Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by progressive destruction of the small intrahepatic bile ducts. Patients with PBC often have extrahepatic autoimmune diseases, which can involve multiple organs and systems including the gastrointestinal tract, lung, rheumatoid immune system, and endocrine system. This article summarizes the research advances in the disease spectrum, pathogenesis, treatment, and prognosis of PBC with extrahepatic autoimmune disease.

ObjectiveTo investigate the association of the expression of the NK cell-activating receptor NKG2D, its ligand major histocompatibility complex class I chain-related gene A (MICA), and related cytokines ［interferon-γ (IFN-γ), interleukin-10 (IL-10), and interleukin-15 (IL-15)］ with intrahepatic inflammation in primary biliary cholangitis (PBC). MethodsLiver biopsy specimens were collected from 30 patients with PBC (PBC group), 15 patients with chronic hepatitis B (CHB group), and 10 patients with nonalcoholic fatty liver disease (NAFLD group), who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from August 2014 to June 2015. The degree of liver inflammation (G) and fibrosis degree (S) of the liver specimens were determined, and immunohistochemistry was used to measure the expression of NKG2D, MICA, IFN-γ, IL-10, and IL-15 in liver tissue (the scores were determined based on the number of cells stained and the degree of staining to evaluate the expression of each marker). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for comparison between two groups; a Spearman correlation analysis was used to investigate correlation. ResultsIn the PBC group, the expression of NKG2D increased with the degree of inflammation, and the patients with G3-4 inflammation had significantly higher expression than those with G1-2 inflammation (G1 vs G2 vs G3 vs G4: 1.4±0.05 vs 1.56±0.05 vs 1.86±0.11 vs 2.60±0.17, F=150.8, P＜0.05); the expression of NKG2D decreased with fibrosis degree (S3 vs S4: 2.30±0.17 vs 1.56±0.05, t=-1.52, P＜0.05). In the PBC group, there was no significant difference in MICA between G3 and G4 (0.11±0.01 vs 0.20±0.03, t=-2.20, P＞0.05) and between S3 and S4 (0.12±0.02 vs 0.18±0.03, t=-2.64, P＞0.05). In the PBC group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3 vs G4: 0.70±0.10 vs 1.50±0.10 vs 1.93±0.11 vs 2.60±0.17, F=251.3, P＜0.05), while there was no significant difference between the patients with different fibrosis degrees (S3 vs S4: 2.00±0.05 vs 2.40±0.30, t=-1.62, P＞0.05). In the CHB group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3: 0.73±0.15 vs 1.96±0.15 vs 2.50±0.17, F=150, P＜0.05) and between the patients with different fibrosis degrees (S1 vs S2 vs S3: 0.70±0.10 vs 21.96±0.15 vs 2.50±0.17, F=158.7, P＜0.05). In the PBC group, the expression of IL-10 was only observed in the patients with G1 inflammation (0.16±0.01), and in the CHB group, the expression of IL-10 was observed in the patients with G1 and G2 inflammation, with no significant difference (G1 vs G2: 0.19±0.01 vs 0.13±0.01, t=-1.522, P＞0.05). In the patients with PBC, the expression of IL-15 in liver tissue was positively correlated with the levels of alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) (r=0.241 and 0.407, P=0.014 and 0.045). ConclusionThe NK cell-activating receptor NKG2D affects the degree of intrahepatic inflammation in PBC, and the NKG2D ligand MICA is expressed in the advanced stage of PBC and can downregulate NKG2D. The expression of IL-15 increases with the degree of inflammation in PBC and is positively correlated with the levels of ALP and GGT, suggesting that the activation of NK cells and abnormal secretion of cytokines are involved in the development and progression of PBC and IL-15 may be used as an auxiliary index for the diagnosis of PBC.

Objective To investigate the application value of combined detection of four diarrhea viral antigens (rotavirus ,enteric adenovirus ,norovirus ,astrovirus) in suspected food poisoning .Methods One hundred and seventy-six stool samples from the pa-tients with acute phase of suspected food poisoning were collected and performed the 4-item viral antigen detection by adopting the immunofluorescence chromatography ,and at the same time the culture and identification of pathogenic bacteria at the same time were performed .Results Among 176 stool samples of patients with suspected food poisoning ,one strain of Shigella was detected and other pathogens were not detected out ;the detection rates of four viral antigens of rotavirus ,enteric adenovirus ,norovirus and astrovirus were 9 .66% ,1 .70% ,14 .77% and 2 .84% respectively .Conclusion The combined detection of four diarrhea viral anti-gens can definite viral pathogens ,timely identify and early warn food-borne disease outbreaks .

Objective To investigate the quality of life (QOL) of the primary caregivers of children with autism and find the influencing factors.Methods 163 caregivers of children with autism were assessed with short form 36 health survey questionnaire(SF-36) in Chinese,and the data were analyzed by correlation.Results The QOL of the caregivers was injured in many fields.The scores of the eight dimensions of SF-36 were listed respectively as:physical functioning (PF) 84.69 ± 16.39,role limitation due to physical health (RP) 28.87 ± 22.85,bodily pain (BP) 64.72 ± 21.85,general health perception (GH) 50.06 ± 21.80,vitality (VT) 42.79 ± 23.42,social functioning (SF) 52.76 ± 25.46,role limitations due to emotional problems (RE) 32.10 ± 22.27,mental health (MH) 46.17 ± 24.43.The QOL of the primary caregiver was closely related to the caregiver's age,educational level,the family economical situation and time of caring (P ＜ 0.01),and also related to the children's age,autism procedure (P＜0.05).There was no relationship betwecn the QOL and the children's gender,time of participating in rehabilitation training,whether the only child or not,type of medical expense,the caregiver's gender,nationality,marital status,religion,relation with the children,and the family residence.Conclusions The QOL of the primary caregivers of children with autism is affected seriously,and should be intervened accordingly.

ObjectiveTo investigate the level of caregiver burden of primary caregivers of children with autism,and explore the factors related to caregiver burden.Methods 177 caregivers of children with autism were tested with caregiver burden inventory(CBI) and childhood autism rating scale(CARS).A cross-sectional and multisite study design was used.ResultsThe scores of caregiver burden was ( 57.50 ± 14.91 ),and time-dependence burden and developmental burden were the most serious domains.Caregiver burden was affected by caregiver's age,caregiver's religious beliefs,caregiver's marital status,caregiver employment status and education degree and children's scores of CARS and degree of CARS( -0.151 ≤ r ≤0.282,P＜ 0.05 ).ConclusionThe data suggest that community care workers should pay attention to caregivers of children with autism and give them personalized health education and intervention according to the demographic characteristics of the caregivers and the severity of children disease.

Objective To evaluate the therapeutic effect of intramyocardial controlled releasing base fibroblast growth factor (b-FGF) stent combined with transplanting bone marrow-derived mesenchymal stem cells (BM-MSCs) in porcine acute myocardial infarction (AMI) models. Methods Eighteen porcines were divided into three groups (each n=6):transmyocardial revascularization (TMR)+naked stent (control group), TMR+b-FGF stent (b-FGF group) and TMR+b-FGF stent+BM-MSCs (b-FGF+BM-MSCs group). Acute myocardial infarction models were induced by ligating the left anterior descending artery in 18 porcine. In the control and b-FGF group, naked stents, b-FGF stents and b-FGF stent+BM-MSCs were implanted into TMR channels in the infarct and border zone. ~(99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging were performed to evaluate changes in myocardial blood flow, and echocardiography and immunohistochemical studies were also performed. Results After 6 weeks, the quality of myocardial infarction, fractional shortening, neovascular density in b-FGF and b-FGF stent+BM-MSCs group were higher than those of control gruop (P<0.05), and in b-FGF stent+BM-MSCs group was higher than those in b-FGF group (P<0.05). Conclusion BM-MSCs combined with controlled releasing intramyocardial b-FGF stent can improve the flow of myocardial infarction area, promote angiogenesis and heart function, and the therapeutic effect which can be evaluated with myocardial SPECT imaging.

In order to improve the bonding strength of the hydroxyapatite (HA) coatings on the metal substrate, we prepared the HA-Ti/HA composite coatings by two-step electrodeposited method, and then we studied the component, microstructure, surface morphologies and the bonding strength of the HA-Ti/HA composite coatings. SBF test and cell culture in vitro were carried out to evaluate the biological properties of the composite coatings. The results showed that the bonding strength of the HA-Ti/HA composite coating (Ti, 51.2wt%) was as high as 21.2 MPa which was 3 times that of pure HA coatings. The coatings' surface was covered by carbonate-apatite layer after being immersed in SBF, and the bone marrow cells attached firmly and proliferated well on the surface of composite coatings. These findings indicate that the composite coatings possess good bioactivity and excellent biocompatibility.
Animals ; Bone Marrow Cells ; cytology ; Cell Adhesion ; Cells, Cultured ; Coated Materials, Biocompatible ; chemistry ; Dogs ; Durapatite ; chemistry ; Electrochemistry ; Surface Properties ; Tissue Engineering ; methods ; Titanium ; chemistry