ABSTRACT. Hand-foot-mouth disease (HFMD) is a common pediatric disease responsible for the development of rashes or herpes on the hand, foot, and mouth. Severe complications of HFMD include myocarditis, pulmonary edema, aseptic meningoencephalitis, and even death. Therefore, early diagnosis of HFMD is of particular importance. In this study, we determined the clinical value of the combined detection of liver function and high-sensitivity C-reactive protein (hs-CRP) expression in children with HFMD. Three hundred children with HFMD were recruited to this study between July 2013 and July 2015 and divided into the mild and severe HFMD groups (N = 150 per group). The liver function [aspartate aminotransferase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP) levels] and hs-CRP expression were evaluated using standardized tests, and the clinical value of combined detection of these indices (in parallel and serially) was determined. Patients in the severe HFMD group showed significantly higher levels of ALT, AST, ALP, and hs-CRP compared to those in the mild HFMD group (P < 0.05). The hs-CRP and liver function tests had low specificity and sensitivity, respectively. However, parallel combined detection improved the sensitivity and negative predicted value of these indices, whereas serial combined detection improved the specificity and positive predicted value. In conclusion, hs-CRP and liver function play a major role in the diagnosis of HFMD (and identifying its severity), and serial combined detection of these indices enhances the positive predicted value, and could be employed to diagnose severe HFMD at an earlier stage.
Objective:To analyze the significance of myocardial enzymes, cardiac troponin T (cTnT) and hepatic and renal function in the treatment of severe pneumonia in children.Methods:One hundred and twenty children with severe pneumonia who were admitted to the hospital between April 2015 and February 2017 were selected and included as a severe pneumonia group; 120 children with common pneumonia were included as a common pneumonia group; 100 healthy children were included as controls. The myocardial enzymes, cTnT and hepatic and renal function of patients in the three groups were detected and compared. The children with severe pneumonia were divided into a mild hypoxia group, a moderate hypoxia group and a severe hypoxia group according to arterial partial pressure of oxygen; the myocardial enzymes, hepatic and renal function and cTnT of the children in the three groups were compared. The correlations of partial pressure of blood oxygen with myocardial enzymes, hepatic and renal function and cTnT were analyzed.Results:The levels of myocardial enzymes, hepatic and renal function and cTnT of the severe pneumonia group, common pneumonia group and control group declined, and the differences had statistical significance (P<0.05). The levels of myocardial enzymes, hepatic and renal function and cTnT were higher in the children with severe hypoxia. The partial pressure of blood oxygen was in a negative correlation with myocardial enzymes, hepatic and renal function and cTnT in the severe pneumonia group.Conclusion:Timely monitoring of myocardial enzymes, hepatic and renal function and cTnT has an extremely important role in the evaluation of children with severe pneumonia.
Objective: To investigate effects of prenatal screening and non-invasive gene sequencing on the clinical diagnosis of fetal birth defects and the outcome of pregnancy. Methods: Totally 2520 pregnant women who received prenatal screening in our hospital were selected as the research subjects. The high-risk pregnant women were further tested by the non-invasive gene sequencing technology. Pregnant women with positive results were diagnosed by amniocentesis and fetal chromosome karyotype analysis, and the pregnancy outcome was followed up for one year. Results: 870 out of the 2520 pregnant women was tested by non-invasive gene sequencing technology; 26 of the 870 women was 13-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 22 of which was diagnosed as 47, XN, +13 and four of which was normal; the diagnosis accuracy of non-invasive prenatal testing (NIPT) was 84.6%. 18 out of the 22 confirmed cases underwent abortion, three cases had termination of embryonic development, and one case had postnatal anomaly. Thirty four out of the 2520 pregnant women was 18-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 31 of which was diagnosed as 47, XN, +18 and three cases were normal; the diagnosis accuracy of NIPT was 91.2%. 29 out of the 31 confirmed cases underwent abortion and two cases had termination of embryonic development. Forty out of the 2520 pregnant women was 21-trisomy-positive and was diagnosed by amniocentesis and fetal chromosome karyotype analysis, 39 of which was diagnosed as 47, XN, +21 and one case was normal; the diagnosis accuracy of NIPT was 97.5%. Thirty four out of the 39 confirmed cases underwent abortion, three cases had termination of embryonic development, and two cases had postnatal anomaly. Twenty eight cases were tested as sex chromosome-positive and were diagnosed by amniocentesis and fetal chromosome karyotype analysis, 25 out of which was diagnosed as abnormal and three cases were normal; the diagnosis accuracy of NIPT was 89.3%. 24 out of the 25 confirmed cases underwent abortion, and one case had termination of embryonic development. Conclusion: Prenatal screening and non-invasive gene sequencing technology have a high accuracy in the diagnosis of fetal birth defects, which can reduce the maternal abortion injury as much as possible and relieve the psychological pressure. The promotion of the mode can be strengthened in clinics. doi: https://doi.org/10.12669/pjms.36.7.2290 How to cite this:Bu J, Jiang P, Cui X, Zhou H, Han F. Application values of prenatal screening and non‑invasive gene sequencing in fetal birth defects. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2290 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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