Syncytial Research Articles

The curative effect of inhaled ribavirin in children with respiratory syncytial virus bronchiolitis

Objective To investigate the clinical effect of inhaled ribavirin on the therapeutic actions and the expression of interleukin 6(IL-6), interleukin 10(IL-10)and CysLTs in children with RSV bronchitis. Methods 81 cases of children with RSV bronchitis, were chosen and randomly divided into observing group and control group. Two groups of children were inhaled pulmicort respulas and accessed others support treatment, until the symptoms disappeared. But observing group were added with ribavirin atomization. Treatments time and symptoms disappearance time in the hospital were compared, and the serum IL-6,IL-10 and CysLTs level changes before and after treatment were observed. Results Treatments time and symptoms(wheezing, coughing, dry and wet rale)disappearance time in observation group were shorter than those of the control group with(6.58±1.36)d vs.(8.92±1.12)d,(1.21± 0.59)d vs. (2.68±1.22)d,(4.86±1.31)d vs.(7.34±1.39)d and(4.00±1.52)d vs.(6.37±1.58)d, which with significant differences(t＝-8.387,-7.012,-8.267,-6.887,all P＜0.01). Before the treatment, two groups had no significant difference(P＞0.05). After treatment, the levels of serum IL-6 and CysLTs were significantly lower in the observation group, and the levels of IL-10 were higher with(76.59±10.77)ng／L vs.(116.81±10.81)ng／L,(34.40±7.19)ng／mL vs.(48.26±8.36)ng／mL and,(43.25±3.97)ng／L vs.(31.39± 4.81)ng／L. The significant differences were observed in two groups(t＝-16.74,-8.024,12.315,all P＜0.05). Conclusion Compared with general therapy, the curative effect was significant. Combined inhaled ribavirin and pul-micort respulas in RSV bronchitis early, can reduce patients'clinical symptoms and the treatment time. Key words: Respiratory syncytial virus; Bronchiolitis; Ribavirin

Effects of virus coinfection on the severity of respiratory syncytial virus bronchiolitis

Objective To investigate the effects of virus coinfection on the severity of respiratory syncytial virus (RSV)bronchiolitis through the clinical analysis of 286 cases. Methods Various virus antibody were measured by using ELISA in 286 cases of RSV bronchiolitis.The frequency of respiratory virus coinfection on the severity of RSV bronchiolitis was observed. Results RSV bronchiolitis complicated with virus coinfection ratio reached 29.37%, especially with the double infection. Compared to patients with RSV infection, the severe cases increased significantly in patients with virus coinfection(χ2=128.7,P<0.01). Conclusion Other respiratory viruses coinfection are not uncommon in infants with RSV bronchiolitis and may increase the severity of RSV bronchiolitis. Key words: Respiratory syncytial virus; Children; Bronchiolitis; Viruses; Bacteria

Detection and clinical analysis of acute lower respiratory tract infection with human coronaviruses in children in Beijing area 2007-2015

To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children. Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in < 1 year group, 788 cases in 1-3 years group, 553 cases in 3-6 years group, 1140 cases in ≥6 years group. One nasopharyngeal aspirate specimen was collected from each patient. RT-PCR methods were applied to detect 9 common respiratory viruses including HCoVs (including HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1), respiratory syncytial virus (RSV) and so on. Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period. (1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23%), in which 147 cases were positive for HCoVs infection (positive rate 3.36%). (2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11%, 3.79%, 4.69%, 4.31%, 2.38% 2.10%, 0.77% and 2.65%, respectively. The mean positive rates of HCoVs for each month from January to December were 2.53%, 2.12%, 3.63%, 6.68%, 1.53%, 3.77%, 3.92%, 3.00%, 2.15%, 5.26%, 3.01% and 2.80%. (3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were: 48 cases positive for HCoV-OC43(1.10%), 32 cases positive for HCoV-229E(0.73%), 25 cases positive for HCoV-NL63 (0.57%), 27 cases positive for HCoV-HKU1 (0.62%). (4) Positive rates of HCoVs infection in <1 year group, 1-3 years group, 3-6 years group and ≥ 6 years group were 4.13%, 5.08%, 2.71% and 1.23%, respectively. There were significant differences in positive rates of HCoV among groups (χ² = 27.218, P<0.01). (5) There were 16 hospitalized cases with single infection of HCoVs in this study, of which 12 cases were diagnosed as bronchopneumonia, 3 cases developed acute laryngeal obstruction, 2 cases had acute bronchial asthma attack. Common clinical manifestations included cough (14 cases), gasping (13 cases), dyspnea (9 cases), fever (6 cases), hoarseness (4 cases), laryngeal stridor (4 cases) and abnormality on chest X-ray (including fuzzy lung texture, patchy shadow and consolidation) (12 cases). (6) There were no significant differences in the incidence of clinical manifestations (including cough, gasping, dyspnea, fever and abnormality on chest X-ray), complications (including respiratory failure, myocardial damage, and acute bronchial asthma attack) and mechanical ventilation between hospitalized ALRTI patients with single HCoV infection and 193 patients with single RSV infection in the same period. HCoVs are pathogens of ALRTI in children, The overall positive rate of HCoVs was 3.36% in this study. The clinical manifestations and severity of ALRTI caused by single HCoVs was comparable to that of ALRTI with single RSV infection in children.

Epidemiologic characteristics and the relationship with disease severity of respiratory syncytial virus genotypes from children with lower respiratory tract infection in the southern Zhejiang province

To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) subtypes and genotypes in southern Zhejiang province, and to determine whether RSV genotypes are correlated with the disease severity of lower respiratory tract infection (LRTI). Nasopharyngeal secretions (NPS) from children under 5 years of age who were hospitalized with LRTI during 5 consecutive seasons from July 1, 2009 to June 30, 2014 were collected. RSV antigen was determined using direct immunofluorescence (DIF). Two hundred strains of RSV were randomly selected from each epidemic season. RNA was extracted and identified as subtype A or B by using reverse transcription-polymerase chain reaction (RT-PCR), and randomly selected strains of the full length attachment (G) genes of both subtype A and subtype B were amplified by PCR and sequencing. Clinical data were collected, and the disease severity between different genotypes were compared simultaneously. Of the total 1 000 randomly selected RSV positive samples, 462 (46.2%) and 538 (53.8%) samples were identified as subtype A and B, respectively. It was found that subtype B predominated in the 2009-2010 and 2012-2014 epidemic seasons and subtype A in 2010-2012 epidemic seasons. A total of 112 strains of complete sequences of G genes were obtained, including four subtype A genotypes NA1, NA4, GA2 and ON1, and six subtype B genotypes BA8-10, BA-C, CB1, and GB2. Phylogenetic analysis revealed that 39/52 (75.0%) subtype A strains were classified as NA1 genotype, followed by ON1 genotype (10/52,19.2%) and 44/60 (73.3%) subtype B strains were classified as BA9 genotype, followed by BA8 genotype (6/60,10.0%). BA9 was the predominant genotype among subtype B except 2010-2011 epidemic season, while NA1 was the predominant genotype among subtype A except 2013-2014 epidemic season. Only ON1 and BA9 genotypes were checked out during 2013-2014 epidemic season. There was statistically significant difference in the average severity score of illness in 39 cases infected with NA1 genotype (4.154) and 44 cases of BA9 genotype (3.341) (U=642.500, P<0.05). Furthermore, in the rate of oxygen uptake, the percentage of those infected with NA1 genotype (33.3%) was higher than those infected with BA9 genotype (13.6%) (χ2=4.544, P<0.05). However, there were no significant difference in the age, clinical symptoms, the percentage of intensive care unit admission, length of hospitalization and the outcome of the disease between NA1 and BA9 infection. The shift of predominant RSV subtype from 2009 to 2014 were B-A-A-B-B in the southern areas of Zhejiang province. Multiple genotypes co-circulated during five RSV epidemic seasons. NA1 and BA9 genotypes were the predominant genotypes of subtype A and B, respectively. Compared with infection with BA9 genotype, NA1 genotype infection was associated with more severe disease and proportion of patients needed oxygen therapy was higher.

Analysis of viral etiology for nasopharyngeal secretions in neonatal pneumonia

Objective To explore the viral etiology spectrum of different age and different seasons for neonatal pneumonia. Methods Medical records of 1 073 cases of neonatal pneumonia in our hospital were retrospectively analyzed, line direct immunofluorescence assay were used to detect nasopharyngeal secretions of newborns, the test results were statistically analyzed. Results In 1 073 cases with neonatal pneumonia, 406 cases were detected positive with virus infected, the positive rate was 37.8%,7 cases were mix infected. 334 cases were infected by respiratory syncytial virus(RSV), which had the highest detection rate, accounting for 82.3%;RSV infection rate in 1-6 month baby was 36.4%, which was higher than the>6-12 month-old baby with RSV infection rate 26.5%, the difference was statistically significant(χ2=12.25,P<0.05);RSV infection rate in winter and spring group was 39.7%, which was significantly higher than that in autumn and winter group(13.6%);PIV3 infection rate in winter and spring group was 1.8%,significantly lower than that in autumn and summer group(9.1%), the difference was statistically significant(χ2=31.27,P<0.05). Conclusion RSV is the most common viral in neonatal pneumonia, more attention should be payed to RSV infection control in small babies and at winter and spring, pay attention to PIV3 infection at autumn and summer. Key words: Virology; Nasopharyngeal secretion; Pneumonia; Infant

Effect of recombinant human interferon α1b on lung tissue pathology and Janus kinase(JAK)/signal transducer and activator of transcription(STAT) signal pathway in mice infected by respiratory syncytial virus

Objective To investigate the impact of different ways and doses of recombinant human interferon α1b(rhIFN-α1b) on antiviral effect on respiratory syncytial virus(RSV)-effected mice and signal pathway of JAK/STAT. Methods Forty-eight mice were divided randomly into 6 groups, negative control group, RSV-infection model group, 12.5, 25.0, 50.0 μg rhIFN-α1b atomization inhalation of intervention group, and 12.5 μg rhIFN-α1b injection of intervention group.After continuous drug therapy for 5 days, the left lung tissues of mice were aseptically dissected in the sixth day.Then it were observed lung tissue pathology changes by optical microscope, and expression of STAT1 and STAT2 protein with laser scanning confocal microscopy. Results It was observed that RSV-infection model mice's lungs had significant inflammatory injury under light microscope.After treatments of rhIFN-α1b, it showed that the mice lung tissue had recovery of inflammation on different degrees.The group of inhaled rhIFN-α1b 50.0 μg was damaged on lightest degree.There were statistically significant differences between each group(all P<0.05). The expression of STAT1 and STAT2 protein in RSV-infection model mice's lungs decreased remarkably under fluorescene microscopy.Treatments of rhIFN-α1b increased the expression of STAT1 and STAT2 inhibited by RSV-infection.The expression of STAT1 and STAT2 protein of the inhaled rhIFN-α1b 50.0 μg group increased significantly.The differences between groups were statistically significant(all P<0.05). Conclusions rhIFN-α1b played an important role in anti-RSV effects, simultaneously, it could improve the activity of JAK/STAT signal pathway inhibited by RSV-infection. The treatment effect of rhIFN-α1b deliveried by atomization inhalation was better than that of intraperitoneal injection. And curative effect is proportional to the atomization inhalation dose within a certain range. Key words: Respiratory syncytial virus; Recombinant human interferon α1b; Lung tissue pathology; Signal transducer and activator of transcription

Severe viral infection in neonatal intensive care unit

There is a lack of knowledge concerning the frequency and significance in patients treated in the NICU because of the confused and difficult techniques in viral testing.Some researches revealed that the incidence of viral infection in the NICU was 5%.We discussed the common viral infections including respiratory syncytial virus, enterovirus, rotavirus, cytomegalovirus, herpes simplex virus, rubella virus, parvovirus and human immunodeficiency virus.Based on the database of the outbreak of viral infections in NICU, we need for more effective outbreak prevention strategies. Key words: Severe viral infection; Newborn; Neonatal intensive care unit

Effects of passive smoking on terminal villi of human placenta and growing foetus

Background : Though ill effects of maternal smoking on growing foetus and placenta is well established, passive/ second hand smoking has recently been implicated as another potential risk factor. The incidence of low birth weight, Intra-Uterine Growth Retardation (IUGR), prematurity and stillbirth has been associated with passive smoking. Our study focuses on the gross and histological changes in the full term placenta of women exposed to passive smoke from a close member of a family smoking at least 20 cigarettes/bidis per day. Method: The present study is an endeavour to observe microscopic features (light microscope under 10X and 40X only) of placenta of pregnant women who are exposed to environmental tobacco smoke from a close member of the family and simultaneously observe changes on growing foetus during level II ultrasound at 2 nd trimester in terms of IUGR if any. This is a descriptive study with statistical analysis done using ‘Independent Sample Test’. Results : The histopathological changes seen in the placenta of passive smokers were almost alike to active smokers showing increased syncytial knots, hyperplasia of cytotrophoblast cells and proliferation of fetal capillaries. However no significant IUGR was noticed during Level II USG of the fetuses. Conclusion : On gross findings there was a definite co-relation with low birth weight babies born to passive smokers and a compensatory enlargement of the placenta. The microscopic changes seen in the placenta of passive smokers was a consistent finding similar to ischemic changes. No definite relationship could be established between the histological changes observed amongst passive smokers and IUGR seen in the growing foetus .

Clinical value of viral detection of liquid chip method in community-acquired pneumonia

To evaluate the clinical value of viral detection of liquid chip method in community-acquired pneumonia (CAP). A total of 342 swabs were collected from 171 patients of community-acquired pneumonia from October 2013 to September 2014. The methods of xTAG(RVP) and Seeplex RV15 ACE were employed to detect respiratory viruses. And traditional methods of indirect immunofluorescence and specific antigen were used for comparison. All results were validated by realtime-PCR and statistically analyzed. Of 171 CAP patients with an average age of 49.17 years, 35.7% (61/171) were virus positive.Influenza A (FluA), influenza B (FluB), respiratory syncytial virus (RSV), human rhinovirus (HRV) and human metapneumovirus (hMPV) accounted for 90.5% of all detected viruses. The detection rates of mouth swabs and nasopharyngeal swabs were 31.6% and 33.9% respectively. Two specimen types showed no significant differences (Kappa = 0.714, P < 0.001; McNemar χ(2) = 0, P = 1.000). The positive rates of viral detection by xTAG(RVP) and Seeplex RV15 were 32.5% and 29.5% respectively. And the consistence rate of results was up to 85.4% (292/342) (Kappa = 0.66). The positive rate of traditional methods was 14.0%.However, xTAG(RVP) had a higher sensitivity (93.3%), higher consistence rate (92.4%) and negative predictive value (96.9%) compared with Seeplex RV15 and traditional methods. Also xTAG(RVP) had a high consistent rate of realtime-PCR (Kappa = 0.83). Liquid chip is superior to other detection methods. And it may be used routinely for viral detection of CAP.

Outbreak of Respiratory Syncytial Virus Infection in Postpartum Nursing Home, Changhua County, 2014

Respiratory syncytial virus (RSV) is one of the major pathogens that cause neonatal bronchiolitis and pneumonia. We report an outbreak of RSV infection among neonates in a postpartum care center. A total of 33 infants (attack rate 73%)and 3 health care (attack rate 8%)workers were infected with RSV. The index neonate contracted RSV through contact of the ill family. The following RSV transmission was associated with inadequate infection control practice. Our report highlights the importance of infection control in the postpartum care center. Health care workers are recommended stringently to follow the infection control guideline for the postpartum care.

Astroglial networks in health and disease: New Frontiers

The common and prevailing point of view considers neurones as main substrates of pathological progression of neurological diseases. Today, however, we know that integration and information processing in the brain occurs though close interactions of two cellular circuits represented by neuronal networks embedded into internally connected astroglial syncytia. Our understanding of glial function changed dramati- cally over last two decades. This change concerns the whole concept of how the brain is organized, and how the development, life and death of neural circuits are controlled. There is compelling evidence demonstrating that these are the astrocytes that are creating the compartmentalisation in the CNS, and these are the astrocytes that are able to integrate neurones, synapses, and brain capillaries into individual and relatively independent units. Astroglial syncytia allow intercellular communica- tion routes, which permit translocation of ions, metabolic factors and second messen- gers. The resulting potential for parallel processing and integration is significant and might easily be larger, but also fuzzier, than the binary coded electrical communica- tion within the neuronal networks. The neuronal-glial circuitry endowed with distinct signalling cascades, form a “diffuse nervous net” suggested by Golgi, where millions of synapses belonging to very different neurones are integrated first into neuronal- glial-vascular units and then into more complex structures connected through glial syncytia. These many levels of integration, both morphological and functional, pre- sented by neuronal-glial circuitry ensure the spatial and temporal multiplication of brain cognitive power. Neuroglial cells are intimately involved in all forms of neurological diseases and this are neuroglia, which, to a very large extent, determine the progression and outcome of neuropathological process. Astrocytes are specifically involved in vari- ous neurodegenerative diseases including Alzheimer’s disease, Amyotrophic lateral sclerosis, Parkinson’s disease and various forms of dementia. Recent evidence sug- gest that early stages of neurodegenerative processes are associated with atrophy of astroglia, which causes disruptions in synaptic connectivity, disbalance in neurotrans- mitter homeostasis and neuronal death through increased excitotoxicity. At the later stages astrocytes became activated and contribute to neuro-inflammatory component of neurodegeneration.

Evaluation of Timeliness of Palivizumab Immunoprophylaxis Based on the Epidemic Period of Respiratory Syncytial Virus: 22 Year Experience in a Single Center

목적: 본 연구는 respiratory syncytial virus (RSV) 유행 시기에 따른 palivizumab 투여 시기의 적절성을 분석함으로써 palivizumab 예방요법을 시작하는 시기의 적절성을 평가하고자 하였다. 방법: 1991년 1월부터 2012년 7월까지 서울대학교 어린이병원에서 호흡기 증상이 있는 소아의 호흡기 검체를 채취하여 RSV 항원 검사, 배양 검사 및 중합효소 연쇄 반응 검사를 시행하였으며 그 결과를 분석하였다. RSV 양성건수와 RSV 검출률을 2주 단위로 조사하였으며 중합효소 연쇄 반응 검사가 도입되기 전, 1991년 1월부터 2007년 10월까지는 RSV 항원 및 배양 검사로 바이러스를 검출하였고 이후에는 중합효소 연쇄 반응 검사 방법으로 검출하였다. RSV 유행 시기의 시작은 2주 동안 4건 이상의 검체에서 양성을 보이면서 RSV의 검출률이 10% 이상을 동시에 만족하는 시기로 정의하였다. 또한 2007년 1월부터 2014년 3월까지 2세 미만의 RSV 감염 고위험군을 대상으로 palivizumab의 예방요법 시작시기를 분석하였다. 결과: 22년간 RSV 검출률은 2,013/21,698 (9.69%)였으며 RSV 평균 유행기간은 10월 2-3주에서 2월 1-2주로 확인되었다. 가장 빨리 유행이 시작되었던 시기는 7월 셋째 주(2001년)이었고 가장 늦게유행 시기가 끝났던 시기는 5월 셋째 주(1990년)였다. 가장 많이 palivizumab을 시작한 시기는 10월셋째 주(18.7%)였으며, 9월 15일 이전에 palivizumab 예방요법을 시작하는 비율이 2007년 3.8%에서2013년에는 14%로 증가하였다. 결론: RSV 유행 시기에는 해마다 차이가 있으며, palivizumab의 비용효과성을 증대시키기 위해 매해RSV 유행이 시작하는 시점에 따라 palivizumab 투여 시작 시기와 투여 기간을 조절해야 할 것으로 사료된다.

Comparison of the Clinical Performance of Binax NOW RSV Versus Multiplex RT-PCR for Detection of Respiratory Syncytial Virus

손종애*·김시현*·신정환·전가원·신종범·이자영·김혜란·전경란·이정녀·송새암 Jong Ae Son, M.D.*, Si Hyun Kim, Ph.D.*, Jeong Hwan Shin, M.D., Ga Won Jeon, M.D., Jong Beom Sin, M.D., Ja Young Lee, M.D., Hye Ran Kim, M.D., Kyung Ran Jun, M.D., Jeong Nyeo Lee, M.D., Sae Am Song, M.D. 인제대학교 의과대학 진단검사의학교실·소아청소년과학교실, 인제대학교 의과대학 백인제기념임상의학연구소 Departments of Laboratory Medicine, and Pediatrics, Inje University College of Medicine, Busan; Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Korea 원저 Lab Med Online Vol. 5, No. 1: 27-32, January 2015 http://dx.doi.org/10.3343/lmo.2015.5.1.27 임상미생물학

798Hospitalization due to Respiratory Syncytial Virus (RSV) and Influenza Infection in Adult Patients: a Retrospective Cohort Study

References 1 Falsey et al., Diagnosis of respiratory syncy0al virus infec0on: comparison of reverse transcrip0on-­‐PCR to viral culture and serology in adults with respiratory illness. J Clin Microbiol, 2002. 40(3): p. 817-­‐20. 2 Falsey et al., Respiratory syncy0al virus infec0on in elderly and high-­‐risk adults. N Engl J Med, 2005. 352(17): p. 1749-­‐59. 3 Couch, et al., Respiratory viral infec0ons in immunocompetent and immunocompromised persons. American Journal of Medicine, 1997. 102(3 A): p. 2-­‐9. 4 Englund, et al., Respiratory syncy0al virus infec0on in immunocompromised adults. Ann Intern Med, 1988. 109(3): p. 203-­‐8. 5 Falsey, A.R., et al., Respiratory syncy0al virus and influenza A infec0ons in the hospitalized elderly. J Infect Dis, 1995. 172(2): p. 389-­‐94. 6 Widmer, K., et al., Rates of hospitaliza0ons for respiratory syncy0al virus, human metapneumovirus, and influenza virus in older adults. J Infect Dis, 2012. 206(1): p. 56-­‐62. Contact: Cheryl Volling cheryl.volling@mail.utoronto.ca

Study of viral etiology in children with wheezing disease in Pediatric Intensive Care Unit

Objective To investigate the viral pathogen spectrums in children with wheezing disease in Pedia-tric Intensive Care Unit(PICU). Methods Nasopharyngeai aspirates specimens (NPA) specimens were collected from 70 children with wheezing disease who were admitted to PICU in the Second Affiliated Hospital of Shantou University Medical College from Jun.2010 to Dec.2011.Multiplex PCR was applied to detect the respiratory viruses, the clinical data of the positive cases were analyzed. Results Seventy throat swab specimens tested positive in 54 cases of respiratory viruses (77%), of which a single virus-positive in 34 cases, 20 cases of mixed infection.For the specimens tested positive for the virus, the most common was respiratory syncytial virus(RSV), and there were 23 copies of them, followed by the human rhinovirus (HRV) 21 copies, adenovirus 8 copies, human Bocavirus 4 copies, 4 copies with parainfluenza virus type 3, 3 copies with parainfluenza virus type 4, there were 1 copy positive for human metapneumovirus, 1 copy positive for WU polyomavirus, 1 copy positive for seasonal flu and 1 copy positive for swine H1N1.Mixed infection in 19 copies with 2 kinds of viruses mixed, 1 copy with 3 kinds of viruses mixed, and hybrid virus was detected in most RSV mixed HRV (6 copies). For the specimens tested positive for the virus, their clinical diagnosis: 39 cases of asthmatic pneumonia, 11 cases of bronchiolitis, 3 cases of asthmatic bronchitis and 1 case of status asthmaticus. Conclusions There was a high rate of detection of viral pathogens in children with wheezing disease in PICU in the Second Affiliated Hospital of Shantou University Medical College, and the most common viruses were respiratory syncytial virus and rhinovirus. Key words: Respiratory infection; Pediatric intensive care unit; Child; Rhinovirus; Respiratory syncytial virus

Clinical features of children infected with influenza virus A in year 2009 in Wuhan area

Objective To explore the clinical and pandemic features and respiratory pathogen co-infection characteristics of children infected with influenza virus A(Flu A)in year 2009. Methods A retrospective study of hospitalized children with flu-like clinical symptoms in 2009 was conducted.The peripheral blood serum was analyzed to detect common respiratory agents, including Flu A, respiratory syncytial virus, adenovirus, influenza virus B, parainfluenza virus 1, 2 and 3, chlamydia pneumonia and mycoplasma pneumonia, klebsiella pneumonia(KP), haemophilus in-fluenza and legionella pneumophila by using indirect immunofluorescence test for the antibody detection (IgM). And a standard medical history was recorded, including epidemiological data, clinical manifestation, and the length of hospital stay, white blood count and chest X-ray elsewhere.All specimens were collected in Department of Pediatrics, Zhongnan Hospital of Wuhan University, from Jan.2009 to Dec.2009. Results Flu A was detected in 234 of the 599 (39.1%, 234/599 cases) flu-like children.The mean age was 48.8 months (range from 3 to 167 months). The detection rate in less than 1-year-old group (11.1%, 18/162 cases) was obviously lower than that of the older groups(P<0.001). Especially for the group< 6 months, there was only 1 infant (1.43%, 1/70 cases) with Flu A positive.Compared with Flu A negative group, the main clinical features of children with Flu A positive group were fever(78.2%, 183/234 cases, P=0.013) and cough(76.5%, 179/234 cases, P=0.04), however asthma (14.1%, 33/234 cases, P=0.003) and diarrhea (6.0%, 14/234 cases, P=0.001) cases were less.The detection rates of Flu A reached a peak of 57.0% in November and December, and a secondary peak of 45.0% in May and June.Flu A infection children less than 1 year old were simple in etiology.The children were older, the etiology was more complex.The primary coinfection pathogen was KP (53.8%, 126/234 cases) and Flu B(48.3%, 113/234 cases). Compared Flu A coinfection with or without KP, there was no difference between these 2 groups in the clinical features. Conclusions Influenza A is the main pathogen of hospitalized children with flu-like symptoms in 2009.Children over 1 year old age were the major infection groups of Flu A. The detection rates of Flu A reached peaks in May to June and November to December.Flu A positive children were prone to KP coinfection. Key words: Influenza A; Child; Respiratory tract infection; Coinfection

Respiratory syncytial virus receptor expression in the mouse and viral tropism.

Human respiratory syncytial virus (RSV) infects airway epithelium and can cause serious illnesses such as bronchiolitis and pneumonia. With the discovery of cell-surface nucleolin as a fusion receptor for RSV, the question arose as to whether nucleolin could explain RSV tropism in vivo. Here, we report the distribution of cell-surface nucleolin expression in tissues of normal mice and how this distribution of expression relates to what is known about RSV tropism and its clinical manifestations. Our results show evidence of cell-surface nucleolin expression in the respiratory tract. In addition, cell-surface nucleolin is expressed in tissues outside of the respiratory tract, many of which correspond to previous reports of tissue-specific RSV infection, and others that may allude to additional potential sites for RSV infection in vivo. Furthermore, our work provides a foundation for the investigation of nucleolin's physiological function in various healthy mammalian tissues.

Transfection of rAAV9-Galectin-9 into PBMCs inh ibits Th17 immune responses in mice with RSV infec-tion

Objective To evaluate the transfection efficiency of a recombinant adeno -associated virus serotype9 （ rAAV9 ） vector carrying Galectin-9 gene （ rAAV9-Galectin-9 ） into peripheral blood mononuclear cells （ PBMCs） and to analyze the effects of Galectin-9 on Th17 cell differentiation in a mouse model of respira -tory syncytial virus （RSV） infection.Meth ods A mouse model of RSV infection was established.Samples of lung sections were stained with HE or PAS to observe inflammatory infiltration.PBMCs were isolated from mice and transfected with rAAV9-Galectin-9.The transfection efficiency was evaluated by using fluorescence micro-scope.The expression of RORγt at mRNA level was detected by quantitative PCR.Flow cytometry analysis was performed to measure the levels of Th17 and Treg cells.ELISA was performed to measure the levels of IL-10, IL-17 and TGF-β1 in the supernatants of cell culture.Results Compared with control group, the mice with RSV infection showed an increased expression of ROR γt at mRNA level and elevated levels of T1h7 cells and IL-17 （all P〈0.05）, but decreased levels of Treg cells and IL-10 （all P〈0.05）.No significant difference with TGF-β1 level was observed.The expression of RORγt at mRNA level and the levels of Th17 cells and IL-17 were decreased in mice with RSV infection upon the transfection of Galectin -9 gene（all P 〈0.05）.Moreover, the levels of Treg cells and IL-10 were increased in mice from RSV＋Galectin-9 treated group （all P〈0.05）.No significant differences were observed between RSV infection group and RSV＋ZsGreen treated group.Conclusion rAAV9-Galectin-9 was successful transfected into PBMCs.rAAV9-Galectin9-could regulate Th17 immune re-sponses through Galectin-9 pathway during RSV infection. Key words: Respiratory syncytial virus; Galectin-9; Thl7 cell; Recombinant adeno-associated virusserotype 9

Epidemic pattern and molecular variation of respiratory syncytial virus strains isolated in Shenzhen from year 2012 to 2013

Objective To study the epidemic pattern and molecular variation of respiratory syncy-tial virus （ RSV） strains isolated in Shenzhen from year 2012 to 2013.Methods The clinical samples iso-lated from patients with influenza-like illness were analyzed by fluorescent RT-PCR to screen RSV positive strains.The C-terminal variable regions of genes encoding G proteins were amplified by nested RT-PCR. Molecular variation was analyzed by using Clustal W and MEGA softwares.Results RSV strains were wide-ly prevalent in Shenzhen from 2012 to 2013.Two epidemic peaks usually occurred in spring and summer/au-tumn of each year.The RSV isolates were subtyped into group A belonging to genotype NA1 and group B be-longing to genotype BAⅨ.Most of the mutations scattered at the C-terminal region of G protein.A few mu-tations caused the disappearance of certain glycosylation sites.A novel recombinant virus strain containing 24 inserted amino acids was identified in 2013, which was likely to be introduced into our country from abroad. Conclusion RSV strains were widely and continuously prevalent in Shenzhen, characterized by constant evolution and variation. Key words: Respiratory syncytial virus; Epidemic pattern; Molecular variation

Antiviral Activity of AV-001 against Influenza and Three Common Cold Viruses

AV-001 is a dietary supplement; it is used as a throat and nose spray composed of natural ingredients, including Sambucus nigra (European elder) and eucalyptus with 1, 8-cineole. The aim of this study was to evaluate the antiviral activity of AV-001 against the pathogenic viruses human influenza A viruses H1N1 and H7N9, respiratory syncytial virus, rhinovirus, human coronavirus, and adenovirus. Antiviral activity was evaluated by reduction of the viral-induced cytopathic effect; AV-001 was assessed against a challenge virus in suspension, inoculated onto host cells, and assayed for infectious viral load. AV-001 inactivated human influenza A viruses H1N1 and H7N9, respiratory syncytial virus, rhinovirus, and human coronavirus, by ³7.17 Log 10 , ³6.42 Log 10 , ³4.72 Log 10 , ³4.35 Log 10 and ³3.92 Log 10 , respectively. Thus, AV-001 exhibited strong and broad-spectrum antiviral activities and may represent an effective treatment or preventive agent for respiratory viral infection by inactivating the viruses upon their entry into the body.