Archive

06 September 2011, Volume 26 Issue 9 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Relationship between gentic polymorphism of surfactant protein B （SPB）-18 and neonatal respiratory distress syndrome susceptibility. ZENG Ling-kong*，LI Wen-bin，LIU Wei，LIU Hang-chu，SHAN Rui-yan，CHANG Li-wen. 2011, 26(9): 671.  Abstract ( )   Abstract：Objective　To study the relationship between gene polymorphism of Surfactant Protein B （SPB）-18 and neonatal respiratory distress symdrome susceptibility. Methods　Totally 100 neonates diagnosed with NRDS and 186 gestational age，gender and birth weight matched neonates were enrolled from May. 2009 to Dec. 2010. The genetic polymorphism of SPB-18 was analyzed with high resolution melting（HRM）and gene sequence. Non-brochoscopic bronchoalveolar lavage（ BALF ）was performed from May 2009 to Dec. 2010 in 31 babies with SPB-18AC and 36 babies with SPB-18CC in Wuhan Children’s hospital. The levels of SPB in BALF were measured using Western blot（WB）.Statistical analyses were carred out using SPSS software ，version 13.0. Results　The SPB-18AA， AC and CC genotype frequencies in NRDS patients were 11.0%， 40.0% and 49.0%，which were 6.5%， 31.7% and 61.8% in control group，P > 0.05，with no significant difference .The frequencies of A allele was higher in NRDS group than that in control group，（31.0% vs 22.3%），P < 0.05. There was difference in amounts of SPB in BALF from SPB-18 CC and AA individuals.The optical density was 14339.2±1076.3 vs 8002.3±452.9，P < 0.05. Conclusion　Our study suggests that SPB-18 polymorphism may confer susceptibility to DRDS in Chinese. Differences in amounts of SPB resulting from the promoter SNP could affect the clinical presentation of NRDS.

Select

Multilocus sequence typing and resistance of methicillin-resistant staphylococcus aureus isolates in the newborn. YANG Fan*，LI Shu-mei，YANG Xiao，NIU Jie，LI Jin-fen. 2011, 26(9): 675.  Abstract ( )   Abstract：Objective　To study the antimicrobial resistant profiles and genotype of methicillin-resistant staphylococcus aureus isolates from the newborn，and discuss their relationship. Methods　Seven pairs of S.aureus home-keeping gene were chosen as target gene，PCR was applied to amplify genotype of 21 samples from the newborn from Apr.2008 to Oct. 2009 in Department of Pediatrics，Xinxiang Medical College，and product sequence was analyzed by multilocus sequence typing（MLST）. Susceptibility for 13 antibiotics was detected by using slip diffuse method. Results　MLST analysis of 120 isolates identified 24 alleles and 13 STs，in which the most prevalent genotype was ST239（28.57%），followed by ST5（14.29%）. All isolates were resistant to other antibiotics except those that were susceptible to VAN and RIF，the resistant rate being 57%～100%. Conclusion　The most prevalent genotype of MRSA is ST239 and ST5 in newborn department of our affiliated hospital. There is no obvious relationship between genotype and drug-resistance.

Select

Value of wireless capsule endoscopy in diagnosis of small bowel disease in children. HE Jin-shui，HUANG Wen-bao，XU Xiang-nong，Liu You-long. 2011, 26(9): 679.  Abstract ( )   Abstract：Objective　To evaluate the safety and effectiveness of capsule endoscopy in children with suspicious small bowel diseases. Methods　Twenty-eight children with suspicious small bowel disorders were referred to our study from Sep. 2007 to Dec. 2010 in Zhangzhou Municipal Hospital Affiliated to Fujian Medical University. The average time of capsule passing through the stomach and the small intestine，the tolerance to and complication of capsule endoscopy in patients，the success rate and the diagnostic accordance rate were observed and recorded. Results　All the patients could easily swallow the capsule and had good tolerance，and no capsule retention occurred during the study.The median time of capsule passing through the stomach and small intestine was 64 min（ranging from 20 to 280 min） and 255 min（ranging from 93 to 380 min），respectively. The detective yield of capsule endoscopy was 71.43%（20/28）. Conclusion　Capsule endoscopy is a safe and useful tool in diagnosis of small bowel diseases in pediatrics.

Select

Diseases associated with the short-term outcome of very low birth weight infant and study of the causes. YUE Guang，YU Jia-lin，DONG Ying. 2011, 26(9): 682.  Abstract ( )   Abstract：Objective　To investigate the causes of diseases associated with the short-term outcome of very low birth weight （VLBW） infant and their risk and protective factors. Methods　Review the critical diseases which can affect the short-term outcome of the total 475 cases in the Neonatology Department of Children`s Hospital of Chongqing Medical University from June 2001 to February 2010. Variables associated with these diseases were identified firstly with univariate analysis and then with a forward stepwise logistic regression. Results　The number of VLBW with favorable and poor short-term outcome was 339 （71.37%） and 136 （28.62%） respectively，and the following diseases were associated with the short-term outcome of VLBW： neonatal respiratory distress syndrome （NRDS）［11.8%（n = 40）vs 38.2%（n = 52），χ2 = 43.434，P = 0.000］ and pulmonary hemorrhage （PH）［2.9%（n = 10） vs 25%（n = 34），χ2 = 56.147，P = 0.000］.The risk factors for development of NRDS were low birth weight（OR = 6.368，P = 0.000）， being small for gestational age （SGA） （OR = 5.806，P = 0.000）， history of asphyxia （OR = 2.087，P = 0.006） and antepartum non-dexamethasone-treated （OR = 1.948，P = 0.014） .The protecting factor was history of premature rupture of membrane （PROM） （OR = 0.419，P = 0.004）.The risk factors for development of PH were NRDS （OR = 10.473，P = 0.002） and scleroma neonatorum（OR = 2.265，P = 0.027）；the protecting factor was PROM（OR = 0.167，P = 0.013）. Conclusion　Important diseases that can affect short-term outcome of VLBW are NRDS and PH.

Select

Expression and clinical significance of MDR3 in liver of patients with infantile cytomegalovirus hepatitis and extrahepatic biliary atresia. ANG Qing，WANG Lin-lin，WANG Hua，SHAN Qin-wen. 2011, 26(9): 686.  Abstract ( )   Abstract：Objective　To explore the expression of MDR3 in liver tissue and the relationship between human cytomegalovirus infection and biliary atresia. Methods　Clinical data of patients were collected，who were refferred to the First Affiliated Hospital of Guangxi Medical University for further investigations of CMV hepatitis and EHBA from Jan. 2000 to Oct. 2009. In the liver tissue samples from children with CMV hepatitis （n = 12） and EHBA（n = 20），and normal children （n = 10），MDR3 expression was examined immunohistochemically. The image analysis technology was used to quantitatively analyze the protein expression. Results　Immunohistochemically，strong canalicular staining for MDR3 was observed in the EHBA liver. Optical density value of MDR3 expression in CMV hepatitis liver，EHBA liver and normal control liver was 0.13±0.02，0.18±0.06 and 0.10±0.03，respectively. MDR3 expression levels in the EHBA were significantly higher than in the normal control liver and CMV hepatitis liver（P < 0.05）. Serum levels of γ-glutamyl transpeptidase were positively correlated with MDR3 levels（r = 0.438，P = 0.003）.Conclusion　MDR3 is associated with cholestasis. In EHBA，MDR3 expression levels are up-regulated，which may represent an adaptive response aimed at the enhanced phosphatidylcholine excretion，which normally protects the biliary epithelium from bile salt toxicity.

Select

Effect of different proportions of mixed blood exchange transfusion on blood circulation in neonates with ABO incompatibility hemolytic disease. LI Jun，HUANG Rui-wen，HU Yue-yuan，XIAO Ai-qing，LIAO Zhen-yu 2011, 26(9): 689.  Abstract ( )   Abstract：Objective　To explore the effect of different proportions （the O type RBCs vs the AB type plasma）of mixed blood exchange transfusion on blood circulation in neonates with ABO incompatibility hemolytic disease. Methods　From Jan. 2009 to Apr. 2010 in Hunan Children’s Hospital，forty newborn infants with the disease， treated by exchange transfusion with different proportions of mixed blood（AB type plasma was mixed with O type red blood cell），were randomly divided into two groups： 16 patients in treatment group， who used O type red blood cells and AB type plasma with the proportion of 3 ∶ 1（ the O type RBCs 300 mL： the AB type plasma 100 mL） during blood transfusion；24 patients in control group with the proportion of 2 ∶ 1. Both of the two groups received the double exchange transfusion in accordance with 150 ～180 mL/kg. After exchange， all the patients in controll group received O type RBCs transfusion with 15～20 mL/kg （total volume was 60mL），while the other group did not. The other therapies in both of the two groups were the same.The indicators， which included the exchange rate of neonatal serum bilirubin， RBC， hemoglobin （Hb）， hematocrit（Hct） ，the elctrocyte and gas analysis，were monitored before and after the exchange transfusion. Results　The total bilirubin of the two groups were lower after the exchange transfusion， and that the treatment group was even lower（P < 0.05）. Before and after exchange transfusion， hemoglobin and hematocrit comparison showed that no significant difference in the treatment group （P > 0.05）， while in the control group the difference was significant （P < 0.05）. Electrolyte（such as K +， Na +， Ca +， Cl +）and blood gas value before and after the exchange transfusion were not significantly different （P > 0.05）. Conclusion　The exchange transfusion， using O type red blood cells and AB type plasma with the proportion of 3 ∶ 1 in hemolytic disease，can not only decrease the level of bilirubin in blood rapidly but also avoid the anemia.The serum electrolytes and acid-base balance have no significant differences. It is worth promoting.

Select

Changes of Th17 cells and CD4+CD25+ regulatory T cells in peripheral blood of asthmatic children and their relationship with the situation of asthma. MA Qiu-li，PENG Shao，LIANG Peng，LI Hui-juan，ZHANG Man. 2011, 26(9): 692.  Abstract ( )   Abstract：Objective　To observe the levels of Th17 cells，CD4+CD25+ regulatory T cells in the asthmatic children and relationship between the two types of cells and children’s condition. Methods　Flow cytometry was used to detect the percentages of the Th17 cells and CD4+CD25+ regulatory T cells in the peripheral blood of acute asthma children （asthma group， n = 60），alleviated period asthma children （n = 30） and healthy children （healthy control group， n = 30）.Acute asthma children were divided into 3 groups： mild， moderate and severe asthmatic patients. Results　Compared with the healthy control group （1.02%±0.28%）and alleviated period asthma children （1.65%±0.38%）， the numbers of CD4+ cells （Th17） expressing IL-17 in peripheral blood of acute asthma（2.24%±1.02%） were increased， and the differences were statistically significant （P < 0.05）. The levels of CD4 + CD25+T cells in peripheral blood of acute asthma and alleviated period asthma children （5.37%±0.80%； 6.05%±0.87%） were significantly lower than those of healthy children（7.11%±0.89%） （P < 0.05）. Th17 cells were positively correlated with the course of childhood asthma（r =  0.649，P < 0.05）.CD4+CD25+ regulatory T cells were negatively correlated with the course of childhood asthma （r =-0.599， P < 0.05）. Conclusion　The immunization response of Th17 cells in peripheral blood of asthmatic children is strengthened，but the immune function of CD4+CD25+regulatory T cells is decresed. The severity of asthma is closely related to the inbalance of Th71/Treg cellular immunity.

Select

Etiology and clinical characteristics of 78 boys presenting with isosexual precocious puberty. ZENG Ting，SU Zhe，MA Hua-mei*，LI Yan-hong，DU Min-lian，CHEN Hong-shan，CHEN Qiu-li 2011, 26(9): 695.  Abstract ( )   Abstract：Objective　To review the etiology and clinical characteristics of isosexual precocious puberty in boys. Methods　Seventy-eight boys referred for evaluation with isosexual precocity in Department of Pediatrics of the First Affiliated Hospital of Sun Yat-sen University between Jan.1988 and Apr.2009 were reviewed. Results　Of the 78 boys referred for isosexual precocity，55（70.51%） were GnRH-dependent precocious puberty （central precocious puberty，CPP） and 23（29.49%） were GnRH-independent precocious puberty （peripheral precocious puberty，PPP）. The three most common diagnoses in CPP were idiopathic precocosious puberty（ICPP），hypothalamic hamartoma and secondary CPP with congenital adrenal hyperplasia（CAH） in order. Among them, the medical age of the hypothalamic hamartoma was the smallest, and the concentration of LH after the GnRHa Stimulation test was the highest. The CAH children had the highest incidence rate of advanced bone age and the maximum negative value of HtSDSba.And the two most common diagnosis in PPP were HCG-secreting germ cell tumor and congenital adrenal hyperplasia (CAH). CAH patients from the PPP into a larger proportion of CPP (5/9), especially untreated older were more likely to occur. HCG-secreting germ cell tumor of blood and (or) CSF β-HCG levels were elevated. Conclusion　Most of male isosexual precious puberty have underlying organic disease，it’s very important to identify the cause.

Select

Positive rate and susceptibility test of Klebsiella pneumoniae in newborn infants with infectious disease. SUN Bai-xiu，JING Xiang-yu. 2011, 26(9): 699.  Abstract ( )   Abstract：Objective　To determine the positive rate and drug resistance rate of Klebsiella pneumoniae in sputum，blood and cerebrospinal fluid specimens. Methods　Samples of transmissibility pneumonia，sepsis and purulent meningitis in neonatal period were collected from January 2008 to June 2010 in Qingdao Women and Children's Medical Center. Identity and susceptibility test were detected by ATB system. Results　The positive rate of Klebsiella pneumoniae in sputum and blood were 40.3% and 22.1% respectively，which were significantly higher than the other dominant bacteria. It was 22.2% in cerebrospinal fluid. Compared with other dominant bacteria，there was no significant difference. Klebsiella pneumoniae was sensitive to carbon vinyl meropenem，imipenem，amikacin and netilmicin，and its drug fast rate was zero. The drug fast rate of ciprofloxacin，piperacillin + tazobactam，cefoxitin and tobramycin was less than 10%. However，it was hardly sensitive to Cefalotin，cefotaxime，ceftazidime，cefepime，amoxicillin，piperacillin and ticarcillin. The drug fast was all more than 80%. The percent age of ESBLs cases in sputum and blood was 75.2% and 84.0%. Two cerebrospinal fluid samples were both ESBLs. Conclusion　Klebsiella pneumoniae has been the predominant bacteria in neonatal infection，and ESBLs strains are rising. Klebsiella pneumoniae is sensitive to carbonalkenes，aminoglycosides and quinolones.

Select

Chylous ascites associated with systemic lupus erythematosus（SLE） in a child：a case report and review of literature. LIANG Yu-jian，MO Ying，JIANG Xiao-yun，HUANG Liu-yi，TAN Hui-zhen，YU Mu-xue. 2011, 26(9): 702.  Abstract ( )   Abstract：Objective　To improve the recognition and treatment of chylous ascites associated with systemic lupus erythematosus （SLE）. Methods　Report a case of chylous ascites as a complication of SLE in a child and review the related literature. Results　The patient was diagnosed with SLE，lupus nephritis（LN） and hemolytic anemia. The LN showed nephrotic syndrome，and renal biopsy suggested LN V+III（A/C）. The patient had persistent severe ascites which was examined to be chylous ascites. After being treated with high dose of Methylprednisolone（MP） and Cyclophosphamide（CTX） and diet therapy，the index of lupus was improved and ascites regressed. According to relevant literature，the mechanisms of chylous ascites may be associated with SLE’s impacting on the lymphoreticular system，bowel edema which was induced by hypoproteinemia，increasing permeability of lymphatic vessels，abnormal lipid metabolism and so on. Conclusion　Chylous ascites is a rare complication of SLE. Abdominal paracentesis is suggested to exclude chylous ascites when SLE is complicated with refractory ascites. The treatment principle of this illness is to cure primary disease，combined with conservative treatment such as diet control，etc.