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06 February 2016, Volume 31 Issue 2 Previous Issue    Next Issue

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Diagnosis and treatment in children with acute otitis media：Clinical practice guidelines（2015） 2016, 31(2): 81.  DOI: 10.7504/ek2016020601 Abstract ( )

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Feeding strategy of the very low birth weight infants to achieve adequate enteral nutrition as soon as possible：Interpretation of Guidelines for Feeding Very Low Birth Weight Infants DING Guo-fang 2016, 31(2): 85.  DOI: 10.7504/ek2016020602 Abstract ( )   Giving good nutrition and feeding for very low birth weight infant （ELBWI） can help to reduce complication during the early stage as well as improve the long-term prognosis. The goal of giving good nutrition and feeding is to establish enteral feeding as soon as possible to achieve full enteral nutrition on the premise of safety. Guidelines for Feeding Very Low Birth Weight Infants published by McMaster University Children’s Hospital in 2015 is analyzed. Those issues include the time to reach full nutrition， frequency of feeding， time of starting feeding， way of feeding， increasing of the amount of milk， assessment of feeding tolerance， management of residuals and clinical diagnosis of gastro-esophageal reflux （GER）.

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Clinical application of noninvasive assisted ventilation in neonatal intensive care unit XUE Xin-dong，TAN Jing 2016, 31(2): 90.  DOI: 10.7504/ek2016020603 Abstract ( )   With the increasing perfection of the treatment level and the management means in NICU，the spectrum of neonatal respiratory disease and severity have also changed a lot. As a result，the mechanical ventilation mode has also changed. In NICU，the use of noninvasive assisted ventilation increases significantly. The clinical pediatricians should pay attention to the principles，indications and clinical application of the nasal continuous positive airway pressure（NCPAP），the nasal intermittent positive pressure ventilation（NIPPV），the nasal biphasic positive airway pressure，（NBiPAP） and heated humidity high flow of nasal catheter （HHHFNC）.

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Clinical application of conventional mechanical ventilation in the newborn ZHU Jian-xing 2016, 31(2): 95.  DOI: 10.7504/ek2016020604 Abstract ( )   Conventional mechanical ventilation（CMV） is the one of the commonest modes applied in neonates. pressure control ventilation（PCV） is still the most frequently used in clinics though volume targeted ventilation（VTV） has shown better therapeutic effects and less adverse effect than pressure limited ventilation（PLV）. Early intervention needs clear and definite indication combined with consideration of pending respiratory failure. Setting and adjusting parameters on ventilator should be based on gestational age of the baby，pulmonary dynamic and blood-gas in relation with particular disease.

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High-frequency ventilation in the newborn DU Li-zhong 2016, 31(2): 99.  DOI: 10.7504/ek2016020605 Abstract ( )   High-frequency ventilation （HFV），as a special mode of mechanical ventilation，has been widely used in treating preterm neonates with hypoxemic respiratory failure. The clinical use，the advantages and disadvantages compared with the conventional mode，and recent clinical evidences of using HFV to prevent BPD and improve the long term pulmonary function are worthy of concern.

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Application of extracorporeal membrane oxygenation in critical neonates WANG Chong-wei，ZHOU Xiao-yu 2016, 31(2): 104.  DOI: 10.7504/ek2016020606 Abstract ( )   Extracorporeal membrane oxygenation（ECMO） is a kind of extra life support technique that can support cardiac and pulmonary function of critical neonates for a relatively long time. The principle and  application of ECMO in foreign  medical institutes and domestic medical institutes were summarized in order to improve the clinical application of ECMO in critically ill newborns to further improve the rescue success rate and reduce the neonatal mortality.

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Application of permissive hypercapnia in mechanical ventilation in the newborn CHANG Li-wen，LI Wen-bin 2016, 31(2): 106.  DOI: 10.7504/ek2016020607 Abstract ( )   Mechanical ventilation plays an important role in treatment of neonatal respiratory failure. But high peak airway pressure and/or large tidal volume often leads to mechanical ventilation associated lung injury. Permissive hypercapnia is currently one of the most commonly used methods to reduce lung injury. Its reasonable range，its effect on ventilator associated lung injury and the current debate are worthy of concern.

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Prevention and treatment strategies of ventilator-associated pneumonia in neonates PAN Yun，YU Jia-lin 2016, 31(2): 109.  DOI: 10.7504/ek2016020608 Abstract ( )   Ventilator-associated pneumonia is a common complication of mechanical ventilation，causing high mortality among critically ill neonates. It remains to be a serious public health threat. A prompt and accurate diagnosis as well as appropriate prevention and treatment strategies towards VAP are urgently needed to decrease its morbidity and mortality among neonates.

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Management and prevention of ventilator-associated pulmonary air leak syndrome MIAO Po，SUN Bin，FENG Xing 2016, 31(2): 114.  DOI: 10.7504/ek2016020609 Abstract ( )   Air leak syndrome refers to a leak of air from the respiratory tract to other body cavities，and the most common is pneumothorax. Mechanical ventilation increases the incidence of the air leak syndrome，which results in the respiration and circulation failure，even death. Gentle and personalized mechanical parameter settings can reduce the incidence and severity of pulmonary air leak，and conservative treatment is usually effective.

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Medications in neonatal mechanical ventilation HU Li-yuan，ZHOU Wen-hao 2016, 31(2): 117.  DOI: 10.7504/ek2016020610 Abstract ( )   Mechanical ventilation is widely applied in NICU for various diseases. Routine administration of sedation，analgesia or muscle relaxation is not recommended. Benzodiazepine should be avoided in preterm infants. Muscle relaxants should be prescribed with caution. Caffeine citrate is highly recommended for preterm infants＜1250 g within 3 days of age to prevent BPD. Diuretics and corticosteroids are not recommended for routine use in clinics but can be applied to the individuals with significant pulmonary edema or difficulty in extubation，or those remained on ventilator longer than 7 days.

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Pneumonia complicated with acute respiratory distress syndrome in pediatric hematological patients：An analysis of 35 cases TANG Xi-kang，CHEN Ze-kai，MAI You-gang，FANG Jian-pei，LIU Ting-hua 2016, 31(2): 122.  DOI: 10.7504/ek2016020611 Abstract ( )   Objective    To analyze the clinical characteristics and prognosis of pneumonia complicated with acute respiratory distress syndrome（ARDS） in pediatric hematological patients in order to improve the clinical treatment level. Methods    The data of clinical symptoms，laboratory result，treatment，prognosis and risk factors of 35 hematological children with pneumonia and ARDS admitted between March 2012 and January 2015 in Department of Pediatrics，Sun Yat-sen Memorial Hospital，Sun Yat-sen University were retrospectively analyzed. Results    The 35 hematological children with  pneumonia and ARDS had high fever（71.4%），cough（85.7%），shortness of breath（88.6%），cyanosis（74.3%），three concave sign positive（74.3%） and lung rale（65.7%）. The level of PaO2/FiO2 decreased，chest X-ray showed patchy or patchy infiltrates，and diffuse exudation and large consolidation in severe cases. A total of 29 strains of pathogens were isolated，including 22 strains of gram-negative bacteria. In 35 ARDS children，23 cases died（65.7%），and the main cause of death was MODS（in 12 cases，52.2%）. The death cause was related to no remission in primary disease，MODS，shock，severe chest infiltration and the use of mechanical ventilation（P＜0.05），but not to the way of mechanical ventilation（P＞0.05）. Logistic regression analysis showed that MODS and shock were the independent risk factors of death（P＜0.05）. Conclusion    The hematological children with pneumonia and ARDS should get more attention for its high mortality. It can be diagnosed early according to the clinical symptoms and signs，the blood gas analysis and chest X-ray. MODS and shock are the independent risk factors of death.

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Application of cerebrospinal fluid flow cytometry detection technique in differential diagnosis of children with acute lymphoblastic leukemia accompanied by central nervous system diseases TAN Hui-zhen*，KE Zhi-yong，ZHANG Ying-chuan，HUANG Li-bin，LUO Xue-qun 2016, 31(2): 127.  DOI: 10.7504/ek2016020612 Abstract ( )   Objective    To explore the differential diagnostic significance of cerebrospinal fluid（CSF） detection with flow cytometry（FCM） technology in children with acute lymphoblastic leukemia（ALL） accompanied by central nervous system diseases. Methods    Seven CSF samples of children with ALL were detected by FCM，cell morphology，CSF routine tests and biochemical examination in Department of Pediatrics，the First Affiliated Hospital，Sun Yat-sen University from February 2009 to February 2014. The children were treated and followed-up. The comparison between FCM and traditional methods in the diagnosis of ALL accompanied with encephalopathy was made. Results    According to the traditional methods，only two patients were diagnosed reliably with CNSL，and in the other five patients，the initial diagnosis （CNSL or non-CNSL） was equivocal. But according to the results of FCM，four patients were diagnosed with CNSL，and three of them had acquired complete remission after systemic and intrathecal chemotherapy. One patient died because of disease progression. Two patients， who were diagnosed with viral meningitis， improved rapidly after treatment with acyclovir. One patient was finally diagnosed with reactive meningitis disease， because the cerebrospinal fluid gradually returned to normal without treatment and the follow-up was uneventful. Conclusion    FCM is a highly sensitive technique capable of accurately detecting malignant cells. It is an important supplement to CSF routine detections，and has significant application value in differential diagnosis of ALL children accompanied by central nervous system diseases.

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Study of association between CITED2 gene mutation and congenital heart disease YANG Xiao-meng，ZHANG Hai-yan，ZHANG Kun，ZHANG Guang-ye，DONG Rui，WANG Ying，WANG Hui，LIU Yi，MA Yan-hui 2016, 31(2): 131.  DOI: 10.7504/ek2016020613 Abstract ( )   Objective    To investigate the association of CITED2 gene mutation with congenital heart disease（CHD）. Methods    The blood samples were collected from 368 children with sporadic CHD and 200 healthy children from January 2013 to January 2015 at Qilu Children’s Hospital of Shandong University. The genomic DNA was extracted and then the exon regions of CITED2 were amplified and sequenced.The results were compared with GenBank database and then analyzed by amino acid sequences. Results    Four heterozygous mutations were identified in four patients with CHD.Case 1（VSD） was c.399C＞T synonymous mutation （p.His133His） and Case 2 （VSD） was c.574A＞G missense mutation（p.Ser192Gly） located in SGJ region；Case 3 （ASD） was a known SNP site of rs191856368 and Case 4（PDA） was c.287 C＞T missense mutation （p.Ser96Phe）. None of which was detected in the control group.  Conclusion    CITED2 gene Ser192Gly and P.Ser96Phe mutations might be associated with the development of local CHD.

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A survey of the detection rate of short stature in primary and middle school students in Anhui province WANG Qian，LIU De-yun，YANG Li-qi，LIU Yue，CHEN Xian-jun，WAN Yu-hui 2016, 31(2): 135.  DOI: 10.7504/ek2016020614 Abstract ( )   Objective    To investigate the distribution characteristics of the detection rate of short stature in primary and middle school students in Anhui province. Methods    A total of 12009 urban and rural primary and middle school students aged from 7 to 19 years in 3 areas （Suzhou，Hefei，Chizhou） in Anhui province from September 2014 to November 2014 were recruited. Body heights were measured using the national standard，and the detection rate of short stature was calculated. Results    The detection rate of short stature in primary and middle school students in Anhui province among all age groups was 3.16%； the detection rate of short stature in rural area was 3.75%，and in urban area 2.56%，which was significantly lower in urban area than that in rural area（χ2＝13.731，P＜0.001）. The detection rate of short stature in boys was 3.05%，in girls 3.28%，and no obvious difference was found of the detection rate of short stature between boys and girls（χ2＝0.517，P＞0.05）. The detection rate of short stature in boys and girls in urban areas was 2.53%and 2.60% respectively，while the rate in rural area was 3.56%and 3.93% respectively. Conclusion    The average detection rate of short stature in the primary and middle school students in Anhui province is 3.16%；the rate is significantly higher in rural area than in urban area；there is no obvious difference in the detection rate of short stature between boys and girls.

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Investigation into the relationship between PVRL2 gene polymorphism and non-syndromic cleft lip with or without cleft palate in Uyghur LI Dong，QI En-chun，YU Lei，PAN Hui-wen，GULIBAHA·Maimaitili，DAI Hong-yan，WANG Ling，HONG Yu 2016, 31(2): 139.  DOI: 10.7504/ek2016020615 Abstract ( )   Objective    To explore the relationship of non-syndromic cleft lip with or without cleft palate（NSCL/P） with poliovirus receptor-related 2（PVRL2） in Xinjiang Uyghur. Methods    Snapshot genotyping was used to detect rs2075642 polymorphism in 120 Uyghur patients with NSCL/P and 100 controls selected randomly between January 2014 and June 2015 in the First People’s Hospital of Urumqi City. Chi-square tests were used to determine whether it fit Hardy-Weinberg equilibrium and the differences of genotype and allele were analyzed between the two groups. Results    Frequencies distribution of genotype conformed to the law of Hardy-Weinberg equilibrium （P＞0.05）； rs2075642 GA genotype and A allele were statistically different between case and control samples of Uyghur （χ2＝5.829；P＜0.05 and χ2＝5.642；P＜0.05，respectively). Conclusion    PVRL2 gene rs2075642 polymorphism is relevant to NSCL/P in Xinjiang Uyghur. Genotype GA and allele A are protective factors.

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Idiopathic pulmonary hemosiderosis：An analysis of 10 cases JIANG Man，WANG Ying，MA Hong-ling，et al 2016, 31(2): 143.  DOI: 10.7504/ek2016020616 Abstract ( )

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Diagnosis and treatment of perinatal ischemic stroke SHI Jing，MU De-zhi 2016, 31(2): 146.  DOI: 10.7504/ek2016020617 Abstract ( )

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Application of resting state functional MRI in children with central  nervous and psycholoical diseases LI Hong-xin，FENG Xing，TU Wen-juan，et al 2016, 31(2): 150.  DOI: 10.7504/ek2016020618 Abstract ( )

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Biliary rhabdomyosarcoma in children：A report of 1 case LI Jin-kui，YANG Pin，LEI Jun-qiang 2016, 31(2): 155.  DOI: 10.7504/ek2016020619 Abstract ( )

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Berardinelli-Seip syndrome in children：A report of 2 case LAO Wen-qin，MENG Zhe，OU Hui，et al 2016, 31(2): 157.  DOI: 10.7504/ek2016020620 Abstract ( )

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Reactive infantile spasms to vitamin B6：A report of 2 case DAI Fang-fang，ZHANG Ping-li，SUN Shi-jing，et al 2016, 31(2): 159.  DOI: 10.7504/ek2016020621 Abstract ( )