To analyze the relationship between the degree of hepatic fibrosis, the inflammatory cell infiltrationandthepostoperativecholangitisafterKasaioperationinchildrenwithbiliaryatresia(BA).Methods Atotalof 92childrendiagnosedasBAinourhospitalfromJanuary2015toDecember2016wereselectedinthisstudy.Patientswere dividedintohepaticfibrosisgradeⅠgroup(n=8),hepaticfibrosisgradeⅡgroup(n=31),hepaticfibrosisgradeⅢgroup(n= 35)andhepaticfibrosisgradeⅣgroup(n=18),accordingtoJapan’sOhkuma’shepaticfibrosisgradingcriteria.Combined with Kasai age, the relationship between hepatic fibrosis and surgical age was analyzed. Samples of liver tissues were evaluatedbyhematoxylin/eosin(HE)andMassonstaining.Theexpressionsofspecificinflammatorycellmarkerantibody LCA,CD4,CD8andCD68inliverwereobservedbyIHCstaining.Combinedwiththepostoperativefollow-updataofKasai, the relationship between the degree of inflammatory infiltration of liver tissue, the degree of hepatic fibrosis and the postoperative cholangitis of Kasai in BA children was analyzed. Results Routine pathological staining showed that lymphocytesinfiltratedmainlyinlivertissue.TheexpressionlevelsofLCAandCD4werehigheringroupⅠandgroupⅣ comparedwiththoseofgroupⅡandgroupⅢ.TherewasnosignificantdifferenceintheCD8expressionbetweenfour groups.All92childrenwithBAwerefollowedup.Itwasfoundthatcholangitisoccurredin 50cases,earlycholangitis occurredin38cases,andfrequentcholangitisoccurredin23cases.Theincidenceofcholangitis,earlycholangitis,and frequentcholangitisafterKasaisurgerywasstatisticallysignificantinBApatientswithdifferentgradesofhepaticfibrosis (P＜0.05). The incidence of cholangitis was higher in the groupⅠand group Ⅳ than that in groupⅡand group Ⅲ. Conclusion TheoccurrenceofcholangitisafterKasaioperationinchildrenwithBAiscorrelatedwiththehepaticfibrosis andliverinflammatorycells,especiallyTlymphocytesubgroups.

OBJECTIVETo explore the relationship between angiotensin converting enzyme (ACE) gene single nucleotide polymorphisms (SNP) and premature coronary heart disease (PCHD) patients with blood stasis syndrome (BSS).

METHODSrs4343, rs4293, and rs4267385 were selected at SNP from ACE gene. Allele and genotype were detected. Frequencies of allele and genotype were compared by using time-of-flight mass spectrometry technique (TOF-MS).

RESULTSCompared with the healthy control group, genotype of rs4293 and rs4267385 in ACE gene were similar, but there was statistical difference in polymorphisms and allele frequencies of rs4343 in the I and II group (P < 0.05, P < 0.01). The frequency of G allele was higher in the 3 groups than in the healthy control group (P < 0.05, P < 0.01). The relative risk analysis showed that the risk for PCHD occurrence in G allele carriers at rs4343 (GG +AG) was 3. 6 times the risk in non-G allele carriers (95% CI: 1.224-10.585, P = 0.02). There was also statistical difference in sex, age, TC, and TG after adjusted Logistic regression analysis (OR = 3.994, 95% CI: 1.230-12.974, P = 0.021).

CONCLUSIONThe polymorphism at rs4343 (G2350A) might be one of risk factors for PCHD occurrence, but not a predisposing factor for PCHD patients of BSS.

Alleles ; Case-Control Studies ; Coronary Artery Disease ; genetics ; Gene Frequency ; Genotype ; Humans ; Medicine, Chinese Traditional ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Single Nucleotide ; Risk Factors

Objective To investigate the image changes of proton magnetic resonance spectroscopy (1H-MRS) in children with epilepsy and their clinical significance. Methods Sixty-four patients with epilepsy,admitted to our hospital from March 2008 to March 2011,and 10 healthy children as control group were chosen in our study; the patients were divided into MR normal group and MR abnormal group according to the results of MR imaging. All of them received 1H-MRS examination on the hippocampal area.The ratio of NAA/Cho+Cr was compared between each 2 groups. Results No significant differences on the ratio of NAA/Cho+Cr were noted between the fight and left sides in all the groups (P＞0.05).The ratio of NAA/Cho+Cr was significantly different:MR normal group and control group enjoyed obvious difference as compared with MR abnormal group (P＜0.05); however,MR normal group and MR abnormal group existed no statistically significant differences (P＞0.05). Conclusion 1H-MRS is more sensitivity than MRI in children with epilepsy,therefore,1H-MRS can find the lesions earlier than MR imaging.

Objective:To evaluate the antimicrobial resistance of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolated from human cases. Methods:From 2011 to 2019, 33 non-O157 STEC strains recovered from diarrheal patients from 7 provinces/cities were collected, including Qinghai (1 isolate), Heilongjiang (1 isolate), Guangxi (2 isolates), Shandong (2 isolates), Guangdong (4 isolates), Henan (11 isolates), and Shanghai (12 isolates). Minimum inhibitory concentration (MIC) of 19 antimicrobials were tested by broth microdilution method; O∶H serotypes, Multi-locus sequence typing (MLST) and antimicrobial resistance genes were determined by whole genome sequencing.Results:A total of 33 non-O157 STEC strains were typed into 19 O∶H serotypes and 17 sequence types (STs), respectively. Ten strains were resistant to one or more antibiotics,of which five were multiple drug-resistant (MDR). The resistance rate of tetracycline was 30.3% (10 isolates), and azithromycin resistant strains were detected (12.12%, 4 isolates), but all strains were susceptible to carbapenems. All strains carried the blaEC gene, and the Extended-Spectrum β-Lactamase (ESBL) genotype blaCTX-M-15 were detected (3.0%, 1 isolates). The fosA7 gene was firstly detected in non-O157 STEC strains. Conclusion:MDR, azithromycin resistance, and multiple drug resistance genes were detected in human-derived non-O157 STECs in many regions in China, but they were all susceptible to carbapenems. Our results might guide the clinical treatment of STEC infections.

Objective:To evaluate the antimicrobial resistance of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolated from human cases. Methods:From 2011 to 2019, 33 non-O157 STEC strains recovered from diarrheal patients from 7 provinces/cities were collected, including Qinghai (1 isolate), Heilongjiang (1 isolate), Guangxi (2 isolates), Shandong (2 isolates), Guangdong (4 isolates), Henan (11 isolates), and Shanghai (12 isolates). Minimum inhibitory concentration (MIC) of 19 antimicrobials were tested by broth microdilution method; O∶H serotypes, Multi-locus sequence typing (MLST) and antimicrobial resistance genes were determined by whole genome sequencing.Results:A total of 33 non-O157 STEC strains were typed into 19 O∶H serotypes and 17 sequence types (STs), respectively. Ten strains were resistant to one or more antibiotics,of which five were multiple drug-resistant (MDR). The resistance rate of tetracycline was 30.3% (10 isolates), and azithromycin resistant strains were detected (12.12%, 4 isolates), but all strains were susceptible to carbapenems. All strains carried the blaEC gene, and the Extended-Spectrum β-Lactamase (ESBL) genotype blaCTX-M-15 were detected (3.0%, 1 isolates). The fosA7 gene was firstly detected in non-O157 STEC strains. Conclusion:MDR, azithromycin resistance, and multiple drug resistance genes were detected in human-derived non-O157 STECs in many regions in China, but they were all susceptible to carbapenems. Our results might guide the clinical treatment of STEC infections.

Objective To investigate the effect of atorvastatin on oxidative stress and intracellular lipid accumulation in HepG2 cells under inflammatory state and explore the underlying mechanism.Methods HepG2 cells were treated with 100 ng · mL-1 TNF-α,100 ng · mL-1 TNF-α ± 10 μmol · L-1 atorvastatin in the presence of LDL for 24 h.Oil red O staining was used to examine the intracellular lipid contents.The mRNA and protein expressions of lipogenic genes (FAS,ACC and SREBP1) were detected by real-time polymerase chain reaction and Western blot.ROS levels were measured with the fluorescent probe of DCFH-DA.Contents of H2O2 and MDA were determined using the colorimetric method.Results Compared with normal group(the gray value of SREBP1 was 1.01 ± 0.001),the gray value of SREBP1 in model group was 1.61 ± 0.34.The mRNA levels in normal group of SREBP1,FAS,ACC respectively were 1.01 ± 0.16,1.03 ± 0.32,0.95 ± 0.29,the values in model group respectively were 3.61 ± 0.39,1.99 ± 0.36,2.37 ± 0.52,the differences were statistically significantly (P ＜ 0.05).Compared with model group,the mRNA levels of SREBP1,FAS,ACC and the gray value of SREBP1 in experimental group respectively were 2.95 ± 0.92,3.99 ± 1.16,2.85 ± 0.91,2.94 ± 0.65,the differences were statistically significantly(P ＜0.05).At the same time,compared with normal group,the levels of ROS(fluorescenceintensity),H2O2,MDA respectively were 1.00 ±0.20,and (2.30 ±0.31) (0.78 ±0.22) nmol · mg-1,the levels in model group respectively were 1.77 ± 0.25 and (4.32 ± 0.77),(1.86 ± 0.23) nmol · mg-1,the differences were statistically significantly (P ＜ 0.05).Compared with model group,the levels of ROS,H2 O2,MDA in HepG2 cells in experimental group respectively were 3.2 ±0.53 and (5.31 ±0.75),(3.43 ± 1.15) nmol · mg-1,the differences were statistically significantly(P ＜ 0.05).Conclusion Atorvastatin induced intracellular lipid accumulation in HepG2 cells under inflammatory stress,which may be associated with the increased oxidative stress.

OBJECTIVETo investigate the relationship between the morphological features of different types of neuronal intestinal malformations (NIM) and their postoperative complications.

METHODSThe data of morphological and clinical features of 324 cases with NIM were analyzed retrospectively.

RESULTSIn all 324 patients, 210 cases were Hirschsprung's disease (HD), 38 intestinal neuronal dysplasia (IND), 45 mixed HD/IND, 8 hypoganglionosis, 22 combined HD/hypoganglionosis and 1 immaturity of ganglion cells. The percentages of normal neuron in bowel of different NIM were 88.1%, 24.4%, 18.4%, 4/8, 27.7% and 0/1 in HD, HD/IND, IND, hypoganglionosis, HD/hypoganglionosis and immaturity of ganglion cells respectively. There were totally 46 cases complicated with recurrent postoperative enterocolitis (EC). Incidence of recurrent postoperative EC in HD patients was 6.7% while in IND/HD and IND patients was 35.6% and 28.9%, respectively. Incidences of EC in cases with the residual IND margins and with the normal margins were 38.2% and 8.7%, respectively. Incidence of EC in cases with transanal endorectal pull-through procedure and with transabdominal procedure was 18.0% and 8.3%, respectively. Nine cases underwent another procedure because of severe persistent constipation or EC after operation, including 4 cases HD/IND, 1 case IND, 3 cases HD and 1 case HD/hypoganglionosis.

CONCLUSIONSNeuron distribution is inconsistent with pathology of NIM. Postoperative EC are rare in the patients only with isolated HD. Furthermore, margins with residual IND and transanal endorectal pull-through procedure are risk factors to recurrent EC. However, the extension of excision about IND is uncertain and need further study.

Adolescent ; Child ; Child, Preschool ; Digestive System Abnormalities ; complications ; pathology ; surgery ; Enteric Nervous System ; abnormalities ; pathology ; Female ; Hirschsprung Disease ; complications ; pathology ; surgery ; Humans ; Infant ; Male ; Postoperative Complications ; etiology ; Retrospective Studies

OBJECTIVETo explore the clinical diagnosis of BK virus (BKV) infection in renal transplant recipients.

METHODSUrine and peripheral blood samples were taken from 234 renal transplant recipients for BKV detection with cytological test and real-time PCR.

RESULTSThe occurrence rate of urine decoy cells, BKV viruria and viremia in these patients was 33.3 %, 33.3% and 16.2%, respectively, and the median level of urine decoy cells was 6/10 HPF, with the median level of urine and peripheral blood BKV of 7.62 x 10(3) copy/ml and 7.61 x 10(3) copy/ml, respectively. The positivity rate of BKV in the urine samples were significantly higher than that in peripheral blood samples (P=0.000). The amount of decoy cells was related to BKV load in the urine samples (gamma=0.59, P=0.000), but the BKV load in the urine samples was not related to that in peripheral blood samples (P=0.14).

CONCLUSIONRenal transplantation is associated with increased BKV shedding, indicating the necessity of BKV monitoring in renal transplant recipients with urine cytology, which is convenient and sensitive and indicates renal histological changes indirectly. Urine and peripheral blood BKV DNA detection is of value in identifying BKV activation to prevent irreversible graft damage of BKV-associated nephropathy.

Adolescent ; Adult ; Aged ; BK Virus ; genetics ; isolation & purification ; physiology ; Child ; Child, Preschool ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Polyomavirus Infections ; diagnosis ; virology ; Young Adult

Escherichia albertii is an emerging zoonotic enteropathogen which mainly causes infectious diarrhea. Since the discovery and naming of Escherichia albertii, it was found to be responsible for several outbreaks of foodborne gastroenteritis and widely distributed in avian and wild animals. Due to the lack of specific identification system, the global Escherichia albertii infections might be underestimated. Though avian has been considered as the important reservoir of Escherichia albertii, its role in disease transmission remains unclear. This study reviewed the biochemical properties, genomic characteristics, isolation and identification methods of Escherichia albertii, and its prevalence in human, host animals and food. The risk of Escherichia albertii infection and future perspectives in this field were also discussed.

Objective:To understand the molecular characteristics of Escherichia coli producing Shiga toxin 2e subtype isolated from different sources in China. Methods:Three human-derived, 13 animal-derived and eight food-derived stx2e-positive Escherichia coli strains which were isolated during 2012 to 2018 were analyzed by antimicrobial susceptibility testing and whole genome sequencing. The stx subtype, serotype, multi-locus sequence type, virulence genes and antimicrobial resistance genes of each strain were determined by whole genome sequences. The phylogenetic relationship and genetic composition of Shiga-toxin prophage were explored. Results:Twenty-four stx2e-STEC strains were typed into 19 O∶H serotypes and 19 sequence types (STs). Each strain carried at least one kind of antimicrobial resistance gene and 19 out of 24 strains were resistant to at least one kind of antimicrobials. Three human-derived strains were heterogenous in serotypes and STs, but there were several animal and food-derived strains shared the same serotype or ST with human strains and showed close relationship in the phylogenetic analysis. The sequences of stx2e among all strains were highly conserved (similarity >99.7%), but there were significant differences in the size and the gene composition of Shiga toxin prophage genome. Conclusions:This is report about the characteristics of rare human-derived Stx2e-STEC strains in China. Comparing human isolates with animal-and food-derived strains, it indicates that Stx2e-STEC strains are highly genetic diversity and have the potential to infect humans.