Objective To explore the characteristics of clinic and epidemiology of neonatal respiratory syncytial virus(RSV) pneumonia in newborn infants.Methods Three hundred and nine neonates(male 196,female 113) who were admitted to children's hospital of Fudan University and identified as having RSV pneumonia from Jan.2004 to Dec.2008 were enrolled.RSV antigen was detected in exfoliated respiratory cells by direct immunofluorescence.All the clinical data were collected and subjects and they were divided into different groups based on path of infection,gestational age and RSV status.Results From case notes over the 5 years,309 eligible neonates with RSV infection were identified.Male term neonates were more likely to acquire infection,as compared to female,1.71.0.The incidence of RSV infection peaked in winter and spring.Compared with community acquired infection group,hospital acquired infection group had more premature infants(23.2% vs 8.7%,P=0.002),lower birth weight[(3 010.8?852.8) g vs(3 153.2?943.4) g,P=0.026],much longer mean length of hospital stay[(19.0?8.0) d vs(12.2?4.5) d,P=0],more expensive cost[(5 646.4?3632.2) RMB vs(4 175.8?2 879.2) RMB,P=0] and later occurrence day[(21.3?8.6) d vs(15.8?6.0) d,P=0].Compared with simple RSV infection group,mixed infection group had more expensive cost[(6 063.1?3 085.4) RMB vs(4 513.2?3 860.8) RMB,P=0.047] and more oxygen use(40.0% vs 25.7%,P=0.006).The clinical characteristics of patients with RSV pneumonia varied.Preterm group compared with term group more frequently exhibited apnea and cyanosis(20.0% vs 0.7%,42.9% vs 22.7%),respectively.Forty-two percent of them had bacterial infection,while 13.3% of them had infection of other part of body.The prognosis of most RSV(99.0%) infections was good.Conclusions RSV was an important cause of respiratory tract infections during the last five years.Clinical characteristics of RSV infections were atypical.Hospital acquired RSV infection was more severe than the community acquired infection in neonates.There are no specific,effective interventions for treating RSV infections,so preventive measures are most important.

Adult ; Ear Neoplasms ; Eustachian Tube ; pathology ; Humans ; Male ; Teratoma

Bibliometrics ; China ; Occupational Exposure ; Poisoning

Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%(28/173); the coupled group was 9.6%(21/219), P

Objective To explore the value of Toll-like receptor 2(TLR2) on the diagnosis of neonatal septicemia especially for the early diagnosis.Methods Twenty-two newborns with septicemia were divided into 2 groups according to the time of onset:early-onset group(n=12) and late-onset group(n=10).Another 14 non-infectious newborns were collected as control group.The TLR2 mRNA in peripheral blood was detected by real-time polymerase chain reaction,and mononuclear cells were isolated by the density gradient centrifuga-tion;the C reaction protein(CRP) was detected,and the co-relationship of the indexes was analyzed by Pearson correlation analysis.Results 1.The level of CRP in early-onset group were(157.89?32.96) ng?L-1,and(89.78?16.24) ng?L-1 in late-onset group,and there was significant difference between both groups(P=0.001);(6.91?1.20) ng?L-1 in control group,which was significantly lower than that in early-onset group and late-onset group(P=0.000,0.001).2.The expression of TLR2 mRNA in early-onset group and late-onset group was(57.38?10.72)?1012 copies?L-1and(32.74?4.65) ?1012 copies?L-1,which was significantly higher than that in control group[(4.12?0.68) ?1012 copies?L-1].3.CRP is positively correlated with TLR2 mRNA(C=0.972,P=0.000).Conclusions TLR2 expression is proven to be related to both the level of CRP and the stage of onset and may play a key role in the pathogenesis of neonatal septicemia.Detection for TLR2 may assist the earlier diagnose of atypical neonatal septicemia.

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.

Objective To explore the dynamic expressions and the significance of Notch/Jagged signal pathway in rat model of hepatic fibrosis. Methods A total of 42 healthy male SD rats were randomly divided into normal control group (n=6) and model group (n= 36). The model group was further divided into six subgroup according to different time points: subgroups of 4 days, 1, 2, 4, 6 and 8 weeks with six rats in each subgroup. The rat model of hepatic fibrosis was induced by dimethylnitrosamine (DMN). The serum levels of alanine aminotransferase (ALT), aspertate aminotransferase (AST), albumin (Alb) and hyaluronic acid (HA) were detected dynamically after 4 days, 1,2,4,6 and 8 weeks of injection. The liver tissues were observed under optical microscope after HE and Masson staining. Notch-1, Jagged-1 mRNA and protein in liver were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. The comparison of means among groups was done by univariate ANOVA. Results The hepatic fibrosis model was successfully induced by DMN injection and pseudolobules were found after 4 weeks of injection. The serum levels of ALT, AST, Alb and HA were all increased after 4 day of injection and peaked at week 4 which were all significantly higher than those in control group (F=83.10, 104.63, 54.24, 203.81,respectively; all P＜0.05). The expressions of Notch-1, Jagged-1 mRNA and protein in model group were all significantly increased than those in control group (F=282. 44, 369.14, 374.17, 256. 14,respectively;P＜0. 01). And the expressions of Notch-1, Jagged-1 were closely correlated with the hepatic fibrosis stages and transforming growth factor β1 (TGFβ1) expression (r=0. 821, 0. 917,0. 767,0. 844, respectively; P＜0. 01 ). Conclusions The Notch/Jagged pathway may participate in the development of hepatic fibrosis, which is closely correlated with the progression and severity of liver fibrosis.

Objective To investigate the dynamic expressions of exchange protein directly activated by cyclic adenosine monophosphate (cAMP) (Epac) in rat model of hepatic fibrosis(HF).Methods Forty-two male SD rats were divided into control group (n = 6) and model group (n = 36)which was divided into six subgroups of day 4, week 1, week 2, week 4,week 6 and week 8 with six rats in each subgroup. The rat model of HF was established by intraperitoneal injection of dimethylnitrosamine (DMN). The pathological changes of liver were observed by Hematoxylin-Eosin and Masson staining. Reverse transcription-polymerase chain reaction (RT-PCR),immunohistochemistry and Western blot were employed to detect the mRNA and protein expressions of Epac1, Epac2 and transforming gronth factor (TGF)β1 during the process of modeling and localization in the liver. The statistical analysis was done using one-factor ANOVA, LSD-t test,Dunnett T3 test and Pearson linear correlation analysis. Results Rat model of liver fibrosis was established successfully. In control group, Epac1 (0. 031 28±0. 008 96) and Epac2 protein (0.034 43±0. 002 45) mainly expressed in the cytoplasm of hepatocytes. In model group, the level of Epac1 decreased at day 4 (0. 023 97±0. 003 81) and week 1 (0. 015 81±0. 002 48) ,then began to increase at week 2 of modeling and peaked at week 6 (0. 039 54±0. 001 43), which had statistical significance compared to the control group (t= 5.47,11.58 and - 6.18, respectively; all P＜0.05). Epac2 protein expression declined after modeling, reached the lowest level at week 4 (0. 011 21 ±0. 001 32), which had statistical significance compared to the control group (t= 24. 50, P＜0. 05). TGFβ1 protein expression increased after modeling and peaked at week 4 (0. 011 30±0.001 03) which had statistical significance (t= -23. 36, P＜0. 05) compared to the control group (0. 002 08 ±0. 000 18). The expressions of Epac1, Epac2 and TGFβ1 mRNA were consistent with the trend of protein levels.Correlation analysis showed that Epac1 protein was positively correlated with the course of HF (r =0. 703, P＜0.01 ), while Epac2 protein was negatively correlated (r = - 0. 409, P＜0.05). Conclusions During the progression of HF, Epac1 expression tends to decrease firstly and increase afterwards,while Epac2 expression declines continually. Epac may be involved in the pathogenesis of HF.