1.Value of γ-interferon release test in the diagnosis of entry-exit people with tuberculosis
Guoping YANG ; Minxia YE ; Qisheng YANG ; Zhujun YIN
International Journal of Laboratory Medicine 2017;38(1):27-28,31
Objective To investigate the clinical significance of γ-interferon release test (IGRA) in the diagnosis of entry-exit people with tuberculosis.Methods A total of 64 patients with tuberculosis and 46 healthy people were detected by IGRA,tuberculin skin test (TST),LAM,38× 103 and 16 × 103.The results of different methods were compared and analyzed.Results The sensitivity of IGRA detection method (88.9 %) and specificity (95.8 %) were both higher,while the sensitivity (92.7 %) of the TST method was higher and the specificity (76.7 %) was lower.Conclusion The sensitivity and specificity of IGRA in the detection of tuberculosis are higher,and it has important clinical application value.
2.Analysis of viral nucleic acid and cytokines in 12 children with 2019-nCoV infection
Xufang LI ; Chunxiao FANG ; Huamei YANG ; Minxia CHEN ; Lanhui SHE ; Yu GONG ; Fansen ZENG ; Jiawei YE ; Limei TAN ; Qian ZHONG ; Lingli LIU ; Yanling WANG ; Yi XU
Chinese Journal of Microbiology and Immunology 2020;40(8):574-578
Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.
3. Clinical analysis of seven cases of H1N1 influenza-associated encephalopathy in children
Xufang LI ; Bin AI ; Jiawei YE ; Dengmin HE ; Limei TAN ; Minxia CHEN ; Huamei YANG ; Fansen ZENG ; Fengxia YANG ; Hongsheng LIU ; Yi XU
Chinese Journal of Pediatrics 2019;57(7):538-542
Objective:
To investigate the clinical manifestations, diagnosis, and treatment of H1N1 influenza A-associated encephalopathy (IAE) in children.
Methods:
The clinical manifestations, laboratory tests, cranial magnetic resonance imaging (MRI), electroencephalography (EEG) examinations and treatments of seven children with H1N1 IAE hospitalized in Guangzhou Women and Children′s Medical Center from December 2018 to January 2019 were retrospectively analyzed.
Results:
Five of the seven children with H1N1 IAE were female. The age at admission was 4 years and 5 months (range 7 months-9 years). Neurological symptoms occurred simultaneously or early (0-3 days) after the flu-like symptom appeared. The main clinical manifestations of neurological symptoms were seizures (repeated seizures in five cases and status convulsion in two cases, including one case of unexpected fever and repeated seizures in a nine-year old girl) accompanied with altered consciousness (drowsiness in five cases and coma in two cases). Cranial MRI in three cases displayed multifocal lesions, mainly in the bilateral thalamus, brainstem and cerebellar hemisphere. MRI also showed reversible splenial lesion in the corpus callusumin in three cases. EEG tracings were characterized by diffuse slow wave activity in four cases, and status epilepticus was monitored in one case. All the 7 cases were treated with oral oseltamivir. Three cases were treated with pulsed methylprednisolone and intravenous immunoglobulin. One case was treated with intravenous immunoglobulin alone and all the patients received oral oseltamivir. All the patients survived, with three patients had minor neurological sequelae at discharge.
Conclusions
The main clinical manifestations of H1N1 IAE are seizures and altered consciousness. Cranial MRI combined with EEG is helpful for early diagnosis. Intravenous immunoglobulin and (or) methylprednisolone should be considered for severe cases.