1.Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children.
Sha CAI ; Chun-Hui ZHU ; Fang-Gen CHEN ; Fei LIU ; Mei-Ling GAO ; Yan XIONG
Chinese Journal of Contemporary Pediatrics 2023;25(6):619-625
OBJECTIVES:
To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP.
METHODS:
Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment.
RESULTS:
Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05).
CONCLUSIONS
The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.
Child
;
Humans
;
Immunoglobulins, Intravenous/therapeutic use*
;
Prospective Studies
;
Retrospective Studies
;
Adenoviridae Infections/drug therapy*
;
Pneumonia, Viral/drug therapy*
;
Adenoviridae
2.Comparative study of confirmed and suspected undiagnosed cases of COVID-19 in Changning District, Shanghai
Hui GAO ; Jia-ling GU ; Wen-sui ZHAO ; Hong TANG ; Yi XIA ; Gen-ming ZHAO ; En-mao CAI ; Jian-lin ZHUANG
Shanghai Journal of Preventive Medicine 2021;33(5):453-457
Objective:To analyze and compare the differences between the epidemiological data and clinical indicators of confirmed and suspected undiagnosed cases of COVID-19 in Changning District, Shanghai. Methods:A retrospective comparative study was conducted. We included 20 confirmed and 34 suspected but undiagnosed COVID-19 cases from January 20 to February 29, 2020. We analyzed the differences in epidemiological history, early clinical symptoms, blood routine indicators, and clinical imaging characteristics between the two groups. Results:The epidemic status of COVID-19 in Changning District of Shanghai was mainly imported, and most cases were promptly confirmed. Early clinical symptoms of confirmed and suspected undiagnosed cases often manifested as respiratory symptoms such as fever and dry cough. Compared with the confirmed cases, the cell counts of leukocytes, eosinophils, and neutrophils in suspected undiagnosed cases were significantly higher. Also, the concentration of serum C-reactive protein in suspected cases was higher than that in confirmed cases (
3.Clinical outcomes of opening coronary chronic total occlusion lesions with the assistance of BridgePoint devices.
Gen Rui CHEN ; Hao Kao GAO ; Qiong WANG ; Fei LI ; Yan LI ; Kun LIAN ; Mao Sen YANG ; Ling TAO ; Cheng Xiang LI
Chinese Journal of Cardiology 2020;48(3):236-243
Objective: To investigate the safety, efficacy and prognosis of antegrade dissection re-entry (ADR) with the assistance of BridgePoint devices in opening coronary chronic total occlusion (CTO). Methods: A total of 87 consecutive patients, who underwent percutaneous coronary intervention using BridgePoint devices from April 2016 to December 2018 in Xijing Hospital, were included in this study. General information of the selected patients, features of CTO lesions and intraoperative parameters were recorded. Short-term outcomes including technical success rate (defined as achieving TIMI 3 blood flow with residual stenosis<30%), surgical success rate (defined as no major adverse cardiovascular events (MACE) occured while hospitalized), complications, and MACE during hospitalization were observed. MACE included death, recurrent myocardial infarction, target vascular reconstruction (TVR) and cardiac tamponade. Patients were followed up by outpatient or telephone visits at 30 days and 6, 12, 24 and 36 months after discharge. Results: Eighty-seven patients, aged (61±10) years with J-CTO scores (2.49±0.52) were included, and 75(86%) were male. Six patients underwent direct ADR with BridgePoint system, and all were successful. Eighty-one patients underwent rescue ADR using BridgePoint devices, and 62 of them were successful. The success rate of ADR with BridgePoint devices was 78.2% (68/87). Nine out of the 19 failed cases succeeded after the application of rescue antegrade/retrograde technique. The technical success rate was 88.5% (77/87). Coronary perforation occurred in 2 cases (2.3%), one case was treated with covered stent and the other case with tamponade was treated with pericardiocentesis. One patient developed periprocedural myocardial infarction, and one patient suffered from sudden death, and one patient had cardiac tamponade. In-hospital MACE occurred in 3 (3.4%) patients. The surgical success rate was 85.1% (74/87).The procedure time was (175±72)minutes and the amount of contrast used was (449±155)ml. During a follow-up of 17(11, 26) months, the incidence of MACE within 30 days was 4.7% (4/86), while 10.5% (9/86) within 6 months, 17.4% (15/86) within 17 months. Conclusion: Opening CTO with the assistance of BridgePoint devices is feasible and safe, with high success rate and satisfactory outcome.
Aged
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Chronic Disease
;
Coronary Angiography
;
Coronary Occlusion
;
Humans
;
Male
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Middle Aged
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Percutaneous Coronary Intervention
;
Risk Factors
;
Time Factors
;
Treatment Outcome
4.Analysis on distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children,Suzhou,2011-2018
Xin-xin XU ; Li-ling CHEN ; Jian-mei TIAN ; Jun ZHU ; Yu-zun LIN ; Yin WANG ; Jun-mei GAO ; Xue-jun SHAO ; Tao ZHANG ; Jun ZHANG ; Gen-ming ZHAO
Chinese Journal of Disease Control & Prevention 2020;24(3):264-268
Objective To understand the distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children in Suzhou. Methods Nasopharyngeal secretions were collected from hospitalized children with clinical pneumonia admitted to the respiratory department of Children's Hospital Affiliated to Suzhou University from April 2011 to March 2018 to detect common viral and bacterial pathogens of children's pneumonia. Results The total positive rate of pathogens was 75. 6% in the 4 765 clinical pneumonia cases. The positive rate of bacterial pathogens was 57. 4%. Streptococcus pneumoniae ( SP) was the highest,followed by Haemophilus influenzae ( H. i) ; The positive rate of viral pathogens was 44. 1%. Respiratory syncytial virus ( RSV) was the highest,followed by Bocavirus ( BoV) . The mixed infection rate of bacteria and virus was 25. 9%,and the most common types were RSV and SP,BoV and Streptococcus viride ( SV) . Conclusions SP,H.i,RSV and BoV are the main pathogens of clinical pneumonia in children. There are statistical differences in different age groups and seasons of hospitalized children's pneumonia in Suzhou. The mixed infection rate of bacteria and virus is high.
5.The estimation of influenza-related outpatient rate in children under 5 years in Suzhou from 2011 to 2017
Jun-mei GAO ; Li-ling CHEN ; Jian-mei TIAN ; Jun ZHU ; Yu-zun LIN ; Yin WANG ; Jia YU ; Wei SHAN ; Xue-jun SHAO ; Tao ZHANG ; Jun ZHANG ; Gen-ming ZHAO
Chinese Journal of Disease Control & Prevention 2019;23(1):34-38
Objective To estimate the outpatient rate of influenza-related influenza-like illness (ILI) for children younger than 5 years in Suzhou municipal districts. Methods From October 2011 to March 2017, we conducted a prospective surveillance program on ILI for children under 5 years in outpatient settings of Soochow University Affiliated Children’s Hospital (SCH). The throat swabs were collected and tested for influenza viruses by RT-PCR. Based on the healthcare utilization surveys and population data, the number of visits and the outpatient rate of influenza-related ILI for children younger than 5 years in Suzhou municipal districts were estimated. Results During 2011-2017, in total, there were 45 930 estimated influenza-related ILI cases younger than 5 years in Suzhou municipal districts, which consisted of 7 490 influenza A/H1N1 cases, 17 843 influenza A/H3N2 cases and 20 597 influenza B cases. The estimated outpatient rate of influenza-related ILI was 6.4% in 2011-2017, which was highest in 2011-2012, 20.5%, and the lowest in 2012-2013, 2.4%. Conclusion The number of visits and the outpatient rate of influenza-related ILI in children younger than 5 years was high in Suzhou municipal districts.
6.Content comparison of four constituents in aqueous extract of three Psoraleae Fructus processed products
hua Gen ZHAO ; Ling LIU ; Heng WANG ; qian Qian GAO ; dong Wei LI ; peng Zhi CHEN
Chinese Traditional Patent Medicine 2017;39(9):1896-1899
AIM To compare the effects of sealed moistening with brine,simple stir-frying and stir-frying with brine on the contents of psoralen,psoralen,psoralen and psoralen in Psoraleae Fructus aqueous extract.METHODS The HPLC analysis of aqueous extract was performed on a 30 ℃ thermostatic Hibar C1s column (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of 0.1% formic acid-methanol flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 246 nm.RESULTS Compared with the raw product,the contents of glycosides and total components in the product processed with sealed moistening with brine were significantly decreased.Stir-frying with brine could significantly promote the dissolution of glycosides (psoralen and psoralen),but had no significant effect on that of aglycones (psoralen and isopsoralen).Simple stirfrying markedly increased the contents of various constituents.CONCLUSION Both simple stir-frying and stir-frying with brine can significantly increase the total content of four constituents in Psoraleae Fructus aqueous extract.
7.Effect of Panax notoginseng saponins on liver drug metablic enzyme activity, mRNA and protein expressions in rats.
Yan-Jin CHEN ; Yu-Guang WANG ; Zeng-Chun MA ; Cheng-Rong XIAO ; Hong-Ling TAN ; Qian-De LIANG ; Xiang-Lin TANG ; Yong-Hong ZHAO ; Dong-Gen WANG ; Yue GAO
China Journal of Chinese Materia Medica 2014;39(19):3824-3828
To study the effect of Panax notoginseng saponins (PNS) on liver drug metabolic enzyme activity, mRNA and protein expressions in rats. Male Wistar rats were randomly divided into nine groups. After administration of the test drugs, their liver microsomes, liver total RNA and total protein were extracted to detect the regulating effect of PNS on liver drug metabolic enzyme activity-related subtype enzymatic activity, mRNA and protein expression by substrate probe, quantitative PCR and Western Blot technology. The result of this experiment was that PNS could significantly induce CYP1A2 and CYP2E1 enzyme activity, mRNA expression, CYP2E1 protein expression level. PNS significantly induced CYP3A mRNA expression, but with no significant effect in CYP3A enzyme activity level. PNS had no significant effect CYP1A1 and CYP2B mRNA expressions and enzyme activity levels. PNS had selective regulations on different P450 subtypes, and the major subtypes were CYP1A2 and CYP2E1. In clinical practice, particularly in the combination with CYP1A2 and CYP2E1 metabolism-related drugs, full consideration shall be given to the possible drug interactions in order to avoid potential toxic and side effects. Meanwhile, whether the induction effect of CYP2E1 gets involved in ginsenoside's effect incavenging free radicals deserves further studies.
Animals
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Cytochrome P-450 Enzyme System
;
genetics
;
metabolism
;
Drugs, Chinese Herbal
;
pharmacology
;
Liver
;
drug effects
;
enzymology
;
Male
;
Microsomes, Liver
;
drug effects
;
enzymology
;
Panax notoginseng
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chemistry
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Rats, Wistar
;
Saponins
;
pharmacology
8.Genetic diagnosis of Liddle's syndrome by mutation analysis of SCNN1B and SCNN1G in a Chinese family.
Lin-ping WANG ; Ling-gen GAO ; Xian-liang ZHOU ; Hai-ying WU ; Lin ZHANG ; Dan WEN ; Yue-hua LI ; Ya-xin LIU ; Tao TIAN ; Xiao-han FAN ; Xiong-Jing JIANG ; Hui-min ZHANG ; Ru-tai HUI
Chinese Medical Journal 2012;125(8):1401-1404
BACKGROUNDLiddle's syndrome is a rare autosomal-dominant monogenic form of salt-sensitive hypertension. This study aimed to screen the gene mutation in β and γ subunits of the epithelial sodium channel (ENaC) of a Chinese family with Liddle's syndrome, an autosomal dominant form of hypertension.
METHODSDNA samples from the proband with early-onset, treatment-resistant hypertension and suppressed plasma renin activity were initially screened for mutations in the C-terminal exons of the ENaC β or γ subunit genes, using amplification by polymerase chain reaction and direct DNA sequencing. We also screened the C-terminus of SCNN1B and SCNN1G in family members, and screened for the mutation in 150 controls.
RESULTSGenetic analysis of the β ENaC gene revealed a missense mutation of CCC to TCC at codon 616 in the proband, her mother and her grandmother. One hundred and fifty randomly selected controls had not the mutation, indicating that this is not a common genetic polymorphism. There was no mutation of the γ ENaC gene in any of the individuals examined.
CONCLUSIONSThrough direct DNA sequencing analysis, we established the diagnosis of Liddle's syndrome for the proband and her families, and provided tailored therapies to this abnormality. These results provide further evidence that Pro616Ser is a critical amino acid that has a key role in the inhibition of sodium channel activity.
Adolescent ; DNA Mutational Analysis ; Epithelial Sodium Channels ; genetics ; Female ; Humans ; Liddle Syndrome ; genetics ; Male ; Mutation, Missense ; Pedigree
9.Molecular analysis for diagnosis of Marfan syndrome and Marfan-associated disorders.
Ling-gen GAO ; Xiu-ping YAO ; Lin ZHANG ; Ru-tai HUI ; Xian-liang ZHOU
Chinese Medical Journal 2011;124(6):930-934
Marfan syndrome is a systemic disorder of connective tissue, caused by mutations in the FBN1, TGFBR1 or TGFBR2 genes. This syndrome is characterized by involvement of three major systems, skeletal, ocular, and cardiovascular. The continuing improvements in molecular biology and increasing availability of molecular diagnosis in clinical practice allow recognition of Marfan syndrome in patients with incomplete phenotypes. Additionally, molecular analyses could also be used for preimplantation genetic diagnosis. The identification of a mutation allows for early diagnosis, prognosis, genetic counseling, preventive management of carriers and reassurance for unaffected relatives. The importance of knowing in advance the location of the putative family mutation is highlighted by its straightforward application to prenatal and postnatal screening.
Fibrillin-1
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Fibrillins
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Humans
;
Marfan Syndrome
;
diagnosis
;
genetics
;
pathology
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Microfilament Proteins
;
genetics
;
Mutation
;
Prenatal Diagnosis
;
ethics
;
methods
;
Protein-Serine-Threonine Kinases
;
genetics
;
Receptors, Transforming Growth Factor beta
;
genetics
10.Identification of a novel lethal fibrillin-1 gene mutation in a Chinese Marfan family and correlation of 3' fibrillin-1 gene mutations with phenotype.
Ling-gen GAO ; Lin ZHANG ; Lei SONG ; Hu WANG ; Qian CHANG ; Yong-bo WU ; Ru-tai HUI ; Xian-liang ZHOU
Chinese Medical Journal 2010;123(20):2874-2878
BACKGROUNDMutations in the fibrillin-1 gene have been identified in patients with Marfan syndrome (MFS). This study aimed to identify the molecular defects in the fibrillin-1 gene in a Chinese family with Marfan syndrome, accompanied by aortic aneurysms/dissection.
METHODSTwo patients and one non-carrier in the family underwent complete physical, ophthalmic, and cardiovascular examinations. Genomic DNA was extracted from leukocytes of venous blood of these individuals in the family as well as 50 healthy normal controls. Polymerase chain reaction amplification and direct sequencing of all 65 coding exons of fibrillin-1 gene were analyzed.
RESULTSWe found a novel mutation (c.8547T > G, p.Tyr2849X) in exon 65 of fibrillin-1 gene in a Chinese proband with Marfan syndrome, accompanied by aortic aneurysms/dissection. Sudden death at a young age of affected members was seen due to aortic aneurysms/dissection. By evaluating genotype-phenotype correlations of patients with mutations in the 3' end of fibrillin-1 gene (exons 64 and 65), we also found that the presence of nonsense mutations occurring in exons 64 and 65 appeared to be an indicator of early-onset aortic risk and sudden death.
CONCLUSIONSThese results expand the mutation spectrum of fibrillin-1 gene and help in the study of the molecular pathogenesis of Marfan syndrome, indicating that mutations occurring in the 3' end of fibrillin-1 gene may play an independent functional role in the pathogenesis of Marfan syndrome.
Adult ; Female ; Fibrillin-1 ; Fibrillins ; Genotype ; Humans ; Male ; Marfan Syndrome ; etiology ; genetics ; Microfilament Proteins ; genetics ; Middle Aged ; Mutation ; Phenotype

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