Objective To analyze the clinical features and risk factors of invasive fungal infections (IFI) in children with acute leukemia.Methods Ninety-six acute leukemia children complicated with IFI admitted in Guangzhou Women and Children's Medical Center during January 2005 and February 2017 were retrospectively reviewed, and 96 cases of acute leukemia without IFI admitted at the same period were randomly selected as control group.The clinical manifestations of IFI were analyzed, multivariate Logistic regression was used to study risk factors of the complication of IFI in pediatric acute leukemia.Results Among 96 children complicated with IFI, fungus were detected in samples from sputum, bronchoalveolar lavage fluid, or blood in 78 cases, in which 42 cases (43.75％) were oral infection, 36 cases (37.50％) were pulmonary infection.Candida albicans (33.33％, 26/78) was the most commonly isolated pathogen, followed by Candida parapsilosis (20.51％, 16/78) and Candida tropicalis (20.51％, 16/78).Univariate analysis revealed hormone-containing chemotherapy, neutropenia (＜ 0.5 × 109/L), time duration of neutropenia ≥ 10 days, usage of carbapenem antibiotics and combined drug administration ≥2 types were associated with fungal infection (P ＜ 0.05 or ＜0.01).Multivariate Logistic regression showed that the time duration of neutropenia ≥ 10 days (OR =11.390, 95％ CI 4.145-55.263, P ＜ 0.01),usage of carbapenem antibiotics (OR =4.825, 95％ CI 1.681-13.842, P ＜ 0.01) and hormone-containing chemotherapy (OR =2.220, 95％ CI 1.542-8.246, P ＜ 0.05) were the independent risk factors of IFI.Conclusion Rational usage of antibiotics and effective measures taken to restore the granulocytes can help to reduce the incidence of IFI in children with acute leukemia.

目的:探讨婴幼儿期患有慢性支气管感染小儿血液中25(OH)D3、BALP、HGB、锌(Zn2+)、钙(Ca2+)、铁(Fe2+)值变化规律,为临床治疗学提供实验依据.方法:收集临床资料应用配对研究的方法,在两组小儿人口学一致的条件下将患病组与正常对照组(体检组)血液检测25(OH)D3、BALP、HGB、Zn2+、Ca2+、Fe2+并对比研究分析.结果:1000例慢性支气管感染组小儿血25(OH)D3HGB、Zn2+、Ca2+、Fe2+值均低于正常对照组,BALP值升高,两组样本对比差异有统计学意义.结论:慢性支气管感染患儿存在明显的微量营养不足的情况,在治疗呼吸道感染同时重视营养支持、指导喂养、及时补充鱼肝油、微量元素,增加机体免疫力抵抗力对呼吸疾病的恢复有帮助.

Objective:To explore the change regularities of 25(OH)D_3,BALP,HGB,Zn2+,Ca2+,and Fe2+ levels in blood samples of infants with chronic bronchial infection,provide an experimental basis for clinical treatment. Methods:The clinical data of infants with chronic bronchial infection were collected,matching research method was used in the study,the values of 25(OH)D_3,BALP,HGB,Zn2+,Ca2+,and Fe2+ in blood samples of case group and control group were compared and analyzed under the circumstance of the same demographic characteristics. Results:The values of 25(OH)D_3,HGB,Zn2+,Ca2+,and Fe2+ in blood samples of case group were significantly lower than those in control group,the value of BALP in case group was significantly higher than that in control group,there was statistically significant difference between the two groups. Conclusion:The infants with chronic bronchial infection have obvious deficiency of trace elements,at the same time of treating respiratory infection,paying attention to nutritional support,directing feeding,supplying cod-liver oil and trace elements timely,improving immunity and resistance are helpful to recovery of the infants with respiratory diseases.

目的:探讨小儿消化道出血的病因构成。方法:将79例小儿消化道出血的临床资料进行分析,并且分析总结其病因。结果:79例患者中,有73例(92.4%)是明确具体出血部位的,其中29例为上消化道出血,40例是下消化道出血。十二指肠溃疡和肠套叠是上、下消化道出血的最常见病因,分别占总病例数的23.9%、24.3%。出血量:少量出血7例,中量出血61例,大量出血11例。结论:小儿消化道出血的病因多样、复杂,需要通过病史,根据出血量、速度、性状及伴随症状,再结合辅助检查结果进行诊断。