ABSTRACT
Children Takayasu arteritis(c-TA)is a potentially life-threatening macrovasculitis that occurs during childhood.The early clinical manifestations are nonspecific, and the damage often leads to ischemic dysfunction of the organ.Non-invasive techniques such as magnetic resonance angiography has been included in the diagnosis and follow-up of children.At present, the conventional treatment plan is the combination of glucocorticoid and immunosuppressant.In the cases of refractory venereal diseases, biological agents should be considered as soon as possible to prevent the damage of ischemia to the terminal organs.When artery stenosis is severe, intravascular(stent or balloon)or bypass intervention is needed to reconstruct the blood vessels of the affected organs.Early diagnosis and timely and correct management are of vital importance in reducing the incidence rate and risk of injury.
ABSTRACT
Children arthritis associated infection can be divided into children infectious (invasive) arthritis and post infectious arthritis.Infectious arthritis onset with direct effects on the joints by pathogens,such as bacteria,fungi,viruses,tuberculosis infection.Post infectious arthritis onset often secondary to infection after infection factors of arthritis due to autoimmune reaction,such as reactive arthritis,arthritis after streptococcus infection,and so on.There are their clinical characteristics respectively in infectious arthritis and post infection arthritis in children,and it is important for the diagnosis,treatment and prognosis of children with arthritis to be familiarity with their characteristics.In addition,the factor of infection is closely related to juvenile idiopathic arthritis.It should be pay attention to the role of infectious factors in triggering and aggravating the disease.
ABSTRACT
BACKGROUND:The mesh size used for herniorrhaphy mainly depends on clinicians' experience, which is less reliable. OBJECTIVE:To obtain the mesh size by measuring the posterior wall of inguinal hernia in Chinese adult men undergoing Rutkow surgery, and to assess the postoperative effect. METHODS:The posterior wall size of inguinal hernia in 180 Chinese adult male patients undergoing tension-free hernioplasty was measured, and then the optical mesh size was calculated. All patients were equivalently randomized into two groups, followed by subjected to Rutkow surgery according the calculated mesh size (experimental group) or subjective size (control group). Clinical indexes, the incidence of complications and recurrence rate were compared between groups. RESULTS AND CONCLUSION:The distance of pubic tubercle to internal oblique inguinal ligament starting point was (6.03±0.58) cm;the vertical distance of the highest point on the edge of the arcuate to inguinal ligament was (3.02±0.32) cm;therefore, the length of mesh should be larger than (13.04±0.74) cm, and width larger than (5.88±0.52) cm. The time of off-bed, dieting and hospitalization in the experimental group were significantly less than those in the control group (P0.05). The rates of postoperative complication and recurrence in the experimental group were significantly lower than those in the control group (P<0.01). These results suggest that after measuring the posterior wall size of inguinal hernia, the Rutkow used for inguinal hernia repair, obtains desired treatment outcomes with low incidence of complications and recurrence.
ABSTRACT
Objectives To explore the changes of T helper (Th) lymphocyte and its related factors in children with syste-mic-onset juvenile idiopathic arthritis (SoJIA). Methods A total of 36 SoJIA inpatients, hospitalized from January 2012 to June 2013, were divided into active phase group and remission group. In addition, 20 healthy children were selected as normal con-trols. Th1, Th2 and Th17 cell ratios in peripheral blood mononuclear cells were detected and compared between each group by flow cytometry. Serum interferon-γ(INF-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) levels were measured by enzyme-linked immunosorbent assay. Results The proportions of Th17 cells over CD3+CD8-cell were (3.30±2.15)%, (1.78±1.14)%and (1.22± 1.14)%in active phase group, remission group and control group. The difference among three groups was significant (H=14.437, P=0.001), and the active phase group had higher proportion of Th17 than the other two groups (P0.05). The serum IL-17 levels were (125.82 ± 45.87) pg/ml, (57.79±25.84)pg/ml and(50.02±18.37)pg/ml in active phase group, remission group and control group with signifi-cant difference among three groups (F=31.82, P=0.000), and the active phase group had higher level of IL-17 than the other two groups (P0.05). Conclusions Acquired cellular immunity is involved in pathogenesis of SoJIA, the increased proportion of Th1 and Th17 cell and the changes of related cytokines seem to correlate with active phage of SoJIA.
ABSTRACT
The American College of Rheumatology (ACR) published treatment recommendations for juvenile idiopathic arthritis (JIA) in 2011.The recommendations meant as a guide to health care providers caring for JIA children with dividing JIA into 5 distinct subtypes.The ACR updated the 2011 recommendations in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtybe is developed to 3 phenotypes.And the conception was firstly addressed that systemic JIA with features concerning for macrophage activation syndrome(MAS).Different treatment options was applied for clinical manifestations score,and these recommendations offered guidance for providers caring for children with the most common phenotypes associated with systemic JIA,rather than exceptional cases with unusual disease manifestations or refractory disease.
ABSTRACT
The American College of Rheumatology (ACR) updated the 2011 recommendations for juvenile idiopathic arthritis (JIA) in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtype is developed to 3 phenotypes:(1) phenotype of systemic JIA with active systemic features and yarying degrees of synovitis; (2) phenotype of systemic JIA without active systemic features and with varying degrees of active synovitis ; (3) phenotype of systemic JIA with features concerning for macrophage activation syndrome (MAS).The treatment recommendation was made according each phenotype,including initial therapeutic options and therapeutic options for continued disease activity.And uncertain or inappropriate options for continued disease were listed alphabetically.Development of treatment recommendations for children with SOJIA and features of MAS is particularly challenging.However,it is anticipated that in the near future,with research of the disease process,the better recommendation may be made.