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Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant( χ2=32.497, P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases( χ2=4.898, P=0.027; χ2=32.169, P<0.001), and the year and age distributions of the accidental death cases also had significant differences( χ2=16.636, P=0.002; χ2=14.727, P=0.002). Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.
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Objective:To explore the protective effect of Shen’an decoction on cisplatin induced renal injury in rats by regulating TLR4/NF-κB signaling pathway. Methods:Sixty SD rats were randomly divided into blank group, model group, positive control group, high dose Shen’an Decoction group, medium dose Shen’an Decoction group and low dose Shen’an Decoction group, with 10 rats in each group. Except the blank group, the other groups were intraperitoneally injected with cisplatin 7.5 mg/kg to prepare the acute kidney injured rat model. After the modeling, the high, medium and low dose groups of Shen’an Decoction were gavaged with 0.698, 1.395 and 2.790 g/ml Shen’an Decoction respectively, and the positive control group was gavaged with benazepril hydrochloride suspension of 5 mg/kg, once a day for 14 days. The kidney histopathological changes of rats in each group were observed by HE staining. The content of BUN, creatinine(CR), Cystatin C (Cys-C), TNF-α, and IL-6 in serum were detected by ELISA. The expression of TLR-4, NF-κB p65, myeloid differentiation factor (MyD88), and tumor necrosis factor receptor related factor 6 (TRAF-6) in renal tissue were detected by Western blot. Results:Compared with the model group, the growth condition of rats in each dose group of Shen’an Decoction was significantly improved ( P<0.05), and the kidney coefficient was significantly decreased ( P<0.05). The serum levels of BUN, Cr, Cys-C, TNF-α, IL-6 of rats in each dose group of Shen’an Decoction were significantly decreased ( P<0.05). The expression of TLR-4 (0.54 ± 0.07, 0.52 ± 0.09, 0.41 ± 0.04 vs. 0.86 ± 0.06), NF-κB (0.74 ± 0.02, 0.72 ± 0.06, 0.67 ± 0.05 vs. 0.93 ± 0.03), MyD88 (0.86 ± 0.02, 0.82 ± 0.03, 0.61 ± 0.02 vs. 1.04 ± 0.03), and TRAF-6 (0.65 ± 0.04, 0.58 ± 0.08, 0.54 ± 0.07 vs. 0.90 ± 0.06) in kidney tissue of rats in each dose group of Shen’an Decoction was significantly decreased ( P<0.05). Conclusion:Shen’an Decoction can protect the renal function of rats by inhibiting TLR4/NF-κB signaling pathway and alleviating the pathological changes of renal injury induced by cisplatin.
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Vasovagal syncope (VVS) is the most common cause of unexplained syncope in children. The etiology of VVS is complex, and its diagnosis is mainly based on clinical manifestations and head-up tilt test (HUT) . It has been pointed out that neuroendocrine system plays an important role in the pathogenesis of syncope. HUT-induced syncope is accompanied by abnormal neurohumoral activation. The changes of plasma concentration of endothelin-1 and nitric oxide secreted by endothelial system before and after VVS syncope in children suggest that endothelial system is involved in the occurrence of VVS in children. This article reviews the research on the involvement of vascular endothelial system in the pathogenesis of VVS in children.
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Objective@#To analyze the distribution of the regulator of G protein signaling 2 (RGS2) gene C1114G polymorphism in children with vasovagal syncope (VVS) and the associated clinical classification groups, and to explore the association between RGS2 C1114G and VVS.@*Methods@#This was a prospective case-control study. A head-up tilt test (HUT) was performed in 300 children visiting Children's Hospital Affiliated to Shanghai Jiaotong University from August 2010 to December 2015 for unexplained syncope. A total of 150 children with positive HUT and a diagnosis of VVS were enrolled and assigned to the VVS group. The VVS group was further divided into 3 subgroups based on characteristics of the heart rate and blood pressure measured during the HUT. A total of 150 children with negative HUT were enrolled and assigned to the HUT-negative group. A total of 150 healthy children were enrolled as the normal control group for genetic polymorphism detection. The clinical characteristics of patients in the VVS group and the HUT-negative group were recorded. Peripheral blood samples of each case were collected. RGS2 C1114G polymorphism was evaluated using high-resolution melting curve and polymerase chain reaction together with gene sequencing. The genotype and allele frequency were analyzed and compared among different groups (VVS, HUT-negative, and normal control) and VVS subgroups. Comparisons among groups were performed using Chi-square test.@*Results@#Patients in the VVS group (48 males and 102 females, aged (10.1±3.2) years) were more frequently female (68.0% vs. 57.3%;χ2=5.090, P=0.024) compared with patients in the HUT-negative group (67 males and 83 females, aged (10.8±2.2) years). No significant difference was found regarding the distribution of the CC genotype, CG genotype and GG genotype among the VVS group (n=98, 65.3%; n=36, 24.0%; n=16, 10.7%), the HUT-negative group (n=112, 74.7%; n=28, 18.7%; n=10, 6.7%) and the normal control group (n=108, 72.0%; n=31, 20.7%; n=11, 7.3%) (χ2=3.632, P=0.458). There was no significant difference in the frequencies of C allele and G allele in the VVS group (n=232, 77.3%; n=68, 22.7%), the HUT-negative group (n=252, 84.0%; n=48,16.0%) and the normal control group (n=247, 82.3%; n=53, 17.7%) (χ2=4.659, P=0.097). The 150 children in the VVS group were further divided into the mixed-response subgroup (n=83), vasodepressor-response subgroup (n=42) and cardioinhibitory-response subgroup (n=25). The CC genotype, CG genotype and GG genotype in the mixed-response subgroup, the vasodepressor-response subgroup and the cardioinhibitory-response subgroup were (n=65, 78.3%; n=16, 19.3%; n=2, 2.4%), (n=20, 47.6%; n=11, 26.2%; n=11, 26.2%) and (n=13, 52.0%; n=9, 36.0%; n=3, 12.0%), respectively. The frequencies of C allele and G allele in the mixed-response subgroup, the vasodepressor-response subgroup, and the cardioinhibitory-response subgroup were (n=146, 88.0%; n=20, 12.0%), (n=51, 60.7%; n=33, 39.3%) and (n=35, 70.0%; n=15, 30.0%), respectively. The percentages of the GG genotype and G allele were significantly higher in the vasodepressor-response subgroup than the other two subgroups (χ2=21.698, 25.345, all P=0.000).@*Conclusions@#No significant association was found between RGS2 C1114G polymorphism and VVS in children. Due to the higher distribution of GG genotype and G allele in the vasopressor-response subgroup, RGS2 C1114G may be associated with the regulation of blood pressure during the onset of VVS in children.
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Objective To analyze the relationship between the expression of WT1 gene in bone marrow mononuclear cells and the cytogenetic characteristics, curative effect and prognosis in patients with myelodysplastic syndromes (MDS). Methods The quantitative expression of WT1 gene was detected by real-time quantitative polymerase chain reaction (RQ-PCR) in bone marrow mononuclear cells of 115 MDS patients who were admitted to Taixing People's Hospital from August 2010 to March 2018, and the relationship between the expression of WT1 gene and the cytogenetic characteristics, curative effect and prognosis were evaluated. Results WT1 gene was highly expressed in 80 cases (69.6 %), lowly expressed in 15 cases (13.0 %), and unexpressed in 20 cases (17.4 %). Of the 80 patients with high WT1 expression, 56 cases (70.0 %) were refractory anemia with excess blasts (RAEB), and 22 cases (27.7 %) were refractory cytopenia with multilineage dysplasia (RCMD). In 55 patients with very poor cytogenetic prognosis, 44 patients had high expression of WT1 gene, and in 28 patients with poor prognosis, 19 patients had high expression of WT1 gene. The complete remission rate of WT1 gene high expression group [12.5 % (10/80)] was lower than that of low expression group [26.7 % (4/15)] and unexpressed group [40.0 % (8/20)], and the difference of complete remission rate between the three groups was statistically significant (χ2＝ 8.96, P< 0.05). Conclusion MDS patients with high expression of WT1 gene have low remission rate and poor prognosis.
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Objective To analyze the clinical features and risk factors of death in pediatric trauma,in order to provide preventing strategies and reduce mortality.Methods A retrospective study of 7936 traumatic children admitted to the emergency department of our hospital from April 2014 to March 2016 was conducted.We retrospectively summarized the clinical features and Logistic regression analysis was used to analyze the risk factors of death in children with trauma.Results Compared to females,male patients contributed higher percentages(1.73∶1).There were more migrant children(5535 cases) than local ones(2 401 cases)(χ2=14.314,P＜0.05).Children in infancy stage(2 024 cases)and toddler period(3 097 cases) were more than in the other periods.Limb[41.9%(3 324/7 936)] and skin injuries[38.5%(3 058 324/7 936)] were the most common.Children trauma causes varied with age,fall,tumble and traffic accidents were common causes of children trauma.Pediatric trauma score of surviving group(n=1933),death group(n=5),general ward group(n=1852) and ICU group(n=86) were 8.53± 2.17,3.17± 1.29,9.72± 1.25,5.23± 1.84,respectively.Shock decompensation,mechanical ventilation,Glasgow coma scale ≤7 and pediatric trauma score＜8 were the risk factors which caused the death of trauma.Conclusion Parents should improve the security sense,strengthen the care of children and obey the traffic rules to reduce the rate of children trauma.Clinicians should pay attention to shock decompensation,mechanical ventilation,Glasgow coma scale and pediatric trauma score in order to identify critically ill patients in early stage and improve the success rate of rescue.
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Objective To explore the factors related to vasovagal syncope (VVS) in children. Methods The clinical data of 125 children with conifrmed VVS were collected. According to the frequency of syncope during the ifve years from ifrst episode to the time of head-up tilt test, the children with 2 or 3 episodes of syncope were assigned into the low episode group, and the children with 4 or more episodes of syncope were assigned into the high episode group. The two groups were analyzed and compared. Results Among the 125 children, 84 children (67.2%) were in the low episode group and 41 children (32.8%) were in the high episode group. The single factor analysis showed that the age at head-up tilt test, onset of syncopal, causes of syncope, history of carsickness, and positive family history were associated with high attack frequency. The results of non-conditional logistic regression analysis showed that causes of syncope (OR?=?3.723, 95%CI:1.163-11.918, P?=?0.027), history of carsickness (OR?=?5.929, 95%CI:2.066-17.015, P?=?0.001), and positive family history (OR?=?6.794, 95%CI:2.006-23.013, P?=?0.002) were the independent risk factors of high attack frequency. Conclusions The causes of syncope (excluding persistent standing), history of carsickness, and positive family history have important clinical signiifcance in predicting high attack frequency of VVS in children.
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Objective To evaluate the efficacy of aminolevulinic acid hydrochloride photodynamic therapy (ALA-PDT) combined with multi-function electronic therapeutic device in the treatment of condyloma acuminatum.Methods Sixty cases with condyloma acuminatum were divided into two groups with 30 cases each according to the treatment method.The combination group was treated with ALA-PDT combined with multi-function electronic therapeutic device,and the control group was treated only with multi-function electronic therapeutic device.Once a week,treatment was not more than three weeks.The adverse reaction was observed.The efficacy was evaluated after 1 week's treatment.The recurrence rate was evaluated after 1,6 months' s treatment.Results The cure rate was 80.00％ (24/30) and 96.67％ (29/30) in combination group and control group,and there was no significant difference (P ＞ 0.05).The recurrence rate was 8.33％ (2/24),12.50％(3/24) in combination group and 17.24％ (5/29),41.38％ (12/29) in control group after 1,6 months's treatment,and there was no significant difference after 1 month's treatment (x2 =0.298,P ＞ 0.05),but there was significant difference after 6 months' s treatment (x2 =4.030,P ＜ 0.05).There was no system adverse reaction,the adverse reaction was 16 cases in combination group and 44 cases in control group.Conclusion ALA-PDT combined with multi-function electronic therapeutic device in the treatment of condyloma acuminatum can improve the cure rate,decrease the recurrence rate and adverse reaction.
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[Objective] To study the effect of family sickbed comprehensive nursing mode on patients with stroke.[Methods] 92 cases of discharged patients with cerebral apoplexy were selected between October 2010 and October 2011,and were divided into the observation group(52 cases)and the control group(40 cases).Among them,the observation group received the family sickbed comprehensive nursing intervention,which was conducted by community nurses.The control group received general discharge mode and did not accept community nursing intervention.As designed,patients were followed weekly or monthly after discharge.After three months the treatment efficacy and quality of life were assessed.[Results] After follow-up for 3 months,HAMD,NIHSS scores in the intervention group were lower than those of the control group,MMSE,FMA and BI scores were higher than those of the control group.The physical,psychological,social and environmental scorcs in the intervention group were higher than those in the control group.[Conclusions] Family sickbed comprehensive nursing of cerebral apoplexy patients during rehabilitation stage can not only save medical resources,but also facilitate to recovery of patients.
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Ohjective To investigate the associations between the Arg389Gly polymorphism of the β_1-adrenergiecreceptor gene (ADRB1) and vasovagal syncope (VVS) in Chinese children. Methods Genotype of ADRB1 was determined by polymerase chain reaction-restriction fragment length pelymorphism analysis. Case-control studies and quantitative trait analysis were carried out by comparing between carriers (one or two copies of the Gly389 allele) and non-carriers (Arg389 genotype) of the ADRBI in 54 patients with unexplained syncope and in 54 healthy control subjects. Patients were subdivided into two groups according to head up tilt test (HUTT) : positive HUTT, known as VVS group and negative HUTT group. Distribution of Arg389Gly genetype in VVS group and the relationship to three clinical patterns were also analyzed. Results An allele frequency of Arg389 was 73.15% and Gly389 was 26.85% in healthy subjects. Higher Gly389 allele frequency was found in VVS group (n = 30) than that in negative HUTT group (33.33% vs. 14.58%, P < 0.05). In VVS group, the frequencies of the Gly389 allele in cardioinhibitory pattern (n = 6), mixed pattern (n = 9) and vasodepressor pattern (n = 15) was 66.67%, 33.3% and 23.33%, respectively, which had significant differences between the cardioinhibitory pattern from any of the other two patterns (both P < 0.05). Conclusions An association of positive HUTT with a single nucleotide pelymorphism of Gly to Arg switch at position 389 of the ADRB1 was found. This polymorphism may contribute to susceptibility to VVS.
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<p><b>BACKGROUND</b>RRM1 may be a prognostic factor in non-small cell lung cancer (NSCLC). The aim of this study is to evaluate RRM1 expression and prognosis in NSCLC by the means of tissue microarray.</p><p><b>METHODS</b>A total of 417 paraffin-embedded specimens of NSCLC from Lung Cancer Study Center in Guangdong Provincial People's Hospital were collected and tissue microarray was constructed. RRM1 expression was detected by SP method and its correlation with prognosis was evaluated.</p><p><b>RESULTS</b>No statistic difference was found in RRM1 expression in different gender, age, tumor site, histology, differentiation, T stage, N stage, M stage and pTNM stage groups (P > 0.05). Univariate analysis showed that RRM1 was not an independent prognostic factor (P > 0.05). At the multivariate analysis, differentiation and N stage were considered independent prognostic factors.</p><p><b>CONCLUSIONS</b>RRM1 expression detected by immunohistology is not an independent prognostic factor in NSCLC. TNM stage is still the best prognostic factor up to now.</p>
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<p><b>BACKGROUND</b>To explore the experience of gefitinib molecular target therapy for Chinese patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The unpublished data of gefitinib for advanced NSCLC in 7 hospitals were collected. The detailed data from Guangdong Provincial People's Hospital were analyzed.</p><p><b>RESULTS</b>A total of 282 patients with advanced NSCLC was treated with gefitinib from July 2001 to December 2003. Response rate was 22.2%-47.7%, disease control rate 62.6%-81.8%. No severe side effects were surveyed.</p><p><b>CONCLUSIONS</b>Gefitinib can be used safely and effectively in Chinese patients with advanced NSCLC.</p>
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Objective To develop HPLC method for determination of polyunsaturated fatty acid(PUFA) in breast milk.Method PUFA were extracted from breast milk with mixture of methanol: N-hexane:phosphoric acid(15:25:3).PUFA were derived by phenacyl bromide.The mobile phase was acetonitrile:water(81:19,v/v) at 1.0 ml/min with UV detection at 252 nm and column temperature was 35℃.The analytic column was Hypersil BDS C18(4.6mm?150mm,5 ?m).Results The average recovery was(98?5)% and the relative standard deviation of intra-day and inter-day were limited within 5.9%.Conclusion The method was stable,sensitive and accurate,and suitable for determination of PUFA in breast milk.