0.05), which were both lower than those in the normal control group (P

Objective\ To evaluate the possibility of predicting renal function from creatinine clearance calculated by lean body weight(LBWCcr).Methods\ 81 patients of renal disease were selected.The ratio between 24-hour urinary creatinine excretion(24hUcr)and lean body weight(LBW)was evaluated in 51 patients.The other 30 patients was determined DTPA-GFR,LBWCcr and 4hCcr.DTPA-GFR was used as criteria.LBWCcr and 4hCcr were compared with it in order to validate the feasibility of LBWCcr and 4hCcr.Results\ There was no statistical significance among the three methods,P=0 56 The correlation coefficient between LBWCcr and 4hCcr with DTPA-GFR was 0 89 and 0 86,respectively.The analysis of linearity regression showed that the trend of LBWCcr was better than 4hCcrmin in predicting renal function.In fatty group and renal failure group the results were similar.Conclusion\ LBWCcr can estimate the renal function accurately,simply and rapidly.

Objective: To study the feasibility of the determination paracetamol in Gangmaoqing by HPLC. Methods: The paracetamol contents of the different samples of Ganmaoqing Tablets were determined by the dead stop titration and HPLC, respectively. Results: The dead stop titration was complex and the error was larger. Whereas HPLC was simple, quick with a good seperation and small error.Conclusion: HPLC is accurate and reliable and reproducible for the determination of paracetamol in Ganmaoqing Tablets.

Chronic pancreatitis is a focal or diffuse chronic inflammation and fibrosis of pancreatic tissue, which is progressive, persistent and irreversible.Chronic pancreatitis in children has its own characteristics of early onset and frequent occurrence, which greatly affects the nutritional status and quality of life of children.Recently, diagnosis and treatment of this severe inflammation gradually improved with a burgeoning technique: endoscopic retrograde cholangiopancreatography (ERCP), especially in the treatment of pediatric chronic pancreatitis.The detection rate of the disease has been increasing year by year.As an effective and safe procedure for the treatment of chronic pancreatitis in children, ERCP has replaced traditional surgery and become the first-line treatment method for pediatric chronic pancreatitis.

Objective: To study the correlation between fractional exhaled nitric oxide (FeNO) and lung function in young children for acute attack of wheezing, and to compare the FeNO in different stages in order to explore the best suitable time for the experiment of FeNO in young children by the method of on-line tidal breathing. Methods: Recurrent wheezing children aged 1-5 year old were selected who were underwent the test at lung function laboratory from January 2016 to March 2018, at Guangzhou Women and Children′s Medical Center.The children aged less than 5 years old were detected for FeNO in both stages of acute exacerbation and 2 weeks after treatment, and the children aged less than 3 years were also detected for the tidal lung function in the acute exacerbation stage.According to time ratio of reaching tidal peak flow to total expiratory time(TPTEF/TE )and ratio of volume at tidal peak flow to total tidal volume (VPEF/VE), the children aged less than 3 years were divided into 4 groups (normal group, mild group, moderate group and severe group). Results: The FeNO of the normal group[9.85(5.17, 19.62) ppb] and mild group[13.00(7.00, 23.30) ppb] were significantly higher than that of the severe group [3.10(2.20, 5.25) ppb], and the differences were statistically significant(all P<0.05). And there was a positive correlation between TPTEF/TE and FeNO(r=0.304, P<0.05), VPEF/VE and FeNO(r=0.320, P<0.05), tidal volume per kilogram(VT/kG)and FeNO(r=0.293, P<0.05)and a negative correlation between respiration rate(RR)and FeNO(r=-0.449, P<0.05). The FeNO in the stage of acute exacerbation was significantly lower than that in the stage of 2 weeks after treatment[(10.49±8.49) ppb vs.(20.41±9.13) ppb], and there was a significant difference among them(t=-5.79, P<0.01). Conclusions If researchers want to use the method of on-line breathing to test FeNO in young children with wheezing, they should choose the time of 2 weeks after treatment, and analyze the results combined with the lung function.

Objective To explore the clinical characteristics and diagnosis of hepatolenticular degeneration (WD) in children. Method The clinical data of 38 children with WD were analyzed retrospectively. Results In the 38 cases (15 males and 23 females), the median age at diagnosis was 6 years, and the average interval between onset and confirmed diagnosis was 5.7 months. The median course of disease was 2 months and the longest was 3 years. Hepatic dysfunction was the most common initial symptom (71.1%), and 27 cases had glutamic acid aminotransferase > 2 ULT (71.1%); Serum ceruloplasmin decreased obviously in 3 cases (94.7%), copper oxidase was significantly reduced in 37 cases (97.4%); 24 h urine copper increased in 33 cases, in which 32 cases(84.2%)had>150 μg/24 h.The K-F rings were presented in 10 cases(26.3%).ATP7B gene sequencing was performed in 19 cases, and the positive rate was 83.3%. Conclusions Onset with liver lesions was common in children with WD, The combination of the results of serum ceruloplasmin, copper oxidase, and 24 h urine copper may made a clinical diagnosis.For a highly suspected case with inadequate evidence,the ATP7B gene detected is helpful.

OBJECTIVETo summarize the clinical characteristics, early diagnosis, comprehensive treatment and prognosis of 6 cases of children with post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation.

METHODData of 6 cases with PTLD seen between January 2011 and December 2013 were retrospectively analyzed. The anti-rejection drug dose adjustments, the effect of rituximab, antiviral therapy and comprehensive treatment program after surgery were explored.

RESULT(1) The diagnosis of PTLD was confirmed by histologic findings. Six cases of PTLD including 3 males and 3 females were diagnosed as congenital biliary atresia and underwent split liver transplantation. The occurrence rate of PTLD was 2.9%. (2) The median time to the development of PTLD was less than 6 months. The initial symptom of PTLD in all patients was fever and clinical manifestations of PTLD were non-specific, depending on the involving organs. Five cases of PTLD developed gastrointestinal symptoms, including diarrhea, abdominal pain, and abdominal distension. One case developed respiratory symptoms, including cough and tachypnea. Three cases had lymph node involvement. In 2 cases pathophysiology involved polymorphic lymphocyte proliferation and in 4 cases B lymphocyte proliferation. (3) Two cases died, in whom EBV DNA was not detected and were diagnosed as PTLD by surgical pathology before death. Four survived cases had high EBV-DNA load and then were diagnosed as PTLD by biopsy pathology. (4) Of the 6 cases of PTLD, 2 cases died and 4 cases survived. The overall mortality was 33%. The dead cases were only treated with laparotomy because of intestinal obstruction or perforation and the survived cases were treated with tacrolimus at reduced doses or discontinuation and rituximab. In 2 cases antiviral therapy (acyclovir) was continued, including 1 cases of intestinal obstruction treated with surgical repair. All the survived patients were followed up for 4 months to 1 year and no evidence has been found.

CONCLUSIONEBV infection is the high risk factor for PTLD after liver transplantation. Close clinical surveillance of EBV DNA for pediatric liver transplantation was important for the early diagnosis of PTLD. Reducing doses of immunosuppressive agents and rituximab is the initial therapy for PTLD. A reduction in the dose of tacrolimus is suggested. Operation therapy can also play a role in the management of local complications.

Antiviral Agents ; administration & dosage ; Biliary Atresia ; therapy ; DNA, Viral ; analysis ; Drug Therapy, Combination ; Early Diagnosis ; Epstein-Barr Virus Infections ; diagnosis ; therapy ; Female ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; Infant ; Liver Transplantation ; adverse effects ; Lymphoproliferative Disorders ; diagnosis ; etiology ; mortality ; therapy ; Male ; Pediatrics ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Tacrolimus ; administration & dosage

OBJECTIVETo evaluate the growth of children in weight and height before and after liver transplantation and the relation between malnutrition and postoperative time.

METHODGrowth was assessed for children who received liver transplantation from July 2007 to December 2012 after operation during follow-up. Weight and height were measured for 51 children in May 30, 2013. Weight and height percentiles of each child were calculated in accordance with data surveying on physical development of children in nine provinces/municipalities. Underweight was defined as weight less than the third percentile of same age and sex groups. Growth retardation was defined as height less than the third percentile of same age and sex groups. Children were set into 2 groups (before liver transplantation group, after liver transplantation group). The incidence of underweight and growth retardation were analyzed by chi-square test. Children were divided into 4 groups according to the length of time from operation time to May 30, 2013: 1 year after liver transplantation (1-365 days); 2 years after liver transplantation (366-730 days); 3 years after liver transplantation (731-1 095 days) ; 4 years or more after liver transplantation (1 096-2 133 days) . The underweight and growth retardation were analyzed by hierarchical log linear model.

RESULTThe mean age of 51 children was 44.78 months (range 13 months to 13 years old), 26 of them were male and 25 female. The number of children with underweight and growth retardation were 20 (39%) and 35 (69%) respectively before transplantation and were 5 (10%) and 14 (27%) respectively after transplantation. There was a significant difference between underweight incidence before and after operation (χ(2) = 10.385, P = 0.001). There was significant difference between growth retardation incidence before and after operation (χ(2) = 15.710, P = 0.000). The subjects included 10 patients at 1 year after operation (underweight n = 3, growth retardation n = 3), 19 patients at 2 years (underweight n = 1, growth retardation n = 9), 10 patients at 3 years (underweight n = 1, growth retardation n = 2), 12 patients at 4 years and above (underweight n = 0, growth retardation n = 0). Parameter analysis of hierarchical log linear estimates: underweight at 1 year = 0.661, underweight at 2 years = -0.214, underweight at 3 years = 0.119, underweight at 4 years and above = -0.566. Growth retardation at 1 year = 0.282, at 2 years = 0.613, at 3 years = 0.051, at 4 years and above = -0.946.

CONCLUSIONCompared with after liver transplantation, obvious malnutrition existed in patients before transplantation. Patients have the ability to catch-up growth after liver transplantation. Reduced effect of underweight occurred in second year after liver transplantation. Reduced effect of growth retardation occurred in third year after liver transplantation.

Adolescent ; Biliary Atresia ; therapy ; Body Height ; Body Weight ; Child ; Child Development ; Child, Preschool ; Female ; Growth Disorders ; epidemiology ; Humans ; Infant ; Liver Cirrhosis ; therapy ; Liver Transplantation ; Male ; Malnutrition ; epidemiology ; Postoperative Period ; Retrospective Studies ; Thinness ; epidemiology ; Time Factors

A 13-year-old girl initially complained of thrombocytopenia 3 years ago and had positive antinuclear antibody(ANA),weakly positive anti-double-stranded (anti-ds) DNA antibodies and decrease of C3 1 month ago.She was admitted to the ward following dyspnea and intermittent cough for three days this time.The initial diagnosis was systemic lupus erythematosus (SLE).The clinical manifestation after admission involved multiple organs such as liver,kidney and spleen.However,cirrhosis could not be explained by SLE.Besides,anti-dsDNA as a specific index for SLE was only weakly positive in this case and the decrease of C3 was independent to activity of the disease.Abnormal signals in bilateral basal ganglia confirmed by MRI could not be explained by SLE,either.Therefore,the initial diagnosis as SLE was suspicious.Further laboratory test showed low ceruloplasmin and increased 24 urine Cu to correct the diagnosis as hepatolenticular degeneration (HLD) and pulmonary infection.Gene sequence analysis revealed heterozygous mutation in ATP7B gene (a splice site mutation:c.1708-5T ＞ G;a missense mutation:c.2333G ＞ T,p.Arg778Leu).HLD should be suspected in any patient with liver abnormalities of uncertain causes along with involvement of multiple systems.Gene sequence analysis is helpful to early diagnosis of HLD.