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Objective@#To explore the effect of valproic acid with different loading doses in treatment of children with status epilepticus.@*Methods@#The data of children who were hospitalized in the intensive care unit of the Children′s Hospital Affiliated to Zhejiang University because of status epilepticus from January 1, 2013 to December 31, 2017 were collected.All the patients were divided into different groups according to loading dose of valproic acid.The effect were analyzed in different groups.@*Results@#(1)There were 66 children with status epilepticus were admitted, including 35 males and 31 females.Among all children with status epilepticus, the etiology included epilepsy(n=36, 54.5%), intracranial infection(n=16, 24.2%), hypoxic asphyxia (n=3, 4.5%), intracranial tumor(n=2, 3.0%), abnormal brain development(n=2, 3.0%), intracranial hemorrhage(n=2, 3.0%), and etiology was not clear(n=5, 7.6%). (2)All children with status epilepticus were divided into four groups according to different valproic acid loading dose(0 mg/kg, 10-15 mg/kg, 16-39 mg/kg, 40 mg/kg). There are no significant differences in gender and age among groups.There were no significant differences in duration of status epilepticus and epileptic treatment efficiency(P=0.402, 0.034). (3)All children were monitored for liver function after the treatment of sodium valproate, and no patient had been found increased alanine aminotransferase.@*Conclusion@#There are no significant differences in the effect of different valproic acid loading doses in children with status epilepticus, and no adverse side effects are observed in children with status epilepticus who received a dose of 40 mg/kg.
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Objective:To explore the effect of valproic acid with different loading doses in treatment of children with status epilepticus.Methods:The data of children who were hospitalized in the intensive care unit of the Children′s Hospital Affiliated to Zhejiang University because of status epilepticus from January 1, 2013 to December 31, 2017 were collected.All the patients were divided into different groups according to loading dose of valproic acid.The effect were analyzed in different groups.Results:(1)There were 66 children with status epilepticus were admitted, including 35 males and 31 females.Among all children with status epilepticus, the etiology included epilepsy( n=36, 54.5%), intracranial infection( n=16, 24.2%), hypoxic asphyxia ( n=3, 4.5%), intracranial tumor( n=2, 3.0%), abnormal brain development( n=2, 3.0%), intracranial hemorrhage( n=2, 3.0%), and etiology was not clear( n=5, 7.6%). (2)All children with status epilepticus were divided into four groups according to different valproic acid loading dose(0 mg/kg, 10-15 mg/kg, 16-39 mg/kg, 40 mg/kg). There are no significant differences in gender and age among groups.There were no significant differences in duration of status epilepticus and epileptic treatment efficiency( P=0.402, 0.034). (3)All children were monitored for liver function after the treatment of sodium valproate, and no patient had been found increased alanine aminotransferase. Conclusion:There are no significant differences in the effect of different valproic acid loading doses in children with status epilepticus, and no adverse side effects are observed in children with status epilepticus who received a dose of 40 mg/kg.
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Objective To analyze the relationship between the level of serum ferritin (SF)and the severity of community acquired pneumonia (CAP)in children,and to explore the timing of glucocorticoid therapy for children with CAP.Methods Retrospective analysis was performed on the clinical data of 738 children with CAP who were hospitalized at the Department of Respiratory,Beijing Children's Hospital,Capital Medical University from January 2014 to December 2015.All patients were divided into a mild group and a severe group based on the severity of CAP,and the levels of SF,C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),white blood cell (WBC) and D-dimer were compared between the 2 groups.In addition,the analysis of receiver operating characteristic (ROC) curve was performed to study the usefulness of SF as severity indicators for CAP,and to learn the relationship between the level of SF and the glucocorticoid therapy in children with CAP.Simultaneous analysis of SF and CRP,WBC,ESR,D-dimer was made at the same time.Results (1) There were all 738 children enrolled into this study.There were 442 children in the mild group and 296 children in the severe group.There was no significant difference in age and sex between the mild group and the severe group(all P ＞ 0.05).(2)Comparisons between the mild group and the severe group were as follows:days of hospitalization [10.0 (9.0,13.0) days],duration of fever [10.0 (7.0,10.0) days] and heat peak [39.9 ℃ (39.1 ℃,40.1 ℃)] in the severe group,which had significant differences than those in the mild group [days of hospitalization 7.0 (6.0,9.0) days,duration of fever 7.0 (5.0,10.0) days and heat peak 39.3 ℃ (39.0 ℃,39.8 ℃)] (all P ＜ 0.05).The levels of SF [229.0 (150.0,436.2) μg/L],CRP [30.00 (9.84,78.20) mg/L],WBC [8.44 (5.91,12.6) × 109/L],ESR [30.5 (16.0,49.0) mm/1 h] and D-dimer [0.871 (0.317,2.532) μg/L] in the severe group were significantly higher than those in the mild group [SF:98.0 (68.2,136.1)μg/L,CRP:11.50 (5.77,11.50) mg/L,WBC:7.59 (5.87,10.1) × 109/L,ESR:23.0 (13.0,36.3) mm/1 h and D-dimer 0.232 (0.159,0.407) μg/L],and the differences were statistically significant (all P ＜ 0.05).(3) The levels of SF [258.5 (177.8,404.9) μg/L] and CRP [8.0 (8.0,16.5) mg/L] in CAP children in the recovery phase were significantly lower than those in the acute phase [SF:912.1 (418.7,1 380.3) μg/L,CRP:47.4 (18.8,105.8)mg/L].(4)The level of SF had significantly positive correlations with CRP,ESR,D-dimer (r =0.485,0.286,0.611,all P ＜ 0.05).(5) The cutoff value for SF,D-dimer for diagnosing severe pneumonia was 168.0 μg/L (sensitivity 70.6％,specificity 86.2％),and 0.616 μg/L (sensitivity 58.1％,specificity 87.1％).(6) There were 17.2％ cases (76/442 cases) in the mild group and 52.7％ cases (159/296 cases) in the severe group who received systemic glucocorticoid therapy.Conclusion The level of SF was correlated with the severity of CAP in children,and the level of SF in patients in recovery phase was significantly lower than that in the acute phase.When SF ≥ 168.0 μg/L,D-dimer ≥0.616 μg/L,attention should be paid to the possibility of severe CAP,regarding the indication for systemic steroid therapy for CAP in children.
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Objective To investigate the sensitivity and specificity of anti ? fodrin polypeptide antibody in Sjgren′s syndrome (SS) patients.Methods Synthesized ? fodrin polypeptide was used as substrate in enzyme linked immunosorbent assay (ELISA) to detect the specific antibody in sera of SS and other rheumatic diseases.Results Antibody against ? fodrin polypeptide were detected in 73% of patients with primary SS,40% of patients with secondary SS,19 5% of patients with SLE,29 5% of patients with RA,and 3 8% of normal blood donors.The positive rates of ? fodrin polypeptide antibody in primary and secondary SS (73% and 40%,respectively) were significantly higer than those in SLE,RA and normal controls ( P
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Objective:To construct and evaluate T7 phage display cDNA library from synovium of rheumatoid arthritis patients.Methods:Total RNA was extracted from pooled RA synovium by Trizol reagents.Messenger RNA was isolated from total RNA by oligo (dT)-conjugated Oligotex particles,and then,the agarose gel electrophoresis showed the range of mRNA size.After mRNA was reverse-transcribed into double-stranded cDNA,end modification,adaptors ligation and EcoR Ⅰ and Hind Ⅲ digestion were performed.After eliminating excess adaptors and small fragments(less than 300 bp),the cDNA was ligated into T7Select 10-3 vector.The RA synovium phage display cDNA library was constructed by package reaction in vitro and plate proliferation.Plaque assay and PCR were used to evaluate the library.Results:We showed that complexity of the library was about 2?107,and the phage titer of the amplified library was 8.9?10 10 pfu/ml.Insert ratio was proved to be 90% with the range of 300-2 000 bp inserts.Meanwhile,a target cDNA gene of BiPwas probed with PCR amplification.Conclusion:The phage display cDNA library from synovium was construted with high quality and can be used as a valuable source in screening of RA self-antigens.