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Streptococcus pneumoniae-associated hemolytic uremic syndrome(SP-HUS) is a thrombotic microvascular disease caused by streptococcus pneumoniae infection, which is one of the causes renal failure in children.Clinical manifestations include thrombocytopenia, hemolytic anemia and acute renal failure.The neuraminidase and surface protein C substance of Streptococcus pneumoniae, immune factors and complement play important roles in the pathogenesis of SP-HUS.The complement inhibitors provides a new solution for the treatment of SP-HUS.However, few SP-HUS cases have been reported in China.This paper reviews the pathogenesis, clinical manifestations and treatment of SP-HUS to help clinicians better understand the disease, early recognition and intervention treatment.
ABSTRACT
Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.
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Bronchial asthma in children is a common chronic inflammation of the lower airway.It is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness.Acute asthma attack in different degrees is often accompanied by multiple system damage, including respiratory system, circulatory system, blood system and so on.At present, the literature reports about acute attack of asthma accompanied by thrombophilia, thrombosis, pulmonary embolism and other life-threatening complications gradually appear, and show an upward trend.This paper summarizes the literature of acute asthma attack with thrombophilia at home and abroad, and reviews the pathogenesis, monitoring indicators and treatment, so as to diagnose and treat early, prevent serious complications and reduce mortality.
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The clinical data of 3 patients with rhabdomyolysis (RM) caused by different viral infections were retrospectively reviewed. The diagnoses were established according to the clinical symptoms, physical signs, myocardial enzymes, and muscle biopsy. Case 1 was a 11-year-old boy with influenza A virus infection, whose major symptoms were fever, cough and myalgia. After the treatment of active anti-virus, hydration, and alkalinization, the patient completely recovered. Case 2 was a 10-year-old girl with Epstein-Barr (EB) virus infection who had significant musculoskeletal pain and muscle weakness symptoms with significantly elevated serum creatine kinase. After active hydration and anti-infective treatment, the patient's condition returned to normal. Case 3 was a 15-year-old boy with human cytomegalovirus infection, whose symptoms were mainly repeated fever, accompanied by myalgia and facial edema. Antibacterial therapy was ineffective, and the disease progressed with respiratory muscle weakness and multiple organ injuries. After antiviral treatment, respiratory support and hemofiltration, the symptoms relieved and patient recovered without sequela. With literature review, we believe that although influenza virus, Epstein-Barr virus and cytomegalovirus rarely cause RM in children, it should be attached attention to. With early diagnosis and treatment, the prognosis is favorable.
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Objective To explore the risk factors of incontinent-associated dermatitis (IAD) in MICU. Methods A retrospective analysis of 141 cases of MICU incontinence in our hospital was done in IAD. The risk factors of IAD were analyzed by single factor and logistic regression analysis. Results The incidence of IAD in MICU fecal incontinence was 43.97%.The risk factors of IAD in MICU incontinence included the amount of defecate,age,body temperature (all P＜0.05). Conclusion The incidence of IAD in patients with MICU incontinence is higher.The risk factor for IAD in patients with ICU incontinence are the amount of defecate, age and body temperature.These high-risk factors should be well-considered and relative measures should be done.
ABSTRACT
Bronchial asthma,a complex genetic disease,is influenced by environmental factors.As a connection of genetic susceptibility factors and environmental factors,the role of epigenetics in the pathogenesis of bronchial asthma is attracting more attention.DNA methylation,the most common form of epigenetic modifi-cations,can be influenced by the environment and dietary factors,thereby have an effect on the differentiation of CD4 +T lymphocyte,promoting the development of asthma.
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Objective To observe the clinical efficacy and safety of GINA regimen and GINA regimen combined with oral Huaiqihuang granule in the treatment of children with bronchial asthma.Methods A ran-domized,single blind,multicenter,parallel controlled clinical trial wascarried out.A total of 1 128 patients with bronchial asthma in children were randomized into two groups.The observation group were treated with GINA regimen combined with oral Huaiqihuang granule.The GINA regimen treatment group was treated by GINA reg-imen.Clinical assessment and C-ACT scores was observed in first month,third month,sixth month after treat-ment.Clinical assessment included the times of upper respiratory tract infection occurrence,bronchitis and pneu-monia,asthmatic attacks,application of emergency medicine,hospitalizations due to asthmatic.Drug adverse effect in the two groups was compared.Results The times of upper respiratory tract infection,bronchitis and pneumonia,asthmatic was significantly decreased(P 0.05).Conclusion The treatment of bronchial asthma in children with GINA regimen combined with oral Huaiqihuang granule can significantly reduce the incidence of respiratory infections and the number of asthmatic attacks dramatically and safely improve clinical curative effect,asthma control.
ABSTRACT
To determine the impact of IL-23 knockdown by RNA interference on the development and severity of ovalbumin (OVA)-induced asthmatic inflammation, and the potential mechanisms in mice, the IL-23-specific RNAi-expressing pSRZsi-IL-23p19 plasmid was constructed and inhaled into OVA-sensitized mice before each challenge, as compared with that of control mice treated with alum or budesonide. Inhalation of the pSRZsi-IL-23p19, significantly reduced the levels of OVA-challenge induced IL-23 in the lung tissues by nearly 75%, determined by RT-PCR. In addition, knockdown of IL-23 expression dramatically reduced the numbers of eosinophils and neutrophils in BALF and mitigated inflammation in the lungs of asthmatic mice. Furthermore, knockdown of IL-23 expression significantly decreased the levels of serum IgE, IL-23, IL-17, and IL-4, but not IFNgamma, and its anti-inflammatory effects were similar to or better than that of treatment with budesonide in asthmatic mice. Our data support the notion that IL-23 and associated Th17 responses contribute to the pathogenic process of bronchial asthma. Knockdown of IL-23 by RNAi effectively inhibits asthmatic inflammation, which is associated with mitigating the production of IL-17 and IL-4 in asthmatic mice.