with Mycoplasma pneumoniae pneumonia. Design: Retrospective, descriptive study. Setting: Tertiary-care hospital in Beijing, China. Participants: 8612 children admitted to Beijing Children's Hospital from June 2006 to June 2014. Methods: According to the testing results of etiology we divided the cases into pure M. pneumoniae infection group and mixed bacterial infection group. We analyzed clinical features, hospital expenses and differences between these two groups. Results: 173 (2%) of included children had bacterial co-infection. 56.2% of bacterial pathogens were identified as Streptococcus pneumoniae. Conclusion: The most common bacterium causing co-infection in children with M. pneumoniae pneumonia was S. pneumoniae.

Recent progress in clinical research on pertussis / 中国当代儿科杂志

Pertussis is a highly contagious respiratory disease. Despite the high vaccination coverage, re-emergence of pertussis has been reported in many countries over the past two decades. With the increase in the incidence of pertussis, there has been a shift in the epidemiological features: an increased incidence of pertussis has been noted in older children and adults, who normally lack typical clinical manifestations, and who may be easily missed according to current diagnostic references for pertussis. In order to achieve better prevention and treatment of pertussis, this review article summarized the recent research progress in the epidemiology, clinical features, etiology, diagnosis, treatment, and prevention of pertussis, particularly focusing on the diagnosis of pertussis in older children and adults.

Genetic polymorphism of cytokine genes in Han children in Beijing area / 中华实用儿科临床杂志

Objective To investigate the genetic polymorphism of 13 cytokines genes in Han individual children from Beijing area.Methods The polymerase chain reaction-sequence specific primers (PCR-SSP) method was used to determine cytokine gene polymorphism including interleukin (IL)-1α (-889C/T),IL-1β (-511C/T,+3942T/C),IL-1 R(pst1 1970C/T),IL-1RA(mspa1 11100T/C),IL-4Ra(+ 1902G/A),IL-12 (-1188C/A),interferon (IFN)-γ(+ 874A/T),transforming growth factor (TGF)-β1 (codon10C/T,codon25 G/C),tumor necrosis factor)(TNF)-α (-308G/A,-238G/A),IL-2 (-330T/G,+ 166G/T),IL-4 (-1098 T/G,-590 T/C,-33 T/C),IL-6(-174G/C,nt565G/A),IL-10 (-1082G/A,-819C/T,-592A/C) 13 cytokines genes in 210 unrelated healthy Han individuals from Beijing area.Results (1) Cytokine genes with frequencies more than or equal to 95 percent included IL-1β +3962 C,TGF-β Codon 25 G,IL-6-174 G,IL-6 nt565 G,TNF-α-308 G and TNF-α-238 G alleles;while cytokine genes with frequencies less than or equal to 5 persent included IL-1β + 3962 T,TGF-β Codon 25 C,IL-6-174C,IL-6 nt 565 A,TNF-α-308 A and TNF-α-238 A alleles.(2) The frequency of the high-producer-type GCC haplotype in IL-10 gene was 8.27％,while the low-producer-type ATA was 59.11％.The frequency of the highproducer-type TG haplotype in the TGF-β gene was 49.77％,while the low-producer-type CC was 0.The frequencies of the high-producer-types AG and AA haplotypes in the TNF-α gene were 3.34％,while those of the low-producer-types GG and GA were 96.67％.The frequency of the high-producer-types T/G genotype in the IL-2-330 gene was 11.90％,while those of the low-producer-types T/T and T/G were 88.10％.The frequencies of the high-producer-types G/G and G/C genotypes in the IL-6-174 gene were 99.52％,while that of the low-producer-types C/C was 0.48％.The frequency of the high-producer-types T/T genotype in the INF-γ+ 874 gene was 1.90％,and the frequency of the medium-producer-types T/A in the INF-γ+ 874 gene was 22.86％,while of the low-producer-types A/A was 75.24％.(3) New genotypes were found:the frequency of IL-2(-330,+ 166) GG/GT/TT genotype was 1.90％,and the frequency of IL-2(-330,+ 166) TG/GG/GT/TT genotype was 0.48％,The frequency of IL-6(-174,nt565) CG/CG genotype was 0.48％,the frequency of IL-6 (-174,nt565) GA/GG genotype was 1.90％,The frequency of IL-6 (-174,nt565) GG/GA/CA genotype was 0.48％,The frequency of IL-10(-1082,-819,-592) GCC/ATC/ATA genotype was 0.95％,The frequency of IL-10(-1082,-819,-592) ACC/ACA/ATC/ATA genotype was 35.71％,The frequency of IL-10 (-1082,-819,-592) GCC/ACC/ACA/ATC/ATA genotype was 0.48％.Conclusion The genetic polymorphism of cytokine genes in Han individuals from Beijing area is different from other areas of China with higher frequencies of IL-10 (-1082,-819,-592) ACC/ACA/ATC/ATA genotype.

Viral etiology of acute respiratory tract infection among pediatric inpatients and outpatients from 2010 to 2012 in Beijing, China / 中华儿科杂志

<p><b>OBJECTIVE</b>Acute respiratory tract infections (ARI) are the leading cause of pediatric morbidity and mortality worldwide, particularly in developing countries. Viruses are the main pathogens of ARI in children. The purpose of the present study was to determine the epidemiologic features of respiratory viruses, including novel viruses, in outpatient and hospitalized children with ARI.</p><p><b>METHOD</b>From March 2010 to February 2012, 2066 children with ARI, including 1050 outpatients and 1016 inpatients, were involved in this study. One nasopharyngeal aspirate or throat swab specimen was collected from each patient. Reverse transcription (RT) PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus (IFV), parainfluenza virus (PIV) type 1-4, adenovirus (ADV), enterovirus (EV), human coronavirus (HCOV), human metapneumonia virus (HMPV) and human bocavirus (HBOV).</p><p><b>RESULT</b>At least one viral pathogen was identified in each of 1274 out of 2066 patients and the overall positive rate was 61.7%. The positive rate in inpatient (69.7%) was higher than that in outpatient (53.9%). The frequencies of detection of various viruses among in- and outpatients were different. RSV was the most prevalent virus detected among hospitalized children, followed by HRV and PIV, whereas IFV was the most frequently identified virus in the outpatient group, followed by ADV and PIV. Simultaneous detection of two or more viruses was found in 377 cases. Coinfection was more frequent in inpatients than in outpatients (30.1% vs. 6.8%, P < 0.001).</p><p><b>CONCLUSION</b>Respiratory viruses play an important role in children with ARI, especially in young children. RSV was the most prevalent virus detected among hospitalized children, whereas IFV was the most frequently identified virus in the outpatient group. Viral coinfections are frequently identified, particularly in hospitalized patients. Further studies are required to better understand the impact of coinfections in children with ARI.</p>

Inflammation accelerates lipid dysregulation mediated cardiac fibrosis through enhancing myocardial endothelial-to-mesenchymal transition / 中华心血管病杂志

<p><b>OBJECTIVE</b>Dyslipidemia and chronic inflammation are risk factors of cardiac fibrosis. This study was aimed to investigate their possible synergetic effects and underlying mechanisms on progression of cardiac fibrosis in apolipoprotein E knockout (ApoE -/-) mice.</p><p><b>METHODS</b>Twenty-four ApoE-/- mice were divided into normal chow diet (control), high fat diet (HFD group), and HFD plus subcutaneously injection of 10% casein (inflammation group) for 8 weeks. Lipid profile and serum amyloid A (SAA) were examined by clinical biochemical assays and Enzyme-Linked Immunosorbent Assay, respectively. Hematoxylin-eosin staining (HE) and Masson staining were used to evaluate the myocardial accumulation of lipid and collagen. Collagen I protein expression was detected by immunohistochemical staining. Endothelial-to-mesenchymal transition related protein expressions were determined by Western blot.</p><p><b>RESULTS</b>Serum SAA level was significantly higher in inflammation group [(127.42 ± 26.99) ng/ml] than in control [(15.40 ± 7.62) ng/ml] and HFD [(8.17 ± 0.72) ng/ml] group (all P < 0.01).However serum levels of triglyceride, total cholesterol, and low density lipoprotein (LDL) cholesterol were significantly higher in HFD group than in inflammation and control groups[TG (7.53 ± 2.05) mmol/L vs. (3.43 ± 0.79) mmol/L; TC (27.80 ± 3.99) mmol/L vs. (14.94 ± 1.92) mmol/L;LDL-C (11.56 ± 2.56) mmol/L vs. (9.46 ± 1.31) mmol/L, all P < 0.05) . Foam cell formation in cardiac vessels, myocardial collagen deposit, protein expressions of collagen I, CD31, and alpha-smooth muscle actin (α-SMA) were all significantly higher in inflammation group than in HFD group (all P < 0.05) suggesting that inflammation contributes to the phenotype endothelial-to-mesenchymal transition in heart.</p><p><b>CONCLUSION</b>Inflammation exacerbates dyslipidemia mediated cardiac fibrosis in ApoE-/- mice partly through enhancing myocardial endothelial-to-mesenchymal transition.</p>

Inhibition of integrin-linked kinase by angiotensin II receptor antagonist, irbesartan attenuates podocyte injury in diabetic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Integrin-linked kinase (ILK) dysregulation is involved in the progression of diabetic nephropathy (DN). The aim of this study was to investigate the effects of angiotensin II receptor blocker (ARB), irbesartan, on ILK expression and podocyte injury in DN.</p><p><b>METHODS</b>DN was induced by the combined feeding of high-sucrose, high-fat diet and intra-peritoneal injection of low dose of streptozotocin (35 mg/kg) in spontaneously hypertensive rats. Diabetic rats were treated with irbesartan (50 mg×kg(-1)×d(-1)) by gavage for 8 weeks. The renal morphologic changes and podocyte injury were investigated by light and electron microscopy, and the ILK expression was evaluated by real-time RT-PCR and Western blotting analysis.</p><p><b>RESULTS</b>Diabetic rats exhibited with the similar clinical feature of type 2 DN. Morphologically, they were characterized by expansion of mesangial matrix, loss of podocyte and podocyte injury. Impressively, compared to controls, the ILK expression in diabetic rats were upregulated, which were positively correlated with both podocyte injury and albuminuria. Irbesartan significantly prevented ILK overexpression, along with the amelioration of podocyte injury and albuminuria.</p><p><b>CONCLUSIONS</b>ILK plays an important role in mediating podocyte injury in DN; irbesartan inhibits ILK upregulation and attenuates podocyte injury, which might offer a new insight into the role of ARB in preventing DN progression.</p>

A child with pulmonary and liver Langerhans'-cell histiocytosis / 中华医学杂志(英文版)

Clinical categories of Langerhans cell histiocytosis (LCH) include single and multi-system disease. Pulmonary LCH is rare, which is an unusual interstitial lung disease with the characteristics of monoclonal proliferation and infiltration of Langerhans' cells to organs. We report our experience of a rare LCH case of multiple organs such as pulmonary and liver as the main clinical manifestation. The patient was treated with chemotherapy which included prednisone, vinblastine, methotrexate and 6-mercaptopurine for 52 weeks and follow up all along. The patient has a favorable clinical outcome.

Questionnaire-based survey of allergic diseases among children aged 0 - 14 years in the downtown of Beijing, Chongqing and Guangzhou / 中华儿科杂志

<p><b>OBJECTIVE</b>In recent years, the incidence of allergic diseases in China is increasing. With serious influence on the patients' quality of life and even life-threatening, now allergic diseases have become an important public health problem in our country. This survey aimed to obtain a general epidemic outline of children's major allergic diseases, i.e., childhood asthma, allergic rhinitis and eczema in the downtown of Beijing, Chongqing and Guangzhou.</p><p><b>METHOD</b>Childhood asthma questionnaire was established by Delphi method based on guidelines for childhood asthma diagnosis and prevention made by Chinese medical association in 2008 with reference to the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). This study was carried out from Oct. 2008-Mar. 2009, in Beijing, Chongqing and Guangzhou by a multi-stage sampling method, covering a sample of 24 290 children aged 0 - 14 years by a multi-stage sampling method, the population of children surveyed in the downtown of Beijing Chongqing and Guangzhou was 10 372, 9874 and 4072 respectively; of whom males were 5545, 5258, 2159, and females were 4917, 4588, 1877; the ratio of males to females in the three cities were 1.11:1, 1.15:1, 1.15:1; the average age of surveyed children were 7.63, 8.74 and 8.30 years old. All the questionnaire was filled in by the parents of children or other guardian of children.</p><p><b>RESULT</b>The self-reported prevalence of asthma in Beijing, Chongqing and Guangzhou was 3.15%, 7.45%, 2.09%, the self-reported prevalence of allergic rhinitis was 14.46%, 20.42%, 7.83%, and the prevalence of eczema was 20.64%, 10.02%, 7.22%. In the survey, asthma combined with allergic rhinitis had the highest rate, 49.54%, 50.14%, 34.83%, respectively in the 3 cities. The self-reported prevalence of asthma and allergic rhinitis was significantly higher in male than female. Besides, the self-reported prevalences of asthma and allergic rhinitis were relatively lower in children under 1 year and over 10 years of age.</p><p><b>CONCLUSION</b>The prevalence of asthma, allergic rhinitis and eczema and other allergic diseases in children 0 - 14 years of age in the three cities gradually increased, and the prevalence of allergic diseases in Chongqing was relatively higher.</p>

Three years surveillance of viral etiology of acute lower respiratory tract infection in children from 2007 to 2010 / 中华儿科杂志

<p><b>OBJECTIVE</b>Viruses are common pathogens of acute lower respiratory tract infection (ALRTI) in children. There are few studies on consecutive monitoring of viral pathogens of ALRTI in a larger cohort during the past several years. The aim of this study was to investigate the viral pathogens of ALRTI in children of different age groups and to outline the epidemic feature of different viruses.</p><p><b>METHOD</b>(1) Totally 1914 (1281 male and 709 female) children with clinical diagnosis of ALRTI during the period of March 2007 to March 2010 were recruited into this study. These patients were hospitalized patients in department of internal medicine or outpatients in emergency department in Beijing Children's Hospital. The patients were divided into four groups, including 1072 patients < 1 year old, 326 patients 1- < 3 years old, 158 patients 3- < 6 years old, 358 patients ≥ 6 years old. One nasopharyngeal aspirate specimen was collected from each patient. Reverse transcription (RT) PCR methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus type A, B and C (IFA, IFB, IFC), parainfluenza virus (PIV) type 1-4, adenovirus (ADV), enterovirus (EV), human coronavirus (HCOV), human metapneumovirus (HMPV) and human bocavirus (HBOV).</p><p><b>RESULT</b>(1) The total positive rate of viruses was 70.3%. The positive rate was 83.0% (890/1072) in the group of < 1 year old, and 80.1% (261/326) in group of 1- < 3 years old, 60.8% (96/158) in group of 3- < 6 years old and 27.7% (99/358) in group of ≥ 6 years old, respectively. There was a significant difference in the positive rate among different age groups (χ² = 2213.5, P = 0.000). The top three viruses were RSV, HRV and PIV; and the positive rates were 50.9%, 36.2% and 12.0% respectively in group of < 1 year old. (2) The epidemic seasons of RSV and HRV were winter and spring, and PIV infection was epidemic in spring and summer. (3) The detection rates of 2 or more viruses were 38.2%, 36.4%, 30.2% and 15.2% in groups of < 1 year old, 1- < 3 years old, 3- < 6 years old and ≥ 6 years old, respectively. There was a significant difference in the mixed infection rate among different age groups (χ² = 1346.00, P = 0.000).</p><p><b>CONCLUSION</b>RSV, HRV and PIV were the most predominant pathogens in younger children with ALRTI. Different viral infections had different seasonal features. Mixed infections with two or more viruses were detected in substantial proportion of patients with ALRTI, but further studies are needed to explore the clinical significance of mixed infection with viruses in patients with ALRTI.</p>

Clinical features and molecular analysis of 2 Chinese children with autosomal recessive chronic granulomatous disease caused by CYBA mutations / 中华儿科杂志

<p><b>OBJECTIVE</b>To summarize clinical and molecular features of two children with autosomal recessive chronic granulomatous disease caused by CYBA mutations.</p><p><b>METHOD</b>The clinical records and CYBA mutations were reviewed for analysis of infections and inflammatory complications.</p><p><b>RESULT</b>The first case was a girl diagnosed with "liver and spleen abscess" in our hospital when she was 2.9 years old, with past history of neonatal impetigo and recurrent purulent lymphadenitis and positive family history. The results of DHR123 flow-cytometry showed that positive phagocytes after phorbol ester (PMA) stimulation was 84.63%. CYBA mutation analysis showed that she had heterozygous 35C > T, Q3X and IVS-2A > G. The second case was a boy diagnosed with "sepsis (salmonella D)" when he was 4 years old with a past history of impetigo, sepsis, perianal abscess, skin infection and positive family history. The results of flow cytometry showed that positive phagocytes after PMA stimulation was 96.13%. CYBA mutation analysis showed that he had homozygous 35C > T, Q3X and his parents were all carriers. All of them had BCG related axillary lymphnode calcification.</p><p><b>CONCLUSION</b>A22CGD cases had recurrent purulent infections (skin, lymphnode, liver and spleen, lung, blood), DHR123 flow cytometric analysis helped the diagnosis of CGD, CYBA mutation analysis ascertained the diagnosis of A22CGD.</p>

Effect of house dust mite immunotherapy on interleukin-10-secreting regulatory T cells in asthmatic children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Subcutaneous specific immunotherapy has been demonstrated to be capable of inducing T-cell regulatory response. Interleukin-10 (IL-10) plays a crucial role in inducing allergen-specific tolerance. However the reports of the changes of IL-10 in house dust mite (HDM)-specific immunotherapy were varied. The aim of this study was to evaluate the function of IL-10-secreting regulatory T cells in asthma children successfully treated with HDM immunotherapy.</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMCs) were isolated from 27 patients following 1.5 - 2 years of HDM-specific immunotherapy (SIT, SIT group) and from 27 matched treated asthmatic children allergic to HDM (asthma group). After 48 hours of in vitro stimulation with HDM extracts, IL-10-secreting regulatory T cells were measured by four colour flow cytometry. Sera were tested for allergen-specific IgG(4) and IgE using the Immuno CAP 100 assay.</p><p><b>RESULTS</b>PBMCs from children undergoing immunotherapy following HDM extracts stimuli produced significantly more IL-10 compared with the asthma group. The frequency of iTreg cells and aTreg cells increased in SIT group after HDM stimulation, while it was not affected in the asthma group. Among the iTreg cells and aTreg cells, the frequency of CD4(+)CD25(-)Foxp3(-)IL-10(+) Treg cells increased the most which was 2 times higher than that in unstimulated cultures in SIT group. The levels of HDM-specific IgG(4) of SIT group was significiently higher compared with asthma group, but there was no correlation of the levels of HDM-specific IgG(4) and IL-10 secreting Treg cells.</p><p><b>CONCLUSIONS</b>HDM-specific immunotherapy can successfully upregulate the frequency of IL-10-secreting Treg cells. CD4(+)CD25(-)Foxp3(-)IL-10(+) Treg cells may play a key role in inducing the immune tolerance in HDM-specific immunotherapy.</p>

Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: a retrospective study of 78 pediatric cases in mainland of China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The clinical characteristics of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) are largely unreported in the pediatric patients in mainland of China. The main aim of this study was to recognize the clinical features of EBV-HLH in children and to explore its prognosis and risk factors.</p><p><b>METHODS</b>A retrospective study was performed on 78 pediatric patients with EBV-HLH who were admitted to Beijing Children's Hospital between 2003 and 2008. All patients' medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory and outcome information was collected. Statistical analysis was conducted via multivariate and univariate analysis.</p><p><b>RESULTS</b>The age of onset peaked between 1 - 2 years and boys were more likely developed EBV-HLH. EBV-HLH occurred mainly in the serological pattern with EBV nuclear antigen (EBNA) positive (70.5%). The overall fatality of the disease was 56.7%. Twelve of the 39 fatalities (30.8%) died rapidly within 2 months after diagnosis. Multivariate analysis revealed that not receiving chemotherapy (P = 0.002), > or = 4 weeks of illness prior to diagnosis (P = 0.004), and albumin levels < 20 g/L (P = 0.045) significantly predicted an increased fatality risk.</p><p><b>CONCLUSIONS</b>EBV-HLH is a severe disease with a high fatality rate that occurs mainly in the serological pattern with EBNA positive. Early initiation of chemotherapy and timely diagnosis significantly improves survival rate. Practical strategies should focus on reducing the likelihood of early death.</p>