Application of esmolol in severe hand, foot, and mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical effect and mechanism of action of esmolol in the treatment of severe hand, foot, and mouth disease (HFMD).</p><p><b>METHODS</b>A prospective randomized controlled trial was performed. A total of 102 children with severe HFMD were enrolled in the study and were randomly divided into conventional treatment and esmolol treatment groups (n=51 each). The children in the conventional treatment group were given conventional treatment according to the guidelines for the diagnosis and treatment of HFMD. Those in the esmolol treatment group were given esmolol in addition to the conventional treatment. The heart rate (HR), systolic blood pressure (SBP), and respiratory rate (RR) were continuously monitored for all children. Blood samples were collected from all children before treatment and 1, 3, and 5 days after treatment to measure the levels of norepinephrine (NE), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and nuclear factor-kappa B (NF-κB) p65 in mononuclear cells. Serum levels of myocardial enzymes and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured before treatment and after 5 days of treatment.</p><p><b>RESULTS</b>There were no significant differences in HR, SBP, RR, NE, TNF-α, IL-6, NF-κB p65, serum myocardial enzymes, and NT-proBNP before treatment between the conventional treatment and esmolol treatment groups. Both groups had significant reductions in these parameters at each time point (P<0.05). Compared with the conventional treatment group, the esmolol treatment group had significant improvements in the above parameters after 1 and 3 days of treatment (P<0.05). After 5 days of treatment, the esmolol treatment group had significant improvements in serum levels of myocardial enzymes and NT-proBNP compared with the conventional treatment group (P<0.05).</p><p><b>CONCLUSIONS</b>Early application of esmolol can effectively stabilize the vital signs of the children with severe HFMD. Its mechanism of action may be related to reducing serum catecholamine concentration, alleviating myocardial damage, improving cardiac function, and reducing inflammatory response.</p>

Expression of vasoactive intestinal peptide in peripheral blood of children with hand, foot and mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the expression of vasoactive intestinal peptide (VIP) in peripheral blood of children with hand, foot and mouth disease and its significance.</p><p><b>METHODS</b>According to the condition of the disease, 86 children with hand, foot and mouth disease were classified into phase 1 group (19 children) and phase 2 group (67 children). ELISA was used to measure the concentrations of plasma VIP, interferon-γ (IFN-γ), and interleukin-4 (IL-4) in peripheral blood. Flow cytometry was used to measure CD3, CD4, and CD8T lymphocyte subsets. RT-PCR was used for qualitative detection of enterovirus 71 (EV71) RNA in stool.</p><p><b>RESULTS</b>Compared with the phase 1 group, the phase 2 group had a significantly higher positive rate of EV71-RNA (P<0.05) and significantly higher serum levels of IgG, IgA, IgM, and C3 (P<0.05). The phase 2 group had significantly lower proportions of peripheral CD3, CD4, and CD8T lymphocyte subsets than the phase 1 group (P<0.05), as well as significantly lower proportion of peripheral B cells and CD4/CD8ratio than the phase 1 group (P<0.05). The phase 2 group also had a significantly lower concentration of VIP in peripheral blood than the phase 1 group (P<0.05). In the 86 children with hand, foot and mouth disease, the concentration of VIP in peripheral blood was positively correlated with the proportion of CD4T lymphocyte subset and CD4/CD8ratio (r=0.533 and 0.532 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>VIP may be an important marker of the severity of hand, foot and mouth disease.</p>

Analysis of Hematology Changes in Children with Malaria / 实用儿科临床杂志

Objective To analyze changes of three periodical circulation systems,erythrocyte sedimentation rate and bone marrow cell morphology in children with malaria.Methods The routine tests of hematology by Sysmex KX-21 Counter, erythrocyte sedimentation rate by Westergren method and bone marrow cell morphology were analyzed. Results In 22 cases of malaria the ratio of Hb level below 110 g/L,WBC below 4?10~9/L and PLT below 100?10~9/L was 68.2%, 41.0%, and 77.3%,respectively. The ratio of children with all three parameters (Hb, WBC and PLT) abnormal was 36.4%, with two parameters abnormal was 63.6%. Ninty-five point five percent of malaria children′s erythrocyte sedimentation rate was abnormal. Fifty-nine point one percent of malaria children had hyperplasia anemia bone marrow morphology, 77.3% secondary thrombocytopenia and 54.5% with both of two bone marrow morphology.Conclusions Three periodical circulation systems of malaria children alter notably, especially in PLT and Hb. The majority has erythrocyte sedimentation rate abnormal, and bone marrow cell morphology shows hyperplasia anemia and thrombocytopenia.