Analysis on the screening and follow-up of cytomegalovirus infection in infants in Lishui / 中国医师进修杂志

Objective:To investigate the current situation of cytomegalovirus (CMV) infection in infants in Lishui, and summarize the related factors of CMV infection, evaluate its influence on the growth and development of infants, and provide evidence for the prevention and control of CMV infection.Methods:In this study, 2 254 cases of infants admitted in pediatric ward in Lishui Maternal and Child Health Hospital, Qingtian County People′s Hospital, Suichang County People′s Hospital, Qingyuan County People′s Hospital from January 1, 2015 to December 31, 2017 with integral clinical data were selected. All the babies were followed up from the time when they were born to 1 year old. The serum CMV antibody and the urine CMV-DNA were screened, the general situation and clinical features of CMV infection were summarized, and the relevant factors of infants CMV infection were analyzed and screened by the single factor and multiple factors analysis. They were followed up to 1 year old to clarify the influence of CMV infection on the growth and development of infants.Results:From 2015 to 2017, the total positive infection rate of CMV-IgM in infants under 1 year old in Lishui was 10.43%(235/2 254), and CMV-IgM positive infection decreased year by year. The positive rate of CMV-IgG did not change significantly with time. The positive rate of CMV-IgM was the highest at 1—3 months, and up to 15.29% (61/399). The positive rate of CMV-IgM decreased with the age of the babies. The positive rate of CMV-IgG increased with the age of the babies. The positive rate of CMV-IgM in infants showed no significant difference in gender ( P>0.05). The positive rate of CMV-IgM was higher in men than that in women [65.43% (810/1 238) vs. 55.51% (564/1 016)], and there was significant difference ( P<0.05). The gestational age of the infected group was lower than that of the non-infected group [(37.41 ± 1.63) weeks vs. (38.97 ± 0.97) weeks], and the breast-feeding rate of the infected group was higher than that of the non-infected group [57.87%(136/235) vs. 40.00%(40/100)], and there were significant differences ( P<0.05). Thrombocytopenia, the increase of transaminase, necrotizing enterocolitis of newborn, and hepatosplenomegaly of infected group is higher that of the non-infected group [18.72%(44/235) vs. 1.00% (1/100), 29.36% (69/235) vs. 13.00% (13/100), 26.81% (63/235) vs. 10.00% (10/100), 9.79% (23/235) vs. 0], and there were significant differences ( P<0.05). Gestational age and breast-feeding were possible risk factors for CMV infection in infants under 1 year old ( P<0.05). There was no significant difference in height, weight, head circumference and intelligence score between the infected group and the non-infected group at the age of 1 year ( P>0.05). The total abnormal rate of hearing development and the abnormal detection rate of B-ultrasound in the infected group were higher than those in the non-infected group [13.62%(64/470) vs. 1.00%(2/200), 6.38%(15/235) vs. 0], and there were significant differences ( P<0.05). Conclusions:The CMV active infection rate of infants under 1 year old in Lishui is relatively high and decreases year by year. It decreases with the prolongation of birth time, and there is no gender difference. Gestational age and breast-feeding are the risk factors for active CMV infection in infants. CMV infection affects the hearing development and the brain development of infants under 1 year old, which is the main cause of hepatitis. It is necessary to pay attention to the prevention of CMV infection, strengthen maternal perinatal health care, and strengthen the screening of CMV infection in high-risk groups.

Epidemiological and clinical features of 4430 cases of measles in Shenzhen Municipality / 中华全科医师杂志

Since the attenuated live vaccine against measles was developed,the epidemic of measles has been controlled effectively,however,there is a trend of gradual increase of measles cases in recent years.The epidemiological and clinical features of 4430 measles patients in Shenzhen Municipality in last 10 years were reviewed.The data showed that the epidemic season was postponed with the peak of June to September;the prevalent age groups were infants and adults,the number of severe cases increased;and the positive rate of serological antibody in infants with measles was the lowest.

Development of a serological ELISA kit for detection of EV71 infection associated with hand-foot and mouth disease and its clinical application / 中华检验医学杂志

Objective To develop an ELISA(Enzyme-Linked Immunosorbent Assay)diagnostic kit for early rapid detection of sarum anti-EV71 antibody and evaluate its clinical application value.Methods Recombinant protein VP1 of EV71 were prepared and purified as an immobilized antigen for establishment of an indirect ELISA for detection of serum anti-EV71 IgM and anti-EV71 IgG.Compared with RT-PCR.isolation of EV71 and micro-neutralizing assay.the clinical application value of anti-EV71 IgM and anti-EV71 ISG in the diagnosis of EV71 disease was evaluated.Results In comparison with RT-PCR.the sensitivity,specificity,positive predictive value and negative predictive value of anti-EV71 IgM antibody were 83%,85%,81%and 87%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of anti-EV71 IgG antibody were 72%,74%,68%and 77%.respectively.Compared with viral isolation assay.the sensitivity and specificity of anti-EV71 IgM antibody were 85%and 97%,respectively.The sensitivity and specificity of anti-EV71 IsG antibody were 75%and 77%,respectively.In addition.the titers of anti-EV71 IgG antibody were significantly correlated with the titers of neutralizing antibody to EV71 by linear regression analysis(r=0.72,P＜0.05).Finally,the serum titers of anti-IgG from patients with EV71 associated hand food and mouth disease at convalescent stage exhibited significantly higher than that of the same patients at acute stage(P＜0.01),but the titers of anti-IgM had no significant difference(P＞0.05).Conclusions With VP1 recombinant protein used as an immobilized antigen,an indirect ELISA diagnostic kit was successfully develooed for detection of serum anti-human EV71 IgM and anti-human EV71 IgG antibodies.

Clinical observation of the ondanseton and dexamethone treatment for vomiting during hematologic diseases chemotherapy / 中国康复理论与实践

@#ObjectiveTo relieve the nausea and vomiting caused by chemotherapy in patients with hematologic diseases, and to secure the completion of chemotherapy.Methods320 cases of hematologic patients were divided randomly into 2 groups: the treatment group (160 cases): ondanseton 4 mg and dexamethone 10 mg I.V.; ondanseton group (160 cases): ondanseton 4 mg I.V.ResultsThe effective rate of the treatment group was 98.75%, and that of the ondansetron group was 43.13%. There was a singificantly difference between two groups (P<0.001).ConclusionOndanseton combined with dexamethone has a good effect on the vomiting and nausea induced by chemotherapy.