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06 August 2006, Volume 21 Issue 08 Previous Issue    Next Issue
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Lymphocyte subsets in children with asthmatic and nonasthmatic viral pneumonia. Ma Lan,Hou Ancun,Lv Fang 2006, 21(08): 577-580 .  Abstract ( )   AbstractObjectiveTo study the lymphocytes subsets in children with viral asthmatic pneumonia. MethodsThe patients who were treated from 2002 to 2004 in Beijing Friendship Hospital were divided into two groups: asthmatic group and nonasthmatic group.Fresh peripheral blood samples of patients in two groups were tested through the flow cytometry.Thirty healthy children were included as the control group. ResultsThe result showed the percentage of Th1 cell was (12.61±7.19) % and(17.32±9.92) % respectively in asthmatic group and nonasthmatic group,and there was significant difference from the control group(P<0.001)； the ratio of Th1/Th2 in asthmatic group and nonasthmatic group was higher than that in control group(P<0.05,P<0.01).The percentage of CD+4 was higher in asthmatic group than that in control group(P<0.01).The ratio of CD+4/CD+8 was higher in asthmatic group than that in nonasthmatic group(P<0.05),but there was no other significant difference between the two groups. ConclusionNo matter what it is asthmatic or nonasthmatic,the cellmediated Th1 type immunity reaction is increased in patients with viral pneumonia.Except for a higher ratio of CD+4/CD+8 in asthmatic group there was no other significant difference between asthmatic group and nonasthmatic group.

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Comparison of allergen spectrum in asthma and allergic rhinitis children with 3~14 years of age. Xiang Li,Shen Kunling,Zhang Yamei 2006, 21(08): 581-583 .  Abstract ( )   AbstractObjectiveTo compare the allergen spectrum in asthma and allergic rhinitis children with 3~14 years of age. MethodsInhalant allergen skin prick test (SPT) were done in 527 asthma and 620 allergic rhinitis children respectively from Oct.2004 to Oct.2005.The positive rates of different allergen and allergen spectrum in asthma and allergic rhinitis were analyzed. ResultsThere was no significant difference on the positive rates of SPT in asthma and allergic rhinitis(77.8% vs78.9%,P>0.05).The main inhalant allergens related to asthma and allergic rhinitis were Dermatophagoids pteronyssinus,Dermatophagoids farinae,alternaria,cat dander and mugwort.The positive rates of Der.p,Der.f and molds mixture in asthma were higher than those in allergic rhinitis( 64.6% vs 49.5%,59.8% vs47.9%,8.8% vs 3.9%,P<0.05).The positive rates of summerautumn pollen and mugwort in allergic rhinitis were higher than those in asthma(25.6% vs 19.3%,26.0% vs 19.3%,P<0.05).About 40.2% asthmatic and 46.2% allergic rhinitis children were single allergen sensitization.The multiple sensitization to mites,molds and pets were common in asthma and allergic rhinitis. ConclusionMites,molds,pets and summerautumn pollen are the main inhalant allergens related to asthma and allergic rhinitis children with 3~14 years of age.The allergen spectrums are similar in asthma and allergic rhinitis.Mites and molds allergy are more popular in asthma while summerautumn pollen in allergic rhinitis.

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Influence of longterm inhaled glucocorticoids on adhesion molecular system and complement activated fragment of bronchial asthmatic children. Lin Rongjun,Pan Yujuan. 2006, 21(08): 584-586 .  Abstract ( )   AbstractObjectiveTo research the influence of longterm inhaled glucocorticoids on adhesion molecular system and complement activated fragment of bronchial asthmatic children. MethodsThrough enzymelinked immunosorbent Assay (ELISA),the the serum sICAM1,sVCAM1 and sC5b9 levels were compared in 28 healthy pupils (normal control group)、26 asthmatic children (uninhaled glucocorticoids group) and asthmatic children after inhaled glucocorticoids(Igs) 3,6 and 12 months. ResultsSerum sICAM1,sVCAM1 and sC5b9 levels were significantly elevated in children with asthma.The levels of sICAM1,sVCAM1 and sC5b9 in children with asthma were decreased gradually after inhaled glucocorticoids for 3,6 and 12 months,and differed significantly compared with uninhaled group.There was no significant difference of the serum sICAM1 and sVCAM1 level in the 12month group compared with that of normal control group. ConclusionAdhesion molecular system and complement activated fragment may play an important role in asthma.Longterm inhaled glucocorticoids can inhibit asthma by lowering the serum sICAM1,sVCAM1 and sC5b9 level.sICAM1,sVCAM1 and sC5b9 level may be an marker of therapeutic effect of Inhaled Glucocorticoids.

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Influence of inhaled budesonide and salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with acute asthma Wang Xiaoming,Zhang Linyun,Zhou Jian 2006, 21(08): 587-589 .  Abstract ( )   AbstractObjectiveTo investigate influence of inhaled budesonide and salbutamol on inflammatory cells and cytokines concentrations in induced sputum from children with an acute exacerbation of asthma. MethodsChildren with acute asthma (n=34) were treated with inhaled budesonide and salbutamol for 7 days.Children with acute asthma underwent sputum induction,sputum induction was repeated when the children had recovered (n=24).Induced sputum was also taken from 15 healthy children as the controls.Total and differential cell counts were performed.Interleukin8 (IL8)、IL6 and TNFα were measured. ResultsEosinophils,neutrophils,and macrophages decreased significantly at resolution,but eosinophils remained a higher percentage at resolution compared with healthy subjects.Levels of IL8 、IL6 and TNFα were elevated during the acute exacerbation and decreased at resolution. ConclusionTherapy of inhaled budesonide and salbutamol can reduce inflammatory cells and cytokines concentrations in induced sputum from children with an acute exacerbation of asthma.

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Detection of the plasma endothelin and von Willebrand factor and its relationship with microalbuminuria in children with type 1 diabetes mellitus. Sun Shuzhen，Li Qian，Wang Yi 2006, 21(08): 590-592 .  Abstract ( )   AbstractObjectiveTo measure the plasma markers of endothelia damages in type 1 diabetes mellitus with normoalbuminuria and with microalbuminuria,and study possible relationship between them，and to find out the reliable indexes of early diagnosis for diabetic nephropathy. MethodsThe study group included 40 children with type 1 diabetes mellitus aged from 4~18 years old.They were divided into two groups according to urinary albumin excretion rate(UAER) at the beginning of the study,UAER≤20μg/min as group A(n=25),and 20≤UAER≤ 200μg/min as group B(n=15).Forty healthy children selected by paired investigation as a control group.Plasma endothelin(ET1) and urinary microalbumin were assayed by radioimmunoassay technique，von Willebrand factor(vWF) was measured by ELISA technique. ResultsThe plasma levels of ET1 and vWF elevated obviously in group A and group B compared with healthy control(P<0.01);all the changes mentioned above were more remarkable in group B than group A.Relative analysis demonstrated ET1 and vWF were positively correlated with UAER and glycated Hb(HbA1c)，respectively. ConclusionThe generalized vascular endothelial damage precedes the development of microalbuminuria in type 1 diabetes mellitus.The plasma levels of ET1 and vWF are well correlated with UAER，and may be the reliable indexes of early monitoring diabetic nephropathy in patients with type 1 diabetes mellitus.

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Pathogens causing lower respiratory infection of children and their antibiotic resistance in Pediatric Hospital of Wenzhou Medical College. Yang Jinhong,Li Xiangyang,Wang Fengping 2006, 21(08): 593-595 .  Abstract ( )   AbstractObjectiveTo investigate the pathogen and antibiotic resistance in the lower respiratory infection of children. MethodsBacteria were isolated and identified,antibiotic resistance was detected. ResultsIn 1763 cases,715 strains were obtained from lower respiratory tract sputum samples of children,gramnegative bacterium in 448 strains,being 40.6%;grampositive bacterium in 148 strains,being 20.7%;fungus in 119 strains,being 16.6%.K.pneumoniae,E.coli,Ps.aeruginosa and A.baumanii were gramnegative bacterium’s primary pathogen.The ratio of ESBLs K.pneumoniae and E.coli was 49.3% and 46.5%，respectively.The better antibiotics for them were imipenem，amikacin,ciprofloxacin，piperacillintazobactam，and cefoperazonesulbactam.Antibiotics resistance of Ps.aeruginosa and A.baumanii were low for all antibiotics except for trimethoprimsulfamethoxazole.S.pneumoniae and S.aureus is grampositive bacterium's primary pathogen.Analysis on antibiotics resistance of S.pneumoniae can be discovered that penicillin was 71.1%,ciprofloxacin and vancomycin were 0.MRSA ratio of S.aureus was 18.0%,the better antibiotics for it were ciprofloxacin，levofloxacin and vancomycin. ConclusionGramnegative bacterum is the primary pathogen causing lower respiratory infections of children,K.pneumoniae,E.coli,Ps.aeruginosa,A.baumanii,S.pneumoniae and S.aureus are their primary pathogen； the antibiotics resistance increases evidently.We must notice antibiotics resistance of those bacterium,and take some measures against them.

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The resistant genes distribution and antimicrobial resistance analysis of erythromycinresistant streptococcus pneumoniae. Huang Xuqiang,Xiao Zuoyuan,Deng Li 2006, 21(08): 596-598 .  Abstract ( )   AbstractObjectiveTo investigate the mechanisms of erythromycinresistant streptococcus pnenoniae and their variable antimicrobial resistance. MethodsClindamycin disks were to screen erythromycinresistant streptococcus pneumoniae mediated by ermB ro mefE genes.Antimicrobial resistance of erythromycinresistant streptococcus pneumoniae mediated by ermB of mefE genes were studied by Etest respectively. ResultsErmB and mefE genes were 70.3%(168/239) and 29.7%(71/239) respectively among 239 strains of erythromycinresistant streptococcus pneumoniae.The rates of resistance to penicillin (MIC50 0.19μg/mL,MIC90 1.5μg/mL),amoxicillin/clavulanic acid (MIC50 0.19μg/mL,MIC90 1.0μg/mL),ceftrixone (MIC50 0.19μg/mL,MIC90 0.75μg/mL),cefuroxime (MIC500.38μg/mL,MIC90 2.0μg/mL),cefaclor (MIC502.0μg/mL,MIC90 32.0μg/mL) of erythromycinresistant streptococcus pneumoniae mediated by ermB were 58.4%,1.2%,20.8%,46.5% and 51.7% respectively,and the resistance rates to penicillin(MIC50 0.5μg/mL,MIC90 1.5μg/mL),amoxicillin/clavulanic acid (MIC50 0.38μg/mL,MIC90 1.0μg/mL),ceftrixone (MIC50 0.38μg/mL,MIC90 0.75μg/mL),cefuroxime (MIC501.0μg/mL,MIC90 3.0μg/mL),cefaclor (MIC506.0μg/mL,MIC90 48.0μg/mL) of erythromycinresistant streptococcus pneumoniae mediated by mefE were 67.6%,0,19.7%,59.2% and 61.9% respectively (including decreased susceptibility). ConclusionErythromycinresistant streptococcus pneumoniae mediated by ermB is predominant in Guangzhou,the level of erythromycin resistance mediated by ermB is usually higher due to mefE.Erythromycinresistant streptococcus pneumoniae mediated by ermB or mefE genes also has βlactam resistance in various level.

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Clinical efficacy inactivated BCG inoculation in infants with asthma. He Xuehua,Li Yun,Yang Yujia 2006, 21(08): 599-601 .  Abstract ( )   AbstractObjectiveTo investigate the clinical value inactivated bacillus CalmetteGuerin(BCG) inoculation in infants with asthma,and to explore the effect between the constant stimulation by inactivated BCG inoculation and the asthma episode. MethodsFortyfive young children with asthma aging from 9 months to 3 years,were included in this study.Serum levels of IgE and ECP were determined with enzyme linked fluoroimmunoassay by Phamacia CAP system.The concentrations of IFNγ,IL4 from peripheral blood mononuclear cells(PBMC)were measured using ELISA before and after inactivated BCG inoculation.PPD,the degree of the asthma episode and the clinical effect were followed after therapy.Forty infants with asthma receiving the the routine treatment served as the controls. ResultsAfter inactivated BCG inoculation for 6 months,the IFNγ levels increased significantly from 16.36±7.10pg/L to 241.59±111.25pg/L(P<0.01).The IL4 and ECP levels decreased significantly from 214.36±90.88pg/L,13.40±20.21μg/L to 46.13±21.46pg/L,5.51±6.46μg/L (P＜0.05) respectively(P<0.05).PPD positive transformation increased from 15.6% to 93.3% after treatment.The degree of the asthma episode and the clinical effect changed significantly. ConclusionInactivated BCG treatment may have significant clinical effect.The vaccine therapy will be aviailable to children with asthma.

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The change and predictive value of pulmonary function of sleep apnea hyperpnoea syndrome in children. Chen Xiaoying,Huang Jingfu. 2006, 21(08): 602-604 .  Abstract ( )   AbstractObjectiveTo investigate the change and predictive value of pulmonary function of sleep apnea hyperpnoea syndrome in children. MethodsOvernight PSG was conducted on 36 snorers with suspected SAHS.Defined PSG(+) was used as an apneahyperpnoea index (AHI)≥5 and LSaO2<0.90,ΔSaO2＞0.03.All patients with snoring and sleep apnea were evaluated pulmonary function by impulse oscillation technique (IOS).Comparison of the two groups according to the AHI was done by multiple regression and logistic regression analysis. ResultsIn the 36 cases with suspected SAHS,23 were found to have SAHS.R5 and FEV1/PEF were significantly different in two groups.(P<0.05).R5 and FEV1/PEF were used to develop a model for predicting the probability (P) of having PSG positive for SAHS.Log it (P)=-12.03446-0.535244×R5+5.797626×FEV1/PEF. ConclusionBased on our study,pulmonary function can serve as a preliminary screening method and it has reference value to clinical diagnoses.

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Clinical observation of serum concentration of LArg,NO and plasma concentration of ET in patients with congenital heart disease complicated with secondary pulmonary hypertension. Cui Dongzhe,Chen Libo,Pan Hongxin. 2006, 21(08): 605-607 .  Abstract ( )   AbstractObjectiveTo explore the influencing factors in forming the secondary pulmonary hypertension of congenital heart disease. MethodsRandomly select 30 healthy people as healthy group.Randomly select 30 patients of left to right congenital heart disease (CHD) with normal pulmonary arterial pressure (PAP) and with pulmonary hypertension (PH).Compare the serum concentration of LArg,NO and plasma concentration of ET1 in different groups. ResultsSerum concentration of LArg: Control group(group A):(72.00±18.01)nmol/mL,Patients with normal PAP(group B),(30.74±8.97)nmol/mL,Patients with PH(group C): (23.51±12.37)nmol/mL.Serum concentration of NO: group A:(76.10±17.10)nmol/mL,group B: (90.55±26.57)nmol/mL,group C:(60.05±17.60)nmol/mL.Plasma concentration of ET1: group A:(50.82±7.58)pg/mL,group B: (64.9±16.28)pg/mL,group C: (69.64±10.66)pg/mL. ConclusionSerum concentration of NO and plasma concentration of ET1 and the balance relationship between them corporately affect the formation and the extent of PH of congenital heart disease.The increase of plasma concentration of ET1 is the direct factor,the decrease of the serum concentration of NO is the indirect factor,while the decrease of the serum concentration of NO is caused by the decrease of the serum concentration of LArg.

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Analysis of clinical characteristics and treatment of refractory status epilepticus in children. Zhou Yudong. 2006, 21(08): 608-610 .  Abstract ( )   AbstractObjectiveTo explore the clinical characteristics of status epilepticus (SE) and refractory status epilepticus (RSE) in children,present the possible factors to forecast RSE,and summarize the effective methods for seizure control. MethodsFifty-two children with SE were evaluated retrospectively,and were divided into groups of SE and RSE to make a compared analysis. Results(1) There were 56% children with RSE in all 52 children with SE.(2) Two patients with tonic seizures,4 with partial motional seizures,1 with partial complex seizures and 8 with mingle seizures belonged to the group of RSE.(3) In 52 children,diazepam and/or sodium pentothal were effective in 23 children.In RSE,there were 19 times of effective action of medicines,in which diazepam plus/or Phenobarbital 15 times(79%),diazepam plus sodium pentothal 1 time(5%),clonazepam 1 time(5%),lidocaine 2 times(11%). Conclusion(1) The mobility of RSE is high in children with SE; (2) Partial seizures,tonic seizures and mixture seizures hint that SE will develop into RSE; (3) Diazepam plus Phenobarbital is the first choice of medicines for seizure control.The patients in RSE group not sensitive to first use of diazepam will have lower response to the repetition of using diazepam.The second line AEDs can be administered in time.Lidocaine can be an effective drug to treat RSE.

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The application of color Doppler echocardiography in interventional treatment of atrial septal defect and ventricular septal defect. Liu Fengying,Xu Zhaofeng,Gong Xin 2006, 21(08): 611-612 .  Abstract ( )   AbstractObjectiveTo evaluate the applied values of 2dimensional echocardiography(2DE) and realtime threedimensional echocardiography(RT3DE) in closing atrial septal defects(ASD) and ventricular septal defects(VSD) with the Amplatzer devices. MethodsTwentyfour cases of secundum atrial defects(ASD) the ten case of ventricular septal defects(VSD) patients were studied by twodimensional teansthoracic echocardiography and RT3DE. ResultsIn 24 cases examined with transthoracic echocardiography (TTE), ASD mean diameter was (15.6±7.9)mm(5~26mm),The diameters of these devices were (19.1±5.1)mm(5~32mm).The device were successfully implanted in 23 cases.Size of VSD at the side of left ventricle (LV) from 5mm to 9mm,Size of VSD at the side of right ventricle (RV) from 2.4mm to 6mm.The diameters of these devices were 4mm to 6mm.The ten case of ventricular septal defects (VSD) patients no residual shunt was found. ConclusionTwodimensional transthoracic echocardiography and RT3DE acts as a important role in successful opration and evaluating the shortterm and longterm therapeutic effectiveness.