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Objective:To explore the clinical characteristics and etiology of children with alimentary tract hemorrhage so as to optimize the diagnosis and treatment.Methods:The clinical data of 2 054 children with alimentary tract hemorrhage in Kunming Children′s Hospital from January 2014 to December 2018 were retrospectively analyzed.Results:Among 2 054 children with alimentary tract hemorrhage, males was in 1 274 cases, females was in 780 cases, and the ratio of males to females was 1.6∶1; <3.0 years old was in 647 cases (31.5%), 3.0 to 5.9 years old was in 488 cases (23.8%), 6.0 to 8.9 years old was in 413 cases (20.1%), 9.0 to 11.9 years old was in 281 cases (13.7%), and ≥12 years old was in 225 cases (11.0%); upper alimentary tract hemorrhage was in 991 cases, lower alimentary tract hemorrhage was in 1063 cases. The top three causes of children with upper alimentary tract hemorrhage were acute or chronic gastritis/ gastric ulcer, anaphylactoid purpura and systemic serious infection; the top three causes of children with lower alimentary tract hemorrhage were intestinal polyps, anaphylactoid purpura and food protein allergic colitis. A rare causes of alimentary tract hemorrhage had Peutz-Jeghers syndrome, cavernous transformation of portal vein, Bartter syndrome, systemic lupus erythematosus, Budd-Chiari syndrome, annular pancreas, Reye syndrome, Klippel-Trenaunay syndrome, Evans syndrome and perianal angiectasia and so on.Conclusions:Alimentary tract hemorrhage is a common disease in pediatrics. With the increase of age, the proportion of children with alimentary tract hemorrhage decreased. The main causes of upper and lower alimentary tract hemorrhage are different in different age stages. In addition to paying attention to common causes, the rare causes of alimentary tract hemorrhage should be vigilant and recognized.
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Objective To investigate the prevalence and trend of Helicobacter pylori (HP) infection in children with gastrointestinal symptoms in Kunming area, and to provide basis for prevention and cure. Methods All of 12 932 cases with gastrointestinal symptoms were adopted by retrospective analysis method from January 2013 to December 2016, and HP infection was detected by 13C-urea breath test (13C-UBT). The epidemioloqical characteristics of children with HP infection in including prevalence trend and gender and age HP were statistically analyzed. Results The rates of HP from January 2013 to December 2016 were respectively 17.85%, 18.26%, 20.41% and 32.93%.The rate of HP positive was 24.08%(3 114/12 932), which was 24.82%(1 706/6 874) in boys and 23.24%(1 408/6 058) in girls. The rate of HP infection was significantly higher in boys than that in girls, and there was statistical differences (P＜0.05). The rate of HP infection showed a gradual upward trend with age. There was statistical differences in gender between age 11 and 14[(29.03% (349/1 202) vs. 22.62% (190/840)] (P＜0.05). Conclusions HP infection rate is high in the children with gastrointestinal symptoms in Kunming, and the rate of HP infection in children is related with gender .The rate of HP infection is significantly higher in boys than that in girls, and the positive rate is directly proportional.
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Objective To investigate the change of plasma vitamin D, A and E levels in infant with infantile hepatitis syndrome (IHS) and to provide reliable basis for clinical treatment. Methods Seventy-three infant with IHS (IHS group) from January 2015 to May 2016 and 82 cases of physical examination infant (control group) were enrolled in this study.The levels of plasma vitamin D, A and E were tested and compared between two groups. Results The levels of vitamin D, A and E in IHS group were significantly lower than those in control group:(37.871 ± 20.111) nmol/L vs. (97.708 ± 28.827) nmol/L, (1.082 ± 0.657)μmol/L vs. (1.810 ± 0.517)μmol/L, (21.252 ± 7.596)μmol/L vs. (26.647 ± 6.495)μmol/L, P<0.01 or <0.05. The nutritional status of vitamin D, A and E in two groups had significant differences (P<0.01). Conclusions There have obvious deficiency in fat-soluble vitamin D, A and E in infant with HIS , and vitamin D deficiency is the most obvious. The levels of vitamin D, A and E are the dynamic monitoring indicators of treatment, nutritional status evaluation and long-term complications development.
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Objective To explore the variation of serum D-lactic acid levels and the correlation between different intestinal viral and intestinal barrier function in children with hand, foot and mouth disease (HFMD). Methods The stools of 129 children with HFMD were collected and were detected by reverse transcription polymerase chain reaction. The children were divided into four groups according the fecal pathogens detection:enterovirus 71 (EV71) positive group, Coxsackie virus A16 (CoxA16) positive group, other intestinal virus positive group (EA positive group), and no intestinal virus group (EA negative group). Two ml venous blood and separation serum was collected in each group of children, and the level of serum D-lactic acid was detected further. Results There were 20 cases of other Coxsackie virus, and they were not grouped. Fifty-seven patients were in EV71 positive group, 26 patients were in CoxA16 positive group, 10 patients were in EA positive group, and 16 patients were in EA negative group. The level of D- lactic acid in four groups was 26.28 (17.02- 58.01), 14.43 (8.93- 20.66), 10.66 (6.64- 18.51) and 14.07 (11.83- 27.46) mg/L. The results of rank test showed the level of D-lactic in EV71 positive group was significantly higher than that in EA positive group (Z=-2.432, P=0.015) and EA negative group (Z=-3.092, P=0.002). Conclusions D-lactic acid level increases significantly in EV71 infection children and suggests that the illness is more serious and the intestinal barrier is damaged. Doctors should pay more attention to monitor and protect gastrointestinal function of children with HFMD.
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0.45, as the normal parameters to assess left ventricular distolic filling in subjects above 40 year old.