CJCP
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2019 Vol.  21 No.  9
Published: 2019-09-25

CLINICAL RESEARCH
CASE ANALYSIS
EXPERIMENTAL RESEARCH
REVIEW
CLINICAL RESEARCH
845 WAN Lin, YANG Guang, ZOU Li-Ping, WANG Jing, SHI Xiu-Yu, REN Wei-Hua, LU Qian
Factors in first-time adrenocorticotropic hormone therapy and their influence on spasm control time in infantile spasms: a Cox proportional-hazards regression model analysis Hot!

Objective To investigate the factors in first-time adrenocorticotropic hormone (ACTH) therapy and their influence on spasm control time in infants with infantile spasms. Methods A total of 72 infants with infantile spasms who were admitted from January 2008 to October 2013 were enrolled. Their clinical data were collected, and the exposure factors for infantile spasms were selected. A Cox proportional-hazards regression model analysis was performed for these factors to analyze their influence on spasm control time. Results Clarification of the etiology (known or unexplained etiology), frequency of spasms before treatment, and presence or absence of combination therapy (ACTH used alone or in combination with magnesium sulfate) had a significant influence on spasm control time in infants with infantile spasms. The infants with a known etiology had a significantly shorter spasm control time than those with unexplained etiology, and the infants with a low frequency of spasms before treatment and receiving ACTH combined with magnesium sulfate early had a significantly longer spasm control time than their counterparts (P < 0.05). Conclusions For infants with infantile spasms at initial diagnosis, etiology should be clarified, which may helpful for evaluating prognosis. A combination of ACTH and magnesium sulfate should be given as soon as possible, which may improve their prognosis.

2019 Vol. 21 (9): 845-850 [Abstract] ( 3232 ) [HTML 1KB] [PDF 1094KB] ( 1218 )
851 LU Yao, LIU Chun-Hua, WANG Yang
Clinical features of infantile neuroaxonal dystrophy and PLA2G6 gene testing

Infantile neuroaxonal dystrophy (INAD) is a rare neurodegenerative disease. Two boys aged 3 years and 4 years and 2 months respectively, were admitted to the hospital due to delayed mental and motor development. There were no abnormalities at birth, and both children had low muscle strength and tension on admission. One child was not able to stand alone and had impaired vision. Electromyography showed neurogenic damage, and head MRI revealed cerebellar atrophy. High-throughput sequencing revealed compound heterozygous mutations in the PLA2G6 gene in the two children. The mutations (IVS11-1G > T and c.1984C > G) in one child were new mutations, and immunohistochemistry showed a reduction in the protein expression of PLAG6 in the muscular tissue of this child. INAD has the main clinical manifestations of psychomotor developmental regression and cerebellar atrophy. High-throughput sequencing can help with clinical diagnosis.

2019 Vol. 21 (9): 851-855 [Abstract] ( 3621 ) [HTML 1KB] [PDF 1835KB] ( 811 )
856 CHANG Qin, HU Bin, WANG Cheng-Ju, YANG Wang, ZHANG Yu-Ping
Infection factors associated with neurodysplasia in early and moderately preterm infants

Objective To investigate the infection factors associated with neurodysplasia in early and moderately preterm infants at a corrected age of 18 months. Methods The preterm infants with a gestational age of 28 weeks to < 34 weeks who were admitted to the neonatal intensive care unit and followed up at the outpatient service for high-risk preterm infants from June 2015 to December 2018 were enrolled as subjects. At a corrected age of 18 months, the revised Bayley Scales of Infant Development was used to evaluate neurodevelopment. Univariate and multivariate logistic regression analyses were used to investigate the infection factors affecting neurodevelopment. Results A total of 138 early or moderately preterm infants were enrolled, among whom 59 had neurodysplasia at a corrected age of 18 months. The univariate logistic regression analysis showed that neurodysplasia was associated with late-onset infection, positive blood culture, and other systemic infections (P < 0.05). The multivariate logistic regression analysis showed that late-onset infection was an independent risk factor for neurodysplasia (OR=1.510, 95%CI:1.133-3.600, P < 0.05). Conclusions Late-onset infection can increase the risk of neurodysplasia in early and moderately preterm infants.

2019 Vol. 21 (9): 856-860 [Abstract] ( 2899 ) [HTML 1KB] [PDF 1096KB] ( 864 )
861 YU Xiao-He, HE Miao, ZHENG Xiang-Rong, WANG Xia, KUANG Jian
Levels of airway inflammatory mediators in peripheral blood in infants and young children with wheezing

Objective To examine the levels of airway inflammatory mediators in peripheral blood in infants and young children with wheezing and to study the possible pathogenesis of wheezing from the aspects of T helper cell 1 (Th1)/T helper cell 2 (Th2) imbalance and airway inflammation. Methods A total of 50 children aged 1 month to 3 years with an acute wheezing episode were enrolled as the wheezing group, and 25 age-matched healthy infants were enrolled as the healthy control group. According to the number of wheezing episodes, the wheezing group was divided into a first-episode group (n=25) and a recurrent wheezing (number of episodes ≥ 2) group (n=25). According to the presence or absence of high-risk factors for asthma, the wheezing group was divided into a high-risk factor group (n=22) and a non-high-risk factor group (n=28). According to the results of pathogen detection, the wheezing group was divided into a positive pathogen group (n=23) and a negative pathogen group (n=27). Levels of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-13 (IL-13), transforming growth factor-β1 (TGF-β1), and total IgE (TIgE) in peripheral blood were measured for each group. For children with wheezing, eosinophil (EOS) count in peripheral blood was measured, and related samples were collected for respiratory pathogen detection. Results The wheezing group had significantly higher levels of IL-4, IL-5, IL-13, TGF-β1, and TIgE in peripheral blood than the healthy control group (P < 0.05). There were no significant differences in the levels of IL-2, IL-4, IL-5, IL-13, TGF-β1, and TIgE in peripheral blood between the first-episode and recurrent wheezing groups, between the high-risk factor and non-high-risk factor groups, and between the positive pathogen and negative pathogen groups (P > 0.05). The correlation analysis showed that in children with wheezing, EOS count was positively correlated with IL-4 level (P < 0.01), IL-4 level was positively correlated with IL-5 and IL-13 levels (P < 0.01), IL-5 level was positively correlated with IL-13 level (P < 0.01), and IL-2 level was positively correlated with TGF-β1 level (P < 0.05). Conclusions Th1/Th2 imbalance with a predominance of Th2 is observed in infants and young children with wheezing. IL-4, IL-5, IL-13, TGF-β1, and IgE are involved in the pathogenesis of wheezing in these children. Airway inflammation is also observed in these children with wheezing, but it is not associated with the number of wheezing episodes, presence or absence of high-risk factors for asthma, or results of pathogen detection.

2019 Vol. 21 (9): 861-867 [Abstract] ( 2746 ) [HTML 1KB] [PDF 1382KB] ( 810 )
868 CHEN Dan, YANG Xiao-Lin, SHEN Zhao-Bo, SUN Xiao-Min, GUO Qing, REN Yan-Hong, ZHANG Guang-Chao
Significance of neutrophil extracellular trap and its markers in the early diagnosis of community-acquired pneumonia in children

Objective To study the significance of plasma neutrophil extracellular trap (NET) and its markers in the diagnosis of community-acquired pneumonia (CAP) in children. Methods A total of 160 children with CAP were enrolled as the CAP group, and 50 healthy children were enrolled the control group. According to disease severity, the CAP group was further divided into a mild CAP subgroup with 137 children and a severe CAP subgroup with 23 children. According to the pathogen, the CAP group was further divided into a bacterial pneumonia subgroup with 78 children, a Mycoplasma pneumonia subgroup with 35 children, and a viral pneumonia subgroup with 47 children. The levels of plasma NET and its markers[antibacterial peptide (LL-37), extracellular free DNA (cfDNA), and deoxyribonuclease I (DNase I)] were measured. Receiver operating characteristic (ROC) curve was used to analyze the value of each index in diagnosing CAP and assessing its severity. Results Compared with the control group, the CAP group had significant increases in the levels of NET, LL-37, and cfDNA and a significant reduction in the activity of DNase I (P < 0.05). Compared with the mild CAP subgroup, the severe CAP subgroup had significantly higher levels of NET, LL-37 and cfDNA and a significantly lower activity of DNase I (P < 0.05). There were no significant differences in the levels of NET, LL-37, and cfDNA and the activity of DNase I among the bacterial pneumonia, Mycoplasma pneumonia, and viral pneumonia subgroups (P > 0.05). In the CAP group, plasma NET levels were positively correlated with white blood cell count (WBC), percentage of neutrophils, and serum levels of C-reactive protein (CRP), procalcitonin and tumor necrosis factor-α (r=0.166, 0.168, 0.275, 0.181 and 0.173 respectively, P < 0.05); LL-37 and cfDNA levels were positively correlated with WBC (r=0.186 and 0.338 respectively, P < 0.05) and CRP levels (r=0.309 and 0.274 respectively, P < 0.05); the activity of DNase I was negatively correlated with CRP levels (r=-0.482, P < 0.05). The ROC curve analysis showed that NET, LL-37, cfDNA, and DNase I had an area under the ROC curve (AUC) of 0.844, 0.648, 0.727, and 0.913 respectively in the diagnosis of CAP, with optimal cut-off values of 182.89, 46.26 ng/mL, 233.13 ng/mL, and 0.39 U/mL respectively, sensitivities of 88.12%, 35.63%, 54.37%, and 91.25% respectively, and specificities of 74.00%, 92.00%, 86.00%, and 76.00% respectively. In the assessment of the severity of CAP, NET, LL-37, cfDNA, and DNase I had an AUC of 0.873, 0.924, 0.820, and 0.778 respectively, with optimal cut-off values of 257.7, 49.11 ng/mL, 252.54 ng/mL, and 0.29 U/mL respectively, sensitivities of 83.21%, 86.96%, 78.26%, and 95.65% respectively, and specificities of 78.26%, 83.94%, 76.64%, and 56.93% respectively. Conclusions Plasma NET and its related markers have a certain value in diagnosing CAP and assessing its severity in children.

2019 Vol. 21 (9): 868-875 [Abstract] ( 3786 ) [HTML 1KB] [PDF 1898KB] ( 1146 )
876 FANG Ke-Nan, WANG Jing, NI Jing-Wen
Correlation between Mycoplasma pneumoniae DNA replication level and disease severity in children with severe Mycoplasma pneumoniae pneumonia

Objective To study the correlation of Mycoplasma pneumoniae DNA (MP-DNA) replication level in throat swab and bronchoalveolar lavage fluid (BALF) with disease severity in children with severe Mycoplasma pneumoniae pneumonia (SMPP). Methods A total of 44 children with SMPP who underwent bronchoalveolar lavage were enrolled as subjects. The serum levels of cytokines and MP-DNA replication times in throat swab were measured in the acute stage and the recovery stage, and the levels of interleukin (IL)-8 and MP-DNA replication times in BALF were measured in the acute stage. According to whether mechanical ventilation was needed for respiratory failure, the children were divided into a mechanical ventilation group (n=19) and a non-mechanical ventilation group (n=25), and the two groups were compared in MP-DNA replication times in BALF. Results For the children with SMPP, serum levels of C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase, IL-1, IL-6, IL-8, and IL-18 in the acute stage were significantly higher than those in the recovery stage (P < 0.05). In the acute stage, MP-DNA replication times in throat swab were positively correlated with those in BALF (r=0.613, P < 0.05), and MP-DNA replication times in BALF were positively correlated with IL-18 levels in peripheral blood and BALF (r=0.613 and 0.41 respectively, P < 0.05). Compared with the non-mechanical ventilation group, the mechanical ventilation group had significantly higher MP-DNA replication times in BALF, a significantly longer duration of systemic hormone treatment, significantly higher serum levels of lactate dehydrogenase and IL-18, and significantly higher white blood cell count and IL-18 level in BALF (P < 0.05). Conclusions In children with SMPP, MP-DNA replication level in throat swab and BALF can be used as a reference index for the assessment of disease severity.

2019 Vol. 21 (9): 876-880 [Abstract] ( 4413 ) [HTML 1KB] [PDF 1285KB] ( 875 )
881 CHENG Lin, XU Fa-Lin, NIU Ming, LI Wen-Li, XIA Lei, ZHANG Yan-Hua, XING Jing-Yue
Pathogens and clinical features of preterm infants with sepsis
Objective To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants. Methods A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of < 7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥ 7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis). Results There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P < 0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P < 0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P < 0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P < 0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P < 0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P < 0.05). Conclusions Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early-and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.
2019 Vol. 21 (9): 881-885 [Abstract] ( 3562 ) [HTML 1KB] [PDF 1264KB] ( 1076 )
886 WANG Lian, LIN Xin-Zhu
Short-term prognosis of the co-twin who survives after single intrauterine fetal demise
Objective To investigate the short-term prognosis of the co-twin who survives after single intrauterine fetal demise (sIUFD). Methods A total of 52 infants who survived after sIUFD were enrolled as the case group, and 104 twins, matched for gestational age, from a pair of live-born twins without sIUFD were enrolled as the control group. Related clinical data were compared between the two groups. Results Among the 52 infants who survived after sIUFD, 42 (80.8%) were preterm infants, 13 (25.0%) had brain injury, and 3 (5.8%) died in the neonatal period. Compared with the control group, the case group had significantly higher incidence rates of meconium stained amniotic fluid/bloody amniotic fluid/polyhydramnios/hypamnion, torsion of cord/nuchal cord, and placenta previa/placenta abruption, as well as significantly higher incidence rates of birth asphyxia, anemia or polycythemia at birth, and coagulation disorder at birth (P < 0.05). The case group also had significantly higher incidence rates of nosocomial infection and brain injury than the control group during hospitalization (P < 0.05). Conclusions There is an increase in the incidence rate of complications in the co-twin who survives after sIUFD. Prenatal evaluation and long-term follow-up should be performed for the surviving co-twin.
2019 Vol. 21 (9): 886-889 [Abstract] ( 3588 ) [HTML 1KB] [PDF 1167KB] ( 815 )
890 CHEN Xiao-Juan, ZOU Yao, LIU Xiao-Ming, YANG Wen-Yu, GUO Ye, RUAN Min, LIU Fang, CHEN Yu-Mei, ZHANG Li, WANG Shu-Chun, ZHU Xiao-Fan
Long-term clinical effect of the CCLG-ALL2008 regimen in treatment of childhood acute lymphoblastic leukemia with different molecular biological features
Objective To study the long-term clinical effect of the CCLG-ALL2008 regimen in the treatment of children newly diagnosed with acute lymphoblastic leukemia (ALL) with different molecular biological features. Methods A total of 940 children who were newly diagnosed with ALL were enrolled in this study. The children were treated with the CCLG-ALL2008 regimen. A retrospective analysis was performed for the long-term outcome of ALL children with different molecular biological features. Results Among the 940 children with ALL, there were 570 boys and 370 girls, with a median age of onset of 5 years (range 1-15 years) and a median follow-up time of 65 months (range 3-123 months). The complete response (CR) rate was 96.7%, the predicted 10-year overall survival (OS) rate was 76.5%±1.5%, and the event-free survival (EFS) rate was 62.6%±3.0%. After CR was achieved after treatment, the overall recurrence rate was 21.9%. The children with positive ETV6-RUNX1 had the lowest recurrence rate and were prone to late recurrence, and those with positive MLL rearrangement had the highest recurrence rate and were prone to early recurrence. The children with positive ETV6-RUNX1 had a significantly higher predicted 10-year OS rate than those with positive TCF3-PBX1, BCR-ABL, or MLL rearrangement and those without molecular biological features (P < 0.05). The children with positive ETV6-RUNX1 had a significantly higher predicted 10-year EFS rate than those with positive BCR-ABL or MLL rearrangement (P < 0.05). Conclusions Molecular biological features may affect the long-term prognosis of children with ALL, and positive MLL rearrangement and BCR-ABL fusion gene are indicators of poor prognosis. Children with positive ETV6-RUNX1 fusion gene have the highest long-term survival rate.
2019 Vol. 21 (9): 890-893 [Abstract] ( 2662 ) [HTML 1KB] [PDF 1309KB] ( 828 )
894 REN Zhen-Min, HUANG Li-Lan, HUANG Bao-Xing, LI Chang-Gang, CHEN Yun-Sheng
Serum level of soluble transferrin receptor in children with hemoglobin H disease
Objective To investigate the serum level of soluble transferrin receptor (sTfR) and its association with the degree of anemia in children with hemoglobin H (HbH) disease. Methods A total of 55 children with HbH disease were enrolled as the HbH group, and 30 healthy children were enrolled as the control group. The HbH group was further divided into a deletional HbH disease group and a non-deletional HbH disease group. A retrospective analysis was performed for hematological parameters and serum sTfR level in all groups. Results Of the 55 children with HbH disease, 39 had deletional HbH disease and 16 had non-deletional HbH disease. Compared with the control group, the deletional and non-deletional HbH disease groups had significantly lower hemoglobin (Hb), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) and a significantly higher serum level of sTfR. Compared with the deletional HbH disease group, the non-deletional HbH disease group had significantly lower red blood cell count (RBC) and Hb level and significantly higher MCV, MCH, and serum sTfR level. In children with HbH disease, serum sTfR level was negatively correlated with RBC and Hb level (r=-0.739 and -0.667 respectively, P < 0.05) and positively correlated with MCV and MCH (r=0.750 and 0.434 respectively, P < 0.05). Conclusions Serum sTfR level is associated the degree of anemia in children with HbH disease, and sTfR may be a target for the treatment of HbH disease.
2019 Vol. 21 (9): 894-897 [Abstract] ( 2581 ) [HTML 1KB] [PDF 1238KB] ( 845 )
898 ZHOU Li-Bing, CHEN Jiao, DU Xiao-Chen, WU Shui-Yan, BAI Zhen-Jiang, LYU Hai-Tao
Value of three scoring systems in evaluating the prognosis of children with severe sepsis
Objective To study the predictive value of Pediatric Age-adapted Sequential Organ Failure Assessment Score (pSOFA), Pediatric Risk of Mortality Score Ⅲ (PRISM Ⅲ), and Pediatric Critical Illness Score (PCIS) in children with severe sepsis. Methods A retrospective analysis was performed for the clinical data of 193 hospitalized children with severe sepsis. According to the final outcome, these children were divided into a survival group with 151 children and a death group with 42 children. The scores of pSOFA, PRISM Ⅲ, and PCIS were determined according to the worst values of each index within 24 hours after admission. The receiver operating characteristic (ROC) curve was used to analyze the efficiency of each scoring system in predicting the risk of death due to sepsis. Smooth curve fitting was used to analyze the correlation between the three scoring systems and the threshold effect of each scoring system. Decision curve analysis (DCA) was used to evaluate the application value of each scoring system. Results The ROC analysis showed that PCIS and pSOFA had a similar predictive value (P=0.182) and that PRISM Ⅲ and pSOFA had a similar predictive value (P=0.210), while PRISM Ⅲ had a better predictive value than PCIS (P=0.045). PRISM Ⅲ had the highest degree of fitting with prognosis, followed by pSOFA and PCIS. The DCA analysis showed that when the risk of death was 0.4 and 0.6 in children with severe sepsis and the three scoring systems were used as the basis for emergency intervention decision-making, pSOFA achieved the highest standardized net benefit, followed by PRISM Ⅲ and PCIS. Conclusions All three scoring systems have a certain value in predicting the prognosis of children with severe sepsis, and pSOFA has a better value than PRISM Ⅲ and PCIS.
2019 Vol. 21 (9): 898-903 [Abstract] ( 3973 ) [HTML 1KB] [PDF 1548KB] ( 1019 )
904 HE Cui-Yao, QIN Yan-Ran, LIU Cheng-Jun, REN Jie, FAN Ji-Shan
Effect of augmented renal clearance on plasma concentration of vancomycin and treatment outcome in children with methicillin-resistant Staphylococcus aureus infection
Objective To investigate the effect of augmented renal clearance (ARC) on plasma concentration of vancomycin, bacteriological outcome, and clinical outcome in children with methicillin-resistant Staphylococcus aureus (MRSA) infection treated by vancomycin. Methods A retrospective analysis was performed for the clinical data of 60 critically ill children who were treated with vancomycin due to MRSA infection from January 2013 to July 2017 and underwent plasma concentration monitoring. According to estimated glomerular filtration rate, these children were divided into an ARC group with 19 children and a normal renal function group with 41 children. The two groups were compared in terms of the use of vancomycin, plasma concentration of vancomycin, and treatment outcome. Results The children in the ARC group had an age of 1-12 years, and the ARC group had significantly higher body weight and body surface area than the normal renal function group (P < 0.05). Compared with the normal renal function group, the ARC group had a significantly lower initial trough concentration of vancomycin and a significantly lower proportion of children who achieved the effective trough concentration of vancomycin (10-20 mg/L) (P < 0.05). There were no significant differences in bacteriological outcome and clinical outcome between the two groups (P > 0.05), but the ARC group had significantly longer length of stay in the pediatric intensive care unit (PICU) and length of hospital stay than the normal renal function group (P < 0.05). Conclusions ARC can significantly reduce the trough concentration of vancomycin and prolong the length of PICU stay and the length of hospital stay in children with MRSA infection. Idividualized medication should be administered to children with ARC.
2019 Vol. 21 (9): 904-909 [Abstract] ( 3096 ) [HTML 1KB] [PDF 1387KB] ( 792 )
910 CHEN Qiong, ZHANG Yao-Dong, WU Sheng-Nan, CHEN Yong-Xing, LIU Xiao-Jing, WEI Hai-Yan
Correlation between serum microRNA-122 and insulin resistance in obese children
Objective To study the relationship between serum microRNA-122 (miR-122) and insulin resistance in obese children. Methods Forty-seven children with severely obesity aged 7-14 years and 45 age-and gender matched healthy children with normal weight (control group) were enrolled. The levels of height, weight, waistline, hip circumference, fasting blood glucose (FBG), fasting insulin (FINS), triglyceride (TG), total cholesterol (TC), free fatty acid (FFA), interleukin-6 (IL-6) and miR-122 in the two groups were measured. Body mass index (BMI), waist-hip ratio (WHR) and insulin resistance index (HOMA-IR) were calculated. Results Compared with the control group, the height, weight, BMI, WHR, FINS, HOMA-IR, TG, FFA, IL-6, and miR-122 levels in the obese group were significantly increased (P < 0.05). MiR-122 levels in the obese group were positively correlated with FINS, HOMA-IR and IL-6 levels (r=0.408, 0.442, and 0.464 respectively, P < 0.05). The changes of miR-122 have a linear regression relationship with IL-6 (b'=0.318, P < 0.05). Conclusions The elevated serum miR-122 levels may be correlated with insulin resistance in obese children. The mechanism needs to be further studied.
2019 Vol. 21 (9): 910-914 [Abstract] ( 2796 ) [HTML 1KB] [PDF 1456KB] ( 815 )
915 CHENG Xiang-Yang, ZHU Yi-Feng, LUO Shu, HE Yan, WANG Xiang-Chuan
An epidemiological investigation of chronic kidney disease in children with hearing disorder in Hunan province, China
Objective To investigate the prevalence of chronic kidney disease (CKD) among the children with hearing disorder in Hunan province, China. Methods In this cross-sectional study, the multi-stage cluster sampling method was used to select 1 500 children as subjects. Questionnaire surveys, physical examinations, and laboratory examinations were performed on the spot. Results Among the 1 500 children, 1 459 with complete data were included in analysis. Among the 1 459 children, 43 had CKD, with a prevalence rate of 2.95%. The < 7 years group had a significantly higher prevalence rate than the 7-14 years group[5.8% (35/604) vs 0.9% (8/855); P < 0.05]. Among the 43 children with CKD, 31 (72%) had proteinuria, 27(63%) had hematuria, and 11 (26%) had a decreased glomerular filtration rate. Among the 43 children with CKD, stage 1, 2, 3a, 3b, 4, and 5 CKD accounted for 30% (13 cases), 44% (19 cases), 12% (5 cases), 7% (3 cases), 7% (3 cases), and 0% (0 case) respectively. The prevalence rate of CKD increased with the severity of hearing disorder (P < 0.01). Conclusions The prevalence rate of CKD is higher among the children with hearing disorder in Hunan province. Most children have early-stage CKD. CKD is commonly seen in preschool children. Severity of hearing disorder is associated with the prevalence of CKD.
2019 Vol. 21 (9): 915-918 [Abstract] ( 2881 ) [HTML 1KB] [PDF 1273KB] ( 683 )
850

No abstract available

2019 Vol. 21 (9): 850-850 [Abstract] ( 1151 ) [HTML 1KB] [PDF 757KB] ( 446 )
948

No abstract available

2019 Vol. 21 (9): 948-948 [Abstract] ( 1325 ) [HTML 1KB] [PDF 922KB] ( 420 )
CASE ANALYSIS
919 LI Ke-Yao, TANG Jian-Ping, LIANG Xiao-Ting, ZHAO Zhou-Ying, YUE Shu-Zhen
Recurrent skin blisters for more than 7 months in a girl aged 15 months
A girl, aged 15 months, attended the hospital due to recurrent skin erythema, blisters, and desquamation for more than 7 months. Giemsa staining and immunohistochemical staining showed mast cell infiltration and degranulation. Hematoxylin staining showed spinous layer edema and blister formation under the epidermis, with a large amount of serous fluid and a small number of inflammatory cells in the blister. Marked edema was observed in the dermis, with diffused mononuclear cell infiltration. The girl was diagnosed with mastocytosis. Mastocytosis should be considered for children with recurrent skin erythema and blisters.
2019 Vol. 21 (9): 919-923 [Abstract] ( 2563 ) [HTML 1KB] [PDF 2025KB] ( 761 )
EXPERIMENTAL RESEARCH
924 LUO Yan, XIE Liang, LIU Han-Min, LIU Bin
Effect of low-concentration paclitaxel on collagen deposition outside rat pulmonary artery smooth muscle cells and related mechanism
Objective To study the effect of low-concentration paclitaxel (PTX) on transforming growth factor-β1 (TGF-β1)-induced collagen deposition outside rat pulmonary artery smooth muscle cells (PASMCs) and related mechanism. Methods Primary rat PASMCs were divided into a blank control group (n=3), a model group (n=3), and a drug intervention group (n=3). No treatment was given for the blank control group. The model group was treated with TGF-β1 with a final concentration of 10 ng/mL. The drug intervention group was treated with PTX with a final concentration of 100 nmol/L in addition to the treatment in the model group. MTT colorimetry was used to measure cell proliferation. Quantitative real-time PCR was used to measure the relative mRNA expression of collagen type I (COL-I) and collagen type Ⅲ (COL-Ⅲ). ELISA was used to measure the OD value of COL-I and COL-Ⅲ proteins. Western blot was used to measure the relative protein expression of COL-I, COL-Ⅲ, and the key proteins of the TGF-β1/Smad3 signaling pathway (Smad3 and p-Smad3). Results Compared with the blank control group, the model group had significant increases in proliferation ability, relative mRNA and protein expression of COL-I and COL-Ⅲ, and relative protein expression of p-Smad3 (P < 0.05). Compared with the model group, the drug intervention group had significant reductions in the above indicators, but which were still higher than those in the blank control group (P < 0.05). There was no significant difference in the relative protein expression of Smad3 among the three groups (P > 0.05). Conclusions Low-concentration PTX exerts a marked inhibitory effect on TGF-β1-induced collagen deposition outside PASMCs, possibly by regulating the phosphorylation of Smad3 protein.
2019 Vol. 21 (9): 924-929 [Abstract] ( 2280 ) [HTML 1KB] [PDF 1677KB] ( 598 )
930 SUN Yong-Hong, LEI Xiao-Yan, CHEN Xing-Xing, CUI Wei-Jing, LIU Jing
Effect and molecular mechanism of interferon-α on podocyte apoptosis induced by hepatitis B virus X protein
Objective To investigate the effect and molecular mechanism of interferon-α (INF-α) on the apoptosis of the mouse podocyte cell line MPC5 induced by hepatitis B virus X (HBx) protein. Methods MPC5 cells were transfected with the pEX plasmid carrying the HBx gene. RT-PCR was used to measure the mRNA expression of HBx at different time points. MPC5 cells were divided into 4 groups:control group (MPC5 cells cultured under normal conditions), INF-α group (MPC5 cells cultured with INF-α), HBx group (MPC5 cells induced by HBx), and HBx+INF-α group (MPC5 cells induced by HBx and cultured with INF-α). After 48 hours of intervention under different experimental conditions, flow cytometry was used to measure the apoptosis of MPC5 cells, and quantitative real-time PCR and Western blot were used to measure the mRNA and protein expression of slit diaphragm-related proteins (nephrin, CD2AP, and synaptopodin) and the cytoskeleton-related protein transient receptor potential cation channel 6 (TRPC6). Results MPC5 cells transfected by pEX-HBx had the highest expression of HBx mRNA at 48 hours after transfection (P < 0.05). Compared with the control, INF-α and HBx+INF-α groups, the HBx group had a significant increase in the apoptosis rate of MPC5 cells (P < 0.05). Compared with the control and INF-α groups, the HBx group had significant reductions in the mRNA and protein expression of nephrin, synaptopodin, and CD2AP and significant increases in the mRNA and protein expression of TRPC6 (P < 0.05). Compared with the HBx group, the HBx+INF-α group had significant increases in the mRNA and protein expression of nephrin, synaptopodin, and CD2AP and significant reductions in the mRNA and protein expression of TRPC6 (P < 0.05). Conclusions INF-α can inhibit the apoptosis of podocytes induced by HBx, possibly through improving the abnormal expression of slit diaphragm-related proteins (CD2AP, nephrin, and synaptopodin) and cytoskeleton-related protein (TRPC6) induced by HBx.
2019 Vol. 21 (9): 930-935 [Abstract] ( 2584 ) [HTML 1KB] [PDF 1534KB] ( 756 )
REVIEW
936 LI Tie-Geng
A review on the clinical application of high-sensitivity cardiac troponin T in neonatal diseases
In recent years, high-sensitivity cardiac troponin T (hs-cTnT) has been recognized as an effective marker for myocardial injury in adults and can be used to diagnose acute myocardial injury and predict major adverse cardiovascular events. It is the gold standard for the diagnosis of acute myocardial infarction in adults. Neonates are a special group, and due to the changes of various physiological processes during the perinatal period, many laboratory markers used in adults may have a low clinical value in neonates. So far, for example, there is still no suitable cardiac serum biomarker that can reflect the true condition of neonatal myocardial injury. In recent years, new breakthroughs have been made in the application of hs-cTnT in the field of neonates. In order to fully understand the role of hs-cTnT in neonatal diseases, this article reviews the research advances in the biological and physiological features of hs-cTnT and its application in neonates.
2019 Vol. 21 (9): 936-941 [Abstract] ( 3319 ) [HTML 1KB] [PDF 1522KB] ( 1045 )
942 LIU Qiu-Tong, ZHONG Xiao-Yun
Application of metabolomics in neonatal clinical practice
Metabolomics is an emerging and popular subject in the post-genome era, and a large number of studies have been noted on the application of metabolomics in health evaluation, growth and development evaluation, disease diagnosis, and therapeutic efficacy evaluation. As a special period of life, the neonatal period is characterized by rapid cell renewing, consumption of a lot of energy and materials, and changes in metabolic pathways, all of which affect the level of metabolites. However, there is still no reference standard for metabolic level and profile in neonates. This article reviews the current status of metabolic research on neonatal growth and development and common diseases and related clinical application of metabolomics, so as to provide new ideas for nutrition guidance and evaluation, selection of therapeutic regimens, and new drug research in neonates.
2019 Vol. 21 (9): 942-948 [Abstract] ( 2931 ) [HTML 1KB] [PDF 1630KB] ( 806 )
949 JIANG Ting, LI Qu-Bei
Diffuse alveolar hemorrhage in children

Diffuse alveolar hemorrhage (DAH) is a clinical syndrome with major clinical manifestations of hemoptysis, anemia, and diffuse infiltration in the lung. DAH has a high mortality rate in the acute stage and is a life-threatening emergency in clinical practice. Compared with adult DHA, childhood DHA tends to have a specific spectrum of underlying diseases. It has long been believed that idiopathic pulmonary hemosiderosis (IPH) is the main cause of childhood DAH; however, with the increase in reports of childhood DAH cases, the etiology spectrum of childhood DAH is expanding. The treatment and prognosis of DAH with different etiologies are different. This review article gives a general outline of childhood DAH, with focuses on DAH caused by IPH, systemic lupus erythematosus, anti-neutrophil cytoplasmic antibody-related vasculitis, COPA syndrome, or IgA vasculitis.

2019 Vol. 21 (9): 949-954 [Abstract] ( 4499 ) [HTML 1KB] [PDF 1472KB] ( 1298 )
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