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25 November 2005, Volume 20 Issue 11 Previous Issue    Next Issue
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Hemorrhagic cystitis after hematopoietic stem cell transplantation in children :clinical characteristics and risk factors. Xu Honggui,Fang Jianpei,Huang Shaoliang 2005, 20(11): 659-662 .  Abstract ( )   Abstract Objective To study the clinical characteristics and risk factors of hemorrhagic cystitis (HC) in children after hematopoietic stem cell transplantation. Methods The clinical records of HC in 11 of 52 pediatric patients who underwent umbilical cord blood transplantation (UCBT) and peripheral blood stem cell transplantation (PBSCT) were analyzed retrospectively. Results HC with a median onset time of day +15 (range day+2~+25) was classified as early in 4 cases,late in 7 cases,and graded as mild to moderate in 6 cases,severe in 5 cases.Of all the patients,11/11 had hematuria and 7/11 had typical pollakisuria,urgent micturition,odynuria and gross hematuria.There were no significant differences between the patients with HC and patients with noHC in the recovery time of ANC≥0.5×109/L and PLT≥20×109/L.However,the incidence of HC was much higher in the group of ≥6 years old,positive group of acute graftversushost disease (aGVHD) and group of cytomegalovirus (CMV) infection than that in group of <6 years old (32.14% vs 833%,P<0.05),negative group of aGVHD(34.62% vs 7.69%,P<0.05)and group of CMV noinfection(62.50% vs 13.64%,P<0.05)respectively.All patients recovered in a median 12.8 days(range 2~53 days).Conclusion HC in children after HSCT has its own clinical characteristics.The risk factors of HC include older age (≥6 years),aGVHD positive and CMV infection.

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A report of hematopoietic stem cell transplantation from maternal donor in the treatment of a patient with nonHodgkin’s disease Tang Xiangfeng,He Yuelin,Li Chunfu. 2005, 20(11): 663-665 .  Abstract ( )   Abstract Objective To explore the efficacy of allogenetic hematopoietic stem cell transplantation from maternal donor in the treatment of a patient with aggressive and refgractory nonHodgkin’s disease and the problem of donor hematopoietic stem cell source. Methods A 8yearold patient with lymphoblastic lymphoma received bone marrow transplantation from HLAuncompatible maternal donor,and the blood type of ABO is uncompatible.The pretreatment regimen was Cytarabine,Etoposide,Cyclophosphamide and total body irradiation.The prophylaxis of acute graft versus host disease(GVHD) is Antithymocyte globulin(ATG),Cyclosporin,Methorexate and CD25 monoclonal antibody.The patient received 8.92×108kg-1 nuclear cell,1.89×108 kg-1 mononuclear cell,1.37×106 kg-1,CD34cell,32.9×107kg-1 CD3cell. Results The day of granulocytes exceeding 0.5×109/L and platelets exceeding 30×109/L were respectively on day 15 and 20 after transplantation,99% donors' hematopoietic stem cells were shown on the 27th day after transplantation by FISH sex chromosome analysis,and the blood type of the patient changed from O to B on the 37th day.The patient experienced gradeⅠacute GVHD which responded to steroids.Chronic GVHD was not found during the one year of followup. Conclusion The allogenetic hematopoietic stem cell transplantation from maternal donor is an effective radical cure for a patient with aggressive and regractory lymphoblastic lymphoma,and to some extent can settle the problem of donor hematopoietic stem cell source.

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Clinical diagnostic value of sublingual glyceryl trinitrate provocation headup tilt table test in children’s vasovagal syncope. Wang Cheng,Li Wen,Li Mingxiang 2005, 20(11): 666-668 .  Abstract ( )   Abstract Objective To probe clinical diagnostic value of sublingual glyceryl trinitrate provocation headup tilt table test in children's vasovagal syncope.Methods There were 143 (male 58 and female 85) patients of unexplained syncope (UPS) aged from 4 to 18 years old (mean 12.10±3.03 years ) who received basic headup tilt table test (BHUT) in 70 degrees with power tilt table.Negative cases of them were given sublingual glyceryl trinitrate 0.2mg and received sublingual glyceryl trinitrate headup tilt table test (SNHUT).The results were evaluated repeatly.These data were statistically analyzed by computer with SPSS 11.0 software.Results①The positive rate in BHUT was 29.4% (42/143),of which the female was 73.8%(31/42).The positive cases were 44 in 64 of SNHUT.The positive rate in SNHUT was 601%(86/143).②The syncope episodes occurred after standing time (21.31±13.24)min in BHUT and (5.41±423)min in SNHUT.③Reaction type:The positive cases were 86 in BHUT and SNHUT.Vasodepressive type was 837%(72/86).Cardioinhibitory type was 7.0%(6/86).Mixed type was 9.3%(8/86).④Side effect:There were no intolerance cases and other side effects in 64 patients with sublingual glyceryl trinitrate.Conclusion SNHUT can increase diagnostic positive rate of VVS in children.Glyceryl trinitrate use is convenient and its side effects are less.SNHUT can be recommended to be used widely in pediatric clinic.

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The effect of highoxygen liquid on endothelin and calcitonin gene related peptide in cerebrospinal fluid of children with critical viral encephalitis. Cai Xiaofang,Sun Jimin,Xu Jun 2005, 20(11): 669-671 .  Abstract ( )   Abstract Objective To study the protective effect of highoxygen liquid on the brain in children with critical viral encephalitis. Methods Forty children with critical viral encephalitis were randomly divided into 2 groups:regular therapy group and highoxygen liquid group (regular therapy plus highoxygen liquid).The clinical symptoms and encephalogram were observed before and after therapy.The contents of endothelin (ET) and calcitonin gene related peptide (CGRP) in the cerebrospinal fluid (CSF) were detected by radioimmunoassay. Results Compared with regular therapy group,the time of hospitalization and disappearance of clinical symptoms and brain damage was shortened obviously(P<0.05 or 0.01); ET、ET/CGRP decreased remarkably and CGRP was statistically higher in highoxygen liquid group (P<0.05 or 0.01). Conclusion1.The imbalance of ET/CGRP in CSF is an important factor to the occurrence and development in viral encephalitis.2.The highoxygen liquid has protective effect on the brain of children with critical viral encephalitis,through ameliorating oxygensupply and restoring the balance of ET/CGRP in CSF.

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Analysis of risk factors of epilepsy after febrile convulsion. Che Guihua,Wang Qingshan,Song Yanhong 2005, 20(11): 672-675 .  Abstract ( )   Abstract Objective To explore the risk factors of epilepsy (EP) after children's febrile convulsion (FC) and to early interfere it. Methods Adopt survival analysis life span table and survival analysis and COX regression to implement 5 years to 17 years and 5 months followed-up for clinical data in 253 FC patient children who were in our hospital from January 1988 to June 2000;take the first FC onset as starting point for following up;take hospitalization again or family visit as way of following up;observe annual incidence of epilepsy after febrile convulsion;collect the following data: duration,the grand total,temperature,frequency in 24 hours for the first FC onset,primary age,convulsion family history,form,EEG in 48 hours for the first FC onset,sex,primary disease of seizures,etc. Results 19 of 253 FC cases were secondary EP.The 5th,10th and 17th annual incidence was 0.53%,1.69%,8.70% respectively. After analysis was completed,FC duration and the grand total respectively were P<0.05 and P<0.01,B was respectively negative and positive，RR<1 and RR>1,and 95% confidence interval excluded 1 in both.For both FC seizures form and convulsion family history,P<0.01,B was positive,RR>1,and 95% confidence interval excluded 1. Conclusion Risk factors for secondary EP are as follows:long duration of seizures,more frequencies of the grand total,focal seizures and family convulsion history.

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Analysis of 328 children with elevated aminotransferase levels. Xie Xinbao,Zhu Qirong,Wang Xiaohong 2005, 20(11): 676-679 .  Abstract ( )   Abstract Objective To investigate the causes of elevated aminotransferase levels of children. Methods Medical records of 328 cases hospitalized with elevated aminotransferase levels from November,2001 to October,2004 were consulted and the causes of elevated aminotransferase levels were analysed. Results 52 (15.9%) cases were not diagnosed,and 38 cases with overlapping diseases that could cause elevated aminotransferase levels were found.The first 6 causes of elevated aminotransferase levels of children were cytomegalovirus (CMV) hepatitis (156),hepatitis B (46),hepatitis A (30),biliary atresia (30),hepatolenticular degeneration (12) and hepatoglycogenosis (12).CMV hepatitis was most common in the cases below 1 year old.Hepatitis A and B were the main causes of elevated aminotransferase levels of children above 3 years old. Conclusion The causes of elevated aminotransferase levels of children are various and deserve researching deeply.CMV hepatitis and hepatitis A and B are the main causes of elevated aminotransferase levels of children.There is much significance to prevent them.

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Expression of SODD and P65 protein in pediatric acute leukemia and clinical significance. Tao Hongfang,Hu Qun,Liu Shuangyou 2005, 20(11): 680-682 .  Abstract ( )   Abstract Objective To study the expression of SODD and P65 in pediatric acute leukemia and its clinical significance. Methods The expression of SODD and P65 proteins were determined by immunohistochemistry method. Results The incidence of SODD and P65 expression was 54.5%(18/33) and 45.5%(15/33)in acute leukemia (AL)(P<0.05 ),in ALL the incidence of SODD and P65 expression was 56%(14/25) and 48%(12/25)respectively(P<0.05 ).The positive incidence of SODD was 933%(14/15) in 15 cases with P65 expression and the positive incidence of P65 was 77.8%(14/18) in 18 cases with SODD expression,which had a positive correlation between SODD expression and P65 expression(P<0.01,r=0.69 ).A significant correlation was found between SODD and the immunity grouping and the judgement of prognosis(P<0.05 ). Conclusion The overexpression of SODD and P65 may promote to tumorgenesis and progression in AL.The SODD can act as markers of predicting biological behaviors and prognosis in ALL.