1.Analysis of clinical etiology in 270 children patients with severe pneumonia complicated with congenital heart disease
Yingying LI ; Xiaoyun WU ; Shan LIU ; Tiewei LV ; Jie TIAN
International Journal of Laboratory Medicine 2014;(15):2026-2028,2030
Objective To analyze the clinical features of severe pneumonia complicated with congenital heart disease (CHD) . Methods The clinical data of 270 children patients with severe pneumonia complicated with CHD (CHD group) were collected to analyze the relative medical history ,etiology ,bacterial drug resistance and clinical outcomes .Moreover ,636 age-matched children pa-tients with pure severe pneumonia were selected as the control group .Results In the CHD group ,250 cases were infants and 35 ca-ses suffered from repeated pneumonia .Compared with the control group ,the CHD group was earlier in onset and more prone to re-peated pneumonia .Among 270 cases ,totally 220 cases were checked out the pathogens ,but no statistically significant difference in the detection rates of pathogens between the CHD group and the control group was found (P>0 .05);179 cases were infected by bacteria ,in which 126 cases were Gram-negative bacteria ,the positive rate of bacterial infection and the detection rate of Gram-nega-tive bacterial were relatively higher than those in the control group ,the difference was statistically significant (P<0 .05);95 cases were infected by virus ,with respiratory syncytial virus being the most common pathogen ,30 cases were infected by fungi ,with Can-dida albicans being predominant ,the infection rates of virus and fungus had no statistical difference between two groups (P>0 .05);in the drug sensitive test ,the detection rate of extended spectrum beta lactamase (ESBLs)-producing positive bacteria in the CHD group was higher than that in the control group ,the difference was statistically significant (P<0 .05) .Main Gram-negative bacteria Pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus inf luenzae were highly sensitive to imipenem ,mero-penem ,levofloxacin and ciprofloxacin ;main Gram-positive bacteria Staphylococcus aureus and streptococcus pneumoniae were highly sensitive to vancomycin and gentamicin .Especially ,pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus influenzaewere100% resistanttopenicillin.TheaveragelengthofhospitalstayintheCHDgroupwas (20.9±12.5)d,207cases developed the respiratory failure ,88 cases appeared the heart failure and 205 cases were effective in treatment ;compared with the control group ,the CHD group had a longer length of hospital stay ,higher occurrence rate of heart and respiratory failure and lower treatment effective rate (P<0 .05) .Conclusion Because of the earlier onset ,more prone to repeated pneumonia ,more sensitive to bacterial infection ,esp .Gram-negative bacteria ,more ESBLs production ,longer hospital stay and more prone to complications ,com-pared with the control group ,children with severe pneumonia complicated with CHD require active treatment .
2.Clustering analysis of anti-nuclear antibodies in systemic lupus erythematosus
Xiaodong LU ; Xiaoyun SHAN ; Shuo ZHAO ; Hongwei DU ; Yadong XUE
Chinese Journal of Laboratory Medicine 2014;37(8):587-592
Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3%,consistent with IIF method,and the total accordance rate of the both methods was 98.2%.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3%,24.8%,38.9% of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0%,39.3%,63.6% respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1%,25.0%,56.8% respectively for C1,C2,C3) (P < 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2%/26.8% or 39.3%); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1%/19.5% or 22.7%) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5%/21.4% or 25.0%) and high risk of lung or upper respiratory tract infection (46.3%/28.6% or 29.5%),but low incidence of neurologic symptoms (0%/ 3.6% % or 11.4%).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.
3.The diagnostic value of anti-mutated citrullinated vimentin, anti-cyclic citrullinated peptide and glucose-6-phosphateisomierase for rheumatoid arthritis
Lijun WU ; Qingli LU ; Xinjie SHAN ; Xiaoyun SONG ; Xinyan MENG
Chinese Journal of Rheumatology 2009;13(1):27-29
Objeictivie To investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) antibody, anti-cyclic citrullinated peptide (anti-CCP) antibodies and glucose-6-phospha-teisomerase (GP1) for rheumatoid arthritis (RA). Methods Anti-MCV antibody, GPI and anti-CCP antibody were detected in serum samples of 109 RA patients, 24 non-RA rheumatic diseases patients and 19 healthy blood donors. The sensitivity and specificity of these parameters for the diagnosis of RA were analyzed. Results Both the positive rate and average cut off concentration of anti-MCV and GPI in RA were higher than those of non-RA rheumatic diseases or healthy controls (P<0.05). A significant difference was found between anti-MCV and GPI in RA patients. The most sensitive and specific parameter in RA was anti-MCV (99.1%) and anti-CCP (90.7%) respectively, but, when anti-MCV combined with anti-CCP, or GPI or anti-CCP and GPI, the specificity could be up to 98.1%. Coniclusions Anti-MCV, anti-CCP and GPI alone or in combination may be valuable parameters for the diagnosis of RA.
4.Clinical observation of conformal radiotherapy with topotecan che-motherapy on patients with platinum-resistant recurrent ovarian cancer
Ping WEI ; Xiugui SHENG ; Changping SHAN ; Xiaoyun HAN
Chinese Journal of Clinical Oncology 2013;(13):779-783
Objective: This study aims to observe the efficacy and toxicity of three-dimensional conformal radiotherapy (3DCRT) combined with weekly topotecan hydrochloride (Top-Hyd) chemotherapy on patients with platinum-resistant recurrent ovarian cancer. Methods: Medical data of 42 patients with platinum-resistant recurrent ovarian cancer between June 2008 and June 2011 were retrospectively reviewed. OAOf these 42 patients, 22 underwent 3DCRT combined with weekly Top–Hyd chemotherapy, whereas the remaining 20 underwent simple chemotherapy (SCT). Doses from 45 Gy to 65 Gy were planned to deliver fractions ranging from 1.8 Gy to 2 Gy to patient abdomen and pelvis. Top–Hyd (4 mg/m2) was aintravenously administered 1, 8, and 15 days from radiotherapy, with a cycle of 28 days. Results: By December 31, 2011, the median follow-up time for the 3DRT group was 18.5 months, whereas that for the SCT group was 10.8 months . The total response rate and the clinical beneficial rate were significantly higher in the 3DCRT group than in the SCT group (total response rate, 42.1% vs. 11.1%; clinical beneficial rate, 68.4% vs 22.2% at P< 0.05). The median of progression-free survival time was 9.8 months for the 3DCRT group and 6.6 months for the SCT group. The median total survival time was 19.7 months in the 3DCRT group, and 12.5 months in the SCT group. Significant differences between the 2 groups were indicated (P<0.001). No significant difference in overall toxicity was indicated between the two groups (P>0.05). Conclusion: The combined 3DCRT treatment and Top-Hyd chemotherapy results in enhanced response and tolerable toxicity compared with SCT in patients with recurrent ovarian cancer infiltrating the pelvic and retroperitoneal lymph node metastasis. So, it may be the salvage regimen for recurrent ovarian cancer and provide a new therapeutic option for the consolidation treatment of advanced ovarian carcinoma.
5.Distribution and Drug-resistant Analysis of Staphylococcus spp in Nosocomial Infections
Yijun ZHU ; Ruilong XU ; Xiaoyun SHAN ; Lihong BU ; Shuo ZHAO
Chinese Journal of Nosocomiology 2006;0(05):-
OBJECTIVE To analyze infection state and drug resistance feature of Staphylococcus spp with a view of offering references for controlling and treating infection led by it.METHODS Totally 652 strains of Staphylococcus isolated from patients with infection were identified and their drug resistance was analyzed.RESULTS From them 204 strains were Staphylococcus aureus and 448 strains were coagulase negative Staphylococcus detected and the isolating rate of MRSA and MRCNS were respectively accounted for 55.4% and 84.6%.The most common coagulase negative Staphylococcus strains were S.haemolyticus and S.epidermidis.The drug-resistant rates of MRS were higher transparently than MSS.CONCLUSIONS Staphylococcus are one of the main pathogens leading to nosocomial infections.As a result, it is very important to use antibiotics properly for infection control and nosocomial infection management.
6.Evaluation of Bacterial Drug Resistance Detection in Lower Respiratory Tract Infection Therapy
Xiaoyun SHAN ; Meihua LI ; Xiuzhi XU ; Lihong BO ; Yijun ZHU
Chinese Journal of Nosocomiology 2006;0(06):-
OBJECTIVE To evaluate bacterial drug resistance detection value in lower respiratory tract infection treatment.METHODS The data of distribution and antimicrobial resistance of clinical strains in sputum samples in patients with lower respiratory tract infection within some periods were collected and analyzed by WHONET software.Meanwhile,the delivery rates and detection positive rates of clinical species and antibiotics application status in clinic were retrospectively analyzed.RESULTS The delivery rates and detection positive rates of clinical species in patients with lower respiratory tract infection within some periods were 67.8% and 55.9%,respectively.The proportion of Gram-negative bacilli and Gram-positive cocci was 82.39% and 14.18%,respectively.Different drug resistance was displayed in different pathogenic bacteria.Resistant rate of Enterobacteriaceae bacteria and non-ferment bacteria against ciprofloxacin and piperacillin/tazobactam was 47.8%,34.8%and 31.5%,44.7%,respectively and resistant rate of S.aureus against levofloxacin was 63.9%.CONCLUSIONS Although the pathogenic bacteria in patients with lower respiratory tract infection show higher drug resistance to general antibiotics,most of patients with lower respiratory tract infection are treated according to clinical experience of doctors,not based on the results of bacterial culture and antimicrobial susceptibility test.Therefore,the results of bacterial culture and antimicrobial susceptibility test do not play a proper role to direct anti-infective therapy in clinic.
7.Analysis and identification of B cell epitopes of the OMP18 from Campy lobacter jejuni
Hongqiang LOU ; Ye HU ; Lan WANG ; Xiaoyun SHAN ; Xiusheng SHENG ; Suhua GAO
Chinese Journal of Zoonoses 2014;(7):739-742
In this study ,we aimed to understand the sequence characteristics ,transmembrane structures ,line B cell epitopes present in the OMP18 from Campylobacter jejuni ,and provide candidate antigens for the antibody detection and vac-cine development .NCBI/Blast ,TMHMM Server V2 and DNA Star softwares were used for the OMP18 sequence analysis . Based on the ELISA ,the whole bacterial antibody IgG of Campylobacter jejuni was used for the identification of the predicted line B cell epitopes .The OMP18 gene was found conserved in different Campylobacter jejuni strains .The OMP18 was predic-ted to be located on the outer surface of the bacteria .And three line B cell epitopes were determined to be present in the OMP18 protein .As a conclusion ,the OMP18 protein was confirmed to be an important outer membrane protein ;three line B cell epitopes were identified in the OMP18 ,which could be further used for Campylobacter jejuni antibody detection and vaccine development .
8.The effect of low frequency transcranial magnetic stimulation on aphasia after cerebral infarction
Yandong SHAN ; Lan WANG ; Jianming WANG ; Ling XIONG ; Zhixiu LUO ; Xiaoyun ZENG
Chinese Journal of Physical Medicine and Rehabilitation 2012;34(5):361-364
Objective To investigate the rehabilitative effect of low frequency repetitive transcranial magnetic stimulation (rTMS) on convalescing patients with Broca's aphasia. MethodsTwenty-eight patients with Broca's aphasia recovering from cerebral infarction were randomly divided into a stimulation group and a control group with 14 subjects in each.Patients in the control group accepted conventional drugs,speech rehabilitation and sham stimulation,while patients in the stimulation group were in given low frequency rTMS in place of the sham stimulation.Their speech performance was evaluated using the China Rehabilitation Research Center's aphasia examination (CRRCAE) pre-stimulation,post-stimulation and 90 days later. ResultsCompared with before treatment and with the controls,the speaking scores of the stimulation group increased significantly after treatment and also 90 days later. ConclusionLow frequency rTMS can not only improve the speech performance of Broca's aphasia sufferers in the short term,but it also plays a lasting role.It may thus have clinical application for patients with Broca's aphasia.
9.A new species of Paragonimus sheni--with a key to the species adult worm and metaceycariae of the genus Paragonimus in China
Xiaoyun SHAN ; Chenxin LIN ; Yousong LI ; Ye HU ; Xiuosheng SHEN ; Hougqiang LOU
Chinese Journal of Zoonoses 2009;(12):1143-1148
This paper gives a report on a new species of paragonimus in MT.Wuyishan,Fujian province during 1978 to 1983.All the type are deposited in the Center for Disease Control and Prevention of Fujian province.Holotype body short-oval,12.5 by 7.0mm,ratio of width to length 1:1.79.Ovary 2.0×2.13mm in size,the third class branches.Testes big,2.5 by 3.75mm(left) and 2.0 by 4.75mm(right)in size,as piece-shapy,only 2 litter branches,being much larger than the ovary.cuticular spines slender,sing in arrangement.Matacercaria obtained from the fresh-water crab,Sinopotamon fujianensis Dai et Chen,1979,measuring 395 by 410 micra,its cyst wall sing ,only 3-5 micra.Basing on the characteristic features mentioned above,This worm found by us differs fromP.westermani,P.skrijabini,P.macrorchis,P.mingqingensis and Euparagonimus cenopiosus,and can be considered as a new species of Paragonimus.
10.Flow cytometry method for antifungal susceptibility test and its clinical application
Ruilong XU ; Yijun ZHU ; Lihong BO ; Jianbo XU ; Yun PAN ; Xiaoyun SHAN ; Zhaojing ZHENG ; Junqing WU ; Huijiao WANG
Chinese Journal of Clinical Infectious Diseases 2011;04(6):343-347
Objective To develop a rapid detection method of flow cytometry for antifungal susceptibility testing.Methods The experiment conditions of flow cytometry were optimized and the minimum inhibitory concentrations (M1Cs) of 230 strains of Candida spp to flucytosin,fluconazol,itraconazole,amphotericin B were detected.The MIC results obtained by flow cytometry were compared with M27-A2 reference assay.Results The agreement of MIC results between flow cytometry and M27-A2method was 85.0% - 100%.Conclusion Flow cytometry can be used as a rapid and reliable method for antifungal susceptibility testing.