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The experimental research of the homemade atrial septal defect occluder device. CHEN Mingwu,LI Fen,CHEN Lanju 2007, 22(02): 95-97 .  Abstract ( )   AbstractObjectiveTo assess the biocompatibility and endothelialization of the homemade atrial septal defect occluder device. MethodsSix piglets were selected.Atrial septal defects with different diameters were created using the Brockenbrough needle and Rashkind balloon atrial septostomy.With the guidance of echocardiography and fluoroscopy,the propersized occluders were implanted corresponding to the stretched diameter of ASD measured by balloon.Two swine had been killed at 1 month,3 months and 6 months after transcatheter procedure.Macroscopic,microscopic assessment and scanning electron microscope (SEM) were done on the explanted devices. ResultsMacroscopic examination showed no excrescence,thrombus formation,arm fractures and corrosion.The devices were covered with collagen fibrosis and discrete endocardial cells,apparent inflammatory infiltration in the devices and around the devices 1 month after implantation.The implants were nearly endothelialized,while the inflammatory reaction relieved gradually,with myocardial cells ingrowth at the edges of the device 3 months after implantation.The devices were completely covered with endocardium and fibrous tissue.Moreover,endothelial cells could be found on the smooth microscrew adaptor.The inflammatory reaction diminished with a few chronic inflammatory cells existing.Neovascularization and lymphatic vessels ingrowth could be observed 6 months after implantation. ConclusionThe homemade atrial septal defect occluder device has good biocompatibility,nearly endothelialized at 3 months,completely by 6 months.

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Treatments and followup studies of conduction system abnormalities after transcatheter closure of ventricular septal defects. LIU Tingliang,WANG Yulin,ZHANG Jianjun 2007, 22(02): 98-100 .  Abstract ( )   AbstractObjectiveDo followup investigations on the conduction system abnormalities after transcatheter closure of ventricular septal defects,and assess the clinical results. MethodsA total of 89 patients with VSD underwent transcatheter occlusion.Followup studies including chest Xray,electrocardiogram (ECG) and transthoracic echocardiography (TTE) were done after the procedure. ResultsAmong 89 cases,Amplatzer membranous VSD occluders were used in 67 patients,homemade symmetric VSD occluders were used in 20 patients,Amplazter duct occluder and pfm coil were used in one case,respectively.ECG followup studies showed that 2 patients developed transient complete atrioventricular block after closure,and both recovered after temporary pace maker implantation and/or transvenous use of desamethasone.And there were 3 cases of complete left bundle branch block,3 cases of complete right bundle branch block,5 cases of incomplete right bundle branch block,2 cases of left anterior hemiblock and 1 case of accelerated atrioventricular junctional tachycardia combined with complete left bundle branch block happened after closure. ConclusionConduction blockades are the common complications after transcatheter closure of VSD,most of them having benign courses.To be noted and treated in time is the key points.Further followup studies are required to document the long term efficacy and safety,especially the effect on the intracardiac conduction.

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A survey on dyslipidemia of 6~18year old children in Beijing area. LIU Ying,MI Jie,DU Junbao. 2007, 22(02): 101-102 .  Abstract ( )   AbstractObjectiveThe present study was designed to understand the prevalence of dyslipidemia in children aged 6 to 18 years in Beijing area. MethodsCluster random sampling methods were used in the investigation.During April to October in 2004,our epidemiological survey group developed field investigations to 19,593 children and adolescents aged 6 to 18 years in Beijing area.Fasting capillary blood total cholesterol (TC) and triglyceride (TG) were detected. ResultsTotal prevalence rate of hyperlipidemia in Beijing children was 9.61 percent.About 1.21 percent children had higher TC than normal value；8.79 percent had high TG level.Only 0.39 percent people had both high TC and TG level.The prevalence rate of urban children was 10.55 percent,10.16 percent in boys and 10.94 percent in girls.The prevalence rate of dyslipidemia in countryside was 8.62 percent,6.11 percent in boys and 11.18 percent in girls. ConclusionThe prevalence rate of children hyperlipidemia in Beijing significantly increases compared to previous studies.This came with epidemiological characteristics of urbancountryside,gender or age differences. KeywordsLipid;Children and adolescents;Prevalence rate 论著 ek2007-02-0101-02 北京地区6~18岁儿童血脂紊乱现况调查 刘颖1，米杰2，杜军保1 基金项目：北京市科技计划项目(H030930030530及H030930030031) 1.北京大学第一医院儿科，北京100034；2.首都儿科研究所，北京100020 Email:junbaodu@ht.rol.cn.net 通讯作者：杜军保 目的通过大样本流行病学调查，了解目前北京地区儿童青少年血脂现状及血脂紊乱的患病水平，以期为动脉粥样硬化的早期预防提供科学依据。 方法采用整群抽样的方法，于200404—200410组织流行病学调查组，对北京市7个城、郊区县的19593名6~18岁儿童青少年进行现场调查，对其空腹末梢血总胆固醇(TC)和甘油三酯(TG)进行检测，从而对北京地区6~18岁儿童青少年的血脂紊乱情况进行横断面流行病学研究。 结果北京地区儿童高脂血症总患病率为9.61%(1874/19501)，其中TC增高者占调查者的1.21%(236/19501)，TG增高者占8.79%(1714/19501)，TC、TG同时增高者占0.39%(76/19501)；城区儿童高脂血症患病率10.55%(1053/9978)，男生患病率10.16%(503/4950)，女生患病率10.94%(550/5028)；郊区儿童该病患病率8.62%(821/9523)，男生患病率6.11%(294/4811)，女生患病率11.18%(527/4712)。 结论北京市儿童高脂血症的现患率较前明显增高，且具地区、年龄、性别差异的流行病学特征。 血脂；儿童青少年；患病率 A survey on dyslipidemia of 6~18year old children in Beijing area. LIU Ying,MI Jie,DU Junbao.Department of Pediatrics,Peking University First Hospital,Beijing 100034,China AbstractObjectiveThe present study was designed to understand the prevalence of dyslipidemia in children aged 6 to 18 years in Beijing area. MethodsCluster random sampling methods were used in the investigation.During April to October in 2004,our epidemiological survey group developed field investigations to 19,593 children and adolescents aged 6 to 18 years in Beijing area.Fasting capillary blood total cholesterol (TC) and triglyceride (TG) were detected. ResultsTotal prevalence rate of hyperlipidemia in Beijing children was 9.61 percent.About 1.21 percent children had higher TC than normal value；8.79 percent had high TG level.Only 0.39 percent people had both high TC and TG level.The prevalence rate of urban children was 10.55 percent,10.16 percent in boys and 10.94 percent in girls.The prevalence rate of dyslipidemia in countryside was 8.62 percent,6.11 percent in boys and 11.18 percent in girls. ConclusionThe prevalence rate of children hyperlipidemia in Beijing significantly increases compared to previous studies.This came with epidemiological characteristics of urbancountryside,gender or age differences.

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Clinical value of the change of serum levels of S100B after open heart surgery of infant patients by cardiopulmonary bypass. GU Xinghua,LI Shouxian,ZHANG Gong 2007, 22(02): 103-104 .  Abstract ( )   AbstractObjectiveTo study on clinical value of the change of the blood serum levels of S100B after open heart surgery of infant patients by cardiopulmonary bypass(CPB). MethodsThirtytwo patients with congenital heart disease(CHD) were selected randomly.Before the operation of heart,at 2 hours,5 hours,12 hours,24 hours,48 hours and 7 days after CPB,whole blood was taken,and the blood serum levels of S100B were assayed by enzymelinked immunosorbent assay(ELISA) method.Data were analysed by statistics method. ResultsSerum level of S100B increased quickly\[(2.13±0.67)μg/L to (2.97±0.82)μg/L,from 2 hours to 5 hours after CPB，P<0.01\],then decreased quickly\[(2.97±0.82)μg/L to (1.07±0.26)μg/L,from 5 hours to 12 hours after CPB，P<0.01\],then decreased steadily\[(0.87±0.21)μg/L to (0.14±0.11)μg/L,from 1 day to 7 days after CPB，P<0.01\].It was slightly higher than the preoperative level\[(0.14±0.11)μg/L vs(0.08±0.04)μg/L，P<0.01\] at 7days after CPB and patients whose levels of S100B returned to the preoperative level were 53.1%(17/32). ConclusionBrain injuries of patients with CHD after CPB are mostly caused by CPB itself,being reversible mostly.Detecting the change of serum level of S100B has important clinical significance in predicting the progress of brain injuries and assessing therapeutic efficacy of patients with CHD after CPB.

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Echocardiography for prediction of spontaneous closure of patent ductus arteriosus in neonates and infants. CHEN Lianglong,OU Ping,ZHONG Ling 2007, 22(02): 105-107 .  Abstract ( )   AbstractObjectiveTo explore the ability of echocardiography for the prediction of spontaneous closure of patent ductus arteriosus (PDA) in neonates and infants and its clinical significance. MethodsFiftysix neonates and infants with PDA (8 premature infants,18 low birthweight infants),aged 15.8±12.3 days,underwent followup by serial echocardiography examination every 3 months for one year.The minimal diameter of PDA (MD2DE) was measured by twodimensional echocardiography (2DE),and the width of PDA shunting jet at its base (WJCDFI) assessed by colorcoded flow imaging (CDFI).The closure rate of PDA at every stage was indicated by CR3,CR6,CR9 and CR12,respectively. ResultsDuring one year followup,CR3,CR6,CR9 and CR12 was 23.2%,30.4%,32.1% and 32.1%,respectively.When four parameters from two techniques(MD2DE≤3mm and ≤2mm,MJCDFI≤3mm and ≤2mm) at the first measurement were used for prediction of spontaneous closure of PDA,the sensitivity was 46.9%、80.0%、65.0% and 83.3%(P<0.05),specificity was 87.5%,94.4%,86.1% and 81.9%(P<0.05),positive prediction value was 83.3%,88.9%,72.2% and 55.5%(P<0.05),negative prediction value was 55.3%,89.5%,81.6% and 81.8%(P<0.05),and accuracy was 64.3%,89.3%,78.6% and 82.1%(P<0.05). ConclusionSimple echocardiographic parameters are capable of prediction of spontaneous closure of PDA in neonates and infants,and may help to decide whether early intervention is necessary.

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Value of early diagnosis about urine epidermal growth factor level in children with HenochSchonlein purpura nephritis. SUN Qing,CHEN Zongbo,WANG Yibing 2007, 22(02): 108-110 .  Abstract ( )   AbstractObjectiveTo investigate the value of early diagnosis about urine epidermal growth factor( EGF) concentration change in children with HenochSchonlein purpura nephritis (HSPN). MethodsBiantibody ELISA was adopted to detect the urine EGF and RBP levels in 91 HSP and 30 healthy children.The urine MA level was detected by automatic special protein analyzer. Results(1)The urine EGF concentration in HSP patients \[(78.59±18.09)ng/mL\] was significantly higher than that of control group\[(29.30±13.92)ng/mL\]，the difference being remarkable (t=13.64，P<0.01).Comparison in every kind found that the urine EGF concentration\[(98.31±17.68)ng/mL\]in purpura nephropathy was higher than that in any other kind:skin type\[(78.76±12.66)ng/mL\]， abdominal type\[(77.16±11.77)ng/mL\]，joint type\[(76.49±17.45)ng/mL\]，mixed type\[(77.71±13.49)ng/mL\];there was clinical statistical significance(both P<0.05)，but there was no statistical significance in the latter four kinds(both P＞0.05).(2) The concentration of urine MA in HSP group was\[(43.21±10.23)mg /L\],much higher than that in control group\[(6.41±2.86)mg/L\];there was notable difference in the two groups(t′=25.91，P<0.01).(3) The concentration urine RBP in HSP group was\[(46.8±20.9)ng/mL\]，much higher than that in control group\[(12.8±4.8)ng/mL\],so there was statistical significance(t′=11.98，P<0.01).(4) In the acute period of 91 HSP children,abnormality in urine routine test was 14(15.38%),higher urine MA level was in 37(61.67%)and higher RBP level was in 45(75%),higher in all the two indicator was in 51(85%)，higher urine EGF level was in 84(92.3%)，and the positive rate of urine EGF was similar to that in kidney puncture reported. ConclusionBoth the concentrations of urine EGF、RBP and MA are remarkably high in HSP children.The EGF level is especially high in early stage of HSPN.The increase of EGF level is possibly correlated with the degree of pathology change in HSP.So,the urine EGF level could be one of sensitive indictors in early kidney damage of HSP.

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Clinical research into renal early injury indexes in children with HenochSchonlein purpura. CHEN Hua,ZHANG Yajing,WANG Xin 2007, 22(02): 111-113 .  Abstract ( )   AbstractObjectiveTo investigate the action and clinical significance of urine microprotein and NAG as indexes of renal early injury,in children with HenochSchonlein purpura(HSP). MethodsWe measured urine micro protein and enzyme by immune scatter turbidimetry and enzymatic assay,and at the same time did urine routine analysis,examined blood urea nitrogen(BUN )and serum creatinine(Scr) in the 43 cases of HSP. ResultsIn 43 cases group the four indexes were obviously higher than control group,abnormal rate of urine routine analysis being 13.95%,abnormal rate of the four indexes 79.07%; 37cases of normal urine routine analysis had abnormal four indexes,being 70.57%,and abnormal rate of the four index were higher than that of the single index. ConclusionCombined four indexes in urine is a sensitive index to find renal early injury in HSP,and could be credibility index in early diagnosis,treatment and in achieving favorable prognosis.

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To explore the effect of light microscopy and urine flow cytometer on detecting the source of hematuria in children. CHU Mei,CAO Li. 2007, 22(02): 114-117 .  Abstract ( )   AbstractObjectiveThis study aims at evaluating the effect and the possible role of light microscopy and urine flow cytometer in detecting the source of hematuria in children,for a better understanding of various histopathology of isolated hematuria. Methods (1) The children who had been diagnosed as having glomerular diseases underwent renal biopsy.(2) The morning urine specimen from the group of glomerular diseases as well as the group of nonglomerular diseases were collected for the red blood cell morphological examination by light microscopy.In addition,the samples from some of the patients with glomerular diseases and some of the patients with nonglomerular diseases were examined by using UF50 urine flow cytometer. Results(1) The group of 125 children with clinical diagnosis of glomerular diseases were confirmed by pathological examination.(2) The diagnostic criteria for glomerular hematuria were those with severe dysmorphic RBC≥30% or dysmorphic RBC≥70%.Both specificity reached over 90%,but the sensitivity of the UF50 automated urine analyzer was lower.(3) The positive rate of glomerular hematuria by ordinary light microscopy and urine flow cytometer in testing the same day’s morning urine and random urine samples had no significant differences. Conclusion(1) This series of data indicate that if we use the diagnostic criteria for glomerular hematuria with dysmorphic RBC≥70% or severe dysmorphic RBC≥30%,the sensitivity and specificity are both higher.(2) Both specificity of the two methods reachs over 90%,but the sensitivity of the UF 50 automated urine flow cytometer is lower.(3)The random urine specimen could be accepted with the two methods in children.

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Relationship between calciumphosphorus metabolism and cardiac and vascular change in patients with chronic renal failure. ZOU Chunbo,XIE Rujuan，JIN Qing.et al. 2007, 22(02): 118-120 .  Abstract ( )   AbstractObjectiveTo study the cardiac and vascular adaptation in patients with chronic renal failure(CRF) and approach the rule of calciumphosphorus metabolism. MethodsBlood biochemical indicators,echocardiography and Bultrasound data of the carotid artery were collected from 44 patients with chronic renal insufficiency(ND group ),40 patients who were on maintenance dialysis(D) and 40 healthy individuals(Control).Carotid artery intimamedia thickness(cIMT) was measured and arterial compliance was calculated to obtain carotid artery structure and function. ResultsBoth the ND and D group had greater Cimt,higher left ventricular mass(LVM) index,and poorer diastolic function than the control group.Patients who were on dialysis had greater cIMT and higher LVM index than those with ND and greater stiffness than both ND and control group.Calciumphosphrous product has positive correlation with cIMT.Increased intact parathyroid hormone(iPTH) was concerned with arterial stiffness,LVM index and poor diastolic function. ConclusionThere are cardiac and vascular abnormalities in CRF patients；the aggravation of cardiac and vascular disease are related with the abnormality of calciumphosphorus metabolism.

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Nephrotoxicity induced by dyslipidemia in children with primary nephritic syndrome. HU Peng,JING Chengxue,QIN Yuanhan 2007, 22(02): 121-123 .  Abstract ( )   AbstractObjectiveTo probe into the relationship between dyslipidemia and the alternation of renal function in children with primary nephritic syndrome(PNS). MethodsTotally 76 children with PNS were divided into two groups,the nonrenal inadequacy group(46 children) and the renal inadequacy group(30 children),according to renal function.Total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),nonHDL,low density lipoprotein(LDL),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),ApoA1/B,blood urea nitrogen(BUN),creatinine clearance rate(Ccr) and uric acid(UA) in plasma were detected. Results(1) TG,BUN,Ccr and UA in the renal inadequacy group significantly increased compared with the nonrenal inadequacy group.(2) There was outstanding positive correlation between TG and Ccr,UA(P<0.01),medium positive correlation between ApoA1 and Ccr(P<0.05),medium positive correlation between ApoB and UA(P<0.05)in 76 PNS children.(3) Outstanding positive correlation was observed between nonHDL and TG(P<0.01)in 76 PNS children. ConclusionSignificantly increased TG is the feature of dyslipidemia in PNS children complicating renal inadequacy.It is favorable identification for TG,nonHDL to judge the degree of renal inadequacy and the efficacy of therapy in clinic.

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A study on the relationship between α and βisoform of glucocorticoid receptors and glucocorticoid in resistant idiopathic thrombocytopenia purpura. WANG Ying,LI Changgang,SHI Hongsong 2007, 22(02): 124-126 .  Abstract ( )   AbstractObjectiveTo identify the relationship between the expression of α and βisoforms of glucocorticoid receptors(GR)and response to glucocorticoid in the patients with idiopathic thrombocytopenia purpura (ITP). MethodsSemiquantitative RTPCR was used to detect the expression of GRα,β in PBMC among 30 patients with ITP and 10 normal controls. Results(1)The expression of GRαmRNA in PBMC showed among the groups.(2)The expression of GRβmRNA in the resistant group of ITP was significantly higher than that in both the sensitive group and control group (P<0.01). ConclusionThe expression of GRβmRNA may play a great role in resisting glucocorticoid resistance in the patients with ITP.

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Expression of cellcycle associated factor cdt1 in children with acute lymphoblastic leukemia. WEN Chuan,WAN Wuqing,LIU Ying 2007, 22(02): 127-129 .  Abstract ( )   AbstractObjectiveTo research the expression of cellcycle associated factor cdt1 in children with acute lymphoblastic leukemia. MethodsSixteen children with acute lymphoblastic leukemia were firstly dianosed and were not treated(research group) and 16 healthy children(control group) whose intravenous blood was collected for isolating the singlenucleus cell were controls.The expression of cdt1 in children was measured by immunohistochemistry for protein,and by reverse transcriptionpolymerase chain reaction(RTPCR) for their mRNA.The data was analyzed by using software SPSS11.5 for windows. ResultsThe expression of cdt1 proteins in research group was obviously higher than those in control group(P<0.05);the expression of cdt1 mRNA in research group was obviously higher than those in control group(P<0.05);the cdt1 proteins were expressed,but the expression levels of their corresponding mRNA were not measured in control group. ConclusionCdt1 is related to cell cycle.The expression of cdt1 will result in the development of acute lymphoblastic leukemia;the cdt1 proteins are not related to the expression level of the corresponding mRNA in control group.

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Changes and significance of CD+4CD+25 regulatory T cells,transforming growth factorβ1 and Flt3 ligand in children with aplastic anemia. HUANG Yonglan，HUANG Shaoliang，LIANG Weiwen 2007, 22(02): 130-133 .  Abstract ( )   AbstractObjectiveTo investigate the roles of immune regulatory T cells and cytokines in immune disorders in pediatric aplastic anemia(AA). MethodsLymphocyte subsets and CD+4CD+25 cells in bone marrow(BM) and peripheral blood(PB) were detected by FACS,and the levels of TGFβ1 and Flt3L in BM were measured by ELISA in 27 patients with idiopathic pediatric AA and controls. ResultsCompared to controls,the frequencies of CD+3CD+8 cells in BM and PB increased significantly in untreated AA patients,and the frequencies of NK in PB and B cells in BM decreased significantly in untreated SAA.The frequency of CD+4CD+25 cells in untreated SAA group \[(7.5±3.4)%\] was higher than that in controls \[(4.3±0.9)%,P<0.05\].The ratio of CD+4CD+25/ CD+4 in BM of untreated SAA group \[(28.9±11.1)%\] and MAA group \[(28.2±9.4)%\] was higher than that of controls \[(17.4±0.9)%，P<0.05,respectively\].The levels of TGFβ1 in untreated SAA group \[(2.2±1.7)μg/L\] and MAA group \[(2.0±0.6)μg/L\] were lower than that in controls\[(4.4±0.9)μg/L,P<0.01、<0.05,respectively\].Flt3L in SAA group \[(1031.1±321.8)ng/L\] and MAA group \[(694.7±424.7)ng/L\] was higher than that in controls\[(63.0±37.5)ng/L,P<0.01,respectively\].In recovered SAA patients treated by immunosuppressive therapy,all of the above but the frequency of CD+3CD+8 cells in PB returned to normal levels.There was significant positive relationship between CD+4CD+25 and CD+3,CD+3CD+4 cells (r=0.495,0.540,P<0.01,respectively),as well as between Flt3L and CD+3,CD+3 CD+4,CD+3CD+8,CD+4CD+25 cells in BM(r=0.732,0.542,0.688,0.405,P<0.01,<0.01,<0.01,<0.05,respectively).Negative relations were found between TGFβ1 and Flt3L,CD+3CD+8 cells(r=-0.431,-0.482,P<0.05、<0.01,respectively). ConclusionThese results indicate that pediatric AA is not related to CD+4CD+25 regulatory T cells deficiency.The decreased TGFβ1 and increased Flt3L in BM may play an important role in T lymphocytes proliferation and function disorders in pediatric AA.