Recovery time and risk factors of childhood coagulopathy caused by rodenticide poisoning / 中华实用儿科临床杂志

Objective@#To explore the recovery time and risk factors of coagulopathy caused by rodenticide poisoning through analyzing and following up the confirmed cases, and to provide more useful guidance information for the clinic practice.@*Methods@#A total of 96 cases with coagulation dysfunction caused by anticoagulant rodenticide poiso-ning in Children′s Hospital, Chongqing Medical University from January 2014 to December 2016, were analyzed retrospectively.The recovery time of coagulation function and the relationship between recovery time and drug involved way, dysfunction organs and poison concentration were studied respectively.@*Results@#(1) A total of 96 patients were hospitalized because of severe coagulopathy caused by the poisoning of second generation anticoagulant rodenticide.Brodifacoum was detected from 33 blood samples and the median concentration was 364 μg/L (55-4 654 μg/L). Bromadiolone was detected from 7 blood samples and the median concentration was 130 μg/L (18-652 μg/L). Brodifacoum and Bromadiolone were both detected from 8 cases and the median concentration was 741 μg/L (63-6 000 μg/L) and 11 μg/L (3-3 694 μg/L), respectively.(2) A total of 57 cases of the patients were successfully followed up.A total of 18 cases were confirmed with oral poisoning, 16 cases with dermal poisoning, while 23 cases denied any involved ways of poisoning, and 7 cases had organs dysfunction.The follow-up time was 12-54 months.All the hospitalized patients were given specific antidote Vitamin K treatment and recovered successfully without any sequelae.(3) The median recovery time of coagulopathy caused by rodenticide poisoning was 2.5 months.(4) The recovery time of coagulation function was positively correlated with the plasma concentration of Brodifacoum(r=0.619, P<0.01). (5) There was no significant correlation between recovery time and organ dysfunction or drug involved ways of poisoning involvement (all P>0.05).@*Conclusions@#The recovery time of coagulation dysfunction caused by anticoagulant rodenticide in children is much longer.The higher the concentration of Brodifacoum poison is, the longer the recovery time.Enough supplementation course of Vitamin K should be given according to the follow-up of coagulation function.

Polycentric analysis of current situation of diagnosis of haemophilia in Chinese children / 中华实用儿科临床杂志

Objective To analyze the diagnostic status of haemophilia in Chinese children in recent years,and to provide information for increasing the life quality of children with haemophilia in China.Methods The pediatric haemophilia cases registration data were collected and analyzed by using questionnaire,from January 1,2008 to March 30,2014 in 13 haemophilia treatment centers of haemophilia treatment center collaboration network of China pediatric group.These centers were from 12 provinces / municipalities.Results A total of 554 cases were collected;median age was 7.0 years old(0.1 to 17.9 years old);among them,481 cases(86.8％) were hemophilia A,and 73 cases were hemophilia B (13.2％);55 mild cases (9.9％),290 moderate cases (52.4％),and 209 severe cases (37.7％);162 cases(29.2％) had family history,the other 392 cases(70.8％) had no family history.The diagnosis was made at a median age of 12.0 month-old(0 to 180.0 months);the diagnosis time was 0.5 months(0 to 144.0 months) after the first bleeding;diagnosis timing with short interval was in 356 cases(64.3％),long interval was in 198 cases(35.7％).The diagnostic timing was not correlated with disease severity (P =0.812) or the family history (P =0.243);but correlated with the severity of first bleeding(P =0.027) and per capita gross domestic product (P ＜ 0.01) in patients' residence.From 1996 to 2013,the annual number of newly diagnosed cases was increasing year by year,with a higher proportion of short interval of diagnose timing.Conclusions With development of hemophilia work in China,the number of diagnosis of haemophilia children is increasing year by year.Moderate and severe hemorrhage are both taken seriously and diagnosed timely.But the diagnosis is delayed in some children.Chinese haemophilia work still need to be strengthen and the propaganda and diagnostic technology are to be popularized.

Establishing a HPLC method to detect urocanic acid in serum and investigate its significance for childhood leukemia / 基础医学与临床

Objective To establish a method for detection of serum urocanic acid (UCA) by high performance liquid chromatography (HPLC),and explore the clinical significance of serum UCA concentration for children acute leukemia.Methods The chromatographic conditions of HPLC were set up and optimized,and the linearity of standard curve,precision,accuracy and stability were validated.Then the serum from ninety acute leukemia children and ninety non-tumor blood disease children was collected,the concentration of serum UCA was detected with HPLC,and the differences of two groups were compared to study the clinical significance of UCA in children acute leukemia.Results The HPLC method for detecting serum UCA was successfully established and optimized.The standard curves of trans-UCA and cis-UCA both showed good linearities(R2=0.999 6 and 0.999 9) at the condition of the mobile phase of acetonitrile-20 mmol/L KH2PO4,pH 3.7(5:95,V/V),flow rate of 1.2 mL/min,detection wavelength of 264 nm in HPLC.The relative standard deviation RSD％ of intra-assay and inter-assay were lower than 5％.Compared with non-tumor blood disease,the serum concentration of cis urocanic acid (cis-UCA) and trans urocanic acid (trans-UCA) of children with acute leukemia were significantly increased (P＜0.001).Compared with cis-UCA,trans-UCA was more valuable for risk classification of acute lymphoblastic leukemia (ALL).Conclusions HPLC is a good technology to titrate of UCA in serum.The concentration of serum UCA in children with acute leukemia may provide the clues for diagnosis and prognosis,with important clinical significance.

Analysis of clinical and laboratory features of 217 pediatric hemophagocytic lymphohistiocytosis / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the incidence, clinical symptoms, signs and laboratory features of childhood hemophagocytic lymphohistiocytosis (HLH) in China.</p><p><b>METHODS</b>A retrospective study was performed on 217 pediatric patients with HLH who were admitted to Children's Hospital of Chongqing Medical University from January 2006 to April 2013. All patients'medical records were reviewed and analyzed.</p><p><b>RESULTS</b>The Male to female ratio was 1.11:1. The median onset age was 3 years and 5 months old (range of 6 months old to 16 years and 9 months old), and the age of onset peaked between 1-5 years old (61.3%). The most common causes of HLH was infection, especially Epstein-Barr virus-associated HLH (71.0%). Other causes included malignant hemophagocytic syndrome (MAHS), macrophage activation syndrome (MAS) and so on. The outstanding clinical manifestations including persistent fever (100.0%), hepatomegaly (92.6%), splenomegaly (88.4%), and more than half of cases with central nervous system involvement and pulmonary manifestations. Laboratory data indicated that the most prominent abnormality was elevated ferritin (98.0%), and the others were hemophagocytosis in bone marrow (90.7%) and coagulation abnormalities (76.5%). Abnormal lymphocytes classification is very common in HLH.</p><p><b>CONCLUSION</b>HLH is a heterogeneous disease, with a variety of the etiology and clinical manifestations. HLH-2004 diagnostic protocol had theoretical basis and clinical operability. The hepatitis damages related indicators, lymphocytes classification, central nervous system involvement and pulmonary performance can be used as reference value for HLH diagnosis.</p>

Clinical study on cytomegalovirus infection after hematopoietic stem cell transplantation in 26 patients with primary immunodeficiency diseases / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the risk factors, and control measures of cytomegalovirus (CMV) infection after hematopoietic stem cell transplantion (HSCT) in children with primary immunodeficiency diseases(PID).</p><p><b>METHODS</b>We retrospectively analyzed results of 26 patients with PID-Wiskott-Aldrich syndrome (WAS, n=20), severe combined immunodeficiency (SCID, n=1) , X-linked chronic granulomatous disease (XCGD, n=2) and X-linked hyper-immunoglobulin M (IgM) syndrome (XHIM, n=3)-who underwent HSCT from June 2007 to December 2012 in our center. Serologic studies (ELISA) and weekly CMV infection surveillance (quantitative PCR, qPCR) were routinely performed before and after HSCT. Ganciclovir or forcarnet was used for pre-emptive and curative therapy.</p><p><b>RESULTS</b>All 26 patients were male with the median age at HSCT of 27 months (range 7-77 months). At a median follow up of 24 months (range 5-66 months), the 5-year overall survival rate was (75.0 ± 9.0) %. CMV infection occurred in 42.3% (11 of 26) of the patients, two of them developed CMV interstitial pneumonia (CMVIP). Univariate analysis revealed that the incidence of pre-transplant CMV infection between with and without CMV activation groups after HSCT was significantly different (62.5% vs 10.0%, P=0.010). Additional variables not associated with CMV infection were stem-cell sources, donor type, HLA disparity and acute GVHD (all P values>0.05).</p><p><b>CONCLUSION</b>CMV infection was a major complication of HSCT. Sensitive monitoring, early diagnosis, timely treatment may improve the survival rate for these PID undergoing HSCT.</p>

5-Aza-cytidine inhibit proliferation of human promyelocytic leukemia cells (HL60) by inducing apoptosis / 重庆医科大学学报

Objevtive:This study was aimed to investigate the effect of 5-aza-cytidine on the proliferation,cell cycles distribution profile and apoptosis of human promyelocytic cell line HL60.Methods: The human promyelocytic cell line HL-60 was cultured in RPMI 1640 medium.3-(4,5-Dimethylthiazol-2-y)l-2,5-diphenylte trazolium(MTT)reduction by cells was used to assess drug-induced cell growth inhibition.Cells were treated with 0.25,0.5,1,2.5?mol/L of freshly prepared 5-aza-cytidine for 48 hours before they were harvested for analyzing distribution of cell cycle phases and apoptosis by flow cytometer.Results:5-aza-cytidine inhibited HL60 cell proliferation in a time-and concentration-dependent manner.Apoptosis was induced as detected by flow cytometry.Determination of the cell cycle distribution by flow cytometry revealed an accumulation of cells in G1 phase.Conclusion:DNA methylation inhibitor 5-aza-cytidine has effects on proliferation of human promyelocytic cell line HL60.Possible mechanism of this inhibition is induction of apoptosis.

Signal processing in monitoring blood oxygen concentration by LMS self-adaptive arithmetic self-adaptive arithmetic / 医疗卫生装备

Lives are maintained by enough oxygen.Blood oxygen saturation is one of the important parameters which reflects oxygen concentration in blood.The accurate monitoring of blood oxygen saturation is very important to both physiological research and medical application.At present,dual-wavelength method is widely adopted in noninvasive detection of blood oxygen saturation.Therefore,accurate recognition of peak-to-peak value of pulse waveform is a key process in monitoring blood oxygen saturation.In the paper,LMS self-adaptive arithmetic is applied to processing pulse waveform signal.The ratio of corrective detection is improved by the method.

Research and design of electronic sphygmomanometer based on charge measurement / 医疗卫生装备

In allusion to the defects of traditional electronic sphygmomanometer in deflation process,this paper puts forward an innovative way which accomplishes the measure of blood pressure during charge process based on oscillometric method.It is proved to be more energy-saving,more subminiature,less measuring time and more stable for individual.

The expression of cyclin kinase inhibitor P21~(WAF1) and P27~(KIP1) in children with acute lymphoblastic leukemia / 重庆医科大学学报

Objective:To probe the expression of P21 WAF1 and P27 KIP1 in children with acute lymphoblastic leukemia (ALL) and its clinical significance.Methods:The method of immunocytochemistry is used to estimate the expression of P21 WAF1 and P27 KIP1 .Both percentage and intensity of positive cells were counted.Results:The results showed that the positive ratio of P21 WAF1 in ALL samples was 9.1% (2/22) and P27 KIP1 was 50%(11/22).The trends of higher expression of P21 WAF1 and P27 KIP1 were noted in follow-up study on eight patients with ALL.Most of the P27 KIP1 positive cells were pigmented in nucleus in the control group while pigmented in both nucleus and plasma in the studied patients.Conclusion:P21 WAF1 ,P27 KIP1 may be a marker for evaluation of therapeutic effects.

Forging and training of interns’clinical thinking ability / 中华医学教育探索杂志

The clinical thoughts of interns have some features such as insufficiency of initiative and enthusiasm and the absence of systemic. It is necessary to develop their good habits of active and diligent thinking as well as comprehensive thinking ability. Clinical teaching rounds, small lectures,discussion of complicated cases and interactive teaching are the specific measures for our medical interns to improve their ability of clinical thoughts effectifally.

Study on programmable gain in ultrasonic guidance system for the blind / 医疗卫生装备

Ultrasonic sensors are optimal to the guidance system for the blind.The previous ultrasonic guidance systems acquire the position information of obstacles,and transform it into audio signal or tactile vibration.The system developed in this paper,utilizing programmable gain technique and digital potentiometer,acquires the power of reflected ultrasonic as additional information,and informs the blind with modulated audio signal.In this paper,the studies on programmable gain is described detailed including the hardware structure,the software design and information post processing.

Mathematical model of the hydrolization of PIP2 with the stimulation of EGF / 医疗卫生装备

To investigate dynamic characteristics of the hydrolization lipid phosphatidylinositol(4,5)-bisphosphate(PIP 2 )with the stimulation of epidermal growth factor(EGF),the mathematical model to simulate the metabolizability of PIP 2 is established based on Law of Mass Action and Law of the Quasi-steady-State Approximation.Differential equations of concentration relations between PIP 2 and EGF receptor are formulated,and the effect of the parameters on the changing trend of PIP 2 is analyzed.This mathematical model describes biology characteristics of metabolized PIP 2 and dependency relationships of concentration between key signal producuts.