Objective To study the status of electrolyte imbalance in infant with moderate to severe malnutrition and discuss reasonable clinical therapy.Methods we examined serum level of electrolyte and analyse retrospectively.96 infants were divided into three group-pneumonia,diarrhea and mixed group,difference of electrolyte imbalance was compared within the three groups.Results Hypokalemia and hyponatremia were the major electrolyte imbalamce.60.4% had hypokalemia,55,2% had hyponatremia;the other imbalance,46.9% had hypochloremia,40.6% had hypocalcemia,32.3% had hypomagnesemia,30.2% had metabolic acidosis and 16.6% had metabolic alkalosis.Conclusions The pneumonia group was more likely to have hyponatremia,and the diarrhea group was more likely to have hypokalemia.Serum level of chloride fluctuated with the change of blood potassium.Hypomagnesemia and hypocalcemia were normal and were influenced by acid-base balance.Acidosis was more likely to be found in diarrhea group,and was metabolic in most situation.There was a trend of emerging metabolic alkalosis in severe dehydration patient.

OBJECTIVE To study pathogen distribution and susceptibility to sevenral antifungal agents.METHODS The CHROMagar candida color medium was applied to isolate and identify Candida strains.Drug sensitivity was analyzed by the K-B diffusion method.The drug sensitivity to econazole(ECO),nystatin(NYS),itraconazole(ITR),ketoconazole(KET),fluconazole(FLU),flucytosine(FCT),and amphotericin B(AMB)was tested.RESULTS Candida albicans was the most frequent isolated organism accounting for 62.5%.C.tropicalis and others accounted for 21.62% and 8.1%,respectively.The respiratory tract infection accounted for 76.57%,and the urinary tract was the second(6.31%),the blood and genitourinary tract were the third(5.00%).The susceptibility of Candada spp strains to nystatin and amphotericin B was more active than to other antifungal agents.CONCLUSIONS The fungal infection is relative to some risk factors,such as using antibiotics,underlying diseases and aging.Therefore,using antibiotics reasonably and improving the immunity are the main measures of preventing the fungal infection.

Objective To detect human metapneumovirus (hMPV)in respiratory intection rapidly and perform molecular analysis of hMPV.Methods Seven respiratory tract virus(11 subtypes)were assessed using multiplex PCR technology and flexible Multi-Analyte Profiling(suspension array).Human metapneumovirus was confirmed by using a real.Time reverse ranscriptase CR(RT-PCR)assay followed by sequencing.The cladogram analysis was performed further.Results The virus were detected in 40.2%(19/47)samples collected from clinicsl respiratory tract infections,including 8(42.1%)HRSV,7(36.8%)influenza virus,1(5.3%)parainfluenza virus,1(5.3%)rhinovirus,1(5.3%) coxsackievirus and 1(5.3%)human etapneumovirus infections.This is the first time that hMPV was deteced from clinical samples in Shenzhen.The sequencing of specific fragment of neucleoprotein of hMPV showed this hMPV shares over 98% homology with Beijing strain.Japan strain and Thailand strain.The cladogram analysis showed that they were in the same cluste.Conclusions Human etapneumovirus is a maior cause of children respiratory tract disease. Multiplex PCR technology and nexible Multi-Analyte Profiling were hish sensitive and high-throughput for detection of human metapneumovirus.They axe very robust and applicable in etiology analysis.

Biopsy ; Bronchial Neoplasms ; diagnosis ; pathology ; surgery ; Bronchoscopy ; Child ; Diagnosis, Differential ; Fatal Outcome ; Female ; Humans ; Lung ; diagnostic imaging ; surgery ; Lung Neoplasms ; diagnosis ; pathology ; surgery ; Neoplasm Metastasis ; Rhabdomyosarcoma, Embryonal ; diagnosis ; pathology ; surgery ; Tomography, X-Ray Computed

OBJECTIVEDeveloping a high-frequency ultrasonic skin imaging system to obtain the high resolution ultrasonic image of the skin. And further analyzing the ultrasonic images of skin to explore the imaging characteristics of skin structure and then explore the value of high-frequency imaging in the application of skin diagnosis.

METHODS50 MHz single element ultrasonic transducer, mechanic linear scanning method is used in the imaging system. The resolution and the ability of recognize the skin issue is verified by linear target scanning and clinical trials.

RESULTSBoth the axial and lateral resolution of the system reaches 50 microm. The subtle structure of normal skin tissue is clearly visible. Some diseases have obvious appearance in the image.

CONCLUSIONS50 MHz ultrasonic skin imaging system is of high resolution and is valuable to skin structure detect and disease diagnosis.

Objective To investigate clinical features and antibiotic resistance of pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infections (DFI) in Tianjin Metabolic Diseases Hospital.Methods Eighty-five PA strains were isolated from 428 patients with diabetic foot in the hospital from Jan 2008 to Dec 2010.The clinical features of patients were summarized.Relationships between the isolates and depth of ulcer or severity of infection were analyzed.The disk-diffusion method was performed to examine antimicrobial susceptibility.Results Gram positive (G+) and Gram negative (Gˉ) isolates were 50.47％ and 41.12％,respectively.Multidrug-resistant PA composed 32.9％ of the total PA isolates.The size of ulcers with PA infections was bigger than those with non-PA bacterial infections (P＜0.05).Compared to G+ strains,patients with PA strains were older,had lower hemoglobin,but higher serum sensitive C-reactive protein; and more frequently,they had ischemic ulcer and osteomyelitis.Compared to G+ strains,the PA strains were more frequently isolated from deeper ulcers and with more serious infections(P＜0.05).The resistant rates of PA to cephalosporins,fluoroquinolones,and aminoglycosides were between 32.9％-61.2％,37.6％-42.4％,and 37.6％-62.4％,respectively.Only one out of 85 PA strains was imipenem-resistant.However,sensitiveness of all PA isolates to cefoperazone and sulbactam reached 100％.Conclusion PA strains are mainly found in patients with deeper ulcers and more serious infections.Multidrug-resistant PA is common in DFI.It is important to isolate pathogens and determine their antibiotic resistance correctly in diabetic foot patients in order to provide appropriate drug administration and to reduce the production and dissemination of drug resistant strains.

Objective To establish the pipeline and evaluate the feasibility of high-throughput sequencing method used in the detection of severe pneumonia pathogens.Methods Clinical control study was used.Bronchi alveolar lavage fluids (BALF) samples from 76 patients with severe pneumonia (treatment group) and 18 patients with tracheal malacia (control group) and without clinical detected pathogens were collected during March 2015 to December 2016 in Shenzhen Children′s Hospital.The pathogens in the samples were detected using clinical tests and high-throughput sequencing respectively.The results of high-throughput sequencing were confirmed by real-time quantitative PCR and the high-throughput sequencing method used in the detection of severe pneumonia pathogens was evaluated.The χ2 test was used to analyze the correlation of detection rate between the high-throughput sequencing group and the non high-throughput sequencing group.Results The pipeline and method of high-throughput sequencing used in the severe pneumonia pathogens detection was established.The pipeline included sample collection, DNA extraction, library construction, sequencing, and bioinformatic analysis.In 76 cases of patients with severe pneumonia, the results of high-throughput sequencing in 66 cases of bronchoalveolar lavage fluid specimens were positive.The sensitivity was 86.84%, which was significantly higher than the total sensitivity of traditional clinical detection methods including bacterial culture, immunofluorescence and quantitative PCR(68.42%,52/76),χ2=7.426,P<0.001.A total of 13 pathogens were detected in 66 positive samples of high-throughput sequencing, including Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae and adenovirus, etc.Nine kinds of pathogens were detected in these samples through non-high-throughput sequencing.In the experimental group, the results obtained by clinical test and high-throughput (80.26%) were entirely consistent in 61 samples and not completely consistent in 15 samples (19.74%) specimens.These inconsistent results were mainly concentrated in the detection of adenovirus, Streptococcus pneumoniae and Haemophilus influenzae through high-throughput sequencing, whereas clinical cultures and immunofluorescence methods were not able to detect these pathogens.PCR validation showed that there was no significant difference between the results of high-throughput sequencing and the PCR tests (χ2=0.517,P=0.472), and the difference between the results of high-throughput sequencing and traditional clinical detection methods was statistically significant (χ2=11.671,P<0.001).Conclusion The method for the detection of severe pneumonia pathogens based on high-throughput sequencing is highly sensitive and can detect unknown pathogens, which is superior to those used in traditional clinical detection.

Objective:To analyze the clinical characteristics of lower respiratory tract infection of influenza virus-related critical illness in children, and provide reference for early diagnosis and treatment of the disease.Methods:Thirty influenza virus-related critical cases of lower respiratory tract infection admitted to Shenzhen Children′s Hospital from October 2018 to October 2019 were enrolled in our study, and the clinical data were compared with influenza virus-related common severe cases with lower respiratory tract infection.Results:We reported that 63.33% of children with critical illness were less than five years old, and most of them were male(25 cases, 83.33%). The incidence of critical cases in the summer was significantly higher compared with common severe cases( χ2=7.050, P=0.008). In addition, pulmonary rales were the most common lung signs in critical cases( χ2=5.222, P=0.022), and the incidence of severe pneumonia increased significantly( χ2=32.651, P<0.001). Besides, we noticed that 60.00% of critical cases had respiratory failure, and the prevalence rates of plastic bronchitis among critical cases significantly increased( χ2=7.797, P=0.005). The absolute counts of neutrophil and the proportion of C-reactive protein in critical cases were higher than those in common severe cases ( Z=-3.805, P<0.001; χ2=5.833, P=0.016). We also found that 30.00% of critically-ill cases had Streptococcus Pneumoniae in lavage, of whom Epstein-Barr(EB) virus detection rate was higher than that of common severe cases ( χ2=6.909, P=0.009). Conclusion:Critically ill cases of lower respiratory tract with influenza virus infection are more common in children under five years old.These cases mainly occur in summer.When patients with lung rales, the absolute counts of neutrophil and the C-reactive protein increased significantly, and specifically with streptococcus pneumoniae and EB virus infection, which are more likely to progress to severe cases.Severe pneumonia, plastic bronchitis and respiratory failure need to be close monitored as the serious complications of critical illness.Early anti-influenza viral and anti-bacterial treatment, as well as active symptomatic life support can improve the prognosis of the disease.

New infectious disease threats, caused by movement of people globally, remain omnipresent.In recent days, unprecedented cases of human monkeypox have been reported in Europe, the Americas and Australia.Which is enough to arouse people′s great attention.This article summarizes the epidemiological characteristics, transmission route, clinical manifestations, diagnosis and prevention of monkeypox, so as to improve the understanding of this disease and take preventive measures as soon as possible.

Group A Streptococcus(GAS) is a very important pathogen, especially for children.GAS may cause more kinds of diseases than any other microorganism and involve many disciplines.Since penicillin was discovered and widely used in the 1940s, bacterial infectious diseases have been conquered, and the incidence rate has decreased.However, the occurrence of antibiotics resistance is becoming more and more serious, and some bacterial infectious diseases have a rising trend.In recent years, GAS infection and disease have also been reported in a small range.There are not many Chinese people who pay attention to GAS, especially those who study GAS.They do not have enough understanding of GAS, which leads to some misunderstandings.There are still many questions about GAS that no one can explain so far.Therefore, we call for attention to GAS and GAS diseases.