Weihua Zhu

Zhejiang Medical University, Hang-hsien, Zhejiang Sheng, China

Are you Weihua Zhu?

Claim your profile

Publications (10)23.44 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To analyze the clinical characteristics, treatment, and outcomes of Kawasaki Disease (KD) patients associated with macrophage activation syndrome (MAS), and compare two diagnostic standards (HLH 2009 and Ravelli’s criteria). Methods All of the studied patients with Kawasaki Disease (KD) were treated at The Children's Hospital, Zhejiang University School of Medicine, during 2007-2010. Clinical and laboratory findings were analyzed. Results In 719 KD patients, eight patients (1.11%, 81.3±49.4 months, all male) were diagnosed by Ravelli’s criteria, but only three (0.42%) patients were diagnosed by HLH 2009 criteria. Aspartate aminotransferase increased significantly in all cases. Alanine aminotransferase, lactate dehydrogenase, and serum ferritin increased significantly in seven cases. Cytopenia and hypertriglyceridemia (>1.5 mmol/L) were found in six and five cases, respectively. Hypofibrinogenemia (<1.5 g/L) was found in two cases. Three cases showed evidence of hemophagocytosis, but only one case met the HLH 2009 criteria. Ectasia of the coronary arteries occurred in two cases. Seven patients were non-responsive to IVIG. One case died after the combined application of DXM, VP16, and CSA. Conclusions MAS may be a frequently under-recognized complication of KD, because the understanding of complications and diagnostic criteria are still in progress. HLH 2009 criteria have low sensitivity and specificity for the diagnosis of MAS complicating KD. When hepatosplenomegaly is present in KD patients with abnormal laboratory findings, such as cytopenia, liver dysfunction, hyperferritinemia, elevated serum LDH, hypofibrinogenemia, and hypertriglyceridemia, the presence of MAS should be considered.
    Seminars in Arthritis and Rheumatism 08/2014; 44(4). DOI:10.1016/j.semarthrit.2014.07.007 · 3.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme for folate metabolism in humans; it is encoded by the MTHFR gene. Several studies have assessed the association between MTHFR C677T polymorphism and the risk of congenital heart defects (CHDs), while the results were inconsistent. Multiple electronic databases were searched to identify relevant studies published up to July 22, 2012. Data from case-control and TDT studies were integrated in an allelic model using the Catmap and Metafor software. Twenty-nine publications were included in this meta-analysis. The overall meta-analysis showed significant association between MTHFR C677T polymorphism and CHDs risk in children with heterogeneity (P heterogeneity = 0.000) and publication bias (P egger = 0.039), but it turned into null after the trim-and-fill method was implemented (OR = 1.12, 95% CI = 0.95-1.31). Nevertheless, positive results were obtained after stratified by ethnicity and sample size in all subgroups except the mixed population. For mothers, there was significant association between the variant and CHDs without heterogeneity (P heterogeneity = 0.150, OR = 1.16, 95% CI = 1.05-1.29) and publication bias (P egger = 0.981). However, the results varied across each subgroup in the stratified analysis of ethnicity and sample size. Both infant and maternal MTHFR C677T polymorphisms may contribute to the risk of CHDs.
    PLoS ONE 03/2013; 8(3):e58041. DOI:10.1371/journal.pone.0058041 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to investigate the expression of receptor for advanced glycation end products (RAGE) on the surface of circulating endothelial cells (CECs) in patients with Kawasaki disease (KD). The positive rate of RAGE on the surface of CECs (CECs-RAGE/CECs) and the fluorescence intensity of RAGE on the surface of CECs (FI-RAGE-CECs) were evaluated in 89 patients with KD in the acute stage (A-KD), subacute stage (SA-KD), or convalescent stage (C-KD). CECs-RAGE/CECs and the FI-RAGE-CECs increased significantly in patients with KD. The CECs-RAGE/CECs was significantly higher in C-KD patients with coronary artery lesions (CALs) than in those without CALs. The FI-RAGE-CECs level was significantly higher in SA-KD and C-KD patients with CALs than in A-KD patients. In SA-KD and C-KD patients, the CECs-RAGE/CECs and FI-RAGE-CECs levels decreased in intravenous immunoglobulin (IVIG)-respondent patients but increased progressively in IVIG-resistant patients and were significantly higher in IVIG-resistant patients than in IVIG-respondent patients. The results suggest that the expression levels of RAGE on the surface of CECs are upregulated in KD patients, and that the upregulated expression levels of RAGE on the surface of CECs can be aggravated in SA-KD and C-KD patients with CALs, and also in IVIG-resistant SA-KD and C-KD patients. The RAGE expression on CECs is involved in the pathophysiology of KD.
    Pediatric Research 02/2012; 71(6):720-4. DOI:10.1038/pr.2012.27 · 2.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Anomalous origin of the pulmonary artery (AOPA) from the aorta is a rare congenital heart malformation. This report describes a case of AOPA from the abdominal aorta in association with an aberrant right subclavian artery and a patent ductus arteriosus, which never has been reported previously in the literature.
    Pediatric Cardiology 02/2011; 32(5):674-7. DOI:10.1007/s00246-011-9923-x · 1.55 Impact Factor
  • Weihua Zhu, Henning Neubauer
    [Show abstract] [Hide abstract]
    ABSTRACT: Interventional occluder implantation has become the preferred mode of treatment in children with clinically significant atrial septal defect (ASD). The continuous increase in the number of patients treated calls for long-term data on device integrity and biocompatibility. We report a child who underwent successful interventional ASD closure at age 5 years. Secondary residual shunt occurred after 3 years of follow-up, and surgical ASD closure became necessary at age 12 years. The Amplatzer occluder device, which was removed after 7 years in vivo, showed no signs of mechanical failure, corrosion, or clinically relevant immunological response at the device-tissue interface.
    Pediatric Cardiology 10/2010; 31(7):1107-10. DOI:10.1007/s00246-010-9757-y · 1.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Congenital diverticulum of the ventricle is a rare disease, but most cases of congenital left ventricular diverticula are asymptomatic. We present a child with congenital left ventricular diverticulum whose routine electrocardiographic examination showed T-wave inversion in inferior and V4 to V6 leads. He was successfully repaired surgically.
    Pediatric Cardiology 08/2010; 31(6):881-3. DOI:10.1007/s00246-010-9719-4 · 1.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate the expression of S100A12 on the surface of circulating endothelial cells (CECs) in children with Kawasaki disease (KD) and the correlations between S100A12 and coronary artery lesions (CALs). The ratio of CECs to mononuclear cells (CECs/MNC), the positive rate of S100A12 on CECs surface (CECs-S100A12/CECs), and the fluorescence intensity of S100A12 on CECs surface (FI-S100A12-CECs) were evaluated respectively in 42 patients with acute stage (A-KD), subacute stage (SA-KD) and convalescent stage KD (C-KD). The CECs/MNC ratio increased significantly in patients with A-KD and SA-KD with CALs. The CECs-S100A12/CECs rate and FI-S100A12-CECs level were significantly higher in patients with KD than in the controls. The FI-S100A12-CECs level decreased to near half levels in patients with SA-KD and C-KD without CALs, but increased continuously in patients with SA-KD with CALs. The CECs/MNC ratio and FI-S100A12-CECs level in patients with SA-KD with CALs were significantly higher than in patients with SA-KD without CALs. The FI-S100A12-CECs level was significantly higher in patients with C-KD with CALs than in C-KD without CALs. The S100A12 expression on the CECs surface increased significantly in patients with KD and persisted for a longer time in patients with CALs, suggesting that the S100A12 expression on CECs may be involved in the development of CALs.
    Pediatric Research 05/2010; 68(2):165-8. DOI:10.1203/PDR.0b013e3181e67ce8 · 2.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Elevated plasma homocysteine is widely seen as an independent risk factor of cardiovascular disease in adults. In order to investigate the role of homocysteine in a paediatric population at risk for early atheroclerosis, we studied plasma homocysteine in obese schoolchildren and non-obese peers. Plasma homocysteine, serum vitamin B12 and serum folic acid were determined in 41 obese and 27 control subjects and related to carotid intima-media thickness and flow-mediated dilatation measured on high-resolution ultrasonography. Homocysteine, vitamin B12 and folic acid were all significantly elevated in obese children. In girls, plasma homocysteine correlated significantly with body mass index (r=0.56, p=0.002), increased ICA intima-media thickness (r=0.39, p=0.035) and flow-mediated dilatation (r=-0.40, p=0.031). In boys, none of these associations reached significance (all p>0.234). No independent association of homocysteine with IMT and FMD was seen after adjustment for BMI. Conclusion: Plasma homocysteine is elevated in obese schoolchildren with hypertension and dyslipidaemia, particularly in girls. This may indicate a high-risk constellation, so that plasma homocysteine should be monitored in these children.
    European Journal of Pediatrics 05/2006; 165(5):326-31. DOI:10.1007/s00431-005-0033-8 · 1.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Since December 2001, a total of 52 obese schoolchildren and 38 non-obese controls have undergone vascular ultrasound at our institution. From this cohort, we enrolled 40 obese children (16 girls, median age 12 years, mean body mass index (BMI) 27.5+/-4.6 kg/m2) and 26 non-obese peers (12 girls, median age 12 years, mean BMI 16.1+/-2.4 kg/m2) for the present study. We analysed the association between obesity, subclinical atherosclerosis and haemorheological variables, including whole blood viscosity (WBV) at four different shear rates (200 s-1, 30 s-1, 5 s-1 and 1 s-1), plasma viscosity, and serum lipid concentrations. Blood lipids and apolipoproteins were also determined and correlated with carotid intima-media thickness (IMT) and flow-mediated dilatation (FMD) of the brachial artery, measured by high-resolution ultrasonography. WBV at 200 s-1, 30 s-1 and 5 s-1, as well as plasma viscosity, were significantly higher in the obesity group (all P <0.01). No difference was seen for WBV at 1 s-1, erythrocyte aggregation and haematocrit. WBV at high shear rates was significantly associated with BMI, increased IMT and decreased FMD ( P <0.05). After controlling for BMI on stepwise linear regression, WBV at 30 s-1 was the strongest predictor of IMT ( P < 0.01) and FMD ( P < 0.05) among our study variables. CONCLUSION: Hyperviscosity is related to subclinical atherosclerosis in obese schoolchildren. Viscosity parameters contribute new information in addition to body mass index, blood pressure and blood lipids and may help to facilitate risk stratification in obese paediatric patients.
    European Journal of Pediatrics 11/2005; 164(10):639-45. DOI:10.1007/s00431-005-1725-9 · 1.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We studied ultrasonographic signs of early atherosclerosis in relation to established risk factors of cardiovascular disease in 43 obese school-age children compared to 28 non-obese controls. The groups did not show significant differences in age, gender ratio and body height. Mean carotid intima-media-thickness (IMT), carotid haemodynamic parameters, flow-mediated dilatation of the brachial artery (FMD), and biochemical markers of dyslipidaemia were measured and correlated. IMT was significantly increased (0.62 mm vs. 0.46 mm, P <0.001) and FMD was markedly reduced (10.9% vs. 18.8%, P <0.001) in the obesity group. Differences in IMT and FMD persisted after adjustment for Body Mass Index (BMI) and blood pressure on ANCOVA. BMI was highly associated with increased IMT ( r =0.58, P <0.01) and reduced FMD ( r =-0.42, P <0.01), as were blood levels of total cholesterol, LDL cholesterol and Apo B. Conclusion:Childhood obesity seems to contribute to the development and progression of early atherosclerosis, particularly in combination with hypertension and dyslipidaemia. In order to prevent coronary atherosclerosis and other cardiovascular complications, it is vital to control obesity starting from childhood. Ultrasonography of the arterial wall may be used in a clinical setting to identify high-risk patients among severely obese children.
    European Journal of Pediatrics 07/2005; 164(6):337-44. DOI:10.1007/s00431-005-1642-y · 1.98 Impact Factor