CJCP
  中文版
  English Version
 
 
2024 Vol.  26 No.  12
Published: 2024-12-26
EXPERT COMMENTARY
SERIES REVIEW—DIAGNOSIS AND TREATMENT OF GROWTH DISORDERS
GUIDELINE INTERPRETATION: GUIDELINE FOR PEDIATRIC TRANSFUSION
CLINICAL RESEARCH
EXPERIMENTAL RESEARCH
CASE REPORT
REVIEW
EXPERT COMMENTARY
1245 WANG Tian-You, LI Tuo-Zhang
The current situation and the future of pediatric blood transfusion Hot!
With advancements in clinical medicine, pediatric blood transfusion has evolved from traditional empirical practices to evidence-based approaches grounded in clinical research data. To better guide pediatric blood transfusion practices and improve clinical outcomes for pediatric patients, the National Health Commission has developed and issued "Guideline for pediatric transfusion". This article summarizes the unique aspects of pediatric blood transfusion, the application of blood component therapy in treating pediatric patients, the significance of interpreting the "Guideline for pediatric transfusion", and anticipates future developments in pediatric blood transfusion medicine.
2024 Vol. 26 (12): 1245-1248 [Abstract] ( 1000 ) [HTML 1KB] [PDF 464KB] ( 315 )
GUIDELINE INTERPRETATION: GUIDELINE FOR PEDIATRIC TRANSFUSION
1249 GUI Rong, HUANG Rong, YANG Ming-Hua, ZHU Xiao-Fan, LU Jun, XU Xiao-Jun, YUAN Tian-Ming, ZHANG Rong, WANG Xu, LIU Jin-Ping, WANG Jing, SHAO Zhi-Li, ZHAO Ming-Yi, GUO Yong-Jian, CHEN Jia-Rui, CHEN Qi-Rong, GUO Jia, WU Xin-Yin, HEI Ming-Yan, HE Qing-Nan
')" href="#"> Explanation and interpretation of the compilation of neonatal blood transfusion in the national health standard "Guideline for pediatric transfusion"
In order to guide clinical blood transfusion practices for pediatric patients, the National Health Commission has released the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Considering the physiological particularities of the neonatal period, blood transfusion practices for neonates are more complex than those for other children, the guidelines include a separate chapter dedicated to neonatal blood transfusion. This paper interprets the background and evidence for the compilation of the neonatal blood transfusion provisions, hoping to aid in the understanding and implementation of the neonatal blood transfusion section of the guidelines.
2024 Vol. 26 (12): 1249-1254 [Abstract] ( 778 ) [HTML 1KB] [PDF 584KB] ( 421 )
SERIES REVIEW—DIAGNOSIS AND TREATMENT OF GROWTH DISORDERS
1255 MAMAT Mireguli
Discussion on the genetic mechanisms and efficacy of growth hormone therapy in children with idiopathic short stature
Idiopathic short stature (ISS) is a term that encompasses a group of short stature disorders with unknown etiology. The genetic factors associated with ISS are complex, and the known genetic mechanisms include alterations in hormones, hormone receptors, or related pathways, defects in fundamental cellular processes (such as intracellular signaling pathways and transcriptional regulation), issues with extracellular matrix or paracrine signaling, as well as genetic variations in the genes encoding these proteins. Recombinant human growth hormone (rhGH) therapy is currently an effective clinical method for improving height in children with ISS. However, the efficacy of rhGH treatment on ISS varies among children with different genetic mechanisms. This paper analyzes and elucidates the genetic mechanisms of ISS and the effects of rhGH on ISS based on existing clinical research, aiming to enhance the understanding of ISS and provide references for improving the height of these children.
2024 Vol. 26 (12): 1255-1260 [Abstract] ( 760 ) [HTML 1KB] [PDF 563KB] ( 292 )
CLINICAL RESEARCH
1261 LIU Qing, ZHANG Wei-Chun, CHEN Bo, SONG Ya-Wen.
Correlation between serum ghrelin and liver-expressed antimicrobial peptide-2 with idiopathic short stature in children
Objective To investigate the expression levels of ghrelin and liver-expressed antimicrobial peptide-2 (LEAP-2) in children with idiopathic short stature (ISS) to provide reference for further understanding the etiology of short stature. Methods A prospective study was conducted from December 2021 to October 2023, involving 46 children diagnosed with ISS (ISS group) and 46 healthy children with normal height (control group) at the First Affiliated Hospital of Shihezi University. General data and serum levels of ghrelin and LEAP-2 were compared between the two groups. The predictive value of these two indicators for ISS was evaluated using receiver operating characteristic (ROC) curve analysis. Results The serum level of ghrelin in the ISS group was higher than that in the control group, while the level of LEAP-2 was lower (P<0.05). The ratio of LEAP-2 to ghrelin was lower in the ISS group compared to the control group (P<0.05). Multivariate logistic regression analysis showed that HtSDS, IGF-1, ghrelin, LEAP-2, and the ratio of LEAP-2/ghrelin were independently associated with the occurrence of ISS (P<0.05). ROC curve analysis indicated that the AUCs for ghrelin, LEAP-2, the ratio of ghrelin to LEAP-2, and their combination in predicting ISS were all >0.8. The optimal cutoff values for ghrelin, LEAP-2, and the LEAP-2/ghrelin ratio were 5 607 pg/mL, 1 155 pg/mL, and 0.212, respectively. In children with ISS, ghrelin showed a negative correlation with chronological age, LEAP-2, and the LEAP-2/ghrelin ratio (P<0.05), while it was positively correlated with growth rate and peak growth hormone levels (P<0.05). LEAP-2 was negatively correlated with growth rate, peak growth hormone levels, and ghrelin (P<0.05), but positively correlated with chronological age and the LEAP-2/ghrelin ratio (P<0.05). Conclusions Ghrelin and LEAP-2 are correlated with the occurrence of ISS, which may provide references for the diagnosis and etiological analysis of children with ISS.
2024 Vol. 26 (12): 1261-1266 [Abstract] ( 1486 ) [HTML 1KB] [PDF 613KB] ( 255 )
1267 QIU Shi-Chao, WANG Zhi-Hua, SONG Na, ZHAO Ting, LIAN Yi-Hua, YU Jia, LI Ma-Li, LIU Chao
Construction of a diagnostic model and scoring system for central precocious puberty in girls, with external validation
Objective To establish an efficient and clinically applicable predictive model and scoring system for central precocious puberty (CPP) in girls, and to develop a diagnostic prediction application. Methods A total of 342 girls aged 4 to 9 years with precocious puberty were included, comprising 216 cases of CPP and 126 cases of isolated premature thelarche. Lasso regression was used to screen for predictive factors, and logistic regression was employed to establish the predictive model. Additionally, a scoring system was constructed using the evidence weight binning method. Data from 129 girls aged 4 to 9 years with precocious puberty were collected for external validation of the scoring system. Results The logistic regression model incorporated five predictive factors: age, insulin-like growth factor-1 (IGF-1), serum follicle-stimulating hormone (FSH), the luteinizing hormone (LH)/FSH baseline ratio, and uterine thickness. The calculation formula was: ln(P/1-P)=-8.439 + 0.216 × age (years) + 0.008 × IGF-1 (ng/mL) + 0.159 × FSH (mIU/mL) + 9.779 × LH/FSH baseline ratio + 0.284 × uterine thickness (mm). This model demonstrated good discriminative ability (area under the curve=0.892) and calibration (Hosmer-Lemeshow test P>0.05). The scoring system based on this logistic regression model showed good discrimination in both the prediction model and external validation datasets, with areas under the curve of 0.895 and 0.805, respectively. Based on scoring system scores, the population was stratified into three risk levels: high, medium, and low. In the high-risk group, the prevalence of CPP exceeded 90%, while the proportion was lower in the medium and low-risk groups. Conclusions The CPP diagnostic predictive model established for girls aged 4 to 9 years exhibits good diagnostic performance. The scoring system can effectively and rapidly stratify the risk of CPP, providing valuable reference for clinical decision-making.
2024 Vol. 26 (12): 1267-1274 [Abstract] ( 757 ) [HTML 1KB] [PDF 713KB] ( 580 )
1275 ZHANG Shuai, LI Cheng-Yue, ZHOU Zhi-Dong
A comorbidity survey of growth retardation and obesity in Chinese children aged 7-12 years and analysis of influencing factors
Objective To investigate the changing trends and influencing factors for growth retardation-related obesity in Chinese children aged 7-12 years in 2010-2020, providing a basis for formulating physical health interventions for children. Methods The data of body height and body mass index were collected from 16 289 children aged 7-12 years in the China Family Panel Studies (CFPS) in 2010-2020, and the trends of growth retardation, obesity, and growth retardation-related obesity in 2010-2020 were analyzed and compared between different sexes and between urban and rural areas. Results From 2010 to 2020, the overall rates of growth retardation and growth retardation-related obesity among children aged 7-12 years in China showed a declining trend (P<0.05). By gender and urban-rural classification, the overall obesity rate from 2010 to 2020 showed an increasing trend in all groups except for the rural male and female children groups, the rural children group, and the female children group (P<0.05). The prevalence rates of growth retardation, obesity, and growth retardation-related obesity in male children were significantly higher than those in female children, and similarly, these indicators were also significantly higher in rural children compared to urban children (P<0.05). Urban/rural residence, age, sex, and year were influencing factors for growth retardation and growth retardation-related obesity in children aged 7-12 years (P<0.05). Conclusions The prevalence of growth retardation, obesity, and growth retardation-related obesity among Chinese children aged 7-12 years shows gender and urban-rural disparities, which highlights the needs for targeted interventions for boys and children in rural areas.
2024 Vol. 26 (12): 1275-1281 [Abstract] ( 870 ) [HTML 1KB] [PDF 528KB] ( 312 )
1282 LUO Xu-Peng, CHEN Qiang, LI Lan, ZHU Xiao-Hua, HUANG Peng, WANG Jing
Epidemiological characteristics of respiratory syncytial virus infection in children in Nanchang and its correlation with climate environmental factors
Objective To explore the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Nanchang and its correlation with climate environmental factors. Methods The clinical data were collected from children with acute respiratory infection in Nanchang who were tested for RSV at Jiangxi Provincial Children's Hospital from January 2019 to December 2023, along with climate environmental data for the same period. The epidemiological characteristics of RSV and their correlation with climate environmental factors were investigated. Results A total of 178 127 children underwent RSV testing from January 2019 to December 2023, with a positive detection rate of 8.35% (14 873/178 127). The positive detection rate in males was 8.92% (10 137/113 660), which was higher than that in females (7.35%, 4 736/64 467). The differences in RSV positive detection rates among different age groups were statistically significant (P<0.001), with the highest rate observed in the 0 to <3 months age group (14.38%, 3 328/23 142). Peaks in RSV positive detection occurred during winter and spring periods in 2019, 2020, and 2022, while in 2023, it occurred in spring and summer periods, with no seasonality noted in 2021. The RSV positive detection rate showed a positive correlation with average humidity, average atmospheric pressure, monthly PM2.5, and monthly carbon monoxide levels (P<0.05), while it showed a negative correlation with average wind speed, average temperature, and maximum 8-hour ozone levels (P<0.05). Conclusions In Nanchang, the RSV positive detection rate in children with acute respiratory infection is higher in males than in females. Among children of all age groups, the infants aged 0 to <3 months have the highest detection rate of RSV. RSV infection predominantly occurs in winter and spring periods. Lower temperatures, lower wind speeds, higher humidity, and elevated levels of PM2.5 and carbon monoxide may increase the risk of RSV infection in children.
2024 Vol. 26 (12): 1282-1287 [Abstract] ( 698 ) [HTML 1KB] [PDF 557KB] ( 315 )
1288 ZHUANG Dong-Lin, FENG Yong, SHANG Yun-Xiao
Value of exercise challenge testing in the diagnosis of cough variant asthma in children
Objective To investigate the value of exercise challenge testing (ECT) in the diagnosis of cough variant asthma (CVA) in children. Methods A prospective study was conducted on 78 children with chronic cough who were admitted between January 2023 and January 2024. ECT was performed, and clinical data were collected. According to the effect of bronchodilator treatment, the children were divided into a CVA group (44 children) and a non-CVA group (34 children), and the two groups were compared in terms of clinical characteristics, pulmonary function, and ECT results before treatment. Results Compared with the non-CVA group, the CVA group had a significantly higher proportion of boys, a significantly higher proportion of children with exercise-induced chronic cough, a significantly higher level of fractional exhaled nitric oxide, and a significantly greater reduction in forced expiratory volume in 1 second (FEV1) after ECT (P<0.05). The regression analysis showed that exercise-induced chronic cough and the reduction in FEV1 were risk factors for CVA (P<0.05). A reduction in FEV1 of 8.44% was the optimal cut-off value for ECT in the diagnosis of CVA, with an area under the curve of 0.751 (P<0.05), a sensitivity of 65.9%, and a specificity of 79.4%. For the children with exercise-induced chronic cough, a reduction in FEV1 of 8.44% was the optimal cut-off value for ECT in the diagnosis of CVA, with an area under the curve of 0.810 (P<0.05), a sensitivity of 77.1%, and a specificity of 77.8%. Conclusions ECT has clinical application value in the etiological diagnosis of pediatric chronic cough, with a reduction in FEV1 of 8.44% serving as the optimal cut-off value for diagnosing CVA. It is particularly suitable for children with exercise-induced chronic cough, increasing the sensitivity for CVA diagnosis.
2024 Vol. 26 (12): 1288-1293 [Abstract] ( 803 ) [HTML 1KB] [PDF 616KB] ( 400 )
1294 MA Yi-Chen, ZHOU Xi-Hui, ZHAO Xiao-Dan, WANG Chen-Yang
Efficacy of prolonged azithromycin versus switching to doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children
Objective To investigate the efficacy and safety of prolonged azithromycin (PAZM) versus switching to doxycycline (SDXC) in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) in children. Methods A total of 173 children with MUMPP who were hospitalized in Baoji Central Hospital, from January to December 2023 were selected as subjects. According to the choice of secondary antibiotic after 72 hours of initial macrolide therapy, they were divided into two groups: PAZM and SDXC. The efficacy and adverse drug reactions were compared between the two groups, and the risk factors for refractory Mycoplasma pneumoniae pneumonia (RMPP) were analyzed. Results Compared with the PAZM group, the SDXC group had significantly shorter time to defervescence and time to cough relief, a significantly lower proportion of patients using glucocorticoids, and a significantly higher proportion of patients with lung lesion absorption (P<0.05). No adverse reactions such as liver and kidney function impairment and tooth discoloration were observed in either group. RMPP occurred in 47 cases in the PAZM group. The univariate analysis showed that lactate dehydrogenase levels and age were risk factors for RMPP (P<0.05). Conclusions The efficacy of SDXC is superior to that of PAZM in children with MUMPP, and short-term use of doxycycline is relatively safe.
2024 Vol. 26 (12): 1294-1300 [Abstract] ( 761 ) [HTML 1KB] [PDF 597KB] ( 239 )
1301 ZHOU Xiao-Hui, WANG Xiao-Dong, LIN Qi-Hong, WANG Chun-Jing, YANG Chun-Lan, LI Yue, ZHANG Xiao-Ling, ZHANG Yu, YU Yue, LIU Si-Xi
Clinical characteristics of cytokine release syndrome after haploidentical hematopoietic stem cell transplantation for thalassemia major
Objective To investigate the clinical characteristics of cytokine release syndrome (CRS) in children with thalassemia major (TM) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) and their prognosis. Methods A retrospective analysis was performed for the clinical data of 280 children with TM who underwent haplo-HSCT in the Department of Hematology and Oncology, Shenzhen Children's Hospital, from January 2019 to December 2021. According to the CRS criteria, they were divided into two groups: CRS grade <3 (260 children) and CRS grade ≥3 (20 children). The children with TM were analyzed in terms of clinical characteristics of CRS after haplo-HSCT and their prognosis. Results There were significant differences between the two groups in neutrophil engraftment time, clinical manifestations of CRS, and the rate of use of glucocorticoids within 4 days after haplo-HSCT (P=0.012, 0.040, and <0.001 respectively). For the CRS grade <3 group, the incidence rate of acute graft-versus-host disease (aGVHD) was 9.6% within 3 months after transplantation, while no aGVHD was observed in the CRS grade ≥3 group within 3 months after transplantation, but there was no significant difference in the incidence of aGVHD between the two groups within 3 months after transplantation (P=0.146). No transplantation-related death was observed in either group within 3 months after haplo-HSCT. Conclusions The children with CRS grade≥3 have an early neutrophil engraftment time, severe and diverse clinical manifestations of CRS, and a high rate of use of glucocorticoids within 4 days after haplo-HSCT. For these children, early use of low-dose glucocorticoids after transplantation may alleviate CRS response and reduce the incidence of aGVHD, thereby bringing more benefits to the children. CRS after haplo-HSCT has no significant impact on the prognosis of the children.
2024 Vol. 26 (12): 1301-1307 [Abstract] ( 948 ) [HTML 1KB] [PDF 571KB] ( 343 )
1308 CHEN Xiao-Yan, WANG Jia-Yi, JIANG Hua, ZHANG Wei-Na.
Clinical characteristics and prognosis of children with T-lineage acute lymphoblastic leukemia: a single-center study
Objective To study the clinical characteristics and prognosis of T-lineage acute lymphoblastic leukemia (T-ALL) and related prognostic factors. Methods A retrospective analysis was conducted on the children with T-ALL who were treated with the Chinese Children's Cancer Group Acute Lymphoblastic Leukemia (CCCG-ALL) regimen in Guangzhou Women and Children's Medical Center between April 2015 and December 2022. Results A total of 80 children were included, with a median age of 7 years and 3 months and a male/female ratio of 6:1. Among these children, the children with mediastinal mass accounted for 20% (16/80), those with central nervous system leukemia accounted for 4% (3/80), and those with testicular leukemia accounted for 1% (1/69). SIL/TAL1 was the most common fusion gene (22%, 18/80), and NOTCH1 was the most common mutation gene (69%, 37/54). The median follow-up time was 52 months, with a 5-year overall survival (OS) rate of 87.3%±4.0% and a 5-year event-free survival rate of 84.0%±4.3%. The non-central nervous system-1 group had a significantly lower 5-year OS rate than the central nervous system-1 group (66.7%±16.1% vs 90.3%±3.8%; P<0.05), and the group with minimal residual disease (MRD) ≥0.01% on day 46 of induction therapy had a significantly lower 5-year OS rate than the group with MRD <0.01% (68.6%±13.5% vs 94.8%±3.0%; P<0.05). Conclusions Children treated with the CCCG-ALL regimen tend to have a good treatment outcome. Non-central nervous system-1 status and MRD ≥0.01% on day 46 of induction therapy are associated with the poor prognosis in these children.
2024 Vol. 26 (12): 1308-1314 [Abstract] ( 1063 ) [HTML 1KB] [PDF 588KB] ( 370 )
1315 CHEN Zhao-Qi, TIAN Yang-Li, LIU Chuan-Jian, CAO Hui-Ying, LAN Jin-Ying, YANG Jun, CHEN Wei-Lan, WAN Ai-Lan.
Factors influencing the levels of fear regarding psychotherapy in adolescents with depression
Objective To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression. Methods A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression. Results The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05). Conclusions In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.
2024 Vol. 26 (12): 1315-1321 [Abstract] ( 779 ) [HTML 1KB] [PDF 587KB] ( 428 )
1322 ZHAO Meng, FENG Jie, WANG Lu-Yao, ZHOU Bo
Interaction between COMT gene polymorphisms and childhood trauma in adolescents with non-suicidal self-injury
Objective To investigate the interaction between catechol-O-methyltransferase (COMT) gene polymorphisms and childhood trauma in adolescents with non-suicidal self-injury (NSSI), and to provide a basis for the prevention and intervention of NSSI among adolescents. Methods A total of 84 adolescents with NSSI and 87 healthy controls were enrolled in this study. Oral saliva samples were collected for genotyping of the COMT gene at rs4680 and rs165599. Childhood Trauma Questionnaire, Behavioral Function Assessment Scale of Non-suicidal Self-injury in Adolescents, and Patient Health Questionnaire-9 Items were used for mental health assessment. A hierarchical linear regression analysis was used to examine the main effect and interactive effect of COMT gene polymorphisms at rs4680 and rs165599 and childhood trauma on NSSI. The Johnson-Neyman technique was used to identify the regions where the moderating variables had a significant impact. Results The interaction between COMT gene polymorphisms at rs165599 and the subtype of emotional neglect in childhood trauma could predict NSSI in adolescents (β=0.251, t=2.329, P=0.022). As for the adolescents carrying the G/G genotype at rs165599, the high emotional neglect group had a significantly higher NSSI score than the low emotional neglect group (F=4.579, P=0.049). Conclusions Adolescents carrying the G/G genotype at rs165599 of the COMT gene may have an increase in susceptibility to NSSI in case of high emotional neglect in childhood.
2024 Vol. 26 (12): 1322-1328 [Abstract] ( 691 ) [HTML 1KB] [PDF 643KB] ( 326 )
1329 BAI Meng-Ke, WANG Long, LI Hang, SU Hang, YANG Yue-Li, YANG Xiao-Qing
Clinical and pathological features of children with immunoglobulin A vasculitis with nephritis accompanied by different proportions of crescent formation
Objective To investigate the impact of the different proportions of crescent formation on clinical manifestations and pathological features in children with immunoglobulin A vasculitis with nephritis (IgAVN). Methods The children with IgAVN were divided into no-crescent group (75 children), ≤25% crescent group (156 children), and >25% crescent group (33 children). Results Compared with the no-crescent group, the other two groups had significant increases in 24-hour urinary protein, urinary immunoglobulin G (IgG)/creatinine ratio, urine red blood cell count, fibrinogen, and neutrophil-lymphocyte ratio, a significant reduction in serum IgG, and a significantly higher proportion of children with low albumin and hypercoagulability, pathological grade III+IV or diffuse mesangial proliferation (P<0.05). Compared with the ≤25% crescent group, the >25% crescent group had significant increases in 24-hour urinary protein, urine red blood cell count, and fibrinogen, significant reductions in serum IgG and glomerular filtration rate, and a significantly higher proportion of children with diffuse mesangial proliferation, tubular atrophy or interstitial fibrosis (P<0.05). Compared with the no-crescent group, the >25% crescent group had significantly higher levels of total cholesterol, triglycerides, urea nitrogen, and serum creatinine (P<0.05). A reduction in serum IgG, hypercoagulability, an increase in 24-hour urinary protein, diffuse mesangial proliferation, and chronic tubulointerstitial lesions were influencing factors for the increase in the proportion of crescent formation (P<0.05). Conclusions For children with IgAVN, the higher proportion of crescent formation is associated with greater abnormalities in laboratory markers and more severe chronic tubulointerstitial lesions, and thus a detailed analysis of the proportion of crescent formation can better guide clinical treatment.
2024 Vol. 26 (12): 1329-1334 [Abstract] ( 790 ) [HTML 1KB] [PDF 536KB] ( 703 )
1335 XIA Lei, ZHAO Jia-Wen, WANG Hui-Juan, QIAO Qing, WU Tian-Bo, WU Hui-Jie
Analysis of treatment outcomes of extremely preterm infants in a real-world single center
Objective To study the treatment outcomes of extremely preterm infants. Methods A retrospective analysis was performed for the clinical data of extremely preterm infants who were admitted to the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2022. The infants were divided into a non-in-hospital death group and a survival group. SPSS 29.0 was used for data analysis. Results A total of 422 extremely preterm infants were included, of which 155 were in the non-in-hospital death group and 267 in the survival group. The gestational age, birth weight, cesarean section rate, and proportion of mothers with premature rupture of membranes >18 hours in the non-in-hospital death group were all lower than those in the survival group (P<0.05). In contrast, the proportions of Apgar score ≤3 at 1 minute, intubation, neonatal respiratory distress syndrome, early-onset sepsis, periventricular-intraventricular hemorrhage (grades III-IV), and pneumorrhagia were higher in the non-in-hospital death group compared to the survival group (P<0.05). Conclusions Low gestational age, low birth weight, the history of birth asphyxia, severe intracranial hemorrhage, and pneumorrhagia may be the main causes of non-in-hospital death in extremely preterm infants, and therefore, perinatal health care should be enhanced to reduce the onset of asphyxia and severe diseases.
2024 Vol. 26 (12): 1335-1340 [Abstract] ( 355 ) [HTML 1KB] [PDF 543KB] ( 350 )
EXPERIMENTAL RESEARCH
1341 ZENG Ting, YANG Yue-Qian, HE Jian, SI Dao-Lin, ZHANG Hui, WANG Xia, XIE Min
Mechanism of WAVE1 regulation of lipopolysaccharide-induced mitochondrial metabolic abnormalities and inflammatory responses in macrophages
Objective To explore the mechanism by which Wiskott-Aldrich syndrome protein family verprolin-homologous protein 1 (WAVE1) regulates lipopolysaccharide (LPS)-induced mitochondrial metabolic abnormalities and inflammatory responses in macrophages. Methods Macrophage cell lines with overexpressed WAVE1 (mouse BMDM and human THP1 cells) were prepared. The macrophages were treated with LPS (500 ng/mL) to simulate sepsis-induced inflammatory responses. The experiment consisted of two parts. The first part included control, LPS, vector (LPS+oe-NC), WAVE1 overexpression (LPS+oe-WAVE1) groups. The second part included LPS, LPS+oe-NC, LPS+oe-WAVE1 and exogenous high mobility group box-1 (HMGB1) intervention (LPS+oe-WAVE1+HMGB1) groups. RT-PCR was used to measure mitochondrial DNA content, and RT-qPCR was used to detect the mRNA expression levels of WAVE1, tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6. Western blot was performed to measure the protein expression of WAVE1, hexokinase 2, and pyruvate kinase M2. ELISA was utilized to detect the levels of TNF-α, IL-1β, IL-6, and HMGB1. JC-1 staining was used to assess mitochondrial membrane potential. Seahorse XP96 was used to evaluate oxygen consumption rate and extracellular acidification rate. MitoSOX probe was employed to measure mitochondrial reactive oxygen species levels, and 2-NBDG method was used to assess glucose uptake. Kits were used to measure pyruvate kinase activity, lactate, adenosine triphosphate (ATP), and HMGB1 levels. Results Compared with the control group, the LPS group showed lower levels of WAVE1 protein and mRNA expression, mitochondrial membrane potential, oxygen consumption rate, and mitochondrial DNA content (P<0.05), while TNF-α, IL-1β, IL-6 levels and mRNA expression, mitochondrial reactive oxygen species, glucose uptake, lactate, ATP, hexokinase 2, and pyruvate kinase M2 protein expression levels as well as extracellular acidification rate, pyruvate kinase activity, and HMGB1 release were significantly increased (P<0.05). Compared with the LPS+oe-NC group, the LPS+oe-WAVE1 group showed increased WAVE1 protein and mRNA expression, mitochondrial membrane potential, oxygen consumption rate, and mitochondrial DNA content (P<0.05), while TNF-α, IL-1β, IL-6 levels and mRNA expression, mitochondrial reactive oxygen species, glucose uptake, lactate, ATP, hexokinase 2, and pyruvate kinase M2 protein expressions, as well as extracellular acidification rate, pyruvate kinase activity, and HMGB1 release were decreased (P<0.05). Compared with the LPS+oe-WAVE1 group, the LPS+oe-WAVE1+HMGB1 group exhibited increased glucose uptake, lactate, ATP levels, and extracellular acidification rate (P<0.05). Conclusions WAVE1 participates in the regulation of LPS-induced inflammatory responses in macrophages by modulating the release of inflammatory factors, mitochondrial metabolism, and HMGB1 release.
2024 Vol. 26 (12): 1341-1351 [Abstract] ( 477 ) [HTML 1KB] [PDF 2078KB] ( 282 )
1352 ZHANG Shu-Juan, WANG Chao, XU Qian-Qian, ZHANG Jun, ZHU Yan-Ping
Role of the nuclear factor-kappa B signaling pathway in the repair of white matter injury in neonatal rats through human umbilical cord mesenchymal stem cell transplantation
Objective To observe the reparative effects of human umbilical cord mesenchymal stem cell (hUC-MSC) transplantation on white matter injury (WMI) in neonatal rats and explore its mechanism through the nuclear factor-kappa B (NF-κB) signaling pathway mediated by microglial cells. Methods Sprague-Dawley rats, aged 2 days, were randomly divided into three groups: sham-operation,WMI, and hUC-MSC (n=18 each). Fourteen days after modeling, hematoxylin-eosin staining was used to observe pathological changes in the white matter, and immunofluorescence staining was used to measure the expression level of ionized calcium-binding adapter molecule 1 (Iba1). Western blotting was used to measure the protein expression levels of inhibitory subunit of nuclear factor-kappa B alpha (IκBα), phosphorylated IκBα (p-IκBα), phosphorylated NF-κB p65 (p-NF-κB p65), myelin basic protein (MBP), and neuron-specific nuclear protein (NeuN). Quantitative real-time PCR was used to assess the mRNA expression levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), MBP, and NeuN. Immunohistochemistry was used to measure the protein expression levels of MBP and NeuN. On day 28, the Morris water maze test was used to evaluate spatial cognitive ability. Results Fourteen days after modeling, the sham-operation group exhibited intact white matter structure with normal cell morphology and orderly nerve fiber arrangement. In the WMI group, large-scale cell degeneration and necrosis were observed, and nerve fiber arrangement was disordered. The hUC-MSC group showed relatively normal cell morphology and more orderly nerve fibers. Compared with the sham-operation group, the WMI group had significantly higher proportions of Iba1-positive cells, increased protein levels of p-IκBα and p-NF-κB p65, and higher mRNA levels of TNF-α and IL-1β. The protein expression of IκBα and the positive expression of MBP and NeuN, as well as their protein and mRNA levels, were significantly reduced in the WMI group (P<0.05). Compared with the WMI group, the hUC-MSC group showed reduced proportions of Iba1-positive cells, decreased protein levels of p-IκBα and p-NF-κB p65, and lower mRNA levels of TNF-α and IL-1β. Furthermore, IκBα protein expression and MBP and NeuN expression (both at the protein and mRNA levels) were significantly increased in the hUC-MSC group (P<0.05). On day 28, the Morris water maze results showed that compared with the sham-operation group, the WMI group had significantly longer escape latency and fewer platform crossings (P<0.05). In contrast, the hUC-MSC group had significantly shorter escape latency and more platform crossings than the WMI group (P<0.05). Conclusions hUC-MSC transplantation can repair WMI in neonatal rats, promote the maturation of oligodendrocytes, and support neuronal survival, likely by inhibiting activation of the NF-κB signaling pathway mediated by microglial cells.
2024 Vol. 26 (12): 1352-1361 [Abstract] ( 277 ) [HTML 1KB] [PDF 2623KB] ( 257 )
CASE REPORT
1362 SUN Ying-Ying, LIU Hui, LIU Miao, MEI Shi-Yue, MA Yan-Li
Autosomal dominant intellectual developmental disorder 60 with seizures: a case report
The patient is a 10-month and 21-day-old girl who began to show developmental delays at 3 months of age, with severe language developmental disorders, stereotyped movements, and easily provoked laughter. Physical examination revealed fair skin and a flattened occiput. At 10 months of age, a video electroencephalogram suggested atypical absence seizures, with migrating slow-wave activity observed during the interictal period. Whole exome sequencing of three family members indicated a novel mutation in the AP2M1 gene, c.508C>T (p.R170W), in the patient. A total of six cases of autosomal dominant intellectual developmental disorder 60 with seizures associated with mutations in the AP2M1 gene have been reported both domestically and internationally (including this study). The main clinical features included developmental delays (6 cases), language developmental disorders (5 cases), stereotyped movements (3 cases), a tendency to smile (1 case), and atypical absence seizures (4 cases). Interictal electroencephalograms showed widespread spike waves and spike-slow wave discharges (5 cases), and migrating slow-wave activity (1 case). The c.508C>T (p.R170W) mutation may be a hotspot for mutations in the AP2M1 gene, and its clinical features are similar to those of Angelman syndrome.
2024 Vol. 26 (12): 1362-1366 [Abstract] ( 328 ) [HTML 1KB] [PDF 1648KB] ( 268 )
REVIEW
1367 FU Sai, SONG Qian, HE Xiang-Jun, TIAN Xiao-Yu
Advances in the application of comprehensive behavioral intervention in tic disorder
Tic disorder is a neurodevelopmental disorder that occurs in children or adolescents, often attracting the attention of others due to involuntary, repetitive, and non-rhythmic tics, and drug therapy often causes negative emotions in children and their families due to its significant adverse reactions, poor compliance, and tendency of recurrence after drug withdrawal. In recent years, comprehensive behavioral intervention has shown great potential as a safe and effective treatment modality for tic disorders, with few adverse reactions. This article reviews the advances in the application of comprehensive behavioral intervention for tic disorder in China and abroad in the past 5 years, in order to provide a reference for clinical application.
2024 Vol. 26 (12): 1367-1372 [Abstract] ( 311 ) [HTML 1KB] [PDF 522KB] ( 370 )
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