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Objective To investigate the trend of cytokines in patients with hemophagocytic lymphohistiocytosis (HLH) and analyze its significance.Methods 16 patients with HLH from January 2011 to May 2013 were selected.The patients were divided into remission group and death group by prognosis.Serums of the two groups were collected when they were hospitalized and at 7 th,14 th,21st,28th and 42nd day during chemotherapy,and they were fractionated HLH 1-6 groups and HLH a-d groups again,then the levels of IL-18,IL-10,IL-12,NF-κB,TNF-α and neopterin were tested by enzyme linked immuno sorbent assay (ELISA) to analysis their trend.Results The levels of all of cytokines in the remission group declined with chemotherapy,the difference between HLH1 group and another HLH groups was statistically significant (P ＜ 0.05).In the death group,the levels of NF-κB,IL-12 and neopterin had no downward trend with chemotherapy,and the difference between HLHa group and another HLH groups was not statistically significant (all P ＞ 0.05).The level of TNF-α declined with chemotherapy,and the differences between HLHa group and HLHc group,HLHa group and HLHd group were statistically significant (P =0.049,0.000).The level of IL-10 declined sharply in the first week of chemotherapy,and the difference between HLHa group and HLHb group was statistically significant (P =0.00).The level of IL-18 declined after the 2nd-weeks' chemotherapy,and the differences between HLHa group and HLHb group,HLHa group and HLHc group were statistically significant (P =0.03,0.02).Conclusions In the remission patients,the levels of serum IL-18,IL-10,IL-12,NF-κB,TNF-α and neopterin declined after chemotherapy.In the death patients,the downward trend is not obvious.It was preliminarily confirmed that the prognosis of HLH is related to the trend of cytokines during chemotherapy.
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Objective To improve the diagnosis rate and decrease misdiagnosis through analyzing the clinical and experimental features of neuroblastoma (NB) in children.Methods The clinical and experimental features associated with the misdiagnosis factors of 22 NB cases were analyzed retrospectively.Results Of the 22 cases,leg pain in 15 cases (68.18 ％),fever in 19 cases (86.36 ％),anemia in 20 cases (90.90 ％),abdominal pain and bloating in 15 cases (68.18 ％),exophthalmoses and bruises eyes in 4 cases (18.18 ％) and easily perspire in 20 cases (90.90 ％).Abdomen was the most common primary site founding in 16 cases (accounting for 72.72 ％),followed by mediastinum founding in 4 cases (accounting for 18.18 ％),other sites were 2 cases (9.09 ％).Laboratory results showed that anemia was the most common cause in 20 cases (90.90 ％),oligoleukocythemia in 2 cases (9.09 ％) and less in thrombocytopenia about 3 cases (13.63 ％).Elevated values were recorded in 77.77 ％ of patients for vanillylmandelic acid (VMA),86.36 ％ for ferritin (Fer),90.90 ％ for lactate dehydrogenase (LDH),and in 100.00 ％ for neuron specific enolase (NSE).20 cases were found metastasis when diagnosed,which accounted for 90.90 ％.16 cases (72.72 ％) were found tumour cells which determined in bone marrow and 20 cases (90.90 ％) were positive for CD56-FITC/CD81-PE/CD45-Percp by flow cytometry (FCM).12 (54.54 ％) of 22 NB cases were misdiagnosed for rheumatoid diseases (4 cases),dyspepsia (4 cases),leukemia (3 cases) and thrambocytopenia (1 case).In 22 cases,20 cases (90.90 ％) were positive for CT scan.16 cases (72.72 ％) were positive for abdominal B ultrasonography,and 14 cases (63.63 ％) were positive for radionuclide bone scan.Conclusion Bultrasonography and CT scan will contribute to find the primary focus of NB at early stage.VMA,bone marrow smear,biopsy and FCM detection could reduce misdiagnose rate.