Bronchopulmonary dysplasia(BPD)is a severe complication in premature infants, and the pathogenesis remains complex, potentially involving pulmonary inflammatory injury and faulty reparative response.T-cell immaturity in preterm neonates and the upregulation of related harmful regulatory genes, as well as the imbalance of T-cell homeostasis, have been reported to contribute significantly to the development of inflammatory diseases.Growing evidence suggests that alterations in the levels and functions of T cell subsets may participate in the development of BPD, serving as a new avenue for BPD prevention and treatment.Herein, we summarize recent advancements in understanding the role of T lymphocytes in the pathogenesis of BPD.

OBJECTIVETo evaluate the efficacy and safety of oseltamivir phosphate as treatment for naturally acquired influenza infection.

METHODSThis study was conducted as a double-blind, randomized, placebo-controlled, multicenter trial during the influenza epidemic season from January to April 2001 at 7 centers in China. A total of 478 adults without other medical history, aged 18 to 65 years, were enrolled into the study. All subjects demonstrated febrile respiratory illness of no more than 36 hours' duration with a temperature of 37.8 degrees C or more plus at least two of the following symptoms: coryza/nasal congestion, sore throat, cough, myalgia/muscles aches and pain, fatigue, headache or chills/sweats. Individuals were randomized into either the oseltamivir phosphate or placebo group with identical-looking capsules. Either oral oseltamivir phosphate, 75 mg twice daily, or placebo was administered to the subjects for 5 days.

RESULTSA total of 451 individuals were analyzed for efficacy as the intent-to-treat population (ITT) (216 oseltamivir and 235 placebo) and 273 individuals were identified as influenza-infected through laboratory test, who were then defined as the intent-to-treat infected population (ITTI) (134 oseltamivir and 139 placebo). Four hundred and fifty nine individuals were included in the safety analysis. In the ITTI population, the cumulative alleviation proportion of oseltamivir group was significantly higher than that of the placebo group (P = 0.0466)). The median duration of illness was 91.6 h [95% confidence interval (CI) = 80.2 - 101.3 h] in the oseltamivir group and 95 h (95% CI = 84.5 - 105.3 h) in the placebo group. The median area under the curve of decreased total score was significantly higher in the oseltamivir group than in the placebo group, 1382.9 and 1236.7 score-hours, respectively (P = 0.0196). For the ITT population, similar results were observed. Adverse events (AE) were similarly reported in both the oseltamivir group and the placebo group. The main adverse events following test drug were gastrointestinal symptoms, neurological symptoms and rashes.

CONCLUSIONOseltamivir was effective and well tolerated as treatment of early naturally acquired influenza.

Acetamides ; adverse effects ; therapeutic use ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Double-Blind Method ; Enzyme Inhibitors ; therapeutic use ; Female ; Humans ; Influenza, Human ; drug therapy ; Male ; Middle Aged ; Neuraminidase ; antagonists & inhibitors ; Oseltamivir

Objective:To analyse the clinical features and prognosis of pertussis in neonates and infants.Methods:The clinical data of neonates and infants with pertussis hospitalized in Children′s Hospital of Soochow University from September 2021 to September 2022 were retrospectively analyzed and grouped in terms of age, the severity of the disease, and whether a mixed infection, respectively.Results:A total of 40 infants with pertussis were analyzed.All cases showed improvement and were discharged after receiving active anti-infective treatment.In the neonatal group, higher rates of apnea and hyponatremia were observed compared to the non-neonatal group(all P<0.05).Additionally, peripheral blood leukocyte counts[20.9(15.0, 28.7)×10 9/L vs.16.6(11.3, 21.2)×10 9/L], neutrophil counts[4.6(3.7, 7.9)×10 9/L vs.3.2(2.1, 5.3)×10 9/L], γ-glutamyltransferase levels[78.0( 50.2, 109.4)U/L vs.22.5(15.1, 38.9)U/L], duration of hospitalization[21.5(16.8, 25.0)d vs.11.5(9.0, 19.8)d], and duration of oxygen use[7.0(0, 21.0)d vs.0(0, 2.3)d]were higher in the neonatal group than in the non-neonatal group(all P<0.05).However, the IgA level[0.02(0.02, 0.04)g/L vs.0.05(0.03, 0.09)g/L]was significantly lower in the neonatal group than in the non-neonatal group( P<0.05).In the severe group, the proportion of onset age of less than 3 months, fever, wheezing, shortness of breath, cyanosis after rough cough, apnea, decreased heart rate, wet rales on lung auscultation, respiratory failure, cardiac insufficiency, hyponatremia, CRP>8 mg/L, spotty/patchy shadows in the lungs, as well as the use of gammaglobulin, cardioactive drug and invasive ventilation, were higher than those in the non-severe group(all P<0.05).Furthermore, peripheral blood leukocyte counts[21.0(15.4, 37.4)×10 9/L vs.17.5(11.8, 21.2)×10 9/L], neutrophil counts[5.6(4.0, 10.7)×10 9/L vs.3.2(2.3, 4.6)×10 9/L], neutrophil to lymphocyte ratio[(0.6±0.4) vs.( 0.3±0.2)], systemic immune-inflammation index[237.5(109.5, 424.9) vs.135.9(75.4, 190.5)], γ-glutamyltransferase level[53.2(31.6, 87.4)U/L vs.29.5(15.2, 65.0)U/L], duration of oxygen use[18.0(12.8, 22.5)d vs.0(0, 0)d], and duration of hospitalization[24.5(21.8, 31.2)d vs.12.0(9.0, 16.8)d]were higher in the severe group than those in the non-severe group(all P<0.05).However, the IgA level[0.03(0.02, 0.04)g/L vs.0.05(0.03, 0.09)g/L]was significantly lower in the severe group than in the non-severe group( P<0.05).The mixed infection group had a longer duration of hospitalization and a higher proportion of fever than the single infection group(all P<0.05). Conclusion:Early detection of infantile pertussis can be challenging.Neonates with pertussis tend to experience severe symptoms, such as apnea, hyponatremia, elevated white blood cell count, and longer duration of oxygen use.Symptoms such as fever, wheezing, shortness of breath, decreased heart rate, wet lung rales, and spotty/patchy shadows in the lungs, as well as early elevated CRP, neutrophil to lymphocyte ratio, systemic immune-inflammation index, and decreased IgA levels are indicators of disease exacerbation.In mixed infections group, there is a higher proportion of fever.

Objective:To explore the changes in serum indoleamine 2, 3-dioxygenase (IDO) and kynurenic acid (KYNA) levels in preterm infants diagnosed with bronchopulmonary dysplasia (BPD).Methods:A nested case-control study was conducted. The inclusion criteria covered premature infants with less than 32 weeks of gestational age within 24 h post-birth, from December 1, 2021, to December 31, 2022, at Children's Hospital of Soochow University. Those diagnosed with BPD were allocated to the BPD group ( n=35). Non-BPD preterm infants matching the BPD cases in terms of gestational age (within one week difference) and birth weight (within a 150 g difference) were selected in a 1∶1 ratio for the control group ( n=35). Serum levels of IDO and KYNA were measured on days 1, 7, 14, and 28 postnatally. Differences in serum IDO and KYNA levels were analyzed between the BPD and control groups and among infants with mild BPD versus moderate-to-severe BPD. The association between serum IDO and KYNA levels with the severity of BPD was also assessed. Statistical analysis was conducted using independent samples t-tests and Spearman's correlation analysis. Results:Elevated levels of serum IDO on days 7, 14, and 28 postnatally [(60.68±9.37) vs. (50.66±10.46), (57.81±11.07) vs. (44.45±8.20), and (50.62±10.77) vs. (41.31±7.74) pg/ml; t=4.21, 5.73, and 4.15, respectively] as well as increased serum KYNA levels on days 14 and 28 [(439.31±41.22) vs. (368.99±68.79), (376.97±45.74) vs. (325.50±60.07) μmol/L; t=5.18 and 4.03, respectively] were observed in the BPD group compared to the control group, with all differences being statistically significant (all P<0.05). Furthermore, positive correlations were observed between serum IDO levels and BPD severity on the 7th, 14th, and 28th days ( r=0.546, 0.495, and 0.502, all P<0.05), as well as between serum KYNA levels and BPD severity on the 14th and 28th days ( r=0.536 and 0.458, both P<0.05). Conclusion:Elevated serum levels of IDO and KYNA in infants with BPD suggest these metabolites may play a role in the pathogenesis and progression of BPD.

【Objective】 To investigate the trend of neutralizing antibody level in plasma donors who received the 3rd shot of inactivated novel coronavirus vaccine. 【Methods】 Three commercial ELISA kits for novel coronavirus neutralization antibody detection, manufactured by Company A, B and C, were chosen and screened by Pseudotype Neutralization Test from December 2021 to June 2022. A total of 410 plasma samples from 64 plasma donors who received the 3rd shot of inactivated novel coronavirus vaccine and there after donated plasma within six months were detected by the selected ELISA kit from July to October, 2022. The data were analyzed by Excel 2013 and SPSS 26 software. 【Results】 The high-throughput ELISA kit for SARS-CoV-2 neutralizing antibody detection, manufactured by Company A, was selected for further antibody titer detection. The mixed plasma titers were 1 337.34, 1 148.89, 852.19, 681.38, 556.44 and 457.19 U/mL from 1 to 6 months, respectively, after the 3rd shot of vaccine. The neutralizing antibody titer level began to increase around 7 days after the 3rd shot of vaccine injection and peaked (peak range: 264.07-2 208.39 U/mL, median: 569.34 U/mL) at 1 month (range: 9-43 days, median: 22 days), and then gradually decreased (P<0.05). 【Conclusion】 The neutralizing antibody titer of plasma donors who received the 3rd shot of inactivated novel coronavirus vaccine began to rise around 7 days after vaccination, which reached the peak value at around 1 month and then gradually decreased.

BACKGROUNDIntegrated positron emission tomography and computed tomography (PET/CT) is increasingly used for the preoperative nodal staging of non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the accuracy of PET/CT in comparison with CT in detection of nodal metastasis and preoperative nodal staging in patients with NSCLC, and to analyze the causes of the PET/CT false-negative and false-positive results.

METHODSConsecutive patients with pathologically proven NSCLC who underwent staging using PET/CT from July 2008 to February 2012 were evaluated retrospectively. Nodal staging was pathologically confirmed on tissue specimens obtained at thoracotomy. The accuracy of PET/CT and CT in the assessment of intrathoracic nodal involvement was determined using histological results as the reference standard. Logistic regression was used to define the causes of the false-negative and false-positive results.

RESULTSA total of 528 lymph node stations were evaluated in 101 patients. Lymph nodes were positive for malignancy in 43 out of 101 patients (42.6%), and 101 out of 528 nodal stations (19.2%). PET/CT was significantly more accurate for nodal staging than CT. The sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT for detecting nodal metastasis were 51.5%, 95.8%, 74.3%, 89.3%, and 87.3% and the corresponding data by CT were 45.5%, 87.1%, 45.5%, 87.1%, and 79.2%, respectively. PET/CT confers significantly higher specificity, positive predictive value, and accuracy than CT in detecting nodal metastasis. False-negative results by PET/CT are significantly associated with smaller lymph node size, whereas false-positive results are related to a combination of inflammatory disorders and larger lymph node size.

CONCLUSIONPET/CT confers significantly higher accuracy than CT in nodal staging, and is more specific and accurate than CT in detecting nodal metastasis but has a low sensitivity and high false-negative rate.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Multimodal Imaging ; Neoplasm Staging ; methods ; Positron-Emission Tomography ; Preoperative Period ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.