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2013 Vol.  15 No.  6
Published: 2013-06-15
TOPIC OF AVIAN INFLUENZA
TOPIC OF EARTHQUAKE DISASTER
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CASE REPORT
REVIEW
TOPIC OF AVIAN INFLUENZA
401 WANG Quan, YAO Kai-Hu
A(H5N1) and A(H7N9) avian influenza: the H7N9 avian influenza outbreak of 2013 Hot!

influenza virus can infect humans and cause disease. The clinical presentation of human infection is usually mild, but the infection caused by A(H5N1) avian influenza virus occurring initially in Hongkong in 1997 or the A(H7N9) virus isolated first at the beginning of this year in China is severe and characterized by high mortality. The mortality rate of adolescents and children caused by H5N1 avian influenza is lower than that of adults and the younger the child the lower the mortality rate. A few pediatric H7N9 avian influenza cases recovered soon after treatment. A child was determined to be a H7N9 avian influenza virus carrier. These findings suggested that the pediatric H7N9 avian influenza infection was mild. It is very important to start anti-virus treatment with oseltamivir as early as possible in cases of avian influenza infection is considered. Combined therapy, including respiratory and circulatory support and inhibiting immunological reaction, is emphasized in the treatment of severe cases.
2013 Vol. 15 (6): 401-404 [Abstract] ( 6392 ) [HTML KB] [PDF 1101KB] ( 1395 )
405 LIU Chun-Yan, AI Jun-Hong
Virological characteristics of avian influenza A H7N9 virus
From February 2013, a novel avian influenza A H7N9 virus causing human infection with fatal outcomes has been identified in eastern China. This avian influenza A H7N9 virus is a triple reassortant of viruses that are avian-origin only and it is low pathogenic in poultry. Several characteristic amino acid mutations in HA and PB2 polymerase subunit (including G186V, Q226L and E627K substitution) have been found through sequence analysis, and these mutations probably facilitate binding to human-type receptors and efficient replication in mammals. Other mutations in NA, M2 and NS genes were also found. Although sustained human-to-human transmission has not been conclusively established, limited human-to-human transmission of the H7N9 virus remains possible. Intensified surveillance for the H7N9 virus in humans and animals is needed to answer questions about the viral origin, spread and potential threat.
2013 Vol. 15 (6): 405-408 [Abstract] ( 4475 ) [HTML KB] [PDF 1025KB] ( 1113 )
409 ZHU Yi-Min
A limited understanding of hazard of influenza A virus subtype H7N9 in children

Since the first human case of influenza A virus subtype H7N9 was reported in Shanghai, China in March 2013, there have been two H7N9-infected children and one healthy H7N9 carrier. With a brief introduction to the basic information of the three children, this paper discusses the variation of Avian influenza virus by referring to the literature, suggests that human-to-human transmission is not confirmed in the small outbreak, and reviews the measures for preventing and treating H7N9 infection in humans. In addition, this paper talks about the use of tamiflu in early stage of infection and the use of peramivir when the patient’s condition is severe.
2013 Vol. 15 (6): 409-411 [Abstract] ( 5421 ) [HTML KB] [PDF 998KB] ( 891 )
TOPIC OF EARTHQUAKE DISASTER
412 WANG Quan
Treatment of pediatric critical trauma following earthquake disasters
Children are the most vulnerable in natural disasters for their poor self-protection ability. Pediatric deaths in earthquakes are mainly due to cardiopulmonary arrest, severe craniocerebral injury, shock, crush syndrome, and multiple organ failure. Priority should be given to centralized, effective treatment for injured children, with multidisciplinary cooperation, and severe cases need to be transferred to the pediatric intensive care unit, thus improving survival and reducing disability.
2013 Vol. 15 (6): 412-415 [Abstract] ( 4758 ) [HTML KB] [PDF 1020KB] ( 890 )
416 ZHANG Ting-Chong
Types of pediatric trauma in earthquake and key points of treatment
Limb trauma is the most common among pediatric victims in earthquake. Compared with traumatic brain injury, which is frequent in earthquake, intracranial injury is rare, but it is the leading cause of death from trauma in earthquake. Thoracoabdominal crush injury, which often causes such crises as visceral hemorrhage, is also one of the main causes of death among pediatric victims in earthquake. Crush syndrome and osteofascial compartment syndrome are often complicated by acute renal failure. Because trauma is emergent in earthquake, the principle of “life-saving first, critical injury priority” should be complied with during on-site rescue. The injured children must be transferred to the medical center as soon as possible. It is essential to treat the critically injured children by multidisciplinary cooperation, and much attention should be paid to prevention of complications, rehabilitation care, and psychological counseling.
2013 Vol. 15 (6): 416-418 [Abstract] ( 4264 ) [HTML KB] [PDF 1004KB] ( 966 )
419 JIANG Xin, XIANG Bo, LIU Li-Jun, LIU Min, TANG Xue-Yang, HUANG Lu-Gang, LI Yuan, PENG Ming-Xing, XIN Wen-Qiong
Clinical characteristics of pediatric victims in the Lushan and Wenchuan earthquakes and experience of medical rescue
OBJECTIVE: To get a more comprehensive understanding of the clinical characteristics of pediatric victims in earthquake and to summarize the experience of medical rescue. METHODS: The clinical information was collected from the pediatric victims who were admitted to West China Hospital, Sichuan University following the Lushan earthquake in 2013 and Wenchuan earthquake in 2008. The clinical data were compared between the pediatric victims in the two earthquakes. RESULTS: Thirty-four children under 14 years of age, who were injured in the Lushan earthquake, were admitted to the West China Hospital before April 30, 2013. Compared with the data in the Wenchuan earthquake, the mean age of the pediatric victims in the Lushan earthquake was significantly lower (P<0.01), and the mean time from earthquake to hospitalization was significantly shorter (P<0.01). In the Lushan earthquake, 67.6% of the injured children had variable limb fractures; traumatic brain injury was found in 29.4% of hospitalized children, versus 9.5% in the Wenchuan earthquake (P<0.05). Among the 34 children, no amputation and death occurred, and all the 13 severe cases started to recover. CONCLUSIONS: There were higher proportions of severely injured children and children with traumatic brain injury in the Lushan earthquake than in the Wenchuan earthquake. But these cases recovered well, which was possibly due to timely on-site rescue and transfer and multi-sector, multi-institution, and multidisciplinary cooperation.
2013 Vol. 15 (6): 419-422 [Abstract] ( 4202 ) [HTML KB] [PDF 1013KB] ( 721 )
423 CUI Yong-Hua
Psychological trauma and crisis intervention in children after earthquake
As a momentous disaster, earthquake would bring severe psychological trauma to children, with an adverse effect not only on the physiological functions, but also on their behaviors, emotions, and cognition, and the short-term and long-term consequences are much greater in children than in adults. The children of different ages have different psychological reactions, so psychological intervention varies with children′s age. Psychological intervention is still important long afterwards to prevent permanent psychological trauma in children.
2013 Vol. 15 (6): 423-426 [Abstract] ( 5347 ) [HTML KB] [PDF 1010KB] ( 1169 )
427 FAN Chao-Nan
Prevalence and prevention of common nutritional risks in children after earthquake
Children have been identified as the most nutritionally vulnerable group when disaster happens. The most common nutritional risks include protein-energy malnutrition, iron-deficiency anemia, and trace element deficiency in children after earthquake. During the disaster relief, effective nutritional interventions should be performed according to the nutritional conditions of children in the affected area, so as to prevent the common nutritional risks. Timely diagnosis and treatment should be provided for children at a high risk of malnutrition.
2013 Vol. 15 (6): 427-430 [Abstract] ( 4686 ) [HTML KB] [PDF 1019KB] ( 915 )
431 YANG Zhi-Quan, ZHANG Qing-Min
Rehabilitation care for children after trauma in the earthquake disaster
For the children who suffer trauma in earthquake, rehabilitation care aims to promote functional recovery, shorten hospital stay, and reduce the incidence of complications or disability by evidence-based, multidisciplinary, and comprehensive early rehabilitation intervention on the basis of first aid and clinical treatment. Children are likely to suffer traumatic brain injury, spinal cord injury, peripheral nerve injury, limb fracture, and amputation in the earthquake disaster, so the clinical rehabilitation care designed considering the characteristics of children should be provided immediately after acute phase of trauma to promote functional recovery.
2013 Vol. 15 (6): 431-434 [Abstract] ( 5021 ) [HTML KB] [PDF 1010KB] ( 993 )
435 YAO Kai-Hu
Common pediatric infectious diseases following natural disasters
Natural disasters may lead to the outbreaks of infectious diseases because they increase the risk factors for infectious diseases. This paper reviews the risk factors for infectious diseases after natural disasters, especially earthquake, and the infectious diseases following disasters reported in recent years. The infectious diseases after earthquake include diarrhea, cholera, viral hepatitis, upper respiratory tract infection, tuberculosis, measles, leptospirosis, dengue fever, tetanus, and gas gangrene, as well as some rare infections. Children are vulnerable to infectious diseases, so pediatricians should pay more attention to the research on relationship between infectious diseases and natural disasters.
2013 Vol. 15 (6): 435-439 [Abstract] ( 5848 ) [HTML KB] [PDF 1031KB] ( 1069 )
CLINICAL RESEARCH
440 ZHANG Rong, LIAO Jing, LI Ge, SUN Huai-Qiang, SHI Yu-Jun, YANG Ji-Yun
Real-time quantitative detection of E2A-PBX1 fusion gene in children with acute lymphoblastic leukemia and its clinical application in minimal residual disease monitoring

OBJECTIVE:　To establish a real-time reverse transcription-polymerase chain reaction (RT-PCR) for quantitative detection of E2A-PBX1 fusion gene mRNA in acute lymphoblastic leukemia (ALL) children and to explore its clinical significance in minimal residual disease monitoring and prognosis evaluation. Methods: Real-time RT-PCR was used to quantitatively detect the mRNA expression of E2A-PBX1 gene in 11 newly diagnosed ALL patients at diagnosis (11 cases), complete remission (11 cases) and periods of relapse (3 cases). Ten children with normal bone marrow cell morphology and without hematopathy or tumor diseases were used as the control group. RESULTS: The median expression levels of E2A-PBX1 fusion gene in the ALL group at diagnosis and the relapse group were significantly higher than in the control and complete remission groups (P<0.01). Compared with E2A-PBX1 negative patients on day 33 during induction of remission, the recurrence rate increased and disease free survival rate at 3 year decreased significantly in E2A-PBX1 positive patients decreased (P<0.05). CONCLUSIONS: Measurement of E2A-PBX1 levels by real-time RT-PCR is useful for monitoing minimal residual disease, prediction of relapse and individual treatment. The expression level of E2A-PBX1 gene on day 33 during induction of remission can be used for prognosis evaluation.
2013 Vol. 15 (6): 440-443 [Abstract] ( 5559 ) [HTML KB] [PDF 1189KB] ( 1196 )
444 SUO Pan, ZHANG Le-Ping, WU Jun, LU Ai-Dong, WANG Bin, ZUO Ying-Xi, CHENG Yi-Fei, LIU Gui-Lan
Therapeutic effect of clofarabine in children with relapsed or refractory acute lymphoblastic leukemia
OBJECTIVE: To explore the efficacy and adverse effects of clofarabine for relapsed/refractory acute lymphoblastic leukemia in children. METHODS: Twentysix pediatric patients with relapsed/refractory acute lymphoblastic leukemia were treated with clofarabine. There were 22 males and 4 females, with a mean age of 9.5 years (ranging from 4 to 17 years). They received clofarabine 52 mg/m2 intravenously over 2 hours daily for 5 days. Thirteen patients received two cycles and one patient received three cycles. RESULTS: In the first cycle of clofarabine, complete remission was obtained in 11 children (42%) and partial remission was obtained in 7 children (27%). Eight children (31%) were considered unresponsive. In the second cycle, 11 (85%) of the 13 children obtained complete remission, 1 (8%) partial remission and 1 (8%) was unresponsive. One child received three cycles and obtained complete remission in each cycle. The common adverse events were myelosuppression, infection, liver dysfunction and gastrointestinal adverse reactions. There were no chemotherapy-related deaths.ConclusionsClofarabine is effective in the treatment of children with relapsed/refractory acute lymphoblastic leukemia and its adverse effects can be tolerated. Clofarabine could be a promising new treatment for relapsed/refractory acute lymphoblastic leukemia.
2013 Vol. 15 (6): 444-447 [Abstract] ( 5428 ) [HTML KB] [PDF 447KB] ( 1063 )
448 YANG Wen-Yu, CHEN Xiao-Juan, ZHANG Pei-Hong, Asahito Hama, Masafumi Ito, Seiji Kojima, ZHU Xiao-Fan
Clinical features of cytopenia with bone marrow hypoplasia in children: an analysis of 100 cases
OBJECTIVE: To summarize the clinical features of cytopenia with bone marrow hypoplasia in 100 children and to investigate an effective treatment regimen for myelodysplastic syndrome (MDS) in children. METHODS: A retrospective analysis was performed on the clinical data of 100 children non-randomly selected from Japan and China who were diagnosed with cytopenia with bone marrow hypoplasia between 2006 and 2011. The data of patients from China were subjected to prognostic analysis. RESULTS: There was no significant difference in the proportion of MDS cases and acquired aplastic anemia (AA) cases between the Japanese and Chinese children. Of the 100 patients, there were 29 cases of acquired AA, 58 cases of refractory cytopenia of childhood (RCC) and 13 cases of refractory cytopenia with multilineage dysplasia (RCMD). There were significant differences in reticulocyte absolute value in peripheral blood and degree of bone marrow proliferation among the three patient groups (P<0.05). The patients from China were followed up for 16-70 months (median, 41 months). After being treated with cyclosporine (CsA) combined with stanozolol, the patients with AA had response rates of 25% and 75%, the patients with RCC had response rates of 47.1% and 82.4%, and the patients with RCMD had response rates of 60% and 60% respectively at 3 and 6 months after treatment. CONCLUSIONS: There are significant differences in reticulocyte absolute value in peripheral blood and degree of bone marrow proliferation among patients with RCC, RCMD and acquired AA. CsA combined with stanozolol has a good therapeutic efficacy in the treatment of acquired AA and hypoplastic MDS in children, but studies of more cases and a longer follow-up duration are needed.
2013 Vol. 15 (6): 448-452 [Abstract] ( 5238 ) [HTML KB] [PDF 1036KB] ( 831 )
453 MA Chao, SHEN Ding-Rong, ZHANG Qing, MENG Xiang-Chun, WANG Yuan-Xiang, PENG Le, MENG Bao-Ying
Protective effect of cold autologous blood cardioplegic solution on the heart of infants with cyanotic congenital heart disease
OBJECTIVE: To study the protective effect of cold autologous blood cardioplegic solution on the heart of infants with cyanotic congenital heart disease (CCHD). METHODS: Ninety-six infants with CCHD who underwent cardiopulmonary bypass (CPB) were randomly and equally divided into three groups: histidine-tryptophan-ketoglutarate (HTK) solution, cold non-autologous blood cardioplegic solution, and cold autologous blood cardioplegic solution. The right auricular tissues were taken before aortic cross-clamping and at 30 minutes after aortic declamping, and ATP level and energy charge (EC) in the myocardium were measured. Venous blood was collected before and immediately after CPB, and the serum levels of creatine kinase (CK)-MB and cardiac troponin I (cTnI) were measured. The clinical parameters, such as the re-beat time and re-beat rate during CPB, cardiac index, dependence on positive inotropic agents, and left ventricular ejection fraction (LVEF) at 2 hours after CPB, the incidence rate of arrhythmia within 24 hours after CPB, and postoperative complications and mortality, were recorded. RESULTS: At 30 minutes after aortic declamping, the three groups showed significantly decreased ATP and EC levels (P<0.05), and the cold autologous blood group had significantly higher ATP and EC levels than the other two groups (P<0.05). Immediately after CPB, the three groups showed significantly increased serum levels of CK-MB and cTnI (P<0.05), and the cold autologous blood group had significantly lower serum levels of CK-MB and cTnI than the other two groups (P<0.05). The cold autologous blood group had significantly better outcomes than the other two groups in terms of the re-beat time during CPB and the dependence on positive inotropic agents and LVEF at 2 hours after CPB (P<0.05). CONCLUSIONS: Cold autologous blood cardioplegic solution is superior to HTK and cold non-autologous blood cardioplegic solutions in preserving myocardial energy and reducing myocardial injury in infants with CCHD who undergo CPB, thus providing a better protective effect on the heart.
2013 Vol. 15 (6): 453-457 [Abstract] ( 4013 ) [HTML KB] [PDF 1032KB] ( 1006 )
458 XU Yi, LIN Ping, WANG Cheng, WU Li-Jia, KANG Mei-Hua, ZHU Li-Ping, LI Fang, LI Yun-Li, CHU Wei-Hong, RAN Jing
Investigation of 24-hour blood pressure monitoring for evaluating treatment outcome of nerve-mediated syncope in children
OBJECTIVE: To investigate the clinical significance of 24-hour blood pressure monitoring (ABPM) for evaluating the treatment outcome of nerve-mediated syncope (NMS) in children. METHODS: Twenty-eight children with NMS confirmed by a head-up tilt table test (HUTT) (12 males and 16 females, aged 6-13 years) and with a chief complaint of unexplained syncope or pre-syncope between February 2010 and August 2012, were included in the study. These children received health education combined with therapy using oral rehydration salts solution and were then reexamined for clinical symptoms as well as HUTT and ABPM results. RESULTS: Of 28 NMS cases, 22 were vasodepressive type, 5 were mixed type, and 1 was cardioinhibitory type. The follow-up showed that 27 (96%) of all cases had improved clinical symptoms, and 18 (64%) had improved HUTT results. The ABPM follow-up revealed no significant changes in 24-hour mean systolic pressure, 24-hour mean diastolic pressure, daytime mean systolic pressure, daytime mean diastolic pressure, nighttime mean systolic pressure, nighttime mean diastolic pressure, day-night difference of systolic pressure, and day-night difference of diastolic pressure after treatment (P>0.05). The percentage of children with a dipper blood pressure pattern increased from 29% (8/28) before treatment to 50% (14/28) after treatment; the percentage of children with a non-dipper blood pressure pattern decreased from 71% (20/28) before treatment to 50% (14/28) after treatment. CONCLUSIONS: As an effective, objective and non-invasive monitoring means, ABPM is of some clinical significance for evaluating the treatment outcome of NMS in children.
2013 Vol. 15 (6): 458-461 [Abstract] ( 5471 ) [HTML KB] [PDF 1022KB] ( 948 )
462 LIN Qian, LIU Quan-Hua, BAO Yi-Xiao
Efficacy and safety of tulobuterol patch versus oral salbutamol sulfate in children with mild or moderate acute attack of bronchial asthma: a comparative study
OBJECTIVE: To compare tulobuterol patch and oral salbutamol sulfate in terms of efficacy and safety in children with mild or moderate acute attack of bronchial asthma. METHODS: A total of 92 children with mild and moderate acute asthmatic attack were randomly divided into salbutamol group (n=46) and tulobuterol group (n=46). Both groups received routine treatment with antihistamine, selective leukotriene receptor antagonist and glucocorticoid. In addition, the salbutamol group was given slow-release capsules of salbutamol sulfate, and the tulobuterol group was treated with tulobuterol patch. The two groups were compared with respect to symptom scores of cough, wheeze, respiratory rate, wheezing sound, three depression sign and peak expiratory flow, as well as adverse events. RESULTS: As the treatment proceeded, symptom scores decreased in both groups; on the third day of treatment, all symptom scores except cough score showed a significant decrease in both groups (P<0.05), but the tulobuterol group had significantly lower symptom scores than the salbutamol group (P<0.05). On the fourteenth day of treatment, both groups had a significant decrease in cough score (P<0.05), but the tulobuterol group had a significantly lower cough score than the salbutamol group (P<0.05). One child developed hand trembling in the salbutamol group, while no adverse event occurred in the tulobuterol group. CONCLUSIONS: Compared with oral salbutamol sulfate, tulobuterol patch has a better therapeutic efficacy and a higher safety in children with mild or moderate acute asthmatic attack.
2013 Vol. 15 (6): 462-465 [Abstract] ( 7377 ) [HTML KB] [PDF 1102KB] ( 2070 )
466 YE Ying, WANG Chang-Shuang, MA Ya-Ting, LU Ming-Xia, ZHANG Xiao-Xiao, ZHANG Yan-Yang, GUO Wan-Shen
Surveillance of adverse events following immunization in Henan Province, China between 2010-2011
OBJECTIVE: To analyze the epidemiological features of adverse events following immunization (AEFI) in Henan Province, China and to evaluate the safety of vaccines currently used in Henan. METHODS: The AEFI cases reported in Henan from January 1, 2010 to December 31, 2011 were collected through the China Surveillance System of Information on National Immunization Program. The descriptive method was used for epidemiological analysis. RESULTS: A total of 2415 cases of AEFI were reported in Henan from January 1, 2010 to December 31, 2011, and 1238 (51.26%) of them were found in Zhengzhou, Luoyang, and Jiaozuo cities. The male-to-female ratio was 1.32:1. Seven hundred and ninety-nine (33.08%) of these cases were less than one year old. Measles vaccine and DPT vaccine (against diphtheria, pertussis, and tetanus) were the main causes of AEFI, contributing to 61.24% of cases; the incidence rates of AEFI among people receiving measles and DPT vaccines were 30.3/105 and 5.0/105, respectively. 1528 cases (63.27%) developed AEFI after the first dose of vaccination. Inflammation and allergic symptoms were the predominant adverse effects caused by the top 5 vaccines AEFI-causing vaccines, and the clinical manifestations were significantly different among AEFI cases caused by different vaccines (χ2=304.5, P<0.001). Among the 2415 AEFI cases, 1946 (80.58%) had common adverse reaction, 348 (14.41%) had rare adverse reaction, 98 (4.06%) had coupling disease, 13 (0.51%) had psychogenic reaction, and 10 (0.41%) had reaction for unknown reasons. The prognosis of most AEFI cases was good, with a cure rate as high as 90.64%. CONCLUSIONS: AEFI occurs mostly in young children and after the first dose of vaccination. This should be brought to the attention of vaccination service personnel and the children′s parents.
2013 Vol. 15 (6): 466-471 [Abstract] ( 4694 ) [HTML KB] [PDF 1132KB] ( 1023 )
472 LI Jiu-Jun, CHEN Yan-Fei, LIN Ye-Xin
Investigation of disease spectrum in the PICU of Shengjing Hospital of China Medical University between 2005 and 2012
OBJECTIVE: To summarize the spectrum of disease and common diseases that cause death in children admitted to the Pediatric Intensive Care Unit (PICU), Shengjing Hospital of China Medical University between 2005 and 2012. METHODS: A retrospective analysis was carried out on the clinical data of 4484 children admitted to the PICU of Shengjing Hospital bettween 2005 and 2012. RESULTS: Acute bronchopneumonia, which was found in 1099 (24.51%) of the 4484 cases, was the most common disease in the PICU bettween 2005 and 2012. The incidence of intracranial infection, sepsis, hand-foot-mouth disease and trauma showed an increasing trend from 2005 to 2012, but that of non-traumatic intracranial hemorrhage, epilepsy and congenital heart disease showed a decreasing trend. The mortality decreased from 11.5% in 2005 to 3.1% in 2012, and the overall mortality was significantly higher in 2005-2008 than in 2009-2012 (11.98% vs 4.41%; P<0.01). The main causes of death included severe acute bronchial pneumonia, severe sepsis, complex congenital heart disease, severe cerebral trauma, respiratory failure, severe hand-foot-mouth disease, acute poisoning and circulatory failure. CONCLUSIONS: Acute bronchopneumonia was the most common disease in the PICU of Shengjing Hospital bettween 2005 and 2012, but the spectrum of disease changed over time. The mortality showed a decreasing trend among the children in the PICU bettween 2005 and 2012, and the main causes of death included severe acute bronchial pneumonia and severe sepsis.
2013 Vol. 15 (6): 472-476 [Abstract] ( 5662 ) [HTML KB] [PDF 1050KB] ( 957 )
477 PENG Qian, CHEN Chang-Hui, WU Qing, YANG Yuan
Association of new functional SNP rs72689236 of CASP3 with Kawasaki disease: a meta-analysis
OBJECTIVE: To investigate the association of rs72689236, a new functional single nucleotide polymorphism (SNP) of the gene encoding caspase-3 (CASP3), with the occurrence and development of Kawasaki disease by a meta analysis. METHODS: A literature search was performed using databases at home and abroad according to inclusion and exclusion criteria, to acquire studies on the relationship between rs72689236 and Kawasaki disease published up to November 2012, including casecontrol studies and transmission disequilibrium tests. An integrated meta analysis was performed using RevMan 5.1 software after the studies were screened and evaluated. RESULTS: Six studies were extracted for systematic review of the association between rs72689236 and Kawasaki disease. The frequency of allele A of the SNP was significantly higher in patients with Kawasaki disease than in the controls (OR=1.34, 95%CI=1.24-1.46, P<0.001); the risk for Kawasaki disease in children with allele A (AA+AG) increased by approximately 44% compared with children with GG (OR=1.44, 95%CI=1.27-1.65, P<0.001). The frequency of allele A of the SNP was significantly higher in Kawasaki disease patients with coronary artery lesions than in those without coronary artery lesions (OR=1.51, 95%CI=1.10-2.07, P= 0.01); the risk for coronary artery lesions in Kawasaki disease patients with allele A (AA+AG) increased by approximately 59% compared with Kawasaki disease patients with GG (OR=1.59, 95%CI= 1.00-2.53, P=0.05］. No association between this SNP and the therapeutic effect of intravenous immunoglobulin (IVIG) was found in patients with Kawasaki disease. CONCLUSIONS: The allele A of functional SNP rs72689236 of CASP3 increases the risk for Kawasaki disease, and it may be used as the genetic marker for susceptibility to coronary artery lesions as a complication of Kawasaki disease. Currently, there is still no sufficient evidence that this SNP has an impact on the therapeutic effect of IVIG in patients with Kawasaki disease, and more studies are needed to investigate the feasibility of its application in individualized treatment.
2013 Vol. 15 (6): 477-483 [Abstract] ( 5070 ) [HTML KB] [PDF 1445KB] ( 1242 )
EXPERIMENTAL RESEARCH
484 WANG Ji-Mei, ZHOU Wen-Hao, CHENG Guo-Qiang, WANG Lai-Shuang, JIANG Ze-Dong, SHAO Xiao-Mei
Changes in MLS-BAEP in newborn piglets with hypoxic-ischemic brain damage during selective moderate head cooling therapy
OBJECTIVE: To study the effect of selective moderate head cooling therapy on maximum length sequences brainstem auditory evoked potential (MLS-BAEP) in newborn piglets with hypoxic-ischemic brain damage. METHODS: Sixteen newborn piglets aged 5-7 day old were randomly divided into three groups: normothermic control (n=4), HI (n=6) and mild hypothermia-treated (n=6). HI was induced through temporary occlusion of both carotid arteries, followed by mechanical ventilation with low concentration of oxygen (FiO2=0.06) for 30 minutes. Mild hypothermia was induced by equipment via circulating water. MLS-BAER was recorded before HI and at 12 hours, 24 hours, 36 hours, 48 hours, 60 hours, 72 hours, 4 days, 7 days, 10 days, 13 days and 15 days after HI. RESULTS: Compared with the normothermic control group, all latencies and intervals tended to increase significantly at 72 hours in the HI group and reached peak values on day 7. From day 10, all latencies and intervals tended to decrease, but apart from wave I latency, still differed significantly from those of the normothermic control group. MLS-BAER variables did not reach normal values until day 15. Ⅲ latency, Ⅰ-Ⅲ interval and Ⅰ-Ⅴ interval were significantly reduced in the hypothermia-treated group between 60 and 7 days after HI compared with the HI group (P<0.05). V latency and Ⅲ-Ⅴ interval in the hypothermia-treated group were also reduced compared with the HI group between 72 hours and 7 days after HI (P<0.05). CONCLUSIONS: Both peripheral and central auditory systems are disturbed by HI, which shows as a significant increase in MLS-BAER variables (all latencies and intervals) in newborn piglets. Involement in central brainstem auditory system reaches a peak on day 7 after injury. MLS-BAER variables still cannot reach to normal values until day 15. Selective moderate head cooling therapy can significantly reduce brainstem damage induced by HI.
2013 Vol. 15 (6): 484-489 [Abstract] ( 4167 ) [HTML KB] [PDF 1283KB] ( 676 )
490 JIN Zhen-Ai, ZHAO Yi-Kun, JIN Zheng-Yong, QI Hai-Feng, Mokhles Wali Gul, GONG Ming-Hua
Effect of insulin-like growth factor-1 on hyperoxia-induced apoptosis in A549 cells
OBJECTIVE: To investigate the effect of insulin-like growth factor-1 (IGF-1), which can promote cell differentiation and inhibit cell apoptosis, on hyperoxia-induced apoptosis in A549 cells and its anti-apoptotic mechanism. METHODS: A549 cells were sub-cultured, exposed to hyperoxic conditions and were then treated with different concentrations of IGF-1 (1, 10, and 100 ng/mL) for 48 hours. Cell viability was measured by MTT assay. Cell apoptosis was evaluated by Annexin V-FITC/PI double-staining flow cytometry. Expression levels of Bax and Bcl-2 were measured by flow cytometry. RESULTS: The middle-dose and high-dose IGF-1 intervention groups had higher cell viabilities than the hyperoxic exposure group ［(64±3）% and (88±4)% vs (51±3)%; P<0.05］. Compared with the air control group, the hyperoxic exposure group had a significantly higher apoptotic rate ［(38.3±5.4)% vs (2.4±0.9）%; P<0.05］, a significantly lower expression level of Bcl-2 ［(72±5)% vs (91±4)%; P<0.05］, and a significantly higher expression level of Bax ［(54±6)% vs (3±2)%; P<0.05］. Compared with the hyperoxic exposure group, the low-dose, middle-dose, and high-dose IGF-1 intervention groups had significantly lower apoptotic rates ［(16.1±4.7)%, (9.2±2.8)%, and (6.9±2.5)% vs (38.3±5.4)%; P<0.05］, significantly higher expression level of Bcl-2 ［(79±4)%, (94±4)%, and (100±5)% vs (72±5)%; P<0.05］, and significantly lower expression level of Bax ［(26±4)%, (5±2)%, and (4±2)% vs (54±6)%; P<0.05］. CONCLUSIONS: Hyperoxia significantly inhibits proliferation and promotes apoptosis in A549 cells. IGF-1 may promote cell proliferation and inhibit hyperoxia-induced apoptosis in A549 cells by regulating the expression of Bcl-2 and Bax.
2013 Vol. 15 (6): 490-493 [Abstract] ( 4414 ) [HTML KB] [PDF 1025KB] ( 683 )
CASE REPORT
494 XIONG Mei, NI Chen
One case of pediatric multiple sclerosis with convulsions as initial symptoms
No abstract available
2013 Vol. 15 (6): 494-495 [Abstract] ( 3553 ) [HTML KB] [PDF 1109KB] ( 818 )
REVIEW
496 WANG Ya-Mei,TAO Yu-Hong
Mechanical ventilation in acute respiratory distress syndrome
The goal of mechanically ventilating patients with acute respiratory distress syndrome (ARDS) is to ensure adequate oxygenation and minimal ventilator-associated lung injury. Non-invasive ventilation should be cautiously used in patients with ARDS. Protective ARDS mechanical ventilation strategies with low tidal volumes can reduce mortality. Driving pressure is the most reasonable parameter to optimize tidal volume. Available evidence does not support the routine use of higher positive end expiratory pressure (PEEP) in patients with ARDS. The optimal level of PEEP may be titrated by the inflection point obtained from static pressure-volume curve. Promising therapies include prone position ventilation, high frequency oscillatory ventilation and extracorporeal membrane oxygenation as salvage treatment. While mechanically ventilating, it is also important for ARDS patients to maintain spontaneous breathing via assisted ventilation mode such as bilevel positive airway pressure, pressure support ventilation and neurally adjusted ventilation assist. Exogenous surfactant, inhaled nitric oxide, bronchodilators, airway pressure release ventilation and partial liquid ventilation are not recommended therapies.
2013 Vol. 15 (6): 496-500 [Abstract] ( 7795 ) [HTML KB] [PDF 1064KB] ( 2914 )
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