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Obejective: To investigate the impact of curcumin (Cur) regulating the brain-derived neurotrophic factor (BDNF) /tropomyosin related kinase B receptor (TrkB) signaling pathway on neuronal apoptosis in neonatal rat with bacterial meningitis (BM). Methods: 15 rats were randomly selected as non-infected group (NF group), other rats injected streptococcus pneumoniae ATCC49619 suspension into frontal subarachnoid space to construct BM rat model, the successful BM model was randomly divided into BM group, L-Cur group (1.25 mg/kg), M-Cur group (2.5 mg/kg), H-Cur group (5 mg/kg), H-Cur+K252a group (5 mg/kg Cur+2.5 +g/kg K252a), 15 rats in each group, once a day, the injections were given continuously for 3 weeks. The rats were weighed and clinical scored, HE staining and Nissl staining were used to observe the damage of nerve cells; TUNEL staining was used to evaluate neuronal apoptosis. The levels of glial fibrillary acid protein (GFAP) and spinal cord calcium ion adaptor protein-1 (IBA-1) were detected by immunofluorescence staining. The levels of inflammatory factors and chemokines in brain tissue were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). Western blot was used to detect the expression of apoptosis protein and BDNF/TrkB pathway protein in brain tissue. Results: The brain tissue structure of the NF group was normal, large area of blue Nissl bodies appeared in the cytoplasm of neurons. In the BM group, a large amount of inflammatory exudate and inflammatory cell infiltration appeared in the subarachnoid space, the cell bodies were enlarged, the processes contracted, and the morphology was irregular; the number of Nissl bodies, weight, the levels of Bcl-2, BDNF, and p-TrkB/TrkB protein decreased obviously (P<0.05), the clinical score, the relative fluorescence intensity values of IBA-1 and GFAP, the relative expression of chemokine ligand-2 (CCL-2), chemokine ligand-3 (CCL-3), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), the rate of neuronal apoptosis, and the level of BCL2-Associated X protein (Bax) protein increased obviously (P<0.05). The inflammatory exudate and cell infiltration of brain tissue were reduced, the number of Nissl bodies, weight, the levels of B-lymphoblastoma-2 gene (Bcl-2), BDNF, and p-TrkB/TrkB protein increased obviously in each group after Cur treatment (P<0.05), the clinical score, the relative fluorescence intensity values of IBA-1 and GFAP, the relative expression of CCL-2, CCL-3, TNF-α, and IL-6, the rate of neuronal apoptosis, and the level of Bax protein decreased obviously (P<0.05), the higher the addition dose of Cur, the more obvious the change; the effect of H-Cur+K252a group was similar to that of BM group, K252a reversed the improvement effects of Cur on neuron apoptosis and damage in BM rat. Conclusion: Cur might reduced neuronal apoptosis in BM rat by activating BDNF/TrkB signaling pathway. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation between the levels of caveolin-1 (Caveolin-1), vascular endothelial calcherin (VE-cadherin), CXC-chemokine ligand 5 (CXCl-5) in cerebrospinal fluid and inflammatory factors in children with bacterial meningitis (BM), and to analyze the diagnostic value of Caveolin-1, VE-cadherin and CXCl-5 in BM. Methods: 106 cases of BM children (BM group), 76 cases of viral meningitis (VM group) and 72 cases of children without nervous system injury (control group) who were admitted to our hospital from January 1, 2016 to May 1, 2020 were selected. The levels of Caveolin-1, VE-cadherin and CXCl-5 in the cerebrospinal fluid of children in BM group and VM group were detected, and the levels of tumor necrosis factor-α(TNF-α), procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in serum of the three groups were detected. Pearson correlation analyzed the relation between Caveolin-1, VE-cadherin, CXCl-5 and TNF-, PCT, CRP, IL-6 correlation. Receiver operating characteristic curve (ROC) analyzed the value of Caveolin-1, VE-cadherin and CXCl-5 in the diagnosis of BM. Results: The levels of Caveolin-1, VE-cadherin and CXCl-5 in cerebrospinal fluid in BM group were higher than those in VM group (P<0.05), the levels of serum TNF-α, PCT, CRP and IL-6 were higher than those in VM group and control group (P<0.05), and the levels of serum TNF-α, PCT, CRP and IL-6 in VM group were higher than those in control group (P<0.05). The levels of Caveolin-1, VE-cadherin and CXCl-5 in cerebrospinal fluid in BM group were positively correlated with the levels of serum TNF-α, PCT, CRP and IL-6 (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of combined Caveolin-1, VE-cadherin and CXCl-5 in diagnosis of BM was 0.888, which was higher than that of single diagnosis of above indicators of 0.690, 0.661, 0.639 respectively. Conclusion: The levels of Caveolin-1, VE-cadherin and CXCl5 in cerebrospinal fluid of children with BM are higher than those of VM, which may play a role in the pathogenesis of BM through mediating the inflammatory response of nervous system. Combined with these three indicators have high value in the differential diagnosis of BM. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation between the levels of caveolin-1 (Caveolin-1), vascular endothelial calcherin (VE-cadherin), CXC-chemokine ligand 5 (CXCl-5) in cerebrospinal fluid and inflammatory factors in children with bacterial meningitis (BM), and to analyze the diagnostic value of Caveolin-1, VE-cadherin and CXCl-5 in BM. Methods: 106 cases of BM children (BM group), 76 cases of viral meningitis (VM group) and 72 cases of children without nervous system injury (control group) who were admitted to our hospital from January 1, 2016 to May 1, 2020 were selected. The levels of Caveolin-1, VE-cadherin and CXCl-5 in the cerebrospinal fluid of children in BM group and VM group were detected, and the levels of tumor necrosis factor-α(TNF-α), procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in serum of the three groups were detected. Pearson correlation analyzed the relation between Caveolin-1, VE-cadherin, CXCl-5 and TNF-, PCT, CRP, IL-6 correlation. Receiver operating characteristic curve (ROC) analyzed the value of Caveolin-1, VE-cadherin and CXCl-5 in the diagnosis of BM. Results: The levels of Caveolin-1, VE-cadherin and CXCl-5 in cerebrospinal fluid in BM group were higher than those in VM group (P<0.05), the levels of serum TNF-α, PCT, CRP and IL-6 were higher than those in VM group and control group (P<0.05), and the levels of serum TNF-α, PCT, CRP and IL-6 in VM group were higher than those in control group (P<0.05). The levels of Caveolin-1, VE-cadherin and CXCl-5 in cerebrospinal fluid in BM group were positively correlated with the levels of serum TNF-α, PCT, CRP and IL-6 (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of combined Caveolin-1, VE-cadherin and CXCl-5 in diagnosis of BM was 0.888, which was higher than that of single diagnosis of above indicators of 0.690, 0.661, 0.639 respectively. Conclusion: The levels of Caveolin-1, VE-cadherin and CXCl5 in cerebrospinal fluid of children with BM are higher than those of VM, which may play a role in the pathogenesis of BM through mediating the inflammatory response of nervous system. Combined with these three indicators have high value in the differential diagnosis of BM. [ABSTRACT FROM AUTHOR]

Objective　To explore the value of 16SrRNA gene detection in cerebrospinal fluid （CSF） in the early diagnosis of bacterial meningitis （BM） in children. Methods　CSF specimens were collected from 40 patients with BM who were diagnosed of BM in Kunming Children’s Hospital between January 2019 and June 2020. PCR was used to detect the 16SrRNA gene in the specimens. Then the 16SrRNA gene was sequenced for the positive samples by PCR， and the sequencing results sequence alignment and homology were analyzed by NCBI BLAST. At the same time， all the specimens were cultured simultaneously. Results　Of the 40 children’s CSF samples， 16 were positive for 16SrRNA gene PCR， with a positive rate of 40%; 7 cases were positive for bacterial culture， with a positive rate of 17.5%. The positive rate of PCR method was higher than that of the bacterial culture method （χ2 = 4.93，P < 0.05），with CSF as the “gold standard”， the sensitivity and specificity of PCR assay were 71.4% （5/7） and 66.7% （22/33）；the results of 16SrRNA gene sequencing were consistent with the results of CSF culture， and five bacterias which were not detected by CSF culture; the time of CSF culture was （61.21±12.62） h， however， the PCR detection time required （7.09±0.45） h， and the difference of detection time between the two methods was statistically significant （P < 0.05）. Conclusion　The PCR detection method of 16SrRNA gene in CSF can improve the detection rate of CSF pathogenic bacteria in BM patients， and it can reduce the missed detection rate. It has the specific and rapid characteristics and can provide the reliable pathogenic basis for early diagnosis of clinical BM in time. [ABSTRACT FROM AUTHOR]

Objective To explore the strategies of drug treatment and pharmaceutical care for children with bacterial meningitis. Methods The anti-infective therapy, therapeutic drug monitoring and dose adjustment of vancomycin in children with bacterial meningitis were analyzed and discussed according to relevant guidelines and literatures. Results Clinical pharmacists analyzed therapeutic regimen. According to the results of etiology and drug sensitivity, meropenem was discontinued and rifampicin was added. Based on drug monitoring of vancomycin, it is suggested to extend the infusion time of vancomycin to reach the target concentration. The child was discharged from hospital. Conclusion Recommendations of the relevant drug treatment guidelines and the latest medical research evidence should be provided by clinical pharmacists in order to promote reasonable and effective clinical uses of medicine. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of high mobility group protein 1 (HMGB1) antagonist BoxA via tail vein injection on the improvement of clinical signs and anti-inflammatory effects in a rat model of bacterial meningitis (BM). Methods: Male Sprague-Dawley (SD) rats were used and the normal rats were set as the control group (n=20). Another sixty rats were injected with Es- cherichia coli (DH5α1× 107 CFU/mL) to establish BM rat model and then were randomly divided into two groups (n=30): after anesthesia one group received intravenous BoxA (BoxA group), the other one received PBS injection as placebo (Vehicle group). Three days after model establishment, the clinical index of each group and pathophysiological parameters (intracranial pressure and CSF white blood cells (WBC) count) were evaluated, Enzyme-linked immunosorbent assay (ELISA) method were used to detect the relative serum HMGB1 content, Evans blue staining were used to observe the blood-brain barrier (BBB) permeability, immunofluorescence staining were used to detect the expression level of cerebral inflammation cytokines (IL-1β and TNF-α). Results: Compared with Control group, clinical indicators, intracranial pressure, WBC count and serum HMGB1 content in Vehicle group has significantly increased (P<0.05). These changes were partially reduced in the BoxA group compared to the Vehicle group (P<0.05). In addition, Vehicle group showed increased EB leakage and increased expression of inflammatory factors (IL-1β and TNF-α) than Control group (P<0.05). These changes were also partially adjusted in the BoxA group compared to the Vehicle group (P<0.05). Conclusion: Tail vein injection of HMGB1's inhibitor BoxA can down-regulate HMGB1 expression and alleviate the clinical symptoms and inflammatory responses in BM rats. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the diagnostic value of cerebrospinal fluid examination in preterm infants and full-term infants bacterial meningitis. Methods: 447 neonates who underwent lumbar puncture in Shanghai Children's Hospital from June 1,2014 to December 31, 2016 were selected. The general data, routine biochemistry and culture of cerebrospinal fluid were analyzed retrospectively. According to gestational age, the children were divided into preterm infants of 167 cases and full-term infants of 280 cases. They were divided into preterm infants bacterial meningitis (preterm infants observation group) of 27 cases, preterm infants non bacterial meningitis(preterminfants control group) of 140 cases, full-terminfants bacterial meningitis(full-terminfants observation group) of 38 cases, full-term infants non bacterial meningitis(full-term infants control group) of 242 cases according to the incidence of bacterial meningitis. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of protein quantification, white blood cell count and glucose for bacterial meningitis in preterm infants and full-term infants. Results: Compared with the control group in the same group, the protein quantitative and white blood cell count in the preterm infants observation group and the full-term infants observation group were significantly increased, and the glucose content were significantly decreased, and the differences were statistically significant (P<0.05). In this study, 11 cases of bacteria (16.9%) were isolated from cerebrospinal fluid cultures of 65 children with bacterial meningitis. The area under the ROC curve of full-term infants cerebrospinal fluid white blood cell count, protein quantification and glucose in the diagnosis of bacterial meningitis were 0.995, 0.846, 0.703 respectively. The area under the ROC curve of preterm infants cerebrospinal fluid white blood cell count, protein quantification and glucose in the diagnosis of bacterial meningitis were 0.970, 0.711, 0.705 respectively. Conclusion: Cerebrospinal fluid white blood cell count and protein quantification have high diagnostic value in preterminfants and full-terminfants bacterial meningitis. [ABSTRACT FROM AUTHOR]