Objective To study the clinicopathological characteristies,differential diagnosis,etiological factor and treatment of anorectal malignant melanoma(AMM). Methods Clinical pathological characteristics and immunohistochemical findings were observed in 13 cases of anorectal malignant melanoma,with review of related literature.Results Average age was 55.8 years. And often occurred in the middle and old. Under microscope, the tumor was complicated constructionally, and the tumor cells were variform. Usually in tightly packed nests, dispersed sheet and trabecular, melanin pigment could be observed in the majority of AMM, but sometimes ameLanotic pigment was present. Immunohistochemiscal the tumor cells were positive for HMB 45, S-100 and vimetin. Conclnsion AMM is a high malignant tumor with very poor prognosis. So,it should be diagnosed and treated early. HMB 45 and S-100 are sensitive tumor markers for AMM.

Objective To investigate the synergetic effect of Aiyishu injection in combination with neoadjuvant chemotherapy in the treatment patients with breast cancer.Methods Seventy patients with breast carcinoma at stage Ⅰ - Ⅲ were randomly divided into treatment group( Aiyishu associated CAF regimen)( n =36) and control group ( CAF regimen) ( n =34).The activities of T cells and NK cells,response rate,change of clinical symptoms,adverse effects and living quality were evaluated in patients of two groups.Results The levels of CD3,CD4,CD8 and the ratio of CD4/CD8 and the activity of NK cells in treatment group were higher than those in control group( P ＜0.05) ;the response rate was 41.67％ and 36.67％ in group 1 and 2 respectively,but had no significant difference;the incidence rates of leucopenia and gastrointestinal disturbance were 33.33％ and 38.89％ respectively in patients of treatment group,whereas the rates were 67.65％ and 67.65 ％,in control group ( P ＜ 0.05).In treatment group,KPS increased in 36.11％ (13/36) patients,and it was higher than that in control group (11.76％,4/34 )( P ＜0.05).Conclusion Aiyishu injection can increase the ability of immunity of body and reduce the toxic and adverse reaction,and improve the living quality in patients with breast cancer when it is used in pre-operative chemotherapy of breast cancer.

Objective To monitor the clinical epidemiology and etiology of acute diarrhea in children in the outpatient setting in Shanghai .Methods An active surveillance study in Children′s Hospital of Fudan University between August 2013 and July 2014 was conducted .Outpatient children with acute diarrhea were enrolled in this study and stool samples were collected .Pathogens including norovirus ,diarrheagenic Escherichia coli (DEC) , nontyphoidal Salmonella spp .(NTS),Campylobacter,Shigella,pathogenic vibrio and Yersinia enterocolitica were identified and typed .The χ2 test was used for statistical analysis .Results Of the 881 stool samples from enrolled children , the pathogens included into the target detection were identified in 246 (27 .92% ) cases . Norovirus ,DEC ,NTS ,Campylobacter and Shigella were detected in 98 (11 .12% ) cases ,74 (8 .40% ) cases , 61 (6 .92% ) cases ,34 (3 .86% ) cases and 2 (0 .23% ) cases ,respectively .Neither pathogenic vibrio nor Yersinia enterocolitica was identified .Children younger than 36 months old (3 .27% ,26/794) had a lower risk (χ2=7 .41 ,P=0 .006) of Campylobacter infection compared with older children (9 .20% ,8/87) .Vomiting (37 .76% ) and watery diarrhea (21 .34% ) were more commonly seen in children with norovirus infection;fever and mucous stool were commonly seen in diarrheal children with NTS infection (40 .98% and 21 .31% ,respectively) and Campylobacter infection (29 .41% and 26 .47% ,respectively) .Conclusion Enteric pathogens play a major role in childhood acute diarrhea in Shanghai .Continuous monitoring of enteric pathogens will be helpful for reasonable treatment and prevention of acute diarrhea in children .

The host inflammatory reaction is a normal response to injury and the presence of foreign substances. Macrophage is one of the principal cell types in controlling host inflammatory and immune processes; hence, its response to biomaterials has a direct impact on biocompatibility and stability of biomaterials in vivo. This review describes the interaction of macrophages with tissue engineering related biomaterials. The bulk physicochemical structure and surface performance of biomaterials could be designed to control macrophages behaviors (i. e. adhesion, activation, fusion, apoptosis) and host responses, resulting in improving biocompatibility of biomaterials.
Apoptosis ; physiology ; Biocompatible Materials ; chemistry ; metabolism ; Cell Adhesion ; physiology ; Foreign-Body Reaction ; immunology ; Humans ; Inflammation ; immunology ; Macrophage Activation ; Macrophages ; cytology ; physiology ; Prosthesis Implantation ; Tissue Engineering ; methods

Objective To monitor the epidemic pattern of influenza in children during the 2011-2012 season in Shanghai and to evaluate the socioeconomic burden of influenza in children.Methods We carried out a prospective surveillance program on influenza among children who visiting the outpatient clinic for influenza-like illness (ILI) between June 2011 and May 2012.Respiratory samples as well as related demographic and clinical data were obtained from the enrolled cases.Socio-economic burden was evaluated using the questionnaires for some of the confirmed cases during the outbreak.Results Out of the 1 119 enrolled cases,influenza viruses were virologically confirmed,using the RT-PCR in 370 (33.1％) otherwise healthy children.Among them,109 (9.7％) were positive for influenza A/H3N2 viruses,and 279 (24.9％) were positive for influenza B viruses.The 2011-2012 seasonal outbreak of influenza among children with Shanghai residency started with the major outbreak of influenza B during December 2011-Feburary 2012,followed by the smaller outbreak of influenza A/H3N2 during March-April,2012.A total of 69 influenza A/H3N2-infected cases and 163 influenza B-infected cases were surveyed to evaluate the influenza-associated disease burden.The average costs per case were 706.10 Yuan and the average indirect costs per case incurred by the work loss of family members were 293.80 Yuan,with the total average costs per case were 999.90 Yuan.Mean visits to medical settings were 2.7,with antibiotics used in 67.2％ of the cases.Secondary household cases were seen in 21.1％ of the cases.Pneumonia was diagnosed in 5.6％ of the cases.The burden of disease increased from both influenza A/H3N2 and influenza B but without significant differences between them.Conclusion Influenza A/H3N2 and influenza B viruses caused outbreaks of influenza in children with Shanghai residency during the 2011-2012 season.Socioeconomic burden of influenza in children showed significantly direct impact on the sick children and an indirect impact on their families.Influenza vaccination should be recommended in children to reduce the disease burden.

Objective:To investigate the serum measles antibody in children with tumor and to provide the clinical evidence for measles vaccination strategy for this special population.Methods:From January 2016 to December 2018, the blood samples of children who were diagnosed with hematological malignancy or solid tumors and received chemotherapy in the Department of Hematology or Oncology Surgery of Children′s Hospital of Fudan University were collected. Enzyme-linked immunosorbent assay was used to quantitatively detect the level of measles IgG antibody, and dynamically monitor the changes of measles antibody level during chemotherapy. Kruskal-Wallis test and chi-square test were used for statistical analysis.Results:A total of 441 children with tumors were enrolled, with the positive rate of measles antibody of 79.1%(349/441), and only 43.3%(191/441) of children had the protective level of IgG antibody. There was a statistically significant difference of the antibody protection rate in children aged0.05). The protection rate of serum measles antibody in children with hematological malignancy and solid tumor were 45.6%(78/171) and 41.9%(113/270), respectively, and there was no statistically significant ( P>0.05). There were 16.3%(16/98) of children who were observed to lose the pre-existing protective antibody during chemotherapy. There was no statistically significant difference of the protection rate of serum among children who had finished chemotherapy 0.05). Conclusions:Serum measles antibody is below the protective level in more than 50% of children with malignancy after chemotherapy. Chemotherapy can compromise the protective antibody against measles. It is recommended for this special population to re-schedule measles vaccine after individualized evaluation to acquire the immuneprotection against measles.

Objective:To investigate the epidemiological characteristics of hospitalized children with respiratory syncytial virus (RSV)-associated acute lower respiratory tract infection (ALRTI), and to analyzed the risk factors for severe infection.Methods:The epidemiological and clinical data of hospitalized children with ALRTI and positive RSV test from Children′s Hospital of Fudan University from January 2013 to December 2018 were retrospectively analyzed.The hospitalized children from October 2016 to November 2017 were selected by random singular sequence and divided into severe infection group and non-severe infection group. The clinical data of the two groups were compared. Multivariate logistic regression analysis was used to analyze the risk factors of severe RSV-associated ALRTI.Results:A total of 34 192 hospitalized children were diagnosed with ALRTI, and 8 113(23.73%) children were positive for respiratory tract viruses, including 4 028(11.78%) children with RSV infection, which was higher than other common respiratory tract viruses. Among the 4 028 RSV-positive children, 2 550(63.31%) were under six months of age, 3 623(89.95%) were under two years of age. The detection rates of RSV in spring, summer, autumn and winter were 6.47%(553/8 551), 2.46%(176/7 161), 12.85%(1 042/8 111) and 21.77%(2 257/10 369), respectively. In 347 hospitalized children with RSV-associated ALRTI, 54 cases were severe cases. Multivariate logistic regression analysis showed that RSV-positive patients complicated with respiratory diseases ( Z=3.43), cardiovascular diseases ( Z=4.96), non-exclusive breast-feeding ( Z=-1.97) and premature birth ( Z=-1.98) were independent risk factors for severe RSV-associated ALRTI (all P<0.050). Conclusions:RSV is the most important and common viral pathogen in hospitalized children with ALRTI in Shanghai, and infants under six months of age are the most susceptible to RSV. RSV patients complicated with respiratory diseases, cardiovascular diseases, non-exclusive breast-feeding and premature birth are more likely to develope severe RSV-associated ALRTI.

Objective:To describe the clinical features of liver involvement in children and adolescent with 2019-nCoV infection.Methods:The clinical data of 77 hospitalized cases admitted to the Children’s Hospital of Fudan University were collected from January 19 to November 28, 2020. The characteristics and risk factors of abnormal liver chemistries in children with laboratory-confirmed 2019-nCoV infection were analyzed.Results:Of the 77 cases, 44 were male (57.1%) and 33 were female (42.9%), with a median age of 10 years. 27(35.1%) were asymptomatic, 28(36.4%) had mild illness, 22(28.6%)had non-severe pneumonia. Hydroxychloroquine was used in 7 cases. Of the 75 children without underlying diseases, alanine aminotransferase was elevated in 1 case (1.5%, during hydroxychloroquine therapy), aspartate aminotransferase was elevated in 7 cases (10.3%), alkaline phosphatase was elevated in 7 cases (28%), and total bilirubin, direct bilirubin, albumin, international normalized ratio were in normal range. There was no statistical difference between the pneumonia group and the non-pneumonia group in term of liver chemistries ( P > 0.05), same as between the elevated erythrocyte sedimentation rate group and the normal group. There was no aggravation of liver injury in the child with biliary atresia. The child with epilepsy showed no abnormal liver chemistries after infection. Conclusion:Children with 2019-nCoV infection had mild clinical symptoms with few cases of liver injury. The abnormal liver chemistries in children with COVID-19 infection may be related to the underlying disease and the use of antiviral drugs.

Objective:To monitor the epidemiological characteristics of viral etiology in children with influenza-like illness and to guide the prevention and management of acute respiratory tract infections in childhood.Methods:Nasopharyngeal swabs were collected from the outpatient children seeking medical care in Children′s Hospital of Fudan University, Shanghai for influenza-like illness between January 2015 and December 2018. Multiplex real-time polymerase chain reaction was performed to detect respiratory syncytial virus (RSV), influenza virus (Flu), adenovirus (ADV), parainfluenza virus (PIV, type Ⅰ to type Ⅳ) and enterovirus (EV), and the epidemiological data were analyzed. Chi-square test was used for statistical analysis.Results:A total of 2 271 patients with influenza-like illness were enrolled, age range from two months to 182 months old, 1 280 cases(56.4%) were positive for the target respiratory viruses tested on respiratory samples. The detection rates of FluA, FluB, PIV, EV, ADV, RSV were 15.1%(343/2 271), 12.5%(284/2 271), 8.4%(191/2 271), 7.8%(177/2 271), 5.1%(116/2 271) and 6.7%(152/2 271), respectively.The detection rates of influenza virus were statistically different among the age groups ( χ2=39.33, P<0.05), which showed an increasing trend with the increasing ages. The detection rate of RSV was 9.7%(35/361) in infant group from zero to 12 months old, which was higher than other age groups. Usually, FluA had two epidemic peaks during the winter and summer seasons, the epidemics of FluB and RSV peaked during the winter season, and EV and PIV were more prevalent in the summer season. Conclusions:Influenza virus remains the most common viral pathogen responsible for childhood influenza-like illness in Shanghai.Influenza virus has high incidence in winter.Widely influenza vaccination is highly recommended for the effective prevention the influenza outbreaks.Continuous monitoring the epidemic trend of viral respiratory infections is imperative for the prevention and control of diseases.