Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children / 中国当代儿科杂志

OBJECTIVES@#To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP.@*METHODS@#Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment.@*RESULTS@#Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05).@*CONCLUSIONS@#The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.

Commentary on relevant issues in surgical treatment of spinal metastatic tumors / 中国骨伤

The multidisciplinary treatment model led by surgery has become a comprehensive strategy and overall concept for the treatment of spinal metastatic tumors. But the surgical treatment of spinal metastatic tumors is different from primary malignant tumors of the spine. Surgery is only a part of the multidisciplinary comprehensive treatment. Therefore, the following aspects need to be evaluated comprehensively based on the survival assessment, evaluation of spinal stability damage, nerve dysfunction, and oncological characteristics of the metastatic tumors with a reasonable surgical intervention. The attention should be paid to the minimally invasive treatment of spinal metastases, progress of new radiotherapy technology, neoadjuvant chemotherapy, targeted drug therapy and other medical treatment to make a comprehensive and individualization decision which is benefit to relieve patients ' pain, reconstruct spinal stability and avoid paralysis. While improving patient survival, increasing local tumor control rate and possibly prolonging survival time, avoiding excessive surgery as much as possible.

[Rapid detection of novel avian influenza virus subtype H7N9 by multiplex real-time RT-PCR].

In order to develop a rapid detection kit for novel avian influenza virus (AIV) subtype H7N9, two sets of specific primers and probes were designed based on the nucleotide sequences of hemagglutinin antigen (HA) and neuraminidase antigen (NA) of novel H7N9 virus (2013) available in GenBank to establish the method of TaqMan probe-based multiplex real-time RT-PCR for rapid detection of AIV subtype H7N9. The primer and probe of HA were for all H7 subtype AIVs, while the primer and probe of NA were only for novel N9 subtype AIVs. The results showed that this method had high sensitivity and specificity. This method was applicable to the testing of positive standard sample with a minimum concentration of 10 copies/microL; it not only distinguished H7 subtype from H1, H3, H5, H6, and H9 subtypes, but also distinguished novel N9 subtype from traditional N9 subtype. A total of 2700 samples from Zhuhai, China were tested by this method, and the results were as expected. For the advantages of sensitivity and specificity, the method holds promise for wide application.

[Inhibition of proliferation of H5N1 subtype AIV in CEF by chemosynthetic siRNA].

In order to study the proliferation inhibition effect of H5N1 subtype avian influenza virus (AIV) with small interfere RNA (siRNA), a total of 4 siRNAs were designed in accordance with the NP and PA genes of H5N1 subtype AIV, the siRNAs were then transfected to chicken embryo fibroblast(CEF), CEF was infected with H5N1 subtype AIV after 6 hrs. Virus titer of cell supernatant was tested at 16-56hrs post infection, and pathological changes of the cells was observed; mRNA levels of NP, PA, HA and p13-actin gene were tested at 36hrs post infection. The results showed that these 4 siRNAs could inhibit the prolif-eration of H5N1 subtype AIV in CEF in varying degrees, and one siRNA targeting PA was best per-formed. The experimental results also showed that the inhibition effect was decreased with the time prolonged. This research provides a basis for further studying RNAi on AIV prevention and control.

Proteomic study of the brain tissues of mice with human cytomegalovirus infection / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish the two-dimensional electrophoresis profiles with high resolution and reproducibility from the brain tissues of mice with human cytomegalovirus (HCMV) infection.</p><p><b>METHODS</b>Forty Kunming mice were randomized into HCMV infection group (n=20) with HCMVAD(169) injection and control group (n=20) with saline injection in the brain. Thirty days after the injections, the brain tissue of the mice were taken and the protein fractions were isolated by two-dimensional gel electrophoresis (2-DE). Image Master 2D software was used to identify the differentially expressed proteins, and the peptide mass fingerprint (PMF) data were obtained for identification of the differential protein spots via database searching. Western blotting was performed to verify the expressions of some of the differential proteins.</p><p><b>RESULTS AND CONCLUSION</b>The 2-D maps of the brain tissues with high Well resolution and reproducibility were obtained. Some of the differentially expressed proteins identified by mass spectrometry (MS) matched their counterparts in the SWISS-2DPAGE database. Western blotting analyses verified the differential expression of the individual proteins. These data can be of value for studying the diagnosis, pathogenesis and effective therapeutic targets of the disease.</p>