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06 May 2007, Volume 22 Issue 05 Previous Issue    Next Issue
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Clinical analysis of 6 cases of nephrotic syndrome due to EPGN. MIN Yue,SONG Xiao-xiang,NI Zheng 2007, 22(05): 355-357 .  Abstract ( )   AbstractObjectiveTo analyze the clinical manifestation,pathological changes and treatment of 6 patients with nephrotic syndrome(NS) due to endocapillary proliferative glomerulonephritis(EPGN) MethodsThe data of patients with NS due to EPGN admitted to our department from 2002 to 2004 were retrospectively analyzed. Results(1)All the 6 patients were manifested clinically by nephritis nephrotic syndrome.(2)The pathological features showed that cell crescent was formed on the basis of endocapillary proliferation;the granular deposition of IgG and C3 was found along the blood capillary,and “nontypical hump” and partial foot process fusion were also detected.(3)Treatment:6 cases were treated with methyprednisolone.Two cases completely alleviated,4 cases weren’t.Among these 4 cases,2 cases were treated with cyclohosphamide,and 2 cases were treated with common three-wing-nut Root,all of them being cured. Conclusion(1)There is close relation ship between pathological changes and clinical manifestations.Those with crescent were presented with long duration of hematuria and those with foot process fusion have long duration of severe proteinuria.(2)Enough doses of steroid should be given once diagnosis is confirmed.A satisfactory effect could be achieved through combination with immunosuppressant if there is no responses after 4 weeks of steroid.But long term prognosis is yet to be investigated.

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Hypoxic ischemic encephalopathy diagnosed according to different criteria:national and international. SONG Bo-song. 2007, 22(05): 358-360 .  Abstract ( )   AbstractObjectiveTo compare the diagnostic value of national standard with international standard for HIE. MethodsA total of 126 neonates with HIE diagnosed first according to national standard were diagnosed again according to international standard.The diagnostic rate was compared. ResultsAccording to international standard,the diagnostic rate of 126 neonates with HIE was 80.16%(P<0.01).Fetus age being≥37 weeks and <37 weeks,it was 86.13%(P<0.01)and 57.14%(P<0.01) respectively.Admission age being≤3 days,~7 days and >7 days,it was 75%(P<0.01)84.38%(P<0.01) and 94.44%(P>0.05) respectively.Condition level being mild,moderate and severe,it was 73.44%(P<0.01),87.18%(P<0.05) and 95.65%(P>0.05) respectively. ConclusionThe national standard is very flabby as it expands diagnosis easily,while the international standard is too strict so it misses out diagnosis easily.If they are combined,it will be scientific and advisable,and suitable to national condition.

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Clinical analysis of HBV markers in infants of HBsAg-positive mothers. YANG Song,ZENG Yue-ping,ZHANG Qiu-lan 2007, 22(05): 361-363 .  Abstract ( )   AbstractObjectiveTo explore clinical features of the markers in newborns of mothers with HBsAg-positive. MethodsHBV markers in serum were determined in 996 infants of 3-day-old，199 of them followed up for periods from 3 months to 4 years. ResultsHBsAg and HBeAg in serum in newborns of the third day of life were 27.2%(271/996) and 48.1%(479/996),respectively.The number of anti-HBc positive was 99.2%( 491/495).Seventeen infants were confirmed to be HBV infection (8.5%，17/199).There was significant difference in the expression of HBsAg in serum in the infected infants with higher loud and HBeAg showed no significant difference as compared to non-infected infants on the third day after birth.In comparison between sera collected from the third day of age and following-up in the infected HBV children,HBsAg and HBeAg of the latter were markedly higher respectively,P<0.001，P<0.05.In non-infected HBV children(182cases),levels of both HBsAg and HBeAg decreased obviously，P< 0.001. ConclusionThe positive HBV markers in serum are predominant in newborn infants of mothers with HBsAg-positive,which can not be considered the markers of HBV infection.High levels of HBsAg and HBeAg in serum can be defined as a high predictor of children with HBV infection after 3 months of age.

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Case report of primary Sjgren's syndrome complicated with chronic atrophic gastritis in children and literature review. LI Fan,SONG Hong-mei,LI Zheng-hong 2007, 22(05): 364-366 .  Abstract ( )   AbstractObjectiveTo recognize the children primary Sjgren's syndrome(pSS) complicated with chronic atrophic gastritis(CAG). MethodsReport one case of children(pSS) complicated with CAG,and review the related literature. ResultspSS in children could also be complicated with CAG as in adults,which could become arcinogenesis,so it could be treated immediately after establishing the diagnosis,then regular follow-up should be performed.If serious intestinal metaplasia and atypical hyperplasia were observed by gastroscopic histopathology,surgical resection should be considered. ConclusionIt is important to emphasize the recognition of children pSS with the splanchna such as stomach.Early diagnosis and treatment may improve the prognosis.

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Efficacy of calcium carbonate oral suspension in the treatment of primary bile reflux gastritis in children. MA Ming,JIANG Mi-zu，YU Jin-dan 2007, 22(05): 367-369 .  Abstract ( )   AbstractObjectiveTo evaluate the effect of calcium carbonate oral suspension in the treatment of primary bile reflux gastritis in children. MethodsThirty-two patients diagnosed as primary bile reflux gastritis by endoscopy were confirmed by 24-hour bilirubin monitoring with Bilitec 2000.They were divided into two groups equally at random.All the 15 patients group A were given calcium carbonate oral suspension,while the other 17 patients in group B were treated with calcium carbonate oral suspension and domperidone simultaneously.Dyspepsia symptoms including abdominal pain,abdominal fullness,nausea and vomiting were evaluated before treatment,2 and 4 weeks after treatment.After four weeks of treatment,the 24h gastric bilirubin monitoring was reexamined after three days of out of medicine. ResultsAfter 4 weeks treatment,symptomatic scores were significantly decreased in two groups compared with before treatment(P<0.05).No significant differences of symptomatic scores were observed between two groups before treatment or after treatment(P>0.05).All the parameters of 24-hour gastric bilirubin monitoring were not significantly decreased after 4 weeks of treatment in two groups(P>0.05). ConclusionIt is effective to improve the symptoms of primary bile reflux gastritis in children by use of calcium carbonate oral suspension,although it can’t prevent the reflux of gastric bile.It is helpless to use domperidone in the treatment.

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Pathologic and ultromicro-pathologic features of liver tissues in children with metabolic depositing liver disease. ZHOU Hua,FANG Feng,XU San-qing 2007, 22(05): 370-372 .  Abstract ( )   AbstractObjectiveTo study the features of pathologic and ultramicro-pathologic changes of abnormal metabolic products depositing liver disease,and investigate its diagnostic significance on the basis of the clinical data. MethodsFrom Aug 2005 to Mar 2006,8 children in our hospitoal who were diagnosed as metabolic liver disease according to their clinical manifestations were carried out liver biopsy.The features of pathologic and ultramicro-pathologic changes of liver were analyzed. ResultsOrdinary pathologic reports indicated 2 cases of glycogenic thesaurismosis,1 Niemann-Pick disease,1 metabolic liver disease;1 chronic mild ordinary hepatitis,and without special indication in other 3 cases.The reports of ultramicro-pathology showed 3 cases of glycogenic thesaurismosis and 5 cases of liver diseases of lipidoses.Three cases were featured as the glycogenic deposite in hepatocytes,so they were diagnosed as glycogenic thesaurismosis.Among them,1 was considered as type I because there were massive PAS positive material in hepatocytes with obvious adipose degeneration and without fibroplasia,1 was type Ⅲ with apparent fibrosis and slight fatty degeneration,and another was considered as type Ⅱ or other slight glycogenic thesaurismosis,whose appearance was evident increase of single granulometric glucogen in cytoplasm of hepatocytes and distension of rough and smooth endoplasmic reticulum with increase of lipid droplet in partial cells and increase of fibra element in Disce septa and between some hepatocytes.Five cases were diagnosed as liver diseases of lipidoses,whose key features were that there were several electronic transparent and bright vacuolus in cytoplasm of hepatocytes which were encapsuled by membrane and filled with porous or compact high density electronic substance.And among them,1 was Niemann-Pick disease because many typical foam cells ere observed under light microscope,and the classification of the other 4 cases was not clear. ConclusionExamining the ultramicro-structure of liver tissue by electronic microscope is more helpful to the diagnosis of liver metabolic thesaurismosis,and the rate of final diagnosis is improved greatly.

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Complications and incidences from blood purification for pediatric severe patients and their prevention and treatment. YANG Yi-yu,ZHENG Yi-nan,ZENG Ping 2007, 22(05): 376-379 .  Abstract ( )   AbstractObjectiveTo investigate the complications and incidences from blood purification (BP) for pediatric severe patients and their prevention and treatment. MethodsThe risk factors were monitored and corrected while the pediatric severe patients were treated with BP in PICU of children's hospital. Results1) There were 16 children treated with BP for 32 times.Finally,there were 12 survival cases and 4 deaths.2)After BP treatment there were decreases in inflammatory indexes,all P value <0.001.3)There were 28 times of complications during 32 times of BP.The most frequent complication happened in circulative system,covering hypotension,unstable blood pressure,shock and hypertension.Others were bleeding,hypothermia,deteriorated oxygenation and pulmonary hemorrhage.There were 6 incidences,including filter blockage,leakage of plasma segregator.4)There were also disorders of acid-base and electrolytes during BP.Most of the complications and all of the incidences were corrected after related treatments under bed-side care. ConclusionThere are all kinds of risk factors during BP for pediatric severe patients,and most of the complications and all of the incidences can be corrected in time if the critical care for the whole course guarantees the therapeutic safety.