CJCP
  中文版
  English Version
 
 
2022 Vol.  24 No.  8
Published: 2022-08-27
READER, AUTHOR AND EDITOR
TOPIC OF EPIDEMIC PREVENTION AND CONTROL
CLINICAL RESEARCH
CASE ANALYSIS
EXPERIMENTAL RESEARCH
REVIEW
TOPIC OF EPIDEMIC PREVENTION AND CONTROL
839 ZHOU Jian-Guo, FAN Qiao-Ling, LU Chun-Mei, XU Pu, YAN Gang-Feng, CHUNYU Ling-Feng, LIU Ya-Zun, CHEN Yi-Wei, LU Yan-Ming, ZHANG Ting, YU Hui, WANG Li-Bo, XU Jiang-Jiang, ZHOU Wen-Hao
Management experience of a designated hospital for children with coronavirus disease 2019
The global pandemic of coronavirus disease 2019 (COVID-19) has brought great challenges to the traditional medical model. During the outbreak of COVID-19 in Shanghai, China, from March to May, 2022, there was a significant increase in the number of pediatric cases due to high transmissibility, immune escape, and vaccine breakthrough capacity of Omicron variants. The designated hospitals for children with COVID-19 served as a connecting link between children's specialized hospitals and mobile cabin hospitals. From April 7 to June 2, 2022, a total of 871 children with COVID-19 were admitted to Renji Hospital, Shanghai Jiao Tong University School of Medicine (South Branch), a designated hospital for children with COVID-19. Among these patients, 568 (65.2%) were children under 3 years old, 870 (99.9%) were mild or moderate, and 1 was severe. This article reports the experience in the management of pediatric cases in this designated hospital, which included the following aspects: establishing an optimal case-admission process; strengthening multidisciplinary standardized diagnosis and treatment; optimizing the management, warning, and rescue system for severe COVID-19; implementing family-centered nursing care; formulating an individualized traditional Chinese medicine treatment regimen; optimizing the discharge process and strengthening bed turnover; implementing strict whole-process control to reduce the risk of nosocomial infection; constructing a structured medical record system and using information platforms to adapt to the work mode of large-volume cases; conducting scientific research and sharing the experience in diagnosis and treatment.
2022 Vol. 24 (8): 839-845 [Abstract] ( 2764 ) [HTML 1KB] [PDF 580KB] ( 887 )
846 HU Ya-Hong, YAO Kai-Hu
Clinical characteristics and epidemiological significance of coronavirus disease 2019 in children and adolescents
The epidemic of coronavirus disease 2019 (COVID-19) started in late December 2019, and spread rapidly throughout the world. In March 2020, the World Health Organization (WHO) declared global epidemic of COVID-19. According to the American Academy of Pediatrics, nearly 13 million children have been diagnosed with COVID-19 since the outbreak. In general, children and teens have milder symptoms and fewer deaths from COVID-19 than adults. Understanding the symptoms, infectivity, and transmission patterns of COVID-19 in children and adolescents is of great significance for timely identifying suspected patients and developing effective control measures. Considering that some children will not be vaccinated for quite some time in the future, it is more important to improve the understanding of the clinical and epidemiological significance of COVID-19 in children and adolescents. This article summarizes the current understanding of the clinical manifestations and epidemiological significance of COVID-19 in children and adolescents to provide a reference for clinical diagnosis and treatment and the formulation of epidemic prevention and control strategies in children's gathering institutions such as kindergartens and schools.
2022 Vol. 24 (8): 846-852 [Abstract] ( 2414 ) [HTML 1KB] [PDF 542KB] ( 964 )
CLINICAL RESEARCH
853 GENG Hai-Yun, CHEN Chao-Ying, TU Juan, LI Hua-Rong, DU Pei-Wei, XIA Hua, YU Xiao-Ning
Clinical effect of different prednisone regimens in the treatment of children with primary nephrotic syndrome and risk factors for recurrence Hot!
Objective To study the clinical effect of full-dose prednisone for 4 or 6 weeks in the treatment of children with primary nephrotic syndrome and its effect on recurrence. Methods A prospective non-randomized controlled clinical trial was performed on 89 children who were hospitalized and diagnosed with incipient primary nephrotic syndrome from December 2017 to May 2019. The children were given prednisone of 2 mg/(kg·day) (maximum 60 mg) for 4 weeks (4-week group) or 6 weeks (6-week group), followed by 2 mg/(kg·day) (maximum 60 mg) every other day for 4 weeks and then a gradual reduction in dose until drug withdrawal. The children were regularly followed up for 1 year. The two groups were compared in terms of the indices including remission maintenance time and recurrence rate. A Cox regression analysis was used to assess the risk factors for recurrence. Results Within 3 months after prednisone treatment, the 4-week group had a significantly higher recurrence rate than the 6-week group (P<0.05). After 1-year of follow-up, there was no significant difference between the two groups in the recurrence rate, remission maintenance time, and recurrence frequency (P>0.05). The risk of recurrence increased in children with an onset age of ≥6 years or increased 24-hour urinary protein (P<0.05). Conclusions For the treatment of incipient primary nephrotic syndrome, full-dose prednisone regimen extended from 4 weeks to 6 weeks can reduce recurrence within 3 months. The children with an onset age of ≥6 years or a high level of urinary protein should be taken seriously in clinical practice, and full-dose prednisone treatment for 6 weeks is recommended to reduce the risk of recurrence.
2022 Vol. 24 (8): 853-857 [Abstract] ( 3694 ) [HTML 1KB] [PDF 539KB] ( 1204 )
858 YUAN Xue-Wen, WANG Xu, TANG Ning, XIE Hang, GU Wei
A clinical study of acute kidney injury in children with type 1 diabetes and diabetic ketoacidosis
Objective To investigate the incidence rate of acute kidney injury (AKI) in children with type 1 diabetes and diabetic ketoacidosis (DKA) and the risk factors for AKI in children with DKA. Methods A retrospective analysis was performed on 45 children with type 1 diabetes and DKA who attended Children's Hospital of Nanjing Medical University from 2018 to 2020. According to the presence or absence of AKI on admission, they were divided into two groups: non-AKI (n=37) and AKI (n=8). Socio-demographic data and physical examination data on admission were collected, including height, weight, blood pressure, and heart rate. Chemiluminescence particle immunoassay was used to determine the levels of serum creatinine and blood urea nitrogen on admission and at discharge. The multivariate logistic regression model was used to assess the risk factors for AKI in children with type 1 diabetes and DKA. Results The 45 children had a median age of 9.2 years at diagnosis. Among the 8 children (18%) with AKI on admission, 6 had stage 1 AKI and 2 had stage 3 AKI. An increase in corrected serum sodium level was an independent risk factor for AKI in children with type 1 diabetes and DKA (P<0.05), and a relatively high insulin level on admission was an independent protective factor against AKI (P<0.05). Conclusions There is a high incidence rate of AKI in children with type 1 diabetes and DKA. It is important to correct DKA actively, control blood glucose in time, and perform renal function tests and follow-up regularly in such children.
2022 Vol. 24 (8): 858-862 [Abstract] ( 3198 ) [HTML 1KB] [PDF 512KB] ( 1519 )
863 PAN Ning, LIN Li-Zi, WANG Xin, GUO Cui-Hua, JING Jin, LI Xiu-Hong
Association between paternal age at childbirth and autism spectrum disorder in offspring
Objective To study the association between paternal age at childbirth and the risk of autism spectrum disorder (ASD) in offspring. Methods In this cross-sectional study, 71 children with ASD who were diagnosed in the Department of Child Healthcare in six hospitals in Guangzhou, Foshan, Beijing, Wuhan, Hangzhou, and Chongqing of China from August 2016 to March 2017 were enrolled as subjects, and 284 typically developing children matched for age, sex, and maternal age at childbirth with the ASD children served as controls. A self-design questionnaire was used to collect the data on social demography, maternal pregnancy, and delivery. The association between paternal age at childbirth and the development of ASD in offspring was evaluated by the logistic regression analysis. Results After control for demographic factors and pregnancy- and delivery-related factors, the logistic regression analysis showed that a relatively high paternal age at childbirth was significantly associated with the increased risk of ASD in offspring (OR=1.12, 95%CI: 1.02-1.23, P<0.05). After grouping based on the paternal age, the logistic regression analysis showed that paternal age at childbirth of ≥40 years was significantly associated with the risk of ASD in offspring (before adjustment: OR=7.08, 95%CI: 1.77-28.32, P<0.05; after adjustment: OR=8.50, 95%CI: 1.71-42.25, P<0.05). Conclusions High paternal age at childbirth is significantly associated with the increased risk of ASD in offspring, and paternal age at childbirth ≥40 years may be the high-risk age group for ASD in offspring.
2022 Vol. 24 (8): 863-868 [Abstract] ( 3580 ) [HTML 1KB] [PDF 562KB] ( 1457 )
869 KOU Cong, WU Zhao-Min, LIU Juan, CAO Xiao-Lan, YANG Bin-Rang
Association between oppositional defiant disorder and parenting style in children with attention deficit hyperactivity disorder
Objective To study the association between oppositional defiant disorder (ODD) and parenting style in children with attention deficit hyperactivity disorder (ADHD). Methods A case-control study was performed on 482 children with ADHD, among whom 322 did not have ODD (simple ADHD group) and 160 had ODD (ADHD+ODD group). General demographic data and the Parenting Style Scale assessment scores were collected from the two groups. A multivariate logistic regression analysis was used to identify the association between parenting style and ODD in children with ADHD. Results There was no significant difference in parenting style scores (including rejection factor, emotional warmth factor, overprotection factor, and preference factor) and general demographic data between the simple ADHD and ADHD+ODD groups (P>0.05). Among the children with the predominantly inattentive type of ADHD, the older the child or the lower the father's educational level, the higher the risk of ODD (P<0.05), while there was no significant association between parenting style and the development of ODD (P>0.05). Conclusions Parenting style is not significantly associated with the development of ODD in children with ADHD. In clinical practice, it is necessary to eliminate the stereotype that the parents of children with ADHD and comorbid ODD have a poor parenting style and look for the causes of development of ODD from multiple perspectives, so as to provide reasonable intervention recommendations.
2022 Vol. 24 (8): 869-873 [Abstract] ( 2996 ) [HTML 1KB] [PDF 515KB] ( 1237 )
874 DENG Wen-Jun, ZHANG Jing-Feng, LI Ping-Yuan, ZHOU Jun-Li, YAO Zhen-Jiang, YE Xiao-Hua
Co-carriage of Streptococcus pneumoniae and Moraxella catarrhalis among preschool children and its influencing factors
Objective To investigate the carriage status of Streptococcus pneumoniae (S. pneumoniae) and Moraxella catarrhalis (M. catarrhalis) in preschool children and the influencing factors for the carriage status. Methods The stratified cluster sampling method was used to select 2 031 healthy children from seven kindergartens in Shunde District of Foshan in Guangdong, China. Nasal swabs were collected from all children for the isolation and identification of S. pneumoniae and M. catarrhalis. The carriage status of S. pneumoniae and M. catarrhalis was analyzed in terms of its association with demographic features and hospital- and community-related factors. Results The carriage rates of S. pneumoniae and M. catarrhalis were 21.81% and 52.44%, respectively among the children. The co-carriage rate of S. pneumoniae and M. catarrhalis was 14.87%. The correspondence analysis showed that the factors such as lower grade, non-local registered residence, living in rural areas, small living area, history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history were significantly associated with the co-carriage of S. pneumoniae and M. catarrhalis among the children (P<0.05). Conclusions Co-carriage of S. pneumoniae and M. catarrhalis can be observed in preschool children. Young age, poor living environment, a history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history are important risk factors for the co-carriage of S. pneumoniae and M. catarrhalis in preschool children.
2022 Vol. 24 (8): 874-880 [Abstract] ( 2988 ) [HTML 1KB] [PDF 851KB] ( 1273 )
881 YE Long, ZHANG Li-Yan, ZHAO Yue, GU Bing, WU Zhu, PENG Yong-Zheng
Clinical features and molecular epidemiology of carbapenem-resistant Enterobacterales infection in children
Objective To study the clinical features of children with carbapenem-resistant Enterobacterales (CRE) infection and the molecular characteristics of isolated strains. Methods A retrospective analysis was performed on the clinical data and infection status of the children who were hospitalized in Guangdong Provincial People's Hospital from January 2018 to June 2021. A total of 1 098 non-repetitive strains of Enterobacterales were obtained. Drug sensitivity test, PCR amplification, and resistance-related gene sequencing were performed for 66 isolated CRE strains to observe molecular epidemiology. Results Among the 1 098 strains of Enterobacterales, the detection rate of CRE was 6.01% (66/1 098). The 66 CRE strains were isolated from 66 children, among whom there were 37 boys (56%) and 29 girls (44%), with an age of 2 days to 14 years. Among these 66 children, 16 (24%) had an age of <1 month, 28 (42%) had an age of 1-12 months, 11 (17%) had an age of 12-36 months, and 11 (17%) had an age of >36 months. The children with CRE were mainly distributed in the department of neonatology (38 children, 58%) and the pediatric intensive care unit (17 children, 26%). The top three types of specimens with CRE detection were respiratory specimens (48%), midstream urine specimens (21%), and blood specimens (17%). The CRE strains were mainly Klebsiella pneumoniae (45 strains, 68%), Escherichia coli (12 strains, 18%), and Enterobacter cloacae (6 strains, 9%), with high resistance to carbapenems (such as imipenem and ertapenem), penicillin, and cephalosporins, slightly high resistance to commonly used antibiotics, and relatively low resistance to amikacin (14%), levofloxacin (23%), and tobramycin (33%). The carbapenemase genotypes of Klebsiella pneumoniae strains were mainly blaNDM (20 strains, 44%), blaIMP (10 strains, 22%), and blaKPC (5 strains, 11%), and the carbapenemase genotypes of Escherichia coli strains were mainly blaNDM (10 strains, 83%). After sequencing, there were 24 blaNDM-1 strains, 6 blaNDM-5 strains, 5 blaIMP-4 strains, and 3 blaKPC-2 strains, and some genotypes were not identified. Conclusions There is a high incidence rate of CRE infection among children, mainly those aged 1-12 months. CRE generally has high resistance to antibacterial drugs, and metalloenzymes are the main type of carbapenemases for CRE strains in children.
2022 Vol. 24 (8): 881-886 [Abstract] ( 3689 ) [HTML 1KB] [PDF 645KB] ( 1502 )
887 WANG Dan, WU Xue-Ge, YAN Shi, ZHOU Tian-Tian, HUANG Ya-Jiao, LI Jie, LUO Xiao-Yan
Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study
Objective To study the risk factors for food sensitization and the influence of food sensitization on quality of life and clinical signs in children with atopic dermatitis (AD). Methods A retrospective analysis was performed on the medical data of 241 children with AD, including demographic features, age of onset, severity of AD, quality of life, physical examination results, skin prick test (SPT) results, serum total IgE levels, and eosinophil count. According to the results of SPT, the children were divided into a food sensitization group (n=127) and a non-food sensitization group (n=114). The multivariate logistic regression analysis was used to identify the risk factors for food sensitization in children with AD. Results The prevalence rate of food sensitization was 52.7% (127/241) in the children with AD. The multivariate logistic regression analysis showed that birth in autumn or winter, age of onset of AD<12 months, severe AD, and total IgE>150 IU/mL were risk factors for food sensitization (P<0.05). Compared with the non-food sensitization group, the food sensitization group had a significantly poorer quality of life (P=0.008) and significantly higher prevalence rates of non-specific hand/foot dermatitis and palmar hyperlinearity (P<0.05). Compared with the single food sensitization group, the multiple food sensitization group had more severe AD and a significantly higher proportion of children with exclusive breastfeeding or total IgE>150 IU/mL (P<0.05). Conclusions The AD children born in autumn or winter, or those with early onset (<12 months), severe AD or total IgE>150 IU/mL have a higher risk of food sensitization. The AD children with food sensitization have a poorer quality of life and are more likely to develop non-specific hand/foot dermatitis and palmar hyperlinearity.
2022 Vol. 24 (8): 887-893 [Abstract] ( 3171 ) [HTML 1KB] [PDF 560KB] ( 1190 )
894 WANG Zhi-Liang, SHENG Kai-Di, LIN Yi, ZHANG Qiu-Ye, ZHANG Li-Juan, CHANG Hong
Serum levels of degraded monosaccharides in children with Henoch-Sch?nlein purpura
Objective To examine the serum levels of degraded monosaccharides in children with Henoch-Sch?nlein purpura (HSP) and to study the clinical significance of degraded monosaccharides in HSP. Methods A prospective analysis was performed on 132 children who were diagnosed with HSP from September 2019 to January 2022, and 132 healthy children were enrolled as the control group. High-performance liquid chromatography was used to determine the content of degraded monosaccharides in serum in both groups. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of degraded monosaccharides for the diagnosis of HSP. Results Compared with the control group, the HSP group had significantly higher serum levels of mannose, glucosamine, aminogalactose, and galactose (P<0.001). The four degraded monosaccharides had an area under the ROC curve of 0.919, 0.913, 0.832, and 0.932 respectively for the diagnosis of HSP (P<0.05). Conclusions Children with HSP have higher serum levels of mannose, glucosamine, aminogalactose, and galactose than the healthy population. The levels of degraded monosaccharides may have an important value for the diagnosis of HSP.
2022 Vol. 24 (8): 894-898 [Abstract] ( 2570 ) [HTML 1KB] [PDF 703KB] ( 1015 )
899 HUANG Xiao-Yun, ZHU Yuan-Fang, LIU Hui-Long, WU Guang-Wu, LIU Chuan-Yong, ZENG Ding-Yuan, HE Jun, SHI Qing-Xi, CHEN Chang-Shui, ZHU Bin, WANG Gao-Xiong, SHI Hao, LU Hao-Hua
Birth weight curves of twin neonates with a gestational age of 25-40 weeks and their regional differences in 11 cities of China: an analysis of 17 256 cases
Objective To develop the birth weight curve of twin neonates with a gestational age of 25-40 weeks, and to investigate the regional differences of the birth weight curve. Methods A total of 11 maternal and child health care hospitals with more than 7 000 neonates delivered annually were selected in 11 cities of China (Haikou, Guangzhou, Liuzhou, Guilin, Quanzhou, Shenzhen, Chongqing, Chengdu, Changsha, Ningbo, and Lianyungang), and all live twin neonates delivered in the 11 hospitals from January 1, 2017 to December 31, 2020 were enrolled for the development of birth weight curves. Results A total of 17 256 twin neonates with a gestational age of 25-40 weeks from the 11 cities were included in the study. The reference values of the 3rd-97th percentiles of birth weight of twin neonates for the total of the 11 cities and for each of the 11 cities in China were established, and the birth weight percentile curves were drawn. The birth weight curve level of twin neonates in Liuzhou was lower than the average level of the 11 cities; the birth weight curve level of twin neonates in Ningbo was higher than the average level of the 11 cities; the birth weight curve level of twin neonates in Lianyungang was obviously higher than the average level of the 11 cities; the birth weight curve level of twin neonates in other 8 cities was almost the same as the average level of the 11 cities. Conclusions The reference values of the 3rd-97th percentiles of birth weight of twin neonates for the total of the 11 cities and for each of the 11 cities are developed, which can be used as a reference for evaluating the intrauterine growth of twin neonates in the region. The level of intrauterine growth of twin neonates in some cities is different from the average level of the 11 cities of China.
2022 Vol. 24 (8): 899-907 [Abstract] ( 3004 ) [HTML 1KB] [PDF 1005KB] ( 871 )
908 LU Chun-Yun, LIU Ke-Feng, QIAO Gao-Xing, LUO Yuan, CHENG Hui-Qing, DU Shu-Zhang
Risk factors for necrotizing enterocolitis in preterm infants: a Meta analysis
Objective To systematically evaluate the risk factors for necrotizing enterocolitis (NEC) in preterm infants. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data were searched for case-control studies and cohort studies on the risk factors for NEC in preterm infants published up to December 2021. RevMan 5.3 software was used to perform the Meta analysis. Results A total of 38 studies were included (28 case-control studies and 10 cohort studies). The Meta analysis showed that maternal gestational diabetes (OR=2.96, P<0.001), intrahepatic cholestasis during pregnancy (OR=2.53, P<0.001), preeclampsia (OR=1.73, P=0.020), history of neonatal asphyxia (OR=2.13, P<0.001), low gestational age (OR=1.23, P=0.010), sepsis (OR=5.32, P<0.001), patent ductus arteriosus (OR=1.57, P=0.001), congenital heart disease (OR=3.78, P<0.001), mechanical ventilation (OR=2.23, P=0.020), history of antibiotic use (OR=1.07, P<0.001), use of vasopressors (OR=2.34, P=0.040), and fasting (OR=1.08, P<0.001) were risk factors for NEC in preterm infants, while cesarean section (OR=0.73, P=0.004), use of pulmonary surfactant (OR=0.43, P=0.008), and breastfeeding (OR=0.24, P=0.020) were protective factors against NEC. Conclusions Maternal gestational diabetes, intrahepatic cholestasis during pregnancy, preeclampsia, low gestational age, fasting, sepsis, patent ductus arteriosus, congenital heart disease, and histories of asphyxia, mechanical ventilation, antibiotic use, and use of vasopressors may increase the risk of NEC in preterm infants, while cesarean section, use of pulmonary surfactant, and breastfeeding may decrease the risk of NEC in preterm infants.
2022 Vol. 24 (8): 908-916 [Abstract] ( 5011 ) [HTML 1KB] [PDF 946KB] ( 2296 )
853 GENG Hai-Yun, CHEN Chao-Ying, TU Juan, LI Hua-Rong, DU Pei-Wei, XIA Hua, YU Xiao-Ning
Clinical effect of different prednisone regimens in the treatment of children with primary nephrotic syndrome and risk factors for recurrence Hot!
Objective To study the clinical effect of full-dose prednisone for 4 or 6 weeks in the treatment of children with primary nephrotic syndrome and its effect on recurrence. Methods A prospective non-randomized controlled clinical trial was performed on 89 children who were hospitalized and diagnosed with incipient primary nephrotic syndrome from December 2017 to May 2019. The children were given prednisone of 2 mg/(kg·day) (maximum 60 mg) for 4 weeks (4-week group) or 6 weeks (6-week group), followed by 2 mg/(kg·day) (maximum 60 mg) every other day for 4 weeks and then a gradual reduction in dose until drug withdrawal. The children were regularly followed up for 1 year. The two groups were compared in terms of the indices including remission maintenance time and recurrence rate. A Cox regression analysis was used to assess the risk factors for recurrence. Results Within 3 months after prednisone treatment, the 4-week group had a significantly higher recurrence rate than the 6-week group (P<0.05). After 1-year of follow-up, there was no significant difference between the two groups in the recurrence rate, remission maintenance time, and recurrence frequency (P>0.05). The risk of recurrence increased in children with an onset age of ≥6 years or increased 24-hour urinary protein (P<0.05). Conclusions For the treatment of incipient primary nephrotic syndrome, full-dose prednisone regimen extended from 4 weeks to 6 weeks can reduce recurrence within 3 months. The children with an onset age of ≥6 years or a high level of urinary protein should be taken seriously in clinical practice, and full-dose prednisone treatment for 6 weeks is recommended to reduce the risk of recurrence.
2022 Vol. 24 (8): 853-857 [Abstract] ( 1232 ) [HTML 1KB] [PDF 1074KB] ( 1488 )
CASE ANALYSIS
917 FANG You-Hong, LIN Hai-Hua, LOU Jin-Gan, CHEN Jie
Recurrent abdominal pain and vomiting with elevated triglyceride and positive antinuclear antibody in a girl aged 12 years
A girl aged 12 years and 2 months presented with recurrent abdominal pain and vomiting for more than 2 years and arthrodynia for 3 months. She was diagnosed with recurrent acute pancreatitis with unknown causes and had been admitted multiple times. Laboratory tests showed recurrent significant increases in fasting serum triglyceride, with elevated immunoglobulin and positive antinuclear antibody. The girl was improved after symptomatic supportive treatment. The girl developed arthrodynia with movement disorders 3 months before, and proteinuria, hematuria, and positive anti-double-stranded DNA antibody were observed. The renal biopsy was performed, and the pathological examination and immunofluorescence assay suggested diffuse lupus nephritis (type Ⅳ). She was finally diagnosed with systemic lupus erythematosus (SLE), lupus nephritis (type Ⅳ), and recurrent acute pancreatitis. Pancreatitis was suspected to be highly associated with SLE. She was treated with oral hydroxychloroquine sulfate and intravenous methylprednisolone sodium succinate and cyclophosphamide. Arthrodynia was partially relieved. She was then switched to oral prednisone acetate tablets. Intravenous cyclophosphamide and pump infusion of belimumab were regularly administered. Now she had improvement in arthrodynia and still presented with proteinuria and hematuria. It is concluded that recurrent acute pancreatitis may be the first clinical presentation of SLE. For pancreatitis with unknown causes, related immunological parameters should be tested, and symptoms of the other systems should be closely monitored to avoid delaying the diagnosis.
2022 Vol. 24 (8): 917-922 [Abstract] ( 3067 ) [HTML 1KB] [PDF 850KB] ( 1716 )
923 LANG Chang-Hui, TIAN Mao-Qiang, SHU Xiao-Mei
Weakness in both lower limbs for 1 week and blepharoptosis for 3 days in a boy aged 1 year and 7 months
A boy, aged 1 year and 7 months, was hospitalized due to weakness in both lower limbs and blepharoptosis, which showed progressive aggravation and developed into irregular breathing. Neurological examinations showed lethargy, blepharoptosis, grade 4 muscle strength of both upper limbs, grade 3 muscle strength of both lower limbs, and disappearance of tendon reflex. Laboratory tests revealed albuminocytological dissociation in cerebrospinal fluid, disappearance of H reflex, and positive serum anti-GD1b IgG. The boy was finally diagnosed with Guillain-Barré syndrome (GBS) overlapping with Miller-Fisher syndrome and Bickerstaff brainstem encephalitis. He recovered and was discharged after treatment including immunoglobulin, plasma exchange, and respiratory support. The GBS overlap syndromes in children have strong clinical heterogeneity due to the injury of both peripheral nerve and brainstem, among which anti-GD1b antibody-related GBS overlap syndromes have special clinical manifestations and complex neuroelectrophysiological changes and are thus difficult to diagnose. Nerve conduction velocity tests, especially H reflex test, should be performed for children with weakness in both lower limbs and blepharoptosis.
2022 Vol. 24 (8): 923-927 [Abstract] ( 2291 ) [HTML 1KB] [PDF 529KB] ( 1155 )
EXPERIMENTAL RESEARCH
928 LI Li-Sha, ZHANG Qian, LIU Huan, WU Qiong-Hui, YANG Ting, CHEN Jie, LI Ting-Yu
Involvement of retinoic acid receptor α in the autistic-like behavior of rats with vitamin A deficiency by regulating neurexin 1 in the visual cortex: a mechanism study
Objective To study the mechanism of retinoic acid receptor α (RARα) signal change to regulate neurexin 1 (NRXN1) in the visual cortex and participate in the autistic-like behavior in rats with vitamin A deficiency (VAD). Methods The models of vitamin A normal (VAN) and VAD pregnant rats were established, and some VAD maternal and offspring rats were given vitamin A supplement (VAS) in the early postnatal period. Behavioral tests were performed on 20 offspring rats in each group at the age of 6 weeks. The three-chamber test and the open-field test were used to observe social behavior and repetitive stereotyped behavior. High-performance liquid chromatography was used to measure the serum level of retinol in the offspring rats in each group. Electrophysiological experiments were used to measure the long-term potentiation (LTP) level of the visual cortex in the offspring rats. Quantitative real-time PCR and Western blot were used to measure the expression levels of RARα, NRXN1, and N-methyl-D-aspartate receptor 1 (NMDAR1). Chromatin co-immunoprecipitation was used to measure the enrichment of RARα transcription factor in the promoter region of the NRXN1 gene. Results The offspring rats in the VAD group had autistic-like behaviors such as impaired social interactions and repetitive stereotypical behaviors, and VAS started immediately after birth improved most of the behavioral deficits in offspring rats. The offspring rats in the VAD group had a significantly lower serum level of retinol than those in the VAN and VAS groups (P<0.05). Compared with the offspring rats in the VAN and VAS groups, the offspring rats in the VAD group had significant reductions in the mRNA and protein expression levels of NMDAR1, RARα, and NRXN1 and the LTP level of the visual cortex (P<0.05). The offspring rats in the VAD group had a significant reduction in the enrichment of RARα transcription factor in the promoter region of the NRXN1 gene in the visual cortex compared with those in the VAN and VAS groups (P<0.05). Conclusions RARα affects the synaptic plasticity of the visual cortex in VAD rats by regulating NRXN1, thereby participating in the formation of autistic-like behaviors in VAD rats.
2022 Vol. 24 (8): 928-935 [Abstract] ( 3054 ) [HTML 1KB] [PDF 1797KB] ( 1299 )
936 TANG Hu-Ting, MU Wei-Hao, XIANG Yu-Jing, AN Yong
Effect of hepatocyte growth factor on mice with hypoxic pulmonary arterial hypertension: a preliminary study
Objective To study the association between hepatocyte growth factor (HGF) and treatment response in mice with hypoxic pulmonary arterial hypertension (HPAH) and the possibility of HGF as a new targeted drug for HPAH. Methods After successful modeling, the HPAH model mice were randomly divided into two groups: HPAH group and HGF treatment group (tail vein injection of recombinant mouse HGF 1 mg/kg), with 10 mice in each group. Ten normal mice were used as the control group. After 5 weeks, echocardiography was used to measure tricuspid peak velocity, right ventricular systolic pressure, right ventricular hypertrophy index, and right ventricular/body weight ratio; the Griess method was used to measure the content of nitric oxide in serum; ELISA was used to measure the serum level of endothelin-1; transmission electron microscopy was used to observe changes in the ultrastructure of pulmonary artery. Results Compared with the HGF treatment and normal control groups, the HPAH group had significantly higher tricuspid peak velocity, right ventricular systolic pressure, right ventricular hypertrophy index, and right ventricular/body weight ratio (P<0.05). The transmission electron microscopy showed that the HPAH group had massive destruction of vascular endothelial cells and disordered arrangement of the elastic membrane of arteriolar intima with rupture and loss. The structure of vascular endothelial cells was almost complete and the structure of arterial intima elastic membrane was almost normal in the HGF treatment group. Compared with the normal control and HGF treatment groups, the HPAH group had significantly higher serum levels of nitric oxide and endothelin-1 (P<0.05). Conclusions Increasing serum HGF level can alleviate the impact of HPAH on the cardiovascular system of mice, possibly by repairing endothelial cell injury, improving vascular remodeling, and restoring the normal vasomotor function of pulmonary vessels.
2022 Vol. 24 (8): 936-941 [Abstract] ( 2639 ) [HTML 1KB] [PDF 979KB] ( 1017 )
REVIEW
942 DUAN Yi-Fei, WEN Fei-Qiu
Recent research on the association between signal transducer and activator of transcription 5 and childhood acute lymphoblastic leukemia
Signal transducer and activator of transcription 5 (STAT5) can be involved in the processes such as cell proliferation, differentiation, apoptosis, and hematopoiesis, and its dysregulation is closely associated with the development and progression of malignant tumors including leukemia and may affect the treatment outcome and prognosis of pediatric patients. Identification of STAT5 can facilitate targeted therapy to improve the response rate of children with acute lymphoblastic leukemia. This article reviews the impact of STAT5 on the development/progression, targeted therapy strategies and the prognosis of childhood acute lymphoblastic leukemia.
2022 Vol. 24 (8): 942-947 [Abstract] ( 2789 ) [HTML 1KB] [PDF 3037KB] ( 1022 )
948 LI Yu-Hang, JIANG Li
Recent research on immunotherapy for anti-N-methyl-D-aspartate receptor encephalitis
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a central nervous system disease characterized by neurological and psychiatric symptoms. Immunotherapy is the basic treatment for this disease, including first- and second-line therapies for the acute stage and the long-course therapy for the chronic stage. Anti-NMDAR encephalitis often has a good prognosis, but some patients may still have neurological dysfunction due to poor response to current immunotherapy. In addition, the adverse reactions and economic burden of drugs are practical problems in clinical practice. To solve the above problems, continuous improvements have been made in immunotherapy regimens in terms of dose, route of administration, and course of treatment, and some new immunotherapy drugs have emerged. This article reviews the recent research on immunotherapy for anti-NMDAR encephalitis.
2022 Vol. 24 (8): 948-953 [Abstract] ( 3283 ) [HTML 1KB] [PDF 517KB] ( 1446 )
READER, AUTHOR AND EDITOR
954
2022 Vol. 24 (8): 954-954 [Abstract] ( 1071 ) [HTML 1KB] [PDF 240KB] ( 1241 )
CJCP
About Journal
Editors members
Contact Us

 
Copyright © 2004-2005 Chinese Journal Of Contemporary Pediatrics All rights reserved.
Addr: 87 Xiangya Road, Changsha, Hunan, 410008, PRC
Tel: 0731-84327402 Fax: 0731-84327922 E-mail: cjcp1999@csu.edu.cn