CJCP
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2009 Vol.  11 No.  12
Published: 2009-12-15
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CLINICAL EXPERIENCE
CASE REPORT
REVIEW
CLINICAL RESEARCH
953 CHU Bo, JIANG Li-Rong, ZHOU Sha, XU Ya-Zhen, ZHANG Bin, DENG Zhao-Hui
Value of the liver function test in differential diagnosis of infantile hepatitis syndrome and biliary atresia
OBJECTIVE: This study aimed to investigate the value of the liver function test in the differential diagnosis of infantile hepatitis syndrome (IHS) and biliary atresia (BA) by analyzing seven conventional serological markers in this test using receiver operating characteristic (ROC) curves. METHODS: Serum levels of seven conventional serological markers: alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), total bilirubin (TB), conjugated bilirubin (CB) and serum albumin (ALB) were measured in 103 children with IHS and 60 children with BA. ROC curves were used to evaluate the sensitivity, specificity, positive and predictive values and optimal cut-off. The united tests (parallel test and serial test) of γ-GT, TB and CB were performed to elevate diagnostic efficiency. RESULTS: Compared with the IHS group, the BA group had significantly increased serum ALT, AST, γ-GT, TB and CB levels (P<0.01). The area under ROC (AUCROC) of AST, γ-GT, CB and TB was 0.77, 0.881, 0.841 and 0.87, respectively. γ-GT showed the highest AUCROC, specificity, positive predictive value and positive likelihood ratio in the diagnosis of BA, followed by CB, TB and AST in turn. The negative predictive value of CB was the highest, followed by TB. The negative likelihood ratio of CB was the lowest but its Youden index was the highest. The Youden index of γ-GT and TB was lower than that of CB. After the parallel tests, the sensitivity and negative predictive value of γ-GT, CB and TB increased to 100%. After the serial tests, the specificity of γ-GT, CB and TB increased to 90.4% and the positive predictive value increased to 87.5%. CONCLUSIONS: The measurement of γ-GT, TB and CB levels are valuable in the differential diagnosis of BA and IHS. An imaging examination is required in the parallel test positive patients.［Chin J Contemp Pediatr, 2009, 11 (12):953-956］
2009 Vol. 11 (12): 953-956 [Abstract] ( 6864 ) [HTML 1KB] [PDF 1093KB] ( 2041 )
957 WANG Feng-Ying, LU Si-Guang, LUO Rong-Hua
Effects of dexamethasone on CTLA-4 expression and apoptosis in lymphocytes obtained from children with mesangial proliferative nephritis
OBJECTIVE: The pathogenesis of mesangial proliferative glomerulonephritis (MsPGN) and mechanisms of glucocorticoid (GC) resistance have not been fully identified. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is an important inhibitor of T-lymphocyte activation. The objective of the study is to investigate the CTLA-4 expression and apoptosis in lymphocytes of children with MsPGN and the effects of dexamethasone (Dex) on the CTLA-4 expression and apoptosis. METHODS: Blood samples were collected from 36 children with MsPGN and 30 healthy children. CTLA-4 expression in in vitro cultured lymphocytes with or without Dex treatment was measured by flow cytometry following direct immune fluorescene. The rate of apoptosis in the lymphocytes was evaluated by annexin V-FITC and propidium iodide staining. RESULTS: The CTLA-4 expression and apoptosis in lymphocytes from children with MsPGN were significantly lower than those in the healthy control children in the absence or presence of Dex treatment (P＜0.05). There was a positive correlation between CTLA-4 expression and apoptosis in lymphocytes (P＜0.05). CONCLUSIONS: Abnormal CTLA-4 expression may participate in the pathogenesis of MsPGN and be one of mechanisms of GC resistance.［Chin J Contemp Pediatr, 2009, 11 (12):957-960］
2009 Vol. 11 (12): 957-960 [Abstract] ( 5156 ) [HTML 1KB] [PDF 1013KB] ( 1321 )
961 HU Long-Hua, XIONG Jian-Qiu, YU Cheng-Lin, YU Xiao-Jun, JIA Kun-Ru, HU Xiao-Yan
Comparison of the antimicrobial resistance of Staphylococcus aureus isolated from children and adults in vitro
OBJECTIVE: To study the differences of the antimicrobial-resistant profiles between the isolates of Staphylococci aureu from children and from adults. METHODS: Staphylococci was identified by the plasma coagulase test，Staphylococci monoclonal antibody and VITEK-32 fully automated microbiology analyzer．Antimicrobial susceptibility testing was done by the K-B disk diffusion for 84 Staphylococci isolates from children and 74 Staphylococci isolates from adults. Cefoxitin was used for detecting methillicin-resistant Staphylococcus aureus (MRSA) by the disk diffusion test．RESULTS: Seven (8%) MRSA isolates were found in Staphylococci isolates from children compared with 35 MRSA isolates (47%) in those from adults (P<0.01). All strains were susceptible to vancomycin． All strains from children were susceptible to fusidic acid．The resistant rates of the isolates from children to cefazolin, cefuroxime, gentamicin, cefoxitin, and levofloxacin were significantly lower than those from adults (P<0.01). CONCLUSIONS: The antimicrobial resistance of the Staphylococcus aureus isolates from adults is more prevalent than that in the isolates from children．［Chin J Contemp Pediatr, 2009, 11 (12):910-912］
2009 Vol. 11 (12): 961-963 [Abstract] ( 4711 ) [HTML 1KB] [PDF 1004KB] ( 1458 )
964 WANG Xi-Ke, CUI Yu-Xia, LUO Xiang-Rong, TIAN Hong-Lun
Antibiotic susceptibility of pathogenic bacteria isolated from 893 children with lower respiratory infection in Guiyang
OBJECTIVE: To investigate the distribution and the antibiotic susceptibility of pathogenic bacteria in children from Guiyang with lower respiratory infection (LRI). METHODS: The nasopharyngeal aspirate samples were obtained from 893 hospitalized children with LRI between August 2006 and June 2008. An antibiotic susceptibility test was performed using the VITEK system and the Kirby-Bauer diffuse method after bacteria were identified. RESULTS: Five hundred and forty-three patients (60.8%) were bacteria-positive. A total of 598 strains (30 kinds of bacteria) were obtained from the sputum samples. Of them, 533 strains (89.1%) were gram-negative and 57 were gram-positive (9.8%). Escherichia coli (E. coli) and Kleb-siella pneumoniae (K. pneumoniae) were common in gram-negative strains. They were susceptive to piperacillin/tazobactam, amikacin, ciprofloxacin, and levofloxacin, especially to imipenem. Streptococcus pneumoniae (S. pneumoniae) and Stapthylococcus aureus (S. aureus) were common in gram-positive strains. S. pneumoniae was susceptive to penicillin and cefazolin sodium, but S. aureus was resistant. Both were high susceptive to vancomycin, and resistant to roxithromycin. CONCLUSIONS: Gram-negative bacteria are the main pathogens in children from Guiyang with LRI, and E. coli and K. pneumoniae are common. The antibiotic susceptibility of pathogenic bacteria varies with different strains of bacteria. A reasonable selection of antibiotics should be based on the antibiotic susceptibility test.［Chin J Contemp Pediatr, 2009, 11 (12):964-966］
2009 Vol. 11 (12): 964-966 [Abstract] ( 9218 ) [HTML 1KB] [PDF 1001KB] ( 1416 )
967 LIU Xiao-Jun, LI Wei, ZHANG Yu-Qin, LIU Ya-Min, LIU Li-Zhen
Clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 infection
OBJECTIVE: To study the clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 (EV71) infection. METHODS: The clinical data of 32 hospitalized children with serious brainstem encephalitis caused by EV71 infection between May and December 2008 were retrospectively reviewed. RESULTS: The children whose age was younger than 3 years old accounted for 88% (22 cases). Fever (>38.5℃) lasting at least 3 days, frequent vomiting and limb twitch were presented as the main manifestations in the 32 children. Cyanosis, tachypnea, tachycardia and cold extremities were observed, and pulmonary edema or even pulmonary hemorrhage occurred in 8 children 3 to 4 days after the onset. The 32 children received a medical treatment: reduction of intracranial pressure with mannitol or frusemide, inhibition of inflammation reactivity with gamma globulin and methylprednisolone, and improvement of cardiac function and pulmonary edema with innotropic agents, fluid restriction and positive mechanical ventilation. CONCLUSIONS: Vegetative nerve functional disturbance is the main clinical feature of brainstem encephalitis caused by EV71 infection in children. An early identification and treatment of pulmonary edema or hemorrhage is of great importance.［Chin J Contemp Pediatr, 2009, 11 (12):967-969］
2009 Vol. 11 (12): 967-969 [Abstract] ( 6577 ) [HTML 1KB] [PDF 1039KB] ( 2089 )
970 ZHONG Dan-Ni, GAO Zong-Yan, LIU You-Nan, LIU Yi, WEI Lu-Ming
Relationship between glucose-6-phosphate dehydrogenase gene mutations and neonatal jaundice in Naning, Guangxi
OBJECTIVE: To study the correlation between glucose-6-phosphate dehydrogenase (G-6-PD) activities and three common mutations of G-6-PD gene G1388A, G1376T and A95G and investigate the effects of G-6-PD gene mutations on neonatal jaundice in Nanning, Guangxi. METHODS: One hundred and twenty-four neonates from Nanning, Guangxi, with hyperbilirubinemia were enrolled. The ARMS-PCR and PCR/REA methods were used to determine G-6-PD gene mutations. G-6-PD activities were measured using the NBT method. The incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth were compared between the neonates with different genotypes and between the G-6-PD mutation and normal groups. The risk of blood serum bilirubin >340 μmol/L was evaluated by logistic regression analysis. RESULTS: Of the 124 cases, gene mutations were found in 37 cases, including G1388A (n=20), G1376T (n=14), A95G (n=4) and G1388A+A95G (n=1). Five cases (25%) showed normal G-6-PD activities in the G1388A gene mutation group and 4 (29%) had normal G-6-PD activities in the G1376T G1388A gene mutation group. All of 4 cases of A95G G1388A gene mutation showed a deficiency of G-6-PD activities. There were no significant differences in the incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth between the G1388A and G1376T G1388A gene mutation groups. The incidence of acute bilirubin encephalopathy, the peak bilirubin concentration 72 hrs after birth and the risk of serum bilirubin >340 μmol/L in the G-6-PD mutation group were not different from the normal group. CONCLUSIONS: G1388A, G1376T and A95G are common G-6-PD gene mutations in Nanning, Guangxi. The false negative results may be received when the NBT method is used for diagnosis of G-6-PD deficiency. There are similar effects on the incidence of acute bilirubin encephalopathy and the peak bilirubin concentration 72 hrs after birth between different gene mutation groups. G-6-PD gene mutations alone may not contribute to the development of acute bilirubin encephalopathy and the changes of peak bilirubin concentration 72 hrs after birth and the risk of serum bilirubin >340 μmol/L.［Chin J Contemp Pediatr, 2009, 11 (12):970-972］
2009 Vol. 11 (12): 970-972 [Abstract] ( 6002 ) [HTML 1KB] [PDF 1006KB] ( 1653 )
973 ZHANG Zhi-Ling, LIN Li-Xing, AN Cai-Xia, TAO Zhong-Bin, YANG Mei
Changes of N-terminal pro-brain natriuretic peptide in neonates with myocardial ischemic injury
OBJECTIVE: To investigate the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in neonates with hypoxic-ischemic encephalopathy (HIE) complicated by myocardial ischemic injury. METHODS: Thirty-five neonates with HIE (17 cases with concurrent myocardial injury and 18 cases without) were enrolled. Twenty healthy neonates were used as the control group. Plasma NT-proBNP levels were measured using enzyme immunoassay. RESULTS: The mean plasma NT-proBNP levels in patients with myocardial injury (338.8±76.2 fmol/mL) were significantly higher than those in patients with non-myocardial injury (137.5±45.1 fmol/mL) and in the control group (113.7±53.6 fmol/mL) (P<0.01). The NT-proBNP levels in mild, moderate and severe HIE neonates were 141.3±41.6, 271.8±118.1 and 347.2±85.1 fmol/mL, respectively. Compared with the control group, the NT-proBNP levels in the moderate and the severe HIE groups significantly increased (P<0.01). There were significant differences in the NT-proBNP level among the mild, moderate and severe HIE groups (P<0.05). In patients with myocardial injury, the NT-proBNP levels significantly decreased in the convalescent phase compared with those in the acute phase (225.0±80.0 fmol/mL vs 338.8±76.2 fmol/mL (P<0.01). CONCLUSIONS: Plasma NT-proBNP levels increase in neonates with HIE complicated by myocardial ischemic injury in the acute phase. Detection of NT-proBNP levels may be useful in the diagnosis of myocardial ischemic injury and the severity evaluation of HIE.［Chin J Contemp Pediatr, 2009, 11 (12):973-975］
2009 Vol. 11 (12): 973-975 [Abstract] ( 5092 ) [HTML 1KB] [PDF 1003KB] ( 1513 )
976 LI Wei-Guang, JIANG Hong-Bin, GAN Tian, ZHOU Wen-Xin, CHEN Ming
Effect of noise on the auditory system and the intelligence development of premature infants treated in the neonatal intensive care unit
OBJECTIVE: High noise levels (>70 dB) in the neonatal intensive care unit (NICU) are common in some primary hospitals. This study aimed to investigate the noise in the NICU on auditory system and intelligence development in premature infants. METHODS: One hundred premature infants with respiratory distress syndrome who needed mechanical ventilation therapy were randomly divided into observation and control groups according to the use of earmuffs. The duration of mechanical ventilation therapy lasted for 2 to 15 days in the two groups. After weaning from mechanical ventilator, the auditory brainstem response, cranial B-ultrasonography, and the intelligence development assessment were performed. RESULTS: The percentage of total (23% vs 47%) and mild hearing loss (15% vs 35%) in the observation group was significantly lower than that in the control group (P<0.05) 2 to 3 days after weaning from mechanical ventilator. The incidence of periventricular hemorrhage intraventricular hemorrhage (PVH-IVH) or periventricular leukomalacia (PVL) in the observation group was significantly lower than that in the control group (21% vs 42%; P<0.05). The intelligence development assessment performed in the first 6 and 12 months of life showed that the mental development index and the psychomotor development index in the observation group were much higher than those in the control group (P<0.05). CONCLUSIONS: The noise in the NICU can result in mild hearing loss and retardation of intelligence development and increase the incidence of PVHIVH and PVL in premature infants. The use of earmuff may reduce the adverse events.［Chin J Contemp Pediatr, 2009, 11 (12):976-979］
2009 Vol. 11 (12): 976-979 [Abstract] ( 7825 ) [HTML 1KB] [PDF 1072KB] ( 2391 )
980 WANG Yu-Hong, XIA Shi-Wen
Risk factors and pathogens of nosocomial infection in preterm infants
OBJECTIVE: To investigate the risk factors and the pathogens of nosocomial infection in preterm infants. METHODS: The medical data of 197 preterm infants with nosocomial infection were retrospectively studied. RESULTS: The incidence of nosocomial infection was 22.2% (197/887). Small gestational age (OR=4.125, P<0.05), low birth weight (OR=5.450, P<0.05), mechanical ventilation therapy (OR=4.435, P<0.05) and delayed enteral feedings (OR=3.765, P<0.05) were found to be important risk factors for nosocomial infection. Klebsiella was the main pathogen (22.3%), followed by Staphylococcus (18.4%). CONCLUSIONS: Hygienic handwashing, decreasing invassive procedures and an early start of enteral feeding are crucial for preventing nosocomal infection in preterm infants. Klebsiella is the main pathogen of nosocomal infections［Chin J Contemp Pediatr, 2009, 11 (12):980-982］
2009 Vol. 11 (12): 980-982 [Abstract] ( 5474 ) [HTML 1KB] [PDF 997KB] ( 1703 )
983 TANG Jun, LI Xi-Hong, WANG Hua, XIONG Ying, MU De-Zhi
Administration of low-dose heparin in total nutrient admixture prevents central venous catheter-related infections in neonates
OBJECTIVE: Peripherally inserted central catheter (PICC) is widely used to provide a long-term access for the administration of total parenteral nutrition and medications. Catheter-related infections (CRI) are common complications of PICC. The purpose of this retrospective study was to investigate the role of low-dose heparin added to the total nutrient admixture (CTNA) in the prevention of CRI. METHODS: Eighty-three neonates who underwent PICC received TNA with (heparin group, n=43) or without heparin (0.5 U/ mL) (control group, n=40). The incidence of CRI was compared between the two groups. RESULTS: The incidences of catheter obstruction (5% vs 20%) and the catheter-tip colonization (2% vs 18%) in the heparin group were significantly lower than those in the control group (P<0.05). None of the neonates in the heparin group had clinical evidence of catheter-related bloodstream infection, but 5 cases in the control group (P＜0.05). CONCLUSIONS: The administration of low-dose heparin in TNA may decrease the incidences of catheter obstruction and CRI.［Chin J Contemp Pediatr, 2009, 11 (12):983-985］
2009 Vol. 11 (12): 983-985 [Abstract] ( 5476 ) [HTML 1KB] [PDF 997KB] ( 1686 )
986 GE Chun-Long, HAO Chuang-Li, TANG Ning-Bo, SUN Yue-Mei, LIU Li-Ping, HE Ning
Changes of exhaled nitric oxide and peripheral blood eosinophils in children with asthma
OBJECTIVE: This study examined the levels of exhaled nitric oxide (eNO) and peripheral blood eosinophils (EOS) as well as the correlation between the two markers in children with bronchial asthma (AS)，AS complicated by allergic rhinitis (AS/AR) and chronic cough variant asthma (CVA), in order to explore the value of eNOS detection in children with AS. METHODS: The eNO level was measured using light-emitting electrochemical photometry in 12 children with AS, 29 children with AS/AR and 10 children with CVA. Peripheral blood EOS was counted by blood cell counter (Coulter JT). Forced expiratory volume in one second (FEV1) was assessed by lung function measurement. Thirty children without atopic disease and acute respiratory infection as well as without a family history of atopic diseasea served as the control group. RESULTS: The levels of eNO and blood EOS in the AS, the AS/AR and the CVA groups were significantly higher than those in the control group (P<0.01). The AS/AR group showed increased levels of eNO (50.3±6.7 ppb) and EOS (5.9±4.2×109 ) compared with the AS (30.5±8.8 ppb and 4.2±3.2×109 respectively) and the CVA groups (26.0±3.2 ppb and 3.7±6.9×109 respectively) (P<0.05). There were no significant differences in eNO and EOS levels between the AS and the CVA groups. The eNO level was positively correlated with the EOS level (r=0.51, P<0.05), but not with FEV1 (r=0.144, P>0.05) in the AS group. CONCLUSIONS: NO is highly expressed in children with symptoms of atopy and can reflect the levels of eosinophilic airway inflammation in children with AS.［Chin J Contemp Pediatr, 2009, 11 (12):986-988］
2009 Vol. 11 (12): 986-988 [Abstract] ( 5684 ) [HTML 1KB] [PDF 1015KB] ( 1420 )
989 CHEN Rui, ZHANG Ai-Rong, ZHAO Xin-Xi, LI Zhan-Hua
Roles of matrix metalloproteinases, tissue inhibitor of matrix metalloproteinase and hs-CRP in Kawasaki disease
OBJECTIVE: To examine the expression of matrix metalloproteinases (MMP)-2, -9, tissue inhibitor of matrix metalloproteinase (TIMP)-1 and hs-CRP, and their relationship with coronary artery in children with Kawasaki disease. METHODS: One hundred and fifty-one children with Kawasaki disease (111 cases with coronary artery damage and 40 cases without) and 60 healthy children were enrolled. The expression of MMP-2, MMP-9 and TIMP-1 was detected using ELISA, and the hs-CRP concentration was measured using the endpoint nephelometry. RESULTS: There were significant differences in the level of MMP-2, MMP-9 and hs-CRP between the patients with or without coronary artery damage and the healthy children (P<0.05). The levels of MMP-2, MMP-9 and hs-CRP were the highest in the cardiovascular damage group (P<0.05). There were positive correlations between MMP-2, MMP-9 and TIMP-1 in children with Kawasaki disease. CONCLUSIONS: MMP-2, MMP-9, TIMP-1 and hs-CRP may play important roles in the development of Kawasaki disease. The combined measurement of MMP-2, MMP-9 and hs-CRP may be useful in the evaluation of the severity in children with Kawasaki disease.［Chin J Contemp Pediatr, 2009, 11 (12):989-991］
2009 Vol. 11 (12): 989-991 [Abstract] ( 4846 ) [HTML 1KB] [PDF 1052KB] ( 1397 )
992 CHEN Yan-Hui, CHEN Hui, LIU Yan-Yan, LIN Gui-Xiu, WEI Li-Xin, CHEN Dan-Ling
Function of the hypothalamus-pituitary-adrenal axis in children with attention deficit hyperactivity disorder
OBJECTIVE: To study the function of the hypothalamus-pituitary-adrenal (HPA) axis in children with attention deficit hyperactivity disorder (ADHD). METHODS: One hundred and twenty-eight boys with ADHD at ages of 6 to 14 years were enrolled. The diagnosis and grouping of ADHD were based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): ADHD-predominantly inattention type (ADHD-I, n=44), ADHD-predominantly hyperactive impulsivetype (ADHDHI, n=32) and ADHD-combined type (ADHD-C, n=52). Thirty healthy boys served as the control group. Plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were measured by automatic particle enzyme immunoassay and electrochemiluminescence respectively at 8∶00 am. The intelligence level was tested by Raven′s standard progressive matrices. RESULTS: The children with ADHD had lower IQ score (84.5±11.3) than the control group (94.6±12.4) (P<0.01). There were significant differences in the IQ score among the three ADHD subgroups (P<0.01). The IQ score in the ADHD-I and the ADHD-C groups was significantly lower than that in the control group. The mean plasma cortisol level in the ADHD group (226.5± 129.1 nmol/L) was significantly lower than that in the control group (384.5±141.4 nmol/L) (P<0.01). The three ADHD subgroups showed significantly decreased plasma cortisol level compared with the control group (P<0.01). The plasma level of cortisol was the lowest in the ADHDHI group (154.4±71.6 nmol/L), followed by the ADHDI group (219.4±117.7 nmol/L) and the ADHD-C group (258.3±136.4 nmol/L). There were no significant differences in plasma concentration of ACTH between ADHD and control children. CONCLUSIONS: In the non-stress state, the HPA axis may be dysfunctional in children with ADHD, which may be attributed to the under reactivity of the HPA axis. Lower plasma cortisol has fewer impacts on the cognitive-behavior function, but it may closely be related to attention deficit, hyperactivity and impulsive behaviors.［Chin J Contemp Pediatr, 2009, 11 (12):992-995］
2009 Vol. 11 (12): 992-995 [Abstract] ( 6543 ) [HTML 1KB] [PDF 1011KB] ( 1692 )
996 WEN Jia-Lun, LIAO Jian-Xiang, CHEN Li, HU Yan, LI Bing, HUANG Tie-Shuan, LU Xin-Guo, WANG Xin-Juan
Follow-up of tuberous sclerosis complex complicated by epilepsy in children
OBJECTIVE: To investigate the treatment outcome and risk factors for intractable seizures in children with tuberous sclerosis complex（TSC）complicated by epilepsy. METHODS: The medical data of 66 cases of TSC were retrospectively studied. RESULTS: Of the 66 children with TSC, 47 cases were available for follow-up. The follow-up period ranged from 7 months to 9.3 years (average 4.5±2.6 years). The patients′ present average age was (7.7±4.1) years (median 8 years). Among the 47 cases, 19 (40%) had infantile spasms, 24 (51%) had tonic seizures, 15 (32%) had partial seizures, and 3 (6%) had tonic-clonic seizures, and additionally, multifocal seizures, atonic seizures, atypical absence seizures and hypomotor seizures each appeared in 1 case (2%) respectively. The average number of antiepileptic drugs used was 1.9±0.86 (median 1). Among the 47 patients, 12 (26%) still had epileptic seizures and 33 (70%）were seizure-free, and 4% were dead. Three cases underwent surgery and continued to receive medication after surgery. The three patients were seizurefree in a 1.5 years follow-up. Among the 30 children over 7 years old, 17 cases (57%) were enrolled in ordinary schools, 3 cases (10%) in special schools and the other 10 cases were off-school for disabilities of intelligence and speech. The non conditional logistic regression showed that the age of onset (RR=1.8, 95% CI 1.0- 3.2, P=0.050), administration of multiple antiepileptic drugs (RR=4.8, 95% CI 1.2-18.6, P=0.024), tonic seizures (RR=0.003, 95% CI 0.0- 0.2, P=0.04) and sex (RR=0.016, 95% CI 0.0-0.5, P=0.017) were risk factors for intractable seizures. CONCLUSIONS: The majority (70%) of children with TSC complicated by epilepsy can be seizure-free with suitable treatment. The risk factors of poor outcome in seizure control may involve in the early onset age, tonic seizures and the administration for multiple anti-epileptic drugs.［Chin J Contemp Pediatr, 2009, 11 (12):996-998］
2009 Vol. 11 (12): 996-998 [Abstract] ( 5409 ) [HTML 1KB] [PDF 1011KB] ( 1582 )
EVIDENCE-BASED MEDICINE
999 ZHANG Yao-Dong, HU Qun, LIU Shuang-You, LIU Ai-Guo, WANG Guan-Ling, XIONG Hao, SUN Yan
Association of human parvovirus B19 infection and childhood idiopathic thrombocytopenic purpura: a meta analysis of Chinese literatures
OBJECTIVE: To study the relationship between human parvovirus B19 infection and childhood idiopathic thrombocytopenic purpura (ITP) by the principle of evidence based medicine. METHODS: Papers related to the relationship between human parvovirus B19 infection and childhood ITP published between 1994 and 2008 were retrieved electronically from the Chinese Journals Full-text Database and the Wanfang Data. These relevant papers on case-control trials were statistically studied by meta analysis. RESULTS: Eight papers that met the inclusion criteria were included for this meta analysis. Five hundred and sixteen cases of childhood ITP and 246 healthy controls were enrolled. The meta analysis showed that the incidence of human parvovirus B19 infection in the ITP group was significantly higher than that in the control group (OR=13.71, 95% CI=7.07-26.59, Z=7.75, P<0.01). CONCLUSIONS: Human parvovirus B19 infection is closely associated with childhood ITP.［Chin J Contemp Pediatr, 2009, 11 (12):999-1001］
2009 Vol. 11 (12): 999-1001 [Abstract] ( 6019 ) [HTML 1KB] [PDF 1198KB] ( 1590 )
CHILD HEALTH CARE
1002 HE Hong-Ling, YAN Hong, ZUO Ling, LIU Ling, ZHANG Xi-Ping
Effects of Montessori education on the intellectual development in children aged 2 to 4 years
OBJECTIVE: To compare the effects of Montessori education and traditional education on the intellectual development in children aged 2 to 4 years. METHODS: Children aged between 2 to 3 years who were enrolled in a kindergarten in September 2006 were randomly assigned to the Montessori education and the traditional education groups. In addition to receiving the traditional education, the Montessori education group participated in the two-hour Montessori pedagogical activities every day. The intellectual development was evaluated by the Neuropsychological Development Examination Format for Children Aged 0~6 years published by Capital Pediatrics Research Institute at enrollment and one year after the trial. RESULTS: There were no significant differences in the intelligence growth level between the Montessori education and the traditional education groups at enrollment. After one year, the levels of fine movements, adaptation ability, language, and social behavior developments in the Montessori education group were significantly higher than those in the traditional education group (P<0.05 or 0.01). The intelligence increasing scores of the large motor ability, fine movements, language, social behavior and development quotient in the Montessori education group were also higher than those in the traditional education group (P<0.05 or 0.01). CONCLUSIONS: Montessori education can promote the development of large motor ability, fine movements, language, and social behavior in children.［Chin J Contemp Pediatr, 2009, 11 (12):1002-1005］
2009 Vol. 11 (12): 1002-1005 [Abstract] ( 7263 ) [HTML 1KB] [PDF 1073KB] ( 2019 )
1006 WANG Ping, SONG Pu, CHEN Cai-Ping, LIANG Juan, JIAN Fang-Fang, ZHANG Jin-Bao
A comparative study on psychological and behavioral development in children aged 1 to 3 years fostered by grandparents and by parents
OBJECTIVE: To investigate the differences of psychological and behavioral development between children aged 1 to 3 years fostered by grandparents and those by parents. METHODS: Psychological and behavioral development of 443 children aged 1 to 3 years fostered by their grandparents and of aged-matched 443 children fostered by their parents were assessed with DST, an intellectual developmental screening test developed by Pediatric Hospital of Fudan University in Shanghai. RESULTS: The abilities of social adaptation and intelligence development in children fostered by their grandparents were obviously retarded as compared with those in children fostered by their parents. CONCLUSIONS: There are shortcomings in psychological and behavioral development in children aged 1 to 3 years fostered by grandparents.［Chin J Contemp Pediatr, 2009, 11 (12):1006-1007］
2009 Vol. 11 (12): 1006-1007 [Abstract] ( 5879 ) [HTML 1KB] [PDF 989KB] ( 1521 )
EXPERIMENTAL RESEARCH
1008 CHEN Xiao-Hui, ZHAO Ya-Ping, ZHU Chun, JI Chen-Bo, ZHANG Chun-Mei, ZHU Jin-Gai,
Regulative role of TNFα on STEAP4 gene in matured human adipocytes
OBJECTIVE: Human STEAP4, a novel obesity-related gene, is associated with insulin sensitivity regulation in human adipocytes. This study aimed to explore the regulative role of TNFα on STEAP4 gene in matured human adipocytes. METHODS: Human preadipocytes were cultured and differentiated into matured adipocytes in vitro. Fully differentiated adipocytes (Day 17) were treated with different concentrations of TNFα (0, 5, 10, 25 and 50 ng/mL) for 24 hrs. Total RNA and protein were extracted from the adipocytes. Levels of STEAP4 mRNA and protein expression were determined by real-time quantitative RT-PCR and Western blot respectively. RESULTS: Different concentrations (5, 10, 25 and 50 ng/mL) of TNFα treatment for 24 hrs resulted in a significant increase in the STEAP4 mRNA expression of human matured adipocytes.The maximal effect was seen in the 50 ng/mL of TNFα treatment group. In parallel, STEAP4 protein synthesis in matured adipocytes increased in response to TNFα treatment of different concentrations (5, 10, 25 and 50 ng/mL) for 24 hrs. The maximal up-regulated effect was seen in the 25 ng/mL of TNFα treatment group. CONCLUSIONS: TNFα can up-regulate STEAP4 mRNA expression in human matured adipocytes.［Chin J Contemp Pediatr, 2009, 11 (12):1008-1011］
2009 Vol. 11 (12): 1008-1011 [Abstract] ( 5313 ) [HTML 1KB] [PDF 1041KB] ( 1257 )
CLINICAL EXPERIENCE
1012 ZHOU Hui, ZHAO Jian-Mei, XU Mei-Yu, ZHU Shao-Peng, LI Bin
Salmonella choleraesuis infection in children: chinical analysis of 21 cases

No abstract available
2009 Vol. 11 (12): 1012-1013 [Abstract] ( 4210 ) [HTML 1KB] [PDF 977KB] ( 1427 )
1014 ZHENG Xian-Qiu, HE Jia-Wei, YE Hai-Yan, WAN Meng-Nan, ZHAN Xin, CHEN Wang-Qiang
Comparative study on the value of digital radiography and spiral CT scan in the evaluation of adenoidal hypertrophy

No abstract available
2009 Vol. 11 (12): 1014-1016 [Abstract] ( 4218 ) [HTML 1KB] [PDF 1039KB] ( 1564 )
1017 WANG Ning, WANG Rui, MA En-He, ZHANG Ge-Xiang, WANG Yu
Food frequency in 327 children aged 2 to 4 years in Huining Gansu

No abstract available
2009 Vol. 11 (12): 1017-1018 [Abstract] ( 3564 ) [HTML 1KB] [PDF 984KB] ( 1409 )
1019 CHEN Jin-Qing
Nonconvulsive status epilepticus: clinical analysis of 22 cases

No abstract available
2009 Vol. 11 (12): 1019-1020 [Abstract] ( 4027 ) [HTML 1KB] [PDF 974KB] ( 1176 )
1021 FU Da-Lin, ZHANG Yue, TANG Jian, SUN Yan, DU Sen-Jie, ZHAO Xiao-Ke, LI Hong-Ying, ZHANG Ling, GAO Wei-Hong, BEN Xiao-Ming
Screening for inborn errors of metabolism in children with cerebral palsy of unknown causes

No abstract available
2009 Vol. 11 (12): 1021-1022 [Abstract] ( 4256 ) [HTML 1KB] [PDF 976KB] ( 1540 )
CASE REPORT
1023 ZHOU Kai-Yu, ZHU Qi, HUA Yi-Min, LIU Han-Min, XING Ai-Yun, YANG Sen, GUO Nan
Successful treatment of fetal atrial flutter and hydrops by maternal administration of oral digoxin: a case report

No abstract available
2009 Vol. 11 (12): 1023-1024 [Abstract] ( 4525 ) [HTML 1KB] [PDF 1135KB] ( 1283 )
1025 QIN Xiao-Fei, FU Wan-Hai, YOU Chu-Ming, CHEN Yan-Yu
Neonatal gigantic rhabdomyoca of the left ventricle: a case report

No abstract available
2009 Vol. 11 (12): 1025-1026 [Abstract] ( 4044 ) [HTML 1KB] [PDF 1176KB] ( 1471 )
1027 WU Jian-Guo, LIU Ming-Hui, GAO Yu-Ming
Giant congenital diaphragmatic hernia complicated by cardiopulmonary hypoplasia: a case report

No abstract available
2009 Vol. 11 (12): 1027-1028 [Abstract] ( 3787 ) [HTML 1KB] [PDF 1125KB] ( 1252 )
1033 CHEN Wen-Chao, LIU Guo-Sheng
Severe pneumonia complicated by heart failure, pulmonary edema edema and cerebral edema: a case report

No abstract available
2009 Vol. 11 (12): 1033-1033 [Abstract] ( 5201 ) [HTML 1KB] [PDF 956KB] ( 1437 )
REVIEW
1029 WENG Hai-Mei, XIANG Ru-Lian
Research porgress of non-cardiovascular complications in Kawasaki disease

No abstract available
2009 Vol. 11 (12): 1029-1032 [Abstract] ( 4310 ) [HTML 1KB] [PDF 1004KB] ( 1528 )
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