BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneu...BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.展开更多
Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Metho...Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.展开更多
Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatr...Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatrics of our hospital from January 2022 to December 2022 were selected as the research subjects.They were divided into an azithromycin group and a reference group according to the random number drawing method,with 60 cases in each group.The azithromycin group was treated with azithromycin,and the reference group was treated with conventional treatment.The efficacy of treatment,laboratory indicators,platelet count and D-dimer,and adverse reactions of both groups were compared.Results:The efficacy of the azithromycin group was significantly higher than that of the reference group(P<0.05).Before treatment,there were no significant differences in the laboratory indicators like ferritin,procalcitonin(PCT),and erythrocyte sedimentation rate(ESR)between the two groups(P>0.05);after treatment,the laboratory indicators of the azithromycin group were significantly better than those of the reference group(P<0.05).Before treatment,there was no statistically significant difference in platelet count and D-dimer between the groups(P>0.05);after medication,the platelet count,and D-dimer in the azithromycin group were significantly better than those in the reference group(P<0.05).The total incidence of adverse reactions in the azithromycin group was significantly lower than that in the reference group(P<0.05).Conclusion:Azithromycin is more effective in treating mycoplasma pneumonia in children,and has certain clinical value.展开更多
The paper was to explore the preventive effects of five drugs on mycoplasma pneumonia of swine (MPS) and to provide reference for clinical medication of pig farms in Hainan Province.A total of 444 health piglets were ...The paper was to explore the preventive effects of five drugs on mycoplasma pneumonia of swine (MPS) and to provide reference for clinical medication of pig farms in Hainan Province.A total of 444 health piglets were randomly divided into 6 groups,including five medication groups (72 piglets in group A,74 piglets in group B,72 piglets in group C,76 piglets in group D,76 piglets in group E) and one control group (74 piglets).The piglets in experimental groups were treated drugs once a day for successive 5 days at 30,60,90,120 and 150 of age.The piglets in control group were free of medication.At 70 and 140 days of age,15 piglets of each group were randomly selected to collect their blood serum.The Mycoplasma hyopneumoniae (M-Hyo) antibodies in serum were measured by enzyme-linked immunosorbent assay (ELISA).During the experiment,the incidence rates of respiratory disease,lung lesion,feed conversion rate,average daily gain (ADG),and mortality rate of pigs were also observed and recorded.The results showed that the five drugs had significant difference in preventative effects.Group C (Zhiyuanjing group) received the best preventive effect and the highest economic benefits.Compared with control group,the ADG and feed conversion rate in group C were increased by 7.53% and 9.09%,respectively; the incidence rate of respiratory disease was reduced by 13.44% and lung lesion was alleviated by81.43%; and the earnings of each pig could rise by 132.70 yuan.The preventative effect and economic benefit of the drugs was sequenced by Chansu Kechuanling and Bingchan Kechuanwang.Wante Feilin and amoxicillin had weaker preventive effects against MPS but greatly influenced growth performance of pigs,so they should be used alternatively with other drugs.展开更多
This study was conducted to develop a method for accurate quantification of Mycoplasma hyopneumoniae during vaccine production or experimental research. Primer and probe concentration that gave the highest ΔRn and th...This study was conducted to develop a method for accurate quantification of Mycoplasma hyopneumoniae during vaccine production or experimental research. Primer and probe concentration that gave the highest ΔRn and the lowest Ct were selected to establish the real-time PCR system for the detection of M. hyopneumoniae. Template DNA of M. hyopneumoniae was extracted by boiling under different conditions and detected by real-time PCR to determine the optimal conditions for DNA extraction. Thereafter, intra-and inter-batch reproducibility tests were carried out using a standard plasmid to evaluate the stability of the PCR system. Subsequently, the effect of medium composition on the quantitative detection was evaluated. Finally, the correlation between real-time PCR and CCU method was explored. The optimal primer and probe concentration for real-time PCR were 0.4 and 0.2 μmol/L, respectively. The intra-and inter-batch coefficients of variation(CV) in Ct value of 10~4-10~9 copies/μl standard plasmid were <5%, indicating good reproducibility of the real-time PCR system. Following incubation in a boiling water bath for 10 min, M. hyopneumoniae samples can be used directly as a template in subsequent real-time PCR assays,and good intra-batch and inter-batch reproducibility was observed. The working concentration of KM2 medium should be less than the 1/10 of the concentration of the stock solution to minimize its influence on the quantitative detection. Spearman's correlation analysis revealed that the log of CCU and the log of DNA copy number had a significant positive relationship(r=0.797,P=0.000). Thus, the two methods can be used in combination in the quantitative detection of M. hyopneumoniae. In summary, a rapid, stable and accurate quantitative PCR system for detecting M. hyopneumoniae culture was established in this study, which provides a technical means for accurate quantification of M. hyopneumoniae in vaccine production and laboratory tests.展开更多
Respiratory diseases are one of the most important health problems in pig herds. The porcine respiratory disease complex (PRDC) is the term used to describe pneumonic diseases caused by multiple infectious agents that...Respiratory diseases are one of the most important health problems in pig herds. The porcine respiratory disease complex (PRDC) is the term used to describe pneumonic diseases caused by multiple infectious agents that provoke weight loss in animals or death. In the PRDC multiple pathogens (bacteria and/or viruses) work in combination to induce this respiratory disease. Within this complex, Actinobacillus pleuropneumoniae, Streptococcus suis, Pasteurella multocida, Bordetella bronchiseptica, Haemophilus parasuis and Mycoplasma hyopneumoniae are the main bacterial pathogens involved in great economic losses to the swine industry. The aim of this work was to estimate the presence of A. pleuropneumoniae, S. suis, P. multocida, B. bronchiseptica, H. parasuis and M. hyopneumoniae in the upper respiratory tract of pigs in representative swine farms inAguascalientes,Mexico, using PCR technique. The study was performed in 14 swine farms. We obtained a total of 212 nasal swabs. Near 20% of samples were positive for A. pleuropneumoniae (located in the 79% of farms);17% were positive for S. suis (in 86% of farms), of these, 3% were S. suis serovar 2;30% were positive for H. parasuis (93% of farms);23% of the samples to P. multocida (in 79% of farms);and 19% to M. hyopneumoniae (in 64% of farms). B. bronchiseptica was not detected in this study. The results obtained show that bacterial pathogens of PRDC were present in the upper respiratory tract of pigs in all farms studied;therefore, these pathogens are widely disseminated in pig farms of Aguascalientes, Mexico.展开更多
Objective:To study the correlation of serum complements C3 and C4 as well as immunoglobulins IgM, IgA and IgG contents with inflammatory stress response in children with mycoplasma pneumoniae pneumonia.Methods: The ch...Objective:To study the correlation of serum complements C3 and C4 as well as immunoglobulins IgM, IgA and IgG contents with inflammatory stress response in children with mycoplasma pneumoniae pneumonia.Methods: The children who were diagnosed with Mycoplasma pneumoniae pneumonia in Xiangyang No. 1 People's Hospital, Hubei University of Medicine between February 2015 and January 2018 were selected as the MPP group, and healthy children who received physical examination during the same period were selected as the control group. The contents of complements, immunoglobulins and inflammatory stress mediators in serum as well as the expression of inflammatory stress molecules in peripheral blood were measured.Results: Serum C3, C4, IgM, sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity of MPP group were significantly higher than those of control group, IgA level was significantly lower than that of control group, and IgG level was not different from that of control group;serum C3, C4 and IgM levels of MPP group were positively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity, and serum IgA level was negatively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity. Conclusion: The changes of serum complements and immunoglobulins in children with Mycoplasma pneumoniae pneumonia are related to the excessive activation of inflammatory stress response in the course of disease.展开更多
Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective ...Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective treatment for MPP, the long-term outcome remained uncertain. A study on status of MPP in China was conducted via a systematic review of published studies which have the Chinese data and collected from published PubMed and core journals of China Knowledge Resource Integrated Database (CNKI). The analysis was based on epidemiology, clinical characteristics, treatment, drug resistance and prognosis. Twenty five articles concerned about MPP in Chinese children and adolescent were enrolled, including 11 studies on epidemiology/etiology, 11 studies on clinical characteristics, 7 studies on drug resistance, 5 studies on treatment from China's Mainland respectively. The overall incidence of MPP ranged from 7.1% to 54.4%. Fever and cough were most frequently identified in manifestations. Drug resistance to macrolides ranged from 18.9% to 90%. The outcome of treatment in patients who received combined treatment of macrolides, cephalosporin antibiotics and/or cortical steroid seems to be better than those who received macrolides only. Macrolide combined with cephalosporin or cortical steroid both may decrease the severity of MPP in the past decade. There was not enough evidence to suggest that cortical steroid can decrease the mortality of MPP in children. And a multi-center, randomized double blind research on the effect of cortical steroid was encouraged.展开更多
Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked ...Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.展开更多
Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia...Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia. The aim of this study was to investigate other possible mutations involved in macrolide resistance in M. pneumoniae. Methods The whole genomes of 10 clinical isolates of M. pneumoniae with macrolide resistance were sequenced by Illumina Hi Seq2000 platform. The role of the macrolide-specific efflux transporter was assessed by efflux-pump inhibition assays with reserpine and carbonyl cyanide m-chlorophenyl-hydrazone(CCCP). Results A total of 56 single nucleotide polymorphisms(SNPs) were identified in 10 clinical isolates in comparison to the reference strains M129 and FH. Strikingly, 4 of 30 SNPs causing non-synonymous mutations were clustered in macrolide-specific efflux system gene mac B encoding macrolide-specific efflux pump protein of the ATP-binding cassette transporter family. In assays of the minimal inhibitory concentrations(MIC) of macrolide antibiotics in the presence of the efflux pump inhibitors caused a significant decrease of MICs, even under detectable levels in some strains. Conclusion Our study suggests that macrolide efflux pump may contribute to macrolide resistance in M. pneumoniae in addition to the common point mutations in 23 S r RNA gene.展开更多
In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infec...In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infection model was developed by infecting rats with MP for 9 times during a period of 24 weeks with a technique of ultrasonic nebulizing inhalation. Then in situ hybridization was performed with PDGF-B chain cDNA probe and the results were quantitatively analyzed to measure the changes in PDGF-B chain mRNA expression in the lung tissue. The results showed that: (1) MP polymerase chain reaction (PCR) tests showed positive results in the bronchoalveotar lavage fluid (BALF) from all of the MP-infected rats (n=4) while they were all negative in BALF from the control animals (n=4, P【0.05) and in BALF from those rats both infected with MP and, at the same time, treated with erythromycin (n=4, P【0.05). Bacterial cultures of the bronchial and lung tissue were negative in all three groups. The展开更多
Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatr...Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients.Methods Real-time quantitative polymerase chain reaction(PCR)was used to identify M.pneumoniae,and MLVA was performed.The domain V of the 23 S rRNA was sequenced to detect macrolide-resistant point mutations.We also investigated the activities of antibiotics against M.pneumoniae isolates in vitro.Results The PCR detection rate of M.pneumoniae in children in Beijing was 40%,and the macrolide resistance rate was 66%.The A2063 G mutation in the 23 S rRNA V region is the dominant mutation(137/146,93.84%),whereas the A2064 G mutation is rare(9/146,6.16%).Seventy-three samples were typed successfully by MLVA typing,including 86.3%(63/73)were MLVA type 4-5-7-2,and 13.7%(10/73)were MLVA type 3-5-6-2.No other types were found.No strains were resistant to levofloxacin or tetracycline.Conclusion In 2016,a specific decrease in the macrolide resistance rate occurred in Beijing.The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients.The A2063 G mutants M.pneumoniae have high levels of resistance to erythromycin and azithromycin.The primary MLVA type is 4-5-7-2,followed by 3-5-6-2.No other MLVA types were detected.No strains resistant to tetracycline or levofloxacin were found in vitro.展开更多
Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagn...Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.展开更多
Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth ...Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.展开更多
Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunolog...Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunological abnormalities that could constitute a favourable terrain for neoplasms. We report on a case in a 2-year-old girl who presented clinical manifestations compatible with Kawasaki disease complicated by coronary aneurysm. Aetiopathological investigations revealed M. pneumoniae infection as specific IgM were present in the serum (Elisa). The patient was initially treated by intravenous immunoglobulins (IVIG) and aspirin to anti-inflammatory dose. Following a few days of desquamation, resolution of the symptomatology occurred. Four weeks later she developed disseminated tumorous syndrome. Lymph node biopsy revealed massive infiltration by large cells lymphomatous proliferation. Histologic and immunophenotypic findings were characteristic of ALK-1+ anaplastic large cell lymphoma. Four weeks later, the patient died from a severe nosocomial infection complicated by septic shock. Our observation is the first cases describing the association between anaplastic large cell lymphoma, KD and M. pneumoniae. Immunologic disorder due to KD and M. pneumoniae infection may play probably a central role for malignancy.展开更多
BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a...BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a 12-year-old girl with Mycoplasma pneumoniae(M.pneumoniae)infection who presented with prolonged fever and lymphadenitis refractory to macrolide antibiotics.CASE SUMMARY A previously healthy 12-year-old girl presented with fever,myalgia,sore throat,swelling,and tenderness on the right side of the neck.She was initially diagnosed with lymphadenitis caused by M.pneumoniae refractory to macrolide antibiotics.She had elevated brain natriuretic peptide(BNP)levels.Finally,the patient was diagnosed with KD.After receiving intravenous immunoglobulin,the fever resolved,and her symptoms improved.CONCLUSION NFKD should be differentiated from adolescent lymphadenitis presenting with prolonged fever by checking the BNP level early.展开更多
Objective: To explore the effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia. Methods: A total of 130 children with mycopla...Objective: To explore the effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia. Methods: A total of 130 children with mycoplasma pneumonia were included in the study and randomized into the treatment group (n=65) and the control group (n=65). The patients in the control group were given azithromycin. On the above basis, the patients in the treatment group were given Yanhuning. The patients in the two groups were continuously treated for 7 d. The levels of serum inflammatory cytokines and immunological function indicators before and after treatment in the two groups were detected and compared. Results: When compared with before treatment, the serum IL-2 level after treatment in the two groups was significantly elevated, while IL-4, IL-10, IL-13, IL-6, TNF-α, and IFN-γ levels were significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. When compared with before treatment, CD3+, CD4+, and CD4+/CD8+ after treatment in the two groups were significantly elevated, and those in the treatment group were significantly higher than those in the control group, while CD8+ was significantly reduced, but the comparison between the two groups was not statistically significant. When compared with before treatment, RBC-C3bR after treatment in the two groups was significantly elevated, while RBC-ICR was significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. Conclusions: Yanhuning in combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly enhance the immunological function, and reduce the inflammatory reaction, with an effect significantly superior to that by single application of azithromycin.展开更多
Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children w...Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children with severe mycoplasma pneumonia who were treated in Huai'an Second People's Hospital between June 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, the intervention group received routine treatment combined with Singulair and methylprednisolone, and control group received routine treatment. Before and after treatment, serum was collected to detect the contents of inflammatory cytokines and corresponding cytokines of T lymphocyte subsets, and peripheral blood was collected to determine the contents of T cell subsets.Results:3 d and 7 d after treatment, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of both groups were significantly lower than those before treatment while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those before treatment, and serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of intervention group were significantly lower than those of control group while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those of control group.Conclusion: Singulair combined with methylprednisolone treatment of mycoplasma pneumonia can inhibit the inflammatory response and regulate the balance of Th1/Th2 and Th17/Treg cells.展开更多
文摘BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.
基金supported by the Evidence-based Capacity Building Project of Traditional Chinese medicine of the National Administration of Traditional Chinese Medicine(60102)the Fundamental Research Funds for the Central Public Welfare Research Institutes(49425).
文摘Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.
文摘Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatrics of our hospital from January 2022 to December 2022 were selected as the research subjects.They were divided into an azithromycin group and a reference group according to the random number drawing method,with 60 cases in each group.The azithromycin group was treated with azithromycin,and the reference group was treated with conventional treatment.The efficacy of treatment,laboratory indicators,platelet count and D-dimer,and adverse reactions of both groups were compared.Results:The efficacy of the azithromycin group was significantly higher than that of the reference group(P<0.05).Before treatment,there were no significant differences in the laboratory indicators like ferritin,procalcitonin(PCT),and erythrocyte sedimentation rate(ESR)between the two groups(P>0.05);after treatment,the laboratory indicators of the azithromycin group were significantly better than those of the reference group(P<0.05).Before treatment,there was no statistically significant difference in platelet count and D-dimer between the groups(P>0.05);after medication,the platelet count,and D-dimer in the azithromycin group were significantly better than those in the reference group(P<0.05).The total incidence of adverse reactions in the azithromycin group was significantly lower than that in the reference group(P<0.05).Conclusion:Azithromycin is more effective in treating mycoplasma pneumonia in children,and has certain clinical value.
基金National Natural Science Foundation of China(31560696)Special Project of Enterprises-Universities-Researches Integration of Hainan Province(cxy20150008)Special Project of Technology Development in Scientific Research Institutes of Hainan Province(KYYS-2014-32)
文摘The paper was to explore the preventive effects of five drugs on mycoplasma pneumonia of swine (MPS) and to provide reference for clinical medication of pig farms in Hainan Province.A total of 444 health piglets were randomly divided into 6 groups,including five medication groups (72 piglets in group A,74 piglets in group B,72 piglets in group C,76 piglets in group D,76 piglets in group E) and one control group (74 piglets).The piglets in experimental groups were treated drugs once a day for successive 5 days at 30,60,90,120 and 150 of age.The piglets in control group were free of medication.At 70 and 140 days of age,15 piglets of each group were randomly selected to collect their blood serum.The Mycoplasma hyopneumoniae (M-Hyo) antibodies in serum were measured by enzyme-linked immunosorbent assay (ELISA).During the experiment,the incidence rates of respiratory disease,lung lesion,feed conversion rate,average daily gain (ADG),and mortality rate of pigs were also observed and recorded.The results showed that the five drugs had significant difference in preventative effects.Group C (Zhiyuanjing group) received the best preventive effect and the highest economic benefits.Compared with control group,the ADG and feed conversion rate in group C were increased by 7.53% and 9.09%,respectively; the incidence rate of respiratory disease was reduced by 13.44% and lung lesion was alleviated by81.43%; and the earnings of each pig could rise by 132.70 yuan.The preventative effect and economic benefit of the drugs was sequenced by Chansu Kechuanling and Bingchan Kechuanwang.Wante Feilin and amoxicillin had weaker preventive effects against MPS but greatly influenced growth performance of pigs,so they should be used alternatively with other drugs.
基金Supported by National Key Research and Development Project of China(2017YFD0501604)National Natural Science Foundation of China(31400164)
文摘This study was conducted to develop a method for accurate quantification of Mycoplasma hyopneumoniae during vaccine production or experimental research. Primer and probe concentration that gave the highest ΔRn and the lowest Ct were selected to establish the real-time PCR system for the detection of M. hyopneumoniae. Template DNA of M. hyopneumoniae was extracted by boiling under different conditions and detected by real-time PCR to determine the optimal conditions for DNA extraction. Thereafter, intra-and inter-batch reproducibility tests were carried out using a standard plasmid to evaluate the stability of the PCR system. Subsequently, the effect of medium composition on the quantitative detection was evaluated. Finally, the correlation between real-time PCR and CCU method was explored. The optimal primer and probe concentration for real-time PCR were 0.4 and 0.2 μmol/L, respectively. The intra-and inter-batch coefficients of variation(CV) in Ct value of 10~4-10~9 copies/μl standard plasmid were <5%, indicating good reproducibility of the real-time PCR system. Following incubation in a boiling water bath for 10 min, M. hyopneumoniae samples can be used directly as a template in subsequent real-time PCR assays,and good intra-batch and inter-batch reproducibility was observed. The working concentration of KM2 medium should be less than the 1/10 of the concentration of the stock solution to minimize its influence on the quantitative detection. Spearman's correlation analysis revealed that the log of CCU and the log of DNA copy number had a significant positive relationship(r=0.797,P=0.000). Thus, the two methods can be used in combination in the quantitative detection of M. hyopneumoniae. In summary, a rapid, stable and accurate quantitative PCR system for detecting M. hyopneumoniae culture was established in this study, which provides a technical means for accurate quantification of M. hyopneumoniae in vaccine production and laboratory tests.
文摘Respiratory diseases are one of the most important health problems in pig herds. The porcine respiratory disease complex (PRDC) is the term used to describe pneumonic diseases caused by multiple infectious agents that provoke weight loss in animals or death. In the PRDC multiple pathogens (bacteria and/or viruses) work in combination to induce this respiratory disease. Within this complex, Actinobacillus pleuropneumoniae, Streptococcus suis, Pasteurella multocida, Bordetella bronchiseptica, Haemophilus parasuis and Mycoplasma hyopneumoniae are the main bacterial pathogens involved in great economic losses to the swine industry. The aim of this work was to estimate the presence of A. pleuropneumoniae, S. suis, P. multocida, B. bronchiseptica, H. parasuis and M. hyopneumoniae in the upper respiratory tract of pigs in representative swine farms inAguascalientes,Mexico, using PCR technique. The study was performed in 14 swine farms. We obtained a total of 212 nasal swabs. Near 20% of samples were positive for A. pleuropneumoniae (located in the 79% of farms);17% were positive for S. suis (in 86% of farms), of these, 3% were S. suis serovar 2;30% were positive for H. parasuis (93% of farms);23% of the samples to P. multocida (in 79% of farms);and 19% to M. hyopneumoniae (in 64% of farms). B. bronchiseptica was not detected in this study. The results obtained show that bacterial pathogens of PRDC were present in the upper respiratory tract of pigs in all farms studied;therefore, these pathogens are widely disseminated in pig farms of Aguascalientes, Mexico.
文摘Objective:To study the correlation of serum complements C3 and C4 as well as immunoglobulins IgM, IgA and IgG contents with inflammatory stress response in children with mycoplasma pneumoniae pneumonia.Methods: The children who were diagnosed with Mycoplasma pneumoniae pneumonia in Xiangyang No. 1 People's Hospital, Hubei University of Medicine between February 2015 and January 2018 were selected as the MPP group, and healthy children who received physical examination during the same period were selected as the control group. The contents of complements, immunoglobulins and inflammatory stress mediators in serum as well as the expression of inflammatory stress molecules in peripheral blood were measured.Results: Serum C3, C4, IgM, sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity of MPP group were significantly higher than those of control group, IgA level was significantly lower than that of control group, and IgG level was not different from that of control group;serum C3, C4 and IgM levels of MPP group were positively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity, and serum IgA level was negatively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity. Conclusion: The changes of serum complements and immunoglobulins in children with Mycoplasma pneumoniae pneumonia are related to the excessive activation of inflammatory stress response in the course of disease.
文摘Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective treatment for MPP, the long-term outcome remained uncertain. A study on status of MPP in China was conducted via a systematic review of published studies which have the Chinese data and collected from published PubMed and core journals of China Knowledge Resource Integrated Database (CNKI). The analysis was based on epidemiology, clinical characteristics, treatment, drug resistance and prognosis. Twenty five articles concerned about MPP in Chinese children and adolescent were enrolled, including 11 studies on epidemiology/etiology, 11 studies on clinical characteristics, 7 studies on drug resistance, 5 studies on treatment from China's Mainland respectively. The overall incidence of MPP ranged from 7.1% to 54.4%. Fever and cough were most frequently identified in manifestations. Drug resistance to macrolides ranged from 18.9% to 90%. The outcome of treatment in patients who received combined treatment of macrolides, cephalosporin antibiotics and/or cortical steroid seems to be better than those who received macrolides only. Macrolide combined with cephalosporin or cortical steroid both may decrease the severity of MPP in the past decade. There was not enough evidence to suggest that cortical steroid can decrease the mortality of MPP in children. And a multi-center, randomized double blind research on the effect of cortical steroid was encouraged.
基金CNPQ (National Counsel of Technological and Scientific Development of Federal Government grant 132905/ 2006-0.) FAPESP (Foundation that supports research in the State of São Paulo, grant 562444/2007).
文摘Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.
基金supported by the grants from National Nature Science Foundation of China(81601778 and 81672062)the Beijing Natural Science Foundation(7152025)Beijing Talents Fund(2015000021469G192)
文摘Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia. The aim of this study was to investigate other possible mutations involved in macrolide resistance in M. pneumoniae. Methods The whole genomes of 10 clinical isolates of M. pneumoniae with macrolide resistance were sequenced by Illumina Hi Seq2000 platform. The role of the macrolide-specific efflux transporter was assessed by efflux-pump inhibition assays with reserpine and carbonyl cyanide m-chlorophenyl-hydrazone(CCCP). Results A total of 56 single nucleotide polymorphisms(SNPs) were identified in 10 clinical isolates in comparison to the reference strains M129 and FH. Strikingly, 4 of 30 SNPs causing non-synonymous mutations were clustered in macrolide-specific efflux system gene mac B encoding macrolide-specific efflux pump protein of the ATP-binding cassette transporter family. In assays of the minimal inhibitory concentrations(MIC) of macrolide antibiotics in the presence of the efflux pump inhibitors caused a significant decrease of MICs, even under detectable levels in some strains. Conclusion Our study suggests that macrolide efflux pump may contribute to macrolide resistance in M. pneumoniae in addition to the common point mutations in 23 S r RNA gene.
文摘In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infection model was developed by infecting rats with MP for 9 times during a period of 24 weeks with a technique of ultrasonic nebulizing inhalation. Then in situ hybridization was performed with PDGF-B chain cDNA probe and the results were quantitatively analyzed to measure the changes in PDGF-B chain mRNA expression in the lung tissue. The results showed that: (1) MP polymerase chain reaction (PCR) tests showed positive results in the bronchoalveotar lavage fluid (BALF) from all of the MP-infected rats (n=4) while they were all negative in BALF from the control animals (n=4, P【0.05) and in BALF from those rats both infected with MP and, at the same time, treated with erythromycin (n=4, P【0.05). Bacterial cultures of the bronchial and lung tissue were negative in all three groups. The
基金supported by the National Natural Science Foundation of China[Grant No.81271890]Beijing Municipal Science&Technology Commission Grant[No.Z161100000116088 and Z1711000017081]
文摘Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients.Methods Real-time quantitative polymerase chain reaction(PCR)was used to identify M.pneumoniae,and MLVA was performed.The domain V of the 23 S rRNA was sequenced to detect macrolide-resistant point mutations.We also investigated the activities of antibiotics against M.pneumoniae isolates in vitro.Results The PCR detection rate of M.pneumoniae in children in Beijing was 40%,and the macrolide resistance rate was 66%.The A2063 G mutation in the 23 S rRNA V region is the dominant mutation(137/146,93.84%),whereas the A2064 G mutation is rare(9/146,6.16%).Seventy-three samples were typed successfully by MLVA typing,including 86.3%(63/73)were MLVA type 4-5-7-2,and 13.7%(10/73)were MLVA type 3-5-6-2.No other types were found.No strains were resistant to levofloxacin or tetracycline.Conclusion In 2016,a specific decrease in the macrolide resistance rate occurred in Beijing.The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients.The A2063 G mutants M.pneumoniae have high levels of resistance to erythromycin and azithromycin.The primary MLVA type is 4-5-7-2,followed by 3-5-6-2.No other MLVA types were detected.No strains resistant to tetracycline or levofloxacin were found in vitro.
基金This study was supported by the Chongqing Science and Health Joint Medical Research Project(No.8187011078)。
文摘Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.
文摘Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.
文摘Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunological abnormalities that could constitute a favourable terrain for neoplasms. We report on a case in a 2-year-old girl who presented clinical manifestations compatible with Kawasaki disease complicated by coronary aneurysm. Aetiopathological investigations revealed M. pneumoniae infection as specific IgM were present in the serum (Elisa). The patient was initially treated by intravenous immunoglobulins (IVIG) and aspirin to anti-inflammatory dose. Following a few days of desquamation, resolution of the symptomatology occurred. Four weeks later she developed disseminated tumorous syndrome. Lymph node biopsy revealed massive infiltration by large cells lymphomatous proliferation. Histologic and immunophenotypic findings were characteristic of ALK-1+ anaplastic large cell lymphoma. Four weeks later, the patient died from a severe nosocomial infection complicated by septic shock. Our observation is the first cases describing the association between anaplastic large cell lymphoma, KD and M. pneumoniae. Immunologic disorder due to KD and M. pneumoniae infection may play probably a central role for malignancy.
文摘BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a 12-year-old girl with Mycoplasma pneumoniae(M.pneumoniae)infection who presented with prolonged fever and lymphadenitis refractory to macrolide antibiotics.CASE SUMMARY A previously healthy 12-year-old girl presented with fever,myalgia,sore throat,swelling,and tenderness on the right side of the neck.She was initially diagnosed with lymphadenitis caused by M.pneumoniae refractory to macrolide antibiotics.She had elevated brain natriuretic peptide(BNP)levels.Finally,the patient was diagnosed with KD.After receiving intravenous immunoglobulin,the fever resolved,and her symptoms improved.CONCLUSION NFKD should be differentiated from adolescent lymphadenitis presenting with prolonged fever by checking the BNP level early.
文摘Objective: To explore the effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia. Methods: A total of 130 children with mycoplasma pneumonia were included in the study and randomized into the treatment group (n=65) and the control group (n=65). The patients in the control group were given azithromycin. On the above basis, the patients in the treatment group were given Yanhuning. The patients in the two groups were continuously treated for 7 d. The levels of serum inflammatory cytokines and immunological function indicators before and after treatment in the two groups were detected and compared. Results: When compared with before treatment, the serum IL-2 level after treatment in the two groups was significantly elevated, while IL-4, IL-10, IL-13, IL-6, TNF-α, and IFN-γ levels were significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. When compared with before treatment, CD3+, CD4+, and CD4+/CD8+ after treatment in the two groups were significantly elevated, and those in the treatment group were significantly higher than those in the control group, while CD8+ was significantly reduced, but the comparison between the two groups was not statistically significant. When compared with before treatment, RBC-C3bR after treatment in the two groups was significantly elevated, while RBC-ICR was significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. Conclusions: Yanhuning in combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly enhance the immunological function, and reduce the inflammatory reaction, with an effect significantly superior to that by single application of azithromycin.
文摘Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children with severe mycoplasma pneumonia who were treated in Huai'an Second People's Hospital between June 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, the intervention group received routine treatment combined with Singulair and methylprednisolone, and control group received routine treatment. Before and after treatment, serum was collected to detect the contents of inflammatory cytokines and corresponding cytokines of T lymphocyte subsets, and peripheral blood was collected to determine the contents of T cell subsets.Results:3 d and 7 d after treatment, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of both groups were significantly lower than those before treatment while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those before treatment, and serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of intervention group were significantly lower than those of control group while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those of control group.Conclusion: Singulair combined with methylprednisolone treatment of mycoplasma pneumonia can inhibit the inflammatory response and regulate the balance of Th1/Th2 and Th17/Treg cells.
