Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20190605-00499
Yongxian Liang, Ping Huang
Kawasaki disease (KD) is an acute febrile eruption disease mainly caused by systemic vascular di-seases, often is diagnosed in infants and young children, and mainly involve small and medium arteries of the whole body.KD can be complicated by coronary artery disease, carditis, interstitial pneumonia, aseptic meningitis and so on.KD complicated with acute abdomen, such as cholecystitis, pancreatitis and intestinal obstruction, has also been paid attention to in recent years.Early identification of acute abdomen as a manifestation of KD complications and timely treatment can help improve the prognosis of coronary artery disease and acute abdomen caused by KD. Key words: Kawasaki disease; Acute abdomen; Complication
{"title":"Re-recognition of Kawasaki disease complicated with acute abdomen","authors":"Yongxian Liang, Ping Huang","doi":"10.3760/CMA.J.CN101070-20190605-00499","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190605-00499","url":null,"abstract":"Kawasaki disease (KD) is an acute febrile eruption disease mainly caused by systemic vascular di-seases, often is diagnosed in infants and young children, and mainly involve small and medium arteries of the whole body.KD can be complicated by coronary artery disease, carditis, interstitial pneumonia, aseptic meningitis and so on.KD complicated with acute abdomen, such as cholecystitis, pancreatitis and intestinal obstruction, has also been paid attention to in recent years.Early identification of acute abdomen as a manifestation of KD complications and timely treatment can help improve the prognosis of coronary artery disease and acute abdomen caused by KD. \u0000 \u0000Key words: \u0000Kawasaki disease; Acute abdomen; Complication","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"475-477"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41486433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20190814-00745
L. Guan, Peng Liu, Hai-ying Li, Wei Ma, L. Xie, P. Jin, X. Fang, Huaili Wang
Objective To discuss the incidence rate and influencing factors of postencephalitic epilepsy (PE) in children with viral encephalitis at acute symptomatic seizure(ASS). Methods The data of 132 children with ASS in the First Affiliated Hospital of Zhengzhou University from September 2013 to July 2018 were retrospectively analyzed, and the patients were divided into PE group (62 cases) and non-PE group (70 cases) according to whether they had PE at final follow-up.The risk factors of PE in children with ASS were analyzed using the multivariate Logistic regre-ssion methods. Results The incidence of PE in children with ASS was 46.97% (62/132 cases). There were statistically significant differences in terms of psychological and behavioral abnormalities[19.4%(12/62 cases) vs.2.9%(2/70 cases)], repetitive seizures (more than 5 seizures) [67.7%(42/62 cases) vs.17.1%(12/70 cases)], status epilepticus (SE) [30.6%(19/62 cases) vs.11.4%(8/70 cases)], generalized seizures [72.6%(45/62 cases) vs.88.6%(62/70 cases)], endotracheal intubation [21.0%(13/62 cases) vs.2.9%(2/70 cases)], the duration of fever [5.5(3.0, 11.0) d vs.3.0(2.0, 6.0) d], the duration in the intensive care unit (ICU) [13(5, 21) d vs.6(3, 8) d], electroencephalography epileptiform discharges [49.1%(27/55 cases) vs.6.8%(4/59 cases)], presence of subcortical involvement on neuroimaging [37.3%(22/55 cases) vs.20.3%(14/59 cases)] in children with ASS between the PE group and the non-PE group(all P<0.05). The multivariate Logistic regression analysis showed that repetitive seizures (more than 5 seizures) (OR=5.256, 95%CI: 1.538-17.961, P=0.008), SE(OR=6.003, 95%CI: 1.411-25.539, P=0.015), electroencephalography epileptiform discharges (OR=36.693, 95%CI: 7.031-191.485, P<0.01) and the duration in ICU (OR=1.170, 95%CI: 1.058-1.298, P=0.002) were the risk factors for PE in children with ASS. Conclusions The incidence rate of PE in children with ASS is high.Children with ASS are more likely to develop into PE if they have repetitive seizures (more than 5 seizures), SE, electroencephalography epileptiform discharges, and the longer duration in ICU. Key words: Child; Viral encephalitis; Seizures; Postencephalitic epilepsy; Risk factor
{"title":"Influencing factors of postencephalitic epilepsy in children with viral encephalitis at acute symptomatic seizure","authors":"L. Guan, Peng Liu, Hai-ying Li, Wei Ma, L. Xie, P. Jin, X. Fang, Huaili Wang","doi":"10.3760/CMA.J.CN101070-20190814-00745","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190814-00745","url":null,"abstract":"Objective \u0000To discuss the incidence rate and influencing factors of postencephalitic epilepsy (PE) in children with viral encephalitis at acute symptomatic seizure(ASS). \u0000 \u0000 \u0000Methods \u0000The data of 132 children with ASS in the First Affiliated Hospital of Zhengzhou University from September 2013 to July 2018 were retrospectively analyzed, and the patients were divided into PE group (62 cases) and non-PE group (70 cases) according to whether they had PE at final follow-up.The risk factors of PE in children with ASS were analyzed using the multivariate Logistic regre-ssion methods. \u0000 \u0000 \u0000Results \u0000The incidence of PE in children with ASS was 46.97% (62/132 cases). There were statistically significant differences in terms of psychological and behavioral abnormalities[19.4%(12/62 cases) vs.2.9%(2/70 cases)], repetitive seizures (more than 5 seizures) [67.7%(42/62 cases) vs.17.1%(12/70 cases)], status epilepticus (SE) [30.6%(19/62 cases) vs.11.4%(8/70 cases)], generalized seizures [72.6%(45/62 cases) vs.88.6%(62/70 cases)], endotracheal intubation [21.0%(13/62 cases) vs.2.9%(2/70 cases)], the duration of fever [5.5(3.0, 11.0) d vs.3.0(2.0, 6.0) d], the duration in the intensive care unit (ICU) [13(5, 21) d vs.6(3, 8) d], electroencephalography epileptiform discharges [49.1%(27/55 cases) vs.6.8%(4/59 cases)], presence of subcortical involvement on neuroimaging [37.3%(22/55 cases) vs.20.3%(14/59 cases)] in children with ASS between the PE group and the non-PE group(all P<0.05). The multivariate Logistic regression analysis showed that repetitive seizures (more than 5 seizures) (OR=5.256, 95%CI: 1.538-17.961, P=0.008), SE(OR=6.003, 95%CI: 1.411-25.539, P=0.015), electroencephalography epileptiform discharges (OR=36.693, 95%CI: 7.031-191.485, P<0.01) and the duration in ICU (OR=1.170, 95%CI: 1.058-1.298, P=0.002) were the risk factors for PE in children with ASS. \u0000 \u0000 \u0000Conclusions \u0000The incidence rate of PE in children with ASS is high.Children with ASS are more likely to develop into PE if they have repetitive seizures (more than 5 seizures), SE, electroencephalography epileptiform discharges, and the longer duration in ICU. \u0000 \u0000 \u0000Key words: \u0000Child; Viral encephalitis; Seizures; Postencephalitic epilepsy; Risk factor","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"454-457"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44461306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20190329-00259
Zhenheng Ou, Mingguo Xu, Cong Liu
Kawasaki disease (KD) is one of the acute vasculitis diseases, and its most common complications are coronary artery lesions and myocarditis.Different degrees of myocardial injury can be observed in the acute phase of KD, and different abnormal waveforms can be detected in the electrocardiogram (ECG). As a noninvasive electrophysiological examination, ECG is of great significance for both early diagnosis and prognosis evaluation of KD.The advance in research enables ECG manifestations and electrophysiological significance in the early phase of KD to be gradually re-cognized.In this article, the foreign and domestic research on the changes and clinical significance of ECG in acute stage of Kawasaki disease in recent years was reviewed and summarized, and recent advance in the application of ECG in the acute phase of KD was also summarized. Key words: Kawasaki disease; Electrocardiogram; QT interval dispersion; T wave; Arrhythmia
{"title":"Research progress on the application of electrocardiogram in acute phase of Kawasaki disease","authors":"Zhenheng Ou, Mingguo Xu, Cong Liu","doi":"10.3760/CMA.J.CN101070-20190329-00259","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190329-00259","url":null,"abstract":"Kawasaki disease (KD) is one of the acute vasculitis diseases, and its most common complications are coronary artery lesions and myocarditis.Different degrees of myocardial injury can be observed in the acute phase of KD, and different abnormal waveforms can be detected in the electrocardiogram (ECG). As a noninvasive electrophysiological examination, ECG is of great significance for both early diagnosis and prognosis evaluation of KD.The advance in research enables ECG manifestations and electrophysiological significance in the early phase of KD to be gradually re-cognized.In this article, the foreign and domestic research on the changes and clinical significance of ECG in acute stage of Kawasaki disease in recent years was reviewed and summarized, and recent advance in the application of ECG in the acute phase of KD was also summarized. \u0000 \u0000Key words: \u0000Kawasaki disease; Electrocardiogram; QT interval dispersion; T wave; Arrhythmia","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"472-474"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41685696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20200309-00356
Yibing Cheng, Meng Wang
Sepsis-associated encephalopathy (SAE) is a common complication of sepsis.Not only the cognitive impairment which may develop in the future can reduce the quality of life, but also there is a high mortality in patients with this complication.There is no clear pathogenesis characterized and no specific therapy developed up to date.The synthetic treatment for sepsis is the most commonly used therapy.However, the treatment for encephalopathy is still under research.Therapy that can reduce inflammation caused by SAE, protect the blood-brain barrier, inhibit neurotransmitter abnormality, and restrain other key pathophysiology injuries should be developed in the future to prevent the permanent brain functional damage caused by SAE in patients. Key words: Sepsis; Encephalopathy; Treatment
{"title":"Progress in sepsis-associated encephalopathy therapy","authors":"Yibing Cheng, Meng Wang","doi":"10.3760/CMA.J.CN101070-20200309-00356","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200309-00356","url":null,"abstract":"Sepsis-associated encephalopathy (SAE) is a common complication of sepsis.Not only the cognitive impairment which may develop in the future can reduce the quality of life, but also there is a high mortality in patients with this complication.There is no clear pathogenesis characterized and no specific therapy developed up to date.The synthetic treatment for sepsis is the most commonly used therapy.However, the treatment for encephalopathy is still under research.Therapy that can reduce inflammation caused by SAE, protect the blood-brain barrier, inhibit neurotransmitter abnormality, and restrain other key pathophysiology injuries should be developed in the future to prevent the permanent brain functional damage caused by SAE in patients. \u0000 \u0000Key words: \u0000Sepsis; Encephalopathy; Treatment","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"415-418"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46482810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20200317-00428
Mei Yang, S. Qian
Sepsis-associated encephalopathy (SAE) is a common complication that leads to an increased mortality rate in septic patients, but its pathogenesis remains unclear, and there is a lack of accepted diagnostic criteria and effective interventions.With the deepening of research on the pathophysiological mechanisms of SAE, investigating SAE-specific biomarkers is of significance to the seeking of effective diagnosis and treatment methods. Key words: Sepsis; Encephalopathy; Biomarkers
{"title":"Research progress in biomarkers of sepsis-associated encephalopathy","authors":"Mei Yang, S. Qian","doi":"10.3760/CMA.J.CN101070-20200317-00428","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200317-00428","url":null,"abstract":"Sepsis-associated encephalopathy (SAE) is a common complication that leads to an increased mortality rate in septic patients, but its pathogenesis remains unclear, and there is a lack of accepted diagnostic criteria and effective interventions.With the deepening of research on the pathophysiological mechanisms of SAE, investigating SAE-specific biomarkers is of significance to the seeking of effective diagnosis and treatment methods. \u0000 \u0000Key words: \u0000Sepsis; Encephalopathy; Biomarkers","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"411-414"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49379915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20200401-00553
Mianling Zhong, Yuge Huang
Objective To investigate the effect of 3 pediatric scores of critical illness including Pediatric Critical Illness Score (PCIS), Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2), and Pediatric Multiple Organ Dysfunction Score (P-MODS) in estimating the prognosis of illness in children with sepsis in pediatric intensive care unit (PICU). Methods The data of 516 pediatric patients diagnosed as sepsis in PICU of Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018 were retrospectively analyzed, and they were divided into survival group and death group according to the clinical outcome on the 28th day after admission.Then, the receiver operating characteristic (ROC) curve was plotted, and the efficiency of PCIS, PELOD-2 and P-MODS for predicting death was evaluated by the area under ROC curve (AUC). Results There were 488 pediatric patients survived, while 28 cases died during hospitalization.Compared with the survival group, the death group had a significantly lower PCIS score [86(82, 88) scores vs.89(84, 92)scores], and significantly higher PELOD-2 and P-MODS scores[PELOD-2: 6.5(4.0, 8.0) scores vs.0 (0, 2.0) scores, P-MODS: 3(2, 6) scores vs.1(1, 2) scores], and the differences were significant(Z=3 259.500, 14.228, 4.688, all P<0.05). ROC curve analysis showed that the AUCs of PCIS, PELOD-2 and P-MODS for predicting prognosis of pediatric patients with sepsis in PICU were 0.761, 0.916 and 0.761, respectively(Z=6.127, 14.228, 4.688, all P<0.05). Conclusions PCIS, PELOD-2 and P-MODS are effective and have good ability to assess the prognosis of pediatric patients with sepsis in the PICU.It seems that PELOD-2 is the most effective. Key words: Pediatric scores of critical illness; Pediatric intensive care unit; Sepsis; Prognostic evaluation
{"title":"Effect of 3 pediatric scores of critical illness in prognostic evaluation of children with sepsis in intensive care units","authors":"Mianling Zhong, Yuge Huang","doi":"10.3760/CMA.J.CN101070-20200401-00553","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200401-00553","url":null,"abstract":"Objective \u0000To investigate the effect of 3 pediatric scores of critical illness including Pediatric Critical Illness Score (PCIS), Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2), and Pediatric Multiple Organ Dysfunction Score (P-MODS) in estimating the prognosis of illness in children with sepsis in pediatric intensive care unit (PICU). \u0000 \u0000 \u0000Methods \u0000The data of 516 pediatric patients diagnosed as sepsis in PICU of Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018 were retrospectively analyzed, and they were divided into survival group and death group according to the clinical outcome on the 28th day after admission.Then, the receiver operating characteristic (ROC) curve was plotted, and the efficiency of PCIS, PELOD-2 and P-MODS for predicting death was evaluated by the area under ROC curve (AUC). \u0000 \u0000 \u0000Results \u0000There were 488 pediatric patients survived, while 28 cases died during hospitalization.Compared with the survival group, the death group had a significantly lower PCIS score [86(82, 88) scores vs.89(84, 92)scores], and significantly higher PELOD-2 and P-MODS scores[PELOD-2: 6.5(4.0, 8.0) scores vs.0 (0, 2.0) scores, P-MODS: 3(2, 6) scores vs.1(1, 2) scores], and the differences were significant(Z=3 259.500, 14.228, 4.688, all P<0.05). ROC curve analysis showed that the AUCs of PCIS, PELOD-2 and P-MODS for predicting prognosis of pediatric patients with sepsis in PICU were 0.761, 0.916 and 0.761, respectively(Z=6.127, 14.228, 4.688, all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000PCIS, PELOD-2 and P-MODS are effective and have good ability to assess the prognosis of pediatric patients with sepsis in the PICU.It seems that PELOD-2 is the most effective. \u0000 \u0000 \u0000Key words: \u0000Pediatric scores of critical illness; Pediatric intensive care unit; Sepsis; Prognostic evaluation","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"426-429"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44978540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A retrospective analysis was conducted on the clinical data of a child with nephrotic syndrome complicated with chylothorax admitted to the Kidney Department of Beijing Children's Hospital Affiliated to Capital Medical University. A 13-year-old female patient was admitted to the hospital due to nephrotic syndrome with pleural effusion. The pleural puncture fluid was chylothorax, and laboratory examination confirmed true chylothorax. Lymphangiography revealed obstruction of the thoracic duct outlet. Renal biopsy showed minimal glomerular lesions. After primary treatment, early active anticoagulation, and symptomatic comprehensive treatment, the prognosis of the patient is good. It is suggested that chylothorax is a rare complication of pediatric nephrotic syndrome. In the absence of contraindications, early chest enhanced CT and vascular ultrasound should be performed to search for evidence of thrombosis. It is also recommended to undergo lymphangiography to assess the presence of lymphatic malformations. In terms of treatment, the main focus is on controlling the primary disease, actively anticoagulating, and symptomatic treatment, with a good prognosis.
{"title":"Case report of nephrotic syndrome complicated with chylothorax","authors":"Q. Fu, Jian-feng Fan, N. Zhou, Zhi Chen, Xiaorong Liu","doi":"10.3760/CMA.J.CN101070-20190130-00076","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190130-00076","url":null,"abstract":"对首都医科大学附属北京儿童医院肾脏科收治的1例肾病综合征合并乳糜胸患儿的临床资料进行回顾性分析。患儿，女，13岁，因肾病综合征入院，并胸腔积液，胸腔穿刺液为乳糜样，实验室检查确诊为真性乳糜胸，淋巴管造影提示胸导管出口梗阻。肾活检为肾小球微小病变。经原发病治疗，早期积极抗凝，对症等综合治疗后，患儿预后良好。提示乳糜胸是儿童肾病综合征罕见并发症，在无禁忌证的情况下尽早胸部增强CT及血管超声寻找血栓证据，同时建议行淋巴管造影评估有无淋巴管畸形存在。治疗方面以控制原发病，积极抗凝及对症治疗为主，预后良好。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"469-471"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45940406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20190111-00016
Junzheng Peng, Zhijie Tong, Senqiang Zeng, Diyuan Yang, G. Lu, Mingjie Zhang, Junhong Lin
Objective To analyze the clinical features and follow-up results of children with acute exogenous lipoid pneumonia (ELP), and to investigate the diagnosis strategy, treatment and risk factors of ELP. Methods The clinical features, imaging manifestations, results of bronchoalveolar lavage fluid (BALF), treatment methods and prognosis of 41 ELP inpatients in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2013 to May 2018, were summarized and analyzed, and the related literature was reviewed. Results (1) Among 41 patients, 29 cases were male and 12 cases were female.The age of onset ranged from 4 to 53 months.Most of them (35/41 cases, 85.4%) were less than 3 years old, and the majority were aged 1 to 2 years (23/41 cases, 56.1%). (2) The grease taken by children by accident included perfume oil (11 cases), white electric oil (7 cases), electric mosquito oil (5 cases), lubricating oil (5 cases), paraffin oil (4 cases), gasoline/diesel oil (3 cases), kerosene (2 cases), cod-liver oil (2 cases), sewing machine oil (1 case), and unclear oil (1 case). (3) The main clinical manifestations were cough (26/41 cases, 63.4%), shortness of breath (23/41 cases, 56.1%), fever (17/41 cases, 41.5%), cyanosis with hypoxemia (15/41 cases, 36.6%), wheezing (9/41 cases, 22.1%), respiratory distress (9/41 cases, 22.1%), pulmonary hemorrhage (6/41 cases, 14.7%), feeding difficulties and transient vomiting (4/41 cases, 9.8%). Some cases showed no symptoms (3/41 cases, 7.3%). (4) Chest X-ray mainly showed bilateral pulmonary exudative changes or pulmonary consolidation.The most common sign of high-resolution computerized tomography (HRCT) was local or extensive exudation, often accompanied by pulmonary consolidation (18/41 cases, 43.9%). The most common affected sites were bilateral lower lobes (8/41 cases, 19.5%), followed by right lower lobes (3/41 cases, 7.3%), right middle lobes (2/41 cases, 4.8%) and left lower lobes (2/41 cases, 4.8%). Other signs included alveolar changes, hyperventilation, ground glass changes, and nodule formation.(5) Seven children needed mechanical ventilation due to respiratory failure, and all patients underwent bronchoalveolar lavage (BAL). All patients recovered without death, with (11.67±4.90) days of hospitalization, and the hospitalization time of ELP patients with adenovirus infection was (19.25±5.93) days.Nine of them were lost to follow-up (8 cases were mild and 1 case was severe). The symptoms of the remaining children disappeared within 1 week to 1 month.The lung images of 21 cases returned to normal within 1 month after discharge, 7 cases returned to normal within 3 months after discharge, and 4 cases returned to normal after 6 months. Conclusion The clinical manifestations and lung imaging of children with acute ELP have no specificity.Pulmonary imaging of severe patients shows multiple lobes involved, and consolidation and vacuolar changes may occur.Most patients have a fav
{"title":"Clinical characteristics and follow-up study of acute exogenous lipoid pneumonia in children","authors":"Junzheng Peng, Zhijie Tong, Senqiang Zeng, Diyuan Yang, G. Lu, Mingjie Zhang, Junhong Lin","doi":"10.3760/CMA.J.CN101070-20190111-00016","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190111-00016","url":null,"abstract":"Objective \u0000To analyze the clinical features and follow-up results of children with acute exogenous lipoid pneumonia (ELP), and to investigate the diagnosis strategy, treatment and risk factors of ELP. \u0000 \u0000 \u0000Methods \u0000The clinical features, imaging manifestations, results of bronchoalveolar lavage fluid (BALF), treatment methods and prognosis of 41 ELP inpatients in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2013 to May 2018, were summarized and analyzed, and the related literature was reviewed. \u0000 \u0000 \u0000Results \u0000(1) Among 41 patients, 29 cases were male and 12 cases were female.The age of onset ranged from 4 to 53 months.Most of them (35/41 cases, 85.4%) were less than 3 years old, and the majority were aged 1 to 2 years (23/41 cases, 56.1%). (2) The grease taken by children by accident included perfume oil (11 cases), white electric oil (7 cases), electric mosquito oil (5 cases), lubricating oil (5 cases), paraffin oil (4 cases), gasoline/diesel oil (3 cases), kerosene (2 cases), cod-liver oil (2 cases), sewing machine oil (1 case), and unclear oil (1 case). (3) The main clinical manifestations were cough (26/41 cases, 63.4%), shortness of breath (23/41 cases, 56.1%), fever (17/41 cases, 41.5%), cyanosis with hypoxemia (15/41 cases, 36.6%), wheezing (9/41 cases, 22.1%), respiratory distress (9/41 cases, 22.1%), pulmonary hemorrhage (6/41 cases, 14.7%), feeding difficulties and transient vomiting (4/41 cases, 9.8%). Some cases showed no symptoms (3/41 cases, 7.3%). (4) Chest X-ray mainly showed bilateral pulmonary exudative changes or pulmonary consolidation.The most common sign of high-resolution computerized tomography (HRCT) was local or extensive exudation, often accompanied by pulmonary consolidation (18/41 cases, 43.9%). The most common affected sites were bilateral lower lobes (8/41 cases, 19.5%), followed by right lower lobes (3/41 cases, 7.3%), right middle lobes (2/41 cases, 4.8%) and left lower lobes (2/41 cases, 4.8%). Other signs included alveolar changes, hyperventilation, ground glass changes, and nodule formation.(5) Seven children needed mechanical ventilation due to respiratory failure, and all patients underwent bronchoalveolar lavage (BAL). All patients recovered without death, with (11.67±4.90) days of hospitalization, and the hospitalization time of ELP patients with adenovirus infection was (19.25±5.93) days.Nine of them were lost to follow-up (8 cases were mild and 1 case was severe). The symptoms of the remaining children disappeared within 1 week to 1 month.The lung images of 21 cases returned to normal within 1 month after discharge, 7 cases returned to normal within 3 months after discharge, and 4 cases returned to normal after 6 months. \u0000 \u0000 \u0000Conclusion \u0000The clinical manifestations and lung imaging of children with acute ELP have no specificity.Pulmonary imaging of severe patients shows multiple lobes involved, and consolidation and vacuolar changes may occur.Most patients have a fav","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"458-461"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48032538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20191224-01288
Li Yang, Baotian Wang, Jiulai Tang, De Wu
Objective To analyze the microdeletion and microduplication characteristics of pathogenic copy number variations (pCNVs) and clinical phenotypes in children with neurodevelopmental disorders, and to clarify the genetic pathogenic cause of children with neurodevelopmental disorders. Methods Children who were identified as neurodevelopment disorders such as global developmental delay and mental disorder, by next generation sequencing-based whole genomic copy number variation testing from January 2017 to November 2019 at the First Affiliated Hospital of Anhui Medical University were enrolled, and the clinical phenotypes and pCNVs were reviewed analyzed. Results There were 36 pCNVs in total 31 children, consisting of 24 microdeletion segments (66.67%)and 12 microduplication segments (33.33%), with sizes ranging from 320.00 kb to 93.26 Mb (mean 11.33 Mb). pCNVs frequently occurred in chromosome 15 , chromosome 8 and chromosome X, there were 9 children with 9 pCNVs in chromosome 15(25.00%), 3 children with 5 pCNVs in chromosome 8(13.89%)and 3 children with 4 pCNVs in chromosome X(11.11%) .The mainly clinical manifestations were motor disorder (30 children, 96.77%), mental disorder (22 children, 70.97%), speech development delay(22 children, 70.97% )accompanied by the malformation(11 children, 35.48%), abnormal face(11 children, 35.48%) and epilepsy(8 children, 25.81%), multisystem abnormalities generally exist in one individual. Conclusion This study demonstrates the clinical utility of whole genome CNVs testing in the genetic diagnosis of children with neurodevelopment disorders.Genetic pathogenesis of children with neurodevelopmental disorders can be revealed by the analysis of pCNVs. Key words: Neurodevelopmental disorder; Pathogenic copy number variation; Child
{"title":"Pathogenic copy number variation and clinical phenotype in children with neurodevelopment disorders","authors":"Li Yang, Baotian Wang, Jiulai Tang, De Wu","doi":"10.3760/CMA.J.CN101070-20191224-01288","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20191224-01288","url":null,"abstract":"Objective \u0000To analyze the microdeletion and microduplication characteristics of pathogenic copy number variations (pCNVs) and clinical phenotypes in children with neurodevelopmental disorders, and to clarify the genetic pathogenic cause of children with neurodevelopmental disorders. \u0000 \u0000 \u0000Methods \u0000Children who were identified as neurodevelopment disorders such as global developmental delay and mental disorder, by next generation sequencing-based whole genomic copy number variation testing from January 2017 to November 2019 at the First Affiliated Hospital of Anhui Medical University were enrolled, and the clinical phenotypes and pCNVs were reviewed analyzed. \u0000 \u0000 \u0000Results \u0000There were 36 pCNVs in total 31 children, consisting of 24 microdeletion segments (66.67%)and 12 microduplication segments (33.33%), with sizes ranging from 320.00 kb to 93.26 Mb (mean 11.33 Mb). pCNVs frequently occurred in chromosome 15 , chromosome 8 and chromosome X, there were 9 children with 9 pCNVs in chromosome 15(25.00%), 3 children with 5 pCNVs in chromosome 8(13.89%)and 3 children with 4 pCNVs in chromosome X(11.11%) .The mainly clinical manifestations were motor disorder (30 children, 96.77%), mental disorder (22 children, 70.97%), speech development delay(22 children, 70.97% )accompanied by the malformation(11 children, 35.48%), abnormal face(11 children, 35.48%) and epilepsy(8 children, 25.81%), multisystem abnormalities generally exist in one individual. \u0000 \u0000 \u0000Conclusion \u0000This study demonstrates the clinical utility of whole genome CNVs testing in the genetic diagnosis of children with neurodevelopment disorders.Genetic pathogenesis of children with neurodevelopmental disorders can be revealed by the analysis of pCNVs. \u0000 \u0000 \u0000Key words: \u0000Neurodevelopmental disorder; Pathogenic copy number variation; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"445-449"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47666124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A retrospective analysis was conducted on the clinical data of a child with three relapses of Kawasaki disease admitted to the Cardiovascular Department of the Children's Hospital Affiliated to Xi'an Jiaotong University. The patient, male, 8 years old and 7 months old, first developed Kawasaki disease at the age of 3, and then recurred at intervals of 18, 23, and 25 months, respectively. Each recurrence exhibited the characteristics of complete Kawasaki disease. The first three episodes of Kawasaki disease in the child were treated with intravenous immunoglobulin (IVIG) [2 g/(kg · time)] pulse therapy once, and the fourth episode of Kawasaki disease was treated with IVIG [2 g/(kg · time)] pulse therapy twice. During the second recurrence of Kawasaki disease in the child, abdominal pain was the first manifestation, and exploratory laparotomy was performed. During the surgery, several enlarged fused lymph nodes were found in the ileocecal region. The child experienced incomplete intestinal obstruction again during the third recurrence of Kawasaki disease, with a progressive increase in anti streptococcal hemolysin O. After treatment with anti infection and IVIG shock, the patient was discharged. No recurrence of Kawasaki disease was observed after 0.5 years of follow-up after discharge. It is suggested that for children with a history of Kawasaki disease and a recurrence of prolonged fever, attention should be paid to the possibility of Kawasaki disease recurrence, and some children with Kawasaki disease may be accompanied by incomplete intestinal obstruction.
{"title":"Case report of Kawasaki disease with three recurrent episodes","authors":"Huang Li, Juanli Wang, Yanmin Zhang, Tao Wang, Zhan Zhang","doi":"10.3760/CMA.J.CN101070-20190507-00383","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190507-00383","url":null,"abstract":"对西安交通大学附属儿童医院心血管内科收治的1例川崎病3次复发患儿的临床资料进行回顾性分析。患儿，男，8岁7个月，于3岁首次川崎病发病，其后分别间隔18个月、23个月、25个月再次复发，且每次复发均表现为完全川崎病的特点。患儿前3次川崎病发病予1次静脉用丙种球蛋白(IVIG)[2 g/(kg·次)]冲击治疗，第4次川崎病发病予2次IVIG[2 g/(kg·次)]冲击治疗。其中患儿第2次川崎病复发时以腹痛为首发表现，并行剖腹探查术，术中发现回盲部数枚肿大融合淋巴结。患儿第3次川崎病复发时再次出现不完全性肠梗阻表现，且抗链球菌溶血素O进行性升高，经抗感染及IVIG冲击等治疗后出院。出院后随访0.5年未见川崎病复发。提示对于既往有川崎病病史且再次出现长时间发热患儿，应警惕川崎病复发可能，且部分川崎病患儿可合并有不完全性肠梗阻。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"467-469"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48796796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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