Chinese Journal Of Contemporary Pediatrics

CJCP

	中文版
	English Version

	2013 Vol. 15 No. 11
	Published: 2013-11-15


	EXPERT LECTURE TOPIC OF GENETIC DISEASE CLINICAL RESEARCH EXPERIMENTAL RESEARCH CLINICAL EXPERIENCE CASE REPORT REVIEW

EXPERT LECTURE

	923	MA Hong-Wei
		Rickets-like genetic diseases ^Hot!
		This paper summarizes the clinical features, causative genes and treatment progress of patients with rickets-like genetic diseases, including X-linked hypophosphatemic rickets (XLH), hypophosphatasia, achondroplasia, vitamin D-dependent rickets, pycnodysostosis and ectodermal dysplasia, who visited the pediatric or child health clinic due to the symptoms of rickets, including bow legs, delayed closure of the anterior fontanelle, and sparse hair. Children with XLH usually go to hospital for bow legs and short stature, and biochemical evaluation reveals significantly low serum phosphorus so it is easily diagnosed. This disease is treated using phosphate mixture and 1,25(OH)2D3, which is different from the treatment of nutritional vitamin D deficiency rickets. Hypophosphatasia is characterized by a significant decrease in serum alkaline phosphatase, as well as normal serum calcium and phosphorus. The disease is caused by mutations in TNSALP gene. Patients with achondroplasia show short-limbed dwarfism and special face in addition to bow legs, but with normal serum calcium, phosphorus and alkaline phosphatase. Bone X-ray and FGFR3 gene test contribute to the diagnosis. Vitamin D-dependent rickets is an autosomal recessive disease, and active vitamin D supplement is effective in treatment of the disease. Patients with pycnodysostosis may be first seen at hospital because of large anterior fontanelle; in addition, they also show obtuse mandibular angle, dental abnormalities and dysplastic nails, which are caused by mutations in TSK gene. Children with ectodermal dysplasia may see a doctor for sparse hair, and they are easily misdiagnosed with nutritional vitamin D deficiency rickets. Ectodermal dysplasia is related to EDA, EDAR, EDARADD and WNT 10A genes.
		2013 Vol. 15 (11): 923-927 [Abstract] ( 5830 ) [HTML KB] [PDF 794KB] ( 1820 )

TOPIC OF GENETIC DISEASE

	928	SONG Ying, MA Hong-Wei, LI Fang, HU Man, REN Shuang, YU Ya-Fen, ZHAO Gui-Jie
		Gene mutation analysis of X-linked hypophosphatemic rickets
		To investigate the frequency and type of PHEX gene mutations in children with X-linked hypophosphatemic rickets (XLH), the possible presence of mutational hot spots, and the relationship between genotype and clinical phenotype. Methods Clinical data of 10 children with XLH was retrospectively reviewed. The relationship between gene mutation type and severity of XLH was evaluated. Results PHEX gene mutations were detected in all 10 children with XLH, including 6 cases of missense mutation, 2 cases of splice site mutation, 1 case of frameshift mutation, and 1 case of nonsense mutation. Two new mutations, c.2048T>C and IVS14+1delAG, were found. The type of PHEX gene mutation was not associated with the degree of short stature and leg deformity (P=0.571 and 0.467), and the mutation site was also not associated with the degree of short stature and leg deformity (P=0.400 and 1.000). Conclusions Missense mutation is the most common type of PHEX gene mutation in children with XLH, and c.2048T>C and IVS14+1delAG are two new PHEX gene mutations. The type and site of PHEX gene mutation are not associated with the severity of XLH.
		2013 Vol. 15 (11): 928-931 [Abstract] ( 4689 ) [HTML KB] [PDF 833KB] ( 1078 )

	932	LI Fang, MA Hong-Wei, SONG Ying, HU Man, REN Shuang, YU Ya-Fen, ZHAO Gui-Jie
		Clinical analysis and genetic diagnosis of short-limb inherited short stature diseases in children
		OBJECTIVE: To analyze the clinical manifestations, bone X-ray findings and genetic analysis results of three short-limb inherited short stature diseases: achondroplasia (ACH), hypochondroplasia (HCH) and pseudoachondroplasia (PSACH). METHODS: The clinical manifestations, bone X-ray findings, and genetic analysis results of 10 children with genetically confirmed short-limb inherited short stature diseases, including 4 cases of ACH 3 cases of HCH, and 3 cases of PSACH, were analyzed. RESULTS: The 10 patients had a mean body height of -3.69±1.79?SD, a mean sitting height/standing height ratio of 0.65±0.03, and a mean finger spacing/body height ratio of 0.93±0.04. Four ACH cases and 3 PSACH cases showed typical bone X-ray findings; one HCH case showed a smaller sciatic notch, and another HCH case showed no widening of interpedicular distance. G380R mutation in FGFR3 gene was detected in 3 of 4 ACH cases, and Y278C mutation in the other ACH case, N540K mutation in FGFR3 gene was detected in 3 HCH cases, and heterozygous mutations in COMP gene were detected in 3 PSACH cases. CONCLUSIONS: Children with ACH and PSACH have severer short stature and skeletal deformities than children with HCH, who have mild, atypical clinical manifestations. Bone X-ray and genetic analysis are helpful for the diagnosis and differential diagnosis of the three diseases. The mutational hotspots in two genes are involved in the three diseases, which is conducive to clinical genetic diagnosis.
		2013 Vol. 15 (11): 932-936 [Abstract] ( 5221 ) [HTML KB] [PDF 1855KB] ( 1208 )

	937	LU Chun-Ting, GUO Li, ZAHNG Zhan-Hui, LIN Wei-Xia, SONG Yuan-Zong, FENG Lie
		Clinical features and COMP gene mutation in a family with a pseudoachondroplasia child
		This study aimed to report the clinical characteristics and COMP gene mutation of a family with pseudoachondroplasia (PSACH), a relatively rare spinal and epiphyseal dysplasia that is inherited as an autosomal dominant trait. Clinical information on a 5-year-2-month-old PSACH child and his parents was collected and analyzed. Diagnosis was confirmed by PCR amplification and direct sequencing of all the 19 exons and their flanking sequences of COMP gene, and the mutation was further ascertained by cloning analysis of exon 10. The child presented with short and stubby fingers, bow leg, short limb dwarfism and metaphysic broadening in long bone as well as lumbar lordosis. A mutation c.1048_1116del (p.Asn350_Asp372del) in exon 10, inherited from his father who did not demonstrate any phenotypic feature of PSACH, was detected in the child. PSACH was diagnosed definitively by means of COMP mutation analysis, on the basis of the child's clinical and imaging features. The non-penetrance phenomenon of COMP mutation was described for the first time in PSACH
		2013 Vol. 15 (11): 937-941 [Abstract] ( 5851 ) [HTML KB] [PDF 2860KB] ( 1224 )

	942	LIN Xiao-Mei, WU Ben-Qing, HUANG Jin-Jie, LI Bo, FAN Yi, LIN Lin-Hua, YAO Qiu-Xuan, WU Wen-Yuan, YU Lian
		Analysis of CYP21A2 gene mutation in one case of congenital adrenal hyperplasia
		CYP21A2 gene mutations in a child with congenital adrenal hyperplasia (CAH), and the child's parents, were detected in the study. The clinical features, treatment monitoring and molecular genetic mechanism of CAH are reviewed. In the study, DNA was extracted from peripheral blood samples using the QIAGEN Blood DNA Mini Kit; a highly specific PCR primer for CYP21A2 gene was designed according to the sequence difference between CYP2lA2 gene and its pseudogene; the whole CYP2lA2 gene was amplified with PrimeSTAR DNA polymerase (Takara), and the amplification product was directly sequenced to detect and analyze CYP2lA2 gene mutation. The child was clinically diagnosed with CAH (21-hydroxylase deficiency, 21-OHD) at the age of 36 days, and the case was confirmed by genetic diagnosis at the age of 1.5 years. The proband had a homozygous mutation at c.293-13C in the second intron of CYP21 gene, while the parents had heterozygous mutations. Early diagnosis and standard treatment of CAH (21-OHD) should be performed to prevent salt-wasting crisis and reduce mortality; bone aging should be avoided to increase final adult height (FAH), and reproductive dysfunction due to oligospermia in adulthood should be avoided. These factors are helpful for improving prognosis and increasing FAH. Investigating the molecular genetic mechanism of CAH can improve recognition and optimize diagnosis of this disease. In addition, carrier diagnosis and genetic counseling for the proband family are of great significance.
		2013 Vol. 15 (11): 942-947 [Abstract] ( 6597 ) [HTML KB] [PDF 1471KB] ( 1830 )

	948	DU Kan, LUAN Zuo, QU Su-Qing, YANG Hui, YANG Yin-Xiang, WANG Zhao-Yan, JIN Hui-Yu, LIU Wei-Peng
		Clinical effect of stem cell transplantation via hepatic artery in the treatment of type II hyperammonemia: a report on 6 cases
		This study aimed to investigate the clinical effect of transplantation of CD133+ peripheral blood stem cells or umbilical cord mesenchymal stem cells via the hepatic artery in children with type II hyperammonemia and its possible action mechanism. Umbilical cord mesenchymal stem cells were obtained by collecting cord blood (100-150 mL) from healthy fetuses and separating stem cell suspension (5 mL) from the cord blood by hydroxyethyl starch sedimentation. CD133+ peripheral blood stem cells were obtained by mobilizing peripheral blood from the fathers of sick children using recombinant human granulocyte colony-stimulating factor for 5 days, collecting mononuclear cells (120 mL), and separating out CD133+ cells by sorting. With catheterization and percutaneous puncture, the obtained stem cells were slowly injected into the liver of sick children via the hepatic artery. The changes in clinical symptoms and laboratory indices such as blood ammonia, liver function, and arginine and citrulline concentrations were observed. After stem cell transplantation via the hepatic artery, the 6 children showed significantly decreased blood ammonia levels, and their blood ammonia levels slowly increased 1 to 2 weeks later, but remained below 100 μmol/L, and changes in glutamic-pyruvic transaminase levels were similar to blood ammonia. Plasma citrulline and arginine concentrations increased significantly after transplantation and the increase in citrulline level exceeded the increase in arginine level. An 8 months follow-up visit for one typical patient showed that the weight and height increased after transplantation and sleep was improved without night crying. The child could actively gaze at interesting objects instead of responding indifferently and started to say simple words. With regard to fine motor skills, the child could pinch things with the thumb and middle finger instead of displaying a lack of hand-eye coordination and progress was also made in gross motor skills. Gesell test showed that the child made progress for an average of 3.82 months in all areas. It was concluded that after stem cell transplantation, children with type II hyperammonemia have decreased blood ammonia levels, stable and improved liver function and steadily increased plasma citrulline and arginine concentrations. They display a progressive trend in such aspects as movement, language and environmental adaptability. It is hypothesized that stem cell transplantation via the hepatic artery partially or totally activates, or provides supplementary ornithine carbamoyl transferase, so that plasma citrulline and arginine concentrations increase and urea cycle disorder can be corrected to some extent.
		2013 Vol. 15 (11): 948-953 [Abstract] ( 4628 ) [HTML KB] [PDF 1352KB] ( 837 )

	954	WU Tong-Fei, YANG Yan-Ling
		Advances in clinical and molecular genetics studies on argininemia
		Argininemia is a rare, autosomal recessive, metabolic disorder caused by an hereditary deficiency of hepatocytes arginase due to ARG1 gene defect. Arginase is the final enzyme in the urea cycle, catalyzing the hydrolysis of arginine to ornithine and urea. Research advances in the clinical manifestations, diagnosis, treatment, prenatal diagnosis and genetics of argininemia were reviewed in this paper. The clinical manifestations of patients with argininemia are complicated and nonspecific so that clinical diagnosis is usually difficult and delayed. Progressive spastic tetraplegia, seizures and cerebella atrophy are common clinical features of the disease. Blood amino acids analysis, arginase assay and ARG1 gene analysis are important to the diagnosis of argininemia. Early diagnosis and a protein-restricted diet with citrulline and benzoate supplements can contribute a lot to improve patient prognosis. With the application of liquid chromatography-tandem mass spectrometry in selective screening and newborn screening for inborn errors of metabolism, an ever-increasing number of patients with argininemia are detected at the asymptomatic or early stages.
		2013 Vol. 15 (11): 954-959 [Abstract] ( 5734 ) [HTML KB] [PDF 1309KB] ( 2129 )

	960	YANG Lin, WANG Hui-Jun, HUANG Guo-Ying, ZHOU Wen-Hao
		Advanced molecular technologies for the diagnosis of congenital malformation in neonates
		Congenital malformation is one of the most frequent causes of infant death in western countries and major cities in China. Though genetic screening of newborns remains a hot issue and concern, the mortality rate associated with birth defects has not been significantly reduced over the past 20 years. Many genetic diseases manifest symptoms during the first 28 days of life, but full clinical symptoms might not be evident in newborns. Moreover, genetic aberrations is highly heterogeneous. These complicated factors lead to the establishment of diagnosis based on nonspecific or obscure symptoms. Recently developed array comparative genomic hybridization (CGH) and next generation sequencing (NGS) techniques with efficient high-resolution allow to screening of the entire genome for DNA copy number variants and sequencing respectively. These new and powerful tools can shorten the differential diagnosis process and quicken to movement towards targeted treatment and genetic and prognostic counseling.
		2013 Vol. 15 (11): 960-964 [Abstract] ( 4575 ) [HTML KB] [PDF 1254KB] ( 1181 )

	965	LV Xi-Qian, HU Jian
		Research advances in molecular genetics and treatment of familial hemophagocytic lymphohistiocytosis
		Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome characterized by pancytopenia and multiple organ infiltrations of lymphocytes and histiocytes with proliferation and hemohpagocytic activity. HLH is classified as primary (or familial) and secondary. Familial HLH is common in infants and young children, and is related to genetic defects. This article aims to review research advances on PRF1, UNC13D, STX11 and STXBP2, as well as the other 5 genes associated with familial HLH based on molecular genetics, and to summarize diagnosis and treatment methods for this disease.
		2013 Vol. 15 (11): 965-969 [Abstract] ( 4677 ) [HTML KB] [PDF 1290KB] ( 1471 )

	970	WEN Xian-Hao, XIAO Jian-Wen, YU Jie, XIAN Ying, GUAN Xian-Min, GUO Yu-Xia
		Pediatric Shwachman-diamond syndrome: report on 5 cases and literature review
		No abstract available
		2013 Vol. 15 (11): 970-974 [Abstract] ( 4327 ) [HTML KB] [PDF 1742KB] ( 1603 )

	975	CHENG Sheng-Quan, CAO Yu-Hong, ZHANG Jin-Song, QIANG Huan
		A case report of Rare Bardet-Biedl syndrome
		No abstract available
		2013 Vol. 15 (11): 975-976 [Abstract] ( 3400 ) [HTML KB] [PDF 1176KB] ( 899 )

	977	ZHANG Yi-Ning, DU Hong-Wei, LI Xu
		A case report of Crouzon syndrome with short status
		No abstract available
		2013 Vol. 15 (11): 977-978 [Abstract] ( 3406 ) [HTML KB] [PDF 1567KB] ( 727 )

CLINICAL RESEARCH

	979	WANG Fang, WANG Min, CHEN Chun-Bao, CAI Zheng-Wei, WEN Dan-Dan, CHEN Feng-Yi, FU Shu-Fang, LI Ming, LI Mei-Rong, LIU Ming-Yun, XIANG Fen
		Epidemiological analysis of childhood asthma in Yichang City, China
		OBJECTIVE: To study the prevalence, epidemiological characteristics, and risk factors for childhood asthma in Yichang City, China and to collect evidence for the early diagnosis and preventive treatment of asthma. METHODS: Preliminary screening questionnaires were distributed to more than 90% of children in 5 kindergartens, 10 primary and secondary schools, and 5 communities in Yichang City to detect children with suspected asthma. These surveyed children were selected by cluster random sampling. A further questionnaire survey was conducted for suspected cases. Meanwhile, a similar number of sex- and age-matched non-asthmatic children were selected for the case-control study. Information from returned questionnaires was entered into a database for statistical analysis. RESULTS: A total of 11?000 questionnaires were distributed, and 10?456 (95.1%) questionnaires were returned. The prevalence rate of asthma among children in Yichang was 3.47%, significantly higher in boys than in girls (P<0.05). A total of 107 out of 363 children with asthma had a history of drug allergy, and 152 cases had a family history of allergy. The majority of asthmatic children had irregular onset-prone seasons and hours. Respiratory tract infections were the most common trigger of asthma attacks, accounting for 93.1% of all onsets; family history of allergy, history of early use of antibiotics, history of housing renovation, and history of passive smoking were the major risk factors for asthma. CONCLUSIONS: Prevention of respiratory tract infections may reduce the frequency of asthma attacks; reducing the use of antibiotics during early childhood, decreasing the frequency of housing renovation, and advocating for smoking cessation among parents have preventive effects on asthma.
		2013 Vol. 15 (11): 979-982 [Abstract] ( 5475 ) [HTML KB] [PDF 1302KB] ( 800 )

	983	YE Ze-Hui, HUANG Ying, WANG Ying, WANG Dong-Juan
		Association between body mass index and lung function in children with asthma after corticosteroids inhalation
		OBJECTIVE: To study the association between body mass index (BMI) and lung function of asthmatic children after inhaling corticosteroids (ICS). METHODS: One hundred and fifty-seven children with asthma were classified into obese (46 cases), over-weight (50 cases) and normal-weight groups (61 cases) based on BMI. All of the children received ICS for one year. Pulmonary functions were evaluated before and after treatment. Large airway function includes forced expiratory volume in one second (FEV1%) and forced vital capacity (FVC%). Small airway function includes maximal expiratory flow 25 (MEF25%) and maximal expiratory flow 50 (MEF50%). RESULTS: The bronchial provocation test before treatment showed that the decline rate of pulmonary function (FVC%, FEV1%, MEF25% and MEF50%) in the obese group was higher than the normal-weight group after methacholine inhalation. After salbutamol inhalation, the improvement rate of the large airway (FVC%) and small airway (MEF25% and MEF50%) functions in the obese group was lower than the normal-weight group, and the improvement rate of small airway (MEF25% and MEF50%) function in the over-weight group was lower than in the normal-weight group. After treatment with ICS for one year, large airway function (FVC% and FEV1%) in the normal-weight group was higher than pre-treatment, however only FVC% in the normal-weight and obese groups was higher than pre-treatment. There was no significant difference in small airway function before and after treatment in all three groups. CONCLUSIONS: Obesity can increase the sensitivity to methacholine and restrain the sensitivity to tosalbutamol in children with asthma. ICS can improve the large airway function in asthmatic children with normal body weight, but has no effect on small airway function. Obesity can restrain the effect of ICS on asthmatic children.
		2013 Vol. 15 (11): 983-986 [Abstract] ( 4320 ) [HTML KB] [PDF 1315KB] ( 835 )

	987	YAO Huan-Yin, WANG Wei, ZHANG Pei-Hong, WANG Xiao-Xian, LIU Shu-Mei, CHEN Xiao-Hong
		Determination and clinical significance of serum surfactant proteins A and D in children with bronchiolitis
		OBJECTIVE: To study the variation and clinical significance of serum levels of surfactant proteins A (SP-A) and D (SP-D) among children with different degrees of bronchiolitis. METHODS: Seventy children with bronchiolitis were divided into acute (n=42) and recovery phase groups (n=28). According to the severity of symptoms, the acute phase group was further divided into severe (n=12) and mild subgroups (n=30). Another 26 children who were hospitalized in the same period due to non-infectious diseases and had not undergone surgery were used as the control group. Competitive enzyme-linked immunosorbent assay was performed to measure serum levels of SP-A and SP-D in each group. RESULTS: The acute phase group had significantly higher serum levels of SP-A and SP-D compared with the recovery phase (P<0.01) and control groups (P<0.01). Compared with the control group, the recovery phase group had elevated levels of SP-A and SP-D (P<0.01). Within the acute phase group, serum levels of SP-A and SP-D in the severe subgroup were significantly higher than in the mild subgroup (P<0.01). CONCLUSIONS: Serum levels of SP-A and SP-D are significantly elevated in children with acute bronchiolitis, and severe cases have higher serum levels of SP-A and SP-D than mild cases. Even after the relief of clinical symptoms, serum levels of SP-A and SP-D remain high. These findings suggest that serum levels of SP-A and SP-D might be useful biomarkers for evaluating the severity of bronchiolitis among children.
		2013 Vol. 15 (11): 987-989 [Abstract] ( 4298 ) [HTML KB] [PDF 1238KB] ( 878 )

	990	HUA Jun, DU Xiao-Chen, LI Ying, XIE Min-Hui, ZHANG Xue-Lan, DING Yun-Fang, HAO Chuang-Li, JI Wei
		Comparison of clinical features and co-infection between pneumonia caused by influenza virus A and pneumonia caused by influenza virus B among children
		OBJECTIVE: To compare the clinical features and co-infection between pneumonia caused by influenza virus A (IVA) and pneumonia caused by influenza virus B (IVB) among children. METHODS: A total of 165 children with pneumonia caused by influenza virus (IV) were included in the study. These subjects were divided into IVA(n=71) and IVB pneumonia groups (n=94) according to the subtypes of IV. The IVA pneumonia group was further divided into simple infection (n=14) and co-infection subgroups (n=57), and the IVB pneumonia group was also further divided into simple infection (n=27) and co-infection subgroups (n=67). Co-infection rate and pathogen spectrum were analysed in children with IV pneumonia. RESULTS: The IVB pneumonia group had significantly increased mean age of onset and significantly prolonged mean duration of fever compared with the IVA pneumonia group (P<0.05). Co-infection rate among children with IV pneumonia was 75.2%, who were co-infected with bacteria (44.2%), Mycoplasma pneumoniae (MP, 21.8%) and other viruses (45.5%). Respiratory syncytial virus (RSV) was most common in children co-infected viruses (89% ). The rate of co-infection with RSV was significantly higher in the IVA pneumonia group than in the IVB pneumonia group. There were no significant differences in age, length of hospital stay, duration of fever, percentage of neutrophils, prealbumin, C-reactive protein, alanine aminotransferase, and creatine kinase-MB between the simple infection and co-infection subgroups of each group. CONCLUSIONS: Children with IVB pneumonia have prolonged duration of fever and increased age of onset compared with those with IVA pneumonia. Co-infection rate is high among children with IV pneumonia, who may be co-infected with bacteria, viruses and MP. Co-infection with RSV is more common in children with IVA pneumonia. It is difficult to identify the presense of co-infection using clinical indices.
		2013 Vol. 15 (11): 990-994 [Abstract] ( 5467 ) [HTML KB] [PDF 1419KB] ( 1313 )

	995	SU Xiao-Yan, WEN Shun-Hang, LIN Li, LI Chang-Chong
		Clinical characteristics of children with Streptococcus pneumoniae septicemia and drug sensitivity of Streptococcus pneumoniae
		OBJECTIVE: To study the clinical characteristics of children who suffered from Streptococcus pneumoniae (SP) septicemia and the drug sensitivity of SP strains. METHODS: A retrospective analysis was performed on the clinical data of 25 children with SP septicemia between January 2009 and December 2012. RESULTS: Of the 25 cases, 16 (64%) were aged under 2 years, 5 (20%) were aged 2-5 years, and 4 (16%) were aged over 5 years. Fourteen cases (56%) were complicated by infection of other organs, and 5 cases (20%) had underlying chronic diseases. Fever was the most common clinical manifestation, and the majority presented with remittent fever. Eight patients with pneumonia or pyothorax had pulmonary symptoms. Five patients with purulent meningitis had neurological symptoms, five cases had hepatosplenomegaly and two cases had septic shock. Nineteen cases (76%, 19/25) had significantly elevated white blood cell (WBC) counts, twenty-one cases (84%, 21/25) had significantly elevated serum C-reactive protein (CRP) levels, and eight cases (50%, 8/16) had significantly elevated serum procalcitonin (PCT) levels. The drug sensitivity analysis showed that invasive SP had high resistance rates to penicillin (96%), clindamycin hydrochloride (88%) and erythromycin (84%), and it was completely sensitive to imipenem, vancomycin, levofloxacin and linezolid. The multi-drug resistance rate of invasive SP was up to 88%. Twenty-three cases (92%) were cured or improved after active treatment. CONCLUSIONS: SP septicemia is commonly seen in children aged under 2 years. The most common clinical manifestation is fever, accompanied by elevated WBC count, CRP level and PCT level, and it is usually complicated by pulmonary or brain infection. Resistance to multiple antibiotics is very common in SP strains, so it is important to properly use antibiotics according to drug sensitivity test results. Patients who receive active treatment have a good clinical outcome.
		2013 Vol. 15 (11): 995-999 [Abstract] ( 4903 ) [HTML KB] [PDF 1470KB] ( 1070 )

	1000	XIE Yong-Mei, GAO Shan, WANG Li-Yuan, WANG Zhi-Ling
		Therapeutic effect of probiotics and oral IgY as supplementary drugs in the treatment of pediatric rotavirus enteritis: a comparative study
		OBJECTIVE: To compare the therapeutic effect of probiotics and oral immunoglobulin on pediatric rotavirus enteritis. METHODS: A randomized, controlled trial was conducted in 150 children with rotavirus enteritis who were randomly divided into control, probiotic and immunoglobulin groups (n=50 each). In addition to basic treatment, the control group was given placebo, the probiotic group was given live combined bifidobacterium and lactobacillus tablets, and the immunoglobulin group was orally given anti-rotavirus egg yolk immunoglobulin (IgY). Clinical symptoms such as stool frequency and stool properties were recorded every day. Fresh stool samples were collected on days 1, 3, 5, 7, 9 and 11 of treatment. Intestinal flora imbalance was detected and divided into three degrees by microscopic examination of stool. Fecal SIgA level and fecal rotavirus shedding were measured by radioimmunoassay and double-antibody sandwich ELISA respectively. RESULTS: Compared with the control group, the probiotic group had reduced intestinal flora imbalance, decreased stool frequency, and reduced incidence of secondary intestinal bacterial infection after 3 days of treatment (P<0.05). There was no significant difference in disease course between the probiotic and control groups. Compared with the control group, the immunoglobulin group had a significantly increased fecal SIgA level after 1 day of treatment (P<0.05), significantly decreased frequency of diarrhea and fecal rotavirus shedding after 3 days of treatment (P<0.05), and a significantly shorter disease course (4.5±1.0 vs 5.8±1.7 days; P<0.05). CONCLUSIONS: For children with rotavirus enteritis, probiotics can reduce intestinal flora imbalance and prevent secondary intestinal bacterial infection, but probiotics take a long time to relieve clinical symptoms and cannot shorten the course of disease. Oral immunoglobulin takes effect quickly and can rapidly eliminate rotavirus, promote the production of SIgA, and shorten the course of disease.
		2013 Vol. 15 (11): 1000-1005 [Abstract] ( 5004 ) [HTML KB] [PDF 1520KB] ( 1480 )

	1006	LUO You-You, SHU Xiao-Li, ZHAO Hong, YU Jin-Dan, MA Ming, CHEN Jie
		Association between vitamin D receptor gene polymorphisms and pediatric Crohn's disease in China: a study based on gene sequencing
		OBJECTIVE: To investigate the association between TaqI, BsmI, and ApaI polymorphisms of vitamin D receptor (VDR) gene and pediatric Crohn's disease (CD) in China. METHODS: Nineteen children with CD were selected as a case group, and 122 healthy children who underwent physical examination were selected as a control group. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured using ELISA. The TaqI, BsmI, and ApaI polymorphisms of VDR gene were determined by gene sequencing, and the two groups were compared in terms of genotype and allele frequencies. RESULTS: The case group had significantly lower serum 25(OH)D3 levels than the control group (17.3±2.4 ng/mL vs 26.9±2.1 ng/mL; P<0.05). There were no significant differences in the frequencies of genotypes and alleles of TaqI, BsmI, and ApaI polymorphisms between the case and control groups (P>0.05). CONCLUSIONS: Children with CD have low serum 25(OH)D3 levels. TaqI, BsmI, and ApaI polymorphisms of VDR gene may not be associated with susceptibility to CD among the Chinese population.
		2013 Vol. 15 (11): 1006-1008 [Abstract] ( 4657 ) [HTML KB] [PDF 1291KB] ( 793 )

	1009	RU Liang, Abulaiti Abudouhaer, GUO Yan-Fang
		Clinical significance of serum levels of IGF-1 and IGFBP-3 in children with Henoch-Schonlein purpura or Henoch-Schonlein purpura nephritis
		OBJECTIVE: To study the clinical significance of serum levels of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) in children with Henoch-Schonlein purpura (HSP) or Henoch-Schonlein purpura nephritis (HSPN). METHODS: Thirty-one children with HSP were selected as the HSP group, and 28 children with HSPN were selected as the HSPN group. Another 31 healthy children were selected as the control group. ELISA was used to measure serum levels of IGF-1 and IGFBP-3 in each group. Measurement of 24-hour urinary protein excretion was performed using an automatic biochemical analyzer in the HSPN group. Serum immunoglobulin (Ig) levels, complement C3 level and complete blood counts in each group were determined, and urine analysis was also performed. RESULTS: Serum levels of IGF-1 and IGFBP-3 in the HSP group were significantly higher than in the control group (P<0.05), and serum levels of IGF-1 and IGFBP-3 in the HSPN group were significantly higher than in the HSP and control groups (P<0.05). Among 12 children who underwent renal puncture biopsy, patients with higher pathological grades had higher serum levels of IGF-1 and IGFBP-3. In children with HSPN, those with proteinuria had significantly higher serum levels of IGF-1 and IGFBP-3 than those without proteinuria (P<0.05). Levels of white cells, red cells, platelet count, complement C3, IgG, and IgA and IgA/C3 ratio were significantly higher in the HSP and HSPN groups than in the control group (P<0.05). CONCLUSIONS: Increased serum levels of IGF-1 and IGFBP-3 are observed in the acute onset period of HSP, which may be related to the degree of proteinuria and renal damage. Serum levels of IGF-1 and IGFBP-3 may be indicators of renal involvement
		2013 Vol. 15 (11): 1009-1013 [Abstract] ( 4223 ) [HTML KB] [PDF 1541KB] ( 953 )

	1014	WEI Li, LU Yong-Yi, QIAO Li-Na, HUA Yi-Min, WANG Yi-Bin, WANG Xiao, LI Xin-Hui
		Significance of Tp-Te interval for risk stratification of ventricular premature contractions in children
		OBJECTIVE: To investigate the significance of Tp-Te interval for risk stratification of ventricular premature contractions (VPC) in children. METHODS: A total of 120 children with VPC were divided into benign VPC (n=40), organic disease (n=40) and ventricular parasystole groups (n=40) according to the etiology of VPC; another 40 children who underwent physical examination were selected as the normal control group. The four groups were compared in terms of Tp-Te intervals and Tp-Te/QT ratios in leads V3, V4 and V5. RESULTS: The Tp-Te interval in lead V3 was significantly longer in the organic disease group than in the other groups (P<0.05), the benign VPC group had a significantly shorter Tp-Te interval in lead V4 than the normal control and organic disease groups (P<0.05), and the organic disease group had a significantly longer Tp-Te interval in lead V5 than the benign VPC group (P<0.05). The Tp-Te/QT ratios in leads V3-V5 were significantly higher in the organic disease group than in the other groups (P<0.05). The Tp-Te/QT ratios in leads V4 and V5 showed significant differences between the ventricular parasystole and benign VPC groups (P<0.05). CONCLUSIONS: Tp-Te interval is susceptible to changes in heart rate, and it is of little value for the risk stratification of VPC in children. Tp-Te/QT ratio, however, may be used as an important non-invasive index for clinical risk stratification of VPC in children and is worthy of further study.
		2013 Vol. 15 (11): 1014-1017 [Abstract] ( 3990 ) [HTML KB] [PDF 1495KB] ( 757 )

EXPERIMENTAL RESEARCH

	1018	YAO Bin, LI Min, PANG Ying
		Effect of Mycobacterium phlei F.U.36 on balance of CD4⁺CD25⁺ regulatory T cells and Th17 cells in asthmatic mice
		OBJECTIVE: To evaluate the effect of early intervention with Mycobacterium phlei F.U.36 injection on the balance of CD4+CD25+ regulatory T cells and Th17 cells in asthmatic mice, and to investigate the immunomodulatory effect of Mycobacterium phlei F.U.36. METHODS: Thirty female BALB/c mice were randomly divided into three groups: normal control (n=10), asthma model (n=10) and Mycobacterium phlei F.U.36 treatment groups (n=10). A mouse model of asthma was prepared by injection and aerosol inhalation of chicken ovalbumin in the asthma model and Mycobacterium phlei F.U.36 treatment groups, while mice in the normal control group were given normal saline instead. The treatment group was intraperitoneally injected with Mycobacterium phlei F.U.36 (0.57 μg, once every other day) three times in the first two weeks after the first sensitization. All mice were sacrificed at 24 hours after the last challenge. Left lung tissues of these mice were obtained and made into sections for observation of inflammatory changes. The percentages of CD4⁺CD25⁺ regulatory T cells and Th17 cells in CD4⁺ T cells among splenic mononuclear cells were determined by flow cytometry. The levels of interleukin (IL)-10 and IL-17 in serum and bronchoalveolar lavage fluid were measured using ELISA. Results Compared with the normal control group, the asthma model group had significantly decreased percentages of CD4⁺CD25⁺ regulatory T cells and IL-10 levels (P<0.05) and significantly increased percentages of Th17 cells and IL-17 levels (P<0.05). Compared with the asthma model group, the Mycobacterium phlei F.U.36 treatment group had significantly increased percentages of CD4⁺CD25⁺ regulatory T cells and IL-10 levels (P<0.05) and significantly decreased percentage of Th17 cells and IL-17 levels (P<0.05). Conclusions Early intervention with Mycobacterium phlei F.U.36 can promote development of CD4⁺CD25⁺ regulatory T cells and production of IL-10 and inhibit generation of Th17 cells and production of IL-17 in asthmatic mice.
		2013 Vol. 15 (11): 1018-1022 [Abstract] ( 3986 ) [HTML KB] [PDF 2112KB] ( 829 )

	1023	LI De-Yuan, QU Yi, LI Jin-Hui, ZHANG Li, XIONG Tao, MU De-Zhi
		Role of the FOXO3a transcription factor in neuronal apoptosis in neonatal rats with hypoxic-ischemic brain damage
		OBJECTIVE: To explore the role and mechanisms of FOXO3a nuclear translocation in neuronal apoptosis after hypoxia-ischemia (HI). METHODS: One hundred and sixty 10-day-old Sprague-Dawly rats were randomly divided into two groups: HI and sham-operated. The right common carotid artery was ligated followed by hypoxia exposure for 2.5 hours in the HI group. The sham-operated group rats were not subjected to carotid artery ligation or hypoxia treatment. Rat cerebral cortex was collected at 0.5, 2, 4, 8 and 24 hours after hypoxia. Western blot was used to detect expression of total FOXO3a protein, pnuclear and cytoplasmic FOXO3a and Bim. TUNEL staining was used to detect apoptotic cells. RESULTS: The nuclear protein of FOXO3a obviously increased from 0.5 to 24 hours after HI in a time-dependent manner compared with the sham-operated group (P<0.01). On the contrary, cytoplasmic protein evidently decreased from 0.5 to 24 hours in the HI group compared with the sham-operated group (P<0.01). Bim protein increased from 0.5 hour, peaked at 2 hours, started to decline at 4 hours (P<0.01), and returned to baseline level at 8 and 24 hours after HI in the HI group compared with the sham-operated group. TUNEL positive cells started to express at 4 hours, and peaked at 24 hours after HI (P<0.01). However, TUNEL positive cells were rarely found in the sham-operated group. CONCLUSIONS: HI induces FOXO3a translocation from cytoplasm to nucleus, and enhances protein expression of its target gene Bim in the neonatal rat brain. The upregulation of Bim expression might be related to neuronal apoptosis
		2013 Vol. 15 (11): 1023-1027 [Abstract] ( 4581 ) [HTML KB] [PDF 1729KB] ( 855 )

CLINICAL EXPERIENCE

	1028	ZHANG Qin, LU Ling, GUO Qi, GUI Ming
		Gastrointestinal symptoms in children with Henoch-Schonlein purpura
		No abstract available
		2013 Vol. 15 (11): 1028-1030 [Abstract] ( 3853 ) [HTML KB] [PDF 1260KB] ( 1307 )

CASE REPORT

	1031	LIU Rui-Hai, QU Xian-Feng, LI Jing
		Intractable pulmonary edema and bulbar paralysis caused by severe hand-foot-mouth disease: a case report
		No abstract availavle
		2013 Vol. 15 (11): 1031-1032 [Abstract] ( 3040 ) [HTML KB] [PDF 1069KB] ( 647 )

REVIEW

	1033	TAN Xin-Rui, XIAO Yan-Feng
		Research advances on CIDEC in insulin resistance
		Childhood obesity has been rising dramatically in recent years and most patients are insulin resistant. Recent studies have indicated that cell death-inducing DFF45-like effector C (CIDEC) is responsible for the development of insulin resistance. CIDEC regulates adipogenesis, lipid storage and lipolysis, thus protecting insulin target tissues from lipotoxity. This paper reviews current findings on the structure and function of CIDEC, its transcriptional and post-translational regulations, and the underlying mechanism of CIDEC causing insulin resistance. As a novel lipid droplet protein, CIDEC may be a drug target for treatment of insulin resistance and relevant metabolic disorders.
		2013 Vol. 15 (11): 1033-1037 [Abstract] ( 3739 ) [HTML KB] [PDF 1507KB] ( 799 )

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