Objective To investigate the awareness rate of knowledge related with vascular cognitive impairment (VCI) in community residents in Shuangjing District,Beijing.Methods 5 communities were randomly selected from 12 communities in Shuangjing District.According to roster,512 residents were selected randomly.Among them,there were 197 males and 315 females with an average age of (64.71±8.22) years.87.9％ of subjects had junior high school culture and over.The awareness rate of knowledge related with VCI was investigated by questionnaires from January 2013 to March 2013.Results Although the awareness rate of knowledge related with vascular dementia was only 36.9％,the awareness rates of symptoms of impairment in memory,orientation,language,execution,calculation,visuospatial and judgement were 43.8％-89.3％.The awareness rates of four outpatient clinics among dementia patients were 21.5％-38.9％,however,the awareness rate of dementia which was not curable was 47.5％.The awareness rates of 5 risk factors for stroke were 54.5％-83.4％,but the awareness rate of cognition impairment caused by hypotension and hypoglycemia was 42.8％ and 43.2％,respectively.About VCI-related preventive knowledge,the awareness rates of VCI population with high risk factors,cognitive abilities screening,and primary prevention were 35.5％-95.5 ％.The main routes taking healthy knowledge were the television and newspapers with the awareness rate of 86.9％ and 60.2％,respectively.85.9％ of subjects agreed that healthy education was helpful to their life qualities.Multiple linear regression analysis showed a significant relationship of accumulated points of VCI-related knowledge with gender and education degree (P＜0.05).Conclusions The awareness rates of risk factors,diagnosis and therapy and primary prevention for VCI are lower in Shuangjing community,and the health education about VCI should be strengthened.

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.

Objective To find out the importance of human bocavirus (HBoV) as an infectious agent for population in Beijing, China. Seroprevalence study was conducted by using expressed recombinant major capsid VP2 protein as an antigen.Methods Serum specimens collected from infants and children who visited the Children's Hospital Affiliated to the Capital Institute of Pediatrics for health check-up and adults visiting the Xuanwu Hospital, Beijing for diseases other than respiratory infections from April 1996 to March 1997 were used for the investigation. The major capsid protein VP2 from HBoV was expressed in E. coli strain BL21 (DE3) with the transformed PET30b vector inserted with full-length VP2 gene of HBoV and the specific antigenicity of this expressed protein was validated by previous study. Western blotting was used to detect specific IgG antibody against HBoV in collected serum specimens diluted to 1:200. Mock expressed protein was E. coli cells strain BL21 (DE3) with the transformed PET30b vector without insert. Anti-His monoclonal antibody and rabbit anti-HBoV VP2 polypeptides hyper-immune serum were used as positive control for antibody detection.Results Out of 677 serum specimens tested, 400 (59.1% ) were positive for HBoV by Western blotting. About 45.3% (34/75) of the newborns under 1 month of age had anti-HBoV antibodies, and antibody positive rates were decreased in age groups of 1 and 2 months (41.4% and 31.3%, respectively) then increased in the following ages from 6 months to 7 years old ( from 45.6% to 69.7% ). The antibody positive rates were maintained at a relatively constant level ( about 70% ) in the age groups from 7 years to 40 years of age and became lower ( 61.8% - 62. 8% ) in those over 50 years.Conclusions The high seroprevalence of antibody against recombinant HBoV VP2 protein and early age antibody acquisition indicate that HBoV has been circulating in population of Beijing, China as early as in 1996 and most of children had been exposed to HBoV by the age of 7 years. Infants under the age of 6 months were susceptible to this virus.

ObjectiveThis work is aimed to investigate the possible association of dendritic cell immunoreceptor (DCIR) with rheumatoid arthritis (RA) susceptibility in Chinese Han population.Methods A total of 523 patients with RA and 510 healthy controls were genotyped for single-nucleotide polymorphism (SNP) rs2377422 and rs10840759.Association analyses were performed on the whole data set and on RA subsets based on the status of anti-cyclic citrullinated peptide antibody (CCP) in RA patients.Finally,we carried out the association analysis of rs2377422 with DCIR mRNA expression in RA patients.Statistical analysis used in this study included X2 test,Logistic regression,and Mann-Whitney U test.ResultsDCIR rs2377422 was found significantly associated with RA(allele analysis: OR 1.26; 95％CI 1.06～1.51,P=0.005; genotype analysis CC vs TT+TC: OR 1.34; 95％CI 1.18～2.06,P=0.004).Following stratification for anti-CCP antibody status,association of ra2377422 with anti-CCP-positive RA was observed(allele analysis: OR 1.22,95％CI 0.99～1.48,P=0.055).In contrast,the SNP rs2377422 was found specifically susceptible to anti-CCP-negative RA(allele analysis: OR 1.46; 95％CI 1.10～1.93,P=0.0091; genotype analysis CC vs TT+TC: OR 1.58;95％CI 1.01～2.47,P=0.043),despite loss of power in the analysis.DCIR gene transcription quantification analysis further proved the dominant effect of rs2480256 CC genotype on DCIR mRNA expression levels in RA patients (CC vs TT+TC: 0.429±0.069 vs 0.238±-0.023,U=1861,P=0.0015).ConclusionThe study provides evidence for the association between DCIR rs2377422 and RA,particularly with anti-CCP-negative RA in Chinese Han populations.

Objectives To evaluate the efficacy of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma (DLBCL) and the relationship of clinical prognosis with the International Prognostic Index (IPI) by the using rituximab in autologous peripheral stem cell transplantation (APBSCT) for the patients of DLBCL. Methods 21 patients with DLBCL, 11 patients of them were at IPI low risk, and 3 patients were IPI at low intermediate risk, 3 patients were at IPI high intermediate risk, 4patients IPI high risk. Rituximab combined with CHOP regimen (cyclophosphamide, adriamycin, vincfistine and prednisone) was given for 4～8 courses. 5 patients received APBSCT. The mobilizing regimen was rituximab combined with cyclophosphamide(CTX) and etoposide(VP16). The conditioning regimen were CBV(CTX combined with VP16 and carmustine). Results In 21 patients, the complete response rate was 61.9 %,with overall response rate 90.5 %. 2-year progression free survival was (69.74±10.43)%. 2-year overall survival was (84.44:1:8.35) %. The complete response rate was 92.9 % and overall response rate was 100 % in the patients IPI≤2. The overall response rate was 71.4 % in the patients with IPI≥3. The complete response rate was higher in the patients with IPI≤ 2 (P＜0.01). The amount of mononuclear cells (M NC) in harvest were 7.34 (4.6～8.53)×108/kg. The CD+34 cells in harvest were 8.82 (2.1～10.34)×1O6/kg. The mean time of neutrephil recovering to 0.5×109/L after APBSCT was +9 day. The mean time of platelet recovering to 20×109/L after APBSCT was +12 day. The major adverse reaction were infusion related response (14.3 %) and hematological toxieities. Conclusion The efficacy of rituximab combined with chemotherapy in the treatment of DLBCL is effective, The complete response rate was higher in the patients with IPI≤2 than in the patients with IPI≥3.Using rituximab in mobilizing regimen, all patients had harvested enough CD+34 cells. Rituximab given at +1day did not affect the hematopoiesis reconstruction.

OBJECTIVETo understand the impact of human parainfluenza virus (HPIV) on acute respiratory infections in infants and young children in Beijing.

METHODSMultiplex reverse transcription-PCR was used to amplify the hemagglutinin (HA) gene fragment of HPIV from clinical specimens. Primer pairs derived from a conserved region of the HA genes of HPIV were used to develop the multiplex RT-PCR for detecting and typing HPIV. The sensitivity and specificity of the method were determined by using various RNA and DNA viruses as controls. Specimens collected from 3519 children with acute respiratory infections from Aug. 2003 to Apr. 2006 were analyzed for HPIV by the multiplex RT-PCR as well as for other respiratory viruses by virus isolation and/or indirect immunofluorescent assay (IFA). Ten amplicons with expected molecular weight matching different types of HPIV were randomly selected for sequence analysis.

RESULTSOnly the cDNA from the isolated strains of HPIV 1 and 3 was positive by the multiplex RT-PCR. Phylogenetic analysis for those 10 amplicons' sequences which belong to HPIV 1 - 4 types respectively as determined by multiplex-PCR indicated that these specimens were truly HPIV positive. These 10 HPIV positive specimens included two specimens of type 4 which was further subtyped as HPIV4A and 4B by sequence analysis. With the multiplex RT-PCR, HPIV were detected in 349 out of 3519 specimens with the positive rate of 9.9% (349/3519), which is higher than 4.8% by the methods of virus isolation and/or IFA. And the HPIV positive rates were high in patients with not only acute upper but also lower respiratory tract infection. No regular seasonality distribution of HPIV infection was found. HPIV 1 and 3 were more common than HPIV 2 and 4.

CONCLUSIONWith higher sensitivity and specificity than virus isolation and IFA, multiplex RT-PCR is beneficial for the etiologic and epidemiologic studies on HPIV, as well as for HPIV typing. The data from this study indicate that HPIV is one of the important etiological viruses of acute respiratory tract infections in infants and young children in Beijing.

Child, Preschool ; China ; epidemiology ; Genes, Viral ; HN Protein ; genetics ; Humans ; Infant ; Paramyxoviridae Infections ; epidemiology ; virology ; Phylogeny ; Prevalence ; Respiratory Tract Infections ; epidemiology ; virology ; Respirovirus ; genetics ; isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

OBJECTIVETo characterize the prevalence and occurrence of subgroups of human respiratory syncytial virus (RSV) in infants and young children with acute respiratory infections (ARI) in Beijing area.

METHODSRSVs were identified from nasopharyngeal aspirates and throat swabs collected from infants and children with ARI who visited the Children's Hospital Affiliated to Capital Institute of Pediatrics during the period of November 2000 to March 2006, by virus isolation in Hep-2 cells and antigen detection by indirect immunofluorescence assay (IFA). RT-PCR was used to differentiate subgroups A and B of RSV from part of the positive specimens.

RESULTSOut of 10 048 specimens including 7176 nasopharyngeal aspirates from inpatients and 2872 throat swabs from outpatients, 2286 (22.8%) were RSV positive. The positive rate for RSV identification were 30.0% (2153/7176) in specimens from the hospitalized patients, which was higher than that from outpatients (4.6%, 133/2872). The youngest of the RSV positive patients was 1 day after birth and the oldest was 15 years of age, with 73.0% younger than 1 year. Among those RSV positives, only 1.6% were older than 5 years. The ratio of male to female who were RSV positive was 2.4:1 (1598:674). The clinical diagnosis for 91.2% (1991) of those RSV positive patients was severe lower respiratory infections including bronchiolitis and pneumonia, whereas in only 8.8% (192) the diagnosis was upper respiratory infections. The data revealed that RSV started to be detected in October each year during the survey period and November to next April was the RSV season. The detection rate declined in May and almost no RSV could be found in summer. Positive rates for RSV detection were 42.3%, 41.0% and 40.5% in the seasons of 2001 - 2002, 2003 - 2004, 2005 - 2006, which were higher than those in seasons of 2000 - 2001 (14.0%), 2002 - 2003 (18.2%), 2004 - 2005 (20.4%). Subtyping of A and B during the surveillance period showed that 73.7% (691/938) were subgroup A and 26.3% (247/938) were subgroup B. Subgroup B was predominant in the 2000 - 2001 and 2004 - 2005 seasons, whereas subgroup A predominated in the 2001 - 2002, 2002 - 2003 and 2003 - 2004 seasons. Almost equal proportions of subgroup A and B appeared in 2005 - 2006 seasons.

CONCLUSIONThe data indicate that RSV is an important etiological agent for lower respiratory infections in infants and young children in winter and spring during the survey period. The pattern of RSV circulation varied alternately with higher rate every other year. The predominant subgroup changed between A and B, and co-circulated in equal proportion in some years.

Adolescent ; Cell Line, Tumor ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Population Surveillance ; Prevalence ; Respiratory Syncytial Virus Infections ; diagnosis ; epidemiology ; Respiratory Syncytial Virus, Human ; genetics ; isolation & purification ; Respiratory Tract Infections ; diagnosis ; epidemiology ; virology ; Seasons

OBJECTIVESTo develop techniques which can be used to detect genetic material of measles virus from clinical samples to make diagnosis and differentiate atypical measles from other exanthematous infections early in clinical course.

METHODSA nested reverse transcriptase-polymerase chain reaction (RT-PCR) was developed to amplify gene fragment with the size of 301 bps from N gene of measles virus in throat swabs and urine samples collected from infants and children who were suspected measles cases. Before the test was used for clinical samples, preliminary tests were performed to determine the sensitivity and specificity of the test. The sensitivity of the test was determined by plaque assay using measles virus strain Edmonton and the specificity of the test was determined by cross-reaction with rubella virus, respiratory syncytial virus, influenza A and B viruses, enterovirus, adenovirus, human cytomegalovirus (hCMV), EB virus, and herpes simplex virus I. Serum specific IgM antibody against measles virus was also tested by ELISA.

RESULTSMeasles virus with the titer of 0.53 pfu could be detected by using the nested RT-PCR developed in this study. No amplification was found with the nested RT-PCR when rubella virus, respiratory syncytial virus, influenza A and B virus, enterovirus, adenovirus, hCMV, EB virus, and herpes simplex virus I were used as templates. Out of 116 throat swabs collected from suspected measles cases, 70 (60.3%) were measles RNA positive. For urine samples, 48 out of 74 (64.9%) were positive. Both throat swab and urine samples were collected simultaneously from 73 patients. Among those, 71 (97.3%) showed consistent results. Serum specimens were collected from 110 suspected patients. Among those, 65 (59.1%) and 61 (55.5%) were measles virus specific IgM antibody positive detected with ELISA kits from two different sources, respectively. Out of 110 sera samples, 106 (96.4%) showed consistent results. The consistency of the gene amplification and specific IgM antibody detection was 80.8% as shown by 84 out of 104 patients from whom throat swab and sera were collected at the same time.

CONCLUSIONThe data indicate that the nested RT-PCR developed in this study is sensitive and specific for detection of gene fragment of measles virus from clinical samples. The test is superior to the commonly used specific IgM antibody detection because of identifying gene material in early clinical stage, and even single clinical sample can be tested.

Humans ; Measles ; diagnosis ; genetics ; Measles virus ; genetics ; isolation & purification ; RNA, Viral ; genetics ; isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

Human metapneumovirus (hMPV) is associated with acute respiratory tract infections (ARTI) in all age groups. However, there is limited information of genetic analysis of hMPV circulating in Beijing. To learn the characteristics of structural protein genes of human metapneumovirus circulating in children in Beijing, sequence analysis of matrix (M), small hydrophobic (SH) and attachment (G) proteins of hMPV from 2006 to 2010 was performed. Phylogenetic analysis of nucleotide sequences of 42 full length M genes, 49 SH gene and 55 G gene revealed that the hMPVs from pediatric patients were divided into sub-genotypes A2, B1 and B. There were highly conserved identities among M gene, with 7 conserved mutations of amino acids between A and B genotypes which were fairly conserved in the same genotype A or B. The amino acid identities of SH were 60.7% to 64.4% between different genotypes, 93.3% - 100% among same sub-genotype and 84.7% - 88.7% between different sub-genotypes. Use of alternative transcription-termination codon, nucleotide deletion and insertion resulted in variable length of nucleotide and deduced amino acid of G protein. Amino acid identities within same genotype ranged from 81.5% - 100%, whereas sequence identities between two genotypes ranged from 34.0% - 38.6% at the amino acid level. A new cluster of G genes in sub-genotype B2 appeared due to the same mutations and insertion of two amino acids in G protein encoding genes amplified from specimens collected from 2008 to 2010. Prediction of antigen sites of SH and G protein indicated that the variation of antigen sites between different sub-genotypes existed.
Child ; China ; epidemiology ; Genetic Variation ; Genotype ; Humans ; Metapneumovirus ; genetics ; Paramyxoviridae Infections ; blood ; epidemiology ; virology ; Phylogeny ; Retroviridae Proteins, Oncogenic ; blood ; genetics ; Viral Envelope Proteins ; blood ; genetics ; Viral Matrix Proteins ; blood ; genetics

OBJECTIVEThe present study was designed to explore the practical application of the rapid etiological diagnosis by detecting specific IgM antibody against common respiratory viruses in children with acute lower respiratory infections (ALRI).

METHODClinical specimens including nasopharyngeal aspirates and serum of acute phase from hospitalized children were collected from 207 infants and children with acute lower respiratory infections from March 2009 to September 2010. Seven common respiratory virus antigens were identified from the collected nasopharyngeal aspirates by direct immunofluorescence assay (DFA). ELISA was used to detect specific IgM antibody against RSV, ADV, IFVA, IFVB and PIV, while indirect immunofluorescence assay (IFA) was used to detect specific IgM antibody against RSV, ADV, IFVA, IFVB, PIV1, PIV2 and PIV3 in collected acute phase serum.

RESULTThe overall positive rates to detect viral antigen by using DFA, ELISA and IFA was 67.6%, 57.5% and 39.6%, respectively. The consistent rate of ELISA and IFA versus accepted DFA were 21.7% and 31.4%, respectively. The average days from onset of the symptoms to blood sample collection for those with the consistent results by ELISA and DFA were 12.0 d for ADV, 9.6 d for PIV2, 9.5 d for IFV, and 5.3 d for RSV, respectively, and by IFA and DFA were 15.0 d for PIV3, 9.2 d for ADV, and 7.4 d for RSV, respectively. Among all age groups, the consistent rate of serum viral IgM and antigen detections was highest in children younger than 3 years old.

CONCLUSIONAlthough there were differences between serum IgM antibody and viral antigen detections, specific IgM antibody detection was of value in early and rapid etiological diagnosis of pediatric ALRI, especially for young children. It could provide serologic evidence of respiratory virus infection. The diagnostic rate of pathogen could be improved if it was used in combination with viral antigen diagnostic methods.

Antibodies, Viral ; analysis ; blood ; Antibody Specificity ; Antigens, Viral ; analysis ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin M ; analysis ; blood ; Infant ; Male ; Nasopharynx ; virology ; RNA Viruses ; genetics ; isolation & purification ; Respiratory Syncytial Virus Infections ; diagnosis ; virology ; Respiratory Syncytial Viruses ; genetics ; isolation & purification ; Respiratory Tract Infections ; diagnosis ; immunology ; virology ; Sensitivity and Specificity