RESUMO
Objective To discuss the clinical features and risk factors of death in children with severe pneumonia treated with invasive mechanical ventilation.Methods Through a retrospective analysis of children with severe pneumonia treated with invasive mechanical ventilation,who were hospitalized in PICU of Tianjin Children′s Hospital from Jan 2011 to Dec 2014,we analyzed the distribution of age,etiologic characteristics,mechanical ventilation,complications and background diseases.The single factor analysis and multiple factors Logistic regression analysis were performed to evaluate the risk factors of death.Results A total of 214 pediatric patients were included,134 were male,and 80 were female.The case fatality rate was 6.17%,the relevance ratio of pathogenic microorganism was 16.36%.The median age of death group was older than that of the survival group(4 mouths vs 2 mouths,P=0.039).The pediatric patients who were more than 1 year old in death group were more than the survival group(21.43% vs 15.8%,P<0.001).The common complications included dencephalopathy(11.68%) and electrolyte imbalance(8.41%).Anemia,cardiopathy and alloplasia of respiratory system were the top background diseases.The results of Logistic multivariate regression analysis showed that there were significant differences in the age above 1 year old(OR:1.019,95%CI:1.003-1.030,P=0.019),secondary acute respiratory distress syndrome(OR:7.254,95%CI:1.581-33.277,P=0.011) and accompanying cardiopathy(OR:0.47,95%CI:0.273-0.81,P=0.007).Conclusion The risk factors of death in children with severe pneumonia treated with invasive mechanical ventilation are the following:the age above 1 year old,secondary acute respiratory distress syndrome or accompanying cardiopathy.
RESUMO
<p><b>OBJECTIVE</b>To investigate the gene expression of osteoprotegerin (OPG) and osteoclast differentiation factor (ODF/TRANCE/RANKL), two new members of the TNF-receptor superfamily, in giant cell tumor (GCT); to discuss the molecular mechanism of extensive bone resorption caused by GCT.</p><p><b>METHODS</b>Using TRIzol reagent to prepare total RNA from GCT sample and normal bone tissue. By a first-strand complementary DNA (cDNA) synthesis kit, cDNA was synthesized from 2.0 micro g RNA according to the manufacturer's instructions. cDNA was then amplified by PCR. Amplification products were resolved by electrophoresis on a 1.5% agarose gel and stained with EB. The relative quantity of the PCR products were determined and the mRNA levels of OPG, ODF, M-CSF (cofactor of ODF), and RANK (receptor of ODF) were compared with that of the normal bone.</p><p><b>RESULTS</b>GCT contained highly expressed mRNA of ODF, OPG, M-CSF and RANK. There was mRNA expression of OPG, M-CSF and RANK and less expression of ODF in normal bone. The ODF mRNA and RANK mRNA in GCT were more abundant than that in normal bone. In GCT, the ratio of ODF mRNA exceeded OPG expression. But in normal bone, the OPG mRNA exceeded ODF expression.</p><p><b>CONCLUSIONS</b>The results suggest that GCT contains all signals including OPG, ODF, M-CSF and RANK that are essential for inducing osteoclastogenesis and promoting bone resorption.</p>