Screening and identification of apolipoprotein A-I as a potential marker for hepatoblastoma in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To screen and identify serum biomarkers for childhood hepatoblastoma (HB).</p><p><b>METHODS</b>The serum samples from 30 children with hepatoblastoma (HB), 20 children with systemic inflammatory response syndrome, and 20 normal children were treated with magnetic bead-based weak cation exchange chromatography. The platform of surface-enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS) was used to eliminate the interference of inflammatory factors and to screen out the differentially expressed proteins in serum between tumor group and normal group. After the purification and separation of target proteins were performed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, matrix-assisted laser desorption/ionization-time of flight-mass spectrometry was used to determine their amino acid sequences. The SwissProt database was searched for matched proteins. Finally, real-time PCR and ELISA were used to verify and measure the expression of target proteins.</p><p><b>RESULTS</b>After SELDI-TOF-MS was used for screening and elimination of the interference of inflammatory factors, a differentially expression protein with a mass-to-charge ratio of 9 348 Da was found in serum between HB group and normal group, and the HB group had significantly lower expression of this protein than the normal group (p<0.05). This protein was identified as apolipoprotein A-1 (Apo A-I). Real-time PCR and ELISA verified the low mRNA and protein expression of Apo A-I in serum in the HB group and high expression in serum in the normal group.</p><p><b>CONCLUSIONS</b>Apo A-I can be used as a non-inflammatory protein marker for HB and has a certain value in the early diagnosis of HB.</p>

Clinical analysis of 41 children's urinary calculus and acute renal failure / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the treatment of acute renal failure caused by irrational drug use.</p><p><b>METHOD</b>Data of 41 cases of acute renal failure seen from July 2008 to June 2012 in our hospital were reviewed. Bilateral renal parenchymas diffuse echo was found enhanced by ultrasound in all cases. Calculus image was not found by X-ray. All children had medical history of using cephalosporins or others. Alkalinization of urine and antispasmodic treatment were given to all children immediately, 17 children were treated with hemodialysis and 4 children accepted intraureteral cannula placement.</p><p><b>RESULT</b>In 24 children who accepted alkalinization of urine and antispasmodic treatment micturition could be restored within 24 hours, in 11 children micturition recovered after only one hemodialysis treatment and 2 children gradually restored micturition after hemodialysis twice, 4 children who accepted intraureteral cannula immediately restored micturition. In all children micturition recovered gradually after a week of treatment. Ultrasound examination showed that 39 children's calculus disappeared totally and renal parenchymas echo recovered to normal. The residual calculi with diameter less than 5 mm were found in 2 children, but they had no symptoms. The children received potassium sodium hydrogen citrate granules per os and were discharged from hospital. Ultrasound showed calculus disappeared totally one month later.</p><p><b>CONCLUSION</b>Irrational drug use can cause children urolithiasis combined with acute renal failure, while renal dysfunction can reverse by drug withdrawal and early alkalinization of urine, antispasmodic treatment, intraureteral cannula or hemodialysis when necessary, most calculus can be expelled after micturition recovered to normal.</p>

Establishment of predictive model of testicular torsion in pediatric patients with acute scrotum / 中华实用儿科临床杂志

Objective To establish a predictive model of testicular torsion according to the clinical data of pediatric patients with acute scrotum.Methods Retrospective study was performed to analyze medical records of 118 pediatric patients with acute scrotum.A case-control study was conducted,the case group included the patients with testicular torsion and the control group included the patients without testicular torsion.Data of patients including physical signs and laboratory tests related to testicular torsion were assessed by univariate analysis through Chi-square test or t test.All factors which had statistical significance in the univariate analysis were used as independent variables for multivariate Logistic analysis to establish a predictive model of pediatric testicular torsion.Results There were 54 patients in the case group and 64 patients in the control group.Vanishment of cremaster reflex,duration of pain,fever,urine positive and fading away of color Doppler flow imaging (CDFI) were independent predictors of pediatric testicular torsion (all P ＜ 0.05),and the OR values were 4.330,0.888,0.229,0.107 and 4.408,respectively.The predictive model of testicular torsion in pediatric patients was as follows:In [P / (1-P)] =2.307 + 1.466 × vanishment of cremaster reflex-0.119 × duration of pain-1.476 × fever-2.235 × urine positive + 1.484 × CDFI.Conclusions The Logistic regression model,which takes into account vanishment of cremaster reflex,duration of pain,fever,urine positive and CDFI,can be used to predict the risk factors of pediatric testicular torsion to provide a basis of surgical exploration.