CJCP
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2016 Vol.  18 No.  10
Published: 2016-10-15
TOPIC OF BREASTFEEDING
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CLINICAL EXPERIENCE
TOPIC OF BREASTFEEDING
921 LIU Xi-Hong
Research advances in breastfeeding Hot!

Human breast milk is the most natural and ideal food for the baby. Breastfeeding provides benefits for maternal and child health, child immune function, growth and development, and society. The operation of human milk bank and the use of donor human milk undoubtedly provides a new way of nutrition support for the preterm infants without their own mother's milk and a new kind of treatment for other diseases. Present research on the composition of breast milk focuses on the variety and quantity of proteins, bioactive substances, probiotics and cell population. Future research may focus on the bioactive substances, the mechanism of regulation and effect of cell population, the application of probiotics and the clinical application of donor human milk.
2016 Vol. 18 (10): 921-925 [Abstract] ( 3810 ) [HTML 1KB] [PDF 1086KB] ( 1507 )
926 MA Jing-Ran, WANG Dan-Hua
Epigenetic effects of human breastfeeding
Breastfeeding is well-known for its benefits of preventing communicable and non-communicable diseases. Human breastmilk consists not only of nutrients, but also of bioactive substances. What's more, the epigenetic effects of human breast milk may also play an important role. Alterations in the epigenetic regulation of genes may lead to profound changes in phenotype. Clarifying the role of human breast milk on genetic expression can potentially benefit the infant's health and his later life. This review article makes a brief summary of the epigenetic mechanism of breast milk, and its epigenetic effects on neonatal necrotizing enterocolitis, infectious diseases, metabolism syndrome, cognitive function and anaphylactic diseases.
2016 Vol. 18 (10): 926-930 [Abstract] ( 4054 ) [HTML 1KB] [PDF 1120KB] ( 1220 )
931 RAN Li-Hong, BAO Lei
Research advances in breast milk-acquired cytomegalovirus infection in premature infants
Breast milk is considered ideal food for premature infants, but it can also be the main source of cytomegalovirus (CMV) infection in premature infants. CMV infection may cause serious clinical symptoms, such as sepsis-like syndrome, thrombocytopenia, neutropenia, jaundice, hepatitis, and pneumonitis. This article reviews the research advances in symptoms, treatment strategies, prognosis and the prevention of breast milk-acquired CMV infection in premature infants
2016 Vol. 18 (10): 931-936 [Abstract] ( 3459 ) [HTML 1KB] [PDF 1138KB] ( 909 )
937 LIU Feng, HAN Shu-Ping, YU Zhang-Bin, ZHANG Jun, CHEN Xiao-Hui, WU Wei-Min, CHU Xue, LIU Bei-Bei
Effect of breastfeeding quality improvement on breastfeeding rate in very low birth weight and extremely low birth weight infants
Objective To study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). Methods A retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups. Results The implementation of breastfeeding quality improvement measures significantly increased breastfeeding rate and amount, significantly shortened time to addition of human milk fortifier, duration of parenteral nutrition, and time to enteral feeding, and significantly decreased the incidence of feeding intolerance. Conclusions Breastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.
2016 Vol. 18 (10): 937-942 [Abstract] ( 4395 ) [HTML 1KB] [PDF 1284KB] ( 1312 )
943 HUANG Li-Li, XIONG Fei, YANG Fan
Relationship between breast milk composition and weight growth velocity of infants fed with exclusive breast milk
Objective To study the effect of breast milk composition on weight growth velocity of infants fed with exclusive breast milk. Methods One hundred and thirty-eight full-term singleton infants who received regular follow-up visits and fed with exclusive breast milk and their mothers were recruited. Body height, weight and head circumference of these infants were measured at regular visits. Z scores were used to evaluate growth velocity. The subjects were classified into a failure to thrive group (ΔZ scores ≤ -0.67), a poor growth group (-0.67 < ΔZ scores<0) and a normal control group (ΔZ scores ≥ 0). The samples of mature breast milk were collected for composition analysis. The differences in the levels of the protein, fats, energy, carbohydrates and minerals in breast milk were compared among the three groups. Results ΔZ scores for weight in the failure to thrive and poor growth groups were lower than in the normal control group (P < 0.05). There was no significant difference in the levels of protein, fats and energy in breast milk among the failure to thrive, poor growth and normal control groups. However, the levels of carbohydrates and minerals in both the failure to thrive and poor growth groups were lower than in the normal control group (P < 0.05). Conclusions Weight growth velocity of infants can be affected by the composition of breast milk to a certain degree in a short period. In order to maintain a good weight growth velocity of infants, mothers should have a balanced diet to improve the quality of breast milk.
2016 Vol. 18 (10): 943-946 [Abstract] ( 3213 ) [HTML 1KB] [PDF 1200KB] ( 967 )
936
2016 Vol. 18 (10): 936-936 [Abstract] ( 1446 ) [HTML KB] [PDF 838KB] ( 324 )
942
2016 Vol. 18 (10): 942-942 [Abstract] ( 1300 ) [HTML KB] [PDF 845KB] ( 424 )
1059
2016 Vol. 18 (10): 1059-1059 [Abstract] ( 1164 ) [HTML KB] [PDF 818KB] ( 354 )
CLINICAL RESEARCH
947 CHEN Guang-Fu, LI Hui-Tao, HUANG Jin-Jie, WANG Zhang-Xing, LI Yun, YANG Chuan-Zhong, WU Ben-Qing, LIU Wen-Lan, LIU Li-Hui, KONG Qi, LIU Rong-Tian
Relationship between serum erythropoietin levels and brain injury in preterm infants
Objective To study the relationship between the levels of erythropoietin (EPO) in serum and brain injury in preterm infants. Methods Three hundred and four preterm infants (gestational age: 28-34 weeks) born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum were detected using ELISA. To compare the incidence of brain injury in different serum EPO levels in preterm infants, and the relationship between brain injury and serum EPO levels was analyzed. Results The incidence rate of brain injury in preterm infants was 41.1% (125/304). The incidence rate of brain injury in the low EPO level group was significantly higher than that in the middle-high EPO level groups (P < 0.01). The serum levels of S100 protein, NSE, and MBP in the brain injury groups were significantly higher than in the control group (P < 0.01). The serum EPO levels were negatively correlated with serum S100 protein concentration and NSE levels (P < 0.05). According to the multiple logistic regression analysis, low gestational age, low birth weight, asphyxia, prolonged mechanical ventilation, anemia and low serum EPO levels were the risk factor for brain injury in preterm infants. Conclusions There is a higher incidence rate of brain injury in preterm infants with lower serum EPO levels. The serum EPO levels may be correlated with brain injury in preterm infants.
2016 Vol. 18 (10): 947-952 [Abstract] ( 3573 ) [HTML 1KB] [PDF 1306KB] ( 834 )
953 ZHOU Ping, CHEN Rui, ZOU Cai-Yan, ZHANG Min, CHEN Zhao-Hong, MA Li-Ya
Effect of perinatal factors on postnatal development of lymphocyte subsets in early preterm infants
Objective To study the postnatal changes in lymphocyte subsets in early preterm infants and the effect of perinatal factors on lymphocyte subsets. Methods A total of 61 early preterm infants were enrolled. Flow cytometry was used to measure the absolute counts of lymphocytes and lymphocyte subsets at 1, 7, 14, and 28 days after birth, as well as at 6 months after birth for 17 of these early preterm infants. The effects of perinatal factors, such as antepartum use of hormone, intrauterine infection, gestational age at birth, and Ureaplasma urealyticum (UU) colonization, on lymphocyte subsets were analyzed. Results The absolute counts of lymphocyte subsets except natural killer (NK) cells were lowest at birth, increased rapidly at 1 week after birth, and reached the levels in healthy infants at 6 months; the count of NK cells remained at a low level and increased significantly at 6 months after birth. Compared with those with a gestational age of <28 weeks, the early preterm infants with a gestational age of ≥28 weeks had significantly higher absolute counts of T cells, T helper (Th) cells, and NK cells at 7 days after birth, a significantly higher absolute count of T cells at 14 days after birth, and significantly higher absolute counts of lymphocytes and Th cells at 28 days after birth (P < 0.05). Compared with the group not using hormone, the group using hormone showed a significantly higher absolute count of T cells at 7 days after birth and significantly higher absolute counts of lymphocytes and all subsets at 14 days after birth (P < 0.05). There was no significant difference in lymphocyte subsets at 1 day after birth between the intrauterine infection and non-infection groups (P>0.05); the intrauterine infection group had significantly higher absolute counts of B cells at 7 and 14 days after birth than the non-infection group. Compared those without UU colonization, the infants with UU colonization had significantly higher absolute counts of lymphocytes, T cells, Th cells, and Ts cells at 1 day after birth and a significantly higher absolute count of B cells at 14 days after birth. Conclusions Early preterm infants have deficiencies in innate immune cells at birth and normal levels at about 6 months after birth. Various perinatal factors including antepartum use of hormone, gestational age at birth, intrauterine infection, and UU colonization have long-term effects on lymphocyte subsets in early preterm infants.
2016 Vol. 18 (10): 953-959 [Abstract] ( 2619 ) [HTML 1KB] [PDF 1598KB] ( 671 )
960 LI Mao-Jun, WU Qing, SHI Wei, YANG Qian, TANG Bin-Zhi, CHEN Chang-Hui
Clinical features of respiratory distress syndrome in neonates of different gestational ages
Objective To study clinical features of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA). Methods According to GA, 133 neonates with RDS were classified into GA <34 weeks group (n=66), GA 34-36 weeks group (late preterm neonates; n=31), and GA ≥37 weeks group (full-term neonates; n=36). The mothers' medical history during pregnancy and the condition of the neonates at birth were retrospectively analyzed, and the clinical data were compared between groups. Results Prenatal corticosteroids supplementation in the GA <34 weeks group was more common than that in the GA 34-36 weeks group (P < 0.05). Compared with the GA ≥37 weeks group and the GA 34-36 weeks group, the GA <34 weeks group showed a significantly lower rate of primary diseases, a significantly later time of the development of dyspnea (P < 0.05), and a higher rate of intraventricular hemorrhage (P < 0.05). Serum albumin levels in the GA <34 weeks group were significantly lower than in the GA ≥37 weeks group (P < 0.05). The GA ≥37 weeks group and the GA 34-36 weeks group showed a significantly higher reuse rate of pulmonary surfactant (P < 0.05). Use of high-frequency oscillatory ventilation was more common in the GA ≥37 weeks group compared with the GA <34 weeks group (P < 0.05). Conclusions The clinical features of RDS are different across neonates of different GA, suggesting that the pathogenesis of RDS may be different in neonates of different GA.
2016 Vol. 18 (10): 960-964 [Abstract] ( 3400 ) [HTML 1KB] [PDF 1300KB] ( 895 )
965 YANG Lei, XU Wei, YAN Chao-Ying
Background patterns and sleep-wake cycles on amplitude-integrated electroencephalography in preterm infants with periventricular-intraventricular hemorrhage
Objective To study the background patterns and sleep-wake cycles (SWC) on amplitude-integrated electroencephalography (aEEG) in preterm infants with different grades of periventricular-intraventricular hemorrhage (PIVH). Methods Fifty-six preterm infants with a gestational age between 25 and 33 weeks who were diagnosed with PIVH and 31 gestational age-matched normal preterm without ICH were enrolled. According to Papile staging criteria, the infants with PIVH were subdivided into mild group (grades I and II) and moderate-severe group (grades III and IV). The results of the aEEG were compared between groups. Results The moderate-severe PIVH group showed a decreased continuity of the voltage, an increased loss rate of SWC, and a lower aEEG score than the mild PIVH and control groups (P < 0.017). There were no significant differences in these parameters between the mild PIVH and control groups. Conclusions The changes of background patterns and SWCs may be associated with the severity of PIVH in preterm infants.
2016 Vol. 18 (10): 965-970 [Abstract] ( 3120 ) [HTML 1KB] [PDF 1970KB] ( 733 )
971 YANG Xiao-Yan, LONG Li-Li, XIAO Bo
Role of video electroencephalogram in diagnosis and localization of epilepsy in children
Objective To study the role of video electroencephalogram (VEEG) versus regular electroencephalogram (REEG) in the diagnosis of epilepsy and localization of origin of epileptic discharge in children through a comparative analysis. Methods A retrospective analysis was performed for the clinical data of 223 children with clinical paroxysmal symptoms in the past and suspected epilepsy. VEEG and REEG were compared from the aspects of monitoring of clinical seizures, interictal epileptiform discharge (IED), localization of the origin of IED, and identification of non-epileptic seizures, and the detection rate of IED during awakening and sleep stages was also compared. Results Compared with REEG, VEEG had significantly higher detection rates of IED and synchronous clinical seizures in children with epileptiform discharge (P < 0.01). Of all children, 86 were diagnosed with epilepsy, 78 were diagnosed with epilepsy syndrome, 31 were diagnosed with non-epileptic seizures, and 81 had a definite location of the origin of epileptic discharge according to the VEEG. The detection rate of IED in the sleep stage was higher than that in the awakening stage (46% vs 13.2%; P < 0.01), and IED was mainly detected in the NREM I-II stages according to the VEEG. Conclusions VEEG has a significantly better performance than REEG in the diagnosis and localization of epilepsy in children and has a high value in clinical practice.
2016 Vol. 18 (10): 971-974 [Abstract] ( 3021 ) [HTML 1KB] [PDF 1227KB] ( 683 )
975 REN Kai, GONG Xiao-Ming, ZHANG Rong, CHEN Xiu-Hui
Effects of virtual reality training on limb movement in children with spastic diplegia cerebral palsy
Objective To study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy. Methods Thirtyfive children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment. Results Before treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P > 0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P < 0.05). Conclusions VR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.
2016 Vol. 18 (10): 975-979 [Abstract] ( 14072 ) [HTML 1KB] [PDF 1338KB] ( 2659 )
980 JIANG Yi-Ling, PENG Dong-Hong
Serum level of vitamin A in children with pneumonia aged less than 3 years
Objective To investigate the association of the serum level of vitamin A (VA) with the severity of pneumonia and recurrent respiratory infection (RRI) within one year after treatment in children with pneumonia, and to provide a basis for serum VA level used as an index for judgment of the condition of pneumonia and prediction of the risk of recurrent respiratory infection. Methods A total of 88 children with pneumonia aged less than 3 years were enrolled as study subjects. Serum VA level was measured on admission, and the development of RRI was followed up by telephone within 1 year after discharge. Results The children with pneumonia showed a reduction in the serum level of VA (0.8±0.3 μmol/L). The severe pneumonia group had a significantly lower serum level of VA than the mild pneumonia group (0.7±0.3 μmol/L vs 0.9±0.3 μmol/L; P < 0.05), as well as a significantly higher detection rate of vitamin A deficiency (VAD) than the mild pneumonia group (63% vs 28%; P < 0.05). The children were followed up for 1 year. The VAD-pneumonia group showed a significantly higher incidence of RRI than the normal VA-pneumonia group (49% vs 18%; P < 0.05), while there were no significant differences in the incidence of RRI between the suspected subclinical vitamin A deficiency (SSVAD) -pneumonia group and the normal VA-pneumonia group, as well as between the VADpneumonia group and the SSVAD-pneumonia group (P>0.05). Conclusions Children with pneumonia often have a low level of VA, and the level of VA is associated with the severity of pneumonia and the development of RRI afterwards.
2016 Vol. 18 (10): 980-983 [Abstract] ( 3429 ) [HTML 1KB] [PDF 1267KB] ( 789 )
984 XIE Hui, LI Ji-Ming, ZHANG Hui-Fen, WANG Ye, ZHONG Li-Lin, LIAN Qing-Rong, DONG Hong-Ba
Application of Mycoplasma pneumoniae antibody and load index in the diagnosis of Mycoplasma pneumoniae pneumonia in children
Objective To study the role of Mycoplasma pneumoniae (MP) load and antibody measurements in the diagnosis of MP pneumonia. Methods A total of 115 children with MP pneumonia and 400 healthy children were enrolled. The MP load and total antibody level were measured at different stages, and the MP load index (MPLI) was calculated. Results The cut-off value of MPLI for MP infection was 6.12. MPLI and total antibody titer increased during the course of the disease, while MP-DNA decreased rapidly. Within the same time of blood collection, the group with a higher MP load had a significantly higher total antibody titer than the group with a lower MP load (P < 0.05). Within 2 weeks of the course of the disease, the negative antibody group had a significantly higher MPLI than the positive antibody group (P < 0.05). Conclusions MPLI provides a standardized quantitative value of MP-DNA and plays an important role in the early diagnosis of MP infection.
2016 Vol. 18 (10): 984-987 [Abstract] ( 3561 ) [HTML 1KB] [PDF 1318KB] ( 919 )
988 XIA Li-Ping, CHEN Xu, JIANG Yi
Clinical effect of gamma globulin pulse therapy for abdominal Henoch-Schönlein purpura in children
Objective To study the clinical effect of high-dose gamma globulin pulse therapy for abdominal Henoch-Schönlein purpura (HSP). Methods Thirty-three children with abdominal HSP were randomly assigned to dexamethasone group (15 children) and gamma globulin group (18 children). The children in the dexamethasone group were treated with dexamethasone and conventional treatment, and those in the gamma globulin group were treated with high-dose gamma globulin pulse therapy in addition to the conventional treatment. Clinical outcome and recurrence rate were observed in both groups. Results Compared with the dexamethasone group, the gamma globulin group had a significantly shorter onset time of rash, a significantly shorter time to complete regression of rash, a significantly shorter time to abdominal pain remission, and a significantly shorter time to disappearance of bloody stool, as well as comparable time to vomiting remission and length of hospital stay. The gamma globulin group had a significantly higher response rate than the dexamethasone group (95% vs 65%; P < 0.05) and a significantly lower recurrence rate within 6 months than the dexamethasone group (5.6% vs 33.3%; P < 0.05). Conclusions High-dose gamma globulin pulse therapy has a marked clinical effect in the treatment of abdominal HSP. It is safe and reliable and has a low recurrence rate, and therefore, it holds promise for clinical application.
2016 Vol. 18 (10): 988-990 [Abstract] ( 3883 ) [HTML 1KB] [PDF 1237KB] ( 846 )
991 CHEN Bo, FENG Shuai, YIN Xiao-Wen
Effect of obesity on treatment outcome of asthma predictive index-positive infants and young children with wheezing
Objective To study the effect of obesity on the treatment outcome of asthma predictive index (API) -positive infants and young children with wheezing. Methods A total of 208 API-positive infants and young children with wheezing were enrolled. According to the Kaup index, the patients were divided into an obese group (n=93) and a non-obese group (n=115). The patients were given multimodality therapy in an acute episode of wheezing and aerosol inhalation of inhaled corticosteroid (ICS) budesonide suspension in the remission stage. The dose of ICS was adjusted according to clinical control. The patients were treated for 6 months, and were followed up at 2 weeks after treatment and once per month afterwards. Results At 2 weeks and 1 month after treatment, the obese group had significantly lower remission rates of clinical symptoms than the non-obese group (35.5%/75.3% vs 53.0%/87.8%; P < 0.05). Compared with the non-obese group, the obese group had significantly higher incidence rates of wheezing at 3 and 6 months after treatment and a significantly higher proportion of patients who visited the emergency service or were hospitalized due to wheezing within 6 months (P < 0.05). Conclusions Obesity can inhibit the response to ICS treatment in API-positive infants and young children with wheezing.
2016 Vol. 18 (10): 991-994 [Abstract] ( 3646 ) [HTML 1KB] [PDF 1307KB] ( 697 )
995 XIE Meng-Yao, YUAN Yong-Hua, LIU Li-Mei, GU Rong, ZHAO Xiao-Dong
Association between use of antibacterial agents in the first year of life and childhood asthma: a Meta analysis
Objective To evaluate the association between the use of antibacterial agents in the first years of life and childhood asthma. Methods The Chinese and English databases CNKI, Wanfang Data, VIP, PubMed, and EBSCO were searched for prospective cohort studies on the association between the use of antibacterial agents in the first years of life and childhood asthma. Stata12.0 software was used to analyze the association through a Meta analysis. Results The articles with a high quality score and adjusted effective values for factors for lower respiratory tract infection were pooled, and a total of 8 studies were included. The results of the Meta analysis showed that the use of antibacterial agents in the first years of life increased the risk of childhood asthma (OR=1.14, 95%CI: 1.10-1.17, P < 0.05). Compared with the children who used antibacterial agents 0-1 times in the first years of life, those who used more than 4 times had an increased risk of asthma (OR=1.28, 95%CI: 1.19-1.38, P < 0.05). High-risk children (at least one immediate family member had asthma) who used antibacterial agents had an increased risk of asthma (OR=1.47, 95%CI: 1.20-1.81, P < 0.05). Conclusions The use of antibacterial agents in the first years of life increases the risk of childhood asthma. High-risk children who use antibacterial agents have an increased risk of asthma. The increased frequency of use of antibacterial agents in the first years of life is associated with an increased risk of childhood asthma, but the detailed dose relationship needs further investigation.
2016 Vol. 18 (10): 995-1000 [Abstract] ( 3164 ) [HTML 1KB] [PDF 1595KB] ( 598 )
1001 XIANG Yun, WANG Zai-Hua, CAI Ping, ZHANG Zhen
Effect of β-lactamase detection on reducing the incidence of antibiotic-associated diarrhea in children with severe bacterial pneumonia
Objective To study the effect of β-lactamase (BLs) detection and β-lactam/β-lactamase inhibitor (BL/BLI) on the incidence of antibiotic-associated diarrhea (AAD) in children with severe bacterial pneumonia. Methods The clinical data of the children with bacterial severe pneumonia were retrospectively studied. Of all the patients, 248 using amoxicillin/clavulanate but without BLs detection and 323 using amoxicillin (BLs negative) or amoxicillin/clavulanate (BLs positive) were used as the amoxicillin group; 208 patients using piperacillin/tazobactam but without BLs detection and 291 patients using piperacillin (BLs negative) or piperacillin/tazobactam (BLs positive) were used as the piperacillin group; and 191 patients using cefoperazone/sulbactam but without BLs detection and 341 patients using cefoperazone (BLs negative) or cefoperazone/sulbactam (BLs positive) were used as the cefoperazone group. The incidence and clinical symptoms of AAD between the undetected and detected BLs patients were compared. Results The incidences of AAD in the amoxicillin, piperacillin and cefoperazone groups without BLs detection groups were significantly higher than those in the corresponding groups with negative or positive results of BLs detection (P < 0.01). The durations of diarrhea, antibiotic use and hospitalization stay in AAD patients receiving BLs detection were shorter than in those without receiving BLs detection (P < 0.01). Conclusions It is very important to detect BLs for reducing the incidence and relieving symptoms of AAD in children with severe bacterial pneumonia.
2016 Vol. 18 (10): 1001-1004 [Abstract] ( 3104 ) [HTML 1KB] [PDF 1356KB] ( 524 )
1005 SHANG Li-Hong, XIONG Li-Jing, LIU Li-Rong, DENG Xiao-Zhi, XIE Xiao-Li
Epidemiological and clinical features of calicivirus-associated diarrhea in hospitalized children in Chengdu, China from 2012 to 2014
Objective To investigate the epidemiological and clinical features of calicivirus-associated diarrhea in hospitalized children in Chengdu, China in recent years. Methods The clinical data of 267 children with calicivirusassociated diarrhea aged <5 years who were hospitalized in Chengdu Women and Children's Central Hospital (the only sentinel hospital for sample collection of pediatric viral diarrhea in Chengdu, Sichuan) between January 2012 and December 2014 were retrospectively studied. Results Among the 267 children, 200 (74.9%) were aged less than 1 year. The infection rate of calicivirus was 28.4%, 21.6%, and 27.1% in 2012, 2013, and 2014, respectively. Calicivirus was prevalent in summer and autumn (August to October). The detection rate of Norovirus II was 85.8% (229/267), and 244 children (91.4%) experienced an acute clinical course. Watery stool was the most common change in stool properties (82.0%, 219 children), and some specimens showed mucus and/or blood. Most children had moderate to severe fever. One hundred and thirty-eight children (53.9%) experienced a reduced serum prealbumin level. One hundred and fiftynine children (59.6%) experienced flora imbalance. Conclusions Calicivirus has become one of the major pathogens for diarrhea in children aged <5 years in Chengdu, with Norovirus II as the dominant strain. Calicivirus is prevalent in summer and autumn. Infants aged <1 year are the main population affected by calicivirus-associated diarrhea, with watery stool as the most common manifestation.
2016 Vol. 18 (10): 1005-1008 [Abstract] ( 2905 ) [HTML 1KB] [PDF 1370KB] ( 545 )
1009 LIN Hai, WANG Zi-Jing, WANG Shi-Biao, KANG Yu-Lan
Changes in serum cortisol and adrenocorticotropic hormone in children with sepsis shock and their clinical significance
Objective To study the changes in serum levels of cortisol and adrenocorticotropic hormone (ACTH) in children with septic shock (SS) and to explore their relationship with the disease severity and prognosis. Methods Twenty-five children with decompensated SS and 24 children with early SS were enrolled. Serum cortisol and ACTH levels were determined on admission and days 3 and 8 after admission. Twenty-five healthy children were used as the control group. The children with decompensated SS were further divided into death group (n=5) and survival group (n=20) based on their clinical outcome. Results On admission, the decompensated SS and early SS groups had significantly higher serum cortisol and ACTH levels than the control group (P < 0.05), and the decompensated SS group had significantly higher serum cortisol and ACTH levels than the early SS group. On day 3 after admission, the decompensated SS group had significantly higher serum cortisol and ACTH levels than the early SS and control groups (P < 0.05), and the early SS group had a significantly higher serum ACTH level than the control group (P < 0.05). Among the children with decompensated SS, the death group had significantly higher serum cortisol and ACTH levels than the survival group on admission (P < 0.01); on day 3 after admission, the death group still had a significantly higher serum cortisol level than the survival group (P < 0.01). Conclusions Children with SS have increased serum cortisol and ACTH levels, which are associated with the disease severity. A persistent high serum cortisol level indicates a poor prognosis. Dynamic monitoring of serum cortisol and ACTH levels in children with SS is of great significance in evaluating the disease severity and prognosis.
2016 Vol. 18 (10): 1009-1012 [Abstract] ( 3197 ) [HTML 1KB] [PDF 1350KB] ( 697 )
1013 PAN Yu-Chun, LIU Yang, WU Wei-Qing, XIE Jian-Sheng
Gene mutation analysis and prenatal diagnosis of four pedigrees with methymalonic aciduria
Objective To study gene mutations in four pedigrees with methymalonic aciduria, as well as the feasibility of prenatal diagnosis of methymalonic aciduria. Methods High-throughput sequencing was performed for related genes in the peripheral blood of children or parents who were diagnosed with methymalonic aciduria to identify the loci with mutations. Then amplification primers were designed for each locus, and PCR and direct sequencing were performed to validate the sequencing in the first generation in the four pedigrees. Whether the mutations were pathogenic were determined with reference to literature review and medical history. In the pedigrees 1, 3, and 4, ultrasound-guided chorionic villi biopsy was performed at weeks 11-13 of pregnancy to perform early prenatal diagnosis. Results In pedigree 1, c.656A > T and c.729-730insTT heterozygous mutations in the MUT gene were detected in the proband’s father and mother, respectively. Early prenatal diagnosis showed c.656A > T and c.729-730insTT double heterozygous mutations in the fetus. The couple decided to terminate pregnancy. In pedigree 2, c.1106G > A and c.755-756insA double heterozygous mutations in the MUT gene were detected in the proband. c.1106G > A came from the father and c.755-756insA came from the mother. In pedigree 3, c.217C > T and c.609G > A double heterozygous mutations in the MMACHC gene were detected in the proband. c.217C > T came from the father and c.609G > A came from the mother. Prenatal diagnosis showed c.609G > A heterozygous mutation in the fetus. The baby was successfully delivered, and the result of umbilical cord blood testing was consistent with the prenatal diagnosis. In pedigree 4, c.609G > A and c.567dupT double heterozygous mutations in the MMACHC gene were detected in the proband. c.609G > A came from the father and c.567dupT came from the mother. Prenatal diagnosis showed c.567dupT heterozygous mutation in the fetus. The baby was successfully delivered, and the result of umbilical cord blood testing was consistent with the prenatal diagnosis.Conclusions Identification of gene mutations helps with prenatal diagnosis in pedigrees with methymalonic aciduria.
2016 Vol. 18 (10): 1013-1018 [Abstract] ( 3234 ) [HTML 1KB] [PDF 2200KB] ( 838 )
1019 TAN Jian-Qiang, CHEN Da-Yu, LI Zhe-Tao, HUANG Ji-Wei, YAN Ti-Zhen, CAI Ren
An analysis of clinical characteristics and gene mutation in two patients with medium-and short-chain acyl-CoA dehydrogenase deficiency
Medium-and short-chain acyl-CoA dehydrogenase deficiency is a disorder of fatty acid β-oxidation. Gene mutation prevents medium-and short-chain fatty acids from entry into mitochondria for oxidation, which leads to multiple organ dysfunction. In this study, serum acylcarnitines and the organic acid profile in urea were analyzed in two children whose clinical symptoms were hypoglycemia and metabolic acidosis. Moreover, gene mutations in the two children and their parents were evaluated. One of the patients was a 3-day-old male who was admitted to the hospital due to neonatal asphyxia, sucking weakness, and sleepiness. The serum acylcarnitine profile showed increases in mediumchain acylcarnitines (C6-C10), particularly in C8, which showed a concentration of 3.52 μmol/L (reference value: 0.02-0.2 μmol/L). The analysis of organic acids in urea gave a normal result. Sanger sequencing revealed a reported c.580A>G (p.Asn194Asp) homozygous mutation at exon 7 of the ACADM gene. The other patient was a 3-month-old female who was admitted to the hospital due to cough and recurrent fever for around 10 days. The serum acylcarnitine profile showed an increase in serum C4 level, which was 1.66 μmol/L (reference value: 0.06-0.6 μmol/L). The analysis of organic acids in urea showed an increase in the level of ethyl malonic acid, which was 55.9 (reference value: 0-6.2). Sanger sequencing revealed a reported c.625G > A (p.Gly209Ser) homozygous mutation in the ACADS gene. This study indicates that screening tests for genetic metabolic diseases are recommended for children who have unexplained metabolic acidosis and hypoglycemia. Genetic analyses of the ACADM and ACADS genes are helpful for the diagnosis of medium-and shortchain acyl-CoA dehydrogenase deficiency.
2016 Vol. 18 (10): 1019-1025 [Abstract] ( 3194 ) [HTML 1KB] [PDF 1926KB] ( 921 )
1026 DENG Yi-Bin, YU Dan, SU Qin, WANG Hui-Min, YIN Hua, ZHOU Zhao-Meng, HE Na, LIU Dan
Prevalence of a high non-high-density lipoprotein cholesterol level in children aged 9-11 years in Mianyang Science City in Sichuan Province, China
Objective To investigate the non-high-density lipoprotein cholesterol (non-HDL-C) level and the prevalence rate of a high non-HDL-C level in children aged 9-11 years in the Mianyang Science City area in Sichuan Province, China. Methods From September to October, 2015, a field investigation was performed for the students from three primary schools in the Mianyang Science City area by cluster sampling. Fasting venous blood was collected for blood lipid tests. The cut-off value of serum non-HDL-C level and prevalence rate of a high non-HDL-C level in children aged 9-11 years in this area were calculated, as well as the prevalence rate of a high non-HDL-C level in obese children. Results In the children aged 9-11 years in this area, the cut-off value of non-HDL-C level was 3.67 mmol/L, and the prevalence rate of a high non-HDL-C level was 3.7% (22/589). Compared with the non-obese children, the obese children had a significantly higher serum non-HDL-C level (P < 0.01) and a significantly higher prevalence rate of a high non-HDL-C level (10.0% vs 2.9%; P < 0.01). Conclusions The cut-off value of serum non-HDL-C level in children aged 9-11 years in the Mianyang Science City area is established. Obesity is associated with an increased prevalence rate of a high non-HDL-C level in children aged 9-11 years.
2016 Vol. 18 (10): 1026-1029 [Abstract] ( 3040 ) [HTML 1KB] [PDF 1433KB] ( 517 )
EXPERIMENTAL RESEARCH
1030 WU Tian-Hui, YIN Fei, PENG Jing, KONG Hui-Min, LI Lin-Hong
Effect of a microRNA-132 antagonist on pilocarpine-induced status epilepticus in young rats
Objective To study the effect of a microRNA-132 antagonist on lithium-pilocarpine-induced status epilepticus (SE) in young Sprague-Dawley (SD) rats. Methods Forty-five 3-week-old SD rats were randomly and equally divided into epilepticus model group, microRNA-132 antagonist group, and microRNA-132 antagonist negative control group. The young SD rat model of SE was established using lithium-pilocarpine. For the microRNA-132 antagonist group and the negative control group, pretreatment was performed 24 hours before the model establishment. Behavioral observation was performed to assess the latency of SE and success rate of induction of SE. The scale of Lado was used to evaluate the seizure severity. Electroencephalography (EEG) was used to assess the frequency and amplitude of epileptiform discharges. The mortality rate was calculated in each group. Results There was no significant difference in the success rate of induction of SE between the three groups (P > 0.05). Compared with the microRNA-132 negative control group and the epilepticus model group, the microRNA-132 antagonist group had significantly prolonged SE latency after model establishment (P < 0.05), a significantly lower Lado score of seizure (P < 0.05), significantly lower frequency and amplitude of epileptiform discharges on EEG (P < 0.05), and a slightly reduced mortality rate. Conclusions The treatment with the microRNA-132 antagonist shows an inhibitory effect on the development and progression of lithium-pilocarpine-induced SE in young SD rats. The inhibition of microRNA-132 is likely to be a potential target or direction for drug treatment of SE.
2016 Vol. 18 (10): 1030-1034 [Abstract] ( 2443 ) [HTML 1KB] [PDF 2553KB] ( 566 )
1035 ZHANG Shi-Fa, ZHOU Yan, ZHANG Kai-Jing, LUAN Jia-Jie, QI Shi-Mei
Neuroprotective effect of Nogo-66 receptor silencing in preterm rats with brain injury caused by intrauterine infection
Objective To investigate the effect of Nogo-66 receptor (NgR) silencing with specific small interfering RNA (siRNA) on brain injury repair in preterm rats with brain injury caused by intrauterine infection and related mechanism of action. Methods The pregnant Sprague-Dawley rats (with a gestational age of 15 days) were selected, and premature delivery was induced by RU486 or lipopolysaccharide (LPS). The preterm rats delivered by those treated with RU486 were selected as the control group. The preterm rats with brain injury caused by intrauterine infection induced by LPS were divided into model, empty vector, and NgR-siRNA groups, with 36 rats in each group. The rats in the control and model groups were given routine feeding only, and those in the empty vector and NgR-siRNA groups were given an injection of lentiviral empty vector or NgR-siRNA lentivirus via the lateral ventricle on postnatal day 1 (P1) and then fed routinely. On P3, P7, and P14, 8 rats in each group were randomly selected and sacrificed to harvest the brain tissue. RT-PCR was used to measure the mRNA expression of NgR. Western blot was used to to measure the protein expression of active RhoA. The immunofluorescence histochemistry was used to determine the degree of activation of microglial cells and the morphology of oligodendrocyte precursor cells (OPCs). Hematoxylin and eosin staining was used to observe the pathological changes in brain tissue. The behavioral score was evaluated on P30. Results On P3, the NgR-siRNA group had significantly lower mRNA expression of NgR and protein expression of active RhoA in brain tissue than the model and empty vector groups (P < 0.05). In each group, the mRNA expression of NgR was positively correlated with the protein expression of active RhoA (P < 0.05). The results of immunofluorescence histochemistry showed that on P3, the NgR-siRNA group had a significantly reduced fluorescence intensity of the microglial cells labeled with CD11b compared with the model and empty vector groups (P < 0.05). The OPCs labeled with O4 antibody in the four groups were mainly presented with tripolar cell morphology. The results of pathological examination showed a normal structure of white matter with clear staining in the periventriclar area in the control group, a loose structure of white matter with disorganized fibers and softening lesions in the model and empty vector groups, and a loose structure of white matter with slightly disorganized fibers, slight gliocyte proliferation, and no significant necrotic lesions in the NgR-siRNA group. As for the behavioral score, compared with the model and empty vector groups, the NgR-siRNA group had a higher score in the suspension test, a longer total activity distance, and greater mean velocity and number of squares crossed, as well as a shorter time of slope test and a shorter time and distance of activity in the central area (P < 0.05), while there were no significant differences in these parameters between the NgR-siRNA and control groups (P > 0.05). Conclusions NgR silencing with specific siRNA can effectively silence the expression of NgR in pertem rats with brain injury caused by interauterine infection and has a significant neuroprotective effect in brain injury repair.
2016 Vol. 18 (10): 1035-1043 [Abstract] ( 2880 ) [HTML 1KB] [PDF 4402KB] ( 535 )
1044 WU Dan-Dan, WU Xing-Heng, ZHANG Li-Na
Effect of leptin on expression of calpain-1 and Bcl-2 and apoptosis in myocardial tissue of neonatal rats after asphyxia
Objective To study the effect of leptin on the expression of calcium-activated neutral protease 1 (calpain-1) and B cell lymphoma-2 (Bcl-2) and apoptosis in the myocardial tissue of neonatal rats after asphyxia. Methods A total of 48 neonatal rats were randomly and equally divided into normal control group, asphyxia group, leptin treatment groups, and calpain-1 inhibitor (CAI-1) group. The neonatal rat model of asphyxia under normal atmospheric condition was established in all groups except the control group. For the leptin treatment groups, rats received 20, 80, and 160 μg/kg leptin by intraperitoneal injection immediately after model establishment, respectively. For the CAI-1 group, rats received 10 mg/kg CAI-1 by intraperitoneal injection immediately after model establishment. For all the groups, the myocardial tissue was collected at 2 hours after model establishment. Immunohistochemistry was used to measure the expression of calpain-1 and Bcl-2. The TUNEL method was used to evaluate apoptosis of myocardial cells. Results The expression of calpain-1 and Bcl-2 and apoptosis index (AI) were significantly higher in the asphyxia group than in the normal control group (P < 0.05). The leptin treatment groups and the CAI-1 group had significantly lower expression of calpain-1, significantly lower AI, and significantly higher expression of Bcl-2 than the asphyxia group (P < 0.05). The CAI-1 group had the largest changes in all the indices compared with the asphyxia group. However, there were no significant differences in all indices between the 160 μg/kg leptin treatment group and the CAI-1 group. After asphyxia, the expression of calpain-1 was positively correlated with AI, while the expression of Bcl-2 was negatively correlated with AI and the expression of calpain-1 (P < 0.05). Conclusions Leptin reduces apoptosis of myocardial cells in asphyxiated neonatal rats by the inhibition of calpain-1 activation and upregulation of Bcl-2 expression.
2016 Vol. 18 (10): 1044-1049 [Abstract] ( 3334 ) [HTML 1KB] [PDF 3421KB] ( 562 )
1050 XIAO Liang, YIN Xiao-Cheng, CAO Qiang-Qiang
The role of the PI3K/AKT signaling pathway in DADS-induced apoptosis of K562 cells
Objective To study the role of the PI3K/AKT signaling pathway in the diallyl disulfide (DADS)-induced apoptosis of K562 cells. Methods K562 cells in the logarithmic growth phase were treated with 10, 20, 40, or 80 mg/L DADS for 48 hours, then fixed and stained with acridine orange/ethidium bromide (AO/EB), and examined for cellular morphological changes under an inverted microscope. Annexin V-FITC/PI staining was used for determining the apoptotic rates, and Western blot for measuring the expression of AKT, p-AKT, and Caspase-3. Two control groups, blank and solvent, were used as references. Results K562 cells treated with DADS for 48 hours exhibited the characteristic morphological features of apoptosis including cell shrinkage, irregular cell shape, and membrane blebbing. AO/EB staining results demonstrated that the number of apoptotic cells with cell shrinkage, pyknotic or bead-like nuclei, chromatin condensation, and orange staining increased with the increasing DADS concentration, and 40 mg/L DADS had the most significant effect. The apoptotic rates of cells treated with 10, 20, 40, and 80 mg/L DADS were all significantly higher than those in the control groups (P < 0.05). There were no significant differences in AKT protein expression between the K562 cells treated with different concentrations of DADS; the p-AKT protein expression decreased with the increasing DADS concentration, while the Caspases-3 protein expression increased with the increasing DADS concentration (P < 0.05). Conclusions DADS induces the apoptosis of K562 cells, probably through inhibiting the protein expression in the PI3K/AKT signaling pathway.
2016 Vol. 18 (10): 1050-1054 [Abstract] ( 3008 ) [HTML 1KB] [PDF 2347KB] ( 543 )
CLINICAL EXPERIENCE
1055 LIU Yue, WANG Hua, WANG Ya-Li
Multisystem damage associated with methylmalonic acidemia in 9 children

No abstract available
2016 Vol. 18 (10): 1055-1058 [Abstract] ( 2753 ) [HTML 1KB] [PDF 1469KB] ( 729 )
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