Child ; China ; Evidence-Based Medicine ; Humans ; Pediatrics

Cheek ; pathology ; Head ; pathology ; Humans ; Keratosis ; diagnosis

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

Objective To explore the protective effect of Red Sage Root on bronchopulmonary dysplasis(BPD) induced by hyperoxia in newborn rats.Methods On the 2nd postnatal day,SD newborn rats were randomly assigned to 4 groups:air and NS group(group Ⅰ),air and Red Sage Root group(group Ⅱ),hyperoxia and NS group(group Ⅲ),hyperoxia and Red Sage Root group(group Ⅳ).The rats in group Ⅲ and group Ⅳ were exposed to hyperoxia(the level of oxygen was 900-960 mL/L).The rats in group Ⅱ and group Ⅳ were injected with Red Sage Root intraperitoneally(10 mg/kg)daily.On 14 days after birth,6 rats in each group were killed.Lung histologic changes,radical alveolar counts(RAC)were monitored.Thiobarbituric acid method,nitrite method,2-nitroben zoic acid method were used to determine the concentration of malony ldialdengde(MDA),superoxidedismutase(SOD),glutathione peroxidase(GSH-Px) were monitored.Results 1.Group Ⅲ and group Ⅳ showed the inhibition of lung development and the evident lung fibrosis.In contrast to group Ⅰ and group Ⅱ,RAC in group Ⅲ and group Ⅳ decreased dramatically(Pa

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To explore the change of activin A(ACT A) in umbilical artery blood of newborns with fetal distress and its clinical significance.Methods Forty healthy pregnant women(control group)and 35 pregnant women with fetal distress (experimental group)were collected.The levels of ACT A of umbilical artery blood in both groups were determined by a solid quantitative biotin-avidin system enzyme-linked immunosorbent assay(BAS-ELISA),umbilical artery blood gas were also measured.Results The level of ACT A of umbilical artery blood in fetal distress group was (1 235.89?178.78)ng/L,and that in control group was (627.28?75.24)ng/L,and the level of ACT A of umbilical artery blood in fetal distress group was significantly higher than that in control group(P

Objectives To reveal etiologies of persistent isolated hematuria (PIH) through ultrastructural pathological examination, to disclose clinicopathological correlation in cases with PIH, and to summarize appropriate management of patients with PIH.
Methods we retrospectively studied 155 PIH patients receiving renal biopsy between January, 2003 and December, 2008 in Peking Union Medical College Hospital. All the clinical data and follow-up result were analyzed.
Results All subjects included 38 children and 117 adults, with mean age of 11.38±3.25 years for children and 35.17±8.44 years for adults. Thin basement membrane nephropathy (TBMN) was the most common pathology (55.3% of children and 49.6% of adults), followed by IgA nephropathy (18.4% of children and 32.5% of adults, mainly grade 2-3) and mesangial proliferative glomerulonephritis (MsPGN) without IgA deposition (13.2%of children and 12.8%of adults). Besides, Alport syndrome (2.6%of children) and membrane nephropathy (2.6%of children and 0.9%of adults) were demonstrated as other causes of PIH. Elevated mean arteral pressure or protein excretion rate, as well as episodic macrohematuria, indicated higher risk for MsPGN rather than TBMN. On the other hand, severity of microhematuria was irrelevant to pathological types of PIH. Totally, 86 patients were followed up and 37 cases therein stayed on track for long term (mean duration 41.11±28.92 months, range 8-113 months). Most cases had benign clinical course except 3 cases with TBMN, 5 cases with IgA nephropathy, 1 case with MsPGN (without IgA deposition), and 1 case with Alport syndrome, who developed hypertension or proteinuria. All of them were administered timely intervention.
Conclusions Close follow-up should be required as the primary management for PIH. Equally important is careful monitoring for early identification of undesirable predictors;while renal biopsy and other timely intervention are warranted if there is hypertension, significant proteinuria or renal impairment.

Objective To investigate the clinical and mammographic features of plasma cell mastitis.Methods Twenty-five patients(28 lesions)with histologically confirmed plasma cell mastitis, aged from 26 to 70 years(mean age 41 years),were examined with X-ray mammography.The clinical manifestations and imaging features were retrospectively reviewed.Results No case was in lactation.The painful irregular masses,ranged from 1.3 to 8cm in size,were found in 22 patients,while 3 patients with acute episode.Recurrent episodes of breast masses were noted in 4 patients.Based on the mammographic appearances,the plasma cell mastitis were classified as the following four types:inflammation-like type (2/28),ductal ectasia type(3/28),focal infiltration type(10/28)and nodular type(13/28).The valuable radiogyaphic signs:(1)An asymmetrically increased density along the lactiferous duct with a flame-like appearance,inhomogeneous low density tubular structures and scattered stick-shape calcifications.(2) Architectural distortion and oil cysts formation in adjacent area,(3)Subareolar ductal ectasia.Conclusions The clinical and mammographic characteristics of plasma cell mastitis are critical to avoiding unnecessary surgery.Histopathological result is needed for the diagnosis in patients highly suspected of malignancy.

Objective To evaluate the feasibility of sentinel lymph node biopsy (SLNB) in patients with vulvar cancer. Methods Twenty-one patients with vulvar squamous cancer undergoing radical surgery admitted in Cancer Hospital of Chinese Academy of Medical Sciences from Oct.2004 to Apr.2008, were enrolled in the study. SLNB procedure was performed with blue dye alone in the first eleven patients, while the later ten patients, a combination procedure with radioactive tracer and blue dye was used to detect sentinel lymph node (SLN). All resected nodes were submitted to the pathological examination, which was considered as the gold standard to determine the efficacy of SLNB. The complications related to SLNB were also observed during the study. Results The sentinel node was identified in 20 patients (95%), included 8 cases with unilateral SLNs and 12 cases with bilateral SLN. A total of 83 SLN were identified with a mean number of 4.2 per patient (range, 1-9) or 2.6 per groin (range, 1-6). Difference between the mean number of SLN (4.4 per patient, 2.5 per groin) identified by blue dye or by combined procedure (3.9 per patient, 2.7 per groin) was not statistically significant (t=0.459,P=0.652;t=-0.421,P=0.717). Twenty patients were detected to positively superficial inguinal SLN and one of them also positively bilateral deep femoral SLN, 8 (10 groins) of them were detected positively nodal metastases. Among of eight patients, 7 (9 groins)of them were detected more than one SLN involved, while 1 of them were detected false-negative node involved. The false negative rate of was 10%(1/10), negative predictive value was 96%(22/23). No complications were attributed to the study. Conclusions SLNB procedure in vulvar cancer is feasible and safe. SLN identification appears to be highly accurate for detecting metastases in the ipsilateral inguinal lymphatic basins.

OBJECTIVE: To explore the clinical efficacy of Qinzhu Liangxue Decoction (QZLXD), a compound traditional Chinese herbal medicine, in patients with blood-heat type psoriasis vulgaris. METHODS: Fifty-eight patients diagnosed with blood-heat type psoriasis vulgaris were randomly divided into two groups: QZLXD group (30 cases) and ampeptide group (28 cases). Patients in both groups were treated for 4 weeks. Psoriasis Area and Severity Index (PASI) score, Dermatology Life Quality Index (DLQI) score and the level of serum vascular endothelial growth factor (VEGF) were obtained to evaluate the efficacy of the two treatments. RESULTS: There was a better curative result in QZLXD group than in ampeptide group (P<0.05). The response rates in QZLXD and ampeptide groups were 83.33% and 64.28% respectively. DLQI score was also significantly improved during 4-week treatment in QZLXD and ampeptide groups (P<0.05). There was no significant difference in VEGF level between QZLXD and ampeptide groups. CONCLUSION: QZLXD is remarkably advantageous in treatment of psoriasis vulgaris of blood-heat syndrome and improvement of patient's quality of life. The mechanism may be related to decrease in serum VEGF level and action against neogenesis of blood vessels.