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BackgroundSevere acute respiratory coronavirus 2 (SARS-CoV-2) is a newly identified virus which mainly spreads from person-to-person. Presence of SARS-CoV-2 has been constantly reported in stools of patients with coronavirus disease 2019 (COVID-19). However, there is a paucity of data concerning fecal shedding of the virus in pediatric patients. ObjectiveTo investigate dynamic changes of SARS-CoV-2 in respiratory and fecal specimens in children with COVID-19. MethodsFrom January 17, 2020 to February 23, 2020, three pediatric cases of COVID-19 were reported in Qingdao, Shandong Province, China. Epidemiological, clinical, laboratory, and radiological characteristics and treatment data of these children were collected. Real-time fluorescence reverse-transcriptase-polymerase-chain reaction (RT-PCR) was performed to detect SARS-CoV-2 RNA in throat swabs and fecal specimens. Patients were followed up to March 10, 2020, the final date of follow-up, and dynamic profiles of RT-PCR results were closely monitored. ResultsAll the three pediatric cases were household contacts of adults whose symptoms developed earlier. Severity of disease was mild to moderate and fever was the most consistent and predominant symptom at onset of illness of these children (two cases had body temperature higher than 38.5{degrees}C). All children showed increased lymphocytes (>4.4x109 /L) with normal white blood cell counts on admission. Radiological changes were not typical for COVID-19. All children showed good response to supportive treatment. Clearance of SARS-CoV-2 in respiratory tract occurred within two weeks after abatement of fever, whereas viral RNA remained positive in stools of pediatric patients for longer than 4 weeks. Two children had fecal SARS-CoV-2 turned negative 20 days after throat swabs showing negative, while that of another child lagged behind for 8 days. InterpretationSARS-CoV-2 may exist in gastrointestinal tract for a longer time than respiratory system. Persistent shedding of SARS-CoV-2 in stools of infected children indicates the potential for the virus to be transmitted through fecal excretion. Massive efforts should be made at all levels to prevent spreading of the infection among children after reopening of kindergartens and schools.

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BackgroundWith the ongoing outbreak of Coronavirus Disease 2019 (COVID-19), infected patients within and beyond the epidemic area, Wuhan, China, showed different epidemiological and clinical characteristics. There is a paucity of data concerning coinfection with other common respiratory pathogens in COVID-19 patients outside of Wuhan. MethodsWe conducted a double-centre study recruiting 68 patients with severe acute respiratory coronavirus 2 (SARS-CoV-2) infection confirmed by nucleic acid testing in Qingdao and Wuhan from January 17 to February 16, 2020. Indirect immunofluorescence was performed to detect the specific IgM antibody against common respiratory pathogens in collected acute phase serum. ResultsOf the 68 patients with SARS-CoV-2 infection, 30 (44.12%) were from Qingdao. The median age of Qingdao and Wuhan patients were 50 (IQR: 37-59) and 31 (IQR: 28-38) years, respectively, and the majority of patients were female in Qingdao (60.00%) and Wuhan (55.26%). Among COVID-19 patients in Qingdao, 24 (80.00%) of them had IgM antibodies against at least one respiratory pathogen, whereas only one (2.63%) of the patients in Wuhan had positive results for serum IgM antibody detection (P<0.0001). The most common respiratory pathogens detected in Qingdao COVID-19 patients were influenza virus A (60.00%) and influenza virus B (53.33%), followed by mycoplasma pneumoniae (23.33%) and legionella pneumophila (20.00%). While the pattern for coinfection in patients with community-acquired pneumonia in Qingdao was quite different, with a positive rate of only 20.90%. InterpretationWe reported a large proportion of COVID-19 patients with coinfection of seasonal respiratory pathogens in Qingdao, northeast China, which differed greatly from the patients in Wuhan, central China. Precautions are needed when dealing with COVID-19 patients beyond the epidemic centre who have coinfection with other respiratory pathogens. We highly recommend adding SARS-CoV-2 to routine diagnostic testing in capable hospitals to prevent misdetection of the virus.

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<p><b>OBJECTIVE</b>To study the function of keratinocyte growth factor (KGF) on apoptosis of oral mucosal epithelial cells and to provide a basis for further investigation of the role of KGF in the occurrence and development of oral mucosal diseases.</p><p><b>METHODS</b>Different concentrations of KGF (control group, 0 ng x mL(-1); experiment 1 group, 5 ng x mL(-1); experimental 2 group, 25 ng x mL(-1); experiment 3 group, 50 ng x mL(-1)) were added in oral mucosa epithelial cells cultured in vitro. After training for 12, 24, and 48 h, cell morphology was observed under an inverted microscope. Apoptosis was detected by using a flow cytometry instrument, and mRNA expression of apoptosis-related genes Bcl-2 and Bax was detected by using Real-Time fluorescent quantitative detection.</p><p><b>RESULTS</b>Cell adherence of the experimental group was more obvious than that of the control group, and the cell nucleolus of the experiment 3 group was obviously cultured at 48 h. After culturing for 48 h, the apoptosis rate and Bcl-2 and Bax mRNA expression among the four groups were statistically significant. The increase of KGF concentration, apoptosis rate, and Bax mRNA expression gradually reduced, whereas Bcl-2 mRNA expression increased (P < 0.05).</p><p><b>CONCLUSION</b>KGF may inhibit epithelial cell apoptosis through upregulation of Bcl-2 mRNA and downregulation of Bax mRNA.</p>

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<p><b>OBJECTIVE</b>The purpose of this study is to assess the height and width of mandibular cross-sections and the thickness of cortical bone for young females in different vertical skeletal pattern by cone beam CT (CBCT) and determine the characteristics and differences of mandible among different vertical skeletal patterns.</p><p><b>METHODS</b>A total of 64 females, aged from 19 to 40 years old, were enrolled from Department of Orthodontics of School of Stomatology of Shandong University. After examination with CBCT scan, they were divided into 3 groups according to the vertical skeletal patterns (14 in low-angle group, 31 in average-angle group and 19 in high-angle group). The mandibular morphology was evaluated according to the height and width of the mandibular cross-sections and the thickness of cortices. SPSS 16.0 was used to analyze the characteristics and differences of mandible among different vertical skeletal patterns.</p><p><b>RESULTS</b>The height of symphysis in the high-angle group was higher than that in the low-angle group, but the height of molars in the low-angle group was higher than that in the high-angle group (P<0.05). In the regions of anterior teeth and premolars, the width of upper one third of the mandibular cross-sections in the low-angle group was significantly larger than those in the high-angle group, while in the symphysis and lateral incisors regions, the width of lower one third of the mandibular cross-sections in the low-angle group was larger than those in the high-angle group (P<0.05). Except of the region of premolars, the cortical thickness of base in the low-angle group was significant thicker than those in the high-angle group (P<0.05). In the regions of canine, premolar and molar, the cortical thickness of buccal upper one third in the low-group was thicker than those in the high-angle group, but in the regions of canine and the second molar, the cortical thickness of buccal lower one third in the low-angle group was thi- cker than those in the high-angle group (P<0.05). In the regions of the symphysis, the cortical thickness of lingual lower one third in the low-angle group was thicker than those in the high-angle group (P<0.05), but in the regions of premolar and molar of lingual upper one third in the low-angle group was thicker than those in the high-angle group (P<0.05).</p><p><b>CONCLUSION</b>The height and width of the cross-sections of the body of mandible differed more than thickness of cortical bone among the three different vertical skeletal patterns. The height of cross-sections decreases gradually from the anterior region to the posterior region in three groups. The width of cross-sections in the low-group is thicker than those in other two groups. The thickness of cortical bones decreases successively from low, average to high angle group.</p>

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