Kawasaki disease (KD) is an acute self-limiting systemic vascular disease commonly observed in children less than 5 years of age. The present study comparatively assesses the clinical characteristics ...of children diagnosed with KD in different age groups. Furthermore, a comprehensive literature review on the clinical features and diagnostic guidelines of KD is performed.
This was a retrospective study conducted on the data of KD children admitted to the Sun Yat-Sen Memorial Hospital, Guangzhou, China, from January 2016 to December 2018. The children were divided into 3 age groups, including children < 1 year of age (group A, n = 66), 1-5 years of age (group B, n = 74), and children > 5 years of age (group C, n = 14). Complete clinical evaluation, hematological, and cardiovascular assessments were conducted and compared between the three groups.
The time of diagnosis, hemoglobin, and neutrophil ratio of children in group A were significantly lower than the other two groups (p < 0.05), while the platelet count was significantly higher (p < 0.05). The proportion of incomplete KD (iKD) was the greatest in group A (40.9%), while the proportion of children with increased coronary Z value and aseptic meningitis was greater than that in group B (p < 0.0167). Group A showed less patients with KD shock syndrome (KDSS) than the other two groups (p < 0.05). Group B showed the greatest number of patients with arthralgia compared to the other two groups (p < 0.05). Three groups showed no significant difference to intravenous immunoglobulin (IVIG) therapy (p > 0.05).
The younger the age of KD onset, the more atypical the conditions are, with a greater risk of affecting other systems and a higher incidences of coronary artery disease. An early treatment with glucocorticoids might be helpful in older children and those with a greater high-risk KD warning score to prevent coronary injury.
The transport sector appears a main energy consumer in China and plays a significant role in energy conservation. Improving energy efficiency proves an effective way to reduce energy consumption in ...transport sector, whereas its effectiveness may be affected by the rebound effect. This paper proposes a dynamic panel quantile regression model to estimate the direct energy rebound effect for road passenger transport in the whole country, eastern, central and western China, respectively, based on the data of 30 provinces from 2003 to 2012. The empirical results reveal that, first of all, the direct rebound effect does exist for road passenger transport and on the whole country, the short-term and long-term direct rebound effects are 25.53% and 26.56% on average, respectively. Second, the direct rebound effect for road passenger transport in central and eastern China tends to decrease, increase and then decrease again, whereas that in western China decreases and then increases, with the increasing passenger kilometers. Finally, when implementing energy efficiency policy in road passenger transport sector, the effectiveness of energy conservation in western China proves much better than that in central China overall, while the effectiveness in central China is relatively better than that in eastern China.
•The direct rebound effect (RE) for road passenger transport in China is estimated.•The direct RE in the whole country, eastern, central, and western China is analyzed.•The short and long-term direct REs are 25.53% and 26.56% within the sample period.•Western China has better energy-saving performance than central and eastern China.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The carbon dioxide emission caused by household consumption has been attracting growing attention; however, the linkage mechanisms of carbon dioxide emission caused by household consumption among ...sectors have been rarely studied. This paper employs the hypothetical extraction method to analyze the linkage of sectoral carbon dioxide emission caused by household consumption in China. The results show that, first, the sectors PDEH, OTHERS, MFT and SPM have the most important influence on carbon dioxide emission produced by each sector. Specifically, the sectors PDEH and SPM play the main role in pushing carbon dioxide emission, while the sectors OTHERS and MFT have important effect on pulling carbon dioxide emission. Second, the sectors with high supply carbon dioxide emission are inconsistent with those having high demand carbon dioxide emission. Finally, the carbon dioxide emission when urban household consumption expenditure rises ten thousand Yuan appears higher than that by rural household consumption expenditure.
The lack of knowledge regarding the pathogenesis and host immune response during SARS-CoV-2 infection has limited the development of effective treatments. Thus, we longitudinally investigated the ...dynamic changes in peripheral blood lymphocyte subsets and parallel changes in cytokine levels in COVID-19 patients with different disease severities to further address disease pathogenesis.
A total of 67 patients (10 moderate, 38 severe and 19 critical cases) with COVID-19 admitted to a tertiary care hospital in Wuhan from February 8th to April 6th, 2020 were retrospectively studied. Dynamic data of lymphocyte subsets and inflammatory cytokines were collected.
On admission, compared with moderate cases, severe and critical cases showed significantly decreased levels of total lymphocytes, T lymphocytes, CD4
T cells, CD8
T cells, B cells and NK cells. IL-6 and IL-10 were significantly higher in the critical group. During the following hospitalization period, most of the lymphocyte subsets in the critical group began to recover to levels comparable to those in the severe group from the fourth week after illness onset, except for NK cells, which recovered after the sixth week. A sustained decrease in the lymphocyte subsets and an increase in IL-6 and IL-10 were observed in the nonsurvivors until death. There was a strong negative correlation between IL-6 and IL-10 and total lymphocytes, T lymphocytes, CD4
T cells, CD8
T cells and NK cells.
A sustained decrease in lymphocyte subsets, especially CD4
T cells and NK cells, interacting with proinflammatory cytokine storms was associated with severe disease and poor prognosis in COVID-19.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Respiratory syncytial virus (RSV) is one of the most important pathogenic infections of children and requires in-depth research worldwide, and especially in developing countries. We used a novel ...multiplex real-time PCR to test 5483 patients (≤ 14 years old) hospitalized with respiratory illness in Guangzhou, China, over a 3-year period. Of these patients, 729 were positive for RSV-A (51.2%, 373/729) or RSV-B (48.8%, 356/729), but none was infected with both viruses. Two seasonal peaks in total RSV were detected at the changes from winter to spring and from summer to autumn. RSV-B was dominant in 2013 and RSV-A in 2015, whereas RSV-A and RSV-B cocirculated in 2014. The clinical presentations of 645 RSV-positive patients were analyzed. Bronchiolitis, dyspnea, coryza, vomiting, poor appetite, and diarrhea occurred more frequently in RSV-A-positive than RSV-B-positive patients, whereas chill, headache, myalgia, debility, and rash etc. were more frequent in RSV-B-positive than RSV-A-positive patients, suggesting specific clinical characteristics for RSV-A and RSV-B. Coinfectons with other pathogens were common and diverse. Bronchiolitis, fever (≥ 38°C), and poor appetite were more frequent in patients with single RSV infections than in coinfected patients, suggesting the key pathogenic activity of RSV. Analysis of the relationships between the comparative viral load and clinical presentations showed significant differences in bronchiolitis, fever (≥ 38°C), and rash etc. among patients with different viral loads. This study provides a novel rapid method for detecting RSV subgroups, and provides new insights into the epidemiology and clinical implications of RSV.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abnormal epigenetic alterations influenced by external factors and affecting DNA expression contribute to the development of asthma. However, the role of the nasal epithelium in airway inflammation ...remains unknown.
The objective of this study is to identify novel DNA promoter hypermethylation, which suppresses mRNA expression in nasal epithelial of asthma.
Microarray datasets were downloaded from the Gene Expression Omnibus (GEO) database. Gene expression and DNA promoter methylation sites in key correlated modules between asthma and normal were identified by weighted gene co-expression network analysis. Gene Oncology and Kyoto Encyclopedia of Genes and Genomes were conducted to analyse the function of genes. Further validation was performed in human BEAS-2B cells challenged by IL-4 or IL-13.
Lightcyan, lightgreen, midnightblue, cyan and tan modules in the mRNA expression dataset showed a close relationship with asthma, in which genes were enriched in TNF, IL-17, ErbB, MAPK and Estrogen signalling pathways. Blue and turquoise modules in the methylation profiling dataset were associated with asthma. Forty nine lowly expressed genes were identified to be correlated with aberrant DNA hypermethylation of promoters. Among these genes, the mRNA levels of BCL10, GADD45B, LSR and SQSTM1 were downregulated in BEAS-2B cells challenged with IL-4 or IL-13.
Four potential genes in the nasal epithelium, by hypermethylating their own DNA promoter, might mediate the inflammatory response in the pathogenesis of asthma. Analyzing epigenomic data by integrated bioinformatics helps to understand the role of DNA methylation in asthma, with the goal of providing new perspectives for diagnosis and therapy.
Interleukin-9 (IL-9) was reported as an active participant in the pathogenesis of allergic asthma. This study aimed to investigate the major source ofIL-9 and its effect on interferon γ (IFN-γ) and ...immunoglobulin (Ig) secretion by B cells.
We isolated peripheral blood mononuclear cells from children with allergic asthma and healthy children. IL-9, IL-4 and IFN-γ expression were detected by ELISA, ELISpot and Flowcytometry. Expression of transcription factor PU.1 was measured by Western Blot. We evaluated the effect of IL-9 on B cell activation and Ig production.
Results showed that compared with healthy children, levels of IL-9, IL-4 and PU.1 were elevated and levels of IFN-γ were lower in children with allergic asthma. IL-9-expressing CD4
T cells did not co-express IL-4. Exogenous IL-9 inhibited IFN-γ production in a dose-dependent manner. Antigen-specific Th9 cells existed in children with house dust mite allergic asthma. IL-9 up-regulated expression of CD69 and CD25 on B cells and combination of IL-9 and IL-4 enhanced IgE production.
In conclusion, our results showed that Th9 cells may be the major source of IL-9 in children with allergic asthma. In these patients, IL-9 impairs IFN-γ production and synergistically promotes IL-4-induced IgE secretion.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Anti-Ku is a rare antibody which can be positive in some rheumatic diseases and it might be related to cardiac involvement. Polymyositis is an inflammatory myopathy, and its cardiac involvement ...seldom presents as myopericarditis and anti-Ku positive.
In this case, we report a mid-aged woman with chest pain, upper limbs weakness and fever unrelated with infection. The diagnosis of this case was unquestionably myopericarditis supported by ECG, cardiac MRI and negative findings in coronary arteries. Diagnosis of polymyositis was further clarified by the evidence of persistently increased CK, degeneration of proximal muscle in MRI, muscular dystrophy with lymphocytes infiltration in muscle biopsy. In the analysis of autoantibodies, we surprisingly discovered positive anti-Ku. Glucocorticoid and mycophenolate mofetil were then prescribed for polymyositis. Patient follow-up indicated remission of both myopericarditis and polymyositis. We finally clarified this rare case as a positive anti-Ku polymyositis with myopericarditis as cardiac involvement.
This report presents a rare case with anti-Ku positive polymyositis and the cardiac involvement of polymyositis was manifested as myopericarditis. Therefore, positive anti-Ku might explain the myopericarditis as cardiac involvement in polymyositis. More cases and longer duration of follow-up is required for the comprehensive understanding of the disease.
Heart failure is the terminal outcome of the majority of cardiovascular diseases, which lacks specific diagnostic biomarkers and therapeutic targets. It contributes to most of cardiovascular ...hospitalizations and death despite of the current therapy. Therefore, it is important to explore potential molecules improving the diagnosis and treatment of heart failure. MicroRNAs (miRNAs) are small non-coding RNAs that have been reported to be involved in regulating processes of heart failure. After the discovery of miRNAs in exosomes, the subcellular distribution analysis of miRNAs is raising researchers' attention. Growing evidence demonstrates that exosomal miRNAs may be promising diagnostic and therapeutic molecules for heart failure. This review summarizes the role of exosomal miRNAs in heart failure in the prospect of molecular and clinical researches.
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