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Objective To explore the diagnosis and treatment of empyema in children. Method The clinical data of empyema in 49 children were reviewed and analyzed. Results In the 49 cases (25 males and 24 females) aged 4.7±3.4 years, the common symptoms were fever, shortness of breath and coughing. There were 11 cases of positive blood culture, 17 cases of positive pleural fluid culture, 3 cases of positive blood and pleural fluid culture. Streptococcus pneumoniae was the most common pathogenic bacteria. All 49 patients were given systemic antibiotics and closed thoracic drainage. In addition, 26 cases were treated with urokinase and intrapleural fibrinolytic therapy and 6 cases were treated surgically. The prognosis was good and there was no death. Conclusion Pneumococcal infection is most common in children with empyema. Systemic antibiotics plus closed thoracic drainage and urokinase are effective, and some require surgical treatment.
Résumé
<p><b>OBJECTIVE</b>To investigate the association between cerebral infarction (CI) and single nucleotide polymorphism (SNP) in the exon of membrane-type 1 matrix metalloproteinase (MMP-14) gene in Chinese Han population.</p><p><b>METHODS</b>Five hundred seventy four patients with CI and 463 healthy individuals were recruited. Serum MMP-14 level was measured with enzyme-linked immunosorbent assay (ELISA). rs1042704 and rs2236307 polymorphisms of the MMP-14 gene were genotyped with a TaqMan assay. Multivariate logistic regression was carried out to analyze the risk factors of CI.</p><p><b>RESULTS</b>A significant lower risk of CI was found in individuals with MMP-14 rs2236307 TC and CC genotypes (vs. TT genotype: P<0.05). The frequencies of MMP-14 rs2236307 C allele were significantly different between the CI group (37.46%) and the control group (43.95%) (P=0.003). Serum level of MMP-14 was higher in the CI group (P=0.003) and was also higher in the group with MMP-14 rs2236307 TT genotype compared with those with CT and CC genotypes (P=0.000; P=0.009). Logistic regression analysis indicated that the MMP-14 rs2236307 CT+CC genotypes was a protective factor, and that history of hypertension, smoking status, triglycerides, diastolic blood pressure and systolic blood pressure were the independent risk factors of CI (AOR:2.027, 1.302, 1.296, 1.434, 2.087; P<0.05).</p><p><b>CONCLUSION</b>The rs2236307 polymorphism of MMP-14 gene is associated with CI, for which the C allele maybe a protective factor. No association of MMP-14 gene rs1042704 polymorphism with CI has been found.</p>