Objective:To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods:Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （n=30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （n=30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results:The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（P<0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion:Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
Child ; Humans ; Tonsillectomy/methods* ; Hypothermia ; Tonsillitis/surgery* ; Adenoidectomy ; Palatine Tonsil/surgery* ; Inflammation ; Chronic Disease ; Immunity

Objective: To analyze the changes in the expression of hypoxia inducible factor-1α (HIF-1α) and inflammatory cytokines and to investigate the role of HIF-1α in regulating the production of inflammatory cytokines during influenza A (H1N1) virus infection. Methods: BALB/c mice were injected with H1N1 virus to establish the mouse model of H1N1 virus infection. Fifteen BALB/c mice were randomly divided into three groups: control group, H1N1 virus group and H1N1 virus+ HIF-1α inhibitor group. Inflammatory cytokines (IL-6, TNF-α, IL-1β and IL-10) in samples of serum and lung tissues were detected by Luminex and ELISA. Levels of HIF-1α in serum and lung tissue samples were detected by Western blot and ELISA, respectively. Results: Compared with the control group, the levels of inflammatory cytokines in serum (IL-6, TNF-α, IL-1β and IL-10) and lung tissues (IL-6 and TNF-α) and the expression of HIF-1α in serum and lung tissues in the H1N1 virus group were significantly increased. The levels of HIF-1α, IL-6, TNF-α IL-1β and IL-10 in lung tissues in H1N1 virus+ HIF-1α inhibitor group were significantly lower than those of the H1N1 virus group. Conclusion During H1N1 virus infection, the levels of inflammatory cytokines and HIF-1α were significantly increased. The production of inflammatory cytokines was significantly reduced after inhibiting HIF-1α expression, suggesting that HIF-1α might promote the production of inflammatory cytokines.

OBJECTIVE To explore the role of adenoidectomy in the treatment of pediatric secretory otitis media.METHODS 120 cases of children diagnosised with secretory otitis media and adenoid hypertrophywho came to our department between January 2013 and May 2015 were devided into 4 groups,30 cases in each group.Group 1 only got drug therapy;Group 2 got adenoidectomy combined with drug therapy;Group 3 got paracentesis or tympanostomy tube;Group 4 got paracentesis or tympanostomy tube,with adenoidectomy at the same time.RESULTS 1.The difference incurative time and recurrence rate were statistically significant between group 1 and group 2.2.There was no statistical difference in healing time but statistical difference in recurrence rate between group 3 and group 4.CONCLUSION For children with secretory otitis media and adenoid hypertrophy,adenoidectomy can shorten the cure time and reduce the recurrence rate at the same time.

Objective: To establish fluorescence quantitative polymerase chain reaction (PCR) to detect integrated HIV DNA in peripheral blood mononuclear cells. Methods: A total of 30 HIV-seropositve individuals were enrolled in this study, including 10 subjects with a detection limit of 20 copies/ml of plasma, 10 patients with drug resistance and 10 patients with no history of antiretroviral therapy (ART). Cultivated ACH2 cells carried a single copy of the integrated HIV genome. We have built pMD19T-CD3 plasmid and calculated the copy number. We used oligonucleotides ULF1 specific for the long terminal repeats (LTR) regions and two oliligonucleotides specific for human Alu sequences to pre-amplified the integrated HIV DNA. Samples and serial dilutions of ACH2 cells were all pre-amplified, the products of which were used for the second round fluorescence amplifications. The Lambda T primers, UR2 primers and HIV Taqman probes were used for second round amplifications in integrated HIV DNA assay. The CD3IN5 primers, CD3IN3 primers and CD3 Taqman probes were used for CD3 quantification. Results: Serial 5-fold dilutions of the plasmid were used as standards for CD3 gene quantifications. The equation of the linear regression was y=-2.731x+ 43.01(R²=0.953). The cellular input was quantified by number of human genome equivalents (CD3 gene, 2 copies/cell). The copies of ACH2 cells was 4.271×10^4, which was the cellular input of the ACH2 cells. Serial 5-fold dilutions of ACH2 cells were used to generate a standard curve for the integrated HIV DNA assays. The equation of the linear regression was y=-3.146x+ 39.11 (R²=0.968). The ratio between the number of copies of the integrated HIV DNA form and the number of cells (CD3 copies) was calculated to obtain the frequency of cells. Based on the test between different groups, each group had no difference (P> 0.05). Conclusions This method presented advantage in detection of the lower copies of virus. It hinted that the current antiretroviral therapy can not effectively attack against latent viral reservoirs. It also provided a basis for new therapeutic intervention.

OBJECTIVETo analyze virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from sporadic cases with diarrhea in tow sentinel hospitals of Shanghai, 2010-2012.

METHODSA total of 2 729 stool samples were collected from two surveillance sentinel hospitals in Shanghai 2010-2012. Vibrio parahaemolyticus strains were isolated and identified from diarrhea out patients using TCBS agar plates and biochemical reactions. Thermostable direct hemolysingene (tdh), thermostable-related hemolysin gene (trh), hemolysin gene (tlh) were detected by multiplex PCR method. Isolates were analyzed by PFGE and MLST. The PFGE profiles were analyzed using BioNumerics software.

RESULTSA total of 30 clinical Vibrio parahaemolyticus strains isolated from 2 729 stool samples. The anually Vibrio parahaemolyticus isolation rate during 2010 to 2012 were 1.1%(11/973), 1.0%(11/1 120) and 1.3%(8/636) respectively. The PCR positive rates of virulence genes tlh, tdh and trh were 100%, 97% and 0 respectively. The Vibrio parahaemolyticus strains were divided into 13 PFGE types (P1-P13)and 3 ST types (ST-189, ST-799, ST-3). Among 13 PFGE types, P4 was the main PFGE type, accounting for 30%(9/30). P9, P10 were accounting for 12% (4/30) respectively, P1, P2, P12, P13 were accounting for 7%(2/30) respectively, the others types were 3%(1/30) respectively. MLST analysis results showed there are three ST types, ST3 was 84%(25/30), ST189 and ST799 were accounting for 13% (4/30) and 3% (1/30) respectively.

CONCLUSIONThe infection rate of Vibrio parahaemolyticus was not very high from 2010-2012 in Shanghai, all strains were positive for tlh and negative for trh. ST3 was the major type of Vibrio parahaemolyticus.

China ; Diarrhea ; Genotype ; Hemolysin Proteins ; Hospitals ; Humans ; Multilocus Sequence Typing ; Outpatients ; Polymerase Chain Reaction ; Sentinel Surveillance ; Vibrio Infections ; Vibrio parahaemolyticus ; Virulence

Objective To ensure the safety of oral administration at night among elderly inpatients. Methods By the purposive sampling method, a total of 165 clinical nurses and 274 elderly patients were selected as sample. Elderly patients received nocturnal tracking and 165 nurses underwent survey questionnaire, that investigate risk factors for night safety of oral-administration. Results For circumstances of night oral medicine administration among 165 nurses, the rate of medicine inspection was highest (90. 9%), while the implementation rate of putting medicine into mouth was lowest (33. 3%). Drug regimen and administration time of elderly patients had positive correlation with the implantation level of putting medicine in the mouth by nurses (r=0.407, 0. 335;P < 0. 05). The compliance and posture of medication administration had positive correlation with medicine knowledge education to patients by nurses (r=0. 380, 0. 429;P<0. 05), and the adverse reactions of patients was positively correlated with nurses observed after taking the drug (r=0. 464,P<0. 05). Conclusions We should focus on guiding elderly patients to take medicine correctly and compliance of medicine order, and carry out the training of comprehensive drug knowledge for nurses to decrease the risks of night medicine administration.

OBJECTIVETo comprehensively analyze the clinical characteristics, treatment strategies and outcome of patients with thrombotic thrombocytopenic purpura (TTP).

METHODSA retrospective survey of 51 TTP patients confirmed in our database. Relevant statistical analyzes were performed by GraphPad Prism 5 software.

RESULTS51 cases of patients with acquired TTP were identified as idiopathic TTP. In our study, only 18 cases (35.29%) had typical pentalogy of TTP, where thrombocytopenia (100.00%), microangiopathic hemolytic anemia (92.16%) and neurologic abnormalities (88.24%) were more common than fever (72.55%) and renal abnormalities (70.59%). Plasma ADAMTS13 activity was detected in 37 patients with TTP with ADAMTS13 deficiency confirmed in 31 patients (83.78%). Plasma exchange with response of 72.3% was still the preferred strategy in TTP with individuation. Among 36 survival TTP patients, 8 patients (22.22%) relapsed. 15 patients (29.41%) died in our study. The mean ages of responders and deaths were of (37.5±14.5) and (50.1±18.9) respectively; whereas total bilirubin level of responders and deaths were of (43.3±23.5)μmol/L and (63.7±39.7) μmol/L respectively, the differences were statistically significant. Conversely, body temperature, WBC, HGB, PLT, serum creatinine and LDH showed no significant differences (P>0.05).

CONCLUSIONThe diagnosis of TTP was based on comprehensive analysis of clinical manifestations. Plasma ADAMTS13 activity test had a higher clinical practical value. The therapeutic alliance with corticosteroids, immunosuppressive agents and Rituximab significantly improved its outcome. The age and high total bilirubin level at onset were associated with less sensitive to plasmapheresis and poor prognosis.

ADAM Proteins ; blood ; ADAMTS13 Protein ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Plasma Exchange ; Purpura, Thrombotic Thrombocytopenic ; diagnosis ; therapy ; Retrospective Studies ; Young Adult

Objective To understand the epidemiologic feature of human parainfluenza virus type 3 (HPIV-3) in Shanghai,and to provide scientific evidence for formulating prevention and control measures in the future.Methods A total of 164 nasopharyngeal aspirates samples taken from children with acute respiratory infection (ARI) were collected from Xinhua Hospital Affiliated to Shanghai Jiaotong University and sent to Shanghai Public Health Clinical Center from June 2009 to June 2010.Samples were detected for HPIV-3 by reversed transcription-polymerase chain reaction (RT-PCR).Full-length hemagglutininneuraminidase (HN) gene (1 719 bp) of five positive samples were sequenced for phylogenetic analysis.Comparison between two groups was evaluated by the precise chi-square test (two sided).Results Of 164 samples,70 samples were infected with parainfluenza virus,and HPIV-3 was detected positive in 23 samples with the positive rate of 32.86％.HPIV-3 infections were most common in spring and summer,and most of infections were mainly found in 13-36 month-old infants.Five Shanghai isolates and 36 reference sequences from different countries and areas were divided by HN gene-based phylogenetic tree into three clusters (A,B and C).Five Shanghai isolates and five Beijing isolates belonged to C3a group.The homologies of nucleotide and amino acid sequences between five Shanghai isolates and five Beijing isolates were 99.0％-99.5％ and 99.7％-100.0％,respectively.Conclusions HPIV-3 accounts for a high proportion in children with ARI in Shanghai.C3a group may be the main lineage of HPIV-3,which suggests that HPIV-3 may be of regionally correlation.

Objective To evaluate the clinical outcome of operative management of displaced intraarticular fractures of the calcaneus using locking plates. Methods From October 2004 to October 2006, 34patients with close displaced intraarticular fractures of the calcaneus were fixed with Calcaneal locking Plates through the extensive lateral approach. The right foot was involved in 20 patients. The mean age was 34 yesrs with a range of 19 to 42 years. Accordiing to Sanders' classification system, there were 16 patients in style Ⅱ and 18 in style Ⅲ The mean interval between injury and operation was 13 days Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a locking calcaneal fracture plate. The result were evaluated with AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot scale. Results Twenty-eight patients were followed up. The follow-up duration ranged from six to forty months, with the mean of twenty months. angle and were measured at, The average B(o)hler angle was 29° and 30° and the average Gissane was 122° and 125° seven days and three months after operation. Bone union was achieved in all cases. All incisons had healed smoothly. No patient sustained lateral impingement syndrome or soft tissue complications The mean AOFAS scores that was measured three months and six months after operation was 74. Conclusion The application of the calcaneal locking plates through extended lateral approach is proved to be an effective treatment for displaced intra-articular calcaneal fracture, offering the combination of good reduction and early rehabilitation.

Objective To evaluate the assistant medial approach used in the surgical management of intraarticular fractures of calcaneus.Methods From January 2005 to December 2009,33 patients with intraarticular fracture of calcaneus were treated by open reduction and internal fixation through the expanded lateral L-shape approach and the assisted medial approach.They were 27 men and 6 women,aged from 18 to 62 years (average,36 years).There were 15 left sides and 18 right sides.According to Sanders' classification system,there were 27 patients with type Ⅲ displaced calcaneal fracture and 6 with type IV.Four cases were complicated with fracture of lumbar vertebra,one with pilon fracture and one with fracture of acetahulun.Fracture healing was observed and the Bǒhler and Gissane angles were measured.The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale system was used to evaluate the functional recovery.Results All patients were followed up postoperatively to assess their functional outcome.The follow-up duration was 6 to 24 months (mean,12 months).All incisions healed primarily and all fractures obtained bony union in an average of 8 weeks (from 6 to 24 months).All the Bǒhler and Gissane angles were corrected and AOFAS scores were improved.There were significant differences between preoperation and pestoperation in all indexes( P ＜ 0.05).Conclusion As the medial approach can be used to assist the expanded lateral L-shape approach in treatment of the intraarticular fractures of the calcaneus,the reduction and insertion of internal implants can be improved to achieve satisfactory functional outcome.