Association of liver damage with coronary artery lesion and no response to intravenous immunoglobulin in the acute stage of Kawasaki disease / 中国当代儿科杂志

OBJECTIVES@#To summarize the clinical features of liver damage in children in the acute stage of Kawasaki disease (KD), and to investigate the clinical value of liver damage in predicting coronary artery lesion and no response to intravenous immunoglobulin (IVIG) in children with KD.@*METHODS@#The medical data were collected from 925 children who were diagnosed with KD for the first time in Beijing Children's Hospital from January 1, 2016 to December 31, 2017. According to the presence or absence of abnormal alanine aminotransferase (ALT) level on admission, the children were divided into a liver damage group (n=284) and a non-liver damage group (n=641). A logistic regression analysis was used to investigate the clinical value of the indicators including liver damage in predicting coronary artery lesion and no response to IVIG in children with KD.@*RESULTS@#Compared with the non-liver damage group, the liver damage group had a significantly earlier admission time and significantly higher serum levels of inflammatory indicators (P<0.05). The liver damage group had a significantly higher incidence rate of coronary artery lesion on admission than the non-liver damage group (P=0.034). After initial IVIG therapy, the liver damage group had a significantly higher proportion of children with no response to IVIG than the non-liver damage group (P<0.001). In children with KD, coronary artery lesion was associated with the reduction in the hemoglobin level and the increases in platelet count, C-reactive protein, and ALT (P<0.05), and no response to IVIG was associated with limb changes, the reduction in the hemoglobin level, the increases in platelet count, C-reactive protein, and ALT, and coronary artery lesion (P<0.05).@*CONCLUSIONS@#Compared with those without liver damage, the children in the early stage of KD with liver damage tend to develop clinical symptoms early and have higher levels of inflammatory indicators, and they are more likely to have coronary artery lesion and show no response to IVIG treatment.

Experimental study of cervical lymph node in thyroid by using radioactive nano tracer / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Using radioactive nano tracer with different sizes (average diameter were 50, 80 and 100 nm) and dosages (0.01 and 0.02 ml) in the thyroids of rabbits, to study the drainage of thyroid to cervical lymph nodes (LNs) in rabbits and to provide experimental evidence for the choice of ideal sizes and dosages of radioactive Nano tracer for the sentinel lymph node biopsy (SLNB) in thyroid cancer patients.</p><p><b>METHODS</b>Thirty adult rabbits were randomly divided into six groups (50 nm - 0.01 ml, 50 nm - 0.02 ml, 80 nm - 0.01 ml, 80 nm - 0.02 ml, 100 nm - 0.01 ml, 100 nm - 0.02 ml of (99m)Tc-Sb(2)S(3)) with five rabbits in each group. A total of 60 sides of thyroids were included. The mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity in LNs in each group were measured.</p><p><b>RESULTS</b>One to three LNs were identified in one side neck of rabbits, totally 86 LNs. Most of LNs with radioactivity existed in level VI, counting for 75.6% (65/86). (99m)Tc-Sb(2)S(3) with 50 nm particles was significantly better than that with 80 nm or 100 nm particles with regarding the initial and the strangest radioactive time of (99m)Tc-Sb(2)S(3) in LNs (P < 0.05). There were no significant difference in the mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity between the dosages of 0.01 ml and 0.02 ml of (99m)Tc-Sb(2)S(3) with same size of particles (P > 0.05).</p><p><b>CONCLUSION</b>(99m)Tc-Sb(2)S(3) with 50 nm particles, in the dosage of 0.01 ml or 0.02 ml, could be good choice for SLNB of thyroid cancer.</p>

Clinical Features and Prognosis of Neonatal Arrhythmias / 实用儿科临床杂志

Objective To explore the clinical features and prognosis of arrhythmia in newborn infants.Methods Eighty children with arrhythmia were diagnosed by physical examination and electrocardiogram monitoring in author's hospital from Jan.2004 to Dec.2006.Their clinical features and 24-hour dynamic electrocardiogram were analyzed at the acute stage and followed up.Results Out of 80 cases of arrhythimics,52 cases were boys and 28 cases were girls,with an average age of 4 days on diagnosis of arrhythmias.Forty-five neonates presented with supraventricular arrhythmia,accounting for 56.3%.Their clinical presentations were atypical,and the hypoxia,infection,electrolyte disturbances and metabolic disorders were the main causes of the arrhythmias.After supportive and anti-arrhythmia treatment,18 cases of arrhythmias disappeared of 25 children with premature atrial beats;10 cases of 21 children with premature ventricular beats were cured,2 cases of 4 children with ventricular tachycardia,1 case died;2 cases of 3 children with supraventricular tachycardia didn't occure;3 cases of 5 with atrio-ventricular block were cured.The prognosis was better in supraventricular arrhythmias than that in ventricular and other arrhythmias at discharge.At the follow-up of(1.2?0.7)years,there were no differences in rates of recovery between supraventricular arrhythmias and ventricular arrhythmias.Conclusions Supraventricular arrhythmia was the most common type of arrhythmias in neonates.Most of the arrhythmia in neonates might be functional and could recover without treatment.Supraventricular arrhythmia usually had better prognosis in acute period.Only a few neonates with severe arrhythmia need anti-arrhythmias treatment.