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    TOPIC OF EPILEPSY AND EPILEPSY-RELATED DISEASE
  • ● TOPIC OF EPILEPSY AND EPILEPSY-RELATED DISEASE
    MECP2 duplication syndrome: a clinical analysis of three cases and literature review
    TANG Dan-Xia, LI Dong-Fang, WU Ruo-Hao, ZHANG Li-Na, LUO Xiang-Yang
    2017, 19(5): 489-493. https://doi.org/10.7499/j.issn.1008-8830.2017.05.001
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    MECP2 duplication syndrome (MDS) is a rare pediatric disease and mainly manifests as delayed motor development, language loss or delay, recurrent infection, severe intellectual disability, epilepsy, autistic symptoms, and early infantile hypotonia. In this article, the three children with this disease were all boys. Cases 1 and 2 had delayed motor development, and language loss or delay as initial manifestations, and case 3 had recurrent infection as initial manifestation. Physical examination showed hypotonia and negative pathological signs in each case. Case 1 had tonic-clonic seizures and electroencephalography showed focal seizures, for which he was given oxcarbazepine, levetiracetam, and clonazepam as the antiepileptic treatment to control seizures. Case 3 experienced one absence seizure and three head-nodding seizures with normal electroencephalographic findings during these seizures, and therefore, he was not given antiepileptic treatment. In each case, recurrent infection was improved with the increase in age, but there were no significant improvements in language or intelligence. Array-based comparative genomic hybridization (aCGH) showed MECP2 duplication in X chromosome in each case, and so they were diagnosed with MDS. MDS should be considered for children with delayed development complicated by recurrent infection and epileptic seizures, and early aCGH helps with the diagnosis of this disease.
  • ● TOPIC OF EPILEPSY AND EPILEPSY-RELATED DISEASE
    MECP2 gene and MECP2-related diseases
    PENG Jing
    2017, 19(5): 494-497. https://doi.org/10.7499/j.issn.1008-8830.2017.05.002
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    No abstract available

  • ● TOPIC OF EPILEPSY AND EPILEPSY-RELATED DISEASE
    Alpers-Huttenlocher syndrome caused by a novel compound hetero zygous mutation of POLG gene: a case report
    2017, 19(5): 498-501. https://doi.org/10.7499/j.issn.1008-8830.2017.05.003
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    No abstract available

  • ● TOPIC OF EPILEPSY AND EPILEPSY-RELATED DISEASE
    Mitochondrial diseases and epilepsy
    CAO De-Zhi
    2017, 19(5): 502-504. https://doi.org/10.7499/j.issn.1008-8830.2017.05.004
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    No abstract available

    • CLINICAL RESEARCH
  • ● CLINICAL RESEARCH
    Clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease
    LI Yu-Wen, HU Yu-Hua, ZHU Tian-Tian, CHU An-Zhen, ZHU Chuan-Long
    2017, 19(5): 505-509. https://doi.org/10.7499/j.issn.1008-8830.2017.05.005
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    Objective To investigate the clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease. Methods A total of 65 children with nonalcoholic fatty liver disease between June 2014 and May 2016 were randomly divided into two groups:compound glycyrrhizin tablets treatment (n=33) and liver-protecting tablets treatment (n=32). The course of treatment was 24 weeks for both groups. The serum levels of alanine aminotransferase, gamma-glutamyl transpeptidase, hyaluronic acid, procollagen type III, type IV collagen, and laminin were measured before and after treatment for both groups. Results There was a significant difference in the overall response rate between the compound glycyrrhizin tablets treatment and liver-protecting tablets treatment groups (85% vs 50%; P < 0.05). Both groups had a significant reduction in the serum level of alanine aminotransferase after treatment, but the compound glycyrrhizin tablets treatment group had a significantly greater reduction (P < 0.01). The compound glycyrrhizin tablets treatment group showed significant improvements in the serum levels of gamma-glutamyl transpeptidase and the four markers of liver fibrosis (hyaluronic acid, procollagen type III, type IV collagen, and laminin) after treatment (P < 0.05), while the liver-protecting tablets treatment group had no significant improvements in these markers. Conclusions Compound glycyrrhizin tablets can effectively improve hepatic function and reduce serum levels of liver fibrosis markers in children with nonalcoholic fatty liver disease and have a better clinical efficacy than liver-protecting tablets.
  • ● CLINICAL RESEARCH
    Effect of allergic rhinitis on disease condition and treatment in patients with juvenile-onset systemic lupus erythematosus
    ZHOU Yan-Qing, CAO Lan-Fang, GUO Ru-Ru, LI Le-Ping, FANG Hui-Fen
    2017, 19(5): 510-513. https://doi.org/10.7499/j.issn.1008-8830.2017.05.006
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    Objective To investigate the effect of allergic rhinitis (AR) and its intervention on disease condition and medications in patients with juvenile-onset systemic lupus erythematosus (JSLE). Methods The clinical data of 96 children diagnosed with JSLE were collected, and according to the presence or absence of AR or other allergic diseases, they were divided into AR group (n=44), non-AR group (n=20), and non-allergic group (n=32). The children in the AR group were randomly administered with or without intervention (n=22 each). All the children were given standard JSLE treatment. The systemic lupus erythematosus disease active index (SLEDAI) and application of hormones and immunosuppressants were compared between groups. Results The AR and non-AR groups had significantly higher SLEDAI scores, daily cumulative doses of glucocorticoids, and number of types of immunosuppressants used than the non-allergic group before treatment (P < 0.05), while there were no significant differences between the AR and non-AR groups (P > 0.05). After one month of treatment, the AR group with intervention had significantly lower SLEDAI scores and daily cumulative doses of glucocorticoids than the AR group without intervention (P < 0.05), while there was no significant difference in the application of immunosuppressants between these two groups (P > 0.05). After 3 and 6 months of treatment, the AR group with intervention had significantly lower SLEDAI scores, daily cumulative doses of glucocorticoids, and number of types of immunosuppressants than the AR group without intervention (P < 0.05). Conclusions JSLE combined with allergic diseases such as AR has an adverse effect on disease condition and treatment, and the intervention for AR helps with the control of JSLE.
  • ● CLINICAL RESEARCH
    Endocrine and metabolic features of female children with Prader-Willi syndrome: an analysis of 4 cases
    WU Mo-Ling, LI Juan, DING Yu, CHEN Yao, CHANG Guo-Ying, WANG Xiu-Min, WANG Jian, SHEN Yi-Ping
    2017, 19(5): 514-518. https://doi.org/10.7499/j.issn.1008-8830.2017.05.007
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    This article reports the clinical features and endocrine and metabolic features of 4 children with Prader-Willi syndrome (PWS). All the patients were female and aged 6-12 years at diagnosis. All of them had clinical manifestations of obesity, unusual facies, developmental retardation, and intellectual disability. Genetic detection showed that 2 patients had paternal deletion of the 15q11.2-q13 region, one patient had maternal autodiploid in the 15q11.2-q13 region, and one patient had no abnormality in the 15q11.2-q13 region. All patients had varying degrees of endocrine and metabolic disorders:2 patients had short stature, among whom one had delayed appearance of secondary sex characteristics and the other one had type 2 diabetes; one patient had insulin resistance and no mammary gland development; one patient had a body height of P3-P10 and precocious puberty. Patients with PWS have various endocrine disorders, so long-term endocrine follow-up and management is very important.
  • ● CLINICAL RESEARCH
    Effect of obesity on pulmonary function in asthmatic children of different age groups
    XU Xiao-Wen, HUANG Ying, WANG Jian, ZHANG Xue-Li, LIANG Fan-Mei, LUO Rong
    2017, 19(5): 519-523. https://doi.org/10.7499/j.issn.1008-8830.2017.05.008
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    Objective To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. Methods Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (< 6 years) and school-age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests[forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests[maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. Results The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (P < 0.05) after adjustment for sex and BMI. The normal-weight children in the school-age group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (P < 0.05). The overweight children in the school-age group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (P < 0.05). Conclusions The effect of obesity on the pulmonary function varies with age in children with asthma, and the effect is more obvious in those of preschool age.
  • ● CLINICAL RESEARCH
    Cardiac autonomic nerve function in obese school-age children
    YI Lan-Fen, WEN Hong-Xia, HUANG Xiao-Li, QIU Mei, CAO Xiao-Xiao
    2017, 19(5): 524-528. https://doi.org/10.7499/j.issn.1008-8830.2017.05.009
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    Objective To analyze the deceleration capacity (DC) of heart rate, acceleration capacity (AC) of heart rate, and heat rate variability (HRV) in obese school-age children, and to observe the correlations of BMI with DC, AC, and HRV in these children. Methods A total of 108 obese school-age children were selected, including 75 cases of ortholiposis and 33 cases of dyslipidemia. A total of 103 healthy school-age children were selected as control group. All the subjects underwent 24-hour ambulatory electrocardiography. The comparisons of DC, AC, and HRV were made between the obese and control groups, as well as between children with ortholiposis and dyslipidemia in the obese group. The correlations of BMI with DC, AC, and HRV were analyzed in the obese group. Results The obese group showed lower DC, standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), root mean square of successive differences (RMSSD), low-frequency power (LF), and high-frequency power (HF) than the control group. The AC of the obese group was significantly higher than that of the control group (P < 0.05). In the obese group, children with dyslipidemia had significantly lower DC, SDNN, SDANN, RMSSD, LF, and HF, but significantly higher AC and BMI, as compared with those with ortholiposis (P < 0.01). In the obese group, BMI was negatively correlated with DC, SDNN, SDANN, RMSSD, and HF (P < 0.05), but positively correlated with AC (P < 0.05). Conclusions Obese school-age children have impaired autonomic nerve function, presenting with reduced vagal tone, which is particularly prominent in those with dyslipidemia. The more obese the children, the lower the vagal tone, which may increase the risks of cardiovascular diseases.
  • ● CLINICAL RESEARCH
    Current status of research on infantile cholestatic liver disease in China: a visualization analysis
    LIAO Qiong, WAN Chao-Min, ZHU Yu, YANG Xiao-Yan, SHU Min
    2017, 19(5): 529-533. https://doi.org/10.7499/j.issn.1008-8830.2017.05.010
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    Objective To investigate the current status of research on infantile cholestatic liver disease in China and future research trends. Methods A co-word analysis was performed in October 2016. Document retrieval and screening were performed in the Chinese databases CNKI and Wanfang Data using "cholestasis" and "infant" as key words. Excel 2010 was used to establish a co-occurrence matrix of high-frequency key words, and Ucinet 6.0 and Netdraw were used to develop a visualized network of these high-frequency key words. Results A total of 383 articles were included. The co-occurrence analysis showed that "infant" and "cholestasis" were the core of research in this field, and "infantile hepatitis syndrome", "neonate", "intrahepatic", "biliary atresia", "heredity and metabolism", "hepatitis", "cytomegalovirus", "jaundice", and "conjugated bilirubin" were main research topics. Most of the other articles focused on "parenteral nutrition", "hepatobiliary imaging", "gene mutation", and "liver biopsy". There were relatively few articles on surgical diagnostic techniques and treatment for this disease. Conclusions The research on infantile cholestatic liver disease in China focuses on etiology and differential diagnosis, and genetic diagnosis has become a hot topic in recent years. The research on treatment should be enhanced, and new diagnostic techniques are the research interest in future.
  • ● CLINICAL RESEARCH
    Novel PHEX gene mutations in patients with X-linked hypophosphatemic rickets: an analysis of 2 cases
    RAN Qing, XIONG Feng, ZHU Min, DENG Lei-Li, LEI Pei-Yun, LUO Yan-Hong, ZENG Yan, ZHU Gao-Hui, SONG Cui
    2017, 19(5): 534-538. https://doi.org/10.7499/j.issn.1008-8830.2017.05.011
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    Objective To investigate PHEX gene mutations in 2 patients with X-linked hypophosphatemic rickets (XLH) and their families and to clarify the genetic etiology. Methods A retrospective analysis was performed for the clinical data of two patients with XLH. High-throughput sequencing was used to detect the PHEX gene, a pathogenic gene of XLH. PCR-Sanger sequencing was used to verify the distribution of mutations in families. Results Both patients had novel mutations in the PHEX gene; one patient had a frameshift mutation, c.931dupC, which caused early termination of translation and produced the truncated protein p.Gln311Profs*13; the other patient had a splice site mutation, IVS14+1G > A, which caused the skipping of exon 15 and produced an incomplete amino acid chain. Their parents had normal gene phenotypes. Conclusions c.931dupC and IVS14+1G > A are two novel mutations of the PHEX gene and might be the new pathogenic mutations of XLH.
  • ● CLINICAL RESEARCH
    Infantile hypophosphatasia caused by a novel compound heterozygous mutation: a case report and pedigree analysis
    LI Deng-Feng, LAN Dan, ZHONG Jing-Zi, Roma Kajal Dewan, XIE Yan-Shu, YANG Ying
    2017, 19(5): 539-544. https://doi.org/10.7499/j.issn.1008-8830.2017.05.012
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    This article reported the clinical features of one child with infantile hypophosphatasia (HPP) and his pedigree information. The proband was a 5-month-old boy with multiple skeletal dysplasia (koilosternia, bending deformity of both radii, and knock-knee deformity of both knees), feeding difficulty, reduction in body weight, developmental delay, recurrent pneumonia and respiratory failure, and a significant reduction in blood alkaline phosphatase. Among his parents, sister, uncle, and aunt (other family members did not cooperate with us in the examination), his parents and aunt had a slight reduction in alkaline phosphatase and his aunt had scoliosis; there were no other clinical phenotypes or abnormal laboratory testing results. His ALPL gene mutation came from c.228delG mutation in his mother and c.407G > A compound heterozygous mutation in his father. His aunt carried c.228delG mutation. The c.407G > A mutation had been reported as the pathogenic mutation of HPP, and c.228delG mutation was a novel pathogenic mutation. Hypophosphatasia is caused by ALPL gene mutation, and ALPL gene detection is an effective diagnostic method. This study expands the mutation spectrum of ALPL gene and provides a theoretical basis for genetic diagnosis of this disease.
  • ● CLINICAL RESEARCH
    Role of short-latency somatosensory evoked potential in the diagnosis of chronic inflammatory demyelinating polyneuropathy
    SUN Rui-Di, FU Bing, JIANG Jun
    2017, 19(5): 545-548. https://doi.org/10.7499/j.issn.1008-8830.2017.05.013
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    Objective To investigate the role of short-latency somatosensory evoked potential (SSEP) in the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Methods A total of 48 children with a confirmed or suspected CIDP and 40 healthy children were enrolled. Nerve electrophysiological examination and/or SSEP examination was performed (the children in the healthy control group only underwent SSEP examination). Four-lead electromyography was used for nerve electrophysiological examination, including at least 4 motor nerves and 2 sensory nerves. N6 (elbow potential), N13 (cervical cord potential), and N20 (cortex potential) of the median nerve and N8 (popliteal fossa potential), N22 (lumbar cord potential), and P39 (cortex potential) of the tibial nerve were observed by SSEP examination. Results Among the 48 children with CIDP, 35 had demyelination in both motor and sensory nerves, 8 had demyelination in sensory nerves, and 5 had axonal degeneration. SSEP examination showed that 7 had conduction abnormality in the trunk of the brachial plexus and/or the posterior root and 33 had damage in the lumbosacral plexus and/or the posterior root. The 40 children with abnormal findings of SSEP examination included 8 children with affected sensory nerves and 5 children with secondary axonal degeneration who did not meet the electrophysiological diagnostic criteria for CIDP. Compared with the healthy control group, the CIDP group had significantly prolonged latency periods of N13 and N22 (P < 0.05). Conclusions SSEP can be used for the auxiliary diagnosis of CIDP, especially in CIDP children with affected sensory nerves or secondary axonal degeneration.
  • ● CLINICAL RESEARCH
    Association between autism spectrum disorder and epilepsy in children
    MEI Song-Li, ZHANG Zhao, LIU Xin, GAO Ting-Ting, PENG Xin-Xian
    2017, 19(5): 549-554. https://doi.org/10.7499/j.issn.1008-8830.2017.05.014
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    Objective To examine the association between autism spectrum disorder (ASD) and epilepsy in children. Methods A total of 190 children with ASD were enrolled. A self-designed questionnaire, Childhood Autism Rating Scale, and Autism Behavior Checklist were used to determine the association between ASD and epilepsy. Results Among the 190 children with ASD, 20 (10.5%) had epileptic seizures and 12 (6.3%) were diagnosed with epilepsy. The rates of abnormal physical development and hearing disorders before the age of one year were significantly higher in ASD children with epileptic seizures than in those without epileptic seizures (P < 0.05). The ASD children diagnosed with epilepsy and those receiving epilepsy treatment had a significantly increased rate of abnormal physical development before the age of one year (P < 0.05). The ASD children with epileptic seizures had poorer sensory responses and behavioral competencies than those without epileptic seizures (P < 0.05). Epilepsy treatment have a positive effect on behavioral competencies in ASD children (P < 0.05). Conclusions There is a significant association between ASD and epilepsy in children. The possibility of the comorbidity between ASD and epilepsy may be assessed according to the status of growth and development before the age of one year, sensory responses and behavioral competencies, and the presence or absence of epileptic seizures.
  • ● CLINICAL RESEARCH
    Influence of home nurture environment on language development and social emotion in children with developmental language disorder
    LI Guo-Kai, LIU Gui-Hua, QIAN Qin-Fang, GE Pin, XIE Yan-Qin, YANG Min-Yan, WANG Zhang-Qiong, OU Ping
    2017, 19(5): 555-559. https://doi.org/10.7499/j.issn.1008-8830.2017.05.015
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    Objective To investigate the influence of home nurture environment on language development and social emotion in children with developmental language disorder (DLD). Methods The 1-3 Years Child Home Nurture Environment Scale, Gesell Developmental Scale, and Infant-Toddler Social and Emotional Assessment Scale were used for the evaluation of 125 children with DLD. A total of 130 children with normal language development matched for age and sex were enrolled as control group. Results Compared with the control group, the DLD group had a significantly higher proportion of children in a bad home nurture environment and significantly lower scores of all domains of home nurture environment (P < 0.05). In children with DLD, the home nurture environment score was positively correlated with the level of language development (r=0.536, P < 0.01) and the score of ability domain in social emotion (r=0.397, P < 0.01) and was negatively correlated with the scores of the domains of explicit behavior, covert behavior, and imbalance in social emotion (r=-0.455, -0.438, and -0.390 respectively, P < 0.01). Home nurture environment had direct influence on language development in children with DLD and affected their language development via the mediating effect of social emotion. Conclusions Home nurture environment influences language development and social emotion in children with DLD, and social emotion has a partial mediating effect between home nurture environment and language development.
  • ● CLINICAL RESEARCH
    Relationship between fever degree and prognosis in children with bacterial bloodstream infection
    ZHANG Tao, LI Jiu-Jun, LIU Chun-Feng, ZHANG Zhi-Jie
    2017, 19(5): 560-563. https://doi.org/10.7499/j.issn.1008-8830.2017.05.016
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    Objective To study the relationship between the degree of fever within 48 hours of admission and the prognosis in children with bacterial bloodstream infection. Methods This study retrospectively analyzed the clinical data of all patients diagnosed with sepsis who were admitted to the pediatric intensive care unit (PICU) of Shengjing Hospital Affiliated to China Medical University between September 2008 and September 2016. The children with bacterial bloodstream infection were classified into 5 groups according to the maximum temperature within 48 hours of admission: < 36.5℃ group, ≥36.5℃ group (normal control), ≥37.5℃ group, ≥38.5℃ group, and ≥39.5℃ group. The mortality was compared between the five groups. Results A total of 213 children with bacterial bloodstream infection were enrolled, consisting of 5 cases in the < 36.5℃ group, 44 cases in the ≥36.5℃ group, 73 cases in the ≥37.5℃ group, 69 cases in the ≥38.5℃ group, and 22 cases in the ≥39.5℃ group. A total of 48 cases died among the 213 patients. A significant difference was observed in the mortality between the five groups (P < 0.01). The < 36.5℃ group and ≥39.5℃ group had significantly higher mortality than the normal control group. However, there were no significant differences in the mortality between the ≥37.5℃ and ≥38.5℃ groups and the normal control group. Conclusions In children with bacterial bloodstream infection, those with a maximum temperature below 36.5℃ or above 39.5℃ within 48 hours of admission have a significantly increased mortality.
  • ● CLINICAL RESEARCH
    A preliminary study on the disappearance time of influenza virus antigen
    CHEN Hao-Feng, ZHANG Li-Li, FANG Yi-Bing, CHEN Min, GUO Chun, YI Hong-Ling, TAO Mei-Ting, LI Yan, DAI Chu-Feng
    2017, 19(5): 564-566. https://doi.org/10.7499/j.issn.1008-8830.2017.05.017
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    Objective To investigate the antigen clearance time, time to symptom disappearance, and the association between them using immunofluorescence assay for dynamic monitoring of influenza virus antigen in children with influenza. Methods A total of 1 063 children suspected of influenza who visited the Hunan People's Hospital from March to April, 2016 were enrolled. The influenza A/B virus antigen detection kit (immunofluorescence assay) was used for influenza virus antigen detection. The children with positive results were given oseltamivir as the antiviral therapy and were asked to re-examine influenza virus antigen at 5, 5-7, and 7 days after onset. Results Of all children suspected of influenza, 560 (52.68%) had an influenza virus infection. A total of 215 children with influenza virus infection were followed up. The clearance rate of influenza virus antigen was 9.8% (21 cases) within 5 days after onset. The cumulative clearance rate of influenza virus antigen was 32.1% (69 cases) within 5-7 days, and 98.1% (211 cases) within 7-10 days after onset. Among these children, 6 children (2.8%) achieved the improvement in clinical symptoms within 3 days after onset. The cumulative rate of symptom improvement was 84.7% (182 cases) within 3-5 days after onset, and 100% achieved the improvement after 5 days of onset. Conclusions The time to improvement in symptoms after treatment is earlier than antigen clearance time. Almost all of the children achieve influenza virus antigen clearance 7-10 days after onset. Therefore, it is relatively safe for children to go back to school within 7-10 days after onset when symptoms disappear.
  • ● CLINICAL RESEARCH
    Clinical features and magnetic resonance imaging evaluation of encephalopathy in high-risk late preterm infants
    ZHU Yan, ZHANG Ke, HU Lan, XIAO Mi-Li, LI Zhi-Hua, CHEN Chao
    2017, 19(5): 567-571. https://doi.org/10.7499/j.issn.1008-8830.2017.05.018
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    Objective To investigate the risk factors, clinical features, and magnetic resonance imaging (MRI) changes of encephalopathy in high-risk late preterm infants. Methods Head MRI scan was performed for late preterm infants with high-risk factors for brain injury who were hospitalized between January 2009 and December 2014. The risk factors, clinical features, and head MRI features of encephalopathy in late preterm infants were analyzed. Results A total of 1 007 late preterm infants underwent MRI scan, among whom 313 (31.1%) had imaging features in accordance with the features of encephalopathy of prematurity. Of all infants, 76.7% had white matter damage. There was no association between the development of encephalopathy and gestational age in late preterm infants, but the detection rate of encephalopathy gradually increased with the increasing birth weight (P < 0.05). The logistic regression analysis showed that a history of resuscitation was an independent risk factor for encephalopathy of prematurity (P < 0.01). Conclusions Encephalopathy of prematurity is commonly seen in high-risk late preterm infants, especially white matter damage. A history of resuscitation is an independent risk factor for encephalopathy in late preterm infants.
  • ● CLINICAL RESEARCH
    Effect of breastfeeding versus formula milk feeding on preterm infants in the neonatal intensive care unit
    LI Yong-Wei, YAN Chao-Ying, YANG Lei, HAN Zong-Lai
    2017, 19(5): 572-575. https://doi.org/10.7499/j.issn.1008-8830.2017.05.019
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    Objective To investigate the importance of breastfeeding in preterm infants with various gestational ages. Methods A total of 639 preterm infants with a gestational age of 28+3-36+6 weeks were enrolled, and according to the feeding pattern, they were divided into exclusive breastfeeding group (n=237) and formula milk feeding group (fed with liquid milk for preterm infants; n=402). These two feeding patterns were compared in terms of their effects on weight gain, laboratory markers including albumin (Alb) and alkaline phosphatase (ALP), incidence rate of feeding intolerance, and incidence rates of complications including necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). Results Compared with the formula milk feeding group, the breastfeeding group had a significantly faster increase in body weight, a significantly lower incidence rate of NEC, a significantly higher ALP level, and a significantly lower Alb level in the preterm infants with a gestational age of 28-30 weeks (P < 0.05); there were no significant differences between the two groups in the incidence rates of anemia, ROP, bronchopulmonary dysplasia (BPD), and nosocomial infection and length of hospital stay (P > 0.05). For the preterm infants with a gestational age of 31-33 weeks, the breastfeeding group had a significantly faster increase in body weight, a significantly lower incidence rate of feeding intolerance, a significantly shorter length of hospital stay, and a significantly higher ALP level (P < 0.05); there were no significant differences between the two groups in the incidence rates of NEC, anemia, ROP, BPD, and nosocomial infection and the Alb level (P > 0.05). For the preterm infants with a gestational age of 34-36 weeks, there were no significant differences in these indices between the two groups (P > 0.05). Conclusions Breastfeeding plays an important role in increasing body weight, reducing the incidence rates of feeding intolerance and NEC, and shortening the length of hospital stay in preterm infants with a gestational age of 28-33 weeks.
    • EXPERIMENTALRESEARCH
  • ● EXPERIMENTALRESEARCH
    Effect of baicalin on ATPase and LDH and its regulatory effect on the AC/cAMP/PKA signaling pathway in rats with attention deficit hyperactivity disorder
    ZHOU Rong-Yi, WANG Jiao-Jiao, YOU Yue, SUN Ji-Chao, SONG Yu-Chen, YUAN Hai-Xia, HAN Xin-Min
    2017, 19(5): 576-582. https://doi.org/10.7499/j.issn.1008-8830.2017.05.020
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    Objective To study the effect of baicalin on synaptosomal adenosine triphosphatase (ATPase) and lactate dehydrogenase (LDH) and its regulatory effect on the adenylate cyclase (AC) /cyclic adenosine monophosphate (cAMP) /protein kinase A (PKA) signaling pathway in rats with attention deficit hyperactivity disorder (ADHD). Methods A total of 40 SHR rats were randomly divided into five groups:ADHD model, methylphenidate hydrochloride treatment (0.07 mg/mL), and low-dose (3.33 mg/mL), medium-dose (6.67 mg/mL), and high-dose (10 mg/mL) baicalin treatment (n=8 each). Eight WKY rats were selected as normal control group. Percoll density gradient centrifugation was used to prepare brain synaptosomes and an electron microscope was used to observe their structure. Colorimetry was used to measure the activities of ATPase and LDH in synaptosomes. ELISA was used to measure the content of AC, cAMP, and PKA. Results Compared with the normal control group, the ADHD model group had a significant reduction in the ATPase activity, a significant increase in the LDH activity, and significant reductions in the content of AC, cAMP, and PKA (P < 0.05). Compared with the ADHD model group, the methylphenidate hydrochloride group and the medium-and high-dose baicalin groups had a significant increase in the ATPase activity (P < 0.05), a significant reduction in the LDH activity (P < 0.05), and significant increases in the content of AC, cAMP, and PKA (P < 0.05). Compared with the methylphenidate hydrochloride group, the high-dose baicalin group had significantly greater changes in these indices (P < 0.05). Compared with the low-dose baicalin group, the high-dose baicalin group had a significant increase in the ATPase activity (P < 0.05); the medium-and high-dose baicalin groups had a significant reduction in the LDH activity (P < 0.05) and significant increases in the content of AC, cAMP, and PKA (P < 0.05). Compared with the medium-dose baicalin group, the high-dose baicalin group had a significant increase in the ATPase activity (P < 0.05). Conclusions Both methylphenidate hydrochloride and baicalin can improve synaptosomal ATPase and LDH activities in rats with ADHD. The effect of baicalin is dose-dependent, and high-dose baicalin has a significantly greater effect than methylphenidate hydrochloride. Baicalin exerts its therapeutic effect possibly by upregulating the AC/cAMP/PKA signaling pathway.
  • ● EXPERIMENTALRESEARCH
    Immunoprotective effect of combined pneumococcal endopeptidase O and pneumococcal surface adhesin A vaccines against Streptococcus pneumoniae infection
    ZHANG Jing, CUI Ya-Li, JIANG Yong-Mei
    2017, 19(5): 583-589. https://doi.org/10.7499/j.issn.1008-8830.2017.05.021
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    Objective To investigate the prokaryotic expression of proteins pneumococcal endopeptidase O (PepO) and pneumococcal surface adhesin A (PsaA) in Streptococcus pneumoniae and their immunoprotective effect as vaccine candidate proteins. Methods Specific primers of target gene fragments were designed, and then PCR amplification was performed to establish recombinant plasmids pET28a (+)-pepO and pET28a (+)-psaA, which were transformed into host cells, Escherichia coli BL21 and DE3, respectively, to induce expression. Highly purified target proteins PepO and PsaA were obtained after purification. Mucosal immunization was performed for BALB/c mice and specific antiserum was prepared. ELISA was used to measure the antibody titer, and Western blot was used to analyze the specificity of the antiserum of target proteins. The mice were randomly divided into negative control group, PepO group, PsaA group, and PepO+PsaA combined immunization group, with 18 mice in each group. The models of different serotypes of Streptococcus pneumoniae infection were established to evaluate the immunoprotective effect of target proteins used alone or in combination. Results The target proteins PepO and PsaA were successfully obtained and Western blot demonstrated that the antiserum of these proteins had good specificity. There was no significant difference in the titers of IgA in saliva and IgG in serum between the PepO group and the combined immunization group (P > 0.05); however, these two groups had significantly higher antibody titers than the PsaA group (P < 0.05). The PepO, PsaA, and combined immunization groups had significantly higher protection rates for mice infected with Streptococcus pneumoniae D39 and CMCC31436 in the nasal cavity than the negative control group (P < 0.05). The PepO and combined immunization groups had a significantly higher protection rate for mice infected with Streptococcus pneumoniae D39 than the PsaA group (P < 0.05). The results of colonization experiment showed that compared with the control group, the PepO, PsaA, and combined immunization groups showed a significant reduction in the colonization of Streptococcus pneumoniae (CMCC31693 and CMCC31207) in the nasopharynx and lung (P < 0.05). The combined immunization group showed a better effect on reducing the colonization of CMCC31207 in the lung than the PepO and PsaA alone groups. Conclusions Combined PepO/PsaA vaccines may produce a better protective effect by mucosal immunization compared with the vaccine used alone in mice. The combined vaccines can effectively reduce the colonization of Streptococcus pneumoniae in the nasopharynx and lung. Therefore, such protein vaccines may have a great potential for research and development.
  • ● EXPERIMENTALRESEARCH
    Effects of adipose-derived stem cells and non-methylated CpG-oligodeoxynucleotides on peripheral blood CD4+CD25+ regulatory T cells in young mice with food allergy
    CHEN Xu-Lin, ZHENG Cheng-Zhong
    2017, 19(5): 590-595. https://doi.org/10.7499/j.issn.1008-8830.2017.05.022
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    Objective To investigate the effects of adipose-derived stem cells (ADSC) and non-methylated CpG-oligodeoxynucleotides (CpG-ODN) on the expression of peripheral blood CD4+CD25+ regulatory T (Treg) cells in young mice with food allergy, as well as their immune intervention effects. Methods A total of 40 female BALB/c mice were randomly divided into control group, allergic group, ADSC treatment group, and CpG-ODN treatment group, with 10 mice in each group. A mouse model of food allergy was established by intraperitoneal injection and intragastric administration of ovalbumin (OVA) for sensitization and challenge. The mice in the control group were treated with normal saline at the same dose; the mice in the ADSC treatment group were given intraperitoneal injection of ADSC (1×106 cells for each mouse) before and after OVA challenge, and those in the CpG-ODN treatment group were given intraperitoneal injection of non-methylated CpG-ODN solution (40 μg for each mouse) at 1 hour before challenge by gavage. The allergic symptom scores were determined for each group after model establishment. ELISA was used to measure the serum level of OVA-IgE. Flow cytometry was used to measure the percentage of peripheral blood CD4+CD25+ Treg cells. Hematoxylin and eosin staining was used for the pathological analysis of the jejunum. Results The allergic group had significantly higher allergic symptom scores and serum level of OVA-IgE than the control group (P < 0.05). There were no significant differences in the allergic symptom score and the serum level of OVA-IgE between the ADSC treatment group and the CpG-ODN treatment group (P > 0.05), but these two groups had significantly lower allergic symptom scores and serum level of OVA-IgE than the allergic group and significantly higher allergic symptom scores and serum level of OVA-IgE than the control group (P < 0.01). The allergic group had a significantly lower percentage of peripheral blood CD4+CD25+ Treg cells than the control group (P < 0.05). The ADSC treatment group and the CpG-ODN treatment group had a significantly higher percentage of peripheral blood CD4+CD25+ Treg cells than the allergic group (P < 0.05); there were no significant differences between these two groups or between them and the control group (P > 0.05). Pathological results showed structural damage and edema in the jejunal villi, a large number of eosinophils, and lymphocyte infiltration in the allergic group, while the ADSC treatment group and the CpG-ODN treatment group had less structural damage and edema in the jejunal villi, a lower number of eosinophils, and less lymphocyte infiltration. Conclusions ADSC and non-methylated CpG-ODN have a certain effect in the treatment of food allergy and can increase the percentage of peripheral blood CD4+CD25+ Treg cells and reduce the level of OVA-IgE. They may be associated with the induction of immune tolerance and these two treatment have comparable effects. Detailed mechanisms of action still need further investigation.
    • REVIEW
  • ● REVIEW
    Research advances in nutritional assessment methods in children with chronic liver diseases
    TONG Shuai, ZHU Yu, WAN Chao-Min
    2017, 19(5): 596-600. https://doi.org/10.7499/j.issn.1008-8830.2017.05.023
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    Malnutrition is commonly seen in children with chronic liver diseases, and there are interactions between them. Chronic liver diseases can cause malnutrition and this can affect the prognosis of children with chronic liver diseases. Due to the complexity of nutritional assessment in children with chronic liver diseases, there are still no unified standards for the diagnosis of malnutrition. Early identification of malnutrition and related intervention helps to improve the prognosis of children with chronic liver diseases. This article reviews the features of nutrition in children with chronic liver diseases and related nutritional assessment methods.
  • ● REVIEW
    Research advances in the association between maternal intake of methyl donor nutrients during pregnancy and DNA methylation in offspring
    WU Meng-Meng, YANG Fan
    2017, 19(5): 601-606. https://doi.org/10.7499/j.issn.1008-8830.2017.05.024
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    Maternal nutrition during pregnancy plays a vital role in the health of the offspring. Methyl donor nutrients, including folate, vitamin B12, choline, betaine, and methionine, directly affect DNA methylation and are closely associated with the health of the offspring. As an important part of epigenetics, DNA methylation plays an important role in the maintenance of normal cellular function, gene expression regulation, and embryonic development. Recent studies have shown that maternal nutrition may have a long-lasting effect on the health of the offspring via the changes in genomic DNA and/or methylation level in the promoter region in specific genes. Therefore, this review article focuses on the effect of maternal intake of methyl donor nutrients during pregnancy on DNA methylation, in order to explore the effect of the changed methylation status on the health of the offspring at the molecular level.
  • ● REVIEW
    Research advances in noninvasive high-frequency oscillatory ventilation in neonates
    HUANG Jia, YUAN Lin, CHEN Chao
    2017, 19(5): 607-611. https://doi.org/10.7499/j.issn.1008-8830.2017.05.025
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    Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure. Therefore, it is considered a new and effective noninvasive ventilation mode. There are many studies on the rational use, efficacy, and safety of noninvasive high-frequency oscillatory ventilation in neonates around the world. This article reviews the advances in the clinical studies on noninvasive high-frequency oscillatory ventilation in neonates.