OBJECTIVETo study the frequency of telomerase gene (TERC and TERT) mutation in Northern Chinese patients with acquired bone marrow failure syndromes (BMFS).

METHODSDNA extracted from blood samples of 90 patients with BMFS (including AA, MDS, and PNH) and 45 normal controls from 4 northern hospitals was collected. TERC and TERT mutation analysis was performed by PCR.

RESULTSTwo TERC mutations (n37 A-->G, and n66 G-->C) and two TERT mutations \[n1870 G-->T (E/*)\]; and \[n1780 G-->T (S/I)\] were identified in 90 BMFS patients. Among them, 3 mutations were reported for the first time. One patient with TERT mutation, however, was finally diagnosed as DKC instead of acquired AA, making the incidence of telomerase gene mutation in northern Chinese people with acquired BMFS 3.4%, similar to that of the western country people.

CONCLUSIONThe incidence of telomerase gene mutation in northern Chinese people with acquired bone marrow failure syndromes is 3.4%, similar to that of the western country people.

DNA Mutational Analysis ; Humans ; Mutation ; RNA ; genetics ; Syndrome ; Telomerase ; metabolism

OBJECTIVETo measure telomere length of patients with bone marrow failure syndrome (BMFS) and explore the relationship between telomerase gene mutation and telomere shortening.

METHODSBlood samples from 10 patients with AA, MDS-RA were collected and performed TERC and TERT gene mutation analysis. Telomere length was measured by Southern blot and compared with normal controls and two patients with MDS-RAEB and AML each.

RESULTSTwo patients in the 10 BMFS patients had TERC and TERT gene mutations and very short telomeres compared with normal controls and with the 8 BMFS counterparts, the telomere length was less than 50% of that of normal control, and was similar to that of patients with MDS-RAEB and acute myelogenous leukemia, indicating the possibility of malignant transformation. Some BMFS patients with no mutations also had short telomeres.

CONCLUSIONSBMFS patients with telomerase gene mutation have very short telomeres, being similar to that of hematological malignancies. Some BMFS patients with no telomerase gene mutations also have short telomere length.

Asian Continental Ancestry Group ; Humans ; Mutation ; Pancytopenia ; Telomerase ; metabolism ; Telomere ; metabolism

OBJECTIVETo measure the telomere length in patients with bone marrow failure syndrome (BMF) using fluorescence in situ hybridization and flow cytometry (Flow-FISH).

METHODSBlood samples were collected from 8 patients with BMF. Telomere lengths of mononuclear cells from 8 BMF patients and granulocytes from 3 of these 8 BMF patients (all these 3 patients were suffered from aplastic anemia) were measured using Flow-FISH, and the results were compared with those of normal controls. Telomere lengths were measured by Southern blot in 3 patients, and the results were compared with those obtained from Flow-FISH.

RESULTSAmong these 8 BMF patients, 5 have decreased telomere length in their mononuclear cells. However, different white cell subgroups, specifically mononucleated cells and granulocytes, have different degree of telomere shortening. In 3 BMF patients who underwent both Flow-FISH and Southern blot, 2 patients had consistent measurement results.

CONCLUSIONFlow-FISH can be used for the measurement of telomere length in Chinese patients with BMF.

Adolescent ; Adult ; Anemia, Aplastic ; Bone Marrow Diseases ; Case-Control Studies ; Female ; Flow Cytometry ; methods ; Hemoglobinuria, Paroxysmal ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Male ; Middle Aged ; Telomere ; genetics ; Young Adult

Objective To understand the infection status, epidemiological characteristics and genetic evolution of adenovirus in children with diarrhea in Tianjin. Methods A total of 1609 fecal specimens were collected from hospitalized children with diarrhea from July 2017 to July 2018 in Tianjin Children's Hospital. Viral nucleic acid was extracted and amplified by the hexon gene fragment. Positive specimens were used for nucleic acid sequence determination and sequence alignment and phylogenetic tree analysis with known sequences in GenBank. Rotavirus in the stool specimens was detected by gold standard method, and campylobacter was detected by latex agglutination method. Bocavirus, Norovirus and Clostridium difficile were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results A total of 69 specimens with adenoviruses were detected in 1609 cases, with a positive rate of 4.3％, in which 82.6％adenovirus-positive children were between 7 and 48 months old. The positive rate of adenovirus peaked in the summer and autumn, and the differences of this value among seasons were statistical significance (χ2=11.467,P=0.009). In these cases, the mixed infection rate of adenovirus was 26.1％(18/69), in which 7 cases were mixed with Norovirus, 7 cases were mixed with rotavirus and 4 cases were mixed with Clostridium difficile. A total of 39 adenovirus-positive PCR products were randomly selected for gene sequence detection, and 7 adenovirus genotypes were detected. Results showed that these viruses were mainly the type 41 enteric adenovirus (46.1％, 18/39), followed by type 31, type 3 and type 7 non-intestinal adenovirus, while types 1, 5 and 6 were relatively rare. Conclusions There are diverse types of adenovirus in children with diarrhea in Tianjin. The adenovirus-infected diarrhea mostly happen in summer and autumn, and is common in children.

OBJECTIVEIn order to evaluate the safety and immunogenicity of group A + C meningococcal polysaccharide vaccine, a controlled field trial was performed among children at 6-24 months and 5-13 years old in Longsheng county, Guangxi Zhuang Autonomous Region.

METHODSMore than 600 children were selected in this trial. 428 children, aged 6-24 month-old and 5-13 year-old were involved in two experimental groups and were inoculated 100 microg of group A + C meningococcal polysaccharide vaccine. 103 children in positive control group were inoculated 50 microg of group A meningococcal polysaccharide vaccine while 94 children in negative control group were inoculated 30 microg of Typhoid Vi polysaccharide vaccine. Both systemic and local reactions were observed in each group at 6 h,24 h,48 h and 72 h after inoculation. Blood samples were collected in all children before and at 1 month after inoculation. Additionally, at least 50 blood samples were taken in each experimental group at 6 and 12 months after inoculation. Serum bactericidal antibody was tested by micro bactericidal test.

RESULTSBoth systemic and local reactions were mild in two experimental groups with only 3 children (0.7%) had > or = 37. 6 degrees C fever, 4 children (0.9%) appeared mild areola but all adverse reaction disappeared within 48 hours. In 5-13 year-old experimental group, the rates for four-fold increase of bactericidal antibody were 96.59% and 92.15% to group A and group C meningococcus respectively at 1 month after inoculation, and remained 90.91% and 90.08% at 12 months after inoculation.

CONCLUSIONGroup A + C meningococal polysaccharide vaccine was safe and having good immunogenicity among Chinese children.

Adolescent ; Antibodies, Bacterial ; blood ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Meningococcal Vaccines ; adverse effects ; immunology ; Polysaccharides, Bacterial ; adverse effects ; immunology ; Typhoid-Paratyphoid Vaccines ; adverse effects ; immunology

OBJECTIVETo assess the clinical therapeutic effects of elastic intramedullary nail on extremity fractures in children.

METHODSFrom June 2005 to March 2008, 40 children with extremity fractures were treated by elastic intramedullary nail, in whom femoral shaft fractures occurred in 26 cases, tibiofibular fractures in 8 cases, radial capitular fractures in 4 cases, ulnoradial fractures in 2 cases. All patients were treated by closed reduction and elastic intramedullary nail fixation.

RESULTSAll the fractures gained satisfactory reduction and healing. The average duration needed for fracture healing was 1-2 months. Postoperative follow-up confirmed a sound functional recovery.

CONCLUSIONSThe elastic intramedullary nail is a minimally invasive and effective surgical approach for treatment of extremity fractures in children. It allows early functional exercises after operation and secures a satisfactory bone union and functional recovery.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Extremities ; diagnostic imaging ; injuries ; surgery ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; Fracture Healing ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Postoperative Complications ; Radiography ; Treatment Outcome

Most of the CHD patients reveal string pulse, mainly due to damage of heart function, lowering of arterial compliance and increase of total peripheral resistance. The common pulse in patients of blood diseases reveal frequent, tiny, string and slippery characteristic, mostly due to the increase of compensatory pumping action of the heart, shortening of ejection time of the left heart, with better vessel compliance and hemorheology, low total peripheral resistance.

Medical insurance payment model is transforming from project-based purchases to service bundle-based strategic purchases. The new form of bundled purchases should found on a scientifically-led design process of such bundles. The core to bundled purchase would be the payment standard, and the key to its success would be process control. Establishment of such a foundation, a core, and a key, would promote the current price standards, and lead service providers to a standardized medical service standard, so as to ensure a precise rewarding system of payment and service. The big data diagnosis-intervention packet(DIP)is able to fulfill mentioned ambitions by integrating insurance payment and supervision into one management. DIP is a full-process payment mode that encompasses pre-service estimation, in-service process control, post-service grading, and resource allocation. It is an innovative practice in line with China′s national conditions for the modern governance of medical security and medical services.

Objective To assess the safety, immunogenicity and efficacy of group A and C meningococcal polysaccharide vaccine (A/C MPV) in response to an outbreak of group C meningococcal disease. Methods A vaccination campaign with A/C MPV was prompted 6 weeks after the use of group A MPV in Laibin city, Guangxi, where an outbreak of group C meningococcal meningitis occurred in 2002.Vaccinees were observed for local and systemic reactions after the vaccination and followed up for the meningococcal disease for 5 years. Blood samples were collected from 71 people in the epidemic and 43 in the non-epidemic areas before and 1 month after the vaccination and examined by ELISA to detect IgG antibodies to group A and C polysaccharides. Results The vaccination coverage was 97%. No significant adverse reactions were observed. The positive rates of group C antibodies after vaccination was between 97.67% and 100% among the populations in the epidemic and non-epidemic areas, as well as among those negative and positive for group C antibodies prior to the vaccination.The geometric mean anti-C concentrations ranged 30.81 μg/ml to 37.44 μg/ml, showing no significant difference between groups. The incidence rate of meningococcal disease in students with timely immunization (218.58/100 000) dropped by 69.02% , when compared to that in those with delayed immunization (705.72/100 000). No clinical cases were identified during the follow-up period of 15 760 person-years. Conclusion The vaccination campaign with the Chinese group A/C MPV seemed successful in controlling the group C meningococcal outbreak.The vaccine was shown to be safe even administered after the group A vaccine only 6 weeks apart. It could induce high levels of antibodies in vulnerable population and significantly increase antibody levels in seropositive individuals, thus providing a protection of at least 5 years.

OBJECTIVETo evaluate the safety of a group A + C meningococcal polysaccharide vaccine as part of a phase IV clinical trial.

METHODSThe study area was divided into 108 clusters according to the principle of cluster randomization, stratified and paired sampling methods. 54 out of 108 clusters served as observation groups were administered A + C vaccine, while the rest 54 groups were administered Vi polysaccharide vaccine. An adverse event surveillance system was established to monitor the adverse events following the vaccination campaign. Identical form and methods were used for data collection to investigate the adverse events following the vaccination of both A+ C vaccine and Vi vaccine.

RESULTS34,543 people were vaccinated, including 18,167 of whom received A + C vaccine, while the other 16,376 received Vi vaccine. The rates of immediate injection reaction and unsolicited non-serious adverse events from A + C vaccine group were 0.44% and 0.38% while of Vi vaccine group were 0.79% and 0.73% respectively. At the solicited adverse event survey on 3-day-post-vaccination, 1239 vaccinees were followed-up including 771 received A + C vaccine and 468 received Vi vaccine. The local injection reaction rate of A + C vaccine group on the 1st day was significantly higher (X2 = 13.98, P = 0.0002) than that of Vi vaccine group. Neither the local injection reaction rate nor the system reaction rate between both groups was significantly different on 2nd and 3rd day, post vaccination. It was not statistically different when comparing fever onset rate between those who received vaccine and those who did not, in each vaccine group. There were no serious adverse events observed.

CONCLUSIONResults showed that the side effects of A + C vaccine and the Vi vaccine were mild and safe for vaccination campaigns targeting on populations at different age.

Adolescent ; Adult ; Age Distribution ; Child ; Child, Preschool ; Female ; Humans ; Male ; Meningococcal Vaccines ; adverse effects ; immunology ; Middle Aged ; Polysaccharides, Bacterial ; immunology ; Sex Distribution ; Young Adult