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06 September 2010, Volume 25 Issue 09 Previous Issue    Next Issue

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A case-control study on family environment factors in attention-deficit hyperactivity disorder with learning disabilities.　 ZHANG Ti-Bing-1, 2 , LUO Hua-Rong-2, LIU 　Xia-3, DING 　Jun-2, GUAN Bing-Qing-4, YUAN Xiu-Hong-4, XIE Hai-Sen-4, YANG 　Wei-5, NING Zhi-Jun-6, HUI 　Zhen-2 2010, 25(09): 685-687.  Abstract ( )   A case-control study on family environment factors in attention-deficit hyperactivity disorder with learning disabilities.　　ZHANG Yue-bing*，LUO Xue-rong，LIU Xia，DING Jun，GUAN Bing-qing，YUAN Xiu-hong，YE Hai-sen，YANG Wei，NING Zhi-jun，WEI Zhen. *Mental Health Institute，Second Xiangya Hospital，Central South University，Changsha 410011，China Abstract：Objective　To further explore the characteristics of family rearing pattern in ADHD with learning disabilities（LD）. Methods　From Sep. to Dec. 2005，a total of 9495 children and their parents were sampled at random in Hunan province using two-stage investigation. Those who were diagnosed with ADHD with LD and the normal control filled out Egna Minnen av Barndoms Uppfostran （EMBU） and family adaptability and cohesion scale （FACESII—CV） by themselves. Results　The parents’ punishments，rejection，excessive intervention，excessive protection and preference of ADHD with LD were lower than the normal children（P < 0.05）. The actual family cohesion，ideal family cohesion， actual family adaptation，ideal family adaptation and affectionate warmth of ADHD with LD were lower than the normal children（P < 0.05 or P < 0.01）. Conclusion　There are some problems in the parental rearing pattern of ADHD with learning disabilities. It is important to avoid bad rearing pattern and find effective interventions.

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Analysis of correlation between sleep postures and sleep disorders among children. WENG Xue-Hua-1, LI Ge-Min-1, JIANG 　Pan-1, LIU Ji-Gong-1, LUO Xue-Mei-1, CA Yi-Min-2 2010, 25(09): 688-690.  Abstract ( )   Analysis of correlation between sleep postures and sleep disorders among children.　　WENG Xue-hua*，LI Jie-min，JIANG Yan，LIU Ji-hong，LUO Xue-mei，CAI Yi-min. *Department of Pediatrics，the Second Xiangya Hospital， Central South University， Changsha 410011，China Abstract：Objective　To investigate the relationship of sleep posture with sleep disorder among children. Methods　Totally 2706 parents of 3 to 12-year old children in five administrative districts of Changsha were randomly selected for questionnaire research from Jun. 2006 to Apr. 2007. Results　As to various sleep positions， 50.92% of children belonged to the lateral position group， 26.42% to the prone position group， and 22.65% to the supine position group respectively. The mean age of children in the lateral position group was （7.83 ± 2.69） yrs，（6.35 ± 2.49）yrs in the prone position group， and （7.79 ± 2.63） yrs in the supine group， with significant difference among the 3 groups （F = 82.871， P < 0.05）. The incidence of sleep disorders was 50.6%，37.6% and 29.9% in the prone position group，lateral position group and the supine group respectively，and the difference among these 3 groups was statistically significant （χ2 = 63.101，P < 0.05）. Incidence of related symptoms of sleep disorders， including hyperhidrosis， bruxism， squirm， body twitching and awakening，in the prone position was higher than that in supine position （χ2 = 61.828、8.973、8.946、8.614、7.154，P < 0.0125）， while the rates of hyperhidrosis， sleep snoring， squirm and breathing by mouth in prone position were still higher than those in the lateral position group （χ2 = 6.553、11.176、9.693、9.552，P < 0.0125）. Conclusion　There is a correlation between sleep postures and sleep disorders among children， which should be concerned about by the health care workers and parents. Children should be accustomed to supine position rather than the prone position.

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Clinical and electroencephalographic characteristics of Panayiotopoulos syndrome.　 CHEN Chun-Gong, TUN Hu-Sheng, LV Dun-Lan 2010, 25(09): 691-693.  Abstract ( )   Clinical and electroencephalographic characteristics of Panayiotopoulos syndrome.　　CHEN Chun-hong，WU Hu-sheng，LV Jun-lan. Neurology and Rehabilitation Center，Beijing Children’s Hospital Affiliated to Capital University of Medical Sciences，Beijing 100045，China Abstract：Objective　To summarize the clinical characteristics and electroencephalographic features of Panayiotopoulos syndrome （PS） and to gain better understanding of it. Methods　The clinical data of 8 patients with PS in Neurology and Rehabiliation Center Beijing Children's Hospital affiliated to Capital University of Medical Sciences were analyzed from Apr. 2008 to Dec. 2009. Results　Of the 8 patients，the age of first seizure was from two years and nine months to five years and eleven months，four years in average. Of all the patients，there personal history （ pregnancy，birth，neonatal period and psychomotor development） was normal except that two patients had febrile seizures. All patients had ictal vomiting，which was the first apparent symptom；3 patients had pallor and general fatigue，3 patients had nausea and felt  uncomfortable，one had dizziness and nausea and one had incontinence of faeces. These autonomic manifestations were followed by seizure symptoms；6 patients manifestated deviation of the eyes； 2 patients had eyes turned upward；2 patients had ipsilateral head deviation which occurred in 6 of them simultaneously with eye deviation；one patient had unilateral limb jerk，two patients had generalized convulsion and 7 patients had unconsciousness. The duration of seizures were 2 to 3 minutes in one patient，10 to 20 minutes in 6 patients and 2 hours in one. EEG studies showed that occipital spikes were observed in 4 patients，frontal spikes in 2 patients ，centrotemporal spikes in one patient and EEG was normal in one patient. Conclusion　Panayiotopoulos syndrome is an age-related benign idiopathic epilepsy syndrome occurring in early and mid-childhood；it is characterized by seizures，often with predominantly autonomic symptoms，espically emesis，followed by unilateral deviation of the eyes or head，with unconsciousness and generalized convulsion. The EEG mainly  reveals multifocal discharge that may appear in any area，often in occipital region. It is emphasized that clinical manifestations are more important in diagnosing PS.

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Children partial epilepsy manifesting hypermotor seizures： analysis of 7 cases and literatures review. CHEN 　Qian, ZHANG Gui-Zhen, JIANG Chi-Chi, WANG 　Yang, ZHONG Di-Xiao, HU Ke-Ming 2010, 25(09): 694-698.  Abstract ( )   Children partial epilepsy manifesting hypermotor seizures： analysis of 7 cases and literatures review.　　CHEN Qian，ZHANG Gui-zhen，JIANG Li-li，WANG Yang，ZHONG Di-xiao，XU Ke-ming.Capital Institute of Pediatrics，Beijing 100020，China Absract：Objective　To approach the clinical characteristics of childhood partial epilepsy presenting HMS. Methods 　From Jun. 2003 to Jua. 2009 in Capital Institute of Pediatrics，Video-EEG was performed on 7 children who met the H. Lüders semiology diagnosis criteria；analyzed the clinical episode by reviewing the videotapes，observe the ictal and interictal EEG manifestations and follow up the effect on antiepileptic drugs. Results　Totally 29 attacks were recorded in 7 cases by Video-EEG monitor. The seizures lasted from 10 to 84 seconds， 22 of which occurred during sleep and 7 during awakeness.HMS consisted of mild or marked agitation and HM behavior including claping，waving arms，boxing，tapping，scratching，kicking or horizontal movements of trunk and pelvis while lying on the bed.The non-HM signs included eyes and head，neck，trunk and limbs deviation，dystonic posturing，flushing and fear or angry expression on the face. Lateral or bilateral sharp or spike waves at frontalpole and frontal leads were found in all cases except one in the interictal EEG，while ictal EEG demonstrated frontalpole or frontal onset rhythmic low amplitude fast activity at lateral or bilateral leads in all the cases ，immediately covered by motor artefacts and recovered by primary background activity after the episode. Conclusion　HMS，as a manifestation of partial epilepsy presents marked agitation and HM behavior characteristics that may accompany with dystonic posturing and expression，ictal and interictal EEG demonstrates lateral or bilateral epileptic waves at frontalpole or frontal leads. Seizures can be controlled satisfactorily by carbamazepine or oxcarbazepine.

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Clinical research of Langerhans cell histiocytosis combined with central nervous system involvement（analysis of 98 cases）.　 ZHANG 　Chi, MA Hong-Gao, GU Chen-Guang, ZHANG Yong-Gong, YANG 　Shuang 2010, 25(09): 698-701.  Abstract ( )   Clinical research of Langerhans cell histiocytosis combined with central nervous system involvement（analysis of 98 cases）.　　ZHANG Li，MA Hong-hao，JIA Chen-guang，ZHANG Yong-hong，YANG Shuang. Beijing Children’s Hospital，Capital Medical University，Beijing 100045，China Abstract：Objective　To study risk factors，clinical and imaging features and prognosis of children LCH combined  with central nervous system involvement. Methods　We conducted neurological signs inspection，cranial MRI and periodical monitoring and assessment in 98 LCH patients in Bejing Children's Hospital，Capital Medical University during the period of 2005-2008. Then we use SPSS13.0 software to analyze the log. Results　（1） We found 24 patients having central nervous system involvement，17 patients in group Ⅰ，7 cases in group Ⅱ.（2）Totally 19 of them had craniofacial bone destruction，16 of them had neurological symptoms and 9 had diabetes insipidus. Cranial MRI showed the involvement of pituitary was common and existed in 14 of them. （3） All of the 24 patients were treated by LCH-Ⅲ schema. From then on，6 of them in non-active status，10 of them in stable status，4 of them in progressive status and 4 of them died. Conclusion　Violation of CNS is a common combination of LCH. The risk factors of CNS include craniofacial bone destruction and “Risk organ” involvement. The most common imaging change is the hypothalamus-pituitary axis changes. MRI is a very important monitoring method. The central nervous system damaged is irreversible. Once occurring，it will significantly affect the life quality of patients.

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Expression and clinical significance of peripheral Th17 cell in children with acute leukemia.　 TUN Xiao-Yan, JIN Run-Ming, TU 　Hui, WANG 　Fang, JIA 　Yi 2010, 25(09): 702-704.  Abstract ( )   Expression and clinical significance of peripheral Th17 cell in children with acute leukemia.　　WU Xiao-yan，JIN Run-ming，YU Hui，WANG Fang，XIA Yi. Pediatrics Department of Union Hospital，Tongji Medical School，Huazhong University of Science and Technology，Wuhan 430022，China Abstract：Objective　To study the relationship between peripheral blood Th17 cells and the occurrence and status of disease of children with acute leukemia. Methods　From Aug. 2008 to Dec. 2009 in Pediatrics Department of Union Hospital，Tongji Medical School Huazhong University of Science and Technology， 42 children with acute leukemia and 18 healthy children were divided into non-remission group （Group A，n = 23），remission group （Group B，n = 19） and control group （Group C，n = 18）. Concentration of IL-17 and IL-23 in the peripheral blood monocytes culture supernatant after stimulated with anti-CD3 and anti-CD28 mAb were determined with ELISA. Expression of CD4+ IL-17+ cells was determined with flow cytometry. Results　The concentrations of IL-17 and IL-23 in Group A and Group B were much lower than those in Group C（P < 0.05）. The level of IL-17 in Group A was lower than that in Group B（P < 0.05），while the difference of IL-23 concentration between Group A and Group B was not significant（P  > 0.05）. The expression level of Th17 in Group A and Group B were much lower than those in Group C（P < 0.05），and the difference of Th17 expression level between Group A and Group B was significant（P < 0.05）. Conclusion　Th17 cells might play important role in the occurrence and development of children acute leukemia through secreting IL-17，and their function level can partly reflect the status of leukemia and evaluating the risks of infection in children with leukemia.

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Molecular genetic study of Y chromosomal material in Turner syndrome. LI 　Cheng-1, CHENG 　Qian-2a, DENG 　Bing-2b, LI Ya-Sha-2b 2010, 25(09): 705-708.  Abstract ( )   Molecular genetic study of Y chromosomal material in Turner syndrome.　　LI Cheng*， CHENG Qian，DENG Bing，LI Ya-sha. *Department of Pediatrics，the Affilicated Hospital of Luzhou Medical College， Luzhou 646000，China Abstract： Objective　To determine the presence of Y chromosomal material for Turner syndrome（TS） in Chongqing，so as to provide suggestion for monitoring the patients after diagnosis and  improve the supervision and care in China. Methods　Thirty patients with TS were recruited from the Outpatient at Children’s hospital of Chongqing Medical University from Feb.2006 to Aug.2007. Cryptic Y chromosomal material was analyzed: TSPY（Testis-specific protein Y-encoded）， DYZ3 （centromeric DYZ3 repeat）and SRY （sex-determining region Y） were amplified by PCR using genomic DNA， and SRY FISH analysis was employed as supplement for the positive. Results　We found 3 cases （10.00%）were positive for TSPY and DYZ3 ， only 1 （3.30%） of whom was positive for SRY in the cases. SRY in 3 cases  were all positive in FISH analysis. Conclusion　It is the first molecular study on cryptic Y chromosome material in China that 3 Y-specific sequences along the Y chromosome have been selected for analysis. Our studies show that the Y chromosomal material is not rare in TS of Chongqing. It suggests that Y chromosomal mosaicism screening should be mandatory supervision after diagnosis.

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Association of hsCRP and HOMA-IR with overweight or obesity in the Hazakh children. LIU 　Xiang-1, LI 　Min-1, XU Pei-Ru-1, XIE Meng-Gang-2, LIU 　Yu-3 2010, 25(09): 709-711.  Abstract ( )   Abstract：Objective　To approach the correlation of overweight or obesity with hsCRP and HOMA-IR in the Hazakh children in Xinjiang. Methods　A total of 2475 Hazakh students at the age of 6～14 years old in the city of Yili， Xinjiang were studied from May 2009 to July 2009 by the method of cluster sampling. Totally 122 children with overweight or obesity were included， and 119 healthy children were enrolled as control at the same level and sex. BMI，hsCRP，FPG and FINS were determined respectively. By calculating HOMA-IR， the difference between the two groups was in comparison， and the relationship was studied. Results　Compared with the control group， hsCRP， FINS and HMOA-IR in the overweight or obesity group increased significantly； FPG ，LDL，CHO and HDL had not statistical significance between the two groups. Pearson correlation analysis showed that there was a notable correlation between BMI，hsCRP，HMOA-IR and FINS，a negative correlation between BMI and FPG without statistical significance，and a positive correlation between CHO， HDL and LDL statistical significance. Multiple linear regression analysis showed that FINS，HMOA-IR，hsCRP，FPG and LDL had correlation with BMI. Conclusion　Overweight or simple obesity children in the Hazakh children exist IR；at the same time，the inflammatory factor CRP plays an important role in the development of overweight or obesity.

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Study on related factors of periventricular leukomalacia among preterm infants. LIU Wei-Min, RUAN Shan-San, ZHANG 　Jian, LIU Guang-Hui, HU Wei-Wei, XU Yu-Mei, LEI Lin-Yang, HU Ke-Fei, FU Yan-Na, ZHENG 　Hong 2010, 25(09): 712-715.  Abstract ( )   Abstract:Objective　Using the skill of head ultrasound to make an early diagnosis for preterm infants with periventricular leukomalacia（PVL），analyze some related risk factors which may result in PVL. Methods　Between Jan. 2006 and Jun. 2009，443 preterm infants were chosen， who were born in Anhui Provincial Children’s Hospital. All subjects were divided into PVL group（125） and non PVL group（318），non Cystic PVL group（116） and Cystic PVL group（9） by different grades of PVL. The factors of PVL were analyzed by Backward Stepwise Logistic regression. Results　Univariate factor analysis showed： the difference was significant （P < 0.05 or P < 0.01）among gestational age， birth weight， delivery pattern， hypothermia， apnea， blood sugar， myocardial enzyme， postnatal infection， cAMP receptor protein and albumin between PVL group and non PVL group. Multiple factors Logistic regression showed： low birth weight and incidence of uterine-incision delivery， postnatal infection， higher level of myocardial enzyme and albumin were risk factors of PVL， and postnatal infection was risk factor of cystic PVL. Conclusion　Low birth weight， spontaneous delivery， postnatal infection and high levels of albumin and myocardial enzyme are risk factors of PVL. Preterm infants with postnatal infection have higher incidence of cystic PVL.

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Change and significance of NT-proBNP in children with incomplete Kawasaki disease.　 2010, 25(09): 716-718.  Abstract ( )   Abstract：Objective　To observe the change of NT-proBNP in incomplete Kawasaki disease and study the value in the diagnosis of incomplete Kawasaki disease. Methods　From Mar. 2007 to Feb. 2009 in department of paediatrics，Provincial Clinical Medical College of Fujian Medical University，we detected the acute- and restoration-stage plasma NT-proBNP level in 36 children with typical Kawasaki disease（TKD） and 20 with incomplete Kawasaki disease （IKD）respectively and 30 children with respiratory tract infection and 30 healthy children， and made a mutual comparison. Meanwhile ultrasound cardiogram examination was made in Kawasaki disease. Results　There was no statistical significance in the difference of plasma NT-proBNP between TKD group and IKD group. Acute-stage plasma NT-preBNP in TKD group and in IKD group was clearly higher than that in restoration stage and control group（respiratory tract infection group and healthy children group）. Coronary lesion in IKD group was significantly higher than that in TKD. Conclusion　The plasma NT-proBNP can be used as a reference index in early diagnosis of IKD.