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BACKGROUND: Newborn screening (NBS) is an important and successful public health program that helps improve the long-term clinical outcomes of newborns by providing early diagnosis and treatment of certain inborn diseases. The development of next-generation sequencing (NGS) technology provides new opportunities to expand current newborn screening methodologies. METHODS: We designed a a newborn genetic screening (NBGS) panel targeting 135 genes associated with 75 inborn disorders by multiplex PCR combined with NGS. With this panel, a large-scale, multicenter, prospective multidisease analysis was conducted on dried blood spot (DBS) profiles from 21,442 neonates nationwide. RESULTS: We presented the positive detection rate and carrier frequency of diseases and related variants in different regions; and 168 (0.78%) positive cases were detected. Glucose-6-Phosphate Dehydrogenase deficiency (G6PDD) and phenylketonuria (PKU) had higher prevalence rates, which were significantly different in different regions. The positive detection of G6PD variants was quite common in south China, whereas PAH variants were most commonly identified in north China. In addition, NBGS identified 3 cases with DUOX2 variants and one with SLC25A13 variants, which were normal in conventional NBS, but were confirmed later as abnormal in repeated biochemical testing after recall. Eighty percent of high-frequency gene carriers and 60% of high-frequency variant carriers had obvious regional differences. On the premise that there was no significant difference in birth weight and gestational age, the biochemical indicators of SLC22A5 c.1400C > G and ACADSB c.1165A > G carriers were significantly different from those of non-carriers. CONCLUSIONS: We demonstrated that NBGS is an effective strategy to identify neonates affected with treatable diseases as a supplement to current NBS methods. Our data also showed that the prevalence of diseases has significant regional characteristics, which provides a theoretical basis for screening diseases in different regions.
Subject(s)
Neonatal Screening , Phenylketonurias , Humans , Infant, Newborn , Neonatal Screening/methods , Prospective Studies , Genetic Testing , High-Throughput Nucleotide Sequencing/methods , Mitochondrial Membrane Transport Proteins/genetics , Solute Carrier Family 22 Member 5/geneticsABSTRACT
OBJECTIVE@#To explore whether femoral plasty can improve the fracture resistance of osteoporotic femoral specimens and prevent hip fracture, and to compare the difference of mechanical strength changes between two different femoral plasty methods in osteoporotic femoral specimens, so as to determine the best strengthening area of the plasty.@*METHODS@#Eighteen pairs of fresh osteoporotic femur specimens were collected and divided into two groups, A and B, 9 pairs in each group. Nine fresh osteoporotic femur specimens in each group were randomly selected for enhancement, and the corresponding contralateral specimens were used as control group. In group A1, the enhancement areas were femoral head, femoral neck, femoral trochanter and subtrochantericregion. And in group B1, the enhancement areas were femoral head, femoral neck and femoral trochanter region. The amount of cement injected into the femoral neck was recorded and the surface temperature of the femoral neck was measured. All specimens were biomechanically tested under simulated falls. Load-displacement curves, final loads were recorded. The final energy and stiffness of specimens were calculated. The biomechanical differences between the specimens of the enhancement group and those of the corresponding control group were compared, and the mechanical changes of the specimens by two different enhancement methods were compared.@*RESULTS@#Compared with the control group, the ultimate load and energy of the specimens in the enhanced group increased significantly, but the stiffness did not change significantly. There was no significant difference in final load and energy between specimens strengthened by two different methods.@*CONCLUSION@#Femoral plasty has the advantages of minimally invasive, simple operationand remarkable effect. It can be used as a new method to prevent osteoporotic hip fracture.
Subject(s)
Humans , Biomechanical Phenomena , Bone Cements , Femur , Femur Neck , Hip Fractures , Osteoporotic FracturesABSTRACT
OBJECTIVE: To investigate the epidemiological characteristics, phenotype, genotype, and prognosis of medium-chain acyl-CoA dehydrogenase deficiency (MCADD) in the Chinese population. METHODS: A retrospective analysis was performed for the clinical data of the neonates who underwent screening with high-performance liquid chromatography-tandem mass spectrometry from January 2009 to June 2018 and were diagnosed with MCADD by gene detection. RESULTS: A total of 2 674 835 neonates underwent neonatal screening, among whom 12 were diagnosed with MCADD. Gene detection was performed for 10 neonates with MCADD and found 13 mutation types at 16 mutation sites of the ACADM gene, among which there were 7 reported mutations (p.T150Rfs*4, p.M1V, p.R206C, p.R294T, p.G310R, p.M328V, and p.G362E), 5 novel mutations (p.N194D, p.A324P, p.N366S, c.118+3A>G, and c.387+1del G), and 1 exon 11 deletion; p.T150Rfs*4 was the most common mutation (4/16). The detection rate of mutation sites in the ACADM gene was 80%. No phenotype-genotype correlation was observed. Dietary guidance and symptomatic treatment were given after confirmed diagnosis. No acute metabolic imbalance was observed within 4-82 months of follow-up. All neonates had good prognosis except one who had brain dysplasia. CONCLUSIONS: MCADD is relatively rare in southern China, and p.T150Rfs*4 is a common mutation in the Chinese population. Cases with positive screening results should be evaluated by octanoylcarnitine C8 value and gene detection.
Subject(s)
Acyl-CoA Dehydrogenase/deficiency , Lipid Metabolism, Inborn Errors , Carnitine , China , Follow-Up Studies , Humans , Infant, Newborn , Mutation , Neonatal Screening , Retrospective StudiesABSTRACT
Aim To establish a cell model to detect the activity of somatostatin (SST) by targeting somatostatin receptor 2 (SSTR2), and to provide a simple and stable evaluation method for the drug screening of SSTR2 agonists and somatostatin analogues (SSTA). Methods The target gene of SSTR2 was integrated into the pEGFP-N3 vector, and the recombinant plasmid was constructed and transfected into HEK293 cells. After G418 screening, positive clone was selected and the stable cell lines were obtained by expanding culture. The stable cell lines were identified by fluorescence cell imaging, Western blot and qPCR. A calcium flow detection system was established to optimize cell number, fluorescence dye concentration and incubation time. Finally, the screening model was used to detect the different batches of the marketed somatostatin preparation Stilamin. Results SSTR2 stable cell lines were successfully constructed, and the receptors were mainly distributed on the cell membrane. The optimal conditions for calcium flow detection were determined as follows; 30 000 cells/Well, Fluo-4/AM indicator concentration was 3 p,mol • L -1 ~5 u,mol • L-1 , incubation time was 45 min. Under this condition, EC50 value of Stilamin in different batches was stable. Conclusions SSTR2 overexpressed stable cell lines are successfully constructed and calcium flow detection method is optimized to provide a simple and stable model for the screening of somatostatin receptor agonists.
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Canada is one of the leading countries in the world with a leading position in medical education and high quality of medical education.Based on the Ottawa-Shanghai joint medical school collaborative program,this article introduces and analyzes the curriculum system of University of Ottawa School of Medicine.The curriculum is designed based on organs and systems,with a focus on the integration of basic and clinical research from the early stage.It adopts a diversified and student-centered teaching method,with practice teaching running through the whole course.Moreover,it attaches importance to family medical education and strengthens the cultivation of medical humanities.Learning from the advanced teaching concepts and methods in North America may help to promote the reform of medical education in China and cultivate high-quality medical talents in line with international standards.
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Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual&medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.
ABSTRACT
Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual & medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.
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Objective:To establish the fingerprint of the volatile oil in Xiangjuganmao granules and study the attribution of original herbs. Methods:The fingerprint of the volatile oil was established by GC-MS,and the characteristic peaks were used to study the attribution of original herbs by comparing with those of single herb and negative herb. Results:Totally 22 characteristic peaks were shown in the fingerprint of Xiangjuganmao granules. The similarities of 18 batches of Xiangjuganmao granules were within the range of 0.892-0.998. Among the 22 peaks,19 ones were defined the attribution of original herbs, and 22 chemical components were identified. Conclusion:The method is with good precision,reproducibility and stability,which can be used to control the quality of Xiangjuganmao granules.
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Objective To understand the tendency of negative emotional expression and its cognitive influencing factors in breast cancer survivors in China, in order to provide evidence for emotional expression intervention. Methods The qualitative research based on the health belief model (HBM) was adopted. In-depth interviews were conducted with 21 breast cancer survivors. Data were analyzed by content analysis method. Results Among 21 people interviewed, 4 were emotionally expressed and 17 were emotionally suppressed. Aware of the negative emotions, recognize the seriousness of emotional depression, the benefits of emotional expression, the less obstacles of expression and the sense of self-efficacy can promote the occurrence of emotional expression. Conclusions Chinese breast cancer survivors are not good at expressing their negative emotions.Health care workers can change the behavior of patients through the aware of the negative emotions, recognize the seriousness of emotional depression, the benefits of emotional expression,the obstacles of expression and the sense of self-efficacy.
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Although, most patients respond initially to therapy for nephrotic syndrome, about 70% of patients have a relapse. Currently, there is no consensus about the most appropriate second-line agent in children who continue to suffer a relapse. This network meta-analysis was designed to compare the efficacy and safety of the commonly used immunosuppressive agents in second-line therapeutic agents (ie, cyclophosphamide, cyclosporine, tacrolimus and mycophenolate mofetil) for refractory childhood nephrotic syndrome. MEDLINE, Cochrane, EMBASE and Google Scholar databases were searched until October 17, 2015 using the following search terms: cyclophosphamide, cyclosporine, tacrolimus, mycophenolate mofetil and childhood nephrotic syndrome. Randomized controlled trials, prospective 2-arm studies and cohort studies were included. 7 studies with 391 patients were included. Bayesian network meta-analysis found that treatment with mycophenolate mofetil had the greatest odds of relapse compared with tacrolimus (pooled OR=49.72, 95% credibility interval (CrI) 1.65 to 2483.32), cyclophosphamide (pooled OR=72.05, 95% CrI 1.44 to 13633.33) and cyclosporine (pooled OR=11.42, 95% CrI 1.03 to 131.60). Rank probability analysis found cyclophosphamide was the best treatment with the lowest relapse rate as compared with other treatments (rank probability=0.58), and tacrolimus was ranked as the second best (rank probability=0.38). Our findings support the use of cyclophosphamide and tacrolimus in treating children with relapsing nephrotic syndrome.
Subject(s)
Immunosuppressive Agents/therapeutic use , Nephrotic Syndrome/drug therapy , Child , Female , Humans , Male , Probability , Publication Bias , Quality Assurance, Health Care , RecurrenceABSTRACT
Objective To discuss the clinical effect of montelukast in the treatment of cough after infection. Methods 100 cases of patients with cough after infection in Taizhou hospital from January 2016 to February 2017 were randomly divided into the experimental group and the control group, 50 cases for each group, the control group was given oral Tianyi Zhike tangjiang liquid, the experimental group was given montelukast sodium on the basis of the control group, the treatment effect and cough integral between two groups after infection were compared and analyzed. Results The clinical effective rate of the experimental group was 96.0%, significantly higher than the control group 70.0%, the differences between groups was statistically significant (P<0.05). Cough scores in the experimental group after the treatment were significantly better than the control groupwith statistical significance (P<0.05). Conclusion Montelukast in the treatment of cough after infectious has clear clinical effect, and high safety.
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AIM:To investigate the protective effect of curcumin analogue L 6H4 on diaphragm of type 2 dia-betic rats.METHODS: SPF male Sprague-Dawley rats ( n=40) were randomly divided into 5 groups: normal control (NC) group, high fat (HF) group, high fat+L6H4 treatment (FT) group, diabetes mellitus (DM) group and DM +L6H4 treatment (DT) group.The rats in the later 4 groups were fed with high-fat diet.After 4 weeks of high-fat diet fee-ding, the rats in DM and DT groups were intraperitoneally injected with streptozotocin to induce type 2 diabetes melliutus. The rats in FT and DT groups were given L6H4 by gavage for 8 weeks.Blood glucose and blood lipid levels were detected biochemically .Fasting serum insulin ( FINS ) level was measured by radioimmunoassay and insulin resistance index (HOMA-IR) was calculated.Serum adiponectin (APN) level was measured by ELISA.The morphological changes of the diaphragm were observed under light and transmission electron microscopes .Lipid deposition and the activity of succinate dehydrogenase (SDH) and NADH-tetrazolium reductase (NADH-TR) were observed by enzyme histochemical staining . The content of malondialdehyde ( MDA) and the activity of superoxide dismutase ( SOD) in the diaphragm were measured by thiobarbituric acid method and hydroxylamine method , respectively .The protein expression of adiponectin receptor 1 ( AdipoR1) in the diaphragm was determined by immunohistochemistry and Western blot .RESULTS:The levels of blood lipids , blood glucose , FINS and HOMA-IR in HF and DM groups were higher than those in NC group , but decreased after L6H4 treatment.The serum APN level in HF and DM groups was lower than that in NC group , but increased after treat-ment with L6H4.The muscle fibers of the diaphragm were shrunk , fat particles accumulated in the muscle fibers , and the mitochondria were slightly swollen in HF and DM groups .The diaphragmatic fibrosis was obvious in DM group .These le-sions were relieved after L6H4 treatment.Compared with NC group, the level of MDA and the activity of SDH and NADH-TR in the diaphragm were increased in HF and DM groups , but decreased after treatment with L 6H4.The activity of SOD and the expression of AdipoR1 in the diaphragm were lower than those in NC group , but increased after L6H4 treatment. CONCLUSION: The curcumin analogue L6H4 exerts a protective effect on diaphragm in type 2 diabetic rats.The strengthened protein expression of AdipoR 1, the increased serum level of APN , and anti-lipid peroxidation may be involved in the process .
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Objective To discuss the clinical effect of montelukast in the treatment of cough after infection. Methods 100 cases of patients with cough after infection in Taizhou hospital from January 2016 to February 2017 were randomly divided into the experimental group and the control group, 50 cases for each group, the control group was given oral Tianyi Zhike tangjiang liquid, the experimental group was given montelukast sodium on the basis of the control group, the treatment effect and cough integral between two groups after infection were compared and analyzed. Results The clinical effective rate of the experimental group was 96.0%, significantly higher than the control group 70.0%, the differences between groups was statistically significant (P<0.05). Cough scores in the experimental group after the treatment were significantly better than the control groupwith statistical significance (P<0.05). Conclusion Montelukast in the treatment of cough after infectious has clear clinical effect, and high safety.
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AIM:To investigate the protective effect of curcumin analogue L 6H4 on diaphragm of type 2 dia-betic rats.METHODS: SPF male Sprague-Dawley rats ( n=40) were randomly divided into 5 groups: normal control (NC) group, high fat (HF) group, high fat+L6H4 treatment (FT) group, diabetes mellitus (DM) group and DM +L6H4 treatment (DT) group.The rats in the later 4 groups were fed with high-fat diet.After 4 weeks of high-fat diet fee-ding, the rats in DM and DT groups were intraperitoneally injected with streptozotocin to induce type 2 diabetes melliutus. The rats in FT and DT groups were given L6H4 by gavage for 8 weeks.Blood glucose and blood lipid levels were detected biochemically .Fasting serum insulin ( FINS ) level was measured by radioimmunoassay and insulin resistance index (HOMA-IR) was calculated.Serum adiponectin (APN) level was measured by ELISA.The morphological changes of the diaphragm were observed under light and transmission electron microscopes .Lipid deposition and the activity of succinate dehydrogenase (SDH) and NADH-tetrazolium reductase (NADH-TR) were observed by enzyme histochemical staining . The content of malondialdehyde ( MDA) and the activity of superoxide dismutase ( SOD) in the diaphragm were measured by thiobarbituric acid method and hydroxylamine method , respectively .The protein expression of adiponectin receptor 1 ( AdipoR1) in the diaphragm was determined by immunohistochemistry and Western blot .RESULTS:The levels of blood lipids , blood glucose , FINS and HOMA-IR in HF and DM groups were higher than those in NC group , but decreased after L6H4 treatment.The serum APN level in HF and DM groups was lower than that in NC group , but increased after treat-ment with L6H4.The muscle fibers of the diaphragm were shrunk , fat particles accumulated in the muscle fibers , and the mitochondria were slightly swollen in HF and DM groups .The diaphragmatic fibrosis was obvious in DM group .These le-sions were relieved after L6H4 treatment.Compared with NC group, the level of MDA and the activity of SDH and NADH-TR in the diaphragm were increased in HF and DM groups , but decreased after treatment with L 6H4.The activity of SOD and the expression of AdipoR1 in the diaphragm were lower than those in NC group , but increased after L6H4 treatment. CONCLUSION: The curcumin analogue L6H4 exerts a protective effect on diaphragm in type 2 diabetic rats.The strengthened protein expression of AdipoR 1, the increased serum level of APN , and anti-lipid peroxidation may be involved in the process .
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BACKGROUND: Glutaric acidemia type I (GA-I) is a rare metabolic disorder caused by mutation of the glutaryl- CoA dehydrogenase (GCDH) gene. The occurrence of rhabdomyolysis with GA-I is extremely rare. METHODS: We reported a child with recurrent rhabdomyolysis and undiagnosed glutaric acidemia type I (GA-I). And a literature review was performed. RESULTS: A 4.5-year-old girl was admitted to our hospital due to recurrent rhabdomyolysis for 3 times within three years. At the third admission, she was diagnosed with GA-I by biochemical testing and mutation analysis. The girl was found to have a serine to leucine replacement mutation of the GCDH gene in exon 8 at position 764. Other three patients with rhabdomyolysis and GA-I were discovered by literature searching. CONCLUSIONS: This report highlights that patients with GA-I may have an increased risk of rhabdomyolysis.
Subject(s)
Amino Acid Metabolism, Inborn Errors/blood , Brain Diseases, Metabolic/blood , Genetic Predisposition to Disease , Glutaryl-CoA Dehydrogenase/deficiency , Glutaryl-CoA Dehydrogenase/genetics , Rhabdomyolysis/diagnosis , Rhabdomyolysis/drug therapy , Amino Acid Metabolism, Inborn Errors/complications , Amino Acid Metabolism, Inborn Errors/genetics , Biopsy, Needle , Brain Diseases, Metabolic/complications , Brain Diseases, Metabolic/genetics , Carnitine/therapeutic use , Child, Preschool , Female , Follow-Up Studies , Glutaryl-CoA Dehydrogenase/blood , Humans , Immunohistochemistry , Magnetic Resonance Imaging/methods , Rare Diseases , Recurrence , Rhabdomyolysis/complications , Risk AssessmentABSTRACT
OBJECTIVE:To investigate the clinical efficacy and safety of aerosol inhalation of magnesium sulfate and salbuta-mol sulfate in the treatment of acute attack of severe bronchial asthma in children. METHODS:85 children with acute attack of se-vere bronchial asthma were divided into control group(45 cases)and intervention group(40 cases)in accordance to even and odd number of hospitalization time. Based on routine treatment of glucocorticoid intravenous injection,oxygen uptake,sedation and nu-tritional support,control group was given aerosol inhalation of salbutamol sulfate,0.6 ml each time,once every 20 min,for 1 h;intervention group was additionally given aerosol inhalation of magnesium sulfate,0.6 ml each time,once every 20 min,for 1 h, on the basis of control group. Therapeutic efficacy,improvement time of shortness of physical examination indexes (breath, wheeze,coughing),lung function indicators and ADR were observed in 2 groups,and discharge time was recorded in 2 groups. RESULTS:The total effective rate of clinical efficacy of intervention group was 95.00%after 1 h treatment,which was significant-ly higher than 77.78% in control group,with statistical significance (P0.05). CONCLUSIONS:On the basis of conventional treatment,the aerosol inhalation of magnesium sulfate and salbutamol sulfate shows good clinical efficacy and safety in the treatment of acute attack of severe bronchi-al asthma in children.
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<p><b>OBJECTIVE</b>To explore the clinical outcomes of open reduction and internal fixation with calcaneal locking plates in treating Sanders type II and III calcaneal fractures.</p><p><b>METHODS</b>From January 2010 and October 2012, 38 calcaneal fractures with Sanders type II or III were treated with open reduction and internal fixation with calcaneal locking plate. According to the Sanders classification, 15 fractures were classified as type II, 23 fractures as type III. The patients were divided into two groups (group A and B) according to the different fixed methods. Sustentaculum tali was fixed with one screw in group A, including 13 males and 5 females, with a mean age of (38.56±8.03) years old (ranged, 25 to 55). And sustentaculum tali was not fixed in group B, including 16 males and 4 females, with a mean age of (42.35±8.29) years old (ranged, 29 to 53). Clinical effects were evaluated according to the changes of Böhler's angle and the Maryland Foot Score and VAS score.</p><p><b>RESULTS</b>All patients were followed up from 12 to 20 months with a mean of 14 months. Böhler's angles and subtalar joints obtained satisfactory reconstruction in all patients. One year after operation, the mean Maryland Foot Score was 88.61±7.59 in group A; and was 82.40±9.24 in group B; Maryland Foot Score of group A was higher and foot functional rehabilitation was better than group B. The mean VAS score was 13.39±11.47 in group A; and was 22.50±13.10 in group B; VAS score of group A was lower and foot pain was less than group B.</p><p><b>CONCLUSION</b>Sustentaculum tall screw fixation has advantages of strong fixed strength, high stability, less postoperative pain, rapid functional recovery in treating Sanders type II and III calcaneal fractures.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Bone Plates , Bone Screws , Calcaneus , Wounds and Injuries , General Surgery , Fracture Fixation, Internal , Methods , Fractures, Bone , General Surgery , Recovery of FunctionABSTRACT
<p><b>OBJECTIVE</b>To study the epidemiological features, treatment status, and risk factors for asthma in children in Zhengzhou, China.</p><p><b>METHODS</b>Questionnaires for primary screening were issued using the method of multi-stage stratified sampling. Suspected asthmatic children were given a second questionnaire, physical examination, medical history review, and auxiliary examination to confirm the diagnosis. Age- and sex-matched non-asthmatic children were randomly recruited to the control group.</p><p><b>RESULTS</b>The number of valid questionnaires was 10 616 (5 444 males and 5 172 females). There were 308 confirmed asthma cases and the overall prevalence was 2.90%. The prevalence in boys was higher than that in girls (3.4% vs 2.4%). The prevalence in children under 3 years of age was 10.2%, which was higher than that in other age groups. The top three triggers for asthma attack in children were respiratory infection (94.2%), weather changes (89.0%), and exercise (35.1%). The most common asthma attack was moderate (71.8%), followed by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (280 cases) of all patients, respectively. Multivariate logistic regression analysis indicated the following major risk factors for asthma: history of allergic rhinitis (OR=150.285, 95% CI: 31.934-707.264), history of eczema (OR=10.600, 95% CI: 1.054-106.624), history of atopic dermatitis (OR=31.368, 95% CI: 3.339-294.683), food allergies (OR=27.373, 95% CI: 2.670-280.621), method of birth (OR=2.853, 95% CI: 1.311-6.208), age of first antibiotic use (OR=0.384, 95% CI: 0.172-0.857), frequency of antibiotic use within 1 year of age (OR=9.940, 95% CI: 6.246-15.820), use of wall decorating materials (OR=2.108, 95% CI: 1.464-3.036), and use of heat supply in winter (OR=6.046, 95% CI: 1.034-35.362).</p><p><b>CONCLUSIONS</b>The prevalence of childhood asthma is associated with age and gender in Zhengzhou. Most asthma attacks are moderate, often triggered by respiratory infection. Treatment of asthma has been standardized, but still needs further improvement. History of allergic rhinitis, eczema, atopic dermatitis and food allergies, cesarean delivery, frequent use of antibiotics within 1 year of age, use of decorating materials on the wall, and use of heating in winter may increase risk for asthma, and use of antibiotics in older age is a protective factor against asthma in children.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Asthma , Epidemiology , China , Epidemiology , Epidemiologic Studies , Logistic Models , Risk Factors , Surveys and QuestionnairesABSTRACT
BACKGROUND: This study involving 351 children who had undergone kidney biopsy secondary to persistent asymptomatic isolated hematuria was undertaken to assess histological diagnosis of the disease and its natural history and prognosis. METHODS: The patients were divided into two groups: 215 patients with asymptomatic isolated microhematuria (AIMH; proteinuria <0.1 g/day) and 136 patients with persistent asymptomatic microhematuria, recurrent macrohematuria and/or proteinuria (AMHP; proteinuria 0.1-0.25 g/day). After kidney biopsy, the patients were monitored for 2-10 years. RESULTS: Normal biopsies or minor abnormalities were more frequent in AIMH patients than those in AMHP patients, who exhibited IgA nephropathy more frequently. During the 2- to 10-year follow-up period, adverse renal events (i.e., development of proteinuria, hypertension, or impaired renal function) were observed in 13/215 (6.0%) patients with AIMH and 31/136 (22.8%) patients with AMHP (χ(2)=15.521, P<0.001). CONCLUSIONS: Normal biopsies or minor abnormalities were more frequently observed in AIMH patients, whereas IgA nephropathy and adverse renal events were more frequent in AMHP. Microscopic hematuria, especially when accompanied by macroscopic hematuria and proteinuria, may represent an important risk factor for the development of chronic kidney disease.
