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06 February 2006, Volume 21 Issue 02 Previous Issue    Next Issue
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Clinical study on induction therapy of arsenic trioxide in combination with alltrans retinoic acid for childhood acute promyelocytic leukemia. Lu Aidong,Zhang Leping,Liu Guilan 2006, 21(02): 93-95 .  Abstract ( )   AbstractObjectiveTo study whether arsenic trioxide combined with alltrans retinoic acid could improve the effect of induction therapy for childhood acute promyelocytic leukemia (APL) and evaluate side effects of this regimen. MethodsTwelve untreated patients with APL in our department from February 2000 to January 2005 were included in this research.The effectiveness and side effects were evaluated after induction therapy with arsenic trioxide and alltrans retinoic acid.Eleven APL patients from 1994 to January 2000 treated with alltrans retinoic acid only were used as control. Results1.Eleven of 12 cases with combined therapy achieved complete remission (CR).The CR rate (91.7%) was significantly higher than that with retinoic acidtreated alone (72.7%).2.The coagulation index of the patients in the group with combined therapy was normal in 7.82±4.12 days after therapy,the control was 14.33±5.77 days (P<0.01).3.Gastrointestinal side effects,pain of muscle and mild abnormal liver function were observed more often in the group with combined therapy but these adverse reactions were temporary.Headache and abnormal renal function occurred more often in the control group.4.The number of white blood cells after therapy was much higher in control group than in the group with combined therapy. ConclusionThe combined therapy shows higher CR rate and rapid recovery of coagulation function.No severe side effects occur.

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An analysis of costeffectiveness of diagnostic approaches to vasovagal syncope in children. Yang Yuanyuan,Chen Jianjun,Hong Dailing 2006, 21(02): 96-98 .  Abstract ( )   AbstractObjectiveThis study aimed to compare and discuss the economic value of the traditional and new diagnosis approach to VVS in children. MethodsA total of 81 children diagnosed as VVS were divided into two groups according to the different diagnostic approaches.The costs of hospitalization and diagnostic testings,and hospital stay were analysed.Data was evaluated by using the cost minimization analysis. ResultsThe cost of hospitalization per patient by the new diagnostic approach was 825.97 yuan RMB,which was less than that of the traditional diagnostic approach (2494.77 yuan RMB),and the cost of diagnostic testings per patient were 645.61 and 2058.85 yuan RMB,respectively. ConclusionCompared to the traditional diagnostic approach to VVS in children,the new diagnostic approach has good economic value,which should be popularized in clinical practice.

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Influence of ratio of balloon to pulmonary artery annulus and length of balloon on the effect of percutaneous balloon pulmonary valvuloplasty in children. Jin Youpeng,Wang Yulin,Han Bo 2006, 21(02): 99-102 .  Abstract ( )   AbstractObjectiveTo explore the effect of percutaneous balloon pulmonary valvuloplasty (PBPV) by various ratio of balloon diameter to pulmonary valve diameter(balloon/valve) and length of balloon in children. MethodsA total of 119 patients (aged 8.6±3.5 years) with pulmonary valve stenosis received PBPV.Peak systolic pressure gradients from the right ventricle to the pulmonary artery before and immediately after PBPV were measured by catheterization.The right ventricular cineangiogram was done before and immediately following dilation to measure the diameter of pulmonary valve annulus and observe the infundibular spazm.Doppler estimated the transvalvular pressure gradients before、24 hours、1 month、3 months、6 months、1 year and yearly after PBPV,respectively.Pulmonary artery regurgitation was observed by echocardiography. ResultsThe pressure gradients from the right ventricle to the pulmonary artery decreased continously after oversized percutaneous balloon pulmonary valvuloplasty in all patients.No significant correlation was found between the ratio of balloon/valve and pressure gradient decreasing rate.No restenosis occurred after PBPV.All cases developed pulmonary valve regurgitation and the degree correlated very well with ratio of balloon/valve.Higher ratio of balloon/valve and balloon length≥40mm led to the right ventricular infundibular spasm and triangular valve regurgitation,especially to children less than 6 years old.The triangular valve regurgitation which happened at mediate and long term after PBPV was perhaps due to the right ventricular volume overload. ConclusionThe best ratio of balloon/valve for PBPV was 1.0~1.2 with satisfying effects and less complications.The length of balloon less than 40mm is suitable for children less than 6 years old.

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Determination and analysis of the levels of plasma ET1 and AngⅡ in children patients with obstructive sleep apnea syndrome. Wan Genping,Gu Xiaoqiong,Liu Dabo 2006, 21(02): 103-105 .  Abstract ( )   AbstractObjectiveTo study the level of plasma ET1 and AngⅡ in child patients with obstructive sleep apneasyndrome and to discuss their clinical significance. MethodsEighty children patients with OSAS and 30 healthy children control were enrolled in the study;plasma ET1 and AngⅡ were measured. ResultsPlasma levels of ET1 and AngⅡ were significantly higher in patients with OSAS than those in control(P<0.05).There were negative correlations between the concentration of ET1 and the PSG in all the 80 children patients with OSAS.There were positive correlations between the concentration of AngⅡ and the lowest oxygen desaturation in all the 80 children patients with OSAS. ConclusionThese results indicate that the elevations of ET1 and AngⅡ in the children patients with OSAS may play an important role for the disease.

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Value of polysomnography in children with obstructive sleep apnea hypopnea syndrome and primary snoring. Xu Peiru,Zhang Xiaoying,Duo Likun. 2006, 21(02): 106-108 .  Abstract ( )   AbstractObjectiveTo explore the polysomnography(PSG) characteristics of obstructive sleep apnea hypopnea syndrome(OSAHS) and primary snoring(PS) in children and clinical value of PSG in children with sleep disorders. MethodsFrom Dec.2002 to Sep.2004 Medical University First Hospital 74 children with OSAHS and 62 with primary snoring were analyzed in Xinjiang,every patient being monitored with PSG for 7 hours at night for 16 parameters,including the apnea and hypopnea index(AHI),periodic leg movement index(PLMI),and the lowest oxygen saturation(LSaO2),etc.The parameters of the 2 groups were compared. ResultsCompared with PS group,there was statistically significant difference in the parameters such as PLMI,AHI,LSaO2,the moderate oxygen saturation(MSaO2)and apnea hypopnea index in NREM(P<0.05). ConclusionPSG is an importment method to distinguish PS from OSAHS in children.Confirmed diagnosis of the sleep disorders in chileren requires PSG recordings.

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Causes and diagnostic procedure of 50 children with chronic solitary cough. Zhao Shunying,,Ren yixin,Jiang Zaifang. 2006, 21(02): 109-111 .  Abstract ( )   AbstractObjectiveTo discuss the causes and diagnostic procedure of chronic solitary cough in children. MethodsWe chose 58 children with chronic cough who visited Beijing Children's Hospital Affiliated to Capital University of Medical Sciences from Oct.2003 to Aug.2004.Diagnostic procedures of two steps were used.Firstly,we differentiated chronic solitary cough from chronic cough.Secondly,we analysed the causes of chronic solitary cough. ResultsFifty cases of chronic solitary cough were identified from 58 children with chronic cough.Among them,20 cases had postnasal drop syndrome,17 cough variant asthma,5 postinfection cough,4 psychogenic cough,1 primary gastroesophageal reflux disease,2 eosinophilic brochitis and 1 unclear cause. ConclusionThe causes of chronic solitary cough in children included postnasal drop syndrome,cough variant asthma,postinfection cough,psychogenic cough and primary gastroesophageal reflux disease.Diagnostic methods of two steps can identify the causes of almost all chronic solitary cough in children.

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Exploration on the association between cytokines TNFα、IL6 、EPO and anemia of chronic diseases in children. Lin Xuefeng,Wang Zhong,Wu Xiumei 2006, 21(02): 112-113 .  Abstract ( )   AbstractObjectiveTo explore the role of TNFα，IL6 and EPO in the pathogensis of anemia of chronic diseases (ACD) in children. MethodsThe levels of serum TNFα，IL6 and EPO were determined by immunoassays in 19 ACD patients. ResultsThe serum levels of TNFα，IL6 in ACD patients were significantly higher than those in the control group (P<0.05).There were a positive correlation between the serum levels of TNFα or IL6 and serum ferritin. ConclusionTNFα，IL6 resulting from immune and inflammatory reaction may play an important role in the development of ACD by intervening iron metabolism,inhibiting the generation of erythropoietin (EPO)and dulling the response of bone marrow to EPO.

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Inspection of ESBLs produced by klebsiella and the relation to the application of clinical antibiotics. Li Xianbin,Zhu Yimin,Huang Caizhi 2006, 21(02): 114-116 .  Abstract ( )   AbstractObjectiveTo understand the relationship among the clinical distribution of klebsiella producing extendspectrum βlactamases (ESBLs),the instance of nosocomial infection and the application of clinical antibiotics. MethodsThe bacteria which were isolated from June 2003 to September 2004 in our hospital were indentified by API system.A KB test analysed the antimicrobial susceptibility and a double disk test detected ESBLs in the isolated klebsiella.The application of antibiotics in the patients before ESBLs were detected and the instances of nosocomial infection were investigated. ResultsA total of 305 strains of klebsiella were gained from the 14704 specimen;282 of the 305 strains were K.pneumoniae.In the 305 strains,51(16.7%) were from hospital.111(36.4%) of the 30 stains were ESBLs.The rate of ESBLs strains and the rate of nosocomial infection in the neonate department and intensive care unit(ICU) were significantly higher than those in other departments.The percentage of producing ESBLs in the klebsiella causing superinfection was significantly higher than that in the non superinfection strains.The resistance rate of IPM was the lowest in the eleven antibiotics;CIP was the later.The percentage of using any antibiotics and using the third generation cephalosporin before detection in the patients infected with ESBLs strains were 90.1%(100/111) and 71.2%(79/111) respectively,which was significantly higher than those in the patients infected with nonESBLs \[67.5%(131/194),18.6%(36/194)\].The difference was significant between the two groups (P<0.005). ConclusionThe nosocomial infection of klebsiella is related to the clinical distribution of the ESBLs strains.The using of the third generation cephalosporins is a risk factor of producing ESBLs.IPM and the compound preparations of antibiotics and enzyme inhibitor are the effective drugs to treat the patients infected with ESBLs klebsiella.

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Questionnaire survery of children allergic rhinitis and correlative life quality. Jiang Manjie,Li Zeqing,Ji Junfeng 2006, 21(02): 117-119 .  Abstract ( )   AbstractObjectiveTo make known the epidemic features of children allergic rhinitis (AR) and correlative life quality in Nanjing city,China. MethodsA questionnaire survey on AR and airway diseases was done among 1087 elementary school children,aged from 9 to10,of seven schools in Nanjing city by random cluster sampling,from March to May 2004.The survey included screening suspects of AR by filling up the questionnaires by their parents and then special examination for accurate diagnosis.All data were dealt with statistically. Results(1)A total of 989 parents returned their questionnaires and 942 questionnaires were available.(2)The prevalence rate of AR of children aged from 9 to 10 was 5.1% in Nanjing city,the difference of prevalence between females(5.6%,27/484)and males(4.6%,21/458) was not statistically significant (χ2=0.480,P>0.05).According to the classification criteria of ARIA(Allergic rhinitis and its impact on asthma) in 2001,26 children suffered from intermittent AR(mild 22 cases，moderatesevere 4 cases)，while 22 from persistent AR(mild 10 cases，moderatesevere 12 cases).(3)Sleep was influenced by nasal blockage 94/273(34.5%),which had statistical significance in children exam grades(χ2=30.691 P=0.000).(4)Survey results of children life quality:allergic rhinitis had statistically profound significance in children sleep、 character and memory.(5)27.1%(13/48)patients of AR had family history.(6) Allergens included dust or stimulating gas (33.4%，16/48)，pollen(37.5%，18/48)， pets(21%，10/48)，living environmental pollution after domestic decoration(23% patients were induced within one month to two years after domestic decoration ).(7)Only 4%(2/48)parents knew about the method of applying intranasal glucocorticoid;no one parent understood therapeutic principle which WHOARIA commended. ConclusionAllergic rhinitis influence many aspects of life( children sleep、 character and memory ).Nasal blockage has statistical significance in children exam grades.Heredity and environment play important roles in pathogenesis.The cognition degree of allergic rhinitis is at low level at present.

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Echocardiography diagnosis and clinical analysis of noncompaction of the ventricular myocardium in children. Yin Guotian,Zhao Guoan,Yang Xiuli 2006, 21(02): 120-122 .  Abstract ( )   AbstractObjectiveTo explore the clinical features of noncompaction of the ventricular myocardium in children. MethodsFour male children aged 5~10 years were included and underwent echocardiography examination with Toshiba PV6000,vivid7 color echocardiography machine and Doppler transducers (2~4MHz). ResultsClinical manifestations were gradually depressed heart function,ventricular arrhythmia,and no systemic embolism.Characteristic echocardiography showed were multiple prominent trabeculations and deep intertrabecular recesses communicating with left ventricular cavity. ConclusionNoncompaction of the ventricular myocardium in children is a rare congenital cardiomyopathy and often coexists with intracardic abnormalities.Its main clinical manifestations are heart failure and ventricular arrhythmia.Echocardiography is a reliable diagnostic tool for noncompaction of the ventricular myocardium in children.

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Clinical review and analysis of atypical EpsteinBarr virus infection in children. Deng Jikui,Zheng Yuejie,Yuan Xiongwei 2006, 21(02): 123-125 .  Abstract ( )   AbstractObjectiveTo evaluate the clinical features of atypical EpsteinBarr virus infection in children. MethodsFrom 2000/03/01 to 2005/04/30,the detection of EBVVCAIgM and/or EBVDNA was positive in 690 hospitalized children;422 were diagnosed infectious mononucleosis;retrospective analysis was made in the other 268 with atypical EBV infection. ResultsIn 268 atypical EBV infection,respiratory tract infection was 191,dermitis 13,diarrhea disease 10,idiopathic thrombcytopenia 10,nephritis or nephropathia 7,adenomesenteritis or deradenitis 8,ophthalmia 7,Kawasaki disease 4,hemophagocytic syndrome 4,central nerve system infection 4,myocarditis 2,desseminate encephalomyelitis 2,aplastic anemia 1,necrotizing lymphademitis 1,parotitis 1,hyperIgM syndrome 1 and acidocytosis 1.One case was not diagnosed.2 died of hemophagocytic syndrome. ConclusionThe systems and organs impaired by atypical EBV infection in children are diverse.The prognosis was different.Detection of EBVVCAIgM or EBVDNA is beneficial to early diagnosis and proper treatment.

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Detection and analysis of endocrinal markers and leptin in obesity boys. Du Hong,Cai Shaojiang,Ding Fengshu 2006, 21(02): 126-128 .  Abstract ( )   AbstractObjectiveTo study the changes of the endocrinal function and the relations between leptin and the endcrinal function in obesity boys. MethodsObesity group and control group are made up of 90 cases each,who were treated in our OPD between 2000 and 2004,aged 5 to 16 years.We have measured the levels of BMI,leptin,insulin,corticoids,sex steroids,blood lipide and had made statistical analysis of all the data. ResultsCompared with normal boys,obesity boys have remarkably higher levels of leptin,insulin,corticoids,estrovite,total cholesteroid,triglyceride,A/B,low density lipoprotein,very low density lipoprotein and obviously lower levels of testosterone and lateining hormone.BMI of obesity boys was correlatd negatively with levels of lepin,insulin,progesterone,prolactin、apoproteinA、A/B and positively with levels of corticoids,estrovite,apoprotein B and very low density lipoprotein. ConclusionSerum leptin level may be of a marker to evaluate the endocrinal function in obesity boys and interacts with insulin,corticoids and sex steroids.So it has influence on development of body,energy metabolism and stress reaction.