Objective To explore the factors of misdiagnosis and missed diagnosis for Kawasaki disease.Methods Clinical data of 27 cases misdiagnosed and missed-diagnosed in Department of Pediatrics of our hospital were retrospectively analyzed.Results There were 8 cases of bronchopneumonia,6 cases of pharyngo-conjunctival fever,5 cases of acute suppurative tonsillitis,4 cases of juvenile rheumatoid arthritis(systemic onset),3 cases of septicemia and 1 case of acute cholecystitis combined hydrops of gallbladder.All these cases were misdiagnosed and missed-diagnosed because the clinical features were not manifest or were covered by other diseases.Conclusion Kawasaki disease was mainly misdiagnosed as fever disease.Echocardiography and other correlative methods should be taken for fever disease which was not reasonably explained by single disease in order to early diagnose and treat Kawasaki disease.

Objective To investigate the changes of coagulation function in the neonates patients with gastrointestinal dysfunction and chnical significance. Methods Forty neonates with gastrointestinal dysfunction were included, which were divided into three groups according to diagnosis criterion of gastrointestinal dysfunction: early group, medium group and late group. Coagulation function was tested and neonatal critical illness score(NCIS) was done. Forty normal neonates were selected as control group. The difference of coagulation function among all groups was observed, and the relationship between coagulation function and NCIS were evaluated. Results Compared with control group, the indexs of coagulation function of early group was no statistical difference (P>0.05), however the result between medium group and late group was significantly difference (P<0.05). The difference of coagulation function between medium group and late group was also significant (P<0.05), the lower NCIS was, the more serious the gastrointestinal function was. Conclusions The more serious the gastrointestinal dysfunction is, the poorer the coagulation function is and the lower the NCIS is, which suggest coagulation function should be monitored in neonates with gastrointestinal dysfunction, and early intervention should be done accordingly.

Objective To investigate the clinical features of children's acute appendicitis in order to reduce the misdiagnose rate.Method Collect and retrospective analyse 77 cases clinical data of children's acute appendicitis from January 2008 to December 2011 in our hospital.Results There are 77 cases abdominal pain,61 cases fever,48 cases vomiting in 77 children,22 cases(28.57％) misdiagnosis or missed diagnosis in total.17 cases with appendix perforation,the perforation rate is 22.07％.49 cases receive surgery,28 cases receive conservative treatment.All are improved and cured and discharged.Conclusions The main clinical features of children's acute appendicitis is abdominal pain,fever and vomiting.When clinical features is not classic,there is higher rate of misdiagnosis and missed diagnosis,especially for infants.Stress that for children with unreasonable abdominal pain and fever,it is necessary to check leukocyte,CRP and type-B ultrasonic,observe the abdominal sign continually,in order to diagnose and treat early.

OBJECTIVE: To explore the relationship of cathepsin L (CatL) with coronary heart disease (CHD), severity of coronary stenosis and risk factors of CHD. METHODS: A total of 137 CHD patients and 48 controls were included in the study, to determined the serum levels of CatL, high sensitive C reactive protein (hs-CRP), fasting glucose (FBS), total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1(Apo-A1) and apolipoprotein B. All the subjects were invited for a coronary angiography, using the sum of the Gensini scores to assess the severity of coronary artery stenosis. RESULTS: Serum CatL levels were significantly higher in CHD patients (5.63 +/= 0.12 microg/L) than non-CHD subjects (3.93 +/= 0.22 microg/L, P<0.01). CatL was an independent risk factor of CHD in Logistic regression analysis [Exp(B)=2.341, 95%CI 1.567 approximately 3.496, P<0.01]. Serum CatL levels were associated positively with the Gensini scores(r=0.228, P<0.01); In fact, CatL was an independent correlator of Gensini scores (P<0.05). CatL inversely associated with HDL-C (r=-0.228, P<0.01) and ApoA1(r=-0.187, P<0.05), and positively with FBS(r=0.161, P<0.05). CONCLUSION CatL is involved in the pathogenesis of CHD. Serum CatL levels could reflect the severity of coronary luminal narrowings. CatL might participate in glucose and lipid metabolic disorders.
Case-Control Studies ; Cathepsin L ; blood ; Coronary Disease ; blood ; pathology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Risk Factors