Clinical features of four atypical pediatric cases of endemic typhus with pneumonia / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze clinical manifestations, treatment and prognosis of 4 cases with endemic typhus.</p><p><b>METHOD</b>The clinical data of four endemic typhus patients in prognosis were retrospectively analyzed. These four atypical cases of endemic typhus with pneumonia were treated in our department from October 2011 to March 2012. They were all male, with an age range of 15 months to 7 years. The four patients had long history, mild respiratory symptom and no improvement was found after treatment with cephalosporins. There were no evidences of bacterial, viral, or fungal infections and we thought they might have infection with other pathogen. Three were from rural areas. Routine blood tests, Weil-Felix reaction, blood smear (Giemsa staining) , and indirect immunofluorescence assay were performed.</p><p><b>RESULT</b>Blood smear and IFA tests showed evidences for endemic typhus. The clinical presentations were atypical, the patients had no headache, but all had fever, rash, and pneumonia of varying severity. None of the patients had a severe cough, but bronchial casts were observed in one case. Recurrent fever was reported in three cases. Physical examinations showed no eschars, but one patient had a subconjunctival hemorrhage, and one had skin scratches, cervical lymphadenopathy, pleural effusion, pericardial effusion, and cardiac dilatation. Two patients had remarkably increased peripheral blood leukocyte counts; both these patients also had high alanine aminotransferase (ALT) levels and one had a high C-reactive protein (CRP) level. Weil-Felix testing was negative or the OX19 titer was low. The peripheral blood smear (Giemsa stain) showed intracellular pathogens in all four cases. After combined therapy with doxycycline and macrolide antibiotics, all four patients recovered well.</p><p><b>CONCLUSION</b>The endemic typhus children often come from rural areas. The clinical presentations were atypical, they usually have no headache, but have fever (often Periodic fever) , rash, and pneumonia of varying severity in these four cases. Combined therapy with doxycycline and macrolide antibiotics was effective in all four patients.</p>

Inhibition of allergic airway inflammation by antisense-induced blockade of STAT6 expression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The signal transducer and activator of transcription 6 (STAT6) expression in lung epithelial cells plays a pivotal role in asthma pathogenesis. Activation of STAT6 expression results in T helper cell type 2 (Th2) cell differentiation leading to Th2-mediated IgE production, development of allergic airway inflammation and hyperreactivity. Therefore, antagonizing the expression and/or the function of STAT6 could be used as a mode of therapy for allergic airway inflammation.</p><p><b>METHODS</b>In this study, we synthesized a 20-mer phosphorothioate antisense oligonucleotide (ASODN) overlapping the translation starting site of STAT6 and constructed STAT6 antisense RNA (pANTI-STAT6), then transfected them into murine spleen lymphocytes and analyzed the effects of antagonizing STAT6 function in vitro and in a murine model of asthma.</p><p><b>RESULTS</b>In vitro, we showed suppression of STAT6 expression and interleukin (IL)-4 production of lymphocytes by STAT6 ASODN. This effect was more prominent when cells were cultured with pANTI-STAT6. In a murine model of asthma associated with allergic pulmonary inflammation in ovalbumin (OVA)-sensitized mice, local intranasal administration of fluorescein isothiocyanate (FITC)-labeled STAT6 ASODN to DNA uptake in lung cells was accompanied by a reduction of intracellular STAT6 expression. Such intrapulmonary blockade of STAT6 expression abrogated signs of lung inflammation, infiltration of eosinophils and Th2 cytokine production.</p><p><b>CONCLUSION</b>These data suggest a critical role of STAT6 in the pathogenesis of asthma and the use of local delivery of STAT6 ASODN as a novel approach for the treatment of allergic airway inflammation such as in asthma.</p>

An epidemiological survey on paragonimiasis in Jin Miaopu township in Shanxi province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological factors and tendency of paragonimiasis in Jin Miaopu township in Zezhou county of Shanxi Province, and to understand the current status of public awareness for providing references to paragonimiasis education and prevention.</p><p><b>METHODS</b>A questionnaire survey was conducted among 2172 villagers probing awareness of paragonimiasis and their experiences of eating crabs; Infection screening and antibody test were also performed by means of ELISA.</p><p><b>RESULTS</b>The paragonimiasis knowledge coverage rate was zero, and 67.7% (1471/2172) of the respondents claimed their histories of crab eating and 96.7% (29/30) of crabs were infected with metacercaria of paragonimus. Of all the study subjects, 11% (241/2172) of them were infected with the positive rate of 4.1% (89/270).</p><p><b>CONCLUSION</b>The incidence of paragonimiasis is closely related to dietetic habit in local residents. It is extremely necessary to increase the public awareness of paragonimiasis prevention and control and to improve the living conditions and dietetic habits.</p>