Table of Content

15 January 2018 Volume 36 Issue 1

  

Analysis of the risk factors of intravenous immunoglobin-resistant Kawasaki diseases

WU Ziming, ZHANG Zhengyu, LUO Zhaoyang, SHI Qinlin, ZHAO Wenlong

. 2018, 36(1):  1.  doi:10.3969/j.issn.1000-3606.2018.01.001

Abstract ( 336 )   PDF (1162KB) ( 313 )  

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Objective　To explore the early laboratory indicators for risk of intravenous immunoglobin-resistant Kawasaki diseases. Methods　The clinical data were retrospectively analyzed in 881 Kawasaki disease patients (group A: 26 cases of intravenous immunoglobin-resistant; group B: 855 cases of intravenous immunoglobin-sensitive) from July 1, 2015 to June 30, 2016. After 1:3 matching with age and sex, the regression model for each of variables including sex, age, fever days, temperature, red blood cell count (RBC), white blood cell count (WBC), neutrophil (N), lymphocyte (L), platelet count (PLT) and C reactive protein (CRP), was constructed by conditional logistic regression analysis. Results　Compared with group B, group A had significantly lower RBC count and higher PLT (P<0.05). Logistic regression analysis showed that, with the age, the regression model was Y=－2.87+0.01×PLT (PLT OR=1.01, 95%CI: 1.00~1.01, P<0.01); with the sex, Y=－32.98+0.44×WBC+0.28×          N+0.01×PLT (WBC OR=1.55, 95%CI: 1.17~2.05, P<0.01; N% OR=1.32, 95%CI: 1.04~1.68, P<0.05; PLT OR=1.01, 95%CI 1.00~1.01, P<0.01). Conclusion　In case that abnormally high levels of PLT exist in confirmed Kawasaki disease, it should be aware of possibility of the intravenous immunoglobin-resistant Kawasaki disease.

The role of costimulatory molecule CD40 in childhood eosinophilic gastroenteritis and its mechanism

FU Qiang, FENG Qihua, YU Konggui, TANG Linfei, LI Aimin

. 2018, 36(1):  5.  doi:10.3969/j.issn.1000-3606.2018.01.002

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　Objective　To explore the dynamic changes and significance of costimulatory molecules CD40 and lymphocyte subsets in peripheral blood of children with eosinophilic gastroenteritis (EG). Methods　The CD40 expression and lymphocyte subsets in peripheral blood were detected by flow cytometry (FCM) in 15 children with EG (acute stage and remission stage) and 15 healthy controls. The level of serum interleukin (IL) -4 was detected by enzyme-linked immunosorbent assay (ELISA). The eosinophil (EOS) was count by blood cell analyzer. Results　In acute stage, the children with EG had significantly higher expression of CD40, CD3+, CD4+, CD4+/CD8+, and CD19+CD23+ in peripheral blood, higher serum IL-4 level, higher EOS count and lower CD8+ than in remission stage and control group (P all<0.05). There were no differences between remission stage and control group (P>0.05). In acute stage, the expression of CD40 in peripheral blood in children with EG was positively correlated with the expression of CD4+ and IL-4 (P all<0.05). Conclusions　CD40 may be involved in the pathogenesis of EG. That the increase of IL-4 secreted by CD4+ T cells that were induced by CD40 results in abnormal increase of EOS may be one of mechanisms of the pathogenesis of EG.

Association of STAT3 gene polymorphism with susceptibility to Henoch-Scho ..nlein purpura　

ZHONG Fangfang, ZHUANG Yuan, MAO Xiaoyan, ZHOU Taiguang, CHEN Hongying, HU Xiao, ZOU Yan, LIU Chunyan, YANG Hong, LIU Wenjun

. 2018, 36(1):  9.  doi:10.3969/j.issn.1000-3606.2018.01.003

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Objective　To explore the relationship of two loci (rs2293152, rs9579700) gene polymorphisms of signal transduction and transcription factor-3 (STAT3) with susceptibility to Henoch-Scho ..nlein purpura (HSP) and HSP nephritis (HSPN). Methods　From September 2013 to September 2015, 180 children with HSP (group HSP) and 205 healthy children (control group) were enrolled in this study. Single nucleotide polymorphism (SNP) of intron 11 rs2293152C/G and intron 23 rs957970C/T of STAT3 gene was detected by sequence specific primer polymerase chain reaction (SSP-PCR). Results　The frequency of CC genotype in STAT3 gene intron 11 rs2293152 in HSP group (26.1%) was significantly higher than that in control group (8.8%), and the frequency of allele gene of rs2293152C in HSP group (48.6%) was significantly higher than that in control group (32.7%) (P=0.013, 0.025). There were no differences in distribution of genotype and allele in rs957970C/T loci of intron 23 of STAT3 gene between two groups (P>0.05). The frequencies of genotype and allele of the two loci of STAT3 gene were no difference between HSPN and non HSPN groups (P>0.05). Conclusions　The allele gene C of intron 11 rs2293152C/G of STAT3 gene may be a susceptible gene of HSP, while there was no association of 23 rs957970C/T polymorphism to HSP and there was no association of the two loci polymorphisms to HSPN.

Comparative study of coronary artery lesions in complete and incomplete Kawasaki disease

　ZHANG Danfeng, ZHONG Jiarong, WANG Dan

. 2018, 36(1):  14.  doi:10.3969/j.issn.1000-3606.2018.1.004

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Objective　To explore the difference of coronary artery lesions (CAL) in complete Kawasaki disease (cKD) and incomplete Kawasaki disease (iKD) in children. Methods　The clinical data of 1 514 hospitalized children with KD from January 2014 to December 2015 were retrospectively analyzed and compared between the children with cKD and those with iKD. The risk factors of CAL were analyzed. Results　There were 1 094 cases (72.3%) of cKD and 420 cases (27.7%) of iKD in 1 514 children with KD. The incidence of CAL in all KD children was 51.9%. And the incidence of CAL in cKD group and iKD group was 57.2% and 37.9%, respectively, and there was statistical difference (P<0.01). The distribution of different degrees of CAL between cKD group and iKD group was statistically different (P<0.01). The incidence of echo enhancement or small coronary artery aneurysm in cKD group (50.4%) was higher, and the incidence of giant coronary artery aneurysm in iKD group (2.4%) was relatively higher. The incidence of thrombosis in iKD group was 3.3%, which was significantly higher than that in cKD group (0.6%) (P<0.001). The time when CAL was found first by clinical ultrasound echocardiography in cKD group and iKD group were 7.842.97 d and 8.472.89 d, respectively, and there was statistical difference (P<0.05). The most frequent involvement was left main trunk in CAL in children with KD. The proportion of simultaneous involvement of the left and right coronary arteries, only right stem involvement, and whole left coronary artery involvement in were significantly higher cKD group than those in iKD group, while the proportion of left main trunk involvement was significantly higher in iKD group than that in cKD group (all P<0.05). Male and iKD were the high risk factors for CAL, and intravenous infusion of immunoglobulin (IVIG) in 5~10 days of the course of disease was the protective factor for CAL. Conclusions　CAL, especially giant coronary artery aneurysms and thrombosis, are more common in children with iKD. In iKD, the left coronary artery is mainly involved in CAL, and in cKD, the simultaneous involvement of left and right coronary arteries is the most common in CAL. Standard use of IVIG can reduce the occurrence of CAL.

Clinical features and genetic characteristics of primary immunodeficiency disease with skin symptoms in 15 children

HE Tingyan, HUANG Yanyan, QI Zhongxiang, LUO Xianze, YANG Jun

. 2018, 36(1):  19.  doi:10.3969/j.issn.1000-3606.2018.01.005

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Objective　To explore the clinical features and genetic characteristics of primary immunodeficiency disease (PIDs) with skin symptoms in children. Methods　The clinical data of PIDs with skin symptoms in 15 children from January 2014 to March 2017 were analyzed retrospectively. Results　The median age at onset in 15 children was 4 months (neonatal period to 11 years 8 months). All of them showed obvious skin symptoms, including eczema or chilblain rash, pustular psoriasis, skin infections, subcutaneous hemorrhage or skin ecchymosis, ichthyosiform erythroderma, progeroid appearance, or other cutaneous vasculitis. The accompanying manifeslations included recurrent infections, auto inflammation, autoimmunity, growth retardation, or lymphoid proliferation, and impairment of brain, lung, kidney and other important organs. Eosinophil counts were increased in 5 children, IgE levels were elevated in 5 children, and 4 children were abnormal in both indicators. Gene detection showed WAS, RNASEH2C, NLRP12, IL36RN, NRAS, PIK3CD, STAT1, FOXP3, STAT3, DOCK8, TYK2, SPINK5, NBAS or ITGB2 gene mutations, respectively. Two children died from multiple organ dysfunction syndrome, 1 child was lost for follow up, the remaining 12 children survived and were under the individualized treatment. Conclusions　A variety of PIDs can have skin symptoms. When accompanied by recurrent infections, auto inflammation, autoimmune, growth retardation, or lymph proliferation, PIDs should be considered, and gene detection is helpful for the diagnosis.

Clinical characteristics and follow-up of Hashimoto encephalopathy in children

LI Jiuwei, DING Changhong, WU Yun, ZHANG Weihua, GONG Shuai, CHEN Chunhong, FANG Fang

. 2018, 36(1):  25.  doi:10.3969/j.issn.1000-3606.2018.01.006

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Objective　To explore the clinical characteristics of Hashimoto encephalopathy (HE) in children. Methods　The clinical data of 4 children with HE were analyzed retrospectively. Results　All the 4 cases were school-age children and 3 of them were girls. They were physically healthy before onset. The main clinical manifestations were epileptic seizures in 3 cases, mental symptoms in 2 cases, disturbance of consciousness in 2 cases, stroke like symptoms in 1 case, decreased memory and decreased sleep in 1 case. Electroencephalogram showed that the background activity was decreased in 4 cases, and MRI showed abnormal in 3 cases. Serum thyroid antibodies were significantly increased in 4 cases, and were returned to normal in 2 cases when clinical symptoms disappeared, while they were significantly reduced, but not completely back to normal in another 2 cases. Only one out of 4 cases had abnormal thyroid function. All the 4 cases responded well to corticosteroid therapy. One of them relapsed after discontinuation of the therapy, but it was still effective when the therapy was reassumed. Conclusions　HE is rare in children. When there are manifestations of unknown cause, such as epileptic seizures, mental disorders, cognitive impairment, movement disorders and disturbance of consciousness, HE should be considered. In addition, the increase of serum thyroid antibody should be considered as a necessary condition for diagnosis.

The clinical and pathological features of capillary endothelial proliferative purpura nephritis in 50 children

QIN Li, LIU Yan, LI Ping, WANG Yajun, TANG Chunhui, LI Li

. 2018, 36(1):  30.  doi:10.3969/j.issn.1000-3606.2018.01.007

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Objective　To investigate the clinical and pathological characteristics of Henoch-Schönlein purpura nephritis with diffuse capillary endothelial cell proliferation as pathological manifestation. Methods　The clinical manifestations and pathology of capillary endothelial proliferative purpura nephritis (DEP-HSPN) diagnosed by renal biopsy were retrospectively analyzed in 50 children in recent 5 years. Results　The pathological lesions in 50 cases included simple DEP-HSPN in 11 cases (7 males and 4 females) and capillary endothelial cell proliferation combined with crescents formation (non-simple DEP-HSPN) in 39 cases (27 males and 12 females). There was no significant difference in the course of disease and age between the two groups (P>0.05). The clinical type of 11 cases of simple DEP-HSPN was type III. In 39 cases of non-simple DEP-HSPN, 16 cases were type III and 23 cases were type V. All of the children had hematuria and proteinuria. The incidence of gross hematuria, urine red blood cell count, 24 h urine protein, and serum creatinine levels in children with non-simple DEP-HSPN were significantly higher than those in simple DEP-HSPN group, but the plasma albumin level was significantly lower than that in simple DEPHSPN group. It was easy to have crescent formation in DEP-HSPN, and the rate of crescent formation was 11.1% (5.0%-27.6%). The incidence of segmental lesions and renal tubular interstitial damage was low. All children had non simple IgA deposits in the mesangial area. In the 50 children treated for 1 year, 22 had complete remission, 28 had asymptomatic hematuria, and none had active nephropathy and renal insufficiency. In 32 cases of non-simple DEP-HSPN, the 24 h urinary protein, plasma albumin level, and the incidences of gross hematuria and microscopic hematuria were statistically different before treatment and 1, 3, 6, 12 months after treatment (P<0.01). The 24 h urine protein and gross hematuria gradually decreased with the prolongation of treatment, while the level of plasma albumin was gradually increased. Conclusions　DEP-HSPN is characterized by gross hematuria and proteinuria. The onset is acute and it is easy to have crescent formation. When combined with crescent formation, the clinical symptoms are more severe. The combination of strong immunosuppressive agents and long-term sequential follow-up treatment is effective in acute stage. The prognosis is good.
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The distribution of CTX-M drug resistance genotypes in Escherichia coli isolated from urethra in children and the influence of pH changes on its drug resistance

　KANG Yulin, WANG Lingzhi, HAO Sheng, WU Ying, ZHANG Hong, HUANG Wenyan, ZHU Guanghua

. 2018, 36(1):  35.  doi:10.3969/j.issn.1000-3606.2018.01.008

Abstract ( 359 )   PDF (1221KB) ( 164 )  

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Objectives　To explore the distribution of CTX-M drug resistance genotypes in Escherichia coli isolated from urethra in children and the influence of pH changes on its drug resistance. Methods　A total of 113 strains of Escherichia coli isolated from clean midstream urine in children with urinary tract infection were cultured from October 2013 to May 2014. The drug sensitivity of ESBL-producing Escherichia coli was detected and counted. The distribution of CTX-M drug resistance genotypes were analyzed by PCR and gene sequencing. Different pH environment was established in vitro to evaluate the effect of pH on drug resistance of CTX-M resistant Escherichia coli. Results　In 113 Escherichia coli strains, there were 68 ESBLproducing strains (60.18%), in which rate of drug resistance to meropenem and imipenem were 1.47% and 2.94% respectively. There were 41 strains carried CTX-M drug resistance genotype, which mainly were type CTX-M-14 and type CTX-M-15, 18 strains each. Compared with neutral environment of the pH value at 6 or 6.5, the rate of Escherichia coli resistant to cefuroxime, cefotaxime, ceftazidime and ceftriaxone had no difference (P>0.05), while the resistance to cefepime was significantly increased when pH was 6.0 (P<0.01). With the pH value at 8 or 8.5, the rate of Escherichia coli resistance to ceftazidime and cefepime was significantly decreased, and with the pH value at 8.5 the rate of Escherichia coli resistance to cefotaxime also significantly decreased (P<0.01). Conclusions　The rate of ESBL-producing Escherichia coli resistance to carbapenem antibiotic is low. The rate of Escherichia coli carrying CTX-M drug resistance genotype is high with CTX-M-14 and CTX-M-15 being the most prevalent genotypes. Properly alkalization of urine may contribute to the treatment of CTX-M resistant Escherichia coli in children with urinary tract infection.

A matched case-control study on perinatal risk factors of early onset thrombocytopenia in full-term small for gestational age infants

　JIANG Yajun, CHEN Shi, WANG Xueqiu, LI Luquan

. 2018, 36(1):  40.  doi:10.3969/j.issn.1000-3606.2018.01.009

Abstract ( 374 )   PDF (1203KB) ( 224 )  

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Objective　To explore the perinatal risk factors of early onset thrombocytopenia (EOT) in full-term small for gestational age infants. Methods　A 1:1 or 1:2 matched case control study was carried out. A total of 93 full-term small for gestational age infants with EOT were selected from April 2008 to July 2014 as the case group, and the non EOT full-term small for gestational age infants with the birth weight difference <250 g and the gestational age difference <3 days were selected as the control group. The clinical data during perinatal period and laboratory examination results after admission were collected retrospectively. And the differences between the two groups were compared. Results　The incidence of intrauterine distress (41.9% vs. 25.8%, χ2=7.35, P=0.007), amniotic fluid contamination (39.8% vs. 27%, χ2=4.66, P=0.031), and early-onset sepsis (39.8% vs. 27%, χ2=4.66, P=0.031) were significantly higher in the case group than those in the control group. Conditional logistics regression analysis showed that intrauterine distress (β=0.60, OR=1.82, 95%CI=1.04~3.17, P=0.035) and early-onset sepsis (β=1.69, OR=5.44, 95%CI=1.11~26.76, P=0.037) were related to EOT. Conclusions　Intrauterine distress and early-onset sepsis are risk factors for the onset of EOT in full-term small for gestational age infants.

Relationship of serum ubiquitin carboxy terminal hydrolase L1 and glial fibrillary acidic protein with brain injury in preterm infants

HUANG Weiling, LU Hongyan, ZHU Haitao, WANG Qiuxia, CHANG Ming

. 2018, 36(1):  44.  doi:10.3969/j.issn.1000-3606.2018.01.010

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Objective　To explore the relationship of serum ubiquitin carboxy terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) with brain injury in preterm infants. Methods　A total of 130 premature infants with gestational age <34 weeks from August 2014 to October 2016 were recruited. Blood samples were collected at 6 h and 72 h after birth. The levels of serum UCH-L1 and GFAP were detected by ELISA method. According to the results of cranial ultrasound and MRI examination, the premature infants were divided into white matter damage (WMD) group, periventricular intraventricular hemorrhage (PVH-IVH) group, and no brain injury group. The levels of serum UCH-L1 and GFAP in preterm infants between the three groups, mild to severe brain injury were compared. Results　At 6 h and 72 h after birth, the levels of serum UCH-L1 and GFAP among no brain injury group, PVH-IVH group and WMD group were significantly different (all P <0.001). The level of serum UCH-L1 and GFAP were the highest in the WMD group and the lowest in no brain injury group at both 6 h and 72 h after birth. The levels of serum UCH-L1 at 72 h after birth were significantly lower than those at 6 h after birth in PVH-IVH group and WMD group, while the levels of serum GFAP at 72 h after birth were significantly higher than those at 6 h after birth in both of the two groups (all P<0.05). The levels of serum UCH-L1 and GFAP in severe PVH-IVH group and severe WMD group were significantly higher than those in the mild group at 6 h and 72 h after birth (all P<0.05). Conclusions　The levels of serum UCH-L1 and GFAP in preterm infants can be used as sensitive markers for early evaluation of brain injury, which can help determine the severity of brain injury in preterm infants.

Clinical characteristics and prognosis of childhood TCF3-PBX1 positive acute lymphoblastic leukemia

WANG Yu， ZHANG Leping，LU Aidong，ZUO Yingxi，WU Jun

. 2018, 36(1):  48.  doi:10.3969/j.issn.1000-3606.2018.01.011

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Objective　To explore the clinical characteristics and relevant factors affecting treatment and prognosis of TCF3-PBX1 positive acute lymphoblastic leukemia (ALL). Methods　The clinical data of 29 children with newly diagnosed TCF3-PBX1 positive ALL from August 2006 to August 2015 were analyzed retrospectively. The expression level of TCF3PXB1 fusion gene was monitored by regular quantitative reverse transcription polymerase chain reaction. The factors influencing prognosis in children with TCF3-PBX1 positive ALL were analyzed. Results　There were 29 children (16 males and 13 females) with a median age of 8 years (9 months to 16 years). The most common immunophenotype was pre-B cell type (pre-B) (58.6%). The karyotype analysis showed that unbalanced translocation was more common (41.4%). The complete remission rate was 100% on thirty-third day in 29 children, but the minimal residual disease (MRD) was not completely negative. Three cases were relapsed, all of whom were MRD positive. Cox multivariate regression analysis showed that age was an independent risk factor for 5 year overall survival (P<0.05). The 5 year overall survival rate and disease-free survival rate were (82±8)% and (81±7)% respectively. Conclusions　Childhood TCF3-PBX1 positive ALL is a highly heterogeneous disease with high rate of complete remission and good long-term efficacy. The risk stratification and individualized treatment is the key to improve the cure rate.

Kabuki syndrome: two case report

　LI Jieling, CAO Jie

. 2018, 36(1):  53.  doi:10.3969/j.issn.1000-3606.2018.01.012

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Objective　To summarize the clinical features and genetic diagnosis of Kabuki syndrome. Methods　The clinical data of Kabuki syndrome in 2 children were retrospectively analyzed. Results　Both of them were male and over 1 year old. They had special facial features and febrile convulsion. Gene detection indicated that both of them had mutation in KMT2D (or MLL2) gene, but the clinical phenotypes were different. Conclusion　Children with clinically suspected Kabuki syndrome can be confirmed by gene detection.

Hypermethioninemia caused by deficient activity of methionine adenosyltransferase

　MA Yanyan, LI Dongxiao, LI Xiyuan, SONG Jingqing, LIU Yupeng, DING Yuan, YANG Yanling

. 2018, 36(1):  57.  doi:10.3969/j.issn.1000-3606.2018.01.013

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Objective　To investigate the clinical and molecular genetic characteristics of hypermethioninemia caused by methionine adenosyltransferase deficiency. Methods　The clinical data and related gene analysis of hypermethioninemia caused by methionine adenosyltransferase deficiency in 3 children were retrospectively analyzed. The core pedigree analysis was carried out. Results　Three children (2 boys and 1 girl) aged from 5 months to 3 years, were from 3 unrelated families. All of them had no family history. One case was found in neonatal screening. One case was onset with pathological jaundice at 1 month old. Another case was found due to tremor and growth retardation at 2 years old. Blood amino acid ester acyl carnitine spectrum analysis showed that all of them had significantly elevated levels of methionine at 134.50-790.67 μmol/L. All children had MAT1A mutation in methionine adenosyltransferase gene. One case was heterozygous mutations with third exon c.274T>C and seventh exon c.895C>T mutation; one case had sixth exon c.757G>A homozygous mutation; and another case had seventh exon c.791G>A homozygous mutation. The core pedigree analysis showed that the mutations were from theirs parents respectively. Conclusions　For children with neurologic impairment, methionine metabolic disorders should be considered. Blood amino acids and gene analysis are important methods for confirmation of the diagnosis. Neonatal screening is an effective way to detect this disease.

Kaposi varicelliform eruption with severe complications: a case report

LUO Yangyang, SHU Ye, LUO Yongqi, CHANG Jing, WEI Zhu, TANG Jianping

. 2018, 36(1):  61.  doi:10.3969/j.issn.1000-3606.2018.01.014

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Objective　To investigate the clinical features and prognosis of Kaposi varicelliform eruption with severe complications. Methods　The clinical data of one child with Kaposi varicelliform eruption with severe complications was retrospectively analyzed. The related literatures were reviewed. Results　A 5-month-old boy presented with recurrent rash on the head and face for 3 months and aggravated for 3 days. The skin lesions showed a characteristic of typical dome-shaped blisters with hemorrhagic crusting. At admission, the boy suffered with severe hypoproteinemia, hypocalcemia, and electrolyte disorder. The hypocalcemia was aggravated gradually. On the fifth day of admission, the boy had fever, convulsions, and tachycardia. Blood culture showed methicillin-resistant Staphylococcus aureus (MASA) infection. The diagnosis of sepsis was confirmed. At that very day, the boy started to have coagulopathy, so Fusidic and Vancomycin for anti-infection, Acyclovir for antivirus, intravenous infusion immunoglobulin, albumin, cryoprecipitate, plasma and calcium gluconate were administered, supplied with albumin and blood coagulation factor. The boy’s condition gradually became stable and discharged on the 19th day after admission. Conclusions　When Kaposi varicelliform eruption is complicated with hypoproteinemia and hypocalcemia, the critical illness is indicated. Clinicians should be alerted to the existence of sepsis, coagulation disorders, even septic shock and disseminated intravascular coagulation.

Effects of erythropoietin on the expression of GFAP and BrdU in hippocampus of neonatal Wistar rats with hypoxicischemic brain damage

WANG Xuqin, CAO Yuntao, DUAN Miao

. 2018, 36(1):  65.  doi:10.3969/j.issn.1000-3606.2018.01.015

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Objectives　To explore the effect of exogenous erythropoietin (EPO) on the expression of glial fibrillary acidic protein (GFAP) in hippocampal CA1 region and 5- bromide -2- uracil (BrdU) in hippocampal DG region in neonatal Wistar rats with hypoxic-ischemic brain damage (HIBD). Methods　Forty-eight Wistar rats aged 7 days were randomly divided into HIBD model group and EPO experimental group, and another 24 rats as sham operated group. The HIBD model was established by ligating the right common carotid artery and inhaling hypoxia gas mixture (8% O2 and 92% N2) for 2 h. The expression of GFAP in hippocampal CA1 region and the number of BrdU positive cells in the hippocampus were detected by immunohistochemical method on at 14 d, 21 d, and 28 d after operation and compared among three groups. Results　On 14 d and 21 d after operation, the expression of GFAP in CA1 region and the number of BrdU positive cells were statistically different among three groups (P<0.01) with EPO experimental group having the highest, HIBD model group having the second highest and sham operation group having the lowest in both, . On 28 d after operation, there was no difference in the expression of GFAP and the number of BrdU positive cells in the DG among three groups (P>0.05). At different time point (14 d, 21 d, 28 d) in every group, the expression of GFAP in CA1 region and the number of BrdU positive cells in DG region were all statistically different (P<0.01), all with the highest on 14 d after operation, second highest on 21 d, and the lowest on 28 d. Conclusions　Early administration of exogenous EPO can promote the expression of GFAP in hippocampal CA1 region and increase the number of BrdU positive cells in DG region, which indicates that EPO can promote the proliferation and regeneration of damaged neurons. EPO had neuroprotective effect on neonatal rats with hypoxic-ischemic brain damage.

Progress in the treatment of infantile spasms

ZHANG Leihong, SUN Dianrong

. 2018, 36(1):  69.  doi:10.3969/j.issn.1000-3606.2018.01.016

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　Infantile spasms (IS) is an age dependent epileptic encephalopathy in early infancy. Early diagnosis and treatment (within 4 weeks of onset) are beneficial to the termination of seizures and long-term cognitive protection. This paper reviewed the related literatures in the treatment of infantile spasms, mainly including the first-line and second-line drugs, the ketogenic diet and surgical treatment, to discuss the recent advances in the treatment of infantile spasms.