Hypercoagulation and elevation of blood triglycerides are characteristics of Kawasaki disease.

BACKGROUND: Cardiovascular damages poses risks to children with Kawasaki disease (KD). Although hypertriglyceridemia and hypercholesteremia are risk factors of cardiovascular damages, studies on the blood lipid metabolism in KD are still limited. This study aims to analyze the blood lipids and coagulation in KD. METHODS: Triglyceride (TG) and cholesterol levels in the plasma and serum from 20 children with KD were examined in comparison with 10 healthy children (HC) as well as 10 children with high fever from identified bacterial infections (BT). Using electrospray ionization mass spectrometry, we profiled the lipid species. Blood coagulation was analyzed. Statistics was analyzed by one-way ANOVA using SigmaStat. RESULTS: We found that in KD, plasma TG level was significantly increased, but not serum TG. A total of 19 molecular species of TG were identified, and they were all increased in KD and BT patients, and more pronounced in KD. On the other hand, major molecular species of plasma phosphotidylcholine and lyso-phosphotidylcholine were decreased in KD and BT. Pronounced hypercoagulation was found in KD blood. CONCLUSION: Our data indicate hyperlipidemia in KD, especially for TG, which contributes to the hypercoagulation and the potential risk of cardiovascular damages. Evaluation of blood lipid levels in severe KD patients could provide valuable information for treatment and prognosis, thus would be worthy of consideration.

[Clinical epidemiologic features in children allergic to Dermatophagoides pteronyssinus].

OBJECTIVE: To investigate the prevalence of Dermatophagoides pteronyssinus in children allergic diseases in Hangzhou and its surrounding areas. METHODS: Western blotting was used to detect the serum antibody for 9 422 children who were admitted due to clinically suspected allergic diseases. Clinical epidemiological features were analyzed for those with total IgE>100 IU/ml and Dermatophagoides pteronyssinus-specific IgE > or = 0.35 IU/ml. RESULTS: The prevalence of Dermatophagoides pteronyssinus in children with allergic diseases was 41.2% (3 878/9 422). The most common symptoms were allergic rhinitis [47.8%(1852/3 878)] and asthma [18.5%(716/3 878)]. The allergic diseases were most prevalent in July, August and October. The diseases were more prevalent in children over 3 years old and above. more in males [68.8% (2668/3878)] than females [31.2% (1210/3878)]. CONCLUSION: Data suggest that Dermatophagoides pteronyssinus is an important allergen causing allergic diseases in children in Hangzhou.

Epidemiology and burden of rotavirus infection among children in Hangzhou, China.

BACKGROUND: Rotavirus is the most common cause of acute diarrhea in children younger than 5 years worldwide. However, few data have been collected on children with rotavirus diarrhea basing on outpatient department surveillance. OBJECTIVES: To define the epidemiology of rotavirus diarrhea and to investigate the burden associated with diarrhea and rotavirus infection in Hangzhou, China. STUDY DESIGN: Systematic surveillance of rotavirus diarrhea was conducted in inpatient wards and outpatient department from January 2007 to December 2008 in the Children's Hospital of Zhejiang University School of Medicine. All stool specimens were tested for rotavirus by latex agglutination test. RESULTS: 46,499 stool samples were collected and 15,649 (33.7%) were tested positive for rotavirus. Positive rate for rotavirus was highest among children aged 12-24 months (39.0-39.6%). 92.4% children with rotavirus infection were <2 years, with constitution ratios of 21.8%, 41.8%, 21.8%, 8.4% and 6.2% in children aged 0-6 months, 7-12 months, 13-18 months, 19-24 months and >24 months, respectively. The percentage of children whose samples were tested positive for rotavirus ranged from 22.6% to 44.9% at different months, with a peak in October, November and December. The estimated annual rotavirus-associated outpatient visit and hospitalization incidences were 20.1 episodes/1000 children and 2.1 cases/1000 children for children <5 years of age, and were 39.1/1000 and 4.1/1000 for children <2 years of age in Hangzhou, respectively. CONCLUSIONS: Rotavirus is the leading cause of severe diarrhea of children in Hangzhou, especially for children <2 years, which highlight the need of widespread rotavirus immunization for young children.

Association analysis of the RET proto-oncogene with Hirschsprung disease in the Han Chinese population of southeastern China.

Hirschsprung disease (HSCR) is a complex congenital disorder characterized by intestinal obstructions caused by the absence of the intestinal ganglion cells of the nerve plexuses in variable lengths of the digestive tract. This study investigated a possible role of the RET proto-oncogene in sporadic HSCR patients in the Han Chinese population. Our results indicated that rs1800858, rs1800860, rs1800863, and rs2075912, located in exons 2, 7, 15, and intron 19 of RET, are strongly associated with the disease (P < 0.01), with rs1800860 and rs1800863 playing a protective role in the pathogenesis of HSCR in the Chinese population. We also showed that the haplotype consisting of four SNPs is significantly associated with HSCR. We did not find a significant difference in the CA-repeat in intron 5 of RET between cases and controls. Our study provided further evidence that the RET gene is involved in the susceptibility to HSCR in the Han Chinese population.

Association analysis of the PHOX2B gene with Hirschsprung disease in the Han Chinese population of Southeastern China.

BACKGROUND: Hirschsprung disease (HSCR, OMIM 142623) is a complex congenital disorder characterized by intestinal obstructions caused by the absence of the intestinal ganglion cells of the nerve plexuses in variable lengths of the digestive tract. The PHOX2B gene is involved in neurogenesis and disruption of Phox2b in mice results in a HSCR-like phenotype. The first association study of the PHOX2B gene with HSCR derived from Chinese population in Hong Kong; here, we address the question of whether PHOX2B acts as a predisposing factor in HSCR pathogenesis in Chinese population in mainland. METHODS: To investigate the contribution of PHOX2B to the HSCR phenotype, polymerase chain reaction amplification and direct sequencing were used to screen PHOX2B coding regions and intron/exon boundaries for mutations and polymorphisms in 102 patients with HSCR and 96 ethnically matched controls, in Han Chinese populations of Southeastern China. RESULTS: In this study, we genotyped 4 single nucleotide polymorphisms (SNPs) (including 1 novel SNP) located within the PHOX2B gene. Statistically significant differences were found for c.701 A > G and IVS2 + 100 A > G, and the log-additive model was accepted as the best inheritance model (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.11-2.87) for IVS2 + 100 A > G. We also showed that the haplotype-A G A N composed of 4 SNPs exhibited significant association with the disease (P = .03); this haplotype was more frequently observed in cases than in controls (OR, 2.31; 95% CI, 1.11-4.82). CONCLUSIONS: Our study provided further evidence that the PHOX2B gene is involved in the susceptibility to HSCR in the Han Chinese population. Our findings are in accordance with the involvement of PHOX2B in the signaling pathways governing the development of enteric neurons.

Gram stain-specific-probe-based real-time PCR for diagnosis and discrimination of bacterial neonatal sepsis.

Sepsis is a serious disease with high mortality in newborns. It is very important to have a convenient and accurate method for pathogenic diagnosis of neonatal sepsis. We developed a method of simultaneous detection and Gram classification of clinically relevant bacterial pathogens causing sepsis directly from blood samples with Gram stain-specific-probe-based real-time PCR (GSPBRT-PCR). With GSPBRT-PCR, 53 clinically important strains representing 25 gram-positive and 28 gram-negative bacterial species were identified correctly with the corresponding Gram probe. The limits of the GSPBRT-PCR assay in serial dilutions of the bacteria revealed that Staphylococcus aureus could be detected at concentrations of 3 CFU per PCR and Escherichia coli at concentrations as low as 1 CFU per PCR. The GSPBRT-PCR assay was further evaluated on 600 blood specimens from patients with suspicion of neonatal sepsis and compared to the results obtained from blood cultures. The positive rate of the GSPBRT-PCR array was 50/600 (8.33%), significantly higher than that of blood culture (34/600; 5.67%) (P = 0.00003). When blood culture was used as a control, the sensitivity of GSPBRT-PCR was 100%, the specificity was 97.17%, and the index of accurate diagnosis was 0.972. This study suggests that GSPBRT-PCR is very useful for the rapid and accurate diagnosis of bacterial infection and that it can have an important impact on the current inappropriate and unnecessary use of antibiotics in the treatment of newborns.

Effects of H pylori infection on gap-junctional intercellular communication and proliferation of gastric epithelial cells in vitro.

AIM: To explore the effects of H pylori infection on gap-junctional intercellular communication (GJIC) and proliferation of gastric epithelial cells in vitro. METHODS: A human gastric epithelial cell line (SGC-7901) cultured on coverslips was exposed overnight to intact H pylori (CagA(+) or CagA(-) strains) and sonicated extracts, respectively. GJIC between the cells was detected by fluorescence redistribution after photobleaching (FRAP) technique. Proliferation of SGC cells was determined by methylthiazolyl tetrazolium (MTT) assay. RESULTS: When compared with control in which cells were cultured with simple medium alone, both CagA(+) and CagA(-) H pylori isolates could inhibit GJIC (CagA(+): F = 57.98, P < 0.01; CagA(-): F = 29.59, P < 0.01) and proliferation (CagA(+): F = 42.65, P < 0.01; CagA(-): F = 58.14, P < 0.01) of SGC-7901 cells. Compared with CagA(-) strains, CagA(+) H pylori more significantly down-regulated GJIC of gastric cells (intact H pylori: t = 13.86, P < 0.01; sonicated extracts: t = 11.87, P < 0.01) and inhibited proliferation gastric cells to a lesser extent in vitro (intact H pylori: t = 3.06, P < 0.05; sonicated extracts: t = 3.94, P < 0.01). CONCLUSION: Compared with CagA(-) H pylori strains, CagA(+) strains down-regulate GJIC of gastric epithelial cells more significantly and inhibit proliferation of gastric cells to a lesser extent in vitro. H pylori, especially CagA(+) strains, may play an important role in gastric carcinogenesis.