Child ; China ; epidemiology ; Humans ; Tuberculosis ; epidemiology ; prevention & control ; therapy

BACKGROUND: The increase of the incidence of autoimmune diseases and the autoimmune pathogenesis of vitiligo were reported. OBJECTIVE: We studied the frequency of autoimmune disorders and positivity of antinuclear antibody in Korean vitiligo patients. METHODS: Vitiligo patients (439 patients) and control subjects (197 patients) were interviewed about their history of autoimmune diseases. Laboratory studies including complete blood cell count, urine analysis, blood chemistry, fasting blood sugar, thyroid function test (T3, free T4, TSH), and antinuclear antibody were performed for the screening of autoimmune disorders. RESULTS: The diseases associated with vitiligo were microcytic hypochromic anemia (3.64%), non-insulin dependent diabetes mellitus (2.96%), thyroid disease (3.96%), atrophic gastritis, and alopecia areata. In the control subjects, the associated diseases were microcytic hypochromic anemia (1.62%), non-insulin dependent diabetes mellitus (4.65%), and thyroid disease (3.49%). These results show that the frequency of autoimmune disorders in vitiligo patients is not significantly higher than that in control subjects. Six (54.5%) out of 11 vitiligo patients with thyroid disease were diagnosed as having thyroid disease for the first time. Four (0.91%) out of 438 vitiligo patients showed positive to antinuclear antibody. Positivity of antinuclear antibody was not higher in vitiligo patients than that in control subjects (1.16%). CONCLUSION: Frequency of autoimmune diseases and positive reaction to antinuclear antibody in vitiligo patients were not significantly higher than those in control subjects.
Alopecia Areata ; Anemia, Hypochromic ; Antibodies, Antinuclear ; Autoimmune Diseases ; Blood Cell Count ; Blood Glucose ; Chemistry ; Diabetes Mellitus ; Fasting ; Gastritis, Atrophic ; Humans ; Incidence ; Mass Screening ; Thyroid Diseases ; Thyroid Function Tests ; Vitiligo*

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No abstract available.

Objective To retrospectively analyze and compare the curative outcome of hematopoietic stem cell transplantation (HSCT) from HLA identical siblings vs intensive immunosuppression therapy (IST) for severe aplastic anemia (SAA).Methods From January 2008 to December 2010,41 patients with severe aplastic anemia were treated with related HSCT (n =14) or IST (n =27) which combined antithymocyte globulin (ATG) with cyclosporine-A (CsA) therapy.Results All the patients receiving HSCT reached complete response.Among the patients receiving IST,21 patients could be responsive to the therapy,and 2 patients died.There was significant difference in the response rate between HSCT group and IST group (100 ％ vs 77.8 ％,P＜0.01 ).Conclusion With the improvement of HSCT technology,the curative outcome of HSCT from HLA identical siblings for SAA is much better than IST.

Objective To evaluate the outcome of combination of intensive preconditioning regimen allo-HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia (ALL). Methods Between 2009 and 2010, 8 patients diagnosed as Ph+ ALL received allo-HSCT from HLA identical sibling during complete remission. Imatinib was added into the therapies of 5 patients.Seven patients received the intensive preconditioning regimen based on BuCy2, one patient received the regimen of TBI-Cy. A median of 6. 02 × 108/kg mononuclear cells and 3. 14 × 106/kg CD34+ cells were transfused. GVHD prophylaxis included cyclosporine A and methotrexate. Results All patients were well tolerant to the regimen without serious regimen-related toxicity. The median time of ANC≥0. 5 × 109/L was 15. 5 days, and that of PLT≥20 × 109/L was 19 days. Thirty days after allo-HSCT, all patients got donor engraftment successfully. Among 8 cases, 4 cases presented acute GVHD, 2 developed degree Ⅰ , one developed degree Ⅱ , and one developed degree Ⅳ. Seven patients were alive 100 days after allo-HSCT, 3 of whom presented chronic GVHD. At the end of following-up period, 6 patients were alive, among them, 3 patients were alive without relapse; 3 patients relapsed; Two patients died, one from acute GVHD, and one from leukemia relapse. Conclusion Combined intensive preconditioning regimen allo-HSCT with Imatinib was an effective treatment for Ph+ ALL, but the effect of anti-chronic GVHD of imatinib should arouse certain attention.

Objective To discuss the clinical diagnostic method of postural orthostatic tachycarda syndrome(POTS) in children.Methods Thirty-six children with POTS were selected for the research.Among them 15 were boys,21 cases were girls.The age ranged from 5.9 to 16 years,average age 12.3 years.Among them 28 patients(78%) were in between 11-16 years.The age distribution,clinical courses and hemodynamic indexes were analyzed and also the incidence of clinical manifestations and investigation reports were observed.Results Among 81 patients of orthostatic regulation disturbance,36 patients were diagnosed POTS,which was 47% of total.The clinical courses ranged from 1 day to 5 years,average clinical course 10.2 months.The clinical courses of more than half of the total patients were within 6 months(56%).The common clinical features of POTS were chest tightness on standing,vertigo,fatigue,palpitation,syncope,orthostatic regulation disturbance.Ten patients were also associated with gastrointestinal symptoms like nausea,vomiting.The most common feature of POTS patients was tachycardia(HR increased by ≥30 times/min) within 10 min after head-up tilt test(HUT).Average HR increased by 38 times/min.In some patients HR increased up to ≥120 times/min.There were no significant changes in blood.In 23 cases(64%),the T waves were descended by ≥0.2 mV in 2 or more than 2 leads in ECG reading.Investigations reports showed that there were 12 cases whose urine specific gravity was increased.In 11 cases HCO_3~-decreased.Conclusions POTS is commonly seen in schooling female children.The common symptoms are vertigo,chest tightness,fatigue,palpitation.HUT is an important method for the diagnosis of POTS.

Objective To master the prevalence trend of Kaschin-Beck disease in Xinghai county (Shanglujuan and X.ialujuan village of Tangnaihai township) from 2003 to 2008 in order to understand changes of selenium level of internal and external environments. Methods According to monitoring method on national Kaschin-Beck disease,we carried out epidemical investigation,clinical examination and X-ray photograph on school children aged 7-12 in Xinghai county,a monitoring region,and collected samples of hair and grain. The content of selenium was detected by 2,3-naphthalene fluorescence. Results From 2003 to 2008,in Shanglujuan village,the prevalence rate of clinic examination was fluctuating between 0(0/34)-17.14%(6/35); the detectable rate of X-ray examination was fluctuating between 11.11% (3/27)-20.59% (7/34),the prevalence rates of metaphysis and extremities were fluctuating between 0 (0/27)-13.21%(7/53) and 2.63% (1/38)-11.43% (4/35). In Xialujuan village,the prevalence rate of clinic examination was fluctuating between 2.94% (1/34)-13.33% (6/45); the detectable rate of X-ray examination was fluctuating between 26.67% (12/45)-43.63%(24/55),the prevalence rate of metaphysis and extremities were fluctuating between 8.33% (6/72)-26.47% (9/34) and 13.33% (6/45)-38.18% (21/55). The selenium contents in hair samples were (139.92±92.27),(134.98±63.77)μg/kg respectively in Shanglujuan and Xialujuan village in 2003; the selenium contents in grain samples were (12.90± 7.18),(14.58±9.90)μg/kg respectively in Shanglujuan and Xialujuan village in 2005. Conclusions The prevalence state of Kaschin-Beck disease in national monitoring region is rigid and pathogenetic factors of Kaschin-Beck disease are active. Selenium levels of internal and external environments are low in this region.

OBJECTIVE To investigate the genotypes of plasmid-mediated AmpC beta-lactamases carried in Klebsiella pneumoniae,to provide reasonable use of antibacterial agents and to reduce the spread of these drug resistant genes.METHODS Two hundred and eighteen strains of K.pneumoniae were performed in Tongji Hospital in Wuhan.Plasmid-mediated AmpC beta-lactamases-producing strains were screened by improved three-dimensional method and identified by multiplex PCR.DNA sequencing method was used to confirm these drug resistant strains.The MIC of 15 kinds of antibacterial agents against the clinical isolates was detected by double agar dilution method.RESULTS Thirteen strains of K.pneumoniae were detected by improved three-dimensional method.The detection rates were 5.96%.There were seven of thirteen positive strains of K.pneumoniae through improved three-dimensional method harboring DHA-1 type plasmid-mediated AmpC beta-lactamase by multiplex PCR and confirmed by DNA sequencing.Plasmid-mediated AmpC beta-lactamase producers revealed a highly drug resistance to cephalosporins,monobactams,beta-lactam/beta-lactamase inhibitor combinations,aminoglycosides and fluoroquinolones.Only imipenem was susceptible to all of these detected strains.CONCLUSIONS DHA-1 plasmid-mediated AmpC beta-lactamase is detected in K.pneumoniae strains from Tongji Hospital.The detection rate is 3.2%.The pAmpC-producing strains reveal multi-drug resistance.Only imipenem is susceptible to them.

Objective To assess the effectiveness of the clinical pathway for the treatment of advanced schistosomiasis he-patic fibrosis. Methods The duration of hospital stay,gross hospitalization expense,individual-paid expense,interior diame-ter of portal vein,levels of four serum hepatic fibrosis-related parameters(PIIIP,CIV,HA,and LN),and activities of ALT, AST andγ-GT were assessed and compared between the advanced schistosomiasis patients receiving the clinical pathway and ones receiving non-clinical pathway. Results There were 142 advanced schistosomiasis patients with hepatic fibrosis receiving the clinical pathway of anti-hepatic fibrosis. Compared with the patients receiving non-clinical pathway ,the gross hospitalization expenses reduced by 11.2％(t=6.310,P<0.05),and the individual-paid expenses reduced by 16.1％(t=4.326,P<0.05). The mean HA level was twice higher than the normal range,with a positive rising from 70.4％to 83.1％,and the abnormal rates of CIV andγ-GT were 64.1％and 28.9％respectively. Conclusions The clinical pathway can drastically reduce the treatment expenses in advanced schistosomiasis patients with hepatic fibrosis. However,the patients have a trend towards the persistent disease progression. Therefore,the researches of more effective therapeutic methods for advanced schistosomiasis hepatic fibro-sis are urgently needed.