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Objective:To study the evolution of Traditional Chinese Medicine (TCM) syndromes of 171 cases of Kawasaki disease (KD) under the intervention of gamma globulin therapy based on factor analysis.Methods:A cross-sectional study. 171 cases of KD children hospitalized in the Department of Cardiology of Guangzhou Women's and Children's Medical Center from July 2019 to December 2020 were collected. All patients were treated with intravenous gamma globulin (2 g/kg) for 1 week. According to the results of the treatment with C-ball, 171 children with C-ball sensitive KD were selected to collect the four diagnostic data, and the representative syndromes of defensive level, qi level, yin level, and nutritive level were observed. Factor analysis was used to analyze the evolution of syndrome in 171 children with KD c-ball sensitivity.Results:The result of factor analysis showed that the KMO statistics of 171 children with c-ball sensitivity before treatment was 0.792, and Bartley test was significant ( P<0.01). 16 common factors were extracted, and 23 syndromes were screened, mainly including defensive level disorder, qi level disorder,nutritive level disorder,yin level disorder, heat stagnation and blood stasis syndrome. One week after treatment, the statistic of KMO test was 0.787, and Bartley test was significant ( P<0.01). 9 common factors were extracted, and 10 syndromes were screened, mainly including qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome. Conclusion:Before treatment, the TCM syndromes in KD C-cell sensitive children are mainly nutritive level disorder, defensive level disorder, qi level disorder yin level disorder, and heat stagnation and blood stasis syndrome; after treatment, the main TCM syndromes are mainly qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome.
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Las inmunodeficiencias primarias constituyen enfermedades determinadas genéticamente, caracterizadas por la alteración cuantitativa y/o funcional de distintos mecanismos implicados en la respuesta inmunitaria. Algunas de ellas se caracterizan por una alteración en la producción de anticuerpos, por lo que algunos pacientes se benefician con la administración supletoria de gammaglobulina, la cual se administra mayormente por vía endovenosa, siendo la vía subcutánea una alternativa terapéutica. La siguiente revisión sistemática tiene por objetivo determinar si la gammaglobulina subcutánea tiene alguna ventaja frente al clásico uso de gammaglobulina endovenosa, en pacientes pediátricos con inmunodeficiencias primarias, revisando la bibliografía disponible hasta la actualidad (AU)
Primary immunodeficiencies are genetically determined diseases characterized by the quantitative and/or functional alteration of different mechanisms involved in the immune response. Some of these diseases are characterized by an alteration in the antibody production and therefore some patients benefit from the supplementary administration of gamma globulin, which is mostly administered intravenously, with the subcutaneous route being a therapeutic alternative. The following systematic literature review aims to determine whether subcutaneous gamma globulin has any advantage over the classic use of intravenous gamma globulin in pediatric patients with primary immunodeficiencies (AU)
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Humans , Child, Preschool , Child , Adolescent , Immunoglobulins/therapeutic use , gamma-Globins/therapeutic use , Primary Immunodeficiency Diseases/drug therapy , Injections, Subcutaneous , Patient SafetyABSTRACT
Henoch-Sch?nlein purpura(HSP) is a common small vessel inflammation in childhood, and most of them have good prognosis.Due to too many inflammatory factors, the body injury will persist in some severe cases of HSP that hormone alone is difficult to improve symptoms in a short time.Recent studies have found that gamma globulin or blood purification combined with hormone can relieve clinical symptoms more quickly.Plasma exchange and hemoperfusion are commomly used.The purpose of this paper is to review the status of gamma globulin and blood purification treatment in severe HSP.
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Objective To observe the effect of peripheral arteriovenous exchange combined with intravenous gamma globulin in the treatment of neonatal hemolysis. Methods Seventy children with neonatal hemolysis admitted to the first affiliated Hospital of China Medical University from January 2013 to May 2018 and who met the indications for peripheral arteriovenous exchange were selected as the study subjects. The patients were divided into peripheral arteriovenous exchange group and ＂peripheral arteriovenous exchange+gamma globulin＂ group by random number table method,with 35 cases in each group. Baseline data of the two groups, changes of serum bilirubin before and after treatment, partial blood biochemical indicators, hospitalization time and jaundice regression time were observed. Results The levels of serum bilirubin ((241. 5±48. 1),(184. 6± 26. 3),(166. 3± 18. 5),(133. 5± 20. 8) μmol／L) in peripheral arteriovenous exchange + gamma globulin group were significantly lower than those in peripheral arteriovenous exchange group ((299. 3±32. 5),( 225. 7± 38. 9),(195. 4± 21. 1),( 173. 8± 35. 4) μmol／L) at 12,24,48 and 72 hours after treatment,the difference was significant (P＜0. 05). RBC in children in two groups after treatment was(4. 3±0. 8)×1012／L,(4. 2±1. 0)×1012／L vs. before(5. 2±1. 1)×1012／L,(6. 4±1. 3)×1012／L,Hb after treatment in both groups was (125. 8 ± 11. 2) g／L,( 124. 9 ± 10. 5) g／L vs. before ( 148. 9 ± 26. 5) g／L, (159. 3±14. 6) g／L and reticulocyte count after treatment in both groups were (7. 6±2. 1)%,(7. 3±1. 8)%vs. ( 5. 2 ± 1. 3)%, ( 3. 1 ± 0. 5)% were significantly improved, but the peripheral arteriovenous exchange+gamma globulin group was significantly better than the peripheral arteriovenous transfusion group, the difference was statistically significant ( all P＜0. 05) . The hospitalization time (10. 3±1. 9) d and jaundice regression time ( 8. 6 ± 0. 5) d in the peripheral arteriovenous exchange + gamma globulin group were significantly lower than those in the peripheral arteriovenous exchange group ((15. 5±2. 6) d,(10. 0±1. 1) d) . The difference was statistically significant ( t＝ 9. 553, 6. 855, P＜0. 05) . The children who had re-hemolytic after treatment in the peripheral arteriovenous exchange + gamma globulin group were significantly lower than the peripheral arteriovenous exchange group ( 5. 7%( 2／35) vs. 25. 7%(9／35)),the difference was statistically significant ( χ2 ＝ 5. 285, P ＝ 0. 022 ) . Conclusion Peripheral arteriovenous exchange combined with intravenous gamma globulin is effective in the treatment of neonatal hemolysis. It can significantly reduce serum bilirubin,improve blood biochemical parameters,shorten hospitalization time and jaundice regression time,and is safe and reliable.
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Objective To analyze the clinical features of children with Kawasaki disease(KD) in order to find out the trend of its clinical features and to provide guidance for clinical diagnosis and treatment.Methods Children with KD hospitalized in the Pediatric Ward of Peking University Third Hospital from January 2007 to December 2016 were collected and analyzed for their characteristics of onset,clinical features and treatment.The children were divided into 2 groups according to the time:2007 to 2011 group,2012 to 2016 group.The changes in clinical characteristics between the 2 stages were analyzed.Results A total of 337 children with KD were enrolled in this study,including 212 males and 125 females,with a ratio of 1.69 ∶ 1.00.The age of onset was from 2 months to 12 years old.The median age was 24 months.A total of 325(96.4％) children were under 6 years of age.There were 114(33.8％) cases of KD children from 2007 to 2011,among whom incomplete KD (IKD),intravenous gamma globulin non-response and coronary artery injury cases accounted for 23.7％ (27 cases),4.5％ (5 cases),38.6％ (44 cases),respectively;there were 223 (66.2％) cases of KD children from 2012 to 2016,among whom IKD,intravenous gamma globulin non-response and coronary artery injury cases accounted for 38.6％ (86 cases),11.9％ (26 cases),31.4％ (70 cases),respectively.The group of 2012 to 2016 was compared with the the group of 2007 to 2011 and it was found that the proportion of IKD and intravenous gamma globulin non-response cases increased,and the differences were significant (x2 =7.495,4.654,P =0.006,0.031),but the proportion of coronary artery injury cases decreased with no statistical difference (x2 =1.750,P =0.186).Conclusion With the incidence of KD increasing,the proportion of incomplete KD and intravenous gamma globulin non-response KD also showed an upward trend,which should be paid more attention to by clinicians in order to promptly diagnose and implement more targeted treatment.
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Introducción: El tétanos es una enfermedad aguda causada por una toxina producida por Clostridium tetanii. La enfermedad puede afectar a personas de cualquier edad, y la tasa de letalidad es alta. Gracias a la inmunización se ha logrado reducir el número de casos de la enfermedad, aunque se siguen presentando casos sobre todo en países con rezago social y económico. Objetivo: Describir caso clínico de un paciente pediátrico con tétanos generalizado, para reforzar la importancia de la profilaxis y diagnóstico precoz. Caso clínico: Escolar femenina de 6 años de edad con antecedente de esquema de inmunizaciones incompleto (una dosis de pentavalente), quien 10 días después de hacerse una herida cortopunzante por astilla de madera en brazo derecho, evolucionó con fiebre, dolor muscular y contracciones generalizadas, diagnosticándose tétanos generalizado en base a los antecedentes y el cuadro clínico. El tratamiento se estableció en base a las últimas recomendaciones de la Organización Mundial de la salud (OMS): esquema antibiótico Penicilina-Metronidazol, toxoide tetánico y gammaglobulina antitetánica a dosis altas. Se da de alta con secuelas motoras leves, las que se remitieron luego de 2 años de seguimiento y terapia de rehabilitación. Conclusión: El tétanos se sigue presentando en la población pediátrica principalmente asociado a falta de vacunación, es necesario conocer la enfermedad para hacer diagnóstico temprano y ofrecer manejo acorde a recomendaciones internacionales.
Introduction: Tetanus is an acute disease caused by a toxin produced by Clostridium tetanii. The disease can affect people of any age, and the fatality rate is high. Thanks to immunization the number of cases of the disease has decreased, although they are still present in isolation in countries with social and economic backwardness. Objective: To describe a case of a pediatric patient with generalized tetanus to reinforce the relevance of prophylaxis and early detection. Case Report: 6 years old female patient, with only one dose of pentavalent vaccine, 10 days after sharps injury by wood chips, starts with fever, muscle pain and generalized contractions, Tetanus was diagnosed by clinical symptoms and history. The management was based on the latest recommendations of the World Health Organization (WHO): Penicillin-Metronidazole antibiotic regimen, tetanus toxoid and tetanus high-dose gammaglobulin. After 2 years of follow-up under physiotherapy support, slight motor sequelae were observed. Conclusion: Tetanus is still presented in the pediatric population, associated with lack of vaccination. It is necessary to know the disease to provide proper diagnosis and management according to international lineaments.
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Humans , Female , Child , Tetanus/diagnosis , Tetanus/etiology , Tetanus/therapy , Tetanus Toxoid , Early DiagnosisABSTRACT
Objective To study and analyze the efficacy of Methylprednisolone and gamma globulin in the treatment of acute myelitis. Methods 100 cases of acute myelitis in the second affiliated hospital of Xi'an Jiaotong University were selected as the research objects, and the control group was treated with Dexamethasone. The experimental group was treated with Methylprednisolone combined with gamma globulin. The clinical efficacy, adverse reactions and related clinical indicators of the experimental group and the control group were compared and analyzed. Results The effective rate of the experimental group (92.0 %) was significantly better than (82.0 %) of the control group with statistical difference (P<0.05). There were no obvious adverse reactions in the two groups, the incidence rate was 8.0% and 10.0 % respectively, and there was no significant difference. Time of muscle strength improved two level in the control group (18.90±5.23) d was significantly longer than that (10.87±4.30) d of the experimental group, the experimental group hospitalization time, sensory recovery time and recovery of urinary function and other indicators are better than the control group, with statistical difference (P<0.05). Conclusion Methylprednisolone combined with gamma globulin in the treatment of acute myelitis has ideal efficacy, could significantly improve the patient's muscle strength with high safety.
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Objective To study and analyze the efficacy of Methylprednisolone and gamma globulin in the treatment of acute myelitis. Methods 100 cases of acute myelitis in the second affiliated hospital of Xi'an Jiaotong University were selected as the research objects, and the control group was treated with Dexamethasone. The experimental group was treated with Methylprednisolone combined with gamma globulin. The clinical efficacy, adverse reactions and related clinical indicators of the experimental group and the control group were compared and analyzed. Results The effective rate of the experimental group (92.0 %) was significantly better than (82.0 %) of the control group with statistical difference (P<0.05). There were no obvious adverse reactions in the two groups, the incidence rate was 8.0% and 10.0 % respectively, and there was no significant difference. Time of muscle strength improved two level in the control group (18.90±5.23) d was significantly longer than that (10.87±4.30) d of the experimental group, the experimental group hospitalization time, sensory recovery time and recovery of urinary function and other indicators are better than the control group, with statistical difference (P<0.05). Conclusion Methylprednisolone combined with gamma globulin in the treatment of acute myelitis has ideal efficacy, could significantly improve the patient's muscle strength with high safety.
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Objective To investigate the advantages of glucocorticoid combined with traditional meth-ods and to explore glucocorticoid use in appropriate time in the whole course of the disease and the appropriate dose.Methods With reference to Kawasaki disease(KD)diagnostic criteria,363 cases of patients with KD were enrolled,and divided into conventional treatment group and combined hormone group randomly. Combined hormone group according to clinical manifestations can be divided into sub groups as typical KD and atypical KD group. We analyzed respectively before and after 1 week treatment in two groups of children with the onset of age,gender,heating duration after treatment, IVIG treatment time, hospitalization days and total hospitalization expenses,tips and course of acute stage,recovery period the relevant indexes to the test,and coronary artery le-sion( CAL) in one month. Results Thermal process after treatment,hospitalization duration and hospitalization expenses decreased significantly in combined hormone group compared with conventional treatment group. The difference between the two,in the clinical laboratory indexes and CAL have no obvious difference. In different types of KD, the thermal process after treatment, hospitalization days and hospitalization expenses, have de-creased significantly in typical KD sub group when treating with combined hormone therapy comparing with hor-mone therapy atypical sub group. Other clinical laboratory indexes and CAL have no obvious differences in com-pared between the sub groups. Conclusion Combined hormone therapy for KD patients,plays an important role in shortening the thermal process after treatment and reducing the hospitalization expense.
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Objective To compare the clinical effect and safety evaluation of three different dose regimens for treating children with viral encephalitis.Methods Totally 126 cases treated in Xi'an Central Hospital from January 2010 to December 2015 were randomly divided into observation group 1 (ganciclovir combined with gangliosides,42 cases),observation group 2 (ganciclovir combined with gamma globulin,43 cases),and control group (39 cases).The clinical effect and levels of NSE,inflammatory cytokine were compared in the three groups.Results The total effective rate in observation group 1 was 95.24％ and that of observation group 2 was 93.02％,which were significantly higher than that of control group (79.48％).The disappearance time of headache,fever,convulsions,clouding of consciousness,meningeal irritation sign,cerebrospinal fluid abnormalities,and length of stay in observation groups (both 1 and 2)were significantly shorter than those in control group (P ＜ 0.05);After therapy,the levels of NSE in three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and those in observation group were significantly lower than the control group (P ＜ 0.05);the levels of inflammatory cytokine in all three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and that of observation group 1 had no statistical difference with the normal group,whereas that in control group was significantly higher than the normal group (P ＜ 0.05).Conclusion Ganciclovir combined with gangliosides as well as ganciclovir combined with gamma globulin were both effective methods in treating children with viral encephalitis and could decrease levels of inflammatory cytokine.Ganciclovir combined with gangliosides could effectively repair nerve damage,which deserves clinical expansion.
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Objective To investigate the effect of gamma globulin combined with glucocorticoid pulse therapy in the treatment of children with refractory mycoplasma pneumonia in CRP and safety.Methods 46 cases of children with refractory mycoplasma pneumonia from February 2012 to February 2016 were selected and randomly divided into the control group and experimental group,23 cases in each group.On the basis of the regular treatment,the control group was given azithromycin,10mg/kg,qd,intravenous drip,on the basis of the control group treatment,the experimental group was treated with methylprednisolone 2mg/kg+human immunoglobulin 400mg/kg,qd,intravenous drip.The levels of serum C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC),therapeutic efficiency and safety were measured before and after treatment.Results After treatment,compared with the control group,the serum levels of CRP、WBC、LC were lower in the experimental group,the difference was statistically significant(P<0.05).The treatment efficiency of the experimental group(91.31％)was significantly higher than that of the control group(65.22％),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The gamma globulin combined with glucocorticoid pulse therapy can significantly reduce the serum levels of CRP,WBC and LC in children with refractory mycoplasma pneumonia,improve clinical efficacy and the safety were good.
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Objective To evaluate the clinical efficacy of cefotaxime combined with gamma globulin on neonatal septicemia. Methods The subjects of this study were selected from 88 cases of neonatal septicemia admitted in Jiangyou No.903 hospital from April 2014 to April 2017. They were randomly divided into two groups, each with 44 cases. The control group was given symptomatic treatment and cefotaxime, while the observation group symptomatic treatment, cefotaxime and gamma globulin as well. After 7days of treatment, the overall effective rates, case fatality rates, clinical symptoms (body temperature, resistance to milk, neurological symptoms), time for improvement and hospital stay were compared between the two groups. Results The overall effective rate of the observation group was 95.45％, much higher than 72.73％ of the control group (P<0.01). The observation group had much lower case fatality rate than the control group did (2.27％ vs 18.19％) (P<0.05). The time the observation group took for improvement in the condition of body temperature, resistance to milk, neurological symptoms, and hospital stay was (3.25±1.07) days, (4.93±1.96) days, (5.92±1.58) days, and (6.80±1.94) days respectively, all significantly shorter than the time the control group took (P<0.01). Conclusion The combination of cefotaxime and gamma globulin is effective in the treatment of neonatal septicemia. It can significantly reduce case fatality rate and shorten the time for clinical symptoms and hospital stay.
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Objective To analyze the efficacy of different doses of intravenous immunoglobulin (IVIG) in the treatment of acquired severe aplastic anemia (AA) in children. Methods The clinical data of hospitalized children with severe AA who received adjuvant immunosuppressive therapy of IVIG from January 2000 to December 2015 were retrospectively analyzed. According to different doses of treatment, the children were divided into low dose group ( IVIG 200-400 mg/ (kg·d) once every 4 weeks for 6 times), high dose group (IVIG 1 g/ (kg·d ) x 2 days once every 4 weeks for 6 times). Results All the children were followed up until December 31, 2015. Among the 61 children, it was effective in 41 children and total effective rate was 67.2%. The effective rate of anti thymocyte globulin (ATG) treatment in high dose group was higher after 3 months than that of low dose group, and there was statistical difference (P=0.020). The interval between first dose of IVIG and first dose of ATG in 20 cases of ineffectiveness was 2.0 (2.0-5.0) d, while that in 41 cases of effectiveness was 8.0 (7.0-9.0) d, and the difference is statistically significant (P<0.001); Among the 20 ineffective children, 18 children had the interval <7 day. The survival rates of the two groups were 80% and 87.1%, respectively, and there was no difference between two groups (P>0.05). The incidence of severe infections in the high-dose group was lower than that in the low-dose group after the use of ATG for 6 months, and there was statistical difference (P=0.008). Conclusions High dose of IVIG therapy can increase the early response rate in children with acquired severe AA, but it does not increase the long-term effectiveness, cure rate and 5 year survival rate. In addition, it can reduce the severe infection rate, but cannot reduce the total infection rate and infection related mortality rate.
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OBJECTIVE:To investigate the effects and safety of gamma globulin combined with phototherapy on serum preal-bumin(PAB)and total bile acid(TBA)of ABO hemolytic children. METHODS:A total of 90 ABO hemolytic children in our hos-pital during Feb. 2014-Sept. 2016 were selected as research objects and divided into observation group and control group according to random number table,with 45 cases in each group. Both groups were given routine active correction of hypoxia and pretreatment for possible hypoglycemia and hypothermia. Control group was additionally given phototherapy with wavelength of 425-475 nm. Ob-servation group was additionally given Human immunoglobulin for intravenous injection (pH4) 1.0g/kg was added to normal saline 10 mL,ivgtt,on the basis of control group and treated for 1 d. The time of jaundice regression,phototherapy duration and hospital-ization time were compared between 2 groups,and the levels of PAB and TBA were compared before and after treatment. The occur-rence of ADR was recorded in 2 groups. RESULTS:The time of jaundice regression,phototherapy duration and hospitalization time in observation group were significantly shorter than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of PAB or TBA between 2 groups(P>0.05). After treatment,the level of PAB was increased significantly in 2 groups,while the level of TBA was decreased significantly;the observation group was significantly better than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Gamma globulin combined with phototherapy can significantly shorten the time of clinical symptom im-provement,increase serum level of PAB whlie decrease serum level of TBA in ABO hemolytic children,with good safety.
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Objective To investigate the advantages of glucocorticoid combined with traditional meth-ods and to explore glucocorticoid use in appropriate time in the whole course of the disease and the appropriate dose.Methods With reference to Kawasaki disease(KD)diagnostic criteria,363 cases of patients with KD were enrolled,and divided into conventional treatment group and combined hormone group randomly. Combined hormone group according to clinical manifestations can be divided into sub groups as typical KD and atypical KD group. We analyzed respectively before and after 1 week treatment in two groups of children with the onset of age,gender,heating duration after treatment, IVIG treatment time, hospitalization days and total hospitalization expenses,tips and course of acute stage,recovery period the relevant indexes to the test,and coronary artery le-sion( CAL) in one month. Results Thermal process after treatment,hospitalization duration and hospitalization expenses decreased significantly in combined hormone group compared with conventional treatment group. The difference between the two,in the clinical laboratory indexes and CAL have no obvious difference. In different types of KD, the thermal process after treatment, hospitalization days and hospitalization expenses, have de-creased significantly in typical KD sub group when treating with combined hormone therapy comparing with hor-mone therapy atypical sub group. Other clinical laboratory indexes and CAL have no obvious differences in com-pared between the sub groups. Conclusion Combined hormone therapy for KD patients,plays an important role in shortening the thermal process after treatment and reducing the hospitalization expense.
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Objective:To explore the efficacy of gamma globulin at different doses combined with dexamethasone in the treatment of children with severe idiopathic thrombocytopenic purpura. Methods: Totally 96 cases of patients with idiopathic thrombocytopenic purpura were divided into group A ( standard high dose of gamma globulin+dexamethasone) , group B ( middle dose of gamma globulin+dexamethasone) and the control group ( dexamethasone) . The clinical effects and platelet parameters of the three groups were com-pared. Results:The levels of PLT, PCT and PDW in group A and group B after the treatment were higher than those in the control group(P0. 05). The clinical effective rate of group A and group B was higher than that in the control group(P0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0. 05). Conclusion:Gamma globulin at middle dose shows significant effect as at high dose in the patients with ITP, which can reduce the dosage and is worthy of clinical promotion.
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Objective To investigate the clinical efficacy and safety of intravenous immunoglobulin and interferon in the treatment of hand foot and mouth disease complicated with viral encephalitis .Methods 80 cases of hand foot and mouth disease complicated with viral encephalitis were randomly divided into the three groups according to the random number table .27 cases in the control group were given comprehensive symptomatic treatment ,27 cases in the study group 1 were given gamma globulin ,and 26 cases in the study group 2 were given interferon .The clinical efficacy,improvement of disease ,incidence of adverse reactions of the three groups were compared .Results Defer-vescence time ,seizure control time ,time of skin rash subsided ,time of psychiatric symptoms relieved and the average hospitalization time in the study 1 group were (3.65 ±0.28)d,(4.04 ±0.33)d,(3.86 ±0.27)d,(5.83 ±0.36)d and (7.53 ±0.83)d,which were significantly less than those in the control group (t=8.43,8.58,9.15,9.80,8.96, all P0.05).The incidence rate of adverse reaction among the three groups showed no sta-tistically significant difference (χ2 =2.17,P>0.05).Conclusion Intravenous immunoglobulin and interferon have significant effect in the treatment of hand foot mouth disease complicated with viral encephalitis , which can quickly improve symptoms ,shorten treatment time and have high safety and good clinical application value .
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High-dose intravenous gamma globulin (2 g/kg) combined with oral aspirin is currently considered as standard strategy for Kawasaki disease (KD) in initial treatment.However,there are still 15％-25％ of KD patients with no response to the treatment,thus leading to persistent fever,or even further damage of the coronary arteries.International literature have also mentioned other methods of treatment,such as corticosteroids,TNF-α blockade,lyclosporin,IL-1 receptor blockade,methotrexate,anti-CD20 rituximab,plasma exchange.But fixed standard for non-reactive gamma globulin require for further treatment.
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Objective To explore the effect and nursing of high dose gamma globulin therapy on preventing Kawasaki disease children from coronary artery damage.Methods 82 cases of children with Kawasaki disease were divided into two groups according to the treatment methods,each with 41 cases.The observation group was treated by high dose shock treatment of gamma globulin,the control group was given conventional dosage of gamma globulin.The control group received routine nursing care.The observation group was given targeted nursing measures according to the symptoms on the basis of the control group.The treatment and nursing effect were compared between two groups.Results 1 cases of coronary artery dilatation appeared in the observation group,while 8 cases in the control group,the difference was statistically significant.The recovery time of main observation index such as fever,lymphadenopathy,skin and mucous membrane alterations was significantly shorter in the observation group than the control group,the differences were statistically significant.Conclusions Careful nursing and health education guidance can increase the understanding of disease for Kawasaki disease children and their families,make them cooperate with medical work actively in order to reduce the complication and accelerate recovery.
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Objective To study the influence of gamma globulin to serum B cell activating factor (BAFF) in therapy of neonatal thrombocytopenic purpura.Methods Fifteen cases with neonatal thrombocytopenic purpura(treatment group) were treated with gamma globulin.Serum BAFF levels of treatment group before and after treatment and 20 healthy neonates(control group) were tested.Results Serum BAFF level of the treatment group before treatment was(0.96±0.48) μg/L,which was statistically significant compared with that of the control group[(0.48 ±0.35) μg/L](P ＜0.05).Serum BAFF level of treatment group after treatment was (0.45 ± 0.37) μg/L,which was statistically significant compared with that of before treatment (P ＜ 0.05),but was not statistically significant compared with that of the control group.Conclusion Gamma globulin can play a role in the therapy of neonatal thrombocytopenic purpura by reducing the BAFF.