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Objective@#To evaluate the effectiveness of eradication therapy based on Helicobacter pylori (Hp) susceptibility and CYP2C19 genotype in children with refractory Hp infection.@*Methods@#In this prospective observational cohort study, 156 children with Hp refractory to amoxicillin+clarithromycin+omeprazole triple regimen in Baoding Children′s Hospital from December 2017 to May 2018 were enrolled. Ninety-two of them underwent Hp culture and CYP2C19 detection. Seventy-five cases with positive Hp culture were defined as culture successful group and were treated according to Hp susceptibility and CYP2C19 genotype. Seventeen cases with negative Hp culture were defined as culture failed group and were treated only based on the results of CYP2C19 genotype. Sixty-four children who did not have Hp culture and CYP2C19 gene testing were defined as the empirical eradication therapy group and were treated with quadruple regimen (amoxicillin+metronidazole+omeprazole+bismuth). Bacterial resistance, CYP2C19 polymorphism and therapeutic effectiveness between the three groups were compared using chi-square test.@*Results@#Among the 75 positive Hp culture results, 72 (96%) were resistant to clarithromycin, 3 (4%) were resistant to metronidazole, 5 (7%) were resistant to levofloxacin, 5 (7%) were resistant to rifampicin, 1 (1%) was resistant to tetracycline, and none was resistant to amoxicillin and furazolidone. The CYP2C19 polymorphism in 92 patients showed that 43 (47%) were extensive metabolizer (EM), 9 (10%) were poor metabolizer (PM), and 40 (43%) were intermediate metabolizer (IM). In terms of the effectiveness, eradication rate in the culture successful group,culture failed group and empirical eradication therapy group were 99% (74/75), 88% (15/17) and 72% (46/64), respectively (χ2=21.325, P<0.05). The eradication rate in the culture successful group was significantly higher than that in empirical eradication therapy group (χ2=21.005, P<0.05), while there was no difference between empirical eradication therapy group and culture failed group (χ2=1.154, P=0.283).@*Conclusion@#Eradication regimen based on bacterial susceptibility and CYP2C19 genotype should be considered in children with refractory Hp infection.
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Objective To study the significance of level changes of serum hydrogen sulfide(H2 S) and interleukin-6(IL-6)in children with hand,foot and mouth disease(HFMD).Methods Nity-two cases with HFMD were enrolled and divided into severe HFMD group(48 cases)and common HFMD group(44 cases).Forty-six healthy children were enrolled as healthy control group.The serum H2 S and IL-6 were detected.Results Acute phase:compared to the healthy control group[H2 S(55.76 ±7.80)μmol /L,IL-6 (61.31 ±13.43)ng /L],the level of serum H2 S significantly reduced and the level of IL-6 significantly increased in severe HFMD group[H2 S(21.72 ±7.52)μmol /L;IL-6(131.33 ±17.82)ng /L]and common HFMD group[H2 S(31.86 ±8.41 )μmol /L;IL-6(95.48 ±15.07)ng /L](P ﹤0.01 ),and there was signifi-cantly difference between the severe HFMD group and common HFMD group(P ﹤0.01 ).Recovery phase:compared to the healthy control group,the serum H2 S level[(34.54 ±13.21 )μmol /L]was lower and IL-6 [(92.73 ±15.25)ng /L]was higher in severe HFMD group(P ﹤0.01 ).The serum H2 S level was negatively correlated with IL-6 in severe HFMD group and common HFMD group(r =-0.31 ,P ﹤0.01 ;r =-0.45, P ﹤0.01 ).Conclusion The serum H2 S and IL-6 participate in the pathological process of HFMD,and the level change can be used as one of indicators of early diagnosis.
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ObjectiveTo analyze the potential risk factors for relapse and development of epilepsy in patients with benign in-fantile convulsions associated with mild gastroenteritis (BICE).MethodsA total of 264 cases of BICE were recruited. Accord-ing to the frequency of convulsions, the patients were divided into single group (n=134, convulsion once), and multiple group (n=130, convulsions≥2 times). According to convulsion duration, the patients were divided into short-term group (n=186, con-vulsions duration <5 minutes) , and long-term group (n=78, convulsion duration≥5 minutes). The clinical data obtained during hospitalization and follow-up were analyzed.ResultsIn multiple group, 9.23% were relapsed and 6.15% developed epilepsy. In single group, 2.99% were relapsed and 0.75% developed epilepsy. There were signiifcantly different in the rate of relapses and development of epilepsy between two groups (P<0.05). In the long-term group, 12.82% were relapsed and 8.97% developed epi-lepsy. In the short-term group, 3.23% were relapsed and 1.08% developed epilepsy. There were signiifcantly different in the rate of relapses and development of epilepsy between the two groups (P<0.05).ConclusionsThere are the risks of relapse and development of epilepsy in BICE patients. Convulsions≥ 2 times and≥5 minutes may be the risk factors of relapse and devel-opment of epilepsy.
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BACKGROUND: There are several ways for treating the trigeminal neuralgia, such as medication, block therapy and surgery, etc. But few reports throughout the world described stereotactic radiotherapy(SRT) for it, which is efficient, non-invasive and painless.OBJECTIVE: To investigate the improvement of SRT for trigeminal neuralgia.DESIGN: Case analysis based on patients.SETTING: X-knife Treatment Center, First Affiliated Hospital, Henan University of Science and Technology.PARTICIPANTS: Totally 30 patients with trigeminal neuralgia were selected from X-knife Treatment Center, the First Affiliated Hospital of Henan Science and Technology University between March 1999 and March 2002. All patients were diagnosed with CT or MRI, and no other diseases were found. Patients without obvious effect from a long-term medicine treatment or surgery were selected as the investigative subjects.METHODS: Thirty patients with trigeminal neuralgia wearing face cover were treated with non-coplanarity fractional stereotactic radiotherapy. The patients received 2 target regions and peripheral does of 60 - 75 Gy. 5 mm collimator and isodose curves referred to ranged from 85% - 90%.MAIN OUTCOME MEASURES: Results of therapeutic assessment and follow up.RESULTS: The follow up period ranged from 1 to 22 months. Among 30patients, 6 patients' symptoms were lightened or eased up over 12-24hours, 20 patients received a marked effect over 1 - 3 months, 4 patients'treatment effects were not obvious. The effect rate reached 87%. A patient occurred numbness in sick face, and a patient showed no obvious effect in the first treatment, but the efficacy became evident in the second treatment.CONCLUSION: It is efficient in the treatment of trigeminal neuralgia with stereotaetic radiotherapy and there is no special side effect.