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Transcatheter Ventricular Septal Defect Closure with Nit-Occlud LêVSD Device—Five Years’Experience and Literature Review

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Congenital Heart Disease 2023年第3期18卷 361-371页

作者： Ivana B.Cerović Vladislav A.Vukomanović Jovan Lj.Košutić Mila S.Stajević Sanja S.Ninić Saša S.Popović Ivan D.Dizdarević Staša D.Krasić Sergej M.Prijić cardiology department Mother and Child Health Institute of Serbia“Dr VukanČupić”Belgrade11070Serbia Faculty of Medicine University of BelgradeBelgrade11070Serbia

Introduction:Transcatheter closure is an alternative to ventricular septal defect(VSD)occlusion surgery.Nit-Occlud LêVSD coil is a new device yet to be evaluated.The study aimed to evaluate immediate and midterm results after transcatheter closure with the Nit-Occlud LêVSD device.Methods:The retrospective analysis included 30 patients with VSD referred for closure during the period from October 2015 to December 2020.Results:At the time of intervention,the patients’mean age and body weights were 7.5±5.6 years and 29.3±19.1 kg.The majority of the defects had perimembranous location(24/30),four defects had muscular and two outlet subaortic position.The mean effective right-side diameter of the VSDs was 3.6±1.3 mm.Single ventricular fibrillation,device embolization,and hemolysis developed in different patients and were successfully treated.None of the patients had a complete atrioventricular block.The coil was successfully placed in 25/30(83.3%)patients.The majority of the devices were 10 mm×6 mm(11/25)and 12 mm×8 mm(8/25)in size.Two patients required the implantation of a second device.The follow-up period was 2.1±1.4 years.Complete VSD closure was achieved in 48%of cases immediately after the intervention,74%during 2.1±1.6 months after the procedure,and 81%over follow-up.The remaining patients had a trivial residual defect.During the follow-up,approximately one-third of patients developed trivial aortic and mitral valve regurgitation,and half of the patients acquired trace/mild tricuspid regurgitation.Standardized(z-score)left ventricular end-diastolic diameter(0.15±0.37 vs.0.92±0.82,p=0.005)and left atrium dimension(0.47±0.58 vs.1.89±1.11,p=0.005),as well as the left atrium to aortic root ratio(1.2±0.1 vs.1.4±0.2,p=0.005)showed a significant decrease over follow-up related to the period before intervention.Conclusion:Intervention with Nit-OccludLêVSD coil showed appropriate results regarding VSD closure rate,complications,and chamber remodeling.The introduction of this device into clinical practice is a significa

关键词： Ventricular septal defect transcatheter device children

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Treatment of multisystem inflammatory syndrome in children

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World Journal of Pediatrics 2024年第4期20卷 325-339页

作者： Tong Tong Yi-Hua Jin Min Wang Fang-Qi Gong department of cardiology Children's HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthNo.3333 Binsheng RoadHangzhou 310052China

Background Multisystem inflammatory syndrome in children(MIS-C),a relatively uncommon but severe pediatric complication,is associated with coronavirus disease 2019(COVID-19).A variety of treatment approaches,including intravenous immunoglobulins(IVIGs),glucocorticoids(GCs)and biologic agents,such as anakinra and infliximab,have been described for the management of COVID-19-related MIS-C.Anticoagulant therapy is also important.However,a well-developed treatment system has not been established,and many issues remain controversial.Several recently published articles related to the treatment of MIS-C have been released.Hence,in this review,we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically.Data sources We reviewed the literature on the treatment of MIS-C through 20 September 2023.The PubMed/Medline,Web of Science,EMBASE,and Cochrane Library databases were searched with the combination of the terms"multisystem inflammatory syndrome","MIS-C","PIMS-TS","therapy","treatment","drug","IVIG","GCs","intravenous immunoglobulin","corticosteroids","biological agent",and"aspirin".Results The severity of MIS-C varies,and different treatment schemes should be used according to the specific condition.Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C.Conclusions MIS-Cis a disease involving multiple systems and has great heterogeneity.With the accumulation of additional experience,we have garnered fresh insights into its treatment strategies.However,there remains a critical need for greater standardization in treatment protocols,alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols.

关键词： Coronavirus disease 2019-Corticosteroids Intravenous immunoglobulin Multisystem inflammatory syndrome in children-Treatment

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Splenic hamartomas in children

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World Journal of Clinical Cases 2024年第11期12卷 1909-1917页

作者： Maja Milickovic Petar Rasic Sofija Cvejic Dejana Bozic Djordje Savic Tanja Mijovic Sava Cvetinovic Slavisa M Djuricic department of Abdominal Surgery Mother and Child Health Care Institute of Serbia"Dr.Vukan Cupic"Belgrade 11000Serbia Faculty of Medicine University of BelgradeBelgrade 11000Serbia department of Radiology The Children’s University HospitalBelgrade 11000Serbia department of Clinical Pathology Mother and Child Health Care Institute of Serbia"Dr.Vukan Cupic"Belgrade 11000Serbia Faculty of Medicine University of Banja LukaBanja Luka 78000Bosnia and Herzegovina

Splenic hamartomas(SHs)are uncommon,benign vascular lesions of unclear etiology and are mostly found incidentally on abdominal images,at surgery,or at autopsy.Since the first case description,in 1861,less than 50 pediatric SH cases have been reported in the literature.In this article,we have performed an analysis of all SH cases in children published in the literature to date and presented our case of an 8-year-old male with SH.These lesions in children were shown to cause symptoms more often than in the adult population.The observed SH sizes in children ranged from a few millimeters to 18 cm,and the symptomatic lesions were mostly larger or multiple.The most common clinical finding was splenomegaly.Signs of hypersplenism were present in children with a single SH larger than 4.5 cm(diameter range:4.5-18.0 cm)and in those with multiple hamartomas,ranging from a few millimeters to 5 cm.Eighty percent of patients with available laboratory findings had hematological abnormalities such as anemia,thrombocytopenia,or pancytopenia.Other symptoms and signs included abdominal pain,recurrent infections,fever,night sweats,lethargy,growth retardation,and weight loss.The use of multiple imaging modalities may suggest the preoperative diagnosis of a splenic mass in children and determine the therapeutic approach.However,the final diagnosis of SH relies on histopathological evaluation.Surgery,including total or partial splenectomy(PS),is the mainstay of SH management.Milickovic M et al.Splenomas in children WJCC https://*** 1910 April 16,2024 Volume 12 Issue 11 Although total splenectomy carries a greater risk of overwhelming post-splenectomy infection than PS it has remained the most performed surgical procedure in children with SH.In the majority of pediatric patients with symptomatic SH,resolution of symptoms and resolution or improvement of cytopenias occurred after surgical treatment.

关键词： Splenic hamartoma Pediatric Splenoma Clinical features Radiological features Histopathology Treatment

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Celiac crisis, a rare occurrence in adult celiac disease: A systematic review

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World Journal of Clinical Cases 2019年第3期7卷 311-319页

作者： Daniel Vasile Balaban Alina Dima Ciprian Jurcut Alina Popp Mariana Jinga department of Internal Medicine and Gastroenterology Carol Davila University of Medicine and Pharmacy department of Internal Medicine Dr. Carol Davila Central Military Emergency University Hospital department of Pediatrics Carol Davila University of Medicine and Pharmacy Alessandrescu-Rusescu Institute for mother and child Health Center for child Health Research University of Tampere and Tampere University Hospital

BACKGROUND Celiac crisis(CC), a potentially life-threatening condition, is one of the rare clinical presentations of celiac disease(CD). Several cases have been documented in the literature, mostly in children.AIM To perform a review of CC cases reported in adult CD patients.METHODS A systematic search of the literature was conducted in two databases,PubMed/MEDLINE and EMBASE, using the term "celiac crisis" and its variant"coeliac crisis", from January 1970 onwards. Altogether, 29 articles reporting 42 biopsy-proven cases were found in the search. Here, we summarized the demographic, clinical characteristics, laboratory and diagnostic work-ups, and therapeutic management in these patients.RESULTS Among the 42 CD cases, the median age was 50 years(range 23-83), with a 2:1 female to male ratio. The majority of patients(88.1%) developed CC prior to CDdiagnosis, while the remaining were previously diagnosed CD cases reporting low adherence to a gluten-free diet(GFD). Clinically, patients presented with severe diarrhea(all cases), weight loss(about two thirds) and, in particular situations, with neurologic(6 cases) or cardiovascular(1 case) manifestations or bleeding diathesis(4 cases). One in four patients had a precipitating factor that could have triggered the CC(e.g. trauma, surgery, infections). Laboratory workup of patients revealed a severe malabsorptive state with metabolic acidosis,dehydration, hypoalbuminemia and anemia. The evolution of GFD was favorable in all cases except one, in whom death was reported due to refeeding syndrome.CONCLUSION Celiac crisis is a rare but severe and potentially fatal clinical feature of CD. A high index of suspicion is needed to recognize this clinical entity and to deliver proper therapy consisting of supportive care and, subsequently, GFD.

关键词： Celiac disease Celiac crisis Malabsorption Malnutrition Diarrhea

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Computed Tomography of the Petrous Bone: Particularities in children

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Advances in Molecular Imaging 2018年第2期8卷 15-24页

作者： Dounia Basraoui Kenza Elatiqi Hicham Jalal mother and child Radiology department Mohamed VI University Hospital Marrakesh Morocco

Like any organ in children, the ear has particular anatomical features that are well shown in imaging. The petrous bone computed tomography (CT) is a valuable tool for diagnosing ear pathologies and evaluating surgical possibilities. In children, the ear has the peculiarity of having the morphology and size of adults, and the only difference resides in the components of the middle and inner ear related to the growth of the temporal bone and the state of ossification which are progressive with age. Some aspects of growth can simulate pathology and must be known. The pneumatisation of the temporal bone occurs gradually after birth and in several outbreaks until adulthood. The external auditory canal, the internal auditory meatus and the petromastoid canal progressively reach the adult aspect because of the growth of the petrous bone. This work aims to highlight the particularities of the petrous bone CT in pediatrics, since it has become widely used in the exploration of malformations, trauma, infectious complications of the ear and in the assessment of deafness.

关键词： Petrous Bone children CT Ear Development

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Acute cardiogenic liver injury caused by heart failure in an adolescent

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Hepatobiliary & Pancreatic Diseases International 2021年第2期20卷 196-197页

作者： Chun-Hong Xie Jie Shen Qing Zhang Jian Hu Fang-Qi Gong department of cardiology Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052China

To the Editor:Heart failure is a systemic clinical syndrome characterized by multiple organ systems involvements[1].With the progression of heart failure,patients may present with liver-related symptoms.However,these symptoms may be misdiagnosed as primary gastrointestinal diseases which lead to treatment delay and aggravation of conditions.We retrospectively reviewed the liver function changes in an adolescent with heart failure,which will help clinicians better understand acute cardiogenic liver injury.

关键词： adolescent involvement liver

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Fibroblast growth factor 5 overexpression ameliorated lipopolysaccharide-induced apoptosis of hepatocytes through regulation of the phosphoinositide-3-kinase/protein kinase B pathway

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Chinese Medical Journal 2022年第23期135卷 2859-2868页

作者： Shengyu Cui Yuhua Li Xutao Zhang Bing Wu Ming Li Jixian Gao Lin Xu Hao Xia department of cardiology Renmin Hospital of Wuhan UniversityWuhanHubei 430060China Cardiovascular Research Institute Wuhan UniversityWuhanHubei 430060China Hubei Key Laboratory of cardiology WuhanHubei 430060China Intensive Care Unit Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital)Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430019China department of Geriatrics Renmin Hospital of Wuhan UniversityWuhanHubei 430060China

Background:Sepsis is a systemic inflammatory syndrome induced by several infectious agents.Multiple organs are affected by sepsis,including the liver,which plays an important role in metabolism and immune homeostasis.Fibroblast growth factors(FGFs)participate in several biological processes,although the role of FGF5 in sepsis is unclear.Methods:In this study,lipopolysaccharide(LPS)was administrated to mice to establish a sepsis-induced liver injury.A similar in vitro study was conducted using L-02 hepatocytes.Western blot and immunohistochemistry staining were performed to evaluate the FGF5 expression level in liver tissues and cells.Inflammatory cell infiltrations,cleaved-caspase-3 expressions,reactive oxygen species and levels of inflammatory cytokines were detected by immunofluorescence,dihydroethidium staining,and reverse transcription quantitative polymerase chain reaction analysis,respectively.Flow cytometry was used to detect the apoptosis level of cells.In addition,ribonucleic acid(RNA)-sequencing was applied to explore the possible mechanism by which FGF5 exerted effects.Results:LPS administration caused FGF5 down-regulation in the mouse liver as well as in L-02 hepatocytes.Additionally,with FGF5 overexpression,liver injury and the level of hepatocyte apoptosis were ameliorated.Further,RNA sequencing performed in hepatocytes revealed the phosphoinositide-3-kinase/protein kinase B(PI3K/AKT)pathway as a possible pathway regulated by FGF5.This was supported using an inhibitor of the PI3K/AKT pathway,which abrogated the protective effect of FGF5 in LPSinduced hepatocyte injury.Conclusion:The anti-apoptotic effect of FGF5 on hepatocytes suffering from LPS has been demonstrated and was dependent on the activation of the PI3K/AKT signaling pathway.

关键词： Apoptosis FGF5 Hepatocyte Liver PI3K/AKT Sepsis

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child retroperitoneal malignant teratoma at the mother and child university hospital Lagune of Cotonou:about a case

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World Journal of Pediatric Surgery 2020年第1期3卷 28-30页

作者： Antoine Seraphin Gbenou Jerome Bonou Michel Armand Fiogbe Rouma Sani Bankole Pediatric Surgery University Hospital of Mother and Child LaguneCotonouBenin Pediatric Surgery National University Hospital HKMCotonouBenin Pediatric Surgery University Hospital TreichvilleAbidjanCôte d'Ivoire

INTRODUCTION Retroperitoneal malignant teratoma is a rare congenital tumor,representing 1%-10%of retroperitoneal tumors in children.12 A pathological migration of primitive germ cells to the genital ridges can stop at various levels,which explains the localizations of these tumors.3 The diagnosis is done either prena-tally,or later in front of an abdominal mass.45 We reported a case treated in our department and reviewed the diagnostic and therapeutic aspects of its management.

关键词： malignant child diagnosis

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Significance of Normal Range Urinary Albumin to Creatinine Ratio in Chinese Subjects with Metabolic Syndrome

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Journal of Huazhong university of Science and Technology(Medical Sciences) 2015年第6期35卷 862-867页

作者：洪靖张金苹谢玲玎何一凡吕岩玉姜红邢小燕 department of Endocrinology China-Japan Friendship Hospital department of child Health Development Capital Institute of Pediatrics department of cardiology China-Japan Friendship Hospital

Summary： This study was aimed to investigate clinical features of Chinese metabolic syndrome （MS） subjects with normal urinary albumin to creatinine ratio （UACR） and to estimate independent correla- tion factor for UACR. Data were drawn from a cross-sectional survey in participants having MS. The patients with different grade of albuminuria were divided into 4 groups according to the value of UACR （〈10, 10-20, 21-30, 〉30 mg/g）. All underwent biochemical tests. Bioelectrical impedance body fat content, islet [3-cell function and insulin sensitivity were measured. Multivariable linear regression mod- els were applied to further determine association between UACR and clinical factors with adjustment. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial pressure （MAP）, fasting plasma glucose （FPG）, glycosylated hemoglobin （HbAlc）, TG, fat mass, fat content and homeostasis model assessment for insulin resistance （HOMA-IR） were significantly higher in the group with UACR at 10-20 mg/g than those in the group with UACA lower than 10 mg/g （P〈0.05）. Multivariable linear regression showed that TG, HbAlc, waist-hip ratio （WHR） and SBP were independently associated with UACR. The patients with normal UACR had abnormal levels of MS components. The factors in- dependently associated with UACR were TG, HbAlc, WHR and SBP.

关键词： metabolic syndrome microalbuminuria insulin resistance

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Down-regulation of Helios Expression in Tregs from Patients with Hypertension

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Journal of Huazhong university of Science and Technology(Medical Sciences) 2018年第1期38卷 58-63页

作者：陈朱越陈凤王燕鸽王定航蒋丽丽程龙献 Laboratory of Cardiovascular Immunology Institute of CardiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and Technology department of Adult Internal Medicine Hubei Maternal and Child Health Hospital

Regulatory T cells（Tregs） play a pivotal role in the pathological development of hypertension.Helios,a transcription factor from the Ikaros family,was recently reported to be a bona fide marker for natural Tregs or activated Tregs with suppression function,however,little has been known about its role in hypertension.This study was aimed to find whether Helios＋ Tregs really play a vital role in hypertension.A total of 60 hypertension patients,and 46 normotension subjects were enrolled in this study.Frequencies of different Tregs subsets in peripheral blood were measured by flow cytometry.Plasma cytokine level was determined by ELISA.The m RNA expression of Foxp3 and Helios in purified CD4＋ T cells was detected by RT-PCR.Proportion of CD4＋Foxp3＋Helios＋ Tregs was decreased significantly in patients with hypertension（62.52%±1.18% vs.71.89%±1.03%,P〈0.01）,and it was correlated with plasma level of IL-10 positively（r=0.505,P〈0.05） and plasma level of IFN-gamma negatively（r=–0.551,P〈0.05）.The m RNA expression of Foxp3（7.23±1.00 vs.10.58±0.54,P〈0.05） and Helios（8.47±0.95 vs.15.52±2.0,P〈0.05） was decreased in CD4＋ T cells from patients with hypertension.Helios＋ Tregs were decreased in patients with hypertension and may play a protective role in hypertension progression.

关键词： hypertension cardiovascular disease regulatory T cells Helios Foxp3

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