Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children

Background

To compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and general MPP (GMPP) children with refractory MPP (RMPP) children and analysis the relationship with the severity of disease.

Methods

The study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP.

Results

Fever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1β) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP.

Conclusion

In conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.     

The relationship between functional capacity (FC) and cardiovascular risk factors (CVRFs) in senile patients after noncardiac surgery

The aim of the present study was to investigate the relationship between the number of cardiovascular risk factors (CVRFs) and functional capacity (FC) in the senile patients undergone noncardiac surgery. One hundred and eighty-two senile patients scheduled for elective noncardiac surgery were selected. According to the Duke activity status index (DASI), the FC of each patient was evaluated, and also their CVRFs were recorded. According to the number of CVRFs, the patients were ranked into different groups. The significant differences in FC between the groups^’ were identified using the analysis of variance. The examination showed that FC decreased with the increasing number of CVRFs. As a conclusion, we emphasize that with the increasing number of CVRFs, the FC of senile patients, i.e., their metabolic equivalents (METs) decrease. The occurrence of low FC and higher CVRFs is a common phenomenon in senile patients.     

改良阴茎成形术治疗青少年男性常见外生殖器畸形的疗效分析

目的:分析探讨2种改良阴茎成形术治疗青少年男性常见外生殖器畸形的临床效果。方法:选取2018年1月至2020年3月在南京医科大学附属常州第二人民医院接受改良阴茎成形术治疗的77例青少年男性外生殖器畸形患者,其中包皮过长及包茎患者56例,年龄（17.8±2.3）岁;隐匿阴茎患者21例,年龄（14.6±2.6）岁。回顾手术...     

A case series of COVID-19 patients with chronic hepatitis B virus infection

Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies reported the impacts of COVID-19 on liver function in patients with chronic liver diseases. We aimed to describe a case series of COVID-19 patients with chronic hepatitis B virus (HBV) infection. Confirmed hospitalized COVID-19 patients from hospitals in 10 cities of Jiangsu province, China, were retrospectively included between 18 January 2020 and 26 February 2020. Demographic information, epidemiologic data, clinical features, and treatment data were extracted from medical records. Seven COVID-19 patients with chronic HBV infection were included. Six (85.7%) patients were male. The patients aged from 33 to 49 years. Two patients had HBV-related cirrhosis. One patient (14.3%) was positive for serum HBV e-antigen. On admission, 1 (14.3%) patient had mildly elevated alanine aminotransferase (ALT) level (>40 U/L) and 1 (14.3%) had elevated aspartate aminotransferase (AST) level (>40 U/L). The serum albumin level and platelet counts were decreased in two patients with HBV-related liver cirrhosis. Three (42.9%) patients had elevated ALT level and 2 (28.6%) patients had elevated AST level in hospitalization. However, the peak ALT and AST level during hospitalization was 51 U/L and 44 U/L, respectively. As of 29 February 2020, all patients were discharged. No patient was admitted to the intensive care units or developed liver failure during hospitalization. The abnormalities of liver function are not uncommon on COVID-19 patients with chronic HBV infection in our case series. However, no patient developed severe liver-related complications during hospitalization.     

β‐glucan restores tumor‐educated dendritic cell maturation to enhance antitumor immune responses

Tumors can induce the generation and accumulation of immunosuppressive cells such as myeloid‐derived suppressor cells (MDSCs) in a tumor microenvironment, contributing to tumor escape from immunological attack. Although dendritic cell‐based cancer vaccines can initiate antitumor immune responses, tumor‐educated dendritic cells (TEDCs) involved in the tolerance induction have attracted much attention recently. In this study, we investigated the effect of β‐glucan on TEDCs and found that β‐glucan treatment could promote the maturation and migration of TEDCs and that the suppressive function of TEDCs was significantly decreased. Treatment with β‐glucan drastically decreased the levels of regulatory T (Treg) cells but increased the infiltration of macrophages, granulocytes and DCs in tumor masses, thus elicited Th1 differentiation and cytotoxic T‐lymphocyte responses and led to a delay in tumor progression. These findings reveal that β‐glucan can inhibit the regulatory function of TEDCs, therefore revealing a novel function for β‐glucan in immunotherapy and suggesting its potential clinical benefit. β‐Glucan directly abrogated tumor‐educated dendritic cells‐associated immune suppression, promoted Th1 differentiation and cytotoxic T‐lymphocyte priming and improved antitumor responses.     

ICU患者并联输注多种药物致静脉导管堵塞的体外药物配伍研究

目的:探讨1例ICU患者采用三通阀输液器并联输注多种静脉药物致导管堵塞的原因,为临床药师重点关注ICU患者静脉联用多种药物的安全性提供实践参考。方法:取患者同时在用的4种药物:氯化钾注射液、丙泊酚中/长链脂肪乳注射液、间羟胺注射液和地佐辛注射液,进行体外药物配伍试验,经整体混合及分别混合(丙泊酚与其他3种药物分别配伍),在电子显微镜下观察配伍后不同时间段药液的变化情况。结果:4种药液混合后,丙泊酚由最初匀质的小粒径乳滴(0.43μm)逐渐聚集增大,稳定性下降,最大乳滴粒径为3.45μm。进一步分别配伍试验证明了丙泊酚与间羟胺配伍时,乳滴蓄积与融合速度最快,4h乳滴粒径达10.36μm,已超过毛细血管平均直径;与氯化钾配伍时,乳滴蓄积与融合速度居中;与地佐辛配伍时,蓄积与融合速度最慢。结论:丙泊酚与间羟胺存在严重的配伍禁忌,应避免同时使用;与其他药物配伍时,其稳定性也会不同程度下降,建议采用双腔或多腔静脉导管单独一路输注丙泊酚中/长链脂肪乳。     

重组腺病毒介导的野生型p53基因对淋巴瘤细胞放疗敏感性的影响

目的观察重组腺病毒介导的野生型p53基因药物转染及联合辐射作用于淋巴瘤细胞后的表达状况及对其产生的杀伤效应。方法用MT(Tmethyl thiazolyl tetrazolium)法测定不同药物浓度、作用不同时间、不同辐射剂量及药物联合辐射对于raji和daudi细胞的生长抑制率;分别针对raji和daudi细胞设置对照组、加药组、照射组、联合组,进行蛋白提取,Western-Blotting法测定p53蛋白的表达,将图像进行比对分析。并用SPSS14.0软件对于上述数据进行分析。结果 raji和daudi细胞的加药组的生长抑制率明显于高于对照组(P<0.05)。两种细胞照射组的生长抑制率则随照射剂量的增加而上升。daudi细胞联合组的生长抑制率在各个剂量点上与照射组相比均无显著差异(P>0.05)。实验组的p53蛋白表达量均比对照组稍多,但两种细胞的联合组和照射组的p53蛋白表达量无明显差异(P>0.05)。结论重组腺病毒介导的p53基因药物能够转染入淋巴细胞,并表达p53蛋白,其对于raji和daudi淋巴瘤细胞有一定的抑制作用。重组腺病毒介导的p53基因药物对于增加放疗效果基本没有帮助。