Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

OBJECTIVE: To study role of TLR4/NF-κB pathway for early change of synovial membrane in knee osteoarthritis rats. METHODS: Eighteen male SD rats weighted (200±20) g were randomly divided into 2 groups, namely control and model group, and 9 in each group. Knee OA model group was established by using modified Hulth method in model group. Control group was not treated. Synovial tissue and serum was extracted at 4 and 21 d after operation. Expression of CD14, TLR4, IL-1β, TNF-α, ADAMTS-4, MMP-13 were detected by real-time PCR respectively. NF-κB p65 protein was detected by Western-blot; serum concentrations of haluronic acid (HA), N-propeptide of type III procollagen(PIIINP) was detected by Elisa. RESULTS: Expression of CD14, ADAMTS-4, and NF-κB p65 in model group were higher than that of control group at 4 and 21 days after operation, while expression of TLR4, IL-1β, TNF-α and MMP-13 were higher than that of control group at 21 days after operation(<0.01). Concentration of PIIINP and HA in model group were higher than that of control group at 4 days after operation, while there was no significant difference at 21 days after operation. CONCLUSIONS NF-κB pathway could mediate occurrence of KOA by early activating and triggeringg synovial increasingly secreting inflammatory secretion CD14, TLR4, IL-1β, TNF-α, ADAMTS-4, MMP-13, PIIINP and HA.
Animals ; Male ; NF-kappa B ; Osteoarthritis, Knee ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Synovial Membrane ; Toll-Like Receptor 4

Aim To investigate the effect of salvianolic acid B(Sal B) on the attenuation of rat hepatocyte in-jury induced by hypoxia/reoxygenation(H/R) and its possible molecular mechanism. Methods Rat hepato-cytes BRL-3A were cultured in vitro. H/R injury mod-el was established and then BRL-3A cells were pretrea-ted with Sal B. The viability of cells was measured by CCK-8 assay;the expression of ALT and AST was de-tected by microplate assay; the levels of TNF-α and IL-1β were determined by ELISA; the apoptosis was detected by flow cytometry;the protein and mRNA lev-els of SIRT1, NF-κB p65, p53, Bax and Bcl-2 were measured by Western blot and qPCR. Results H/R intervention decreased the viability and increased the apoptosis of cells;the production of ALT, AST, TNF-α and IL-1β was elevated;the protein and mRNA lev-els of SIRT1, Bcl-2 were reduced, but the levels of NF-κB p65, p53 and Bax increased. After pretreated with Sal B, the viability of cells increased while the apoptosis decreased; the expression of ALT, AST, TNF-α and IL-1β was inhibited;moreover,the protein and mRNA levels of SIRT1,Bcl-2 were enhanced,and the levels of NF-κB p65, p53 and Bax decreased sig-nificantly. Conclusion Sal B may attenuate rat hepa-tocyte injury induced by H/R via the SIRT1/NF-κB/p53 pathway.

ABATRACT Objective:To observe the incidence,causes and deviation angle of axial offset in patients with fracture un-united treated by Ilizarov bone transport technology. Methods:From January 2007 to December 2012,10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3±10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases ,medial tibia in 2 cases,lower tibial in 5 cases,upper femoral in 1 case. For Paley type of bone defect,6 cases were type B1,4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley as-sessment. Results:All patients were followed up from 19 to 32 months with an average of (22.0±5.6) months. Three cases were natural healed at fracture ends,the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow up,there were 3 cases occurred coronal angulation of angle 5° to 11 ° with an average of (8.7±3.2)°. Sagittal angulation was in 4 cases,angle 6° to 9° with an average of (8.5±2.1)°. There were 4 cases occurred axial offset. In the last fol-low up,according to Paley evaluation criteria,osseous results were excellent in 7 cases,good in 3 cases;functional results were excellent in 6 cases,good in 4 cases. Conclusion:Axial deviation after the Ilizarov bone transport treatment is relatively com-mon,which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing ,corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.

BACKGROUNDChromosomal abnormalities have been shown to play an important prognostic role in multiple myeloma (MM). Interphase fluorescence in situ hybridization (i-FISH) has been much more effective to identify cytogenetic aberrations in MM than conventional cytogenetic technique (CC). To clearly determine the cytogenetic features of Chinese MM patients and identify their prognostic implications, we designed a multicenter study based on i-FISH including 672 patients from 52 hospitals in China.

METHODSAll 672 patients were systematically screened for the following genomic aberrations: del(13q), IgH rearrangement, del(p53) and 1q21 amplifications.

RESULTSThe analysis showed that the chromosomal changes were detected in 22.1% patients by CC and in 82.3% patients by i-FISH. The most common abnormalities by CC were chromosome 1 aberrations (48.4%), -13/13q- (37.6%), hyperdiploidy (36.6%), hypodiploidy (30.1%) and IgH rearrangements (23.7%). The most frequent abnormalities by FISH was del(13q), which was found in 60.4% patients, whereas IgH rearrangement, 1q21 amplification and p53 deletions were detected in 57.6%, 49.0% and 34.7% cases, respectively. By statistical analysis, -13/13q- by CC was associated with low level of platelet (P = 0.015), hyperdiploidy was associated with low level of serum albumin (P = 0.028), and IgH rearrangement by FISH was associated with high level of β2 microglobulin (P = 0.019). Moreover, 1q21 amplification and del(p53) by FISH conferred a high incidence of progressive disease (PD) after initial therapy. Metaphase detection of IgH rearrangements and chromosome 1 aberrations concurrently was associated with a short progression free survival (PFS) (P = 0.036). No significant prognostic implications of other cytogenetic abnormalities were found associated with overall survival and PFS.

CONCLUSIONSChinese MM patients had similar cytogenetic abnormalities compared with the previous reported studies. However, the prognostic significance of FISH aberrations were not clearly determined and further study is required.

Adult ; China ; Chromosome Aberrations ; Chromosomes, Human, Pair 1 ; genetics ; Cytogenetic Analysis ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Multiple Myeloma ; genetics ; pathology

Matteuccia struthiopteris is a nature plant, which contains a lot of potential active components. In the present study, we investigated the effect of polysaccharides extracted from Matteuccia struthiopteris on lupus-like syndrome induced by Campylobacter jejuni CJ-S131 in BALB/c mice. Mice were randomly divided into normal, model control, SLE model (vehicle treated), Matteuccia struthiopteris polysaccharides treated (30 and 15 mg x kg(-1)) groups and prednisone 5 mg x kg(-1) treated groups. The effect of Matteuccia struthiopteris polysaccharides (Ms) on weight and organ index of BALB/c mice was detected. Autoantibodies and total IgG production were measured by enzyme linked immunosorbent assay. Proteinuria was measured and kidneys were examined by light microscopy. Compared with SLE model group, treatment with Matteuccia struthiopteris polysaccharides 30 and 15 mg x kg(-1) reduced weight loss and Matteuccia struthiopteris polysaccharides 15 mg x kg(-1) reduced spleen swelling (P < 0.05). The increased production of autoantibodies and total immunoglobulin G (IgG) were also significantly inhibited. Matteuccia struthiopteris polysaccharides protected kidney against glomerular injury in BALB/c mice with reduced immunoglobulin deposition and lowered proteinuria (P < 0.01). Matteuccia struthiopteris polysaccharides had a protective effect on lupus-like syndrome induced by CJ-S131 in BALB/c mice.
Animals ; Autoantibodies ; blood ; Campylobacter Infections ; Campylobacter jejuni ; Ferns ; chemistry ; Immunoglobulin G ; blood ; Kidney ; pathology ; Lupus Erythematosus, Systemic ; drug therapy ; immunology ; microbiology ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Phytotherapy ; Plants, Medicinal ; chemistry ; Polysaccharides ; isolation & purification ; pharmacology ; Proteinuria ; urine ; Random Allocation ; Spleen ; pathology ; Syndrome ; Weight Loss ; drug effects

OBJECTIVETo explore the feasibility of functional magnetic resonance imaging (fMRI) in analysis of olfaction function with modified OEP-98C olfactometer and event-related design.

METHODSSix young right-handed men underwent olfactory fMRI with event-related design. OEP-98C olfactometer was modified to accommodate MR environment. There were 2 types of tasks in the experiment. In one task, only isoamyl acetate was used as odorant. In the other task, to avoid possible decreased olfactory attention, vanillin was given before each presentation of isoamyl acetate.

RESULTSIn both tasks, uniform activation in piriform cortex and secondary olfactory cortexes was determined. The activation of piriform cortex was not significantly different between the two tasks (P > 0.01).

CONCLUSIONSWith isoamyl acetate as odorant, modified OEP-98C olfactometer, and event-related design, olfaction fMRI can depict cortex activation at primary and secondary olfactory cortex. Applying other odorant with similar quality to avoid olfactory attention decrease can not promote depiction of activation in primary olfactory cortex.

Adult ; Evoked Potentials ; physiology ; Feasibility Studies ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Olfactory Pathways ; physiology ; Olfactory Perception ; physiology ; Pentanols

Objective To analyze the clinical features and treatment protocols of otogenic intracranial complications in Peking Union Medical College ospital. Methods Retrospective study of 14 patients (10 males and 4 females, aged between 12 -62 years, mean age 32. 1 years) hospitalized from 1982 - 2006. Twelve cases were otitis media (OM) with cholesteatoma, the other 2 cases were non-cholesteatomatons OM. All the otogenic intracranial complications located at the same sides as otologic disorders. Brain abscess was the most common type of orogenic complications and Proteus was the most common microorganism detected. Suppurative ear discharge, headache, high fever and nausea with vomiting were the most common clinical manifestations with very high incidences. All the patients received combined protocols of mastoid surgeries and antibiotics treatment. Results All the 14 patients recovered clinically. For patients discharged before 1987, there were 4 patients followed up for 22. 5 - 24. 4 years with a mean time of 23. 8 without recurrence, 1 patient died of cardiovascular disease 19. 2 years later after discharge, 4 patients lost follow-up. For the 5 patients discharged after 1997 ,brain abscess recurred in one patient with pseudo-recovery after 24 days and he fitlly recovered after re-hospitalization and treatment. All the five patients were followed up for 1.5 years to 10. 6 years with a mean time of 6. 5 years without recurrence. Conclusions Youngsters and males seemed to be more vulnerable. Brain abscess was the most common intracranial complication and Proteus was the most common pyogenic microorganism. Combination of mastoid surgery and antibiotics were essential for effectively controlling the intracranial complications and improvingthe recovery. CT and MRI were essential for correct diagnosis betimes and MRI seemed to have a better performance.

OBJECTIVETo investigate the morphologic changes of upper airway in obstructive sleep apnea and hypopnea syndrome (OSAHS) associated with micrognathism before and after orthognathic surgery and distraction osteogenesis, and subsequently to instruct clinical jobs effectively.

METHODSNine OSAHS patients associated with micrognathism (8 males, 1 female, mean age: 28.6 years) received orthognathic surgery and (or) distraction osteogenesis, and the curative effect was evaluated according to the subjective feelings and PSG. Upper airway structure before and after the treatment was measured by Somatom Sensation 16 CT scanner.

RESULTSAll 9 patients were clinically cured. The transverse length, the cross section area, and especially the sagittal length of the upper airway were obviously increased after the orthognathic surgery. The changes involved mainly in the velopharyngeal region and the laryngopharyngeal region, but not in the laryngopharyngeal region.

CONCLUSIONSThe orthognathic surgery and distraction osteogenesis can treat the OSAHS patients with microgonathism effectively by increasing their velopharyngeal and laryngopharyngeal sagittal length of upper airway.

Adolescent ; Adult ; Female ; Humans ; Male ; Micrognathism ; complications ; diagnostic imaging ; surgery ; Osteogenesis, Distraction ; Pharynx ; diagnostic imaging ; Polysomnography ; Sleep Apnea, Obstructive ; diagnostic imaging ; etiology ; surgery ; Tomography, Spiral Computed ; Treatment Outcome ; Young Adult

OBJECTIVEA hepatitis B immunogenic complex therapeutic vaccine, yeast-derived recombinant HBsAg combined with human anti-HBs immunoglobulin (YIC), was evaluated for safety and immune response in phase I clinical trial.

METHODSThe subtypes IgG1, IgG2, IgG3 and IgG4 of serum anti-HBs collected from 20 immunized subjects were analyzed by ELISA. The lymphocyte proliferation assay was carried out in five subjects and was analyzed by 3H-thymidine incorporation. The assays for IFNgamma, IL-2, IL-4, IL-6, IL-10 and TNFalpha were measured using Human Cytometric Bead Array Kit with FACSCalibur.

RESULTSThe results showed that the subtypes of anti-HBs antibodies induced by 30, 60 and 90 microg YIC-immunized groups among all of the adult volunteers (20/20) were IgG1 and IgG3. The level of IgG1 was higher than that of IgG3 in each volunteer but the strength was different from each other. The rHBsAg-stimulated lymphocyte proliferation induced by three injections of 90 microg of YIC showed that the stimulation index was more than 2.0 in four out of the five individuals (4/5), ranging from 2.70 to 4.75. PHA-stimulated lymphocyte proliferation was not related to rHBsAg-stimulated lymphocyte proliferation. In the 60 microg YIC-immunized group there was no significant difference between the levels of IFNgamma, IL-2, IL-4, IL-6 and IL-10 at day 0 and day 42. At day 71, in comparison to day 0, the level of IFNgamma was higher in all eight subjects studied (P = 0.015) and the level of IL-2 was also increased in seven out of eight subjects (P = 0.002). In contrast, the levels of IL-4, IL-6, IL-10 and TNFalpha showed no significant difference in all the subjects (P-values: 0.298, 0.976, 0.202 and 0.996).

CONCLUSIONOur results indicate that this hepatitis B immunogenic complex therapeutic vaccine (YIC) can induce a potent anti-HBs response.

Adolescent ; Adult ; Female ; Hepatitis B ; immunology ; therapy ; Hepatitis B Antibodies ; biosynthesis ; immunology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; immunology ; therapeutic use ; Humans ; Immunoglobulin G ; immunology ; Male ; Middle Aged ; Recombinant Proteins ; biosynthesis ; immunology ; therapeutic use ; Vaccination ; Vaccines, Synthetic ; immunology ; therapeutic use