Clinical characteristics of children with 2019 novel coronavirus infection in Putian City / 中华传染病杂志

Objective:To analyze the clinical characteristics of children with 2019 novel coronavirus (2019-nCoV) infection in Putian City, and to provide a reference for the diagnosis and treatment of children with 2019-nCoV infection.Methods:Clinical characteristics, laboratory examination, pulmonary compated tomography findings, treatment, and clinical outcomes of 78 children with 2019-nCoV infection who were admitted to Putian University Affiliated Hospital Medical Group Putian City Children′s Hospital from September 10 to October 20, 2021 were retrospectively collected and analyzed.Results:Of the 78 children included in the analysis, two cases (2.6%) were asymptomatic infection, 36 cases (46.2%) were mild and 40 cases (51.3%) were ordinary. Five children were vaccinated against 2019-nCoV. The main symptoms were fever (24 cases), cough (13 cases), and fatigue (nine cases). A total of 34 cases (43.6%) had neutropenia, 29 cases (37.2%) had lymphopenia, 36 cases (46.2%) had D-dimer increase, 38 cases (48.7%) had hypokalemia, 27 cases (34.6%) had hypoglycemia and 11 cases (14.1%) had elevated creatine kinase isoenzyme. The neutropenia mostly occurred two to four days after admission. Fifty-six cases (71.8%) showed pulmonary computed tomography abnormalities. The cycle threshold of virus open reading frame ( ORF)1 ab was 20.90±7.15 and the cycle threshold of N gene was 20.29±7.78 in the first nucleic acid detection of 78 children after admission. The time of nucleic acid negative conversion of the 78 children was (20.73±6.94) days. IgM antibody titer in five vaccinated children was 0.36 (0.34, 4.89) and IgG antibody was 10.42 (0.50, 19.42). IgM antibody titer was 1.82 (1.66, 8.12) and IgG antibody was 76.63 (16.92, 79.84) in cases with disease duration ≥10 days. Nine children (11.5%) had resurgence of virus and were sent to the isolation site. All the other children were cured and discharged from hospital. Conclusions:Children with 2019-nCoV infection have mild clinical symptoms, and some children have lymphopenia, neutropenia, and D-dimer elevation during the course of the disease. The overall prognosis is good. The children vaccinated against 2019-nCoV have higher antibody levels.

Study on genetics and early diagnosis of early onset epileptic encephalopathy of unknown etiology / 中华实用儿科临床杂志

Objective:To explore the genetic etiology and the value of early diagnosis of early onset epileptic encephalopathy (EOEE) with unknown etiology.Methods:A total of 60 children with EOEE of unknown etiology were prospectively enrolled in the outpatient and inpatient departments of Fujian Provincial Hospital from January 2018 to January 2021.Peripheral blood was collected prospectively for whole-exome sequencing and copy number variation (CNV) detection to analyze the clinical characteristics and genetic sequencing results of the children.Results:Twenty-four patients with EOEE-related pathogenic or suspected pathogenic mutations were detected, including infantile spasms (10 cases), Dravet syndrome (3 cases), pyridoxine-dependent epilepsy (1 case) and ohtahara syndrome (1 case), and unknown epileptic encephalopathy (9 cases). The onset age of EOEE-related patients ranged from 1 day to 11 months (median age was 4.2 months), the treatment age ranged from 2 days to 4 years (median age was 10 months), and the age of diagnosis was controlled within 1 month after treatment.There were 20 cases (33.3%) single gene variants and 4 cases (6.7%) CNV variants.A total of 13 genes were involved: KCNQ2, SCN1A, SCN8A, CACNA1E, CDKL5, PPP3CA, PCDH19, TSC1, TSC2, ZEB2, ALDH7A1, DCX and HNRNPU.The 4 CNV abnormalities were 17p13.3 deletion, 11q23.3q25 deletion, 1q36.31-p36.33 deletion, 1q43-1q44 deletion and Xp22.33 duplication, respectively.Totally, 20 mutations were new loci reported for the first time at home and abroad; 11q23.3q25 deletion that resulted in infantile spasm was first reported at home and abroad.Infantile spasm caused by ZEB2 mutation and epileptic encephalopathy caused by PPP3CA gene were both reported for the first time in China. Conclusions:Gene and CNV are important potential causes of children suffering from EOEE.When the etiology is unclear, the combination of whole-exome sequencing and CNV sequencing technology can improve the diagnosis level of genetic etiology of children with EOEE.The early genetic detection of these children can early diagnose and accurately treat epilepsy.

Effect of prenatal taurine supplementation on sensorimotor ability and hippocampal synaptophysin expression of juvenile rats with intrauterine growth restriction / 中华实用儿科临床杂志

Objective:To investigate the effect of prenatal taurine supplementation on sensorimotor ability and synaptophysin (Syn) expression in the hippocampus of juvenile rats with intrauterine growth restriction (IUGR).Methods:The IUGR rat model was induced by food restriction throughout pregnancy.Pregnant rats were randomly divided into normal control group, IUGR group and IUGR+ taurine group.Sensorimotor ability was tested in 2-week-old juvenile rats via grading the tail suspension scores and beam balance test scores, followed by detecting Syn expression in the hippocampus of juvenile rats by immunohistochemistry and Western blot.The correlation between sensorimotor ability scores and Syn expression was assessed.Results:Tail suspension time[(14.62±3.46) s vs.(25.38±5.92) s, P<0.001] and beam balance test scores [(9.08±1.38) scores vs.(12.08±1.16) scores, P<0.001] in the IUGR group were significant lower than those of normal control group.Tail suspension time (22.77±5.16) s and beam balance test scores (11.08±1.38) scores in IUGR+ taurine group were significantly higher than those in IUGR group (all P<0.05), but there was no significant difference comparable to those in normal control group ( P>0.05). The average optical density ( A) value [(53.96±2.37)% vs.(61.68±3.07)%, P<0.001] and protein expression of Syn (1.82±0.23 vs.2.23±0.17, P<0.001) in rat hippocampus of IUGR group were all signi-ficantly lower than those in normal control group.The A value [(60.27±2.59)%] and expression of Syn protein (2.07±0.17) in IUGR+ taurine group were significantly higher than those in IUGR group (all P<0.05), but there was no significant difference comparable to those in normal control group ( P>0.05). The expression of Syn in rat hippocampus was positively correlated with the tail suspension test time and beam balance test scores (all P<0.05). Conclusions:Prenatal taurine supplementation can improve the sensorimotor ability of juvenile rats with IUGR by upregulating Syn in the hippocampus.

Risk factor analysis of benign childhood epilepsy with centrotemporal spikes complicated by electrical status epilepticus in sleep / 中华实用儿科临床杂志

Objective To evaluate the risk factors for benign childhood epilepsy with centrotemporal spikes (BECT) complicated by electrical status epilepticus in sleep(ESES).Methods From January 2013 to January 2017,a total of 80 children diagnosed as BECT in pediatric neurology outpatient department of Provincial Clinical Medical College Affiliated to Fujian Medical University were enrolled.According to whether there was an attack of ESES or not,patients were divided into ESES group(38 cases) and non-ESES group(42 cases).In order to elucidate risk factors for BECT complicated by ESES,clinical data including age,gender,first seizure age,seizure frequency before treatment,types of seizure,therapeutic drug,recurrence of seizure after treatment,febrile seizure,status at birth,family history,brain MRI,discharge quantity,discharge location,and intelligence score were investigated by multivariate Logistic regression analysis.Results Compared with non-ESES patients,ESES patients were more likely to have recurrence of epilepsy after treatment (68.4％ vs 26.2％,P ＜ 0.001),and had worse intellectual development (＜ 90 scores;73.7％ vs 38.1％,P =0.001);while electroencephalogram showed more discharge in anterior location (47.4％ vs 21.4％,P =0.014) and bilateral distribution of brain (52.6％ vs 26.2％,P =0.015).However,the multivariate Logistic regression analysis showed that only recurrence of seizure after treatment was the risk factor for ESES in BECT patients(P=0.008,OR=4.039,95％CI:1.429-11.418).Conclusion Recurrence of seizure after treatment of BECT was a high risk factor for ESES.Controlling seizure and reducing ESES phenomenon could be beneficial to alleviate the intellectual impairment of patients with BECT.

Infection Distribution and Drug Resistance Analysis of Pseudomonas Aeruginosa in Third District Hospital in Shenzhen Area / 现代检验医学杂志

Objective To understand the shenzhen longhua new district and the light district three third district hospital pseudomonas aeruginosa infection the clinical distribution and drug resistance,for clinical provides the basis for scientific and medical treatment.Methods Collected 3 176 clinical specimens in three district hospital from June 2013 to November 2014 and they were done bacteria identification with VITEK-32 bacteria identification instrument of French biomerieux.For pseudomonas aeruginosa specimens using the K-B method and trace the broth dilution method (MIC)to do drug sensitive test,and the inspection results were statistically processed.Results 3 176 specimens pseudomonas aeruginosa isolated total separation rate was 51.16% (1 625/3 176),including respiratory sputum specimens was 52.8% (858/1 625),followed by bronchoalveolar lavage and pus,were 20.1% (327/1 625)and 16.7% (271/1 625).Ward,neurosurgery and thoracic sur-geons are mainly distributed in the ICU,were 41.6% (676/1 625),15.9% (259/1 625)and 19.1% (310/1 625).Carbon penicillium,resistance to carbon alkene sensitive penicillium alkene and extensive drug resistance rate of pseudomonas aerug-inosa isolated were 67.1% (1 090/1 625),31.6% (514/1 625)and 1.29% (21/1 625).Resistance to carbon penicillium al-kene the drug resistance of pseudomonas aeruginosa from penicillium carbon alkene sensitive serious,in addition to the poly-myxin B resistance to both comparative difference was statistically significant (χ2 = 12.617~ 12.617,P 60%.Conclusion Clinical pseudomonas aeruginosa had a high separation rate,mainly comes from the respiratory tract and the distribution of the ICU ward.Penicillium carbon alkene resistant pseudomonas aeruginosa than carbon penicillium sensitive resistance was serious,should pay close attention to carbon blue mould resistant pseudomonas aeruginosa resistance development,take effective measures of preventing transmission and infection of scientific use of antimicrobials,put an end to resistance to car-bon penicillium alkene and the spread of drug resistance pseudomonas aeruginosa .

Clinical features of child mitochondrial encephalopathy with lactic acidosis and stroke with status epileptics / 临床儿科杂志

Objective To investigate the clinical features and treatment of a group of patients of mitochondrial encepha-lomyopathy with actic acidosis and stroke (MELAS) with onset of status epileptics. Methods Clinical features, EEGs, image ifndings, and therapeutic data of 4 cases with onset of status epileptics patients ifnally diagnosed as MELAS were retrospectively reviewed. Results Four Patients were onset with status epileptics. The levels of serum lactic acid, ammonia, myocardial enzymes were increased, and the serum sodium level was reduced, and accompanied with metabolic acidosis. EEG found corresponding paroxysmal and interictal activities. Brain images showed basal ganglia calciifcation, brain atrophy, and acute cortex edema. Genetic detection found mtDNA3243 mutation. Conclusions The status epilepticus was commonly present in MELAS. The treatment of epileptic attack in this disease was dififcult, which needs early diagnosis. Appropriate anti-leptic drugs and relevant treatment to symptoms are important to alleviate cerebral injury.

Protective effects of mouse nerve growth factor on brain in epileptic young rats / 临床儿科杂志

Objective To explore the effects of mouse nerve growth factor (mNGF) on expression of metallothionein I/II (MT I/II) and cytochrome C (Cyt C) in hippocampus of pentylenetetrazol (PTZ)-induced epileptic (EP) young rats. Methods Fif-ty SD rats aged 19 days were randomly divided into control group, EP group, mNGF low, medium, and high dose groups. Each group had 10 rats. Control group was injected with normal saline every day, and EP group was intraperitoneally injected with PTZ 40 mg/(kg·d) for 21 days in succession. The mNGF low, medium, and high dose groups were respectively intramuscularly injected with mNGF 500, 1 000, 2 000 AU/(kg·d) for 7 days in succession after PTZ injection. Changes of body weight, behav-ioral performance were recorded. The positive cells of MT I/II, Cyt C were examined by immunohistochemisty. The levels of MT I, Cyt C mRNA in hippocampus were measured by real-time PCR. Results The number of MT I/II, Cyt C positive cells and the levels of MT I, Cyt C mRNA in hippocampus had signiifcant differences among groups (F=15.98-105.76, P=0.000). The number of MT I/II, Cyt C positive cells and the levels of MT I, Cyt C mRNA of EP group were higher than those in control group, mNGF low, medium, and high dose groups (P0.05). Conclusions As a stress protein, metallothionein is involved in the process of chronic epilepsy along with Cyt C. mNGF has neuroprotective effects on the hippocampus of epileptic rats in dose dependent manner.