Diagnostic value of interleukin 6 for neonatal sepsis: a Meta analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of interleukin 6 for neonatal sepsis.</p><p><b>METHODS</b>The databases of CNKI, VIP, Wangfang, Pubmed, Embase, Web of Science, Cochrane Library were searched (by September 2014) to identify relevantly published studies about estimating the diagnostic value of interleukin 6 for neonatal sepsis. QUADAS tools were used for quality evaluation of the studies. A Meta analysis was performed by employing Meta Disc 1.4 and Stata11.0 software. Heterogeneity of the included articles was tested to select proper efficacy model for calculating pooled weighted sensitivity, specificity and 95%CI. Summary receiver operating characteristic (SROC) curve was made and the area under the curve and Q(*) index were calculated.</p><p><b>RESULTS</b>A total of 33 studies including 3 135 neonates were enrolled. The sensitivity and specificity of interleukin 6 for the diagnosis of neonatal sepsis were 0.79 (95%CI: 0.76-0.81) and 0.83 (95%CI: 0.81-0.85) respectively. The area under SROC curve of interleukin 6 for the diagnosis of neonatal sepsis was 0.89 and Q(*) index was 0.83. The post-test probability of diagnosing neonatal sepsis indicated by negative interleukin 6 was 5%, while that of positive interleukin 6 was 60%.</p><p><b>CONCLUSIONS</b>Interleukin 6 measurement is useful for the diagnosis of neonatal sepsis with a high sensitivity and specificity.</p>

Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease

An 11-month-old male infant was admitted to our hospital with fever, fussiness, poor feeding, vomiting, and tachypnea for two days prior. Physical examination revealed sporadic papules and vesicles occurring on his hands, feet, face, and perianal mucosa. Enterovirus 71 was identified from both throat swab and vesicle fluid using virus isolation techniques. The patient's heart rate fluctuated in a very narrow range from 180~210/beats/min regardless of his physiologic state. An electrocardiogram showed P-waves buried within or occurring just after regular, narrow, QRS complexes. The patient was diagnosed as having hand, foot, and mouth disease in combination with paroxysmal supraventricular tachycardia (PSVT). The child recovered well with symptomatic treatment, including intravenous administration of acyclovir, glucocorticoids, immunoglobulin, adenosine, and sotalol. PSVT was terminated within 36 hours of hospitalization. The skin lesions became crusted on the third day, and then proceeded to heal spontaneously. Here we report on this unusual case and review the associated literature.

Liver involvement in melamine-associated nephrolithiasis

It is currently believed that melamine ingestion can lead to insoluble crystals in an animal's urinary system with subsequent physical obstruction or bladder carcinoma. However, whether melamine can cause injury of other tissues and organs in humans is yet unknown. In this study, we encountered 3 affected children with liver lesions, 2 males and 1 female, and detailed their clinical characterizations. Their ages were respectively 2, 6, and 10 months. Among the 3 patients with liver lesions, only 1 exhibited symptoms of gradual progressive jaundice, abdominal distention, hepatic intumesce, and bilirubin abnormality; the other 2 were asymptomatic. The mechanism associated with liver lesion may, at least in part, be due to physical deposition and blockage of the biliary tract system. Disturbance of the acid-base equilibrium may be another reason that accelerates stone formation in human tissues