Objective:To analyze the clinical characteristics and cytokines expression characteristics in infants with mild and severe respiratory syncytial virus (RSV) infection.Methods:From May 2023 to December 2023, plasma samples and clinical information were collected from 16 infants with RSV infection and 14 control infants. Cytek Aurora flow cytometry (Cytek, America) and Enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of 25 cytokines after mild and severe RSV infection.Results:Cough and nasal obstruction were the main clinical manifestations in infants with mild RSV infection, accompanied by polypnea, wheezing and other symptoms. The main symptoms of severe RSV infection were cough and rales, accompanied by fever and polypnea. In comparison with the control group, the expression levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-13, IL-22, TNF-α, IFN-α, IFN-β, MIP-1β, I-TAC, ENA-78, GROα, Eotaxin, and MCP-1 in the RSV infection group all exhibited an upregulation trend. Both IP-10 and MIP-3α demonstrated a downward trend in the RSV infection group; however, there was no statistically significant difference ( P>0.05). The levels of IL-10, IFN-γ, MIP-1α, and IL-8 in the RSV infection group were significantly higher than those in the control group, whereas the levels of MIG, TARC, and RANTES in the RSV infection group were significantly lower than those in the control group ( P<0.05). The levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-22, IFN-β, IFN-γ, TNF-α, IL-8, I-TAC, MIP-1β, Eotaxin, and MCP-1 in the mild RSV infection group were significantly higher than those in the severe RSV infection group ( P>0.05). Among these, the levels of MIG, RANTES, TARC, MIP-3α, and ENA-78 in the mild infection group were all lower than those in the severe infection group. The expressions of ENA-78 and MIP-1α in the severe infection group were significantly higher than those in the mild infection group and also higher than those in the control group. There was no significant difference in IP-10 and GROα between the mild and severe RSV infection groups ( P>0.05). Conclusions:The differences in clinical features and cytokines between infants with mild and severe RSV infection provide important data support for the prevention and treatment of RSV infection in infants.

Objective:To analyze the clinical characteristics and cytokines expression characteristics in infants with mild and severe respiratory syncytial virus (RSV) infection.Methods:From May 2023 to December 2023, plasma samples and clinical information were collected from 16 infants with RSV infection and 14 control infants. Cytek Aurora flow cytometry (Cytek, America) and Enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of 25 cytokines after mild and severe RSV infection.Results:Cough and nasal obstruction were the main clinical manifestations in infants with mild RSV infection, accompanied by polypnea, wheezing and other symptoms. The main symptoms of severe RSV infection were cough and rales, accompanied by fever and polypnea. In comparison with the control group, the expression levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-13, IL-22, TNF-α, IFN-α, IFN-β, MIP-1β, I-TAC, ENA-78, GROα, Eotaxin, and MCP-1 in the RSV infection group all exhibited an upregulation trend. Both IP-10 and MIP-3α demonstrated a downward trend in the RSV infection group; however, there was no statistically significant difference ( P>0.05). The levels of IL-10, IFN-γ, MIP-1α, and IL-8 in the RSV infection group were significantly higher than those in the control group, whereas the levels of MIG, TARC, and RANTES in the RSV infection group were significantly lower than those in the control group ( P<0.05). The levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-22, IFN-β, IFN-γ, TNF-α, IL-8, I-TAC, MIP-1β, Eotaxin, and MCP-1 in the mild RSV infection group were significantly higher than those in the severe RSV infection group ( P>0.05). Among these, the levels of MIG, RANTES, TARC, MIP-3α, and ENA-78 in the mild infection group were all lower than those in the severe infection group. The expressions of ENA-78 and MIP-1α in the severe infection group were significantly higher than those in the mild infection group and also higher than those in the control group. There was no significant difference in IP-10 and GROα between the mild and severe RSV infection groups ( P>0.05). Conclusions:The differences in clinical features and cytokines between infants with mild and severe RSV infection provide important data support for the prevention and treatment of RSV infection in infants.

Objective:To determine the erythromycin resistance of Bordetella pertussis isolates and their ptxP1 and ptxP3 phenotypic composition and compare clinical manifestations of children with pertussis caused by the two types of strains. Methods:This was a cross-sectional study, the pertussis cases diagnosed using bacterial culture from January 2019 to December 2022 in Beijing Children′s Hospital and the First People′s Hospital of Wuhu were collected.Any suspected Bordetella pertussis colonies were identified by the slide agglutination test.The susceptibility of isolates to erythromycin was detected by the E-test and K-B test.The ptxP gene was amplified by polymerase chain reaction and sequenced to determine its genotype. t-test, Mann-Whitney U-test, Chi-square test and Fisher′s exact test were use to statistical analysis. Results:A total of 192 strains of Bordetella pertussis were identified, including 188 (97.9%) erythromycin-resistant strains.Among the 188 strains, 30.3%(57/188) belonged to the ptxP1 genotype and 69.7%(131/188) belonged to the ptxP3 genotype.In children aged below 1 year old, the incidence of paroxysmal cough caused by infection with the ptxP3 strain was higher than that with the ptxP1 strain (57.1% vs.29.4%, P<0.05), and children infected with the ptxP3 strain were more likely to develop apnea or asphyxia (23.8% vs.17.6%), post-tussive vomiting (44.4% vs.32.4%), whooping cough (72.0% vs.50.0%) and pneumonia or bronchitis (85.7% vs.73.5%) compared to those infected with the ptxP1 strain, but the differences were not statistically significant(all P>0.05). In children aged 1 year old and above, the white blood cell count of children infected with the ptxP1 strain was higher than that of infections with the ptxP3 strain [13.5(9.9, 24.5)×10 9/L, 10.3 (7.0, 16.4)×10 9/L, P<0.05], and children infected with the ptxP1 strain were more likely to contract other pathogen infections than those infected with the ptxP3 strain (17.4% vs.4.4%, P>0.05). Conclusions:ptxP3 erythromycin-resistant Bordetella pertussis has become the main pathogen of pertussis.Infants with pertussis caused by the ptxP3 erythromycin-resistant strain show more significant manifestations and a higher possibility of severe symptoms than those infected with the ptxP1 erythromycin-resistant strain.

BACKGROUND: Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population. METHODS: From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models. RESULTS: (1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity. CONCLUSIONS Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.
Humans ; COVID-19 ; Retrospective Studies ; Lung Neoplasms/drug therapy* ; Incidence ; Pneumonia/etiology*

Objective:To explore the clinical value of shear wave elastography in the diagnosis and pathological classification of nephrotic syndrome.Methods:A retrospective analysis was conducted on the clinical data of 43 patients with primary nephrotic syndrome (primary nephrotic syndrome group) diagnosed through renal biopsy at the Yongchuan Hospital Affiliated to Chongqing Medical University from June 2022 to March 2023. They were further divided into three subgroups: mesangial proliferative glomerulonephritis group, membranous nephropathy group, and minimal change nephropathy group. Another 30 healthy individuals were selected as the control group. We applied shear wave elastography to measure the shear wave velocity of the right renal lower pole parenchyma and statistically analyzed the differences in shear wave velocity between each group.Results:There was a statistically significant difference in shear wave velocity between the primary nephrotic syndrome group [(1.76±0.41)m/s] and the control group [(1.55±0.34)m/s] ( P<0.05); The shear wave velocity in the membranous nephropathy group [(1.97±0.36)m/s] was the highest, and there was a statistically significant difference ( P<0.05) compared to the small lesion nephropathy group [(1.54±0.42)m/s]; There was no statistically significant difference in shear wave velocity between the membranous nephropathy group and the mesangial proliferative glomerulonephritis group [(1.74±0.38)m/s], as well as between the mesangial proliferative glomerulonephritis group and the small lesion nephropathy group (all P>0.05). Conclusions:Shear wave elastography is a non-invasive examination that provides valuable clinical clues for the diagnosis and pathological classification of nephrotic syndrome by detecting the shear wave velocity of the kidney.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Objective:To construct an early postoperative frailty prevention nursing program for elderly patients with enterostomy, so as to provide a basis for formulating targeted nursing programs.Methods:The overall research period was from July to October 2022. Guided by the frailty integration model and cross-cultural nursing theory, the content framework indicators of the early postoperative frailty prevention nursing program for elderly patients with enterostomy were initially constructed through literature research, semi-structured interviews, and combined with the results of the previous cross-sectional survey. A total of 20 gastroenterostomy and nursing experts from 10 ClassⅢ hospitals in 7 provinces and municipalities were selected through the purposive sampling. Delphi method was used to carry out 2 rounds of consultation with 20 experts to determine the early postoperative frailty prevention nursing program for elderly patients with enterostomy.Results:In the 2 rounds of expert consultations, the effective response rates of the questionnaire were all 100% (20/20), the expert authority coefficients were all 0.95, and the Kendall's W were 0.23 and 0.32 respectively ( P<0.05). The coefficient of variation of indicators at all levels ranged from 0.050 to 0.167. The final early postoperative frailty prevention nursing program for elderly patients with enterostomy included 5 first-level indicators, 23 second-level indicators, and 63 third-level indicators. Conclusions:The early postoperative frailty prevention nursing program for elderly patients with enterostomy is scientific and necessary, and can provide a theoretical basis for nurses to implement frailty prevention and nursing for elderly patients.

Objective:To explore the clinical features and diagnosis of coexistence of ankylosing spondylitis (AS) and Beh?et's disease associated with antiphospholipid syndrome (APS).Methods:We analyzed a case of coexistence of ankylosing spondylitis and Beh?et's disease associated with APS in Seventh Medical Center of Chinese PLA General Hospital in 2016, and the related literature were reviewed.Results:A 26-year-old male patient suffered from inflammatory low back pain, arthralgia and iritis. A His CT imaging revealed bilateral grade Ⅱ of bilateral sacroiliac arthritis. He was diagnosed as AS. He also had recurrent oral ulceration, iritis, vascular disorders and positive acupuncture pathergy test. He was diagnosed as Beh?et's disease. He suffered from recurrentpeated venous thrombosis. Laboratory tests revealed positive antiphospholipid antibodies. He was diagnosed as secondary APS complicated with Beh?et's disease. After he was treated with of glucocorticosteroid, cyclophosphamide, adalimumab and dabigatran, his condition improved significantly.Conclusion:There are some cases reported of AS with Beh?et's disease, or Beh?et's disease with APS, or AS with APS. The relationship between them is complex. The possibility of coexistence of AS and Beh?et's disease and APS should not be ignored, in order to avoid misdiagnosis.

Objective: To study the clinical and molecular characteristics of Staphylococcus aureus(S.aureus ) isolated from neonates of Beijng Children′s Hospital. Methods: The clinical information of S. aureus infection in newborns of Beijing Children′s Hospital from February 2016 to January 2017 was collected.The molecular biological characteristics of S. aureus isolates were detected.Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus(MSSA)were identified, using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing(MLST)and spa typing were analyzed using the PCR, and the staphylococcal chromosomal cassette mec(SCCmec) type was analyzed for the MRSA isolates.Eleven adhesion gene and three virulence genes(pvl, psma, hlα )were also detected by PCR.Antimicrobial susceptibility testing was performed by agra dilution method or E-test method. Results: The total of 57 cases of neonatal S. aureus infection were collected during the study.The most common clinical diagnosis was 38 cases (66.7%) of pneumonia and 28 cases (49.1%) of skin infection syndrome (SSTI). There were 31 cases (54.4%) with MRSA infection and 26 cases (45.6%) with MSSA infection.The proportion of SSTI in the MRSA group (64.5%) and the infection of more than 2 sites (61.3%, 19/31) were significantly higher than those in the MSSA group (30.8%, 8/26 and 23.1%, 6/31). There were 16 MLST types and 29 spa types, the most common ones were ST59 (40.4%) and t437 (33.33%), respectively.The most common popular clones of MRSA and MSSA were ST59-SCCmecIVa-t437 (54.8%) and ST22-t309, respectively(11.5%). The sdrE carrying rate of MRSA was higher than that of MSSA, while the sdrD and cna carrying rates were lower than those of MSSA (P<0.05). The other adhesion and virulence gene carrying rates were not significantly different between the two strains.The multi-drug resistance rate of all strains was 61.4%(35/57). Except for lactam antibiotics, the most common resistant phenotypes of MRSA and MSSA were ERY-CLI, accounting for 74.2% and 26.9%, respectively. Conclusion The main types of neonatal S. aureus infection in our hospital were pneumonia and SSTI.SSTI and multi-site infections of MRSA infection are more common.MRSA and MSSA isolates have clonal dissemination characteristics.The most common clones are ST59-SCCmecIVa-t43 and ST22-t309, which show no significant differences in the status of carrying virulence factors between them.The multi-drug resistance rate of neonatal S. aureus isolates is higher.

ObjectiveTo explore the application effect of doctor-nurse integration combined with WeChat platform in thrombolytic therapy for acute cerebral infarction.Methods Totally 72 patients with thrombolytic treatment for acute cerebral infarction in our hospital from October 2013 to December 2015 were selected and divided into the observation group(36 cases)and the control group(36 cases)according to the patient′s admission sequence. The primary nursing team model was applied in the control group,and the doctor-nurse integration treatment model combined with WeChat platform was applied in the observation group. The thrombolytic preparation time,the national institutes of health stroke scale(NIHSS)score after treatment,Barthel index,the average hospitalization time and other indicators between two groups were compared.Results The thrombolytic preparation time(78.86±15.34) min and the average hospitalization time(10.08 ±3.11) d in the observation group were significantly shorter than the data in the control group [(93.47±15.58) min,(13.92±4.73) d;(P<0.05)];the NIHSS score after treatment(2.25±2.59)in the observation group was significantly lower than that(3.69±3.26)in the control group(P<0.05);the Barthel index(82.78±24.80)in the observation group was higher than that(70.00±28.44)in the control group(P<0.05);Compared with the patient satisfaction(88.9%) and medical staff satisfaction(98.6%)in the observation group,the data in the control group(69.4%,72.9%) were lower(P<0.05).Conclusions The doctor-nurse integration treatment model combined with WeChat platform in patients with acute cerebral infarction thrombolysis is conductive to implement the standardization of specialist treatment in patients with acute cerebral infarction.