Efficacy of Wen-Luo-Tong on Peripheral Neuropathy Induced by Chemotherapy or Target Therapy: A Randomized, Double-Blinded, Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy of Wen-Luo-Tong Granules (WLT) local administration in the treatment of patients with peripheral neuropathy (PN) induced by chemotherapy or target therapy.@*METHODS@#This study is a randomized, double-blinded, and placebo-controlled trial. Seventy-eight patients with PN induced by chemotherapy or target therapy were enrolled from China-Japan Friendship Hospital between July 2019 and January 2020. They were randomly assigned to WLT (39 cases) and control groups (39 cases) using a block randomization method. The WLT group received WLT (hand and foot bath) plus oral Mecobalamin for 1 week, while the control group received placebo plus oral Mecobalamin. The primary endpoint was PN grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE). The secondary endpoints included quantitative touch-detection threshold, neuropathy symptoms, Quality of Life Questionnaire-Chemotherapy Induced Peripheral Neuropathy (QLQ-CIPN20), and Quality of Life Questionnaire-Core30 (QLQ-C30).@*RESULTS@#After treatment, the PN grade in the WLT group was significantly lower than that in the control group (1.00 ± 0.29 vs. 1.75 ± 0.68, P<0.01). The total effective rate in the WLT group was significantly higher than that in the control group (82.05% vs. 51.28%, P<0.01). Compared with the control group, the touch-detection thresholds at fingertips, neuropathy symptom score, QLQ-CIPN 20 (sensory scale, motor scale, autonomic scale, and sum score), and QLQ-C30 (physical functioning, role functioning, emotional functioning, and global health) in the WLT group significantly improved after treatment (P<0.01 or P<0.05).@*CONCLUSION@#WLT local administration was significantly effective in the treatment of patients with PN induced by chemotherapy or target therapy. (Trial registration No. ChiCTR1900023862).

TCM Intervention in Progression of Esophageal Precancerous Lesions into Esophageal Cancer： A Review / 中国实验方剂学杂志

China has a high incidence of esophageal cancer，more than 90% of which are esophageal squamous cell carcinoma （ESCC）. Abnormal proliferation，migration and new microvessels of intraepithelial neoplasia cells are the important pathogenic links in the transformation from esophageal intraepithelial neoplasia （EIN） to ESCC. Studies on the progression of esophageal precancerous lesions into esophageal cancer mostly focus on environment and genetic susceptibility，such as inflammatory factors，abnormal vascular endothelial growth factor （VEGF） signaling pathway transduction，p53 gene mutation，and DNA methylation. Some pharmacology studies have confirmed that traditional Chinese medicine （TCM） can inhibit inflammatory factors，regulate abnormal signaling pathways and improve the microenvironment. A large number of patients with esophageal cancer have been found to be in advanced stage，and the 5-year survival rate is low even after active treatment. The quality of life of patients in advanced stage is worrying due to esophageal obstruction and lung infection，and therefore， early prevention is important. Early intervention in patients with esophageal precancerous lesions is in line with clinical needs and embodies the TCM theory of “treating disease before its onset.” The mechanism of action and clinical efficacy of TCM has been gradually confirmed and promoted， with certain clinical significance. To explore simple，economical and effective TCM intervention measures conforms to the clinical diagnosis and treatment standards and the modernization of TCM.

Application of Computer-Aided Tongue Inspection for Preliminary Screening of Esophageal Cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To differentiate patients with esophageal cancer or premalignant lesions from the high-risk population for preliminary screening of esophageal cancer using a feature index determined by a computer-aided tongue information acquisition and processing system (DS01-B).</p><p><b>METHODS</b>Totally, 213 patients diagnosed with esophageal cancer or premalignant lesions and 2,840 normal subjects were collected including primarily screened and reexamined, all of them were confirmed with histological examinations. Their tongue color space values and manifestation features were extracted by DS01-B and analyzed. Firstly, the analysis of variance was performed to differentiate normal subjects from patients with esophageal cancer and premalignant lesions. Secondly, the logistic regression was conducted using 10 features and gender, age to get a predictive equation of the possibility of esophageal cancer or premalignant lesions. Lastly, the equation was tested by subjects undergoing primary screening.</p><p><b>RESULTS</b>Saturation (S) values in the HSV color space showed significant differences between patients with esophageal cancer and normal subjects or those with mild atypical hyperplasia (P<0.05); blue-to-yellow (b) values in the Lab color space showed significant differences between patients with esophageal cancer or premalignant lesions and normal subjects (P<0.05). Logistic regression analysis showed that the computer-aided tongue inspection approach had an accuracy of 72.3% (2008/2776) in identifying patients with esophageal cancer or premalignant lesions for preliminary screening in high-risk population.</p><p><b>CONCLUSION</b>Computer-aided tongue inspection, with descriptive and quantitative profile as described in this study, could be applied as a cost- and timeefficient, non-invasive approach for preliminary screening of esophageal cancer in high-risk population.</p>

Effect of Shengjiang Xiexin Decoction on the Repair of Damaged Rat Intestinal Mucosa after Irinotecan Chemotherapy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Shengjiang Xiexin Decoction (SXD) on the intestinal mucosal and functional cells of rats after irinotecan (CPT-11) chemotherapy.</p><p><b>METHODS</b>Totally 24 healthy Sprague-Dawley (SD) male rats were divided into three groups, the normal control group, the CPT-11 group, the SXD combined CPT-11 group according to random digit table, 8 in each group. CPT-11 was injected at the daily dose of 150 mg/kg to rats in the CPT-11 group and the SXD combined CPT-11 group from the caudal vein on the 4th day, once daily for 2 successive days to duplicate delayed diarrhea model. Equal volume of normal saline was injected to rats in the normal control group from the caudal vein. SXD at 2 g/mL (10 g/kg body weight) was administered to rats in the SXD combined CPT-11 group by gastrogavage for 9 successive days. Deionized water was administered to rats in the CPT-11 group and the normal control group. Diarrhea was observed at 48, 60, 72, 84, 96, and 108 h to calculate the incidence rate of diarrhea. Meanwhile, scoring for diarrhea was performed by referring methods of Akinobu Kurita. Rats were killed on day 10, ileum, cecum, and colon tissues were collected and fixed in 10% formalin solution. HE staining was performed. Intestinal mucosa injuries were graded under light microscope according to the criterion of Chiu's score. The expressions of goblet cells and Paneth cells were observed by PAS stain. Enteroendocrine cells were observed by immunohistochemical CgA staining. Positive cells were counted and cumulative optical density (IOD) analyzed by Image-Pro-Plus 6.0.</p><p><b>RESULTS</b>No diarrhea occurred in rats of the normal control group at each time point. The incidence rate of diarrhea was 75.0% (6/8) at 48 h, 100.0% (8/8) at 60 h, 100.0% (8/8) at 72 h, 87.5% (7/8) at 84 h, 75.0% (6/8) at 96 h, and 75.0% (6/8) at 108 h in the CPT-11 group. The incidence rate of diarrhea was 25.0% (2/8) at 48 h, 50.0% (4/8) at 60 h, 12.5% (1/8) at 72 h, 0.0% (0/8) at 84 h in the SXD combined CPT-11 group. Compared with the same group at 60 h, scores for diarrhea at 48, 84, 96, and 108 h obviously decreased in the CPT-11 group, and scores for diarrhea at 48, 72, 84, 96, and 108 h obviously decreased in the SXD combined CPT-11 group (P < 0.05, P < 0.01). Compared with the same group at 72 h, scores for diarrhea at 84, 96, and 108 h obviously decreased in the CPT-11 group (P < 0.05, P < 0.01). Compared with the normal control group, scores for diarrhea increased in the CPT-11 group at each time point (P < 0.01); grading of ileum, cecum, and colon mucosal tissues increased (P < 0.05, P < 0.01); expressions of ileum and cecum mucosal epithelial goblet cells obviously decreased (P < 0.05); the number and expressions of ileum and cecum mucosal epithelial Paneth cells increased (P < 0.01). Expressions of ilium endocrine cells increased, while those of cecum and colon endocrine cells decreased in the CPT-11 group (P < 0.01). Compared with the CPT-11 group, scores for diarrhea were obviously lowered (P < 0.05, P < 0.01), grading of ileum, and cecum mucosal tissues decreased (P < 0.05, P < 0.01); expressions of ileum, cecum, and colon mucosal epithelial goblet cells obviously increased (P < 0.05, P < 0.01); the number and expressions of ileum cecum mucosal epithelial Paneth cells increased (P < 0.05); expressions of cecum and colon endocrine cells increased (P < 0.05, P < 0.01) in the SXD combined CPT-11 group.</p><p><b>CONCLUSION</b>SXD played roles in preventing and treating CPT-11 induced delayed diarrhea by improving CPT-11 chemotherapy induced apoptosis and necrosis of intestinal mucosal and functional cells.</p>

Ultrasonographic appearance in children with thyroglossal cyst and thyroglossal fistula / 中华医学超声杂志（电子版）

Objective To analyze the ultrasonographic appearance of thyroglossal duct cysts and thyroglossal duct ifstula, and disicuss the value of ultrasonography in the diagnosis of thyroglossal duct cysts and thyroglossal duct ifstula. Methods Totally 142 cases of surgically and pathologically conifrmed thyroglossal duct cysts and thyroglossal duct ifstula cases in Beijing Children′s Hospital Afifliated to Capital Medical University from 2005 to 2012 were retrospectively reviewed and the ultrasonographic characteristics were analyzed. Results Among 142 cases, 128 cases of thyroglossal duct cyst were diagnosed by ultrasound. The ultrasonographic manifestation generally presented as anechoic and uneven medium echo cystic masses, with posteria wall echo enhancement. Most of the cyst walls were thin, and close to the thyoid, with or without deep ifstula. If the cysts were associated with infection, the wall would be thickening and echo enhancement of the surrounding soft tissue could be seen. Cysts ranged from the root of tongue to the suprasternal fossa, mostly in midline level of the neck. Of all the 128 cases, 95 cases were single cyst, round in shape; 33 cases had irregular shape with a fistula extended deeply, 13 cysts extended to the hyoid trailing edge, 20 cases extended to the mouth lfoor. Ultrasound examination revealed ifstulas in 10 cases, which presented as a hypoechoic thin strip-like echo inside the neck soft tissue, 6 cases extended to the hyoid bone direction, 2 cases extended to the mouthlfoor, 2 cases extended to the front thyroid. The other 4 cases showed anterior hypoechoic area, without cyst or ifstula structure. Conclusions Ultrasound is valuable in detcting the size, position, internal echo of the cyst and sinus, as well as showing their relationship with the hyoid. It is an optimal choice for the diagnosis of thyroglossal cyst and thyroglossal ifstula.

Ultrasonic manifestations of heptic mesenchymal hamartoma in children / 中华医学超声杂志（电子版）

Objective To describe the sonographic appearance of mesenchymal hamartoma of the liver(MHL)and to analyze the diagnostic value of ultrasound.Methods Eleven surgically and pathologically confirmed cases of MHL from January 2005 to May 2011 in the Beijing Children′s Hospital were retrospectively reviewed.Results Ultrasound examinations showed 9 cystic hamartomas,including 7 multiseptate cystic and 2 monocystic lesions.Of the 7 multiseptate cystic hamartomas,4 had a honeycomb appearance and 3 had irregularly-distributed multiple cysts with varied septations.Of the 2 monocystic hamartomas,1 had a large cystic portion while the other was mainly solid with approximately 4% cystic portion of the tumor.Two cases in this group were solid,presenting with a well-defined homogenous mass.Conclusions Ultrasonography is an effective imaging modality for the diagnosis for MHL.A mixed or a mainly-cystic liver mass found in a child less than 2 years old should be suspicious for MHL.

The sonographic characteristics of Peutz-Jeghers syndrome in children / 中华医学超声杂志（电子版）

Objective To summarize the sonographic characteristics of Peutz-Jeghers syndrome in children and investigate the diagnostic value of ultrasound.Methods Retrospective analysis of sonographic characteristics of 19 cases with pathologically-confirmed Peutz-Jeghers syndrome were conducted.ResultsExcept for one child,other 18 patients all had more than one polyp with the maximum of sixteen.The polyp with the smallest size of 0.8 cm×0.5 cm×0.8 cm was found in left colic flexure,while the largest one was found in superior rectal with a measurement of 7.6 cm×2.7 cm×3.6 cm.The polyps showed radiatiform echotexture.And hypoechoic and hyperechoic components were present alternately.Blood flow was easily identified within these polyps by color Doppler sonography.Intussusceptions were observed in 11/19 patients.Among them,10 cases were located at small intestine.The sonographic finding was a concentric structure with a polyp at the top.Conclusions The sonographic appearence of Peutz-Jeghers syndrome is characteristic.Before surgery,ultrasonographic examination could achieve a accurate diagnosis for Peutz-Jeghers syndrome.

The Doppler parameters changes of superior mesenteric artery in children with abdominal type Henoch-Schonlein purpura / 中华医学超声杂志（电子版）

Objective To study the changes of flow parameters of superior mesenteric artery (SMA) in children with abdominal type Henoch-Schonlein purpura (HSP) using color Doppler ultrasound.Methods Ten children with abdominal type HSP and 17 controls were included in present study.The blood flow parameters of SMA[including peak velocity(PV),end-diastole velocity(EDV),resistant index(RI)]were measured at acute and recovery stage separately.Statistical analysis was conducted among groups.Results PV were (41.57±8.02)cm/s,(33.38±7.44)cm/s and (35.34±9.73)cm/s in acute stage,recovery stage and control group,respectively.There was no statistically significant difference among groups(F=2.471,P=0.10).EDV were(7.63±4.28)cm/s,(4.23±2.57)cm/s and (3.77±0.87) cm/s in acute stage,recovery stage and control group,respectively.There was significantly significant differences between acute stage group and other two groups(t=0.066,P=0.025;t=0.059,P=0.003).RI were (0.85±0.17),(1.00±0.15) and (1.04±0.13) in acute stage,recovery stage and control group,respectively.Also there was significantly significant differences between acute stage group and other two groups(t=1.391,P=0.020;t=1.239,P=0.026).Conclusion For abdominal type HSP in children,the changes of PV,EDV and RI of SMA were significant,which may help us determine the stage of disease.

Effect of Sangu Decoction () on metastatic bone destruction in rats with mammary cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study and evaluate the effect of Sangu Decoction (SGD, ) on the bone destruction due to mammary cancer metastasis.</p><p><b>METHODS</b>Metastasis rat mammary tumor-1 cells were transplanted into the left hind limb tibia of SD rats to establish the bone metastasis of the mammary cancer model. The modeled rats were treated with SGD for observing its effect on rats' pain behavior, including 50% paw withdrawal threshold (50% PWT) after von Frey fiber stimulation, burden difference of bilateral feet, and thermal withdrawal latency (TWL), with zoledronic acid as the positive control. Moreover, the damage in the tibia sample of rats was scored by an iconographic method, and the bone mineral density (BMD) as well as the bone mineral content (BMC) were estimated.</p><p><b>RESULTS</b>The model established showed characteristics of mixed metastasis, revealing the manifestations of tumor development, bone destruction, cancerous pain, etc. In the SGD-treated group, 50% PWT was prolonged (8.13 ± 4.76 vs. 2.30 ± 2.19), and TWL was longer (3.48 ± 0.62 s vs. 2.89 ± 0.26 s) than those in the control group, respectively (P<0.05 or P<0.01). Iconographic scoring also showed improvement of BMD (0.134 ± 0.009 vs. 0.120 ± 0.007, P<0.01) and an elevating trend of BMC in the SGD-treated group.</p><p><b>CONCLUSION</b>SGD could effectively alleviate the cancerous pain of bone metastasis and mitigate the metastasis that cause osteolytic destruction of bone.</p>

Pathological changes in rat model of urinary calculus induced by melamine / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate melamine-induced pathological changes in the kidney.</p><p><b>METHOD</b>Wistar rats were fed with a diet containing 0, 1% and 2% melamine for 15 weeks. After melamine feeding was stopped, various outcome measures were observed for 4 weeks.</p><p><b>RESULT</b>Rats fed with melamine showed reduced caloric intake, slower weight gain and impaired renal function. The blood urea nitrogen of group A and B [(13.23 ± 5.10) mmol/L and (18.30 ± 5.90) mmol/L, respectively] and serum creatinine levels of group B [(19.90 ± 2.90) mmol/L] were higher than that of group C [(8.23 ± 2.30) mmol/L and (10.04 ± 1.73) mmol/L](P < 0.01, respectively). Additionally, the kidney coefficients of group A and B were higher than that of group C (P < 0.01, respectively). Crystals, tubular ectasia and interstitial inflammation and fibrosis were found in the kidneys of melamine fed rats. Four weeks after discontinuation of feeding with melamine-contained diet, the caloric intake and weight of the rats increased, the coefficients of the kidney decreased, and the blood urea nitrogen of group A and B [(17.96 ± 2.04) mmol/L and (19.20 ± 3.36) mmol/L, respectively] and serum creatinine levels of group B [(24.20 ± 5.28) mmol/L], which became worse than 4 weeks before (P < 0.01;P < 0.05, respectively), and were still higher than that of group C [(8.30 ± 1.79) mmol/L and (9.87 ± 2.71) mmol/L, P < 0.01, respectively]. Crystals remained inside the kidney, changes in the renal interstitium did not improve.</p><p><b>CONCLUSION</b>(1) Melamine-induced urinary calculus rat model can be established by feeding 3-week old male Wistar rats with a diet containing 2% melamine for 15 weeks. The main constituent of the urinary calculus was melamine (> 90%), with a little uric acid and traces of cyanuric acid. (2) Melamine damaged the renal function, formed renal crystals, and led to the pathological changes of kidneys. All the influences seemed to be dose-depended and was related with the obstruction of the crystals or calculus in the kidney. (3) The renal function and the pathological changes did not improve 4 weeks after discontinuation of feeding with melamine-contained diet.</p>

Incidence, diagnosis and treatment of children's congenital abnormalities of the kidney and urinary tract detected in ultrasound screening / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the proportion of children with congenital abnormalities of the kidney and urinary tract (CAKUT) among those who received screening, analyze the rate, diagnosis and treatment of each abnormality, and evaluate the value of ultrasonography in the CAKUT diagnosis.</p><p><b>METHOD</b>Totally 489 of 26 989 children who received screening for urinary tract abnormalities were found to have CAKUT and were followed up by telephone interviews and were asked whether they had defined diagnosis of CAKUT, had clinical symptoms and received treatment. Children who had been operated on were also asked about the operation time, surgical procedure, postoperative diagnosis, and outcome. Children who had never been reviewed or still had no diagnosis were arranged to Beijing Children's Hospital for ultrasound follow-up. The final data were summed up for a retrospective analysis.</p><p><b>RESULT</b>1) The proportion of children with CAKUT was 1.67%. Most children with CAKUT had no clinical manifestations. 2) Of the 489 cases, 320 were followed up, and 169 were lost. Of the cases who were followed up, 16 out of 295 cases who had clear diagnosis showed inconsistent results in ultrasound screening. 3) Hydronephrosis was identified in 137 cases (0.78%), among whom 111 were males and 26 were females, in 98 cases the hydronephrosis was on the left, in 28 on the right and in 11 were bilateral. Ureterovesical junction obstruction occurred in 33 cases (0.19%), 25 males and 8 females, in 22 cases on the left, in 10 on right and bilateral in 1 case. Renal dysplasia was shown in 30 cases (0.17%), 22 males and 8 females; renal cysts in 26 cases (0.15%); duplex kidney in 24 cases (0.14%); solitary kidney in 22 cases (0.12%); ureterocele in 16 cases (0.09%); fused kidney in 10 cases (0.06%); renal hypoplasia in 9 cases (0.05%); ectopic kidney in 5 cases (0.03%); polycystic kidney in 3 cases (0.02%). Primary vesicoureteral reflux, posterior urethral valves, renal malrotation, branch renal pelvis, extrarenal pelvis in 1 case each. 4) Totally 114 of the 295 cases (38.6%) who were followed up for CAKUT in screening test required surgical treatment. Only one case of ureteropelvic junction obstruction (UPJO) failed in surgery.</p><p><b>CONCLUSION</b>The proportion of children with CAKUT was high. CAKUT is difficult to detect since there is no significant clinical manifestations in early ages. More than one third of patients with CAKUT needed surgical treatment. Ultrasonography showed obvious advantages in detecting children's CAKUT, proven to be the most preferred method of screening, thus could be recommended as a routine of children's physical examination.</p>

Late endothelial function in children with coronary aneurysm due to Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the late endothelial function in children with coronary aneurysm due to Kawasaki disease (KD).</p><p><b>METHODS</b>Thirty-one children with coronary aneurysms due to KD who had the disease course for more than 1 year and twenty-one age-matched healthy children were enrolled. Brachial artery endothelium-dependent and -independent flow-mediated dilation (FMD), carotid arterial stiffness index (SI) and intima-media thickness (IMT) were measured by high-frequency ultrasound.</p><p><b>RESULTS</b>There were 9 cases of medium and 22 cases of giant coronary aneurysms in the KD group. Twelve KD patients had evidence of myocardial ischemia. Compared to the normal controls, the endothelium-dependent FMD decreased (P<0.05), the carotid arterial SI increased (P<0.05), and the carotid arterial intima-media thickness increased significantly (P<0.05) in children with coronary aneurysms due to KD. The endothelium-dependent FMD decreased more significantly in 12 KD patients with myocardial ischemia than in those without any evidence of myocardial ischemia (P<0.05).</p><p><b>CONCLUSIONS</b>Late endothelial dysfunction exists in children with coronary aneurysms due to KD, especially in those with myocardial ischemia.</p>

Therapeutic effects of potassium sodium hydrogen citrate on melamine-induced urinary calculi in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In 2008, a sharp increase of the number of children diagnosed with urinary calculi was observed in China, 9433 children were diagnosed as having melamine-induced urinary calculi at outpatient clinic in Beijing Children's Hospital. This study examined the therapeutic efficacy of potassium sodium hydrogen citrate (PSHC) used to treat melamine-induced urinary stones in Chinese children who consumed melamine-containing infant formula.</p><p><b>METHODS</b>Seventy-two infants and children (average age (18.2 +/- 7.7) months) who were diagnosed with urinary calculi were randomly divided into three treatment groups using the SAS Plan program. Group 1 was given a low dose (1 g/d) of PSHC, group 2 was given high dose of PSHC (2 g/d) and group 3 was given no PSHC (control group). The dose of drug was adjusted according to the baseline urinary pH. This study analyzed the influence of the dose of PSHC, the age of patients, stone size and position, and urinary pH on the level of efficacy of PSHC (cured, effectively treated or not cured).</p><p><b>RESULTS</b>After 1 - 6 months of therapy, 19 patients from group 1, five patients from group 2 and six patients from group 3 were cured. Five patients from group 1, five patients from group 2 and four patients from group 3 were effectively treated. There were significant differences in therapeutic efficacy between the two treatment doses after 3 and 6 months as measured by the increase in the successful expulsion rate and time of melamine-induced urinary calculi. After 6 months the mean time of expulsion of urinary calculi in groups 1 and 2 was significantly shorter than in the control group.</p><p><b>CONCLUSIONS</b>PSHC can significantly increase the successful expulsion rate and time of melamine-induced urinary calculi. The therapeutic efficacy is affected by PSHC dose, treatment duration, calculi position, and urinary pH. There is no relationship between the therapeutic efficacy and the stone size or patient age.</p>

Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.</p><p><b>METHODS</b>Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.</p><p><b>RESULTS</b>All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1+/-8.2) mmol/L and creatinine (Cr) was (384.2+/-201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5+/-1.9) days for cystoscopy group, (2.7+/-1.1) days for lithotomy group, (3.8+/-2.3) days for dialysis group, and (2.7+/-1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00+/-1.78) days.</p><p><b>CONCLUSIONS</b>Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It was observed that the short-term prognosis was satisfactory.</p>

Ultrasonographic diagnosis of urinary calculus caused by melamine in children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intake of melamine can cause renal and ureteral lithiasis in infants and children. The present study aimed to understand the value of ultrasonography in the diagnosis of renal and ureteral lithiasis in infants and young children caused by melamine, and the characteristics of ultrasonograms of melamine-associated calculi.</p><p><b>METHODS</b>Ultrasonographic examination on the urinary system was performed for 28 332 children who ingested milk powder that was possibly tainted with melamine; 395 of the children were diagnosed by ultrasonography as having urinary calculus, and 231 cases had lump-like calculi and 164 cases had sand gravel-like calculi. The features of the calculi, the sites of obstruction and the status of hydronephrosis and hydroureterosis were analyzed. Ultrasonographic reexamination was performed for 116 patients and the findings were compared with those of the first ultrasonography, and the short-term expulsion of the calculi was evaluated.</p><p><b>RESULTS</b>Most of the 395 patients with urinary lithiasis, except for those who developed renal failure, had no symptoms. The whole profile of the calculi could be seen in most of the cases, because the echogenicity of the calculi with no sharp or absent acoustical shadowing, was weaker as compared with those from calcium-containing calculi. Comet tail sign could be seen behind the echogenicity of single gravel calculus. The rate of diagnostic consistency of ureteral lithiasis between the ultrasound and the results of clinical observation (including stones expelled spontaneously or after cystoscopic intervention) in 51 cases for 76 ureters was 100%. Percutaneous renal biopsy was performed for one case, and histopathological examination showed flocculent, fine strip-like, ellipse and circular deeply stained sand gravel-like material in the renal tubules, and the circular calculi were found to be attached to the walls of the tubules. Chemical analysis of the calculi expelled from 12 cases showed that the main contents of the calculi were uric acid and melamine. Short-term ultrasound reexamination in 116 patients showed that gravel-like calculi disappeared in 80.4% of the cases; in 26 non-hospitalized cases who had lump-like calculi without hydronephrosis or hydroureterosis, none of the lump-like calculi were expelled.</p><p><b>CONCLUSIONS</b>The ultrasonographic findings of urinary calculi in children caused by ingestion of melamine-tainted milk powder have a certain features as compared to the calculi containing calcium. Careful ultrasound examination can avoid missed diagnoses of ureteral calculi. Most of the gravel-like calculi can be expelled within a short period of term, while lump-like calculi can hardly be expelled. Ultrasonography is an accurate and reliable method of diagnosis of urinary calculus caused by melamine intake in children and it can be used as diagnostic method of choice although abdominal X-ray plain film can also visualize some of larger calculi.</p>

Melamine related urinary calculus and acute renal failure in infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.</p><p><b>METHODS</b>Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, image features as well as effects of 4 types of therapies.</p><p><b>RESULTS</b>All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1 +/- 8.2) mmol/L and creatinine (Cr) was (384.2 +/- 201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 14 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5 +/- 1.9) d for cystoscopy group, (2.7 +/- 1.1) d for lithotomy group, (3.8 +/- 2.3) d for dialysis group, and (2.7 +/- 1.6) d for medical treatment group, which had no statistically significant difference (P = 0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.0 +/- 1.8) d.</p><p><b>CONCLUSION</b>Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbances, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It is observed that the short term prognosis is satisfactory.</p>

Ultrasonic Features of Wilms′ Tumor in Children / 实用儿科临床杂志

Objective To study the ultrasonographic characteristics of Wilms′tumor (WT), aims at elevating the diagnostic level.Methods We retrospectively studied sonographic features in 30 cases of WT proved by operation and pathology.Results The tumors with heterogeneous pattern of solid and cystic tissue were shown in 22 cases.Seven cases demonstrate predominantly echogenic tumor. A huge cystic mass with numerous septas was shown in 1 case. The tumor extended into renal pelvis in 4, into renal vine in 1.The tumor metastasized to lymphnod in 1, to bilateral lungs in 1. Among 30 cases, the tumor was huge and grew beyond the renal profile in 26 cases, in 3 cases the tumors took up the renal sinus and made its structure turbulence, the renal shape was approximately normal.One case was extrarenal WT,the tumor located in retroperitonemu.Conclusions Sonographically, typical WT is a large heterogeneous mass within or without cystic areas, it also can be a pure cyst. It is easy to diagnose. When the tumor is limited to renal outline, it is easy to confusion with renal cancer. In addition, there are bilateral WT and extrarenal WT. The sonographic characteristics is similar among WT, clear cell sarcoma of kidney, malignant rhabdoid tumor and congenital mesoblastic nephroma. It is difficult to distinguish them from ultrasonography.

Sequencing and Homology Analysis for the Nucleocapsid Gene of JS/95/03 Strain of Avian Infectious Bronchitis Virus Isolated from Jiangsu, China / 中国病毒学

Field avian infectious bronchitis virus (IBV) designated as JS/9 5/03, which was isolated from Jiangsu province of china, was cultivated in chicken emb ryo. It's single strain RNA was extracted from purified virus and worked as temp late of reverse transcription polymerase chain reaction (RT-PCR), a pair of pri mer designed according to megalign results of published IBV sequences in Genbank was used to amplify the neucleocapsid gene, the RT-PCR product was sequenced d irectly. Sequence analysis revealed that the sequence of JS/95/03 is most homolo gized with that of M41 strain.