RESUMO
Objective To explore the clinical characteristics of glucocorticoid induced eye damage in children with primary nephrotic syndrome. Methods The clinical data of steroid－induced high intraocular pressure or cataract in 49 children who were from Zhengzhou Children′s Hospital with primary nephrotic syndrome admitted from September 2016 to April 2018 were analyzed retrospectively in order to observe the relationship between relevant eye damage and clinical medication. Results There were 37 boys and 12 girls in the 49 cases,of which the average age of onset was (7. 6 ± 3. 0)years old,and among them there were 22 cases with glucocorticoid high intraocular pressure,19 cases with glucocorticoid cataract,8 cases with glucocorticoid high intraocular pressure combined with cataract,but no glaucoma in 49 cases. The shortest time of using glucocorticoid was 15 －3 240 days[(863. 33 ± 871. 46)days];the cumulative dose of glucocorticoid was(7 865 ± 3 691. 66)mg/m2 ,the left eye pressure was(26. 68 ± 5. 95)mmHg(1 mmHg﹦0. 133 kPa)and the right eye pressure was(27. 71 ± 5. 82)mmHg. There was no significant correlation between glu﹣cocorticoid using time,cumulative dose and high intraocular pressure( r﹦ －0. 158,－0. 264,－0. 237,－0. 361,all P＞0. 05). All the 19 patients with glucocorticoid cataract and 8 patients with glucocorticoid high intraocular pressure combined with cataract presented posterior capsular opacity,including 23 males and 4 females,and their time of using glucocorticoid was(1 296. 67 ± 903. 35)days,who were followed up continuously. Conclusions Glucocorticoid－in﹣duced high intraocular pressure and cataract should be paid attention to by clinicians. Once high intraocular pressure or cataract occurs,the dosage of glucocorticoid should be gradually reduced or stopped,at the same time,ophthalmologic treatment should be actively performed to avoid serious eye diseases.
RESUMO
Objective To explore the diagnosis,treatment and prognosis of neuroblastoma in children. Methods The clinical data of 36 children With neuroblastoma admitted to Department of Pediatric Surgery,Henan Pro﹣vincial People＇s Hospital betWeen August 2013 and August 2018,Were retrospectively analyzed. The patients included 22 males and 14 females With the age of 1 month－13 years old[( 20. 0 ± 18. 5)months]. TWenty－one cases of neu﹣roblastoma originated from the adrenal glands,the other 15 cases from the sympathetic ganglion( including 7 cases in retroperitoneum,6 cases in postmediastinum,and 2 cases in neck). Fifteen patients in loW risk and intermediate risk groups underWent primary surgery before multiple chemotherapy,While other 21 cases in high risk groups underWent chemotherapy until the mass could be removed completely,then continuely underWent multiple chemotherapy. Results Of the 36 patients,23 cases(63. 9%)had a radical resection,13 patients underWent palliative resection and 2 pa﹣tients Were treated With vascular repair during surgery(abdominal aorta in 1 patient,inferior vena cava in 1 patient). TWenty－seven patients had effective in formation and 16 patients survived,during folloW－up,12 patients belonged to stage Ⅰ－Ⅲ disease,2 patients stage Ⅳ disease and 2 patients stage Ⅳs disease,respectively. Four cases underWent re－operation due to disease recurrence,then they underWent chemothearopy,and 3 patients Were survival With tumor. Conclusions Neuroblastoma is a highly malignant pediatric cancer accompanied With a high rate of metastasis on ini﹣tial diagnosis. Radical resection is an effective therapeutic strategy for improving the survival rate. If radical resection is impractical,palliative resection combined With chemotherapy can significantly prolong patients＇ survival time. And a better prognosis is achieved if it can be early diagnosed and treated timely.