Anti-Asthmatic Agents ; adverse effects ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Lung Diseases ; chemically induced ; Pneumoconiosis ; drug therapy

Objective To investigate the clinical features of the enterovirus 71 ( EV71 ) infection complicated with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness.Methods The medical records of three cases with EV71 infection were retrospectively reviewed for clinical manifestations, laboratory data, medications, and outcome.Results All the cases were infants and died of the infection. These infants had no skin or mucosal lesions, however, they had sudden onset of cyanosis and tachypnea 1 to 2 days after the onset of the febrile disease with vomiting. All these 3 cases were misdiagnosed and were treated for shock on admission. Pulmonary hemorrhage was not considered in any of the cases on admission. All the cases received tracheal intubation when foamy secretions were discharged from the mouth and nose of the patients and notable cyanosis occurred. After intubation, pink foamy fluid flew out from the endotracheal tube in all the 3 cases. The patients had hyperglycemia and limb weakness, two had tachycardia, and hypertension was found in one case. Chest X-ray showed bilateral or unilateral widespread air space opacity, but the cardiac size and shape were normal. All the patients had leukocytosis. Enterovirus 71 infection was confirmed by detection of specific nucleic acid sequences of the virus from throat swab and tracheal secretions samples and in one case in cerebrospinal fluid.Conclusions Pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71 infection. The initial presentation was nonspecific with fever and vomiting, and sudden appearance of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness, which may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment.

Objective To investigate the impact of reduced glutathione(GSH) on the prolifera- tion,oxidative stress and transforming growth factor?1(TGF-?1) expression of human hepatocytes and hepatic stellate cells(HSCs)(LX-2 cell line).Methods Human hepatocytes and HSCs were incubated with various concentrations of GSH(0.5—50 mmol/L or 0.5—10 mmol/L).The effects of GSH on the proliferation of hepatocytes and HSCs were studied by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphennyhera- zolium bromide colorimetric assay.Human hepatocytes and HSCs were co-cultured with GSH and ferric nitrilotriacetic acid,superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were detected.HSCs were incubated with high(5.0 mmol/L),media(2.5 mmol/L) and low (0.5 mmol/L) concentrations of GSH,the expressions of TGF-?1 mRNA and protein were detected by ELISA and real- time PCR.Results In concentration ranged from 2.5 to 10 mmol/L,the GSH could promote the pro- liferation of hepatocytes but no HSCs,significantly increased the activity of SOD and decrease the con- tents of MDA in hepatocytes and HSCs,and inhibited the expression of TGF-?1 in HSCs.Conclusions GSH can not only promote the proliferation of hepatocytes,but also protect hepatocytes and HSCs from oxidative stress,and inhibit the secretion of TGF-?1 in HSCs.GSH may play a role in hepatocellular protection,antioxidation and anti-fibrosis.

Objective To evaluate the effect of comprehensive prevention and control of soil?transmitted nematodiasis in Runzhou District Zhenjiang City Jiangsu Province from 1997 to 2012. Methods The comprehensive prevention and control measures included the helminthicide health education improvement of water supplier and harmless toilets and these mea?sures were implemented continuously. At the same time the infection rates of soil?transmitted nematodes the local economic in?dicators and the coverage rates of tap water and harmless toilets were surveyed. Results The mass chemotherapy was per?formed for 202 100 person?times and the diagnosed chemotherapy was performed for 2 006 person?times in Runzhou District from 1997 to 2012. The awareness rates of health knowledge were 57.18%in 1997 and 95.62%in 2012. The coverage rates of tap water and harmless toilets were 10.14%and 10.21%in 1997 and 100.0%and 90.38%in 2012 respectively. There were negative correlations between the awareness rate of per capita GDP per capita net income coverage rates of tap water cover?age rates of harmless toilets health knowledge and the infection rate of soil?transmitted nematodes respectively rper capita GDP=-0.526 P 0.05 rper capita net income=-0.671 P 0.01 rcoverage rates of tap water=-0.936 P 0.01 rcoverage rates of harmles toilets=-0.922 P 0.01 rawarenes=-0.774 P 0.01 . The statistical analysis showed that the infection rate of soil?transmitted nematodes had a downward trend as an expo?nential curve in Runzhou District from 1997 to 2012 y=42.031 7e?0.357 6x R2=0.803 6 F=57.28 P=0.000 . The infection rate of degradation by an annual rate was 29.18%. The infection rate in farmers was significantly higher than that in students χ2=17.998 P 0.01 . There was no significant difference between men and women in the infection rate of soil?transmitted nema?todes χ2=3.627 P=0.057 . Conclusion The comprehensive prevention and control measures and the development of so?cial economy contribute to the steady decline of soil?transmitted nematode infections.

0.05).2.Neonates umbilical serum leptin concentration was positively correlated with body mass index(r=0.520 P

OBJECTIVETo investigate the cardiac effect of interleukin-2 (IL-2) and to explore the underlying mechanism.

METHODSThe video tracking system and spectrofluorometric method were used to measure the cell contraction and intracellular calcium. Fura-2/AM was used as a calcium fluorescence probe. Langendorff perfusion technique was used to determine the effect of IL-2 on the intact heart.

RESULTSCompared with the control group, IL-2 5 U/ml, 50 U/ml significantly decreased cell contraction amplitude [(74.95+/-4.79) vs (98.09+/-5.02)%, (64.30+/-5.24) vs (97.38+/-4.05)%], peak velocity of cell shortening [(70.23+/-4.85)% vs (98.09+/-5.46)%, (61.15+/-5.20)% vs (97.38+/-6.85)%], peak velocity of cell relengthening [(71.22+/-4.79)% vs (98.32+/-6.08)%, (68.16+/-5.24)% vs (97.55+/-5.00)%] and end- diastolic cell length [(88.28+/-5.84)% vs (97.95+/-5.52)%, (84.18+/-6.52)% vs (98.94+/-6.76)%]. IL-2 (5 U/ml, 50 U/ml) also markedly inhibited intracellular calcium transient [(74.94+/-4.90)% vs (98.09+/-3.74)%,(71.00+/-5.28)% vs (97.38+/-5.52)%], and elevated end-diastolic calcium level of ventricular myocytes [(113.91+/-5.93)% vs (100.10+/-3.02)%, (119.09+/-7.12)% vs (100.52+/-6.00)%], which were attenuated by the opioid receptor antagonist naloxone (Nal,10 nmol/L). In the isolated perfused rat heart,when compared with the control group, IL-2 50 U/ml markedly decreased left ventricular developed pressure [(79.91+/-2.18) vs (93.84+/-2.94)mmHg], maximal rate of rise of left ventricular pressure [(2370.7358.29) vs (2591.50+/-62.81)mmHg] maximal rate of fall of left ventricular [-(1460.95+/-38.6) vs -(1634.24+/-54.05) mmHg/s] and heart rate [(217.35+/-10.56) vs (244.52+/-11.23) beats/min], but increased left ventricular end-diastolic pressure (11.44+/-1.02 vs 9.23+/-0.46). Pretreatment with Nal (10 nmol/L) antagonized the cardiac depression and left ventricular end-diastolic pressure elevation induced by IL-2.

CONCLUSIONThe cardiac effect of IL-2 is mediated by opioid receptors on the membrane of cardiomyocytes.

Animals ; Calcium ; metabolism ; Depression, Chemical ; In Vitro Techniques ; Interleukin-2 ; pharmacology ; Male ; Myocardial Contraction ; drug effects ; Naloxone ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Opioid, kappa ; drug effects ; physiology

Background: Despite substantial progress toward measles control are making in China, measles outbreaks in immunocompromised population still pose a challenge to interrupt endemic transmission. This study aimed to investigate the features of measles in pediatric hematology and oncology patients and explore the reasons behind the outbreak. Methods: We collected demographic, epidemiological, and clinical data of immunocompromised measles children.All suspected measles cases were laboratory?confirmed based on the presence of measles IgM and/or identification of measles RNA. The clinical data were statistically analyzed by t?test for continuous variables and Fisher''s exact test for categorical variables. Results: From March 9 to July 25 in 2015, a total of 23 children with malignancies and post hematopoietic stem cell transplantation (post?HSCT) were notified to develop measles in Shanghai. Of these 23 patients with the median age of 5.5 years (range: 11 months–14 years), 20 (87.0%) had received 1–3 doses of measles vaccine previously; all patients had fever with the median fever duration of 8 days;21 (91.3%) had cough; 18 (78.3%) had rash; 13 (56.5%) had Koplik''s spot; 13 (56.5%) had complications including pneumonia and acute liver failure; and five (21.7%) vaccinated patients died from severe pneumonia or acute liver failure. Except the first patient, all patients had hospital visits within 7–21 days before measles onset and 20 patients were likely to be exposed to each other. Conclusions: The outcome of measles outbreak in previously vaccinated oncology and post?HSCT pediatric patients during chemotherapy and immunosuppressant medication was severe. Complete loss of protective immunity induced by measles vaccine during chemotherapy was the potential reason. Improved infection control practice was critical for the prevention of measles in malignancy patients and transplant recipients.

OBJECTIVEThis study sought to analyze the clinical manifestations and intervention of fulminant septic shock in community-acquired Pseudomonas aeruginosa septicemia.

METHODSWe retrospectively reviewed the medical records for diagnosis, antibiotic therapy, clinical course of septic shock, respiratory support, laboratory data etc.

RESULTSEight of nine cases with P. aeruginosa septic shock died. Fever (nine cases) and cough (three cases) or diarrhea (3 cases) were the 2 most common initial symptoms, three cases developed skin gangrenosum later. Pseudomonas aeruginosa infection was not considered in any of the cases before death or blood culture showed positive result. Only 3 cases were initially treated with susceptible antibiotic regimen but no anti pseudomonas combination therapy was applied, susceptible antibiotic monotherapy was applied in 7 cases after transfer to the ICU. The mean latency of shock occurrence was 5.1 hours (range 0 to 21 hours) after admission, the mean duration from the occurrence of shock to death was 13.8 hours (range, 1 - 32 hours). All the patients were transfer red to ICU for shock, the appropriate resuscitation of shock patients was delayed by 49.3 minutes (range 25 - 80 minutes) by transfer. Only two cases were diagnosed and treated for shock on admission; after transferred to ICU, only 5 patients were diagnosed as having shock, and only 3 received anti-shock treatment. Eight of the patients died of persistent shock. In 6 patients who died, mechanical ventilation was not applied until cardiac arrest occurred. All the patients had hypoalbuminaemia, elevated serum C-reactive protein concentration, leukopenia and 6 cases had DIC.

CONCLUSIONThe initial presentation of the cases with community-acquired Pseudomonas aeruginosa septicemia was nonspecific with fever and cough or diarrhea. Clinicians often underestimated the severity of the infection, few patients received effective antimicrobial therapy. The authors suggest that an anti-pseudomonas antibiotic should be included in the initial empiric antibiotic regimen to cover P. aeruginosa high-risk patients; the front-line clinician should be educated for early recognition and aggressive resuscitation of P infection. aeruginosa septicemia.

Adolescent ; Child, Preschool ; Community-Acquired Infections ; Female ; Humans ; Infant ; Male ; Pseudomonas Infections ; Pseudomonas aeruginosa ; Retrospective Studies ; Shock, Septic ; microbiology

OBJECTIVETo recognize the clinical features of the enterovirus 71 (EV71) infection with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness.

METHODSWe retrospectively reviewed the medical records of the three cases with EV71 infection for clinical manifestation, laboratory data, medications, outcome etc.

RESULTSAll the cases were infants and they all died. These infants had no skin or mucosal lesions, however, they had sudden onset of cyanosis and tachypnea 1 to 2 days after the onset of the febrile disease with vomiting. All these 3 cases were misdiagnosed and were treated for shock on admission. Pulmonary hemorrhage was not considered in any of the cases on admission. All the cases received tracheal intubation when foamy secretions were discharged from mouth and nose of the patients and notable cyanosis was noted. After intubation, all had pink foamy fluid flew out from the endotracheal tube. The patients had hyperglycemia and limb weakness, two had tachycardia, and hypertension was found in one case. Chest X-ray showed bilateral or unilateral widespread air space opacity, but the cardiac size and shape were normal. All the patients had leucocytosis. EV71 infection was confirmed by detection of specific sequences of the virus in throat swab and tracheal secretions samples and in one case in cerebrospinal fluid sample.

CONCLUSIONPulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71-infected infants. The initial presentation was often nonspecific with fever and vomiting, and sudden appearances of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment.

Enterovirus A, Human ; Enterovirus Infections ; pathology ; Female ; Hemorrhage ; etiology ; virology ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; virology ; Retrospective Studies