RÉSUMÉ
Objective To explore the expression level of visceral adipose tissue-derived serine protease inhibitor(Vaspin)and secreted frizzled-related protein5(SFRP5)in the serum of children with idiopathic short stature(ISS)and its diagnostic value.Methods 70 children with ISS diagnosed in the First Hospital of Zhangjiakou from December 2021 to February 2023 were selected as the disease group,while 72 healthy volunteer children who underwent physical examination were collected as the control group.Immunoluminescence was applied to detect the expression level of VASPIN,Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression level of SFRP5 the clinical data of children in two groups were analyzed.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Vaspin and SFRP5 for ISS,multivariate Logistic regression was used to analyze the influencing factors of ISS.Results Compared with the control group,the serum Vaspin level in the disease group was obviously increased(2.89±0.92 ng/ml vs 1.81±0.42 ng/ml),while the SFRP5 level was obviously reduced(10.22±2.84 pg/ml vs 13.21±3.53 pg/ml),the differences were statistically significant(t=9.040,5.552,all P＜0.05).The weight,height,body mass index(BMI)and proportion of sexual development stage II～V of children in the disease group were obviously lower than those in the control group,and the differences were statistically significant(t=7.687,6.330,5.559,7.024,all P＜0.05).The area under ROC curve showed that the AUC of Vaspin and SFRP5 and their combined detection in the diagnosis of ISS were 0.768,0.849 and 0.925,respectively,the combined diagnosis efficacy of Vaspin and SFRP5 was better than that of serum Vaspin and SFRP5 alone(Z =3.829,P＜0.001;Z =2.141,P=0.032).Multivariate Logistic regression analysis showed that BMI(OR=0.508,95%CI:0.260～0.991),Vaspin(OR=3.458,95%CI:1.125～10.631)and SFRP5(OR=0.378,95%CI:0.153～0.935)were the influencing factors for ISS(all P＜0.05).Conclusion The expression level of Vaspin in the serum of children with ISS is obviously increased,while the expression level of SFRP5 is obviously reduced.The two are influencing factors of ISS,and the combined detection of their expression levels has certain value in the diagnosis of ISS.
RÉSUMÉ
Objective:To explore the incidence, diagnosis, treatment, and prognosis of central nervous system (CNS) infiltration in chronic lymphocytic leukemia (CLL). Methods:One case with symptomatic CNS involvement reported dizziness, diplopia, and gen-eral fatigue as initial manifestations of CLL, as shown in a literature review. Results:Autopsy studies revealed that leukemic invasion of CNS was found in 8%to 71%of CLL patients, whereas incidence of leukemic infiltration in symptomatic CNS was approximately 1%. The complication did not correlate with any evident risk factors, and symptoms in patients with leukemic CNS infiltration were het-erogeneous and non-specific. Diagnosis of the disease depends on cerebrospinal fluid (CSF) cytology and flow cytometry. In most of similar cases, neurologic improvement is achieved by either intrathecal chemotherapy or radiation therapy. Failure to treat leukemic CNS infiltration leads to rapid deterioration and death. Conclusion:Leukemic involvement of the CNS is very rare in CLL cases and in-dicates poor prognosis. Prompt diagnosis and aggressive treatment are crucial for long-term remission and complete resolution of neuro-logical symptoms.