OBJECTIVE: To identify the relationship between the expression of α and β-isoforms of glucocorticoid receptors (GR) in peripheral blood mononuclear cells (PBMC) and glucocorticoid resistance in children with idiopathic thrombocytopenia purpura (ITP). METHODS: Real-time PCR was used to detect the expression of GRα and GRβ mRNA in PBMC from 30 children with ITP (glucocorticoid-sensitive, n=18; glucocorticoid-resistant, n=12) and 10 healthy children (control group). Enzyme immunoassay was used to measure plasma levels of total glucocoticoits. RESULTS: There were no significant differences in PBMC GRα mRNA levels among the glucocorticoid sensitive, the glucocorticoid-resistant and the control groups. Compared with the glucocorticoid-sensitive and the control groups, the expression of GRβ mRNA in the glucocorticoid-resistant group was significantly up-regulated (P<0.01). Plasma total glucocoticoits level in the glucocorticoid-resistant group was found to be much higher than that in the glucocorticoid-sensitive and the control groups (P<0.01). CONCLUSIONS: The up-regulated expression of GRβ mRNA may associated with glucocorticoid resistance in children with ITP.［Chin J Contemp Pediatr, 2009, 11 (9):714-716］
OBJECTIVE: To investigate the relationship between vascular endothelial growth factor (VEGF) expression and microvessel injury of renal interstitium in children with Henoch-Sch?nlein purpura nephritis (HSPN). METHODS: Thirty-two children with HSPN and who had not received glucocorticoid or immunodepressants treatment before hospitalization were enrolled. Five children undergoing nephrectomy due to renal trauma were used as the control group. Renal samples were stained by hematoxylin and eosin and renal pathological changes were evaluated semiquantitatively. CD34 and VEGF expression was detected by immunohistochemistry. CD34 was used as the marker for endothelial cells of renal microvessels. The microvessel density (MVD) was calculated by CD34 immunostaining. RESULTS: Compared with the control and the renal pathological grade II HSPN groups, MVD in the grade III and above HSPN groups decreased significantly, with an obvious reduction in MVD with the increased renal pathological grade (P<0.05). The renal microvessel score in the grades IIIa, IIIb, IV, and V HSPN groups decreased obviously compared with that in the control group. The renal microvessel score decreased with the increased renal pathological grade (P<0.05). VEGF expression in the grade II HSPN group was higher (P<0.05), while that in the grades IV and V HSPN group was lower than that in the control group (P<0.05). VEGF expression in the HSPN group showed a significant reduction with the increased renal pathological grade (P<0.05). There was a positive correlation between VEGF expression and MVD in renal tissue in the HSPN group (r=0.935, P<0.01). CONCLUSIONS: The decreased expression of VEGF may be responsible for the renal pathological damage and microvessel injury in HSPN.［Chin J Contemp Pediatr, 2009, 11 (9):717-721］
OBJECTIVE: This study examined the expression of Toll-like receptors (TLR) in peripheral blood mononuclear cells (PBMC) and serum levels of IL-6, IL-10 and TNF-α in children with recurrent herpes simplex, in order to investigate the role of TLR2 and TLR9 in recurrent herpes simplex. METHODS: The expression of TLR2 and TLR9 in PBMC was examined by flow cytometer, and serum levels of IL-6, IL-10 and TNF-α were detected using ELISA in 22 children with recurrent herpes simplex and in 13 age-matched healthy volunteers. RESULTS: The expression of both TLR2 and TLR9 obviously increased in children with recurrent herpes simplex compared with that in healthy controls (P<0.01). Serum levels of IL-6 and IL-10 increased, while serum TNF-α levels decreased significantly in children with recurrent herpes simplex compared with those in healthy controls (P<0.01). There were positive correlations between TLR2 and TLR9 expression and serum IL-6 and IL-10 levels in children with recurrent herpes simplex (P<0.01). CONCLUSIONS: TLR2 and TLR9 in PBMC may participate in the recognition of herpes simplex virus and activate the signal pathway of TLR in children with recurrent herpes simplex. The production and release of IL-6 and IL-10 might be mediated by TLR2 and TLR9.［Chin J Contemp Pediatr, 2009, 11 (9):722-724］
OBJECTIVE: It is widely agreed that comprehensive parental advice and education is a cornerstone of allergic disease management. This study was designed to investigate the parental cognition condition on allergic diseases and information needs, so that medical staff can carry on related education and prevention work for children's parents more efficiently. METHODS: A total of 357 parents from the department of child health care were randomly enrolled. A cross-sectional study was carried out using a self-designed questionnaire. Descriptive statistical analysis, logistic regression model and t test were used to analyze the survey results. RESULTS: Three hundred and fifty (98.0%) effective responses were received to the questionnaires. Fifty-six percent of the parents did not know that asthma was one of the stages in an allergic disease. Seventy-two percent of the parents did not know the fact that allergic disease could manifest as diarrhea. The majority of the parents (70.9%) thought that the most common food leading to allergy was seafood, and 37.4% of parents thought that if a child was allergic to some food, then he or she should not eat the food for life. Almost all of the parents (97.7%) required information on allergic diseases and 53% of the parents wanted to understand clinical manifestations of allergic diseases. There were statistical significances in the needs to information on clinical manifestations of allergic diseases among parents with different education levels (OR=2.042, P<0.05). The need for knowledge of allergic diseases in parents with an allergic disease or an allergic family history were different from the parents without (OR=8.045, P<0.05). Listening to lectures and receiving education handbooks on allergic diseases from doctors or health care workers were regarded as essential by parents. CONCLUSIONS: Parental knowledge about allergic diseases is limited, and some of the knowledge is wrong. The parents want much information about allergic diseases. It is necessary to provide education and prevention programs on allergic diseases for parents through various ways.［Chin J Contemp Pediatr, 2009, 11 (9):725-728］
OBJECTIVE: Damage control surgery (DCS) deals with the complex surgical problems by stages. This study investigated the application of DCS in serious pediatric abdominal surgery. METHODS: The clinical data of 49 children with serious abdominal diseases (age: 4 months to 10 years) were retrospectively studied. Of them, 32 children underwent damage control surgery (DCS) and 17 children underwent conventional operation. The preoperative critical severity score (CSS), postoperative temperature, blood pH and prothrombin time (PT), and the treatment outcome were compared between the DCS and the conventional operation groups. RESULTS: No significant difference was found in the preoperative CSS between the two groups. There were significant differences in postoperative blood pH and PT values between the two groups (P<0.05). As for postoperative temperature, there was no statistical difference between the two groups, yet the tendency of temperature recovery in the DCS group was milder than that in the conventional operation group. Twenty-seven children (84.4%) were successfully cured in the DCS group, while 9 children (52.9%) in the conventional operation group (P<0.05). CONCLUSIONS: The curative effect of DCS surpasses the conventional operation in children with serious abdominal diseases, suggesting that DCS is of value in the management of serious pediatric abdominal diseases.［Chin J Contemp Pediatr, 2009, 11 (9):729-732］
OBJECTIVE: To study the insular development of small for gestational age (SGA) infants. METHODS: The insular area and circle were measured by cerebral ultrasonography in 92 SGA infants. The results were compared with those from 109 appropriate for gestational age (AGA) infants. RESULTS: The insular area and circle were positively correlated with the birth weight and gestational age in SGA infants. The insular area in SGA infants with a gestational age of either >37 weeks (451±92 mm2 vs 516±116 mm2; P37 weeks was also significantly less than that in the AGA infants (92±11 mm vs 97±11 mm; P<0.05). CONCLUSIONS: The insular development of SGA infants seems to be immature. The insular development may be assessed based on the insular area and circle measured by cerebral ultrasonography.［Chin J Contemp Pediatr, 2009, 11 (9):733-735］
OBJECTIVE: To investigate the birth state of neonates and the disease spectrum of hospitalized neonates from a primary hospital, and compare with the national data of the same period. METHODS: A retrospective investigation was carried out in 1 434 neonates born or hospitalized in this hospital from January 2005 to December 2005. RESULTS: During the investigation period, there were 1 100 neonates born in the department of obstetrics. The incidence of premature birth was 2.3%. The caesarean birth accounted for 54.2%, significantly higher than the national average (49.2%, P<0.01). The neonatal mortality was 0.2%. The incidences of antepartum hemorrhage, threatened abortion, and pregnancy infection in preterm infant's mothers were significantly higher than those in full-term infant's mothers. A total of 344 neonates were admitted to the department of pediatrics during the investigation period. Preterm infants accounted for 38.0% which was higher than the national average (26.2%; P<0.01). Beside preterm infants, asphyxia, respiratory distress syndrome (RDS), sepsis and intracranial hemorrhage were shown to have a significantly higher proportion than the national averages. The mortality of hospitalized neonates was 0.9%. CONCLUSIONS: The higher cesarean section rate should be controlled in our hospital. Prenatal health care and fetal monitoring should be strengthened to decrease the incidence of premature birth, RDS, sepsis and intracranial hemorrhage, thus reducing the mortality of neonates.［Chin J Contemp Pediatr, 2009, 11 (9):736-739］
OBJECTIVE: Pharmacological intervention is an important means for the treatment of hypoxic-ischemic encephalopathy (HIE). As meta-analyses and randomized controlled clinical trials based on evidence-based medicine are able to provide the most reliable evidence for clinical practice, this study searched several databases in order to find the clinical evidence for the pharmacological treatment of neonatal HIE. METHODS: Meta-analyses and randomized (or quasi-randomized) controlled trials (RCT) for pharmacological therapy of HIE in term or late preterm newborn infants were searched from the databases of MEDLINE, EMBASE, Oxford Neonatal Group and Cochrane Library. The relevant literatures were statistically analyzed. RESULTS: Four Meta-analyses and thirteen RCTs were found to be involved in barbiturate, allopurinol, magnesium sulfate, mannitol, naloxone and dopamine therapy. None of the drugs could significantly decrease the mortality and the incidence of seizure or severe neurodevelopmental disabilities in newborn infants with HIE. CONCLUSIONS: Current clinical evidence indicates that no individual drug could decrease mortality and improve the neurodevelopmental outcomes in infants with HIE. Problems such as small scale in sampling and discrepancy in the identification of drug efficacy which exist in the clinical trials might lead to the uncertain effect of the drugs, and large sized and collaborative clinical trials are needed in the future.［Chin J Contemp Pediatr, 2009, 11 (9):740-744］
OBJECTIVE: To investigate serum leptin level and its relationship with bone mineral density in obese children from Changsha City. METHODS: One hundred and nineteen obese children and 103 normal children aged 7 to 12 years from five primary schools of Changsha City were enrolled. Obesity was assessed based on the body mass index (BMI). Dual energy X-ray absorptiometry (DEXA) was used to determine bone mineral density (BMD) and body composition. Serum leptin level was measured using enzyme-linked immunosorbentassay (ELISA). RESULTS: The obesity group had higher height, weight, BMI, waist circumference and waist to hip ratio (WHR) compared with the normal group (P<0.01). BMD, bone mineral content (BMC), lean mass (LM), fat mass (FM), percentage of body fat (%BF) and leptin concentration in the obesity group were significantly higher than those in the normal group (P<0.01). Serum leptin level was positively correlated with BMD, BMC, LM and FM (r=0.528-0.903, P<0.01). Multiple stepwise regression analysis indicated that BMI and %BF were independent influencing factors for serum leptin level. CONCLUSIONS: Obese children have higher serum leptin level. Serum leptin concentration is significantly correlated with BMD and body composition. BMI and %BF are independent influencing factors for serum leptin level in children.［Chin J Contemp Pediatr, 2009, 11 (9):745-748］
OBJECTIVE: To explore the effects of hyperbaric oxygen (HBO) treatment on the migration and differentiation of endogenous neural stem cells (NSCs) in neonatal rats with hypoxic-ischemic brain damage (HIBD). METHODS: Seven-day-old Sprague-Dawley rats were randomly divided into the normal control (CON), the HIBD model and the HBO groups (HBO treatment was administered at 2 ATA, once daily for 7 days within 3 hrs after HIBD). HIBD model was prepared according to the classic Rice-Vannucci method. BrdU/DCX, BrdU/β-tubulin, BrdU/GFAP and BrdU/O4 immunofluorescence were examined by confocal microscopy in the subventricular zone (SVZ) and the cortex 7, 14 and 28 days after HBO treatment. RESULTS: The BrdU+DCX+ cells in the SVZ (84±21 cells/mm2) in the HBO group were significantly higher than those in the CON group (39±14 cells/mm2) (P<0.05) and the HIBD model group (68±17 cells/mm2) (P<0.05) 7 days after HBO treatment. Fourteen days after HBO treatment, the BrdU+ DCX+ cells decreased in the SVZ and more cells were observed in the cortex in the HBO group as compared with the CON group (P<0.01). The BrdU+ β-tubulin+, BrdU+GFAP+ and BrdU+ O4+ cells were observed in the cortex, and more BrdU+β-tubulin+ and BrdU+ O4+ cells were observed in the HBO group as compared with the CON and the HIBD model groups (P<0.05) 28 days after HBO treatment. CONCLUSIONS: HBO treatment may promote endogenous NSCs to migrate to the cortex and differentiate into mature neurocytes in neonatal rats with HIBD.［Chin J Contemp Pediatr, 2009, 11 (9):749-752］
OBJECTIVE: To investigate the effects of intrauterine growth retardation (IUGR) caused by malnutrition during pregnancy on the acetylation of histone H3 and expression of histonedeacetylase1(HDAC1) in the hepar of the adult offspring and to explore the relationship between them. METHODS: Male 8-week-old offspring from maternal protein-malnutrition dams were studied. The expression of HDAC1 mRNA in the hepar was measured by fluorescent quantization RT-PCR. The levels of hepatic nuclear HDAC1 protein and acetylation of histone H3/K9 were assessed by Western blot. RESULTS: The hepatic HDAC1 mRNA expression in IUGR rats was reduced to 54% of that of normal control rats (t=2.042, P<0.05). A decline in nuclear expression of HDAC1 protein (438±47) was also noted when compared with normal controls (1 128±110)(t=2.179, P<0.05). In contrast, the percentage of acetylated histone H3/K9 in IUGR rats (17.3±1.6%) increased significantly compared with that of normal control rats (10.5±1.2%) (t=3.597, P<0.01). The level of acetylated histone H3/K9 was negatively correlated with the HDAC1 protein concentration (r=-0.781, P<0.01). CONCLUSIONS: Increased hepatic acetylation of histone H3 in the IUGR offspring might be caused by decreased HDAC1 expression in nuclear protein. This may contribute to the transcription change of some genes in the hepar.［Chin J Contemp Pediatr, 2009, 11 (9):753-756］
OBJECTIVE: To compare the characteristics of immunomagnetic beads and hespan precipitation for isolation of mononuclear cells (MNCs) from umbilical cord blood and try to find a better isolation method for MNCs. METHODS: Fifteen umbilical cord blood samples from healthy parturiens were collected between December 2007 and March 2008. MNCs were isolated using hespan precipitation and CD133 immunomagnetic beads, respectively. MNCs were identified using the surface marker CD34 by flow cytometry on the 30th of primary culture. Growth conditions and morphologic changes of primary cells were observed by an inverted microscope. RESULTS: The number of MNCs from umbilical cord blood isolated by hespan precipitation (15.23±4.30×106/mL) was significantly greater than that by CD133 immunomagnetic beads (0.066±0.027×106/mL) (P<0.05). The MNCs isolated by hespan precipitation suspended at the culture medium and their growth was slow after passage. The growth of MNCs isolated by CD133 immunomagnetic beads was kept in a good condition. The CD34 positive rate of MNCs isolated by hespan precipitation and immunomagnetic beads was 10.1% and 0.5%, respectively. CONCLUSIONS: The hespan precipitation is an effective method for MNCs isolation from human umbilical cord blood, but with a cell growth condition below the mark. The MNCs isolated by CD133 immunomagnetic beads are in a high purity quotient.［Chin J Contemp Pediatr, 2009, 11 (9):757-760］
OBJECTIVE: To construct a recombination retroviral expression vector pLNC-IL-4RA with high efficiency transfection and carrying a screening label. METHODS: IL-4RA was inserted into retroviral vector pLNC-Laz to get recombination retroviral expression vector pLNC-IL-4RA and then transfected into packaging cell line PA317 by liposome transfection. The transfected PA317 cells were obtained and amplified by G418 pressure screening. The cell culture supernatants containing viruses were harvested and the viral titer was determined by NIH3T3 cells infection. RESULTS: The G418 resistant clones were titrated and checked for the presence of replication virus. The results showed that the highest titer of viral supernatant was 1×104 CFU/mL. Genome DNA isolated from the cell clone of the highest titer showed the function gene, IL-4RA cDNA, had integrated into the genome of host cells verified by PCR. CONCLUSIONS: The recombination retroviral vector pLNC-IL-4RA encoding IL-4RA after packaging PA317 cells have higher viral titer. This provides a basis for gene treatment of asthma.［Chin J Contemp Pediatr, 2009, 11 (9):761-764］
