Table of Content

15 February 2015 Volume 33 Issue 2

  

Effects of infant antibiotic usage on childhood asthma morbidity

ZHANG Jianhua, HU Runfang

. 2015, 33(2):  101.  doi:10.3969 j.issn.1000-3606.2015.02.001

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According to clinical epidemiological researches, the usage of antibiotics in infant increases the risk of childhood asthma morbidity. The mechanism of this link is not entirely clarified, and it is assumed of being related to side effects of antibiotics, which changes the colonization of normal intestinal flora and reduces the diversity. It is clear that normal intestinal flora of infant help to construct innate immune system and adaptive immune system, and forge immune tolerance. Therefore, normal intestinal flora might be helpful in reducing allergies. The usage of antibiotics in early life changes the quantity and the composition of intestinal flora, and breaks the balance of immune homeostasis, which might increase the risk of asthma morbidity. The abuse of antibiotics in children is a general phenomenon in China which needs attention from pediatricians.

Expression of microRNA-206 in peripheral blood mononuclear cells in asthmatic children

XU Qinglei, ZHU Baolin,MA Xiaobo, ZHANG Wei, LIU Lingling, WANG Shengjun, CHEN Jianguo

. 2015, 33(2):  105.  doi:10.3969 j.issn.1000-3606.2015.02.002

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Objective　To explore the role of microRNA-206 in peripheral blood mononuclear cells (PBMC) in the pathogenesis and development of childhood asthma. Methods Twenty-seven asthmatic children and 25 healthy controls were enrolled in the study. Peripheral blood mononuclear cells were isolated in both healthy subjects and asthmatic children in acute attack and remission stages. Total RNAs were extracted from PBMC stimulated by PMA and ionomycin, and then the RNA was reversely transcribed into cDNA. The expressions of microRNA-206 and Kruppel-like factor 4 (KLF4) and IL-17 mRNA were detected by real-time quantitative PCR (qRT-PCR) method. Results There was significant difference of microRNA-206 levels among asthmatic children in attack stage and in remission stage and normal controls (F=46.58~72.81, P=0.000). Through pairwise comparison, the microRNA-206 levels of asthmatic children in attack stage were significantly lower than those in remission stage and normal control groups (P<0.01). The KLF4 and IL-17 mRNA levels of asthmatic children in attack stage were significantly higher than those in remission stage and normal control groups (P<0.01). There was no significant difference of miR-206, KLF4 and IL-17 mRNA between asthmatic children in remission stage and the healthy controls (P>0.05). Furthermore, a negative correlation was found between the expression of miR-206 and KLF4 (r=–0.66, P<0.01) and between the expression of miR-206 and IL-17 mRNA (r=–0.81, P<0.01) in asthmatic children in attack stage. A positive correlation was also found between KLF4 and IL-17 mRNA in asthmatic children in attack stage (r=0.70, P<0.01). Conclusions The expression of miR-206 is decreased in asthmatic children, and miR-206 might be involved in the pathogenesis and development of asthma.

Relationship between exhaled nitric oxide and atopy in children with chronic persistent asthma

　ZHANG Dongwei，ZHANG Guangli，LI Junqi，LI Ying，ZHANG Hui，LIU Ru，LIU Sha，LUO Zhengxiu

. 2015, 33(2):  109.  doi:10.3969 j.issn.1000-3606.2015.02.003

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　Objective　to evaluate the influence of atopy on exhaled nitric oxide in chronic persistent asthmatic children. Methods A total of 52 chronic persistent asthmatic children who completed FeNO measurements and skin prick testing were enrolled. Patients were divided into non-atopic group and atopic group by skin prick testing results, and subdivided into non- allergic rhinitis and rhinitis group according to whether combined with allergic rhinitis. At the same time 78 healthy children were chosen as control group. Moreover, 32 chronic persistent asthmatic children who completed FeNO measurements twice interval of three months were enrolled. Results The FeNO level was significantly different among the atopic group (n=40), the non-atopic group (n=12) and the control group (H=33.29, P=0.000); The FeNO level was significantly higher in the atopic group than that in the non-atopic group (P<0.05). And the FeNO level were significantly different among the rhinitis group (n=41), the non- rhinitis group (n=11) and the control group (H=30.63, P=0.000). The FeNO level was significantly higher in the rhinitis group than that in the control group (P<0.05), however there were no difference between the rhinitis group and the non- rhinitis group(P>0.05).There were no correlations between FeNO levels of chronic persistent asthmatic children and the wheal diameter of house dust mites or dust mites (r=2.05, P=0.135; r=1.58, P=0.312). Moreover, the FeNO level was significantly lower after 3 months ICS treatment (z=-2.05, P=0.041). Conclusions Atopy had major influence on the FeNO level of chronic persistent asthmatic children, and the FeNO level declined with the theatment of ICS.

The regulatory role of chemerin in infant with respiratory syncytial virus pneumonia

JIN Tingting，ZHANG Mingzhi，WANG Libo，LU Aizhen，ZHANG Xiaobo

. 2015, 33(2):  113.  doi:10.3969 j.issn.1000-3606.2015.02.004

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Objective　To study the regulatory role of chemerin in infant with respiratory syncytial virus (RSV) pneumonia by investigating the level of serum chemerin，pro-inflammatory cytokine (TNF-α, IL-17), and anti-inflammatory cytokine (IL-10, TGF-β). Methods　The serum level of chemerin，TNF-α，IL-1，IL-10，TGF-β were tested in 82 RSV pneumonia inpatients (17 severe RSV pneumonia cases，65 mild cases) and 40 controls by ELISA and the severity of the RSV pneumonia was evaluated using a scoring system. Results　The serum level of chemerin of RSV pneumonia cases were (610.45±106.63pg/ml) which were significantly higher than the control(337.24±43.37 pg/ml). Chemerin level of severe RSV pneumonia group is significantly higher than mi d cases as well [(786.62±82.59 pg/ml)vs (539.98±65.86 pg/ml)P ＜ 0.01 ]. Significant positive correlations were found between serum chemerin level and TNF-α，IL-17 level (r=0.81，r=0.61；P ＜ 0.01) while the serum level of chemerin is negatively correlated with IL-10, TGF-β (r=-0.80，r=-0.75；P ＜ 0.01). Conclusions　The level of chemerin increased in RSV pneumonia patients，and related to clinical severity after RSV infection. These results indicate that chemerin may play an important role in the pathogenesis of RSV pneumonia and to the severity of the infection.

Multiple risk factor analysis of recurrent respiratory tract infection after Mycoplasma pneumoniae pneumonia in children

HE Ling, Wang Song, FU Zongming, CUN Liping

. 2015, 33(2):  117.  doi:10.3969 j.issn.1000-3606.2015.02.005

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　Objective　To investigate the occurrence trend and risk factors of recurrent respiratory tract infection during the first year after Mycoplasma pneumoniae pneumonia (MPP) in children. Methods The clinical data of 133 children completely recoved from MPP and one year follow-up after MPP were included in this study, MPP IgM IgG double antibody titer were measured in different time slots (3 month, 6 months, 9 months, 12 months) after discharge. Information on frequency of recurrent respiratory tract infections, respiratory tract infection site, and drug use within one year were collected. Possible factors affecting the occurrence of recurrent respiratory tract infection were analyzed by means of single factor and multi factor analyses. Results In 133 patients, the recurrent rate was 31.58% in the first year; aged 3-6 years old (OR=2.29，95%CI：1.13~4.64), or continuous positive or negative to positive antibodies (OR=4.47，95%CI：1.47~13.65), or low CD4/CD8 (OR=10.26，95%CI：3.30~31.90), or low IgA (OR=1.90，95%CI：1.06~3.40) is independent risk factor of recurrent respiratory tract after MPP; immune enhancer therapy is an independent protective factor (OR=0.29，95%CI：0.11~0.78). Conclusions Immune function disorders in the first year after MPP were independent risk factors of recurrent respiratory tract infection. MP antibody positive without clinical symptoms and sustained antibody positive can not prevent the recurrence of respiratory tract infection without use of antibiotics. Immune enhancer was advocate to adjust immune function and reduce the incidence of repeated respiratory tract infection.


Refractory Mycoplasma pneumoniae pneumonia combined with thrombosis: a case report and literature review

CHEN Yu, HUANG Ping, TIAN Weimin, CHEN Ling, LIN Zhiqing, CHEN Qi

. 2015, 33(2):  121.  doi:10.3969 j.issn.1000-3606.2015.02.006

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Objective　To investigate clinical features, diagnosis, and treatment of refractory Mycoplasma pneumoniae pneumonia (MPP) combined with thrombosis. Methods One case with refractory MPP associated with thrombosis was retrospectively analyzed with literature review. Results The patient presented with respiratory symptom at the onset, while melosalgia and decreased respiratory sound in left lung were occurred during anti-infection therapy. Thereafter, thrombosis of lower extremity veins and pulmonary embolism were confirmed by a series of examinations. Serum anti-phospholipid antibody was positive. Finally, the patient was treated with a combination of anticoagulation and immunosuppressive therapies. Conclusions The mechanism of refractory MPP combined with thrombosis may be associated with excessive inflammatory response and endothelial cells injury. The thrombosis complication should be suspected in patient of Mycoplasma pneumonia infection with positive anti-phospholipid antibody and low concentration of protein C and immunosuppressive therapy should be implemented promptly.

A comparative study of upper and lower respiratory aspirates on pathogen detection of lower respiratory tract infection in children

ZHANG Xinxing, CHEN Zhengrong, HUANG Li, WANG Meijuan, YAN Yongdong, GU Wenjing, SHAO Xuejun, ZHANG Xuelan, LI Wei

. 2015, 33(2):  126.  doi:10.3969 j.issn.1000-3606.2015.02.007

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Objective　To study the pathogenic etiology between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in children with lower respiratory infection. Methods Multiple pathogen in NPA and BALF from 210 cases with lower respiratory tract infection was detected. Seven common respiratory virus (respiratory syncytial virus, adenovirus, influenza virus A, influenza virus B, parainfluenza 1, parainfluenza 2, parainfluenza 3) were detected by direct immunofluorescence assay. MP, CP and HBoV were detected by fluorescence quantitative PCR.HRV and hMPV were detected by RT-PCR. Aspirates were cultured for bacteria. The results of pathogen detection in secretions of upper and lower respiratory tract were analyzed. Results Total positive detection rate of NPA and BALF in 210 cases was 91.9% (193/210), which is higher than that in NPA 75.2% (158/210) and that in BALF 85.2% (179/210). Bacteria detection rate in NPA was 13.3% (28/210), and 8.6% (18/210) in BALF, without significant difference (P=0.118). Bacteria detection rate in NPA and BALF was of poor consistency (Kappa=0.262). Virus detection rate in NPA was 24.3%, which is higher than that in BALF15.2%. BALF-MP detection rate was 77.6% (163/210), significantly higher than that in NPA 53.3% (112/210). There are 95.5% (107/112) cases with positive results in NPA-MP detectioncan also be detected in the BALF-MP. MP copies in BALF were significantly higher than that in NPA (4.28×106 vs. 1.31×105), and its positive rate in NPA was still higher than that in BALF. MP detection rate in NPA in children with clinical course of longer than two weeks was much lower than those with clinical course of two weeks or less. Conclusions The pathogen detection of virus and MP in NPA can be used as a reference for lower respiratory tract infection. The joint detection of NPA and BALF can improve the detection power. The sensitivity of virus detection in NPA is higher than that in BALF. NPA pathogen detection of virus and MP is of great important evidence-based medicine in the diagnosis of lower respiratory infection. MP detection rate and its copies in BALF are significantly higher than that in NPA. BALF detection is the supplement of pathogen diagnosis in severe or refractory lower respiratory infections.

Effects of in utero exposure to inflammation on innate immune response in preterm infants

WU Ying, LIU Zhiwei, LI Juan, TANG Zheng, WANG Hui, SA Ting

. 2015, 33(2):  131.  doi:10.3969 j.issn.1000-3606.2015.02.008

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Objective　To explore the effect of in utero exposure to inflammation on innate immune response in preterm infants. Methods Forty-seven premature infants with gestational age < 35 weeks were recruited in this study. According to histological evidence of placental infection, all neonates were divided into intrauterine inflammation positive group and negative group. Mononuclear cells and monocytes were isolated from umbilical cord blood, and were cultured in vitro in the presence or absence of LPS (100 ng/ml). The levels of interleukin 1β (IL-1β), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and interleukin 10 (IL-10) in cord blood plasma and monocyte cultural supernatants were measured by ELISA respectively. The level of IL-1β, TNF-α, IL-6 and IL-10 mRNA were detected by Real-time PCR. Expression of HLA-DR on surface of CD14+ monocytes and ratio of CD3+CD4+ / CD3+CD8+ T was analyzed by flow cytometry. Results (1) The level of cord plasma IL-6 in intrauterine inflammation positive group was significantly higher than in negative group. (p=0.02). (2) After stimulation of LPS, levels of IL-1β, IL-6, TNF-α, IL-10 in supernatants were increased significantly, in consistence with their mRNA expression (p<0.05) in both groups. (3) Expression of HLA-DR on surface of monocytes was significantly decreased after stimulation with LPS in intrauterine inflammation positive group (p=0.012), but was significantly increased in negative group (p=0.0305). Conclusions In utero exposure to inflammation does not suppress the response of monocytes to LPS in preterm neonates, but impairs the antigen presenting function in monocytes.

Predictors and risk factors of poor outcome in full-term newborns with severe hyperbilirubinemia

YE Shan, BAO Lei

. 2015, 33(2):  136.  doi:10.3969 j.issn.1000-3606.2015.02.009

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Objective　To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were significantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not significantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

Clinical features and influencing factors in neonatal coagulant function abnormality in the first 24 hours after birth

Han Hongwei，Ding Sheng，Chen Hong

. 2015, 33(2):  141.  doi:10.3969 j.issn.1000-3606.2015.02.010

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　Objective　To investigate the clinical manifestations and influencing factors in the newborns with coagulant function abnormality in the first 24 hours after birth. Methods The coagulation test results and clinical data of 169 newborns in our hospital were studied. Children receiving anticoagulant therapy were assigned as coagulation abnormalities group (n=76) and other healthy newborns were assigned as control group (n=93). The differences of coagulation function between the two groups were analyzed and the influencing factors of coagulation abnormalities were explored. Results The proportions of fetal distress, pneumonia, acidosis and hypothermia of coagulation abnormalities group were significantly higher than that of the control group (χ2= 6.18–38.01, P<0.05). Logistic regression analysis showed that fetal distress (OR=12.06, 95%CI: 3.71–39.25), pneumonia (OR=4.10, 95%CI: 1.43–11.74) were the high risk factors for coagulant function abnormality, and the differences were statistically significant (both P<0.05). Conclusions Fetal distress, pneumonia were the high risk factors for coagulant function abnormality. Early prevention can help to reduce the incidence of neonatal hemorrhagic disease.

Expression and clinical significance of miR-200a in childhood B-cell acute lymphoblastic leukemia

GAO Shunli，WANG Lizhong，LIU Haiying，LIU Danli

. 2015, 33(2):  144.  doi:10.3969 j.issn.1000-3606.2015.02.011

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　Objective　To explore the expression and clinical significance of microRNA-200a in childhood B-cell acute lymphoblastic leukemia (ALL). Methods　Bone marrow samples were collected from 45 children with B-cell ALL and 18 children without hematology disease as control. Total RNA was acquired from bone marrow. qRT-PCR was performed to detect the expression level of miR-200a. Results　The relative expression level of miR-200a in B-cell ALL group was significantly lower than that in control group (p<0.05); the expression of miR-200a in children over 10 years old was significantly lower than those in children under 10 years old (p<0.05); the expression of miR-200a in newly diagnosed samples was lower than those in those samples taken on Day 33 and at Week 12, respectively (p<0.05, p<0.01). In addition, the expression of miR-200a in low-risk group was higher than those in mid-risk and high-risk group, respectively (p<0.05). Conclusions　Low level of miR-200a had a close correlation with the development and prognosis of childhood B cell ALL, which could be used as a potential target of therapy and a biomarker of childhood B cell ALL in the future.

Expression of DNA methyltransferase mRNA in children with immune thrombocytopenia

　XIAO Aiju, WANG Tuanjie, CAO Lijia, SHI Taixin, ZHAO Dongju, LI Peiling, REN Ruijuan

. 2015, 33(2):  147.  doi:10.3969 j.issn.1000-3606.2015.02.012

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Objective　To study the relationship between DNA methylation and pathogenesis of childhood immune thrombocytopenic purpura (ITP) by examining the expression of DNA methyltransferase 1(Dnmt1) and DNA methyltransferase 3a (Dnmt3a) mRNA in peripheral blood lymphocytes of the children with ITP. Methods Expression of Dnmt 1 and Dnmt3a mRNA in the peripheral blood lymphocytes in 36 children with newly diagnosed ITP and 26 healthy children were detected using RT-PCR. Results Dnmt1 mRNA expression in peripheral blood lymphocytes in children diagnosed with ITP was 3.02±0.49, significantly lower than 4.58±0.52 in the control group (t=11.95, p<0.001). Dnmt3a mRNA expression in peripheral blood lymphocytes in children diagnosed with ITP was 1.49±0.44, significantly lower than 2.41±0.32 in the control group (t=9.12, p<0.001). Conclusions Children with newly diagnosed ITP have lower DNA methylation status in peripheral blood lymphocytes as compared to that in healthy children. The DNA methylation may play an important role in the etiology of acute ITP in children.

Clinical and pathological analysis in children with Henoch-Schönlein purpura nephritis　

　LIU Ling，ZHANG Dongfeng，LI Chunzhen，LIU Fujuan

. 2015, 33(2):  151.  doi:10.3969 j.issn.1000-3606.2015.02.013

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Objective　To analyze the relationship between clinical and pathological features in children with Henoche-Schönelin purpura nephritis (HSPN). Methods Clinical and pathological data of 89 children with HSPN from April 2009 to April 2013 in our hospital were retrospectively analyzed. Results A majority of patients (94.83%) suffered nephritis within two month after purpura. Clinically, hematuria and proteinuria (41.6%), nephrotic syndrome (27.0%), and isolated proteinuria (21.3%) are the most common type in children with HSPN. The majority of pathological changes of these three types HSPN are grade Ⅲ , which accounts for 67.6%, 70.8%, and 73.7%, respectively. The clinical manifestations are closely associated with pathologic classification (H=26.88, P=0.000). IgA plus IgM deposit was the most common type (40.45%) in histological and immunopathologic changes.There was no statistical difference between the pathologic classification and immunopathologic types. Gastrointestinal bleeding was associated with pathologic classification. Conclusions The pathological changes of HPSN patients are mainly of grades Ⅱ and Ⅲ , and the clinical manifestations, gastrointestinal bleeding in particular, are closely associated with pathological classification.

A study of bisphenol A and precocious puberty in 6-8 years old girls

WU Haiying，CHEN Linqi，WANG Fengyun，CHEN Xiuli，XIE Rongrong，CHEN Ting，HE Guangzhao，Wang Weipeng

. 2015, 33(2):  155.  doi:10.3969 j.issn.1000-3606.2015.02.014

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　Objective　To study the relationship between bisphenol A and precocious puberty in 6-8 years girls. Methods Atotal of 103 girls aged 6-8 years with precocious puberty in our Endocrine clinic from August to December 2012 were selected. According to the classification standard of precocious puberty, girls are divided into idiopathic central precocious puberty (ICPP) group (n=47) and permature thelarche (PT) group (n=56), 53 girls with no puberty development were chosen as control group. BPA concentrations were determined with HPLC-MS-MS, sex hormones were determined with chemiluminescence method and Kisspeptin concentrations were determined with ELISA, then the differences among the three groups were compared and the relationships between bisphenol A and sex hormones and Kisspeptin were analyzed. Results The BPA relevance ratio and concentration in ICPP group were higher than those of PT group and control group (P<0.05). The peak concentration of LH and LH/FSH in ICPP group were higher than those of PT group (P<0.05). The concentration of E2 in ICPP group and PT group were higher than that of control group (P<0.05). The concentration of Kisspeptin in ICPP group was higher than that of PT group and control group (P<0.05). There were no relationship between the concentrations of bisphenol A and Kisspeptin and FSH peak concentration (P>0.05). There were correlations between the concentrations of BPA and E2 and LH peak concentration and LH/FSH
(P<0.05). Conclusions There is a certain correlation between the concentrations of BPA and ICPP.

Clinical features of child mitochondrial encephalopathy with lactic acidosis and stroke with status epileptics

Fang Qiong，Chen Lang，Chen Qiaobin，Yang Fang

. 2015, 33(2):  160.  doi:10.3969 j.issn.1000-3606.2015.02.015

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　Objective　To investigate the clinical features and treatment of a group of patients of mitochondrial encephalomyopathy with actic acidosis and stroke (MELAS) with onset of status epileptics. Methods Clinical features, EEGs, image findings, and therapeutic data of 4 cases with onset of status epileptics patients finally diagnosed as MELAS were retrospectively reviewed. Results　Four Patients were onset with status epileptics. The levels of serum lactic acid, ammonia, myocardial enzymes were increased, and the serum sodium level was reduced, and accompanied with metabolic acidosis. EEG found corresponding paroxysmal and interictal activities. Brain images showed basal ganglia calcification, brain atrophy, and acute cortex edema. Genetic detection found mtDNA3243 mutation. Conclusions The status epilepticus was commonly present in MELAS. The treatment of epileptic attack in this disease was difficult, which needs early diagnosis. Appropriate anti-leptic drugs and relevant treatment to symptoms are important to alleviate cerebral injury.

Analysis of disease spectrum in Epstein-Barr virus infected children in Zhongshan　

REN Wei, LONG Xiaoling, LIU Yuling, FU Simao

. 2015, 33(2):  164.  doi:10.3969 j.issn.1000-3606.2015.02.016

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　Objective　To study the epidemic characteristics and disease spectrum of Epstein-Barr virus (EBV) infected children in Zhongshan region, Guangdong province. Methods Clinical data from the children with positive EBV-DNA detected by real-time fluorescent quantitative PCR between 2011 and 2013 was retrospectively analyzed. Results A total of 409 cases were detected with EBV-DNA positive from 3402 cases, with a total positive rate 12%, and the positive rate is 8.1% in 2011, 10.4% in 2012, 19.5% in 2013, there were significant differences among positive rate (χ2=6804.00, P<0.05). There was no statistically significant difference in the positive rate of EBV-DNA between different gender (χ2=0.239, P>0.05) and different age groups (χ2=136.96, P<0.05). The positive rate of pre-school group is the highest. EBV infection can cause multiple system diseases. The most common disease caused by EBV infection was infectious mononucleosis (61.6%), followed by respiratory tract infection (26.7%), neck lymphadenitis (3.4%), idiopathic thrombocytopenic purpura (2.4%), etc. Among the 409 cases of EBV infection, the concurrent other pathogen specific IgM positive cases as MP-IgM positive (n=79), CP-IgM positive (n=47), Parvovirus B19-IgM positive (n=20), HSV-IgM positive (n=11), CMV-IgM positive (n=10), and RV-IgM positive (n=4) were found. Conclusions Infectious mononucleosis is the leading disease in children infected by EBV in Zhongshan region, the annual positive rate is increasing. Multiple pathogen specific IgM may be detected positive in children with EBV infection, which should be interpreted in combination with clinical status.

A case report of childhood Pseudomonas aeruginosa sepsis

LI Yiyuan，LI Deyuan，WAN Chaomin

. 2015, 33(2):  167.  doi:10.3969 j.issn.1000-3606.2015.02.017

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　Objective　To summarize the clinical features of Pseudomonas aeruginosa sepsis in children. Methods　We retrospectively review the clinical data of a baby boy with Pseudomonas aeruginosa sepsis and summarize its clinical characteristics. Results　A ten-month male infants with onset symptom of fever, irritability, drowsiness, cough and sputum was diagnosed as Pseudomonas aeruginosa sepsis through blood and sputum culture. The baby recovered well after anti-infection treatment. Conclusions　Timely and appropriate use of sensitive antibiotics can decrease severe complications and mortality rate of Pseudomonas aeruginosa sepsis in children.

Effects of maternal high-fat diet on liver fatty acid metabolism-related gene expression in the early life of rat offspring

YE Tingting, HUANG Yanhong, FANG Fang, LIU Chongxiao, CHEN Yuanwen, DONG Yan

. 2015, 33(2):  170.  doi:10.3969 j.issn.1000-3606.2015.02.018

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　Objective　To study the impact of maternal high-fat diet during pregnancy and lactation on hepatic steatosis in the early life of offspring rats and its possible mechanism. Methods Female Sprague-Dawley rats were fed either a high fat diet (HF) or control (C) diet for 8 weeks before mating and throughout gestation and first 3 weeks of lactation. The expressions of hepatic fatty acid catabolism related genes, including peroxisome proliferator-activated receptor alpha (PPARα), acyl-CoA synthease long-chain family member3 (ACSL3), carnitine palmitoyltransferase-1α (CPT-1α) and 3-hydroxyacyl CoA dehydrogenase (Ehhadh) were determined in offspring liver tissue. The liver pathology was examined in offspring rats at 3 weeks of age. Results Pathohistological findings at 3 weeks of age showed that there were diffuse vacuolar degeneration in cytoplasm of hepatocytes and spot necrosis in hepatic lobular in the HF offspring liver. The mRNA expressions of PPARα and Ehhadh genes were markedly increased in the HF offspring as compared to the control group (P<0.05). The mRNA expression of CPT-1α gene was also higher in the HF offspring than that in control group (P=0.19). The level of ACSL3 gene expression, however, was markedly decreased (P<0.05). Conclusions Maternal high fat diet during pregnancy and lactation could result in an increased expression of genes related to hepatic fatty acid β-oxidation, including PPARα, CPT1α and Ehhadh, but the liver steatosis cannot be reversed in the early life of offspring.

BCG HSP70 gene transfection and its effect on immunogenicity of murine lymphocytic leukemia

LI Xiaoling，SUN Lirong

. 2015, 33(2):  174.  doi:10.3969 j.issn.1000-3606.2015.02.019

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Objective　To assess the effect of heat shock protein 70 of BCG (BCG HSP70) gene transfection on tumorigenicity and immunogenicity of murine lymphocytic leukemia cells (L1210). Methods BCG HSP70 gene was transfected onto the surface of murine lymphocytic leukemia cells (L1210) by lipofectamine 2000. And then the positive clone (L1210-HSP70) highly expressing HSP70 was selected as the tumor vaccine to study the tumorigenicity experiments in nude mice and syngeneic mice, the therapeutic experiments, and the immunoprotective effects. Results The expression of BCG HSP70 on the L1210 cells surface was detected, and the L1210-HSP70 cells had the same tumorigenicity as the parental L1210 cells did. Tumorigenicity experiments in syngeneic mice: In L1210-HSP70 group, tumor growth was slow or without the formation of tumor. As compared with L1210 group and L1210-neo group the mice survival time was significantly prolonged, showing a marked stimulating effect on L1210 specific Th1 cells,. Tumor-bearing mice showed complete coagulation necrosis and abundant CD8+ T lymphocyte infiltration (P<0.05). The tumor vaccine of L1210-HSP70 cells had the antitumor therapeutic efficacy and immune protection effect, demonstrating that the tumor growth was significantly inhibited, tumor diameter was markedly reduced and the survival time of tumor-bearing DBA/2 mice was further prolonged. Conclusions BCG HSP70 gene transfection could effectively improve the immunogenicity of tumor cells, activate specific T cells and enhance the anti-tumor immunity in vivo. Meanwhile, the host anti-tumor immunity could be enhanced.

The effect of rhEPO on the expression of Bcl-2 and Caspase-3 in intestinal tract of newborn rats with necrotizing enterocolitis

YANG Xiao, LIANG Kun

. 2015, 33(2):  179.  doi:10.3969 j.issn.1000-3606.2015.02.020

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Objectives　To investigate the effect of rhEPO on newborn rats with necrotizing enterocolitis (NEC). Methods Sixty newborn Sprague-Dewley (SD) rats at the age of 48 hours were randomly divided into 5 groups: control group, NEC group, and intervention groups 1, 2 and 3 treated with rhEPO. The rats were fed rat breast milk substitutes and stressed under hypoxia and cold exposure to establish NEC model. The rats with NEC were treated with different doses of rhEPO (0.1U/ml, 1U/ml and 10U/ml) in intervention groups. The expression of Bcl-2 and caspase-3 were measured by immunohistochemistry, and intestinal pathological changes were observed using HE staining. The value of positive expression was analyzed by IOD (integral optical density) image analysis system. Results Abdominal distention, decreased activity and unresponsiveness occurred in NEC rats 24 hours after stress exposure, and pale skin, decreased skin temperature and respiratory rhythm change were observed in severe cases. The symptoms appeared later and milder in three intervention groups. The NEC incidence of newborn rats was as followings: control group(0%), model group(60%), intervention group 1( 30%), intervention group 2(18.2%), intervention group 3(9.1%) and the difference was significant between each group (P=0.008). The grades of intestinal injury, the expression of active caspase-3 and Bcl-2 were significantly different among groups (P<0.01). Intestinal injury was the most severe and the expression level of active caspase-3 was the highest in NEC group. After rhEPO treatment, the intestinal injury and the production of active caspase-3 protein were decreased, and the expression of Bcl-2 was increased. Conclusions Oral rhEPO could decrease the expression of intestinal active caspase 3, and increase the expression of Bcl-2. The protective effect of rhEPO on NEC is dosedependent.

Progress of ketogenic diet treatment of intractable epilepsy in Children

WANG Mingmei,XIE Mengmeng

. 2015, 33(2):  184.  doi:10.3969 j.issn.1000-3606.2015.02.021

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　Refractory childhood epilepsy refers to those cases with difficult control of epileptic attacks after at least two formal anticonvulsants treatment. Recently, ketogenic diet (KD), a high-fat, low-carbohydrate and adequate-protein diet, becomes an important method for the treatment of refractory epilepsy in children. Before employing KD, children should be checked to exclude known metabolic diseases. Although the mechanism of KD treatment is not entirely clear, it has a certain clinical curative effect. Many factors influence the curative effect of KD. Most of the adverse effects of KD treatment are transient and can be recovered through active prevention and handling, which gives a generally good prognosis.

Research progress of newborns’patent ductus venosus

ZHOU Mengjie，CHEN Wenjuan

. 2015, 33(2):  188.  doi:10.3969 j.issn.1000-3606.2015.02.022

Abstract ( 506 )   PDF (1135KB) ( 563 )  

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Patent ductus venous is a kind of the congenital portosystemic shunts (CPSS). In recent years, the related case report increased gradually, but the domestic research is rare. In this article, we review the current diagnosis and treatment of neonatal patent ductus venous based on literature available.

Rotavirus molecular epidemiology and vaccine protection efficiency in China

YU Feng

. 2015, 33(2):  191.  doi:10.3969 j.issn.1000-3606.2015.02.023

Abstract ( 474 )   PDF (1138KB) ( 506 )  

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Retrovirus (RV), a major pathogen in acute gastroenteritis in children that may lead to severe disease and heavy burdens on national economy. There is no specific drug treatment for the gastroenteritis caused by RV, and vaccine has been identified as the most effective intervention to control the associated disease burden. The RV vaccine showed differential effects on different RV infection. In China, epidemiology of RV is more complex hence demands more epidemiologic studies. In this article, we will review the epidemiology of RV in China and further discuss the importance of generalized RV vaccine.