Résumé
Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.
Résumé
Objective:To evaluate the prognostic value of amplitude-integrated electroencephalogram(aEEG) on predicting long-term neurodevelopmental outcome of preterm infants.Methods:Literatures were searched in PubMed, the Cochrane library, Web of science, Wanfang database, CNKI and CBM database from inception to August, 2020.The studies which investigated the prognostic value of aEEG on neurodevelopmental outcome of preterm infants were included.Articles screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by Meta-disc1.4.Results:Six studies were included with 557 cases.The Meta-analysis revealed that the pooled sensitivity was 0.81 (95% CI 0.75-0.87), specificity was 0.68 (95% CI 0.63-0.73), positive likelihood ratio was 2.32(95% CI 1.52-3.52), negative likelihood ratio was 0.27(95% CI 0.19-0.37)and the area under the curve of summary receiver operating characteristic curve was 0.79(95% CI 0.75-0.82). Burst-suppression, continuous low voltage and flat trace were regard as a index of poor neurodevelopmental prognosis. Conclusion:aEEG is a valuable tool for predicting the outcome of long-term neurodevelopment in preterm infants.
Résumé
Henoch-Schonlein purpura (HSP) is one of the most common clinical manifestations of systemic small vasculitis in children with non-thrombocytopenic, and mainly manifested as skin purpura, arthritis, gastrointestinal symptoms and Henoch-Schonlein purpura nephritis (HSPN). The severity of renal involvement is the main factor determining the long-term prognosis of children with HSP.Studies have revealed that the determination of pentraxin 3 (PTX3) in serum can be used for early diagnosis of HSPN and prediction of renal injury.In this paper, the origin, gene and protein structure, function, potential relationship and mechanism of action between PTX3 and HSP were discussed, so as to provide new ideas for the early diagnosis and treatment of HSPN.
Résumé
Objective:To evaluate the treatment effect of hemoperfusion(HP) on Henoch-Sch?nlein purpura(HSP) outcomes.Methods:PubMed, Cochrane library, Web of science, Wanfang database, CNKI and CBM database were searched from inception to February 2020.Literatures of randomized controlled trials(RCTs) that investigated the effect of HP on HSP outcomes were included.Articles screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by RevMan 5.3.Results:Thirteen RCTs were included with 803 cases, of which, 397 cases were in the HP group while 406 cases were in the control group.The Meta-analysis revealed the HP group had less disappearing time of hematuresis or albuminuria[ MD=-2.77, 95% CI(-3.18, -2.36), P<0.001], relieving time of abdominal pain[ MD=-1.70, 95% CI(-2.17, -1.23), P<0.001], disappearing time of hematochezia[ MD=-1.54, 95% CI(-1.68, -1.40), P<0.001], and the length of hospital stay[ MD=-3.23, 95% CI(-3.60, -2.87), P<0.001] than the control group. Conclusion:The HP could shorten disappearing time of hematuresis or albuminuria, relieving time of abdominal pain, disappearing time of hematochezia, and the length of hospital stay of HSP.
Résumé
Objective To evaluate the application effect of clinical pathways (CP) in children with bronchopneumonia.Methods The literature of randomized controlled trials (RCTs) in children with bronchopneumonia were retrieved by searching PubMed,Cochrane Library,Web of Knowledge,Wanfang database,VIP,and CNKI from their inception date to March 2014.Meta-analysis was performed by Revman 5.2software.Results Six RCTs involving 24 559 patients were finally selected,with 12 269 cases in the CP group and 12 290 cases in the traditional treatment group.The results of Meta-analysis showed that there were significant differences between the CP group and the traditional treatment group in the cure rate [OR =1.67,95 ％ CI (1.03,2.77),P =0.04],length of hospital stay [MD =-1.21,95 ％ CI (-1.95,-0.48),P =0.001],hospitalization expenses [SMD =-3.68,95 ％ CI (-5.04,-2.32),P ＜ 0.000 1],days of antibiotic using [MD =-1.20,95 ％ CI (-1.51,-0.89),P ＜ 0.000 01] and patient satisfaction [OR =6.12,95 ％ CI(3.12,12.04),P ＜ 0.000 01].Conclusion CP is superior compared with the traditional treatment for bronchopneumonia,and is worthy of spread in clinical.
Résumé
Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that:(1)the increase of Serum 25-(OH)vitamin D:Combined therapy group and vitamin D group (MD= -7. 88,95%CI:-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI:-22. 61~ -14. 04). (2)the increase of serum phosphate:Combined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI:-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI:-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALP:Combined therapy group and vitamin D group (MD= 109. 99,95%CI:20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI:10. 09~109. 59 ). (4)the increase of serum calcium :Combined therapy group and vitamin D group (MD= -0. 71,95%CI:-0. 91,-0. 52);the decrease of Radiographic score:Com-bined therapy group and vitamin D group( MD=0. 68,95%CI:0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.
Résumé
Objective To study the association of vitamin D receptor(VDR) gene BsmI polymorphism and the genetic susceptibility of vitamin D deficiency rickets in infants and to explore a new way of diagnosis and treat-ment. Methods Case-control study was adopted. 56 infants confirmed with rickets (case group) and 76 cases of normal infants (control group) were chosen as the subjects. PCR-RFLP was applied to examine VDR gene BsmI site polymorphism. The frequencies of the VDR genotype and allele were compared between the two groups. Results Frequencies of BB,Bb and bb genotypes were 3.6% (2/56),21.4% (12/56) and 75.0% (42/56) in the rickets group,and 1.3% (1/76),18.4% (14/76) and 80.3% (61/76) in the control group respectively(χ20.521,P> 0.05),frequencies of B,b alleles were 14.3% (16/112),85.7% (96/112) in the rickets group and 10.5% (16/152),89.5% (134/152) in the control group respectively(χ20.783,P>0.05). Multiple logistic regression analysis showed that VDR gene polymorphism Bsml had not higher risk of vitamin D deficiency rickets in Infants. Conclusion VDR gene polymorphism BsmI doesn't appear to pose risk on infants in developing vitamin D deficien-cy rickets.
Résumé
Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.