Objective To analyze the allergens detection in asthmatic infants and young children. Methods The specific IgE test and allergens screening test were conducted in 243 infants and young children with whooping diseases including asthmatic bronchitis, asthmatic pneumonia and asthma by skin prick test and Pharmacia UniCAP test. Results 1. Food allergen was the allergen detection most frequently in infants(P = 0.03). The proportion of aeroallergens increased significantly with age (positive rate:67. 2%). Milk and egg white was the main food allergen detection in infants and young children,and the main aeroallergen detection was house dust mite. 2. The allergen - specific IgE test using UniCAP test system was more accurate than skin prick test. Conclusions The infants are more susceptible to food hypersensitivity; the increasing opportunity of aeroallergen exposure may lead to a higher prevalence of aeroallergens in young children. UniCAP system is more accurate than other methods.

Adolescent ; Biopsy, Fine-Needle ; Chromosomes, Human, Pair 18 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Oncogene Proteins, Fusion ; genetics ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Sarcoma, Synovial ; genetics ; metabolism ; pathology ; Soft Tissue Neoplasms ; genetics ; metabolism ; pathology ; Translocation, Genetic ; Vimentin ; metabolism

Objective To investigate the clinical application value of the modified radiography by digital ra- diography of the tempro-mandibular joint in the tempro-mandibular joint radiography.Methods A digital radiogra- phy machine(Siemens Aristos MX)was used to the tempro-mandibular joint disorders of 68 patients with the meth- ods of the modified radiography of the tempro-mandibular joint,and the results were compared with those of 45 cases acquired with conventional radiography.Results The modified radiography by digital radiography provided high res- olution,precise location and excellent images,and the total structures of tempro-mandibular joint was clearly dis- played,with a success rate of 99%(67/68),while the results acquired by conventional radiography were not clear, only with a success rate of 60%(18/45).There is significant statistical differences between the modified radiography by digital radiography and conventional radiography(x~2 = 35.08,P

5 days.Blood gas analysis and blood pressure were determined at admitted day.Meanwhile,peripheral white blood cells at d1,3,5,and blood glucose were measured every day,respectively.GCS at d1,3,5 and hyperglycemia scorce(HS) were evaluated.Results Of the 82 studied patients,36 cases died.Univariate analysis showed that hypotension,lower GCS,higher peripheral white blood cells and HS were the independent death risk factors(Pa0.05).In multivariate logistic regression,the factors significantly associated with an increase in mortality were hypotension,lower GCS and higher HS.Conclusion Lower GCS,higher HS and hypotension are associated with poor outcome of children with severe trauma brain injury.

OBJECTIVESince the dermatology life quality index (DLQI), a self-administered general dermatology quality of life instrument, was originally developed and published in a dermatology clinic at University hospital of Wales, our goal was to popularize the disease-specific scale used in measuring the quality of life of patients with skin diseases and to assess the reliability and validity of its Chinese version.

METHODSWe administered the DLQI to 236 out-patients attending our dermatology clinic and results that had been found by those who originated the DLQI, were examined. The reliability and validity of DLQI were assessed by means of reliability analysis and factor analysis.

RESULTSOverall, the DLQI seemed easy to administer and could be completed within 3 minutes. The internal consistency coefficient rates of this unidimensional measure were 0.87 (Cronbach's alpha) and 0.85 (Spearman-brown, s) with high inter-correlations found between the dimensions with a correlation coefficient ranging from 0.4024 - 0.6569. Factor analysis resulted in a unidimensional pattern, which supported the use of a total DLQI-C score.

CONCLUSIONDLQI was an easy and efficient instrument for assessing the quality of life in patients with dermatological problems and with better reliability and validity. Thus, it could be used in both research and clinical settings in China.

Eczema ; psychology ; Female ; Humans ; Male ; Psoriasis ; psychology ; Quality of Life ; Reproducibility of Results ; Sickness Impact Profile ; Skin Diseases ; psychology ; Surveys and Questionnaires

The aim of this study was to explore the effects of cholecystokinin octapeptide (CCK-8) on cardiac function and the receptor mechanism in anesthetized rats. The mean arterial pressure (MAP), heart rate (HR), the left ventricle systolic pressure (LVP) and the maximal/minimum rate of LVP (+/-LV dp/dt(max)) were measured. The results obtained are as follows. (1) Low dose of CCK-8 (0. 4 microgram/kg i.v.) caused tachycardia and slight increase in MAP, LVP and LV dp/dt(max) (P<0.01), while medium dose (4.0 microgram/kg i.v.) and high dose of CCK-8 (40 microgram/kg i.v.) elicited a bradycardia and marked increase in MAP, LVP and LV dp/dtmax (P<0.01). (2) Proglumide (1.0 mg/kg i.v.), a CCK-receptor (CCK-R) antagonist, significantly inhibited the pressor effects of CCK-8, whilst it reversed the bradycardic responses (P<0.01). (3) Using reverse transcription polymerase chain reaction (RT-PCR), CCK-A receptor (CCK-AR) and CCK-B receptor (CCK-BR) mRNA were expressed in myocardium of rats. The above results indicate that CCK-8 may enhance cardiac function in a dose-dependent manner and elicit a change in HR, which is likely induced by the activation of CCK-R on myocardium.
Animals ; Dose-Response Relationship, Drug ; Heart Rate ; drug effects ; Male ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, Cholecystokinin ; drug effects ; Sincalide ; administration & dosage ; pharmacology ; Ventricular Function, Left ; drug effects ; Ventricular Pressure ; drug effects

OBJECTIVESevere pneumonia is one of the common severe diseases in children. Increasing evidences show that immune response greatly contribute to severe pneumonia. Dendritic cells (DC) are the important antigen presenting cells in the lung. To study the role of dendritic cells in development of severe pneumonia in children, the authors measured the number of mature DC in bronchoalveolar lavage fluid (BALF), and evaluated the relationship among IL-12, pro-inflammatory cytokines and clinical scores.

METHODSThe following 3 groups of children were enrolled in this study: severe pneumonia group: 27 children with severe pneumonia treated between November 2002 and May 2003 in PICU; mild pneumonia group: 30 children with mild pneumonia in department of pulmonology; control group: 29 children without pneumonia but receiving ventilator treatment for chest surgery. Mature DC in BALF was determined in severe pneumonia group and the control group on the day of tracheal intubation for mechanical ventilation. Acute lung injury scores and severe disease scores were evaluated in children with severe pneumonia and mild pneumonia. All children's serum levels of TNF-alpha, IL-6 and IL-12 were measured by using ELISA within 24 hours after admission. SPSS version 11.5 was used for statistical analysis.

RESULTS(1) The percent of mature DC in children with severe pneumonia was significantly higher when compared with the control group on the first day after ventilation [14.2 (3.9 - 51.8)] vs. [1.3 (0.2 - 22.5)] (Z = 5.44, P < 0.01). (2) In severe pneumonia group, the concentration of serum IL-12 [117.0 (79.9 - 159.4) ng/L], TNF-alpha [90.6 (52.2 - 185.9) ng/L], IL-6 [128.7 (73.3 - 793.8) ng/L] were significantly higher than those in mild pneumonia group where the values were [71.6 (19.4 - 196.8)], [26.6 (2.5 - 113.9)], and [39.9 (7.8 - 82.5)] (P < 0.01), and the control group [6.4 (12.2 - 92.0)], [6.4 (1.8 - 91.9)], and [23.0 (6.4 - 54.2)] (P < 0.01). Serum IL-12, TNF-alpha and IL-6 levels in children with mild pneumonia were higher than those of control group (P < 0.01). (3) The percent of mature DC was increased with the serum level of IL-12 (r = 0.48, P < 0.01), TNF-alpha (r = 0.58, P < 0.01), IL-6 (r = 0.51, P < 0.01) and lung injury scores (r = 0.39, P < 0.05), but it did not correlate with severe disease scores (r = -0.11, P > 0.05).

CONCLUSIONSThere is excessive production of pro-inflammatory cytokines and over-stimulation of lung dendritic cells in children with severe pneumonia. Over-stimulation of lung dendritic cells, the increased serum levels of IL-12, TNF-alpha, IL-6 and the severity of pneumonia may suggest that DC plays an important role in pathogenesis of severe pneumonia in children.

Bronchoalveolar Lavage Fluid ; cytology ; Child, Preschool ; Cytokines ; biosynthesis ; blood ; Dendritic Cells ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Interleukin-12 ; biosynthesis ; Interleukin-6 ; biosynthesis ; Male ; Pneumonia ; immunology ; pathology ; physiopathology ; Severity of Illness Index ; Tumor Necrosis Factor-alpha ; biosynthesis

OBJECTIVESince continuous blood purification (CBP) has the effects of eliminating inflammatory mediators and improving organs function, CBP had been applied to treat non-renal diseases for nearly 10 years, but few studies have been conducted in children with sepsis and multiorgan dysfunction syndrome (MODS), especially in China. The present study aimed to evaluate the clinical effect of CBP in treatment of children with severe sepsis and MODS.

METHODSTwenty-two children with severe sepsis and MODS admitted to our PICU from Aug. 2003 to Aug. 2005 were treated with continuous veno-venous hemodialysis filtration. Their heart rate, arterial blood pressure, doses of vasoactive agents, spontaneous respiratory rate, PO2/FiO2 and prognosis were investigated.

RESULTSCatheterization and CBP were carried out in all the 22 children. Continuous vein-vein hemodialysis filtration (CVVHDF) and pre-dilution were chosen. The duration of CBP was (64.4 +/- 34.5) h. All the children had tachycardia before CBP and the heart rate fell gradually to 45 +/- 13 bpm 4 h after CBP. Blood pressure (BP) was stable in 7 children without shock during CBP. Ten children with early shock could maintain normal BP during CBP, but the doses of vasoactive agents were tapered 1 to 5 h after beginning of CBP and use of these agents was discontinued at 2 to 8 h. BP was elevated by (25.2 +/- 10.7) mmHg (1 mmHg = 0.133 kPa) in 5 refractorily shocked children 4 h after CBP and returned to normal level 8 h later. The doses of the vasoactive drugs were reduced at 2 to 8 h and ended 4 to 16 h later, which was longer than that of children with early stage shock. The accelerated spontaneous respiratory rate was slowed down by 7 +/- 4 per minute 4 h later, PO2/FiO2 rose from (177.7 +/- 53.1) mmHg before CBP to (341.0 +/- 60.2) mmHg 4 h after CBP in children with respiratory failure and reached the normal value (5.3 +/- 2.1) h later. FiO2 declined to less than 50%. Pediatric critical illness score was 62.2 +/- 7.4 on admission and elevated to (86.6 +/- 9.0) 24 h later, which was a significant elevation as compared to that of children with sepsis who were not treated with CBP seen between Aug. 2001 and July 2003. The survival rate was 72.7% after CBP and the effective rate of the treatment was 90.9%, but was 36% in children who were not treated with CVVHDF.

CONCLUSIONCBP can effectively improve the vital organ's function of children with sepsis and MODS and raise their survival rate. Replacement fluid of modified Ports formula was useful for stability of serum potassium and sodium, but resulted in elevation of serum glucose, calcium, and osmolarity. The application of CBP in children with sepsis can lead to slight drop of blood pressure at the beginning and to bleeding during CBP.

Adolescent ; Blood Pressure ; Child ; Child, Preschool ; Female ; Heart Rate ; Hemofiltration ; methods ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Multiple Organ Failure ; etiology ; mortality ; physiopathology ; therapy ; Prognosis ; Sepsis ; complications ; mortality ; physiopathology ; therapy ; Severity of Illness Index ; Survival Rate ; Treatment Outcome

To study the pathogenic spectrum of hand, foot and mouth disease (HFMD) and the molecular characterizations of human enteroviruses 71 (HEV71) isolated from the clinical specimens of HFMD patients in Inner Mongolia in 2010. A total of 921 clinical specimens including stools and throat swabs were collected from HFMD patients in outpatient service in Inner Mongolia and then viral isolation was performed, the positive viral isolates were identified by using the real-time PCR method (detecting EV, HEV71 and CVA16 in a single tube), and VP4 and VP1 coding region amplification and sequencing was performed with the viral isolates that were identified as non-HEV71, non-CVA16 HEVs. A total of 153 viruses were isolated form 921 clinical specimens, the positive rate was 16.61%, of which 61 (39.87%) were HEV71, 82 (53.59%) were CVA16, 7 (6.53%) were other HEVs(6 were CVB4 and 1 was polio vaccine virus type II) and 3 (1.96%) were adenoviruses. Nine viruses were isolated from severe cases, of which 6 were HEV71 and 3 were CVA16. Thirty two HEV71 isolates were selected from the patients presenting mild symptoms and the patients presenting severe symptoms randomly, and the VP1 coding regions of represented HEV71 isolates were amplified and sequenced. Finally the phylogenetic tree was constructed among the VP1 coding regions of the different genotypes and subgenotypes of HEV71 strains. The nucleotide acid and amino acid of 32 represented HEV71 strains in Inner Mongolia were closed to HEV71 strains isolated from mainland China since 2007, especially from Beijing in 2008, and it showed that all HEV71 strains clustered within the C4a evolution branch of C4 subgenotype. There was slight difference in the nucleotide and the amino acid sequence in VP1 region among the 32 Inner Mongolia HEV71 strains, the identity were 96.4%-100% and 98.14%-100%, respectively, and there was a little difference in the nucleotide acid sequence between the HEV71 strains from Inner Mongolia in 2010 and in 2007, the identity was from 96.95% to 97.87%. Thirty two HEV71 strains were in different lineages in the phylogenetic tree, and it indicated that these strains belonged to many different viral transmission chains. HEV71 and CVA16 were the main pathogens of HFMD in Inner Mongolia in 2010 and most severe cases were caused by HEV71. All the HEV71 strains circulated in Inner Mongolia belonged to C4a evolution branch within C4 subgenotype. Phylogenetic analysis revealed that 2010 Inner Mongolia HEV71 strains were located in different lineages, and had more nucleotide identity with 2008 Beijing HEV71 strains than with 2007 Inner Mongolia HEV71 strains. This indicated that Inner Mongolia HEV71 strains had not evolved independently, but co-evolved with the HEV71 strains in other provinces in mainland China.
Adolescent ; Adult ; Child ; Child, Preschool ; China ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; pathogenicity ; Female ; Hand, Foot and Mouth Disease ; virology ; Humans ; Infant ; Male ; Molecular Sequence Data ; Phylogeny ; Young Adult

OBJECTIVETo evaluate the role of nutritional status on serum immunoglobulins, body weight and postoperative infectious-related complications in patients with Crohn's disease receiving perioperative parenteral nutrition (PN).

METHODS32 patients with Crohn's disease receiving perioperative parenteral nutrition in our department between 1984 and 1994 were enrolled in this survey. 16 patients with loss of body weight in the range of 15%-30% were assigned to the malnutrition group, the other 16 patients with normal weight or loss of body weight less than 15% to the control group. Serum IgM, IgG and IgA levels were measured before and after PN by enzyme-linked immunosorbent assays. Liver function, body weight changes and postoperative complications were also analyzed.

RESULTSIgM levels were elevated before PN in both groups [control group: (133 +/- 16) mg/dl, malnutrition group: (139 +/- 41) mg/dl; normal value: (110 +/- 35) mg/dl; P = 0.04], decreased to normal value [(105 +/- 29) mg/dl, P = 0.02] in the malnutrition group while having no obvious changes in the control group [(129 +/- 13) mg/dl, P = 0.34]. No significant changes in concentrations of IgG and IgA were found (P in the range of 0.20-0.57). The average weight gain was 1.862 kg in malnutrition group [before PN: (45.8 +/- 8.9) kg, after PN: (48.0 +/- 8.8) kg; P = 0.005] and no significant changes in the control group [before PN: (55.6 +/- 6.1) kg, after PN: (56.3 +/- 6.0) kg; P = 0.46]. There was an increase in infectious complications in the control group (control group: 4 cases, 25%, malnourished group: 2 cases, 12.5%; P = 0.13).

CONCLUSIONSPerioperative parenteral nutrition ameliorated the humoral immunity, increased the body weight in patients with obvious malnutrition, whereas it had little value for those without or with mild malnutrition.

Adult ; Aged ; Body Weight ; Crohn Disease ; immunology ; surgery ; therapy ; Female ; Humans ; Immunoglobulins ; blood ; Male ; Malnutrition ; etiology ; Middle Aged ; Nutritional Status ; Parenteral Nutrition ; Pneumonia ; etiology ; Postoperative Complications ; etiology