Journal of Clinical Pediatrics

Clinical comparison between early-onset and late-onset necrotizing enterocolitis in full-term infants

　LI Qiuyu, AN Yao, LIU Li, RAN Yalin, LI Luquan

. 2017, 35(3): 161. doi:10.3969/j.issn.1000-3606.2017.03.001

Abstract ( 381 )

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　Objective　To explore the relevant factors that impacted the morbidity and prognosis of early-onset and late-onset necrotizing enterocolitis (NEC) in full-term infants. Methods　A total of 253 full-term infants with NEC hospitalized during 1996 to 2015 were retrospectively analyzed. They were divided into early onset group (onset within one week of birth, n=150) and late onset group (onset after one week of birth, n=103) according to their onset time. The perinatal conditions, co-conditions and complications between two groups were compared. Results　The average gestational age of the early onset group was older than that of late onset group (39.2±1.2 vs. 38.8±1.1), and the morbidity of NEC III stage (27.3% vs.12.6%) and peritonitis (20.7% vs.8.7%) were higher in early onset group than those in late onset group. The differences were statistically significant (P all>0.05). In the early onset group, the proportion of deceased infants with NEC III stage, peritonitis, septicemia, respiratory failure, renal dysfunction, shock, and multi-organ functional disturbance in infants died finally were higher than those survived. In the late onset group, the proportion of infants with NEC III stage, peritonitis, septicemia, respiratory failure, renal dysfunction, and shock in infants died finally were higher than survived infants. The differences were statistically significant (P all>0.05). Logistic regression analysis showed that the risk factors of poor prognosis in early onset group were peritonitis (OR=17.49, 95% CI: 5.89-51.93, P<0.001) and renal dysfunction (OR=10.33, 95% CI: 2.7-154.17, P=0.003), while those in late onset group were peritonitis (OR=20.58, 95% CI: 3.62-116.85, P=0.001) and respiratory failure (OR=12.03, 95% CI: 1.33-109.14, P=0.027). Conclusions　The condition of early-onset NEC was more severe than that in late-onset NEC in full-term infants. In addition, in full-term infants, peritonitis and renal dysfunction were risk factors of poor prognosis in early-onset NEC, and peritonitis and respiratory failure were risk factors of poor prognosis in late-onset NEC.

Neonatal necrotizing pneumonia: two case report and literature review

　ZHANG Ke, ZHOU Jianguo, HU Lan, DENG Yingping, CHEN Chao

. 2017, 35(3): 166. doi:10.3969/j.issn.1000-3606.2017.03.002

Abstract ( 417 )

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Objective　To explore the clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia. Methods　The clinical data of two cases of neonatal necrotizing pneumonia were retrospectively analyzed. The clinical features, diagnosis, and treatment of neonatal necrotizing pneumonia in literatures were summarized. Results　Two cases were diagnosed of community-acquired Staphylococcus aureus necrotizing pneumonia and had the onset with fever. The chest X-ray showed exudative change with cystic shadow. The chest CT showed multiple cavity changes. The sputum and blood cultures were positive for Staphylococcus aureus. Both of them were effectively treated by vancomycin. The imaging was improved during the follow-up. Searching the database, 4 related literatures were being found, and there were totally 7 cases of neonatal necrotizing pneumonia including current 2 cases. The main features were as follows: The pathogenic bacteria in all cases include Staphylococcus aureus. One case was combined with pseudomonas aeruginosa. Six cases were community-acquired infections. All of them were non-immune deficiency newborn. Six cases were primary necrotizing pneumonia. Six cases were unilateral lung involvement. Five cases got fever, 5 cases had septicemia, 3 cases had pleural effusion, 2 cases had aerothorax, one case had bronchial chest and 2 cases had extrapulmonary infection. The C-reactive protein was increased in all cases. Three cases need mechanical ventilation. Six cases had a good prognosis. Conclusions　The main pathogenic bacterium in neonatal necrotizing pneumonia was Staphylococcus aureus. The diagnosis was mainly depends on the typical imaging and pathogenic examination. The treatment is mainly the use of antibiotic for gram positive cocci.

The clinical feature of neonatal pertussis

　LI Xiaowen, WANG Xueqiu, LI Luquan

. 2017, 35(3): 170. doi:10.3969/j.issn.1000-3606.2017.03.003

Abstract ( 347 )

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　Objective　To explore the clinical feature of neonatal pertussis. Methods　The clinical data of 29 neonates with pertussis admitted during 2012 to 2016 were retrospectively analyzed. Results　In 29 neonates only 1 had a history of exposure to pertussis. All of the cases had paroxysmal cough (100.0%), 22 cases had vomit after cough (75.9%), 16 cases had spasmodic cough with cyanosis (55.2%), 7 cases had crow-like echo (24.1%), and 4 cases had apnea (13.8%). 15 cases had positive deep sputum culture, and totally 16 strains of pathogenic bacteria were isolated. In addition, 4 cases were combined with respiratory syncytial virus infection. All of the patients were treated with azithromycin or clindamycin. 19 cases were recovered, 8 cases improved, and 2 cases abandoned treatment. Conclusions　Neonatal pertussis infection is occult, and usually has no clear contact history of pertussis. The clinical feature was mainly paroxysmal cough. The crow like echo was seldom. Pertussis cannot be completely excluded in neonates with positive respiratory syncytial virus.

Clinical analysis of 9 cases of neonatal septicemia caused by Lester bacteria

. 2017, 35(3): 173. doi:10.3969/j.issn.1000-3606.2017.03.004

Abstract ( 423 )

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　Objective　To explore the clinical features of neonatal septicemia caused by Lester. Methods　The clinical features of septicemia caused by Lester bacteria in 9 neonates confirmed by blood culture during from January 2011 to June 2016 were retrospectively analyzed. Results　All of the 9 cases were premature and cesarean delivery. The main clinical manifestations were cyanosis (7 cases), fever (5 cases), anhelation (4 cases), hypomyotonia (4 cases), and respiratory distress (3 cases). Blood cultures in 9 cases were detected Lester bacteria with 3 cases found in sputum and 1 case in both sputum and cerebrospinal fluid. Drug sensitivity test showed that Lester bacteria were sensitive to ampicillin, penicillin, and sulfamethoxazole. All of the 9 cases adjusted anti-infective medications after the diagnosis of Lester septicemia by blood culture, and all of them were cured or improved, and discharged. Conclusion　Neonatal Lester infection is a serious infectious disease. Fever in pregnant women should alert clinicians to Lester infection. Early detection of pathogens and targeted treatment can help improve prognosis.

Misdiagnosis of incomplete Kawasaki disease in neonate: a case report and literature review

XIONG Peng，LIU Tonglin，CHEN Yu，ZHANG Wei

. 2017, 35(3): 176. doi:10.3969/j.issn.1000-3606.2017.03.005

Abstract ( 353 )

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　Objective　To explore the clinical features, diagnosis, and treatment of Kawasaki disease in neonates. Methods　The diagnosis and treatment of incomplete Kawasaki disease in one case were retrospectively analyzed. The related literatures were reviewed. Results　Male infant had persistent fever with rash at 26 days after birth. The anti-infective treatment was ineffective. No abnormality was found in the first coronary artery ultrasonography. However, coronary artery dilatation was confirmed by ultrasonography after skin peeling at fingertips. After the treatment of gamma globulin and aspirin, the symptoms of fever and rash were improved. The left dilated coronary artery returned to normal after 3 month. The size of coronary artery and the corresponding indexes were normal in 6-months, 1-year and 3 year follow-ups. Conclusion　Neonatal Kawasaki disease is rare and atypical.

Analysis of SLC37A4 gene in 3 cases of glycogen storage disease type Ib　

　YUAN Yuheng, LIU Yan, QIU Zhengqing

. 2017, 35(3): 179. doi:10.3969/j.issn.1000-3606.2017.03.006

Abstract ( 632 )

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Objectives　To analyze SLC37A4 gene mutations in glycogen storage disease type Ib patients and to investigate the correlation between genotype and phenotype. Methods　The clinical data and SLC37A4 gene detection results of 3 cases of glycogen storage disease type Ib were analyzed retrospectively. Results　Two males and one female aged 6 years, 9 years, and 16 years respectively were presented with hepatomegaly, fasting hypoglycemia, slactic academia, hyperlipidemia, and granulocytopenia. The analysis of 6 alleles in SLC37A4 gene by direct sequencing of peripheral blood DNA found 4 mutations, including 2 missense mutation (p. Leu23Arg and p.Pro191Leu), one shear mutation (c.870+5G>A), and one deletion mutation (c.1042_1043 del CT). The genotypes of these 3 cases were p.Pro191Leu, p.Pro191Leu；p. Leu23Arg, c.870+5G>A；p.Pro191Leu, p.Leu347ValfsX53 respectively. Conclusions　There were 4 mutations detected among these 3 cases of glycogen storage disease type Ib. All of those were known mutations. The most common mutation was p.Pro191Leu. It can not be excluded that P.Gly149Glu homozygous mutation is associated with repeated infections.

The clinical feature, pathology, and prognosis of Kimura disease complicated with nephrotic syndrome in children　

LI Zhijuan, ZHANG Xiaoge, BAO Ying, CHEN Guoqiang, TANG Jun, HUANG Huimei

. 2017, 35(3): 183. doi:10.3969/j.issn.1000-3606.2017.03.007

Abstract ( 400 )

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　Objective　To explore the clinical feature of Kimura disease complicated with nephrotic syndrome in children. Methods　The clinical data from 4 children with Kimura disease complicated with nephrotic syndrome were retrospectively analyzed. Results　In all of the 4 male children, level of serum IgE was increased but level of eosinophils was not increased in peripheral blood. The renal pathological manifestations were different among them. Two cases had acute tubular injury, one case had pathological changes in repeated renal biopsy, and one case had a little of eosinophils infiltration in renal interstitium. All of them were sensitive to oral hormone treatment. Except that one case had no relapse yet in short follow-up period, the other 3 cases had relapsed and all manifested as positive urinary protein without lymphadenectasis. The 3 cases with recurrence were treated by combined immunosuppressive agents, the palindromia of two cases were reduced which were combined with tacrolimus. Conclusion　The Kimura disease complicated with nephrotic syndrome in children has a long course and different renal pathological manifestations. It is sensitive to hormone treatment but easy to relapse, and the treatment should be combined with immunosuppressive therapy. Tacrolimus may have the effect on reducing relapse and delaying the progress of renal pathology.

Effect of human leukocyte antigen B*1502 genotype and age on serum homocysteine levels in children with seizures or epilepsy

ZHANG Chun, HE Dake, HUANG Xiaohui, WEI Xin, MA Jing, QI Jia, LIU Yan, XU Ajing, BO Shuhong

. 2017, 35(3): 187. doi:10.3969/j.issn.1000-3606.2017.03.008

Abstract ( 329 )

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　Objective　To explore the effect of human leukocyte antigen B* genotype and age on serum homocysteine (Hcy) levels in children with seizures or epilepsy. Methods　Fifteen children with seizures or epilepsy in whom HLA-B*15:02 genotype was detected during October 2015 to June 2016 were included. The plasma Hcy concentration in children with different genotypes was compared. The association of Hcy concentration and age was performed by linear-regression analysis. Results　The mean concentration of Hcy was 8.38±4.23 μmol/L in children not carrying HLA-B*15:02 gene, which was obviously higher than that in children carrying HLA-B*15:02 gene 13.03±0.97 μmol/L (P<0.05). The Hcy concentration increased with the age (r2 =0.29, P<0.05). Conclusions　Elder children with seizures or epilepsy carrying HLA-B*15:02 gene tend to have higher Hcy concentration and increased potential risk of disease. HLA-B*15:02 gene type and age can predict the changes of Hcy concentration in children with convulsions.

Clinical analysis of 46 cases of childhood visceral leishmaniasis

HE Fang

. 2017, 35(3): 191. doi:10.3969/j.issn.1000-3606.2017.03.009

Abstract ( 442 )

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　Objective　To study the clinical characteristics, diagnosis and treatment of childhood visceral leishmaniasis. Methods　A retrospective analysis of 46 cases of children with visceral leishmaniasis was performed, epidemiological and clinical characteristics, laboratory and special inspection, diagnosis and treatment were analyzed. Results　All 46 cases (27 males and 19 females) were mostly from the epidemic area and sporadically happened in spring, autumn, and winter, lacking of specific symptoms. Clinical features include long-term and repeated fever, anemia, abdominal distention and respiratory infection, the most common feature is fever accompanied with liver, spleen and lymph node enlargement. Laboratory tests were mainly found with anemia, pancytopenia in peripheral blood , damaged liver function, and elevated CRP. Bone marrow cytology smear found duchenne body- in 26 cases, the positive rate was 61.36%. Visceral leishmaniasis serological antibody were positive in 28 patients, positive rate was 96.29% (28/30). 30 cases were treated with meglumine antimoniate, 26 cases were cured, 3 cases died, and 1 case were not cured and discharged from the hospital. The treatment effective rate was 86.67%. Conclusions　Childhood visceral leishmaniasis is still popular in recent years lacking of characteristic clinical symptom. Therefore, for the patients in the epidemic area who presented with long-term fever, anemia, or pancytopenia in peripheral blood, hepatosplenomegaly (especially the splenomegaly), and liver function damage, bone marrow puncture, visceral leishmaniasis antibodies and/or RK39 dipstick test and relevant auxiliary examination should be considered for early diagnosis and treatment, thus to reduce the complications and to improve the cure rate.

Congenital disorder of glycosylation type 1a: a case report

WANG Haijun, LU Xiangpeng,LU Tingting, ZHENG Hong, DING Yuan,LI Dongxiao,QIN Yaping,YANG Yanling，CHENG Yibing

. 2017, 35(3): 195. doi:10.3969/j.issn.1000-3606.2017.03.010

Abstract ( 897 )

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Objective　To explore the clinical features, diagnosis, and treatment of congenital disorder of glycosylation type 1a (CDG-Ia), a rare inherited metabolic disease. Methods　The clinical data and the gene detection results of one case of CDG-Ia which was discovered because the case had encephalopathy and hepatopathy were retrospectively analyzed. The related literatures were reviewed. Results　Male infant suffered with face and trunk rash, motor development retardation, malnutrition, cheek fat plump, low limbs muscle tone, and bilateral crater nipple at 3 months old. Abnormal liver function and mild renal impairment were found after examination. The development quotient was low. Head MRI showed that bilateral frontal and temporal sulcus widening, and cerebellar atrophy. Urinary organic acids, amino acids, carnitine, and biotin activities were normal. Gene sequencing revealed that there were two heterozygous mutations, c.430T>C (p.F144L) and c.713G>C (p.R238P), in the PMM2 gene. The diagnosis of CDG-Ia was confirmed. Both of the infant’s parents were healthy, and each of them carries a pathogenic mutation. The infant had an elder brother who had mental disorder and died for liver and kidney function damage and hydronephrosis at 8 months old. Conclusion　CDG-Ia is an autosomal recessive disease. For infants with unexplained multiple organ damage, especially combined with intelligent and motor development retardations, strabismus, nipple retraction, and cerebellar atrophy, the possibility of CDG-Ia should be considered. Gene detection of PMM2 can help the diagnosis.

Van Wyk-Grumbach syndrome in children: a case report and literature review

　ZHANG Dongguang, YANG Yu, YANG Li

. 2017, 35(3): 199. doi:10.3969/j.issn.1000-3606.2017.03.011

Abstract ( 424 )

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　Objective　To explore the early diagnosis and treatment of Van Wyk-Grumbach syndrome (VWGS). Methods　The clinical data of a child with VWGS were retrospectively analyzed. The related literatures were reviewed. Results　Nine-year-old female presented with growth retardation and obesity for 3 years, combined with breast development for 6 months and vaginal bleeding for 3 month. The level of free thyroxine (FT4) was 0.46 ng/dL and thyrotropin (TSH) >150 mIU/L. The GnRH stimulation test showed that the gonad axis was not activated. The serum prolactin and estradiol were significantly increased. Bone age was delayed. Color Doppler ultrasound showed enlarged uterus and enlarged ovary, and ovarian cyst was seen. Pituitary MRI showed hyperplasia of the pituitary gland. The patient received the treatment of Euthyrox, and 2 months later, thyroid function was back to normal, ovaries were significantly reduced by reexamine of color doppler ultrasound, body weight was reduced by 6 kg, and there was no vaginal bleeding. Three months later, both ovaries returned to normal size, and pituitary MRI showed hyperplasia of adenohypophysis was improved. After 6 months, both of uterus and ovary were turn to normal size, ovarian cyst disappeared, and pituitary MRI showed normal. Conclusions　VWGS is a rare complication of severe primary hypothyroidism untreated for long time and it mainly occurs in adolescent girls. Thyroid replacement therapy is effective.

Isolated hypogonadotropic hypogonadism by GnRHR gene mutation: a pedigree report and literature review　

CHENG Qing, LI Xin, LI Juan, DING Yu, WANG Jian, WANG Xiuming

. 2017, 35(3): 203. doi:10.3969/j.issn.1000-3606.2017.03.012

Abstract ( 385 )

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Objective　To explore the clinical feature, gene mutations and treatment of isolated hypogonadotropic hypogonadism (IHH). Methods　The clinical data from a case of IHH and his families were retrospectively analyzed. The related literatures were reviewed. Results　The propositus was a 7-year-old boy with a small penis and testes, whose younger brother was 5-year-old with a small penis and cryptorchidism. In both boys testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) levels were low. The GnRH provocation test was not reactive. Their parents denied the consanguineous marriage. Illumina sequencing revealed that both of the brothers had homozygous mutation of GnRHR gene in C.806C>T, and their parents were heterozygous mutations in C.806C>T gene. After confirmation of the diagnosis, human choronic gonadotropin (hCG) treatment was given. The levels of testosterone and dihydrotestosterone were significantly increased after 6 weeks. Conclusion　The combination of clinical phenotype, biochemical analysis, and gene detection is helpful for early diagnosis of IHH.

Genetic analysis of Cornelia de Lange syndrome in one case　

YANG Baowang, XU Lingyang, WANG Aihua

. 2017, 35(3): 207. doi:10.3969/j.issn.1000-3606.2017.03.013

Abstract ( 491 )

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　Objective　To explore the clinical features and gene mutation types of Cornelia de Lange syndrome (CdLS), an inherited metabolic disease. Methods　The clinical data and gene detection results of one case of CdLS were retrospectively analyzed. Results　Two-year-old male had special appearance, microcephaly, bushy eyebrows with both sides meeting in the midline, long curly eyelashes, low body mass, and motor and mental retardation. NIPBL gene detection found the variation of the nucleotide in c.7176T>A (nucleotide 7176 in coding region changed from T to A). Conclusions　CdLS is a rare congenital inherited metabolic disease. The clinical manifestations were special appearance and signs. The c.7176T>A mutation in NIPBL gene has not been reported at home and abroad.

Childhood primary bladder telangiectasia: a case report and literature review

ZHANG Hongwen, CUI Jieyuan, SU Baige, YAO Yong, XIAO Huijie

. 2017, 35(3): 210. doi:10.3969/j.issn.1000-3606.2017.03.014

Abstract ( 417 )

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　Objective　To explore the diagnosis of primary bladder telangiectasia. Methods　The clinical data of a child with primary bladder telangiectasia were reviewed. Results　A 9-year-old girl had gross hematuria without obvious cause at 3 years old. After that she presented intermittent gross hematuria and persistent microscopic hematuria with blood clots in the urine following repeatedly respiratory tract infections, and had hemorrhagic shock once. Urine routine examination showed albumin 1+~2+ and RBC full in entire field of view. 24 hours urine protein quantitation was 0.96 g. Ultrasound of abdomen and urinary tract and enhanced CT of urinary system had no abnormal findings. Renal artery angiography showed no arteriovenous malformation or fistula. Cystoscopy showed telangiectasia. There was neither family history nor telangiectasia in other parts. Both genetic telangiectasia and ataxia telangiectasia gene mutation analysis were normal. Conclusion　It is rarely seen primary bladder telangiectasia in children. However, children with early onset, long-term, and intermittent gross hematuria with blood clots, especially suffered with hemorrhagic shock, vascular disease should firstly be considered. And routine urinary imaging should be performed, including angiography and ,if necessary, cystoscopy.

Spinal muscular atrophy combined with respiratory distress type I but no respiratory failure: a case report

GUO Li, SUN Longmei, LIU Fang

. 2017, 35(3): 213. doi:10.3969/j.issn.1000-3606.2017.03.015

Abstract ( 343 )

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Objective　To explore the diagnosis and differential diagnosis of spinal muscular atrophy with respiratory distress type I (SMARD1). Method　The clinical data, results of gene detection, and follow-up information of a girl diagnosed with SMARD1 were retrospectively analyzed, and related literatures were reviewed. Results　The girl was born by cesarean section due to oligohydramnios. After birth, she was transferred to neonatology department for poor feeding and response, and diagnosed with neonatal sepsis, infectious shock, disseminated inravascular coagulation and atypical purulent meningitis. She was discharged after one month of treatment. However, at 2 months old, she presented contracture of ankle joint, abnormal liver function, and myocardial damage. At 6 months old, she had obvious reduced muscular tension and development retardation. At 8 months old, the SMA gene was detected and it was normal. At 9 months old, The panel gene of peripheral neuropathy was detected and found 2 heterozygosis mutations in IGHMBP2 gene, exon8 c.1061-2A>G and exon12 c.1708C>T, which came from her father and mother respectively. Locus of exon12 c.1708C>T has been reported to be associated with the disease, and the other is a shear mutation. The diagnosis of SMARD1 was confirmed by the clinical and gene detection. The girl, 2-year-old now, suffered with recurrent respiratory tract infections, but had no respiratory distress or no respiratory failure yet. Conclusion　The clinical phenotype of SMARD1 is complex and diverse. This case is the first domestic case comfirmed by gene detection.

Effects of Quercetin on nerve regeneration in neonatal rats with hypoxic-ischemic brain damage

YANG Qingli, CHEN Yanfeng

. 2017, 35(3): 218. doi:10.3969/j.issn.1000-3606.2017.03.016

Abstract ( 297 )

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Objective　To explore the protective effects of Quercetin on hypoxic ischemic brain damage (HIBD). Methods 　Forty-eight 7-day-old SD rats were randomly divided into sham-operation group, HIBD group and Que treatment group, 16 rats each. HIBD group and Que treatment group were treated by ligation of right common carotid artery to make anoxia and build HIBD model; sham-operation group had the separation of the right common carotid artery only. Que treatment group were injected intraperitoneally with quercetin (40 mg/kg) once a day for 7 days immediately after modeling while sham-operation group and HIBD group received equivalent normal saline at the same time. The rats in each group were scored of neurological function at 1 h after the last administration, and the ability of spatial learning-memory was tested by Morris water maze at the age of 28 days. After performing the test above, all rats were decapitated and the brains were taken. Pathological changes of hippocampus were observed by HE staining; the expression of brain-derived neurotrophic factor (BDNF) and nerve growth associated protein (GAP-43) in hippocampus CA1 area were detected by immunohistochemistry. Results　There were significant differences in neurological deficit score and learning-memory ability among the three groups (P<0.01), and neurological deficit score was the highest and the learning-memory ability was the lowest in HIBD group. Pathological examination showed that the structure of hippocampal neurons was intact in sham-operation group. It was loose and disorder, and even loss of neurons in HIBD group. Compared with the HIBD group, the loose in the structure of hippocampal was lighter, and the number of neurons was increased in the Que treatment group. There was statistical difference in the positive expression of BDNF and GAP-43 in the hippocampal CA1 area among the three groups (P<0.01), with those in HIBD group being lower than in Que treatment group and sham-operation group and those in treatment group being lower than in sham-operation group (P<0.01). Conclusions　Quercetin can enhance the expression of BDNF and GAP-43 in hippocampal CA1 region, promote nerve regeneration, improve the longterm learning-memory ability of HIBD neonatal rats, and protect the brain.

Systematic review of the effectiveness of intratracheal injection of pulmonary surfactant in the treatment of neonatal respiratory distress syndrome　

　XU Fen, LUO Jun, LI Hongping, HUANG Yan, LIN HungChih

. 2017, 35(3): 223. doi:10.3969/j.issn.1000-3606.2017.03.017

Abstract ( 622 )

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Objective　To evaluate the effectiveness of intratracheal injection of pulmonary surfactant (LISA) combined with continuous positive airway pressure (CPAP) on the treatment of neonatal respiratory distress syndrome (RDS). Methods　 The databases of PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database and China Biology Medicine disc (CBM) were searched, and all of the randomized controlled trial of LISA combined with CPAP for treatment of RDS were included. RevMan 5.2 was used to perform meta-analysis. The differences of mortality, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and other complications between LISA group and control group were compared in <34 weeks gestational age preterm infants with RDS. Results　Five randomized controlled trials were included with 759 infants in total. Compared with control group, the rate of mechanical ventilation (RR: 0.32，95% CI: 0.13-0.82) and the incidence of BPD (RR: 0.61，95% CI: 0.42-0.88) were significantly decreased in LISA group. There were no differences in mortality and the incidences of ROP, IVH, and PVL between two groups (P>0.05). Conclusion　The mechanical ventilation and the incidence of BPD is significantly reduced in the treatment of neonatal respiratory distress syndrome by LISA, but it has no effect on the incidences of other complications and mortality.

Progress in research of narcolepsy in children　

ZHAO Xianchao

. 2017, 35(3): 229. doi:10.3969/j.issn.1000-3606.2017.03.018

Abstract ( 332 )

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　Narcolepsy is a chronic rapid eye movement sleep disorder that is characterized by lethargy and its four common clinical features are excessive daytime sleeps, cataplexy, hypnagogic and hypnopompic hallucinations, and sleep paralysis. Narcolepsy onset usually occurs in childhood. Because of the onset with atypical symptoms, the poor expression in children and currently no special diagnostic criteria for children, the rate of missed diagnosis and misdiagnosis were increased in children. This paper reviews the progress of research in pathogenesis of narcolepsy and the differences of children from adult in clinical symptoms, diagnosis and treatment.

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