Pub Date : 2020-04-08DOI: 10.3760/CMA.J.CN101070-20190716-00644
Yuanhong Lyu, Guo-bing Wang, P. Wen, Cong Liu, Mingguo Xu, J. Mei, Heng Lai, Chengrong Li
Objective To investigate the histone acetylation of interleukin-4(IL-4) gene and its roles in immunological pathogenesis of Kawasaki disease (KD). Methods Thirty-six children with KD and 28 age-matched healthy children in Shenzhen Children′s Hospital from October 2016 to December 2018 were recruited in this study.Peripheral venous blood samples were collected from healthy controls (28 cases) and patients with KD during acute phase and 4 to 5 days after effective intravenous immunoglobulin (IVIG) treatment.Co-immunoprecipitation followed by real-time PCR was used to assess histone H4 acetylation levels of IL-4 promoter and Va enhancer, and binding abilities of p300 and CREB-binding protein (CBP) with promoter and Va enhancer of IL-4 gene in peripheral blood CD4+ T cells.Flow cytometry was performed to analyze the proportion of CD4+ IL-4+ T cells (Th2) and protein le-vels of phosphorylated signal transducer and activator of transcription 6 (pSTAT6), GATA binding protein 3 (GATA3), nuclear factor 1 of activated T cells(NFAT1), transforming growth factor-β receptor Ⅱ (TGF-βRⅡ), and phosphorylated L-type amino acid transporter 1(pLAT1). Quantitative real-time PCR was used to evaluate the transcription levels of IL-4, IL-5, IL-13, IL-4 receptor α (IL-4Rα), transforming growth factor-β receptor Ⅰ (TGF-βRⅠ) and sex-determining region Y(SRY)-box 4 (SOX4) in CD4+ T cells.Plasma concentrations of IL-4 and transforming growth factor-β(TGF-β) were measured by enzyme-linked immunosorbent assay. Results (1)Compared with control group, the proportion of Th2 cells, expression levels of Th2-associated cytokines (IL-4, IL-5 and IL-13) and histone H4 acetylation levels associating with IL-4 promoter and Va enhancer, increased remarkably during acute KD(all P<0.05), and restored after IVIG therapy(all P<0.05). Meanwhile, all the former items in KD patients with coronary artery lesions (CAL) were higher than those in patients with non-coronary artery lesions (NCAL) (all P<0.05). (2) Compared with control group, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CD4+ T cells were up-regulated significantly during acute KD (all P<0.05), and decreased in varying degrees after IVIG treatment (all P<0.05). Positive correlations between binding abilities of p300 with IL-4 (promoter and Va enhancer) and the expression of IL-4 promoter and Va enhancer were detected in patients with acute KD (r=0.72, 0.43, all P<0.05). Furthermore, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CAL group were higher than those in NCAL group (all P<0.05). (3) Compared with control group, patients with acute KD had remarkably increased plasma concentration of IL-4, and expression levels of IL-4Rα/STAT6/GATA-3 and pLAT1/NFAT1 in CD4+ T cells (all P<0.05), and significantly down-regulated plasma concentration of TGF-β and expression level of TGF-βRⅡ/TGF-βRⅠ/SOX4 (all P<0.05). All the items mentioned above restored in varying degrees after
{"title":"Modification and significance of histone acetylation associated with interleukin-4 gene in pediatric Kawasaki disease","authors":"Yuanhong Lyu, Guo-bing Wang, P. Wen, Cong Liu, Mingguo Xu, J. Mei, Heng Lai, Chengrong Li","doi":"10.3760/CMA.J.CN101070-20190716-00644","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190716-00644","url":null,"abstract":"Objective \u0000To investigate the histone acetylation of interleukin-4(IL-4) gene and its roles in immunological pathogenesis of Kawasaki disease (KD). \u0000 \u0000 \u0000Methods \u0000Thirty-six children with KD and 28 age-matched healthy children in Shenzhen Children′s Hospital from October 2016 to December 2018 were recruited in this study.Peripheral venous blood samples were collected from healthy controls (28 cases) and patients with KD during acute phase and 4 to 5 days after effective intravenous immunoglobulin (IVIG) treatment.Co-immunoprecipitation followed by real-time PCR was used to assess histone H4 acetylation levels of IL-4 promoter and Va enhancer, and binding abilities of p300 and CREB-binding protein (CBP) with promoter and Va enhancer of IL-4 gene in peripheral blood CD4+ T cells.Flow cytometry was performed to analyze the proportion of CD4+ IL-4+ T cells (Th2) and protein le-vels of phosphorylated signal transducer and activator of transcription 6 (pSTAT6), GATA binding protein 3 (GATA3), nuclear factor 1 of activated T cells(NFAT1), transforming growth factor-β receptor Ⅱ (TGF-βRⅡ), and phosphorylated L-type amino acid transporter 1(pLAT1). Quantitative real-time PCR was used to evaluate the transcription levels of IL-4, IL-5, IL-13, IL-4 receptor α (IL-4Rα), transforming growth factor-β receptor Ⅰ (TGF-βRⅠ) and sex-determining region Y(SRY)-box 4 (SOX4) in CD4+ T cells.Plasma concentrations of IL-4 and transforming growth factor-β(TGF-β) were measured by enzyme-linked immunosorbent assay. \u0000 \u0000 \u0000Results \u0000(1)Compared with control group, the proportion of Th2 cells, expression levels of Th2-associated cytokines (IL-4, IL-5 and IL-13) and histone H4 acetylation levels associating with IL-4 promoter and Va enhancer, increased remarkably during acute KD(all P<0.05), and restored after IVIG therapy(all P<0.05). Meanwhile, all the former items in KD patients with coronary artery lesions (CAL) were higher than those in patients with non-coronary artery lesions (NCAL) (all P<0.05). (2) Compared with control group, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CD4+ T cells were up-regulated significantly during acute KD (all P<0.05), and decreased in varying degrees after IVIG treatment (all P<0.05). Positive correlations between binding abilities of p300 with IL-4 (promoter and Va enhancer) and the expression of IL-4 promoter and Va enhancer were detected in patients with acute KD (r=0.72, 0.43, all P<0.05). Furthermore, binding abilities of p300 and CBP with IL-4 promoter and Va enhancer in CAL group were higher than those in NCAL group (all P<0.05). (3) Compared with control group, patients with acute KD had remarkably increased plasma concentration of IL-4, and expression levels of IL-4Rα/STAT6/GATA-3 and pLAT1/NFAT1 in CD4+ T cells (all P<0.05), and significantly down-regulated plasma concentration of TGF-β and expression level of TGF-βRⅡ/TGF-βRⅠ/SOX4 (all P<0.05). All the items mentioned above restored in varying degrees after ","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"462-466"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47606531","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.CN101070-20190610-00513
Yi Hua, Weiqing Zhang, Jue Shen, S. Mao, Zhefeng Yuan, P. Jiang, F. Gao
Objective To investigate the clinical features and treatment effect of children with central nervous system demyelinating diseases and seropositivity to myelin-oligodendrocyte glycoprotein (MOG) antibody. Methods The clinical characteristics of 28 had seropositivity to MOG among 115 children with central nervous system demyelinating diseases and who were hospitalized at Department of Neurology, Children′s Hospital of Zhejiang University School of Medicine from March 2017 to February 2019 were retrospectively analyzed. Results Twenty-eight patients were included in this study, including 10 males and 18 females, with the ratio of male/female of 1.00∶1.80, and the median age of 7 years and 9 months.The clinical manifestations were diverse, including encephalopathy symptoms such as hea-dache, vomiting, and drowsiness (13/28 cases), vision loss (7/28 cases), spinal symptoms (6/28 cases), cerebellar symptoms such as ataxia, slurred speech (4/28 cases), convulsions (2/28 cases), and cranial nerve symptoms (1/28 cases). Among 24 cases who underwent CSF detection, 10 patients (41.7%) had slightly increased white blood cells, 2 patients (8.3%) had elevated protein, 6 patients (25.0%) had positive MOG antibody, and CSF-restricted oligoclonal band was negative in all 24 patients.Twenty-five cases (89.3%) showed brain magnetic resonance imaging (MRI) abnormalities, including cerebral white matter (20/28 cases), cerebellum (10/28 cases), cerebral gray matter (9/28 cases), thalamus/basal ganglia (6/28 cases), brainstem (6/28 cases), optic nerve (5/28 cases), and corpus callosum (4/28 cases). Of the 28 cases, 13 patients had spinal cord involvement, involving cervical spinal cord in 10 cases, thoracic cord in 9 cases and lumbar spinal cord in 5 cases; besides, 8 cases of them had long segmental spinal cord lesions with ≥ 3 segments.Fourteen patients received the visual evoked potentials′ examination, and the subclinical visual impairment was found in 2 of them with unobstructed clinical performance.All patients underwent high-dose Methylprednisolone therapy.The clinical symptoms of 16 patients who were treated with Gamma globulin were relieved in the acute phase.Seven patients had recurrence during the follow-up period, with the recurrence rate of 25.0%.Relapsed patients re-treated with high-dose Methylprednisolone therapy combined with Gamma globulin, clinical symptoms could be alleviated. Conclusion The main clinical phenotype of children with central nervous system demyelinating diseases and seropositivity to MOG is acute disseminated encephalomyelitis.The spinal cord lesions are mainly involving cervical and thoracic segments.The current treatments of this disease include glucocorticoid and Gamma globulin, which have significant effect, but the disease is easy to relapse.The re-use of glucocorticoid and Gamma globulin after relapse is still effective. Key words: Myelin-oligodendrocyte glycoprotein antibody; Child; Central nervous sys
{"title":"Clinical features of central nervous system demyelinating diseases with myelin-oligodendrocyte glycoprotein antibody positive in children","authors":"Yi Hua, Weiqing Zhang, Jue Shen, S. Mao, Zhefeng Yuan, P. Jiang, F. Gao","doi":"10.3760/CMA.J.CN101070-20190610-00513","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190610-00513","url":null,"abstract":"Objective \u0000To investigate the clinical features and treatment effect of children with central nervous system demyelinating diseases and seropositivity to myelin-oligodendrocyte glycoprotein (MOG) antibody. \u0000 \u0000 \u0000Methods \u0000The clinical characteristics of 28 had seropositivity to MOG among 115 children with central nervous system demyelinating diseases and who were hospitalized at Department of Neurology, Children′s Hospital of Zhejiang University School of Medicine from March 2017 to February 2019 were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Twenty-eight patients were included in this study, including 10 males and 18 females, with the ratio of male/female of 1.00∶1.80, and the median age of 7 years and 9 months.The clinical manifestations were diverse, including encephalopathy symptoms such as hea-dache, vomiting, and drowsiness (13/28 cases), vision loss (7/28 cases), spinal symptoms (6/28 cases), cerebellar symptoms such as ataxia, slurred speech (4/28 cases), convulsions (2/28 cases), and cranial nerve symptoms (1/28 cases). Among 24 cases who underwent CSF detection, 10 patients (41.7%) had slightly increased white blood cells, 2 patients (8.3%) had elevated protein, 6 patients (25.0%) had positive MOG antibody, and CSF-restricted oligoclonal band was negative in all 24 patients.Twenty-five cases (89.3%) showed brain magnetic resonance imaging (MRI) abnormalities, including cerebral white matter (20/28 cases), cerebellum (10/28 cases), cerebral gray matter (9/28 cases), thalamus/basal ganglia (6/28 cases), brainstem (6/28 cases), optic nerve (5/28 cases), and corpus callosum (4/28 cases). Of the 28 cases, 13 patients had spinal cord involvement, involving cervical spinal cord in 10 cases, thoracic cord in 9 cases and lumbar spinal cord in 5 cases; besides, 8 cases of them had long segmental spinal cord lesions with ≥ 3 segments.Fourteen patients received the visual evoked potentials′ examination, and the subclinical visual impairment was found in 2 of them with unobstructed clinical performance.All patients underwent high-dose Methylprednisolone therapy.The clinical symptoms of 16 patients who were treated with Gamma globulin were relieved in the acute phase.Seven patients had recurrence during the follow-up period, with the recurrence rate of 25.0%.Relapsed patients re-treated with high-dose Methylprednisolone therapy combined with Gamma globulin, clinical symptoms could be alleviated. \u0000 \u0000 \u0000Conclusion \u0000The main clinical phenotype of children with central nervous system demyelinating diseases and seropositivity to MOG is acute disseminated encephalomyelitis.The spinal cord lesions are mainly involving cervical and thoracic segments.The current treatments of this disease include glucocorticoid and Gamma globulin, which have significant effect, but the disease is easy to relapse.The re-use of glucocorticoid and Gamma globulin after relapse is still effective. \u0000 \u0000 \u0000Key words: \u0000Myelin-oligodendrocyte glycoprotein antibody; Child; Central nervous sys","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"450-453"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42323564","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 case of neonatal lupus syndrome with ventricular tachycardia and developmental abnormalities admitted to the Pediatrics Department of Tongji Medical College Affiliated Union Hospital, Huazhong University of Science and Technology. Child, female, 3 days; The clinical features include ventricular arrhythmia, rash, jaundice, and developmental abnormalities; Physical examination: Fast pulse rate, yellow stained skin, wide eye distance, epicanthus, high nasal bridge, right side through palm; Anti Sjogren's syndrome antigen A (SSA) antibodies and anti Ro-52 antibodies are positive. The electrocardiogram shows paroxysmal ventricular tachycardia (accompanied by ventricular atrial retrograde transmission), and chromosome karyotype analysis shows 46, XX. Provide treatment such as electrocardiographic monitoring, anti arrhythmia, anti infection, protection of heart function, immunoglobulin therapy, and jaundice treatment. After 11 days of hospitalization, the condition improved and was discharged; Regularly follow up until 8 months of birth, and the child can recover. The clinical manifestations of neonatal lupus syndrome are atypical, with prominent cardiac damage. In addition to heart conduction block, it may also lead to other arrhythmias, such as ventricular tachycardia.
{"title":"Case report of neonatal lupus syndrome with ventricular tachycardia","authors":"Zhongjian Wang, Nan Wang, Lin Wang, R. Jin","doi":"10.3760/CMA.J.CN101070-20200316-00423","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200316-00423","url":null,"abstract":"对华中科技大学同济医学院附属协和医院儿科收治的1例新生儿狼疮综合征并室性心动过速伴发育异常患儿的临床资料进行回顾性分析。患儿，女，3 d；临床特点为室性心律失常、皮疹、黄疸、发育异常；查体：脉率快，皮肤黄染，宽眼距、内眦赘皮、高鼻梁，右侧通贯掌；抗干燥综合征抗原A(SSA)抗体、抗Ro-52抗体阳性，心电图示阵发性室性心动过速(伴室房逆传)，染色体核型分析示46，XX。予心电监护、抗心律失常、抗感染、保护心功能、免疫球蛋白、退黄等治疗，住院11 d后病情好转出院；定期随访至出生8个月，患儿恢复可。新生儿狼疮综合征临床表现不典型，心脏损害较为突出，除心脏传导阻滞外，也可能导致其他心律失常，如室性心动过速。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"392-394"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48810371","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20190219-00115
Chang Dong, Yu-ming Qin, Shiwei Yang
Recent studies have found that children with congenital heart disease (CHD) are at increased risk of neurodevelopmental disorders (NDDs), including cognitive, adaptive, motor, speech and autism spectrum disorders.Structural and functional neuroimaging has indicated that brain abnormalities in children with CHD might be caused by an in utero developmental insult.Specific genetic abnormalities, particularly copy number variants(CNVs), have been increasingly implicated in both CHD and NDDs.Variations in genes involved in apolipoprotein E production, the Wnt signaling pathway, and histone modification, as well as in the 1q21.1, 16p13.1-11 and 8p23.1 genetic loci, are associated with CHD and NDDs.Understanding these associations is important for risk stratification, disease classification, improving screening and pharmacologic management of individuals with CHD. Key words: Congenital heart disease; Neurodevelopmental disorders; Clinical manifestation; Genetics
{"title":"Clinical manifestations and genetics research progress of congenital heart disease with neurodevelopmental disorders in children","authors":"Chang Dong, Yu-ming Qin, Shiwei Yang","doi":"10.3760/CMA.J.CN101070-20190219-00115","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190219-00115","url":null,"abstract":"Recent studies have found that children with congenital heart disease (CHD) are at increased risk of neurodevelopmental disorders (NDDs), including cognitive, adaptive, motor, speech and autism spectrum disorders.Structural and functional neuroimaging has indicated that brain abnormalities in children with CHD might be caused by an in utero developmental insult.Specific genetic abnormalities, particularly copy number variants(CNVs), have been increasingly implicated in both CHD and NDDs.Variations in genes involved in apolipoprotein E production, the Wnt signaling pathway, and histone modification, as well as in the 1q21.1, 16p13.1-11 and 8p23.1 genetic loci, are associated with CHD and NDDs.Understanding these associations is important for risk stratification, disease classification, improving screening and pharmacologic management of individuals with CHD. \u0000 \u0000Key words: \u0000Congenital heart disease; Neurodevelopmental disorders; Clinical manifestation; Genetics","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"395-397"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43136335","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}
Objective To analyze the drug resistance and molecular epidemiological characteristics of Acinetobacter baumannii isolated from pediatric patients. Methods Acinetobacter baumannii isolated from patients hospitalized in Inner Mongolia Medical University Affiliated Hospital from January 2016 to June 2018 was collected.Vitek-2 Compact automatic microbiological identification and drug sensitivity analysis system was used to identify and test the drug sensitivity of Acinetobacter baumannii isolates, and pulse field gel electrophoresis (PFGE) and multilocus sequence analysis (MLST) were applied to the homology analysis of the strains. Results A total of 94 clinical isolates of Acinetobacter baumannii were collected, of which 42 strains were isolated from pediatric patients and 52 strains from adult patients.The drug resistance rates of pediatric isolates to Imipenem, and Meropenem and Tigecycline were 7.1%, 7.1% and 0, respectively, and the drug resistance rates of adult isolates to these 3 antibiotics were 67.3%, 54.8%, and 5.5%, respectively.The results of PFGE typing showed that 94 strains were divided into 49 genotypes (X1-X49 type), 52 adult strains were distributed in 22 genotypes, and 42 pediatric strains were distributed in 33 genotypes.The dominant genotype was X23 (21 strains, 22.3%), of which 18 strains(85.7%) were adult isolates and 3 strains (14.3%) were children isolates.The drug resistance rate of X23 genotypes to carbapenems was 100%, which was significantly higher than that of other genotypes.The results of MLST genotyping showed that X23 genotype was ST195, which belonged to clonal complex(CC92) clone. Conclusions The overall drug resistance rate of Acinetobacter baumannii isolates in Inner Mongolia Medical University Affiliated Hospital was significantly lower than that of adult isolates, and the diversity of genotypes was obvious.The dominant genotypes of the strains belongs to the CC92 clone population, and is the dominant clone strain in many places of our country. Key words: Pediatrics; Acinetobacter baumannii; Drug resistance; Homology analysis
{"title":"Drug resistance and molecular epidemiology of Acinetobacter baumannii isolated from pediatric patients","authors":"Xiaona Zhao, Junrui Wang, Jichun Wang, Peng Sun, null Chaolumenqiqige","doi":"10.3760/CMA.J.CN101070-20190228-00141","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190228-00141","url":null,"abstract":"Objective \u0000To analyze the drug resistance and molecular epidemiological characteristics of Acinetobacter baumannii isolated from pediatric patients. \u0000 \u0000 \u0000Methods \u0000Acinetobacter baumannii isolated from patients hospitalized in Inner Mongolia Medical University Affiliated Hospital from January 2016 to June 2018 was collected.Vitek-2 Compact automatic microbiological identification and drug sensitivity analysis system was used to identify and test the drug sensitivity of Acinetobacter baumannii isolates, and pulse field gel electrophoresis (PFGE) and multilocus sequence analysis (MLST) were applied to the homology analysis of the strains. \u0000 \u0000 \u0000Results \u0000A total of 94 clinical isolates of Acinetobacter baumannii were collected, of which 42 strains were isolated from pediatric patients and 52 strains from adult patients.The drug resistance rates of pediatric isolates to Imipenem, and Meropenem and Tigecycline were 7.1%, 7.1% and 0, respectively, and the drug resistance rates of adult isolates to these 3 antibiotics were 67.3%, 54.8%, and 5.5%, respectively.The results of PFGE typing showed that 94 strains were divided into 49 genotypes (X1-X49 type), 52 adult strains were distributed in 22 genotypes, and 42 pediatric strains were distributed in 33 genotypes.The dominant genotype was X23 (21 strains, 22.3%), of which 18 strains(85.7%) were adult isolates and 3 strains (14.3%) were children isolates.The drug resistance rate of X23 genotypes to carbapenems was 100%, which was significantly higher than that of other genotypes.The results of MLST genotyping showed that X23 genotype was ST195, which belonged to clonal complex(CC92) clone. \u0000 \u0000 \u0000Conclusions \u0000The overall drug resistance rate of Acinetobacter baumannii isolates in Inner Mongolia Medical University Affiliated Hospital was significantly lower than that of adult isolates, and the diversity of genotypes was obvious.The dominant genotypes of the strains belongs to the CC92 clone population, and is the dominant clone strain in many places of our country. \u0000 \u0000 \u0000Key words: \u0000Pediatrics; Acinetobacter baumannii; Drug resistance; Homology analysis","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"379-382"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44714540","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20190604-00496
Lin Huang, Xiaowen Wang, J. Luan, Chang Qi, Juanjuan Ding, G. Zhu, Li Yuan, Xiantao Shen, Xing Wu
Objective To analyze the correlation between clinical phenotypes and genotypes in 6 children with primary distal renal tubular acidosis (dRTA). Methods The clinical data of 6 children confirmed as dRTA in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from November 2017 to August 2019 were collected, and related auxiliary examination was performed to assess their growth and development.The venous whole blood was reserved for Trio whole exome sequencing, and full spectrum genetic disease accurate diagnosis cloud platform was applied to systematic data screening and analysis.The suspected mutations were checked by Sanger sequencing, and then the role of protein was predicted by software. Results Clinical manifestations, signs and auxiliary examination results of the 6 children accorded with the diagnostic criteria of dRTA, and the prominent characteristics was growth retardation.One case had knee valgus, one had osteoporosis, and the auxiliary examination results showed that both of them had alkaline urine, metabolic acidosis, and hypokalemia.Three children had nephrocalcinosis, and 2 children had nephrolithiasis.The parents of the 6 patients were all normal without phenotypes.Mutations in the SLC4A1 gene were identified in 4 patients, including 1 child with a reported homozygous autosomal recessive missense mutation(c.2102G>A, p.G701D), who had dRTA and hemolytic anemia, and 3 children with the reported de novo heterozygous autosomal dominant missense mutation(c.1766G>A, p.R589H, c.1765C>T, p.R589C), whose age at diagnosis was related to abnormal renal imaging.Compound heterozygous autosomal recessive mutations in the ATPV1B1 gene were identified in 1 patient, and they were novel heterozygous missense mutations (1153C>A, p.P385T and c. 806C>T, p.P269L). A novel homozygous autosomal recessive missense mutation was identified in 1 patient in the ATPV0A4 gene(c.1899C>A, p.Y633X, 208). Conclusions Mutations in SLC4A1, ATP6V1B1, ATP6V0A4 genes are identified as the main causes of the primary dRTA, and the phenotypes was related to the mutation features and genotypes.Genetic test should be conducted on patients suspected as dRTA for early molecular diagnosis, thereby improving clinical phenotypic screening and individualized treatment. Key words: Distal renal tubular acidosis; Genetic mutation; SLC4A1 gene; ATP6V1B1 gene; ATP6V0A4 gene
{"title":"Analysis of correlation between clinical phenotypes and genotypes in children with distal renal tubular acidosis","authors":"Lin Huang, Xiaowen Wang, J. Luan, Chang Qi, Juanjuan Ding, G. Zhu, Li Yuan, Xiantao Shen, Xing Wu","doi":"10.3760/CMA.J.CN101070-20190604-00496","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190604-00496","url":null,"abstract":"Objective \u0000To analyze the correlation between clinical phenotypes and genotypes in 6 children with primary distal renal tubular acidosis (dRTA). \u0000 \u0000 \u0000Methods \u0000The clinical data of 6 children confirmed as dRTA in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from November 2017 to August 2019 were collected, and related auxiliary examination was performed to assess their growth and development.The venous whole blood was reserved for Trio whole exome sequencing, and full spectrum genetic disease accurate diagnosis cloud platform was applied to systematic data screening and analysis.The suspected mutations were checked by Sanger sequencing, and then the role of protein was predicted by software. \u0000 \u0000 \u0000Results \u0000Clinical manifestations, signs and auxiliary examination results of the 6 children accorded with the diagnostic criteria of dRTA, and the prominent characteristics was growth retardation.One case had knee valgus, one had osteoporosis, and the auxiliary examination results showed that both of them had alkaline urine, metabolic acidosis, and hypokalemia.Three children had nephrocalcinosis, and 2 children had nephrolithiasis.The parents of the 6 patients were all normal without phenotypes.Mutations in the SLC4A1 gene were identified in 4 patients, including 1 child with a reported homozygous autosomal recessive missense mutation(c.2102G>A, p.G701D), who had dRTA and hemolytic anemia, and 3 children with the reported de novo heterozygous autosomal dominant missense mutation(c.1766G>A, p.R589H, c.1765C>T, p.R589C), whose age at diagnosis was related to abnormal renal imaging.Compound heterozygous autosomal recessive mutations in the ATPV1B1 gene were identified in 1 patient, and they were novel heterozygous missense mutations (1153C>A, p.P385T and c. 806C>T, p.P269L). A novel homozygous autosomal recessive missense mutation was identified in 1 patient in the ATPV0A4 gene(c.1899C>A, p.Y633X, 208). \u0000 \u0000 \u0000Conclusions \u0000Mutations in SLC4A1, ATP6V1B1, ATP6V0A4 genes are identified as the main causes of the primary dRTA, and the phenotypes was related to the mutation features and genotypes.Genetic test should be conducted on patients suspected as dRTA for early molecular diagnosis, thereby improving clinical phenotypic screening and individualized treatment. \u0000 \u0000 \u0000Key words: \u0000Distal renal tubular acidosis; Genetic mutation; SLC4A1 gene; ATP6V1B1 gene; ATP6V0A4 gene","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"344-349"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42456546","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20190323-00234
Pei Zhang, Qianhuining Kuang, C. Gao, Z. Fan, Zhuo Shi, X. Yang, Jun Yao, Z. Xia
Objective To investigate the clinical manifestations, auxiliary examination results, prognosis and treatment of children with typical hemolytic uremic syndrome (D+ HUS). Methods The clinical data of 36 patients diagnosed as D+ HUS in the Department of Pediatrics of Nanjing Jinling Hospital from January 2001 to January 2019 were collected, and the laboratory results including blood routine, liver and kidney function, coagulation function, humoral immunity and urine were compared before and after treatment. Results The white blood cell count[ (9.28±6.77)×109/L vs.(11.20±5.93) ×109/ L ], C-reactive protein [7.15(3.34, 29.33) mg/L vs.31.83(25.03, 39.75) mg/L], reticulocyte count [(112.49±76.25)×109/L vs. (206.49±147.99)×109/L], erythrocyte sedimentation[15.02(11.79, 22.83) mm/1 h vs.28.06(24.13, 40.52) mm/1 h] , aspartate aminotransferase[50.04(41.92, 60.11) U/L vs.62.61(54.58, 83.52) U/L], alanine aminotransferase [16.72(11.80, 24.74) U/L vs.24.54(20.30, 34.36) U/L], uric acid [(532.84±309.06) μmol/L vs.(606.64±327.23) μmol/L], serum creatinine[160.07(124.87, 221.18) μmol/L vs.200.56(160.62, 283.01)μmol/L ], blood urea nitrogen [20.74(15.77, 28.40) mmol/L vs.33.67(25.91, 45.84) mmol/L], lactate dehydrogenase [488.21(337.59, 692.82) U/L vs.1 520.68(734.24, 2 272.10) U/L ], prothrombin time [(12.14±5.89) s vs. (17.91±6.12) s ], activated partial thrombin time [(25.05±6.26) s vs.(32.38±5.49) s], fibrinogen [ (3.79±2.17) g/L vs.(5.17±3.88) g/L], D-dimer [0.92(0.30, 1.13) mg/L vs. 1.27(1.01, 1.90) mg/L ], 24-hour urinary proteinuria [ (84.05±44.19) mg/(kg·24 h) vs.(112.18±78.26) mg/(kg·24 h) ], urinary sediment [175.73(79.72, 258.66)×107/L vs. 160.38(118.68, 361.83)×107/L], N-acetyl-β-D-glucosaminidase [25.10(18.84, 33.02) U/(g·cr) vs. 41.57(29.49, 58.61) U/(g·cr)], urinary retinol binding protein [0.35(0.18, 1.33) mg/L vs 1.05(0.66, 1.68) mg/L.] in patients after treatment were significantly lower than those before treatment, and the differences were all statistically significant(all P<0.05); patients had higher levels of red blood cell count [ (4.51±1.73)×109/L vs.(2.43±1.40) ×109/L], platelet[(126.82±78.35)×109/L vs. (85.21±69.38)×109/L], hemoglobin[(118.46±18.27) g/L vs. (62.36±16.11) g/L], and complement C3levels [(0.74±0.39) g/L vs.(0.58±0.27) g/L ] after treatment, and the differences were all all statistically significant(all P<0.05). Children with D+ HUS showed multiple system injuries.Among 36 cases, 17 cases (47.22%) had fever, 31 cases (86.11%) had abdominal pain and diarrhea, 29 cases (80.56%) had nausea and vomiting, 8 cases (22.22%) had headache and dizziness, 36 cases (100.00%) had proteinuria and hematuria, 34 cases (94.44%) had renal insufficiency, and 21 cases (58.33%) had yellow staining of skin and sclera.The auxiliary examination for abnormal results mainly included renal pathology (100.00%) (mesangial proliferation endothelial cell proliferation and swelling, and shedding of renal tubular brush borders), bone marrow pa
目的探讨儿童典型溶血性尿毒症综合征(D+ HUS)的临床表现、辅助检查结果、预后及治疗。方法收集南京金陵医院儿科2001年1月至2019年1月诊断为D+溶血性尿毒综合征的36例患者的临床资料，比较治疗前后血常规、肝肾功能、凝血功能、体液免疫、尿液化验结果。结果白细胞计数((9.28±6.77)×109 / L和(11.20±5.93)×109 / L, c反应蛋白[7.15 (3.34,29.33)mg / L vs.31.83 (25.03, 39.75) mg / L),网织红细胞计数[(112.49±76.25)×109 / L和(206.49±147.99)×109 / L),红细胞沉降[15.02(11.79,22.83)毫米/ 1 h vs.28.06(24.13, 40.52)毫米/ 1 h)、天冬氨酸转氨酶[50.04 (41.92,60.11)U / L vs.62.61 (54.58, 83.52) U / L),丙氨酸转氨酶[16.72 (11.80,24.74)U / L vs.24.54 (20.30, 34.36) U / L),尿酸[(532.84±309.06)μmol/L vs(606.64±327.23)μmol/L]、血清肌酐[160.07(124.87、221.18)μmol/L vs.200.56(160.62、283.01)μmol/L]、血尿素氮[20.74(15.77、28.40)mmol/L vs.33.67(25.91、45.84)mmol/L]、乳酸脱氢酶[488.21(337.59、692.82)U/L vs. 1520.68(734.24、2 272.10)U/L]、凝血酶原时间[(12.14±5.89)s vs(17.91±6.12)s]、活化部分凝血酶时间[(25.05±6.26)s vs(32.38±5.49)s]、纤维蛋白原[(3.79±2.17)g/L vs(5.17±3.88)g/L]、d -二聚体[0.92(0.30,1.13)mg/L vs. 1.27(1.01, 1.90) mg/L]、24小时尿蛋白尿[(84.05±44.19)mg/(kg·24 h) vs.(112.18±78.26)mg/(kg·24 h)]、尿沉渣[175.73(79.72,258.66)×107/L vs. 160.38(118.68, 361.83)×107/L]、n -乙酰基-β- d -氨基葡萄糖苷酶[25.10(18.84,33.02)U/(g·cr) vs. 41.57(29.49, 58.61) U/(g·cr)]、尿视黄醇结合蛋白[0.35(0.18,1.33)mg/L vs. 1.05(0.66, 1.68) mg/L]。]，均显著低于治疗前，差异均有统计学意义(P<0.05);治疗后患者红细胞计数[(4.51±1.73)×109/L比(2.43±1.40)×109/L]、血小板[(126.82±78.35)×109/L比(85.21±69.38)×109/L]、血红蛋白[(118.46±18.27)g/L比(62.36±16.11)g/L]、补体c3水平[(0.74±0.39)g/L比(0.58±0.27)g/L]均升高，差异均有统计学意义(均P<0.05)。D+ HUS患儿表现为多系统损伤。其中发热17例(47.22%)，腹痛腹泻31例(86.11%)，恶心呕吐29例(80.56%)，头痛头晕8例(22.22%)，蛋白尿、血尿36例(100.00%)，肾功能不全34例(94.44%)，皮肤及巩膜黄染21例(58.33%)。异常结果的辅助检查主要包括肾脏病理(100.00%)(系膜增生、内皮细胞增生、肿胀、肾小管刷缘脱落)、骨髓病理(100.00%)(骨髓增生活动性)、肾b超(86.67%)(肾损伤样声像)。结论儿童D+ HUS表现为多系统损害。消化系统异常是儿童D+溶血性尿毒综合征的主要致病因素，病情危险。因此，早期诊断和积极治疗可以改善预后。关键词:典型溶血性尿毒症综合征;临床分析;孩子;治疗
{"title":"Clinical analysis of 36 children with typical hemolytic uremic syndrome","authors":"Pei Zhang, Qianhuining Kuang, C. Gao, Z. Fan, Zhuo Shi, X. Yang, Jun Yao, Z. Xia","doi":"10.3760/CMA.J.CN101070-20190323-00234","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190323-00234","url":null,"abstract":"Objective \u0000To investigate the clinical manifestations, auxiliary examination results, prognosis and treatment of children with typical hemolytic uremic syndrome (D+ HUS). \u0000 \u0000 \u0000Methods \u0000The clinical data of 36 patients diagnosed as D+ HUS in the Department of Pediatrics of Nanjing Jinling Hospital from January 2001 to January 2019 were collected, and the laboratory results including blood routine, liver and kidney function, coagulation function, humoral immunity and urine were compared before and after treatment. \u0000 \u0000 \u0000Results \u0000The white blood cell count[ (9.28±6.77)×109/L vs.(11.20±5.93) ×109/ L ], C-reactive protein [7.15(3.34, 29.33) mg/L vs.31.83(25.03, 39.75) mg/L], reticulocyte count [(112.49±76.25)×109/L vs. (206.49±147.99)×109/L], erythrocyte sedimentation[15.02(11.79, 22.83) mm/1 h vs.28.06(24.13, 40.52) mm/1 h] , aspartate aminotransferase[50.04(41.92, 60.11) U/L vs.62.61(54.58, 83.52) U/L], alanine aminotransferase [16.72(11.80, 24.74) U/L vs.24.54(20.30, 34.36) U/L], uric acid [(532.84±309.06) μmol/L vs.(606.64±327.23) μmol/L], serum creatinine[160.07(124.87, 221.18) μmol/L vs.200.56(160.62, 283.01)μmol/L ], blood urea nitrogen [20.74(15.77, 28.40) mmol/L vs.33.67(25.91, 45.84) mmol/L], lactate dehydrogenase [488.21(337.59, 692.82) U/L vs.1 520.68(734.24, 2 272.10) U/L ], prothrombin time [(12.14±5.89) s vs. (17.91±6.12) s ], activated partial thrombin time [(25.05±6.26) s vs.(32.38±5.49) s], fibrinogen [ (3.79±2.17) g/L vs.(5.17±3.88) g/L], D-dimer [0.92(0.30, 1.13) mg/L vs. 1.27(1.01, 1.90) mg/L ], 24-hour urinary proteinuria [ (84.05±44.19) mg/(kg·24 h) vs.(112.18±78.26) mg/(kg·24 h) ], urinary sediment [175.73(79.72, 258.66)×107/L vs. 160.38(118.68, 361.83)×107/L], N-acetyl-β-D-glucosaminidase [25.10(18.84, 33.02) U/(g·cr) vs. 41.57(29.49, 58.61) U/(g·cr)], urinary retinol binding protein [0.35(0.18, 1.33) mg/L vs 1.05(0.66, 1.68) mg/L.] in patients after treatment were significantly lower than those before treatment, and the differences were all statistically significant(all P<0.05); patients had higher levels of red blood cell count [ (4.51±1.73)×109/L vs.(2.43±1.40) ×109/L], platelet[(126.82±78.35)×109/L vs. (85.21±69.38)×109/L], hemoglobin[(118.46±18.27) g/L vs. (62.36±16.11) g/L], and complement C3levels [(0.74±0.39) g/L vs.(0.58±0.27) g/L ] after treatment, and the differences were all all statistically significant(all P<0.05). Children with D+ HUS showed multiple system injuries.Among 36 cases, 17 cases (47.22%) had fever, 31 cases (86.11%) had abdominal pain and diarrhea, 29 cases (80.56%) had nausea and vomiting, 8 cases (22.22%) had headache and dizziness, 36 cases (100.00%) had proteinuria and hematuria, 34 cases (94.44%) had renal insufficiency, and 21 cases (58.33%) had yellow staining of skin and sclera.The auxiliary examination for abnormal results mainly included renal pathology (100.00%) (mesangial proliferation endothelial cell proliferation and swelling, and shedding of renal tubular brush borders), bone marrow pa","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"360-364"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43722873","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20200107-00030
Zhi-hui Li, D. Wen, Zhijuan Kang
Objective To investigate the risk factors for prolonged acute post-streptococcal glomerulonephritis(APSGN) in children, and to provide evidence for the prevention and treatment of chronic kidney diseases in children. Methods A retrospective analysis was performed on the patients who were diagnosed as APSGN and hospitalized in the Department of Nephrology and Rheumatology of Hunan Children′s Hospital from January 2005 to August 2017 with complete clinical data, and follow-up time of more than 12 months.The patients were divided into the non-prolonged group and the prolonged group according to whether the disease course of the children exceeded 1 year.Logistic regression analysis of the high-risk factors for the prolonged disease was conducted. Results Among 271 children included in the study, 197 cases were males, 74 cases were females; with the median age of 9.91 (7.66, 11.33) years old; there were 154 cases in the non-prolonged group (course of disease < 1 year) and 117 patients in the prolonged group (course of disease ≥1 year). Logistic regression analysis showed that duration of proteinuria ≥8 weeks, acute kidney injury, a large amount of proteinuria, and female were the risk factors for the prolonged APSGN (all P<0.05). Giving 1 point to the acute kidney injury duration of proteinuria ≥8 weeks and female, and 2 points to a large amount of proteinuria, the receiver operating characteristic curve analysis showed that for patient whose risk score was 3 points or more, the sensitivity of APSGN to be belonged was 43.6%, specificity was 86.4%, and positive predictive value and negative predictive value were 70.8% and 66.8%. Conclusions Patients with a large amount of proteinuria accompanied by acute kidney injury or proteinuria duration ≥8 weeks, or female patients with a large amount of proteinuria, or female patients with acute kidney injury and proteinuria duration ≥8 weeks, but without a large amount of proteinuria, have a higher risk of prolonged APSGN. Key words: Acute post-streptococcal glomerulonephritis; Persistent; Child
{"title":"Risk factors for prolonged glomerulonephritis after acute post-streptococcal glomerulonephritis","authors":"Zhi-hui Li, D. Wen, Zhijuan Kang","doi":"10.3760/CMA.J.CN101070-20200107-00030","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200107-00030","url":null,"abstract":"Objective \u0000To investigate the risk factors for prolonged acute post-streptococcal glomerulonephritis(APSGN) in children, and to provide evidence for the prevention and treatment of chronic kidney diseases in children. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed on the patients who were diagnosed as APSGN and hospitalized in the Department of Nephrology and Rheumatology of Hunan Children′s Hospital from January 2005 to August 2017 with complete clinical data, and follow-up time of more than 12 months.The patients were divided into the non-prolonged group and the prolonged group according to whether the disease course of the children exceeded 1 year.Logistic regression analysis of the high-risk factors for the prolonged disease was conducted. \u0000 \u0000 \u0000Results \u0000Among 271 children included in the study, 197 cases were males, 74 cases were females; with the median age of 9.91 (7.66, 11.33) years old; there were 154 cases in the non-prolonged group (course of disease < 1 year) and 117 patients in the prolonged group (course of disease ≥1 year). Logistic regression analysis showed that duration of proteinuria ≥8 weeks, acute kidney injury, a large amount of proteinuria, and female were the risk factors for the prolonged APSGN (all P<0.05). Giving 1 point to the acute kidney injury duration of proteinuria ≥8 weeks and female, and 2 points to a large amount of proteinuria, the receiver operating characteristic curve analysis showed that for patient whose risk score was 3 points or more, the sensitivity of APSGN to be belonged was 43.6%, specificity was 86.4%, and positive predictive value and negative predictive value were 70.8% and 66.8%. \u0000 \u0000 \u0000Conclusions \u0000Patients with a large amount of proteinuria accompanied by acute kidney injury or proteinuria duration ≥8 weeks, or female patients with a large amount of proteinuria, or female patients with acute kidney injury and proteinuria duration ≥8 weeks, but without a large amount of proteinuria, have a higher risk of prolonged APSGN. \u0000 \u0000 \u0000Key words: \u0000Acute post-streptococcal glomerulonephritis; Persistent; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"350-354"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43998205","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20190510-00395
J. Wan, Jiacheng Li, Gaofu Zhang, Mo Wang
Objective To explore the differences in clinical indicators of different pathological types of children with hematuria as the main manifestation, and to establish a BP neural network prediction model based on clinical data. Methods The clinical data and renal pathological results of children who were referred to Children′s Hospital of Chongqing Medical University from June 2003 to December 2018 for evaluation of hematuria as the main manifestation were collected, the significant differences in these clinical indicators were analyzed, and a BP neural network model for predicting renal pathology in children with hematuria as the main manifestation was established. Results A total of 438 cases were enrolled in this study, including 232 males and 206 females, with the onset age of (7.00±3.15) years old.According to different clinical manifestations, the children were divided into microscopic hematuria group(179 cases), gross hematuria group(81 cases), microscopic hematuria and proteinuria group (44 cases), and gross hematuria and proteinuria group(134 cases). There were significant differences in sex ratio, onset age, course of disease, inducement, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin and serum IgA levels among different clinical manifestations (all P< 0.05). Pathological grouping indicated that there were significant differences in sex ratio, onset age, course of disease, family history, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin, serum IgA and C3 levels among different pathological groups (all P< 0.05). The BP neural network prediction model was then constructed based on the above indicators, and the accuracy of the prediction model was measured to be 61.19% by using the leave one out method. Conclusions By comparing the differences of various indicators under different clinical manifestations and pathological types, a BP neural network prediction model for renal pathology in children with hematuria as the main manifestation is established.The model can accurately predict renal pathology with the help of related indicators, and provides a basis for determining the time of kidney biopsy. Key words: Hematuria; Renal pathology; BP neural network; Prediction
{"title":"Application of BP neural network in renal pathological prediction in children with hematuria as main clinical manifestation","authors":"J. Wan, Jiacheng Li, Gaofu Zhang, Mo Wang","doi":"10.3760/CMA.J.CN101070-20190510-00395","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190510-00395","url":null,"abstract":"Objective \u0000To explore the differences in clinical indicators of different pathological types of children with hematuria as the main manifestation, and to establish a BP neural network prediction model based on clinical data. \u0000 \u0000 \u0000Methods \u0000The clinical data and renal pathological results of children who were referred to Children′s Hospital of Chongqing Medical University from June 2003 to December 2018 for evaluation of hematuria as the main manifestation were collected, the significant differences in these clinical indicators were analyzed, and a BP neural network model for predicting renal pathology in children with hematuria as the main manifestation was established. \u0000 \u0000 \u0000Results \u0000A total of 438 cases were enrolled in this study, including 232 males and 206 females, with the onset age of (7.00±3.15) years old.According to different clinical manifestations, the children were divided into microscopic hematuria group(179 cases), gross hematuria group(81 cases), microscopic hematuria and proteinuria group (44 cases), and gross hematuria and proteinuria group(134 cases). There were significant differences in sex ratio, onset age, course of disease, inducement, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin and serum IgA levels among different clinical manifestations (all P< 0.05). Pathological grouping indicated that there were significant differences in sex ratio, onset age, course of disease, family history, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin, serum IgA and C3 levels among different pathological groups (all P< 0.05). The BP neural network prediction model was then constructed based on the above indicators, and the accuracy of the prediction model was measured to be 61.19% by using the leave one out method. \u0000 \u0000 \u0000Conclusions \u0000By comparing the differences of various indicators under different clinical manifestations and pathological types, a BP neural network prediction model for renal pathology in children with hematuria as the main manifestation is established.The model can accurately predict renal pathology with the help of related indicators, and provides a basis for determining the time of kidney biopsy. \u0000 \u0000 \u0000Key words: \u0000Hematuria; Renal pathology; BP neural network; Prediction","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"365-369"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48174681","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 : 2020-03-30DOI: 10.3760/CMA.J.CN101070-20200225-00244
Hui Wang, Ying Shen
Vesicoureteral reflux is the main cause of urinary tract infection in infants.About 30% of reflux nephropathy caused by vesicoureteral reflux can develop to chronic renal failure, and often leads to end-stage renal disease in children ultimately.Early diagnosis, standard treatment and follow-up are important links to prevent renal function damage in children with vesicoureteral reflux.In this paper, primary vesicoureteral reflux in children was described generally in order to offer help to the diagnosis and treatment of this disease. Key words: Vesicoureteral reflux; Urinary tract infection; Child; Diagnosis; Treatment; Follow-up
{"title":"Suggestions for diagnosis and treatment of primary vesicoureteral reflux in children","authors":"Hui Wang, Ying Shen","doi":"10.3760/CMA.J.CN101070-20200225-00244","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200225-00244","url":null,"abstract":"Vesicoureteral reflux is the main cause of urinary tract infection in infants.About 30% of reflux nephropathy caused by vesicoureteral reflux can develop to chronic renal failure, and often leads to end-stage renal disease in children ultimately.Early diagnosis, standard treatment and follow-up are important links to prevent renal function damage in children with vesicoureteral reflux.In this paper, primary vesicoureteral reflux in children was described generally in order to offer help to the diagnosis and treatment of this disease. \u0000 \u0000Key words: \u0000Vesicoureteral reflux; Urinary tract infection; Child; Diagnosis; Treatment; Follow-up","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48621743","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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