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Objective:To study the classification of persistent fifth aortic arch (PFAA) and the value of echocardiography in the diagnosis of PFAA.Methods:A total of 16 cases (male 6, female 10, at ages from 7 days to 4 years and 2 months old, the median age was 3 months) diagnosed with PFAA in Beijing Children′s Hospital Affiliated to Capital Medical University from January 2013 to June 2019 were studied retrospectively. The diagnosis standard, differential methods and misdiagnosed analysis of different subtypes of PFAA by echocardiography were summarized and analyzed.Results:The 16 cases included 1 case of type A1 double lumen aortic arch, 8 cases of type A2 single-lumen aortic arch, 3 cases of type B1 with pulmonary atresia and 4 cases of type B3 pulmonary artery branch arising from the distal end of ascending aorta. Only one patient of double lumen aortic arch missed diagnosis by echocardiography, and the rest were accurately diagnosed by echocardiography. CTA was performed in 13 cases, including 9 cases of type A, 1 case of type B1 and 3 cases of type B3, which confirmed the echocardiography diagnosis. Seven cases of Type A2 were operated.Conclusions:PFAA is a rare and complicated aortic arch malformation, which is divided into four major classification and multiple subtypes. Echocardiography can diagnose the PFAA and its classification, it is of great clinical significance for the early diagnosis, treatment and prognosis of children.
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Objective To investigate the clinical significance of PRL-3 expression in sinonasal squamous cell cancer(SNSCC).Meth-ods The immunohistochemical method and RT-PCR were adopted to detect the PRL-3 protein expression level in 62 cases of SNSCC tissue (SNSCC group),30 cases of nasal polyps(NP group)tissue and 25 cases of normal nasal mucosa tissue(control group).The obtained results were compared.Results Both in the protein level and gene level detection,the expression of PRL-3 in the SNSCC group was higher than that in the NP group and control group,the difference was statistically significant (P 0.05),but with TNM stage increasing,differentiation degree decreasing and complicating lymph node metastasis,the expression of PRL-3 was significantly increased(P <0.05).Conclusion The PRL-3 expression can serve as good reference for the proliferation activity of SNSCC,its expressing intensity can obviously reflect the SNSCC cell proliferation activity,PRL-3 probably is an independent prognostic index of SNSCC,indicating poor prognosis.
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Objective To study the relationship between the severity of Mycoplasma pneumoniae pneumonia(MPP) and interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-α level.Methods From Jan.to Jul.2012,according to clinical pulmonary infection score(CPIS),30 children with severe MPP(severe MPP group) and 32 children with mild MPP(mild MPP group) were enrolled,and 30 healthy children were enrolled as control group).Subjects of all groups were detected for the levels of IL-6,IL-10,TNF-α,IgA,IgM and IgG.Besides,children with MPP were also detected for the levels of IL-6,IL-10 and TNF-α after treatment.Results The levels of IL-6,IL-10 and TNF-α in bronchoalveolar lavage fluid(BALF) and serum in severe MPP group were higher than those in mild MPP group and control group(P<0.05).The levels of IL-6,IL-10 and TNF-α in BALF and serum were significantly higher in mild MPP group than those in control group(P<0.05).In all children,the levels of IL-6,IL-10 and TNF-α in BALF were higher than those in serum.After treatment,the levels of IL-6 and TNF-α in BALF in children with severe MPP were significantly decreased,while that of IL-10 were increased(P<0.05).Compared with control group,the IgM level in children with MPP was increased significantly,and the IgG level was decreased notablely(P<0.05).Conclusion There might be significant correlation between levels of cytokines IL-6,IL-10,TNF-α and the disease severity of MPP in children patients,which could be used as the basis for the clinical diagnosis and treatment.
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Objective To investigate clinical value of high sensitive-cardiac troponin T(hs-cTnT) combined with creatine kinase isoenzyme MB(CK-MB) in the diagnosis of children with myocarditis.Methods From Nov.2014 to Nov.2015,a total of 102 cases of myocarditis,suspected with myocardial damage and without myocardial damage(pneumonia and capillary bronchitis),and 50 healthy children were enrolled.Plasma levels of hs-cTnT and CK-MB were detected and compared.Results The levels of plasma hs-cTnT and CK-MB in children with myocarditis were significantly higher than those without myocarditis and healthy subjects(P<0.05).Hs-cTnT and CK-MB levels in children with myocarditis,less than one month old,were significantly higher than those with age of 1 month to 3 years old(P<0.05).Conclusion Combined detection of hs-cTnT and CK-MB could be with high sensitive and specificity in diagnosis of children with myocarditis,accurately assess the disease condition and improve the therapeutic effect and prognosis,which might be worthy of clinical application.
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Objective To summarize the echocardiographic findings and clinical characteristics of Kawasaki disease(KD) complicated with coronary artery thrombosis (CAT).Methods Thirty-five patients with KD combined with CAT were enrolled,who were admitted to Beijing Children's Hospital,Capital Medical University between July 2005 and August 2016.The clinical characteristics and echocardiographic findings during follow-ups were retrospectively studied.According to whether the childrenhad been complicated with myocardial ischemia,the patients were divided into 2 groups:ischemic group and non-ischemic group.The duration of fever,the time when the intravenous immunoglobulin(IVIG) was first injected,the time when coronary artery aneurysms (CAA) was formed,the maximum diameter of CAA and inflammatory index inthe acute phase were compared between 2 groups.Results All of the 35 children diagnosed as KD combined with CAT suffered firom CAA,and the coronary thrombosis was detected in all the cases with aneurysms.Thirty-five patients had 99 branches of CAA,of which the maximum diameter of CAA was (9.6 ± 3.1) mm(4.0-19.0 mm).Fifty-four plots of CAT were detected in the aneurysms.The diameter of CAA that thrombosis located was larger than that of which the thrombosis was not located[(10.9 ± 2.8) mm vs.(7.9 ± 2.6) mm],and the difference was significant(P <0.01).During 4 months to 10 years and 8 months [(39.2 ±29.5) months] follow-ups,CAA regressed in 32 branches [32.3% (32/99 branches)],of which 4 branches [4.0% (4/99 branches)] completely regressed to the normal diameter.The maximum diameter of CAA regressed was smaller than the maximum diameter of CAA consistence [(7.3 ± 1.9) mm vs.(10.6 ± 3.0) mm],and the difference was significant (P < 0.01).Out of 35 patients,15 cases [42.9% (15/35 cases) had myocardial ischemia,while the other 20 cases[57.2% (20/35 cases)] didn't have.Among 15 cases with myocardial ischemia,6 cases[17.1% (6/35 cases)] had myocardial infarction,4 cases [11.4% (4/35 cases)] had heart failure,and 1 case[2.9% (1/35 cases)] died of acute heart failure complicated with severe ventricular arrhythmia.Compared with non-ischemic group,the children in the ischemic group had longer duration of fever[(19.1 ± 7.8) d vs.(12.1 ± 3.3) d],higher white blood cell account in the acute phase[(24.8 ± 13.5) × 1012/L vs.(19.7 ±4.0) × 1012/L],later treatment of IVIG [(13.9 ± 5.5) d vs.(9.8 ±3.8) d],and earlier CAA formation [(16.0 ±4.9) d vs.(20.9 ± 14.5) d],and the differences were statistically significant (all P < 0.05).Conclusions CAT of children with KD commonly originates from CAA.Patients who have more serious inflammatory reaction in the acute phase,earlier formation,heavy severity and longer consistence of CAA are prone to have myocardial ischemia.Echocardiographic study plays an important role in monitoring CAA,detecting the CAT and finding the early left ventricle dysfunction,which is of clinical significance.
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Objective: To evaluate the post-operative complication of pulmonary vein stenosis in patients with total anomalous pulmonary venous connection (TAPVC) by echocardiography. Methods: A total of 66 TAPVC pediatric patients with surgical repair in our hospital were retrospectively studied. The peri-operative and mid-term post-operative echocardiography was conducted to evaluate the complication of pulmonary vein stenosis. Results: The peri-operative and mid-term post-operative echocardiography presented the increased left ventricular diastolic end diameter (LVEDd) and decreased right ventricular diameter in all 66 patients, P0.05. Conclusion: Echocardiography may monitor the operative effect of TAPVC, the occurrence of post-operative pulmonary vein stenosis could be found by examining right ventricular diameter and pulmonary artery pressure in pediatric patients.
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OBJECTIVE@#To investigate the expression of matrix metalloproteinase-1 (MMP-1), E26 transformation-specific-1 (Ets-1) in laryngeal carcinoma and to discuss their relevance and the roles in carcinogenesis and development of laryngeal carcinoma.@*METHOD@#Immunohistochemical technique was used to detect the expression of MMP-1 and Ets-1 protein in 34 tissues of laryngeal carcinoma and 34 para-carcinoma tissues, 15 cases of vocal cord polyps, and the use of the pathological image analysis software, we analysis the results of immunohistochemical semi-quantitatively.@*RESULT@#(1) The expression of MMP-1 and Ets-1 protein in laryngeal carcinoma tissues is obviously higher than that in para-carcinoma and in vocal cord polyps respectively (P 0.05). (2) The expression of MMP-1, Ets-1 protein isn't related to patients' age and sex, tumor size,clinical classification (P > 0.05), but related to pathological grade, clinical stage and lymph nodes metastasis (P < 0.05). (3) There is a positive correlation between the expression of MMP-1 and Ets-1 in laryngeal carcinoma.@*CONCLUSION@#Overexpression of MMP-1 and Ets-1 was observed in laryngeal carcinoma. The high expression of MMP-1 and Ets-1 may contribute to the carcinogenesis and development of laryngeal carcinoma,which is a important value to judge the malignant degree and progress of laryngeal carcinoma.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas , Metabolismo , Patologia , Neoplasias Laríngeas , Metabolismo , Patologia , Metaloproteinase 1 da Matriz , Metabolismo , Proteína Proto-Oncogênica c-ets-1 , MetabolismoRESUMO
Objective To evaluate the role of echocardiography in diagnosis and post-operative evaluation of infants and children with double aortic arch. Methods Echocardiography was performed in 6 patients with double aortic arch from January 2006 to June 2008. The outcome of postoperative follow-up was also evaluated. Results Six patients ranged in age from 3 months to 4 years and averaged 18 months. There were 2 boys and 4 girls. Echocardiography diagnosed double aortic arch in 4 patients, one balanced arch and 3 right arch dominant, and was confirmed by surgical observation in each patient. The size of the two arches were almost same in balanced arch,and the diameter of right arch was bigger than that of left arch in right arch dominant. Echocardiography failed to diagnose in 2 patients with balanced arch. Three patients had associated heart defect, such as patent ductus arteriosus and ventricular septal defect. Five of the 6 patients underwent surgical division of the left arch in order to relieve esophageal and tracheal compression. At about 2 years postoperative follow-up,echocardiography can clearly show the flow of aortic arch and it's branches. Conclusions It is an important clue to double aortic arch if only two branches of aortic arch was shown on supersternal view by echocardiography. As a non-invasive techniqe, echocardiography is useful for diagnosing and post-operative evaluating of patients with double aortic arch.
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5 mm had surgery in 100%. Conclusion Most severe CHD could be detected prenatally by fetal echocardiography, and the pregnancy should be terminated. The critical NCHD should be diagnosed by echocardiography for corrective or palliative surgery as early as possible in the first days of life. In mild cases of left to right shunts may close spontaneously, they should be followed up regularly.