Chinese Journal Of Contemporary Pediatrics

CJCP

	中文版
	English Version

	2014 Vol. 16 No. 7
	Published: 2014-07-15


	TOPIC OF NUTRITION FOR PRETERM INFANTS CLINICAL RESEARCH EXPERIMENTAL RESEARCH CASE REPORT REVIEW

TOPIC OF NUTRITION FOR PRETERM INFANTS

	661	CAI Wei
		Nutritional support in preterm infants
		Extrauterine growth restriction is much popular in China and it is still challenge job for pediatricians. This article described the benefits for PICC in route of PN choice. New fat emulsions were appeared recently years, however they are no strong evidence for using in premature infants and need do more clinical trial. Parenteral nutrition associated with liver damage still is a serious complication of TPN and we encourage early enteral feeding, appropriate calore intake, anti sepsis for prevention.
		2014 Vol. 16 (7): 661-663 [Abstract] ( 5504 ) [HTML 1KB] [PDF 1008KB] ( 1720 )

	664	WANG Dan-Hua
		Attention to nutrition and health of preterm infants：interpretation of The Global Consensus for Feeding the Preterm Infant
		The Global Consensus for Feeding the Preterm Infant was published in the Journal of Pediatrics 3 supplement, 2013. The content of the consensus includes recommended nutrient intake for different gestational age preterm infants, identifying appropriate growth curves, the use of breast milk, nutritional recommendations for the latepreterm infant and the preterm infant after hospital discharge, nutritional requirements and feeding recommendations for small gestation age infants, reconsideration of the importance of vitamin A and vitamin D for immature infants, recommendations for immunonutrients, and the association of feeding of preterm infants with later metabolic and cardiovascular outcomes. The main characteristics of the consensus: (1) aimed to improve prognosis; (2) individualized nutritional strategy based on gestational ages; (3) coexistence of consensus and controversy in feeding of preterm infants.
		2014 Vol. 16 (7): 664-669 [Abstract] ( 7160 ) [HTML 1KB] [PDF 1080KB] ( 3049 )

	670	FENG Qi
		Risk factors for parenteral nutrition-associated cholestasis in neonates
		Parenteral nutrition (PN) is a life saving and support therapy for critical newborn infants. Parenteral nutrition-associated cholestasis (PNAC) is one of its common complications. This article focuses on the risk factors for PNAC in newborn infants in both non-nutrient and nutrient associated risk factors. The main risk factors include prematurity, small for gestational age, prolonged PN, diseases (especially sepsis and necrotizing enterocolitis), delayed or less proportional enteral nutrition, non cyclic PN, amino acids/lipids composition and dosage, energy supply and trace elements contents.
		2014 Vol. 16 (7): 670-673 [Abstract] ( 6141 ) [HTML 1KB] [PDF 1064KB] ( 1722 )

	674	LIU Xi-Hong, DING Zong-Yi
		Medical application of breast milk banks
		The history of breast milk banks is over 100 years. Most of the milk banks were closed because of HIV in the 80's. But more and more milk banks are re-opening and new ones are being established as the composition and superiority of breast milk are recognized again. The Human Milk Banking Association of North America and European Milk Bank Association have been set up and they have established and revised the standards and guidelines of breast milk banks. There is no doubt of the clinical effects of donor human milk on preterm infants worldwide. The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition recommended that the preterm infants should use donor human milk when their own mothers' milk is not enough. The first breast milk bank was set up in China in 2013, and its clinical and social significance is worthy of further study.
		2014 Vol. 16 (7): 674-678 [Abstract] ( 5928 ) [HTML 1KB] [PDF 1077KB] ( 1649 )

	679	HE Bi-Zi, SUN Xiu-Jing, QUAN Mei-Ying, WANG Dan-Hua
		Macronutrients and energy in milk from mothers of premature infants
		Objective To study the dynamic changes in macronutrients and energy in human milk from mothers of premature infants. Methods A total of 339 human milk samples were collected from 170 women who delivered preterm or full-term infants in the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital between November 2012 and January 2014. Macronutrients (proteins, fats and carbohydrates and energy were measured using a MIRIS human milk analyzer and compared between groups. Results In milk samples from premature infants' mothers, the protein levels were the highest in colostrum (2.22±0.49 g/dL), less in transitional milk (1.83±0.39 g/dL), and the least in mature milk (1.40±0.28 g/dL) (P<0.01), and the levels of fats (2.4±1.3 g/dL vs 3.1±1.1 g/dL; P<0.01), carbohydrates (6.4±0.9 g/dL vs 6.6±0.4 g/dL; P<0.05) and energy (55±9 kcal/dL vs 62±8 kcal/dL; P<0.01) were significantly lower in colostrum than in transitional milk. The protein levels in colostrum from premature infants' mothers were significantly higher than those in colostrum from term infants' mothers (2.22±0.49 g/dL vs 2.07±0.34 g/dL; P<0.05). The colostrum from mothers of premature infants with a gestational age of ≤30 weeks had significantly higher protein levels than those from mothers of premature infants with gestational ages of 30⁺¹-33⁺⁶ weeks and ≥34 weeks (2.48±0.68 g/dL vs 2.11±0.25 g/dL and 2.22±0.39 g/dL respectively, P<0.05); the energy levels in colostrum from mothers of premature infants with a gestational age of ≤30 weeks group (51±6 kcal/dL) were significantly lower than those in colostrum from mothers of premature infants with a gestational age of 30⁺¹-33⁺⁶ weeks (58±8 kcal/d; P<0.05). The carbohydrate levels in transitional milk from mothers of premature infants with a gestational age of ≤30 weeks were significantly higher than those in transitional milk from mothers of premature infants with gestational ages of 30⁺¹-33⁺⁶ weeks and ≥34 weeks (P<0.05). The protein levels in mature milk from mothers of premature infants with a gestational age of 30⁺¹-33⁺⁶ weeks were significantly higher than those in mature milk from mothers of premature infants with gestational ages of ≤30 weeks and ≥34 weeks (P<0.05). Conclusions The levels of macronutrients and energy in milk from mothers of premature infants vary significantly between colostrum, transitional milk, and mature milk. Protein levels are significantly higher in colostrum from premature infants' mothers than in colostrum from term infants' mothers, but the significant difference is not seen for mature milk. Macronutrient and energy levels show significant differences between milk samples from mothers of premature infants with different gestational ages, so as to meet different needs of premature infants.
		2014 Vol. 16 (7): 679-683 [Abstract] ( 6339 ) [HTML 1KB] [PDF 1165KB] ( 1699 )

	684	YU Mu-Xue, ZHUANG Si-Qi, WANG Dan-Hua, ZHOU Xiao-Yu, LIU Xiao-Hong, SHI Li-Ping, YUE Shao-Jie, QIAN Ji-Hong, SUN Jian-Hua
		Effects of extensively hydrolyzed protein formula on feeding and growth in preterm infants：a multicenter controlled clinical study
		Objective To study the effects of extensively hydrolyzed protein formula (eHF) on the feeding and growth in preterm infants through a multicenter controlled clinical study. Methods Preterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected. They were divided into two observation groups and two control groups. The first observation group consisted of preterm infants with a gestational age of <32 weeks, who were fed with eHF for 10-14 days after birth and then with standard preterm formula (SPF) until discharge. The second observation group consisted of preterm infants with a gestational age of 32-34 weeks, who were fed with SPF after birth, but were switched to eHF (7-14 days) if suffering feeding intolerance at 6-8 days after birth. The two control groups with corresponding gestational ages kept to be fed with SPF after birth. Clinical data were recorded to compare feeding condition, physical growth, blood biochemical indices, and major complications between different groups. Results A total of 328 preterm infants were enrolled. Preterm infants with a gestational age of <32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group (P<0.05). They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group (P<0.05). The observation group needed more time in reaching enteral nutrition (EN) basic energy uptake of 50 kcal/(kg·d), partial parenteral nutrition (PPN), hospitalization, and corrected gestational age at discharge compared with the controlled infants (P<0.05). There was no difference in the incidence of extrauterine growth retardation (EUGR) at discharge between the two groups (P>0.05). Preterm infants with a gestational age of 32-34 weeks in the observation group had significantly lower serum total bilirubin levels at 2 weeks after birth compared with the corresponding control group (P<0.05). They required more time in achieving EN basic energy and PPN than in the control group (P<0.05). There was no difference in the incidence of EUGR at discharge between the two groups (P>0.05). Conclusions For preterm infants, eHF can improve gastrointestinal motility, accelerate bilirubin metabolism and excretion and does not increase the incidence of EUGR.
		2014 Vol. 16 (7): 684-690 [Abstract] ( 7520 ) [HTML 1KB] [PDF 1370KB] ( 2266 )

	691	LI Zheng-Hong, DONG Mei, WANG Dan-Hua, Christina J Valentine
		Comparison of feeding pattern of preterm infants between two hospitals in China and the United States
		Objective To compare the feeding pattern of preterm infants between two hospitals in China and the United States. Methods A retrospective cohort study was conducted. Infants < 32 weeks were enrolled from Cincinnati Children's Hospital Center Cincinnati University Hospital (CCHMC group) between January 2011 and January 2012 and Peking Union Medical College Hospital (PUMCH group) between January 2011 and May 2012. Enteral and parenteral feeding data of the two groups was compared. Results Eighty-two infants in the CCHMC group and 74 infants in the PUMCH group were enrolled. The gestational age and birth weight of infants in the CCHMC group were smaller than the PUMCH group (P<0.01). The total dosage of amino acid (58±30 g/kg vs 24.0(19.6, 32.8) g/kg; P<0.01) and fat [35±16 g/kg vs 14.0(11.0, 22.5) g/kg; P<0.01], in the PUMCH group were higher than the CCHMC group. The duration of parenteral nutrition in the PUMCH group was longer than the CCHMC group[(24±10 d vs 8.0(6.0, 11.0) d; P<0.01]. The breast feeding rate in the CCHMC group was higher (94% vs 10%; P<0.01) than in the PUMCH group. The time for achieving full enteral feeding in the CCHMC group was shorter [12.0(10.0, 14.0) d vs 22.4±9.3 d, P<0.01] than in the PUMCH group. The incidences of necrotizing enterocolitis (13% vs 3%; P<0.05) and sepsis (32% vs 12%; P<0.01) in the CCHMC group were higher than in the PUMCH group. Conclusions Preterm infants in the PUMCH group have a prolonged duration of parenteral nutrition and an increased incidence of sepsis compared to the CCHMC group. Fortified human milk feeding and more aggressive enteral feeding proposal in PUMCH is recommended.
		2014 Vol. 16 (7): 691-695 [Abstract] ( 5593 ) [HTML 1KB] [PDF 1212KB] ( 1328 )

CLINICAL RESEARCH

	696	LI Jiang, BO Tao, CHEN Tie-Qiang, KUANG Xiao-Ni, YU Zhong, ZHANG Lu, ZENG Yu-Dong
		Neurobehavioral development in preterm infants：a retrospective study of 181 cases
		Objective To investigate the results of Gesell Developmental Scale in follow-up of preterm infants and to determine possible high-risk factors for poor long-term neurological outcome. Methods A preterm infants' questionnaire was designed, and a retrospective study was conducted on the clinical data of 181 preterm infants (corrected age 2-12 months) and their mothers. The developmental quotient (DQ) scores were determined by the Gesell Developmental Scale and statistically analyzed. Results Compared with those with a birth weight (BW) of ≥1 500 g, the preterm infants with a BW of <1 500 g had significantly reduced DQ scores of adaptability, gross motor movement, and fine movement (P<0.05). Compared with those with a gestational age (GA) of ≥32 weeks, the preterm infants with a GA of <32 weeks had significantly reduced DQ scores of adaptability, gross motor movement, fine movement, and social contact (P<0.05). DQ scores on five Gesell subscales were significantly positively correlated with GA and BW (P<0.05). The DQ scores on Gesell subscales showed a significant negative correlation with severe complications in neonatal period (P<0.001). Conclusions For preterm infants, BW <1 500 g and GA <32 weeks are high-risk factors for abnormal adaptability, gross motor movement, fine movement, and social contact, and this group of infants should be followed up closely. Severe complications in neonatal period may be associated with poor long-term neurological outcome and should be effectively prevented and treated.
		2014 Vol. 16 (7): 696-700 [Abstract] ( 5577 ) [HTML 1KB] [PDF 1317KB] ( 1331 )

	701	LIU Li-Li, HOU Xin-Lin, ZHOU Cong-Le, TANG Ze-Zhong, BAO Xin-Hua, JIANG Yi
		STXBP1 gene mutation in newborns with refractory seizures ^Hot!
		Objective To study the relationship between STXBP1 gene mutations and refractory seizures with unknown causes in newborns. Methods The coding region of STXBP1 gene was detected using direct Sanger sequencing in 11 newborns with refractory seizures of unknown causes. Results STXBP1 gene mutation was found in 1 out of 11 patients. It was a missense mutation: c.1439C>T (p.P480L). Conclusions STXBP1 gene mutation can be found in neonatal refractory seizures of unknown causes, suggesting a new approach of further research of this disease.
		2014 Vol. 16 (7): 701-704 [Abstract] ( 5975 ) [HTML 1KB] [PDF 1302KB] ( 1414 )

	705	PEI Xue-Mei, GAO Ran, ZHANG Guo-Ying, LIN Ling, WAN Sheng-Ming, QIU Su-Qing
		Effects of erythropoietin on serum NSE and S-100B levels in neonates with hypoxicischemic encephalopathy
		Objective To study the effects of erythropoietin (EPO) on serum levels of neuron-specific enolase (NSE) and S-100B in neonates with hypoxic-ischemic encephalopathy (HIE) and the underlying mechanism. Methods Forty neonates with HIE were randomly divided into conventional treatment (n=20) and EPO treatment groups (n=20). Twenty healthy full-term neonates born during the same period were randomly selected as the normal control group. The conventional treatment group received conventional treatment, while the EPO treatment group received conventional treatment as well as EPO [200 IU/(kg·d)] which was given by intravenous infusion from the second day after birth. The course of treatment was 7 days. Blood samples of the three groups were collected on the first day after birth (before treatment) and the ninth day after birth (after treatment). Serum levels of NSE and S-100B were measured by doubleantibody sandwich ABC-ELISA. Results Before treatment, the two treatment groups had significantly higher serum NSE and S-100B levels than the normal control group (P<0.01), whereas no significant differences in the levels of NSE and S-100B were observed between the conventional treatment and EPO treatment groups (P>0.05). The serum NSE and S-100B levels on the ninth day after birth were significantly lower than those on the first day after birth in the three groups (P<0.01). After treatment, the serum NSE and S-100B levels were significantly lower in the EPO treatment group than in the conventional treatment group (P<0.05). Conclusions Dynamic monitoring of serum NSE and S-100B levels may be helpful for the early diagnosis of HIE and the assessment of brain injury repair in newborns with HIE. EPO may be helpful for the repair of neurons and glial cells.
		2014 Vol. 16 (7): 705-708 [Abstract] ( 6391 ) [HTML 1KB] [PDF 1225KB] ( 1427 )

	709	LIN Xin-Zhu, LAI Ji-Dong, LAN Zhao-Yang, LIN Ya-Yin
		Clinical effect of endotracheal lavage with porcine pulmonary surfactant in term neonates with severe meconium aspiration syndrome
		Objective To evaluate the clinical effect of endotracheal lavage with porcine pulmonary surfactant (PS) in term neonates with severe meconium aspiration syndrome (MAS). Methods A total of 136 full-term infants with severe MAS who were admitted to the neonatal intensive care unit between January 2010 and June 2013 were randomly and equally divided into PS lavage and PS injection groups. In the PS lavage group, patients were treated with endotracheal lavage using 3-5 mL of diluted PS (12 mg/mL) each time, and the PS injection group was given PS by intratracheal injection at the first dose of 200 mg/kg. Blood gas, oxygenation index (OI), and PaO₂/FiO₂ (P/F) of the two groups were evaluated before and 2, 12, 24, and 48 hours after the treatment, and the duration of mechanical ventilation, complication rate, and cure rate were compared between the two groups. Results Compared with the PS injection group, the PS lavage group had significantly higher PaO₂ and P/F ration and significantly lower PaCO₂ and OI at 12, 24, and 48 hours post-treatment (P<0.01), a significantly shorter duration of mechanical ventilation (P<0.01), a significantly smaller amount of PS (P<0.01), a significantly lower complication rate (P<0.05), and a significantly higher cure rate (97% vs 88%; P<0.05). Conclusions Compared with the intratracheal injection of PS, endotracheal lavage with diluted PS in term neonates with severe MAS can increase ventilation and oxygenation efficiency, shorten the duration of mechanical ventilation, reduce the complication rate, and increase the cure rate, indicating that this method is a safe and effective therapeutic strategy.
		2014 Vol. 16 (7): 709-713 [Abstract] ( 6129 ) [HTML 1KB] [PDF 1312KB] ( 1623 )

	714	LUAN Zuo, TANG Xiang-Feng, WU Nan-Hai, XU Shi-Xia, ZHANG Bo, WANG Kai, DU Hong
		Clinical effect of umbilical cord blood transplantation in 37 pediatric patients with hematologic malignancies：a single-center experience
		Objective To evaluate the clinical effect of umbilical cord blood transplantation (UCBT) in children with hematologic malignancies. Methods A retrospective analysis was performed on the clinical data of 37 pediatric patients with hematologic malignancies that consisted of 14 cases of acute lymphocyte leukemia, 9 cases of acute myeloid leukemia, 5 cases of juvenile myelomonocytic leukemia, 3 cases of chronic myeloid leukemia, 2 cases of acute mixed leukemia, 3 cases of myelodysplastic syndrome, and 1 case of lymphosarcomatous leukemia. Thirty-seven children with hematologic malignancies received UCBT from unrelated donors (34 cases) and related donors (3 cases). Grafts were 6/6 HLA-matched in 5 cases, 5/6 HLA-matched in 12 cases, 4/6 HLA-matched in 11 cases, and 3/6 HLAmatched in 9 cases. Before transplantation, these patients received rabbit antithymocyte globulin-containing conditioning regimen. The myeloablative conditioning regimen was given in 36 cases and the reduced-intensity conditioning regimen in one case. The median age of transplantation was 5.7 years, and the median weight was 20 kg. The grafts that contained a median of 6.2×10⁷ total nucleated cells (TNC)/kg and 2.7×105 CD34⁺ cells/kg were infused. Results The median times to neutrophil engraftment and platelet engraftment were 12 days and 25 days, respectively, and the rates of neutrophil engraftment and platelet engraftment were 95% and 78%, respectively. The rate of neutrophil engraftment was positively correlated with the number of CD34⁺ cells (P=0.011), while the rate of platelet engraftment was correlated with the numbers of CD34⁺ cells and TNC (P=0.001; P=0.014). The incidence rates of acute and chronic graft-versushost disease were 49% and 11%, respectively. The median follow-up was 54 months. The 5-year transplant-related mortality, overall survival, and disease-free survival were 27%, 57.4% and 41%, respectively. Conclusions UCBT is an alternative source of hematopoietic stem cells for patients with hematologic malignancies.
		2014 Vol. 16 (7): 714-719 [Abstract] ( 5204 ) [HTML 1KB] [PDF 1355KB] ( 1044 )

	720	NIU Guo-Hui, ZHANG Xiao-Li, ZHU Deng-Na, CAI Zhi-Jun, LI San-Song, ZHANG Wei
		Therapeutic effects of different doses of botulinum toxin A injection on tiptoe deformation in children with cerebral palsy
		Objective To study the therapeutic effects of different doses of botulinum toxin A (BTX-A) injection on tiptoe deformation in children with cerebral palsy. Methods A total of 256 children with tiptoe deformation due to spastic cerebral palsy were classified into group A (muscle tension levels I-II, n=147) and group B (muscle tension levels III-IV, n=109). Group A was randomly divided into group A1 (injected with high-dose BTX-A, n=73) and group A2 (injected with low-dose BTX-A, n=74). Group B was randomly divided into group B1 (injected with high-dose BTX-A, n=55) and group B2 (injected with low-dose BTX-A, n=54). The dose of BTX-A was 6 U/kg for groups A1 and B1 and was 3 U/kg for groups A2 and B2. Before the injection and at 1,2,6, and 12 months after injection, the muscle tension of limbs was evaluated with the modified Ashworth Scale, and the recovery of motor function of lower limbs was assessed with the Gross Motor Function Measure (GMFM). Results Before and after treatment, there were no significant differences in Ashworth and GMFM scores between groups A1 and A2 (P>0.05). After treatment, group B1 had a significantly reduced Ashworth score and a significantly increased GMFM score, and group B1 had a significantly lower Ashworth score and a significantly higher GMFM score compared with group B2 (P<0.05). For groups A and B, Ashworth score gradually declined post-treatment, reached the lowest point at 3 months after treatment, and returned to the level before treatment at 12 months after treatment; GMFM score gradually increased post-treatment and reached the peak level at 12 months after treatment (P<0.05). Conclusions The level of muscle tension should be considered when BTX-A injection is used for treating tiptoe deformation in children with cerebral palsy. It makes no difference to use high-or low-dose BTX-A when the muscle tension level is within I-II, but high-dose BTX-A has a better performance in reducing muscle tension and improving motor function when the muscle tension level is within III-IV.
		2014 Vol. 16 (7): 720-724 [Abstract] ( 5787 ) [HTML 1KB] [PDF 1370KB] ( 1446 )

	725	OU Shan, OU Hui, TANG Bin, CHEN Shao-Ke, XU Yu-Qi, ZHENG Chen-Guang
		Analysis of chromosomal abnormalities and a report of eight new karyotypes among children in genetic counseling
		Objective To study the relationship between abnormal karyotypes and clinical phenotypes among children in genetic counseling in Guangxi Zhuang Autonomous Region, China. Methods We studied 601 children who visited Guangxi Zhuang Autonomous Region Women and Children Care Hospital for genetic counseling between January 2009 and July 2012. Blood samples were cultured routinely for karyotype analysis with G banding as well as clinical analysis. Results Out of 601 patients, 329 (54.7%) had chromosomal abnormalities, and 8 new abnormal human karyotypes were found. Among 329 children with abnormal karyotypes, 317 (96.4%) had an abnormal number of chromosomes, and 12 (3.6%) had abnormal chromosomal structure. Abnormal karyotypes were clinically manifested by Down's syndrome (74.5%), growth retardation (10.9%), and mental retardation (3.0%). Conclusions Eight rare abnormal karyotypes were found in the study, providing new resources for the genetic studies and etiological analysis of growth retardation, mental retardation, gonadal dysgenesis, and multiple congenital anomalies in children.
		2014 Vol. 16 (7): 725-728 [Abstract] ( 5057 ) [HTML 1KB] [PDF 1422KB] ( 1319 )

	729	DING Xiao-Fang, ZHONG Li-Li, ZHANG Bing, LIN Lin, HUANG Han, LIANG Mo
		Clinical features and pathogens of plastic bronchitis in children：an analysis of 9 cases
		Objective To study the clinical features and pathogens of plastic bronchitis in children. Methods A retrospective analysis was performed on the clinical data of 9 children who were diagnosed with plastic bronchitis between January 2011 and December 2012. Results Plastic bronchitis began with a fever and cough in all cases, followed by progressive dyspnea on days 1-3 of onset; unilateral or bilateral decreased breath sounds and hepatosplenomegaly were found; complications included respiratory failure (6 cases), toxic encephalopathy (6 cases), toxic hepatitis (7 cases), shock (3 cases), heart failure (3 cases), and renal failure (2 cases). Chest X-ray or chest CT showed single and multiple lobar or segmental consolidation and atelectasis, as well as pleural effusion (4 cases). The bronchofibroscopy revealed some grey-white mucus plugs that blocked bronchial openings and aspirates of bronchial shape. Influenza viruses (IFVs) were detected in all cases, including IFV-A (6 cases, 67%) and IFV-B (3 cases, 33%). Mixed infection with IFV-A and Mycoplasma pneumoniae (MP)/bacteria was found in 50% of all cases. In the three cases of IFV-B infection, one was complicated by MP infection. Nine patients were given treatment of antibiotics, hormones, gamma globulin and necessary respiratory support, and also were given removal of endogenous foreign body by bronchoscopy. Five patients were given antiviral therapy of oseltamivir. Seven cases cured, and 2 died. Conclusions Plastic bronchitis and severe pneumonia are similar in clinical manifestations. IFVs are the main pathogen. In addition to anti-infection treatment, hormone, gamma globulin, respiratory support, and other conventional treatments, endogenous foreign body removal by bronchofibroscopy and early antiviral therapy with oseltamivir have good efficacy.
		2014 Vol. 16 (7): 729-733 [Abstract] ( 6056 ) [HTML 1KB] [PDF 1179KB] ( 1763 )

	734	HUANG Dong-Ming, XIAO Xiao-Xiong, FU Si-Mao, LUO Cui-Mei, WANG Ke-Ming, WANG Ye-Hong, FENG Yuan-Hui, RUAN Jian, ZHENG Bo-Qiang, HUANG Juan, LI Min, CUI Bi-Yun, LI Lan, HUANG Gui-Zhen, GUO Xiao-Ling
		Incidence of wheezing and chronic cough in children aged 3-14 years in rural and urban areas of Zhongshan, China：a questionnaire survey
		Objective To investigate the incidence of wheezing and chronic cough in children aged 3-14 years in different living areas of Zhongshan, China. Methods According to the unified program of the 2010 national epidemiological survey of asthmatic children aged 0-14 years, a questionnaire survey of the children aged 3-14 years in rural and urban areas of Zhongshan was conducted. Results A total of 15 763 children were included in the survey. Among all participants, 8 248 were from the urban area, and 7 515 from the rual area; 8 306 were boys, and 7 457 were girls. The percentage of children with a history of wheezing was significantly higher in the urban group than in the rural group (6.6% vs 3.2%; P<0.05), and it was significantly higher in boys than in girls for each group (P<0.05). The urban group had a significantly higher percentage of individuals who had wheezing in the past one year than the rural group (2.8% vs 1.5%; P<0.05), and this percentage was significantly higher in boys than in girls for each group (P<0.05). Compared with the rural group, the urban group had a significantly higher percentage of individuals who had chronic cough (duration 1 year) (7.9% vs 3.1%; P<0.05). The above indices were relatively high in children under 6 years of age, and all but the percentage of girls who had wheezing in the past one year in both rural and urban areas showed significant differences between all age groups. Conclusions The incidence of wheezing and chronic cough varies with age, sex, and living area for children aged 3-14 years in Zhongshan, and it is relatively high under 6 years of age, in the urban area, and among boys.
		2014 Vol. 16 (7): 734-739 [Abstract] ( 5451 ) [HTML 1KB] [PDF 1590KB] ( 997 )

	740	ZHAO Jian-Mei, WANG Xiao-Hua
		Clinical significance of anti-neutrophil cytoplasmic antibodies and anti-endothelial cell antibodies in children with Kawasaki disease
		Objective To study the clinical significance of anti-endothelial cell antibodies (AECA) and antineutrophil cytoplasmic antibodies (ANCA) in Kawasaki disease (KD) and its complication of coronary arterial lesions (CAL). Methods Forty-two children with KD, as well as 20 children with fever caused by respiratory infection (fever control group) and 15 children for selective operation (normal control group), were included in the study. Serum levels of AECA and ANCA were measured using enzyme-linked immunosorbent assay. Echocardiography was performed to evaluate CAL in KD patients. Results During the acute phase, the KD patients had significantly higher serum AECA and ANCA levels than the two control groups (P<0.01). The KD patients had reduced serum ANCA levels (P<0.01) in the remission phase, but they were still higher than those of the two control groups (P<0.05). Among KD patients, those with CAL had significantly higher ANCA levels than those without CAL (P<0.01) in the acute phase. There was a positive correlation between serum ANCA levels and the ratio of left coronary artery to aortic annular diameter in KD patients with CAL (r=0.88, P<0.01). Conclusions AECA and ANCA may be involved in vasculitis and CAL among children with KD. Serum levels of AECA and ANCA may be used as indicators for the diagnosis of suspected KD cases in the acute phase. Elevated ANCA level has a certain predictive value for CAL.
		2014 Vol. 16 (7): 740-744 [Abstract] ( 5655 ) [HTML 1KB] [PDF 1588KB] ( 1245 )

	745	XIA Yan-Liang, YAN Wei-Xiao, CHEN Hong
		Efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension in children：a preliminary evaluation
		Objective To observe the clinical efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension (PAH) in children. Methods Fifty children (aged 2 months to 2 years) with high altitude heart disease associated with severe PAH, who were continuously transferred to the Intensive Care Unit between January 2011 and October 2013, were randomly assigned to observation and control groups. The control group was given conventional treatment, while the observation group received oral sildenafil [1 mg/(kg·d)] three times daily for 7-10 days in addition to the conventional treatment. Before and after treatment, hemodynamics, blood gas, routine blood parameters, and blood biochemical parameters were recorded. Results After treatment, the observation group had a significantly higher decrease in mean pulmonary artery pressure and significantly higher increases in arterial partial pressure of oxygen, cardiac output, cardiac index, and oxygenation index compared with the control group (P<0.05). In the observation group, there were no significant changes in mean arterial pressure, routine blood parameters and blood biochemical parameters (P>0.05), and no obvious adverse reactions were found. Conclusions For children with high altitude heart disease associated with severe PAH, sildenafil can effectively reduce pulmonary artery pressure and improve cardiac function and does not cause adverse reactions. This therapy has good safety according to the preliminary evaluation.
		2014 Vol. 16 (7): 745-748 [Abstract] ( 6142 ) [HTML 1KB] [PDF 1303KB] ( 1421 )

	749	ZHU Hong-Tao, RU Liang, GUO Yan-Fang
		Clinical significance of TGF-β1 in children with primary IgA nephropathy
		Objective To investigate the clinical significance of transforming growth factor-beta 1 (TGF-β1) in children with primary IgA nephropathy (IgAN). Methods Thirty children who were diagnosed with primary IgAN by renal biopsy between May 2008 and October 2012 were included in the study. Thirty healthy children were used as the control group. Urinary and blood TGF-β1 levels were measured using enzyme-linked immunosorbent assay, and the protein expression of TGF-β1 in the renal tissue was measured by immunohistochemistry. The correlation between TGF-β1 levels in blood, urine, and renal tissue and their relationship with clinical indices were analyzed. Results Children with primary IgAN had significantly higher urinary and blood TGF-β1 levels than the control group (P<0.01). Urinary TGF-β1 level was positively correlated with the pathological grade of renal tissue (r=0.557, P=0.001), and a significant positive correlation was also found between the TGF-β1 expression in the renal tissue and the pathological grade of renal tissue (r=0.682, P<0.01). There was no correlation between TGF-β1 levels in blood and renal tissue (r=0.038, P=0.844). Conclusions Urinary TGF-β1 level is significantly positively correlated with the pathological severity of disease in children with primary IgAN. Clinical measurement of urinary TGF-β1 may be of great practical value in predicting the progression and prognosis of chronic nephropathy.
		2014 Vol. 16 (7): 749-753 [Abstract] ( 4971 ) [HTML 1KB] [PDF 2129KB] ( 1072 )

EXPERIMENTAL RESEARCH

	754	YANG Fan, CHEN Lin-Qi, JIN Mei-Fang, ZHOU Wen-Wen, WU Hai-Ying
		Impact of neonatal exposure to different doses of bisphenol A on puberty in female rats
		Objective To evaluate the effects of neonatal exposure to different doses of bisphenol A (BPA) on the vaginal opening day (VOD), hypothalamic Kiss-1 mRNA expression, and ovarian estrogen receptor (ER) mRNA expression in female rats. Methods Neonatal female Sprague-Dawley (SD) rats were randomly divided into six groups: blank control, vehicle, 17β-estradiol (17β-estradiol, E₂, 10 μg/d), low-dose BPA [25 μg(kg·d)], medium-dose BPA [50 μg(kg·d)], and high-dose BPA groups [250 μg(kg·d)]. The rats were subcutaneously injected with respective agents on postnatal days 0-6. The VOD was recorded, and each rat was sacrificed on the same day. The hypothalamus and ovary were taken and weighed, and the organ coefficients of hypothalamus and ovary were calculated. The hypothalamic Kiss-1 mRNA expression and ovarian ERα and ERβ mRNA expression were measured by real-time PCR. Results Compared with the control group, the E₂ and medium-and high-dose BPA groups had advanced VOD, and the E₂ group had significantly reduced hypothalamic Kiss-1 mRNA expression and ovarian ERβ mRNA expression (P<0.05). Conclusions Neonatal exposure to medium-and high-dose BPA[50 and 250 μg/(kg·d)] can induce precocious puberty in rats, but it may not result from the change in hypothalamic Kiss-1 mRNA expression. Neonatal exposure to low-dose BPA [25 μg/(kg·d)] does not induce precocious puberty in rats.
		2014 Vol. 16 (7): 754-758 [Abstract] ( 5658 ) [HTML 1KB] [PDF 1476KB] ( 1449 )

	759	LIU Dan, LI Yun, ZHONG Li-Li, TAN Yu-Pin
		Effects of suplatast tosilate on airway inflammation and interleukin-5 in asthmatic rats
		Objective To study the effects of suplatast tosilate (IPD) on the airway inflammation and expression of interleukin-5 in asthmatic rats. Methods Fifty adult male Sprague-Dawley rats (4-week-old) were randomly assigned to five groups: placebo control, untreated asthma, budesonide(BUD)-treated asthma, early or late IPD intervention group (n=10 rats each). Asthmatic mode was prepared by ovalbumin sensitizion and challenge. Inflammatory cells and the percentage of EOS were detected in bronchoalveolar lavage fluid (BALF). The lung tissues were removed to detect the lung histomorphology. Gene expression of IL-5 was measured by reverse transcription-polymerase chain reaction (RTPCR). Levels of interleukin 5 (IL-5) in BALF were measured using ELISA. Results The inflammatory cells and the percentage of EOS in BALF, IL-5 levels in BALF and IL-5 mRNA expression in the lung tissues were obviously higher in the untreated asthma group than the control group (P<0.05), while the parameters in the IPD or BUD-treated asthma groups were significantly lower than the untreated asthma group (P<0.05). Conclusions IPD treatment can alleviate airway inflammation in asthmatic rats, possibly through inhibiting IL-5 mRNA transcripts.
		2014 Vol. 16 (7): 759-763 [Abstract] ( 5058 ) [HTML 1KB] [PDF 2488KB] ( 977 )

CASE REPORT

	764	YE Qi-Xiang, WANG Ping, TAO Li, CHEN Xiaowen, ZHOU Wei
		Orchiepididymitis and abscess of scrotum in a newborn infant
		No abstract available
		2014 Vol. 16 (7): 764-764 [Abstract] ( 4478 ) [HTML 1KB] [PDF 928KB] ( 1116 )

	765	YU Pu, ZHANG Jing-Jing, PAN Kai-Li
		Clinical manifestations of hyperthyroidism as the first symptom in a boy with acute leukemia
		No abstract available
		2014 Vol. 16 (7): 765-766 [Abstract] ( 4380 ) [HTML 1KB] [PDF 1065KB] ( 1102 )

	767	WANG Wen-Hua, XU Ding, HAN YA-Mei, WAN Qian
		Osteofascial compartment syndrome caused by hand crush injury in a newborn infant
		No abstract available
		2014 Vol. 16 (7): 767-768 [Abstract] ( 4472 ) [HTML 1KB] [PDF 1456KB] ( 1143 )

REVIEW

	769	ZHANG Wei, CHEN Chao
		Research advances in aggressive posterior retinopathy of prematurity
		Aggressive posterior retinopathy of prematurity (AP-ROP) is a special kind of ROP, which is characterized by ill-defined, dilated and tortuous vessels in the posterior portion of the eye and rapidly progresses to severe ROP with retinal detachment. As more and more AP-ROP cases, who usually have poor prognosis, have been found, this disease has been increasingly noted. Which premature infants are at risks? How to make earlier diagnosis? Is there any better treatment protocols? There is much research about AP-ROP and this article summarizes the risks, screening, diagnosis and treatment of this disease.
		2014 Vol. 16 (7): 769-773 [Abstract] ( 6150 ) [HTML 1KB] [PDF 1462KB] ( 1334 )

	774	LV Rong-Yu, WEN Fei-Qiu, YU Jie
		Advances in pathogenesis and correlated clinical research of hypercoagulability in β thalassemia
		This article summarizes the pathogenesis of hypercoagulability in β thalassemia patients, including platelet activation, alteration of red blood cell membranes, abnormal expression of adhesion molecules on vascular endothelial cells and iron overload. Clinical evidence, clinical manifestations of hypercoagulable state and thrombosis in β thalassemia and the effect of splenectomy on hypercoagulable state were reviewed. Strategies to prevent and treat the thromboembolic events in β-thalassemia intermedia are also discussed, including transfusion therapy to raise hemoglobin levels, avoidance or delay of splenectomy and a number of treatments in the exploration.
		2014 Vol. 16 (7): 774-778 [Abstract] ( 6355 ) [HTML 1KB] [PDF 1480KB] ( 1987 )

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