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06 May 2009, Volume 24 Issue 05 Previous Issue    Next Issue
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Study on serotype and the resistance of haemophilus influenzae from children with respiratory tract infection in Guangzhou. DENG Qiu-lian,DENG Li,XIE Yong-qiang,HUANG Yong,ZHONG Hua-min，ZHOU Zhen-wen，HUANG Xu-qiang，SHEN Xu-zhuang. 2009, 24(05): 362-365 .  Abstract ( )   Objective 　This study was designed to dynamically investigate resistance and serotyping of Haemophilus influenzae （Hi） isolated from children’s respiratory tract during 2000—2007. Methods　The specimens of sputum and swabes from children with acute respiratory tract infection were collected and incubated on improved Collumbia chocolate medium. Totally 381 Hi strains isolated during 2000—2003 were serotyped by Haemophilus Influenzae Antiserum. Results　The prevalence of β- lactamase was 30.75% in all Hi isolates. Hib and NTHi were 1.57% and 95.53% among 381 Hi strains isolated during 2000—2003. The Hi isolates were slightly resistant to amoxicillin-clavulanic ， ceftriaxone， cefaclor，and cefuroxime， the resistant rate to ampicillin and chloramphenicol being 12.61%～41.60% and 10.81%～21.11% respectively. About 13.51%～44.24% of Hi isolates were resistant to tetracycline and 41.20% ～72.13% resistant to trimethoprim-sulfamethoxazole. Conclusion　NTHi is the major serotype of Hi in children with acute respiratory tract infection . The prevalence of Hib is low. The resistant rate to ampicillin， chloramphenicol， tetracycline and trimethoprim-sulfamethoxazole are increasing. The use of β-lactamase is the first choice in the treatment of infections caused by Hi.

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Analysis of the clinical phenotype and pathogenesis in seven children with 22q11.2 deletion syndrome. WU Xiao-yun,TIAN Jie,Nick Archer. 2009, 24(05): 366-368 .  Abstract ( )   Objective　This retrospective study is designed to improve our understanding and diagnosis ability by analyzing the various clinical features and its pathogenesis in children with 22q11.2 deletion syndrome. Methods　Seven patients confirmed with 22q11.2 DS who were diagnosed in individuals with a submicroscopic deletion of chromosome 22 detected by molecular cytogenetic analysis were reviewed. We analyzed their clinical characteristics， diagnosis evidences and management. Results　There were 2 boys and 5 girls in this group； one of them was prenatal diagnosis， and others were confirmed at the mean age of two months. The clinical findings comprised of one hundred percent of heart malformation and anomaly face， immune deficiency present in 28.6%， hypocalcemia and cleft palate present in 14.3%. All cases were confirmed by FISH test， managed with usual manners depending on the individuals clinical features. Conclusion　Heart malformation and anomaly face are the prominent characteristics in this group of 22q11.2 DS. It is mainly caused by gene mutation and can be diagnosed early in life by individuals clinical features and FISH test. The cardiovascular defects involved with outflow tract problems and immunodeficiency secondary to the T-cell production abnormality are the key factors related to the anticipation.

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Influence of prednisone on CD4+CD25+ regulatory T cell in children with primary nephrotic syndrome. YANG Jun,LI Cheng-rong，HUANG Hui-jun,ZU Ying，WANG Guo-bing，LI Yong-bai，ZHANG Lei. 2009, 24(05): 369-371 .  Abstract ( )   Objective 　To study the changes of CD4+CD25+ Tr in primary nephrotic syndrome before and after treatment with prednisone.To explore the immuno-pathogenesis in children with primary nephrotic syndrome. Methods　A total of 42 patients with PNS in Shenzhen Children's Hospital from 2004 to 2007 were divided into the steroid-responsive group （32 cases） and the steroid-resistant group（10 cases）， and 20 age-matched healthy subjects were studied. Before and after treatment ，flow cytometric analysis （FCM） was performed to detect the percentage of T cells subpopulation （including CD3+CD4+CD8-，CD3+CD4-CD8+、CD4+CD25+Tr） ； real-time PCR was used to detect Foxp3 ， CTLA-4 and GITR mRNA expression in peripheral blood mononuclear cell （PBMC）.Results　Compared with healthy control subjects ， the percentage of CD3+CD4+CD8- T cell ， CD3+CD4-CD8+ T cell and CD4+CD25+ Tr cell in patients with PNS had no change . The percentage of CD4+CD25+Tr of the steroid-responsive group was significantly higher after treatment with prednisone than before（P < 0.01）. The percentage of CD4+CD25+Tr of steroid-resistant group had no change before and after treatment（P > 0.05）. At the same time， after treatment ，the Foxp3 ， CTLA-4 and GITR mRNA expression in PBMC were significantly higher in the steroid-responsive group， while in the steroid-resistant group the Foxp3 ， CTLA-4 mRNA expression had no change， and only GITR mRNA expression was significantly higher. Conclusion　The glucocoticoid drugs （including prednisone） might perform immunotherapy effect through upregulating CD4+CD25+ Tr gene expression in steroid-responsive children with PNS.

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Research on right ventricular function in neonates with hypoxia-induced pulmonary artery hypertension by the Tei index of right ventricle. LI Ming-xia,ZHU Yan-ping，TANG Qi. 2009, 24(05): 372-374 .  Abstract ( )   Objective　To investigate the roles of the Tei index of right ventricle （RV-Tei） in assessing right ventricular function in neonates with HPH. Methods　Echocardiographic examinations were performed on day 3 on 75 cases （HPH group）， which included 29 cases of mild HPH， 21 cases of moderate HPH and 25 cases of severe HPH , and 22 cases of neonates as control group， and pulmonary artery systolic pressure （PASP）， right ventricular ejection fraction （RVEF）， tricuspid early diastolic peak （peak E）and the late diastolic peak （peak A） were estimated， and E/A ratio was acquired. The Tei index of right ventricle （RV-Tei） was measured by Doppler spectrum. Results　（1） Comparing the neonates of HPH groups with the control group， the RVEF and E/A ratio of right ventricle was decreased significantly in severe HPH group （ P < 0.01）， while in the other two groups there was no statistical difference. （2） The RV-Tei in three HPH groups was higher than the control group （ P < 0.01）. The RV-Tei in the three HPH groups had statistical difference （P < 0.05）.（3） RV-Tei and PASP in HPH group were positively correlated （ r = 0.75， P < 0.05）， but had no correlation with their gestational age， birth weight and heart rate. Conclusion　Neonatal pulmonary artery hypertension can lead to disorders of the right ventricular function. RV-Tei index can evaluate early overall changes of the right ventricular function and is better than conventional ultrasound technology in newborns with HPH.

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Effect of the application of recombinant human erythropoietin on retinopathy of prematurity. HE Jin-shui，HUANG Zhong-ling,YANG Hong,WENG Kai-zhi,ZHU Shao-bo,LUO Tian-chang,ZHANG Bao-xian,CAI Hui-fang,ZHOU Ji-guang. 2009, 24(05): 375-378 .  Abstract ( )   Objective　To evaluate the effect of the application of recombinant human erythropoietin （rhu-EPO） on retinopathy of prematurity（ROP）. Methods　All the clinical data of in-patient infants whose body weights were no more than 1500g during the period from March 2005 to June 2008 were reviewed. The group treated with rhu-EPO had 94 infants. Control group of 65 infants were not treated with rhu-EPO. Perform examination of fundus to the infants who were postnatal 6 weeks or whose correctal gestational ages were 35 weeks. Diagnosis and staging of ROP were established according to the international guidelines， and statistical analysis was done on several correlation factors at the same time. Results　Treatment group had higher incidence rate of serious ROP than control group （P < 0.05）.Analysis of single factor showed no-less-than 10 doses of rhu-EPO treatment had higher risk of serious ROP than less than 10 doses of rhu-EPO treatment （r = 6.429，P < 0.001）. The beginning therapy time no less than fourteen days had higher risk of serious ROP than that of less than fourteen days（r = 46.000，P < 0.001）. Logistic analysis of multiple factors displayed that no less than 10 doses of rhu-EPO treatment had higher risk of serious ROP（r = 9.348，P < 0.001）.Conclusion The application of recombinant Human Erythropoietin （rhu-EPO） is an independent risk factor of retinopathy of prematurity.

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A controlled study on efficacy of different mechanical ventilation mode for neonates with meconium aspiration syndrome. XIA Yao-fang,LIU Cui-qing,WEI Su-fang,Zhang Gu-ying. 2009, 24(05): 379-382 .  Abstract ( )   Objective　To compare the effect and the differences of complication incidence rate of different mechanical ventilation mode in neonates with meconium aspiration syndrome. Methods　Eligible patients diagnosed with severe MAS admitted consecutively to Neonatal Intensively Care Unit （NICU）of Hebei Children Hospital from July 2006 to July 2008 were included in the study.The patients with an oxygenation index（OI） ≥15 were randomized in a non-blinded manner to receive different mechanical ventilation . They were assigned randomly into Group A（HFOV，n = 25） ，Group B（SIPPV+VG，n = 29） and GroupC（IMV，n = 30）. OI and a/APO2 were monitored at 0 h，24 h，48 h and 72 h after mechanical ventilation . Frequent hemorrhoid and the incidence of interventtricular hemorrhage were recorded. A prospective study was carried on. Informed consent was obtained from parents before enrollment. The protocol and the informed consent forms were approved by the Institutional Review Board .Results　At the beginning of the treatment，no significant differences were detected in OI and a/APO2 among three groups .24 hour later，OI and a/APO2 of group A and group B changed significantly（P＜0.05）. While in group C，the difference was not found until 72 hours. There were no significant differences in OI and a/APO2 between groupA and group B. There were significance difference in statistics between group A and group C as well as group B and group C（P＜0.05）. The incidence rate of lung frequent hemorrhoid and ventilation associated pneumonia in group A and group B were lower than group C . There were no significant differences in the mortality and incidence rate of intracranial hemorrhage among 3 groups （P > 0.05）. Conclusion　Compared with IMV，HFOV and SIPPV+VG can improve oxygenation condition， shorten ventilation time， and decrease the lung frequent hemorrhoid and ventilation-associated pneumonia.It may be conducted as a safe therapy method for MAS.

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Study on the relationship between plasma leptin ， neuropeptide Y and motilin and gastric emptying in children with anorexia. XIAO Man-tian，QIU Xiao-shan，CAI Yong-yi. 2009, 24(05): 383-385 .  Abstract ( )   Objective　To investigate the relationship between the levels of plasma leptin、neuropeptide Y and motilin and gastric emptying in children with anorexia. Methods　From September 2007 to August 2008 in Liwan Hospital Affiliated Hospital of Guangzhou Medical College， the levels of plasma neuropeptide Y and motilin were measured by immunoradioassay and the level of leptin was measured by ELISA in 40 anorectics children and 30 healthy children. All of them received gastric emptying test. Results The levels of plasma leptin、 neuropeptide Y and motilin in anorectics children were significantly lower than those of healthy children （P < 0.01）. Gastric emptying test showed the rate of gastric antrum remaing in anorectics children was higher than that of healthy children in postprandial 60 mins ， 90 mins and 120 mins respectively. The rate of gastric antrum remaing in postprandial 30 mins was similar in two groups. Conclusion　The decreased level of plasma inhibiting factors leptin does not lead to anorectics ； the decreased level of plasma aperitive factors neuropeptide Y can lead to motilin decrease ； gastric emptying disturbance can increase gastric retention.The feedback control mechanism of plasma inhibiting factors leptin and aperitive factors neuropeptide Y might be disturbed.

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Effect of delayed ligature of the umbilical cord on the blood inculcation of neonates via caesarean section in early time. LIU Shao-ji，LI Xiao-ling，MA Ke-ze. 2009, 24(05): 386-387 .  Abstract ( )   Objective　To evaluate the effect of delayed ligature of the umbilical cord on he blood inculcation of neonates via caesarean section in early time. Methods　From July 2007 to September 2009，137 newborns in Department of Neonatology，Dongguan Shilong Boai Hospital were randomly divided into routine ligature of the umbilical cord group （71 cases） and delayed ligature umbilical group （66 cases）； comparison was made on delayed ligature time， blood routine examination at 48 h after birth ，hemobilirubin and anemia incidence 3 days after birth. Results　There was significant difference between the 2 groups in delayed ligature time， blood routine examination at 48 h after birth ，and the incidence rate of anemia， which was decreased significantly in delayed ligature umbilical group （P < 0.05）. Conclusion　Delayed ligature of umbilical cord has a significant influence on hemoglobin and hematocrit of newborn via caesarean section in early time， and it can reduce the incidence of anemia.