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06 April 2006, Volume 21 Issue 04 Previous Issue    Next Issue
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Quality control for spirometry in preschool children. Zhang Qingling,Zheng Jinping,Yuan Bentong 2006, 21(04): 259-264 .  Abstract ( )   AbstractObjectiveTo probe into the criteria of quality control for spirometry in preschool children. MethodsA survey in 343 healthy preschool children(184 boys,159girls) aged 3 to 7 years old was carried out in Shenzhen in 2004.Eleven flow volume tests parameters \[forced vital capacity(FVC),forced expiratory volume at o.5 second(FEV0.5),forced expiratory volume at 0.75 second(FEV0.75),forced expiratory volume at one second(FEV1),extrapolated volume(VBE),extrapolated volume to FVC ratio(VBE/FVC),the difference between the two highest values of FVC or FEV0.5,FEV0.75,FEV1 and forced expiratory time(FET 100%)］ were measured by using COSMED spirometry of Italian. ResultsThe average extrapolated volume(VBE) was 42.71±13.61 mL， 95Percentile value being 64mL；the average VBE/FVC was (393±134)%，95Percentile value being 636% in this group.Fiftytwo of 279 children (18.6%) were not able to produce a VBE/FVC value less than 5%.The younger children tended to have higher VBE/FVC values.There was significant relationship between VBE/FVC and height (P< 0.05).The average forced expiratory time(FET) was 1.61±0.52sec，5Percentile value being 09sec,and 18 of 279 (6.5%) children produced a FET less than 1 second.Forced expiratory volume in 0.50 and 0.75 sec(FEV0.5,FEV0.75) were thus measured in preschool children.All children presented their two best efforts(FVC、FEV0.75、FEV0.5、FEV1 FVC ) no more than 0.2L.About 63.1%of the tested children presented their two best efforts(FEV0.75) no more than 5%.About 66.2% of the tested children presented their two best efforts( FEV1) no more than 5%.More than 90% of the tested children presented their two best efforts(FVC、FEV0.75、FEV0.5、FEV1 FVC ) no more than 0.1L. ConclusionStart of test can be quantitatively assessed as in adults,but results greater than 65 mL for VBE or 6.5% for VBE/ FVC should be indications for visual reinspection of the flow volume trace,rather than automatic exclusion.Expiratory time should not be less than 0.9s and expiration continues until there is a clear plateau on the volume time trace,and there should be no volume change for 1 second.In all preschool children both FEV0.75 and FEV0.5 should be reported in addition to FEV1.Repeatability can be assessed as for adults,but criteria of 100 mL and 10% of best effort for FVC and FEVt may be more appropriate than the criteria applied to adults

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The role of cells,interleukin8,interleukin9 and eotaxin in induced sputum in childhood asthma. Luo Zhengxiu,Liu Enmei,Wang Lijia 2006, 21(04): 265-268 .  Abstract ( )   AbstractObjectiveTo investigate the cells,interleukin8,interleukin9 and eotaxin roles in induced sputum of asthmatic children. MethodsFrom Sep.2004 to Mar.2005,44 asthmatic children(including 25 exacerbation,19 remission) and 10 normal children were selected to induce sputum by hypertonic saline in the Affiliated Children's Hospital of Chongqing University of Medical Sciences.Sputum was processed and cytospin was examined for a differential cell count.The levels of IL8,IL9 and eotaxin in sputum supernatant were detected by ELISA. ResultsThere were more cells in asthmatic children induced sputum than in normal children.The number of sputum neutrophil was higher in exacerbation children than in remission children and normal children.The number of sputum lymphocyte was higher in remission children than in exacerbation and normal children.The difference of sputum eosinophil was not found in each group.The levels of sputum supernatant IL8 and IL9 were significantly higher in asthmatic children than in normal children.A significant positive correlation between the levels of IL8 and neutrophil,IL9 and neutrophil was found.There was no difference in the sputum supernatant eotaxin level in each group. ConclusionUnlike adult allergic asthma,neutrophil plays a critical role in childhood asthma.Interaction of neutrophil,IL8 and IL9 secretion attributes to the pathogenesis of childhood asthma.

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Study on insulin dosage adjustment and related indexes in different period of type 1 diabetes mellitus in children. Huo Meiling,Li Guimei,Wang Yi 2006, 21(04): 269-271 .  Abstract ( )   AbstractObjectiveTo study the insulin dosage and the metabolic indexes,βcell function of islets of pancreas in different period of type 1 diabetes mellitus and the correlation. MethodsFrom Oct.1998 to Dec.2004,thirtyfive newly diagnosed patients with type 1 diabetes mellitus(T1DM) during acute metabolic disturbance period(acute period)，the temporary remission period(honeymoon period) and reinforcement period were included in this study.Calculate ISF in different stage.Compare the difference among the mentioned indexes above,and compare the former four indexes with those of thirtythree healthy children.Percentage of patients from acute period to honeymoon period was calculated.Linear correlation analysis was made between Cpeptide/FBG and insulin dosage. ResultsFBG and 2hPBG were significantly different in different periods,one by one from the highest to the lowest being acute、reinforcement and honeymoon period.There was no significant difference between T1DM group during honeymoon period and control group about FBG and 2hPBG.There was no significant difference between acute and reinforcement period about Cpeptide/FBG,and between honeymoon period and control group.There was significant difference between any two of others about Cpeptide/FBG.Insulin dosage was significantly different in different period,the sequence of them from the highest to the lowest being acute,reinforcement and honeymoon period.ISF was significantly different between acute and honeymoon,honeymoon and reinforcement period,but no significant difference between acute and reinforcement period.There were 657% of acute peri od patients entering honeymoon period.There was a significant negative linear correlation between insulin dosage and Cpeptide/FBG(r=-091,P<0001).The regression equation：insulin dosage［U/(kg·d)=106-177×(Cpeptide/FBG)］. ConclusionMetabolic indexes are significantly different in different period of T1DM in children；particularly,insulin dosage can be calculated from Cpeptide/FBG by the regression equation of them and can be adjusted according to FBG and ISF.

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Different effect of initial treatment age on congenital adrenal hyperplasia patients. Tian Yumei,Ye Jun,Han Lianshu 2006, 21(04): 272-273 .  Abstract ( )   AbstractObjectiveTo observe the influence of the initial treatment time on the height,bone age and precocious puberty in patients with congenital adrenal hyperplasia. MethodsThirtytwo patients with CAH were divided into 2 groups from 1982 to 2004,under 3 years old and above 3 years old subgroup,by their initial treatment age.Observe the difference about bone age,the height age and the cases of precocious puberty between two groups on last time visit and the difference about the cases of precocious puberty between male and female subgroup. ResultsThe difference of bone age and height age was significantly different between under 3 years old subgroup (n=14,30±20 yr) and above 3 years old subgroup (n=18,46±16 yr),P<005.The incidence rate of central precocious puberty in above 3 years old subgroup (n=9,50%) was higher than under 3 years old subgroup (n=2,143%) (χ2=4453，P<005).The incidence of central precocious puberty in male subgroup (n=9,692%) was found to be higher than female subgroup (χ2=4794，P<005). ConclusionThe prediction of final height in patients with CAH can be more obviously improved in the initial treatment age under 3 years old group than above 3 years old group;the early treatment can also decrease the incidence rate of central precocious puberty.The incidence of central precocious puberty is higher in boy than in girls.

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Application of helical CT virtual endoscopy to the diagnosis of foreign bodies in the trachea and bronchi of children. Hong Xinghe,Ning Bo,Li Yu 2006, 21(04): 277-279 .  Abstract ( )   AbstractObjectiveTo probe into the value of helical CT virtual endoscopy in the diagnosis of foreign bodies in the trachea and bronchi of children. MethodsFrom Jan.1998 to Dec.2004,121 patients with foreign bodies in the trachea and bronchi confirmed by helical CT virtual endoscopy were extracted by fibreoptic bronchoscope.The data of all cases were retrospectively analyzed,especially the value of helical CT virtual endoscopy in the diagnosis,and false positive and false negative result were studied. ResultsAmong 121 cases with foreign bodies in the trachea and bronchi confirmed by helical CT virtual endoscopy,there were 115 cases in which foreign bodies were found and extracted by fibreoptic bronchoscope.Compared with helical CT virtual endoscopy,the rate of conformed diagnosis was 9504%. ConclusionHelical CT virtual endoscopy is the most ideal invasive method in the diagnosis of foreign bodies at present.

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Effect of adenotonsillectomy on sleep architecture in pediatric obstructive sleep apnea syndrome. Zhou Lifeng,Liu Dabo,Zhong Jianwen 2006, 21(04): 280-282 .  Abstract ( )   AbstractObjectiveTo evaluate change of sleep architecture in children with obstructive sleep apnea syndrome (OSAS) before and after adenoidectomy and/or tonsillectomy (A&T). MethodsFrom Dec.1998 to Oct.2003,polysomnography (PSG) was performed on 115 children with pediatric OSAS 1 or 2 days before and 3 months after A&T.Various polygraphic parameters to describe the macrostructure of sleep and the microstructure of sleep were analyzed. ResultsNo significant difference was observed in the macrostructure of sleep before and after A&T,however,OSAS had higher Arousals index(62±04) before than after A&T (27±02),t=725,P<001. ConclusionA&T can influence the microstructure of sleep.Therefore the improvement of the microstructure of sleep is the physiopathological basis of clinical relief after A&T.

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High risk factors,prevention and treatment of neonatal ventilatorassociated pneumonia. Deng Choufen,Wu Yuyu,Zhong Honglei 2006, 21(04): 283-285 .  Abstract ( )   AbstractObjectiveTo investigate the high risk factors,prevention and treatments of neonatal ventilatorassociated pneumonia. MethodsRetrospective study was made on the clinical data of 98 critical neonates who were treated with ventilator in our hospital's NICU in the latest 5 years. ResultsThe incidence of VAP was 4694%,and the gestational ages and the birth weights were negatively correlated,but the duration of MV,the times of intubation and MV were positively correlated (P<001).The main pathogens were opportunistic drugresistant bacteria,and mostly were G bacilli (8039%),then G+ cocci ( 1373%);2 strains of fungi were found in the cases of repeated MV;complicating with VAP or not had a significant effect on the cure rate (P<005). ConclusionThe incidence of VAP has a close correlation with the gestational ages,the birth weights,the duration of MV,and the times of intubation and MV.The main pathogens are drugresistant opportunistic bacteria;integrated prevention and treatment are very important.

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Clinical analysis of epilepsy in 32 children with cerebral palsy. Zhou Jianping,Huang Shaoping,Xu Erdi 2006, 21(04): 286-288 .  Abstract ( )   AbstractObjectiveTo explore the clinical characteristics of cerebral palsy(CP) children with epilepsy and therapeutic effect on epilepsy. MethodsTo sum up the incidence of epilepsy,clinical type,the age of first seizure,brain computer tomography(CT) and/ or magnetic resonance imagery(MRI),electroencephalogram(EEG),and therapeutic effect on epilepsy in CP children with epilepsy from Oct. 1999 to May 2004 in the Second Hospital of Xi'an Jiaotong University. ResultsThere were 32 epileptic cases in the total 139 children with CP,the percentage of epilepsy being 230%(32/139).The common type of epilepsy were tonicclonic (375%) and partial(188%) seizures781% epilepsy occurred in under the age of one year.The percentages of abnormal brain image and EEG were 938% and 844% respectively.The main abnormal brain images were cerebral hysplasia(367%) and hydrocephalus(200%).The percentages of focal and diffused changes in EEG were 482%(13/27) and 518% (14/27) respectively.688% epilepsies occurred in spastic CP children.813%(26/32) epilepsies should be treated by polytherapy with 2 or more than 2 antiepileptic drugs. ConclusionThe incidence of epilepsy in CP children is high.The main changes of brain image and EEG are cerebral hysplasia and abnormal background activities with epileptic waves respectively.Most of the epilepsies in children with CP are intractable ones and need polytherapy.

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Clinical study of 94 children with myelodysplastic syndrome. Liu Aiguo,Hu Qun,Zhang Liuqing 2006, 21(04): 289-291 .  Abstract ( )   AbstractObjectiveTo study the clinical characteristics and prognosis factors of myelodysplastic syndrome (MDS) in children. MethodsNinetyfour children with MDS from 1991 to 2005 were retrospectively analyzed.Bone marrow biopsy and chromosome analysis was performed in some of the patients,as well as hemoglobin F (HbF),serum ferritin (SF) and serum lactate dehydrogenase (LDH).The correlations between these factors and prognosis were analyzed. ResultsAmong all cases,RA,RAEB and RAEBT were 48 (51%),26(28%) and 20(21%),respectively.Bone marrow biopsy showed abnormal localization of immature precursors (ALIP) in 44%(11/25) of the patients,4 of whom transformed to leukemia in followup.Eosinophilia was found in 10%(9/94) of the children,all of whom died after a median survival time of 105 months.The mean levels of SF and LDH of the high risk group (RAEB group and RAEBT group) were much higher than those of the low risk group (RA group) (P<005).The median survival time of the patients with LDH < 300 U/L was longer than that with LDH ≥300U/L (P<005).43% of the cases (9/21) had clonal chromosome aberrations and 56% (5/9)of them transformed to leukemia. ConclusionThe poor prognostic factors of pediatric MDS include eosinophilia and obviously increased level of SF and LDH.Karyotype analysis is helpful for its diagnosis and prognosis estimation.

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Clinical retrospective analysis of 429 childhood patients with haemophilia. Guo Ye,Zhang Lei,Zhu Xiaofan 2006, 21(04): 292-295 .  Abstract ( )   AbstractObjectiveTo analyze the data of diagnosis,symptom and joint deformity of childhood patients with haemophilia. MethodsA total of 429 childhood patients with haemophilia were referred to our hospital and diagnosed in our hospital from July 1986 to August 2004,and were retrospectively analyzed. ResultsThe 429 childhood patients(male,median age 5) were analyzed,390 of whom (909%) had haemophilia A (subclinical 5,mild 43,moderate 181,severe 161),and 39(91%) had haemophilia B(subclinical 2,mild 6,moderate 26,severe 5).The mean age at initial bleeding symptoms was 16 years (0~12years),and that of initial diagnosis was 52 years (03~12years).It was significantly different between them (P＜001). ConclusionThe delay of diagnosis,insufficiency of period of replacement treatment and the dose of factor concentration lead to high prevalence of joint deformity in childhood patients in China.

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Survey of the situation of asthma prevention and therapy in children. Sha Li,Liu Chuanhe,Zhao Jing 2006, 21(04): 296-299 .  Abstract ( )   AbstractObjectiveTo investigate the situation of asthma prevention and therapy mastered by mostly pediatricians and physicians of respiratory diseases. MethodsQuestionnaires were handed out to clinical professionals at different levels and returned immediately after being answered before asthma meetings or seminars. Results872% of them have known about GINA,and 614% have implemented it.938% of the doctors knew the main pathologic basis of asthma.631% of them used peak expiratory flow meter in their clinical practice.717% of them selected glucocorticosteriod inhalation was the most important therapeutic measure in managing asthma patients with moderate and severe persistent symptoms.934% of the doctors selected inhalation glucocorticosteriod.Intranasal glucocorticosteriod was accepted by 60% of the doctors in the treatment of allergic rhinitis. ConclusionThe basic knowledge about asthma,selection of medication,implementation of GINA and the use of peak expiratory flow meter have been greatly improved than those of 6 years ago.GINA should be disseminated from big cities to counties and communities.