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Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.
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Objective:To explore the influencing factors of acute bilirubin encephalopathy (ABE) in neonates with severe hyperbilirubinemia.Methods:A total of 123 cases of severe neonatal hyperbilirubinemia (serum total bilirubin > 342 μmol/L) in our hospital from January 2018 to May 2020 were retrospectively analyzed.According to the occurrence of ABE, they were divided into ABE group (28 cases) and non-ABE group (95 cases). The perinatal data and laboratory examination results between two groups were compared.The variables with statistical differences in univariate analysis were included in multivariate Logistic regression analysis.Results:Univariate analysis showed that the hemoglobin level and hematocrit of ABE group were higher than those of non-ABE group.The total bilirubin value, length of hospital stay, natural childbirth, mixed feeding, infection with craniocerebral hemorrhage were all higher than those in the non-ABE group, and the differences were statistically significant( P<0.05). Multivariate Logistic regression analysis showed that high hemoglobin level ( OR=1.032, 95% CI 1.007 to 1.057) and long hospital stay ( OR=1.15, 95% CI 1.007 to 1.312) were independent risk factors for ABE patients.Breastfeeding was a protective factor for ABE patients( OR=0.151, 95% CI 0.028 to 0.821). Conclusion:High hemoglobin value and long hospital stay are independent risk factors for ABE patients, and breast feeding is a protective factor for ABE.
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Objective:To evaluate the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of one hundred VLBWI, hospitalized from July, 2016 to June, 2019, were studied retrospectively.The infants were divided into two groups according to whether they received blood transfusion.The general information, incidence of diseases and treatment measures were compared between two groups.The risk factors influencing the blood transfusion were analyzed.Results:Of the one hundred VLBWI, sixty-nine cases needed blood transfusion.The first time of blood transfusion ranged from one to four weeks after birth, and average number of transfusions was 6 times.Maternal anemia during pregnancy, birth weight, gestational age, hemoglobin and hematocrit at birth, volume of blood taking within two weeks after birth, duration of hospitalization, duration of paraenteral nutrition, delivery method, need for intubation and neonatal respiratory distress syndrome, apnea, bronchopulmonary dysplasia, patent ductus arteriosus showed significant differences between the two groups( P<0.05). Logistic regression analysis revealed that lower gestation( OR=0.386, 95% CI 0.212-0.704, P=0.002), longer duration of hospital stay( OR=2.177, 95% CI 1.170-4.049, P=0.014), prolonged parenteral nutrition( OR=1.195, 95% CI 1.083-1.319, P<0.001), greater volume of blood taking within two weeks after birth ( OR=1.269, 95% CI 1.083-1.487, P=0.003)and cesarean delivery( OR=5.513, 95% CI 1.056-28.770, P=0.043) were associated with increasing risk of blood transfusion in VLBWI. Conclusion:The gestational age, length of hospital stay, blood intake within two weeks after birth, duration of paraenteral nutrition and delivery method all affected the risk of blood transfusion to varying degrees.
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Henoch-Schonlein purpura (HSP) is a type of systemic leucocytoclastic vasculitis mediated by IgA immune complex deposition, which mainly affects the skin, joints, gastrointestinal tract and small blood vessels in the glomeruli.It is a common systemic vasculitis in children.Due to severe complications of HSP, conventional clinical medicine has limited efficacy in some serious, even life-threatening or organ dysfunction cases, such as advanced renal insufficiency, fatal gastrointestinal bleeding, nervous vasculitis, pulmonal bleeding, etc.As an adjunctive therapy, plasma exchange has led to significant results for this type of HSP.In this paper, the status of plasma exchange in HSP treatment was reviewed.
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Objectives To investigate the serum uric acid level and its related factors in obese children. Methods Obese children were selected from all pupils (ages 7-14) of 3 primary schools. Age-and sex-matched children with normal body mass index (BMI) were chosen as normal controls. Fasting venous blood samples were collected to detect uric acid (UA), glucose (GLU), total cholesterol (CHOL), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipopro-tein cholesterol (LDL-C). Results Sixty-eight (2.2%) obese children (57 boys and 11 girls) were detected from 3 000 children. Compared with 136 normal controls, the blood pressure (BP), levels of UA, CHOL, TG and LDL-C, and waist circumference (WC) were higher while HDL-C was lower in obese children (P<0.05). The detection rate of hyperuricemia in obese children (35.3%) were signiifcantly higher than that in normal controls (5.9%) (P<0.05). UA was positively related with WC, BMI, BP and TG, negatively related with HDL-C. Conclusions Obesity can lead to higher serum UA, higher BP and abnormal lipid metabolism. The level of serum UA was correlated with BP and abnormal lipid metabolism.