Objective To investigate the imaging features and the treatments of ischemic cerebrovascular disease with unruptured intracranial aneurysms.Methods The clinical data of 23 patients of ischemic cerebrovascular disease with unruptured intracranial aneurysms ( unruptured group) and 147 patients of hemorrhagic cerebrovascular with ruptured intracranial aneurysms ( ruptured group) were retrospectively analyzed.Results There were no statistical significances between the two groups baselines such as age, gender, hypertension, diabetes, hyperlipidemia, heart disease, smoking, drinking alcohol (all P>0.05).There were 16 patients (69.6%) with single intracranial aneurysm and 7 patients (30.4%) with multi-intracranial aneurysms in the unruptured group, and the number of intracranial aneurysms were 34.There were 125 patients (85%) with single intracranial aneurysm and 22 patients ( 15%) with multi-intracranial aneurysms in the ruptured group, and the number of intracranial aneurysms were 170.There was no statistical significance of single aneurysm and multi-aneurysms percentage between the two groups (P>0.05).The maximum aneurysm diameter and the percentage of large aneurysms, dissecting aneurysms of the unruptured group were significantly greater than the ruptured group; and the percentage of small-middle aneurysms and saccular aneurysms were significantly smaller than the ruptured group ( all P<0.05 ) .In the unruptured group, 5 cases were treated with intervention treatment and 1 case was treated with aneurysm clip surgery, all of which recovered well after surgery;6 cases were treated with Plavix antiplatelet therapy, 5 cases were treated with Aspirin antiplatelet therapy, cerebrovascular disease events were not found of which followed-up for 6 months;6 cases were not taken antiplatelet therapy, and 1 case of which followed-up and occurred cerebral infarction.In the ruptured group, 46 cases were treated with intervention treatment, 2 cases of which were died;101 cases were treated with aneurysm clip surgery, 6 cases of which were died.Conclusions Small-middle aneurysms are more commonly occurred in patients of ischemic cerebrovascular disease with unruptured intracranial aneurysm, however, the maximum aneurysm diameter of which is significantly bigger than patiehts of hemorrhagic cerebrovascular with ruptured intracranial aneurysms.Most of unruptured aneurysms which had duty relationship with cerebral ischemic events are dissecting aneurysms and saccular aneurysms.Intervention treatment of unruptured intracranial aneurysms is relatively safe and effective.

Objective To obtain the molecular epidemiology of human Parechovirus (HPeV)infections m children with central nervous system (CNS)-related disease and sepsis,as well as understand the pathogenic properties of HPeV infections by detecting HPeV in cerebrospinal fluid (CSF) and blood samples.Methods From January to December in the year of 2009,a total of 359enterovirus-negative specimens including 210 CSF and 149 blood samples were collected from 328children ＜14 years of age who were hospitalized for CNS-related disease and sepsis at Children's Hospital,Fudan University,Shanghai,China.HPeV was detected by nested reverse transcription polymerase chain reaction (RT-PCR),and then directly genotyped by sequencing nested RT-PCR product of VP3/VP1 region.Ninty-nine blood samples from healthy children were collected as controls during the same period.Results Twenty-seven children (8.2％) were HPeV positive in 328 children.HPeV infections were found in all age groups of children and the highest frequency was seen in children ＜3 months old (18.2％,12/66).HPeV was detected in several months,with the peak in December (18.8％,9/48).Of all the positive samples,20 were genotyped successfully and identified to be HPeV1.No HPeV infections were found in blood of healthy controls.ConclusionsHPeV is the pathogen of CNS infections and sepsis in children.HPeV screening should be enrolled in the routine virus testing in specimens obtained from children.HPeV1 is the prevalent type in children in the year of 2009 in Shanghai.

Objective To investigate the clinical and pathological diagnosis of cutaneous calcifying epithelioma.Methods Thirty cases of calcified epithelioma were diagnosed and treated by our hospital.The clinical features and pathological features were retrospectively reviewed.Results The main pathological features of the tumor were that the main tumor (basophilic cells) basal cells and shadow cells were mixed composition,combined with ossification and calcification and with no recurrence after surgical resection.Conclusion The clinical manifestations of calcifying epithelium are lack of characteristics and diverse pathological features.It is necessary to make the correct pathological diagnosis with the time,location and imaging of tumor growth.

OBJECTIVETo investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles.

METHODA retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR (RT-PCR) was adopted to detect sputum specimens from suspected patients with measles,who were selected randomly,the sequence of the part of the PCR products was analyzed.

RESULT(1) Clinical and epidemiological data: Totally were 182 children with measles (125 males, 57 females) were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months (69. 8%). The prevalence season was from April to August, while the peak month was April and May (22. 5%, 23. 1%). Among 182 hospitalized children, only 11 cases underwent measles vaccination (6. 0%), and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases (91. 8%) had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population (8. 45%, 6/71) and the settled children (29.4%, 5/17, χ =8. 11 P =0. 004). In total, 24 cases (13. 2%) had definite measles exposure history, with 153 cases (84. 1%) of unknown origin,5 cases (2.7%) without any history of contact. (2) Clinical manifestations: All the 182 patients had fever (100%) and obvious rashes (100%), among them 145 cases had body temperature higher than 39 °C (79. 7%). The fever period ranged from 2 to 38 days. Among 182 hospitalized children,165 cases (90. 7%) had typical measles,17 cases had atypical measles. Among the 17 cases, two had severe measles, one had heterotypic measles. (3) The common complica tions: 96 cases had pneumonia (52. 8%), 80 had laryngitis (44. 0%), 38 had bronchitis (20. 9%),15 had hepatic dysfunction (8. 2%), 11 had myocardial damage (6. 0%), 3 had febrile seizures (1. 6%), and no patient had encephalitis. Of the 96 cases with pneumonia, 92 received sputum test; 38 were sputum culture positive (41%). The dominant pathogens were Streptococcus pneumoniae(11/38,29%), Haemophilus influenzae (6/ 38,16%), Moraxella catarrhalis (4/38, 11%), Escherichia coli (4/38, 11%), Candida albicans (4/38, 11%), Mycoplasma pneumoniae (4/38, 11%) and Staphylococcus aureus (3/38, 8%). (4) The H1a genotype was the only one genotype in the detected sequence of 54 measles virus strains.

CONCLUSIONMeasles was more often seen in the children under the age of 9 months from the floating population. The morbidity peak month was from April to May in Shanghai. The H1a genotype was the only one genotype. We should try to improve vaccination coverage rate in the children who are at the age for vaccination, so as to prevent measles outbreak.

Child ; Child, Hospitalized ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Female ; Genotype ; Humans ; Infant ; Male ; Measles ; epidemiology ; Measles Vaccine ; administration & dosage ; Measles virus ; classification ; Retrospective Studies ; Vaccination ; statistics & numerical data

Objective To compare the molecular epidemic characteristics of human astrovirus (HAstV) between outpatient and hospitalized children with acute diarrhea,and to investigate the relationship between HAstY infection and diarrhea in children.Methods A total of 298 cases were randomly collected from hospitalized children from January 2008 to December 2010 in Children's Hospital of Fudan University,and 360 specimens were collected from outpatients with acute diarrhea from August 2010 to July 2011.Reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect rotavirus (RV),human calicivirus (HuCV),HAstV and human adenovirus (HAdV).H AstV genotype was determined by gene sequencing and phylogenetic analysis.Results Epidemiology of HAstV in hospitalized children was as follows:among the included 298 samples,HAstV was detected in 27.2％ (81/298) of the patients,compared with 33.9％ (42/124),33.8％ (25/74) and 14.0％ (14/100),respectively from 2008 to 2010.HAstV diarrhea occurred throughout the year and peaked in January,March,and April.95.1％ (77/81) of the infected children were 0-35 months old.All the episodes of HAstV were mixed with other diarrhea virus infection.Molecular epidemiology of HAstV in outpatient children with diarrhea was as follows:the overall incidence of HAstV was 1.9 ％ among the 360 cases (7/360).The seasonal distribution of HAstV's gastroenteritis showed a peak in November.All the outpatient children were 0-35 months old.Three cases were single infection with HAstV and the others were coinfection with RV (3 cases) or HAdV (1 case).All of the detected HAstV,either in inpatients or outpatients,belonged to HAstV-1.Conclusions The detection rate of HAstV in hospitalized children is significantly higher than that in outpatients.Most HAstV infections in hospitalized children are ascribed to nosocomial infections.Most episodes of HAstV infection were accompanied with other diarrhea viruses infection.HAstY single infection is seen in outpatient children while the detection rate is very low,implying that HAstV co-infection with other viruses plays a main role in diarrhea in most instances.

Objective To investigate the dynamic characteristic of molecular epidemiology of group A Rotavirus (RV) by analyzing viral genotypes,disease seasonality,and the patients' age distribution,so that to provide theoretical basis for preyention and control of RV diarrhea in children.MethodsA total of 380 RV antigen positive samples were selected from 5176 stool specimens collected from ＜5 year-old patients with acute diarrhea who were admitted to Children's Hospital of Fudan University during January 2006 to December 2008. Multiplex nested reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the RV genotypes.ResultsDuring 2006-2008,the incidence of RV related diarrhea peaked from October to December and about 96.8％ of all RV episodes occurred in patients younger than 3 years old,The predominant genotype was G3 which accounted for 58.4％ (222/380),G9 was an emerging genotype with the prevalence rate as high as 10.8％ (41/380).G1 and G2 types were rarely found during the three years.Infections with both G3 and G9 were the major mixed genotype G infection. Genotype P [8] was predominant with the prevalence rates of 64.6％ (53/82) and 46.8％ (58/124) in 2006 and 2008,respectively,whereasgenotype P[4] was predominant in 2007 (38,5％,67/174).P[6] and P[9] were found as minor types.The major mixed genotype P infection were genotype P[4] and P[8]. The proportion of undetermined genotype G and genotype P strains tended to increasing during 2006-2008.Genotype P [8]G3 was the major RV strain (20.5％) in Shanghai during 2006-2008 and the other prevalent genotypes included P[4]G3 and P[m]G3.Conclusion The infection of group A RV in Shanghai presents some new molecular epidemiology characteristics during 2006-2008,such as switch of predominant genotypes and diversification of prevalent genotypes.

In traditional biomedical research, a series of mechanism and measures had been taken for identity protection of data subjects, such as data disclosure in aggregated methods, information restricted in public only after identified variables removal and etc. The purpose of such process was aimed to properly keep confidentiality of health information for the target subjects in research. As the protection of subject privacy was viewed as one of the most essential principle of medical ethics in human research, the effects to fulfill and accomplish such process can help to maintain the trust and support among participants and social public. Currently, such traditional modes of privacy safeguard are widely-applied in genetics and genomics study. However, the universal applicability also causes a number of controversies, and the effectiveness remains to be proven. Nowadays, the risk assessments of data subjects’ privacy call for taking the whole“data context” into consideration, not just self-restricted in isolation and confined to quality control of data disclosure. With the soaring increasing of data resources in research involved human subjects, the issues of releasing genetic data have caused more and more public attention, especially for the sensitive domains of privacy protection. Based on the core problem and principles, this article attempted to discuss the controversial bioethical issues such as data context, data-intruder concept, privacy of data subject, identity control of releasing data, potential risk of individual identification, privacy protection of data subject, and etc. We hope these considerations can provide references to the bioethical understanding of biobanks research and decision-making of ethic review.

Fourteen neonatal diabetes mellitus(NDM)patients were recruited. 9 patients were treated with glyburide and the other 5 with insulin. ABCC8, KCNJ11, and INS genes were sequenced in 6 of them. Gene mutations were found in 2, 1, and 1 cases in these genes, respectively. One case with 6q24 hypomethylation and another without known mutation were also found. 8 out of 9 patients treated with glyburide reached euglycemia(88.9%). The other 5 patients with insulin therapy either died or lost contact. The results suggest that glyburide therapy is effective in neonatal diabetes mellitus, while insulin therapy may contribute to poor compliance.

Since the discovery of adipose-derived mesenchymal stem cell (ADSC) in more than ten years, a great progress has been made from its basic research to clinical application. Compared with bone marrow mesenchymal stem cells, ADSCs are more abundant in reserve, easier to obtain with fewer injuries and less complications. These cells have multiple differentiation potential and can differentiate into adipocytes, chondrocytes and osteoblasts with the influence of different inducing factors. Early studies of ADSCs mainly focused on the ability of multi-directional differentiation, espe-cially on the regeneration of bone defects and cartilage tissue. At present, the researches mainly focus on immunoregulation and paracrine function of ADSCs. Although ADSCs have made a great progress in clinical application, the cell preparation, use pattern, and mechanisms in clinical treatment are not clear. This paper elaborates on these issues.

Objective:To understand the clinical and laboratory characteristics of primary Epstein-Barr virus (EBV) infection in children.Methods:Totally 210 cases with primary EBV infection from September 2016 to March 2017 in Department of Infectious Diseases, Children′s Hospital of Fudan University in Shanghai were retrospectively collected. The clinical information (fever, rash, etc), and laboratory data such as liver function, EBV test (serological test, polymerase chain reaction (PCR)-DNA) were analyzed.Results:The age of children with primary EBV infection was (4.2±2.4) years. Numbers of patients with fever, tonsil and/or pharynx exudation, cervical lymphadenopathy, eyelid edema and rash were 187 (89.0%), 130 (61.9%), 204 (97.1%), 95 (45.2%) and 21 (10.0%), respectively. A total of 120 cases (57.1%) presented with typical triplets of infectious mononucleosis. Absolute lymphocyte count ≥5.0×10 9/L was found in 177 cases (84.3%), and abnormal lymphocyte ratio≥0.10 was found in 184 cases (87.6%). Elevated transaminase level was found in 96 cases (45.6%), and 72 cases were followed until transaminase level back to normal, in whom 97.2% (70/72) patient returned to normal within six weeks. Epstein-Barr viral capsid antigen (EBV-VCA)-IgM was positive in 192 cases (91.4%). EBV-VCA-IgG and Epstein-Barr viral early antigen (EBV-EA)-IgG positive were presented in 182 cases (86.7%) and 62 cases (29.5%), respectively. Epstein-Barr viral nuclear antigen (EBV-NA)-IgG was negative in all cases. EBV DNA test was carried in 199 cases, of which 122 cases (61.3%) were positive. Conclusions:Pediatric primary EBV infection mainly occurs in preschoolers. Most patients are presented with enlarged cervical lymph nodes, fever, and positive EBV serological markers. Transient transaminase elevation is observed in some cases.