Objective To investigate the clinical features of neonatal lower respiratory tract infection (LRTI)with respiratory syncytial virus(RSV),and to explore the relationship between clinical features and recurrcnt cough or wheezing after discharge.Methods From May 2008 to May 2013,the data of 41 neonates diagnosed as LRTI with RSV infection in New Century International Children's Hospital were analyzed retrospectively.The clinical features and follow-up results were observed.Results All the neonates had cough,92.7％ (38/41 cases) had choking,85.4％ (35/41 cases) had runny nose and nasal obstruction,31.7％ (13/41 cases) had fever,65.9％ (27/41 cases) had wheezing sound during physical examination,29.3％ (12/41 cases)of the neonates were accompanied with bacterial infection(n=29),in which 50.0％ (6/12 cases) were infected by staphylococcus aureus.Compared to the neonates only with RSV infection,the proportion of fever was higher in those with RSV combined with bacterial infection (n =12)(x2 =6.034,P ＜ 0.05),and there were no statistical differences between the neonates with or without bacterial infection in white blood cell count and with or without shadow in chest X-ray(x2 =0.859,2.064,P =0.485,0.202).Compared with the neonates without family history of atopy,the neonates with the family history of atopy were more likely to get wheezing (88.2％ vs 57.1％,x2 =4.871,P ＜ 0.05) during primary infection.During the follow-up,there was higher proportion of children with family history of atopy in the group with subsequent recurrent cough and/or wheezing than in the group without subsequent recurrent cough and/or wheezing (71.4％ vs 26.3％,x2 =6.388,P ＜ 0.05).Conclusions Cough,choking are most common symptoms in neonatal LRTI with RSV,and there is no wheezing sound during phy-sical examination in some neonates.LRTI with RSV is likely combined with bacterial infection.Wheezing is more common in the neonates with family history of atopy.The RSV LTRI neonates with family history of atopy incline to get subsequent recurrent cough or wheeze after discharge.

Objective To make up the time versus enhancement index curves of normal pancreas and to investigate the best multiphasedelay scanning time window. Methods 60 patients without pancreatic diseases were randomly assigned to A, B, C group. Test-bolusimaging was performed to determine aortic transit time (TV-A) in individual patients. According to the formula: D=T V-A-1/4TA+t,the multiphase scanning time after administration of Gd-DTPA was defined at t=0,5,10 seconds respectively to A,B,C group. Signalintensity of pancreas, liver, and per-pancreatic vessels were measured ,enhancement index was calculated and images quality wasassessed . Results B delay of 5 s after arrival of Gd-DTPA to the abdominal aorta , the enhancement index of pancreas in B group was 18.6 , which evidently higher than A group 10.4 and C group 15.0 (P0.05 ) . Conclusion Biphasic imaging at 5 and 33 seconds after arrival of contrast media to abdominal aorta is a practical method for acquisition of high-quality dynamic enhanced MR imaging of the pancreas.

OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) with different imaging changes in children.Methods Hospitalized patients with MPP during September 2012 to August 2013 in Beijing New Century Children's Hospital were retrospectively reviewed.The data including clinical features,laboratory tests,treatment and prognosis were collected.The patients were divided into 3 groups according to the radiological findings,including interstitial infiltration (group 1),intralobular infiltration (group 2) and segmental or larger infiltration (group 3).The clinical data were compared among the 3 groups.Results The percentages of patients in the 3 groups were 18.8％ (36/191 cases) in group 1,39.8％ (76/19 cases) in group 2 and 41.4％ (79/191 cases) in group 3,respectively.In 144 cases of MPP patients older than 3 years old,48.6％ (70/144 cases) were segmental or larger infiltration.The incidence of higher fever,hypoxemia and elevated C-reaction protein and lactate dehydrogenase in group 3 [50.6％ (40/79 cases),87.3％ (69/79 cases),78.5％ (62/79 cases),29.1％ (23/79 cases)] were higher than those in group 1 [5.6％ (2/36 cases),61.1％ (22/36 cases),19.4％ (7/36 cases),0] and group 2 [10.5％ (8/76 cases),67.1％ (51/76 cases),14.5％ (11/76 cases),3.9％ (3/76 cases)],and the differences were significant(all P ＜ 0.01).Patients in group 3 had higher risk of cardiac and/or liver impairment,refractory MPP,and treated by glucocorticoids and bronchoalveolar lavage [41.8 ％ (33/79 cases),29.1％ (23/79 cases),94.9 ％ (75/79 cases),50.6％ (40/79 cases)].The hospital stay was (9.48 ±3.26) d in group 1,(9.24 ±2.97) d in group 2,and (12.09 ±3.01) d in group 3,respectively,and the difference was significant among 3 groups (F =19.348,P =0.005),the hospital stay in group 3 was longer than that in the other 2 groups (t =4.210,5.931,all P =0.000),while there was no difference between group 1 and group 2 (P ＞ 0.05).Patients in group 1 with wheeze were more co-mmon,and were treated by Azithromycin earlier than that in group 3 [(5.08 ± 3.43) d vs.(4.16 ± 2.20) d],the difference was significant(t =2.498,P =0.014),while the incidence of hypoxemia was common than that in group 2 (x2 =3.176,P =0.012).Conclusions MPP patients with segmental or larger infiltration are older than patients in the other groups,and present with severe complications,higher inflammatory factors,longer hospital stay,and higher risk for refractory MPP.Glucocorticoids and bronchoalveolar lavage are usually used in these patients.Patients with interstitial infiltration are prone to manifest with wheeze and hypoxemia,and its diagnosis and treatment by Azithromycin are usually delayed.Therefore,pediatrician should pay more attention to MPP patients with different imaging changes,in order to diagnose and treat the patients timely.

Objective To investigate the effect of tea polyphenols on global cerebral ischemia reperfusion injury in rats.Method Forty-five pathogen-free male SD rats weighing 180-220 g were randomly divided into 3 groups( n =15 each):sham operation group (group S),cerebral ischemia reperfusion group (group IR) and tea polyphenols group (group TP).Global cerebral ischemia reperfusion injury was establish by four-vessel occlusion method.At 24 h of reperfusion,five rats were chosen and Evan's blue(EB) was injected iv,and then sacrificed and brain was removed for determination of EB content; another five rats were sacrificed and brain was removed for determination of water content; five rats were chosen for Morris water maze test.Result Compared with group S,EB content and water content in brain tissue were increased in groups IR and 'rP,and escape latency was prolonged,frequency of crossing the original platform was reduced in group IR ( P ＜ 0.05 ).Compared with group IR,EB content and water content in brain tissue were decreased,and escape latency was shortened,frequency of crossing the original platform was increased in group Tp ( P ＜ 0.05).Conclusion Tea polyphenols can attenuate global cerebral ischemia reperfusion injury in rats.

Objective To study the relationship of insulin receptor substrate-1 (Irs1) and metabolic disease, we generated Irs1 gene knockout rat by CRISPR/Cas9 system.Methods Two sgRNA targeting sites were designed for Irs1 targeting.The Cas9 and sgRNAs were transcribed by T7 RNA polymerase in vitro.Cas9 mRNA and sgRNA mixtures were pooled and microinjected into one-cell fertilized eggs of SD rats to generate rats with targeted mutation .Results Five rats with the mutations were detected with the efficiency of 83%.Conclusion The Irs1 gene knockout rats generated in this study can be transmitted by germline .

ObjectiveTo investigate the changes of high resolution computerized tomography (HRCT) of chest and quality of life and the main correlated factors of HRCT for interstitial lung disease(ILD) in patients with rheumatoid arthritis(RA).MethodsTwenty-six initial treatment patients with RA-ILD were enrolled.The following parameters were noted at baseline,12 and24 weeks for each patient:clinical features,HRCT,quality of life.ANOVA was used for repeated measurement data and stepwise multiple regression analysis were used to analyze the relativity between HRCT and other parameters.ResultsTwentysix patients were included.Twelve male(46％) patients were followed up for 24 weeks and pulmonary infection occurred in 11 patients,so the frequency rate was 42％.After being treated with prednisone and cyclophosphamide for 24 weeks,the HRCT scores were lower than before [(8+6) vs(12±5),respectively] and 16 patients' condition were improved,6 were in stable and 4 had deteriorated disease.For quality of life,the impact scores,symptom scores,activity scores,and total scores of St.George's respiratory questionnaire (SGRQ) were significantly decreased(F=3.783,6.362,4.217,4.426,P＜0.05) and all domains of the short form-36 health survey questionnaire(SF-36) had significant improvement after treatment.Stepwise multiple regression analysis showed that the impact scores(P=0.000) and symptom scores(P=0.001) of SGRQ,vitality (P=0.012) of questionnaire,globulin (P=0.027) in prior treatment and symptom scores (P--0.001 ) of SGRQ,course of disease (P=0.002),MRC score (P=0.011),vitality (P=0.036) of SF-36 questionnaire in post-treatment were the main correlated factors with HRCT features.ConclusionMale RA patients are prone to develop ILD and RA-ILD is susceptible to pulmonary infection.After early treatment,HRCT and quality of life in most patients can be improved.Respiratory symptoms,severity of dyspnea,globulin level,course of disease and vitality of patients are significantly correlated with HRCT.

Objective To study the expression of interleukin-1β in aortic dissections and aneurysms. Methods Aortic specimens were obtained from patients with type Ⅰ thoracic aortic dissection (11 cases),ascending thoracic aortic aneurysms (10 cases),and healthy organ donors (7 cases).Expression of interleukin-1β,matrix metalloproteinase-9,and signal transduction factors phospho-p38 and phospho-JNK were detected by real time RT-PCR,Western blot,and immunohistochemistry,respectively.TUNEL staining was performed to detect apoptosis of media cells. Results Apoptosis in the media of thoracic aortic dissection and ascending thoracic aortic aneurysms was dramatically higher than control group.Expression of interleukin-1β gradually increased in an order of control group,thoracic aortic dissection to ascending thoracic aortic aneurysms ( P ＜ 0.01,respectively).Expression of matrix metalloproteinase-9significantly increased in the media of thoracic aortic dissection and ascending thoracic aortic aneurysms compared with control group (P ＜ 0.01,respectively).There were positive correlations between interleukin1 β and matrix metalloproteinase-9,interleukin-1β and phospho-p38 in thoracic aortic dissection ( P ＜ 0.01,respectively),interleukin-1β and apoptosis in ascending thoracic aortic aneurysms (P ＜ 0.01 ).Conclusions Interleukin-1β and interferon-γ might effect the formation of thoracic aortic dissection and ascending thoracic aortic aneurysms possibly through the up-regulation of matrix metalloproteinase-9 and apoptosis of media cells in humans.

Coronaviruses (CoVs) are generally associated with respiratory and enteric infections and have long been recognized as important pathogens of livestock and companion animals. Mouse hepatitis virus (MHV) is a widely studied model system for Coronavirus replication and pathogenesis. In this study, we created a MHV-A59 temperature sensitive (ts) mutant Wu"-ts18(cd) using the recombinant vaccinia reverse genetics system. Virus replication assay in 17C1-1 cells showed the plaque phenotype and replication characterization of constructed Wu"-ts18(cd) were indistinguishable from the reported ts mutant Wu"-ts 18. Then we cultured the ts mutant Wu"-ts 18(cd) at non-permissive temperature 39.5℃, which "forced" the ts recombinant virus to use second-site mutation to revert from a ts to a non-ts phenotype. Sequence analysis showed most of the revertants had the same single amino acid mutation at Nsp16 position 43. The single amino acid mutation at Nsp16 position 76 or position 130 could also revert the ts mutant Wu"-ts 18 (cd) to non-ts phenotype, an additional independent mutation in Nsp13 position 115 played an important role on plaque size. The results provided us with genetic information on the functional determinants of Nsp16. This allowed us to build up a more reasonable model of CoVs replication-transcription complex.

Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; cytology ; metabolism ; Myocardium ; cytology ; Pravastatin ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; genetics ; metabolism