Viral metagenomics reveals diverse viruses in the fecal samples of children with diarrhea

Diarrhea is the third leading cause of death in developing countries in children under the age of five. About half a million children die of diarrhea every year, most of which in developing countries. Viruses are the main pathogen of diarrhea. In China, the fecal virome of children with diarrhea has been rarely studied. Using an unbiased viral metagenomics approach, we analyzed the fecal virome in children with diarrhea. Many DNA or RNA viruses associated with diarrhea identified in those fecal samples were mainly from six families of Adenoviridae, Astroviridae, Caliciviridae, Parvoviridae, Picornaviridae, and Reoviridae. Among them, the family of Caliciviridae accounts for the largest proportion of 78.42%, following with Adenoviridae (8.94%) and Picornaviridae (8.36%). In addition to those diarrhea-related viruses that have already been confirmed to cause human diarrhea, the viruses not associated with diarrhea were also identified including anellovirus and picobirnavirus. This study increased our understanding of diarrheic children fecal virome and provided valuable information for the prevention and treatment of viral diarrhea in this area.     

USE OF A PETHIDINE AND MIDAZOLAM COMBINATION FOR THE REVERSIBLE SEDATION OF CRABEATER SEALS (LOBODON CARCINOPHAGUS)

Between October and December of 1996–1999, off eastern Antarctica (60°-150°E), we darted 31 crabeater seals with midazolam and pethidine at estimated dose rates of 0.15–0.4 mg/kg and 1–3 mg/kg, respectively. Maximum sedation was reached at 23 ± 9 min (n = 18) and first signs of recovery were noted at 54 ± 24 min (n = 4). Seals greater than 250 kg body-mass were sedated by administration of approximately 90–100 mg midazolam and 600 mg pethidine, but the degree of sedation was unpredictable and did not permit invasive procedures in some cases. Behavior of the seal and adjacent conspecifics affected the success of procedures and our ability to monitor vital signs. Naloxone and flumazenil reversed sedation, making this combination attractive for use in animals adjacent to water. Additional ketamine was administered to two seals, resulting in improved restraint.     

Isolation of ouabain-resistant human diploid fibroblasts

Seventeen clones resistant to the cytotoxic action of ouabain were isolated in culture by direct selection from 5 independent strains of diploid human fibroblasts. Resistant clones were recovered at frequencies on the order of 10^?7 per wild type cell selected from populations treated with the mutagen EMS, but no resistant cells were detected among 10⁸ unmutagenized cells. Most selected clones remained ouabain-resistant following further propagation in the absence of drug. The growth of wild type cells was inhibited by 50% at ouabain concentrations of 2–5 × 10^?8 M, while resistant clones required 15–180 fold higher drug concentrations to cause equivalent inhibition. Ouabain-resistant clones showed increased resistance of K+ transport function to ouabain inhibition that paralleled their increased resistance to growth inhibition. Initial experiments suggest that under selective conditions the resistant diploid fibroblasts differ significantly from wild type in binding of ³H-ouabain per unit surface area. The ouabain-resistant cells were similar to wild type in transport properties unrelated to ouabain inhibition. Resistant cells had normal karyotypes and senesced with a lifespan similar to control clones. The ouabain-resistant phenotypes of these diploid human fibroblast isolates apparently reflect point mutations that specifically affect the Na+/K+ transport ATPase with respect to ouabain-binding and/or response to bound ouabain.     

酪酸梭菌活菌散联合葡萄糖酸锌治疗儿童急性腹泻的疗效观察

目的探讨酪酸梭菌活菌散联合葡萄糖酸锌治疗儿童急性腹泻的疗效。方法选取急性腹泻患儿76例,随机分为观察组和对照组各38例。两组患儿均予以调整饮食、口服或静脉补液和纠正水电解质酸碱失衡紊乱等常规治疗。观察组患儿予以酪酸梭菌活菌散和葡萄糖酸锌联合治疗,对照组患儿予以单纯酪酸梭菌活菌散治疗。观察两组患儿治疗后主要症状和体征改善的时间,并比较其临床疗效及治疗后3个月内腹泻的复发率。结果观察组患儿治疗后的止泻、呕吐、腹痛和粪常规等恢复正常时间均明显短于对照组（P〈0.05）;同时治疗3 d后,观察组患儿临床总有效率为94.74%,明显高于对照组的78.95%（χ2=4.15,P〈0.05）。两组患儿治疗后随访3个月,其中观察组和对照组分别腹泻复发5例（13.16%）和13例（34.21%）,观察组腹泻的复发率明显低于对照组（χ2=4.66,P〈0.05）。结论酪酸梭菌活菌散联合葡萄糖酸锌治疗儿童急性腹泻的疗效较肯定,能明显改善患儿腹泻症状,缩短腹泻病程,并能减少腹泻的复发。     

冬季肺炎和哮喘急性加重患儿呼吸道微生物多样性

目的 研究冬季肺炎和哮喘患儿呼吸道微生物的多样性。方法 选择2017年11月至2018年1月在我院急诊科治疗的确诊为肺炎和哮喘急性加重的患儿159例,其中肺炎患儿102例,哮喘急性加重患儿57例。选择同时期在本院就诊的无呼吸道疾病患儿88例,设为对照组。检测患儿呼吸道微生物分布情况。结果 肺炎和哮喘患儿呼吸道微生物多样性增加。肺炎患儿菌群丰度前3位的菌属分别是链球菌属、不动杆菌属、克雷伯菌属。哮喘患儿菌群丰度前3位的分别是嗜血杆菌属、莫拉氏菌属、葡萄球菌属。呼吸道病毒检测结果显示,肺炎患儿检出率前3位的病毒分别是肺炎支原体、呼吸道合胞病毒和副流感病毒3型。哮喘患儿病毒检出率前3位的是柯萨奇病毒、呼吸道合胞病毒和肺炎支原体。肺炎患儿肺炎支原体检出率明显高于哮喘患儿,柯萨奇病毒检出率明显低于哮喘患儿。结论 冬季肺炎和哮喘患儿的临床表现和体征较为相似,但是病原微生物检出情况有所不同。病原微生物检出的差异性有助于正确诊断和鉴别儿童肺炎和哮喘。     

全程心理疏导预防全麻术后导尿管刺激躁动的临床观察

目的:评价全程心理疏导预防全身麻醉术后导尿管刺激躁动的临床效果。方法:全麻下实施胆囊切除手术的80例男性患者为观察对象,随机均分为全程心理疏导组(Ⅰ组)和对照组(Ⅱ组),每组40例。Ⅰ组:术前、麻醉诱导前、苏醒后均对患者施行个体化心理疏导,根据患者具体情况进行沟通,解除其焦虑与恐惧心理。Ⅱ组:常规访视,不进行全程心理疏导。飞利浦多功能监测仪连续监测ECG、HR、SpO2及每3分钟监测一次BP,记录入室后MAP、HR的基础值(T0)、术毕(T1)、拔管后3 min(T2)、10 min(T3)、20min(T4)的血流动力学变化,观察记录拔管后患者因尿管刺激引发躁动评分。结果:Ⅰ组患者苏醒期对尿管刺激反应程度明显低于Ⅱ组,患者在苏醒期血压、心率也较稳定。结论:全程心理疏导可以预防、减轻全麻术后因导尿管刺激而引发的躁动。     

Lymphocyte transformation to connective tissue antigens in adult and juvenile rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, systemic lupus erythematosus, and a nonarthritic control population

Transformation of peripheral blood lymphocytes after exposure to connective tissue antigens was measured in patients with adult (n = 35) and juvenile rheumatoid arthritis (n = 34), osteoarthritis (n = 21), ankylosing spondylitis (n = 15), and systemic lupus erythematosus (n = 26) and in control subjects (n = 36). The connective tissue antigens included homologous cartilage-type proteoglycan, cyanogen bromide-derived peptides of type I, II, and III collagens, and type I and II helical collagens. Lymphocyte transformation was not detected in the osteoarthritic and control groups, with one exception. Sensitization to at least one connective tissue antigen was detected in approximately one-third of the rheumatoid arthritic and lupus patients and in one-quarter of the juvenile rheumatoid patients. In ankylosing spondylitis, positive responses occurred to proteoglycan in 20% of patients tested but never to collagens or peptides. Sensitivity to proteoglycan was detected only in ankylosing spondylitis except for one patient with juvenile rheumatoid arthritis. In patients with systemic lupus erythematosus and both forms of rheumatoid arthritis, lymphocyte transformation was usually more frequently detected to peptides than to the helical collagens. In adult rheumatoid arthritis, type II peptides elicited an elevated number of responses (14%) as did type I (9%) and III (8%) peptides to lesser degrees. Responses to type I (4%) and II (4%) helical collagens were infrequent. Rheumatoid arthritic patients usually exhibited sensitivity to only one antigen and lymphocyte transformation was often detected when the arthritis was improving. In juvenile rheumatoid arthritis, lymphocyte transformation was detected to peptides of type I (16%), II (9%), and III (29%) collagens and to helical type I (12%) and II (8%) collagens. In systemic lupus erythematosus, sensitization was detected to peptides of type I (13%), II (20%), and III (14%) collagens and to helical type I collagen (18%) but not type II collagen. Simultaneous sensitivity to several antigens often occurred in both systemic lupus erythematosus and juvenile rheumatoid arthritis. Examination of individual patients in all three rheumatic disease groups revealed that immune sensitivity developed to collagen peptides rather than to the helical molecules, particularly in the case of type II collagen. Thus, some patients with inflammatory arthritis exhibit immune responses to connective tissue components which are, as a group, characteristic for each type of arthritis. These responses, which were not obviously associated with disease activity, may develop as a result of inflammation or trauma which destroys connective tissue and exposes molecules, in either a native or degraded state, to cells of the immune system. Expression of sensitivity to these tissue antigens may contribute to the chronicity of the inflammatory arthritides.