CJCP
  中文版
  English Version
 
 
2014 Vol.  16 No.  4
Published: 2014-04-15
EDITORIAL
ENVIRONMENT & RENAL INJURY
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CASE REPORT
EDITORIAL
317 YI Zhu-Wen
Environmental pollution and childhood renal injury Hot!
2014 Vol. 16 (4): 317-318 [Abstract] ( 3839 ) [HTML 1KB] [PDF 796KB] ( 1118 )
ENVIRONMENT & RENAL INJURY
319 XU Zhi-Quan, YI Zhu-Wen
Hazardous environmental factors causing renal damage in children
Hazardous environmental factors invade the body through multiple routes, including ingestion, inhalation and absorption by contact with the skin and mucous membrane. They are from various sources and soil, water, air, building and decorative materials, foods and daily necessities are the main carriers. According to their physical and chemical properties and morphological characteristics, these hazardous factors are classified as metals, inorganic matter, organic matter, radioactive substances, biological toxins, viruses, bacteria, mycoplasmas, chlamydiae and parasites. They cause diseases through blood and urine and also have kidney susceptibility. This article suggests that pediatricians should fully understand the characteristics and seriousness of hazardous environmental factors that cause renal damage, and pay attention to the prevention and control of these factors so as to minimize renal damage in children.
2014 Vol. 16 (4): 319-324 [Abstract] ( 5360 ) [HTML 1KB] [PDF 1135KB] ( 1800 )
325 RONG Li-Ping, XU Yuan-Yuan, JIANG Xiao-Yun
Heavy metal poisoning and renal injury in children
Along with global environmental pollution resulting from economic development, heavy metal poisoning in children has become an increasingly serious health problem in the world. It can lead to renal injury, which tends to be misdiagnosed due to the lack of obvious or specific early clinical manifestations in children. Early prevention, diagnosis and intervention are valuable for the recovery of renal function and children's good health and growth. This paper reviews the mechanism of renal injury caused by heavy metal poisoning in children, as well as the clinical manifestations, diagnosis, and prevention and treatment of renal injury caused by lead, mercury, cadmium, and chromium.
2014 Vol. 16 (4): 325-329 [Abstract] ( 7318 ) [HTML 1KB] [PDF 1124KB] ( 2051 )
330 MAO Hua-Xiong
Research progress in mechanisms of drug-induced nephrotoxicity
Drug-induced nephrotoxicity in children is dependent upon the histological, anatomical and physiological features of their kidneys and the structural and functional characteristics of drugs. The kidney is mainly composed of microvascular network and tubulointerstitial tissue, so drug-induced nephrotoxicity is usually manifested by interstitial nephropathy. The mechanisms of drug-induced nephrotoxicity include cytotoxicity (necrosis or apoptosis), ischemic injury, and immunological injury. Individual drugs cause renal damage by various mechanisms due to differences in chemical structure and pharmacology. This article reviews the main features of nephrotoxicity induced by common antibiotics (cephalosporins, aminoglycosides, vancomycin, carbapenems and amphotericin B), non-steroidal anti-inflammatory drugs, and cyclosporine A.
2014 Vol. 16 (4): 330-334 [Abstract] ( 7888 ) [HTML 1KB] [PDF 1134KB] ( 2428 )
335 LI Zhi-Hui
Children’s renal injury caused by food
Mushroom and fish bile toxins are the most representative toxins of food origin. According to the clinical manifestations, renal injury caused by mushroom toxins can be divided into early-, late-, and delayed-onset. Fish bile toxins mainly cause acute renal tubular necrosis and food contamination related to renal injury includes chemical and biological contamination. Urinary calculus and renal failure caused by "poisonous milk powder" is a typical, food-related chemical contamination event. E.coli contaminated cucumber caused hemolytic uremic syndrome in 3 493 people. Contamination of the food chain is spreading from land to sea and to sky. It requires the efforts of the whole society to prevent human food chain contamination.
2014 Vol. 16 (4): 335-338 [Abstract] ( 5410 ) [HTML 1KB] [PDF 1107KB] ( 1322 )
339 HEI Ming-Yan, YI Zhu-Wen
Environment and congenital urinary malformations
The development of the kidneys and other organs of the urinary tract follows the natural rule of gene–environment–lifestyle interaction. Both intrinsic and extrinsic factors may be associated with the etiology of various kinds of urinary malformations, but the environmental factor is an extrinsic factor. Related literatures were reviewed in this paper, which focuses on the association of congenital urinary malformations with possible environmental factors. It is concluded that urinary malformation is associated with low birth weight, maternal disease, placental insufficiency, maternal drug exposure, and maternal exposure to environmental pesticides. Living environment and socioeconomic factors may also influence the incidence of urinary malformation.
2014 Vol. 16 (4): 339-344 [Abstract] ( 5508 ) [HTML 1KB] [PDF 1223KB] ( 1311 )
345 WU Xiao-Chuan
Recognizing pediatric acute kidney injury
Acute kidney injury (AKI) is characterized by a reversible increase in blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. AKI in hospitalized patients is independently associated with increased morbidity and mortality in pediatric and adult populations. Continued reliance on serum creatinine and urine output for the diagnosis of AKI has resulted in an inability to provide successful therapeutic and supportive interventions to prevent and mitigate AKI. Research efforts over the last decade have foused on the discovery and validation of novel biomarkers to detect AKI prior to a change in kidney function and to make a differential diagnosis of AKI.
2014 Vol. 16 (4): 345-348 [Abstract] ( 5305 ) [HTML 1KB] [PDF 1166KB] ( 1435 )
CLINICAL RESEARCH
349 ZHAO Feng, YU Zi-Hua, YANG Yong-Hui, NIE Xiao-Jing, HUANG Jun, WANG Cheng-Feng, XIA Gui-Zhi, CHEN Guang-Ming
Mutational analysis of MYO1E in Chinese children with familial steroid-resistant nephrotic syndrome
Objective Steroid-resistant nephrotic syndrome (SRNS) with MYO1E mutations has been identified as autosomal recessive focal segmental glomerulosclerosis (FSGS). To date, only two homozygous mutations in the MYO1E gene were reported in three families with FSGS. This study aimed to examine mutations in the MYO1E gene in children with familial SRNS in the Han Chinese ethnic group. Methods Between 2005 and 2010, peripheral blood samples were collected from the probands, their siblings and parents of four families with autosomal recessive SRNS in the Han Chinese ethnic group. Four probands were studied from nine patients. The mutational analysis of MYO1E was performed by polymerase chain reaction and direct DNA sequencing. Fifty-nine healthy volunteers with normal urine analysis were included as controls. Results Twenty-five MYO1E variants in the prohands from 4 families with SRNS were identified in this study. Among them, 24 variants were found in NCBI dbSNP. One heterozygous mutation IVS21-85G>A was found in the prohand from Family D, whereas it was absent in 59 normal Chinese controls. No splice site change caused by IVS21-85G>A was reported by analysis with NetGene2. Conclusions MYO1E mutations are not a major cause of Chinese familial SRNS in this study.
2014 Vol. 16 (4): 349-355 [Abstract] ( 5783 ) [HTML 1KB] [PDF 1790KB] ( 1238 )
356 ZHANG Jian-Jiang, FU Shu-Qin, DOU Wen-Jie, SHI Pei-Pei, WANG Miao, TIAN Xi-Yan
Significance of serum cholesterol and fibrinogen in evaluating the risk of glomerulosc-lerosis in children with nephrotic syndrome
Objective To investigate the significance of serum cholesterol and fibrinogen (Fib) in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome. Methods Sixty-three children with primary nephrotic syndrome were divided into two groups according to their pathological types: minimal change glomerulopathy (MCG) (n=39) and focal segmental glomerulosclerosis (FSGS) groups (n=24). Serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C and Fib and 24-hour urinary protein excretion were retrospectively analyzed. Results Serum levels of TC, non-HDL-C, and LDL-C were significantly higher in the FSGS group than in the MCG group (P<0.05), but there were no significant differences in HDL-C, Fib and 24-hour urinary protein excretion between the two groups (P>0.05). According to the results of logistic regression analysis, high levels of LDL-C, non-HDL-C and TC were risk factors for FSGS (P<0.05). In patients whose proteinuria did not disappear after taking enough glucocorticoid for 4 weeks, the level of non-HDL-C was significantly higher in the FSGS group than in the MCG group (P<0.05); there were no significant differences in TC, LDL-C, HDL-C, and Fib between the MCG and FSGS groups (P>0.05). Conclusions Serum cholesterol, especially non-LDL-C, is of great significance in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome. There is no sufficient evidence to support serum Fib as a marker for predicting glomerulosclerosis in these children.
2014 Vol. 16 (4): 356-360 [Abstract] ( 4958 ) [HTML 1KB] [PDF 1847KB] ( 1104 )
361 ZHANG Liang, LI Zhi-Hui, DENG Xu, YIN Yan
Expression of tight junction protein claudin-2 in renal tissues and its significance in children with acute kidney injury
Objective To examine changes in expression of tight junction protein claudin-2 in the renal tissues of children with acute kidney injury (AKI), and to investigate the relationship of claudin-2 expression with renal pathological lesion and renal functional lesion. Methods Twenty-four children who were diagnosed with AKI and had renal biopsies between December 2009 and December 2011 were included in the study. These patients were divided into mild AKI (n=7) and severe AKI groups (n=17). Children with isolated hematuria whose renal biopsy showed minor glomerular lesion were selected as the control group. Serum creatinine levels were measured by automatic biochemical analyzer. Tubulointerstitial damage was evaluated by renal pathological scores and expression of claudin-2 was examined by immunohistochemistry. The correlations of claudin-2 expression with renal pathological score and serum creatinine level were assessed by Pearson correlation analysis. Results The mild and severe AKI groups had significantly higher serum creatinine levels than the control group (190±68 μmol/L and 477±128 μmol/L vs 29±7 μmol/L, P<0.01), and the severe AKI group had a significantly higher serum creatinine level than the mild AKI group (P<0.01). The tubulointerstitial damage score was significantly lower in the mild AKI group than in the severe AKI group (10.4±1.7 vs 14.0±1.5; P<0.05). The mild and severe AKI groups had significantly smaller areas of claudin-2 expression than the control group (5.0±0.5% and 3.7±0.7% vs 8.0±0.7%; P<0.01), and the severe AKI group had a significantly smaller area of claudin-2 expression than the mild AKI group (P<0.01). The area of claudin-2 expression was negatively correlated with serum creatinine level and tubulointerstitial damage score (r=-0.809 and -0.903; P<0.01). Conclusions There are changes in the distribution and expression of claudin-2 in proximal tubular epithelial cells among children with AKI, and claudin-2 expression is closely related to renal pathological lesion and renal functional lesion.
2014 Vol. 16 (4): 361-365 [Abstract] ( 5967 ) [HTML 1KB] [PDF 2367KB] ( 1127 )
366 SHI Rui-Ming, BIAN Xu-Hua, LI Li-Min, LIU Xiao-Hong
Investigation and OCRL mutation analysis of a family with oculocerebrorenal syndrome of Lowe
Oculocerebrorenal syndrome of Lowe (OCRL) is an X-linked recessive disorder. This study investigated the history of a Chinese family with OCRL and used direct DNA sequencing to screen all exons of OCRL gene for mutations. A missense mutation (1736 A→G) in exon 15 was revealed, which resulted in the change of His (H) 507 to Arg (R). The patient's mother was the carrier of the heterozygous mutation in X-chromosome. To our knowledge, H507R mutation in OCRL gene has not been reported in Chinese people.
2014 Vol. 16 (4): 366-369 [Abstract] ( 5399 ) [HTML 1KB] [PDF 1542KB] ( 1588 )
370 HUANG Mei-Ling, LI Chang-Gang, WANG Guo-Bing, ZU Ying
Expression of leukocyte-associated Ig-like receptor-1 in children with immune thrombocytopenia
Objective To study the expression of leukocyte-associated Ig-like receptor-1(LAIR-1) in children with immune thrombocytopenia (ITP), in order to explore the possible role of LAIR-1 in the pathogenesis of childhood ITP. Methods Expression levels of LAIR-1 on CD4+ T cells, CD8+ T cells and CD19+CD20+ B cells of peripheral blood were measured in 40 children with ITP by flow cytometry. Serum level of solubility LAIR-1 (sLAIR-1) was measured using ELISA. Real-time PCR was used to measure LAIR-1 mRNA expression. Thirty-two healthy children served as the control group. Results The percentages of CD19+CD20+ B cells in the ITP group were significantly higher than in the control group (P<0.05). In contrast, the percentage of CD4+ T cells in the ITP group was significantly lower than in the control group (P<0.05). The expression levels of LAIR-1 on CD4+ T cells and CD8+ T cells were significantly lower in the ITP group than in the control group (P<0.05). Serum sLAIR-1 level and LAIR-1 mRNA expression in the ITP group significantly increased compared with the control group (P<0.05). Conclusions LAIR-1 expression on CD4+ and CD8+ T cells decreases and serum sLAIR-1 level increases in children with ITP, suggesting that LAIR-1 may play an important role in immune imbalance in these children.
2014 Vol. 16 (4): 370-374 [Abstract] ( 6411 ) [HTML 1KB] [PDF 1535KB] ( 1278 )
375 WANG Xi-Ge, WANG Xuan, LIU Song, ZHOU Yu-Jie, WANG Dan-Feng
Telomere length and telomerase mutations in peripheral blood leukocytes of children with chronic aplastic anemia
Objective To investigate the change in telomere length and TERC and TERT mutations in peripheral blood leukocytes of children with chronic aplastic anemia (CAA). Methods Sixty-nine children with CAA were divided into u ntreated group (n=24) who did not receive immunosuppressive therapy (IST), response group (n=36) who showed response to IST, and non-response group (n=9) who showed no response to IST; another 35 healthy children matched for age and sex were selected as the control group. The telomere-to-single copy gene (T/S) ratio in peripheral blood leukocytes was measured by real-time PCR in all groups. PCR was performed to detect TERC and TERT mutations in all children with CAA. Results The untreated and non-response groups had significantly lower T/S ratios than the control and response groups (P<0.01), whereas there was no significant difference in T/S ratio between the response and control groups (P>0.05). TERC and TERT mutations were not found in all children with CAA. Conclusions The change in telomere length in children with CAA may be related to the development and progression of disease. Telomere length measurement may be used as a prognostic indicator in children with CAA.
2014 Vol. 16 (4): 375-379 [Abstract] ( 6071 ) [HTML 1KB] [PDF 1624KB] ( 1310 )
380 ZHANG Li-Ya, LI Yan, JIN Mei-Fang
383Diagnostic values of neopterin and S100b for central nervous system infections in children
Objective To study the diagnostic values of cerebrospinal concentrations of neopterin (NPT) and S100b for central nervous system infections in children. Methods Enzyme-linked immunosorbent assay was used to determinate the cerebrospinal concentrations of NPT and S100b in children with central nervous system infections and control children. The two groups of children were compared in terms of the two indicators, and the diagnostic values of the two indicators were evaluated by ROC curve analysis. Results Children with viral encephalitis had significantly increased cerebrospinal concentrations of NPT and S100b compared with the control group and children with purulent meningitis (P<0.01); there was no difference in the cerebrospinal concentration of NPT between children with purulent meningitis and the control group, while the concentration of S100b in the purulent meningitis group was significantly higher than in the control group (P<0.01). According to the ROC curves, S100b was more valuable than NPT in the diagnosis of viral encephalitis; when cerebrospinal concentration was more than 0.384 ng/mL, S100b had a sensitivity of 93.3% and a specificity of 97.9%; a combination of the two indicators had a higher diagnostic value for viral encephalitis, with a sensitivity of 96.7% and a specificity of 97.9%. Conclusions Both NPT and S100b have certain values in the diagnosis of central nervous system infections in children, and S100b is better than NPT.
2014 Vol. 16 (4): 380-383 [Abstract] ( 5256 ) [HTML 1KB] [PDF 1335KB] ( 1151 )
384 QI Ying-Zheng, Duolikun MUZHAPER
Levels and prognostic significance of serum procalcitonin and D-dimer in children with systemic inflammatory response syndrome
Objective To evaluate the prognostic significance of serum levels of procalcitonin (PCT) and D-dimer in children with systemic inflammatory response syndrome (SIRS). Methods A prospective case control study was conducted on 67 pediatric patients with SIRS who were treated in the pediatric intensive care unit (PICU). Based on the presence or absence of infectious lesions, patients were categorized as sepsis and non-sepsis. Within 24 hours after admission, white blood cell (WBC) count and serum levels of PCT, C-reactive protein (CRP) and D-dimer were determined, and the pediatric critical illness score (PCIS) was calculated. The correlation of PCIS with each of the other measurements was analyzed. On day 28 of follow-up, receiver operator characteristic (ROC) curve was plotted, and the area under ROC (AUC) was calculated. 28-day survival was estimated. Multivariate logistic regression analysis was performed to identify independent risk factors for in-hospital mortality. Results Serum levels of PCT and D-dimer were significantly higher (P<0.05) but PCIS was significantly lower (P<0.05) in patients with sepsis than in those without sepsis. Both PCT and D-dimer were negatively correlated with PCIS (P<0.01). Serum levels of PCT and D-dimer 24 hours after admission were higher (P<0.05) and PCIS was lower (P<0.05) in non-survivors than in survivors on day 28. AUC was 0.875, 0.872 and 0.863 respectively for PCT, D-dimer and PCIS in the prediction of 28-day survival (P<0.01). Logistic regression analysis revealed that PCT and D-dimer were independent prognostic factors (odd ratio: 1.684 and 1.003; P<0.01). Conclusions Serum levels of PCT may be helpful in differentiating sepsis and non-sepsis at early stage of SIRS in children. PCT and D-dimer are independent risk factors for in-hospital mortality in children with SIRS, and thus have a prognostic significance in clinical settings.
2014 Vol. 16 (4): 384-388 [Abstract] ( 6293 ) [HTML 1KB] [PDF 1442KB] ( 1622 )
389 LIU Yi-Ling, WANG Xian-Min, LI Yan, SHI Kun, GUO Yong-Hong, YANG Yan-Feng, CHEN Ting-Ting
The role of endogenous vascular elastase in coronary artery reconstruction in Kawasaki disease
Objective To investigate the role of endogenous vascular elastase (EVE) in coronary artery between reconstruction among pediatric patients with Kawasaki disease (KD). Methods Sixty children who were diagnosed with KD between January 2012 and April 2013 were selected as the case group, and peripheral venous blood samples were collected on days 0-11 (pathological stage I) and days 12-25 (pathological stage Ⅱ) after the onset of disease; another 60 children without KD who visited the hospital due to acute fever during the same period were selected as the control group, and fasting peripheral venous blood samples were collected in the acute stage of fever. For both groups, serum levels of EVE and interleukin-6 (IL-6) and plasma vascular endothelial growth factor (VEGF) level were measured by enzyme-linked immunosorbent assay. For the case group, ultrasonic cardiography was used to detect coronary artery lesions (CALs) at the first, second and fourth weekends. The correlations of EVE level with IL-6 and VEGF levels were evaluated by Pearson correlation analysis. Results Serum levels of EVE and IL-6 in the case group in pathological stages I and Ⅱ were significantly higher than in the control group (P<0.05), but plasma VEGF levels in stages I and Ⅱ were significantly lower than in the control group (P<0.05); in the case group, EVE and IL-6 levels were significantly higher in stage Ⅱ than in stage I (P<0.05). In pathological stage Ⅱ, KD patients with CALs had significantly higher serum levels of EVE and IL-6 but significantly lower plasma VEGF levels compared with those without CALs (P<0.05); KD patients with coronary artery aneurysms (CAAs) had significantly higher serum levels of EVE and IL-6 but significantly lower plasma VEGF level compared with those without CAAs (P<0.05 for all). EVE level was positively correlated with IL-6 level (r=0.915, P<0.05), yet negatively correlated with VEGF level (r=-0.769, P<0.05). Conclusions EVE may participate in coronary artery reconstruction in children with KD. To interfere EVE activity may reduce and prevent CALs.
2014 Vol. 16 (4): 389-392 [Abstract] ( 5800 ) [HTML 1KB] [PDF 1353KB] ( 1267 )
393 ZHAO Pei-Wei, HE Xue-Lian, LIN Jun, WU Ge-Fei, YUE Xin, BI Bo, HU Jia-Sheng, LIU Zhi-Sheng
Clinical features and MECP2 mutations in children with Rett syndrome
Objective To study the clinical features and mutations in methyl-CpG-binding protein 2 (MECP2) gene among children with classical Rett syndrome in China. Methods PCR and direct sequencing were employed to analyze the three exons of MECP2 gene in 9 children recently diagnosed with Rett syndrome and their parents. Results Heterozygous mutations were identified in 5 out of 9 patients, with a mutation rate of over 50%; there was one case of insert mutation (c.913insT) and 4 cases of missense mutation (exon 3: c.316C>T (R106W); exon 4: c.502C>T (R168X), c.808C>T (R270X), and c.1126C>T (P376S)). A new mutation (c.913insT) was found. No mutations were detected in their parents. Two patients had MECP2 mutations in the transcriptional repression domain (TRD). They had almost lost language functions and were found to have significantly delayed development compared with other patients. Conclusions Mutations in MECP2 gene were detected in 5 confirmed cases of Rett syndrome, and most of them were on exon 4. Mutations in the TRD of MECP2 protein may affect the language ability and development in children with Rett syndrome.
2014 Vol. 16 (4): 393-396 [Abstract] ( 7301 ) [HTML 1KB] [PDF 1514KB] ( 2017 )
397 ZHAO Xiu, ZHANG Qin
Clinical efficacy of letrozole in boys with idiopathic central precocious puberty
Objective To investigate the efficacy of letrozole for delaying bone maturation and increasing predicted adult height in boys with idiopathic central precocious puberty (ICPP) who have a bone age above 13 years and a short stature, and its adverse effects. Methods Twenty ICPP boys with a bone age above 13 years and a short stature were randomly divided into letrozole treatment (n=10) and control groups (n=10). The letrozole treatment group received oral letrozole [2.5 mg/(m2·d), Qd] for 6 months, while the control group received no treatment and was observed periodically. Bone age, growth rate, height standard deviation (SD) score, predicted adult height SD score, sexual maturity, and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone, testosterone (T), estradiol (E2), progesterone (P), and androstenedione (ASD) were measured. The letrozole-related adverse reactions were evaluated. Results After 6 months of treatment, both groups had a significantly increased bone age, but the letrozole group had a significantly slowed increase in bone age compared with the control group (13.82±0.23 years vs 14.47±0.30 years; P<0.05); compared with the control group, the letrozole group had a significantly increased predicted adult height SD score (-1.69±0.26 vs -1.91±0.35; P<0.05) and a significantly increased T level (4.9±0.9 nmol/L vs 4.4±0.8 nmol/L; P<0.05). There was no significant difference in testicular volume between the two groups. The treatment led to no significant changes in growth rate, Tanner stage, and levels of FSH, LH, P, E2 and ASD in the two groups, and there was no significant difference in these indices between the two groups. No adverse reactions were observed during letrozole treatment. Conclusions Letrozole delays bone maturation and increases predicted adult height in ICPP boys with a bone age above 13 years and a short stature, and it causes no obvious adverse reactions.
2014 Vol. 16 (4): 397-400 [Abstract] ( 8301 ) [HTML 1KB] [PDF 1408KB] ( 2128 )
401 WU Yue-Jin, SUN Jie, ZHANG Jian-Hua, FENG Ling-Ling
Clinical efficacy of adjuvant therapy with glucocorticoids in children with lobar pneumonia caused by Mycoplasma pneumoniae
Objective To study the clinical efficacy of adjuvant therapy with glucocorticoids in children with lobar pneumonia caused by Mycoplasma pneumoniae. Methods One hundred and eight children with lobar pneumonia caused by Mycoplasma pneumoniae were randomly divided into routine treatment and hormone treatment groups. Both groups were treated with azithromycin and other symptomatic therapies. In addition to the basic treatment, the hormone treatment group was given dexamethasone 0.25-0.3 mg/(kg·d) by intravenous drip until the body temperature was normal. Then given oral prednisone tablets 0.5-1 mg/(kg·d) (gradually reduced) for a total treatment course of 7-10 days. Before and after treatment pulmonary functions were examined, and serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-2 (IL-2) and interleukin-6 (IL-6) were measured. Results The duration of fever, cough relief time and pulmonary shadow absorption time on chest X-ray were significantly shorter in the hormone treatment group than in the routine treatment group (P<0.05). After treatment, the two groups showed improvements in serum CRP, ESR, IL-2, and IL-6 (P<0.05), but the hormone treatment group showed significantly more improvement (P<0.05). Varying degrees of mixed ventilation dysfunction were seen in the two groups before treatment, and hormone therapy significantly improved pulmonary function, especially promoting the recovery of small airway function. Conclusions Adjuvant therapy with glucocorticoids can effectively alleviate clinical symptoms, promote the absorption of pulmonary inflammation, and improve pulmonary function in children with lobar pneumonia caused by Mycoplasma pneumoniae.
2014 Vol. 16 (4): 401-405 [Abstract] ( 6883 ) [HTML 1KB] [PDF 1533KB] ( 2397 )
406 LIU Hua, HE Xiang-Ling, ZHANG Bing, XIAO Ni-Guang, YOU Ya-Lan, DUAN Zhao-Jun
Viral etiology in children with acute lower respiratory tract infections plus platelet disorders in Changsha, China：an analysis of 255 cases
Objective To investigate the viral etiology in hospitalized children with acute lower respiratory tract infections (ALRTI) plus platelet disorders. Methods A total of 255 children with ALRTI plus platelet disorders and 442 children with ALRTI and normal platelets, all of whom were hospitalized between March 2010 and February 2011, were included in the study. Their nasopharyngeal aspirate samples were collected, and RT-PCR or PCR was performed to detect 14 viruses. Results Of 255 ALRTI patients with platelet disorders, thrombocytosis was found in 253 cases (99.2%) and thrombocytopenia in 2 cases (0.8%). Among ALRTI patients with platelet disorders, 173 (67.8%) were infected with at least one virus, with human rhinovirus as the most common one, followed by parainfluenza virus type 3 (PIV3) and respiratory syncytial virus (RSV). The detection rate of PIV3 in the abnormal platelet group was significantly higher than in the normal platelet group (P<0.05). In contrast, the detection rate of influenza virus B (IFVB) in the abonormal platelet group was significantly lower than in the normal platelet group (P<0.05). The age distribution showed significant difference between the abnormal and normal platelet groups (P<0.01). Platelet disorders were mainly found in children under one year of age (P<0.01). Conclusions Thrombocytosis is often found in children with ALRTI caused by viruses, especially PIV3, but infection with IFVB seldom causes platelet disorders. Hospitalized children with ALRTI under one year tend to develop platelet disorders.
2014 Vol. 16 (4): 406-409 [Abstract] ( 5544 ) [HTML 1KB] [PDF 1385KB] ( 1245 )
410 DUAN Xiao-Jun, CHEN Yan-Ping, QIU Jun
Clinical features of tracheobronchial foreign bodies in children
Objective To investigate the clinical features of tracheobronchial foreign bodies in children and to provide a basis for feasible preventive measures. Methods A retrospective analysis was performed on the clinical data of 114 children with tracheobronchial foreign bodies confirmed by fiberoptic bronchoscopy between February 2012 and February 2013. Results The majority (71.9%) of children with tracheobronchial foreign bodies were younger than three years old, and the male-to-female ratio was 2:l. The proportion of cases in winter was higher than that in summer. The incidence of tracheobronchial foreign bodies was significantly higher among rural children than among urban children. The positive rate of CT varied significantly for tracheobronchial foreign bodies at different sites, and the patients with tracheal foreign bodies had a significantly lower positive rate of chest CT than patients with foreign bodies in the left and right main bronchi (P<0.01). The misdiagnosis rate in children with a history of aspiration of foreign bodies was significantly lower than in children without one (P<0.01). Conclusions Health education related to the prevention of tracheobronchial foreign bodies in children should be conducted primarily in rural areas. Tracheobronchial foreign bodies are common in children younger than three years old. Bronchoscopy should be performed early for suspected cases of tracheobronchial foreign bodies.
2014 Vol. 16 (4): 410-413 [Abstract] ( 5029 ) [HTML 1KB] [PDF 1425KB] ( 1088 )
414 WANG Rui-Juan, KONG Xiang-Yong, CAI Na, CHEN Ying, FENG Zhi-Chun
Perinatal high-risk factors for necrotizing enterocolitis in preterm infants：a case-control study
Objective To study the timing of presentation and perinatal high-risk factors for necrotizing enterocolitis (NEC) in preterm infants with a gestational age of <33 weeks. Methods A case-control study was conducted in 49 preterm infants with NEC (gestational age <33 weeks) who were admitted to the Neonatal Intensive Care Unit of Beijing Bayi Children's Hospital between October 1, 2010 and December 30, 2012, as well as preterm infants without NEC during the same period. The timing of presentation of NEC was retrospectively analyzed, and the perinatal high-risk factors for NEC were determined by multivariate logistic regression analysis. Results The median age of onset was 17.5 days (range: 3-106 d) in preterm infants with NEC. Sex, being small for gestational age, delivery mode and antenatal corticosteroid therapy were not associated with the development of NEC; low gestational age, low birth weight and neonatal asphyxia increased the risk of NEC, and low gestational age was identified as an independent high-risk factor for the development of NEC. Conclusions Low gestational age is an important risk factor for the development NEC in preterm infants under 33 weeks' gestation, and the median age of onset is 17.5 days.
2014 Vol. 16 (4): 414-417 [Abstract] ( 6061 ) [HTML 1KB] [PDF 1402KB] ( 1471 )
EXPERIMENTAL RESEARCH
418 PENG Chang, ZHANG Wei-Hua, PAN Bo, GAO Wen-Qun, TIAN Jie
Temporal regulation of transcription factor Mef2c by histone acetylases during cardiogenesis
Objective To observe the temporal modification of transcription factor Mef2c by histone acetylases (HATs) P300, PCAF, and SRC1 during cardiogenesis and to provide a basis for investigating the pathogenesis of congenital heart disease. Methods The normal heart tissues from embryonic mice (embryonic days 14.5 and 16.5) and neonatal mice (postnatal days 0.5 and 7) were collected. The binding of P300, PCAF, and SRC1 to Mef2c gene and level of histone H3 acetylation in the promoter region of Mef2c were evaluated by chromatin immunoprecipitation assays. Meanwhile, real-time PCR was used to measure the mRNA expression of Mef2c. Results P300, PCAF, SRC1 were involved in histone acetylation in the promoter region of Mef2c during cardiogenesis in mice, and binding of P300, PCAF, and SRC1 to the promoter of Mef2c varied significantly in different stages of cardiogenesis (P<0.01). The level of histone H3 acetylation and mRNA expression of Mef2c in the promoter region of Mef2c also varied significantly in different stages of cardiac development (P<0.01). The levels of acetylated H3, Mef2c mRNA, and HATs (P300, PCAF, SRC1) changed over time. They were highest on embryonic day 14.5 (P<0.01), decreased gradually with cardiac development, and were maintained at low levels after birth. Conclusions The mRNA expression of Mef2c varies during cardiogenesis in mice, which indicates that Mef2c plays an important role in the process of cardiac development. Meanwhile, histone acetylation in the promoter region of Mef2c is regulated temporally by HATs P300, PCAF, and SRC1.
2014 Vol. 16 (4): 418-423 [Abstract] ( 5743 ) [HTML 1KB] [PDF 1671KB] ( 1163 )
424 DING Yan, XU Fang, XIONG Xiao-Li, LI Hua-Rong
Effect of emodin on expression of farnesoid X receptor in rats with acute cholestatic hepatitis
Objective To investigate the expression of farnesoid X receptor (FXR) and the effect of emodin on FXR expression in a rat model of acute cholestatic hepatitis. Methods Ninety adult Sprague-Dawley rats were randomly divided into normal control, model, and emodin groups (n=30 each). The model and emodin groups were given alpha-naphthylisothiocyanate (ANIT) 50 mg/kg by gavage to establish an animal model of cholestatic hepatitis, while the normal control group was given an equal volume of sesame oil. The emodin group was given emodin by gavage every day from 4 days before the model was prepared until the time of sacrifice, while the model and normal control groups were given an equal volume of sodium carboxymethyl cellulose solution. At 24, 48 and 72 hours after the model was prepared, serum level of total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), and total bile acids (TBA) were measured by Aeroset automatic biochemical analyzer, and the mRNA expression of FXR in the liver tissue was measured by real-time PCR. Results At all time points FXR mRNA expression in the model group decreased, but serum levels of TB, DB, ALT and TBA increased significantly compared with the normal control group (P<0.05). The emodin group had significantly higher mRNA expression of FXR and significantly lower serum levels of TB, DB, ALT, and TBA compared with the model group (P<0.05). Conclusions Emodin can significantly reduce serum levels of TB, DB, ALT, and TBA in rats with ANIT-induced cholestatic hepatitis, probably by promoting FXR expression.
2014 Vol. 16 (4): 424-429 [Abstract] ( 5281 ) [HTML 1KB] [PDF 3337KB] ( 1170 )
CASE REPORT
430 WANG Yan, PENG Li, CHANG Gui-Fen
A case report of infant hepatitis syndrome caused by cholelithiasis

No abstract available
2014 Vol. 16 (4): 430-431 [Abstract] ( 4503 ) [HTML 1KB] [PDF 1175KB] ( 972 )
432 WU Ge-Fei, MAO Bing, HU Jia-Sheng, et al
Anti-N-methyl-D-aspartate receptor encephalitis: a case report of an over 2-year-old girl

No abstract available
2014 Vol. 16 (4): 432-434 [Abstract] ( 4454 ) [HTML 1KB] [PDF 1189KB] ( 1077 )
435 LUO Yue, HE Xu-Xiang, LI Li-Yi
Fulminant type 1 diabetes in a child

No abstract available
2014 Vol. 16 (4): 435-436 [Abstract] ( 4283 ) [HTML 1KB] [PDF 1136KB] ( 1155 )
CJCP
About Journal
Editors members
Contact Us

 
Copyright © 2004-2005 Chinese Journal Of Contemporary Pediatrics All rights reserved.
Addr: 87 Xiangya Road, Changsha, Hunan, 410008, PRC
Tel: 0731-84327402 Fax: 0731-84327922 E-mail: cjcp1999@csu.edu.cn