Objective To evaluate clinical factors associated with laboratory-confirmed influenza infection and probe into the effects of different influenza-like illness(ILI) definitions on influenza surveillance in hospitalized children. Methods The influenza surveillance on the hospitalized children with acute respiratory infection was carried out in Soochow university affiliated children’s hospital from October 2017 to May 2018. The definition of influenza-like illness(ILI), which proposed by world health organization (WHO), the European center for disease prevention and control (ECDC) and ministry of public health of China, was analyzed to determine the area under receiver operating characteristic curve (ROC), sensibility, specificity, and the positive and negative predictive values of the ILI definition using the laboratory evidence of influenza virus infection as golden criteria. Logistic regression model was employed to explore the risk factors of the laboratory confirmed influenza infection among the hospitalized children. Results Of the enrolled 1 459 hospitalized children, 204(14.0%) were lab-confirmed influenza cases. The ECDC definition had the highest sensitivity (91.7%, 95% CI: 87.9%-95.5%) but the lowest specificity (44.6%, 95% CI: 41.9%-47.4%). The WHO definition had the lowest specificity (70.6%, 95% CI: 64.3%-76.8%). China’s definition was the most discriminant definition with relatively high sensitivity (91.2%, 95% CI: 87.3%-95.1%) and specificity (51.5%, 95% CI: 48.8%-54.3%), and its positive area under curve value (71.2%, 95% CI: 67.9%-74.5%) was the highest. Multivariate analysis model showed that the detection rate of influenza virus in children with fever (≥38 ℃) was higher than that in children without fever (OR=7.03, 95% CI:3.89-12.70). Conclusions It is suggested to adopt China’s ILI definition to get better output during influenza surveillance among hospitalized children.

A new electrochemical method for telomerase activity assay was developed on the basis of hybridization chain reaction ( HCR)-assisted multiple signal amplification, aiming at improving the sensitivity and specificity of telomerase assay. The experiments utilized HeLa cells as original source of the telomerase in the electrochemical studies. The telomerase primer was firstly self-assembled on the surface of gold electrode. The telomerase catalyzed the elongation of the primer, producing the complementary sequences of hairpin probe H1. In this case, HCR was then initiated by interacting with two hairpin probes H1 and H2. Because both H1 and H2 were modified by biotin, horseradish peroxidase could be captured on the electrode surface through the high-affinity interaction between biotin and streptavidin, catalyzing the oxidation of o-phenylenediamine to produce 2,3-diaminophenazine. Therefore, the telomerase assay was realized by tracing the electrochemical signals with differential pulse voltammetry. This electrochemical method was of high efficiency and feasibility for detecting telomerase activity, and could trace the telomerase activity down to 10 cells/mL HeLa cells with a wide linear range. Besides, it could also easily distinguish the target enzyme from the control proteins with high specificity.

OBJECTIVETo explore the clinical effects of VSD combined with continual irrigation in treating the infection of limbs fracture after internal fixation.

METHODSFrom March 2010 to June 2015, 10 patients with infection of limbs fracture after internal fixation were treated with VSD combined with continual irrigation. There were 7 males and 3 females, aged from 11 to 58 years with an average of 34.4 years. Course of disease was from 1 to 8 months with an average of 4.8 months. Postoperative infection occurred in fractures of ulna and radius of 4 cases, tibiofibular fractures of 3 cases, calcaneal fractures of 2 cases, femoral fractures of 1 case. Eight infections were open fracture and 2 infections were close fracture. In additon to above treatment, antibiotics, dressing changing or skingrafting were used in the patients. Informations of wound surface healing, change dressings, original infection focus were observed.

RESULTSAll infections got control, the wound healing after change dressings or skingrafting, and no complications such as osteomyelitis were found. The mean treatment time was 38.4 days(ranged, 29 to 45 days) and replacement times was 2.2 times(ranged, 1 to 4 times). All patients were followed up, no recurrent infections were found at 1 year after fracture healing.

CONCLUSIONSVSD combined with continual irrigation can effectively decrease the incidence of complications and promote the wound growth, healing and considerably shorten the healing time. It is an effective method for the treatment of infection of limbs fracture after internal fixation.

OBJECTIVETo explore the clinical effects of Mobi-C cervical artificial disc replacement (CADR) and anterior cervical decompression and fusion (ACDF) in treating single cervical disc herniation.

METHODSFrom June 2009 to June 2012, the clinical data of 27 patients with single cervical disc herniation were retrospectively analyzed. There were 18 males and 9 females, aged from 30 to 62 years old with an average of 46.7 years. Of them, 12 patients were treated with CADR (CADR group) and 15 patients with ACDF (ACDF group). All patients had pain and numbness in neck, shoulder and upper limbs, and courses of disease was from 1 to 13 months with an average of 2.4 months. The data of clinical evaluation and questionnaire survey about quality of life were collected before operation, postoperative at 1 week and final follow-up. Odom criterion was used to evaluate postoperative effect. Visual analogue scale (VAS) was used to record pain levels. Neck disability index (NDI) and health questionnaire SF-36 were used to assess the quality of life.

RESULTSNo complications about nerve and blood vessel were found and the patients were followed up from 6 to 30 months, with an average of 16 months. One week after operation, 10 cases got excellent results and 2 good in CADR group; 5 cases got excellent results and 10 good in ACDF group; there was significant difference between two groups (P<0.05). At final follow-up, 10 cases got excellent results and 2 good in CADR group; 12 cases got excellent results and 3 good in ACDF group; there was no significant difference between two groups (P> 0.05). Pain of upper limbs had obviously relieved between two groups at 1 week after operation and final follow-up (P<0.05). VAS of neck and NDI in CADR group had decreased respectively from preoperative 3.58±0.79, 23.42±6.36 to 0.58±0.51, 5.42±1.68 at 1 week after operation (P<0.05); but the index in ACDF group was no obvious at 1 week after operation. At final follow-up, VAS of neck and NDI and SF-36 score were obviously improved than preoperation (P<0.05) between two groups.

CONCLUSIONMobi-C CADR retains the movement unit in the decompression segment and can quickly recover normal action for patients. Using CADR method has a good curative effect in the early phase, and the clinical effect is reliable, may improve the quality of life.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Total Disc Replacement ; methods ; Visual Analog Scale

OBJECTIVETo identify the disease-causing gene in a four-generation Chinese family with 9 members affected with primary congenital lymphoedema (PCL, also known as Milroy disease).

METHODSLinkage analysis was performed with a few microsatellite markers flanking the candidate genetic loci for PCL, including 3 known genes associated with autosomal dominant PCL. For mutation analysis, VEGFR3 gene was sequenced with DNA from the proband. Direct DNA sequencing of exon 25 of the VEGFR3 gene was performed in all family members.

RESULTSThe disease gene in the family was mapped to chromosome 5q35.3 with a maximum Lod score of 2.07. Direct DNA sequencing of VEGFR3 gene revealed a heterozygous C to T transition at nucleotide 3341, resulting in p.Pro1114Leu mutation. The p.Pro1114Leu mutation co-segregated with all affected individuals in the family.

CONCLUSIONThis study identified a C3341T (p.Pro1114Leu) mutation in the VEGFR3 gene in a Chinese family with PCL, provided evidence that VEGFR3 mutation can cause PCL in Chinese.

Amino Acid Substitution ; Asian Continental Ancestry Group ; genetics ; Cataract ; genetics ; Genetic Loci ; Humans ; Lod Score ; Lymphedema ; genetics ; Microsatellite Repeats ; genetics ; Mutation ; Point Mutation ; Vascular Endothelial Growth Factor Receptor-3 ; genetics

Objective To observe the changes of multi-noninvasive indexes including endothelial function, arterial flexibility, carotid intima-media thickness (IMT) and serum inflammatory cytokines in patients with mild coronary stenosis. Methods One hundred and five patients were divided into three groups according to the result of coronary angiography: coronary heart disease (stenosis ≥ 50% in at least one coronary segment), mild coronary stenosis (stenosis < 50% in at least one coronary segment) and control group (normal coronary). Brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI), reflecting arterial flexibility and the lower extremity vascular disease respectively, were measured by a Colin system, carotid artery IMT was detected echocardiographically. Serum levels of NO, vWF, hs-CRP were measured before coronary angiography in all patients. Results baPWV [(1482±155) cm/s vs. (1249±158)cm/s] and carotid IMT [(0.88±0.18)mm vs. (0.72±0.20) mm] were significantly higher while serum levels of NO [(64±17) μmol/L vs. (83±17) μmol/L] was significantly lower in mild coronary stenosis group than those in control group (all P<0.05). vWF, ABI and hs-CRP were similar between the two groups (all P> 0.05). Logistic regression analysis showed that NO, baPWV, smoking are independent predicting factors for mild coronary stenosis (all P < 0.05) . Conclusions Endothelial dysfunction, reduction of the arterial flexibility as well as increased serum inflammation were associated with mild coronary stenosis.

OBJECTIVETo investigate the effects of dendritic cells (DCs) infected with adenovirus vector encoding mTERT on induction of mTERT antigen specific immunity against H22 hepatoma in vivo.

METHODSForty Bal B/c mice were subcutaneously immunized with Ad-mTERT infected DC. Cytotoxicity of mTERT specific CTL was determined by 51Cr release assay. IL-2 and IFN-gamma were tested by ELISA. IFN-gamma ELISPOT assays were performed for measuring antigen specific IFN-gamma production by T cells. Tumor size and survival of the immunized mice were recorded and evaluated whether preexisting hepatoma metastases could be supressed after immunization with mTERT-expressing DCs.

RESULTSThe lytic activity of CTL, IL-2 (871.25 pg/ml), IFN-gamma (169.15 ng/ml) and IFN-gamma secreting cells (378/10(6) spleen cells) elicited by the Ad-mTERT infected DCs were much stronger and higher than that by Ad-GFP group (131.6 pg/ml, 15.4 ng/ml, 36/10(6) spleen cells, P<0.05), DC group (71.3 pg/ml, 10.5 ng/ml, 21/10(6) spleen cells, P<0.05), PBS group (65.8 pg/ml, 7.4 ng/ml, 18/10(6) spleen cells, P<0.05). In prophylaxis and treatment experiment the Ad-mTERT/DCs immunized mice lived significantly longer than other groups, demonstrating that primary DCs were genetically modified to express the mTERT antigen and could suppress the tumor growth.

CONCLUSIONAdenovirus vector mediated mTERT infected DCs can effectively induce mTERT antigen specific antitumor activity, and can induce protective and therapeutic antitumor immunity.

Adenoviridae ; genetics ; Animals ; Cell Line, Tumor ; Dendritic Cells ; immunology ; metabolism ; Female ; Genetic Vectors ; Immunization ; Interferon-gamma ; Interleukin-2 ; Liver Neoplasms, Experimental ; immunology ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Recombinant Proteins ; genetics ; metabolism ; T-Lymphocytes, Cytotoxic ; immunology ; Telomerase ; immunology ; metabolism ; Tumor Burden

OBJECTIVETo observe the effect of orthotopic liver transplantation (OLT) on hepatopulmonary syndrome (HPS) and investigate risk factors predicting the prognosis of OLT.

METHODSTwenty-six cases of HPS and 30 cases of non-HPS were analyzed treated from April 2004 to January 2006. Survival rates after OLT were compared and risk factors predicting the prognosis of OLT in HPS were researched by univariant and COX analysis.

RESULTSThe 28 days survival rate in HPS after OLT was 76.9% (20/26), half a year survival rate and one year survival rate were both 61.5% (16/26). Whereas the one year survival rate of patients without HPS was 100%(P < 0.05). By univariant analysis, shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs, PaO2 and PaO2/FiO2 in room air before operation were relative to the prognosis of peri-operative period and half a year outcome after OLT in HPS (P < 0.05). Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs (OR = 1.182, P = 0.001), and mechanical ventilation time (OR = 1.003, P = 0.053) after OLT were independent risk factors predicting the prognosis of OLT in HPS by COX analysis. Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs > or = 28.4%, or PaO2 < or = 56 mm Hg (1 mm Hg = 0.133 kPa) before OLT predicted the poor outcome of OLT in HPS. The sensitivity were 83.3% and 85.0% respectively, and the specificity were 95.0% and 83.3% respectively.

CONCLUSIONSOLT is an effective treatment for HPS.Shunt of (99)Tc(m)-labeled macro-aggregated albumin in lungs before OLT and mechanical ventilation time after OLT were independent risk factors for the prognosis of OLT in HPS.

Adult ; Aged ; Female ; Follow-Up Studies ; Hepatopulmonary Syndrome ; surgery ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Survival Analysis ; Treatment Outcome

OBJECTIVETo evaluate the prophylactic efficacy of adefovir dipivoxil (ADV) for post-transplant recurrence of hepatitis B virus (HBV) with lamivudine-resistant YMDD mutation in liver recipients.

METHODSFrom March 2004 to May 2006, 20 patients with chronic hepatitis B associated with YMDD mutant HBV prior to liver transplantation received treatment with ADV and additional intramuscular hepatitis B immunoglobulin (HBIG) for prevention of post-transplant graft reinfection. The liver function, serum HBsAg, anti-HBs (HBIG), HBeAg, anti-HBc, anti-HBe, HBV DNA and creatinine were examined in all the patients before and after the transplantation.

RESULTSThe median follow-up duration of these patients after the transplantation was 33.5 months. Nineteen patients survived and one patient died of recurrent hepatocellular carcinoma. There was significant difference in YMDD mutation rate between the patients with HBV-DNA over 10(6) copies/ml and those with HBV-DNA less than 10(6) copies/ml (12.4% vs 2.5%, P < 0.05). HBV-DNA was undetectable at 4 weeks after the transplantation in 95.0% of the patients (19/20) and at 6 months in one case. No recurrence of hepatitis B was detected by long-term regular testing of HBsAg, HBeAg and HBV-DNA. Serum creatinine increased in 1 case 1 year after the use of ADV.

CONCLUSIONADV offers protection against recurrence of HBV with YMDD mutation after liver transplantation with only mild nephrotoxicity, but renal function monitoring during the use of ADV is still necessary.

Adult ; Aged ; Amino Acid Motifs ; Antiviral Agents ; therapeutic use ; DNA-Directed DNA Polymerase ; genetics ; Drug Resistance, Viral ; Female ; Hepatitis B ; prevention & control ; Hepatitis B virus ; genetics ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; surgery ; virology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Mutation ; Recurrence

BACKGROUNDThe main therapeutic treatments for hepatic artery complications after orthotopic liver transplantation (OLT) include thrombolysis, percutaneous transluminal angioplasty, stent placement, and liver retransplantation. The prognosis of hepatic artery complications after OLT is not only related to the type, extent, and timing but also closely associated with the selection and timing of the therapeutic methods. However, there is no consensus of opinion regarding the treatment of these complications. The aim of this study was to determine optimal treatment for hepatic artery complications after OLT.

METHODSThe clinical data of 25 patients diagnosed with hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) between October 2003 and March 2007 were retrospectively reviewed. Treatments included liver retransplantation and interventions which contain thrombolysis, percutaneous transluminal angioplasty and stent placement.

RESULTSAmong five patients with HAT, 3 were treated with thrombolysis. One recovered, one died after thrombolysis and another one died of multi-organ failure after retransplantation because of recurrent HAT. The remaining 2 patients underwent successful retransplantation and have survived after that. Among 12 patients presented with HAS within 1 month postoperatively, 2 patients underwent retransplantation due to irreversible liver failure and another 10 patients were treated with interventions. The liver function failed to improve in 3 patients and retransplantations were performed in 4 patients after stent placement because of ischemic cholangitis. Among 6 patients undergoing liver retransplantations, two died of intracranial hemorrhage and infection respectively. Eight patients presented with HAS after 1 month postoperatively, 5 patients were treated with interventional management and recovered after stent placement. Among another 3 patients presented with HAS, 2 patients' liver function was stable and one patient received late liver retransplantation due to ischemic bile duct lesion.

CONCLUSIONSIndividualized therapeutic regimens should be adopted in treating hepatic artery complications after OLT, according to postoperative periods, types and whether ischemic bile duct lesion exists or not. Liver retransplantation is the best treatment for patients with hepatic artery thrombosis. Interventional treatments of late HAS without irreversible liver failure or bile duct ischemia are appropriate, whereas retransplantation is recommended for early HAS.

Adult ; Aged ; Constriction, Pathologic ; Female ; Hepatic Artery ; pathology ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Thrombosis ; therapy