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Wang LJ, Li KC, Qian SY, Gao HM, Liu J, Li Z, Jia XL, Fan CN, Wang Q. [Clinical characteristics and prognosis of 8 cases of severe infant botulism]. Zhonghua Er Ke Za Zhi 2024; 62:218-222. [PMID: 38378282 DOI: 10.3760/cma.j.cn112140-20230908-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: To summarize the clinical characteristics and prognosis of severe infant botulism and evaluate the therapeutic effect of botulinum antitoxin in the pediatric intensive care unit (PICU). Methods: The clinical data of 8 cases diagnosed with infantile botulism were retrospectively analyzed in the PICU of Beijing Children's Hospital from October 2019 to August 2023. Data of basic demographic information, clinical manifestations, laboratory tests, treatment and prognosis of each child were collected and analyzed using descriptive statistical methods. Results: Eight laboratory-confirmed cases of infant botulism were included in this study, all of which were male infants with an age of 6.0 (3.3,6.8) months. Three of the children were from Inner Mongolia Autonomous Region, 2 of them were from Hebei, and the other 3 were from Beijing, Shandong and Xinjiang Uyghur Autonomous Region, respectively. All the patients were previously healthy. In 4 of these cases, the possible cause was the ingestion of either honey and its products or sealed pickled food by the mother or child before the onset of the disease. The first symptom was poor milk intake (4 cases), followed by shallow shortness of breath (7 cases), limb weakness (7 cases) and so on. The typical signs were bilateral dilated pupils (8 cases) and decreased limb muscle strength (8 cases). The main subtype was type B (7 cases), and only 1 case was classified as type A. Six of the children were treated with antitoxin therapy for a duration of 24 (19, 49) d. Seven of them had invasive mechanical ventilation. All the patients survived upon discharge with a follow-up period of 29 d to 3 years and 8 months. Six patients had fully recovered, and 2 recently discharged patients were gradually recovering. Conclusions: For infants with suspected contact or ingestion of botulinum and presented with bilateral pupillary paralysis, muscle weakness and clear consciousness, the stool should be collected for diagnostic testing using a mouse bioassay as soon as possible. Type B was the most common type. The antitoxin treatment was effectiveness and the prognosis was well.
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Affiliation(s)
- L J Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - K C Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - H M Gao
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - J Liu
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Z Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X L Jia
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - C N Fan
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Q Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Liu G, Zhang CM, Li Y, Sun JY, Cheng YB, Chen YP, Wang ZH, Ren H, Liu CF, Jin YP, Chen S, Wang XM, Xu F, Xu XZ, Zhu QJ, Wang XD, Liu XH, Liu Y, Hu Y, Wang W, Ai Q, Dang HX, Gao HM, Fan CN, Qian SY. [Respiratory virus infection and its influence on outcome in children with septic shock]. Zhonghua Er Ke Za Zhi 2024; 62:211-217. [PMID: 38378281 DOI: 10.3760/cma.j.cn112140-20231014-00286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes. Methods: The clinical data of children with septic shock in children's PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results: A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs (OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions: The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.
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Affiliation(s)
- G Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - C M Zhang
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Y Li
- Department of Pediatric Intensive Care Unit, Children's Hospital Affiliated to Soochow University, Suzhou 215025, China
| | - J Y Sun
- Department of Pediatric Critical Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Y B Cheng
- Department of Pediatric Intensive Care Unit, Henan Children's Hospital, Zhengzhou 450018, China
| | - Y P Chen
- Department of Pediatric Intensive Care Unit, Baoding Children's Hospital, Baoding 071051, China
| | - Z H Wang
- Department of Pediatric Intensive Care Unit, Baoding Children's Hospital, Baoding 071051, China
| | - H Ren
- Department of Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - C F Liu
- Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Y P Jin
- Department of Pediatric Intensive Care Unit, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - S Chen
- Department of Pediatric Intensive Care Unit, Tianjin Children's Hospital, Tianjin 300074, China
| | - X M Wang
- Department of Hematology, Tianjin Children's Hospital, Tianjin 300074, China
| | - F Xu
- Department of Pediatric Critical Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - X Z Xu
- Department of Pediatric Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Q J Zhu
- Department of Pediatric Intensive Care Unit, Children's Hospital Affiliated to Soochow University, Suzhou 215025, China
| | - X D Wang
- Department of Pediatric Intensive Care Unit, Henan Children's Hospital, Zhengzhou 450018, China
| | - X H Liu
- Department of Pediatric Intensive Care Unit, Baoding Children's Hospital, Baoding 071051, China
| | - Y Liu
- Department of Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y Hu
- Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - W Wang
- Department of Pediatric Intensive Care Unit, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Q Ai
- Department of Hematology, Tianjin Children's Hospital, Tianjin 300074, China
| | - H X Dang
- Department of Pediatric Critical Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - H M Gao
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - C N Fan
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Cai LM, Wang XY, Feng GS, Zeng YP, Xu X, Guo YL, Tian J, Gao HM. [Poisonous substances and geographical distribution of poisoning in hospitalized children based on data from 25 hospitals in China from 2016 to 2020]. Zhonghua Er Ke Za Zhi 2023; 61:910-916. [PMID: 37803858 DOI: 10.3760/cma.j.cn112140-20230328-00214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To investigate the poisonous substances and geographical distribution of poisoning in children in China. Methods: A cross-sectional study. The clinical data of 8 385 hospitalized children from January 2016 to December 2020 were extracted from the FUTang Updating Medical Records database. These children aged 0 to 18 years and were admitted due to poisoning. They were grouped according to age (newborns and infants, toddlers, preschoolers, school-age children, adolescents), place of residence (Northeast China, North China, Central China, East China, South China, Southwest China, Northwest China), and mode of discharge (discharge under medical advice, transfer to another hospital under medical advice, discharge without medical advice, death, other). The poisonous substance and causes of poisoning in different groups were analyzed. Results: Among these 8 385 children, 4 734 (56.5%) were male and 3 651 (43.5%) female, with a male-to-female ratio of 1.3∶1. The age was 3 (2, 7) years. The prevalence of poisoning was 51.8% (4 343/8 385) in toddlers, 16.5% (1 380/8 385) in adolescents, 14.8% (1 242/8 385) in preschoolers, 14.4% (1 206/8 385) in school-age children, and 2.5% (214/8 385) in newborns and infants. Drug poisoning accounted for 43.5% (3 649/8 385) and pesticide accounted for 26.8% (2 249/8 385). Drug poisoning was more common in adolescents (684/1 380, 49.6%) and toddlers (2 041/4 343, 47.0%); non-drug poisoning was more common in school-age children (891/1 206, 73.9%), of which carbon monoxide was mainly in newborns and infants (41/214, 19.2%) and food poisoning in children of school age (241/1 206, 20.0%). Regarding regional characteristics, drug poisoning was more frequent in South China (188/246, 64.2%) and non-drug poisoning was more frequent in Southwest China (815/1 123, 72.5%). For drugs, anti-epileptic drugs, sedative-hypnotic drugs and anti-Parkinson's disease drugs had a higher proportion of poisoning in North China (138/1 034, 13.0%) than that in other regions. For non-drug poisoning, pesticides (375/1 123, 33.3%), food poisoning (209/1 123, 18.6%) and contact with poisonous animals (86/1 123, 7.7%) were more common in Southwest China than in other regions; carbon monoxide poisoning was more common in North China (81/1 034, 7.6%) and Northwest China (65/1 064, 6.3%). In Central China, poisoning happened more in toddlers (792/1 295, 61.2%) and less in adolescents (115/1 295, 8.8%) than in other regions. Regarding different age groups, poisoning in adolescent happened more in Northeast China (121/457, 26.5%), North China (240/1 034, 23.2%), and Northwest China (245/1 064, 23.0%). The rate of discharge under medical advice, discharge without medical advice, and mortality rate within the 5 years were 77.0% (6 458/8 385), 20.8% (1 743/8 385), 0.5% (40/8 385), respectively. Conclusions: Poisoning is more common in male and toddlers. Poisonous substances show a regional characteristic and vary in different age groups, with drugs and insecticides as the most common substances.
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Affiliation(s)
- L M Cai
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X Y Wang
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - G S Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y P Zeng
- Department of Medical Record Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X Xu
- Information Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y L Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - J Tian
- President's Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - H M Gao
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Wang ZH, Liu G, Fan CN, Wang XD, Liu XH, Su J, Gao HM, Qian SY, Li Z, Cheng YB. [Diagnosis and treatment of pediatric septic shock in pediatric intensive care units from hospitals of different levels]. Zhonghua Er Ke Za Zhi 2023; 61:209-215. [PMID: 36849346 DOI: 10.3760/cma.j.cn112140-20221028-00916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Objective: To investigate the differences in clinical characteristics, diagnosis, and treatment of pediatric septic shock in pediatric intensive care unit (PICU) among hospitals of different levels. Methods: This retrospective study enrolled 368 children with septic shock treated in the PICU of Beijing Children's Hospital, Henan Children's Hospital, and Baoding Children's Hospital from January 2018 to December 2021. Their clinical data were collected, including the general information, location of onset (community or hospital-acquired), severity, pathogen positivity, consistence of guideline (the rate of standard attainment at 6 h after resuscitation and the rate of anti-infective drug administration within 1 h after diagnosis), treatment, and in-hospital mortality. The 3 hospitals were national, provincial, and municipal, respectively. Furthermore, the patients were divided into the tumor group and the non-tumor group, and into the in-hospital referral group and the outpatient or emergency admission group. Chi-square test and Mann-Whitney U test were used to analyze the data. Results: The 368 patients aged 32 (11, 98) months, of whom 223 were males and 145 females. There were 215, 107, and 46 patients with septic shock, with males of 141, 51, and 31 cases, from the national, provincial, and municipal hospitals, respectively. The difference in pediatric risk of mortality Ⅲ (PRISM Ⅲ) scores among the national,provincial and municipal group was statistically significant (26(19, 32) vs.19(12, 26) vs. 12(6, 19), Z=60.25,P<0.001). The difference in community acquired septic shock among the national,provincial and municipal group was statistically significant (31.6%(68/215) vs. 84.1%(90/107) vs. 91.3%(42/46), χ2=108.26,P<0.001). There were no significant differences in compliance with guidelines among the 3 groups (P>0.05). The main bacteria detected in the national group were Klebsiella pneumoniae (15.4% (12/78)) and Staphylococcus aureus (15.4% (12/78)); in the provincial group were Staphylococcus aureus (19.0% (12/63)) and Pseudomonas aeruginosa (12.7% (8/63)), and in the municipal group were Streptococcus pneumoniae (40.0% (10/25)) and Enteric bacilli (16.0% (4/25)). The difference in the proportion of virus and the proportion of 3 or more initial antimicrobials used among the national,provincial and municipal group was statistically significant (27.7% (43/155) vs. 14.9% (13/87) vs. 9.1% (3/33), 22.8%(49/215) vs. 11.2%(12/107) vs. 6.5%(3/46), χ2=8.82, 10.99, both P<0.05). There was no difference in the in-hospital mortality among the 3 groups (P>0.05). Regarding the subgroups of tumor and non-tumor, the national group had higher PRISM Ⅲ (31(24, 38) vs. 22 (21, 28) vs.16 (9, 22), 24 (18, 30) vs. 17(8, 24) vs. 10 (5, 16), Z=30.34, 10.45, both P<0.001), and it was the same for the subgroups of in-hospital referral and out-patient or emergency admission (29 (21, 39) vs. 23 (17, 30) vs. 15 (10, 29), 23 (17, 29) vs. 18 (10, 24) vs. 11 (5, 16), Z=20.33, 14.25, both P<0.001) as compared to the provincial and municipal group. There was no significant difference in the in-hospital mortality among the 2 pairs of subgroups (all P>0.05). Conclusion: There are differences in the severity, location of onset, pathogen composition, and initial antibiotics of pediatric septic shock in children's hospitals of different levels, but no differences in compliance with guidelines and in-hospital survival rate.
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Affiliation(s)
- Z H Wang
- Baoding Research Laboratory of Pediatric Severe Infectious Diseases, Department of Pediatric Intensive Care Medicine, Baoding Children's Hospital, Baoding 071051, China
| | - G Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - C N Fan
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X D Wang
- Department of Pediatric Intensive Care Unit, Henan Children's Hospital, Zhengzhou 450000, China
| | - X H Liu
- Baoding Research Laboratory of Pediatric Severe Infectious Diseases, Department of Pediatric Intensive Care Medicine, Baoding Children's Hospital, Baoding 071051, China
| | - J Su
- Department of Pediatric Intensive Care Unit, Henan Children's Hospital, Zhengzhou 450000, China
| | - H M Gao
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Z Li
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y B Cheng
- Department of Pediatric Intensive Care Unit, Henan Children's Hospital, Zhengzhou 450000, China
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Liu G, Zheng YLC, Tan N, Wang LJ, Liu YC, Gao HM, Qian SY. [Application of initial anti-infectives and trends in children with septic shock]. Zhonghua Er Ke Za Zhi 2022; 60:1288-1294. [PMID: 36444432 DOI: 10.3760/cma.j.cn112140-20220511-00443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the pathogen composition, initial anti-infectives and pathogen coverage, and trends over the last 5 years in children with septic shock in pediatric intensive care unit (PICU). Methods: The single-center retrospective study included 257 children with septic shock who were admitted to PICU of Beijing Children's Hospital, Capital Medical University from 2017 to 2021. The causitive pathogen composition, initial use of anti-infective drugs, pathogen coverage, and changes in recent years were analyzed. The children were divided into sufficient and insufficient coverage groups according to whether the pathogen were sufficiently covered by initial anti-infectives; community-and hospital-acquired groups; and with and without underlying disease groups. T test, rank-sum test and Chi-square test were used for comparison between the groups to investigate the differences in pathogen, treatment and prognosis. Results: A total of 257 septic shock children were included, with 162 males and 95 females, aged 36 (12, 117) months. The pathogen positive rate was 64.6% (166/257) and the in-hospital mortality was 27.6% (71/257). In the 208 pathogen-positive samples, bacteria was the most common (57.7%, 120/208) with G-negative bacteria predominating (55.8%, 67/120), followed by viruses (26.0%, 54/208). Nearly 99.2% (255/257) of the children were treated with antibacterial at the beginning, of whom 47.1% (121/257) were treated with carbapenems combined with vancomycin or linezolid. The proportion of 3 or more antibacterial combinations was higher in children with underlying diseases and hospital-acquired septic shock than in those without underlying disease or community-acquired septic shock (27.4% (49/179) vs. 14.1% (11/78), 29.4% (52/177) vs. 10.0% (8/80), χ2=5.35,11.56,all P<0.05). The proportion of initial combination of carbapenem and vancomycin or linezolid reduced from 52.5% (21/40) to 41.3% (19/46), and of adequate pathogen coverage increased from 40.0% (16/40) to 58.7% (27/46) in the last five years. Conclusions: The initial use of antibacterial drugs is common in children with septic shock in PICU, especially in those with hospital-acquired septic shock and underlying diseases. In recent years, antimicrobial combinations have decreased, but the pathogen coverage has improved, indicating that drug selection is more reasonable and accurate.
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Affiliation(s)
- G Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y L C Zheng
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - N Tan
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L J Wang
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y C Liu
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - H M Gao
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Xu WM, Gao HM, Liu YC, Wang LJ, Qian SY. [Clinical analysis of 6 critically ill children with acute chlorine poisoning]. Zhonghua Er Ke Za Zhi 2022; 60:124-128. [PMID: 35090229 DOI: 10.3760/cma.j.cn112140-20210723-00622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the clinical characteristics and treatment of critically ill children with acute chlorine poisoning and explore the risk factors and effective strategies. Methods: This retrospective study collected the clinical data, including general state, clinical characteristics, treatment and follow-up(till 1 year and 6 months after discharge), of 6 critically ill children who were hospitalized in the Pediatric Intensive Care Unit of Beijing Children's Hospital due to acute chlorine poisoning in August 2019. Results: There were 6 children characterized by severe dyspnea in this accident, among whom 4 were boys and two girls, aged 4-12 years. When the accident occurred, they were within 5 m of the chlorine source. These patients underwent tracheal intubation and mechanical ventilation in 3.5-7.0 h after poisoning. The child who was the closest to the chlorine source (1.5 m) and took the longest time (5 min) to evacuate was the most severe one. He suffered hypoxia which could not be corrected by conventional mechanical ventilation and severe shock, then had veno-arterial extracorporeal membrane oxygenation(ECMO) treatment started 10 h after the accident. All the 6 children in this study survived. Following-up found no growth and developmental abnormality. The pulmonary function tests were normal except for one case with increased small airway resistance due to previous suspected asthma, and the lung CT, electhoencephalogram, and brain magnetic resonance imaging were all normal. Conclusions: Severe chlorine poisoning is mainly characterized by respiratory failure. Mechanical ventilation is often required within a few hours after poisoning. When conventional mechanical ventilation is ineffective, ECMO could save live. Timely treatment could improve prognosis.
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Affiliation(s)
- W M Xu
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - H M Gao
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y C Liu
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L J Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Li KC, Wang LJ, Liu G, Jin P, Wang YQ, Zhang T, Xu MX, Liu CY, Gao HM, Zhou T, Liu CF, Qian SY. [Analysis of 39 children with acute necrotizing encephalopathy]. Zhonghua Er Ke Za Zhi 2021; 59:582-587. [PMID: 34405641 DOI: 10.3760/cma.j.cn112140-20210208-00119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the risk factors for death in children with acute necrotizing encephalopathy (ANE) in pediatric intensive care unit (PICU). Methods: This was a multicenter retrospective study. Thirty-nine children with ANE were from PICUs in 4 centers from December 1, 2014 to December 1, 2020. The 4 participating centers were Beijing Children's Hospital, Shengjing Hospital of China Medical University, Hebei Children's Hospital, and Bao'an Maternity & Child Health Hospital. Patients were divided into survival and non-survival groups by the outcome at discharge, and the differences in clinical data between the two groups were compared. Risk factors for death in children with ANE and the odds ratios (OR) were analyzed by univariable Logistic regression. Results: Thirty-nine children with ANE were included. There were 18 males and 21 females. The median onset age was 30 months. The mortality at discharge was 41% (16/39). The onset age of most patients (74%, 29/39) was younger than 4 years old. Influenza virus was the most common precursor infection (80%, 20/25). Patients with shock at PICU admission were more common in the non-survival group (12/16 vs. 17% (4/23), P=0.001). Glasgow coma score (GCS) at PICU admission was significantly lower in the non-survival group than survival group (3 (3, 6) vs. 6 (5, 7), Z=-2.598, P=0.009). The optimal cut-off value was 4. The proportion of patients with GCS ≤ 4 at PICU admission was higher in the non-survival group (10/16 vs. 22% (5/23), P=0.018). ANE severity score (ANE-SS) at PICU admission was significantly higher in the non-survival group (5 (2, 6) vs. 2 (1, 4), Z=-2.436, P=0.015). The proportion of patients with high risk ANE-SS was higher in non-survival group than the survival group (9/16 vs. 22% (5/23), P=0.043). The proportion of application of high-dose methylprednisolone (20 mg/(kg·d)) was significantly higher in survival group than non-survival group (43% (10/23) vs. 1/13, P=0.031). Univariable Logistic regression indicated that risk factors for death in children with ANE were shock (OR=14.250, 95%CI 2.985-68.018, P=0.001), GCS≤4 (OR=6.000, 95%CI 1.456-24.733, P=0.013) and high risk ANE-SS (OR=4.629, 95%CI 1.142-18.752, P=0.032) at PICU admission. Conclusions: ANE usually occurs in children under 4 years old after influenza infection. Shock, GCS≤4 and high risk ANE-SS at PICU admission were risk factors for death in children with ANE. High-dose methylprednisolone may improve the prognosis of children with ANE.
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Affiliation(s)
- K C Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L J Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - G Liu
- Pediatric Intensive Care Unit, Hebei Children's Hospital, Hebei Medical University, Shijiazhuang 050031, China
| | - P Jin
- Pediatric Intensive Care Unit, Bao'an Maternity & Child Health Hospital, Shenzhen 518133, China
| | - Y Q Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - T Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - M X Xu
- Pediatric Intensive Care Unit, Hebei Children's Hospital, Hebei Medical University, Shijiazhuang 050031, China
| | - C Y Liu
- Pediatric Intensive Care Unit, Bao'an Maternity & Child Health Hospital, Shenzhen 518133, China
| | - H M Gao
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - T Zhou
- Pediatric Intensive Care Unit, Bao'an Maternity & Child Health Hospital, Shenzhen 518133, China
| | - C F Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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8
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Liu LJ, Xu M, Zhu J, Li N, Zhao XZ, Gao HM. Adiponectin alleviates liver injury in sepsis rats through AMPK/MTOR pathway. Eur Rev Med Pharmacol Sci 2021; 24:10745-10752. [PMID: 33155235 DOI: 10.26355/eurrev_202010_23435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the influences of adiponectin (APN) on the liver injury in sepsis rats and to explore whether it exerts a therapeutic effect through the adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway. MATERIALS AND METHODS A rat model of sepsis was established through cecal ligation and puncture (CLP) (CLP group), and APN treatment group (APN group) and control group were also set. The changes in the liver function-related indicators, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were determined by automatic biochemistry analyzer, and the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1, and IL-6 were measured via enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) staining was employed to detect liver tissue injury, and the hepatocyte apoptosis and necrosis after intervention with APN were evaluated using in situ fluorescence staining. Moreover, the mRNA expression of APN in liver tissues was detected via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR), and the expression levels of phosphorylated AMPK and mTOR proteins in liver tissue samples were determined using Western blotting. RESULTS In terms of changes in liver function-related indicators, the concentrations of ALT and AST were substantially raised in the CLP group, and compared with those in the control group, the concentrations of the two indicators significantly declined in the APN group, showing statistically significant differences (p<0.05). CLP and APN group had evidently higher levels of inflammatory factors than the control group, but their levels in APN group were notably lower than those in the CLP group (p<0.05). It was found through the HE staining that the sepsis rats in CLP group had massive inflammatory cell infiltration, and that the inflammatory cells were remarkably decreased in the APN group after APN treatment. According to the in-situ fluorescence staining detection results, CLP group exhibited a notable increase in the cell apoptosis rate, and APN group had substantially reduced apoptotic cells (p<0.05). The determination results of APN expression revealed that CLP group had a lowered level of APN, and that the level of APN in APN group was markedly higher than that in the control group. Based on the results of Western blotting, the level of phosphorylated AMPK was remarkably elevated, and that of phosphorylated mTOR was lowered in the CLP group compared with those in the control group, while in comparison with CLP group, APN group showed a considerable elevation of phosphorylated AMPK level and a distinct decline in the phosphorylated mTOR level. CONCLUSIONS APN can activate the AMPK/mTOR pathway and reduce hepatocyte apoptosis to alleviate liver injury in sepsis rats.
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Affiliation(s)
- L-J Liu
- Department of Clinical Laboratory, Jinan City People's Hospital, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, China.
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Luo N, Gao HM, Wang YQ, Li HJ, Li Y. MiR-942-5p alleviates septic acute kidney injury by targeting FOXO3. Eur Rev Med Pharmacol Sci 2021; 24:6237-6244. [PMID: 32572890 DOI: 10.26355/eurrev_202006_21521] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Sepsis refers to the systemic inflammatory response caused by infection. Acute kidney injury (AKI) in sepsis is very common, and there are many complicated mechanisms for the occurrence of septic AKI. This article aimed to study the role of miR-942-5p in inflammation and apoptosis of septic AKI and its potential mechanism. MATERIALS AND METHODS Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was performed to detect the expression of RNAs. The protein expression was detected using Western blot. The contents of inflammatory factors in the cell supernatant were detected using commercial enzyme-linked immunosorbent assay (ELISA) kits. Cell Counting Kit-8 (CCK-8) assay was utilized to compare the cell viability of each group. Terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) staining and flow cytometry were used to observe cell apoptosis. RESULTS MiR-942-5p expression was reduced in lipopolysaccharide (LPS)-treated HK-2 cells. MiR-942-5p mimic could observably increase miR-942-5p expression. The overexpression of miR-942-5p dramatically inhibits the expression of inflammatory factors and Bax, but increase Bcl-2 expression. MiR-942-5p overexpression greatly reversed the LPS-induced decrease in viability of HK-2 cells. In addition, we observed that LPS can markedly increase the number of apoptosis, while miR-942-5p mimic can reduce it. CONCLUSIONS Taken together, our results demonstrated that miR-942-5p expression was reduced in the LPS-treated HK-2 cells, and miR-942-5p overexpression can inhibit LPS-induced inflammation and apoptosis of HK-2 cells via targeting FOXO3.
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Affiliation(s)
- N Luo
- Department of Intensive Care Unit, Tianjin First Central Hospital, Tianjin, China.
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Gao HM, Liu J, Qian SY. [Approach to diagnosis and treatment of hyperlactatemia]. Zhonghua Er Ke Za Zhi 2021; 59:345-347. [PMID: 33775060 DOI: 10.3760/cma.j.cn112140-20210202-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H M Gao
- Department of Pediatric Critical Care Medicine, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health, Beijing 100045, China
| | - J Liu
- Department of Pediatric Critical Care Medicine, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Department of Pediatric Critical Care Medicine, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health, Beijing 100045, China
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Chen HC, Peng SJ, Gao HM, Su WT, Mei Y, Yi GL. [Determination of n-butyl alcohol in urine by headspace solid-phase microextraction coupled with gas chromatography]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 38:932-935. [PMID: 33406560 DOI: 10.3760/cma.j.cn121094-20200102-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish a headspace solid phase microextraction-gas chromatography method for determination of n-Butyl alcohol in urine. Methods: In October 2019, the n-butyl alcohol in urine was extracted with a polydimethylsiloxane/divinylbenzene (PDMS/DVB) solid-phase microextraction head. The conditions of salt amount, extraction temperature, extraction time and desorption time were optimized. The separation was performed on HP-5 (30 m×0.32 mm×0.25 μm) capillary column and detected with flame ionization detector. The quantification was based on the external standard curve. Results: The linear relationship of n-butyl alcohol in urine was good in the range of 0.04-3.00 mg/L, the correlation coefficient was 0.999, the detection limit of the method was 0.04 mg/L, the recovery was 77.4%-102.8%, the intra-run precision was 3.67%-8.11%, and the inter-assay precision was 4.94%-6.90%. Conclusion: The method has simple operation, high concentration efficiency and high sensitivity, and it is suitable for the determination of n-butyl alcohol in urine of occupational exposure to n-butyl alcohol.
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Affiliation(s)
- H C Chen
- Key Laboratory of Occupational Hazards Identification and Control in Hubei Province, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - S J Peng
- Key Laboratory of Occupational Hazards Identification and Control in Hubei Province, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - H M Gao
- Key Laboratory of Occupational Hazards Identification and Control in Hubei Province, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - W T Su
- Key Laboratory of Occupational Hazards Identification and Control in Hubei Province, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Y Mei
- Key Laboratory of Occupational Hazards Identification and Control in Hubei Province, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - G L Yi
- Wuhan Prevention and Treatment Center for Occupational Disease, Wuhan 430015, China
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12
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Wang HF, Wang YQ, Dou L, Gao HM, Wang B, Luo N, Li Y. Influences of up-regulation of miR-126 on septic inflammation and prognosis through AKT/Rac1 signaling pathway. Eur Rev Med Pharmacol Sci 2020; 23:2132-2138. [PMID: 30915758 DOI: 10.26355/eurrev_201903_17257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the influences of the up-regulation of micro ribonucleic acid (miR)-126 on septic inflammation and prognosis through the AKT/Rac1 signaling pathway. MATERIALS AND METHODS Human pulmonary microvascular endothelial cells (HMVECs) were cultured and transfected with miR-126 mimics. The HMVECs in the logarithmic growth phase in different groups were incubated with thrombin. The transmembrane resistivity of HMVECs was detected as the permeability via Electric Cell-substrate Impedance Sensing (ECIS) system. The endothelial cell space was observed via immunofluorescence. The mouse model of sepsis was then established and the serum was extracted to detect interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The survival curve was plotted based on the death time. The Statistical Product and Service Solutions (SPSS) 22.0 was used for statistical analysis, and p<0.05 suggested that the difference was statistically significant. RESULTS Thrombin could significantly increase the permeability of HMVECs, while the overexpression of miR-126 markedly inhibited the increased permeability. The overexpression of miR-126 also reduced the endothelial cell space induced by thrombin. In addition, the serum IL-6 and TNF-α levels of sepsis mice in miR-126 overexpression group were significantly decreased compared to those in the control group. Moreover, the death rate of mice exogenously expressing miR-126 was lower than that in the control group. CONCLUSIONS The up-regulation of miR-126 inhibited the septic inflammation and improved the prognosis of sepsis mice through the AKT/Rac1 signaling pathway.
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Affiliation(s)
- H-F Wang
- Department of Intensive Care Unit, Tianjin First Center Hospital, Tianjin, China.
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Gao HM, Wang LJ, Qian SY, Ren XX, Liu CF, Zhu YM. [A comparative study of four cross-sectional investigations on the status of pediatric intensive care unit in China over the past 30 years]. Zhonghua Er Ke Za Zhi 2020; 58:488-492. [PMID: 32521961 DOI: 10.3760/cma.j.cn112140-20191118-00735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the history, current situation and trends of intensive care unit (ICU) of pediatrics in China over the past 30 years. Methods: The results of the cross-sectional investigation on the status of ICU of pediatrics in 2014 were compared with those in 1993, 2001 and 2009. The main measurements were the number of participated provinces and hospitals, the availability of equipment, staffing, and medical technologies, the major diseases and the source of the patients. Besides, the equipment allocation and technology implementation in 2014 were compared with the standards in the "recommendations on grading construction and management of children's intensive care unit in China" published in 2016. Results: The contents of the four surveys were slightly different, with only a few measurements not documented in one or more surveys. (1) The number of provinces and hospitals involved in the four surveys were 20 hospitals in 14 provinces in year 1993, 27 hospitals in 17 provinces in year 2001, 33 hospitals in 25 provinces in year 2009 and 108 hospitals in 25 provinces in year 2014. (2) In 1993, 2001, 2009 and 2014, the ratio of doctors/beds were 0.7∶1,0.8∶1, (0.4-0.5) ∶1 and 0.5∶1, and the ratio of nurses/beds were 1.1∶1,1.4∶1, (1.1-1.7) ∶1 and 1.3∶1, respectively. (3) Regarding the equipment availability, in 1993, 2001, 2009, and 2014, the numbers of monitors were 0.3/ICU, 0.3/bed, 1.1-1.4/bed and 1.0/bed; the numbers of invasive ventilators were 0.4/bed, 0.5/bed, 0.6/bed and 0.4/bed, respectively. In 2001, 2009 and 2014, there were 60.0%, 100.0% (33/33) and 88.0% (95/108) of the participating ICU equipped with blood gas analyzer, and 70.0%, 93.9% (31/33) and 90.7% (98/108) with bedside X-ray machines, respectively. In 2009 and 2014, 69.7% (23/33) and 92.6% (100/108) ICU were equipped with non-invasive ventilators respectively. In 2014, 10.2% (11/108) ICU were equipped with extracorporeal membrane oxygenation (ECMO) equipment and 45.4% (49/108) ICU with bedside continuous blood purification equipment. In 1993, 2001 and 2014, the numbers of infusion pump were 0.5/ICU, 1.1/bed and 1.7/bed, respectively. (4) Regarding the conducted medical technology, in 2014, invasive mechanical ventilation was used in 100% (108/108) ICU, and non-invasive ventilation in 89.8% (97/108) ICU. High frequency ventilation was used in 78.8% (26/33) and 38.0% (41/108) ICU in 2009 and 2014 respectively. Blood purification was used in 22.0%, 69.7% (23/33) and 47.2% (51/108) ICU, and the application of surfactant was in 48.0%, 97.0% (32/33) and 24.1% (26/108) ICU in 2001, 2009 and 2014, respectively. Nitric oxide inhalation (iNO) was used in 24.0% and 9.3% (10/108) in 2001 and 2014 respectively. ECMO was used in 6 and 7 hospitals in 2009 and 2014 respectively. (5) Compared with the criteria in the "recommendations on grading construction and management of children's intensive care units in China" in 2016, only the availability of monitors and conventional mechanical ventilation in 2014 met the standards.The original data in 2001 was not shown due to the lack of absolute values. Conclusions: The number of ICU of pediatrics and its beds in China increased significantly from 1993 to 2014, as well as the equipment availability and the conducted medical technology. But the status in 2014 was still far behind the recommendations in 2016, with a significant shortage of professional staff.
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Affiliation(s)
- H M Gao
- Pediatric Intensive Care Unit, Beijing Children's Hosptial, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - L J Wang
- Pediatric Intensive Care Unit, Beijing Children's Hosptial, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hosptial, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X X Ren
- Department of Intensive Care Unit, Beijing Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - C F Liu
- Department of PICU, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Y M Zhu
- Hunan Provincial Institute of Emergency Medicine, Changsha 410005, China
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He YX, Yin J, Liu TT, Gao HM, Zhang R, Yao JF, Liu XY, Jia XL, Li XL, Li SL, Wu RH. [FGA gene variation causing congenital dysfibrinogenemia with recurrent arteriovenous thrombosis]. Zhonghua Er Ke Za Zhi 2020; 58:236-238. [PMID: 32135598 DOI: 10.3760/cma.j.issn.0578-1310.2020.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Y X He
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J Yin
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University,Beijing 100045, China
| | - T T Liu
- Department of Emergency Surgery, Beijing Children's Hospital, CapitalmedicalUniversity, Beijing 100045, China
| | - H M Gao
- Department of Critical Care Medicine, Capital Medical University, Beijing Children's Hospital, Beijing 100045, China
| | - R Zhang
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J F Yao
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - X Y Liu
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University,Beijing 100045, China
| | - X L Jia
- Department of Critical Care Medicine, Capital Medical University, Beijing Children's Hospital, Beijing 100045, China
| | - X L Li
- Department of Emergency Surgery, Beijing Children's Hospital, CapitalmedicalUniversity, Beijing 100045, China
| | - S L Li
- Department of Emergency Surgery, Beijing Children's Hospital, CapitalmedicalUniversity, Beijing 100045, China
| | - R H Wu
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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Song Y, Qian SY, Li Y, Liu J, Li Z, Jia XL, Gao HM, Zeng JS. [Effectiveness and safety of nimodipine in preventing cerebral vasospasm after subarachnoid hemorrhage in children]. Zhonghua Er Ke Za Zhi 2019; 57:338-343. [PMID: 31060125 DOI: 10.3760/cma.j.issn.0578-1310.2019.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effect of prophylactic nimodipine in vasospasm prevention and outcome improvement in children with subarachnoid hemorrhage (SAH). Methods: A prospective, randomized controlled clinical trial which enrolled children with SAH who were admitted to pediatric intensive care unit (PICU) of Beijing Children's Hospital from January 2015 to October 2018 was conducted. A total of 43 patients were randomly divided into nimodipine group (24 patients) and control group (19 patients) according to random number table. Transcranial Doppler (TCD) was used to dynamically monitor blood flow velocity and spectrum monography of bilateral middle cerebral artery (MCA) for vasospasm evaluation. Pediatric cerebral performance category (PCPC) scale was used to evaluate patients' brain function on 28(th) day after discharge. Data were analyzed by t test, Mann-Whitney U test, χ(2) test. Results: Except heart rate ((157±26) vs. (137±34) beats/min, t=2.079, P=0.045), no significant differences existed between the two groups in basic demographic characteristics, primary diseases, and clinical manifestations (all P>0.05). The peak velocities of bilateral MCA on the 5(th) day after admission were significantly lower in nimodipine group (left MCA (136±34) vs. (158±23) cm/s, t=-2.890, P=0.006; right MCA (129±34) vs. (176±27) cm/s, t=-3.717, P=0.001). Likewise, a lower peak velocity of left MCA was observed on the 7(th) day after admission in nimodipine group ((127±45) vs. (152±13) cm/s, t=-2.903, P=0.007), but no significant difference existed in that of right MCA ((131±48) vs. (150±22) cm/s, t=-1.760, P=0.090). Eleven patients suffered from vasospasm, 25% (6/24) in nimodipine group and 26% (5/19) in control group (χ(2)=0.010, P=1.000), within whom 8 patients had complete remission after continuing nimodipine treatment, one died in hospital and the other two's vasospasm still existed at the time of discharge. No significant differences were found between the two groups in mean length of hospitalization, proportion of mechanical ventilation, Glasgow coma scale at discharge, survival rate at discharge or survival rate on 28(t)h day after discharge (all P>0.05). However, nimodipine group had a higher proportion of favorable PCPC brain function (92% (22/24) vs. 63% (12/19), χ(2)=5.208, P=0.030). No side effects such as hypotension, rash or injection site erythema were observed. Conclusion: Prophylactic nimodipine cannot reduce vasospasm incidence in children with SAH but may improve short-term brain function, without any significant safety issues.
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Affiliation(s)
- Y Song
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Gao HM, Wang C, Zhang SS, Xiao DJ, Sun SH, Wang YS, Zhang MX. Application of Multiple Kits in Special Parentage Testing Cases. Fa Yi Xue Za Zhi 2018; 34:405-410. [PMID: 30465408 DOI: 10.12116/j.issn.1004-5619.2018.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To analyse the genetic polymorphism of 21 autosome STR loci in Han population of Shandong Province and the cases with loci mutation or allelic loss typed by Goldeneye® DNA identification system 25A. METHODS Totally 40 autosome STR loci types of 273 unrelated individuals in Han population of Shandong Province were typed by Goldeneye® DNA identification system 25A and 22NC, and the genetic polymorphism of 21 STR loci in those was analysed. Meanwhile, six cases with loci mutation were analysed by adding the tests with Goldeneye® DNA identification system 22NC, 20Y and 17X. Another three cases with allelic loss were tested by AmpFℓSTR® Identifiler® Plus PCR and analysed by gene sequencing. RESULTS The genetic parameters of 21 autosome STR loci in Han population of Shandong Province were obtained. When STR loci were added up to 40, five of those with loci mutation met the identification requirements, and the results of X-STR or Y-STR types were consistent with that of STR loci. There was another duo case with one suspected loci mutation, biological source of six STR loci genotypes could not be found in the genotypes of supposed father. The Y-STR genotype of two individuals was identical that indicated both of them came from same paternal line. However, the fatherhood was excluded according to the autosome STR loci system. For two cases with allelic loss on D18S51, base mutation or loss were found in the primer binding domain of mother and child by gene sequencing. Another mother-child case with allelic loss on D13S317 was certified by AmpFℓSTR® Identifiler® Plus PCR kit. CONCLUSIONS The 21 autosome STR loci in Han population of Shandong Province have high polymorphism, which can be used in routine cases of paternity identification. For some duo cases with loci mutation, Goldeneye® DNA identification system 25A cannot satisfy the identification requirements, thus more autosome STR loci should be added properly. For the cases with allelic loss, the problem can be resolved by gene sequencing or using different merchant kits.
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Affiliation(s)
- H M Gao
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
| | - C Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
| | - S S Zhang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
| | - D J Xiao
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
| | - S H Sun
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
| | - Y S Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
| | - M X Zhang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine, Jinan 250013, China
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Gao HM, Fan BY, Min YX, Chang Q. Investigation on the optimized algorithm for electrostatic tomography. Rev Sci Instrum 2018; 89:085116. [PMID: 30184655 DOI: 10.1063/1.4993686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
Particle charging in gas-solid two-phase flow is an important concern in many industrial processes. The technique of electrostatic tomography (EST) based on particle charging can achieve flow regime identification and infer concentration and flow rate by detecting the charged particles. Successful application of EST depends on the sensitivity map and the image reconstruction algorithm. In this paper, the effects of the sensitivity map on EST were demonstrated and a novel sensitivity map was presented. Then, optimized Tikhonov iterative algorithm (ITIK) was proposed to improve the quality of EST. The simulated results illustrate that the novel sensitivity map improves the quality of the reconstructed image of EST and the optimized ITIK has better performance in reconstructing the image of EST when compared with linearized back-projection algorithm, iterative linearized back-projection algorithm, and ITIK. Finally, the experimental studies were conducted and the simulated results were validated. The results indicate that the novel sensitivity map and the optimized algorithm can enable good applications of EST in gas-solid two-phase flow measurement.
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Affiliation(s)
- H M Gao
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, No. 5 Jinhuanan Road, Xi'an 710048, People's Republic of China
| | - B Y Fan
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, No. 5 Jinhuanan Road, Xi'an 710048, People's Republic of China
| | - Y X Min
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, No. 5 Jinhuanan Road, Xi'an 710048, People's Republic of China
| | - Qi Chang
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, No. 5 Jinhuanan Road, Xi'an 710048, People's Republic of China
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Zhang SS, Tang YQ, Zhang MX, Gao HM, Wang C, Wang YS, Han SY. [Genetic Polymorphisms of 19 STR Loci in Populations of Three Culture Region in Shandong]. Fa Yi Xue Za Zhi 2018; 34:264-269. [PMID: 30051665 DOI: 10.12116/j.issn.1004-5619.2018.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To analyse the genetic polymorphisms of 19 autosomal STR loci in Han population of east, middle-northwest and southwest-south Shandong and to explore its genetic relationships among the population of these three regions. METHODS STR loci of 1 044 unrelated Han individuals in three Shandong regions were typed with a Goldeneye® DNA ID System 20A kit. The allele frequency and population genetics parameters of 19 autosomal STR loci were statistically analysed by Modified-Powerstates software. The genetic distances among the population in three regions were calculated by Arlequin v3.5 software. The phylogenetic tree was conducted using MEGA v4.0 software. RESULTS Fifteen of 19 autosomal STR loci were detected with the H values greater than 0.7, PIC values greater than 0.7, and DP values greater than 0.9 in the populations of all three Shandong regions. Among the populations in these three regions, the genetic distance between the populations in middle-northwest and southwest-south Shandong was closest (Fst=0.000 16), followed by east and southwest-south Shandong (Fst=0.0003 6). The genetic distance between the populations in east and middle-northwest Shandong was the farthest (Fst=0.000 66, P<0.05). CONCLUSIONS The 19 autosomal STR loci show good genetic polymorphisms in Han population of three Shandong regions, and 15 of them are high. There are genetic differences between the populations in east and middle-northwest Shandong.
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Affiliation(s)
- S S Zhang
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
| | - Y Q Tang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
| | - M X Zhang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
- Jinan Dien Forensic Judical Appraisal Institute, Jinan 250013, China
| | - H M Gao
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
- Jinan Dien Forensic Judical Appraisal Institute, Jinan 250013, China
| | - C Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
- Jinan Dien Forensic Judical Appraisal Institute, Jinan 250013, China
| | - Y S Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
- Jinan Dien Forensic Judical Appraisal Institute, Jinan 250013, China
| | - S Y Han
- Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
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Gao HM, Wang C, Han SY, Sun SH, Xiao DJ, Wang YS, Li CT, Zhang MX. Analysis of the 19 Y-STR and 16 X-STR loci system in the Han population of Shandong province, China. Genet Mol Res 2017; 16:gmr-16-01-gmr.16019573. [PMID: 28363008 DOI: 10.4238/gmr16019573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The sex-linked short tandem repeats (STR), Y-STR and X-STR, are important for autosomal STRs in forensic paternity testing. We evaluated the forensic parameters of 19 Y-STRs and 16 X-STRs in the Han population of Shandong province, China. A Goldeneye 20Y kit (DYS391, DYS389I, DYS390, DYS389II, DYS348, DYS456, Y-GATA-H4, DYS447, DYS19, DYS392, DYS393, DYS388, DYS439, DYS635, DYS448, DYS460, DYS458, DYS437, DYS385 a/b) was used to analyze the forensic parameters of 534 unrelated males. A Goldeneye17X system (DXS6795, DXS9902, DXS8378, HPRTB, GATA165B12, DXS7132, DXS7424, DXS6807, DXS6803, GATA172D05, DXS6800, DXS10134, GATA31E08, DXS10159, DXS6789, DXS6810, amelogenin) was used to analyze 97 unrelated males and 214 females. In addition, we used the kits to examine 5 cases with abnormal amelogenin test results, as well as a male child with agenosomia typed by autosomal STR. We found 203 Y-STR haplotypes with allele frequencies ranging from 0.0019 to 0.7959, and GD ranging from 0.3429 to 0.9667. Expect in DXS6803, the allele frequencies of the other 15 X-STR loci showed no differences between females and males. PDF ranged from 0.5504 to 0.9638, while PDM ranged from 0.3176 to 0.8377. With the exception of DXS6803 and DXS6810, the allele frequencies of other X-STR loci were in accordance with Hardy-Weinberg equilibrium in females. One amelogenin negative case was characterized as a deletion of Y-DYS458. This paper provided data regarding the genetic polymorphism of Y-STRs and X-STRs in the Han population, and demonstrated the importance of Y-STR and X-STR in forensic autosomal STR analysis.
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Affiliation(s)
- H M Gao
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
| | - C Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
| | - S Y Han
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - S H Sun
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
| | - D J Xiao
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
| | - Y S Wang
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
| | - C T Li
- Institute of Forensic Sciences, Ministry of Justice, Shanghai, China
| | - M X Zhang
- Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China .,Jinan Di'en Legal Expertise Institute of Forensic Medicine of Jinan Central Hospital, Jinan, Shandong, China
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Yang SY, Wang YQ, Gao HM, Wang B, He Q. The clinical value of circulating miR-99a in plasma of patients with acute myocardial infarction. Eur Rev Med Pharmacol Sci 2016; 20:5193-5197. [PMID: 28051249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Acute myocardial infarction (AMI) contributes to be a significant public health problem, and it is the leading cause of morbidity and mortality in the world. However, the molecular mechanisms underlying AMI is poorly known. The purpose of this study was to investigate the change of plasma microRNA-99a (miR-99a) level in AMI patients and its potential clinical value. PATIENTS AND METHODS Plasma samples from 54 patients with AMI and 30 healthy volunteers were collected. Quantitative real-time PCR (qPCR) and ELISA assays were used to detect the expression of circulating plasma miR-99a and of cardiac troponin I (cTnI)/creatine kinase-MB (CK-MB), respectively. AMI patients were categorized into subgroups according to the number of stenosed coronary vessels, and the association between the plasma miR-99a level and the severity of AMI was analyzed. The expression level of miR-99a was also evaluated in patients receiving percutaneous coronary intervention (PCI). RESULTS The expression of miR-99a was significantly downregulated in patients with AMI compared with the normal controls (p < 0.01). In the AMI patients, miR-99a level had a negative correlation with cTnI level (r = -0.8202, p < 0.01) and CK-MB (r = -0.6924, p < 0.01). Also, the expression of miR-99a was markedly lower in patients with more stenosed coronary vessels (p < 0.01). The relative expression level of miR-99a in AMI patients was significantly increased after receiving PCI (p < 0.01). CONCLUSIONS The expression level of plasma miR-99a was remarkably reduced following AMI and closely associated with the severity of AMI. Therefore, it was a promising novel diagnostic biomarker for AMI.
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Affiliation(s)
- S-Y Yang
- Department of Intensive Care Unit, Tianjin First Center Hospital, Tianjin, China.
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An L, Wu ZH, Wu YF, Zhang XL, Liu X, Zhu YB, Cheng WM, Gao HM, Guo M, Tian JH. Fertility in Single-ovulating and Superovulated Dairy Heifers after Insemination with Low Dose Sex-sorted Sperm. Reprod Domest Anim 2010; 45:e344-50. [DOI: 10.1111/j.1439-0531.2009.01574.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Microglia, the resident immune cells in the brain, play a pivotal role in immune surveillance, host defense, and tissue repair in the CNS. In response to immunological challenges, microglia readily become activated as characterized by morphological changes, expression of surface antigens, and production of immune modulators that impact on neurons to induce neurodegeneration. However, little is known concerning the fate of activated microglia. In the present study, stimulation of cultured rat primary microglia with 1 ng/mL of the inflammagen lipopolysaccharide (LPS) resulted in a maximal activation as measured by the release of tumor necrosis factor alpha (TNF alpha). However, treatment with higher concentrations of LPS resulted in significantly lower quantities of detectable TNF alpha. Further analysis revealed that overactivation of microglia with higher concentrations of LPS (> 1 ng/mL) resulted in a time- and dose-dependent apoptotic death of microglia as defined by DNA strand breaks, surface expression of apoptosis-specific markers (phosphatidylserine), and activation of caspase-3. In contrast, astrocytes were insensitive to LPS-induced cytotoxicity. In light of the importance of microglia and the limited replenishment mechanism, depletion of microglia from the brain may severely hamper its capacity for combating inflammatory challenges and tissue repair. Furthermore, overactivation-induced apoptosis of microglia may be a fundamental self-regulatory mechanism devised to limit bystander killing of vulnerable neurons.
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Affiliation(s)
- B Liu
- Neuropharmacology Section, Laboratory of Pharmacology and Chemistry, National Institute of Environmental Health Sciences/National Institutes of Health, Research Triangle Park, North Carolina 27709, USA.
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Ye ZS, Hu XF, Gao HM, Li JQ. [Automatic analyzing system for human chromosome]. Zhongguo Yi Liao Qi Xie Za Zhi 2001; 25:16-25. [PMID: 12583294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A designing method for chromosome automatic analyzing system is presented in the paper. The system accomplishes chromosome automatic recognizing, sorting, pairing, picking out aberrant chromosomes and then makes diseases-diagnosis.
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Li XS, Zhao CY, Gao HM, Zhang YQ, Ishida M, Kanegae Y, Endo A, Nerome R, Omoe K, Nerome K. Origin and evolutionary characteristics of antigenic reassortant influenza A (H1N2) viruses isolated from man in China. J Gen Virol 1992; 73 ( Pt 6):1329-37. [PMID: 1607856 DOI: 10.1099/0022-1317-73-6-1329] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
During the 1988/1989 influenza season, five antigenic reassortant influenza A (H1N2) viruses not previously isolated from man were isolated in Hebei province, People's Republic of China. All isolates contained haemagglutinins (HAs) and neuraminidases (NAs) which were antigenically similar to those of the recent Russian (H1N1) and Hong Kong influenza A (H3N2) viruses, respectively. The results of antigenic and nucleotide sequence analyses revealed that the genes encoding the polymerase, nucleoprotein, NA, matrix and non-structural proteins of the reassortant A/Hebei/24/89 (H1N2) virus were derived from the H3N2 parent virus, whereas its HA gene was from the H1N1 parent virus. The nucleotide sequences of the HA (encoding the HA1 subunit) and NA genes of the reassortant viruses were also determined. Phylogenetic trees constructed from these data by the neighbour-joining method revealed that the HA gene of the reassortant virus was closely related to those of recent human H1N1 viruses, whereas the NA gene was related to a recent human Hong Kong (H3N2) virus lineage.
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Affiliation(s)
- X S Li
- Hebei Provincial Sanitation and Antiepidemic Station, Baoding, China
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