OBJECTIVE: An early onset of puberty may occur during convalescence from chronic malnutrition in children. This study aims to explore the effect of a high protein and high caloric diet during convalescence on the onset of puberty in female rats with malnutrition induced by recurrent endotoxemia, and to investigate the change of IGF-1 axis during the period. METHODS: This study was done using the randomized paired design and consisted of two experiments with newborn SD rats. Two female rats from the same litter and matched in weight were randomized to a control group (C group) or a lipopolysaccharide (LPS) treated group (L group) (both n=8). In Experiment one, during 7-13 days of age, rats in the L1 group were given 4 intraperitoneal injections of LPS every other day to duplicate recurrent infection. In Experiment two, during 14-20 days of age, rats in the L2 group were given LPS every other day in the same dose as L1 group. Rats in the C groups were given intraperitoneal injections of 0.1 ml PBS at the same time as the corresponding L group and were fed with a regular diet. During convalescence, rats in the L1 and L2 group were given high protein and high caloric diets (containing 30% casein and 10% fat) until their weights caught up with that of the matched rats in the C1 or C2 group. The age of vaginal opening (VO) and first estrus were observed, and the number of corpora lutea of their ovaries during metestrus (M) were examined. The concentrations of plasma IGF-1, IGF binding protein-3 (IGFBP-3) and TNF-α were measured at ages of 14, 17 and 28 days. RESULTS: 1) There were no significant differences between the L1 and C1 groups in the average age of VO and first estrus. The number of corpora lutea were similar in both groups. 2) On the 14 th day of age, the plasma TNF-α concentration of rats in the L1 group was higher than that of the C1 group ( 1.13± 0.57 U/ml vs 0.71± 0.18 U/ml, P< 0.05), and plasma IGF-1 concentration of rats in the L1 group was lower than that of the C1 group ( 201.63± 28.31 ng/ml vs 250.91± 35.07 ng/ml, P< 0.05). At the early stage of convalescence, weight of rats in the L1 group was still lower than that of control rats ( 34.79± 2.74 g vs 39.23± 2.04 g, P< 0.01), but the plasma IGF-I concentration in the L1 group was significantly higher than that of the controls ( 289.20± 39.07 ng/ml vs 249.88± 33.50 ng/ml, P< 0.05). The correlation between the plasma IGF-I concentration and body weight had disappeared (r= -0.447, P> 0.05). 3) In Experiment 2 there was no difference in the puberty onset between the L2 and C2 groups. CONCLUSIONS: Nutrition intervention with a high protein and high calorie diet during convalescence is useful in inducing a normal onset of puberty and sexual maturation in female rats following endotoxemia. An increased level of IGF-1 during early convalescence may be associated with catch-up growth, but not with precocious puberty.

OBJECTIVE: Recurrent apnoea and bradycardia are common in extremely low birth weight (ELBW) infants, especially in the babies who suffered from chronic lung disease (CLD). Gasrtroesophageal reflux (GOR) is believed to be responsible for recurrent apnoea and bradycardia. The aim of the study was to evaluate the effects of transpyloric feeding on the frequency of apnea and bradycardia episodes in infants who had suspected GOR. METHODS: Clinical data of 81 ELBW infants were retrospectively reviewed. In those who received transpyloric feeding (TP group, n=30), the frequency of apnoea and bradycardia episodes, feeding tolerance, nutritional intake, and weight gain were recorded before and during transpyloric feeding and were compared to those who received intermittent intragastric feeding (IG group, n=49). The complications related to feeding were observed in the two groups. RESULTS: In the TP group, the number of apnoea episodes (from 1.64 to 0.66; P< 0.05) and bradycardia (B1 from 3.32 to 2.06 and B2 from 3.18 to 1.66; both P< 0.05) per day decreased significantly, and vomiting and abdominal distension did not recur after the commencement of transpyloric feeding. There were no significant differences in protein and energy intakes before and during transpyloric feeding, but the rate of weight gain per day during transpyloric feeding was significantly lower than that before transpyloric feeding (from 15.3 g/kg to 13.3 g/kg; P< 0.05). Protein and energy intakes and weight gain were the same for the two groups. Necrotising enterocolitis and duodenal perforation did not occur in the TP group. CONCLUSIONS: Transpyloric feeding may significantly reduce the frequency of apnoea and bradycardia episodes and improve feeding tolerance in the ELBW infants who are unable to tolerate intragastric feeding.

OBJECTIVE: Neonates are susceptible to infectious diseases and are associated with high mortality due to transient low immunity. This study aims to assess the significance of serum levels of IL-8, IL-10 and IL-13 in early diagnosis and therapy of neonatal infectious diseases in term neonates. METHODS: Three groups were studied: 1) an Infected group consisting of 21 term neonates with proven bacterial infection; 2) a Non-infected group consisting of 20 sick but non-infected term neonates; and 3) a Umbilical blood group consisting of 30 healthy term neonates from whom umbilical vein blood was obtained immediately after birth. Serum levels of IL-8, IL-10 and IL-13 were examined using enzyme-linked immunosorbant assay. RESULTS: The serum levels of IL-8, IL-10 and IL-13 were significantly higher in the Infected group ( 87.0± 82.6, 35.1± 34.8 and 23.2± 46.2 pg/ml) compared with Non-infected group ( 56.6± 13.2, 21.6± 12.9 and 12.0± 32.3 pg/ml) (all P< 0.05). The serum levels of IL-8 and IL-10 in the Infected group decreased significantly after anti-infection treatment ( 51.2± 3.1 and 18.5± 3.3 pg/ml) (both P< 0.05). There was no significant difference in the IL-13 level before and after treatment. Serum IL-13 level was significantly higher in the Non-infected group compared to the Umbilical blood group ( 1.2± 0.3 pg/ml) (P< 0.05), although the IL-8 and IL-10 levels were the same for the two groups. CONCLUSIONS: Serum IL-8, IL-10 and IL-13 may be useful as indicators of neonatal bacterial infection. Serum IL-8 and IL-10 might be useful in the evaluation of efficacy of therapy in bacterial infection.

OBJECTIVE: The hypothalamus-hypophysis-thyroid axis may influence the secretion and metabolism of leptin. The aim of the study was to assess the effect of hypothyroidism and hyperthyroidism on serum leptin levels and adipocyte leptin mRNA expression. METHODS: Hypo-and hyperthyroidism were induced in rats by administering methimazole and L-thyroxine respectively. The serum levels of leptin, T3, T4 and TSH, body weight and adipocyte leptin mRNA expression were measured 10 days after methimazole or L-thyroxine administration and withdrawal respectively. Ten normal rats treated with normal saline served as the Control group. RESULTS: Serum leptin levels in rats with hypo- and hyperthyroidism and the Control group were correlated with body weight 10 days after administration (r= 0.84, 0.83, and 0.94 respectively; P< 0.05). After the effect of body weight had been factored out, serum leptin levels and adipocyte leptin mRNA expression in the rats with hyperthyroid 10 days after either administration or withdrawal were not different from the Control group. Ten days after administration, hypothyroid rats showed significantly decreased leptin levels and adipocyte leptin mRNA expression in comparison with those of 10 days after withdrawal ( 0.68± 0.07 ng/nl vs 1.98± 0.09 ng/ml and 0.39± 0.02 vs 0.87± 0.05, respectively; P< 0.05) and in comparison with the Control group ( 2.14± 0.46 ng/ml and 0.95± 0.03; P< 0.05). CONCLUSIONS: Thyroid hormone may play a role in maintaining a steady secretion of leptin.

OBJECTIVE: The abnormal proliferation of renal cells underlies the pathology of progressive glomerulosclerosis. Cell proliferation is regulated by cell cycle regulatory proteins. This study aims to investigate the expression of cell cycle regulatory protein p18 in renal tissues of the children with primary nephrotic syndrome (PNS), and to elucidate the relationship between p18 expression and cell proliferation. METHODS: Paraffin-embedded renal biopsy tissue sections from 39 patients with PNS [8 with minimal change disease (MCD), 15 with mesangialproliferative glomerulonephritis (MsPGN), 7 with membranoproliferative glomerulonephritis (MPGN), and 9 with focal and segmental glomerulosclerosis (FSGS)] were examined by immunohistochemical staining with anti-p18 monoclonal antibody and anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody. Normal renal tissue sections from 6 nephrectomized patients with nephroma were used as controls. Possible correlation between the percentage of PCNA and p18 positive cells and their relationships with the pathological categories of PNS were evaluated. RESULTS: The percentage of PCNA positive cells ( 28.6%± 3.4%) in glomeruli of PNS patients was significantly higher than that of the controls ( 10.8%± 3.4%) (P< 0.05). The percentage of p18 positive cells ( 35.8%± 4.0%) in glomeruli of PNS patients was also significantly higher than that of the controls ( 6.0%± 1.9%) (P< 0.05). The percentage of PCNA positive cells ( 68.3%± 11.6%) in tubulointerstitium of PNS patients was significantly higher than that of the controls ( 12.6%± 2.6%) (P< 0.05) but there was no significant difference in the percentage of p18 positive cells in tubulointerstitium between the two groups. The percentages of PCNA positive cells in glomeruli of MCD, MsPGN, MPGN and FSGS were 23.6%± 4.6%, 40.2%± 5.1%, 27.5%± 3.6% and 34.6%± 5.1% respectively. There were significant differences among them (all P< 0.05). The percentage of p18 positive cells in glomeruli of MCD, MsPGN, MPGN and FSGS were 25.2%± 4.2%, 35.7%± 7.1%, 37.7%± 4.0% and 40.1%± 6.4% respectively. There were also significant differences among them (all P< 0.05). The percentage of p18 positive cells in glomeruli of PNS patients were positively correlated with the percentage of PCNA positive cells in glomeruli (r= 0.6632, P< 0.05). CONCLUSIONS: The overexpression of p18 in renal tissues of the children with PNS may promote the regression of abnormally proliferative cells in renal tissues.

OBJECTIVE: The production of dendritic cells depends on the different culture conditions. It is necessary to establish a high effective dendritic cells culture system for high production. This study aims to explore the feasibility of programmable expansion of dendritic cells from cord blood mononuclear cytes by the induction of combination of granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-4 and TNF-α. METHODS: Cord blood mononuclear cytes were separated by density centrifugation on Ficoll-Hypaque grad. Dendritic cells generated from cord blood mononuclear cytes were produced by the induction of a combination of GM-CSF, IL-4 and TNF-α. After 12 days of induction, the morphology of the harvested cells was observed under the light and electron microscopes, and the surface expression was examined using a flow cytometer. RESULTS: On the 12th day of induction, ( 0.46± 0.13)×10 6 dendritic cells were harvested from 2×10 6 cord blood mononuclear cytes. The proportion of CD80 +, CD86 + and CD1a + positive cells were 89.98%± 4.32%, 86.86%± 7.17% and 43.16%± 5.80% respectively. The expanded cells presented a typical dendritic cell morphology. CONCLUSIONS: The programmable culture system with combination of GM-CSF, IL-4 and TNF-α can effectively induce and expand cord blood dendritic cells.

OBJECTIVE: Abnormal expression of Survivin has been found in the majority of tumor tissues and it can directly inhibit the expression of Caspase-3. It is suggested that Survivin plays an important role in the development of tumors. This study aims to investigate the expression of Survivin and Caspase-3 mRNA in Wilms tumor. METHODS: Survivin and Caspase-3 mRNA were detected by RT-PCR in 48 specimens from Wilms tumor tissues and 24 from adjacent normal kidney tissues. RESULTS: Survivin mRNA was expressed in 72.9% of Wilms tumor tissue samples, while no Survivin mRNA expression was detected in adjacent normal kidney tissues. In contrast, Caspase-3 mRNA was expressed in only 8.3% of Wilms tumor tissues but 45.8% of adjacent normal kidney samples (P< 0.05). CONCLUSIONS: Increased expressions of Survivin mRNA and decreased expression of Caspase-3 mRNA were found in Wilms tumor, and may be related to the development of Wilms tumor.

OBJECTIVE: To investigate the cerebrospinal fluid (CSF) and plasma vascular endothelial growth factor (VEGF) and nitric oxide (NO) levels in newborns with different degrees of hypoxic-ischemic encephalopathy (HIE) and to study the correlation between NO and VEGF. METHODS: CSF and plasma samples from 38 newborns with HIE (16 mild, 13 moderate and 9 severe) were obtained within the first 24 hours of life. CSF samples of 13 neonates without nervous system diseases were used as controls. The levels of VEGF and NO in CSF and plasma were measured by ELISA and nitrate reduction respectively. The correlation between VEGF and NO was analyzed by Pearson correlation analysis. RESULTS: The CSF NO levels in the moderate and severe HIE neonates ( 12.65± 1.44 and 14.82± 1.91 μmol/L) were higher than those of the controls ( 8.11± 1.33 μmol/L) and the mild HIE neonates ( 9.21± 1.74 μmol/L) (P< 0.01). The highest CSF NO level was found in the severe HIE neonates, whereas that of the mild HIE neonates was similar to that of the controls. The CSF VEGF levels in the three HIE groups ( 12.30± 1.24, 13.60± 0.85 and 14.79± 1.63 pg/ml) were significantly higher than that of controls ( 10.94± 1.48 pg/ml) (P< 0.01). The more serious the disease, the higher the VEGF level. There was a significant positive correlation between VEGF and NO levels in the CSF of neonates with HIE (r= 0.617, P< 0.01). There were no significant differences in plasma VEGF and NO levels among the three HIE groups. CONCLUSIONS: VEGF may be useful for early diagnosis and severity and prognosis evaluation of HIE.

Objective Cough variant asthma (CVA) is correlated with interleukin-13 (IL-13) and characterized by inflammation of the air way. Among the products induced by IL-13, squamous cell carcinoma antigen (SccAg) is of the highest amount, which suggests that SccAg may play a role in the pathogenesis of CVA. This study aims to evaluate the values of IL-13, SccAg and immunoglobulin E (IgE) in CVA. Methods Serum IL-13, SccAg and IgE levels were measured using enzyme-linked immunosorbent assay (ELISA) in 51 children with CVA (CVA group), 26 with asthma (Asthma group) and 33 normal children (Normal control group). Results ① In the CVA group, serum levels of IL-13 ( 238.88± 40.07 ng/L) and SccAg ( 2.81± 0.38 ng/ml) on the acute phase were significantly higher than those on the remission phase ( 85.15± 17.98 ng/L and 2.29± 0.31 ng/ml, respectively; P< 0.01). No differences were found between the remission phase patients from the CVA group and the Normal control group. ② There were significant differences in the serum IgE level between the patients from the acute and remission phases in the CVA group ( 622.48± 295.01 KU/L vs 373.81± 157.92 KU/L; P< 0.01), and the serum levels of both the acute and remission phases were significantly higher than that of the Normal control group ( 102.99± 38.81 KU/L; both P< 0.01). ③ The serum IL-13, SccAg and IgE levels in the CVA group on the acute phase were not statistically different from those of the Asthma group. Conclusions The detection of serum IL-13, SccAg and IgE levels may be valuable in the diagnosis and treatment of CVA. IL-13 and SccAg may play a role in the genesis of CVA. The pathogenesis of CVA might be identical to asthma, and CVA seems to be a pioneer manifestation of typical asthma.

Objective The hormone leptin is believed to be an important component of the anti-inflammatory cascade. The serum leptin levels were measured as to evaluate whether the levels correlated with C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in children with septicemia. Methods The fasting serum levels of leptin, CRP, TNF-α and IL-6 were measured in 17 children with septicemia and 15 healthy children. Results The serum leptin levels in children with septicemia were significantly higher than those in healthy children (P< 0.01). In the children with septicemia, there were significant correlations between serum leptin levels and CRP levels (r= 0.647, P< 0.01) as well as TNF-α levels (r= 0.596, P< 0.05), while no correlation was found between serum leptin and IL-6 levels (r= 0.250, P> 0.05). Conclusions Leptin could be an acute phase reactant in bacterial infection and could be involved in anti-inflammatory response in children with septicemia.

Objective To examine nitric oxide (NO) and nitric oxide synthase (NOS) concentrations in serum and cerebrospinal fluid (CSF) of children with epilepsy (EP) or febrile convulsions (FC) and to investigate the role of NO in the pathogenesis of EP and FC. Methods The serum and CSF concentrations of NO and NOS in children with EP (EP group, n=31) or FC (FC group, n=39) were examined by nitrate reductase and enzyme determination assays respectively within 24 hours after seizures. The results were compared with 38 control children with upper respiratory infection. Results Both EP and FC groups demonstrated a lower CSF NO levels compared with the Control group (P< 0.05). In contrast, serum NO levels in both groups were significantly higher than those in the Control group (P< 0.05). CSF levels of NOS in the FC group decreased significantly when compared with the Control group (P< 0.05). Conclusions CSF NO levels decreased after seizures in children with either EP or FC. CSF levels of NOS also decreased in the FC children. The results indicate a possible role of NO in anti-convulsion.

Pseudohypoparathyroidism is a rare genetic disease. Its features consist of biochemical disturbances - hypocalcemia, hyperphosphoremia and hyperparathyroidiemia and lack of response to the parathormone of target organs. The patients usually manifest tetany seizures and parathyroid gland hypertrophy accompanied by hereditary osteodystrophy. There is no specific therapy for this disorder. The treatment with calcium and active form of vitamin D is effective for preventing acute attacks and limiting the irreversible changes. Thyroxine substitutive therapy is needed when hypothyroidism occurs with pseudohypoparathyroidism.

No abstract available