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Objective:To study the effect of thermal effect on the filling effect of bioceramic paste combined with thermal gel gutta-percha vertical obturation method in different parts of root canal.Methods:Forty single-root canal teeth samples were randomly and randomized divided into the control group, the iRoot SP group, the 10 s group and the 20 s group. All tooth samples were root canal prepared to 0.04 taper after crown removal. The control group received AH-plus paste combined with thermal gel gutta-percha vertical obturation. The iRoot SP group received iRoot SP single-point filling. The 10 s group and 20 s group received iRoot SP single-point filling combined with thermal gel gutta-percha vertical obturation, in which the root canal of the two groups were heated at 180 °C for 10 s and 20 s, respectively, before using the thermosetting gutta-percha. Methylene blue staining, scanning electron microscope (SEM) observation and dental microscope observation were used to analyze the occurrence of gaps in the middle and upper segment of the root canal and the apical 1/3 of the root canal after filling.Results:For the filling in the apical 1/3 of the root canal, no obvious gap appeared in the 10 s group and the 20 s group, and there was no significant difference between the dye infection depth and the control group (all P>0.05). For the filling of the middle and upper segment of the root canal, the probability of porosity is higher when using iRoot SP combined with single-point filling. Conclusions:Short-term high temperature heating will not affect the sealing effect of iRoot SP on the apical 1/3 of the root canal. For the middle and upper segment of the root canal, the filling effect of iRoot SP single-point filling combined with thermal gel gutta-percha vertical obturation method is better than that of iRoot SP single-point filling.
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Objective:To investigate the effects of critical care chest ultrasonic examination(CCUE)on different fluid management phases among septic shock infants in pediatric intensive care unit(PICU).Methods:Twenty-two infants who were hospitalized in PICU during January 2017 to December 2018 and diagnosed as septic shock were included in this study.These infants received shock and infection management as well as mechanical ventilation according to the septic shock management guidelines.CCUE was applied as needed to monitor the hemodynamic status for titrated adjustment in fluid and vasoactive drug management and its impacts were evaluated.Results:The change frequencies of treatment regimen according to CCUE evaluation were different among different phases( P<0.001). Compared with the other 3 phases, the number of adjustment made to fluid management scheme caused by CCUE during the first phase was the largest(75.0%, P<0.001), and that during the fourth phase was the smallest(2.3%, P<0.01). The frequency of change during the second phase(30.5%) and the third phase(23.5%) showed no difference( P=0.210). During the first phase, compared with the group with intravenous infusion speed<10 mL/(kg·h), the group with faster intravenous infusion speed had lower LUS score and more proportion of LVEF and RVEF above 50%( P<0.05). During the second phase and the third phase, compared with group receiving slower intravenous infusion, group with faster intravenous infusion had more LVEF>50%( P<0.05). Conclusion:Application of CCUE to monitor dynamic hemodynamic of infants with septic shock in PICU has different effects on fluid management scheme adjustment at different phase.CCUE evaluation during the early 3 phases, especially during the first phase has greater influence on fluid management strategy.Rapid infusion under CCUE monitoring is often limited by cardiac ejection fraction, LUS, and mainly LVEF, especially during the first phase.Multiple ultrasonic indicators should be combined with clinical data for full evaluation.
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Objective@#To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU).@*Methods@#Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management.@*Results@#Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] (P<0.05). The CCUE group also had a more positive fluid balance and larger dosage of midazolam and fentanyl administration[(3.87±2.33)ml/(kg·h) vs.(2.37±2.10)ml/(kg·h), (5.62±2.39)μg/(kg·min) vs.(1.68±0.82)μg/(kg·min), (1.41±0.39)μg/(kg·h) vs.(0.95±0.56)μg/(kg·h)] (P<0.05). The two groups showed no differences in vasoactive-inotropic score within 48 h(11.11±6.08 vs.9.90±4.12), dosage of furosemide[(1.07±0.52)mg/(kg.d) vs.(0.94±0.15)mg/(kg·d)], length of PICU stay[(10.73±7.48)d vs.(10.00±2.91)d], intubation rate after 1 hour of volume resuscitation[54.5%(12/22)vs.33.33%(6/18)] or mortality[8.3%(2/24)vs.5.3%(1/19)] (P>0.05).@*Conclusion@#Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU.
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Objective:To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU).Methods:Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management.Results:Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] ( P<0.05). The CCUE group also had a more positive fluid balance and larger dosage of midazolam and fentanyl administration[(3.87±2.33)ml/(kg·h) vs.(2.37±2.10)ml/(kg·h), (5.62±2.39)μg/(kg·min) vs.(1.68±0.82)μg/(kg·min), (1.41±0.39)μg/(kg·h) vs.(0.95±0.56)μg/(kg·h)] ( P<0.05). The two groups showed no differences in vasoactive-inotropic score within 48 h(11.11±6.08 vs.9.90±4.12), dosage of furosemide[(1.07±0.52)mg/(kg.d) vs.(0.94±0.15)mg/(kg·d)], length of PICU stay[(10.73±7.48)d vs.(10.00±2.91)d], intubation rate after 1 hour of volume resuscitation[54.5%(12/22)vs.33.33%(6/18)] or mortality[8.3%(2/24)vs.5.3%(1/19)] ( P>0.05). Conclusion:Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU.
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Objective:To investigate the isolation characteristics and the antibiotic resistance of Streptococcus pneumoniae in hospitalized children from the Bao′an District of Shenzhen for many consecutive years, and to provide evidence for the assessment as well as clinical prevention and treatment of Streptococcus pneumoniae infection. Methods:The isolation rate and sample source of Streptococcus pneumoniae isolates as well as age composition of hospitalized children in Bao′an Maternal and Child Health Hospital of Shenzhen city from January 2012 to December 2018 were retrospectively analyzed.The susceptibility of the isolates to antibiotics was tested by disk diffusion method and E-test method. Results:(1) From 2012 to 2018, a total of 90 807 specimens were retrospectively summarized, 9 193 strains of Streptococcus pneumoniae were isolated, with an isolation rate of 10.1%, which was the first pathogen; 98.68% (9 072/9 193 cases) from respiratory tract samples and 97.20% from sputum samples.Among 107 strains isolated from aseptic body fluid specimens, 97 strains were blood specimens. Streptococcus pneumoniae was the most common bacteria with positive culture in aseptic body fluids.(2) The isolation rate of Streptococcus pneumoniae was 10.7% in children under 2 years old, 10.2% in children between 2 and 5 years old and 4.1% in children over 5 years old.About 97% of Streptococcus pneumoniae isolates came from children under 5 years old.(3) According to breakpoints of non-meningitis strains, the sensitivity rate of parenteral Penicillin was 93.18%, the mediation rate was 6.79%, the resistance rate was only 0.03%, the lowest drug concentration to inhibit the growth of 50% bacteria(MIC 50) value was 0.50 and the lowest drug concentration to inhibit the growth of 90% bacteria(MIC 90) value was 2.00; the sensitivity rate of Ceftria-xone was 76.55%, the mediation rate was 20.18%, the resistance rate was 3.26%, the MIC 50 value was 1.00 and the MIC 90 value was 2.00; when interpreted by the breakpoint of meningitis strains, the resistance rate of extra-gastrointestinal Penicillin reached 77.22%, and the mediation rate of Ceftriaxone increased to 30.48% and the drug resistance rate reached 18.45%.The drug resistance rates of Erythromycin, Clindamycin, Tetracycline and Compound neomycin were all over 85.00%.The resistance rates against Levofloxacin and Chloramphenicol were 0.16% and 7.85% respectively.No Vancomycin-resistant Streptococcus pneumoniae was found. Conclusions:Streptococcus pneumoniae is the first bacterial pathogen causing respiratory tract and invasive infection in hospitalized children under 5 years old in this area.Penicillin is still the preferred drug for non-meningitis pneumococcal infection, but the drug resistance rate is high in meningitis patients.
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Objective@#To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland.@*Methods@#In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy.@*Results@#By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children′s hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77).@*Conclusion@#The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.
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Objective To investigate the expression of Rab11 in children with sepsis at different sta-ges and severe sepsis and its relationship with the occurrence and development of sepsis in children. Methods A prospective control study was performed. All cases were enrolled from Bao′an Maternal and Children Health Care Hospital, and they were divided into sepsis group(40 cases) who were diagnosed as sepsis, severe sepsis group(20 cases) with diagnosis of severe sepsis,and healthy control group(40 healthy chil-dren) . Venous blood samples were collected at admission,and the expression level of blood leukocyte Rab11 was determined by Western blot. In the sepsis group,the expression levels of Rab11 were evaluated at the initial,the extreme and the recovery stages of sepsis,and were compared with those in severe sepsis group and healthy control group, respectively. Spearman correlation analysis was used to evaluate the relationship between the expressions of Rab11 and the levels of some parameters in blood,including white blood cell,neu-trophils,lymphocytes,monocytes,eosinophilic granulocyte,C-reactive protein and procalcitonin in blood,at the extreme stage. Meanwhile,the levels of Rab11 at extreme stage of sepsis,caused by different diseases, such as severe pneumonia,bronchiectasis complicated pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enteric viruses infection, were compared with each other. Results At the initial and the extreme stages of sepsis, as well as in severe sepsis group,the levels of Rab11 were significantly lower than that in the healthy control group(0. 54 times,0. 23 times and 0. 07 times, P<0. 05,respectively). There were no significant differences in the expression levels of Rab11 at the recovery stages of sepsis compared with that in the healthy control group(P>0. 05). There was no relation-ship between the level of Rab11 and the number of white blood cell, neutrophils, lymphocytes, monocytes, eosinophilic granulocyte, while the level of Rab11 was negatively correlated with C-reactive protein ( r =-0. 58,P=0. 014) and procalcitonin(r= -0. 63,P=0. 003) at the extreme stage of sepsis. There was no significant difference in the expression level of Rab11,at the extreme stage of sepsis,among those patients with severe pneumonia,bronchiectasis and pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enterovirus infection(P>0. 05). Conclusion The level of Rab11 is differently expressed at different stages of sepsis,and could be used as a predictor of the severity of sepsis in children.
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Objective To explore relationship of the anesthetic risks and intraoperative complications.Methods Preoperative anesthetic risks were assessed with Hussman's method from May 2015 to May 2016 in 2 494 surgical patients, including 1 462 males and 1 032 females.Intraoperative data and complications were tracked and recorded.Results Three hundred and thirty-six intraoperative complications occurred, accounting for 13.47% of total patients.The cardiovascular complications were a major intraoperative complications, accounting for 80.7%.2 494 patients were graded respectively into risk grade 1 with 1 540 (61.75%), grade 2 with 660 (26.46%), grade 3 with 202 (8.10%), grade 4 with 80 (3.21%) and grade 5 with 12 (0.48%).The incidence of complications were 112 (7.28%), 82 (12.42%), 82 (40.59%), 50 (62.50%) and 10 (83.33%) respectively.The sensitivity of prediction was 33.33%, 24.40%, 24.40%, 14.88% and 2.78%;the specificity 33.76%, 73.26%, 94.44%, 98.61% and 99.91%;and the accuracy 33.76%, 66.64%, 85.01%, 87.33% and 86.85%, respectively, in patients with risk grade 1, 2, 3, 4 and 5.Conclusion Hussman's method of anesthetic risks well predicts the intraoperative complications.
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Objective@#To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children.@*Method@#A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children′s Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children′s Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days.@*Result@#No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting).@*Conclusion@#The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.
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Objective To analysis clinical effect of Diyu Shengbai tablets combined with granulocyte colony stimulating factor on cancer related fatigue syndrome.Methods II-VI primary cancer 60 patients from January 2011 to December 2013 were admitted to department of internal medicine, Fourth Hospital of Hebei Medical University,and randomly divided into two groups.Control goup(n=30)were treated with granulocyte colony stimulating factor(G-CSF).Experimental group(n=30)were treated with Diyu Shengbai tablets and G-CSF.Results After chemotherapy, ratio of patients in the experimental group appeared fatigue syndrome and changes in leukocyte was significantly lower than that of control group, the difference was statistically significant ( P <0.05 ) . Conclusion Diyu Shengbai tablets combined with G-CSF have better clinical efficacy for leukopenia caused by tumor chemotherapy, the symptom of fatigue also can improve significantly.
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Objective To explore the risk factors of severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,and antimicrobial drug resistance among these isolates.It may help to prevent and control the disease and promote to rational use of antibiotics.Methods We conducted the case-control study in our PICU.It included 89 patients with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia as case group and 68 patients with severe pneumonia caused by Klebsiella pneumonia as control group during the same period.To compare the two groups on irrationality use of antibiotics (especial for third generation cephalosporin),length of stay,tracheal cannula,time of mechanical ventilation and underlying conditions (malnutrition,congenital heart disease,heredity and metabolic disease).Antimicrobial susceptibilities among 89 multi-drug resistant Klebsiella pneumonia isolates were analyzed.Results There were 63 cases (70.79％) for irrationality use antibiotics in case group,while there were 27 cases (39.70％) in control group (P ＜ 0.01).The cases for length of stay over 7 days in case group (48 cases,53.93％) were more than those cases with the same situation in control group (12 cases,17.65 ％) (P ＜ 0.01).Thirty-eight cases (42.69 ％) needed mechanical ventilation therapy in case group,while 16 cases (23.53％) needed mechanical ventilation therapy in control group (P ＜ 0.01).The cases for duration of mechanical ventilation over 5 days in case group (18 cases,20.22％) were more than those cases in control group (5 cases,7.35％) (P ＜0.05).The cases with underlying disease in case group (13 cases,14.61％) were more than those cases in control group (2 cases,2.94％) (P ＜ 0.05).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to carbapenems.Conclusion Several risk factors are associated with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,including irrational use of antibiotics (especial for third generation cephalosporin),long term of length of stay,endotracheal intubation,long term of mechanical ventilation,and having underlying disease (malnutrition,congenital heart disease,heredity and metabolic disease).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to Carbapenems.Carbapenems should be used as first-line drugs for severe pneumonia caused by multi-drug resistant Klebsiella pneumonia.
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Objective To study the distribution of pathogenic spectrum in children with severe community-acquired pneumonia(CAP) and bacteria antibiotic resistance.Methods One hundred and ninety-three children with severe CAP were enrolled from Mar 2011 to Feb 2012.Sputum specimens were collected for bacterial culture and drug sensitive test.Meanwhile mycoplasma pneumonia and chlamydia trachomatis were detected by fluorescent quantitative polymerase enzyme technology.Antigen of virus were detected by immunofluorescence assay.Results A total of 96 cases (49.7％) were bacteria positive in 193 children with severe CAP.The top four bacteria strains were klebsiella pneumoniae,staphylococcus aureus,escherichia coli and streptococcus pneumoniae.Most of gram-negative bacteria were resistant to ampicillin,cefazolin,ceftriaxone,ceftazidime,and compound sulfamethoxazole,but were sensitive to piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin.Gram-positive bacteria were resistant to penicillin and erythromycin,but sensitive to vancomycin.Fifty-three cases (27.5 ％,53/193) were virus Positive,81.1％ of which were less than 1 year old.Respiratory syncytial virus accounted for the most prevalent pathogen,followed by adenovirus,influenza virus A.Mycoplasma pneumoniae were positive in 4 patients (2.1％,4/193),chlamydia trachomatis were positive in 3 patients (1.6％,3/193).Mixed infection was found in 23 cases (11.9％,23/193).There were 14 cases (7.2％,14/193) with undetected pathogens.Conclusion Bacterium is the major pathogen in children with severe CAP and the virus is the second.The initial antibiotics administration of piperacillin/tazobactam or carbapenem and vancomycin should be chosen for severe bacteria pneumonia.
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Objective To explore the clinical feature of severe enterovirus 71 (EV71) associated hand foot and mouth disease (HFMD),and genotype of EV71.Methods Fluorescent quantitation PCR was done for detecting EV71.RT-PCR was performed to amplify VP1 for sequencing and identifying genotype.A retrospective analysis was performed based on the clinical data of 15 cases with severe EV71 infection.Results EV71 nucleotide was positive in all 15 cases.The genotype of EV71 was C4.All cases had abnormal temperature and followed with nervous symptoms in the early stage.Average time was 1.26 days from onset to severe complications appearance.Eleven cases progressed to neurogenic pulmonary edema.Four cases accepted nasal continuous positive airway pressure.Eleven cases accepted oral trachea cannula mechanical ventilation.Except for 3 cases died,one case abandoned,others 11 cases were cured.Conclusion The isolated strains of EV71 in this study are all C4 genotype.All cases with severe EV71 infection were followed with nervous symptoms in the early stage,most of whom would progress to neurogenic pulmonary edema.The mortality would be cut down by using mechanical ventilation in early stage.
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Objective To explore the relationship between extraintestinal rotavirus infections and serum MBP levels. Methods Serum MBP levels were measured by double-antibody sandwich enzyme-linked immunosorbent assays (ELISA) in children including extraintestinal rotavirus infections (n = 76) and common rotavirus enteritis ( n = 63 ) during the acute and convalescence phases. A group of healthy children ( n =50) were recruited as control. Results MBP levels were significantly lower in patients with extraintestinal rotavirus infections( 176.35 ± 113.12 ) μg/L in acute phases than those in patients with common rotavirus enteritis (392. 27 ± 128.96) μg/L and healthy control group(676. 25 ± 248. 63) μg/L, and the difference was significant (P ＜0. 001 ). The serum MBP levels in convalescence phases in the group of extraintestinal rotavirus infections( 358.63 ± 106. 54 ) μg/L was lower than those in the group of common rotavirus enteritis (558. 49 ± 173. 24 ) μg/L and the healthy controls, and their difference was significant ( P ＜ 0. 001 ). The MBP levels in the acute phases among pneumonia group, hepatic lesion group, cardiac damage group and central nervous system damage group caused by rotavirus infection were ( 198.24 ± 126.47) μg/L, ( 169.34 ±124. 38) μg/L,( 184. 62 ± 123.64) μg/L, ( 180. 74 ± 126. 86) μg/L, respectively. The difference among those groups was not significant ( P ＞ 0. 05 ). Conclusion Patients with extraintestinal rotavirus infections showed significantly lower MBP levels during acute and convalescence phases than patients with common rotavirus enteritis. But MBP levels showed no significant differences among those groups of patients with different extraintestinal organ damage caused by rotavirus infection. Lower MBP levels may be associated with the increased susceptibility to extraintestinal rotavirus infections.
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Objective To investigate the clinical features of rotavirus enteritis combined with hepatic lesion. Methods Hepatic function and B type ultrasonic wave inspection were carried out among 485 cases of rotavirus enteritis and clinical features of 108 cases united with hepatic lesion were analyzed. Results (1) Among 108 cases of rotavirus enteritis united with hepatic lesion, ALT increased in 30 cases, accounted for 27.8% of all patients and AST increased in 18 cases (16.7% ) ; ?-GT increased in 10 cases , constituting 9.3% of all patients . simultaneous increased of ALT and AST occurred in 24 cases, accounting for 22.3% ; simultaneous increased of ALT , AST and ?-GT occurred in 12 cases, accounting for 11.1% ; simultaneous increased of transaminase and cholochrome ( TBIL or DBIL ) in 3 cases , accounting for 2.7%; hepatic disfunction and tumefaction were also observed in 8 cases (7.4% ) ; The total cases of increase in ALT were 66 (61.1%) ; the total cases of increase in AST are 54 ( 50 % ) ; The total cases of increase in?-GT are 21 (20.4%). (2)After two weeks , ALT returned to normal in 60 cases ( 90.9%) ; AST returned to normal in 51 cases (94.4%) ; ?-GT returned to normal in 21 cases ( 95.5% ) ; Cases with TBIL or DBIL increased and ALB decreased, hepatic tumefaction recovered within 2 weeks. Conclusion The cases of rotavirus enteritis may be combine with hepatic lesion, increase in ALT and AST are most frequently observed. The prognosis is fairly good after antivirus and protect hepatic therapy , most of the sick children recover from hepatic function lesion and hepatic tumefaction within 2 weeks.