Acute Disease ; Child ; Humans ; Orbital Cellulitis ; therapy ; Sinusitis ; therapy

Objective To compare the effectiveness,safety and related clinical indicators between simple drainage treatment and drainage treatment combined with intrathoracic urokinase for children with parapneumonic pleural effusion(PPE).Methods Twenty-nine in patients with PPE given pleural effusion drainage in the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2015 were selected as research subjects,who were divided into a simple group and an urokinase group based on whether intrathoracic urokinase was injected or not.The total number of hospital stay,the total drainage volume,the total number of catheter days,the total cost,the days with fever,efficient rate,operation rate and security of the patients were retrospectively analyzed between two groups.Results The intrathoracic days of hospital stay [M(P25,P75)] of urokinase group[19(11,30) days]were less than those of simple group[30(21,38) days],and the difference was significant (Z =-2.545,P =0.011);the total drainage volume[M(P25,P75)] of the urokinase group [430 (175,1 308) mL] was more than that of the simple group [110 (10,325)mL],and the difference was significant (Z =-2.811,P =0.005);the total number of catheter days [M (P25,P75)] of urokinase group [9 (7,19) days] was less than that of the simple group [20 (10,30) days],and the difference was significant (Z =-2.020,P =0.043);the total cost [M(P25,P75)] of the urokinase group [20 000(10 000,30 000)RMB] was less than that of the simple group [40 000 (30 000,50 000) RMB],and the difference was significant (Z =-2.631,P =0.009);the days with fever between urokinase group and the simple group was not significant (Z =-0.820,P =0.412).The urokinase group had a higher cure rate[76.9％ (10/13 cases)] and a lower surgical rate [23.1％ (3/13 cases)] compared with those of the simple group[18.7％ (3/16 cases),81.3％ (3/16 cases)],and the difference was significant (x2 =9.814,P =0.003).Conclusions Intrapleural urokinase therapy as an adjuvant treatment of PPE is simple and convenient,economic,higher efficiency,lower risk,which can be used as an effective clinical solution such disease.

Objective To investigate clinical signifieances of serum levels of vascular endothelial growth factor (VEGF) in patients with diffuse large B-cell lymphoma (DLBCL) and to analyze the relationships with international prognostic index (IPI). Methods Serum levels of VEGF were measured by ELISA in 26 cases with newly diagnosed DLBCL and 9 cases with relapsed DLBCL. The clinical data of 26 patients were collected. According to the IPI, 26 patients were divided into two group: low risk group (IPI＜2) and moderate to high risk group (IPI≥2). Results Compared with the normal controls, newly diagnosed and relapsed DLBCL had significantly higher VEGF serum levels (P ＜0.01). In the patients responding to CHOP or RCHOP regimen a significantly decrease in VEGF serum levels occurred, while in the patients who did not achieve complete remission(CR) there was no significant decrease. Furthermore, pretreatment serum levels of VEGF were significantly lower in CR group than in partial remission (PR) and no remission (NR) group. In addition, serum levels of VEGF were significantly elevated in the high risk group than those at the low risk group(P＜0.01). Conclusion The serum levels of angiogenic factor VEGF are related to the development and progression of DLBCL. The VEGF combined with IPI can be used for evaluating the prognosis of DLBCL.

Objective To evaluate the efficacy and safety of intrapleural fibrinolytic agents in the treatment of childhood empyema.Methods The data from China National Knowledge Infrastructure (CNKI),Chinese BioMedical (CBM),PubMed,VIP Database and Cochrane library were reviewed.Randomized control trials by using intrapleural fibrinolytic agents to treat childhood empyema were included.Two reviewers independently extracted the data from the eligible studies and evaluated the quality of the included studies.Meta-analysis was performed for the results of homogeneous studies using RevMan 5.2 software,while others analyzed descriptively.Results Five randomized control trials involving 248 children with empyema were included.Meta-analysis was not made in all of the indexes because of apparent heterogeneity and limited data.Two trials were compared which involved 98 patients receiving fibrinolytic agents or 9 g/L saline.The results suggested that fibrinolytic agents shortened the length of hospital stay and reduced complication(all P ＜ 0.05),but no significant differences were found between the 2 groups in the effective rate,duration of fever and pleural effusion amount(OR =3.61,95％ CI 0.84-15.49,P ＞ 0.05).Three trials involving 150 patients compared fibrinolytic agents and video-assisted thoracoscopic surgery (VATS).The data suggested that no significant differences were found between 2 groups in the effective rate (OR =0.70,95 ％ CI 0.30-0.61,P ＞ 0.05),but fibrinolytic agents cost less (P ＜ 0.05).The adverse drug reactions to intrapleural fibrinolytic agents were mild to moderate,and well tolerated.Conclusions The findings suggest that intrapleural fibrinolytic agents in the treatment of childhood empyema is safe and effective,especially in encapsulated effusion.Compared to 9 g/L saline,it can shorten the length of hospital stay and reduce complication.Compared with VATS,the curative effect is similar,while intrapleural fibrinolytic agents are economic.

Objective To investigate the changes in serum cortisol and adrenocorticotrophic hormone(ACTH) levels in children with steroid-sensitive nephritic syndrome (SSNS) and the clinical significance of intervention.Methods According to whether a child with SSNS would relapse,48 children with SSNS were divided into non-recurrence group(n =19) and recurrence group(n =29),at the same time 14 age-matched healthy children were enrolled as the healthy control group.Serum cortisol and ACTH were measured in patients with SSNS by using electrochemiluminesence methods.In recurrence group,methylpredisolone or methylprednisolone combined with ACTH injection therapy was used on 15 patients with their serum cortisol and ACTH below normal.Results Before standard glucocorticoid treatment,the serum levels of cortisol and ACTH had no difference among 3 groups (all P ＞ 0.05).By the end of remission phase,the serum levels of cortisol and ACTH in recurrence group were statistically lower than those of the non-recurrence group[(113.03 ± 80.02) μg/L vs (251.54 ± 185.05) μg/L,t =-2.925,P ＜ 0.05 ; (12.81 ± 10.14) ng/L vs (23.53 ± 12.05) ng/L,t =-0.885,P ＜ 0.05].Eight to 12 weeks after being adjusted,the serum level of cortisol and the average monthly time of recurrent were both significantly improved in 15 abnormal children in recurrence group [(168.90 ± 133.43) μg/L vs (73.62 ± 58.04) μg/L,t =3.016,P ＜ 0.05 ; (0.09 ± 0.08) times vs (0.35 ± 0.11) times,t =-7.560,P ＜0.05],but as to the serum level of ACTH,there was no significant difference in abnormal children in recurrence group [(14.05 ± 10.99) ng/L vs (8.72 ± 4.11) ng/L,t =1.991,P ＞ 0.05].Conclusions The concentrations of serum cortisol and ACTH can reveal the risk of recurrence for children with SSNS to some extent,and effective intervention can reduce the recurrence rate and shorten the course of disease.

Objective:To analyze and compare rehabilitation research funded by China′s National Natural Science Foundation (NSFC) with that funded by America′s National Institutes of Health (NIH) so as to provide references for future funding.Methods:Articles reporting rehabilitation research funded by the NSFC and the NIH were retrieved from the NSFC′s Science Output Service website and the NIH′s Project Report website and analyzed.Results:From 2009 to 2018 the NSFC funded 421 rehabilitation studies which resulted in a published report while the NIH funded 312. In 2018, the NSFC budget (US$3.89 million) was 8.46 times that of 2009 (US$460, 000), while the NIH′s grant budget (US$36.08 million) was 2.17 times that of 2009 (US$16.62 million). The number of published papers resulting from the Chinese and American studies was 1111 and 2571 respectively. Their impact factors mainly ranged between 0 and 3 points. Among the journals with an impact factor of 6 or more, published papers from the United States (297) were much more numerous than those from China (18). The number of SCI papers per million US dollars increased by 2.25 times in China and 0.05 times in the US.Conclusions:Both China and the United States have been investing more in rehabilitation medicine research, and that has resulted in more published papers. There is still a gap in funding and output between the two countries.

Objective:To investigate research into medical rehabilitation supported by China′s Natural Science Foundation (NSFC) between 2009 and 2018.Methods:Medical rehabilitation research projects supported by the NSFC between 2009 and 2018 were compiled. The project leaders, funding, awardee organization, research area and results were collected and analyzed.Results:There were 348 researchers who were supported in 421 projects during the period studied. They received ￥168.541 million and made 1395 achievements between 2009 and 2018. Neurological rehabilitation was the most popular research area, followed by musculoskeletal rehabilitation, while cardiopulmonary and pain rehabilitation were rarely covered.Conclusions:Rehabilitation medicine has been developed actively, but NSFC support has still been insufficient.

Objective To discuss the clinical characteristics and prognosis of lipoprotein glomerulopathy (LPG) in chil-dren. Method Clinical data of one pediatric LPG patient were retrospectively analyzed. The clinical features and prognosis of childhood LPG were summarized based on literature review. Results A nine years old girl presented with frequent urination. The ifrst urine test revealed hematuria and proteinuria. After one week anti-infection treatment, the hematuria and proteinuria were continued. The serum albumin was slightly reduced. The hyperlipidemia and mild anemia were emerged. Kidney biopsy showed that enlarged glomeruli, with dilated capillary loops and weak eosinophilic lipoprotein thrombi in the capillary lumina under the light microscope;layered or tuftedemboluscontaining particulated lipid vacuoles under electron microscope. Gene sequencing identified APOE Tokyo (Leu141-Lys143→0). The diagnosis of LPG was confirmed. The lipid-lowering therapy was administrated and the disease was alleviated. Conclusion LPG is a rare disease in children. The level of blood lipid was signiifcantly increased, and the hormone therapy was ineffective. Kidney biopsy is the main basis for diagnosis. The genetic testing can prompt the genetic background. Lipid lowering therapy can relieve the progress of the disease.

OBJECTIVETo study the efficacy and safety of brucea javanica oil emulsion (BJOE) combining platinum-contained first-line chemotherapy in treating non small cell lung cancer (NSCLC).

METHODCochrane library, PubMed, EMBASE, VIP, CBM and CNKI were searched through computers. The search was finished in February, 2011. Randomized controlled trials (RCTs) of BJOE combining platinum-contained first-line chemotherapy were included. Two researchers extracted data and assess literature quality separately,and made a meta-analyses by RevMan 5.1.2 software.

RESULTTotally 22 RCTs involving 1512 patients were included. The Meta-analysis showed that compared with the pure application of platinum-contained first-line chemotherapy,the combination of BJOE and chemotherapy can enhance the near-term curative effect (RR = 1. 31, 95% CI: 1.18-1.45, P < 0. 000 01), improve the quality of life (RR = 1.78, 95% CI: 1.51-2. 09, P < 0.00001) and reduce the suppression of bone marrow (OR = 0.37, 95% CI: 0. 27-0. 51, P < 0.00001) and the gastrointestinal reactions (OR = 0.59, 95% CI: 0.44-0.80, P = 0.0007) ,with an improvement in organism immunity.

CONCLUSIONThe current evidence indicates that BJOE can enhance the chemotherapeutic effect on NSCLC patients, improve the quality of life and reduce adverse effect of platinum-contained chemotherapeutics and thus it is worth referring in clinic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brucea ; chemistry ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Emulsions ; administration & dosage ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Phytotherapy ; Randomized Controlled Trials as Topic ; Young Adult