Acupuncture combined with cranial electrotherapy stimulation on generalized anxiety disorder: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of acupuncture combined with cranial electrotherapy stimulation (CES) on generalized anxiety disorder (GAD).@*METHODS@#A total of 200 patients with GAD were randomized into an acupuncture+CES group, an acupuncture group, a CES group and a medication group, 50 cases in each one. In the medication group, patients were treated with tandospirone citrate tablet orally, 10 mg after breakfast, lunch and dinner respectively. In the CES group, CES was adopted by SCS brain electromedical instrument, 60 min each time, once a day. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Yintang (GV 29), Shenting (GV 24), etc., 30 min each time, once a day. In the acupuncture+CES group, CES was adopted before acupuncture. Treatment of sixty days was required in the 4 groups. Before and after treatment, the scores of Hamilton anxiety scale (HAMA), World Health Organization's quality of life questionnaire-brief version (WHOQOL-BREF) and treatment emergent symptom scale (TESS) were observed, the clinical effect was evaluated, and the relapse of anxiety during follow-up of 1 year after treatment was recorded in the 4 groups.@*RESULTS@#Compared before treatment, the scores of HAMA after treatment were decreased (@*CONCLUSION@#Acupuncture combined with CES can effectively relieve the symptoms in patients with GAD, improve the quality of life, reduce the occurrence of adverse reactions and the relapse rate, and its clinical effect is obviously superior to the western medication, the simple application of acupuncture or CES.

Detection of Subclinical Anthracyclines' Cardiotoxicity in Children with Solid Tumor / 中华医学杂志(英文版)

<p><b>Background</b>Cardiotoxicity is one of the most serious chronic complications of anthracyclines therapy. Assessment of the left ventricular ejection fraction (LVEF) fails to detect subtle cardiac dysfunction of left ventricular (LV). This study aimed to detect and evaluate new parameters of subclinical anthracyclines' cardiotoxicity in children with solid tumor.</p><p><b>Methods</b>A detailed echocardiographic examination was performed in 36 children with hepatoblastoma or rhabdomyosarcoma after receiving anthracyclines' chemotherapy and 36 healthy controls from January 2015 to December 2016. The LVEF, ratio of early diastolic peak velocity of transmitral flow (E) and septal diastolic e' mitral annular peak velocity (e'), tricuspid annular plane systolic excursion (TAPSE), and LV global longitudinal strain (GLS) were evaluated using M-mode, tissue Doppler imaging (TDI), and two-dimensional speckle tracking echocardiography (2D-STE), respectively. Echocardiographic parameters were compared between patient group and healthy controls. All patients were divided into two subgroups based on their anthracyclines' cumulative dosage (<300 mg/m subgroup and ≥300 mg/m subgroup).</p><p><b>Results</b>All patients had no presentation of heart failure and LVEF within normal range (65.7 ± 5.1%). Compared with healthy controls, the mean E/e' increased significantly (7.9 ± 0.7 vs. 10.2 ± 3.5, t = 3.72, P < 0.01), mean TAPSE decreased significantly (17.2 ± 1.3 mm vs. 14.2 ± 3.0 mm, t = -4.03, P < 0.01), and mean LV GLS decreased significantly (-22.2% ± 1.9% vs. -17.9% ± 2.9%, t = -5.58, P < 0.01) in patient group. Compared with subgroup with anthracyclines' cumulative dosage < 300 mg/m, mean LV GLS decreased significantly (-18.7 ± 2.7% vs. -16.5 ± 2.1%, t = 2.15, P = 0.04), the mean E/e' increased significantly (9.1 ± 1.5 vs. 11.5 ± 4.9, t = -2.17, P = 0.04), and mean TAPSE decreased significantly (14.2 ± 2.1 mm vs. 12.5 ± 2.2 mm, t = -2.82, P = 0.02) in subgroup with anthracyclines' cumulative dosage ≥300 mg/m.</p><p><b>Conclusions</b>LV GLS is helpful in the early detection of subclinical LV dysfunction using 2D-STE. E/e' and TAPSE are other sensitive parameters in detecting subclinical cardiac dysfunction of both ventricles by TDI. These parameters show significant change with different anthracyclines' cumulative dosage, so cumulative dosage should be controlled in clinical treatment.</p>

Prognostic Significance of Joint Detection of miR-210 and Minimal Residual Disease in Pediatric Acute Lymphoblastic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the expression of microRNA-210(miR-210) in childhood acute lymphoblastic leukemia(ALL), and to evaluate the role of the joint detection of miR-210 and MRD in the prognosis and clinical treatment of pediatric ALL.</p><p><b>METHODS</b>Eighty-eight children diagnosed with ALL were included in the study. miR-210 was quantitatively detected by real-time quantitative polymerase chain reaction(RQ-PCR) in 88 ALL patients. The average Ct value of samples obtained from 5 pediatric ALL patients with long-term complete continuous remission (CCR>5 years) was used as a calibrator. The expression levels of miR-210 in newly diagnosed patients was calculated by the 2method and presented as multiple changes compared with that of the 5 CCR patients.</p><p><b>RESULTS</b>The expression of miR-210 in the favorable prognosis group was significantly higher than that in the unfavorable prognosis group (10.64±1.5 vs 3.27±0.68)(P<0.05). Compared with the miR-210 high-expression group, poorer relapse-free survival(RFS), event-free survival(EFS) and overall survival(OS) (P all <0.001) were found in the low-expression group. Based on the expression of miR-210 and MRD, the 88 cases were divided into 3 groups. The relapse rate of miR-210-MRD high-risk group (70%) was significantly higher than that of the miR-210-MRD middle-risk group(6.25%) and miR-210-MRD low-risk group (2.1%). Kaplan-Meier survival analysis demonstrated that the miR-210-MRD high-risk group had poorer RFS, EFS and OS than those in other 2 groups (P all <0.01).</p><p><b>CONCLUSION</b>The expression level of miR-210 is an independent prognostic factor for pediatric ALL, and the miR-210 is a good useful indicator for predicting the relapse and induction failure of childhood ALL. Joint detection of miR-210 and MRD can help predict outcomes more precisely, thus may be used as an effective mean of determining prognosis, monitoring recurrence, and guiding treatment.</p>

Clinical features and outcomes of neuroblastoma patients aged above 5 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features and outcomes of neuroblastoma (NB) children aged above 5 years, and to provide a theoretical basis for improving prognosis.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 54 previously untreated NB children, and their clinical features and outcome were analyzed. The Kaplan-Meier method was used for survival analysis.</p><p><b>RESULTS</b>Among the 54 children, there were 36 boys and 18 girls, and all of them had stage 3 or 4 NB. Of all the children, 41 (41/54, 76%) had retroperitoneal space-occupying lesions, 10 (10/54, 18%) had mediastinal space-occupying lesions, 2 (2/54, 4%) had intraspinal space-occupying lesions, and 1 (1/54, 2%) had pelvic space-occupying lesions. At the end of the follow-up, 30 children (30/54, 56%) survived, among whom 23 (77%) achieved disease-free survival (9 achieved complete remission after chemotherapy for recurrence), 6 (20%) achieved partial remission of tumor (all of them received chemotherapy again due to recurrence), and 1 (3%) experienced progression (with progression after chemotherapy again due to recurrence); 24 children (44%) died, among whom 22 died after chemotherapy again due to recurrence and 2 died of multiple organ failure during the first treatment. According to the Kaplan-Meier survival analysis, the mean survival time was 53.8 months, and the children with stage 3 NB had a significantly higher overall survival rate than those with stage 4 NB (80% vs 53%; p<0.01). The children with recurrence had a significantly lower mean survival time than those without recurrence (51.68 months vs 62.57 months; p<0.01).</p><p><b>CONCLUSIONS</b>Older children often have late-stage NB, but standard treatment can improve their outcomes.</p>

Optimization of Jiawei Qing'e Oral Fast Disintegrating Tablets Based on Response Surface-Central Composite Design / 中草药·英文版

Objective: To apply the response surface-central composite design to developing and optimizing the oral fast disintegrating tablets (ODT) formulation for Jiawei Qing'e, a kind of prescription of Chinese herbal medicine. Methods: The bitterness of Jiawei Qing'e was masked using Eudragit E-100 by solvent evaporation technique. Response surface approach was applied to investigating the interaction of formulation parameters in optimizing the formulation. The independent variables were Eudragit E-100/drug ratio (X1), amount of disintegrants (X2), and the amount of diluents (X3). The disintegration time (Y1), hardness (Y2), and weight variations of the tablets were characterized. Results: The models predicted levels of X1 = 4.63%, X2 = 5.25%, and X3 = 34.33%, for the optimal formulation having a hardness of 3.0 kg with the disintegration time of 30 s within experimental region. The observed response of Y1 = 26.5 s and Y2 = 3.14 kg reasonably agreed with the predicted response. Conclusion: Response surface methodology shows the good predictability and reliability in optimizing the formulation. The optimized ODT of Jiawei Qing'e has acceptable taste, rapid disintegrating ability, and good mechanical strength. © 2013 Tianjin Press of Chinese Herbal Medicines.

Clinical efficacy and prognosis with advanced Wilms' tumor in children / 中华实用儿科临床杂志

Objective To analyze the clinical data of 12 children with advanced Wlims' tumor in children from Feb.2009 to Jun.2012.All cases were diagnosed by pathology and to analysis the clinic efficacy and treatment experience were analyzed.Methods Of 12 patients,10 cases were male and 2 cases were female.The medium age of 12 patients was 2.54 years old(9 months-15 years old).According to pathological stage and clinical stage of The National Wilms' Tumor Study Group(NWTSG),5 cases belonged to stage lⅢ,and 7 cases stage Ⅳ.Six cases were well-differentiated tissue type,and 6 cases were poorly differentiated tissue type according to NWTSG.In all patients,different ways of chemotherapy and radiotherapy were selected according to clinical stage and tissue type differentiation.If a patient had repeated recurrence after common surgery and chemotherapy,would treated by antologous peripheral blood stem cell transplantation(APBSCT).Statistic analysis was used to analyze the clinical characters and efficacy and prognosis for 12 patients.Results 1.Initial symptoms:in 12 cases,8 cases presented abdominal mass (66.6％),2 cases with abdominal pain and fever(12.7％),and 2 cases with hematuria(12.7％).2.Eleven cases followed up to Jan.2013,the medium time was 31.5 months(8-131 months).Of 12 cases,1 case give up therapy and follow-up and 11 cases were followed up.Of those 11 cases followed-up,4 cases had complete remission(CR),and 1 case had remission in part(PR),the conditions of 5 cases were progressively worse,1 case replapsed,and 4 patients died.Total survival rate was 63.63％ (7/11 cases),and mortality was 36.37％ (4/11 cases),and free survival rate was 36.37％ (4/11 cases),of that,1 patient of stage Ⅳ,relapsed 3 times after common radiotherapy and chemotherapy,achieved complete remission after high dose chemotherapy (Melphalan + Carboplatin + Etoposide,CEM) and APBSCT.The estimated 3-yearsurvival rate was 51.4％.Conclusions The prognosis of advanced Wilms' tumor is poor,and the mortality is still high.High dose chemotherapy with APBSCT may be a valuable method for advanced cases.

Observation on clinical efficacy of depression treated with the alliance of acupuncture and medication / 中国针灸

<p><b>OBJECTIVE</b>To observe the differences in the clinical efficacy on depression in comparison among the alliance of acupuncture and Chinese herbal medicine, simple herbal medicine and flupentixol and melitracen tablets.</p><p><b>METHODS</b>Two hundred and twenty-seven cases were randomized into a Chinese medicine group(75 cases), an acupuncture + medication group(78 cases) and a western medicine group(74 cases). In the Chinese medicine group, Shugan Jianwei Anshen Decoction was prescribed, in which Radix Bupleuri and Radix Paeoniae Alba were the monarch herbs, one dose a day. In the acupuncture + medication group, on the basic treatment of Chinese medicine, acupuncture was combined every day at Baihui (GV 20), Sishencong (EX-HN 1), Shenmen (HT 7), Lingdao (HT 4), Daling (PC 7), Laogong (PC 8), Yongquan (KI 1), etc. In the western medicine group, deanxit was taken orally, 1 tablet after getting up in the morning and after lunch respectively. The treatment lasted for 8 weeks in the three groups. The change of Hamilton depression scale (HAMD) score and clinical efficacy were observed before and after treatment.</p><p><b>RESULTS</b>In 8 weeks of treatment, in the acupuncture + medication group, 19 cases were cured, 35 cases were markedly effective, 14 cases were effective and 10 cases failed, the effective rate was 87.2%; in the western medicine group, 11 cases were cured, 32 cases were markedly effective, 18 cases were effective and 13 cases failed, the effective rate was 82.4%; in the Chinese medicine group, 5 cases were cured, 14 cases were markedly effective, 35 cases were effective and 21 cases failed, the effective rate was 72.0%. HAMD assessment was done in 8 weeks of treatment, which was (5.71 +/- 4.32) scores in the acupuncture + medication group, (6.09 +/- 3.78) scores in the western medicine group and (9.24 +/- 3.49) in the Chinese medicine group, the differences were significant in the Chinese medicine group compared with the western medicine group and the acupuncture + medication group (both P < 0.05). The differences in the scores after treatment were not significant statistically between the acupuncture + medication group and the western medicine group (both P > 0.05), but the cured and markedly effective rate in the acupuncture + medication group was superior to that in the western medicine group (P < 0.05).</p><p><b>CONCLUSION</b>The alliance of acupuncture and medication achieves the definite efficacy on depression, characterized as less adverse reactions and better safety.</p>

Clinical features of 39 children with head and neck rhabdomysarcoma in a single medical center, and treatment outcomes / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features and treatment outcomes of head and neck rhabdomysarcoma (RMS) in children.</p><p><b>METHODS</b>The clinical data and results of follow-up visits for 39 children with head and neck RMS were retrospectively reviewed. The children (23 males and 16 females) with a median age of 6 years old (ranged 3 months to 14 years) were admitted to the Beijing Tongren Hospital between November, 2004 and November, 2010.</p><p><b>RESULTS</b>The 39 children mainly presented with exophthalmos and eyelid swelling (56%, 22/39), rhinostegnosis and nasal bleeding (28%, 11/39) and check mass (15%, 6/39). Common primary sites were the eyelid and orbit (56%, 22/39), followed by the nasopharynx and ethmoid antrum (28%, 11/39). Thirty-seven of the 39 patients showed a definite pathologic type and the embryo type was the most common (89%, 33/37). Follow-up visits were carried out for 35 children, with a median follow-up time of 38 months (10-80 months). Of the 35 children, 4 cases received surgery alone, 1 case received chemotherapy alone, 12 cases received surgery plus chemotherapy, 2 cases received surgery plus radiochemotherapy, 13 cases received surgery, chemotherapy and radiochemotherapy (8 cases received 125I particles implants), 2 cases received surgery, chemotherapy, radiochemotherapy and autologous peripheral blood stem cells transplantation (APBSCT), and 1 case received chemotherapy and APBSCT. Seven cases relapsed and 5 cases died of brain metastasis. The total survival rate was 86% (30/35), the complete remission rate was 66% (23/35), and the partial remission rate was 20%. In the 8 cases receiving 125I particles implants, 6 survived without tumor.</p><p><b>CONCLUSIONS</b>Exophthalmos and eyelid swelling are the main presentations in children with head and neck RMS. Common primary sites of this disease are the eye and nasopharynx. The most common pathologic type is embryo type. Comprehensive treatment, including chemotherapy, surgery, 125I particles implants and APBSCT therapy, can improve outcome.</p>

Clinical application of 125I particle implantation in children with rhabdomysarcoma of the head and neck / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficacy and safety of 125I particle implantation in the treatment of rhabdomysarcoma (RMS) of the head and neck in children.</p><p><b>METHODS</b>Eight children (four males and four females) with RMS of the head and neck received 125I particle implantation targeted to the primary lesion area. The primary lesions were noted in eyelids or eyes in two children, in the orbit in four children, and in the nasal cavity or nasal wing in two children. Treatment outcomes and side effects were observed.</p><p><b>RESULTS</b>The follow-up visits averaged 45±17 months (median 43 months) in the eight children receiving 125I particle implantation. Five children achieved a complete remission, 2 children achieved a complete remission and 1 child died. The total survival rate was 88% in the 8 children. Local pigmentation was observed in all eight children (100%). Nubecula (one case), eyeball pain (one case), serious blurred vision (one case), cornea ulcer and blindness (one case) and bleeding of the nasal cavity (one case) were also observed. Except for nubecula and blindness, these side effects were improved by symptomatic treatment.</p><p><b>CONCLUSIONS</b>125I particle implantation appears to be effective in the treatment of RMS of the head and neck in children. Most treatment-related side effects can be improved by symptomatic treatment.</p>

Mobilization and collection of autologous peripheral blood stem cells by CIE or IEV protocol in children with malignant solid tumors / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Autologous peripheral blood stem cell transplantation (APBSCT) is an important method for treatment of malignant solid tumors in children. The mobilization and collection of blood stem cells is crucial for APBSCT. This study aimed to evaluate the clinical efficacy of mobilization and collection of blood stem cells by CIE or IEV chemotherapy protocol in APBSCT in children with neuroblastoma (NB) or rhabdomyosarcoma.</p><p><b>METHODS</b>The protocols of CIE (cisplatin, etoposide) and IEV (vincristine, dosfamide, etoposide) were used as mobilization chemotherapy in 8 cases of NB with stage IV and 3 cases of rhabdomysacoma with stage III, respectively. The results of the mobilization of blood stem cells were observed.</p><p><b>RESULTS</b>Of the 11 cases, mononuclear cells (MNC) and CD34+ cells were successfully collected and the volume of MNC and CD34 averaged (5.55 ± 1.43)× 10(8)/kg and (4.88 ± 2.48) × 10(6)/kg, respectively. No severe complications were observed during the mobilization and collection. A rapid hemopoietic reconstitution was observed in 10 children after APBSCT. One with NB out of the 10 children died of left heart failure 32 days after APBSCT. Others (9 cases) showed a nearly normal result of routine peripheral blood test 60 days after APBSCT.</p><p><b>CONCLUSIONS</b>CIE or IEV protocol is effective and safe for the mobilization and collection of peripheral blood stem cells in children with NB or rhabdomysacoma.</p>

Therapeutic effects of high dose chemotherapy combined with autologous peripheral blood stem cell transplantation for neural ectodermal solid tumor originated from neural crest in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of high dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) for the treatment of neural ectodermal solid tumor originated from neural crest in children.</p><p><b>METHODS</b>Twenty-three children at a medium age of 5.8 + or - 3.5 years with neural ectodermal solid tumor originated from neural crest were enrolled. Of the 23 children, 20 with stage IV neuroblastoma (9 were in complete remission, 7 were in partial remission and 4 were in progressive disease), 2 with stage IV primitive neuroectodermal tumor (PNET) in complete remission, and 1 with retinoblastoma in partial remission. Before APBSCT the children received 8.0 + or - 4.3 courses of chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor excision was performed. Then APBSCT was performed.</p><p><b>RESULTS</b>The reconstruction of the hematopoietic system was noted in 19 of 20 children with stage IV neuroblastoma 16.5 + or - 0.9 days after transplantation. A follow-up (median 15.8 months) was done in these children. The follow-up showed that the survival rate in children in complete remission before transplantation was 100%, 57% in those in partial remission, and none of children in progressive disease survived (P<0.05). The total survival rate was 67% in children with neuroblastoma. The child with retinoblastoma had complete remission in a 6-months follow-up. The tumors recurred in children with PNET 5 to 8 months after transplantation and all died within one year after transplantation.</p><p><b>CONCLUSIONS</b>High dose chemotherapy combined with APBSCT can result in a good outcome in children with neural ectodermal solid tumor originated from neural crest in complete remission before transplantation and can improve the outcome in patients in partial remission before transplantation. However, the children with PNET, even in complete remission before transplantation, do not respond to the therapy.</p>

Serum types of enterovirus and clinical characteristics of 237 children with hand, foot and mouth disease in Shenzhen / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical and epidemiologic characteristics and the serum types of enterovirus of hand, foot and mouth disease (HFMD) in children.</p><p><b>METHODS</b>The RT-nPCR method was established with universal primers within 5' untranslated region of enterovirus and VP1 region of Coxsackievirus A16 (CAV16) and enterovirus 71 (EV 71). Enteroviruses were detected with RT-nPCR in 237 children with HFMD. Clinical and epidemiologic characteristics and serum types of enterovirus of the patients with HFMD were studied.</p><p><b>RESULTS</b>The patients'age ranged from 7 months to 11 years (mean 4.2 +/- 0.5 years). The majority (94.5%) were less than 6 years old. HFMD was mostly seen in spring and winter (67.9%). Oral mucosal pox or ulcer as well as hand and foot rashes were observed in all 237 patients. Fever occurred in 141 patients (59.5%). Of the 237 patients, 133 (56.1%) were RT-nPCR positive. Of the 133 cases, 38 were positive for EV71, 64 were positive for CAV16, and 31 were negative for both EV71 and CAV16. The patients infected by different types of enteroviruses had similar clinical characteristics. Gene colon and sequence analysis for 12 strains of enteroviruses PCR positive products presented as EV71 (n=5), CAV16 (n=5), ECHO13 (n=1), and CAV5 (n=1).</p><p><b>CONCLUSIONS</b>HFMD tends to occur in younger children less than 6 years old. The majority are affected in spring and winter. EV71 and CAV16 are common pathogens of HFMD. There is no relationship between clinical characteristics and serum types of enteroviruses in HFMD patients.</p>

Mean values of brain natriuretic peptide in 190 healthy children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Overseas research has shown the value of brain natriuretic peptide (BNP) in the diagnosis and treatment of heart failure in children. However, a reference range of BNP values is lacking, limiting its clinical application. This study was designed to determine a reference range for children aged 1 to 16 years.</p><p><b>METHODS</b>Plasma BNP (BNP32, NT-proBNP) concentrations were measured in 190 healthy children (95 boys and 95 girls) using an enzyme immunoassay. Their age ranged from 1 to 16 years (mean=10.6 +/- 4.2 years).</p><p><b>RESULTS</b>The mean plasma concentration of BNP32 in 190 children was 51.89 +/- 48.36 pg/mL, with the 10th and the 90th percentile rank of 27.00 pg/mL and 75.00 pg/mL respectively. The mean plasma concentration of BNP32 in girls was 60.33 +/- 62.91 pg/mL, and 44.22 +/- 27.14 pg/mL in boys, but no statistical differences were found. The mean plasma concentration of NT-proBNP in 190 children was 246.04 +/- 67.27 fmol/mL. The girls had slightly higher plasma NT-proBNP levels than the boys, but there were no statistical differences between them. Neither plasma BNP32 concentration nor NT-proBNP concentration was related to age.</p><p><b>CONCLUSIONS</b>This study first reported a reference range of BNP values for healthy Chinese children aged 1-16 years. Both age and gender are not related to BNP values.</p>

Changes of N-Terminal Pro-Brain Natriuretic Peptide in Normal Children and Children with Congestive Heart Failure / 实用儿科临床杂志

Objective To determine the normal ranges of N-terminal pro-brain natriuretic peptide(NT-proBNP) in normal children and children with symptoms of heart failure(HF),and to study their clinical implications.Methods Concentrations of serum NT-proBNP were determined in 80 normal children and 70 children with clinical symptoms of HF.Venous blood was taken in each subject,and plasma NT-proBNP was determined by ELISA method.Eighty normal children included 40 boys and 40 girls.Their ages ranged from 1 to 16 years old.Seventy children with HF were divided into two groups.The first group(n=45,21 males,24 females) included children with symptoms of HF caused by dilated cardiomyopathy(DCM).Their ages ranged from 1 to 16 years,and they had a left ventricular ejection fraction(LVEF) of less than 50%.The second group(n=25,11 male,14 female) consisted of children with symptoms of HF due to ventricular septal defect(VSD).Their ages ranged from 1 to 16 years,and they had an LVEF of 51%-78%.The serum NT-pro BNP levels were determined by ELISA method and LVEF was measured by echocardiography and clinical symptom score of heart failure was defined by using Ross Score.Results Serum concentration of NT-proBNP was 223.05 fmol/mL in normal children from 1 to 16 years old.NT-proBNP levels did not show a significant age-related or sex-related differences.In children with HF,the plasma NT-proBNP levels were significantly elevated(mean:1353.3 fmol/mL) compared to normal children(t=8.964 P

Clinical Features of Cord and Artery Blood Gas Analysis in Neonate with Acid-Bas eImbalance / 实用儿科临床杂志

Objective To discuss clinical features and harmfulness of acid-base imbalance in newborn by investigating the changes in blood gas of cord and artery blood,and to establish more appropriate prevention measures. Methods One hundred and ninety-two cord blood and 113 peripheral artery blood of neonates were measured for blood gas analysis by automatic blood gas analysis instrument from America;meanwhile,the concentrations of K~+,Na~+ and Cl~- were detected by biochemical analyzer.Results Among 192 neonates,179 were normal labor and 13 neonates underwent acidosis of different degrees.The incidence was 79.9%.Among the 13 ca-(ses),2 cases had severe asphyxia and both of them got serious mixed acidosis.For all the neonates, 156 cases got acidosis, 84 neonates underwent respiratory acidosis (43.8%), 47 cases with metabolic acidosis (24.5%) and 25 cases with mixed acidosis (13.0%).The left 113 neonates were abnormal labor.Among them,99 cases had acid-base disturbance of different degrees (87.6%). Among the 99 acid-base disturbance cases, 50 cases were single metabolic acidosis (44.2%) and presented the most common changes; the second was single respiratory acidosis, totally 20 cases (17.7%).The third was metabolic acidosis combined with respiratory alkalosis, totally 16 neonates (14.2%).Eleven cases had mixed acidosis (9.7%) and 2 cases were respiratory alkalosis combined with metabolic alkalosis (1.8%).Conclusions While the normal labor neonates still got acidosis of different degrees,the acid-base imbalance of abnormal labor is much more prominent,and the critical neonates often got mixed acid-base imbalance.Serious acid-base imbalance can cause fatal pathological changes in body.The dangers of acidosis and alkalosis can not ignore either. The condition of acid-base imbalance can be judged more accurately by the combination of blood gas analysis and anion gap.The perinatal health cares are important measures to prevent acid-base imbalance.

Value of Seeking Tumor Cells Through Cerebrospinal Fluid in Retinoblastoma / 实用儿科临床杂志

Objective To explore the value of seeking tumor cells through cerebrospinal fluid in the metastasis and prognosis of retinoblastoma.Methods Two hundred and fifty-six cases clinic diagnosed retinoblastoma were collected,154 cases were boys and 102 cases were girls.There were 85 children with bilateral disease and 171 children with unilateral disease.Lumbar puncture was examined before treatment,compare the result and prognosis.Children who were found tumor cells in their cerebrospinal fluid were treated with 6 to 9 cycles of systemic chemotherapy with CTV(carboplatin,teniposide and vincristine)protocol and 8 to 10 intrathecal injections with cytrarabine,methotrexate and dexametha-sone.Follow-up were between 8 to 23 months,the mean time was 14.6 months.Results There were 8 cases found tumor cells in their cerebrospinal fluid in all 256 children,one of them died of wide spread intracranial metastasis;the other patient was given high dose chemotherapy with autologous perip-heral stem cell transplantation(APBSCT) because of intracranial metastasis,follow-up to now the patient′s condition was stable.The rest 6 children were enucleated in follow-up period,there were 4 cases(67%) with the histopathology of the eye indicates spread of tumour cells beyond the lamina cribrosa,and 2 cases with invading the cut end of the optic nerve.Six children were no metabasis evidences at other tissues.Conclusions Intracranial metastasis is the common metastasis style in retinoblastoma,so lumbar puncture to seeking tumor cells was important to evaluate intracranial metastasis,early treatment and prognosis.