Table of Content

15 September 2015 Volume 33 Issue 9

  

Prevention and control of nosocomial infection in NICU: current status and future challenges

LI Qiuping, MA Qianqian, FENG Zhichun

. 2015, 33(9):  761.  doi:10.3969 j.issn.1000-3606.2015.09.001

Abstract ( 332 )   PDF (1049KB) ( 405 )  

Related Articles | Metrics

Nosocomial infection (NI), a major cause of morbidity and mortality in neonates, is the common challenges faced by health workers worldwide. This paper was to review the epidemiology, major challenges, prevention and control measures of NI in neonatal intensive care unit. The present situation of NI in China and the corresponding countermeasures are also discussed.

Intrauterine infection and neonatal brain damagev

SHI Jing, MU Dezhi

. 2015, 33(9):  767.  doi:10.3969 j.issn.1000-3606.2015.09.002

Abstract ( 424 )   PDF (1046KB) ( 653 )  

Related Articles | Metrics

Intrauterine infection is an important risk factor for neonatal brain damage and neurological dysfunction. Viruses, bacteria, and protozoa can cause intrauterine infection which results in neonatal brain damage. The inflammatory response is an important pathogenic factor for neonatal brain damage caused by intrauterine infection. Intrauterine infection in different periods of pregnancy might cause different types of brain damage in neonates. Clinicians should pay attention to the prevention of intrauterine infection during pregnancy. It is necessary to further strengthen the clinical and basic research to explore effective interventions for neonatal brain damage caused by intrauterine infection.

Visualized study of current status of the research in neonatal non-invasive ventilation

YANG Xiaoyan, CHEN Chao, SHI Jing, TANG Jun, MU Dezhi

. 2015, 33(9):  771.  doi:10.3969 j.issn.1000-3606.2015.09.003

Abstract ( 427 )   PDF (1401KB) ( 330 )  

Related Articles | Metrics

　Objectives 　To present the current condition of non-invasive ventilation in newborns in the last five years in China, to describe the probable research trends of this field, and to provide the possible research directions in future. Methods Using co-word analysis, the keywords “neonate” and “non-invasive ventilation” were searched in the CNKI database. The search results included 457 articles. Then the relation matrix was built by Excel 2010. Finally the visualized network was drawn by Ucinet 6.3. Results　Nasal continuous positive airway pressure (nCPAP) is primarily for the treatment of neonatal respiratory distress syndrome (NRDS) in China. Meanwhile, nasal intermittent positive pressure ventilation (nIPPV) and bilevel positive airway pressure (BiPAP) are gradually applied in clinic. The application scope of non-invasive ventilation is expanding. Besides the neonatologists, nurses are also paying close attention to non-invasive ventilation. Conclusions 　The visualized network, successfully built by Netdraw, reflects the hot topics and current condition in this field.

One case report of neonatal onset Crohn disease

　LIU Xiaojing, YANG Wei, CHEN Yongxing, LI Chunzhi, GAO Jing, WEI Haiyan, ZHOU Xihong

. 2015, 33(9):  776.  doi:10.3969 j.issn.1000-3606.2015.09.004

Abstract ( 441 )   PDF (1364KB) ( 333 )  

Related Articles | Metrics

Objective　To investigate the diagnosis and treatment of Crohn disease in neonates. Methods　 The clinical data of one case of neonatal onset Crohn disease were retrospectively analyzed. Results　 Male infant had intermittent fever, recurrent oral ulcers, skin impetigo and intermittent diarrhea with increased WBC counts from five days after birth. He had been diagnosed as sepsis, bacterial enteritis, Behcet's disease, immunodeficiency disease, nutritional anemia, milk intolerance, and inflammatory bowel disease. Finally he was diagnosed as Crohn disease by rectal mucosa pathology and postoperative bowel pathology. He died of intestinal perforation on 8 months. Conclusions 　The infants who have recurrent oral ulcers, skin impetigo, perianal ulcers and fever from neonatal should undergo colonoscopy for the diagnosis.

A 28-year retrospective analysis of clinicopathological data of children's renal biopsy　

　RONG Liping, JIANG Mengjie, MO Ying, XU Yuanyuan, QIU Zeting, LIU Sanxin, JIANG Xiaoyun

. 2015, 33(9):  779.  doi:10.3969 j.issn.1000-3606.2015.09.005

Abstract ( 332 )   PDF (1165KB) ( 272 )  

Related Articles | Metrics

　Objectives　To investigate the composition of clinical classification and pathological patterns and their relationships and change in children with renal disease undergoing biopsy. Methods　A retrospective analysis of pathological and clinical data obtained from children ( ≤ 14 year) with renal disease undergoing biopsy from 1984-1997 and from 1998-2011 was performed. Results　One thousand four hundred and sixty-two children underwent renal biopsy in 28 years, and 1313 patients were recruited in this study, 824 males (62.8%) and 489 females (37.2%). The mean age was 9 years and 4 months at renal biopsy. There were 921 children (70.1%) with primary glomerular disease (PGD) and 312 children (23.8%) with secondary glomerular disease (SDG). The main clinical classifications of PGD were nephrotic syndrome (NS, 31.2%), isolated hematuria (IH, 16.1%), and acute glomerulonephritis (AGN, 11.0%). The main pathological patterns of PGD were IgA nephropathy (IgAN, 27.6%), minimal change disease (MCD, 24.0%), and mesangial proliferative glomerulonephritis (MsPGN, 16.9%). The main causes of SGD were lupus nephritis (LN, 40.7%), Henoch-Sch?nlein purpura nephritis (HSPN, 34.3%), and hepatitis B virus related glomerulonephritis (HBV-GN, 19.6%). In this 28 years, the composition of PGD was decreased, however, the compositions of SGD and other renal diseases were increased. Compared with 1984-1997, the pathological manifestations of IgAN, MCD and focal segmental glomeralosclerosis were increased, MsPGN, IgMN, and crescentic glomerulonephritis were decreased in 1998-2011. The difference was statistically significant (P<0.05). In SGD patients, HBV-GN was significantly decreased (P<0.05). Conclusions　PGD is the main disease in children undergoing renal biopsy. IgAN is the most common pathological pattern. NS is the most common clinical classification. In this 28 years, the composition of PGD is decreased, SGD and other renal diseases are increased in children undergoing renal biopsy.

The sensitivity and specificity analysis of circulating hsa-miR-342-5p to diagnose childhood tuberculosis

ZHOU Mengyao, ZHAN Xue，ZHANG Zhenzhen

. 2015, 33(9):  784.  doi:10.3969 j.issn.1000-3606.2015.09.006

Abstract ( 431 )   PDF (1420KB) ( 291 )  

Related Articles | Metrics

　Objective 　To evaluate the value of hsa-miR-342-5p for the childhood tuberculosis (TB) diagnosis. Methods 　 Twenty culture-positive TB, 20 culture-negative TB, 20 pneumonia and 20 healthy children were enrolled in the study. The venous blood was collected. The peripheral blood total RNA was extracted by TRIzol reagent. The expression of hsa-miR-342- 5p was detected by qRT-PCR. Receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of hsa-miR-342-5p to diagnose childhood TB. Results　There was a significant difference of hsa-miR-342-5p level among culture-positive TB, culture-negative TB, pneumonia and healthy controls (F=21.94, P=0.00). Compared to health control, hsamiR- 342-5p was significantly lower in culture-positive TB, culture-negative TB, and pneumonia children (P<0.01). Compared to pneumonia children, hsa-miR-342-5p was also significantly lower in culture-positive TB and culture-negative TB groups (P<0.01). For distinguish culture-positive TB and pneumonia by hsa-miR-342-5p, the sensitivity and specificity were 90% and 90% respectively. For distinguish culture-negative TB and pneumonia by hsa-miR-342-5p, the sensitivity and specificity were 65% and 100% respectively. Conclusions　 The peripheral hsa-miR-342-5p is expected to become a new biomarker for early diagnosis of tuberculosis in children.

Association between polymorphism of SLC26A9 gene and clinical characteristics of asthma in children

HUANG Juan, CHENG Yanyang, ZHAO Hongling

. 2015, 33(9):  788.  doi:10.3969 j.issn.1000-3606.2015.09.007

Abstract ( 303 )   PDF (1200KB) ( 276 )  

Related Articles | Metrics

Objective 　To investigate the association between nucleotide polymorphisms (SNP) of rs2282430 and rs2031234 in SLC26A9 gene and clinical characteristics of asthma in Han children in central China. Methods 　A case-control study was performed. Two hundreds and three children with asthma were recruited in this study and 221 normal children were selected as controls. The genotypes of two SNPs in SLC26A9 gene were examined using PCR-RFLP. Results　Between children with asthma and controls, the distribution of three genotypes (AA, AG and GG) in rs2282430 locus had significant difference (P=0.042). The percentage of AA genotype was higher in children with asthma than that in controls. In implicit mode (AA vs. AG+GG), the two groups was statistically significant difference (P=0.028). The frequency of A allele was higher in children with asthma than that in controls (P=0.011). Between children with asthma and controls, the distribution of three genotypes (TT, GT, and GG) in rs12031234 locus had no significant difference (P=0.479). The frequency of alleles in rs12031234 locus also had no significant difference (P=0.215). Among asthmatic children with different genotype of rs2282430, the lymphocytecounts (LYM), C-reaction protein (CRP), IgE, neutrophils (NEU%), and eosinophils (EOS%) were not significantly different (P>0.05). Conclusions 　The rs2282430 polymorphism in SLC26A9 gene is associated with childhood asthma in the central China and the A allele is the risk factor. The rs2282430 polymorphism is not associated with LYM counts, CRP level, IgE level, NEU%, and EOS%.

Current status and influencing factors for child neglect in 3-6 years old rural children in Henan

ZHAO Yuxia, ZHANG Han

. 2015, 33(9):  792.  doi:10.3969 j.issn.1000-3606.2015.09.008

Abstract ( 266 )   PDF (1141KB) ( 269 )  

Related Articles | Metrics

Objectives　 To study the current status of child neglect and its influencing factors in children aged 3-6 years in rural Henan. Methods　Scales and evaluation methods in the "Chinese rural child aged 3-6 years neglected evaluation model" were applied in this study. The neglect rate and the neglect degree were used to describe the neglect status of rural children aged 3-6 years in Henan. The influencing factors for child neglect were also analyzed. Results　The total neglect rate in 450 enrolled children was 37.1% (167/450). The total neglect degree was 51.9±6.5. The boys had significantly higher neglect rate than girls (P<0.05). There was no significant difference in neglect degree between boys and girls (P>0.05). There were significant differences in neglect rate and neglect degree among the different age groups (P<0.05), the higher neglect rate and higher neglect degree over age. The neglect rate and neglect degree in nuclear families and families with three generations were lower than those in single-parent families and remarried families (P<0.05). The neglect rate and neglect degree in non-only children were higher than those in only children (P<0.05). The left-behind children had significantly higher neglect rate and neglect degree than children living with parents (P<0.05). Based on multivariate logistic regression analysis, the risk factors of child neglect were single-parent families (OR = 4.78, 95% CI : 2.10-10.87) and remarried families (OR=4.53, 95% CI : 1.99-10.01). The protective factors of child neglect were parents working on science (OR = 0.20, 95% CI : 0.10-0.67) and living with parents (OR = 0.03, 95% CI : 0.00-0.54). Conclusions　The neglect status is serious in Henan rural children, particularly in left-behind children.

A study on platelet indices and platelet membrane glycoprotein in children with primary immune thrombocytopenia

BAI Jing, LIU Wenjun

. 2015, 33(9):  797.  doi:10.3969 j.issn.1000-3606.2015.09.009

Abstract ( 393 )   PDF (1133KB) ( 413 )  

Related Articles | Metrics

Objective　To investigate the change of the platelet function in children with primary immune thrombocytopenia (ITP) before and after treatment. Methods　The platelet indices, immature platelet fraction (IPF%), immature platelet counts (IPC), granule membrane glycoproteins of platelet (CD62p, PAC-1, CD42b) were tested by automatic blood cell analyzer and flow cytometry (FCM) in 18 children with ITP before treatment and after complete response and in 17 children undergoing elective surgery (control gourp). Results　Compared with control group, MPV, PDW, P-LCR and IPF% were significantly higher and PLT, PCT, IPC were significantly lower in children with ITP. The expressions of three platelet membrane glycoproteins (PAC-1, CD62p, CD42b) were significantly lower in children with ITP. After treatment, children with ITP achieved completely response. Compared with before treatment, MPV, PDW, P-LCR and IPF% were significantly lower, and PLT, PCT, IPC, and the expressions of three platelet membrane glycoproteins (PAC-1, CD62p and CD42b) were significantly higher. Conclusions　The platelet function is depressed and in status of low activity in children with ITP. The relative platelet indices provide new references for the diagnosis and the judgment of therapeutic effect in ITP patients.

The changes and clinical significance of heart-type fatty acid binding protein and soluble ST2 protein in children with chronic heart failure

　MA Yanyan, FENG Song, LI Binglu, AN Jindou

. 2015, 33(9):  802.  doi:10.3969 j.issn.1000-3606.2015.09.010

Abstract ( 398 )   PDF (1155KB) ( 439 )  

Related Articles | Metrics

Objective　To study the changes and clinical significance of serum heart-type fatty acid-binding protein (H-FABP) and soluble ST2 protein (sST2) in children with chronic heart failure (CHF). Methods　Thirty-nine children with CHF and 30 healthy children were recruited. Serum levels of H-FABP and sST2 were determined by ELISA, The left ventricular ejection fraction (LVEF) and fractional shortening of the left ventricle (LVFS) were measured by two-dimensional echocardiography. Results　In 39 children with CHF, 15 males and 24 females, aged 2 months to 14 years, included 27 cases of endocardial fibroelastosis (EFE) and 12 cases of dilated cardiomyopathy (DCM). According to the cardiac functional grading standard, the children with CHF were divided into 10 cases with cardiac function II, 15 cases with cardiac function III, and 14 cases with cardiac function IV. The mean levels of H-FABP, sST2 and NT-Pro-BNP in children with CHF at stage of heart failure and heart failure remission were statistically higher than those in the healthy children (all P<0.01). The serum H-FABP and sST2 levels had significant differences among groups grouped according to cardiac functional grading standard (all P<0.05). The serum H-FABP and sST2 levels had no significant difference between the EFE and DCM groups (all P>0.05). The Spearman correlation analysis showed that, in children with CHF at stage of heart failure, the serum H-FABP level was positively correlated with NT-Pro-BNP, sST2 and cardiac function (r=0.402、0.621、0.644, P<0.05). Serum sST2 level was positively correlated with NT-Pro-BNP and cardiac function (r = 0.501、 0.678, P<0.05), and was negatively correlated with LVEF and LVFS (r= − 0.340、− 0.329, P<0.05). Conclusions　H-FABP and sST2 are involved in the development of heart failure. H-FABP and sST2 can be used as reference indices for clinical diagnosis and assessment of CHF.

eNOS gene G10T polymorphism in 1290 children with sporadic congenital heart disease

ZHOU Kai, QIN Yuming,MO Xuming

. 2015, 33(9):  807.  doi:10.3969 j.issn.1000-3606.2015.09.011

Abstract ( 309 )   PDF (1132KB) ( 248 )  

Related Articles | Metrics

Objective To investigate the association between endothelial NO synthase (eNOS) gene G10T polymorphism nd the susceptibility of sporadic congenital heart disease (CHD). Methods The genotype on eNOS G10T locus was detected nd compared in 1323 children with sporadic CHD and 1323 non-CHD children. Results Compared with the CC genotype, the A genotype significantly increased the risk of CHD (adjusted OR=1.42, 95% CI=1.01-2.04). Compared with the CC/AC genotype, he AA genotype significantly increased the risk of CHD (adjusted OR=1.39, 95% CI=1.08-1.92). Based on stratified analysis, he AA genotype was associated with the susceptibility of perimembranous ventricular septal defects (adjusted OR=1.56, 95% CI=1.17-2.47). Conclusions In Chinese population, the eNOS G10T polymorphism may increase the susceptibility of sporadic CHD.

Etiological analysis of asymptomatic hematuria in 431 children and follow-up

SUN Zhicai, LIU Yuling, PAN Xiaofen, LI Guomo, LEI Xinyan

. 2015, 33(9):  810.  doi:10.3969 j.issn.1000-3606.2015.09.013

Abstract ( 366 )   PDF (1103KB) ( 599 )  

Related Articles | Metrics

Objective To investigate the etiology and prognosis of asymptomatic hematuria in children. Methods The etiological factors, clinical features and prognosis of asymptomatic hematuria were analyzed retrospectively in 431 children from Jan. 2001 to Dec . 2014. Results In 431 children (197 males and 234 females) with asymptomatic hematuria, the mean age of first visit was 5.52±2.77 years (8 months-17 years). Four hundred and twenty-five cases had persistent microscopic hematuria and 6 cases had gross hematuria. Three hundred and fifteen cases (73.1%) were glomerular hematuria, among which 286 cases were isolated hematuria, 5 cases were acute glomerulonephritis, 13 cases were minimal change glomerulopathy, 4 cases were IgA nephropathy, 4 cases were mesangial proliferation glomerulonephritis and 3 cases were thin basement membrane nephropathy. One hundred and thirty-six cases (31.5%) were non-glomerular hematuria, among whom 113 cases were left renal vein entrapment syndrome, 17 cases were idiopathic hypercalciuria, 4 cases were kidney stone, 1 case was urinary tract infection and 1 case was left kidney absence. The mean follow-up period was 3.05±2.69 years (0.5-13.5 years). One hundred and forty-five patients showed the resolution of microscopic hematuria, among whom 110 cases (75.8%) had the resolution in 3 years after the first visit. In 24 cases with family history of hematuria, only 6 cases showed the resolution. At the end of the follow-up, renal function remained stable in all children. Conclusions The onset age of asymptomatic hematuria in children varies widely, and most of them are glomerular hematuria. Most children with isolated hematuria show resolution within three years after the first visit. The children with familial hematuria may last longer. The isolated hematuria has good prognosis but needs to be followed up.

Cerebellar mutism and childhood medulloblastoma

　LIANG Yunmei, LU Yansong, ZHANG Jin, REN Siqi, GUO Fang

. 2015, 33(9):  813.  doi:10.3969 j.issn.1000-3606.2015.09.014

Abstract ( 370 )   PDF (1132KB) ( 322 )  

Related Articles | Metrics

　Objective　 To investigate the relationships among cerebellar mutism (CM), relapsed medulloblastoma (MB) and the primary tumor location. Methods　A retrospective analysis was conducted in 114 children over 3 years old with MB from November 2011 to April 2015. Results　The median onset age was 84.7 months (36.4 to 184.7 months) in 114 children with MB (77 boys and 37 girls), of whom there were 48 cases of recurrence. There were twenty two cases of CM and the overall incidence of CM was 19.3% (22/114). The incidence of CM was 19.7% (13/66) in non-recurrent cases and 18.8% (9/48) in recurrent cases, and there was no significant difference between two groups (P=0.899). The incidence of CM was 17.6% (9/51) in cases with primary tumor in the fourth ventricle, 7.1% (1/14) in cases with primary tumor in the cerebellar vermis, 21.4% (3/14) in cases with primary tumor in both fourth ventricle and cerebellar vermis, 45.5% (5/11) in cases with primary tumor in fourth ventricle and other parts of the brain, and 50.0% (4/8) in cases with primary tumor in cerebellar vermis and other parts of the brain. No CM incidence was observed in cases with primary tumor in central nerve system except for the fourth ventricle and cerebellar vermis. The incidence of CM between the cases with fourth ventricle/cerebellar vermis involvement and those without fourth ventricle/ cerebellar vermis involvement had significant difference (P=0.039). Conclusions　There is no relationship between CM and relapsed MB. Children with MB whose primary tumor is located in the fourth ventricle and/or the cerebellar vermis is susceptible to CM.

Relation of oxygen-induced apoptosis of alveolar epithelial cells with surfactant protein C and surfactant protein D in neonatal rats

GAN Yanzi, HAO Jinli, ZENG Qiyi,YANG Peng

. 2015, 33(9):  817.  doi:10.3969 j.issn.1000-3606.2015.09.015

Abstract ( 333 )   PDF (2558KB) ( 279 )  

Related Articles | Metrics

Objective 　To study the change of the pulmonary surfactant protein C, D (SP-C, SP-D) and apoptosis of alveolar epithelium cells in neonatal rats with hyperoxia-induced lung injury. Methods　The neonatal rats born within 24 hours were divided into the air group (n=50) and the hyperoxia group (n=50). The lung tissue was collected on the first, third, seventh, tenth, fourteenth day after the hyperoxia exposure. The pathological changes were observed by HE staining. The apoptosis rate of lung epithelial cells was detected by TUNEL (terminal deoxyn ucleotidyl transfer-mediated end labeling). The content of SP-C and SP-D in broncho alveolar lavage fluid (BALF) was detected by enzyme-linked immunosorbent assay. Results　In the air group, as age increased, the alveolar were gradually more completely formed with the regular shape and uniform size. Meanwhile, in the hyperoxia group, as age increased, the number of alveolar was reduced, the small blood vessels expanded, the alveolar hemorrhage was increased, the interstitial cells were increased and the lung tissue was swelling. The levels of SP-C, SP-D decreased with the increase of age in the air group. The level of SP-C in hyperoxia group was lower than that in the air group on the first day. It was higher than that in the air group on the third day, peaked on the seventh day, and then it began to decline on the tenth day and decreased more obviously on the fourteenth day. The level of SP-D in hyperoxia group was not significantly different from that in the air group on the first day, was higher than that in the air group on the third day and peaked on the seventh day. Then it began to decline on the tenth day and decreased more on the fourteenth day. Conclusions　Long-term inhalation of high concentrations of oxygen inhibits alveolar development. With the prolonged time of oxygen inhalation, the apoptosis of lung epithelial cells is increased, and the level of SP-C and SP-D in BALF was increased first and then decreased.

Research progress in diagnosis of early-onset neonatal sepsis

LU Jiangyi

. 2015, 33(9):  822.  doi:10.3969 j.issn.1000-3606.2015.09.016

Abstract ( 307 )   PDF (1120KB) ( 634 )  

Related Articles | Metrics

Early-onset neonatal sepsis (EONS) is one of the major causes of mortality in neonates, especially in very low irth weight infants. EONS has no specific manifestations, and progresses rapidly and unexpectedly. EONS is often missed diagnosed r even misdiagnosed due to the absence of ideal diagnostic methods in current clinical practice, and this dilemma leads to he high mortality of EONS. Therefore the accurate diagnosis in the early stage of EONS is very important. This review describes the progress in diagnostic methods of EONS including culture, blood cell counts, molecular biological technique, procalcitonin and C-reactive protein measurements, cytokine profiling and some other novel means. It may provide useful information for early diagnosis of EONS.

Mitochondrial cardiomyopathy

PENG Huiyun

. 2015, 33(9):  827.  doi:10.3969 j.issn.1000-3606.2015.09.017

Abstract ( 372 )   PDF (1046KB) ( 484 )  

Related Articles | Metrics

　Mitochondria are the energy factory of all the cells, the center of aerobic metabolism, and essential for the metabolism of cells. Mitochondrial cardiomyopathy refers to myocardial damage caused by mitochondrial dysfunction and is characterized by cardiac structural and (or) functional abnormalities. The typical clinical feature of mitochondrial cardiomyopathy is hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmias, noncompaction of left ventricular and heart failure. This article focuses on the pathophysiology, clinical manifestations and possible treatments of mitochondrial cardiomyopathy.

The progress in defensin research

HU Qingfeng

. 2015, 33(9):  831.  doi:10.3969 j.issn.1000-3606.2015.09.018

Abstract ( 280 )   PDF (1088KB) ( 405 )  

Related Articles | Metrics

Defensin is a cysteine-rich, low molecular weight and cationic antimicrobial peptide. Human breast milk contains high level of defensin. The defensin in human breast milk can not only inhibit the growth of various pathogenic microorganisms, but also promote the development of infant immune system and reduce the incidence of infantile upper respiratory infection. Nowadays, the roles of defensin in breast milk is more recognized. This paper focuses on the molecular characteristics of human defensin, its antibacterial and antiviral roles, and the latest progress in defensin research.