Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant / 中华实用儿科临床杂志

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition) / 中华实用儿科临床杂志

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Expert consensus on the diagnosis, treatment and prevention of monkeypox in children / 中华实用儿科临床杂志

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children / 中华实用儿科临床杂志

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

Experts′ consensus on severe acute respiratory syndrome coronavirus-2 vaccination of children / 中华实用儿科临床杂志

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

Genetic analysis of a male infant with Menkes disease / 中华医学遗传学杂志

OBJECTIVE@#To carry out genetic testing for a male infant suspected for Menkes disease.@*METHODS@#Genomic DNA of the proband and his parents were extracted and subjected to family trio whole exome sequencing (WES). Microduplication and microdeletion of the ATP7A gene were detected by multiplex ligation-dependent probe amplification (MLPA). Suspected variants were subjected to bioinformatic analysis and verified by Sanger sequencing.@*RESULTS@#The proband was found to harbor a de novo c.1870 -13T>G variation of the ATP7A gene, which may alter a splice site and affect its protein product.@*CONCLUSION@#The patient was diagnosed with Menkes disease due to the c.1870 -13T>G variant of the ATP7A gene. Whole exome sequencing of family trios is a powerful tool for the diagnosis of diseases with strong phenotypic heterogeneity.

Clinical and genetic analysis of two patients with congenital neutropenia caused by ELANE gene mutation / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics of congenital neutropenia caused by ELANE gene mutations.@*METHODS@#Clinical manifestations, absolute blood neutrophil count, high-throughput exome sequencing for mutation screening, suspected locus Sanger sequencing verification, processes of diagnosis and treatment of two patients with congenital neutropenia caused by ELANE gene mutation were retrospectively analyzed.@*RESULTS@#High-throughput sequencing has found that proband 1 has carried a heterozygous c.170C>T (p.Ala57Val) missense mutation in exon 2 of the ELANE gene, which was known to be pathological, and a heterozygous c.251T>G (p.Leu84Arg) mutation in exon 3 of proband 2, which was unreported previously. Sanger sequencing confirmed that neither mutation was inherited from their parents.@*CONCLUSION@#ELANE mutation is an important cause for congenital neutropenia. Detection of new pathogenic variants has enriched the mutation spectrum of the ELANE gene.

The effects of extracorporeal shock wave therapy on the lower limb function and articular cartilage of pa-tients with knee osteoarthritis / 中华物理医学与康复杂志

Objective To evaluate the effect and safety of extracorporeal shock wave therapy ( ESWT) for knee osteoarthritis ( KOA) and its effect on the articular cartilage. Methods Sixty-three persons with KOA were randomly divided into an ESWT group ( n=32) and a control group ( n=31) . Both groups received routine knee mus-cle strength training, but the ESWT group was also given ESWT ( a total of 2000 pulses at 8 Hz and 2.5 bar pressure) once a week for four consecutive weeks. The control group was given sham therapy at 0.2 bar with the rest of the pa-rameters the same as in the ESWT group. All of the subjects were assessed using a visual analogue scale ( VAS) , the Western Ontario and McMaster Universities Osteoarthritis Score ( WOMAC) , the Lequesne Index and knee cartilage T2 values before as well as one and 8 weeks after the intervention. Results The average VAS score, WOMAC in-dex, and Lequesne index of the ESWT group at 8 weeks after the treatment were significantly better than those before the intervention, and significantly better than the control group' s averages. The T2 values of the ESWT group at 8 weeks after the treatment were significantly better than before the intervention, though not significantly different from those of the control group at that point. No serious adverse reactions occurred in either group, and all of the minor ad-verse reactions had disappeared before the end of the assessment period. Conclusion ESWT can significantly im-prove the lower limb functioning of KOA patients, and its influence on knee cartilage is within the safe range.

Prostate cancer detected in the specimen of radial cystoprostatectomy for bladder cancer and its prognostic impact / 中华泌尿外科杂志

Objective To study the incidence rate of prostate cancer detected in the specimen of radial cystoprostatectomy for bladder cancer and to evaluate its effect on the prognosis.Methods From June 2012 to June 2017,the clinical data of 132 patients with bladder cancer undergoing radical cystectomy (RCP) were analyzed retrospectively.The average age of 132 patients with bladder cancer was 61.2 years (37-89 years old).The serum of PSA of 89 cases out of 132 patients was examined before operation,21 cases 4 ng/ml ＜ tPSA ＜ 10 ng/ml,1 case tPSA 17 ng/ml and 67 cases tPSA ＜ 4 ng/ml.The pathology of bladder and prostate,the location and range of prostate cancer and Gleason score and the prognostic effect of prostate cancer was evaluated.Results The 132 patients with bladder cancer,116 cases (87.9％) were high grade urothelial carcinoma,8 cases (6.0％) were bladder carcinoma in situ,6 cases (4.5％) were low grade urothelial carcinoma,1 case was neuroendocrine bladder carcinoma and 1 case was signet ring cell carcinoma.The 21 cases of prostate cancer were combined with Gleason score,among which 3 + 2 score in 1 cases,3 +3 score in 17 cases,4 +3 and 3 +4 in 1 cases,and 4 +5 score in 1 cases.The lesions were unilateral in 14 cases and bilateral in 7 cases.The lesions were ＜0.5 ml in 3 cases,0.5-0.7 ml in 14 cases and 0.7-1.0 ml in 4 cases.The average age of 21 cases with prostate cancer was 67.5 years old (41-89 years).Of the 21 cases of prostate cancer,the serum tPSA was abnormal in 4 cases with an average of 8.8 ng/ml (4.2-17.0 ng/ml),the serum tPSA was normal in 12 cases with an average of 2.5 ng/ml (1.3-3.7 ng/ml),and the serum PSA in 5 cases was not detected before operation.Three cases of prostate cancer aged less than 60 years old with the detection rate of 9.6％ (3/31);18 cases were equal or older than 60 years old with the detection rate of 17.8％ (18/101).Multi parameter analysis showed that the incidence of prostate cancer increased with the age of the patients (OR =1.36,P =0.048).Followed up for 5 to 51 months,no PSA relapse was found and no patient receiving related treatment.Conclusions The detection rate of prostate cancer is very high in the specimen of radial cystoprostatectomy for bladder cancer.The clinical manifestation of the prostatic involvement is concealed.Radical resection of the prostate is necessary in radical resection of bladder cancer.

Detection of four human coronaviruses in respiratory infections in children in Fuzhou, China / 中华实验和临床病毒学杂志

Objective@#In this study, we tested for the presence of four human coronaviruses (HCoVs) in children with respiratory tract disease in Fuzhou, Fujian, China.@*Methods@#Nasopharyngeal aspirates were collected from children with respiratory tract disease from Nov, 2007 to Jan, 2015. A total of 266 clinical samples were tested for HCoVs using reverse-transcription polymerase chain reaction (RT-PCR). The positive products were sequenced and compared with those in GenBank by BLAST. The positive samples were then tested for HCoV-HKU1 and HCoV-NL63 using RT-PCR method . We compared the 440 bp pol gene sequence of the 8 HCoV isolates in Fuzhou, China to other HCoV isolates documented in the GenBank database by using MEGA software version 6.06 and the neighbor-joining method .@*Results@#HCoVs were detected in 8 patients (3.0%) out of the 266 children. Two of 266 (0.38%) were positive for HCoV-HKU1; 1 of 266(0.38%)were positive for HCoV-NL63; 1 of 266 (0.38%) were positive for HCoV-229E; 4 of 266 (1.5%)were positive for HCoV-OC43. All of children who were positive for HCoV had respiratory illness. Two HCoV-HKU1 were found to co-infect with human parainfluenza virus type 3 (HPIV-3). The 8 HCoV strains in our study fell into four clusters. Two strains of HCoV-HKU1 were genotype A.@*Conclusions@#HCoV infections were probably associated with upper and lower respiratory illness in children. Additional studies are needed to investigate the potential roles of these HCoVs in diseases.

Curative effect of Sandplay therapy on attention deficit hyperactivity disorder in preschool children co - mor-bid sleep disorder / 中华实用儿科临床杂志

Objective To investigate the curative effect of Sandplay therapy on attention deficit hyperactivity disorder (ADHD)preschool children co - morbid sleep disorder. Methods According to the random number generated by EXCEL software's RAND function,a total of 62 ADHD children co - morbid sleep disorder were randomly divi-ded into experimental group(n = 31)and control group (n = 31). The control group was treated with family behavior therapy and the experimental group was treated with sandplay therapy based on the family behavior therapy. With the Achenbach Child Behavior Check List (CBCL),Conners Parent Symptom Questionnaire (PSQ),Conner Concise Questionnaire (Conners Abbreviated Symptom Questionnaire,ASQ)and Children′s Sleep Habit Questionnaire(CSHQ),the overall curative effect was evaluated before and after treatment by their scores. Results The results of independent - samples t test showed that the scores of PSQ′s all factors,ASQ′s and CBCL′s total score,CSHQ′s total score and all factors had no significant difference between the two groups before the intervention (t conduct problem = - 0. 847,t learning problems =0. 504,t psychosomatic disorder = - 1. 008,t hyperactivity/ impulsion = - 0. 331,t anxiety = 0. 690,t hyperactivity index = 0. 757,t CBCL′s total score =- 0. 532,t ASQ′s total score = 0. 514,t CSHQ′s total score = 1. 132,t sleep impedance = - 0. 767,t sleep latency = - 0. 634,t sleep duration = 0. 150, tsleep anxiety = 0. 149,t sleep wake = 0. 417,t sleep disorder = 0. 709,t sleep apnea = 0. 950,t daytime sleepiness = 1. 530,all P > 0. 05). The scores of PSQ′s all factors,ASQ′s and CBCL′s total score,sleep impedance,sleep latency,sleep duration,sleep wake, daytime sleepiness and CSHQ′s total score all had significant differences between the two groups after the intervention(t conduct problem = - 3. 982,t learning problems = - 2. 258,t psychosomatic disorder = - 2. 470,t hyperactivity/ impulsion = - 4. 377,t anxiety =- 2. 684,t hyperactivity index = - 4. 249,t CBCL′s total score = - 3. 982,t ASQ′s total score = - 5. 576,t sleep impedance = - 3. 712,t sleep latency =- 2. 947,t sleep duration = - 2. 332,t sleep wake = - 6. 031,t daytime sleepiness = - 6. 256,t CSHQ′s total score = - 6. 706,all P < 0. 05). The results of analysis of variance of repeated measurement showed that PSQ behaviour problem,psychosomatic disor-der,hyperactivity and hyperactivity index scores of the main effects of intervention had significant difference (F conduct problem = 4. 966,F psychosomatic disorder = 5. 176,F hyperactivity/ impulsion = 4. 949,F hyperactivity index = 4. 926,all P < 0. 05);the main intervention effects of ASQ and CBCL′s total score had statistical difference (F CBCL = 4. 398,F ASQ = 4. 814,all P < 0. 05);the main intervention effects of sleep impedance,sleep duration,sleep wake and CSHQ′s total score had statistical difference (F sleep impedance = 5. 697,F sleep duration = 4. 467,F sleep wake = 6. 610,F CSHQ′s total score = 6. 016,all P <0. 05). There were significant differences in the characteristics of the initial sand table and the final sand table in the experimental group [traumatic subject:(4. 48 ± 1. 55)cases vs. (1. 23 ± 0. 81)cases,t = 8. 247;curing subject:(1. 77 ± 1. 09)cases vs. (4. 55 ± 1. 46)cases,t = 11. 274,all P < 0. 05]. Conclusion Sandplay therapy can effectively improve the core symptoms of preschool ADHD children co - morbid sleep disorders,which can be used as an early in-tervention.

Analysis of prognostic factors in patients with hepatocellular carcinoma complicated by diabetes mellitus after transcatheter arterial chemoembolization / 介入放射学杂志

Objective To analyze the effect of diabetes mellitus (DM) on the prognosis of patients with unresectable hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE).Methods A total of 858 HCC patients,who were admitted to the Affiliated Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,China,during the period from January 2010 to June 2015 to receive TACE,were selected.Among the 858 HCC patients,175 patients suffered from coexisting DM (DM group) and 683 patients had no DM (non-DM group).The differences in general clinical data and overall survival between the two groups were analyzed.Kaplan-Meier method was used to calculate the survival rate,the difference between the two groups was evaluated by log-rank method,and Cox proportional hazards regression was adopted to analyze the prognostic factors of HCC patients after receiving TACE.Results There were no statistically significant differences in sex,age,serum albumin,total bilirubin,prothrombin time,alpha fetoprotein (AFP),Child-Pugh grade,tumor size and number,cirrhosis,number of TACE treatment times and BCLC staging between the two groups (P＞0.05);the fasting blood glucose (FPG)level in DM group was higher than that in non-DM group (P＜0.05).The 1-,3-and5-year survival rates of the DM group were 60.9％,27.5％ and 10.7％ respectively,which were 70.9％,36.0％ and 17.6％ respectively in the non-DM group;the Log-rank test showed that the difference between the two groups was statistically significant (P=0.008).Multivariate Cox proportional hazard regression analysis revealed that the largest tumor diameter ＞5 cm,multiple tumor lesions,AFP＞20 ng/ml,BCLC stage and coexisting DM were independent risk factors that affected the prognosis of HCC patients after receiving TACE.Conclusion The coexisting DM is an independent risk factor that may affect the prognosis of patients with inoperable HCC after receiving TACE.

The value of peripheral blood neutrophil CD64 expression in early differential diagnosis of etiology in children with community-acquired pneumonia / 中国小儿急救医学

Objective To evaluate the apphcation value of peripheral blood neutrophil CD64 expression in early differential diagnosis of etiology in children with community-acquired pneumonia.Methods From June 2014 to June 2015 in our hospital,total of 99 cases of different pathogen infection were divided into three groups,bacterial pneumonia group (n =41),non-bacterial pneumonia group(n =38),healthy children group (n =20);and the non-bacterial pneumonia group was divided into two subgroups,viral pneumonia group (n =22) and mycoplasma pneumoniae pneumonia group(n =16).Flow cytometry was used to test the median fluorescence intensity (MFI) of peripheral blood neutrophil CD64.The levels of peripheral blood CRP,WBC and neutrophil percentage were detected.Results The levels of CD64 expression,CRP and WBC in bacterial pneumonia group were statistically higher than those of non-bacterial pneumonia group and healthy children group respectively (both P ＜ 0.01).The optimal cutoff value of CD64 was 6 519 MFI when using ROC curve,and the sensitivity and specificity of the diagnosis of bacterial pneumonia were 87.8％ and 89.7％ respectively.The levels of CD64 expression in bacterial pneumonia group were significantly higher than those in viral pneumonia group,mycoplasma pneumoniae pneumonia group and healthy children group (all P ＜ 0.01).Conclusion The expression of peripheral blood neutrophil CD64 increases in children with community-acquired pneumonia of bacteria infection.It can be used to guide early diagnosis of children with bacterial pneumonia and the using of antibiotics.

Safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney / 国际外科学杂志

Objective To investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney.Methods Between May 2014 and June 2016,Clinical records of 17 cases of stones in a solitary kidney who underwent flexible ureteroscopy and holmium laser lithotripsy were reviewed.10 of these cases were male and the others female;mean age of these cases was 45.8 (32-67) years.9 were on the left side while 8 were on the right.6 cases were with functional solitary kidney (with the GFR of the contralateral kidney less than 10ml/min),while 11 others were with anatomical solitary kidney (6 due to tumor,2 due to tuberculosis,3 being congenital).All cases underwent BUS,KUB as well as CTU to confirm diagnosis before surgery,with 8 diagnosed with renal pelvis calculi,5 were with upper or middle calyx calculi,and 4 were with subrenal calyx calculi.The mean ± SD size of the stones was 1.2 ± 0.3 cm.Clinical m anifestations were asymptomatic in 10cases,backache in 5 cases and fever in 2 cases.All patients underwent exams of CBC,urinalysis,liver and kidney function,coagulation function,ECG,chest X-ray as well as cleaning midstream urine cultivation after admission.Results Mean ± SD operation time among all cases was (74.2 ± 23.6) min,the amount of bleeding during surgery was 5-15 (mean:8) ml,duration of hospitalization was 3-12 (mean:4.5)days,ureteral stents are kept for an average time of 4 weeks after surgery.3 patients developed fever after operation,1 developed urosepsis;all these patients recovered after active anti-infection treatment.No post-operative complications such as fever,renal colic,hematuresis,ureteral perforation,active bleeding as well as sepsis were found among the other patients.The preoperative and postoperative serum creatinine had statistical difference (P ＜0.05).14 patients were proved to be stone-free by KUB or CTU.The stone-free rate after a single operation was 82.3％ (14/17).Residual stone were found in the 3 patients,who subsequently underwent a second flexible ureteroscopy and holmium laser lithotripsy.The stone-free rate after a second operation was 94.1％.Conclusions Flexible ureteroscopy and holmium laser lithotripsy is a safe and effective method for the treatment of nephrolithiasis in patients with a solitary kidney with a lower procedure-related injury rate,smaller amount of bleeding,a lower complication rate and a shorter time required to recover after surgery.

Diagnosis and treatment of ureteral fibroepithelial polyp / 国际外科学杂志

Objective To improve the experience of diagnosis and evaluate the clinical efficacy and safety of the surgical management for ureteral fibroepithelial polyp.Methods The clinical date of 29 patients with ureteral polyps admitted in Peking Union Medical College Hospital during 2001 to 2014 were analysed retrospectively.The patients' age was between 1 1 to 84 years and 19 were male.Twenty patients with frank pain and two patients with hematuria were enrolled.Seven patients were found hydronephrosis.Results Twenty-nine cases were treated surgically.Fifteen cases were treated by ureteroscopic laser ablation,10 cases local resection and reanastomosis,1 case of abnormalities duplex kidney and ureter underwent local resection and ureteroplasty,2 case Partial ureterectomy including the polyps and pyeloplasty,1 cases nephroureterectomy because of giant hydronephrosis and nonfunctional kidney.No recurrences were seen during a mean follow-up of 32 months (range 10-56 mos).No ureteral stricture occurs.Conclusions Ureteral fibroepithelial polyps represent a rare pathology.Local resection is the main treatment.Endoscopic management is recommended to minimize morbidity and complications in treatment of ureteral fibroepithelial polyps.Recurrences seem to be rare in these tumors.

Apoptosis of SMMC-7721 cells induced by the low-intensity pulsed ultrasound in vitro / 中华物理医学与康复杂志

Objective To explore whether the low-intensity pulsed ultrasound (LIPU) could induce apoptosis on SMMC-7721 cells and to explore the underlying mechanism.Methods The SMMC-7721 cells were randomly divided into 4 groups:a blank control group,which was subject to sham exposure to ultrasound,and 3 ultrasound intervention groups exposed to ultrasound at intensities of 0.5,1.3 and 2.0 W/cm2,respectively.Then they were incubated for 6 h.The cell apoptosis,necrosis and changes of cell cycles were measured using the flow cytometry.The transmission electron microscope (TEM) was used to observe microstructural changes in the cells.The agarose gel electrophoresis (AGE) was used to examine the DNA fragmentation,and Western-blotting was employed to assess the protein expression of caspase-3.Results The average cell apoptosis rate of the 3 intervention groups were 4.66％,8.99％ and 32.41％,respectively.The percentage of cells in G2 phase increased significantly and those in G1 phase decreased significantly in the 3 intervention groups compared to the blank control group at the same time points.In the intervention groups,significant cell apoptosis was observed under TEM,and DNA ladders was seen in AGE,with DNA fragments appearing obviously when cells were incubated for 6 h and 9 h after ultrasound exposure.In intervention groups subject to 1.3 and 2.0 W/cm2 ultrasound exposure,the protein expression of caspase-3 was significantly higher than that of the control group.Conclusion LIPU can inhibit the proliferation and induce apoptosis of SMMC-7721 cells with a dose-dependent feature.The possible mechanism underlying the LIPU-induced cell apoptosis might be related to the activation of the mitochondria pathway,and especially the caspase-3 protein.

Anin vitro study of the effect of low intensity ultrasound on the migration and invasion of MHCC97H / 中国癌症杂志

Background and purpose:Low intensity ultrasound (LIUS) can kill cancer cells and promote their apoptosis. However, it is still unknown how it affects the migration and invasion of tumor cells. This study aimed to explore the effect of LIUS on human hepatocellular line MHCC97H in migration and metastasis and the possible mechanismin vitro.Methods:According to the intensity of ultrasonic irradiation, 4 experimental groups were established: control group (0 W/cm2), 0.5 W/cm2, 1.0 W/cm2 and 1.5 W/cm2group. The migration and invasion ability of hepatocellular cells was detected by scratch assay and Transwell migration and invasion assay after the irradiation of LIUS. The changes of cytoskeleton after irradiation were observed by microscope and F-actin green lfuorescence staining. The expressions of MMP-2 and MMP-9 were examined by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot.Results:Low intensity ultrasound (≤1.5 W/cm2) promoted the migration and invasion of hepatocellular line MHCC97H. Scratch assay and Transwell assay showed much more cells under irradiation migrated through membrane than untreated. It was found that morphology of liver cancer cells changed after LIUS irradiation using optical microscope and lfuorescence microscope. The results of RTFQ-PCR and Western blot showed upregulation of MMP-2 expression by LIUS in MHCC97H and high expression of MMP-9 mRNA. Conclusion:Low intensity ultrasound may promote the migration and invasion of MHCC97H through changing cytoskeleton and upregulating protein expression of MMP-2.

Analysis of clinical features of retroperitoneal bronchogenic cyst / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of retroperitoneal bronchogenic cyst.</p><p><b>METHODS</b>The clinical data of 6 cases with retroperitoneal brochogenic cyst treated in Peking Union Medical College Hospital from April 1996 to October 2014 were retrospectively analyzed. The clinical manifestation, diagnosis, treatment and prognosis were analyzed.</p><p><b>RESULTS</b>Of the patients, 1 was male and 5 were female aging from 31 to 50 years with a mean age of 38.3 years. Three cases were diagnosed from physical examination, 2 cases from upper abdominal pain and 1 case from left flank pain. The cysts located in the left adrenal region, between the liver and the pancreas, and anterior aspect of the tail of the pancreas were seen in 4 cases, 1 case and 1 case, respectively. The major diameter was from 5 cm to 13 cm, and the mean major diameter was 7 cm. Ultrasonography and CT scan could reveal cystic, cystic-solid or solid masses. Color doppler flow imaging showed no obvious blood flow, and contrast-enhanced CT scans showed no enhancement or no obvious enhancement. Six cases were all misdiagnosed preoperatively. They all underwent operations via retroperitoneal laparoscopic resection for 3 cases, laparotomy for 2 cases and open flank resection for 1 case respectively. The pathological diagnoses were all bronchogenic cysts. Three symptomatic patients became asymptomatic after operations. Five patients had been followed up. During the follow-up of 2 months to 15 years, no recurrence had been found with CT scan.</p><p><b>CONCLUSIONS</b>Retroperitoneal bronchogenic cyst is rare and easily misdiagnosed. It should be considered in the differential diagnosis of a retroperitoneal mass. Most cysts are positioned in the left adrenal region and adjacent regions. Some cysts demonstrate soft tissue characteristics in image. After surgical removal, the patients have a good prognosis.</p>

Transurethral resection of paragangliomas in urinary bladder (report of 11 cases) / 中华泌尿外科杂志

Objective To evaluate the safety and feasibility of transurethral resection of paragangliomas in urinary bladder.Methods Clinical data of 11 patients (5 males and 6 females) with paragangliomas in urinary bladder who underwent transurethral resection in Peking Union Medical College Hospital from June 2008 to February 2014 were analyzed retrospectively.The age ranged from 30 to 76 years (mean 54± 14 years).All cases were diagnosed as single primary tumor.The preoperative CT or MRI showed the tumors located in bladder wall.The diameter of tumors ranged from 0.9-3.0 cm (mean 1.9±0.8).Nine cases presented with hypertension after micturition and 2 cases presented with sustained hypertension.The tumors were localized by B ultrasound,enhanced CT or MRI.The diagnosis was confirmed by detection of 24 hours urinary catecholamine,Octreotide scanning or 131I-MIBG scanning.Transurethral resection of tumors was performed after pharmachological preperation.Eight cases underwent conventional transurethral electroresection and 3 cases underwent transurethral resection with 2 μm thulium laser.All cases were followed up every 3 to 6 months and 24 hours urinary catecholamine and CT scan were performed.Results All tumors were successfully resected without open conversion.The operative time was 20 to 45 min (mean 34±8 min).The estimated blood loss ranged from 10 to 100 ml (mean 27±26 ml).Fluctuation of blood pressure during operation occurred in 9 cases.The maximum systolic blood pressure during operation rised to 220 mmHg (1 mmHg =0.133 kPa) and sodium Nitroprusside was administed to control blood pressure.Blood pressure of all cases returned to normal after operation.No perioperative complications occurred.No recurrence was found during follow-up (3-58 months,mean 26 months).Conclusions For small localized paraganglioma (the diameter less than 3 cm) in urinary bladder,transurethral resection could be a safe and feasible choice of treatment.And 2 μm thulium laser resection has an advantage over conventional electroresection for tumors located in lateral bladder wall to avoid obturator nerve reflex.

A study on the efficacy ofβ-lactam antibiotics combined with macrolides in treatment of severe community-acquired pneumonia in children / 临床儿科杂志

Objective To investigate the clinical efficacy ofβ-lactam combined with macrolides antibiotics in treatment of severe community-acquired pneumonia (CAP) in children. Methods Children with severe CAP on admission between 2012 February and 2012 April were divided into treatment group and control group. With the same symptom specific supportive treat-ment, the patients in the treatment group were treated with both cefmetazole and azithromycin, while the patients in the control group were treated with cefmetazole alone. The total effective rate, number of days of symptoms and signs disappeared and num-ber of days of hospitalization were observed. Results The total effective rate was 87.8%in the trearment group and 61.3%in the control group with significant difference (P<0.05). Compared with control group, the recovery time of temperature, time of pulmonary rale disappearing and cough retraction were reduced (P<0.05). As well as the number of days of hospitalization was decreased (P<0.05). Conclusions The treatment of severe CAP in children with combination of azithromycin and cefmetazole results in better curative effect. A combined medication ofβ-lactam and macrolides antibiotics may be rational and effective.