The diagnostic value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio in severe Mycoplasma pneumoniae pneumonia / 中华实用儿科临床杂志

Objective:To study the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diagnosing severe Mycoplasma pneumoniae pneumonia (MPP).Methods:A total of 616 cases of MPP patients in the Children′s Hospital of Soochow University from January 2015 to December 2017 were retrospectively analyzed.During the same period, 100 healthy children were selected as the healthy control group.NLR and PLR between MPP group and healthy control group, and those between severe MPP group and ordinary MPP group were compared by t test or rank sum test.Risk factors for severe MPP were identified.Receiver operating characteristic(ROC) curves were plotted to identify the cut-off point of NLR and PLR in distinguishing MPP from healthy subjects. Results:(1)The median of white blood cell count (WBC), neutrophil count (N), platelet count (PLT), NLR, PLR, immunoglobulin M (IgM) and the median percentage of CD3 -CD 19+ , CD 19+ CD 23+ in MPP group were significantly higher than those in healthy control group(8.36×10 9/L vs.7.49×10 9/L, 4.41×10 9/L vs.3.11×10 9/L, 340.92×10 9/L vs.234.00×10 9/L, 1.70 vs.0.91, 112.99 vs.70.34, 1.33 g/L vs.1.29 g/L, 20.95% vs.17.10%, 11.25% vs.9.70%), whereas the median of lymphocyte count (L), IgA and the median percentage of CD3 + , CD3 + CD8 + , and CD3 -CD +(16+ 56) were significantly lower(2.64×10 9/L vs.3.37×10 9/L, 0.86 g/L vs.1.30 g/L, 64.55% vs.68.00%, 23.65% vs.24.90%, 10.50% vs.12.20%)( Z=-3.074, -2.413, -2.972, -1.357, -1.863, -2.251, -4.282, -3.420, -2.221, -4.181, -2.784, -2.024, -2.791, all P<0.05). (2)The median of N, NLR, PLR, IgA, IgG, IgM and the average of percentage of CD3 + , CD3 + CD8 + in severe MPP group were significantly higher than those in ordinary MPP group[5.18×10 9/L vs.3.52×10 9/L, 2.39 vs.1.03, 149.32 vs.94.23, 1.29 g/L vs.0.71 g/L, 9.63 g/L vs.8.19 g/L, 1.40 g/L vs.1.29 g/L, (65.53±9.75)% vs.(62.81±9.89)%, (25.35±6.65)% vs.(23.38±6.91)%], whereas the median of L, the median percentage of CD3 -CD 19+ , and CD 19+ CD 23+ were significantly lower than those of ordinary MPP group(2.02×10 9/L vs.3.25×10 9/L, 17.40% vs.21.50%, 9.00% vs.11.70%)( Z/ t=-7.807, -11.313, -10.452, -8.819, -6.162, -3.047, -3.128, -3.270, -9.402, -5.191, -5.214, all P<0.05). (3)Univariate and multivariate Logistic regression analysis showed that CD3 -CD 19+ was the protective factor for severe MPP, while N, NLR and PLR were the risk factors for severe MPP (all P<0.05), with the risk sequence of NLR>PLR>N.(4)Area under ROC curve analysis of NLR and PLR in the diagnosis of severe MPP: NLR: AUC=0.789, 95% CI: 0.754~0.823, P<0.001; PLR: AUC=0.767, 95% CI: 0.730~0.804, P<0.001; when the critical value of NLR was 1.09, the sensitivity was 98.9%, and the specificity was 70.6%.When the critical value of PLR was 97.47, the sensitivity and specificity were 88.5% and 69.4%. Conclusions:NLR and PLR can be served as independent influencing factors for severe MPP, showing the diagnostic potential in severe MPP.

Epidemiologic and clinical features of hand, foot, and mouth disease caused by Coxsackie virus A16 infection in Suzhou and analysis of polymorphisms ofOAS1 / 临床儿科杂志

Objective To explore the epidemiologic and clinical features of hand, foot and mouth disease (HFMD) caused by Coxsackie virus A16 (CA16) in Suzhou from 2010 to 2014, and analyze the relationship between the SNPs of oligoadenylate synthetase 1 (OAS1) and HFMD caused by CA16 infection.MethodsThe clinical data of children diagnosed with HFMD caused by CA16 during 2010 and 2014 were collected. The epidemiological characteristics were analyzed. Among them, 167 cases were selected to make comparison of the clinical features with 166 cases of HFMD caused by EV71 infection in the same period. The genotyping ofOAS1 rs10774671 was detected by TaqMan probe technique in 167 cases of CA16 infection children, 166 cases of EV71 infection children with HFMD and 163 healthy children. The relationship between polymorphism of gene and infection of CA 16 was analyzed.ResultsA total of 9 016 children with HFMD were included. CA16 nucleic acid detected to be positive in 762 cases. The detection rate was 8.45%. CA16 infection was most commonly in summer. Children under 5 years old accounted for 94.62% infected. Compared with EV71 infected children, CA16 infected children had shorter fever time, severer oral herpes, ulcer, and rash in hand, foot and hip, lesser nervous system involvement, fewer cases of high lactate dehydrogenase, high C reactive protein, high IgM or IgG, and signiifcant changes in the percentage of CD3+, CD3+CD4+, CD3+CD8+ and CD3-CD19+ (P all?

The relationship between meteorological parameters and the prevalence of Moraxella catarrhalis infection in chil-dren hospitalized with acute respiratory infection in Suzhou / 临床儿科杂志

Objective To explore the correlation of meteorological parameters with the epidemic of acute Moraxella ca-tarrhalis respiratory infection in hospitalized children in Suzhou. Methods A total of 8143 children with acute respiratory infec-tion were participated in the trial during 2006 to 2010, and the secretions of nasopharynx were collected for bacterium culture. Moraxella catarrhalis was identified according to the routine technique of culture. Meteorological parameters including mean temperature, relative humidity, rainfall amount, duration of sunshine and mean wind velocity were collected monthly during the same period. The relationship between the epidemic of Moraxella catarrhalis and metrorological parameters were analyzed by seasonal decomposition method, the Spearman rank correlation and stepwise regression analysis. Results Moraxella catarrhalis was identified in 4.04% of 8 143 specimens. The prevalence of acute Moraxella catarrhalis respiratory infection was higher during winter and spring. The monthly infection rate of Moraxella catarrhalis was negatively correlated with mean temperature as well as duration of sunshine and wind velocity. Wind velocity was independent risk factor for Moraxella catarrhalis infection. Conclusions Moraxella catarrhalis is a primary pathogen in respiratory tract infection in children in Suzhou. The epidemic of Moraxella catarrhalis is closely related to meteorological parameters.

The correlation study of viral load of human bocavirus and clinical features of children with acute respiratory tract infection / 中华传染病杂志

Objective To investigate the detection of human bocavirus (HBoV) in children with acute respiratory infection and to explore the relationship between viral load and clinical characteristics of acute respiratory infection in children.Methods A total of 4 501 nasopharyngeal secretion samples were collected from hospitalized children with acute respiratory infection from January 2013 to June 2013.HBoV-positive children were divided into simple infection group and mixed infection group.Children with HBoV DNA≥1 × 104 copy/mL were categorized into high viral load group,while those with HBoV DNA ＜1 × 104 copy/mL were categorized into low viral load group.HBoV was determined by fluorescence quantitative polymerase chain reaction (PCR).Respiratory syncytial virus (RSV),influenza virus (Inf)-A,Inf-B,parainfluenza virus (Pinf)-Ⅰ 、Pinf-Ⅱ 、Pinf-Ⅲ and adeno virus antigen were detected by direct antigen-specific immunofluorescence assays.Mycoplasm Pnuemonia was detected by real-time fluorescence quantitative PCR.Serum mycoplasma antibodies were detected by enzyme-linked immunosorbent assay (ELISA).Bacteria was detected by sputum culture.Over the same period,23 children undergoing elective inguinal hernia operation with no respiratory infection or fever were considered as control group.The percentage of peripheral blood T lymphocyte subsets were tested by flow cytometry.Inter-group differences were compared using Chi-square test or Fisher exact test.Viral loads were compared using Mann-Whitney test.Results Two hundred and twenty-two HBoV-positive cases were detected with a positive rate of 5.41％ (222/4 105),33.33％ (74/222) of which were with high viral load and 66.67％ (148/222) were with low viral load.There was a high incidence in the age group of 1-2 years.The simple HBoV infection accounted for 24.32％,including 26 cases with high viral load and 28 cases with low viral load.Wheezing was more common in patients with high viral load than those with low viral load,and the difference was statistically significant (88.46 ％ vs 42.86 ％,x2 =12.295,P=0.001).Among the 222 HBoV-positive cases,the median viral load of HBoV in simple infection group was 3.86 × 103 copy/mL,and 1.0× 103 copy/mL in mixed infection group.The difference of the viral load between these two groups was statistically significant (Z =2.906,P =0.004).Mycoplasma and Streptococcus pneumonia were most commonly detected in the 168 patients with mixed infection.Percentages of CD3+ and CD3+/CD8+ subsets were significantly lower in HBoV simple infection group and mixed infection group,compared to control group (both P＜0.05).However,percentages of CD3 /CD19+,CD19+/ CD23+ subsets were significantly higher in HBoV simple infection group and mixed infection group,compared to control group (both P＜0.05).Conclusions HBoV is one of the pathogens causing acute respiratory tract infection in children,which lead to cellular immunity dysfunction in children.Moreover,children with higher HBoV load are more likely to develop wheezing.Co-infection with other pathogens should be considered in children with low HBoV load.

Significance of electronic bronchoscopy in diagnosis and treatment of lung diseases with pulmonary mass lesion ;in children / 临床儿科杂志

Objectives To investigate the significance of electronic bronchoscopy and bronchoalveolar lavage in diagno-sis and treatment in children with pulmonary mass lesion. Methods A total of 74 hospitalized children from January 2011 to June 2012 whose imaging examinations showed massive patchy shadow were examined and treated by electronic bronchoscopy and bronchoalveolar lavage. Their clinical data were retrospectively analyzed. Results The major cause for the massive shadow was infection according to electronic bronchoscopy examination (68/74, 91.89%), 65 cases of them were lobar pneumonia, 3 cas-es were pulmonary tuberculosis followed by 5 cases of foreign body (6.76%) and one case of pneumorrhagia (1.35%).The lower left lung was the most frequently seen site of infection, followed by lower right lung. The agreement between infection sites and imaging examination was 97.30%. Bronchoalveolar lavage fluid showed that the primary pathogen of lobar pneumonia infection is Mycoplasma pneumoniae (MP) (42/65, 64.62%). The highest detection rate of MP was found in preschool group and the detec-tion rate between different age groups indicated statistically significant difference (P3 weeks, 35.71%) (P<0.05). Conclusions Electronic bronchoscopy and bronchoalveolar lavage play dual roles in etiological diagnosis and therapy in children with pulmo-nary mass lesion.

Correlation of bacteria population confirmed by semi-quantitative culture of sputum with clinical features in hospitalized infants with wheezing diseases / 中华实用儿科临床杂志

Objective To explore the relationship between the clinical features and the bacteria quantity confirmed by semi-quantitative culture of sputum in hospitalized infants with wheezing diseases.Methods Nine hundred and fifty-seven patients with wheezing diseases were enrolled from Jan.1,2010 to Dec.3 1,2011,and their clinical characteristics were collected.Respiratory seeretions were collected on admission by the pathogenic examination.They were grouped into 3 groups by the bacteria quantity,and the predictive analytics statistical saftware 20.0 was used to analyze the relationship between the clinical features and the bacteria quantity confirmed by semi-quantitative culture of sputum.Results 1.A total of 372(38.87％,372/957 cases)patients had positive sputum cuhures,and there were 585 patients in 0 + group,225 patients in 1 +-2 + group,147 patients in 3 +-4 + group;the main pathogens in 1 +-2 + group were haemophilus influenza (24.89％,56/225 cases) and streptococcus pneumonia (16.00％,36/225 cases) ;the main pathogens in 3 +-4 + group were streptococcus pneumonia(54.42％,80/147 cases) and haemophilus influenza(8.84％,13/147 cases).2.Presence of siblings,cyanosis,neutrophils and C-reactive protein were higher in 3 +-4 + group when compared with those of 0 + group,shortness of breath was common in 1 +-2 + group.3.Multinomial Logistic regression analysis identified the presence of siblings,residence,passive smoking,course of disease and cyanosis were identified as risk factors in 3 +-4 + group; gender,fever peak ＞ 38.5 ℃,breast-feeding,passive smoking,age,course of disease and cyanosis were as risk factors in 1 +-2 + group.4.Severe pneumonia was common in 3 +-4 + group.Conclusions Bacterial are often detected in infants hospitaled with wheezy episodes,and bacteria quantity is correlated with clinical presentation.Severe pneumonia is common in higher bacteria quantity group.

Association between activity of hand, foot and mouth disease and meteorological factors in Suzhou / 中华传染病杂志

Objective To study the association between activity of hand,foot and mouth disease (HFMD) and the meteorological factors in Suzhou.Methods A total of 17 653 children diagnosed with HFMD in Children's Hospital Affiliated to Suzhou University during 2008 to 2011 were enrolled.The meteorological factors in(c)luding mean temperature,relative humidity,rainfall amount,sum of sunshine and mean wind velocity during Jan 2008 to Dec 2011 were collected monthly.Numeration data were analyzed using chi square or Fisher exact test.Normal distribution data were analyzed using Pearson correlation and non-normal distribution data were analyzed using Spearman rank correlation.Results HFMD could be found all over the year and had obvious seasonality which peaked in Summer,followed by Spring and Autumn and HFMD decreased markedly in Winter.The activity of HFMD was positive correlated with mean temperature(r=0.716,P＜0.01),wind velocity (r=0.630,P＜0.01),rainfall(r=0.477,P＜0.01) and sum of sunshine(r=0.311,P＜0.05).No statistical significance was observed between relative humidity and HFMD(r =0.276,P＞0.05).Multivariate stepwise regression analysis showed that only mean temperature and rainfall were associated with HFMD and mean temperature had stronger influence on HFMD than rainfall (t =4.687,P ＜ 0.01 ; t =2.258,P ＜ 0.05).Conclusions HFMD has obvious seasonality.Mean temperature and rainfall are the main factors affecting this seasonality.

Dynamics of Liver Granuloma and the Relative Changes of Th1/Th2 Cytokine Levels in Mice Infected with Schistosoma Japonicum / 复旦学报（医学版）

Purpose To oberve the dynamics of liver granuloma and the relative changes of Thl/Th2cytokine levels in mice infected with Schistosoma japonicum, and investigate the role of Th1/Th2 in S.japontcum granuloma formation and regulation. Methods Liver granuloma measurement were performedby histological examination and the ELISA were used for the quantitative determination of IL-2, IFNr andIL-4 in murine serum and spleen lymphocyte culture medium at 0,4,6,8,10 and 12 wk after infection.Results At 6 wk liver granuloma formation appeared and at 8 wk liver granuloma peaked. After 12 wk livergranuhoma diminished obviously. Meanwhile, at 4 - 6 wk IL-2, IFNr and IL-4 began to rise, at 8 wk thelevels of Th1 cytokines IL-2 and IFNγ peaked and then declined, and at 8 wk the levels of Th2 cytokines IL-4 were rapidly enhanced and increased obviously with a prolongation of the infection duration.Conclusions The Th1cytokines IL-2 and IFNγ were correlated well with S. japonicum granulomaformation and vigour, and the Th2 cytokines IL-4 might play an important role in down-regulating egggranuloma reaction at chronic schistosomiasis by inhibiting the Th1cytokines.

Differentiation of Monocyte derived Dendritic Cells in Patients with Psoriasis / 中华皮肤科杂志

Objective To investigate the differentiation of dendritic cells from monocytes of the peripheral blood in patients with psoriasis. Methods Flow cytometry was used to analyze the phenotype of monocyte derived dendritic cells (MoDC). The capacity of MoDC to stimulate the proliferation of T lymphocytes was evaluated by allogeneic mixed lymphocyte reaction. Results Monocytes in the peripheral blood of patients with psoriasis could differentiate into dendritic cells. Expression of CD40, CD80, CD86 and HLA-DR by MoDC was significantly increased in patients with psoriasis compared with that in normal controls (P

FURTHER OBSERVATION ON DYNAMICS OF IN VITRO GRANULOMATOUS RESPONSES SURROUNDING SCHISTOSOME EGGS / 中国血吸虫病防治杂志

Objective To further observe the morphologic changes of in vitro model of granulomatous responses around Schistosoma japonica eggs and determine the relationship of reaction inten-suy to infection stage of those schistosome-infected mice from which the splenocytes were obtained for in vitro experiments.Methods The spleen cells isolated from schistosome-infected mice were incubated and dry schistosome eggs were added into those cultures. These splenocytes responses surrounding eggs were observed and counted under the microscope.Results The splenocytes from infected mice showed obvious adherent responses to the dry eggs. Adhering cells were,at first,granulocytes,then replaced by the macrophages. Around the eggs proliferating lymphocytes,later fibroblasts, were found. The reaction index (RI) of the spleen cells from infected mice were significantly higher (P