Clinical features of children with severe adenovirus pneumonia and hemophagocytic syndrome: an analysis of 30 cases / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with severe adenovirus pneumonia (SAP) and hemophagocytic syndrome (HPS).@*METHODS@#A retrospective analysis was performed from the chart review data of 30 children with SAP and HPS who were admitted from January 2014 to June 2019. According to the prognosis, the children were divided into a good prognosis group (n=18) and a poor prognosis group (n=12).@*RESULTS@#Among the 30 children with SAP and HPS, the ratio of male to female was 2:1. The median age of onset was 1 year and 3 months (range 3 months to 5 years), and the mean course of fever was 19±7 d. Of the 30 children, 28 (93%) experienced disease onset in January to June. High-throughput gene detection of serum pathogens showed that 16 (53%) children were positive for human adenovirus type 7 (HAdV-7), and the other 14 (47%) children were positive for HAdV antigen based on immunofluorescence assay for throat swab, with unknown type. Of all 30 children, 29 (97%) had respiratory complications, 24 (80%) had cardiovascular complications, 16 (53%) had gastrointestinal complications, and 9 (30%) had toxic encephalopathy. Eighteen children (60%) improved or recovered and 12 (40%) did not recover (3 died). Compared with the good prognosis group, the poor prognosis group had a significantly longer course from onset to diagnosis of HPS (P<0.05), significantly higher levels of fibrinogen and tumor necrosis factor-α (P<0.05), and a significantly lower level of interferon-γ (P<0.05). The mean follow-up time was 6±2 months; 11 (41%) children recovered, 1 (4%) experienced recurrence of HPS, and 15 (56%) had the sequela of post-infectious bronchiolitis obliterans (PIBO).@*CONCLUSIONS@#HPS may be observed in children with SAP, and PIBO is the most common sequela of SAP.

Serum lipid profile in children with different subtypes of juvenile idiopathic arthritis / 中国当代儿科杂志

OBJECTIVE@#To study the serum lipid profile in children with different subtypes of juvenile idiopathic arthritis (JIA) during active and remission stages, as well as the long-term risk of atherosclerosis in children with JIA.@*METHODS@#A total of 128 children newly diagnosed with active JIA were divided into oligoarticular JIA group with 48 children, polyarticular JIA group with 38 children, systemic JIA group with 22 children, and enthesitis-related JIA group with 20 children. According to the presence or absence of rheumatoid factor (RF), the polyarticular JIA group was further divided into RF-positive polyarticular JIA group with 15 children and RF-negative polyarticular JIA group with 23 children. A total of 45 children who underwent physical examination were randomly selected as healthy control group. The serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured and compared between groups. Blood lipid parameters were reexamined for 87 children in the remission stage after treatment and were compared with those in the active stage.@*RESULTS@#Compared with the healthy control group, the systemic JIA group and the RF-positive polyarticular JIA group had a significant reduction in HDL-C and a significant increase in TG (P0.05). There were no significant differences in blood lipid parameters between the other subtype JIA groups and the healthy control group (P>0.05). The RF-positive polyarticular JIA group had a significant increase in plasma HDL-C from the active stage to the remission stage (P0.05).@*CONCLUSIONS@#Dyslipidemia may be observed in the active stage of children with systemic and RF-positive polyarticular JIA, with improvement in the remission stage of children with RF-positive polyarticular JIA. Further studies are needed to observe the long-term risk of atherosclerosis.

Clinical features and prognostic factors in children with dilated cardiomyopathy / 中华实用儿科临床杂志

Objective To discuss the clinical features and prognostic factors in the children with dilated cardiomyopathy(DCM).Methods The clinical data of 45 cases of DCM,including 27 boys and 18 girls,from May 2007 to Nov.2011 in Wuhan Children's Hospital were analyzed by retrospective medical record survey methods.The average age of onset was(19.20 ± 18.98) months.Eight cases (17.8％) were of cardiac function grade Ⅰ-lⅡ,and 37 cases (82.2％) were of cardiac function grade Ⅲ-Ⅳ.The patients whose left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) increased by 10％-15％ compared with those before treatment were defined as improved group,and the patient's LVEF and LVFS levels declined persistently or those of dead cases were defined as worsened group.There were 34 cases assigned as the improved group,8 cases as the worsened group,and 5 out of 8 cases were dead.The age,occurrence of abnormal Q waves,cardiac function,LVEF and LVFS in the 2 groups were analyzed.Results The cardiac troponin,creatine kinase,creatine kinase isoenzyme in the cardiac function grade Ⅲ-Ⅳgroup were significantly higher than those in the cardiac function grade Ⅰ-Ⅱ group (all P ＜ 0.01).There were 11 patients who had abnormal Q waves by electrocardiogram when they were diagnosed.The LVEF and LVFS levels in the cardiac function grade Ⅰ-Ⅱ group were significantly higher than those in the cardiac function grade Ⅲ-Ⅳ group (all P ＜ 0.05).There were statistically significant differences in age on diagnosed,proportion of newly diagnosed cases age ≤ 1 year old,occurrence of abnormal Q waves,cardiac function in grade Ⅲ-Ⅳ,LVEF and LVFS levels between the improved group and the worsened group (all P ＜ 0.05).Conclusions Most of the children with DCM were diagnosed more when they were ≤ 1 year old,mostly with cardiac function grade Ⅲ-Ⅳ.The occurrence of abnormal Q waves,cardiac function grade,LVEF and LVFS levels could be used as important prognostic indicators for DCM.

Changes in serum insulin-like growth factor-1 and insulin-like growth factor-binding protein-3, and their significance in children with left-to-right shunt congenital heart disease associated with heart failure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate changes in serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) and their significance in children with left-to-right shunt congenital heart disease (CHD) associated with heart failure (HF).</p><p><b>METHODS</b>Twenty healthy children (control group), 20 children with HF, without basic heart disease (HF group), 20 children with left-to-right shunt CHD, without HF (CHD group), and 30 children with left-to-right shunt CHD associated with HF (CHD+HF group) were included in the study. These groups were compared in terms of serum IGF-1 and IGFBP-3 levels. According to the New York Heart Association (NYHA) Functional Classification, the CHD+HF group was further divided into NYHA-II, NYHA-III and NYHA-IV subgroups and the subgroups were compared in terms of serum IGF-1, IGFBP-3, and cardiac troponin I (cTnI) levels. The correlation of serum IGF-1 and IGFBP-3 levels with serum cTnI level in the CHD+HF group was analyzed.</p><p><b>RESULTS</b>The CHD group showed decreased serum IGF-1 and IGFBP-3 levels compared with the control group (P<0.01). The CHD+HF group showed a significantly decreased serum IGF-1 level compared with the control group (P<0.01) and CHD group (P<0.05). The HF group had significantly increased serum IGF-1 and IGFBP-3 levels compared with other groups (P<0.01). The NYHA-II subgroup had the highest serum IGF-1 level and the NYHA-IV subgroup had the lowest serum IGF-1 level (P<0.01). In the CHD+HF group, serum IGF-1 and IGFBP-3 levels were negatively correlated with serum cTnI level (r=-0.692, P<0.05; r=-0.530, P<0.05).</p><p><b>CONCLUSIONS</b>Serum IGF-1 level can be used as an objective condition evaluation indicator for CHD, and low serum IGF-1 level is a risk factor for HF. This also provides a clinical basis for treatment of HF using exogenous IGF-1.</p>

Effect of peribulbar anesthesia on intraocular pressure and ocular pulse amplitude / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of peribulbar anesthesia on intraocular pressure(IOP)and ocular amplitude pulse(OPA).METHODS: Thirty-two consecutive adult patients with monocular cataract enrolled in this study. IOP and OPA were measured with dynamic contour tonometer(DCT)before and 3, 10 minutes after administration of lidocaine anesthesia. Data were analyzed with software SPSS 11.5.RESULTS: The IOP remained stable in the injected eyes and the non-injected eyes after administration of lidocaine anesthesia. The OPA was significantly decreased after injection of anesthesia agent in the injected eyes. The OPA in the non-injected eyes increased significantly 3 minutes after injection of the anesthesia agent, returning to preinjection level 10 minutes after the injection.CONCLUSION: Peribulbar anesthesia leads to decrease of OPA and shows no effect on IOP in the injected eyes.

Changes of Hematoxin,Lipopolysaccharide,Lipopolysaccharide Binding Protein/Membrane CD_(14) in Children with Systemic Inflammatory Response Syndrome / 实用儿科临床杂志

Objective To investigate the effect of hematoxin,lipopolysaccharide(LPS),lipopolysaccharide binding protein(LBP)/membrane CD14(mCD14) in occurrence and development of systemic inflammatory response syndrome(SIRS) in children.Methods Serum LPS,LBP,mean fluorescence intensity(MFI) of mCD14 on monocytes of 30 patients with SIRS were measured,at the same time 21 healthy children had been chosen to serve as control group.Results Compared with control group,the serum LPS,LBP,MFI of mCD14 on monocytes of patients with SIRS were significantly higher(Pa