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06 May 2012, Volume 27 Issue 05 Previous Issue    Next Issue

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Effect of glibenclamide treatment on 4 Chinese patients with neonatal diabetes mellitus. 2012, 27(05): 364-367.  Abstract ( )   Abstract：Objective    To assess the effect of glibenclamide treatment on patients with neonatal diabetes mellitus （NDM）. Methods    Clinical data of 4 cases （ male 1 case，female 3 cases） of NDM admitted to Guangzhou Women and Children’s Medical Center from Apr. 2010 to Jan. 2011 were analyzed and the treatment methods and effects of glibenclamide on NDM was evaluated. KCNJ11and ABCC8 gene mutations were also searched in these 4 cases.  Results   The birth weight of 4 cases was 2.5 ~ 3.0 kg and the diagnosis time from 3 days to 1 month. All of them presented with severe hyperglycemia（30.5 ~ 45.3 mmol/L）and ketoacidosis and were treated with insulin infusion. They switched from insulin to oral glibenclamide when their glucose was stable. Two patients （50%） successfully discontinued insulin after receiving glibenclamide and the dose was 0.5 mg/（kg·d） and 0.6 mg/（kg·d） respectively. They were followed up for 9 months and 7 months， still receiving glibenclamide 0.3 mg/（kg·d）to keep their blood glucose within normal range. No obvious side effects occurred. A KCNJ11 （R201H）mutation was found in 1 case who could  successfully switched to  glibenclamide，but no mutation was found in the other 3 cases. Conclusion    Glibenclamide therapy is effective in some patients with NDM and may successfully discontinue insulin injection，especially in those with KCNJ11 mutation.

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Pathogen isolation in 459 infants with acute diarrhea.   2012, 27(05): 368-370.  Abstract ( )   Abstract：Objective    To study pathogen isolations from infants with acute diarrhea with the purpose to provide basic evidence for reasonable and effective control of infant acute diarrhea. Methods    Totally 459 cases of acute diarrhea from Digestive Department in Fuzhou Children’s Hospital from Jan. to Dec. 2009 were selected，and their faeces samples were cultivated. Rotavirus（RV） was detected using Colloidal Gold method；218 cases were selected for RV detection again using ELISA method，norovirus nuclear acid were detected using RT-PCR method. Results    Thirty-five of 459 cases were infected with bacteria，5 cases were infected with fungi （1.1%），and 117 cases were RV positive （25.5%）； 69 of 218 cases were RV postive （31.7%），61 cases were NV positive （28%），and 14 cases were two viruses mixed infections （6.4%）.The difference between male and female with two virus mixed infections had no statistical significance （P > 0.05）；difference between different age groups in RV and NV positive rates had statistical significance （P < 0.05）；all cases mainly were under 2 years old. RV and NV infections obviously had season difference，and RV infection peaked from October to December，while NV infection peaked from July to September，the difference having statistical significance （P < 0.05）. Conclusion    The pathogenic types that cause infant infectious diarrhea are complex and diverse，thus we should pay attention to pathogen detection in clinical diagnosis and treatment.

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The clinical characteristics and therapy of the late-preterm neonates with placental abruption. 2012, 27(05): 371-374.  Abstract ( )   Objective    To conclude the clinical characteristics of the late-preterm neonates with placental abruption and to build up the therapeutic protocol. Methods    Retrospective analysis was conducted. According to enrolling qualifications，83 subjects from the hospitalized children of the NICU of Bayi Children’s Hospital Affiliated to General Hospital of Beijing Military Command of PLA were enrolled  from October 2009 to May 2011，in which 37 late-preterm neonates were with placental abruption and 46 late-preterm neonates without placental abruption as the control group included. Results    From clinical manifestations，lab and therapy data，significant differences were detected in gestational age，multiplets，premature rupture of membrane，birth weight，intrauterine growth retardation，mother age，mother gestational diabetes mellitus，asphyxia，APTT，D-dimer on admission，red cell transfusion，plasma transfusion and use of heparin between the observation group and control group （P < 0.05）. Conclusion    Placental abruption is due to placental insufficiency，often resulting in coagulation disorder ； low-dose heparin as well as plasma transfusion can improve neonates’ outcome.

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The prevalence of eating disorders in 6~36 month-old infants in China. 2012, 27(05): 375-377.  Abstract ( )   Objective    To study the prevalence of infant eating disorders in China. Methods    With fixed-point sampling，doctors and caregivers filled in the Chinese version of the Montreal Children Hospital Feeding Scale （MCH-FS）. Results    The prevalence of infant eating disorders was 21.4%.The prevalence of infant eating disorders in boys and girls were 21.1% and 21.8%， respectively. The difference was statistically significant in different regions，caregivers，educational levels of caregivers and income levels of families（all P＜0.01）. Conclusion    The prevalence of infant eating disorders was different in different areas，caregivers，educational levels of caregivers and income levels of families.

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Analysis of 174 child cases of gastrointestinal hemorrhage. 2012, 27(05): 378-380.  Abstract ( )   Objective    To analyze the etiology of children with different lesions of gastrointestinal hemorrhage in different age and summarize the localization diagnostic methods，etiological diagnostic methods and corresponding treatment protocols of child gastrointestinal hemorrhage. Methods    The characters of the hospitalization cases of children with gastrointestinal hemorrhage in Shengjing Hospital from Jua.2005. to Jun. 2008 were analyzed and summarized by consulting and grouping these cases retrospectively. Results    The common etiologies of upper gastrointestinal hemorrhage were stomach or duodenal bula ulcer，acute stomach mucomembranous injury and chronic superficial gastritis in turn. The common etiologies of lower gastrointestinal hemorrhage were HSP，intestinal polyps and Meckel diverticulum or duplication of intestine with ectopic stomach mucomembrane in turn. In 28 days to one year old group，the most common etiology was acute or chronic diarrhea；in 1 ~ ＜4 years old group and 4 ~＜7 years old group，it is intestinal polyps；in 7 ~ 14 years old group，it was HSP. Comparing different age groups，CMP intolerance（with chronic diarrhea） and VitK1 deficiency were more common in 28 days to one year old group，HSP was more common in 7 ~ 14 years old group，while other diseases had no significant deviation in different age groups. Conclusion    When treating children with gastrointestinal hemorrhage，we should emphasize on collecting detailed medical histories，consummating auxiliary examinations and offering treatments in time，and most of them have good prognosis.

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Burkholderia cepacia infections in children with X-linked chronic granulomatous disease 2012, 27(05): 381-383.  Abstract ( )   Objective    To summarize and analyze clinical features of Burkholderia cepacia infections in two children with X-linked chronic granulomatous disease. Methods    Clinical data of 2 patients with Burkholderia cepacia infections with X-linked chronic granulomatous disease of Beijing children's hospital from Jan.2010 to Feb.2010.Results    Two male children who were 0.5 and 1.7 years old，respectively，were admitted to our hospital，diagnosed with X-linked chronic granulomatous disease through CYBB mutation analysis. Burkholderia cepacia infections were ascertained by recurrent blood and urine cultures. Drugs sensitivity analysis showed that they were sensitive to relevant antibiotics. Conclusion    Burkholderia cepacia is opportunistic pathogen for human. Community-acquired infection implies underlying disease，and chronic granulomatous disease is the most common. Routine antibiotic treatment can eradicate its infection. Prophylactic treatment with trimethoprim-sulfamethoxazole can be beneficial to this fragile group of people.

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High-pressure balloon dilatation of bronchial stenosis in children application 2012, 27(05): 384-386.  Abstract ( )   ：Objective    To access the clinical efficacy and safety of high-pressure balloon dilatation of bronchial stenosis in children. Methods    5 cases of bronchial stenosis in children, including congenital stenosis, were managed by high-pressure balloon dilation using the flexible fiberopic brochoscope, the balloon was inflated for 1 to 3 min.  Before the management and after the last balloon, the effectiveness were evaluated with  chest X-ray and all of patients were followed-up 1-6 months. Results    Patients required a 2-4 sessions balloon dilatation. After high-pressure balloon dilatations, the airway diameter was obviously increased and the clinical symptoms and signs were significant improvement.  Chest X-ray manifestation of expanded sites was improved and pulmonary atelectasis and consolidation disappeared after follow-up periods of 1-6 months. The child with congenital stenosis had no recurrence of high-profile metal-like cough, pulmonary emphysema disappeared. Conclusion    High-pressure balloon dilatation of is a safe, efficient, simple and rapid method for treatment of bronchial stenosis  in children.