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Objective:To explore the early identification, diagnosis and pathogenesis of childhood acute lymphoblastic leukemia (ALL) complicated with cytokine release syndrome(CRS).Methods:The clinical data of childhood ALL complicated with CRS admitted to Shenzhen Children's Hospital in February 2021 were retrospectively analyzed. The relevant literature was reviewed.Results:The little girl was 2 months and 11 days of age and was diagnosed with ALL with MLL rearrangement positive by bone marrow aspiration because of abdominal mass and abnormal hemogram. She had recurrent high fever with pulmonary imaging characteristic changes during the early intensive induction chemotherapy, accompanied by the elevated interlukin (IL)-2, IL-6, IL-10 and interferon (IFN)-γ. Finally, she was diagnosed with ALL complicated with CRS. Glucocorticoid therapy showed a good efficacy and her clinical symptoms improved.Conclusions:ALL complicated with CRS is essentially induced by cytarabine syndrome drugs in the chemotherapy. The main clinical manifestations include recurrent high fever accompanied by the elevated IL-2, IL-6, IL-10 and IFN-γ. The symptomatic and supportive therapy is usually based on glucocorticoids. Early identification and diagnosis can reduce adverse drug reactions and improve the life quality of children.
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【Objective】 To investigate the expression level of B7-H6 in peripheral blood and bone marrow of patient with chronic myeloid leukemia (CML), and to analyze its association with clinicopathological characteristics and prognosis. 【Methods】 A total of 120 CML patients from January 2010 to May 2013 were selected as study subjects. The expression of B7-H6 mRNA in CML peripheral blood and bone marrow pre- and 3-, 6-, 12-month-posttreatment was detected by quantitative real time PCR, and its correlation between prognosis and clinicopathological factors was analyzed. 【Results】 The expression level of B7-H6 mRNA in the PB, BMMCs of CML patients was lower than that of the normal population (P0.1%(P<0.0001) or without CCR (P<0.001). The expression level of B7-H6 in BMMCs was negatively correlated with the BCR-ABL1/ABL level (r=–0.260, P<0.05). Signifiant difference in PFS was observed between patients with high expression level of B7-H6 (not reached, HR: 0.06, 95% CI =0.03-0.37) and low expression level (81 months, HR: 15.58, 95% CI =2.68-30.23) in BM (P<0.05). 【Conclusion】 The low expression of the B7-H6 gene in CML is correlated with BCR-ABL1 copy number and responsiveness to treatment, and monitoring of B7-H6 expression may be used to evaluate CML prognosis, progression and treatment efficacy.
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Objective To investigate the prognosis of grommet insertions for osecretory otitis media in children and analyze the factors that may influence the results.Methods A retrospective review of 103 children (182 ears) with grommet insertions for osecretory otitis media from January 2011 to December 2011 was performed.They were divided into two groups(A and B) basing on the median age of 6 years old and observed their clinical manifestations,etiology and prognosis through two years' follow-up.The preoperative pure tone audiometry(PTA) hearing threshold,PTA in two weeks after surgery,the proportion of adenoid hypertro phy,the time of tube extrusion,the relapse of osecretory otitis media and repeat operation between two groups were compared.Results The difference of preoperative PTA and post operative PTA were not significant different between two groups(P＞0.05).But post operative PTA was lower than preoperative PTA(P＜0.05).The difference of otitis media recurrence was not significant different between two groups(P=0.088),but adenoid hypertrophy's proportion,tube extrusion's time and relapse were significant different(P＜0.05).Conclusion For school-age children with secretory otitis media need to extend the catheter time to reduce the probability of secondary catheterization.
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Objective To study whether the usage of antibiotics and white -blood -cell counts affect the effects of 2~12-year-old children with acute otitis media (AOM ) .Methods A total of 126 children (2~12 years old)with AOM ,from Jan 2013 to Dec 2013 ,were retrospectively analyzed .Usage of antibiotics and white -blood-cell count were recorded at first ,and the relationships between two factors and outcomes of children with AOM were studyed in one week ,one month and three months after treatment ,respectively .Results White blood cell counts were higher than normal in 59 .52% (75/126) 2~12 -year -old children with AOM ,and antibiotics were used in 73 .81% (93 /126) .Ninty three cases were followed -up until 3 month or more .Antibiotics were used in 74 cases ,and watchful waiting were used in the other 19 patients .The effective rates of two groups were 59 .45% and 52 .63% ,75 .68% and 84 .21% ,85 .14% and 78 .95% in one week ,one month and 3 months after treatment ,re‐spectively .There were no statistically significant differences(χ2 values were 0 .295 ,0 .903 ,0 .799 ,P>0 .05) .But the effective rates were signifantly higher in 1 and 3 months than that of in one week (P0 .05) between one and three months .Whether white-blood-cell count higher than normal or not ,the difference in efficacy was not statistically significant in 1 week ,1 month and 3 months after treatment (P >0 .05) .Conclusion In 2~12-year-old children with acute otitis media (AOM ) ,the final outcomes were inde‐pendent of the usage of antibiotics and white -blood-cell count .
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OBJECTIVE@#To discuss the diagnosis, differential diagnosis, treatment and first aid treatment of trachea foreign bodies in children.@*METHOD@#One hundred and sixty-four patients,who were operation with the diagnosis of trachea foreign bodies were retrospectively analyzed.@*RESULT@#The foreign bodies were successfully removed through the rigid bronchoscope in 163 patients and through the incision of tracheotomy in 1 patient. No post-operation complication in 163 patients except 1 patient with subcutaneous and mediastinum emphysema. No foreign body remained by the examination of perspective X-ray or electronic bronchoscope three days post-operation.@*CONCLUSION@#History of foreign body aspiration and physical examination were significant important in diagnosis of trachea foreign bodies. The diagnosis must be made quickly based on the history and physical examination. The clapping sound has high specially in diagnosis of trachea foreign bodies. The electronic bronchoscope has a better accuracy in diagnosis of trachea foreign bodies than radiographic examination.
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Child , Child, Preschool , Female , Humans , Infant , Male , Bronchi , Bronchoscopy , Diagnosis, Differential , Foreign Bodies , Diagnosis , General Surgery , Retrospective Studies , TracheaABSTRACT
OBJECTIVE@#To study the clinical features and conservative treatment of petrositis.@*METHOD@#One case of petrositis was reported and literatures were reviewed. Opacificated air cells in CT, and anomalous, discontinuous hypersignal in MRI T1 and T2 provided evidence of infection of the apex of the petrous temporal bone.@*RESULT@#The patient recovered totally after conservative treatment with intravenous antibiotic, glucocorticoid and neurotrophic therapy, and no recurrence occurred in 1 year follow-up. CT rescan showed the clear air cells of the petrous apex 4 months later.@*CONCLUSION@#Petrositis can be diagnosed with specific clinical features, the image of CT and MRI. Conservative treatment could be a good choice.
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Adolescent , Female , Humans , Magnetic Resonance Imaging , Otitis Media , Diagnosis , Petrositis , Diagnosis , Therapeutics , Tomography, X-Ray ComputedABSTRACT
Objective To analyze the common causes and clinical features associated with hoarseness in chil-dren of different ages. Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic [aryngofiberscopy retrospectively. Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%, 1 105 cases), vocal hypertrophy (38.2% ,955cases), acute and subacute laryngitis (6.5 %, 163cases), the paralysis of vocal cord(6.82 %, 141cases), and laryngeal papilloma(1.6 %, 40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32 : 1. The top five diseases were statisti-cally distributed in different age groups (P<0.01) . Conclusion The main causes of hoarseness were different in different age groups. The preschoolers made up the largest group (928/2 500), showing the greatest incidence of hoarseness in children . The incidence for male patients was higher than female and the vocal cord nodules was the top disease (1 105/2 500 cases,44.2%). Hoarseness in children was different from that of adults so that to under-stand the characteristics of this disorder in children will be beneficial to the proper diagnosis and effective treatment.
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Objective To analyze the common causes and clinical features associated with hoarseness in children of different ages.Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic laryngofiberscopy retrospectively.Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%,1 105 cases),vocal hypertrophy (38.2%,955cases),acute and subacute laryngitis(6.5%,163cases),the paralysis of vocal cord(6.82%,141cases),and laryngeal papilloma(1.6%,40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32:1. The top five diseases were statistically distributed in different age groups (P