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06 October 2018, Volume 33 Issue 10 Previous Issue    Next Issue

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Expert consensus on immunization in children with special health state 2018, 33(10): 737-742.  DOI: 10.19538/j.ek2018100601 Abstract ( )

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Interpretation of Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment published by JAMA Pediatrics in 2017 2018, 33(10): 743-749.  DOI: 10.19538/j.ek2018100602 Abstract ( )   Historically，the diagnosis of cerebral palsy has been made after 1 year old. However，a systematical review published on JAMA Pediatrics in 2017 indicates that the diagnosis of cerebral palsy can be made before 6 months’ corrected age， based on the best available evidence of standardized predictive tools for detecting risk of cerebral palsy early. This review also emphasized that early diagnosis and intervention can promote the continuing development of children’s motor and intelligence，prevent complications and ensure that the caregivers can obtain full support. On the basis of Chinese national condition，we wrote this interpretation aiming to improve our capability of diagnosis and treatment of cerebral palsy， and to promote refinements of relevant policy.

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Present situation of the diagnosis and treatment of malignant solid tumor in children TANG Jing-yan 2018, 33(10): 750-753.  DOI: 10.19538/j.ek2018100603 Abstract ( )   Discussed the importance of multi-center clinical research and multidiscipline term model for childhood malignant solid tumor. The results of Adolescent and childhood malignant germ cell tumor，vinblastine and anaplastic large cell lymphoma, maintenance therapy for osteosarcoma were introduced as samples. Radiotherapy，stem cell transplantation and target therapy were discussed in comprehensive therapies of malignant solid tumor. The current situation and of China was presented. We needs further improving in this field.

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Gene detection for solid tumor in children HE Jing 2018, 33(10): 754-757.  DOI: 10.19538/j.ek2018100604 Abstract ( )   Gene detection is used to detect the DNA molecular information of biological samples，analyze the gene types，gene defects and gene expression，which may be used for early disease diagnosis and risk prediction. Gene detection plays an important role in the prediction of the risk of developing a solid tumor in children and the prognosis. The most common pathological gene detection of extracranial solid tumor-neuroblastoma is mainly focused on chromosome analysis，mutation detection，and single nucleotide polymorphism detection. Gene detection of neuroblastoma can provide reference for the study of other solid tumors in children.

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Retinoblastoma in children HUANG Dong-sheng，ZHANG Yi 2018, 33(10): 757-763.  DOI: 10.19538/j.ek2018100605 Abstract ( )   Retinoblastoma（RB） is the most common intraocular tumor in population，and represents 3% of pediatric cancers. The most common intimal sign of RB was "leucocoria". It develops in the retina as a primitive neuroectodermal tumor that affects development during gestation. It is initiated by mutation of the RB1 gene，which was the first described tumour-suppressor gene. It could be in one eye or both eyes. The treatment for RB included interventional treatment，intraocular conservation，chemotherapy and radiotherapy，and the long-term survival rate reached over 95%. However，with the deepening of understanding and improvement of economic conditions，the rate of visits for RB and spread of RB in the central nervous system has been increasing year by year. Understanding the diagnosis and comprehensive treatment of retinoblastoma and research progress at home and abroad are necessary to improving the eye-protection rate and quality of life in children with RB.

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Neuroblastoma in children WANG Jing-fu 2018, 33(10): 763-768.  DOI: 10.19538/j.ek2018100606 Abstract ( )   Neuroblastoma is the most common extracranial solid tumor in childhood. Heterogeneity is the main feature of NB with diverse clinical presentations，various molecular-pathology，and vastly contrasting prognosis. Treatment selection must be based on risk grade. The therapy for high-risk disease is the focus，which includes three phases：induction，consolidation，and maintenance. With the introduction of single cell technology and precise sequencing，NB will enter the era of molecular targeting and immunotherapy.

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null CHANG Jian 2018, 33(10): 769-773.  DOI: 10.19538/j.ek2018100607 Abstract ( )   This article will focus on the difficulties we have to face during HB treatment. First，we will start with molecular alterations in HB. HB is associated with several genetic syndromes in small amounts of HB. WNT/β-catenin signaling play an important role in somatic HB. However，how to make it valuable moleculare target remains unkown. Yet，many questions remain unsolved. More sophisticated research is necessary to unravel the exact implications of targeting WNT to achieve the maximum desired clinical effect. Second，we will focus on the difficulties in clinical procedures. What is the best optimal management of lung metastasis and refractory/recurrent diseases? How do we manage children affected by HB aged less than 6 months at diagnosis? Moreover， the role of postoperative chemotherapy in the post-transplant setting remains controversial.

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A summary of the COG-RTC clinical research results in the initial treatment for Wilms tumor in children and adolescents GAO Yi-jin 2018, 33(10): 773-778.  DOI: 10.19538/j.ek2018100608 Abstract ( )   Childhood kidney tumors account for about 7% of all childhood cancers. Most childhood kidney tumors are Wilms tumor，but in the 15- to 19-year age group，most tumors are renal cell carcinoma. In medically developed countries，clinical trials in Wilms tumor（WT） have resulted in overall survival rates of greater than 90%. Children’s Oncology Group Renal Tumor Committee（COG-RTC） is one of the clinical study groups internationally known for its clinical research in childhood kidney tumor. Its standard treatment for children with Wilms tumor consists of initial nephrectomy（when feasible） followed by chemotherapy and，in some patients，radiation therapy. This summary reviewed peer-reviewed，evidence-based reports about the treatment for Wilms tumor published recently and intended to be a resource to assist clinicians who care for children with Wilms tumor.

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null WANG Zhu-jun，JIN Run-ming，WU Xiao-yan 2018, 33(10): 779-783.  DOI: 10.19538/j.ek2018100609 Abstract ( )   It is very important to make a definite diagnosis of children mediastinal lymphoma with suitable methods，which is a critical and emergency disease having a different therapy and prognosis for the different sub-types. This review will introduce the progress of diagnosis, clinical staging and treatment of Hodgkin’s lymphoma，T-lymphoblastic lymphoma and primary mediastinal large B-cell lymphoma，which are common subtypes of children mediastinal lymphoma. The current review will indicate the direction of a standardized approach to diagnosis and management of children with mediastinal lymphoma in the future.

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Surgical treatment for solid tumor in children HU Jia-jian，WANG Huan-min 2018, 33(10): 784-787.  DOI: 10.19538/j.ek2018100610 Abstract ( )   Pediatric oncological surgery，as an important branch of pediatric surgery，has been developing rapidly in recent years. The pediatric oncology surgeons should not only do proper surgery，but also participate in the diagnosis and the staging of the tumor as well as the management of prognosis and complications. Surgery team strive to improve surgical skills and keep up with latest theory and concept of childhood cancer. Most important of all，they should consciously combine relevant departments in the multimodal team work to improve the prognosis of children with cancer.

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Radiotherapy for solid tumors in children JIANG Ma-wei，ZHOU Ren-hua，LU Dong-qing，et al 2018, 33(10): 787-791.  DOI: 10.19538/j.ek2018100611 Abstract ( )   Radiation therapy（RT） is used to treat children with CNS tumors，solid tumors or Hodgkin lymphoma，including TBI. Pediatric radiation oncologists have provided critical input into the development and implementation of concepts for clinical trials to further define the modality’s role and test newer methods to reduce side effects or intensify therapy. The quality of pediatric oncology clinical trials that include radiation therapy is linked to the quality of guidelines. Radiation oncology is an adult medical specialty；thus，pediatric radiation oncologists are uniquely positioned to work with adult cancer investigators.

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Molecular biology and potential therapeutic targets in alveolar rhabdomyosarcoma PENG Xiao-min，LI Yang 2018, 33(10): 791-795.  DOI: 10.19538/j.ek2018100612 Abstract ( )   Alveolar rhabdomyosarcoma（ARMS） is a highly invasive histological subtype of rhabdomyosarcoma（RMS），which has poor prognosis with unsatisfactory response to conventional treatment on account of early metastasis potential and frequent recurrence. In recent years，with the development of research，the biological characteristics of ARMS are better understood and biotargeted therapy，which is currently the hotspot and trend of research，has promising prospect to improve the prognosis of ARMS patients. Here we describe the most recent discoveries in the molecular and cellular biology of ARMS，including the generation and carcinogenicity of characteristic fusion genes，alterations in cell signaling pathways and potential targeted drugs tested in vitro or in vivo. This review will provide new ideas for the current treatment of ARMS.

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Clinical characteristics of gastrointestinal symptoms and follow-up of children with IgE-related food allergy　 LI Dong-dan，XU Xi-wei 2018, 33(10): 796-799.  DOI: 10.19538/j.ek2018100613 Abstract ( )   Objective　To observe the clinical characteristics and prognosis of children with IgE-related food allergy．Methods　The study was enrolled 174 children with food allergy in Beijing Children Hospital between March 2012 and November 2013. All patients were given treatment of avoid allergic food and filled out the standard questionnaire and followed up . Results　The sIgE positive rates of milk and eggs were higher than other food，were 66.1% and 27.6%. Mildly sensitive to milk was 65.5%，moderately sensitive to chicken protein was 5.2%. Main clinical manifestations of children with food allergy were vary in different age groups . In the infant group, diarrhea was the main manifestation（51.3%），and in the toddler group，vomiting was the main manifestation（37.5%）. In the school age and adolescence group，abdominal pain was the main manifestation（43.5%）. The severity of diarrhea are not connected with the types and concentration of allergens IgE. The results of follow-up analysis showed that patients of milk sIgE 2 level（7.54±5.1） months need more longer time to acquire tolerance than sIgE 1 level（3.50±3.53） months. Conclusion　Milk and eggs are the main allergens. The gastrointestinal symptoms of children with IgE-related food allergy were different with age. Children with high concentration of milk specific IgE is not easy to acquire food tolerance. The concentration of milk specific IgE had certain predictive value for the patient’s tolerance.

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Clinical features and gene analysis of 1 case of adenosine deaminase 2 deficiency in children and literature review LI Ji，WU Yue-fang，ZHONG Lin-qing，et al 2018, 33(10): 800-804.  DOI: 10.19538/j.ek2018100614 Abstract ( )   Objective　To strengthen the pediatrians’understanding of ADA2 deficiency in children，in order to recognize and diagnose the disease early. Methods　To introduces one ADA2 patient’s clinical manifestations and laboratory，imaging and gene characteristics. Results　The child had recurrent oral ulcers and fever at onset，and there was the gradual emergence of livedo reticularis and nervous system symptoms. Skin biopsies suggested microthrombosis；head MRI showed cerebral infarction and hemorrhagic focus；genetic testing showed mutation of the CECR1 gene，which was a novel mutation，and laboratory examination showed a significant decrease in peripheral blood ADA，so she is diagnosed with ADA2 deficiency. The patient was treated with calcium channel blockers（CCB） and anticoagulents which achieved good results. Conclusion ADA2 deficiency is a clinically rare disease. This is the first child case in China. The mutation site （c.254A＞T p.N85I，c.851G＞T p.G284V） of the gene detected in this case is not reported. It is a new mutation point. Mastering the clinical characteristics of ADA2 deficiency is helpful to improve the level of clinical diagnosis and treatment.

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Complex febrile seizure in children：A multivariate clinical analysis of 285 cases JIANG Chun-ying，TENG Zi-teng，WANG Dan，et al 2018, 33(10): 805-808.  DOI: 10.19538/j.ek2018100615 Abstract ( )   Objective　To explore the clinical features of complex febrile seizure（CFS） in children，and to improve the understanding on CFS in pediatricians. Methods　Retrospective analysis of clinical data of 285 children with CFS was performed. Results　There were many factors affecting CFS，and the infection of different pathogens and abnormal serum ion content may cause CFS. CT/MRI and electroencephalogram（EEG） were useful for assessing the onset of convulsion and secondary epilepsy. Conclusion　There were many factors affecting CFS，the imaging examination and EEG were valuable in evaluating the recurrent convulsion and secondary  epilepsy.

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Bickerstaff brainstem encephalitis in children：A report of 1 case and literature SUN Gui-lian，YANG Zhi-liang，YAO Fang 2018, 33(10): 809-811.  DOI: 10.19538/j.ek2018100616 Abstract ( )

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Effect of probiotics in the control and immune regulation of bronchial asthma in children ZHEN Xing-gang，GUO Yan-jun，ZHANG Ying-hui，et al 2018, 33(10): 812-814.  DOI: 10.19538/j.ek2018100617 Abstract ( )

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Bartter syndrome combined with glomerulosclerosis and renal failure in children：A report of 1 case ZHANG Hai-ting，LUO Gang，JIANG Hong 2018, 33(10): 815-816.  DOI: 10.19538/j.ek2018100618 Abstract ( )