Liver and heart iron deposition status in patients with β thalassemia major: a multicenter study / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the status of iron deposition in patient with β thalassemia major, and to formulate appropriate treatment strategies.</p><p><b>METHOD</b>The data of status of transfusion and chelation in 135 patients aged from 6 years and 4 months to 17 years and 11 months with β thalassemia major were collected and analyzed. Serum ferritin levels were determined and cardiac and hepatic iron deposition was determined using MRI T2(*) technology.</p><p><b>RESULT</b>Of the 135 cases studied, 66 were male, and 69 were female, their average age was 12.1 years. Serum ferritin (SF) was determined for 111 cases, it varied from 1 086.8 µg/L to 15 011.5 µg/L. Among them, 16 cases had SF level <2 000 µg/L (14.5%) , in 41 cases SF were between 2 000 and 4 000 µg/L (36.0%) ;in 54 cases SF >4 000 µg/L (48.7%) . Liver MRI T2(*) results showed that in only 8 cases (5.9%) iron content in the liver was in normal range, 19 cases (14.9%) showed mild liver iron deposition;34 (25.2%) moderate and 74 (54.8%, the youngest one was only 6 years and 4 months of age) had severe iron deposition respectively. Cardiac MRI T2(*) showed that in 89 cases (65.9%) iron content in the heart was in normal range;19 cases (14.1%) had mild cardiac iron deposition and 27 (20.0%) presented severe iron deposition (the youngest one was only 9 years and 3 months of age) . SF level was obviously related to liver and cardiac iron deposition (MRI T2(*)) r and P value were -0.284, 0.003 and -0.374, 0.000 respectively. In 108 cases regular transfusion and chelation were delayed due to financial problem. The late and insufficient dosage administered and irregular chelation caused the higher SF level and the severe iron deposition.</p><p><b>CONCLUSION</b>The survival status of β thalassemia major in China is worrisome. Majority of them had not received regular transfusion and chelation. Liver and cardiac iron deposition occur early and had a high incidence.</p>

Influence of two kinds of infusion methods on nosocomial infection of children with leukemia during treatment progress / 中国实用护理杂志

Objective To investigate the incidence of nosocomial infection of placing peripherally inserted central catheter (PICC) and venous port acess(VPA) in children with leukemia. Methods 60 cases with leukemia were treated in our hospital from January 2005 to September 2009.35 cases were mail, 25 cases were femail.Their ages ranged from 2.0 to 16.5 years old.42 cases fell to the PICC group, hospital-ization for 202 times, 18 cases belonged to the VPA group, hospitalization for 109 times. The incidence of infection in hospital, infection site, common pathogens and prognosis of two groups were analyzed retro-spectively.Results The incidence of fever and increasing of C-reactive protein of the PICC group were significantly lower than those of the VPA group. There was no difference of the incidence of white blood cells decreasing between two groups. The incidence of infection in hospital in the PICC group was 38.61%, higher than 28.44% of the VPA group. Their difference was significant. There was significant difference of the distribution of infection between two groups. There was no significant difference of the major pathogens of sputum culture and blood culture between two groups. Conclusions Using venous port acess(VPA) could reduce the incidence of infection in hospital compared using peripherally insertied central catheters in children with leukemia, so venous port acess( VPA ) may be safer.

Compare of curative effect on creasentic lupus nephritis by two drug treatment / 中国基层医药

Objective To compare the effect relapse rate and outconles between pulse intravenous cyclophosphamide(CTX)and mycophenolate mofeti(MMF)in the induction therapy of crescentic lupus nephritis(CLN)in children.Methods A retrspective comparative analysis in the general situation,clinical performance,patholoped features,ease of treatment,recurrence rate,the indicence of side effects and prognosis was done between the treatment group(n=10)and the control group(n=10).Results The results in the general situation,and clinical manifestations of lupus activity index,the pathological damage had no significant difference between the treatment group and the control group for 12 months,remission rates were 60% and 70% in the treatment group complete remission rate (50%)was significantly higher(30%),the recurrence rate(10%)was significantly lower than the control group (30%).2 cases of the control group(20%)died;without treatment group died.The side effect of infection was more significant in the CTX group.Conclusion Higher complete remission rates and less infection complications were observed in crescentic lupus nephritis patients who received MMF induction regime than in patients who received intravenous pulse(CTX)regime.