Expert consensus on diagnosis, treatment and prevention of antibiotic-associated diarrhea in children / 中华实用儿科临床杂志

Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.

Review on the Construction Methods of Ontology-based Medical Knowledge Base / 医学信息学杂志

Around the ontology construction,diagnosis rule construction,ontology inference mechanism and so on in the process of ontology-based construction of medical knowledge base,the paper states respectively the involved key technologies and methods in each link,lists the examples of the construction of the domain knowledge base through relevant technologies,explores the best method of constructing the medical domain knowledge base.

Analysis of diagnosis and treatment of childhood colonic polyps / 临床儿科杂志

Objective To analyze the influence factors ofpathogenesis,clinical manifestations,microscopic morphology and histopathology in children with colonic polyps.Methods 193 cases of colonic polyps were collected in the children's hospital of Soochow University during the period of July 2010 to July 2015.According to the length of the course,all cases were divided into two groups:short-term group (6 months or less),long-term group (＞ 6 months).Results There were 131 boys and 62 girls.The average age was 4.61+2.16 years old.The average disease duration was 7.29±8.30 months (one week to 4 years).There was no significant difference between the two groups in the rate of underweight and anemia,the level of hemoglobin,serum albumin and pre-albumin (P ＞0.05);The main clinical manifestation included hematochezia (98.7％),abdominal pain (17.10％) and protruding tumor (13.47％);The colonoscopy found 197 polyps,in which 189 were single polyp (95.94％),and 8 were multiple polyps (4.06％).Nine polyps (4.57％) were in the right colon,and 188 polyps (95.43％) in the left colon.All of the polyps were divided into 3 groups:huge polyps group (＞ 1.5 cm),large polyps group (0.5～1.5 cm),and small polyps group (＜ 0.5 cm).There were 17 cases found with small polyps (8.63％),119 cases with large polyps (60.40％),and 61 cases with huge polyps (30.96％).Between the three groups,there was no significant difference in age,gender,and duration of the disease (P ＞ 0.05).Histopathologic examination showed that most polyps were juvenile polyps (98.69％),inflammatory polyp account for 1.31％.No adenomatous polyps and malignant polyps were found.Conclusions Hematochezia,abdominal pain and anal tumor are the main complains of colonic polyps in children,there was no significant difference in age and gender.The colonic polyps only have few effects on nutritional status,growth and development in children.Constipation and atopic constitution may be important factors in the development of colonic polyps.The size of colonic polyps has no close relationship with the age,gender and duration of the disease.

Genotyping of 67 norovirus strains / 中华传染病杂志

Objective To investigate the prevalent situations of norovirus infection and genotype distributions in 2014 in Suzhou area .Methods A total of 322 fecal specimens were collected from infants with suspected viral diarrhea at Children′s Hospital of Soochow University in 2014 .Norovirus genogroupⅠ and Ⅱ was detected by reverse transcription (RT )‐polymerase chain reaction (PCR) ,In an effort to identify norovirus genotypes , RNA dependent RNA polymerase region (region A ) and capsid region (region C) segment of some samples positive for norovirus was amplified by RT‐PCR .Comprehensive molecular characteristics of norovirus were obtained by sequence analysis of the same samples in different regions .Results Among 322 fecal specimens ,67 cases were positive for norovirus of G Ⅱ group ,and norovirus of GⅠ group was not found .The genetic fragments of region A was successfully detected in 42 strains .Among all 42 specimens ,there were 35 GⅡ .e strains ,3 GⅡ .7 strains ,2 GⅡ .17 strains and 2 GⅡ .12 strains .The genetic fragments of region C was successfully detected in 53 strains .Among these 53 specimens ,there were 44 GⅡ .4‐2012Sydney strains ,4 GⅡ .6 strains ,2 GⅡ .17 strains ,2 GⅡ .3 strains and 1 GⅡ .2 strain .Conclusions It′s indicated that G Ⅱ .4‐2012Sydney is the main genotype of norovirus causing viral diarrhea in Suzhou ,and other genotypes including the new GⅡ .17 variant ,GⅡ . 7/GⅡ .6 and GⅡ .12/GⅡ .3 recombinant strains also exist .

Epidemiology of intussusception related hospitalizations in children aged ＜2 years in Suzhou, 2007-2013 / 中华流行病学杂志

Objective To understand the epidemiological and clinical characteristics of ＜ 2 years old children hospitalized due to intussusceptions.Methods Clinical and demographic data of ＜2 years old children hospitalized due to intussusception between January 2007 and August 2013 were retrospectively collected in Affiliated Children' s Hospital of Soochow University in Suzhou.The incidence data,age distribution,seasonality and clinical characteristics of hospitalized intussusceptions cases were analyzed.Results A total of 594 intussusception-related hospitalizations were identified during this period in children aged ＜2 years,no death occurred.The crude incidence of hospitalized intussusception was 57.3 per 100 000 in children aged ＜2 years (95％CI:52.8-62.1),and 100.6 per 100 000 in children aged ＜1 year (95％CI:92.1-109.8).The male to female ratio was 1.90 ∶ 1.Up to 85.4％ (507/594) of the cases were aged ＜ 1 year,and 66.2％ (393/594) of the cases were aged 3-8 months.The incidence peaked in age group 5-8 months.The median age of the cases was 6.8 months (QR=4.4),and increased from 6.3 months (QR=4.2) in 2007 to 7.3 months (QR=4.0) in 2013.No obvious seasonality was observed.Main symptoms or signs included vomiting (83.2％,494/594),abdominal mass (81.1％,482/594),and bloody stool (64.5％,383/594).Abdominal ultrasonic testing was the most frequently used diagnostic approach (98.7％,586/594).Up to 86.2％ (512/594) of patients were successfully treated by surgical intervention.The main sites for acute intussusception in children aged ＜2 years were ileo-colic (34.5％,183/530),ileo-ileo (30.8％,163/530) or ileo-ileo-colic (27.9％,148/530).Conclusion The incidence of hospitalized intussusception in children aged ＜2 years was high in Suzhou.It is necessary to establish an active surveillance system to provide baseline data for the evaluation of rotavirus vaccine safety.

Design and Application of the Multi-mode Diagnosing Distribution System / 医学信息学杂志

〔Abstract〕 The paper analyzes problems existing in the traditional outpatient diagnosing distribution process of hospitals , redesigns and optimizes the triage process .It designs a unified diagnosing distribution system , introduces the advantages , system composition , queuing rules and treatment priority strategies of the optimized process , and illustrates the application effects of the diagnosing distribution system with the outpatient of obstetrics and gynecology department of a large grade -III level-a hospital as an example .

Comparative study on the clinical features of rotavirus gastroenteritis between the children with or without convul-sion / 临床儿科杂志

ObjectiveTo investigate the clinical features and prognosis of children with rotavirus gastroenteritis and convulsion.MethodsClinical data of children with rotavirus gastroenteritis hospitalized from January 2010 to December 2013 were retrospectively analyzed. Subjects were divided into the seizure group and no seizure group according to the presence of seizure in the course and compared between the two groups.ResultsThere were no signiifcant differences in sex, age, and the average duration of hospitalization between two groups (allP>0.05). The family history, history of seizures, the levels of serum sodium, calcium, lactate, standard bicarbonate concentration (SB), actual bicarbonate concentration (AB), carbon dioxide content (TCO2) and pH were statistically signiifcant between two groups (allP>0.05). During the follow-up period (outpatient telephone follow-up), the recurrence of seizure in two groups was signiifcant different (P<0.05) and only one (0.54%) child in seizure group developed epilepsy.ConclusionThis study showed that rotavirus gastroenteritis with convulsion is a benign clinical course.

The cognition of infected risk factors among families with children of Helicobacter pylori infection / 中国实用护理杂志

Objective To comprehend the awareness rate and the implementation of risk factors related to Helicobacter pylori (HP) infection in families with children of Helicobacter pylori infection.To analyze the existing problems and formulate effective methods of health education.Methods Totally 558 families infected with HP were investigated with a self-designed structured questionnaire by call-back.Results 527 did not use separate eating tools,350 did not use independent tablewares,14 drank unboiled water,14 did not use bath appliances separately,7 used tooth glasses together,4 did not wash hands before eating and after toilet,no one had mouth-to-mouth feeding.248 children with HP sleeped with their family members and 246 family members used to have HP infections or stomach troubles.Conclusions The families with HP do not establish correct ways of separate eating,so the hospital need to develop multi-channel education.Most families with HP infected children have satisfactory health habits.Nearly half of the children with HP do not sleep in their own beds.Caregivers of children with HP infection should be the capital objects of health education.

Microvascular protective role of pericytes in melatonin-treated spinal cord injury in the C57BL/6 mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pericytes, located on microvessels, help to maintain vascular stability and blood-brain barrier integrity. The influence of pericytes on microvessels after spinal cord injury (SCI) is less clear. Therefore, the aim of this study was to investigate whether pericytes took a protective effect on microvessels in melatonin-treated SCI.</p><p><b>METHODS</b>C57BL/6 mice were randomly divided into three groups: sham group, SCI group, and melatonin group (n = 27 per group). Functional recovery was evaluated using the Basso Mouse Scale. Motor neurons were observed using hematoxylin and eosin staining. Pericyte coverage was analyzed using immunofluorescence. Permeability of blood-spinal cord barrier (BSCB) was assessed by administration of Evan's Blue. Protein levels of occludin, aquaporin-4 (AQP4), angiopoietin-1 (Ang1), intercellular cell adhesion molecule-1 (ICAM-1), Bcl-2, and Bax were determined using Western blotting. Mimicking the pathological conditions of SCI, melatonin-treated primary pericytes were subjected to oxygen-glucose deprivation/reperfusion (OGD/R). Secretion of Ang1 was analyzed using an enzyme-linked immunosorbent assay, and the expression of ICAM-1 was detected by immunofluorescence.</p><p><b>RESULTS</b>Melatonin treatment improved locomotor functional outcome and rescued motor neurons. Pericyte coverage was significantly reduced after SCI; melatonin treatment alleviated the loss of pericyte coverage and rescued perfused microvessels 7 days after injury. The permeability of BSCB and loss of occludin were attenuated, and edema formation and upregulation of AQP4 were inhibited, after melatonin treatment. The expression of Ang1 and Bcl-2 was improved, while the expression of ICAM-1 and Bax was inhibited, in melatonin-treated SCI mice. Furthermore, the secretion of Ang1 was increased and the expression of ICAM-1 was inhibited in melatonin-treated pericytes after OGD/R.</p><p><b>CONCLUSIONS</b>Melatonin ameliorated the loss of blood vessels and disruption of BSCB to exert a protective effect on SCI, which might be mediated by increased pericyte coverage. The upregulation of Ang1 in pericytes could inhibit inflammation and apoptosis to protect the microvessels.</p>

Detection of Food-specific Serum IgG to Food Allergens in Children with Chronic Digestive Diseases / 医学研究杂志

Objective To assess the value of 14 common food allergens specific IgG in children with chronic digestive diseases.Methods The specific allergen food IgG was measured by utilizing enzyme-linked immunosorbent assay(ELISA) in 69 children with chronic digestive diseases,who had chronic abdominal pain and recurrent vomiting above three months with no organic disorders,incurable chronic diarrhea and anorexia with failing to thrive.Results The food allergen specific IgG increased was detected in 68 cases.The positive cases were 98.55%.There was one to nigh kind of food allergen specific IgG increased in 68 patients.Positive above two kind of specific IgG was 86.96%.The most specific IgG was to egg 92.8% and milk 73.9%;the other rates were: wheat 40.6%,soybean 27.5%.Chicken and pork were negative.All the patients changed their daily diet according to the assay results.More than 58.46% cases improved with their symptoms significantly in four weeks,about 26.15% cases improved to some extent.15.38% cases did not improved.After followed four months,there were 70.70% cases improved with their symptoms significantly,18.46% cases improved to some extent,only 10.76% cases no improved.Conclusion The detection of 14 common food allergens specific IgG might be significant valuable in assessment and treatment children with chronic digestive diseases.