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06 March 2010, Volume 25 Issue 03 Previous Issue    Next Issue

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Significance of epithelial to mesenchymal transition in children with steroid-resistant nephrotic syndrome. ZHOU Pin， HE Qing-nan， TAN Ai-bin， LI Xiao-yan， JIANG Ying， HUANG Ai-wen， YI Zhu 2010, 25(03): 191.  Abstract ( )   Objective　To study the relationship of epithelial to mesenchymal transition with renal pathological progression and slucocorticoid resistance in idiopathic nephrotic syndrome. Methods　The different expressions of CK and vimentin were detected with the immunohistochemistry double staining technique in renal biopsy tissues obtained from 20 SRNS children，20 SSNS children and 5 nephrectomized healthy children， respectively. Renal histopathological lesion was evaluated by the semi-quantitative counting scores. Results　The tubulointerstitial pahological counting scores in SRNS group was higher than that in SSNS group （P < 0.05）. There was no vimentin but CK expression on the tubular epithelium in the control group and different levels of expression of vimentin were found in INS group. In SRNS group，the expression of CK was lower than SSNS group [（66.25±12.13）% ，（76.64±7.64），P < 0.05] and the expression of vimentin was higher than SSNS group [（11.51±7.48）%， （4.98±2.27）％， P < 0.05]. With the raising grade of tubulointerstitial lesions （graded as mild， moderate and severe lesions），the expression of vimentin was increased wheres expression of CK was decreased [vimentin， （4.74±1.84 ）％，（9.65±5.10）％，（23.60±7.72）％， P < 0.05]； CK，（79.97±3.70）％，（65.47±7.93）％，（48.47±5.98）％，P < 0.05]. The counting scores of the tubulointerstitial lesions were positively correlated with the level of vimentin expression（r = 0.868，P < 0.01）， but negatively correlated with CK expression level in renal tissues （r = -0.887，P < 0.01）. Conclusion　The phenomenon of EMT exists differently in renal tissues of INS cases and the degree of those is higher in SRNS group. The detection of EMT in renal tissues can be adopted to tell the different prognoses in INS.

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Relationship between family history and dyslipidemia in children. YAN Hui*， MI Jie， LIU Ying， CHENG Hong，CHEN Jian-jun， ZHANG Xiu-zhi 2010, 25(03): 195.  Abstract ( )   To investigate the relationship between family history and dyslipidemia in children. Methods　This study was performed by research group on adult chronic diseases prevention and therapy in children.Cluster randomized sampling in a transecting epidemiological survey of children aged 6 to 18 years in Beijing area were used； 9665 boys and 9641 girls were virtually included in the study. They were divided into four subgroups， including school boys， school girls， adolescent boys and adolescent girls. Parent history of metabolic syndrome and premature cardiovascular diseases were defined as first degree family history， grandparent or/and uncle/aunt history of metabolic syndrome and cardiovascular diseases were defined as second degree family history， while others were defined as without family history. Fasting capillary blood total cholesterol （TC） and triglyceride （TG） levels were detected. Results　TC and TG levels of school boys and adolescent boys with first degree family history were all much higher than boys without family history（4.07±0.41）mmo/L vs（4.00± 0.33） mmo/L，P < 0.05； TG of adolescent girls was significantly higher than girls without family history （1.26±0.75） mmo/L vs （1.20± 0.66 ） mmo/L，P < 0.05. TC and TG levels of school boys and adolescent boys with second degree family history were all much higher than boys without family history（P < 0.05）； TC levels of school girls and adolescent girls with second degree family history were all much higher than girls without family history（P < 0.05）. Possibility of dyslipidemia of  school and adolescent boys and school girls with first degree family history was much higher than those with non- first degree family history（11.6 %vs 7.1%， 11.2 %vs 8.4%， 10.8% vs 8.0%，P < 0.05）. Possibility of dyslipidemia of adolescent boys and girls with second degree family history were significantly higher than those without family history （10.3% vs 7.8%，14.7% vs 11.8%，P < 0.05）. Conclusion　The lipid level of children differed significantly according to different background of family history. Not only first degree family history but also second degree family history ought to be considered in screening of dyslipidemia in children.

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A study of clinical features，EEG and prognosis of patients with early-onset benign childhood occipital epilepsy. ZHOU Hao，LIANG Jin-ping 2010, 25(03): 199.  Abstract ( )   Objective　To investigate the clinical seizure patterns， morphology and topography of epileptic discharges and prognosis of Early -Onset Benign Childhood Occipital Epilepsy（EOBCOE）. Methods　According to the criteria of EOBCOE made by ILAE（2001），eighteen patients with EOBCOE were retrospectively followed up and the data analyzed regarding clinical manifestation， interictal and ictal EEG during awakeness and sleep as well as therapeutic efficacy of 4 years. Results　The onset of seizures occurred at the age between 2 years and 2 months and 8 years and 6 months with a mean age of 4.7 yrs. Five of eighteen cases had a family history of epilepsy and/or febrile seizures， one of whom was identified as the idiopathic epilepsy；4 cases had febrile seizures. The remarkable autonomic seizures and delayed specific motor seizures were the clinical hallmark of EOBCOE， including pallor and ictal vomiting， followed by the eye and head deviation， and unilateral or generalized motor seizures， and even autonomic status epilepticus associated with a partial impairment of consciousness. Two cases had Rolandic seizures including speech arrest， hemifacial spasms and salivation. Most of cases had sporadic seizures with free- intervals of 1~6 months or longer， but some of them still had frequent seizures. EEG showed 13 cases had occipital or occipital predominance of multifocal epileptic discharges including focal occipital spikes in 9 cases， the occipito-temporo-parietal or occipito-frontal spikes in 4 cases；4 had extraoccipital spikes， including Rolandic spikes or frontal predominance of paroxysmal generalized discharges in 2 cases respectively. Interictal spikes were typically of high voltage of polyphasic spike-waves and easily blocked by eye opening. Ictal EEG showed the occipital or frontal predominance and generalized rhythmic spike-wave complex. Patients with EOBCOE were responsive to CBZ，VPA and TPM. Seizures ceased in 11 cases， were partially controlled and fluctuated in 4 and 2 cases respectively；one died of sudden unexplained death. The abnormal EEGs were improved in 8， unchanged in 4 and became normal in 5 cases. All patients developed normally except 7 who were found to have mild learning and behavour problems. Conclusion　EOBCOE is characterized by  paroxysmal autonomic symptoms and signs， focal or generalized motor seizures or autonomic status epilepticus，which is associated with other benign childhood focal seizures and epilepsy. EEGs show the occipital predominance or extraoccipital spikes of multifoci. Prognosis is generally good.

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Correlation between impulsivity and executive function in children with attention deficit　hyperactivity disorder. GENG Yao-guo*，SU Lin-yan，WANG Hong，CAO Feng-lin. 2010, 25(03): 204.  Abstract ( )   Objective　To survey the correlation between impulsivity and execute function in children with ADHD. Methods　A total of 187 ADHD children（who met the DSM-IV criteria） and 126 controls were evaluated with the Barratt Impulsiveness Scale （BIS） and Wisconsin Card Sorting Test （WCST）. Results　There were no significant differences between ADHD children and controls（P > 0.05），negative correlation was found between total score，three keys of BIS and non-persistence errors（P < 0.05）. Conclusion　In current study，ADHD children do not show obvious executive deficit function；there was significant negative correlation between non-persistence errors and BIS.

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Behavioral features of children with autism in developmental test. WAN Guo-bin， WANG Wei-shi， WEI Zhen， HE Hui-jing， HE Man-yu. 2010, 25(03): 206.  Abstract ( )   Objective　To explore behavioral features of children with autism in developmental test. Methods　The subjects were 70 Autistic children ranging from 18 to 42 months in age（31.98±6.38）， and 140 normal children ranging from 18 to 42 months in age（31.39±6.30）. They were assessed by the Bayley Scales of Infant Development （BSID）， the Developmental Diagnostic Scale of Children Aged 0～4 Years， and infants and toddler’ behavior rating scale （ITBRS）. Results　T tests showed that scores of orientation， emotional regulation， responsiveness and motor quality ， and total scores of ITBRS were lower in autistic children than normal children（P < 0.01）. In autistic children group， scores of orientation， emotional regulation， responsiveness and motor quality ， and total scores of ITBRS were 14.54± 4.60， 19.36±4.74， 18.53±3.75， 9.37±1.22， 72.01±11.01 respectively. In normal children group， scores of orientation， emotional regulation， responsiveness and motor quality ， and total scores of ITBRS were 26.78±4.89， 31.69±4.50， 21.76±2.14， 9.86±0.54， 102.72 ±9.54 respectively. Conclusion　There are differences in tested behaviors between autistic children and normal children. Ability of orientation， emotional regulation， responsiveness and motor quality were lower in Autistic children than those in normal children. The results indicated that ITBRS can be used as a Screening tool for autistic disorders.

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Clinical outcomes of extremely premature infants. 2010, 25(03): 209.  Abstract ( )   Objective　To analyze the mortality ， morbidity and a variety of perinatal and neonatal factors of extremely premature infants with gestational age of < 28 weeks.  Methods　The clinical charts of 219 infants with gestational age of < 28 weeks cared in NICU of St Louise Children’s Hospital in USA were reviewed and the data were analyzed retrospectively with SPSS software. Results　The mortality was 37.7% and NEC， grade 3 or 4 IVH and PIH were independent risk factors for death. For survivors， the mean length of hospital stay was （106.0±78.1） days； the duration of mechanical ventilation， nasal continuous positive airway pressure and oxygen administration， was （30.8±38.5）days， （10.5±11.5）days and （84.0±46.7）days， respectively. The incidences of RDS，PDA，BPD，IVH，ROP，PVL，NEC and BSI were 85.5%、62.3%、74.2%、36.5%、71.1%、12.6%、12.6% and 29.6%， respectively， with 55.9% infants discharging home on oxygen. Conclusion　 Survival without disability is possible， but the morbidities are still high in extremely premature infant with gestational age of < 28 weeks. Individualized discussions and approaches to this group of infants are suggested.

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Analysis of clinical characteristics in 109 children with postural orthostatic tachycardia syndrome. LIAO Ying，ZHANG Feng-wen，CHEN Li，JIN Hong-fang，DU Jun-bao. 2010, 25(03): 212.  Abstract ( )   Objective　To investigate clinical characteristics of children with postural orthostatic tachycardia syndrome （POTS）. Methods　 One hundred and nine children aged （11.79±2.55） years who were diagnosed with POTS by standing test or head-up tilt test in the clinics were selected as POTS group. Twenty healthy children aged （11.55±3.65） years served as control group. History collection and physical examination were done for every POTS child.  Clinical characteristics of POTS children were summarized by comparing the two groups. Results　 There were no statistical differences between POTS children and healthy children in age， sex ratio， height， body weight， supine heart rate and supine mean arterial pressure between the two groups. About 52.3% POTS children took syncope as major symptoms. About 42.2% of them experienced frequent episodes （> 10）. The symptoms were most likely to occur in summer and autumn （42.1%） among seasons and in the daytime （56.0%） during a day. The most common trigger of symptoms was prolonged standing （50.5%）. Eighteen cases had their OI symptoms accompanied by seizures or some other symptoms. And fatigue was the most common feeling after the episodes. Ninety children （82.6%） had healthy past history. Forty-six cases had motion sickness （42.2%）. POTS children were more likely to take light diets and less water compared with healthy children. About 27.6% POTS children had family history of OI symptoms. Conclusion　Children with POTS are usually in school-age or adolescent period and have a high incidence of syncope. Their symptoms mostly occurr in summer and autumn. Prolonged standing， postual change， mental tension and infection was common triggers. Some of the POTS children have family history and experience of motion sickness.