Objective To analyze the clinical features of the hospitalized children with laboratory-confirmed influenza in Suzhou. Methods The demographic information, laboratory test results, clinical features, treatments and outcomes of the hospitalized children with laboratoryconfirmed influenza were collected retrospectively. The data were analyzed using chi square test,Cochran-Armitage trend test. Results Four hundred and eighty hospitalized children were diagnosed with laboratory-confirmed influenza during the period of 2005 to 2009. Among these cases, 414 were subtype A and 66 were subtype B. The positive rate was 2.66%. Four hundred and nineteen cases (87.29 %) were ≤ 5 years old. Most of the cases developed during winter (from December to April the next year) and summer (from July to August). The age and sex distribution didn't vary from year to year (x2=9. 7768,x2 = 8. 7573; both P＞0.05). The mean disease course was (16.22± 9.41)days, and the mean hospitalization duration was (7.89 ±2.97) days. The percentages of patients with symptoms of fever, dyspnea and diarrhea or requiring oxygen treatment decreased with age (Z =4. 9430, Z=2. 1021, Z=3. 2073 and Z=2. 3277, respectively; all P＜0.05). The percentages of cases with concomitant pneumonia and upper respiratory infection also decreased with age (Z =-3. 8762 and Z=-3. 5095, respectively; both P＜0.01). Fifteen point five percent (60/387 cases)of the cases were co-infected with pneumococcus and 15. 0% (72/480 cases) were co-infected with respiratory syncytial virus (RSV). The level of C-reactive protein was significantly higher in cases with bacterial co-infection than those with viral co-infection (Z= -3.1290, P ＜ 0. 01 ).Conclusions Hospitalized children with influenza are more common in winter and summer in Shuzhou.Many patients are co-infected with pneumococcus or RSV. The symptoms are more severe in younger children.

Objective To assess the value of 14 common food allergens specific IgG in children with chronic digestive diseases.Methods The specific allergen food IgG was measured by utilizing enzyme-linked immunosorbent assay(ELISA) in 69 children with chronic digestive diseases,who had chronic abdominal pain and recurrent vomiting above three months with no organic disorders,incurable chronic diarrhea and anorexia with failing to thrive.Results The food allergen specific IgG increased was detected in 68 cases.The positive cases were 98.55%.There was one to nigh kind of food allergen specific IgG increased in 68 patients.Positive above two kind of specific IgG was 86.96%.The most specific IgG was to egg 92.8% and milk 73.9%;the other rates were: wheat 40.6%,soybean 27.5%.Chicken and pork were negative.All the patients changed their daily diet according to the assay results.More than 58.46% cases improved with their symptoms significantly in four weeks,about 26.15% cases improved to some extent.15.38% cases did not improved.After followed four months,there were 70.70% cases improved with their symptoms significantly,18.46% cases improved to some extent,only 10.76% cases no improved.Conclusion The detection of 14 common food allergens specific IgG might be significant valuable in assessment and treatment children with chronic digestive diseases.

AIM　To study the therapeutic action of leflunomide(Lef) on adjuvant arthritis (AA) rats and its mechanisms. METHODS　To observe the change of secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Lef and to detect the effect of A771726—the active product of Lef on T cell subgroup in mice in vitro.RESULTS　Lef(2,6,18 mg*kg-1×12 d) intragastric injection(ig) could signifcantly inhibit secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats.Lef couldnt effect the lowed response of Con A-induced splenolytes, and the decreased IL-2 synthesis in AA rats. But lef(2,6,18 mg*kg-1) could inhibit the elevated IL-1 released from peritoneal macrophage (PMΦ) in AA rats. A771726—the active product of Lef(0.1，0.5，2.5，12.5，25，100 μmol*L-1) could inhibit Con A-induced Th cells but has no effect in Con A-induced Ts cells in vitro.CONCLUSION　Lef has therapeutic action on AA rats which could be related to its immunosuppressory activities——mainly through inhibit cell-mediated immunity.

Objective To analyze the resistance genes in a muhidrug resistant Klebsiella pneumoniae (MDRKP) strain.Methods A MDRKP strain was isolated from bronchoalveolar lavage fluid in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University in February 2012.Acquired resistance genes to beta-lactams,aminoglycosides,quinolones,ompK35 and ompK36 gene for outer membrane porin protein,and carbapenems targeting PBP2 gene were analyzed by PCR and verified by DNA sequencing.Results Acquired resistance genes TEM-1,SHV-1 to beta-lactam antimicrobial agents and aac(6′)-I b to aminoglycoside antimicrobial agents were positive in the strain of MDRKP.While 16S rRNA methylase,ompK35 and ompK36 genes for outer membrane porin protein were negative.Compared with susceptible strains,there were 9 synonymous mutations in PBP2 gene sequence of this MDRKP strain,but the amino acid sequences were the same.No mutation in quinolone resistance determining region (QRDR) was observed.Conclusion The multidrug resistance of the isolated Klebsiella pneumoniae strain may be related to 2 kinds of beta-lactam acquired resistance genes,1 kind of aminoglycoside acquired resistance gene,ompK35 and ompK36 genes defects and synonymous mutation in PBP2 gene.

AIM To study the therapeutic action of leflunomide(Lef) on adjuvant arthritis (AA) rats and its mechanisms. METHODS To observe the change of secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Lef and to detect the effect of A 771726 —the active product of Lef on T cell subgroup in mice in vitro .RESULTS Lef(2,6,18 mg?kg -1 ?12 d) intragastric injection(ig) could signifcantly inhibit secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats.Lef couldnt effect the lowed response of Con A induced splenolytes, and the decreased IL 2 synthesis in AA rats. But lef(2,6,18 mg?kg -1 ) could inhibit the elevated IL 1 released from peritoneal macrophage (PM?) in AA rats. A 771726 —the active product of Lef(0 1,0 5,2 5,12 5,25,100 ?mol?L -1 ) could inhibit Con A induced T h cells but has no effect in Con A induced T s cells in vitro .CONCLUSION Lef has therapeutic action on AA rats which could be related to its immunosuppressory activities——mainly through inhibit cell mediated immunity.

Objective To investigate the characteristics and essential points of diagnosis and treatment of double trisomy 47,XXX/48,XXX,+8 combined Behcet disease, a rare inherited immunodeficiency disorder. Methods The clinical manifestations, karyotype analysis and gene test results of the patients were analyzed, and relevant literatures were reviewed. Results A 11-year-old girl presented repeated fever for more than 6 years, accompanied with recurrent genital herpes infection and oral apthosis, was clinically diagnosed with Behcet disease. Cytogentic and molecular karyotyping on peripheral lymphocytes demonstrated 47,XXX[12]/48,XXX,+8[18]. Conclusions Conventional karyotype analysis and chromosomal microarray analysis have a complementary role in the diagnosis of the disease. We conclude that patients with constitutional trisomy 8 and those with trisomy 8 confined to the bone marrow are both at increased risk of developing features of Behcet disease. The mechanism may relate to increased gene dosage of candidate genes for Behcet's disease on chromosome 8.

OBJECTIVE To study the carriage,the risk factors and the antibiotic resistant pattern of Streptococcus pneumoniae isolated from hospitalized children with respiratory infection below 3 years old.METHODS A total of 453 children with respiratory infection hospitalized at Children′s Hospital of Soochow University in Suzhou Jiangsu Province from Mar 2006 to Mar 2007 were enrolled and given deep orotracheal aspiration(OTA) technique to get the sputum.S.pneumoniae strains were tested and analyzed.RESULTS The carriage rate of S.pneumoniae was 9.3% which was related with age and season.The percentage of resistance to penicillin,erythromycin,tetracycline,clindamycin,chloramphenicol and trimethoprim/sulfamethoxazole was 16.7%,100%,95.2%,95.2%,14.3% and 73.8%,respectively.No resistant strains to ceftriaxone,ofloxacin and vancomycin were detected.All S.pneumoniae strains were resistant to multiple drugs.CONCLUSIONS The carriage of S.pneumoniae in respiratory infected children below 3 years old in Suzhou area is relatively low.Age and incidence season are the risk factors.The antibiotic resistance is serious.

Objective To establish a flow cytometric measurement of detecting minimal residual disease(MRD) according to the leukemia-associated immunophenotypes in children with acute lymphoblastic leukemia(ALL) and to explore the significance of MRD detection in ALL children for a individualized treatment. Methods A variety of four-color fluorescent antibody combinations were used to investigate the children's normal bone marrow. The normal bone marrow pattern at two-parameter plots was established to identify the residual tumor cells, seventy-five bone marrow samples from newly diagnosed ALL children were analyzed with four-color cytometry to determined the optimal combinations which can clearly distinguish the tumor cells from normal cells. The bone marrow samples were monitored with the combination panel in 60 patients at the end of induction therapy and follow-up treatment. Cytomorphology test, PCR amplification of 29 fusion genes as well as IgG and TCR gene rearrangements were performed simultaneously. Results Sixty-nine cases (92.0%) could be identified for effective antibody combinations to monitor MRD by four-color cytometry. Fusion genes or IgG and T cell receptor (TCR) gene rearrangements can be detected in 21 cases (28.0%) to monitor MRD by PCR. No MRD can be detected in 25 bone marrow samples at the end of induction therapy and follow-up treatment. Four-color cytometry could detect as low as 0.021%-4.130% residual leukemia cells. Conclusion MRD can be monitored by flow cytometry which is faster than PCR, and the sensitivity is superior to morphology method.