Objective To study the epidemiological and clinical features of human parainfluenza virus (HPIV) infection in children in Suzhou,and to provide the evidence-based foundation for early warning,diagnosis and treatment of respiratory infection in children.Methods The sputum specimens and medical history were obtained from children with acute respiratory tract infection hospitalized at the Childen's Hospital Affiliated to Soochow University from January 2006 to December 2015.Seven kinds of common respiratory viruses including respiratory syncytial virus,influenza virus A,influenza virus B,HPIV Ⅰ,HPIV Ⅱ,HPⅣV Ⅲ and adenovirus were detected by using the direct im-munofluorescence.Mycoplasma pneumoniae(MP),chlamydia pneumoniae,human bocavirns (hBoV) were detected by using fluorescence quantitative PCR.Rhinovirus and human metapneumovirus were detected by using reverse transcription-PCR.Sputum was cultured for bacteria.Results In 21 769 cases,the detection rate of HPIV positive was 3.21％ (829 cases),among which,HPIV Ⅰ,HPIV Ⅱ,HPIV Ⅲ were respectively detected in 113 cases (0.52％),16 cases (0.07 ％) and 700 cases (3.21％),respectively.There were 378 cases of simple infection and 428 cases of mixed infection,and the mixed infection was very common in Streptococcus pneumoniae,Haemophilus influenza,MP and hBoV.There was a difference in HPIV infection among genders,and the detection rate of the boys was higher than that of girls[4.14％ (563/13 591 cases) vs.3.25％ (266/8 178 cases),x2 =11.036,P =0.001].In the 28 d-1 year old and ＞ 1-3 year old group,the detection rate of HPIV was higher[4.71％ (494/10 476 cases) and 4.21％ (244/5 793 cases),respectively].In spring and summer,there was a higher detection rate of HPIV infection.The clinical manifestations with simple infection of HPIV Ⅰ and HPIV Ⅲ were cough,fever and wheezing.The rate of fever and shortness of breath in those of HPIV Ⅰ was 71.74％ (33/46 cases),10.87％ (5/46 cases),and that in HPIV Ⅲ was 40.12％ (134/334 cases),2.10％ (7/334 cases),HPIV Ⅰ infection was more likely to cause fever and shortness of breath than those of HPIV Ⅲ,there were significant differences (x2 =16.410,P ＜ 0.001;x2 =10.177,P =0.001).Pneumonia had the highest detection rate of viral infection.Conclusions HPIV Ⅲ is the leading pathogen among the types of HPIV in the hospitalized children in Suzhou area.Among the subtypes of HPIV,the peak of HPIV infection occurs in spring and summer.The children less than 3 years old are the most susceptible to parainfluenza virus,and the HPIV detection rate is gradually declines with age.

Objective:To observe the efficacy, median progression-free survival (PFS) and adverse reaction induced by rh-endostatin injection (Endostar) plus platin-based chemotherapy for advanced non-small cell lung cancer (NSCLC).Methods:Fifty five histologically or cytologically confirmed advanced NSCLC patients received Endostar combined with platin-based chemotherapy for more than 2 cycles. The evaluated parameters included PFS, response rate (RR), clinical benefit rate (CBR) and adverse reaction. Results:Of the 51 patients who can be evaluated for response, 15 (29.4%) achieved partial response (PR), 27 (52.9%) had stable disease (SD), 9 (17.6%) had progressive disease(PD), no patient had complete response(CR). The overall RR was 29.4% (15/51) and CBR was 82.4% (42/51). The median PFS was 6.3 months. There were no significant differences in the short-term efficacy and PFS between the patients who had different pathological features (P=0.037), those had naive or relapsed diseases (P=0.101), or those received different chemotherapeutic regimens (P=0.232). The total white cells and platelets decreased by 72.7% and 54.5%, respectively. The frequency of grade Ⅲ or Ⅳ neutropenia and thrombocytopenia were 36.4% (20 caces) and 21.8% (12 cases), respectively. Four patients stopped the therapy for adverse reaction. One died of gastrointestinal hemorrhage; one had uncontrolled grade Ⅲ hypertension; one had superventricular arrhythmia; one had grade Ⅳ hepatic dysfunction. Conclusion:The combination of Endostar and platin-based chemotherapy increased the CBR and prolonged the PFS of the patients with advanced NSCLC. The toxicities were tolerable.

OBJECTIVETo investigate the anti-oxidative stress and anti-fibrotic mechanisms of adiponectin by examining effects on oxidative stress levels and expression of fibrosis-related signaling factors, including transforming growth factor-beta 1 (TGFb1), collagen I (COL-1), and the adenosine monophosphate-activated protein kinase (AMPK) pathway by using an in vitro HSC-T6 cultured cell system.

METHODSActivated HSC-T6 cells were pre-treated with 1.0 mug/mL adiponectin for 0, 30, 60 and 120 min, or left untreated to serve as controls, and both groups were then exposed to 5 mumol/L H2O2; a portion of the adiponectin-treated oxidative stress-induced cells were treated with an AMPK inhibitor (Compound C). The effects on mRNA levels of TGFb1. and COL-1 were analyzed by real-time PCR, in the levels of secreted TGF-b1 and COL-1 were detected by enzyme-linked immunosorbent assay of supernatants, and in the phosphoAMPK and AMPK protein expressions were detected by Western blotting.

RESULTSCompared to the H2O2 group without adiponectin pre-treatment, the H2O2 group with adiponectin pre-treatment showed significantly increased activity of superoxide dismutase (SOD), decreased content of malondialdehyde (MDA), and decreased gene and protein expressions of TGF-b1 and COL-1 (P less than 0.05). Moreover, inhibition of the AMPK pathway inhibited these adiponectin-mediated effects. The H2O2 group with adiponectin pre-treatment also showed increased levels of phospho-AMPK protein expression, with the maximum effect detected after 120 min of the adiponectin pre-treatment (P less than 0.01).

CONCLUSIONInhibition of oxidative stress is one of the mechanisms of the anti-fibrotic effects of adiponectin. Adiponectin can attenuate oxidative stress levels, resulting in down-regulation of TGFb1 and COL-1 expression through activation of the AMPK pathway.

AMP-Activated Protein Kinases ; Adiponectin ; Cell Line ; Collagen Type I ; Down-Regulation ; Hepatic Stellate Cells ; Humans ; Hydrogen Peroxide ; Oxidative Stress ; RNA, Messenger ; Signal Transduction ; Transforming Growth Factor beta1

Objective To explore the effect ofpolycyclic aromatic hydrocarbons (PAHs) and p16,FHIT gene CpG island methylation,as well as their interaction in cervical intraepithelial neoplasias.Methods Objects of this study were from a cohort of cervical lesions study in Yangqu county of Shanxi province.All the patients were diagnosed pathologically,that including 83 patients with high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ),86 patients with low-grade cervical intraepithelial neoplasia (C1N Ⅰ) and another 91 women under normal cervical (NC) condition.1-hydroxy pyrene in the urine was detected by high performance liquid chromatography (HPLC)while CpG island methylation status of tumor suppressor gene p16 and FHIT were measured by methylation-specifc polymerase chain reaction (MSP).Data were analyzed with Kruskal-Wallis H test,chi-square test and trend of chi-square test.Logistic regression models were used to estimate the odds ratio (OR) and corresponding 95％ confidence intervals (95％CI) between influencing factors and the cervical disease by using the SPSS statistical software (version 20.0).The interaction under study was evaluated by using the generalized multifactor dimensionality reduction (GMDR) model.Results Level of 1-hydroxy pyrene (H=50.743,P＜0.001) and the high exposure rate of 1-hydroxy pyrene (trend x2=20.146,P＜0.001) were gradually increasing along with the severity of cervical intraepithelial neoplasia.The CpG island methylation rates ofpl6,FHIT in CIN] and CIN Ⅱ/Ⅲl group were higher than that in NC group,and gradually increasing along with the severity of cervical intraepithelial neoplasia (trend x2=9.75,P=0.002;trend x 2 =10.39,P=0.001).Results from the GMDR model showed that interaction existed among the high exposure of l-hydroxy pyrene and the CpG island methylation ofpl6,FHIT in CIN Ⅰ and CIN Ⅱ]/Ⅲ group.Conclusion Under the high exposure of 1-hydroxy pyrene and the CpG island methylation of p16,FHIT appeared to have increased the risk of cervical intraepithelial neoplasia and causing synergistic effect in cervical intraepithelial neoplasia.

Objective To explore the effect of Src on cervical cancer cells through ERK signal transduction pathway.Methods Experimental study was carried out in vitro.Cervical cancer cell lines Hela (HPV-positive) and C33A (HPV-negative) were treated with Src kinase inhibitor PP2.Then,the cell cycle and apoptosis of each group were evaluated by using flow cytometry (FCM).Western blotting and Real-time PCR were used to detect the levels of the expression of ERK 1/2,c-Fos and c-Jun mRNA and protein respectively.The database was established and analyzed with SPSS statistical software (version 20.0).Results After down-regulating Src,the cell proliferation was inhibited and cell apoptosis was induced.The proportions of G0/G 1 stage of Hela and C33A cell in cell cycle increased while G2/M and S stages decreased.Meanwhile,the mRNA levels of ERK 1,ERK 2,c-Fos and c-Jun increased.And the expression levels of ERK 1/2,phosphorylated ERK 1/2 (p-ERK 1/2)and phosphorylated c-Fos (p-c-Fos) protein decreased,while c-Jun and phosphorylated c-Jun (p-c-Jun)protein expression increased.In addtion,the change level of Hela cell,p-ERK 1/2 and c-Fos protein were lower than that of C33A cell before and after the Src inhibition.Conclusions Src,involved in regulating the expression of key factors of the ERK signal transduction pathway including p-ERK 1/2 and p-c-Fos,might be capable of promoting the proliferation of cervical cancer cells and inhibiting their apoptosis.The infection with HPV might have adjustable effect on this process.

Objective To explore the diagnostic efficiency of ultrasound-guided biopsy in the diagnosis of gastrointestinal lesions.Methods The study retrospectively analyzed 41 cases who underwent ultrasound-guided biopsy and diagnosis were confirmed as gastrointestinal lesions either by surgery resections or by biopsies in our hospital from January 2006 to April 2018.The detection rate and the safety in the diagnosis of gastrointestinal lesions by ultrasound-guided biopsy were evaluated and they were compared with clinical efficiency of the endoscopic biopsy.Results (1) Of the 41 cases underwent ultrasound-guided biopsies,38 cases were confirmed by pathology.A 92.7％ detection rate had achieved by ultrasound-guided biopsies.In the 38 cases,the diagnoses were grouped in benign and malignant,with 29 malignant and 9 benign.(2) Among the 13 cases examined by both of the ultrasound-guided biopsy and endoscopic biopsy,the diagnostic accuracy of ultrasound-guided biopsy was 84.6％ and 61.5％ with endoscopy.No significant difference (P =0.378) between the two modalities.(3) No complication occurred with both of methods.Conclusions Ultrasound-guided biopsy of gastrointestinal lesions is a safe and effective method.It would be an alternative solution to provide clinicians with reliable diagnosis,especially when endoscopic diagnosis is not inapplicable or failed.

Objective:To investigate whether in vitro cultured human bone marrow mesenchymal stem cells (BMSCs) express sodium taurocholate cotransporting polypeptide (NTCP), assess their susceptibility to hepatitis B virus (HBV) infection and analyze the role of NTCP during HBV infection. Methods:BMSCs were infected with HBV-positive serum under different conditions. HBV DNA load in cell culture supernatants as well as in BMSCs and the amount of hepatitis B virus surface antigen (HBsAg) and hepatitis B virus e antigen (HBeAg) in cell culture supernatants were detected. To analyze the role of NTCP, BMSCs were first transfected with small interfering RNA targeting NTCP (NTCP-siRNA) and then infected with HBV-positive serum under different conditions. Virus loads and the amount of HBsAg and HBsAg were also detected. Western blot assay was performed to measure the expression of NTCP in BMSCs in each group.Results:In vitro cultured adherent BMSCs were susceptible to HBV infection albeit with a really low efficiency, but the infection efficiency was significantly increased when infecting the BMSCs in suspension. NTCP was expressed in BMSCs and the expression could be upregulated during HBV infection, especially in BMSCs in suspension. HBV infection was blocked when BMSCs were transfected with NTCP-siRNA. Conclusions:In vitro cultured human BMSCs were susceptible to HBV infection and the expressed NTCP served as a functional receptor for HBV. Human BMSCs could be used as a highly susceptible and stable cell model that needed no molecular adjuvant modification for research on the early stages of the HBV life cycle and for development of antiviral therapy.

OBJECTIVE To analyze the clinical manifestations and characteristics of adverse drug reactions （ADR） caused by cefotaxime sodium in Shandong province， and to explore the effects of skin test before medication of cefotaxime sodium on serious ADR， so as to provide reference for safe drug use in clinic. METHODS The relevant data of cefotaxime sodium-induced ADR reported by Shandong Province ADR Monitoring Center during December 2019 to December 2021 were collected from National ADR Monitoring System. The ADR classification， age， gender， ADR occurrence time， route of administration， history of allergy， primary diseases， ADR systems/organs involved， clinical manifestations， outcome， skin test or not before medication were statistically analyzed. RESULTS A total of 1 057 ADR reports caused by cefotaxime sodium were included. Among them， there were 867 patients （82.02%） with general ADR and 190 patients （17.98%） with serious ADR. The majority were ＜11 years old （40.30%）. The main route of administration was intravenous drip （96.69%）. A total of 1 033 patients （97.73%） developed ADR 30 min to 24 h after medication. A total of 814 patients （77.01%） had no history of allergy. The primary diseases were respiratory system infection （56.58%）. Main systems/organs involved in ADR were skin and its appendants， digestive system and respiratory system， and its clinical manifestations were rash， pruritus， nausea， vomiting， chest tightness， etc. After withdrawal or symptomatic treatment， 1 050 patients （99.34%） were cured or improved. Before the use of cefotaxime sodium， 850 patients underwent skin test （151 patients occurred serious ADR）； there was no statistical significance in the incidence of serious renzhen202102@163.com ADR， compared with the incidence of serious ADR in 207 patients without skin test （39 patients occurred serious ADR）（P＝0.718）. CONCLUSIONS ADR caused by cefotaxime sodium is mainly seen in patients ＜11 years old， mostly occurring 30 min to 24 h after intravenous drip； skin test before medication of cefotaxime sodium cannot reduce the risk of serious ADR. Before using cefotaxime sodium in clinical practice， patients should be asked about their allergy and medication history in detail. During use， it is important to focus on the patient’s condition within 24 h after medication to prevent serious ADR and ensure the safety of clinical medication.

OBJECTIVE To compare the efficacy and safety of Saccharomyces boulardii and Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CBM， Wanfang data， CNKI and VIP， randomized controlled trials （RCTs） about S. boulardii （S. boulardii group） versus Bifidobacterium triple liver bacteria （Bifidobacterium group） were collected. After screening the literature， extracting data and evaluating the quality， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 9 RCTs were included， involving 898 patients. Results of meta-analysis showed there was no statistical significance in total response rate [OR＝1.69， 95%CI （0.93， 3.09）， P＝0.09]， duration of diarrhea [MD＝－1.39， 95%CI （－3.35， 0.57）， P＝0.16]， the time of abdominal pain disappearance [MD＝0.09， 95%CI（－0.87， 1.05），P＝0.86] or the incidence of adverse reactions [OR＝0.65， 95%CI （0.05， 8.03）， P＝0.74]. The number of stools in S. boulardii group was significantly less than Bifidobacterium group [MD＝－0.91， 95%CI （－1.80， －0.02）， P＝0.04]. The results of subgroup analysis showed that the duration of diarrhea in children with antibiotic-associated diarrhea in S. boulardii group was significantly shorter than Bifidobacterium group （P＜0.05）. CONCLUSIONS The efficacy and safety of S. boulardii are similar to those of Bifidobacterium in the treatment of diarrhea， but S. boulardii is better than Bifidobacterium in terms of stool number， the duration of diarrhea in children with antibiotic-associated diarrhea.

OBJECTIVE To eva luate the clinical comprehensive value of desloratadine in the treatment of urticaria. METHODS The clinical comprehensive evaluation index system based on six dimensions such as safety ，effectiveness，economy，suitability， innovation and accessibility were preliminarily determined by using the methods of literature investigation and expert investigation ； the core contents of the evaluation index system were evaluated and screened by Delphi method and analytic hierarchy process ；the importance of the index was assigned by Likert 5-level scoring method ；the evidence from various sources were collected and qualitative and quantitative integration analysis were conducted according to the clinical comprehensive evaluation index system with the help of system evaluation ，drug instructions ，expert guidelines/consensus ，adverse drug reaction monitoring report ，etc； the experts scored its clinical comprehensive value according to the clinical comprehensive evaluation evidence of each dimension of desloratadine ，combined with the weight of the clinical comprehensive evaluation index system ，the clinical comprehensive evaluation score of the tertiary indexes of desloratadine were calculated. The total clinical comprehensive evaluation score was obtained by accumulating the scores of each index ，and compared with loratadine. RESULTS This study successfully constructed the clinical comprehensive evaluation index system of desloratadine in the treatment of urticaria ，including 6 primary indexes ，13 secondary indexes and 30 tertiary indexes. The total clinical comprehensive evaluation score of desloratadine was 93.63 and that of loratadine was 70.91. CONCLUSIONS The clinical comprehensive value of desloratadine is higher than that of loratadine ，which can provide a reference basis for clinical rational drug use in medical institutions ，selection of drug use catalogue and improvement of national drug policy.