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Objective To explore the clinical characteristics of glucocorticoid induced eye damage in children with primary nephrotic syndrome. Methods The clinical data of steroid－induced high intraocular pressure or cataract in 49 children who were from Zhengzhou Children′s Hospital with primary nephrotic syndrome admitted from September 2016 to April 2018 were analyzed retrospectively in order to observe the relationship between relevant eye damage and clinical medication. Results There were 37 boys and 12 girls in the 49 cases,of which the average age of onset was (7. 6 ± 3. 0)years old,and among them there were 22 cases with glucocorticoid high intraocular pressure,19 cases with glucocorticoid cataract,8 cases with glucocorticoid high intraocular pressure combined with cataract,but no glaucoma in 49 cases. The shortest time of using glucocorticoid was 15 －3 240 days[(863. 33 ± 871. 46)days];the cumulative dose of glucocorticoid was(7 865 ± 3 691. 66)mg/m2 ,the left eye pressure was(26. 68 ± 5. 95)mmHg(1 mmHg﹦0. 133 kPa)and the right eye pressure was(27. 71 ± 5. 82)mmHg. There was no significant correlation between glu﹣cocorticoid using time,cumulative dose and high intraocular pressure( r﹦ －0. 158,－0. 264,－0. 237,－0. 361,all P＞0. 05). All the 19 patients with glucocorticoid cataract and 8 patients with glucocorticoid high intraocular pressure combined with cataract presented posterior capsular opacity,including 23 males and 4 females,and their time of using glucocorticoid was(1 296. 67 ± 903. 35)days,who were followed up continuously. Conclusions Glucocorticoid－in﹣duced high intraocular pressure and cataract should be paid attention to by clinicians. Once high intraocular pressure or cataract occurs,the dosage of glucocorticoid should be gradually reduced or stopped,at the same time,ophthalmologic treatment should be actively performed to avoid serious eye diseases.
ABSTRACT
Objective@#To explore the clinical characteristics of glucocorticoid induced eye damage in children with primary nephrotic syndrome.@*Methods@#The clinical data of steroid-induced high intraocular pressure or cataract in 49 children who were from Zhengzhou Children′s Hospital with primary nephrotic syndrome admitted from September 2016 to April 2018 were analyzed retrospectively in order to observe the relationship between relevant eye damage and clinical medication.@*Results@#There were 37 boys and 12 girls in the 49 cases, of which the average age of onset was (7.6±3.0) years old, and among them there were 22 cases with glucocorticoid high intraocular pressure, 19 cases with glucocorticoid cataract, 8 cases with glucocorticoid high intraocular pressure combined with cataract, but no glaucoma in 49 cases.The shortest time of using glucocorticoid was 15-3 240 days[(863.33±871.46) days]; the cumulative dose of glucocorticoid was (7 865±3 691.66) mg/m2, the left eye pressure was (26.68±5.95) mmHg(1 mmHg=0.133 kPa) and the right eye pressure was (27.71±5.82) mmHg.There was no significant correlation between glucocorticoid using time, cumulative dose and high intraocular pressure(r=-0.158, -0.264, -0.237, -0.361, all P>0.05). All the 19 patients with glucocorticoid cataract and 8 patients with glucocorticoid high intraocular pressure combined with cataract presented posterior capsular opacity, including 23 males and 4 females, and their time of using glucocorticoid was(1 296.67±903.35)days, who were followed up continuously.@*Conclusions@#Glucocorticoid-induced high intraocular pressure and cataract should be paid attention to by clinicians.Once high intraocular pressure or cataract occurs, the dosage of glucocorticoid should be gradually reduced or stopped, at the same time, ophthalmologic treatment should be actively performed to avoid serious eye diseases.
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Objective To explore the breakthrough point of pharmaceutical care for a patient with bronchiectasis ,diabe-tes and gout .Methods The clinical pharmacist recommended appropriate antibiotics and gout medications .The dosage and therapy regimen were optimized based on the patient′s renal function ,allergy and disease history .Results The physician ac-cepted the suggestions from clinical pharmacists .The patient recovered well with no adverse drug reactions .Conclusion With the knowledge of clinical pharmacist ,clinical treatment plan was optimized .The patient received better pharmaceutical care .
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Objective To explore and provide guidelines for the clinical diagnosis and treatment of primary nephrotic syndrome complicated with acute pancreatitis. Methods The clinical data of 14 children with primary nephrotic syndrome complicated with acute pancreatitis during September 2013 to September 2016 were retrospectively analyzed. Results In 14 children (6 males and 8 females) aged 3 to 15 years. all children presented massive proteinuria, hypoalbuminemia, varying degrees of edema, hyperlipidemia and pain in upper abdomen or left hypochondrium. Seven children had nausea and vomiting, and their amylase in serum and urine fluctuated at 392–802 U/L and 561–3180 U/L, and the lipase level was 339.1±2.52 U/L. After supportive treatment, 13 children were cured from pancreatitis except one who gave up the treatment. Conclusion Due to infection, coagulation disorder, hyperlipidemia and drug application in primary nephrotic syndrome, acute pancreatitis may be induced. Clinician should be alerted to it and early diagnosis and treatment were needed for acute pancreatitis.
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Objective To explore the effects of parent-adolescent conflict and cohesion on relational aggression among junior students.Methods Parent-adolescent Conflict Questionnaires,Parent-adolescent Cohesion Questionnaires,and the Relational Aggression Questionnaires were used in investigating 392 junior students.Results The level of relational aggression of junior students was low (22.52±5.15).There was no differences between relational aggression of male students (22.93± 5.43) and female students (22.00± 4.73) (P＞ 0.05),and of grade 1 students(22.72±5.14)and grade 2 students(22.64±5.67),grade 3 students(21.93±4.22) (P＞0.05).The students' relational aggression showed a significantly positive correlation with frequency and intensity of parent-adolescent conflict(r=0.269,r=0.307,r=0.268,r=0.271,P＜0.01),and negative correlation with father-adolescent cohesion(r=-0.171,P＜0.01).Parent-adolescent cohesion was negative predictor of relational aggression(β=-0.123,P＜0.05),and the intensity of parent-adolescent conflict was positive predictor(β=0.301,P＜0.01).Conclusion Parent-adolescent conflict and cohesion have significant effect on relational aggression among junior students.