Clinical features and prognostic factors in children with fulminant myocarditis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features and prognostic factors in children with fulminant myocarditis.</p><p><b>METHODS</b>The clinical data of 24 children with fulminant myocarditis were retrospectively analyzed. According to the prognosis, these children were classified into two groups: survival (n=12) and death (n=12). The risk factors influencing prognosis in children with fulminant myocarditis were identified by logistic regression analysis.</p><p><b>RESULTS</b>Among the 24 cases of fulminant myocarditis, gastrointestinal symptoms were found as initial symptoms in 14 cases, neurological symptoms in 12 cases, respiratory symptoms in 1 case, and cardiac symptoms in 2 cases. On admission, serum levels of creatine kinase MB, troponin I, and brain natriuretic peptide (BNP) were all increased. Besides, left ventricular ejection fraction (LVEF) decreased in 22 cases (92%), cardiothoracic ratio increased in 10 cases, third-degree atrioventricular block was observed in 8 cases, ST-segment changes were found in 11 cases and ventricular tachycardia was identified in 2 cases. LVEF in the death group was lower than in the survival group (P<0.05), while the peak level of serum BNP during hospitalization in the death group was higher than in the survival group (P<0.05). The multivariate logistic regression analysis revealed that LVEF was the risk factor influencing prognosis (OR=7.418; P<0.05).</p><p><b>CONCLUSIONS</b>Fulminant myocarditis has no specific clinical features in children. A decreased LVEF is a risk factor for poor prognosis in children with fulminant myocarditis.</p>

Short-term prognostic factors in children with acute liver failure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the factors that influence the short-term (6 months) prognosis in children with acute liver failure.</p><p><b>METHODS</b>The clinical information of 53 children with acute liver failure treated between June 2008 and September 2013 was retrospectively analyzed. The patients were divided into survival group (n=21) and death group (n=32) according to their outcomes. The liver function parameters and incidence of complications were compared between the two groups, and multivariate logistic regression analysis was used to identify major factors affecting the short-term prognosis in these patients.</p><p><b>RESULTS</b>There were significant differences between the death and survival groups in the indices of international normalized ratio (INR), blood ammonia and serum albumin (Alb), and complications such as hepatic encephalopathy, gastrointestinal hemorrhage, and multiple organ failure (P<0.05). Multivariate logistic regression analysis demonstrated that serum Alb, INR, and hepatic encephalopathy were the major factors affecting the short-term prognosis of acute liver failure (OR=0.616, 75.493 and 1210.727 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>INR, hepatic encephalopathy and serum Alb are the major factors that influence the short-term prognosis in children with acute liver failure.</p>

Review of the clinical features of skin cancer: a study of 1, 048 cases from a hospital in West China

Skin cancer [SC] is a group of malignancies which include primary and metastatic tumors which involve the skin and its appendages. Up to the present, only a few studies on the clinical features and the trend of S have been reported but the status in West China is still undetermined. The S cases were from a major hospital in West China. A total of 1048 cases from 1981 to 2006 were included in our study. The clinical features of S including age, gender, lesion location and pathological diagnosis were analyzed. In order to illustrate the trend of S incidence, the patients from 1981-1993 and 1994- 2006 were assigned to group A and B respectively. The percentage of S in all malignancies [Ms], including all kinds of internal carcinomas and skin cancers, and the percentage of S in inpatients and outpatients [IOPs] between group A and B were separately compared to illustrate the trend in S incidence in this area. [1] Of the 1048 S s included, 308 [29.4%] were squamous cell carcinoma [S C], 293 [28.0%] basal cell carcinoma [B] and 168 [16.0%] cutaneous malignant melanoma [MM] .Ratio of male to female was 1.5:1.0.Median age was 54.0 +/- 23.0 years.40.8%of the S s occurred on the head, 35.0%on the trunk and 24.2%on the extremities. Median age of MM [53.0 +/- 22.5] was less than those of B [58.0 +/- 18.3 years] and S [57.0 +/- 20.0 years] .83.6%of the B s, 49.8%of the S s and 13.5% of the CMMs occurred on the head. [2] Of the 168 MMs, 106 [63.1%] occurred on the acral, 23 [13.7%] on the head, 24 [14.3%] on the trunk and 15 [8.9%] on the limbs. Of the 106 acral melanoma [AM], 41 [38.7%] occurred on the plantar skin, 19 [17.9%] on the heel, 15 [14.2%] on the subungual skin of thumbs, 13 [12.3%] on the subungual skin of big toes and 18 [17.0%] on other acra. [3] The percentages of S in IOPs [S s/IOPs] in Group A and B were 0.0038% [325/8, 457, 672], 0.0066% [723/11, 037, 720], an increase of by 74%.The percentages of S in all Ms [S /Ms] were 2.1% [325/15, 363] and 3.1% [723/23, 364], an increase of 48%.During the same period, the percentages of Ms in IOPs [Ms/IOPs] were 0.18% [15, 363/8, 457, 672] and 0.21% [23, 364/11, 037, 720], increased only by 17%. In our study, S C, B and MM were major S types. The head and trunk are the main sites for S occurring. AM is the most common MM. In past 26 years, the percentages of S in all malignancies and in inpatients and outpatients have increased in this hospital. The finding in our study provides a clue for understanding of the trend of S in West China