CJCP
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2014 Vol.  16 No.  12
Published: 2014-12-15
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CLINICAL EXPERIENCE
CASE REPORT
REVIEW
CLINICAL RESEARCH
1193 JIANG Shu-Hong, WANG Jin-Xiu, ZHANG Yi-Ming, JIANG Hui-Fen
Effect of hypothermia therapy on serum GFAP and UCH-L1 levels in neonates with hypoxic-ischemic encephalopathy

Objective To evaluate the effect of hypothermia therapy on serum glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) levels in neonates with hypoxic-ischemic encephalopathy (HIE). Methods Sixty-four HIE neonates were enrolled in this study. Thirty-three neonates with mild HIE were given conventional treatment and 31 neonates with moderate or severe HIE received conventional treatment and hypothermia therapy. Serum levels of GFAP and UCH-L1 were measured using ELISA before treatment and 6-12 hours after treatment. Results Serum levels of IL-6, IL-8, GFAP and UCH-L1 in the moderate/severe HIE group were significantly higher than in the mild HIE group (P<0.05) before treatment. Serum GFAP level was positively correlated with serum IL-6 (r=0.54; P<0.05) and IL-8 levels (r=0.63; P<0.05) , while negatively correlated with Apgar score (r=-0.47, P<0.05). After treatment, serum levels of IL-6, IL-8 and UCH-L1 in the moderate/severe HIE group were significantly reduced (P<0.05), while serum GFAP levels increased significantly (P<0.05). The patients with abnormal neurological development showed higher serum GFAP levels than those with favourable prognosis (P<0.05). Receiver operating characteristic (ROC) curves analysis demonstrated that the area under curve (AUC) of GFAP and UCH-L1 were 0.714 and 0.703 respectively. At a cut-off value of 0.07 ng/mL, the sensitivity and specificity of GFAP for the diagnosis of HIE were 77% and 78% respectively. Conclusions Hypothermia therapy can decrease serum UCH-L1 levels and increase serum GFAP levels in neonates with HIE. Based on their diagnostic value of brain injury, GFAP and UCH-L1 are promising to be novel biomarkers for HIE.
2014 Vol. 16 (12): 1193-1196 [Abstract] ( 5384 ) [HTML 1KB] [PDF 1172KB] ( 1604 )
1197 LUO Rui, LIU Jie, HU Ping, CHENG Shu-Shu, SHI Bi-Zhen, ZHU Jian-Hua, LIU Ling
Results of 779 cases of neonatal fundus screening and risk factors for neonatal fundus diseases

Objective To determine the prevalence and risk factors of retinal diseases of preterm infants and full term for newborns small gestational age born (SGA) by using wide-angle digital retinal imaging system (RetCam3). Methods Clinical data of 779 preterm and SGA infants whose eyes were detected by RetCam3 between January and December 2013 before discharge were studied retrospectively. Results Among the 779 infants, there were 69 cases of retinal hemorrhage (8.9%), 10 cases (1.3%) of retinopathy of prematurity (ROP), 9 cases of retinal exudative changes, 4 cases of retinal myelinated nerve fibers, 2 cases of congenita cataract, 3 cases of retinal chromatosis, 2 cases of retinal crystalline changes and 1 case of retinoblastoma. Logistic regression analysis indicated that low birth weight and gestational age and the history of oxygen inhalation were risk factors for the development of ROP and that vaginal delivery and mechanical ventilation increased the risk of retinal hemorrhage. Conclusions Neonatal fundus diseases may be so various and harmful that early fundus screening should be carried out on high-risk infants, such as preterm and SAG infants. Preventive measures should be taken against the risk factors for fundus diseases.
2014 Vol. 16 (12): 1197-1201 [Abstract] ( 5653 ) [HTML 1KB] [PDF 1148KB] ( 1471 )
1202 ZHONG Xin-Qi, CUI Qi-Liang
Comparative analysis of risk factors for preterm and small-for-gestational-age births

Objective To compare the risk factors between preterm and small-for-gestational-age (SGA) births. Methods A total of 1 270 newborns who had no obstetric risk factors or maternal diseases were enrolled in this study. Their mothers' stature, body weight, passive smoking, and history of abnormal pregnancy were investigated using the self-designed questionnaire. The infants were divided into four groups: preterm, appropriate-for-gestational-age (AGA), SGA, and term infants. Multivariate logistic regression analysis was performed to compare the risk factors between preterm and SGA births. Results A weight gain less than 9 kg during pregnancy increased the risks of preterm (OR=1.63, 95% CI: 1.12-2.07) and SGA (OR=1.92, 95% CI: 1.56-2.58). The histories of abortion (OR=1.46, 95% CI: 1.09-1.93) and preterm birth (OR=2.63, 95% CI: 1.81-3.92) were independent risk factors for preterm births, while low pre-pregnancy body mass index (<18.5) (OR=2.16, 95% CI: 1.53-3.16), short stature (<1.55 m) (OR=2.46, 95% CI: 1.78-3.48), and passive smoking (OR=2.24, 95% CI: 1.65-2.98) were independent risk factors for SGA births. Conclusions Due to different risk factors between preterm and SGA births, specific preventive measures should be taken pertinently to reduce the incidence of the two bad pregnancy outcomes.
2014 Vol. 16 (12): 1202-1205 [Abstract] ( 5402 ) [HTML 1KB] [PDF 1117KB] ( 1407 )
1206 DING Lian-Fu, CHEN Qiang, LI Lan, LIU Jian-Mei, ZHANG Gao-Ping, ZHU Xiao-Hua, WU Ai-Min, KE Jiang-Wei, DAI Yu-Lan, WU Chun-Xue
Effects of sublingual immunotherapy on serum IL-17 and IL-35 levels in children with allergic rhinitis or asthma

Objective To study the clinical effect and mechanisms of specific sublingual immunotherapy (SLIT) for the treatment of allergic rhinitis or asthma in children. Methods Thirty children suffering from Dermatophagoides farinae-allergic rhinitis or asthma (case group) and 30 healthy children (control group) were enrolled in this study. The case group accepted SLIT between January and December 2011. The ratio of forced expiratory volume in one second (FEV1) and its expected value, the ratio of airway resistance and its expected value, peripheral blood eosinophil (Eos) count and serum levels of IL-17 and IL-35 were measured before treatment and one and two years after treatment. The rhinitis or asthma symptom scores were rated and the level of asthma control was monitored. Results Serum IL-17 level in the case group was significantly higher than in the control group before treatment and one year after treatment (P<0.01). Furthermore, serum IL-17 level in the case group gradually decreased from before treatment to 1 year to 2 years after treatment (P<0.01). By two years of treatment, there was no significant difference in serum IL-17 level between the case and control groups (P>0.05). The changes of serum IL-35 level after treatment were opposite to serum IL-17 in the case group. The ratio of FEV1 and its expected value gradually increased from before treatment to 1 year to 2 years after treatment (P<0.01) in the case group. In contrast, the change of the ratio of airway resistance and its expected value and Eos count gradually decreased from before treatment to 1 year to 2 years after treatment (P<0.01) in the case group. More patients achieved improved rhinitis or asthma symptom scores two years after treatment than one year after treatment in the case group (P<0.01). SLIT was effective in 85% of children with allergic rhinitis one after treatment vs 100% two years after treatment. Asthma control was observed in 76% of the asthmatic patients one after treatment vs 92% two years after treatment. Conclusions SLIT is effective for allergic rhinitis and asthma in children, and the treatment period of two years seems to be superior to one year. The mechanism of action of SLIT for the treatment of allergic rhinitis and asthma may be associated with inhibition of IL-17 expression and promotion of IL-35 expression.
2014 Vol. 16 (12): 1206-1210 [Abstract] ( 6117 ) [HTML 1KB] [PDF 1163KB] ( 1993 )
1211 PAN Zhen-Zhen, LI Ling, GUO Yun, HE Jian
Roles of CD4+CD25+Foxp3+ regulatory T cells and IL-33 in the pathogenesis of asthma in children

Objective To study the roles of CD4+CD25+Foxp3+ regulatory T cells (Treg) and IL-33 in the pathogenesis of asthma in children. Methods Flow cytometry was used to detect peripheral blood CD4+CD25+Foxp3+Treg proportion in CD4+T lymphocytes in.45 children with asthma, 50 children with wheezing caused by respiratory syncytial virus infection and 40 healthy children. Serum levels of IFN-γ, IL-4, IL-5 and IL-33 were measured using ELISA. Results The level of peripheral blood CD4+CD25+Foxp3+Treg in the asthma group was significantly lower than in the wheezing and control groups (P<0.05). In contrast, serum levels of IL-33 in the asthma group was significantly higher than in the wheezing and control groups (P<0.05). Peripheral blood CD4+CD25+Foxp3+Treg level was negatively correlated with serum IL-33 level in the asthma group(r=-0.156, P<0.01). Conclusions CD4+CD25+Foxp3+Treg may interact with IL-33 in the pathogenesis of childhood asthma.
2014 Vol. 16 (12): 1211-1214 [Abstract] ( 5811 ) [HTML 1KB] [PDF 1197KB] ( 1368 )
1215 CUI Ya-Jie, CHEN Guo-Hong, WANG Jun-Ling, MA Lin, GUO Xiao-Ling, LIAO Jian-Xiang, LI Cheng-Rong, WANG Guo-Bing
Alterations of CD4+CXCR5+Tfh cells and its transcription regulatory factors in children with asthma
Objective To study the alterations of follicular T helper cells (CD4+CXCR5+Tfh cells, Tfh) on circulating T lymphocytes in children with asthma, and to study the expression of transcription regulatory factors BCL-6 and BLIMP-1 mRNA. Methods Sixty-four children with asthma and 25 healthy controls were enrolled in this study. On the basis of the disease, the children with asthma were classified into acute phase group (n=36) and remission phase group (n=28). The flow cytometry was used to detect the proportion of CD4+CXCR5+Tfh cells on CD4+T lymphocytes. Real-time PCR was performed to detect the levels of BCL-6 mRNA and BLIMP-1 mRNA. The double-antibody Sandwich ELISA was used to detect plasma concentrations of total IgE, IL-2, IL-6 and IL-21. Results The proportion of CD4+CXCR5+Tfh cells was significantly higher in the acute group than in the control group and the remission group (P<0.05). Transcription levels of BCL-6 mRNA were significantly higher, while the inhibitory factors BLIMP-1 mRNA was significantly lower in the acute group than in the remission group and control group (P<0.05). The plasma concentration of IL-6 in the acute group increased significantly compared with the control group (P<0.05). Plasma concentrations of total IgE and IL-21 increased significantly, in contrast, plasma IL-2 concentration decreased significantly in the acute group, compared with the control group and the remission group (P<0.05). Correlation analysis showed that both IL-21 and IL-6 concentrations were positively correlated with the proportion of CD4+CXCR5+Tfh cells (r=0.76, r=0.46 respectively; P<0.05), while IL-2 level was negatively correlated with the proportion of Tfh cells (r=-0.68, P<0.05). Conclusions The abnormal proportion of CD4+CXCR5+Tfh cells might be involved in the immunological pathogenesis of acute asthma in children. The increased expression of BCL-6 mRNA and decreased expression of BLIMP-1 mRNA as well as the alterations of plasma total IgE, cytokines IL-2, IL-6 and IL-21 in microenvironment might be account for the increased proportion of CD4+CXCR5+Tfh cells in children with acute asthma.
2014 Vol. 16 (12): 1215-1219 [Abstract] ( 6280 ) [HTML 1KB] [PDF 1513KB] ( 1228 )
1220 ZHAO Kun, SONG Gui-Hua, GU Hua-Qian, LIU Shuang, ZHANG Yan, GUO Yan-Rong
Epidemiological survey and risk factor analysis of asthma in children in urban districts of Zhengzhou, China
Objective To study the epidemiological features, treatment status, and risk factors for asthma in children in Zhengzhou, China. Methods Questionnaires for primary screening were issued using the method of multi-stage stratified sampling. Suspected asthmatic children were given a second questionnaire, physical examination, medical history review, and auxiliary examination to confirm the diagnosis. Age-and sex-matched non-asthmatic children were randomly recruited to the control group. Results The number of valid questionnaires was 10 616 (5 444 males and 5 172 females). There were 308 confirmed asthma cases and the overall prevalence was 2.90%. The prevalence in boys was higher than that in girls (3.4% vs 2.4%). The prevalence in children under 3 years of age was 10.2%, which was higher than that in other age groups. The top three triggers for asthma attack in children were respiratory infection (94.2%), weather changes (89.0%), and exercise (35.1%). The most common asthma attack was moderate (71.8%), followed by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (280 cases) of all patients, respectively. Multivariate logistic regression analysis indicated the following major risk factors for asthma: history of allergic rhinitis (OR=150.285, 95% CI: 31.934-707.264), history of eczema (OR=10.600, 95% CI: 1.054-106.624), history of atopic dermatitis (OR=31.368, 95% CI: 3.339-294.683), food allergies (OR=27.373, 95% CI: 2.670-280.621), method of birth (OR=2.853, 95% CI: 1.311-6.208), age of first antibiotic use (OR=0.384, 95% CI: 0.172-0.857), frequency of antibiotic use within 1 year of age (OR=9.940, 95% CI: 6.246-15.820), use of wall decorating materials (OR=2.108, 95% CI: 1.464-3.036), and use of heat supply in winter (OR=6.046, 95% CI: 1.034-35.362). Conclusions The prevalence of childhood asthma is associated with age and gender in Zhengzhou. Most asthma attacks are moderate, often triggered by respiratory infection. Treatment of asthma has been standardized, but still needs further improvement. History of allergic rhinitis, eczema, atopic dermatitis and food allergies, cesarean delivery, frequent use of antibiotics within 1 year of age, use of decorating materials on the wall, and use of heating in winter may increase risk for asthma, and use of antibiotics in older age is a protective factor against asthma in children.
2014 Vol. 16 (12): 1220-1225 [Abstract] ( 5951 ) [HTML 1KB] [PDF 1365KB] ( 1313 )
1226 ZUO Man-Feng, LIU He-Lin, ZHU Mu-Liang, SHU Qiong-Zhang, JIANG Ling
Pathologic bacterial distribution and antibiotic resistance in induced sputum of infants aged from 1 to 3 months with lower respiratory tract infection
Objective To investigate the pathologic bacterial distribution and their antibiotic resistance in infants aged from 1 to 3 months with lower respiratory tract infection, so as to provide instructions for clinical application of antibiotics. Methods Induced sputum was extracted from 622 cases of hospitalized infants aged from 1 to 3 months with lower respiratory tract infection between January 2013 and December 2013, and microbial sensitivity test was performed with agar diffusion sensitivity test. Results A total of 379 (60.9%) strains of bacteria were isolated from induced sputum in the 622 infants. The Gram-negative strains were detected in 325 strains (85.8%), and the Gram-positive strains were found in 50 strains (13.2%) in the 379 strains. The others were Fungal strains (4 strains, 1.1%). The Gram-negative bacteria included Escherichia coli (31.1%) and Klebsiella pneumoniae (18.2%), with extended-spectrum β-lactamases (ESBLs) production of 48.3% and 52.2% respectively. The average rate of antibiotic resistance for ESBLs-producing bacteria was 53%. ESBLs-producing bacteria were highly resistant (100%) to ampicillin and cefotaxime, but sensitive to carbapenems. Staphylococcus aureus (10.0%) was the dominant bacteria in Gram-positive bacteria. A lower proportion of methicillin-resistant Staphylococcus aureus (1.8%) was observed, however the resistance rate of methicillin-resistant Staphylococcus aureus to β-lactam antibiotics were 100%. Conclusions Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria causing lower respiratory tract infection in infants aged from 1 to 3 months. ESBLs-producing bacteria accounted for over 48%, and the antibiotic resistance rate were more than 53% in these infants. These results provide a basis for the first empirical clinical use of antimicrobial in infants with lower respiratory tract infection.
2014 Vol. 16 (12): 1226-1230 [Abstract] ( 4700 ) [HTML 1KB] [PDF 1272KB] ( 1163 )
1231 YANG Zhen, GUO Lin, XIONG Hao, GANG Zhu, LI Jian-Xin, DENG Yu-Ping, DAWA Qu-Zhen, PUBU Zha-Xi, LI Hui
Clinical analysis of childhood Henoch-Schonlein purpura on the Tibetan Plateau, China
Objective To study the clinical characteristics of childhood Henoch-Schonlein purpura (HSP) on the Tibetan Plateau, China. Methods One hundred and twenty-five HSP children admitted to Shannan People's Hospital, Tibet, were assigned to the observation group, and 96 HSP children admitted to Wuhan Children's Hospital were assigned to the control group. The disease characteristics, clinical manifestations, treatment, and prognosis in both groups were retrospectively analyzed and compared. Results The mean age of HSP onset and the female-to-male ratio in the observation group were both significantly higher than in the control group (P<0.05). There was a significant difference in seasonal onset between two groups. Significant differences in the etiological factors were observed between the two groups (P<0.05). The gastrointestinal manifestation was more prominent in the observation group compared with that in the control group (P<0.05). Laboratory findings showed that the mean erythrocyte sedimentation rate, counts of white blood cells and platelets, and percentage of neutrophil leucocytes were significantly lower, while the hemoglobin level was significantly higher in the observation group than in the control group (P<0.05). A total of 124 HSP patients (99.2%) in the observation group had a full recovery or improvement, and the overall cure rate and improvement rate showed no significant differences between two groups (P>0.05). Only 2.4% of the patients (3 cases) in the observation group had recurrent attack during follow-up, which was significantly lower than that in the control group (16.7%; P<0.05). Conclusions Childhood HSP on the Tibetan Plateau shows partial differences in disease characteristics, clinical manifestations, and laboratory measurements compared with that in the plain area. The overall prognosis is better and the recurrent rate is lower among HSP children on the Tibetan Plateau.
2014 Vol. 16 (12): 1231-1235 [Abstract] ( 4803 ) [HTML 1KB] [PDF 1320KB] ( 1128 )
1236 ZHENG Fang-Yuan, WANG Xue-Mei, WANG Xin-Li
Effects of r-hGH replacement therapy on glucose and lipid metabolism and thyroid function in children with idiopathic short stature
Objective To study the effects of recombinant human growth hormone (r-hGH) replacement therapy on glucose and lipid metabolism and thyroid function in children with idiopathic short stature (ISS). Methods Forty-seven ISS children with a mean age of 10±3 years treated between January 2009 and January 2013 were enrolled. All children underwent r-hGH replacement therapy for 3-24 months and were followed up once every 3 months. Fasting blood glucose (FBG), insulin (INS), blood lipids and thyroid function were measured before treatment and after 0-1 and 1-2 years of treatment. Results After treatment with r-hGH, there were no significant changes in FBG, INS, insulin sensitivity index (ISI), and FBG/ INS ratio (FGIR), but the FGIR showed a declining trend. The percentage of patients with FGIR<7 (a marker of insulin resistance) was 13% before treatment compared to 18% 1-2 years after treatment. The atherosclerosis index decreased after r-hGH treatment, but there were no significant changes in total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and BMI. Furthermore, no significant change in thyroid function was observed after r-hGH therapy. Conclusions r-hGH therapy can improve lipid metabolism, without significant impacts on thyroid function, FBG and INS. It seems to be a safe and reliable therapy for children with ISS. However, this therapy possibly reduces insulin sensitivity.
2014 Vol. 16 (12): 1236-1240 [Abstract] ( 5238 ) [HTML 1KB] [PDF 1287KB] ( 1249 )
1241 GUO Li, LU Mei-Ping, TANG Yong-Min, TENG Li-Ping, XU Yi-Ping, ZOU Li-Xia, ZHENG Rong-Jun, ZHENG Qi
Serum cytokine levels in children with newly diagnosed active systemic juvenile idiopathic arthritis
Objective To study the changes in serum cytokines levels in children with newly diagnosed active systemic juvenile idiopathic arthritis (SJIA) and to explore the role of cytokines in the development and progression of SJIA. Methods Seventy-four pediatric patients with active SJIA between January 2010 and December 2013 were included in the study. Serum levels of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukine-10 (IL-10), tumor necrosis factor (TNF), and interferon gamma (IFN-γ) were measured by flow cytometry in these patients. The levels of cytokines were also determined in 202 healthy children as the control group. Routine laboratory parameters including white blood cell (WBC) count, percentage of neutrophils, hemoglobin level, platelet count, hypersensitive C-reactive protein (hs-CRP), and erythrocyte sedimentation rate (ESR) were monitored in the patient group. Results The WBC count, percentage of neutrophils, hs-CRP, and ESR in 74 cases of SJIA were significantly above the normal range, their platelet counts were within the normal range, whereas hemoglobin levels were below the normal range. Compared with the control group, the patient group showed a significantly increased level of IL-6 (P<0.01) and significantly reduced levels of IL-4, IL-10, and TNF (P<0.01). However, there were no significant changes in serum levels of IL-2 and IFN-γ in the patient group (P>0.05). In SJIA children, IL-6 level, which was significantly elevated, was negatively correlated with hemoglobin level, which was significantly reduced (r=-0.244, P<0.05). Conclusions Serum level of IL-6 is significantly increased in children with SJIA, and it has a negative correlation with anemia.
2014 Vol. 16 (12): 1241-1244 [Abstract] ( 5941 ) [HTML 1KB] [PDF 1239KB] ( 1147 )
1245 CHANG Li, ZHANG Ge, SHI Hua, YE Lei, JIANG Yong-Mei
Clinical value of minimal residual disease detection by flow cytometry in childhood B-cell acute lymphoblastic leukemia
Objective To elevate the prognostic value of minimal residual disease (MRD) detection by four-color flow cytometry with the antibody panel in childhood B-cell acute lymphoblastic leukemia (B-ALL). Methods The clinical data of 183 children with newly-diagnosed acute B-ALL and who accepted MRD detection between October 2010 and March 2012 was retrospectively reviewed. According to the detection time and result of MRD, the 183 children were classified into four groups: MRD negative (n=37) and positive (n=18) in the induction chemotherapy and MRD negative (n=113) and positive (n=15) in the maintenance chemotherapy. Results During both induction and maintenance chemotherapy, the percentage of patients at high and median risk in the MRD positive group was higher than in the MRD positive group (P<0.05). In the maintenance chemotherapy group, the 3-year cumulative incidence of relapse in MRD positive patients was higher than negative patients (P=0.04). The Cox's proportional hazards regression analysis showed that insensitive reaction for prednisone (RR=1.005, 95%CI: 0.864-1.170, P=0.032), bone marrow morphology that did not meet M1 on the 15th day (RR=6.454, 95%CI: 2.191-19.01, P=0.002) and MRD≥0.01% (RR=1.923, 95%CI: 0.750-4.933, P=0.043) were risk factors for relapse in children with B-ALL. Conclusions The four-color flow cytometry with the antibody panel can distinguish from MRD positive patients from negative patients with B-ALL. The result of MRD detection, as prednisone sensitivity and bone marrow morphology on the 15th day, is also a independent prognostic factor in children with B-ALL.
2014 Vol. 16 (12): 1245-1249 [Abstract] ( 4977 ) [HTML 1KB] [PDF 1385KB] ( 1507 )
1250 PEI Liang, WEN Guang-Fu, GUO Zhang-Yan, SONG Wen-Liang, WANG Li-Jie, LIU Chun-Feng
Short-term prognostic factors in children with acute liver failure
Objective To investigate the factors that influence the short-term (6 months) prognosis in children with acute liver failure. Methods The clinical information of 53 children with acute liver failure treated between June 2008 and September 2013 was retrospectively analyzed. The patients were divided into survival group (n=21) and death group (n=32) according to their outcomes. The liver function parameters and incidence of complications were compared between the two groups, and multivariate logistic regression analysis was used to identify major factors affecting the short-term prognosis in these patients. Results There were significant differences between the death and survival groups in the indices of international normalized ratio (INR), blood ammonia and serum albumin (Alb), and complications such as hepatic encephalopathy, gastrointestinal hemorrhage, and multiple organ failure (P<0.05). Multivariate logistic regression analysis demonstrated that serum Alb, INR, and hepatic encephalopathy were the major factors affecting the short-term prognosis of acute liver failure (OR=0.616, 75.493 and 1210.727 respectively; P<0.05). Conclusions INR, hepatic encephalopathy and serum Alb are the major factors that influence the short-term prognosis in children with acute liver failure.
2014 Vol. 16 (12): 1250-1254 [Abstract] ( 5265 ) [HTML 1KB] [PDF 1353KB] ( 1279 )
1255 CHEN Si-Si, ZHOU Le-Shan
Incidence of accident proneness and its influencing factors in rural children
Objective To investigate the incidence of accident proneness and its influencing factors in rural children. Methods By random cluster sampling, 1 560 children were enrolled from one rural area in Hunan Province, China, and were surveyed with self-designed general and injury questionnaires. Unconditional multivariate logistic regression analysis was used to explore the major risk factors for accident-prone children. Results One hundred and forty-seven accident-prone children were screened out and the incidence of accident proneness was 9.42%. Univariate analysis showed that gender (P<0.01), academic record (P<0.01), left-behind status (P<0.05), family type (P<0.05), family economic status (P<0.01), guardian's gender (P<0.05), guardian's marital status (P<0.05), guardian's occupation (P<0.05), and family educational mode (P<0.05) were influencing factors for accident proneness in rural children. Multivariate logistic regression analysis further revealed that low grade (OR=3.683, 95%CI: 1.028-4.283) and very low grade (OR=2.099, 95% CI: 1.587-8.546) in academic record, poverty in family economic status (OR=2.353, 95% CI: 1.222-4.533), and indulgence or indifference (OR=1.914, 95% CI: 1.029-3.559) and fickleness (OR=4.153, 95% CI: 1.847-9.338) in guardian's educational mode were risk factors for accident proneness in rural children, while female gender (OR=0.539, 95% CI: 0.369-0.788) was a protective factor. Conclusions Low academic record, poor family economy, and incorrect family education mode (indulgence or indifference and fickleness) would increase the incidence of accident proneness in rural children, but girls have less accident proneness than boys.
2014 Vol. 16 (12): 1255-1259 [Abstract] ( 4356 ) [HTML 1KB] [PDF 1459KB] ( 1034 )
EXPERIMENTAL RESEARCH
1260 SONG Li-Li, HUANG Zhi-Heng, PEI Yi-Ling, CHEN Chao
Effect of perinatal recurrent infection on the brain development in immature mice

Objective To study the effects of perinatal recurrent infection on the brain development in immature mice. Methods Six pregnant C57BL6 mice were randomly assigned to three groups: intrauterine infection, perinatal recurrent infection and control. The intrauterine infection group was intraperitoneally injected with LPS (0.5 mg/kg) on the 18th day of pregnancy. The perinatal recurrent infection group was injected with LPS (0.5 mg/kg) on the 18th day of pregnancy and their offsprings were intraperitoneally injected with the same dose of LPS daily from postnatal day 3 to 12. The control group was administered with normal saline at the same time points as the recurrent infection group. The short-time neurobehaviors were assessed on postnatal day 13. The mice were then sacrificed to measure brain weights and neuropathological changes using cresyl violet staining. Western blot was used to evaluate the expression of TNF-α, Caspase-3 and myelin basic protein (MBP). Results The brain weights of the recurrent infection group were significantly lower than the control and intrauterine infection groups (P<0.05) and the recurrent infection group displayed significant neuropathological changes. Perinatal recurrent infection resulted in increased expression levels of TNF-α and Caspase-3, and decreased expression level of MBP compared with the intrauterine infection and control groups (P<0.01). The neurobehavior test showed that the recurrent infection group used longer time in gait reflex, right reflex and geotaxis reflex compared with the control and intrauterine infection groups on postnatal day 13 (P<0.05). Conclusions Perinatal recurrent infection may exacerbate inflammatory response and cell death in the immature brain, which may be one of the important factors for perinatal brain injury.
2014 Vol. 16 (12): 1260-1264 [Abstract] ( 4466 ) [HTML 1KB] [PDF 1926KB] ( 1020 )
1265 SUN Hai-Hui, SHANG Yun-Xiao, YANG Nan
Effect of dexamethasone on osteopontin expression in the lung tissue of asthmatic mice
Objective To study the correlation between airway inflammation and osteopontin (OPN) level in the lung tissue, and to study the effect of dexamethasone (DXM) on OPN expression. Methods Fifty mice were randomly divided into 5 groups: normal control, ovalbumin (OVA)-challenged asthma groups (OVA inhalation for 1 week or 2 weeks) and DXM-treated asthma groups (DXM treatment for 1 week or 2 weeks). The mice were sensitized and challenged with OVA to prepare mouse model of acute asthma. Alterations of airway inflammation were observed by haematoxylin-eosin staining. Serum level of OVA-sIgE was evaluated using ELISA. OPN expression in the lung tissue was located and measured by immunohistochemistry and Western blot respectively. OPN mRNA level in the lung tissue was detected by real-time PCR. Results The asthma groups showed more pathological changes in the airway than the normal control and the DXM-treated groups. Compared with the OVA-challenged 1 week group, the pathological alterations increased in the OVA-challenged 2 weeks group. The level of OVA-sIgE in serum increased in the asthma groups compared with the control and the DXM groups (P<0.01). Serum OVA-sIgE sevel increased more significantly in the OVA-challenged 2 weeks group compared with the OVA-challenged 1 week group (P<0.01). OPN protein and mRNA levels were significantly raised in the asthma groups compared with the normal control and the DXM groups (P<0.01) , and both levels increased more significantly in the OVA-challenged 2 weeks group compared with the OVA-challenged 1 week group (P<0.01). Conclusions The increased OPN expression in the lung tissue is associated with more severe airway inflammation in asthmatic mice, suggesting that OPN may play an important role in the pathogenesis of asthma. DXM can alleviate airway inflammation possibly by inhibiting OPN production.
2014 Vol. 16 (12): 1265-1270 [Abstract] ( 5154 ) [HTML 1KB] [PDF 3616KB] ( 1190 )
1271 GUO Hui, MAO Meng, YU Dan, ZHOU Hui, TONG Yu
A modified culture method for astrocytes from rat cortical tissue in vitro Hot!

Objective To evaluate the efficiency of a modified culture method for rat cerebral cortical astrocytes in vitro. Methods The astrocytes derived from the cerebral cortex of 3-day-old Sprague-Dawley rats were first purified as described previously, then the cells were replanted at a low density. The culture flask was changed after 1 hour and substratum was replaced after 24 hours. Cells were syncretized to a monolayer, followed by cell passage. After three passages the cells were cultured in DMEM medium containing 10% fetal serum for a long period. The derivation of the cells was identified by immunofluorescent staining with anti-GFAP polyclonal antibodies. Results A variety of morphologically distinct astrocytes with many long processes and small cell bodies were obtained. Finally an astrocytic network occurred through cellular process connections. The immunofluorescent staining demonstrated the percentage of GFAP-positive cells was above 98%. Conclusions The modified culture method for astrocytes from rat cerebral tissue is reliable, with a high purity. The cultured astrocytes have a similar morphological development to those in vivo.
2014 Vol. 16 (12): 1271-1274 [Abstract] ( 5069 ) [HTML 1KB] [PDF 1782KB] ( 1155 )
CLINICAL EXPERIENCE
1275 TANG Jian-Ping, HU Meng-Ye, WEI Zhu
Clinical features of onychomadesis following hand-foot-mouth disease in children
No abstract available
2014 Vol. 16 (12): 1275-1276 [Abstract] ( 4502 ) [HTML 1KB] [PDF 1162KB] ( 1327 )
CASE REPORT
1277 QUE Li-Ping, LIANG Li-Yang, MENG Zhe, et al
Diagnosis of Wolf-Hirschhorn syndrome by array-comparative genomic hybridization in an infant
No abstract available
2014 Vol. 16 (12): 1277-1278 [Abstract] ( 3878 ) [HTML 1KB] [PDF 1013KB] ( 1075 )
1279 ZHANG Xi-Yuan
A case report of congenital esophageal stenosis owing to ectopic tracheobronchial remnants
No abstract available
2014 Vol. 16 (12): 1279-1280 [Abstract] ( 3441 ) [HTML 1KB] [PDF 1256KB] ( 1040 )
1281 WANG Yu, ZHANG Le-Ping, WU Jun, et al
A case report of giardia lamblia and EB virus associated hemophagocytic syndrome
No abstract available
2014 Vol. 16 (12): 1281-1282 [Abstract] ( 3982 ) [HTML 1KB] [PDF 1350KB] ( 1266 )
REVIEW
1283 WU Lin-Lin, HAN Bo
Diagnosis and treatment of myocarditis
Myocarditis is a focal or diffuse inflammatory process of the myocardium. Along with the deepening of research, there are new technological advances which are useful to the diagnosis and treatment of myocarditis. Cardiovascular magnetic resonance imaging has become a useful noninvasive imaging tool for diagnosis of myocarditis, but does not replace endomyocardial biopsy. The supportive treatment has remained the mainstay of therapy for patients with myocarditis, especially with fulminant myocarditis, including the comprehensive treatment of shock, heart failure, and arrhythmia. Due to the lack of large clinical data, diagnosis and treatment for myocarditis remains to be further explored.
2014 Vol. 16 (12): 1283-1288 [Abstract] ( 5517 ) [HTML 1KB] [PDF 1485KB] ( 2741 )
1289 WANG Tian-Tian, DU Lin, SHAN Ling, JIA Fei-Yong
Research advances in immunological dysfunction in children with autism spectrum disorders
Autism spectrum disorders (ASD) are a group of neuro-developmental disorders in early childhood which are defined by social difficulties, communication deficits and repetitive or restrictive interests and behaviours. The etiology of ASD remains poorly understood. Much research has shown that children with ASD suffer from immunological dysfunction. This article reviews the current research progress on immunological dysfunction in children with ASD, including abnormalities in immune cells, antibodies, complements, cytokines, major histocompatibility complex and their potential association with ASD, and explores the impacts of maternal immunological activation on the immune dysfunction of children with ASD.
2014 Vol. 16 (12): 1289-1293 [Abstract] ( 4985 ) [HTML 1KB] [PDF 1433KB] ( 1423 )
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