ABSTRACT
Objective: To explore the correlation among serum levels of carbohydrate antigen 125 (CA125), uric acid (UA) and cardiac function in advanced aged patients with chronic heart failure (CHF). Methods: A total of 110 advanced aged inpatients were enrolled. According to NYHA cardiac function classification, they were divided into heart failure (HF) group (n=65, including 30 cases of class II and 35 cases of class III～IV) and normal cardiac function group (n=45). Levels of CA125, CA199, carcino-embryonic antigen (CEA), UA and N terminal pro brain natriuretic peptide (NT-proBNP), mitral early diastolic peak flow velocity/mitral late diastolic peak flow velocity (E/A) and left ventricular ejection fraction (LVEF) were measured and compared between two groups and between patients with difference NYHA class. Results: Compared with normal cardiac function group, there were significant rise in levels of CA125 [(15. 9±6. 3) U/ml vs. (40. 1±12. 2) U/ml], UA [(319. 2±61. 3) μmol/L vs. (435. 7±72. 9) μmol/L]and NT-proBNP [(298. 5±132. 4) pg/ml vs. (1923. 7±868. 6) pg/ml], and significant reductions in E/A [(1. 02±0. 46) vs. (0. 71±0. 25)] and LVEF [(62. 1±11. 9) ％ vs. (48. 7±14. 7) ％]in HF group, P=0. 001 all. Compared with class II group, there were significant rise in levels of CA125 [(28. 4±9. 3) U/ml vs. (50. 1±13. 9) U/ml], UA [(383. 4±71. 8) μmol/L vs. (478. 4±73. 9) μmol/L]and NT-proBNP [(853. 2±361. 5) pg/ ml vs. (2841. 3±1303. 3) pg/ml], and significant reductions in E/A [(0. 78±0. 23) vs. (0. 65±0. 19)] and LVEF [(52. 6±10. 1) ％ vs. (45. 3±13. 1) ％]in class III～IV group, P＜0. 05 or＜0. 01. Pearson linear correlation regression analysis indicated that levels of CA125, UA and NT-proBNP were significant inversely correlated with E/A and LVEF in HF group (r=-0. 679～-0. 457, P＜0. 05 or＜0. 01). Conclusion: Levels of CA125, UA and NT-proBNP are significant inversely correlated with LVEF in advanced aged CHF patients, which help to determine HF severity.
ABSTRACT
<p><b>BACKGROUND</b>Despite substantial progress toward measles control are making in China, measles outbreaks in immunocompromised population still pose a challenge to interrupt endemic transmission. This study aimed to investigate the features of measles in pediatric hematology and oncology patients and explore the reasons behind the outbreak.</p><p><b>METHODS</b>We collected demographic, epidemiological, and clinical data of immunocompromised measles children. All suspected measles cases were laboratory-confirmed based on the presence of measles IgM and/or identification of measles RNA. The clinical data were statistically analyzed by t-test for continuous variables and Fisher's exact test for categorical variables.</p><p><b>RESULTS</b>From March 9 to July 25 in 2015, a total of 23 children with malignancies and post hematopoietic stem cell transplantation (post-HSCT) were notified to develop measles in Shanghai. Of these 23 patients with the median age of 5.5 years (range: 11 months-14 years), 20 (87.0%) had received 1-3 doses of measles vaccine previously; all patients had fever with the median fever duration of 8 days; 21 (91.3%) had cough; 18 (78.3%) had rash; 13 (56.5%) had Koplik's spot; 13 (56.5%) had complications including pneumonia and acute liver failure; and five (21.7%) vaccinated patients died from severe pneumonia or acute liver failure. Except the first patient, all patients had hospital visits within 7-21 days before measles onset and 20 patients were likely to be exposed to each other.</p><p><b>CONCLUSIONS</b>The outcome of measles outbreak in previously vaccinated oncology and post-HSCT pediatric patients during chemotherapy and immunosuppressant medication was severe. Complete loss of protective immunity induced by measles vaccine during chemotherapy was the potential reason. Improved infection control practice was critical for the prevention of measles in malignancy patients and transplant recipients.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , China , Disease Outbreaks , Hematologic Diseases , Epidemiology , Immunocompromised Host , Allergy and Immunology , Measles , Epidemiology , Neoplasms , EpidemiologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of hydrochloride valacyclovir in treatment of varicella in pediatric patients between April 2006 and March 2007.</p><p><b>METHODS</b>A randomized controlled multi-center clinical trial was conducted in 5 pediatric centers, i.e., Children's Hospital of Fudan University, Children's Hospital of Zhejiang University, Children's Hospital of Nanjing Medical University, Pediatric Department of Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology and Children's Hospital, Chongqing University of Medical Sciences. Patients who were clinically diagnosed as varicella without any complications and were beyond 3 years of age were enrolled into the study from the out-patient clinics. The subjects were divided into two groups randomly, one was treated with hydrochloride valacyclovir, the other with ribavirin. There were 128 cases in the group treated with hydrochloride valacyclovir and 132 cases in control group treated with ribavirin. The treatment duration of two groups was five days. The clinical efficacy and safety were evaluated after the first day and the fourth day of the treatment and within three days after the end of the treatment. The clinical efficacy was assessed by efficacy index.</p><p><b>RESULTS</b>(1) The efficacy index on the fourth day of the therapy (0.80 +/- 0.24) in the valacyclovir group was significantly higher than that of ribavirin control group (0.59 +/- 0.37) (t = 5.42, P < 0.01). The efficacy index at the end of the treatment (0.86 +/- 0.14) in the hydrochloride valacyclovir group was also significantly higher than that (0.70 +/- 0.30) of the ribavirin control group (t = 5.43, P < 0.01). (2) In the valacyclovir and ribavirin groups, the effective rates on the fourth day of the therapy were 94.53% and 72.7% respectively (chi2) = 22.38, P < 0.01). The effective rates at the end of the therapy were 99.2% and 88.6%, respectively (chi(2) = 12.60, P < 0.01). The rates of cure of the two groups were 33.6% and 25.0% (chi2) = 2.32, P > 0.05). (3) No severe adverse drug reactions were observed in any of the two groups.</p><p><b>CONCLUSIONS</b>The hydrochloride valacyclovir was safe, reliable and convenient in treatment of uncomplicated varicella in children.</p>