Archive

06 December 2009, Volume 24 Issue 12 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Clinical analysis of 5 children with severe influenza A（H1N1）virus infection . QU 　Dong, LIN Xiao-Xu, WANG 　Fei, LI 　Ying, GUO Lin-Ying, HU Feng-Hua 2009, 24(12): 923.  Abstract ( )   Abstract：Objective　To discuss the clinical features and realizations of severe influenza A（H1N1） virus infection in children. Methods　Analyzed the clinical features， laboratory examinations and imaging data of 5 children with severe influenza A（H1N1） virus infection. Results　5 children with severe influenza A（H1N1） virus infection do not have special symptoms and signs， just have flu-like symptoms such as fever， cough， headache， some children are also accompanied with digestive symptoms such as abdominal pain， vomit and diahorrea. When the patients’ conditions worsen， they have bad coughs， breathing difficulties， wet rales in the lungs， high heart rates， poor peripheral circulation， drowsiness or dysphoric and so on. The patients often experience MODS， among them the lungs are prominent. In laboratory examinations， white blood cells counts normal， low or high， most patients experience abnormal function of the liver， kidney and coagulation. The main x-ray manifest that many parts of the lungs are damaged. Conclusion　Severe  influenza A（H1N1） virus infection in children develop at an alarming rate， the risk of death is high. Early recognization， early diagnosis and early treatment is the key to decrease the death rate of severe influenza A（H1N1） virus infection.

Select

Perinatal risk factors of nosocomial neonatal sepsis in very low birth weight （VLBW） infants.　 DING 　Yan, SHI Ying-Ying, CHEN Ru-Hua 2009, 24(12): 926.  Abstract ( )   Abstract：Objective　To explore the perinatal risk factors and clinical features of nosocomial neonatal sepsis in very-low-birth-weight（VLBW ）infants. Methods　Twenty-nine VLBW infants with nosocomial sepsis and 108 VLBW infants with non-sepsis born in hospital from January 2005 to June 2008 composed the study population. Their maternal， perinatal，or postnatal variables were retrospectively analyzed. SPSS11.0 software was used to do statistical tests and  multiple logistic regression. Results　Among 137 VLBW infants ，twenty-nine were nosocomial neonatal sepsis （21.16% ，29/137）. The mortality rate was 13.79%（4/29），The incidence of nosocomial sepsis was increased with the gestational age and birth weight decreased. Gram-negative bacteria accounted for 70% of microbes， Klebsiella pneumoniae and Escherichia coli were the most common bacterial pathogen causing nosocomial infection， mainly extended spectrum betalactamase producing enterobacteriaceae （ESBLs）. Birth weight≤1000g was the most impotant risk predictor of nosocomial neonatal sepsis，incidence of NBSIs was 75%（6/8），OR 7.56（4.35～14.24）. The risk factors were in the order of percutaneously inserted central catheter （PICC）， anaemia，necrotizing enterocolitis（NEC） and apnea . Conclusion　Nosocomial neonatal sepsis is a common problem and the main cause of late-onset death among very-low- birth-weight （VLBW） infants. This nosocomial infection should be lowered by active management.

Select

The treatment of plasma exchange for the children with hemolytic-uremic syndrome and follow-up.　 DU 　Yue, TUN Yu-Bin, HAN 　Mei 2009, 24(12): 930.  Abstract ( )   Abstract: Objectives　To investigate the clinical characteristics of the children with hemolytic-uremic syndrome（HUS） and to verify the effect of plasma exchange in HUS. Methods　We analyzed 9 patients with HUS in renal service in Shengjing Hospital of China Medical University from July 2001 to September 2007. All patients were analyzed with main symptoms，lab examinations， treatment efficiency of steroid and IVIG and plasma exchange（PE）. All patients had been followed up from 0.5～6 years with treatment of oral administration of steroid. Results　It seemed that there was no difference in the clinical characteristics and the lab examinations between the patients with D+ HUS and D- HUS. The patients should be treated with plasma exchange as soon as possible if there was no effect with steroid or IVIG. Blood dialysis or plasma exchange would be added if there was no obvious effect with PE for the first time. Steroid would be orally administered by the HUS patients with proteinuria after PE， which was effective for proteinuria. Among the following 9 patients， 1 patient was followed with proteinuria and was done with re-renal biopsy， which showed increased antigen and renal interstitial injury， 1 patient with hypertention. There was no abnormal signs for the other 7 patients. Conclusion　It is effective for the patients with HUS treated with plasma exchange. It seems that oral administration of steroid is effective for the HUS patients with proteinuria. All patients with HUS should be paid more attention to in the long-term follow up.

Select

Variation of pathogens and analysis of drug resistance of bacterial diarrhea in children during recent 10 years. JI Wen-Jing, DONG 　Fang, XU Xi-Wei 2009, 24(12): 934.  Abstract ( )   Abstract： Objective　To study variation of pathogens of bacterial diarrhea in children during recent 10 years， and to analyze drug resistance of these bacterial strains. Methods　A total of 859 cases， who were hospitalized in Beijing Children’s Hospital due to bacterial diarrhea from 1998 to 2007，with positive stool culture， were included in our study. And their clinical data were also studied retrospectively. Statistics was analyzed by SPSS13.0. Results　（1）Among 859 bacterial trains of positive stool culture， there were 585 Shigella，89 Salmonella，56 E coli，92 Proteus， and 37 Staphylococcus aureus. （2）The ratio of Shigella decreased from 82.5% of 1998 to 52.9% of 2007.Detection of Staphylococcus aureus and E coli were began at 2001 and 2002， respectively， and their ratios gradually increased to 9.4% and 14.1% in 2007， respectively. （3）The peak onset（73.9%） of bacterial diarrhea was in summer and autumn. Salmonella， E coli， and conditional pathogenic bacteria were found with high detection ratio in younger-aged group. （4）The drug resistance ratio of enteric pathogenic bacteria to penicillin and sulfamethoxazole were both above 50%. Except E coli， the enteric pathogens showed low drug resistance to quinolones， third generation cephalosporins and imipenem， with ratios of 13.0％～24.2%，5.9％～62.5% and 0，respectively. The resistance ratios of E coli to amikacin and imipenem were 7.5% and 0%，respectively， and its ratios to other antibiotics were all above 50%. Conclusion　The structure of pathogens of bacterial diarrhea in children and their drug resistance pattern are changing continuously. It should be emphasized to monitor pathogens and drug resistance in order to select antibiotics reasonably.

Select

Detection for phenotype and genetype of the enterococci in children . LV 　Ping, XU Xi-Wei, SONG Wen-Qi, DONG 　Fang, YANG Yong-Hong, CHEN Xu-Peng 2009, 24(12): 937.  Abstract ( )   Abstract：Objective　To detect the drug resistant phenotype and drug resistant genetype of the enterococci in children. Methods　Agar dilution was used to study the drug resistance and polymerase chain reaction was used to test ermB，mefA ，TetM，TEM，aac（6'）-aph（2″） and ant（6）-I gene. Results　The resistant rate of E.faecium toampicillin，amoxicillin-clavulanic acid，ciprofloxacin， rifampin， high level gentamicin and streptomycin were higher than E.faecalis.The resistant rate of E.faecium to chloramphenicol was higher than E.faecalis.The MIC of vancomycin was 8ug/ml in two E.faecalis.In E.faecalis and E.faecium isolates were all susceptible to teicoplanin.High rates of antibiotic resistance genes were found.The detectable rate of ermB， TetM aac（6'）-aph（2″） and ant（6）-I gene in E.faecalis was higher than in E.faecium. In only one E.faecium was found MefA. The detecable rate of TEM in E.faecium was higher than in E.faecalis. Conclusions　The antimicrobial resistant status of the enterococci is very serious.High rate of antibiotic resistance for multiple antibiotics were found in enterococci，the antibiotic resistante rate in E.faecium is higher than in E.faecalis.

Select

Value of biochemical markers in the diagnosis of biliary atresia and NICCD. BANG Bing-Wei- , XU 　Yi, XIE Jia-Wei, OU 　Qian, SU Yan-Chi 2009, 24(12): 940.  Abstract ( )   Abstract： Objective　To evaluate the value of biochemical markers in the diagnosis of biliary atresia （BA） and neonatal intrahepatic cholestasis caused by citrin deficiency （NICCD）. Methods　Totally 77 infants in hospital with infantile hepatitis syndrome （IHS） were enrolled from December 1， 2008 to March 31， 2009. Totally 27 patients were diagnosed as having BA and 11 with NICCD. Biochemical markers were compared between groups including alanine transaminase ALT， aspartate transaminase AST ， alkaline phosphatase ALP， γ-glutamyl transpeptidase γ-GT， total bilirubin TB， direct bilirubin DB， total bile acid TBA， total cholesterol TC，to compute ALT/AST，ALP/γ-GT and glucose GLU， lactic acid LAC， total protein TP，  albumin ALB in the NICCD group. The data were analyzed by T test and ROC curve with SPSS10.0. Results　γ-GT was significantly elevated in the infants with BA when compared to non-BA group （P = 0.003）； cut-off point was 332.5U/L. ALP/γ-GT was significantly lower in the patients with BA，and cut-off point was 1.93. The infants with NICCD had significantly different biochemical markers including GLU， LAC， TP， ALB， ALT/AST and γ-GT. Conclusion　Biochemical markers could be considered as complementary diagnosis of BA and NICCD for differentiating infants with IHS.

Select

The relationship of climatic factor and dermatophagoides farinae positive rate of skin prick tests（SPT） on Chongming island. TAN Yong-Jiang-1, GU Hai-Ping-2, CAO Lan-Fang-3 2009, 24(12): 943.  Abstract ( )   Abstract  Objective　To explore the relation between climatic factor and dermatophagoides farinae positive rate of skin prick tests（SPT） on Chongming island. Methods　The 290 children patient who were diagnosed with allergic diseases were examined by skin prick tests（SPT） with dermatophagoides farinae provided by Allergopharm Corporation from January 2005 to December 2008 on Chongming island，at the same time the climatic data were collected every day. The positive rate of  dermatophagoides farinae examined by skin prick tests（SPT） of different months and seasons ，different monthly average air temperature and relative humidity before skin prick tests were analyzed.The data were analyzed by SPSS15.0. Results　The general dermatophagoides farinae positive rate of 290 children with allergic diseases was 81.7%（238/290），and the positive rate of children with asthma and allergic rhinitis was higher than the others（χ2 = 21.51，P = 0.000）. The positive rate of  dermatophagoides farinae of different months and seasons were different. The positive rate from July to November，both summer and autumn,was higher than the others（Z = 2.789、P = 0.005 andχ2 = 11.959、P = 0.008）.When the monthly average air temperature exceeded 18℃ and the monthly average relative humidity surpassed 70%； the positive rate of  dermatophagoides farinae was higher than the others（χ2 = 6.643、P = 0.036 and χ2 = 5.138、P = 0.023）. All of the differences were significant. Conclusion　The general dermatophagoides farinae positive rate of SPT with allergic diseases is 81.7% on Chongming Island. The positive rate of dermatophagoides farinae of different months and seasons are different. The dermatophagoides farinae positive rate of SPT under different monthly average air temperature and relative humidity are different too. The climatic factor， such as air temperature and relative humidity， may impact the results on SPT of dermatophagoides farinae.

Select

Effect of neuropeptide substance P on the type Ⅱ alveolar epithelial cells exposed to hyperxia and relationship with extracellular signal-regulated protein kinase signal transduction pathway. HUANG 　Bei-1, LI 　Jing-1, XIE 　Mei-1, YANG Hai-Yan-1, KUANG Feng-Wu-2, HU 　Feng-2 2009, 24(12): 959.  Abstract ( )   Abstract Objective　To investigate the regulatory mechanism of neuropeptide substance P（SP） in lung injury induced by hyperxia and the relationship between SP and extracellular signal-regulated protein kinase（ERK）signal transduction pathway. Methods　The primary premature rats type II alveolar epithelial cells（AECⅡ） were isolated and purified.They were randomly divided into 3 groups， including air group， hyperxia group and SP intervention group. Air（21% oxygen） group and hyperxia（95% oxygen） group were placed in the closed oxygen chamber for 48 h respectively. With regard to SP intervention group， SP（1×10-6 mol/L） was added before the exposure.As following， the group was exposed to 21% and 95% oxygen for 48 h respectively. Sample of each group was obtained at 12，24 and 48 h and morphologic change of AECⅡ was observed under electron microscope.MTT and flow cytometry was employed to detect the growth rate and apoptosis rate respectively.Dynamic change of phosphorylated ERK was determined using Western blot. Results　Growth rate of AECⅡ in hyperxia group decreased signifcantly and the apoptosis rate increased remarkbly compared to air group.The growth rate increased notablely and the apoptosis rate decreased obviously after the intervention of SP.Meanwhile， the morphologic injure improved signifcantly.Hyperxia stimulation could result in activation of ERK phosphorylation，and the expression of phosphorylated ERK increased remarkbly in the impaired AECⅡ induced by hyperxia.Nevertheless，the expression of ERK increased notably after the intervention of SP. Conclusion　SP could promote the proliferation and inhibit the apoptosis of AECⅡ exposed to hyperxia via suppressing activation of ERK signal and then inhibiting the apoptosis，which has a protective effect on AECⅡunder oxidative stress.