CJCP
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2021 Vol.  23 No.  11
Published: 2021-11-09
OVERSEAS PEDIATRIC RESEARCH PROGRESS
STANDARD·PROTOCOL·GUIDELINE
CLINICAL RESEARCH
CASE ANALYSIS
EXPERIMENTAL RESEARCH
REVIEW
STANDARD·PROTOCOL·GUIDELINE
1075 HUANG Rong, ZOU Fu-Lan, LI Mao-Jun, WU Qing, YANG Qian, TANG Bin-Zhi, LIANG Xiao-Ming
—an ENDO-European Reference Network initiative endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology"[J]. Chinese Journal of Contemporary Pediatrics, 2021,23(11): 1075-1079>')" href="#"> An interpretation of "congenital hypothyroidism: a 2020-2021 consensus guidelines update—an ENDO-European Reference Network initiative endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology" Hot!
Congenital hypothyroidism is one of the common diseases causing delayed intelligence development and growth retardation in children. In 2021, the ENDO-European Reference Network updated the practice guidelines for the diagnosis and management of congenital hypothyroidism. The guidelines give a comprehensive and detailed description of the screening, diagnosis, and management of congenital hypothyroidism in neonates. This article gives an interpretation of the guidelines in order to provide a reference for clinicians in China.
2021 Vol. 23 (11): 1075-1079 [Abstract] ( 1832 ) [HTML 1KB] [PDF 567KB] ( 1133 )
OVERSEAS PEDIATRIC RESEARCH PROGRESS
1080 Mahmood Majid Mohammed, Jafarli Ilhama, Al-Barazanchi Aras Fathi, Mosa Nadhim Mohammed, Al-Ameen Zenab Ghanim Younus, Alkhanchi Taghreed
What you need to know about children's COVID-19: a systematic review Hot!
The aim of the systematic review is to describe clinical features of coronavirus disease 2019 (COVID-19) in children with a focus on the possible reasons why children are less susceptible to COVID-19 and whether their immune response works better than adults. The three research questions below were determined. (1) Why do pediatric COVID-19 cases have milder clinical symptoms than adults? (2) What are clinical manifestations, diagnosis, and treatment of COVID-19 in children? (3) How long lasts viral shedding after recovery? We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects, as well as foreign literature with English translations. Extra information and data have been collected from Google Scholar and the American Society for Microbiology. Information on patients' age, comorbidities, methods of treatment, and effects on mortality and morbidity were extracted. It is concluded that children are less susceptible to COVID-19 than adults and that the symptoms in children are less severe than in adults. A low incidence of COVID-19 in children and milder disease than in adults might be attributed to many theories and reasons; however, the mechanisms involved are not fully understood. Citation:
2021 Vol. 23 (11): 1080-1090 [Abstract] ( 2737 ) [HTML 1KB] [PDF 611KB] ( 604 )
CLINICAL RESEARCH
1091 DENG Yong-Chao, TANG Xi-Chun, LI Xun, DONG Cai-Xia
An investigation of vitamin D nutritional status in children after outbreak of coronavirus disease 2019 Hot!
Objective To investigate vitamin D nutritional status in children after outbreak of coronavirus disease 2019 (COVID-19), as well as the effect of strict epidemic prevention and control measures for the COVID-19 epidemic on vitamin D nutritional status in children. Methods A total of 7 460 children who underwent routine physical examinations from February to August, 2020 and had normal results were retrospectively enrolled as the observation group, and 10 102 children who underwent routine physical examinations from February to August, 2019 (no epidemic of COVID-19) and had normal results were enrolled as the control group. The serum level of 25-hydroxy vitamin D [25(OH)D] was compared between the two groups. The children in the observation and control groups who underwent physical examinations in March and April were selected as the epidemic prevention subgroup (n=1 710) and non-epidemic subgroup (n=2 877) respectively. The subjects were divided into five age groups (infancy, early childhood, preschool, school age and adolescence), and serum 25(OH)D levels of children of all ages were compared between the epidemic prevention and non-epidemic subgroups. Results The observation group had a lower serum level of 25(OH)D than the control group in March and April (P<0.001). The epidemic prevention subgroup had a lower serum level of 25(OH)D than the non-epidemic subgroup in all age groups (P<0.001). The vitamin D sufficiency rate in early childhood, preschool, school and adolescent children from the epidemic prevention subgroup was lower than the non-epidemic subgroup (P<0.001), with a reduction of 10.71%, 18.76%, 59.63% and 56.29% respectively. Conclusions Strict prevention and control measures for the COVID-19 epidemic may lead to a significant reduction in vitamin D level in children, especially school-aged and adolescent children. It is recommended to timely monitor vitamin D level in children, take vitamin D supplements, and increase the time of outdoor sunshine as far as possible under the premise of adherence to epidemic prevention regulations. Citation:
2021 Vol. 23 (11): 1091-1096 [Abstract] ( 1496 ) [HTML 1KB] [PDF 570KB] ( 477 )
1097 LI Xiao-Lan, CAI Yue-Ju, ZHANG Zhe, LI Jian, CHEN Xiao-Wen, SONG Yan-Yan, ZHOU Wei
Effect of different maintenance doses of caffeine citrate on ventilator weaning in very preterm infants with respiratory distress syndrome: a prospective randomized controlled trial Hot!
Objective To study the effect of different maintenance doses of caffeine citrate on the success rate of ventilator weaning in very preterm infants (gestational age of ≤32 weeks) with respiratory distress syndrome (RDS). Methods A total of 162 preterm infants with RDS who were admitted to the hospital from January 2016 to December 2018 were enrolled in this prospective trial. These infants had a gestational age of ≤32 weeks and required invasive mechanical ventilation. They were randomly divided into a high-dose caffeine group and a low-dose caffeine group, with 81 infants in each group. Within 6 hours after birth, both groups were given caffeine at a dose of 20 mg/kg. After 24 hours, the high- and low-dose caffeine groups were given caffeine at a maintenance dose of 10 mg/kg and 5 mg/kg, respectively. The two groups were compared in terms of re-intubation rate within 48 hours after ventilator weaning, durations of ventilation and oxygen therapy, enteral feeding, weight gain, and the incidence rates of complications and adverse reactions during hospitalization. Results The high-dose caffeine group had a significantly lower re-intubation rate within 48 hours after ventilator weaning than the low-dose caffeine group (P<0.05), with frequent apnea as the main reason for failed ventilator weaning in both groups. The high-dose caffeine group had significantly shorter durations of mechanical ventilation and oxygen therapy than the low-dose caffeine group (P<0.05). There were no significant differences between the two groups in the time to total enteral feeding, average daily weight gain, body weight at discharge, and the incidence rates of complications (bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and intracranial hemorrhage) and adverse reactions (tachycardia, hypertension, and feeding intolerance) (P>0.05). Conclusions A high maintenance dose of caffeine can safely and effectively reduce the incidence rate of apnea after ventilator weaning and the failure rate of ventilator weaning in RDS preterm infants with a gestational age of ≤32 weeks, and therefore, it holds promise for clinical application.
2021 Vol. 23 (11): 1097-1102 [Abstract] ( 1359 ) [HTML 1KB] [PDF 595KB] ( 532 )
1103 LI Yu-Qin, SUN Ying-Hong, LIANG Ya-Peng, ZHOU Fan, YANG Jie, JIN Sheng-Li
Effect of probiotics combined with applied behavior analysis in the treatment of children with autism spectrum disorder: a prospective randomized controlled trial Hot!
Objective To study the effect of probiotics combined with applied behavior analysis (ABA) in the treatment of children with autism spectrum disorder (ASD). Methods A total of 41 children with ASD who attended the Affiliated Hospital of Jiangsu University from May 2019 to December 2020 were enrolled and randomly divided into an observation group with 21 children and a control group with 20 children. The children in the observation group were given oral probiotics combined with ABA intervention, while those in the control group were given ABA intervention alone. The treatment outcomes were compared between the two groups. Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the severity of behavioral symptoms in both groups before intervention and at 3 months after intervention. The fecal samples were collected to analyze the difference in intestinal flora between the two groups based on 16s rRNA high-throughput sequencing. Results Before intervention, there was no significant difference in the ATEC score between the observation and control groups (P>0.05). At 3 months after intervention, both groups had a significant reduction in the ATEC score, and the observation group had a significantly lower ATEC score than the control group (P<0.05). Before intervention, there was no significant difference in the composition of intestinal flora between the observation and control groups. At 3 months after intervention, there was a significant difference in the composition of intestinal flora between the observation and control groups. Compared with the control group, the observation group had significantly higher relative abundances of Bifidobacterium, Lactobacillus, Coprobacillus, Ruminococcus, Prevotella, and Blautia (P<0.05) and significantly lower relative abundances of Shigella and Clostridium (P<0.05). Conclusions Probiotics may improve the effect of conventional ABA intervention in children with ASD by regulating intestinal flora. Citation:
2021 Vol. 23 (11): 1103-1110 [Abstract] ( 1439 ) [HTML 1KB] [PDF 756KB] ( 807 )
1111 HUO Ya, GUAN Xian-Min, DOU Ying, WEN Xian-Hao, GUO Yu-Xia, SHEN Ya-Li, AN Xi-Zhou, YU Jie
Prognostic significance of measurable residual disease based on multiparameter flow cytometry in childhood acute myeloid leukemia Hot!
Objective To study the prognostic value of measurable residual disease (MRD) for childhood acute myeloid leukemia (AML) by analyzing MRD-guided risk stratification therapy. Methods A total of 93 children with AML were prospectively enrolled in this study. Chemotherapy with the 2015-AML-03 regimen was completed according to the risk stratification determined by genetic abnormality at initial diagnosis and MRD and bone marrow cytology after induction therapy I. Multiparameter flow cytometry was used to dynamically monitor MRD and analyze the prognostic effect of MRD on 3-year cumulative incidence of recurrence (CIR) rate, event-free survival (EFS) rate, and overall survival (OS) rate. Results The 93 children with AML had a 3-year CIR rate of 48%±6%, a median time to recurrence of 11 months (range 2-32 months), a 3-year OS rate of 65%±6%, and a 3-year EFS rate of 50%±5%. After induction therapy I and intensive therapy I, the MRD-positive children had a significantly higher 3-year CIR rate and significantly lower 3-year EFS and OS rates than the MRD-negative children (P<0.05). There were no significant differences in 3-year CIR, EFS, and OS rates between the MRD-positive children with a low risk at initial diagnosis and the MRD-negative children after adjustment of chemotherapy intensity (P>0.05). The multivariate analysis showed that positive MRD after intensive treatment I was a risk factor for 3-year OS rate in children with AML (P<0.05). Conclusions MRD has predictive value for the prognosis of children with AML. Based on the MRD-guided risk stratification therapy, reasonable application of chemotherapy may improve the overall prognosis of children with AML. Citation:
2021 Vol. 23 (11): 1111-1118 [Abstract] ( 1254 ) [HTML 1KB] [PDF 608KB] ( 436 )
1119 FENG Yong, YU Xiu-Hua, SONG Yu-Xin, LIU Jian-Cheng, LIU Li, WU Tian-Tian, SHANG Yun-Xiao
Establishment of a predictive equation for pulmonary ventilation function in school-aged children in northeast China: a prospective study Hot!
Objective To establish a predictive equation for commonly used pulmonary ventilation function parameters in children aged 6-<16 years in northeast China. Methods A total of 504 healthy children from Liaoning, Jilin, and Heilongjiang provinces of China were selected for the prospective study, among whom there were 242 boys and 262 girls. The JAEGER MasterScreen Pneumo spirometer was used to measure pulmonary ventilation function. With the measured values of 10 parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and back-extrapolated volume (BEV), as dependent variables and age, body height, and body weight as independent variables, the stepwise multivariate regression method was used to establish the regression equation for children of different sexes. The mean of relative prediction error was used to evaluate the applicability of the predictive equation. Results The boys aged 9-<10 years and 15-<16 years had significantly higher body height, FVC, and FEV1 than the girls of the same age (P<0.05), and the boys aged 9-<10, 10-<11, 11-<12, and 13-<14 years had a significantly lower FEV1/FVC ratio than the girls of the same age (P<0.05). The correlation analysis showed that all parameters, except FEV1/FVC ratio and BEV/FVC ratio, were significantly positively correlated with age, body height, and body weight (P<0.001). Further regression analysis showed that age and body height were the influencing factors for most parameters, while body weight was less frequently included in the regression equation. Compared with the predictive equations from previous studies, the regression equation established in this study had relatively good applicability in the study population. Conclusions A new predictive equation for the main pulmonary ventilation function parameters has been established in this study for children aged 6-<16 years in northeast China, which provides a basis for accurate judgment of pulmonary function abnormalities in clinical practice. Citation:
2021 Vol. 23 (11): 1119-1126 [Abstract] ( 1321 ) [HTML 1KB] [PDF 761KB] ( 478 )
1127 LUO Yong-Han, DAI Ji-Hong, GENG Gang, FU Wen-Long, LI Qu-Bei, SHU Chang
Consistency between nasopharyngeal aspirates and bronchoalveolar lavage fluid in pathogen detection in children with pneumonia: an analysis of 533 cases Hot!
Objective To study the consistency between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in pathogen detection in children with pneumonia. Methods A retrospective analysis was performed on the data of pathogens detected in 533 children with pneumonia from February 2017 to March 2020. The paired McNemar's test was used to compare the difference in pathogen detection between NPA and BALF groups. The Kappa coefficient was used to analyze the consistency in pathogen detection between the two groups. Results NPA had a sensitivity of 28%, a specificity of 74%, a positive predictive value of 14%, and a negative predictive value of 91% in detecting bacteria, and a Kappa coefficient of 0.013 suggested poor consistency between NPA and BALF. NPA had a sensitivity of 52%, a specificity of 81%, a positive predictive value of 24%, and a negative predictive value of 94% in detecting viruses, and a Kappa coefficient of 0.213 suggested poor consistency between NPA and BALF. NPA had a sensitivity of 78%, a specificity of 71%, a positive predictive value of 49%, and a negative predictive value of 90% in detecting Mycoplasma pneumoniae, and a Kappa coefficient of 0.407 suggested moderate consistency between NPA and BALF. Conclusions There is poor consistency between NPA and BALF in the detection of bacteria and viruses, and clinicians should be cautious in diagnosing lower respiratory tract infection based on bacteria or viruses detected in NPA. There is moderate consistency between NPA and BALF in the detection of Mycoplasma pneumoniae, suggesting that it may be reliable to diagnose lower respiratory tract infection based on Mycoplasma pneumoniae detected in NPA, while comprehensive judgment in combination with clinical conditions is needed.
2021 Vol. 23 (11): 1127-1131 [Abstract] ( 1403 ) [HTML 1KB] [PDF 564KB] ( 591 )
1132 CAI Ming-Xuan, WEI Bing, LIAO Shi-E, FU Jin-Yue, LIU Ya-Jun, LI Ling-Xue
Association between ADRB2 regulatory region polymorphisms and susceptibility to childhood asthma Hot!
Objective To study the association of β2-drenergic receptor (ADRB2) regulatory region single nucleotides polymorphism (SNP)/haplotypes at rs11168070, rs17108803, rs2053044, rs12654778, rs11959427, and rs2895795 loci with childhood asthma. Methods A total of 143 children with asthma who attended the hospital from October 2016 to October 2020 were enrolled as the asthma group, among whom 61 children had mild symptoms (mild group) and 82 children had moderate-to-severe symptoms (moderate-to-severe group). A total of 137 healthy children were enrolled as the control group. Peripheral venous blood samples were collected from the two groups. The SNaPshot SNP technique was used to analyze the SNP and haplotypes of the ADRB2 regulatory region at rs11168070, rs17108803, rs2053044, rs12654778, rs11959427, and rs2895795 loci in all children. The asthma group and the control group were compared in terms of the association of ADRB2 regulatory region SNP and haplotypes at the above six loci with susceptibility to asthma and severity of asthma. Results Polymorphisms were observed in the ADRB2 regulation region at the above six loci in both the asthma group and the control group, with significant differences between the two groups in the distribution of genotype and allele frequencies at rs2895795 (-1429T /A), rs2053044(-1023G/A), and rs12654778 (-654G/A) loci (P<0.05). Linkage disequilibrium of SNP was observed at the six loci of the ADRB2 regulatory region.The haplotypes of TATGCT, TATGGC, and AGTGCT were associated with susceptibility to childhood asthma, among which TATGCT and TATGGC were risk factors for childhood asthma (OR=1.792 and 1.946 respectively, P<0.05), while AGTGCT was a protective factor (OR=0.523, P<0.05). Conclusions SNP/haplotype of the ADRB2 regulatory region is associated with the susceptibility to childhood asthma. The haplotypes of TATGCT and TATGGC formed by such SNP/haplotype are risk factors for childhood asthma, while AGTGCT is a protective factor.
2021 Vol. 23 (11): 1132-1140 [Abstract] ( 1332 ) [HTML 1KB] [PDF 1091KB] ( 458 )
1141 WEI Jian-Hui, WU Rong, XING De-Xiu, SHU Jing, HU Shi-Xiong, QIN Jia-Bi
Epidemiological characteristics and spatial epidemiology of hand-foot-mouth disease in Hunan Province, China, from 2008 to 2019 Hot!
Objective To investigate the epidemic situation of hand-foot-mouth disease (HFMD) in Hunan Province, China, from 2008 to 2019, as well as its spatial autocorrelation characteristics and spatial-temporal clustering, and to provide a reference for the prevention and control of HFMD in Hunan Province. Methods Spatial autocorrelation and spatial-temporal clustering analyses were used to analyze the monitoring data of HFMD in Hunan Province from 2008 to 2019. Results The epidemic situation of HFMD in Hunan Province from 2008 to 2019 showed obvious seasonal distribution, with a low incidence rate in January to March and a high incidence rate in April to July. As for population distribution, children aged 0-5 years had the highest number of HFMD cases and accounted for 95.89% (1 460 391/1 522 910) of all cases, with a mean annual incidence rate of 2 197.784/100 000, and scattered children had the highest number of cases and accounted for 82.59% (1 257 739/1 522 910) of all cases. The global spatial autocorrelation analysis showed that the onset of HFMD in Hunan Province showed a significant clustering distribution, and the local spatial autocorrelation analysis showed that the high clustering areas of HFMD were mainly the districts and counties of Changsha, Zhuzhou, and Yueyang cities. Time-space scanning showed that clustering time was mainly April to July; the cases were clustered in the northeast of Hunan Province from 2008 to 2010 and in the central part of Hunan Province from 2011 to 2019. Conclusions The high incidence rate of HFMD is observed in April to July in Hunan Province. Children under 5 years of age are at a high risk of this disease. Spatial-temporal clustering is observed for the epidemic of HFMD, mainly clustered in the northeastern and central areas of Hunan Province. It is suggested that the results may be used as guidance to determine the key areas for HFMD prevention and control in Hunan Province and optimize the allocation of health resources.
2021 Vol. 23 (11): 1141-1148 [Abstract] ( 1414 ) [HTML 1KB] [PDF 1671KB] ( 534 )
1149 REN Lu, LI Hui-Wen, XIONG Li-Ya, CHEN Pei-Yu, GENG Lan-Lan
Predictive factors for glucocorticoid therapy in children with eosinophilic gastroenteritis Hot!
Objective To study the predictive factors for glucocorticoid therapy by analyzing the association between the clinical features and treatment regimens in children with eosinophilic gastroenteritis. Methods A retrospective analysis was performed on the medical data of 182 children with eosinophilic gastroenteritis who were admitted to Guangzhou Women and Children's Medical Center from January 2012 to December 2020. According to whether glucocorticoids were used, these children were divided into a glucocorticoid treatment group and a control group. The two groups were compared in terms of age, history of allergy, clinical symptoms, laboratory examination results, endoscopic findings, and pathological results of gastrointestinal mucosa. A multivariate logistic regression analysis was performed for the results with statistical significance. Results Of the 182 children, 36 (19.8%) received glucocorticoid therapy. The rates of hematochezia, anemia, and mucosal ulceration/luminal stenosis under endoscopy and the mucosal eosinophil infiltration count were significantly higher in the glucocorticoid treatment group than those in the control group (P<0.05). The serum albumin level in the glucocorticoid treatment group was significantly lower than that in the control group (P<0.05). The multivariate logistic regression analysis showed that mucosal ulceration/luminal stenosis under endoscopy (OR=10.830, 95%CI: 3.090-37.961, P<0.001) and the increased mucosal eosinophil infiltration count (OR=0.967, 95%CI: 0.941-0.993, P=0.015) were predictive factors for glucocorticoid therapy in children with eosinophil gastroenteritis. Conclusions Mucosal ulceration/luminal stenosis under endoscopy or a significant increase in the mucosal eosinophil infiltration count based on pathology suggests that glucocorticoid therapy can be considered in children with eosinophil gastroenteritis. Citation:
2021 Vol. 23 (11): 1149-1153 [Abstract] ( 1409 ) [HTML 1KB] [PDF 506KB] ( 505 )
1154 HUANG Xun-Bin, YE Shu-Zhen, WU Ji-Wei, FU Qing-Song, LIU Bi-Hua, QIU Hui-Xian, CHENG Guo-Qiang
Diversity of the T cell receptor β chain complementarity-determining region 3 in peripheral blood of neonates with sepsis: an analysis based on immune repertoire sequencing Hot!
Objective To investigate the diversity of peripheral blood T cell receptor (TCR) β chain complementarity-determining region 3 (CDR3) based on immune repertoire sequencing in neonates with sepsis and the possible pathogenesis of neonatal sepsis. Methods A total of 12 neonates with sepsis were enrolled as the case group, and 9 healthy full-term infants, matched for gestational age, birth weight, and age, were enrolled as the control group. Omega nucleic acid purification kit (SQ blood DNA Kit II) was used to extract DNA from peripheral blood samples, TCR β chain CDR3 was amplified by multiplex PCR, and then high-throughput sequencing was performed for the products to analyze the diversity of TCR β chain CDR3 and the difference in expression. Results The length and type of TCR β chain CDR3 were similar between the case and control groups, and Gaussian distribution was observed in both groups. With D50 and Shannon-Wiener index as the evaluation indices for diversity, the case group had a significantly lower diversity of TCR β chain CDR3 than the control group (P<0.05). The frequency of 48 genes in TCR β chain V segment was compared, and the results showed that compared with the control group, the case group had significantly higher frequencies of TRBV10-3, TRBV2, and TRBV20-1 (P<0.05). The frequency of 13 genes in TCR β chain J segment were compared, and the results showed that compared with the control group, the case group had significantly higher frequencies of TRBJ2-3, TRBJ2-5, and TRBJ2-7 (P<0.05). Conclusions There is a significant change in the diversity of TCR β chain CDR3 in the peripheral blood of neonates with sepsis, suggesting that it might be associated with the immune pathogenesis of neonatal sepsis. Citation:
2021 Vol. 23 (11): 1154-1160 [Abstract] ( 1220 ) [HTML 1KB] [PDF 1996KB] ( 461 )
1161 CHU Zhao-Le, JIANG Hui, WU Qian
Effect of gonadotropin-releasing hormone analogue treatment in improving final adult height of children with central precocious puberty or early and fast puberty: a Meta analysis Hot!
Objective To systematically evaluate the effect of gonadotropin-releasing hormone analogue (GnRHa) treatment on the final adult height of children over 6 years of age with central precocious puberty (CPP) or early and fast puberty (EFP). Methods PubMed, MEDLINE, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for related articles on GnRHa treatment for children with CPP or EFP. Stata 12.0 software was used to perform a Meta analysis of related data. Results A total of 10 studies were included, and the total sample size was 720 children, with 475 children in the GnRHa treatment group and 245 children in the control group. The Meta analysis showed that compared with the control group, the GnRHa treatment group had significantly better final adult height (WMD=3.30, 95%CI: 2.49-4.12, P<0.001), standard deviation score of final adult height (WMD=0.51, 95%CI: 0.29-0.73, P<0.001), and height gain (WMD=2.89, 95%CI: 2.17-3.60, P<0.001). No severe adverse events were reported in these studies. Conclusions GnRHa treatment is safe and effective in improving the final adult height of children over 6 years of age with CPP or EFP. Citation:
2021 Vol. 23 (11): 1161-1168 [Abstract] ( 1266 ) [HTML 1KB] [PDF 869KB] ( 539 )
CASE ANALYSIS
1169 YANG Kun, LUO Rong-Hua, SUN Yi-Lai
Recurrent abdominal pain, peritoneal effusion, and eosinophilia in a boy aged 17 years Hot!
A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis. [Citation:Chinese Journal of Contemporary Pediatrics, 2021, 23(11): 1169-1173]
2021 Vol. 23 (11): 1169-1173 [Abstract] ( 1390 ) [HTML 1KB] [PDF 917KB] ( 614 )
EXPERIMENTAL RESEARCH
1174 WEI Ming, ZHAN Di, LI Zhu-Xi, WANG Huan-Yu, XING Ying, LUO Xiao-Ping
Effect of high-fat diet for rats at different stages on glucose and lipid metabolism in offspring and related mechanisms Hot!
Objective To study the effect of high-fat diet for maternal Sprague-Dawley rats at different stages on glucose and lipid metabolism in offspring and related mechanisms. Methods According to the diet before pregnancy and during pregnancy and lactation, maternal rats were randomly divided into four groups (n=9 each): CC (control diet before pregnancy and during pregnancy and lactation), HC (high-fat diet before pregnancy and control diet during pregnancy and lactation), CH (control diet before pregnancy and high-fat diet during pregnancy and lactation), and HH (high-fat diet before pregnancy and during pregnancy and lactation), and all offspring rats were given control diet after weaning. The body weight of maternal rats was recorded before and during pregnancy. Male offspring rats were selected from each group at the juvenile stage (3-week old) and the adult stage (12-week old) to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) and the levels of triglyceride (TG) and total cholesterol (TC) in the liver. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated, and the area under the curve (AUC) was calculated for glucose tolerance test (GTT) and insulin tolerance test (ITT). Lipid deposition in the liver was observed, and the mRNA and protein expression levels of the key genes in glucose and lipid metabolism (IR, IRS, and AKT), FASN, SREBP1c, and PPARα in the liver were also measured. Results Compared with the control diet groups (CC and CH groups), the groups with high-fat diet before pregnancy (HC and HH groups) had a significant increase in body weight (P<0.001). Compared with the CC group, the HC, CH, and HH groups had a significantly greater increase in body weight (P<0.001). Compared with the CC group, the HC, CH, and HH groups had significant increases in body weight, the levels of TG and TC in the liver, and the mRNA and protein expression levels of FASN, SREBP1c, and PPARα in the offspring rats at week 3 after birth (P<0.05), as well as a significant increase in lipid deposition in the liver, with the most significant increase of the parameters in the HH group. Compared with the CC group, the HH group had significant increases in the levels of FBG and FINS, HOMA-IR index, GTT-AUC, ITT-AUC, and the protein expression level of p-IRS in the liver and significant reductions in the mRNA and protein expression levels of IR and IRS in the liver in the offspring rats at week 3 after birth (P<0.05). Compared with the CC group, the HC, CH, and HH groups had significant increases in body weight, the levels of FBG and FINS, HOMA-IR index, GTT-AUC, ITT-AUC, the levels of TG and TC in the liver, protein expression level of p-IRS in the liver, and the mRNA and protein expression levels of FASN, SREBP1c, and PPARα in the offspring rats at week 12 after birth (P<0.05), as well as a significant increase in lipid deposition in the liver, with the most increase of the parameters in the HH group. Compared with the CC group, the HC, CH, and HH groups had significant reductions in the mRNA expression levels of IR, IRS, and AKT and the protein expression levels of IR, IRS, and p-AKT in the offspring rats at week 12 after birth (P<0.05). There were no significant differences in the levels of glucose and lipid metabolism between the HC and CH groups at various stages (P>0.05). Conclusions High-fat diet for rats at different stages before and after pregnancy has different effects on glucose and lipid metabolism of offspring rats, and high-fat diet before pregnancy and during pregnancy and lactation has the greatest effect. The effect of high-fat diet on glucose and lipid metabolism of offspring rats is considered associated with the changes in the expression of genes involved in glucose and lipid metabolism.
2021 Vol. 23 (11): 1174-1183 [Abstract] ( 1228 ) [HTML 1KB] [PDF 1403KB] ( 495 )
REVIEW
1184 ZHANG Yi-Jia
Recent research on the influence of intrauterine growth restriction on the structure and function of the nervous system Hot!
Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system. Citation:
2021 Vol. 23 (11): 1184-1189 [Abstract] ( 1319 ) [HTML 1KB] [PDF 606KB] ( 509 )
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2021 Vol. 23 (11): 1190-1190 [Abstract] ( 986 ) [HTML 1KB] [PDF 492KB] ( 565 )
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