Objective To investigate the etiology, complications and treatment of children with chronic kidney disease(CKD), in order to provide evidence for the comprehensive management. Methods The clinical data of 371 children patients with CKD at stage 2 to 5 admitted to the Department of Nephrology, Beijing Children′s Hospital Affiliated to Capital Medical University from January 2012 to December 2018 were collected.The etiology, complications and treatment and other data were retrospectively investigated and analyzed. Results (1)A total of 371 children with CKD were enrolled, and the male to female ratio was 1.44∶1.00.Thirty-five cases aged from 0 to 3, 54 cases aged from 4 to 6, 189 cases aged from 7 to 12, 93 cases aged from 13 to 18.Eleven cases were diagnosed at stage 2, 59 cases at stage 3, 62 cases at stage 4, and 239 cases at stage 5.(2) In all patients, 135 cases (36.39%) had congenital anomalies of the kidney and urinary tract(CAKUT), 77 cases (20.76%) had glomerular diseases, 21 cases (5.66%) had hereditary kidney diseases, 12 cases (3.23%) had tubulointerstitial diseases, 4 cases (1.08%) had inherited metabolic diseases, 5 cases (1.35%) had other diseases and in 117 cases (31.64%) the causes of disease were unknown.(3) Renal biopsy was performed in 57 cases with the rate of renal biopsy of 15.36%.The main pathologic types included focal segmental glomerulosclerosis(18 cases, 31.58%), sclerosing glomerulonephritis (13 cases, 22.81%) and tubulointerstitial nephropathy (10 cases, 17.54%). (4)Anemia and secondary hyperparathyroidism(SHPT) were the most common complications, accounting for 77.90% (289 cases) and 73.05% (271 cases), respectively, followed by hypertension (183 cases, 49.33%), cardiovascular disease (CVD) (139 cases, 37.47%) and protein-energy wasting (PEW) (51 cases, 13.75%) successively.The incidence of hypertension, anemia, SHPT and CVD in children with CKD at stage 5 were significantly higher than those in CKD at stage 2-4, and the differences were statistically significant(χ2=50.03, 122.36, 77.07, 64.89, all P<0.01). The incidence of hypertension and CVD in patients with glomerular diseases were higher than those in CAKUT patients, and the differences were statistically significant(χ2=65.63, 40.89, all P<0.01). The incidence of PEW in CAKUT was higher than that in patients with glomerular diseases, and the difference was statistically significant(χ2=10.58, P<0.01). (5)Initial renal replacement therapy was performed in 190 children, hemodialysis in 129 cases (67.89%), peritoneal dialysis in 31 cases (16.32%), and 30 cases (15.79%) refused treatment There was no transplant patient in initial treatment modality. Conclusions In the center, the major cause of CKD stage 2 to 5 in children was CAKUT, but the proportion of CAKUT and glomerular diseases was similar in CKD stage 5.The most common complication of CKD in children is anemia.Hypertension, anemia, SHPT and CVD increased with the progression of CKD staging.S
{"title":"A single center retrospective study of 371 children with chronic kidney disease at stage 2 to 5","authors":"Q. Fu, Xiaorong Liu, Zhi Chen, Jian-feng Fan, Qiang Sun, Chen Ling","doi":"10.3760/CMA.J.CN101070-20190430-00369","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190430-00369","url":null,"abstract":"Objective \u0000To investigate the etiology, complications and treatment of children with chronic kidney disease(CKD), in order to provide evidence for the comprehensive management. \u0000 \u0000 \u0000Methods \u0000The clinical data of 371 children patients with CKD at stage 2 to 5 admitted to the Department of Nephrology, Beijing Children′s Hospital Affiliated to Capital Medical University from January 2012 to December 2018 were collected.The etiology, complications and treatment and other data were retrospectively investigated and analyzed. \u0000 \u0000 \u0000Results \u0000(1)A total of 371 children with CKD were enrolled, and the male to female ratio was 1.44∶1.00.Thirty-five cases aged from 0 to 3, 54 cases aged from 4 to 6, 189 cases aged from 7 to 12, 93 cases aged from 13 to 18.Eleven cases were diagnosed at stage 2, 59 cases at stage 3, 62 cases at stage 4, and 239 cases at stage 5.(2) In all patients, 135 cases (36.39%) had congenital anomalies of the kidney and urinary tract(CAKUT), 77 cases (20.76%) had glomerular diseases, 21 cases (5.66%) had hereditary kidney diseases, 12 cases (3.23%) had tubulointerstitial diseases, 4 cases (1.08%) had inherited metabolic diseases, 5 cases (1.35%) had other diseases and in 117 cases (31.64%) the causes of disease were unknown.(3) Renal biopsy was performed in 57 cases with the rate of renal biopsy of 15.36%.The main pathologic types included focal segmental glomerulosclerosis(18 cases, 31.58%), sclerosing glomerulonephritis (13 cases, 22.81%) and tubulointerstitial nephropathy (10 cases, 17.54%). (4)Anemia and secondary hyperparathyroidism(SHPT) were the most common complications, accounting for 77.90% (289 cases) and 73.05% (271 cases), respectively, followed by hypertension (183 cases, 49.33%), cardiovascular disease (CVD) (139 cases, 37.47%) and protein-energy wasting (PEW) (51 cases, 13.75%) successively.The incidence of hypertension, anemia, SHPT and CVD in children with CKD at stage 5 were significantly higher than those in CKD at stage 2-4, and the differences were statistically significant(χ2=50.03, 122.36, 77.07, 64.89, all P<0.01). The incidence of hypertension and CVD in patients with glomerular diseases were higher than those in CAKUT patients, and the differences were statistically significant(χ2=65.63, 40.89, all P<0.01). The incidence of PEW in CAKUT was higher than that in patients with glomerular diseases, and the difference was statistically significant(χ2=10.58, P<0.01). (5)Initial renal replacement therapy was performed in 190 children, hemodialysis in 129 cases (67.89%), peritoneal dialysis in 31 cases (16.32%), and 30 cases (15.79%) refused treatment There was no transplant patient in initial treatment modality. \u0000 \u0000 \u0000Conclusions \u0000In the center, the major cause of CKD stage 2 to 5 in children was CAKUT, but the proportion of CAKUT and glomerular diseases was similar in CKD stage 5.The most common complication of CKD in children is anemia.Hypertension, anemia, SHPT and CVD increased with the progression of CKD staging.S","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"338-343"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43652602","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.CN101070-20200304-00319
Y. Bao, P. Qian
Urinary tract infections (UTI) are one of the most common bacterial infections in children up to 30% of who suffer from recurrent infections during the first 6 to 12 months after initial UTI.UTI can be the first sign in almost 30% of children with urinary tract abnormalities, so UTI may be an outpost event of underlying renal disorders.UTI in infants is often associated with congenital abnormalities of the kidney and urinary tract, such as vesicoureteral reflux.Children with recurrent infection are prone to renal damaging and scarring, which further leads to end-stage renal disease.Therefore, early identification, timely treatment and reasonable management are extremely important to improving the prognosis.In this article, domestic and foreign relevant literature in recent years were reviewed to provide reference for diagnosis and treatment of UTI in children. Key words: Urinary tract infection; Child; Vesicoureteral reflux
{"title":"Advances in diagnosis and treatment of urinary tract infection in children","authors":"Y. Bao, P. Qian","doi":"10.3760/CMA.J.CN101070-20200304-00319","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200304-00319","url":null,"abstract":"Urinary tract infections (UTI) are one of the most common bacterial infections in children up to 30% of who suffer from recurrent infections during the first 6 to 12 months after initial UTI.UTI can be the first sign in almost 30% of children with urinary tract abnormalities, so UTI may be an outpost event of underlying renal disorders.UTI in infants is often associated with congenital abnormalities of the kidney and urinary tract, such as vesicoureteral reflux.Children with recurrent infection are prone to renal damaging and scarring, which further leads to end-stage renal disease.Therefore, early identification, timely treatment and reasonable management are extremely important to improving the prognosis.In this article, domestic and foreign relevant literature in recent years were reviewed to provide reference for diagnosis and treatment of UTI in children. \u0000 \u0000Key words: \u0000Urinary tract infection; Child; Vesicoureteral reflux","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"331-337"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43706046","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 investigate the expression and significance of Toll-like receptor 4 (TLR4) in renal tissue and peripheral blood of children with idiopathic nephrotic syndrome(INS). Methods The renal biopsy tissues of 78 children with INS diagnosed in the First Affiliated Hospital of Xinxiang Medical University from October 2015 to June 2018 and normal renal tissues of 21 children (control group 1) were collected, and the expressions of TLR4 in the renal tissue was detected by using immunohistochemical method.The expression of TLR4 in different renal pathological types and clinical types of INS was compared, and the correlation of TLR4 with 24-hour urinary protein and serum albumin was analyzed.The expression levels of TLR4 in peripheral blood of children with INS before and after treatment (active stage and remission stage) and 23 healthy children (control group 2) were detected by enzyme linked immunosorbent assay(ELISA). The serum expression levels of TLR4 in different renal pathological types and clinical types of INS were compared, and the correlation of TLR4 with 24-hour urinary protein and serum albumin was analyzed; The correlation between TLR4 expression in renal tubules and in the serum of children with INS was also analyzed. Results (1)Compared with the expression of TLR4 in normal renal tissues[(0.93±0.26)%], the expression of TLR4 in glomeruli and interstitium of all pathological types of INS [mesangial proliferative glomerulonephritis (MsPGN): (0.93 ± 0.21)%, focal segmental glomerulosclerosis (FSGS): (1.02±0.25)%, membranous glomerulonephritis(MN): (1.03±0.09)%, minimal change disease(MCD): (1.02±0.27)%]was not significantly different (F=0.741, P=0.562), but the expression of TLR4 in renal tubules[MCD: (82.94±4.62)%, MN: (63.54±1.98)%, MsPGN(42.32±2.97)%, FSGS: (22.60±2.07)%] was significantly increased (F=1 929.842, P<0.01), Especially, the expression of TLR4 in renal tubules of MCD type INS was significantly higher than that of MN, MsPG N and FSGS [MCD: (82.94±4.62)%, MN: (63.54±1.98)%, MsPGN: (42.32±2.97)%, FSGS: (22.60±2.07)%], and the differences were statistically significant(all P<0.01). TLR4 expression in renal tubules was the highest in steroid-sensitive nephrotic syndrome (SSNS) type and the lowest in INS patients with steroid-resistant nephrotic syndrome (SRNS) type, and the differences were statistically significant(F=220.951, P<0.01). (2)The expression of serum TLR4 in INS children at the active stage [MsPNG: (143.36±12.99) ng/L, FSGS(75.94±7.29) ng/L, MN(210.22±14.66) ng/L, MCD(283.93±21.58) ng/L]was significantly higher than that in INS children at remission stage [MsPNG: (29.51±4.93) ng/L, FSGS(15.66±3.78) ng/L, MN(45.40±5.73) ng/L, MCD(62.29±7.90) ng/L]and control group 2[(0.69 ± 0.33) ng/L], and the differences were statistically significant(all P<0.01); the expression of serum TLR4 in INS children at remission stage was significantly higher than that in the control group 2 (F=286.287, P<0.01). TLR4 had t
{"title":"Expression and significance of Toll-like receptor 4 in renal tissue and peripheral blood of children with idiopathic nephrotic syndrome","authors":"Fang Zhang, De-an Zhao, Yulong Hou, Meigui Han, Xiaojuan Zhu, Ling-yan Wang, Yu Yu, Ziming Han","doi":"10.3760/CMA.J.CN101070-20190521-00437","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190521-00437","url":null,"abstract":"Objective \u0000To investigate the expression and significance of Toll-like receptor 4 (TLR4) in renal tissue and peripheral blood of children with idiopathic nephrotic syndrome(INS). \u0000 \u0000 \u0000Methods \u0000The renal biopsy tissues of 78 children with INS diagnosed in the First Affiliated Hospital of Xinxiang Medical University from October 2015 to June 2018 and normal renal tissues of 21 children (control group 1) were collected, and the expressions of TLR4 in the renal tissue was detected by using immunohistochemical method.The expression of TLR4 in different renal pathological types and clinical types of INS was compared, and the correlation of TLR4 with 24-hour urinary protein and serum albumin was analyzed.The expression levels of TLR4 in peripheral blood of children with INS before and after treatment (active stage and remission stage) and 23 healthy children (control group 2) were detected by enzyme linked immunosorbent assay(ELISA). The serum expression levels of TLR4 in different renal pathological types and clinical types of INS were compared, and the correlation of TLR4 with 24-hour urinary protein and serum albumin was analyzed; The correlation between TLR4 expression in renal tubules and in the serum of children with INS was also analyzed. \u0000 \u0000 \u0000Results \u0000(1)Compared with the expression of TLR4 in normal renal tissues[(0.93±0.26)%], the expression of TLR4 in glomeruli and interstitium of all pathological types of INS [mesangial proliferative glomerulonephritis (MsPGN): (0.93 ± 0.21)%, focal segmental glomerulosclerosis (FSGS): (1.02±0.25)%, membranous glomerulonephritis(MN): (1.03±0.09)%, minimal change disease(MCD): (1.02±0.27)%]was not significantly different (F=0.741, P=0.562), but the expression of TLR4 in renal tubules[MCD: (82.94±4.62)%, MN: (63.54±1.98)%, MsPGN(42.32±2.97)%, FSGS: (22.60±2.07)%] was significantly increased (F=1 929.842, P<0.01), Especially, the expression of TLR4 in renal tubules of MCD type INS was significantly higher than that of MN, MsPG N and FSGS [MCD: (82.94±4.62)%, MN: (63.54±1.98)%, MsPGN: (42.32±2.97)%, FSGS: (22.60±2.07)%], and the differences were statistically significant(all P<0.01). TLR4 expression in renal tubules was the highest in steroid-sensitive nephrotic syndrome (SSNS) type and the lowest in INS patients with steroid-resistant nephrotic syndrome (SRNS) type, and the differences were statistically significant(F=220.951, P<0.01). (2)The expression of serum TLR4 in INS children at the active stage [MsPNG: (143.36±12.99) ng/L, FSGS(75.94±7.29) ng/L, MN(210.22±14.66) ng/L, MCD(283.93±21.58) ng/L]was significantly higher than that in INS children at remission stage [MsPNG: (29.51±4.93) ng/L, FSGS(15.66±3.78) ng/L, MN(45.40±5.73) ng/L, MCD(62.29±7.90) ng/L]and control group 2[(0.69 ± 0.33) ng/L], and the differences were statistically significant(all P<0.01); the expression of serum TLR4 in INS children at remission stage was significantly higher than that in the control group 2 (F=286.287, P<0.01). TLR4 had t","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"355-359"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44835332","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.CN101070-20190217-00105
Kaiyuan Wu, Bin Li, Y. Hua, Taibing Fan
Objective To explore the risk factors of puncture- or catheter-related lower extremity venous thrombosis after surgery for congenital heart disease(CHD). Methods A retrospective analysis was performed on 683 children with venipuncture or venous catheterization in the lower extremities who underwent surgery for CHD in Children′s Heart Center Intensive Care Unit, Henan Provincial People′s Hospital from January 2017 to December 2018, and there were 55 children suspected thrombosis, among whom, 26 cases of thrombosis confirmed by ultrasound were included in the thrombosis group, and 29 cases without thrombosis seen by ultrasound were assigned to the control group.A comparative analysis was carried out to see whether there were statistical differences in the possible risk factors between the 2 groups, and the risk factors of puncture- or catheter-related lower extremity venous thrombosis after operation of CHD. Results The incidence of puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD was 3.81% (26/683 cases). The differences between the thrombosis group and the control group in age (62 d vs.92 d), weight [(3.92±0.66) kg vs.(4.61±0.86) kg], CHD postoperative critical score (Vasoactive-Ventilation-Renal score, VVR)[(29.58±15.50) scores vs.(22.14±11.72) scores], peak blood lactate within 24 hours after surgery [(3.59±0.66) mmol/L vs.(1.71±1.13) mmol/L], postoperative blood transfusion[76.9%(20/26 cases) vs.34.5%(10/29 cases)], co-infection[53.8%(14/26 cases) vs.24.1%(7/29 cases)], cyanotic congenital heart disease [84.6%(22/26 cases) vs.34.5%(10/29 cases)] and puncture difficulty[69.2%(18/26 cases) vs.17.2%(5/29 cases)] were statistically significant(all P<0.05). Logistic regression analysis showed postoperative VVR score (OR=0.88, 95%CI: 0.77-0.99, P=0.04), blood lactate peak within 24 hours after surgery (OR=6.62, 95%CI: 1.35-32.46, P=0.02), and cyanotic congenital heart disease (OR=0.04, 95%CI: 0.00-0.63, P=0.04) were risk factors for venous thrombosis in the lower extremities. Conclusions High postoperative VVR score, high 24 h blood lactate peak after surgery and cyanotic congenital heart disease are high risk factors for puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD. Key words: Congenital heart disease; Lower extremity vein; Thrombosis; Infant
{"title":"Analysis of risk factors of lower extremity venous thrombosis in pediatric patients after surgery for congenital heart disease","authors":"Kaiyuan Wu, Bin Li, Y. Hua, Taibing Fan","doi":"10.3760/CMA.J.CN101070-20190217-00105","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190217-00105","url":null,"abstract":"Objective \u0000To explore the risk factors of puncture- or catheter-related lower extremity venous thrombosis after surgery for congenital heart disease(CHD). \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed on 683 children with venipuncture or venous catheterization in the lower extremities who underwent surgery for CHD in Children′s Heart Center Intensive Care Unit, Henan Provincial People′s Hospital from January 2017 to December 2018, and there were 55 children suspected thrombosis, among whom, 26 cases of thrombosis confirmed by ultrasound were included in the thrombosis group, and 29 cases without thrombosis seen by ultrasound were assigned to the control group.A comparative analysis was carried out to see whether there were statistical differences in the possible risk factors between the 2 groups, and the risk factors of puncture- or catheter-related lower extremity venous thrombosis after operation of CHD. \u0000 \u0000 \u0000Results \u0000The incidence of puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD was 3.81% (26/683 cases). The differences between the thrombosis group and the control group in age (62 d vs.92 d), weight [(3.92±0.66) kg vs.(4.61±0.86) kg], CHD postoperative critical score (Vasoactive-Ventilation-Renal score, VVR)[(29.58±15.50) scores vs.(22.14±11.72) scores], peak blood lactate within 24 hours after surgery [(3.59±0.66) mmol/L vs.(1.71±1.13) mmol/L], postoperative blood transfusion[76.9%(20/26 cases) vs.34.5%(10/29 cases)], co-infection[53.8%(14/26 cases) vs.24.1%(7/29 cases)], cyanotic congenital heart disease [84.6%(22/26 cases) vs.34.5%(10/29 cases)] and puncture difficulty[69.2%(18/26 cases) vs.17.2%(5/29 cases)] were statistically significant(all P<0.05). Logistic regression analysis showed postoperative VVR score (OR=0.88, 95%CI: 0.77-0.99, P=0.04), blood lactate peak within 24 hours after surgery (OR=6.62, 95%CI: 1.35-32.46, P=0.02), and cyanotic congenital heart disease (OR=0.04, 95%CI: 0.00-0.63, P=0.04) were risk factors for venous thrombosis in the lower extremities. \u0000 \u0000 \u0000Conclusions \u0000High postoperative VVR score, high 24 h blood lactate peak after surgery and cyanotic congenital heart disease are high risk factors for puncture- or catheter-related lower extremity venous thrombosis after surgery for CHD. \u0000 \u0000 \u0000Key words: \u0000Congenital heart disease; Lower extremity vein; Thrombosis; Infant","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"375-378"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46999408","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.CN101070-20190607-00506
Huimin Hu, Weiling Zhang, D. Huang, Yizhuo Wang, Yi Zhang, Y. Yi, Jing Li, Yan Zhou
Objective To investigate the clinical features, diagnosis, treatment and prognosis of advanced clear cell sarcoma of kidney(CCSK) in children. Methods The clinical data of 10 children with advanced CCSK hospitalized in Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University from January 2014 to December 2017 were collected, and their clinical features, diagnosis, treatment and prognosis were analyzed retrospectively. Results (1) Clinical features of CCSK: ten cases of CCSK included 6 boys and 4 girls, with the median onset age of 32 months; 7 cases were left CCSK and 3 cases were right CCSK.There were 9 cases of stage Ⅲ and 1 case of stage Ⅳ at the time of initial diagnosis, when 4 cases were misdiagnosed as other renal tumors at the time of initial diagnosis(40%, 4/10 cases). Five patients with stage Ⅲ CCSK had recurrence and metastasis during treatment and follow-up, and the main distant metastasis sites were lung, bone, liver and brain.(2) Treatment and prognosis of CCSK: seven cases received surgery combined with radiotherapy and chemotherapy, and 3 cases whose parents gave up treatment adopted non-standardized treatment.The median follow-up time was 33.5 months.Seven patients survived and 3 cases died.The 3-year overall survival rate of all 10 patients was 65.6%.The 3-year overall survival rate of stage Ⅲ was 74.1%, and that of stage Ⅳ was 0.The prognosis of stage Ⅲ was significantly better than that of stage Ⅳ(χ2=9, P=0.003). Among the 5 recurrent cases, only 1 case achieved completely remission, 2 cases achieved partially remission, 1 case suffered from disease progression and 1 case died.The 3 cases without recurrence were given standardized treatment of surgery, che-motherapy and radiotherapy, and all were completely remitted. Conclusions CCSK is easy to be misdiagnosed, and the risk of recurrence and distant metastasis is high in stage Ⅲ patients during treatment and follow-up.Stage Ⅲ patients who actively receive standard treatment including surgery, chemotherapy and radiotherapy have good prognosis, while the mortality of patients with relapse and distant metastasis is high. Key words: Clear cell sarcoma of kidney; Child; Diagnosis; Prognosis
{"title":"Diagnosis, treatment and prognosis of 10 children with advanced clear cell sarcoma of kidney","authors":"Huimin Hu, Weiling Zhang, D. Huang, Yizhuo Wang, Yi Zhang, Y. Yi, Jing Li, Yan Zhou","doi":"10.3760/CMA.J.CN101070-20190607-00506","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190607-00506","url":null,"abstract":"Objective \u0000To investigate the clinical features, diagnosis, treatment and prognosis of advanced clear cell sarcoma of kidney(CCSK) in children. \u0000 \u0000 \u0000Methods \u0000The clinical data of 10 children with advanced CCSK hospitalized in Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University from January 2014 to December 2017 were collected, and their clinical features, diagnosis, treatment and prognosis were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000(1) Clinical features of CCSK: ten cases of CCSK included 6 boys and 4 girls, with the median onset age of 32 months; 7 cases were left CCSK and 3 cases were right CCSK.There were 9 cases of stage Ⅲ and 1 case of stage Ⅳ at the time of initial diagnosis, when 4 cases were misdiagnosed as other renal tumors at the time of initial diagnosis(40%, 4/10 cases). Five patients with stage Ⅲ CCSK had recurrence and metastasis during treatment and follow-up, and the main distant metastasis sites were lung, bone, liver and brain.(2) Treatment and prognosis of CCSK: seven cases received surgery combined with radiotherapy and chemotherapy, and 3 cases whose parents gave up treatment adopted non-standardized treatment.The median follow-up time was 33.5 months.Seven patients survived and 3 cases died.The 3-year overall survival rate of all 10 patients was 65.6%.The 3-year overall survival rate of stage Ⅲ was 74.1%, and that of stage Ⅳ was 0.The prognosis of stage Ⅲ was significantly better than that of stage Ⅳ(χ2=9, P=0.003). Among the 5 recurrent cases, only 1 case achieved completely remission, 2 cases achieved partially remission, 1 case suffered from disease progression and 1 case died.The 3 cases without recurrence were given standardized treatment of surgery, che-motherapy and radiotherapy, and all were completely remitted. \u0000 \u0000 \u0000Conclusions \u0000CCSK is easy to be misdiagnosed, and the risk of recurrence and distant metastasis is high in stage Ⅲ patients during treatment and follow-up.Stage Ⅲ patients who actively receive standard treatment including surgery, chemotherapy and radiotherapy have good prognosis, while the mortality of patients with relapse and distant metastasis is high. \u0000 \u0000 \u0000Key words: \u0000Clear cell sarcoma of kidney; Child; Diagnosis; Prognosis","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"370-374"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44681780","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.CN101070-20200224-00236
Q. Shen
Congenital anomalies of the kidney and urinary tract (CAKUT) is a type of diseases caused by the defects in the embryonic development of the kidney and urinary tract, and characterized by congenital anatomic abnormalities of urinary system, having various phenotypes.CAKUT is the main cause of end-stage renal disease in children, and many studies have proved that its pathogenesis is related to multiple factors like gene mutation, gene copy number variation and environment although the pathogenesis is not fully clear at present.The early diagnosis and prognosis prediction of CAKUT can be conducted by using appropriate imaging methods and some new biomarkers.In addition, prenatal screening and intervention of CAKUT are of great significance to prevent the occurrence and delay the progress of CAKUT.The etiology, diagnosis and treatment of CAKUT in children were reviewed in this study to allow medical workers to have a fuller understanding of this disease. Key words: Congenital anomalies of the kidney and urinary tract; Etiology; Diagnosis; Intervention; Child
{"title":"Progress in diagnosis and treatment of congenital anomalies of the kidney and urinary tract","authors":"Q. Shen","doi":"10.3760/CMA.J.CN101070-20200224-00236","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200224-00236","url":null,"abstract":"Congenital anomalies of the kidney and urinary tract (CAKUT) is a type of diseases caused by the defects in the embryonic development of the kidney and urinary tract, and characterized by congenital anatomic abnormalities of urinary system, having various phenotypes.CAKUT is the main cause of end-stage renal disease in children, and many studies have proved that its pathogenesis is related to multiple factors like gene mutation, gene copy number variation and environment although the pathogenesis is not fully clear at present.The early diagnosis and prognosis prediction of CAKUT can be conducted by using appropriate imaging methods and some new biomarkers.In addition, prenatal screening and intervention of CAKUT are of great significance to prevent the occurrence and delay the progress of CAKUT.The etiology, diagnosis and treatment of CAKUT in children were reviewed in this study to allow medical workers to have a fuller understanding of this disease. \u0000 \u0000Key words: \u0000Congenital anomalies of the kidney and urinary tract; Etiology; Diagnosis; Intervention; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"321-326"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44819868","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 explore the effects of human recombinant erythropoietin (rhEPO) on inflammation of hyperoxic lung injury in neonatal rats. Methods Seventy-two neonatal rats were randomly divided into 4 groups: control group, BPD group, hyperoxia + low-dose recombinant erythropoietin [EPO(L)]group, and hyperoxia + high-dose recombinant erythropoietin [EPO(H)]group.The neonatal rats in BPD group, hyperoxia + EPO(L)group and hyperoxia + EPO(H)group were exposed to 850 mL/L oxygen.Then the neonatal rats in hyperoxia + EPO(L)group and hyperoxia + EPO(H)group were given 800 IU/kg and 2 000 IU/kg rhEPO by subcutaneous injection respectively at 1 d, 3 d and 7 d, while the control group and BPD group were given the same amount of 9 g/L saline water.Initially, the body weight of each group was recorded at 3 d, 7 d and 14 d. The morphological structure changes of lung tissues were observed by HE staining under light microscope, and the radial alveolar count(RAC) in lung tissues were detected.The expression of nuclear factor kappa B(NF-κB) was detected by immunofluorescence staining; Western blot was applied to determine the protein expression of phosphorylated NF-κB(pNF-κB), inhibitor protein(IκB) and Caspase-3 in lung tissues; and the expression of interleukin-1β(IL-1β) in bronchoalveolar lavage fluid was determined using enzyme linked immunosorbent assay (ELISA). Results (1) On the 14th day, the body weight of neonatal rats in the BPD group was lower than that in the control group [(18.97±3.21) g vs.(27.97±2.30) g], and the difference was statistically significant(P<0.01); however, the body weights of neonatal rats in the hyperoxia+ EPO(L)group and hyperoxia+ EPO(H)group[(24.16±2.15) g, (26.04±1.97) g] was much heavier than that in the BPD group, and the differences was statistically significant(all P<0.05). (2) The morphological structure of lung tissues which was observed by HE staining showed that in the BPD group, there were a few inflammatory cells infiltration in alveolar septum on the 3rd day, the inflammatory response was more evident on the 7th day, when exudation could be seen in the alveolar cavity; and on the 14th day, the number of pulmonary alveoli decreased, pulmonary bulla formed, and septa were thickened.Besides, it was also observed that compared with control group, RAC was significantly decreased in BPD group on the 14th day(5.50±1.29 vs.14.33±2.80), and the difference was statistically significant(P<0.01). Pathological changes were ameliorated and the infiltration of inflammatory reaction cells was reduced in the hyperoxia+ EPO(L)group and hyperoxia + EPO(H)group.RAC was remarkably higher in the hyperoxia+ EPO(L)group and hyperoxia+ EPO(H)group than that in the BPD group on the 14th day, and the differences were statistically significant (all P<0.05). (3)Immunofluorescence results showed that: the number of NF-κB p65 positive cells increased significantly and fluorescence intensity increased in the BPD group, while EPO could
目的探讨重组人红细胞生成素（rhEPO）对新生大鼠高氧肺损伤炎症反应的影响。方法72只新生大鼠随机分为4组：对照组、BPD组、高氧+低剂量重组红细胞生成素[EPO（L）]组和高氧+高剂量重组红血球生成素[EEPO（H）]组。高氧+EPO（L）组和高氧+EPO（H）组新生大鼠分别于1d、3d和7d皮下注射rhEPO 800IU/kg和2000IU/kg，对照组和BPD组给予等量的9g/L盐水。最初，在第3天、第7天和第14天记录各组的体重。在光学显微镜下通过HE染色观察肺组织的形态结构变化，并检测肺组织中的径向肺泡计数（RAC）。免疫荧光染色检测核因子κB（NF-κB）的表达；Western blot检测肺组织中磷酸化NF-κB（pNF-κB）、抑制蛋白（IκB）和半胱氨酸蛋白酶-3的蛋白表达；应用酶联免疫吸附法（ELISA）检测支气管肺泡灌洗液中白细胞介素1β（IL-1β）的表达。结果（1）第14天，BPD组新生大鼠体重低于对照组[（18.97±3.21）gvs.（27.97±2.30）g]，差异有统计学意义（P<0.01）；高氧+EPO（L）组和高氧+EPO（H）组的新生大鼠体重[（24.16±2.15）g，（26.04±1.97）g]明显重于BPD组，差异有统计学意义（均P<0.05），肺泡隔第3天有少量炎性细胞浸润，第7天炎症反应更为明显，肺泡腔内可见渗出；第14天肺泡数量减少，肺大泡形成，间隔增厚。此外，与对照组相比，BPD组在第14天的RAC显著降低（5.50±1.29 vs.14.33±2.80），高氧+EPO（L）组和高氧+EPO（H）组病理改变明显改善，炎性反应细胞浸润减少，14天AC明显高于BPD组，（3）免疫荧光结果显示：BPD组NF-κB p65阳性细胞数显著增加，荧光强度增加，而EPO可显著减少NF-κBp65阳性的细胞数，降低荧光强度。（4） Western blot结果显示，与对照组相比，pNF-κB p65和Cleaved Caspase-3的表达显著增加，差异有统计学意义（均P<0.05）；NF-κBp65和Cleaved Caspase-3的表达在高氧+EPO（L）组和高氧+EPO（H）组明显低于BPD组，（5）ELISA结果显示，BPD组IL-1β的表达明显高于对照组，差异有统计学意义（P<0.05）；高氧+EPO（L）组和高氧+EPO（H）组IL-1β表达明显低于BPD组，结论EPO可通过抑制细胞对BPD的炎症反应，减少高氧诱导的肺组织凋亡，保护新生大鼠免受高氧肺损伤。关键词：支气管肺发育不良；人重组红细胞生成素；高氧血症；炎症反应；核转录因子κB
{"title":"Effect of human recombinant erythropoietin on inflammation of hyperoxic lung injury in neonatal rats","authors":"Qilin Huang, Jing-jing Ren, Yanmei Xie, Ze-quan Ji, Haiyan Liu, Cui-wen Huang","doi":"10.3760/CMA.J.CN101070-20190202-00084","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190202-00084","url":null,"abstract":"Objective \u0000To explore the effects of human recombinant erythropoietin (rhEPO) on inflammation of hyperoxic lung injury in neonatal rats. \u0000 \u0000 \u0000Methods \u0000Seventy-two neonatal rats were randomly divided into 4 groups: control group, BPD group, hyperoxia + low-dose recombinant erythropoietin [EPO(L)]group, and hyperoxia + high-dose recombinant erythropoietin [EPO(H)]group.The neonatal rats in BPD group, hyperoxia + EPO(L)group and hyperoxia + EPO(H)group were exposed to 850 mL/L oxygen.Then the neonatal rats in hyperoxia + EPO(L)group and hyperoxia + EPO(H)group were given 800 IU/kg and 2 000 IU/kg rhEPO by subcutaneous injection respectively at 1 d, 3 d and 7 d, while the control group and BPD group were given the same amount of 9 g/L saline water.Initially, the body weight of each group was recorded at 3 d, 7 d and 14 d. The morphological structure changes of lung tissues were observed by HE staining under light microscope, and the radial alveolar count(RAC) in lung tissues were detected.The expression of nuclear factor kappa B(NF-κB) was detected by immunofluorescence staining; Western blot was applied to determine the protein expression of phosphorylated NF-κB(pNF-κB), inhibitor protein(IκB) and Caspase-3 in lung tissues; and the expression of interleukin-1β(IL-1β) in bronchoalveolar lavage fluid was determined using enzyme linked immunosorbent assay (ELISA). \u0000 \u0000 \u0000Results \u0000(1) On the 14th day, the body weight of neonatal rats in the BPD group was lower than that in the control group [(18.97±3.21) g vs.(27.97±2.30) g], and the difference was statistically significant(P<0.01); however, the body weights of neonatal rats in the hyperoxia+ EPO(L)group and hyperoxia+ EPO(H)group[(24.16±2.15) g, (26.04±1.97) g] was much heavier than that in the BPD group, and the differences was statistically significant(all P<0.05). (2) The morphological structure of lung tissues which was observed by HE staining showed that in the BPD group, there were a few inflammatory cells infiltration in alveolar septum on the 3rd day, the inflammatory response was more evident on the 7th day, when exudation could be seen in the alveolar cavity; and on the 14th day, the number of pulmonary alveoli decreased, pulmonary bulla formed, and septa were thickened.Besides, it was also observed that compared with control group, RAC was significantly decreased in BPD group on the 14th day(5.50±1.29 vs.14.33±2.80), and the difference was statistically significant(P<0.01). Pathological changes were ameliorated and the infiltration of inflammatory reaction cells was reduced in the hyperoxia+ EPO(L)group and hyperoxia + EPO(H)group.RAC was remarkably higher in the hyperoxia+ EPO(L)group and hyperoxia+ EPO(H)group than that in the BPD group on the 14th day, and the differences were statistically significant (all P<0.05). (3)Immunofluorescence results showed that: the number of NF-κB p65 positive cells increased significantly and fluorescence intensity increased in the BPD group, while EPO could ","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"383-388"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49377327","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.CN101070-20190219-00116
Xi-Yun Ruan, Xuemei Tang
High mobility group box 1 is a kind of non-histone protein which expressed in the nucleus of eukaryotic cells.Which can promote inflammatory reaction and participate in the positive feedback loop of the production of cytokines after translocated outside the cells.As a result, it′s closely related to the pathogenesis of various autoimmune and inflammatory diseases.Recent studies have revealed that high mobility group box 1 may serve as a serum marker of Henoch-Schonlein purpura nephritis and lupus nephritis, and a predicator of the prognosis of juvenile idiopathic arthritis and intravenous immunoglobulin resistance in Kawasaki disease. Key words: High mobility group box 1; Rheumatic disease; Child
{"title":"Progress in research on the effects of high mobility group box 1 in pediatric rheumatic diseases","authors":"Xi-Yun Ruan, Xuemei Tang","doi":"10.3760/CMA.J.CN101070-20190219-00116","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190219-00116","url":null,"abstract":"High mobility group box 1 is a kind of non-histone protein which expressed in the nucleus of eukaryotic cells.Which can promote inflammatory reaction and participate in the positive feedback loop of the production of cytokines after translocated outside the cells.As a result, it′s closely related to the pathogenesis of various autoimmune and inflammatory diseases.Recent studies have revealed that high mobility group box 1 may serve as a serum marker of Henoch-Schonlein purpura nephritis and lupus nephritis, and a predicator of the prognosis of juvenile idiopathic arthritis and intravenous immunoglobulin resistance in Kawasaki disease. \u0000 \u0000Key words: \u0000High mobility group box 1; Rheumatic disease; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"398-400"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47065234","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 investigate the safety and effectiveness of extracorporeal radiation inactivation and replantation of tumor bone in the treatment of malignant/invasive bone tumors in children's limbs. Method: From June to December 2016, Zhengzhou University Affiliated Cancer Hospital applied intraoperative external radiation inactivation and replantation of tumor bone segments to treat a total of 8 children with limb bone tumors, including 4 males and 4 females; The average age is 12.75 years (11-14 years old). There were 6 cases of osteosarcoma, 1 case of Ewing's sarcoma, and 1 case of recurrent Langerhans histiocytosis. There were 4 tumors located in the middle and lower femur, 2 in the middle and upper tibia, 1 in the middle tibia, and 1 in the middle and upper humerus. The average length of bone resection for the tumor segment is 23 cm (16-35 cm). After the tumor segment is detached, a single dose of isocenter penetrating radiation of 60 Gy is administered using a linear electron accelerator X-ray. After inactivation, it is replanted and reconstructed using steel plate internal fixation. All cases received effective follow-up, with an average follow-up time of 20.4 months (18-24 months). As of the last follow-up, there were no local relapses. One case died of lung metastasis 6 months after surgery, and one case was found to have lung metastasis 12 months after surgery. Currently, the tumor is still present and the remaining 6 cases have not been found to have metastasis. Among the surviving cases, except for one case where the inactivated bone had not fully healed at the last follow-up, the remaining 6 cases all achieved healing, with an average healing time of 8.7 months (6-11 months). The American Skeletal Muscle Tumor Association Functional Score (MSTS) averaged 24.3 points (21-29 points). Complications occurred in 3 cases, including 1 case of internal fixation fracture and 2 cases of knee joint ankylosis. After reoperation, satisfactory results were achieved. No infection, replanted bone fracture, resorption, bone non union, etc. occurred. Conclusion: Extracorporeal radiation inactivation and replantation of tumor segment bone during surgery is an effective method for bone defect reconstruction after limb bone tumor resection in children.
{"title":"Recycling of extracorporeal irradiated autograft for treatment of limb bone tumor in children","authors":"Xin Wang, Weitao Yao, Zhiyong Liu, Z. Tian, Po Li, Qiqing Cai","doi":"10.3760/CMA.J.CN101070-20200316-00419","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20200316-00419","url":null,"abstract":"目的 \u0000探讨瘤段骨体外射线灭活回植术在儿童四肢恶性/侵袭性骨肿瘤治疗中应用的安全性及有效性。 \u0000 \u0000 \u0000方法 \u00002016年6月至12月郑州大学附属肿瘤医院应用术中瘤段骨体外射线灭活回植术治疗儿童四肢骨肿瘤共8例，其中男4例，女4例；平均年龄12.75岁(11～14岁)。骨肉瘤6例，尤文氏肉瘤1例，反复复发的朗格汉斯组织细胞增生症1例。肿瘤位于股骨中下段4例，胫骨中上段2例，胫骨中段1例，肱骨中上段1例。瘤段骨切除平均长度23 cm(16～35 cm)，瘤段离体后应用直线电子加速器-X线给予一次性等中心对穿照射60 Gy，灭活后回植，应用钢板内固定重建。 \u0000 \u0000 \u0000结果 \u0000所有病例均获得有效随访，平均随访时间20.4个月(18～24个月)，截止末次随访，均无局部复发，1例术后6个月死于肺转移，1例术后12个月发现肺转移，目前带瘤存活，其余6例未发现转移。存活病例中除1例末次随访时灭活骨尚未完全愈合，其余6例均获得愈合，平均愈合时间8.7个月(6～11个月)，美国骨骼肌肉肿瘤协会功能评分(MSTS)平均24.3分(21～29分)。出现并发症3例，其中内固定断裂1例，膝关节强直2例，经再次手术后均获得满意效果。未发生感染、回植骨骨折、吸收、骨不愈合等。 \u0000 \u0000 \u0000结论 \u0000术中瘤段骨体外射线灭活回植是儿童四肢骨肿瘤切除后骨缺损重建的有效方式。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"389-391"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48488403","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 evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children. Method s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated. Result s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant(χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed (χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P 0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P 0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (
{"title":"A prospective multicenter randomized controlled study on the efficacy and safety of pharyngeal spraying recombinant human interferon alpha 2b in the treatment of children with herpangina","authors":"Jiahua Pan, Zeyu Yang, Jiayan Pan, X. Wen, M. Han, Lirong Yang, Xian′gao Cheng, Yanling Li, Haiqing Lin, Chuanjing Li, Chengming Yan","doi":"10.3760/CMA.J.CN101070-20190520-00429","DOIUrl":"https://doi.org/10.3760/CMA.J.CN101070-20190520-00429","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children. \u0000 \u0000 \u0000Method \u0000s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated. \u0000 \u0000 \u0000Result \u0000s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant(χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed (χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P 0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P 0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"279-284"},"PeriodicalIF":0.0,"publicationDate":"2020-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45732385","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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