Influencing factors and hormone resistance of 510 children with nephrotic syndrome / 公共卫生与预防医学

Objective To investigate the hormone resistance and analyze its influencing factors in 510 children with nephrotic syndrome. Methods The clinical data of 510 children with primary nephrotic syndrome admitted to our hospital from January 2019 to August 2023 were retrospectively collected and analyzed. After 8 weeks of continuous treatment with conventional full-dose prednisone, urine protein detection was performed. Urine protein (+-+++) was listed as drug-resistant group, and urine protein (-) was regarded as control group. The general data, pathological types, and laboratory indicators were compared. Univariate analysis and Logistic regression analysis were used to screen the risk factors for hormone resistance in children with nephrotic syndrome. Results (1) After the end of 8 weeks of treatment, among the 510 children, there were 19 children with urine protein (+), 22 children with urine protein (++), 12 children with urinary protein (+++) and 457 children with urine protein (-). The total number of children with hormone resistance (drug-resistant group) was 53 cases (10.39%, 53/510), and the number of children with hormone sensitivity (control group) was 457 cases (89.61%, 457/510). (2) The proportions of children with onset age>8 years old and pathological type of focal stage glomerulosclerosis in drug-resistant group were higher than those in control group (P8, serum creatinine, D-dimer and β2-microglobulin, and low 25-hydroxyvitamin and CD4 at disease onset were risk factors for hormone resistance in children with nephrotic syndrome (P8, serum creatinine, D-dimer and β2-microglobulin and low 25-hydroxyvitamin and CD4 at disease onset, it is necessary to take targeted anticoagulation, immune regulation and other treatments as soon as possible in order to achieve the best efficacy and improve the prognosis.

Correlation analysis of electronic screen use and myopia among primary and secondary school students in six provinces and cities of China / 中国学校卫生

Objective@#To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia.@*Methods@#From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chisquare test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia.@*Results@#About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for nonstudy purposes. After adjusting for confounding factors, parents unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P<0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P<0.05). The results of grade stratification analysis showed that parents unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P<0.05). Among the higher grade of primary school students, continuous use of electronic screens for nonstudy purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P<0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P<0.05).@*Conclusions@#Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.

Prenatal diagnosis and intrauterine treatment of a giant fetal hepatic hemangioma:a case report / 中华围产医学杂志

This article reported a case of fetal giant hepatic hemangioma with cardiomegaly managed with intrauterine treatment. At 23 weeks of gestation, the patient was referred to Guangdong Women and Children Hospital due to abnormal abdominal echogenicity of the fetus, which was suspected to be a hepatic hemangioma or a hepatic arteriovenous fistula. The prenatal ultrasound at 26 weeks of gestation revealed an enlarged fetal hepatic hemangioma of 45 mm×35 mm×42 mm and an enlarged heart (cardiothoracic area ratio of 0.50). So, with the patient's informed consent, the fetus was treated with intrauterine administration of propranolol and dexamethasone and closely monitored by ultrasound. The volume of the lump still increased at the beginning of the medication, but started to shrink in the 7th week. Besides, the fetal cardiac load was reduced and the condition was controlled. The patient delivered at 37 weeks of gestation. The baby received a CT examination on the fourth day after birth which revealed an abdominal mass of 40 mm×30 mm×44 mm requiring no treatment, and no abnormalities were reported during a one-year follow-up.

Therapeutic effects of pediatric renal transplantation: A report of 138 cases / 中华器官移植杂志

Objective To summary the clinical data of pediatric renal transplantation from multiple renal transplant centers in China,and analyze the factors influencing the therapeutic outcomes of pediatric renal transplantation.Methods From March 1986 to May 2010,the clinical data of 138 children who underwent renal transplantation in eight centers of renal transplantation in China were retrospectively analyzed.Results The one-year patient and graft survival rate was 99.3％ and 95.7％respectively.Acute rejection episodes occurred in 38 cases (27.5％),15 cases suffered delayed graft function (DGF),and graft functions were returned to normal in all recipients within one month.Moreover,other complications included transplant renal artery stenosis in 8 cases (5.8％),ureteral necrosis in 2 cases (1.4％),urinary fistula in 5 cases (3.6％),hypertension in 57 cases (41.3 ％),hyperlipidemia in 38 cases (27.5％),hirsutism in 32 cases (23.2％),drug-induced liver damage in 26 cases (18.8％),urinary tract infection in 25 cases (18.1％ ),gingival hyperplasia in 22 cases (15.9％),pulmonary infection in 21 cases (15.2％),bone marrow suppression in 12 patients (8.7％),herpes simplex in 10 cases (7.2％),and diabetes in 8 cases (5.8％).The body weight was increased by 4 to 13 kg and the body height was increased by 2 to 7 cm during the first year posttransplantation. Conclusion The careful perioperative management, rational use of immunosuppressive agents,strengthening the follow-up management of children and social support,and improving compliance were the key points to obtain good outcomes in pediatric renal transplantation.

A clinical study of pediatric and adolescent renal transplantation: a report of 46 cases / 中华器官移植杂志

Objective To investigate the technical features, postoperative complication and therapeutic regimen of immunosuppressant in pediatric and adolescent renal transplantation. Methods From February 1998 to December 2004, clinical data of 46 pediatric and adolescent patients who underwent renal transplantation were retrospectively analyzed to observe the patient and graft survival rate, growth and development of recipients and postoperative complication. Results Ten episodes of acute rejection (AR) were diagnosed in 46 cases. Four cases suffered delayed graft function (DGF), one urinary leakage and 8 drug-induced hepatic injury occurred. Eight cases suffered pulmonary infection, 3 cases suffered bone marrow depression and 2 granulocytopenia. One allograft artery stenosis and one ureteral necrosis occurred. Renal functions were returned to normal in all recipients 4 weeks after operation. The 1-year patient and graft survival rates were all 100 %, and the 3-year patient and graft survival rates were 100 % and 97.4 % respectively. Conclusions Renal transplantation is an effective treatment for pediatric and adolescent patients with end-stage renal disease. In addition to its higher AR incidence than adult, pediatric renal transplantation has especial treatment in the operation process and therapeutic regimen of immunosuppressant.