OBJECTIVE: To establish a population pharmacokinetics (PPK) model of lamotrigine, an antiepileptic drug, in Chinese children with epilepsy to formulate an individualized dosage guideline. METHODS: A total of 303 data, including the random ones of serum lamotrigine concentrations from 165 epileptic children were analyzed. Lamotrigine concentrations were determined by the RP-HPLC method. PPK model of lamotrigine was established using NONMEM, a population pharmacokinetic computer program, according to one-compartment model with first-order absorption and elimination. To evaluate the accuracy and precision of predicting lamotrigine concentrations, mean error (ME), mean squared prediction error (MSE), standard mean squared prediction error (SME), root mean squared prediction error (RSME), WRES and their 95% confidence interval were calculated in both the base and the final models. RESULTS: Regression equation of the base model of lamotrigine was obtained, ie, clearance (CL/F)=0.664×EXP［ETA(1)］, volume of distribution (V/F)=45×EXP［ETA(2)］, and KA=4.0×EXP ［ETA(3)］, and that of the final model was as follows: CL/F=0.717×(10.601×VPA)×(1+1.18×EI)× (1.62∧［AGE/7.02)］×EXP［ETA(1)］, V/F=40.2×EXP［ETA(2)］, KA=3.27×EXP ［ETA(3)］. The population values of CL/F, V/F and KA were 1.16 L/h (0.042 L/h/kg), 40.2 L(1.46 L/kg) and 3.27/h for lamotrigine respectively in the final model. The final PPK model was demonstrated to be stable and effective in the prediction of serum lamotrigine concentrations by internal and external approaches validation. CONCLUSIONS: A PPK model of lamotrigine in Chinese children with epilepsy was successfully established using NONMEM. Lamotrigine concentrations can be predicted accurately by the model. The model may be helpful to reasonable use of antiepileptic drugs in clinical practice.

OBJECTIVE: To study the value of a new technique, maximum length sequences brainstem auditory evoked potential (MLS BAEP), in the assessment of the severity of brain damage following asphyxia in term neonates. METHODS: One hundred and three neonates with perinatal asphyxia and 26 normal term neonates were eligible for the study. Conventional and MLS BAEP examinations were performed within three days after birth. Of the 103 neonates with asphyxia, 17 did not suffer from HIE, 37 had mild HIE, 31 had moderate HIE, and 18 had severe HIE. The latencies and amplitudes of waves I, III and V, and the inter-peak intervals of I-III, III-V, and I-V were analyzed. RESULTS: The latencies of wave V and the inter-peak intervals of I-III, III-V and I-V prolonged gradually with the more severe HIE in both the MLS and the conventional BAEP (P<0.05 or 0.01). The differences among groups were more significant with the increasing repetition rate of click in the MLS BAEP. Compared with the normal controls, conventional BAEP did not show prolonged intervals of I-III and III-V in the mild HIE subgroup, and a prolonged inter-peak interval of III-V in the moderate HIE subgroup, while the MLS BAEP showed significantly prolonged inter-peak intervals of I-III and III-V in the three HIE subgroups and the differences were more and more significant as an increase in the repetition rate of click from 91 to 910 times/seconds. CONCLUSIONS: MLS BAEP is more sensitive and valuable than the conventional one in detecting hypoxic-ischemic brain damage following asphyxia by increasing the repetition rate of click. MLS BAEP provides a new measurement in quantity to assess the severity of HIE in neonates with perinatal asphyxia.

OBJECTIVE: To study the relationship between clinical and imaging features in neonates with hypoglycemic brain injury. METHODS: Sixteen neonates with hypoglycemic brain injury received a MRI scan with the sequences of T1WI, T2WI and DWI within 48 hrs after admission. Of the 16 patients, 11 received second MRI scan at two weeks of their lives, and 3 received a third scan at ages of 1-5 months. RESULTS: Repeated seizures, lethargy and hypotonia were common clinical manifestations. Five severe hypoglycemia cases presented coma, respiratory failure and even cardiorespiratory arrest. The minimum mean value of whole blood glucose (WBG) in the 16 patients was 0.98±0.43 mmol/L, and that of the 5 severe cases was 0.72±0.42 mmol/L. EEG showed intermittent low voltage in the mild hypoglycemia cases. Flatten pattern and even electrocerebral silence was noted in the severe cases. Occipital and parietal cortexes (OPC) injuries were found in all of the 16 patients and 2 patients had concurrent periventricular white matter injury. A widespread involvement of cortex was found in the 5 severe hypoglycemia cases in which 1 showed widespread involvement of white matter, and 2 showed involvement of basal ganglia and thalamus. The 5 patients with widespread cortex injury and the 2 patients with OPC and periventricular white matter injury showed lower minimum WBG levels compared with those with OPC alone (0.71±0.35 mmol/L vs 1.19±0.42 mmol/L; t= 2.4124,P<0.05). The appearance of high-intensity signals on DWI was shown as early changes of signals in all of the 16 patients. The second MRI scan for 7 patients with OPC showed abnormal signals on T1WI and T2WI in 5 patients and abnormal signals on DWI in 3 cases. Cerebral atrophy and multicystic encephalomalacia were found in four patients with widespread involvement of cortex on DWI. In the follow-up one patient with OPC presented delayed myelination and one with concurrent white matter injury showed spastic diplegia. One patient with widespread involvement of cortex showed diffused encephalomalacia. CONCLUSIONS: The severity of hypoglycemic brain injury demonstrated by serial MRIs relates to the severity of hypoglycemia. The occipital and parietal areas are the most vulnerable following hypoglycemia in neonates. Severe hypoglycemic brain injury manifests as a widespread involvement of cortex, or combined with white matter, or basal ganglia and thalamus. DWI can show early hypoglycemic brain injury.

OBJECTIVE: What is the best suitable position for neonates who were weaned from mechanical ventilation has not been identified. This study aimed to evaluate the effect of the supine and prone positions on oxygenation in neonates within 6 hrs after weaning from mechanical ventilation. METHODS: Sixty neonates who were weaned from mechanical ventilation were randomly given prone or supine position (n=30 each). They all received oxygen inspiration and SPO2 was maintained in a normal range by adjusting the oxygen flow rate (FiO2). Blood PaO2 and PaCO2 levels were measured 1 and 6 hrs after weaning and then the alveolo-arterial oxygen partial pressure difference (A-aDO2), respiratory index and oxygenation index were calculated. RESULTS: Mean FiO2 used in the prone position group was significantly lower than that in the supine position group 1 and 6 hrs after weaning (P<0.01). The value of A-aDO2 in the prone position group 1 hr (171.06±86.55 vs 253.62±71.56; P<0.01) and 6 hrs after weaning (105.85±78.18 vs 208.48±86.80; P<0.01) were significantly lower than that in the supine position group. The respiratory index in the prone position group 1 and 6 hrs after weaning (2.16±1.24 and 1.35±1.11) was also reduced compared to 3.74±1.68 and 3.65±1.28 in the supine position group (P<0.01). In contrast, PaO2 in the prone position group 1 hr (88.70±32.65 vs 73.43±17.68; P<0.01) and 6 hrs (84.10±13.95 vs 70.20±20.27; P<0.01) after weaning was significantly higher than that in the supine position group. The oxygenation index in the prone position group 1 and 6 hrs after weaning (213.49±88.96 and 275.23±108.83) increased significantly compared to 141.54±43.25 and 160.62±63.03 in the supine position (P<0.01). CONCLUSIONS: The prone position is better than the supine position for the improvement of oxygenation within 6 hrs after weaning from mechanical ventilation in neonates.

OBJECTIVE: To study the evidence-based therapy of inhaled nitric oxide （iNO）for hypoxic respiratory failure (HRF) in term and near-term infants by analyzing the literature systematically. METHODS: The literature related to the treatment of HRF with iNO was retrieved from the following: PubMed, EMBASE, OVID, Springer and Chinese Journals Full-Text Database (CNKI). The relevant literature on randomized controlled trials (RCTs) that met the criteria was statistically analyzed by the software of Review Manager 4.2, as recommended by Cochrane Collaboration. RESULTS: A total of 162 articles were retrieved. Fifteen met the criteria and were selected for Meta analysis (4 single center and 11 multicenter randomized trials). Meta analysis showed that 30-60 minutes iNO therapy decreased the oxygenation index (P<0.05), increased PaO2 significantly, and reduced need of extracorporeal membrane oxygenation(ECMO) (P<0.05). However, for the neonates with HRF caused by congenital diaphragmatic hernia, iNO therapy did not result in a significant reduction in the oxygenation index and death rate. There was no significant difference in the occurrence of neurodevelopmental sequelae between the iNO and control groups. CONCLUSIONS: The currently published evidence from RCTs supports the use of iNO in term and near-term infants with HRF but except for the HRF infants caused by diaphragmatic hernia. The effect of iNO therapy on long-term neurodevelopment needs to be further studied.

OBJECTIVE: To determine whether serum homocysteine and folate levels are correlated with the occurrence of neonatal asphyxia and to study the effects of gender and gestational age on serum homocysteine and folate levels. METHODS: Thirty-five neonates with mild asphyxia (19 males and 16 females) and 40 normal neonates (control group,18 males and 22 female) were enrolled in this study. The asphyxia and the control groups consisted of 10 and 11 cases of preterm infants respectively. Serum homocysteine levels were measured using ELASA. Serum folate levels were measured using radioimmunity assay. RESULTS: Serum homocysteine level (14.66±2.61 μmol/L vs 7.55±0.50 μmol/L; P<0.05) was significantly higher and serum folate level (2.47±0.24 ng/mL vs 3.28±0.28 ng/mL; P<0.05) was significantly lower in the asphyxia group than that in the control group. There were no significant differences in serum levels of homocysteine and folate between males and females either in the asphyxia group or the control group. The asphyxiated neonates born at premature showed increased serum homocysteine level compared with the full-term neonates with asphyxia (21.25±5.01 μmol/L vs 12.34±2. 01 μmol/L; P<0.05). CONCLUSIONS: The increased serum homocysteine level and decreased serum folate level are correlated with the occurrence of neonatal asphyxia. Serum homocysteine and folate levels are not associated with the gender. A more significantly increased serum homocysteine level may be found in asphyxiated neonates born at premature

OBJECTIVE: Some research has shown that hyperbaric oxygen (HBO) can decrease the rate of mortality and disability caused by hypoxic-ischemic encephalopathy (HIE) in neonates. However, the HBO pressure used in the clinical reports and the efficacy of HBO are different. This study was designed to investigate the efficacy of HBO therapy under different pressures by observing the changes of peroxidation, antioxidant levels and brain vasomotor regulation factors as well as the score of neonatal behavioral neurological assessment (NBNA) in neonates with HIE after HBO therapy. METHODS: Sixty neonates with HIE were randomly administered with 1.4, 1.5 or 1.6 atmosphere absolute (ATA) of HBO, once daily for seven days. Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO) and nitric oxide synthase (NOS) were measured before and after HBO therapy. Meanwhile, NBNA and eye ground examination were performed. RESULTS: Serum SOD level increased and serum levels of MDA, NO and NOS decreased significantly after HBO therapy in the three HBO therapy groups (P<0.01). Serum SOD level was significantly higher and serum levels of MDA, NO and NOS were significantly lower in the 1.6 ATA HBO group than those in the 1.4 ATA group after therapy (P<0.05). The 1.6 ATA HBO group also showed increased SOD and decreased MDA levels compared with the 1.5 ATA HBO group after therapy (P<0.05). NBNA scores in the three groups increased significantly after HBO therapy (P<0.05). None of the three HBO therapy group patients showed abnormal eye grounds after therapy. CONCLUSIONS: HBO therapy with 1.4, 1.5 or 1.6 ATA is safe and effective for neonatal HIE. The antioxidant capacity increases with the increasing HBO pressure in neonates with HIE.

OBJECTIVE: This study examined serum level of heart-type fatty acid-binding protein (h-FABP) in children with Kawasaki disease (KD) in order to assess its value in KD. METHODS: Forty children with KD and 30 healthy children were enrolled. Serum levels of h-FABP and cardiac troponin I (cTnI) were measured using ELISA. Serum creatine kinase-MB (CK-MB) level was detected using an autoanalyer. The KD group was classified into two subgroups, with or without coronary artery lesions, based on the findings of the echocardiography. RESULTS: Mean serum levels of h-FABP (18.17±13.38 ng/mL vs 6.25±1.70 ng/mL; P<0.01) and cTnI (0.27±0.22 ng/mL vs 0.11±0.02 ng/mL; P<0.05) in the KD group was significantly higher than those in the control group. There was no significant difference in serum CK-MB concentrations between the two groups. Twenty-six patients (65%) and eight patients (20%) showed abnormally increased h-FABP and cTnI levels respectively in the KD group, but none of the control group showed increased levels of both. In the KD group, the percentage of patients with increased h-FABP was significantly higher than those with increased CTnI (P<0.01). The patients with coronary artery lesions had higher serum h-FABP level than those without (28.14±14.26 ng/mL vs 11.52±6.28 ng/mL; P<0.01). CONCLUSIONS: Serum levels of h-FABP and cTnI increase and can be used as the biomarkers of myocardial damage in children with KD. h-FABP appears to be more sensitive and specific. Detection of serum h-FABP level is useful for diagnosis of KD and coronary artery lesions secondary to KD.

OBJECTIVE: To investigate clinical features of X-linked agammaglobulinemia (XLA) in children. METHODS: The medical records of 17 children with XLA between January 2001 and April 2007 were reviewed. RESULTS: The age at first diagnosis in 88.2% of patients was more than 6 years, with a mean of 7.7 years. Twelve patients(70.6%) presented first symptoms over 2 years old, with a mean of 4.2 years. Respiratory infections as first symptoms and complaints occurred in 64.7% of the patients and 35.3% of the patients presented with polyarthritis. Skin and soft tissue infections were rarely seen in less than 1 year old group children. Abrupt sepsis and abscess in deep tissues were seen in the older children. CD4+ T cells decreased and CD8+ T cells increased in 9 patients and an inversed ratio of CD4+/ CD8+ was observed in 11 patients. CONCLUSIONS: Both the age presenting first symptoms and the age at first diagnosis in children with XLA in this study were later than the reported data. Respiratory infection was the most common manifestation. High prevalence of polyarthritis was observed. Abnormal T cell phenotypes occurred in more than one half of patients.

OBJECTIVE: To understand the etiology of pneumonia in hospitalized patients less than 3 years of age. METHODS: A total of 316 children with pneumonia admitted to the Children's Hospital of Suzhou University in Jiangsu Province from March, 2006 to January, 2007 were enrolled in this study. Sputum samples were obtained by deep nasotracheal aspiration technique for bacterial and viral cultures. RESULTS: Of the 316 samples, specific microbial etiology was obtained in 192 cases (60.8%). Bacterial infection was found in 162 cases (51.3 %), viral infection in 19 cases (6.3%), and compound infection with virus and bacteria in 11 cases (3.5 %). Haemophilus influenzae was the most common agent (46 cases; 14.6%) in bacterial infection, followed by Streptococcus pneumoniae (32 cases; 10.1%). Respiratory syncycial virus (RSV) was the most common agent (12 cases; 4.0%) in viral infection, followed by adenovirus (11 cases; 3.6%). CONCLUSIONS: Bacterial infection was a leading cause of pneumonia in children less than 3 years of age in Suzhou area. Haemophilus influenzae was the most common agent, followed by Streptococcus pneumoniae.

OBJECTIVE: This study examined the changes of serum levels of interleukin 12 ( IL-12), transforming growth factor β1 (TGFβ1) and immunoglobulin E ( IgE) in children with asthma as well as the correlation of IL-12 and TGFβ1 with IgE in order to investigate their roles in asthma. METHODS: Serum levels of IL-12 , TGFβ1 and IgE were detected using ELISA in 85 asthmatic children at the acute and the remission stages. Thirty healthy children served as control group. RESULTS: Compared with the control group, serum IL-12 and TGFβ1 levels were significantly lower and serum IgE levels were significantly higher in the asthmatic group through the acute to the remission stages. Serum IL-12 and TGFβ1 levels (40.42±15.26 ng/L and 65.41±22.38 pg/mL) significantly increased in the asthmatic group at the remission stage compared with those at the acute stage (28.42±10.73 ng/L and 40.25±11.73 pg/mL) (P<0.01), but remained lower levels than those in the control group (67.42±20.58 ng/L and 178.54±90.56 pg/mL) (P<0.01). The asthmatic patients at the remission stage showed significantly decreased serum IgE levels (145.67 ±51.25 IU/mL) compared with those at the acute stage (280.35 ±80.54 IU/mL) (P<0.01), but the IgE level in the remission stage was obviously higher than in the control group (53.61±13.32 IU/mL) (P<0.01). Serum IL-12 and TGFβ1 levels were negatively correlated with serum IgE level in asthmatic children. CONCLUSIONS: There might be an imbalance in serum IL-12, TGFβ1 and IgE levels in asthmatic children. IL-12, TGFβ1 and IgE may play an important role in the pathogenesis of asthma. They may be useful in the diagnosis and severity evaluation of asthma

OBJECTIVE:Mannan-binding lectin (MBL) is a C-type serum lectin that plays a central role in the innate immune response. At present there is no a reference range of serum MBL levels for children in China. This study investigated serum MBL levels in preschool children from Shenzhen. METHODS: A total of 118 children (62 boys and 56 girls) at ages of 3-6 years and sampled randomly from three kindergartens of Shenzhen were enrolled in this study. Serum MBL concentrations were determined using enzyme-linked immunosorbent assay. RESULTS: The mean serum MBL concentration in these children was 779.07±268.98 ng/mL. There were no significant differences in the value of serum MBL between boys and girls (783.89±252.30 ng/mL vs 773.65±288.29 ng/mL) (P>0.05). Sixteen children (13.6%) had MBL concentrations less than 500 ng/mL (the low limited value used abroad), including 14 cases with 50-500 ng/mL and 2 cases with less than 50 ng/mL. CONCLUSIONS: This study provides a reference range of serum MBL concentration for preschool children. MBL may be a useful marker for the prevention of infection in children.

OBJECTIVE: Infants are usually subjected to serious complications after cardiac surgery with cardiopulmonary bypass (CPB). This study was conducted to evaluate the effects of a modified ultrafiltration technique (MUF) on infants undergoing cardiac surgery with CPB. METHODS: A total of 261 infants less than 1 year old with congenital heart disease and who required CPB were randomized into receive MUF during CPB (n=205) or not (n=56, control group). Bypass duration, aortic cross-clamp duration, postoperative blood effluents and transfusions, mechanical ventilation duration following operation, and hematocrit and oxygenation index 24 hrs postoperatively were compared between the two groups. RESULTS: No ultrafiltration-related complication was found in the MUF group. There were no significant differences in the duration of bypass and aortic crossclamp between the two groups. Postoperative blood effluents and transfusions in the MFU group were significantly reduced (79.5±18.6 mL vs 57.3±15.4 mL and 78.1±32.5 mL vs 67.9±25.6 mL respectively) compared with the control group (P<0.05). The duration of mechanical ventilation following operation in the MFU group was shorter than that in the control group (28.6 ± 9.1 hrs vs 32.3 ± 8.7 hrs; P<0.05). MUF produced a significant improvement in hematocrit (34.6 ± 3.7 min vs 29.8±2.8 min; P<0.01) and oxygenation index ( 275.2±39.1 vs 202.2±25.6; P<0.01) 24 hrs postoperatively when compared with the control group. CONCLUSIONS: MFU can reduce postoperative bleeding and blood transfusions, improve pulmonary function and shorten the duration of mechanical ventilation in infants undergoing cardiac surgery with CPB.

OBJECTIVE: To study the therapeutic effect of ventilation tube insertion in the middle ear and the external auditory canal on chronic secretory otitis media in children. METHODS: A retrospective study on 30 patients (40 ears) with chronic secretory otitis media and who underwent the operation of middle ear exploration and ventilation tube insertion in the middle ear and the external auditory canal was performed. Poor tympanic membrane, even with adhesion, was seen in 23 ears. Ten patients had evidence of bilateral secretory otitis media. From this group one ear was first injected with drugs (dexamethasone, mucosolvin, etc) and then tube insertion into the auditory tube was performed; the other ear only received drug injections into the auditory tube. The remaining 20 patients who had evidence of unilateral secretory otitis media only received drug injections into the auditory tube. RESULTS: The tubes inserting into the auditory tube all dropped out 5-8 days after operation. None of the ventilation tubes into the middle ear dropped out and the patients' tympanum recovered after the ventilation tubes were removed (6-8 months after operation). The total cure rate was 87.5% (35/40) and the improvement rate was 12.5% (5/40). The operation of inserting tubes into the auditorytube did not improve the therapeutic effects. In the 0.5-2 years postoperative follow-up, middle ear effusions recurred in one ear, and three ears were transferred from type C to type A. CONCLUSIONS: The surgery of ventilation tube insertion in the middle ear and the external auditory canal for chronic secretory otitis media can prevent the tympanic membrane from damage and dropping out of the ventilation tube and reduce recurrence in children. It is a preferred selection for the patients with poor tympanic membrane or adhesive tympanic membrane. It is no use to insert the tube into the auditory tube for the improvement of therapeutic effects.

OBJECTIVE: To study the relationship of karyotypes and gonadal development in children with Turner syndrome. METHODS: Fifty-one children with Turner syndrome were studied. Pelvic ultrasonography was performed on the children. Twenty healthy age-matched girls were used as control group. RESULTS: Eleven kinds of karyotypes were detected in 51 children with Turner syndrome. Children were classified into two groups based on karyotypes: Group 1 (45,XO; n= 24) and Group 2 (karyotypes other than 45, XO; n=27). 45,XO karyotype was the most common (47.1%), followed by 46,X,i (Xq)/45, XO (21.6%), 46,XX/45, XO (7.8%) and 47,XXX/45, XO (5.9%). Pelvic ultrasonography showed a primordial uterus in 41 cases, infantile uterus in 7 cases, congenital absence of uterus and ovary in 3 cases, simple anovarism in 42 cases and ovarian dysgenesis in 6 cases. Uterine size in both Groups 1 and 2 were significantly smaller than those of the control group (P<0.05). Group 1 showed smaller size of uterus than Group 2 (P<0.05). Ovaries were not detected in all Group 1 patients. CONCLUSIONS: The dysplasia and atrophy of ovaries and uterus exist in children with Turner syndrome. The patients with 45,XO karyotype had poorer gonadal development than those with other karyotypes.

OBJECTIVE: The information on the ultrasonographic features of pediatric intussusception complicated by intestinal necrosis is limited at present. This study aimed to investigate the ultrasonographic findings of this disorder in children in order to provide references for selecting a right means of reduction in clinical practice. METHODS: The ultrasonographic findings of 48 children with intussusception complicated by intestinal necrosis and who underwent operative reduction between 2004 and 2006 were reviewed retrospectively. RESULTS: The type of intussusception was closely correlated to the development of intestinal necrosis and the ileo-ileo-colonic intussusception was the most common one resulting in intestinal necrosis. The bowel wall of the invaginated segment was obviously thickened and the center of the invaginated segment was often accompanied with swollen lymph node and appendix caecalis. The intussusceptional fluidify, the expanding of distal segment accompanied with the thickened bowels wall, and weakening or disappearance of enterokinesia were the appearances of necrosis of most of bowel walls. The secondary intussusception was an important factor resulting in intestinal necrosis, and sound image of primary lesion was found in some patients. Seroperitoneum was a common manifestation in all of infants with intussusception complicated by intestinal necrosis. CONCLUSIONS: There are some obvious sonographic characteristics of intussusception complicated by intestinal necrosis in children. The means of intussusception reduction may be selected according to ultrasonographic characteristics.

OBJECTIVE: To study the clinical response to comprehensive therapy in children with rhabdomyosarcoma. METHODS: Clinical data of 13 children (8 males and 5 females) with rhabdomyosarcoma from January 1998 through October 2005 were retrospectively studied. Their ages ranged from 7 months to 12 years. The 13 cases of rhabdomyosarcoma consisted of 2 cases in stage I, 2 cases in stage II, 3 cases in stage III, and 6 cases in stage IV. Rhabdomyosarcoma was confirmed by biopsy, 12 cases (92.3%) presenting as embryonal type and 1 as alveolar type in histology. One patient underwent surgery treatment alone, one patient received surgery plus local radiation treatment, one patient received surgery plus chemotherapy and 10 patients were administered with a combination of surgery, local radiation treatment and chemotherapy. The chemotherapy protocol before 2002 was VDCA, VAC or VadrC. After 2002, the COG protocol was employed, with CDV+IE for stage III, and CT+VAC or CT+VAC+VCT for stage IV patients. RESULTS: The 2-year overall survival was 60% in the 10 patients who received a combination of surgery, local radiation treatment and chemotherapy, but the three patients died without receiving combination therapy. The 2-year overall survival in the 13 patients was 46.2%. The 2-year overall survival of the patients after 2002 (60%, 3/5) was higher than that before 2002 (37.5%, 3/8). CONCLUSIONS: Embryonal rhabdomyosarcoma dominates the histology type in children, which is highly malignant. A combination therapy of surgery, local radiation and chemotherapy can result in a satisfactory therapeutic effect in children with rhabdomyosarcoma.

OBJECTIVE: To study the eletrogastrographic pattern in children diagnosed as functional dyspepsia (FD), with or without anorexia, and to investigate whether there is a link between the pattern of eletrogastrographic activity and anorexia. METHODS: Thirty-two children with FD and receiving eletrogastrography (EGG) examination were classified to two groups: anorexia group (n=18) and non-anorexia (n=14). EGG was performed for 30 minutes during fasting and for 120 minutes postprandially. EEG variables measured included the percentage of normal gastric rhythm, the percentage of bradygastria and tachygastria, EGG domain frequency and its instability coefficient, and the fed-to-fasting ratio of the EEG domain power. RESULTS: The percentage of abnormal gastric rhythm before a meal in the anorexia and non-anorexia groups was 77.8% and 78.6 % respectively (P>0.05); and that was 77.8% and 57.1% respectively after a meal (P>0.05). The fasting (31.6% vs 48.9%) and postprandial bradygastria frequencies (33.4 % vs 27.8 %) between the two groups were not significantly different. However, the percentage of tachygastria in the anorexia group was significantly higher than that in the non-anorexia group (fasting: 6.2% vs 0, P<0.01; postprandial: 14.8 % vs 1.9%, P<0.05). There were no significant differences in the instability coefficient of the dominant frequency and the fed-to-fasting ratio of the EEG domain power between the two groups both during fasting and after a meal. CONCLUSIONS: EGG abnormalities were associated with pediatric FD. Tachygastria occurred more often in the anorexia group than in the non anorexia group.

OBJECTIVE: To study the association of functional bladder capacity with the severity of bedwetting in children with nocturnal enuresis. METHODS: A questionnaire investigation was performed in 1 500 children with nocturnal enuresis and the functional bladder capacity was examined by B-ultrasound. RESULTS: The ratio of males to females was 1.3:1. The majority of patients (87%)were in an age range of 5-10 years, followed by the 10-14 years group (12%), and the 15-18 years group (1%). Six hundred and thirty-seven patients (42.4%) showed a decreased functional bladder capacity (less than 50% of normal level). The patients were classified into four groups according to the severity of bedwetting (from severe to mild): ≥2 times per night (n=53, 3.5%), ≥7 times per week (n=969, 64.6%), 3-6 times per week (n=380, 25.3%) and 1-2 times per week (n=98, 6.5%). The incidence of the reduction in functional bladder capacity in the above four groups was 79.2%, 48.3%, 29.7% and 14.3% respectively and a significant difference was noted among the four groups. CONCLUSIONS: Most of children with nocturnal enuresis showed decreased functional bladder capacity. Functional bladder capacity is associated with the severity of bedwetting in children with nocturnal enuresis.

OBJECTIVE: To study the effect of intracerebral transplantation of bone marrow stromal cells (BMSCs) on brain white matter of neonatal rats with hypoxic-ischemic brain damage (HIBD). METHODS: Thirty-four 7-day-old neonatal rats were randomly assigned to three groups: normal control (n=10), HIBD (n=12) and HIBD+BMSCs transplantation (n=12). The HIBD and the HIBD+BMSCs transplantation group rats were subjected to left carotid artery ligation, followed by hypoxia exposure for 2 hrs, in order to induce HIBD. The rats in the HIBD+BMSCs transplantation group received transplantation of BMSCs labeled nucleus with Hochest 33324 into the left hippocampus 24 hrs after HIBD induction. Myelin basic protein (MBP) expression in the left corpus callosum and the subcortical white matter and the number of oligodendrocyte precursors positively stained O4 in the left periventricular area and the subcortical white matter were detected by immunohistochemistry at ages of 45 days. RESULTS: The labeled BMSCs survived and were found mainly in the left hemisphere 37 days after transplantation. The positive rate of O4 expressed by the transplanted BMSCs was 3.70±1.09%. More hypomyelination in the left corpus callosum and the subcortical white matter, and less number of O4 positive oligodendrocytes in the left periventricular area and the subcortical white matter were found in the HIBD group compared with the normal control group (P<0.01). The HIBD rats receiving BMSCs transplantation had increased O4 positive oligodendrocytes in the left periventricular area and the subcortical white matter and improved MBP immunoreactivity in the left corpus callosum and the subcortical white matter compared with the HIBD group (P<0.01). CONCLUSIONS: Intracerebral transplantation of BMSCs can improve brain white matter damage in neonatal rats with HIBD.

OBJECTIVE: To explore the role of exogenous connective tissue growth factor (CTGF) in the collagen Ⅲ synthesis of human renal tubular epithelial cell line HK2 in vitro. METHODS: Cultured HK2 cells were randomly assigned to three groups: placebo-control, low-dose CTGF-treated (2.5 ng/mL) and high-dose CTGF-treated groups (20 ng/mL). Cell morphological changes were observed under an inverted microscope. Collagen Ⅲα mRNA expression was detected using RT-PCR. Immunohistochemistry staining was used to assess the levels of intracellular collagen Ⅲα protein. RESULTS: After 48 hrs of low-or high-dose CTGF treatment, the appearances of HK2 cells were changed from oval to fusiform. High-dose CTGF treatment increased collagen Ⅲα mRNA expression (0.4461±0.0274 vs 0.2999±0.0115;P<0.05) as well as the protein expression of collagen Ⅲα (0.4075±0.0071 vs 0.3503±0.0136; P<0.05) compared with the placebo-control group. CONCLUSIONS: CTGF can induce morphological changes of human renal tubular epithelial cells in vitro. High concentration of CTGF may increase the synthesis of collagen Ⅲα.

OBJECTIVE: To investigate the effects of astragalus on tubulointerstitial lesions in rats with IgA nephropathy (IgAN）and to explore the possible mechanism. METHODS: Twenty-eight Sprague-Dawley rats were randomly assigned to three groups. The rat model of IgA nephropathy was induced by intragastric administration of bovine serum albumin and injections of LPS and CC14. Six weeks later, the rats with IgAN were randomly treated with oral astragalus (3 g/kg·d, for 6 weeks) or normal saline. Normal control rats which were not subjected to IgAN were treated with normal saline. The number of urinary erythrocytes and urinary protein and B-D-N-Acetyl glucosaminidase (NAG) contents were determined by Pan-automatic biochemistry analyzing meter. Expression of monocyte chemotactic protein-1 (MCP-1) and nuclear factor-kappa B (NF-κB）in tubulointerstitial tissues were analyzed by immunohistochemistry. A semiquantitative score was used to evaluate the degree of renal pathologic lesions. RESULTS: The number of urinary erythrocytes (74.02±16.58 / μL vs 383.23±4.94 /μL) and urinary protein (13.88±4.94 vs 59.82±14.73 mg/L) and NAG contents (2.84±0.31 vs 5.24±0.80 U/L) in the astragalus-treated IgAN rats decreased remarkably compared with those in the IgAN rats without astragalus treatment (P<0.01). Expression of the NF-κB and MCP-1 in the renal tissues in the IgAN rats without astragalus treatment was significantly higher than that in the astragalus-treated IgAN rats and normal control rats (P<0.01). There were significant differences in the scores of renal pathologic lesions between the IgAN rats with or without astragalus treatment (6.03±0.46 vs 10.57±1.23; P<0.01). CONCLUSIONS: Astragalus can decrease the number of urinary erythrocytes and urinary protein and NAG contents, and relieves tubulointerstitial lesions, possibly through the down-regulation of NF-κB and MCP-1 expression in rats with IgAN

OBJECTIVE: To investigate the effects of preweaning enrichment on the expression of activity-regulated cytoskeletal protein (Arc), an immediate early gene, and on the long-term memory in rats. METHODS: Forty neonatal Sprague-Dawley rats were randomly assigned to control group (standard environment, n=20) and experimental group (enriched environment, n=20). The experimental group received enriched environment exposure from postnatal day 10 until weaning (2 weeks, 20 minutes per day). The open field and novel object recognition tests were performed at postnatal day 28. Arc expression was detected by Western blotting and immunohistochemistry. RESULTS: There was no significant difference in the open field test between the two groups. However, in the novel object recognition test, the experimental group rats performed significantly better than the control rats after 1 and 24-hr retention. The preference index in the experimental group after 1-hr (59.61%±9.61% vs 50.46%±9.34%; P<0.05) and 24-hr retention (62.72%±14.12% vs 52.39%±9.16%; P<0.05 ) was significantly higher than that in the control group. Arc expression in both areas CA1 and DG of hippocampus in the experimental group increased significantly compared with that in the control group (P<0.01). CONCLUSIONS: Preweaning enrichment can up-regulate the expression of immediate early gene, Arc, in the hippocampus of the rats, and promote their long-term memory.

OBJECTIVE: To study the prophylactic effects of nasal tolerance with a dual analogue, Lys262-Ala207, on the mouse model of experimental autoimmune myasthenia gravis (EAMG) and the underlying mechanism. METHODS: Mouse model of EAMG was induced by intraperitoneal injection of mAb35. Lys262-Ala207 or PBS was given nasally before 10 days (study group A and control group A) or on the day (study group B and control group B) of immunization for 10 days. Clinical syndromes were evaluated after immunization. Serum level of acetylcholine receptor antibody (AChR-Ab) IgG was detected using ELISA. The number of monouclear cells expressing CD4+ and CD4+ CD25+T from spleen was measured using flow cytometry. RESULTS: Compared with the corresponding control groups, the clinical syndromes were improved (P<0.01) in mice from the study groups A and B. The positive rate of the repetitive nerve stimulation (RNS) test in the study groups A and B was significantly lower than that in the corresponding control groups (P<0.01). The study group A showed lower positive rate of RNS than the study group B (P<0.05). The serum levels of AChR-Ab IgG in the study groups A and B (15.01±1.09 and 19.23±1.31 μg/mL) decreased compared with that in the corresponding control groups (28.12±1.28 and 29.35±1.28 μg/mL) (P<0.01). The study group A mice had lower serum AChR-Ab IgG levels than the study group B (P<0.01). The number of CD4+ CD25+T cells in the study groups A (4.516±0.598%) and B (3.671±0.300%) increased significantly compared with that in the corresponding control groups (2.661±0.411% and 2.412±0.500%) (P<0.01) and more CD4+ CD25+T cells were found in the study group A than in the study group B (P<0.01). CONCLUSIONS: Nasal administration with dual analogues may ameliorate clinical syndromes in EAMG rats, which may be associated with decreased serum AChR-Ab IgG levels and increased number of CD4+ CD25+T cells from spleen.

OBJECTIVE: To study the effect of hyperbaric oxygenation (HBO) on the differentiation of the implanted human neural stem cells (hNSCs) into neurons in neonatal rats following hypoxic-ischemic brain damage (HIBD). METHODS: HIBD model was prepared by ligation of the left common carotid artery, followed by 8% hypoxia exposure in 7-day-old Sprague-Dawley rat pups. Three days later, the rats received implantation of hNSCs into the left cerebral ventricles. Then the survived rats were randomly divided into two groups: transplantation alone and transplantation+HBO (n=8 each). HBO treatment was administered (1.8 ATA, 1 hr once daily for 10 days) in the transplantation+HBO group 1 hr after hNSCs transplantation. Brains were removed 10 days after transplantation. Frozen coronal sections were prepared for immunofluorescence analysis to detect the neural differentiation of the transplanted cells in the cerebral cortex and hippocampus. RESULTS: Differentiated neurons of implanted cells distributed mainly in the cortex and the hippocampus of the injured side. There was no difference in the number of neurons in the cortex between the two groups, while the number of neurons in the hippocampus significantly increased in the transplantation+HBO group compared with that in the transplantation alone group (231.4+15.1 vs 162.6+5.6; P<0.05). CONCLUSIONS: HBO treatment may promote the differentiation of implanted hNSCs into neurons in the hippocampus of neonatal rats following HIBD.

OBJECTIVE: Fructose-1, 6-diphosphate (FDP), serving as a cellular energy substance, has shown its roles in the treatment of hypoxic-ischemic encephalopathy and myocardial damage. The present study aimed at exploring the potentiality of the protective effect of FDP against ultrastructural damage of the hippocampus caused by febrile seizures (FS) in rats. METHODS: Thirty-six 21-day-old male Sprague-Dawley rats were randomly divided into three groups: untreated FS (control), high-dose FDP-treated FS and low-dose FDP-treated FS. FS were induced by hyperthermal bath. Thirty minutes before FS induction, rats in the high-dose and low-dose FDP-treated groups received a peritoneal injection of FDP at a dosage of 50 and 25 mg per 100 g of body weight respectively, whereas the same volume of 0.9% sodium chloride solution were injected to the rats in the control group. Transmission electron microscopy was used to examine the ultrastructural pathologic changes of neurons and organelles as well as the features of synaptic morphological parameters in the hippocampal CA1 area. RESULTS: Neuronal degeneration and necrosis, mitochondria swelling, polyribosomes disaggregation from endoplasmic reticula, and golgiosomes dilation in the hippocampal CA1 area in the two FDP intervention groups were less severe compared with the control group. FDP treatment resulted in significant increases in postsynaptic density thickness (F=12.47, P<0.01), synaptic active zone length (F=14.75, P<0.01) and synaptic interface curvature (F=3.77, P<0.05), as well as a shorter interspace of neural synapses (F=7.29, P<0.01) when compared with the control group. There were no significant differences in the ultrastructural changes between the two FDP treatment groups. CONCLUSIONS: FDP can ameliorate ultrastructural damage in the hippocampus caused by FS in rats. However, further research is warranted for a reasonable and effective dosage of FDP.

OBJECTIVE: Pulmonary surfactant protein A (SP-A) plays an important role in the maintenance of pulmonary surfactant function and innative immune defence. This study aimed to explore the changes of SP-A concentration in the lungs of young rats with acute lung injury. METHODS: Sprague-Dawley rats were randomly assigned to control and lung injury groups. Acute lung injury was induced by intraperitoneal injection of lipopolysaccharide (LPS) (4 mg/kg) in the lung injury group. The same amount of normal saline was given for the control group. The two groups were subdivided into 6 groups sacrificed at 6, 12, 24, 36, 48 and 72 hrs of injection (n=8 each). Western blot was employed to detect SP-A concentration in the lung tissues. RESULTS: SP-A concentration in the lung injury group was not different from the the control group within 12 hrs after LPS injection. SP-A concentration in the lung injury group was elevated significantly during 24-48 hrs after LPS injection, peaking at 36 hrs (6.94±0.80 vs 5.01±0.36; P< 0.01), compared with the controls. However, SP-A concentration in the lung injury group was significantly reduced 72 hrs after LPS injection compared with the controls (P< 0.01). CONCLUSIONS: The changes of lung SP-A concentration in rats following acute lung injury were time-dependent. The transient elevation of SP-A concentration in the lungs indicated a strong compensation ability of SP-A in the host defence against acute lung injury.

OBJECTIVE: Vascular endothelial growth factor (VEGF) contributes to lung development and recovery of lung structure from lung injury. This study aimed to explore the changes of expression of VEGF protein and mRNA in neonatal rats following hyperoxic lung injury. METHODS: Forty-eight Sprague-Dawley neonatal rats were randomly continually exposed to hyperoxia (FiO2=95%) or to room air (FiO2=21%, control group) 30 minutes after birth. VEGF protein and mRNA expression in the lungs was determined by immunohistochemical methods and reverse tanscription polymerasechain reaction (RT-PCR) respectively 3,7 and 14 days after birth. RESULTS: VEGF protein and mRNA expression increased with increasing postnatal age in the control group. In the hyperoxia exposure group VEGF protein expression decreased markedly at 7 days (7.79±5.23 vs 12.67±3.82; P<0.01) and 14 days of hyperoxia exposure (5.85±3.37 vs 15.10±8.91; P<0.01) compared with the controls. VEGF mRNA expression in the hyperoxia exposure group was significantly reduced from 3 days (0.78±0.22 vs 1.19±0.63) through 14 days of hyperoxia exposure (0.48±0.12 vs 1.89±0.81) compared with the controls (P<0.01). CONCLUSIONS: VEGF is associated with lung development in neonatal rats. Hyperoxia exposure can decrease VEGF protein and VEGF mRNA expression in the lungs of neonatal rats. VEGF might be involved in the pathogenesis of hyperoxic lung injury.

OBJECTIVE: This study examined the effect of high concentration of phenylalanine (Phe) on Nogo-66 receptor (NgR) expression in the cortical neurons of rats in vitro in order to investigate whether NgR is involved in the etiology of Phe-induced brain damage. METHODS: Neurons from the cerebral cortex of embryonic rats were cultured for 3 days and then were treated with 0.9 mM Phe. After 12, 24 and 48 hrs of Phe treatment, mRNA and protein expression of NgR was detected by real-time PCR and Western blot respectively. Growth cones and growth axons of neurons were detected by immunofluorescence and immunohistochemistry respectively after 12 and 24 hrs of Phe treatment. RESULTS: The length of growth axons of neurons was significantly shorter after 12 and 24 hrs of Phe treatment compared with the control group without Phe treatment (P<0.05). Growth cones collapse occurred in 12.5±9.7% and 24.1±4.5% of neurons respectively after 12 and 24 hrs of Phe treatment but only in 3.5±1.5% in the control group (P<0.01). The protein level of NgR after 12, 24 and 48 hrs of Phe treatment was up-regulated, with 9.0, 9.4 and 12.6 times as the control. mRNA level of NgR in the Phe treatment group did not differ from control. CONCLUSIONS: High concentration of Phe can induce an increased NgR protein expression in cortical neurons, and the increased NgR expression may contribute to the growth cones collapse and the inhibitory activities of axon regeneration after injury.

OBJECTIVE: Intrauterine growth retardation (IUGR) is associated with insulin resistance in later life but the mechanism remains unclear. To explore the molecular mechanism of insulin resistance, we determined the expression of gluconeogenic enzymes as well as the expression of transcription factor which promotes gluconeogenesis in the liver of IUGR rats. METHODS: Rat model of IUGR was established by maternal protein-malnutrition. Hepatic mRNA levels of the key enzymes for gluconeogenesis, PEPCK and G6Pase, and of peroxisome proliferator-activated receptor-γcoactivator (PGC) -1α were measured by RT-PCR in male IUGR pup rats at 3 and 8 weeks of their lives. Hepatic PGC-1α protein levels were determined by Western blot. RESULTS: The average birth weights of the IUGR group (4.97±0.83 g) were significantly lower than normal controls (6.54±0.52 g) (P<0.01). Until to 4 weeks of age, the weights of the IUGR rats increased to the control level and were higher than normal controls at 8 weeks of age (P<0.05). There were no significant differences in blood glucose and insulin concentrations between the IUGR rats and normal controls at 3 weeks of age. By 8 weeks of age, the IUGR rats showed high insulin concentrations (P<0.01) and high insulin resistance index (P<0.05) compared with the controls. Hepatic PGC-1α mRNA and protein levels as well as hepatic mRNA levels of PEPCK and G6Pase in IUGR rats significantly increased at 3 and 8 weeks compared with controls. CONCLUSIONS: An increased PGC-1α expression may contribute to increased mRNA levels of PEPCK and G6Pase, and thus induce the development of insulin resistance in later life in IUGR rats.

OBJECTIVE: Growth, regeneration and reparation of gastric mucosal epithelium may relate to the expression of peptides. This study aimed to investigate the effect of pS2, TGF-α and PCNA in endotoxin-induced acute gastric mucosal injury in young rats. METHODS: Eighteen-day-old Wistar rats were randomly injected intraperitoneally with lipopolysaccharide (LPS) (5 mg/kg) or normal saline (control). The gastric mucosal specimens were harvested 1.5, 3, 6, 24, 48, and 72 hrs after LPS or normal saline injection (n=8 each). The pathological changes of the gastric mucosa were observed by hematoxylin-eosin staining. The expression of pS2,TGF-α and PCNA was measured by immunohistochemistry SP method. RESULTS: Gastric mucosal injuries were the most serious 6 hrs after LPS injection, characterized by massive erosion, bleeding and cord necrosis of the gastric mucosa paralleling with gastric longitudinal axis. PCNA expression in the gastric mucosa in the LPS group 3, 6, 24 and 48 hrs after LPS injection was significantly lower than that in the control group (P<0.01). pS2 expression in the gastric mucosa weakened 1.5 hrs after LPS injection, recovered to the control level at 3 hrs and was significantly higher than the control at 6, 24, 48 and 72 hrs of LPS injection (P<0.01). TGF-α expression in the gastric mucosa in the LPS group increased significantly 6, 24 and 48 hrs after LPS injection when compared with the control group (P<0.01). CONCLUSIONS: PCNA expression may be associated with the proliferation activity of the gastric mucosa in the process of gastric mucosal injury/reparation. pS2 and TGF-α might participate in the defense and reparation of gastric mucosal cells through mediating cell proliferation following acute gastric mucosal injury.

OBJECTIVE: Neuroblastoma is the most common malignant solid tumor in children under 4 years. Amplification of MYCN oncogene is associated with advanced-stage disease, rapid tumor progression, resistance to treatment, and poor outcome. Matirne has the anti-tumor activity. This study was designed to investigate the effects of matrine on LA-N-5 cell line proliferation and MYCN gene mRNA expression. METHODS: Neuroblastoma LA-N-5 cells were treated by 0.25,0.50,0.75 or 1.00 mg/mL matrine. MTT was used to measure the levels of the proliferation of LA-N-5 cells cultured with different concentrations of matrine. MYCN gene mRNA expression in LA-N-5 cells was measured using real time RT-PCR with SYBR GREEN I fluorescence. RESULTS: The proliferation of LA-N-5 cells was obviously inhibited by matrine in a dose-and time-dependent manner. Matrine of 1.00 mg/mL treatment for 72 hrs produced a best effect, with an inhibitory rate of LA-N-5 cell proliferation of 36.3% and an inhibitory rate of MYCN gene mRNA expression of 44.6%. CONCLUSIONS: Matrine may inhibit the growth of neuroblastoma cells and down-regulate MYCN mRNA expression. It may be promising as a new drug for treatment of neuroblastoma.

OBJECTIVE: Emotional abuse and neglect is an under-recognized, but is a common form of child abuse. This study aimed to investigate the risk factors for emotional abuse in adolescents. METHODS: A cross-sectional survey on emotional abuse was conducted by anonymous self-administered questionnaire in 865 adolescents randomly sampled from three junior schools in Harbin City. A total of 844 valid questionnaires were received. Risk factors were studied by multivariate non-conditional regression analysis. RESULTS: Over the past year, 47.3% of the 844 respondents suffered from emotional abuse. Monovariate regression analysis indicated that emotional abuse was related to 19 factors, including children′s health status, parental marital status, parental educational levels, family rearing patterns, family atmosphere and so on. Multivariate regression analysis showed poor children's health status (OR=1.877, P=0.001), bad parental marital status (OR=1.768, P=0.004), and unjustifiable family rearing patterns [ over-interference (OR=3.004, P=0.006) and assentation (OR=5.430, P=0.032) ] were risk factors for the occurrence of emotional abuse. The harmonious family atmosphere and the harmonious relations between children and their parents were protective factors for emotional abuse. CONCLUSIONS: The prevalence of emotional abuse is high in adolescents. Poor children's health status, bad parental marital status and unjustifiable family rearing patterns are risk factors for the occurrence of emotional abuse.

OBJECTIVE: To study the prevalence of obesity and the influencing factors for obesity in primary school students from Kaifu District of Changsha City. METHODS: A total of 4 140 students aged 7 to 12 years sampled randomly from Kaifu District of Changsha City were enrolled. Obesity was identified based on the body mass index (BMI). The influencing factors for obesity were investigated by non-logistic regression analysis. RESULTS: The prevalence of overweight and obesity were 9.76% and 7.39% respectively, and the prevalence of obesity in boys and girls were 9.37% and 5.13% respectively (P<0.05). The obese children had significantly higher BMI, waist circumference (WC), waist to hip ratio(WHR), percentage of body fat (%BF), systolic blood pressure, and serum triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) levels but significantly lower serum high density lipoproteincholesterol (HDL-C) level compared with the children with normal weight. BMI, %BF, WC and WHR were all positively correlated to serum levels of TG and LDL-C in obese children. Binge overeating, increased television viewing time, fast speed of eating and increased consumption of fried foods are all risk factors for the development of obesity. Preference for physical activity and sufficient physical activity were protective factors for obesity. CONCLUSIONS: The prevalence of obesity of primary school students from Kaifu District of Changsha City is high in China. The development of childhood obesity is associated with poor eating behaviors, less physical activity and increased television viewing time. The control of childhood obesity may be beneficial to early prevention of some adult chronic diseases.