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Objective To analyze the characteristics of chest CT in children with invasive pulmonary fungal infections(IPFIs),and to explore the influencing factors on chest CT manifestations in children with IPFIs.Methods A retrospective case-control study was conducted to select 97 children with IPFIs from October 2010 to October 2016 in the department of respiratory medicine,PICU and hematology.The children were divided into CT characteristic change group(39 cases) and CT non-characteristic change group(58 cases) according to the chest CT manifestations. Non-conditional multivariate Logistic regression analysis was used to identify the independent influencing factors of CT characteristic changes in children with IPFIs. Results The ratios of less than 3-year-old infants, Candida, the proportion of ICU admission in the CT characteristic change group were lower than those in the CT non-characteristic change group(P<0.05). The proportions of more than 3-year-old, neutropenia,Aspergillus,central venous catheter,hematological malig-nancies were higher than those in the CT non-characteristic change group(P<0.05).Multivariate Logistic regression analysis showed that the hematological malignancies was an independent influencing factor for the characteristic changes of CT in children with IPFIs.Conclusion When children with blood system malignant tumors manifest as fever,cough and other symptoms of infection,chest CT manifestations show characteristic changes,Aspergillus infection should be considered,and empirical antifungal treatment should be focused.
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The human gut harbours a certain quantity and variety of microbes called intestinal flora, which is in a state of balance under normal circumstances, and dysbacteriosis occurs when the balance of the intestinal flora is dis-turbed by the host and the changes of the external environment.Circadian clock is the biological regulation system to adapt to natural circadian rhythm, including central clock and peripheral clock.Circadian clock disturbance, particularly rotating shift-workers with irregular light-night schedules, is associated with an increased risk of immune-related diseases.The de-velopment of these diseases is closely related to intestinal dysbacteriosis.Therefore, the correlation between intestinal dys-bacteriosis and circadian clock disturbance has attracted much attention.This review aims to explore the pathophysiological basis of the development in some immune-related diseases based on the latest scientific findings about the relationship be-tween intestinal microbial flora and circadian clock.
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Objective To develop a new treament strategy for Kasabach-Merritt syndrome.Methods Three infants who were diagnosed with Kasabach-Merritt syndrome and suffered from thrombocytopenia as well as bleeding and clotting disorders were treated with percutaneous selective digital subtraction angiography combined with transarterial hardened embolization under general anesthesia.Sclerosing agents included bleomycin A5 (4.0 mg),iodized oil (1.5 ml),dexamethasone (2.5 mg) and iopamidol (3 ml).Polyvinyl alcohol mixed with iopamidol (at a volume fraction of 0.5) served as the embolic material.Results All the three patients were successfully treated by the minimally invasive surgery.The amount of blood platelet returned to normal within 24 hours after the operation.On the fourth day,all the patients were discharged from hospital with the restoration of coagulation function.Revisits at one month and three months after the operation showed that hemangiomas markedly shrank and even subsided,and blood platelet count was maintained within normal range.Conclusions Percutaneous selective digital subtraction angiography combined with transarterial hardened embolization can result in a recovery of blood platelet count and shrinkage of hemangioma,and may serve as a minimally invasive treatment option for Kasabach-Merritt syndrome.