BACKGROUND: Bone joint immobilization is often used to prevent the injured tissue from secondary injury.OBJECTIVE: To investigate the effects of knee immobilization on biomechanical changes in rabbit patellar tendon and ultrastructure morphology. METHODS: Twenty adult rabbits were assigned into two groups. The left hindlimbs of rabbits in the immobilized group (n = 10) were immobilized by plaster of paris and two adjustable aluminium splints for 6 weeks, while those left hindlimbs in the control group (n = 10) served as controls. Rabbit knees were immobilized in extension and the ankle was immobilized at 90°flexion for 6 weeks. Then the patellar tendon-bone complex was harvested to observe the biomechanical properties and ultrastructure changes of patellar tendon. RESULTS AND CONCLUSION: After 6-week immobilization, the tensile strength and tangent modulus of patellar tendon-bone complex were decreased to 64.44% and 53.08% of the control values (P < 0.01). However, there was no significant difference in the elongation at failure and the maximum load between the immobilized and control groups. The curves of stress and strain of patellar tendon based on the average material constant were greatly different. The cross-sectional area of patellar tendon was significantly larger in the immobilized group than in the control group (P < 0.01). Smaller collagen fibrils took the predominance in the immobilized group. These results showed that immobilization of knee joint could result in biomechanical changes of patellar tendon and produce influence on patellar tendon.

Hemophagocytic lymphohistiocytosis (HLH)is a severe syndrome characterised by fever,splenomegaly,cytopenia,hyperferritinemia,hypertriglyceridemia and hypofibrinogennemia.HLH includes primary and secondary HLH.Secondary HLH can be encountered in.association with a variety of underlying condtions.Infectious triggers are most commonly due to viral infections,especially EBV infection.This review mainly introduces clinical characteration of several viral infections associated HLH.

After primary EB virus(EBV) infection there are expansions of EBV-specific CD8~+/CD4~+ CTLs responses against lytic peptides and latent peptides in order to control EBV infection. Clinical manifestations of EBV infection are diverse.Its pathogenesis is not clear. The surveillance of EBV specific-immunity plays an important role to control viral replication.There are differences between the CTL responses against lytic peptides and latent peptides. And the migration and activation of EBV specific CTLs with different cell surface molecules play an important role in EBV infection .

Objective To investigate the clinical application of radionuclide pulmonary V/Q scan in the diagnosis,evaluation of the severity and prognosis of pediatric patients with bronchiolitis obliterans (BO).Methods From February 2005 to April 2011,30 BO pediatric patients (18 males,12 females,age range:7 months-14 years) were prospectively recruited for radionuclide pulmonary V/Q scan.The relationship between the radionuclide pulmonary V/Q scan and clinical presentations was analyzed.Results Perfusion defects were seen in 25 cases (83.3％) and ventilation defects in 27 cases(90.0％).Among the 27patients with abnormal V/Q scan,matched abnormalities were seen in 13 cases (48.1％),mismatched in 1 case (3.7％) and reverse mismatched in 13 cases (48.1％).Of the 3 patients with mild disease,1 had normal V/Q scan while 2 showed V/Q defect in 1 segment.In the 10 patients with moderate disease,the mean number of segments having perfusion and ventilation defects was 3.7 and 5.6,respectively.In the 17 patients with severe disease,the mean number of segments having perfusion and ventilation defects was 6.0 and 8.2,respectively.During follow-up,all 8 patients with progressive disease presented with severe impairment of pulmonary perfusion and ventilation;while the 16 patients with improvement had mild impairment of pulmonary perfusion and ventilation or normal V/Q scan.Conclusion Radionuclide pulmonary V/Q scan is valuable for diagnosis,evaluation of the disease severity,and prognosis in pediatric patients with BO.

The Epstein-Barr virus (EBV) is a gamma herpes virus associated with several types of malignancies. The EBV encodes viral microRNAs (miRNAs) that can target genes within cells. The EBV participates in signal transduction as well as the proliferation and differentiation of cells. How the target genes and functions of EBV-encoded miRNAs contribute to the pathogenesis of EBV is an important research topic. Some target genes have been validated since EBV-encoded miRNAs were discovered and, in this article, we summarize them and their functions.
Animals ; Epstein-Barr Virus Infections ; genetics ; metabolism ; virology ; Herpesvirus 4, Human ; genetics ; physiology ; Humans ; MicroRNAs ; genetics ; metabolism ; RNA, Viral ; genetics ; metabolism

Objective To explore the current status of healthcare-associated infection (HAI)and antimicrobial use in a children’s hospital.Methods Prevalence rates of HAI and antimicrobial use among hospitalized patients at 0∶00—24∶00 of May 1 ,2014 were investigated by combination of bedside visiting and medical record reviewing. Results A total of 1 027 patients were investigated,8 patients developed 10 times of infection,prevalence rate of HAI was 0.78%,prevalence case rate was 0.97%.HAI mainly occurred in patients in blood center (n =4),the main infection site was respiratory tract(upper respiratory tract,n=2;lower respiratory tract,n=2),antimicrobial usage rate was 62.12%.Antimicrobial usage rate,purpose of antimicrobial use,and combination use of antimicro-bial agents among different departments were all significantly different(all P <0.05).The departments with top 3 antimicrobial usage rates were neonatal center(89.69%),emergency center(76.00%),and comprehensive depart-ment(73.91 %);except department of ophthalmology-otorhinolaryngology-stomatology (preventive antimicrobial use accounted for 57.89%)and department of surgery(therapeutic antimicrobial use accounted for 26.32%),the other departments mainly used therapeutic antimicrobial agents;department of ophthalmology-otorhinolaryngology-stoma-tology,heart center,and neurological rehabilitation center mainly adopted single medication treatment (all >95%), two-drug combination rate in neonatal center accounted for 48.28%,three-drug combination rate in blood center ac-counted for 30.30%.Conclusion Routine surveillance on departments and sites of high HAI incidence should be in-tensified in children’s hospitals,training on knowledge of HAI among health care workers should be strengthened, and antimicrobial should be used rationally.

Objective To describe the clinical characteristics of acute lower respiratory tract infection (ALRTI)caused by human coronavirus (HCoV)in children.Methods Three thousand five hundred and three hospi-talized children diagnosed with ALRTI in Beijing Children′s Hospital from March 2007 to February 201 3 were re-viewed.Nasopharyngeal aspirate(NPA)specimen was collected from each patient.Reverse transcription (RT)-poly-merase chain reaction(PCR)methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV),rhinovirus (RV),parainfluenza virus (PIV)type 1 -4,influenza virus type A and B (IFA,IFB),adeno-virus (AdV),enterovirus (EV),HCoV,human metapneumovirus (hMPV)and human bocavirus (HBoV).Serum anti-bodies of mycoplasma and sputum bacterial culture were also detected.Only HCoV positive patients were analyzed in this study.Results Eleven of 3 503 patients were proved as HCoV -positive in NPA specimens.Of the 1 1 children,8 cases were male and 3 cases were female (2.71 .0).The median age was 3 months.The clinical symptoms of HCoV infection included cough (1 1 /1 1 cases,1 00.0%),wheezing (1 0 /1 1 cases,90.9%),fever (6 /1 1 cases,54.5%)and poor appetite (7 /1 1 cases,63.6%).Wheezing (8 /1 1 cases,72.7%)and moist rale in inspiratory phase (5 /1 1 ca-ses,45.4%)could be heard.Most patient′s chest X -ray showed bronchopneumonia.Full blood count displayed that leukocyte was in the normal range.Conclusions Respiratory tract infection with HCoV -positive will be easier to spread to ALRTI,especially in infants less than 1 year old.The symptoms include fever,cough and wheezing,but poor appetite and diarrhea can also be detected.

The global morbidity of invasive fungal diseases (IFD) tends to increase, especially in immunocompromised people.Due to the atypical symptoms, unclear etiological mechanism, and emerging antifungal resistance, IFD challenge current clinical diagnosis and treatment.The World Health Organization (WHO) developed the first WHO fungal priority pathogens list in 2022.The most concerning fungal pathogens were listed and summarized to promote further understanding of the epidemiology of IFD and antifungal drug resistance.It is hoped to provide a basis for the prevention and interventions of IFD.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

Objective To analyze the relationship between the level of serum ferritin (SF)and the severity of community acquired pneumonia (CAP)in children,and to explore the timing of glucocorticoid therapy for children with CAP.Methods Retrospective analysis was performed on the clinical data of 738 children with CAP who were hospitalized at the Department of Respiratory,Beijing Children's Hospital,Capital Medical University from January 2014 to December 2015.All patients were divided into a mild group and a severe group based on the severity of CAP,and the levels of SF,C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),white blood cell (WBC) and D-dimer were compared between the 2 groups.In addition,the analysis of receiver operating characteristic (ROC) curve was performed to study the usefulness of SF as severity indicators for CAP,and to learn the relationship between the level of SF and the glucocorticoid therapy in children with CAP.Simultaneous analysis of SF and CRP,WBC,ESR,D-dimer was made at the same time.Results (1) There were all 738 children enrolled into this study.There were 442 children in the mild group and 296 children in the severe group.There was no significant difference in age and sex between the mild group and the severe group(all P ＞ 0.05).(2)Comparisons between the mild group and the severe group were as follows:days of hospitalization [10.0 (9.0,13.0) days],duration of fever [10.0 (7.0,10.0) days] and heat peak [39.9 ℃ (39.1 ℃,40.1 ℃)] in the severe group,which had significant differences than those in the mild group [days of hospitalization 7.0 (6.0,9.0) days,duration of fever 7.0 (5.0,10.0) days and heat peak 39.3 ℃ (39.0 ℃,39.8 ℃)] (all P ＜ 0.05).The levels of SF [229.0 (150.0,436.2) μg/L],CRP [30.00 (9.84,78.20) mg/L],WBC [8.44 (5.91,12.6) × 109/L],ESR [30.5 (16.0,49.0) mm/1 h] and D-dimer [0.871 (0.317,2.532) μg/L] in the severe group were significantly higher than those in the mild group [SF:98.0 (68.2,136.1)μg/L,CRP:11.50 (5.77,11.50) mg/L,WBC:7.59 (5.87,10.1) × 109/L,ESR:23.0 (13.0,36.3) mm/1 h and D-dimer 0.232 (0.159,0.407) μg/L],and the differences were statistically significant (all P ＜ 0.05).(3) The levels of SF [258.5 (177.8,404.9) μg/L] and CRP [8.0 (8.0,16.5) mg/L] in CAP children in the recovery phase were significantly lower than those in the acute phase [SF:912.1 (418.7,1 380.3) μg/L,CRP:47.4 (18.8,105.8)mg/L].(4)The level of SF had significantly positive correlations with CRP,ESR,D-dimer (r =0.485,0.286,0.611,all P ＜ 0.05).(5) The cutoff value for SF,D-dimer for diagnosing severe pneumonia was 168.0 μg/L (sensitivity 70.6％,specificity 86.2％),and 0.616 μg/L (sensitivity 58.1％,specificity 87.1％).(6) There were 17.2％ cases (76/442 cases) in the mild group and 52.7％ cases (159/296 cases) in the severe group who received systemic glucocorticoid therapy.Conclusion The level of SF was correlated with the severity of CAP in children,and the level of SF in patients in recovery phase was significantly lower than that in the acute phase.When SF ≥ 168.0 μg/L,D-dimer ≥0.616 μg/L,attention should be paid to the possibility of severe CAP,regarding the indication for systemic steroid therapy for CAP in children.