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06 September 2012, Volume 27 Issue 09 Previous Issue    Next Issue

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Relationship between pathological change of gastric mucosa in children with chronic gastritis and Helicobacter pylori infection.   2012, 27(09): 671-674.  Abstract ( )   Objective    To investigate the correlation between the Helicobacter pylori（HP） infection in children with chronic gastritis of different age and the pathologic change of their gastric mucosa. Methods    Electronic gastroscope examinations were performed in 1634 children who came to Ruijin Hospital，Shanghai Jiaotong University School of Medicine for repeated upper gastrointestinal symptoms from January 2007 to December 2010. Then the antral mucosal tissues were extracted for the HP detection and pathologic analysis. The histopathological findings were scored and classified according to the Sydney System. Correlations between the inflammatory severity and HP infection were discussed. The detection rate of HP infection，active inflammation and lymphoid follicle were compared among the four different groups divided according to age. Results    Totally 524 （32.1%） patients showed HP positive，and the positive rate increased with age. The detection rates of active pathological change，severe inflammation，polymorphonuclear leukocyte infiltration，severe lymphocyte infiltration and lymphoid follicle were all higher in HP-positive group than in the control. The proportions of the midrange to severe chronic superficial gastritis and the midrange chronic atrophic gastritis were higher in HP-positive group than in the control. The detection rates of active inflammation and lymphoid follicles were significantly higher in all age groups of children with HP infection than in HP negative patients. Conclusion    The infection rate of HP in children increases with age. HP infection is positively correlated with the severity of the gastric mucosal inflammation，the incidence of the active pathological change and lymphoid follicle.

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Gastric emptying of solids in children with chronic gastritis. 2012, 27(09): 675-677.  Abstract ( )   Objective    To study the gastric emptying of solids in children with chronic gastritis. Methods    From Jan.2008 to Jan.2012 in Capital Institute of Pediatrics，the children aged 6 to 17 years with recurrent upper abdominal（or cullen）pain，upper abdominal discomfort associated with bloating，belching，nausea，vomiting，early satiety lasting for 2 months or more，and the onset more than once per week were asked to undergo electric endoscopy；65 chronic gastritis patients were enrolled. The gastric emptying was measured by a radioscopic technique 5 h after a solid meal with radiopaque markers. Results    HP positive patients accounted for 27.7%. There were no significant differences between HP positive patients and HP negative patients（11.1% and 21.3%， respectively，P > 0.05）. Moderate and severe gastritis patients accounted for 66.7% in HP positive patients. For the postprandial 5 h emptying，18.5% children with chronic gastritis had less than 50% gastric emptying of solids，and 23.1% of them had less than 75% gastric emptying of solids. There were not any side effects of radiopaque markers in 24h in children with chronic gastritis. Conclusion    Some of the children with chronic gastritis have gastro-obstraction，the clinical symptom hardly reflects the gastric emptying of solids. Radiopaque markers are safe and comply with its natural physiological state for children aged from 6 to 17. The incidence of moderate and severe gastritis is higher in HP positive patients than in mild gastritis.

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Clinical features of allergic colitis in children： analysis of 53 cases. 2012, 27(09): 678-681.  Abstract ( )    Objective    To study the clinical features of allergic colitis（AC）in children in order to improve accurate diagnosis and treatment. Methods    A retrospective analysis was performed about the clinical manifestations，endoscopic and histopathological features，laboratory test results and managements of 53 AC children admitted to Department of Gastroenterology，Children’s Hospital of Zhejiang University，from January 2008 to December 2010. Results    （1）AC was commonly found in children under 2 years old，49 cases（92.5%）.Hematochezia（46 cases）and diarrhea（35 cases）were the most common clinical features，while vomiting，abdominal pain and malnutrition were rare. （2）Gross endoscopic findings included diffuse erythema-friability（62.3%）， lymphoid nodular hyperplasia（58.5%），superficial erosions（18.9%）and frank ulceration with surface exudates（1.9%）. Rectum（43 cases，81.1%）and sigmoid colon（45 cases，84.9%）were most frequently affected. Eosinophilic infiltration throughout the mucosal layer，mostly 6 ~ 20/HP，particularly in the lamina propria， was the characteristic histopathologic change.（3）Clinical histories and laboratory tests results：16 children had atopic history，including drug allergy（5 cases），eczema （8 cases）and so on； 41 cases received allergen specific antibody test，and 8 showed positive results. Laboratory tests results showed high serum IgE（5/43 cases），peripheral eosinophilia（16/53 cases） and anemia（12/53 cases）. （4） All children were hospitalized and dismissed after symptomatic relief，with an average of （6.9 ± 4.0）days. Leukotriene receptor antagonist was more effective for breast feeding infants， but special formulae and leukotriene receptor antagonist both had effect on non-breast feeding infants.（5）The relationship between gross endoscopy changes and eosinophilic infiltration showed that lymphoid nodular hyperplasia found by gross endoscopy was correlated with eosinophilic infiltration（P＜0.05）. Conclusion    AC has different clinical symptoms and endoscopic changes，so detailed clinical histories，laboratory and endoscopic findings，multiple mucosal biopsy are important for diagnosis and treatment. Avoiding suspected allergens and use of hypoallergic formulae are the main ways of treatments，leukotriene receptor antagonist may also be effective for AC，but it needs more studies.

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Relationship between gene polymorphisms of vascular endothelial growth factor and bronchopulmonary dysplasia.    2012, 27(09): 682-685.  Abstract ( )   Objective    To investigate the association between single nucleotide polymorphism of vascular endothelial growth factor（VEGF）and bronchopulmonary dysplasia（BPD）. Methods    A total of 64 BPD patients in BPD group and 106 patients without lung disease in control group from July 1，2009 to February 1，2012 were included in the study.Genotype of VEGF polymorphisms were performed by polymerase chain reaction and restriction fragment length polymorphism analysis（PCR-RFLP）. Enzyme-linked immunosorbent assay（ELISA）was used to detect the expression level of VEGF in plasma in BPD group. Results    （1）VEGF +405G＞C： compared with control group，the genotype and allele frequencies of G was higher in BPD group with statistical difference（P＜0.05）. VEGF-2578C>A： compared with control group，the genotype and allele frequencies of A was higher in BPD group with statistical difference（P＜0.05）. （2）In BPD group the level of VEGF+405 was lower in the patients with genotype GG（P＜0.05）compared with CC while there was no difference for VEGF-2578 with genotype CC and GG（P＞0.05）.Conclusion    Single nucleotide polymorphisms of VEGF+405 and VEGF-2578 could be associated with  BPD，and VEGF+405 influences its protein expression，and the lower VEGF level in plasma could be one of the factors for BPD pathogenesis .

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Comparison of the value of waist circumference with that of body mass index in diagnosing metabolic syndrome in children and adolescents. 2012, 27(09): 686-689.  Abstract ( )   Objective    To evaluate the practical value of waist circumference and body mass index（BMI）in diagnosing metabolic syndrome（MS） in children and adolescents. Methods    A random sampling method was used to select 7893 children and adolescents aged 6 to 18 years from 14 schools in Nanning City from June 2009 to October 2010.They were surveyed to analyze the correlation among waist circumference，BMI and MS detection indicators. Based on MS diagnostic criteria proposed by CDS and IDF（2007），receiver operating characteristic curve（ROC）was used to compare waist circumference’s area under ROC curve and body mass index（BMI）’s for reflecting the accuracy of diagnosis of MS. Results    （1）Average value of MS detection indicators，except for fasting blood glucose（FBG）and aspartate aminotransferase（AST），was significantly different among the three groups， except that the mean of HDL-C decreased with the increase of obesity.These indexes in obesity group were higher than other two groups（P＜0.05）.（2）Waist circumference and BMI were positively correlated with hip， waist-hip ratio， SBP，DBP，FBG，TG，LDL-C，FINS and HOMA-IR，but were negatively correlated with HDL-C.（3）Waist circumference predicted each component of MS more sensitively than BMI. In addition，waist circumference positive predictive value （except for HDL-C）was relatively better than BMI.（4） According to standard CDS，the area under ROC curve of waist circumference and BMI were 0.949 and 0.951，respectively. According to IDF（2007），their area were 0.941 and 0.921.Conclusion    Waist circumference has more diagnostic value than BMI in children and adolescents with MS. The waist measurement may be helpful for MS screening in children and adolescents.

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A preliminary study on polysomnographic in the newborn with some common diseases.  2012, 27(09): 690-692.  Abstract ( )   Objective    To evaluate sleep and breath pattern and observe apnea of newborns with some common diseases in polysomnographic（PSG） recording. Methods    The study was carried out in neonatal care units of Beijing Children’s Hospital Affiliated to Capital Medical University between April 2010 and August 2010；36 newborns completed PSG recording of four hours. Results    Twelve patients presented apnea events.Among them，11 patients presented obstructive apnea events and 1 patient presented central apnea.In addition，one neonate presented hypopnea with hypoxemia and bradycardia. Conclusion    PSG is an important examination for studying disease of neonate，especially apnea.

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Analysis of 5α-reductase-2 gene mutation in 52 patients with hypospadias.  2012, 27(09): 693-696.  Abstract ( )   Objective    To investigate the prevalences of SRD5A2 gene mutation in Chinese children with hypospadias and explore the possible molecular mechanism of the disease. Methods    Totally 52 children with hypospadias were enrolled from January 1st，2006 to December 1st，2011，the clinical characteristics were observed，and assistant examinations were performed. Polymerase chain reaction（PCR）and direct sequencing were performed to analyze the 1-5 exons of SRD5A2 gene. Results    SRD5A2 gene mutations were found in 13.5%（7/52）of patients. Four mutational sites were detected from 7 patients，including 5 compound heterozygous mutations（p.G203S/p.R227Q，p.L20P/p.R227Q，p.L20P/p.R227Q，p.L20P/p.G203S，p.R227Q /p.R246Q）and 2 homozygous mutations（p.R227Q and p.L20P）. Conclusion    The mutation of SR5DA2 gene may be a frequent cause of hypospadias in Chinese children. Molecular analysis of SRD5A2 gene should be performed before gender assignment or any surgical intervention for better prevention and treatment of hypospadias.

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Comparison of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome. 2012, 27(09): 697-699.  Abstract ( )   Objective    To evaluate the efficacy of nasal intermittent positive pressure ventilation（NIPPV） treatment for neonatal respiratory distress syndrome（NRDS）. Methods    Select 66 cases of NRDS and randomly divide them into NIPPV group （32 cases）and NCPAP group （34 cases）. After admission compare the improvement in oxygenation，duration of oxygen therapy，ventilator use，and complications. Results    After treatment of 12 h，24 h，72 h，PaCO2 and PaO2 were improved（P＜0.05），and NIPPV group were better than NCPAP group，the difference being statistically significant（P＜0.05）. P/F and a/APO2 of the two groups showed some improvement after treatment .NIPPV group improved more significantly compared with NCPAP group；at 12 h， 24 h and 72 h，the differences were statistically significant （P＜0.05）. The occurrence rate of CO2 retention and abdominal distension had statistical difference （P＜0.05）. In NIPPV group intubation and ventilator rate after nasal airway treatment failure was significantly lower than NCPAP group，the difference being statistically significant（P＜0.05）.  Conclusion    Compared to NCPAP，NIPPV improves lung oxygenation function and shortens the oxygen therapy time in a short time，reducing CO2 retention and bloating，and moving feeding time.