1.Microflora on mucosa under different pontics of fixed partial bridge.
Zhen-hua WANG ; Jin-yu WANG ; Su-hui LIU ; Ping JI ; Cai-mei DAO ; Xiang-min YUAN
Chinese Journal of Stomatology 2005;40(3):227-229
OBJECTIVETo investigate the influence of three pontic types on alveolar ridge mucosal microecosystem.
METHODSSixty patients ready to accept three unit metal ceramic bridges were selected. The bacterial type and the cultivable flora were counted and the proportions of bacteria detected on the top of alveolar ridge mucosal contact area before tooth preparation and three months after bridge insertion.
RESULTSType and CFU of bacteria on the alveolar ridge mucosa under modified base-type pontics and modified ridge lap pontics increased significantly (P < 0.05); while there was no significant change under the ovata pontics (P > 0.05). Before tooth preparation and 3 months after fixed prosthesis insertion, the percentages of oral Streptococci and Neisseriae changed significantly (P < 0.05).
CONCLUSIONSThe ovata pontic had less influence on mucosal microecosystem than the other two pontics and is the appropriate pontic design for clinical dentist.
Adult ; Alveolar Process ; microbiology ; Denture Design ; Denture, Partial, Fixed ; microbiology ; Humans ; Middle Aged ; Mouth Mucosa ; microbiology
2.Anti-angiogenetic effect of arenobufagin in vitro and in vivo.
Jun-shan LIU ; Dong-mei ZHANG ; Min-feng CHEN ; Man-mei LI ; Qing-dao LUO ; Hiroshi KURIHARA ; Wen-cai YE
Acta Pharmaceutica Sinica 2011;46(5):527-533
This study is to investigate the anti-angiogenetic effect of arenobufagin in vitro and in vivo. The anti-proliferation effect of arenobufagin on CNE-2, Hep2, SH-SY5Y, LOVO, PC-3 and DU145 cells as well as human umbilical vein endothelial cells (HUVECs) was determined by MTT assay. Cell morphological changes of LOVO and HUVECs after arenobufagin treatment were observed by microscopy. Arenobufagin inhibited the proliferation of CNE-2, Hep2, SH-SY5Y, LOVO, PC-3, DU145 and HUVECs in a dose-dependent manner. Furthermore, it was obviously observed that the subcytotoxic concentration of arenobufagin in human carcinoma cells induced a marked decrease in the viability of HUVECs. Chick embryo chorioallantoic membrane (CAM) model was used to detect the anti-angiogenetic effect of arenobufagin in vivo. Arenobufagin significantly suppressed the angiogenesis of CAM. Cell cycle analysis demonstrated that G2/M phase was arrested and the sub-G1 peak appeared with the increase of arenobufagin concentration. PI/Annexin V double staining assay further demonstrated that arenobufagin could induce apoptosis in a dose- and time-dependent manner. Mitochondrial potential collapse detected by flow cytometric analysis was increased after arenobufagin treatment. It also observed that PARP was cleaved to p85 active form by Western blotting. Taken together, arenobufagin has significant anti-angiogenetic effect in vitro and in vivo, and the action mechanisms behind its anti-angiogenesis may be associated with cell cycle arrest and apoptosis of vein endothelial cells.
Angiogenesis Inhibitors
;
administration & dosage
;
pharmacology
;
Animals
;
Antineoplastic Agents
;
administration & dosage
;
pharmacology
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Apoptosis
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Bufanolides
;
administration & dosage
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pharmacology
;
Cell Cycle
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Cell Line, Tumor
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Cell Proliferation
;
drug effects
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Cell Survival
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Chick Embryo
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Chorioallantoic Membrane
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blood supply
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Dose-Response Relationship, Drug
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Human Umbilical Vein Endothelial Cells
;
Humans
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Membrane Potential, Mitochondrial
;
drug effects
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Neovascularization, Pathologic
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prevention & control
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Poly(ADP-ribose) Polymerases
;
metabolism
3.Long-term results of mitral-aortic valve replacement in 1,154 patients with rheumatic valvular disease.
Bao-ren ZHANG ; Liang-jian ZOU ; Zhi-yun XU ; Ju MEI ; Zhi-nong WANG ; Dao-hua SUN ; Wei-yong YU ; Lian-cai WANG
Chinese Journal of Surgery 2003;41(4):243-246
OBJECTIVETo analyze the early and long-term results after mitral-aortic valve replacement for rheumatic valvular disease and the determinant factors involved and subsequent therapies.
METHODS1 154 patients receiving combined mitral-aortic valve replacement for rheumatic valvular disease from May 1981 to May 2001 were reviewed. The mean age of the patients was 41.48 +/- 10.00 years. Concomitant valve plasty was performed for associated tricuspid organic or significant functional lesions. Lateral tilting disc or bileaflet valve prostheses were used for replacement. New York Heart Association functional status showed Class III or IV in 91.77% of the patients. Moderate to severe pulmonary hypertension occurred in 29.38% of the patients. The duration of follow-up varied from 8 months to 20 years.
RESULTSThe hospital mortality was decreased from 6.50% to 4.45%. The 5-, 10- and l5-year survival rates were 89.46% +/- 1.35%, 86.50% +/- l.91% and 67.86% +/- 6.16%, respectively. The 5-, 10- and l5-year thromboembolic event free rates were 97.80% +/- 0.74%, 88.31% +/- 2.20% and 94.08% +/- 2.29%, respectively. the 5-, 10- and l5-year anticoagulant related bleeding free rates were 94.80% +/- 1.09%, 89.32% +/- 2.10% and 83.12% +/- 3.57% respectively. Cardiac functional status returned to Class II in 98% patients and to Class III in 2% during follow-up.
CONCLUSIONSBoth left and right ventricular functions may be impaired as a result of rheumatic valvular disease. Tricuspid valve should be explored during surgery and any significant tricuspid annular enlargement and regurgitation showed be corrected in concomitance. Long-acting penicillin regimen is needed for 3 - 5 years for the prevention of rheumatic fever relapse. A low intensity anticoagulant regimen after valve replacement with prothrombin time targeting at 1.5 - 2.0 times is advisable in lessening anticoagulant related bleeding yet optimizing sufficient prevention against thromboembolic complications.
Adolescent ; Adult ; Aged ; Aortic Valve ; surgery ; Female ; Follow-Up Studies ; Heart Valve Diseases ; etiology ; surgery ; Heart Valve Prosthesis Implantation ; methods ; mortality ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Postoperative Complications ; prevention & control ; Recurrence ; Retrospective Studies ; Rheumatic Heart Disease ; complications ; prevention & control ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Tricuspid Valve ; surgery ; Young Adult
4.Study on the characteristics of inheritance and epidemiology in one pedigree with gallstone disease.
Jian QIN ; Tian-quan HAN ; Xing-xing CAI ; Zhi-hong JIANG ; Xiao-mei YANG ; Yu ZHANG ; Shi-yong YANG ; Zhao-yan JIANG ; Sheng-dao ZHANG
Chinese Journal of Epidemiology 2005;26(6):448-450
OBJECTIVETo study the characteristics of inheritance and epidemiology of gallstone disease in one pedigree.
METHODSA gallbladder disease-specific questionnaire was administered to all family members to ascertain histories of cholecystectomy and other medical conditions as well as anthropometrical data. Laboratory examination and ultrasonography were performed to determine the existence of gallstone.
RESULTSOne hundred and thirteen members of four generations in the index family were enrolled in the study. The prevalence of gallstone in females (34.48%) was higher than in males (23.64%) but with no significant difference. The prevalence in the second and third generations (52%) was higher than in others (20%) (P < 0.05). The heritability and standard error showed as 86.38% +/- 46.46% in I generations. Body mass index, histories of hypertension, hyperlipidemia and blood glucose were positively related to gallstone disease (P = 0.012, < 0.01, 0.017, 0.043, respectively) in this family. Gallstone disease was not significantly related to history of diabetes, daily alcohol or diet habit. Plasma cholesterol and triglyceride levels were not correlated with gallstone disease.
CONCLUSIONGallstone disease presented aggregation in the family and was in accordance with the characteristics of autosomal dominant inheritance. Being female, obesity, hypertension and history of hyperlipidemia might serve as risk factors to this family.
Adolescent ; Adult ; China ; epidemiology ; Family Health ; Female ; Gallstones ; epidemiology ; genetics ; Genetic Predisposition to Disease ; genetics ; Humans ; Hyperlipidemias ; complications ; Hypertension ; complications ; Male ; Middle Aged ; Obesity ; complications ; Pedigree ; Prevalence ; Risk Factors ; Sex Factors ; Surveys and Questionnaires
5.Analyse related factors of impact and prognosis of 73 cases of severe hepatitis.
Jun-Mei ZHAO ; Lu ZHANG ; Qing-Wei DU ; Cai-Qin MU ; Yv-Lian REN ; Lei-Ping HU ; Ge SHEN ; Li-Wei ZHUANG ; Yao LU ; Guo-Hua QIU ; Qing-Feng SUN ; Yun-Zhong WU ; Min YANG ; Ming-Hui LI ; Yao XIE ; Jun CHENG ; Dao-Zhen XU
Chinese Journal of Experimental and Clinical Virology 2013;27(5):366-369
OBJECTIVEA retrospective study was conducted to investigate the clinical features and prognostic factors of 73 cases of severe hepatitis.
METHODSTo summarize clinical features of 73 cases of severe hepatitis, grouping by etiology and pathogenesis. A retrospective analysis was performed to evaluate the relationship between biochemical characteristics (liver function, renal function, electrolytes, PTA, etc) and complications (hepatic encephalopathy, upper gastrointestinal bleeding, hepatorenal syndrome, ascites, abdominal infections, etc) and prognosis.
RESULTS(1) HBV infection alone accounted for 65.75%. Alcoholic liver disease, drug-induced liver injury, hepatitis E, autoimmune hepatitis, overlapping causes and other factors were five cases (6.85%), six cases (8.22%), two cases (2.74%), two cases (2.74%), seven cases (9.59%) and three cases (4.11%) respectively. According to the incidence rate, severity and underlying liver condition, subacute hepatitis, cases based on chronic hepatitis and on cirrhosis were 12 cases (16.43%), 11 cases (15.07%), 50 cases (68.49%) respectively. Clinical manifestations with or without hepatic encephalopathy accounted for 58.90% or 41.10%. (2) The highest mortality of severe hepatitis was alcoholic liver disease and patients on the basis of overlapping factors (66.67%), followed by autoimmune liver disease (50%). The mortality of HBV-related hepatitis was 18.75%. Overall mortality of 73 cases of severe hepatitis was 28.77%, of which cirrhosis group was higher than non-cirrhotic group (40% vs 4.3%, P = 0.002). The difference was statistically significant. Patients without hepatic encephalopathy had lower mortality than with hepatic encephalopathy (3.33% vs 46.51%). The mortality of patients with hepatic encephalopathy Stage III and IV was 72.73%. (3) Independent samples t test filtered nine factors associated with death, namely cirrhosis, upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, serum creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB) and serum sodium. The results of multivariate conditional logistic regression analysis indicated that hepatic encephalopathy, serum creatinine levels were risk factors for death, whereas ALB as a protective factor.
CONCLUSIONHepatic encephalopathy, serum creatinine levels were risk factors for severe hepatitis death, But ALB was protective factor. Nucleotide analogs using was the main reason why the mortality of hepatitis B was as low as 18.75%.
Adult ; Aged ; Female ; Hepatitis ; complications ; mortality ; pathology ; virology ; Hepatitis B virus ; genetics ; isolation & purification ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors
6.Potential distribution of Rhodiola crenulata in Tibetan Plateau based on Maxent model.
Jian WEN ; Xiu-Mei LV ; Dao-Xin HONG ; Cai-Xiang XIE ; Jing ZHANG ; Yi ZHANG
China Journal of Chinese Materia Medica 2016;41(21):3931-3936
Wildlife tending and artificial cultivation is an important way to protect the wild resources of Rhodiola crenulata. It is a study hotspot at present. The distribution information of R. crenulata was collected by query data and field survey, the ecological suitability regionalization was conducted based on maximum entropy model combine with ecological factors, including climate, soil and altitude. To provide the reference for production layout, suitable planting area and the selection of artificial planting base by studying the ecological suitability regionalization of R. crenulata. The potential distribution areas mainly concentrated in the easen Tibet, western Sichuan, southern Qinghai, and Gansu Gannan Tibetan Autonomous Prefecture, Yunnan Diqing Tibetan Autonomous Prefecture. There were 5 major environmental factors to have obvious influence on ecology suitability distributions of R. crenulata, including altitude (contribution rate of 61.8%), precipitation of warmest quarter (contribution rate of 19%), the coefficient of variation of precipitation seasonality (contribution rate of 4.7%), the SD of temperature seasonality (contribution rate of 4%), mean temperature of driest quarter (contribution rate of 2.5%). The AUCs of ROC curve were both above 0.9, indicating that the predictive results with the Maxent model were highly precise. The study of the ecological suitability regionalization of R. crenulata based on Maxent can provide a scientific basis for the selection of artificial planting base.
7.Prognostic power of abnormal cytogenetics for multiple myeloma: a multicenter study in China.
Yue-Yun LAI ; Xiao-Jun HUANG ; Zhen CAI ; Xiang-Shan CAO ; Fang-Ping CHEN ; Xie-Qun CHEN ; Bao-An CHEN ; Mei-Yun FANG ; Jia-Fu FENG ; Wei-Ling FU ; Hai-Ying GUO ; Ming HOU ; Jian HOU ; Yu HU ; Xiao-Tong HU ; Xiao-Mei HU ; Li-Qiang HUANG ; Jie JIN ; Jian-Yong LI ; Juan LI ; Wei LI ; Ying-Min LIANG ; Ting LIU ; Qi-Fa LIU ; Yan-Hui LIU ; Ping MAO ; Jian OUYANG ; Lu-Gui QIU ; Lin QIU ; Chun-Kui SHAO ; Bin SHI ; Yong-Ping SONG ; Zi-Min SUN ; Qi-Shan WANG ; Chun WANG ; Jian-Ming WANG ; Yun-Shan WANG ; Zhao WANG ; Jian-Bo WU ; Yin-Xia WU ; Rui-Xiang XIA ; Yong-Quan XUE ; Bao-Zhen YANG ; Guang YANG ; Zheng-Lin YANG ; Li YU ; Zhong YUAN ; Sheng ZHANG ; Yin ZHANG ; Hong-Guo ZHAO ; Li ZHAO ; Dao-Bin ZHOU ; Shan-Hua ZOU ; Yun-Feng ZHU
Chinese Medical Journal 2012;125(15):2663-2670
BACKGROUNDChromosomal abnormalities have been shown to play an important prognostic role in multiple myeloma (MM). Interphase fluorescence in situ hybridization (i-FISH) has been much more effective to identify cytogenetic aberrations in MM than conventional cytogenetic technique (CC). To clearly determine the cytogenetic features of Chinese MM patients and identify their prognostic implications, we designed a multicenter study based on i-FISH including 672 patients from 52 hospitals in China.
METHODSAll 672 patients were systematically screened for the following genomic aberrations: del(13q), IgH rearrangement, del(p53) and 1q21 amplifications.
RESULTSThe analysis showed that the chromosomal changes were detected in 22.1% patients by CC and in 82.3% patients by i-FISH. The most common abnormalities by CC were chromosome 1 aberrations (48.4%), -13/13q- (37.6%), hyperdiploidy (36.6%), hypodiploidy (30.1%) and IgH rearrangements (23.7%). The most frequent abnormalities by FISH was del(13q), which was found in 60.4% patients, whereas IgH rearrangement, 1q21 amplification and p53 deletions were detected in 57.6%, 49.0% and 34.7% cases, respectively. By statistical analysis, -13/13q- by CC was associated with low level of platelet (P = 0.015), hyperdiploidy was associated with low level of serum albumin (P = 0.028), and IgH rearrangement by FISH was associated with high level of β2 microglobulin (P = 0.019). Moreover, 1q21 amplification and del(p53) by FISH conferred a high incidence of progressive disease (PD) after initial therapy. Metaphase detection of IgH rearrangements and chromosome 1 aberrations concurrently was associated with a short progression free survival (PFS) (P = 0.036). No significant prognostic implications of other cytogenetic abnormalities were found associated with overall survival and PFS.
CONCLUSIONSChinese MM patients had similar cytogenetic abnormalities compared with the previous reported studies. However, the prognostic significance of FISH aberrations were not clearly determined and further study is required.
Adult ; China ; Chromosome Aberrations ; Chromosomes, Human, Pair 1 ; genetics ; Cytogenetic Analysis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; pathology
8.Genetic Polymorphisms of 21 STR Loci in Hunan Province-based Han Population.
Ying ZOU ; Juan Juan GUO ; Qing Peng LI ; Dao Hong ZUO ; Jin Shan LIU ; Ya Dong GUO ; Jie YAN ; Lagabaiyila ZHA ; Ji Feng CAI ; Ling Mei LAN
Journal of Forensic Medicine 2016;32(5):356-362
OBJECTIVES:
To investigate the genetic polymorphisms of 21 short tandem repeat (STR) loci (D3S1358, D13S317, D7S820, D16S539, Penta E, D2S441, TPOX, TH01, D2S1338, CSF1PO, Penta D, D10S1248, D19S433, vWA, D21S11, D18S51, D6S1043, D8S1179, D5S818, D12S391 and FGA).
METHODS:
A total of 560 blood samples were collected from unrelated healthy individuals of Han population in Hunan Province. Chelex-100 extraction method was applied to the extraction of genomic DNA, and an AGCU EX22 Kit and 9700 STR amplification was used in amplification reactions. The products were separated and analyzed on 310 Genetic Analyzer.
RESULTS:
A total of 248 alleles were observed, the allelic frequencies ranging from 0.001 to 0.518. Observation of genotype distributions for each locus showed no deviations from Hardy-Weinberg equilibrium except Penta E (P=0.023). The combined power of discrimination, combined power of exclusion, and combined matching probability of the 21 STR loci were approximately 0.999 999 999 999 999 999 999 999 8, 0.999 999 998, and 1.36×10⁻²⁵, respectively.
CONCLUSIONS
The 21 STR loci show high polymorphisms in the Han population, which can provide valuable data and a theoretical basis for forensic individual identification and paternity testing.
Alleles
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Asian People/genetics*
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China
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DNA Fingerprinting
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Gene Frequency
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Genetic Testing
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Genetics, Population
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Genotype
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Humans
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Microsatellite Repeats
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Polymerase Chain Reaction
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Polymorphism, Genetic
;
Probability
9.A monogenic lupus family caused by homozygous deletions of DNASE1L3 gene and literature review.
Wei WANG ; Xiao Lin LI ; Wen Dao LI ; Jun Bin OU ; Si Hao GAO ; Cai Hui ZHANG ; Yu Ling LIU ; Zhi Cai SUN ; Ming Sheng MA ; Hong Mei SONG
Chinese Journal of Pediatrics 2022;60(12):1276-1281
Objective: To report the clinical features and genetic variations of monogenic lupus caused by DNASE1L3 deficiency and to introduce preliminary experience on diagnosis and treatment for this disease. Methods: Clinical data of 3 children from the same pedigree were collected who were diagnosed with DNASE1L3 defect-associated monogenic lupus in August 2020 by Department of Pediatrics, Peking Union Medical College Hospital referred from Department of Pediatrics, Boai Hospital of Zhongshan. DNA was extracted from the peripheral blood of the patients and their parients to perform genetic analysis and confirmation. Six interferon-stimulated genes were relatively quantified to examine the activation of the type I interferon signaling. "DNASE1L3" "systemic lupus erythematosus" and "SLE" were searched in PubMed, Wangfang Data, CNKI databases for related reports from database established date to June 2022. Spectrum of genetic variations and clinical phenotypes were analyzed in combination with this pedigree. Results: Case 1, a 14-year-old girl with edema, hematuria, and heavy proteinuria, presented with membranous nephropathy. Case 2, the 12-year-old younger brother of case 1 with hematologic, cardiac, pulmonary, renal involvement, positive antinuclear antibody, positive anti-double-stranded DNA antibody and low complement C3, manifested with systemic lupus erythematosus. Case 3, the 8-year-old younger sister of case 1 with hematologic, cardiac, pulmonary and renal involvement, positive antinuclear antibody, positive anti-double-stranded DNA antibody, and low complement C3 and C4, manifested with systemic lupus erythematosus. Genetic testing revealed that all 3 patients carried homozygous deletions in exons 3 and 4 on DNASE1L3 gene. Interferon scores were elevated in case 1, 2 and their parents but normal in case 3. All 3 patients were diagnosed with monogenic lupus caused by DNASE1L3 defects. Literature searching identified 10 relevant publications in English and 0 publication in Chinese, involving 42 patients from 18 pedigrees (including the 3 cases from this pedigree). Nine variants were found: c.289_290delAC (p.T97Ifs*2), c.643delT (p.W215Gfs*2), c.320+4delAGTA, c.321-1G>A, Ex5 del, c.433G>A, c.581G>A (p.C194Y), c.537G>A (p.W179X), and Ex3-4 del. The hotspot variants were c.643delT (43% (36/84)) and c.289_290delAC (36% (30/84)). Kidney was affected in 31 cases (74%) of the 42 cases. Among the 25 patients, joints were affected in 16 cases (64%), fever were reported in 13 cases (52%) hematologic system was involved 13 cases (52%), rash was present in 10 cases (40%), intestinal tract was involved in 8 cases (32%), lungs were involved in 6 cases (24%), eyes were involved in 4 cases (16%), and the heart was involved in 4 cases (16%). The 2 cardiopulmonary affected patients from literature showed poor prognosis, with 1 died, and 1 right heart failure. Conclusions: The clinical manifestations of monogenic lupus caused by DNASE1L3 defect are highly heterogenous, primarily with renal, blood, joint, intestinal, and cardiopulmonary involvement. There is no correlation between the genotype and the phenotype. DNASE1L3 defects were predominantly mediated by null varations including nonsense, splicing, frameshift and exon deletions. The hotspot variants are c.643delT and c.289_290delAC. DNASE1L3 defects should be cautioned in early-onset lupus-like patients with renal, joint and hematologic involvement. Cardiopulmonary involved patients require close monitoring for poor prognosis. Copy number variations should be carefully analyzed after negative whole exome sequencing.
Male
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Child
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Humans
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Homozygote
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Complement C3
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Antibodies, Antinuclear
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DNA Copy Number Variations
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Sequence Deletion
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Interferons
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Lupus Erythematosus, Systemic/genetics*
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Antiviral Agents
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Endodeoxyribonucleases
10.A multicenter epidemiological study of acute bacterial meningitis in children.
Cai Yun WANG ; Hong Mei XU ; Jiao TIAN ; Si Qi HONG ; Gang LIU ; Si Xuan WANG ; Feng GAO ; Jing LIU ; Fu Rong LIU ; Hui YU ; Xia WU ; Bi Quan CHEN ; Fang Fang SHEN ; Guo ZHENG ; Jie YU ; Min SHU ; Lu LIU ; Li Jun DU ; Pei LI ; Zhi Wei XU ; Meng Quan ZHU ; Li Su HUANG ; He Yu HUANG ; Hai Bo LI ; Yuan Yuan HUANG ; Dong WANG ; Fang WU ; Song Ting BAI ; Jing Jing TANG ; Qing Wen SHAN ; Lian Cheng LAN ; Chun Hui ZHU ; Yan XIONG ; Jian Mei TIAN ; Jia Hui WU ; Jian Hua HAO ; Hui Ya ZHAO ; Ai Wei LIN ; Shuang Shuang SONG ; Dao Jiong LIN ; Qiong Hua ZHOU ; Yu Ping GUO ; Jin Zhun WU ; Xiao Qing YANG ; Xin Hua ZHANG ; Ying GUO ; Qing CAO ; Li Juan LUO ; Zhong Bin TAO ; Wen Kai YANG ; Yong Kang ZHOU ; Yuan CHEN ; Li Jie FENG ; Guo Long ZHU ; Yan Hong ZHANG ; Ping XUE ; Xiao Qin LI ; Zheng Zhen TANG ; De Hui ZHANG ; Xue Wen SU ; Zheng Hai QU ; Ying ZHANG ; Shi Yong ZHAO ; Zheng Hong QI ; Lin PANG ; Cai Ying WANG ; Hui Ling DENG ; Xing Lou LIU ; Ying Hu CHEN ; Sainan SHU
Chinese Journal of Pediatrics 2022;60(10):1045-1053
Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent
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Brain Abscess
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Child
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Child, Preschool
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Escherichia coli
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Female
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Humans
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Hydrocephalus
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Infant
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Infant, Newborn
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Male
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Meningitis, Bacterial/epidemiology*
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Retrospective Studies
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Streptococcus agalactiae
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Streptococcus pneumoniae
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Subdural Effusion
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beta-Lactamases