Table of Content

06 February 2011, Volume 19 Issue 2

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Metabonomic research based on ¹H-NMR in preterm infants with neonatal respiratory distress syndrome(NRDS)

LIU Xi-hong, SUN Bo, LIU Hai-hong, YAN Xian-zhong, DING Zong-yi, FENG Zhi-chun

2011, 19(2):  104-107. 

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【Objective】 To detect the metabolite profiling and find the early biomarker or biomarkers in preterm infants with neonatal respiratory distress syndrome(NRDS) by a metabonomics technique based on ¹H-NMR. 【Methods】 The preterm infants divided into 2 groups as NRDS group (NRDS) and pneumonia group(pneumonia) with 20 cases respectively. There was no difference in the age, gestational age and birth weight etc. Blood samples were drewed within 30 minutes after admission and the plasma were collected after centrifugalization. The plasma low-molecular mectabolites and lipid were detected. 【Results】 1)The concentrations of lactate, some lipid and alcohol were higher, the concentration of glucose, creatine, glutamine, OAc, NAc, alanine, valine, isoleucine were lower in NRDS group comparing to pneumonia group .2)The concentrations of HC=CH lipid, NAc, PtdCho, LDL and VLDL were lower in NRDS comparing to pneumonia. 【Conclusions】 Preterm infants with NRDS has lactate accumulation and lack the main energy substances like glucose and important amino acids with a lipid metabolic disturbance as while. Metabonomics has a great perspective in preterm infants diseases.

Apply tandem mass spectrometry to determine blood spots amino acids non-derivatized for metabolic diseases

TIAN Guo-li, GONG Zhen-hua, WANG Yan-min, YAO Jing

2011, 19(2):  108-110. 

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【Objective】 The non-derivatized MS/MS method to measure amino acids was established for the detection and screening of the amino acid disorders. 【Methods】 The measurement of amino acids including Alanine(Ala), Arginine(Arg), Citrulline(Cit), Glycine(Gly), Leucine(Leu), Methionine(Met), Methionine(Met), Ornithine(Orn), Phenylalanine(Phe), Proline(Pro), Tyrosine(Tyr) and Valine(Val)involved extraction of dried blood spots with a solution containing 11 stable-isotope labeled internal standards and analysis using a tandem mass spectrometry(MS/MS) system. The precision, accuracy of the method were analyzed and 1 093 high-risk children were screened by MS/MS. 【Results】 The precisions(CV) of the amino acids with lower concentration were in the area of 5.84%～9.57%(within-run) and 13.89%～18.65%(between-run), respectively. The precisions of the amino acids with higher concentration were in the area of 4.57%～8.78%(within-run) and 13.55%～17.25%(between-run), respectively. The derivation in the assay of amino acids varied from 4.24% to 16.16%, the average was 4.10%. 11 patients were positive including four with hyperphenylalaninemia, three with Maple Syrup Urine Disease, two with Citrullinemia, one with tyrosinemia and one with Arginemia. 【Conclusion】 The high precision and accuracy of the non-derivatized MS/MS method provides the values in the clinical application.

Study of refractive development state and clinic affective factors in premature infants without retinopathy during their early life

TONG Mei-ling, WANG Miao, WEI Ning, WU Guang-qiang, ZHANG Gui-ying, XUE Zi-ying

2011, 19(2):  111-113. 

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【Objective】 To explore the development of the refractive status and clinical risk factors in premature infants without retinopathy during their first year after birth. 【Methods】 94 medical health premature infants at 6 months of corrected age during January 2008 to March 2010 were selected, and their refractive development to 12 months were tracked up. Refraction was determined at 6 months, 9 months and 12 months old by Suresight Welch. The impact of gestational age and birth weight on refractive status of premature infants were analyzed. 【Results】 High incidence of astigmatism was found on preterm infants, and it declined with the age increasing. At 9 and 12 months old of corrected age, birth weight was an influencing factor of refractive error in premature infants. At 12 months old of corrected age, gestational age was another important influencing factor of refractive error in premature infants. 【Conclusions】 During the first year after birth, refraction of premature infants is changeable. The incidence of ametropia, especially the degree of astigmatism, is decreased with age increasing. Birth weight and gestational age both are important factors which can influence refraction of premature infants.

Dynamic analysis on the infant mortality rate from 1961 to 2008 in Luwan district of Shanghai municipality

WANG Yi, XU Jing-yi, WU Jian-hua, YUAN Jia-lin, GAO Shu-na

2011, 19(2):  114-116. 

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【Objective】 To monitor the changing trend of infant mortality rate (IMR) in Luwan district Shanghai, observe how IMR affected average life expectancy, in order to take proper measures to reduce the rate. 【Method】 Dynamic series analysis was used to analyze monitoring data of 194 195 cases of live birth, 2 379 cases of infant death in Luwan district Shanghai during 1961—2008. 【Results】 The infant mortality rate and neonatal mortality rate were 25.20‰ and 8.98‰ respectively in 1961.Through intervention,they were reduced to 1.64‰ and 1.64‰ respectively in 2008. The decline speed were 93.50% and 81.76% respectively, which had significant effects on the average life expectancy and death structure. The four leading causes of IMR were congenital malformation, pneumonia, preterm infant and birth trauma and asphyxia. 【Conclusions】 Along with the development of the medical profession in Luwan district, their great effort have been taken to reduce the infant mortality rate. Now we should lay stress on monitoring birth defects and advocate perinatal health care, in order to reduce the IMR and increase the average life expectancy effectively.

Incidence of fetal macrosomia in rural China, 2008

ZHANG Yu-han, HE Dian, HOU Li-yan, GAN Kang, MENG Yu-cui, CHENG Yi-min

2011, 19(2):  117-120. 

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【Objective】 To describe the epidemiological distribution of fetal macrosomia in six counties (2 counties×3 provinces) of rural China. 【Method】 Stratified random cluster sampling was used to sample medical records of all live births in 2008 in 25 research medical institution. 【Results】 17 805 live births were investigated. The macrosomia incidence in rural China was 9.91%(95%CI:9.47,10.35), male for 12.01% and female for 7.54%. The macrosomia incidence in Mengcheng and Biyang County both reached to 15%. Male macrosomia reached to 18%, which was higher six percents than female infants. The incidence of macrosomia born in spring was higher than that of other seasons. Macrosomia incidence trended to rise with the increase of delivery age. Increased macrosomia incidence was observed in women with peasants, more parities, overweight and prolonged pregnancy. Relations between birth check frequency, first birth check week and macrosomia incidence appeared to be U-shaped, all the differences had statistical significance(P<0.05). 【Conclusions】 The 2008 macrosomia incidence in Anhui and Henan have reached to a high level. The male macrosomia incidence is higher than female in rural China. The incidence of macrosomia born in spring is higher and it show significant difference between characteristic maternal population.

Effect of comprehensive rehabilitation on quality of life in children with cerebral palsy

LIN Qing-mei, LIU Zhen-huan, WAN Rui-ping, ZHAO Yong, QIAN Xu-guang, LI Su-ping,MA Mei-mei

2011, 19(2):  121-123. 

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【Objective】 To investigate quality of life in children with cerebral palsy(CP) which were treated with comprehensive rehabilitation. 【Method】 70 children with cerebral palsy aged 2 to 6 years were selected, and measured by PedsQL4.0 before and after comprehensive rehabilitation of 6 months. 【Results】 There were 70 participants with cerebral palsy of mean age(35.3±11.3)months, in all 48 were boy and 22 were girl. For education, in all the 70 cases, 7 children had been in kindergarten. The enrollment rate was 10%. Before comprehensive rehabilitation, the scores of physical functioning were (25.40±21.84), emotional functioning were (64.00±20.16)and social functioning were (29.14±21.97). The total scores of PedsQL were (37.16±16.45). After comprehensive rehabilitation, the scores of physical functioning were (31.38±24.98), emotional functioning were (64.00±20.16)and social functioning were (34.50±21.32). The total scores of PedsQL were (42.22±17.06). Mean scores of physical functioning, emotional functioning, social functioning and total scores of PedsQL that measured after comprehensive inhabilitation were higher than that were measured before comprehensive inhabilitation, the differences were significant by paired t-test(P<0.01). For the factors affecting quality of life, the results of multivariate analysis of variance showed that family monthly income more than 3 000 yuan and the primary education of parents had a positive effect. And the effect of Gross Motor Classification System(GMFCS) on quality of life had no statistical significance (P=0.797). 【Conclusions】 Comprehensive rehabilitation can improve the quality of life of children with cerebral palsy. The analysis for influence factor suggest that we should invest more manpower and financial resources to improve quality of life of children with cerebral palsy.

Differences of fatty acid composition between children with high and low intelligence quotient and the influence of dietary supply of n-3 fatty acids on children with low intelligence quotient in Yuyao

ZHOU Ting-ting, PENG Yong-mei, WANG Yan-yan, MA Li-ping, YUAN Dong-juan, KANG Jing-xuan

2011, 19(2):  124-127. 

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【Objective】 To investigate the differences of fatty acid(FA) composition between children with high(>135) and low(<90) intelligence quotient(IQ) and the influence of dietary supply of n-3 polyunsaturated fatty acids(PUFAs) on children with low IQ(<90) in Yuyao. 【Methods】 In two common primary schools of Yuyao, students from Grade two to Grade five were selected to two groups(IQ >135 and IQ<90) by intelligence test(Combined Raven Test, CRT). Their blood were collected and the FA composition was analyzed by capillary gas chromatography. In the IQ<90 group, students were randomly assigned to receive either control food or food supplemented with n-3 PUFAs according to the randomized controlled trial(RCT) rules. Data of fatty acid composition were collected before and after the dietary supplementation. 【Results】 There were significant differences of the long-chain polyunsaturated fatty acids(LC-PUFAs) composition in these students with high and low intelligence quotient. Among students with high IQ, arachidonic acid (AA), eicosapentaenoic acid(EPA), docosahexaenoic acid(DHA) and n-3 PUFAs levels were higher(P<0.001 or <0.05) than students with low IQ, while linoleic acid(LA) and the n-6/n-3 ratio was lower(P＜0.05 or ＜0.01) than students with low IQ. In the IQ<90 group, α-linolenic acid(ALA), EPA, DHA and n-3 PUFAs level were significantly increased(P<0.05 or <0.001) and the n-6/n-3 ratio was decreased(P<0.001) after the n-3 PUFAs supplementation. 【Conclusions】 The students with high IQ had higher AA and DHA level and lower n-6/n-3 ratio. And the supplementation of n-3 PUFAs could improve their FA level in students with IQ<90, making it close to those IQ>135. We hope more studies will concentrate on the functional outcomes after the FA improvement in those IQ<90.

Relations between stunting and soil-transmitted helminths infections in school-age pupils

SHANG Yu, YAN Cheng-sheng, ZHAI Shu-mei, LI Zhong-qiu, SHI Xiao-yong, JIANG Yan, TANG Lin-hua

2011, 19(2):  128-130. 

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【Objective】 To understand stunting status and explore the influence factor of stunting. 【Methods】 A cross-sectional method to examine 1 031 pupils aged 9 to 12 years. These pupils came from 15 schools in Guangxi Autonomous Regional and Hainan Province rural areas in China. Study contects included questionnaires survey; physical examination, based on the new WHO Child Growth Standards(WHO Anthroplus, 2007); haemoglobin detection; stool samples were examined by Kato-Katz technique to choose soil-transmitted helminthes (Hookworm, Ascaris lumbricoides and Trichuris trichiura) infections. EpiData3.0 was used to establish a database. Statistical analyses of the data were performed using statistical package for Social Sciences for Windows SPSS(version 16.0). 【Results】 The overall prevalence of stunting (HAZ<2SD) was 25.6% (264/1 031). Risk factors for stunting that based on logistic regression analyses were: 1) Soil-transmitted helminthes moderate-to-heavy intensity infections(OR=1.927,95%CI:1.194~3.110); 2)anaemia(OR=3.26,95%CI: 2.018~5.268); 3)education level of mother(OR=2.125,95%CI:1.388~3.254).The overall prevalence of STH infections was 36.7% (378/1 031),moderate-to-heavy intensity STH infections was 16.8%(173/1 031). Ascariasis, hookworm trichuriasis and co-infection were 11.2%(115/1 031),11.5%(119/1 031),4.9%(51/1 031), and 9.1%(93/1 031) respectively. The anaemia (Hb<120 g/L) was 13.1%. 【Conclusions】 The present study shows that stunting is highly prevalence among study population and STH infections is one of the important risk factors for stunting, especially moderate-to-heavy intensity infections is the main predictors of stunting.

Epidemiological analysis of acute lower respiratory infection children hospitalized infection by atypical pathogens in five years

WU Qian, WEN Bai-ping, YANG Yue-huang, NI Lin-xian, FAN Mao, ZHAO Ming-bo

2011, 19(2):  131-133. 

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【Objective】 To recognize the clinical epidemiological characteristics of acute lower respiratory infection (ALRI) children patients infected by three kinds of atypical pathogens through investigated it between the year 2003 and 2007 in Kunming region. 【Methods】 Based on indirect immunofluorescence assay, simultaneously detected blood IgM levels of M-pneumoniae (MP), L-pneumoniae(LP1) and Chlamydia pneumoniae (CPn) from 12 083 hospitalized children patients between 2003 and 2007, so that acquired statistics results through investigations of the age and gender distribution characteristics, of atypical pathogen infection and of the epidemiological features of the five years' results. 【Results】 The combined infection rate by atypical pathogen in Kunming region between the year 2003 and 2007 was 30.1%; the infection rate by Mp, LP1 and CPn were 17.3%,11.3% and 1.4%, respectively. In autumn and winter the infection rates were the highest. In the summer and autumn of 2003 and in the autumn and winter of 2007, there seemed Mp outbreaks in the local area. The infection rates by Lp1 in summer and autumn were higher than those in spring and winter. Children infected by CPn showed the epidemiological characteristics or sporadic infection all year round. Atypical pathogen infection rate increased as the children grew up. Mycoplasma pneumoniae was the main local causative agent responsible for ALRI children aged above one yers's old in Kunming region. 【Conclusions】 MP and Lp1 are the two leading atypical pathogen lnfection of children in Kunming region. Infection rate varied from seasons. The atypical pathogen infection rate increases with children grow up.

Factor analysis of the metabolic syndrome in adolescents

SUN Yu-ye, ZHANG Hui-ying, YU Wei-ping

2011, 19(2):  134-136. 

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【Objective】 To identify the clustering characteristics of metabolic syndrome (MS) and to explore the mechanisms of it in adolescents by factor analysis. 【Methods】 130 students were sampled from a senior high school in Harbin. The height, weight, waist circumference, blood pressure (BP), the body mass index (BMI) and the waist-to-height ratio (WHtR) were measured or calculated. The FPG, TC, TG, HDL-C, and LDL were detected by automatic biochemical analyzer. The hs-CRP was detected. Spearman correlation and factor analysis were used by SPSS17.0 program. 【Results】 Without the hs-CRP, principal component factor analysis revealed three factors: adiposity, lipid-metabolic, blood pressure and carbohydrate-metabolic that cumulatively explained 70.784% of the observed variance of metabolic syndrome; With the hs-CRP, it revealed three factors: adiposity lipid-metabolic, blood pressure and carbohydrate-metabolic (DBP, SBP, FPG) that cumulatively explained 68.427% of the observed variance of metabolic syndrome. 【Conclusions】 Adiposity plays a major role in the pathogenesis of MS in adolescents; WHtR is more suitable for evaluating central obesity of MS in adolescents than WC; hs-CRP may be involved in the pathogenesis of MS in adolescents.

Genetic variations in the UL144 genes of human cytomegalovirus strains collected from late jaundice infants

HU Hong-bo, WANG Wei-peng, PENG Qiao-ying, GUAN Wan-hua, HU Xing-wen

2011, 19(2):  137-140. 

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【Objective】 To investigate the genetic variations of cytomegalovirus UL144 gene in clinical strains and to explore the relationship between the UL144 genotype and specimens in late jaundice cases. 【Methods】 PCR was performed to amplify the entire HCMV-UL144 gene region of clinical strains, which had been proven containing detectable HCMV-DNA by FQ-PCR. The PCR products were sequenced and phylogenetic analysis was conducted using BioEdit, DNAstar, GeneDoc. 【Results】 1) 30 infants with late jaundice were HCMV infection, the positive rate was 30.6 %; 2) Alignment comparison of clinical strains UL144 sequences with Toledo disclosed nucleic acid variability rate 80.4% to 99.2%. The UL144 sequence distributed among three genotypes,Group1(25%), Group2(25%), and Group3(50%)respectively.3) The UL144 protein consists of two cysteine-rich domains (CRD), one transmembrane domain, and one cytoplasmic domain (cyto). There was a high level of conservation in the transmembrane and cytoplasmic domains of UL144 between the different isolates while was slightly more variable in CRD1. 【Conclusions】 1)HCMV infection may be etiologically associated with late jaundice in some infants. 2) Although the genomic sequence of UL144 are generally well conserved in the transmembrane and cytoplasmic domains, a certain number of genes exhibit a high degree of inter-strain variation in CRD1. 3)The group 3 genotype is more prevalent in the late jaundice cases than other genotype.

Study on a new synchronous screening model for congenital heart disease and developmental dysplasia of the hip during the period of the newborn infants visit in Beijing

ZHANG Wan-xia, YUAN Xue, CHEN Xue-hui

2011, 19(2):  149-151. 

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【Objective】 To establish a new synchronous screening model for congenital heart disease(CHD) and developmental dysplasia of the hip(DDH) during the period of the newborn infants visit in Beijing, in order that suspicious CHD or DDH cases can be diagnosed and restored to health earlier and their life quality can be increased. 【Method】 Professional trained medical staff in child health services used standard methods to screen the suspicious CHD and DDH cases,then 1 799 cases were collected were screening data from June to August in 2010 and analysed it. 【Results】 In total 1 799 cases, 42 suspicious CHD cases were discovered and 17 CHD cases were diagnosed finally. Meanwhile, 24 suspicious DDH cases were discovered and 2 DDH cases were diagnosed. 【Conclusions】 The new synchronous screening model for CHD and DDH during the period of the newborn infants visit in Beijing has outstanding features such as the earlier screening time, wide screening coverage, simple and effective screening skill and stronger universal applicability. The model will be beneficial to the suspicious CHD and DDH cases to win best recovery time.

Clinical observation of blood coagulation dysfunction and microcirculation changes in 30 neonates with high blood pressure

CAO Bi-xia, YOU Yue-ming, WU Fan

2011, 19(2):  152-153. 

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【Objective】 To observe changes of microcirculation and blood coagulation when blood pressure in dangerously ill newborn was high and to provide evidence for treatment. 【Methods】 30 newborn children with high blood pressure were chosen, 30 cases were control group. External ear microcirculation in neonates by WX-10C microcirculation microscope, Determination of Serum prothrombin time (PT), Thrombin time (TT), Activated partial thromboplastin time (APTT), Fibrinogen were observed and compared the results between the two groups. 【Results】 The accumulated points about shape of microvessel and blood flow of microcirculation were increased. Discrepancy was significant (P<0.05). Serum prothrombin time (PT), Thrombin time (TT), Activated partial thromboplastin time (APTT) in group of high blood pressure were decline, Fibrinogen was increased (P<0.05). 【Conclusions】 There are disfunction of microcirculation and blood coagulation when blood pressure is high in dangerously ill newborn. Dealing with these disfunction at the same time is necessary while to treat primary disease and reduce blood pressure.

Assessment of neonatal nutrition through serum protein mass

WANG Cui, JIANG Hong

2011, 19(2):  154-156. 

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【Objective】 To explore the value of neonatal serum protein mass in assessment of neonatal nutrition. 【Methods】 120 studied neonates were divided into four groups: premature neonates in small for gestational age(SGA), premature neonates in appropriate for gestational age(AGA), full-term neonates in SGA and full-term neonates in AGA including 30 neonates, respectively. All the neonates were collected the venous serum to detect the serum protein within 24 hours after delivery. The results were compared and analyzed to sum up their characteristics. 【Results】 1)The serum protein mass of prealbumin (SPM/PA) in SGA were lower than those in AGA significantly. 2)The albumin (ALB) of premature neonates in AGA were lower than those of full-term neonates in AGA significantly. 3)The concentration of prealbumin (PA) and SPM/PA in premature neonates was significantly lower than that in full-term neonates(P<0.05, respectively). 【Conclusions】 1)The neonatal SPM/PA is not only important but also sensitive to reflect neonatal nutrition status and evaluate the effect of support therapy. 2)Furthermore, as an effective indicator, SPM/PA can also distinguish SGA from AGA neonates.

Control study of physical and motor development between macrosomia and term infants appropriate for gestational within one year old

JIANG Wen, WEI Zhen, HE Hui-jing, WAN Guo-bin

2011, 19(2):  156-158. 

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【Objective】 To explore the influence of birth weight on infant's early physical, intellectual and motor development, and provide scientific evidences for early health education of macrosomia. 【Methods】 The physical and motor development characteristics of the two groups in different periods were selected by regular tracing the macrosomia and term infants appropriate for gestational age who were born in obstetric department of the maternal and child health hospital of Shenzhen. And intellectual and motors development of two infant groups were evaluated when they were one year old by using Bayley Scales of Infant Development. 【Results】 The weight, height and head circumference developmental status of Macrosomia were significantly better than those of term infants appropriate for gestational age (P＜0.05).There was no significant difference between the two groups of children within one year of age in developmental milestones (P＞0.05). The moter development index of macrosomia was significantly higher than that of term infants appropriate for gestational age (P＜0.05). 【Conclusions】 The physical developmental status of normal macrosomia are significantly better than those of term infants appropriate for gestational age. Heavier weight has no significant effects on developmental milestones and the intellectual and motor development of children.

Analysis of the mental development of children with phenylketonuria by dietary treatment

ZHAO Cai-hong, ZHANG Li-qin, QIU Li-hua, XU Ning, FU Ping

2011, 19(2):  159-161. 

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【Objective】 To study on the mental development status of children with phenylketonuria, to investigate the interference factors and provide guidance for clinical treatment of PKU. 【Methods】 32 children with phenylketonuria detected by neonatal screening in Qingdao were studied and compared to 46 matched normal children born at the same time. Mental development of children was evaluated by self-made inventory questionnaire and Wechsler Intelligence Scale for Children Chinese Version. 【Results】 1)No significant difference was found in Wechsler Intelligence Scale for Children Chinese Version between the time of obtaining initial treatment less than 30d group and more than 30d group(P>0.05).2)Intelligence development of children in totally cooperative group, partly cooperative group and uncooperative group had significant differences(P<0.01). 【Conclusions】 By giving strictly low-phenylalanine dietotherapy to keep ideal phenylalanine levels is a key to mental development of children with PKU. Developing treat cooperativity plays an essential role in it which must be done so the children with PKU could grow healthy.

Detection of measles antibody level among healthy children in Jinan

LIU Xing-li, LI Jian-zhi, ZHANG Chun-yan, WANG Su-lan

2011, 19(2):  162-164. 

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【Objective】 To know the measles antibody level among healthy children in urban field of Jinan, and to provide the evidence for working out measles control strategy. 【Method】 With cluster sampling, stratified sampling, and random sampling surveys, 243 individuals were selected by age-stratified sampling in urban field, and their serum antibody levels were detected. 【Results】 The results showed that the positive rate of measles antibody was 89.7%, GMT was 894. No statistically significant difference was found in the positive rate of measles antibody between sex(P＞0.05), female had higher measles antibody level(P<0.05); statistically significant difference was found in the positive rate of measles antibody, GMT and protection rate among age(P<0.01); statistically significant difference was found in the positive rate of measles antibody, GMT and protection rate between inoculation history (P<0.01), No statistically significant difference was found in GMT between inoculation times (P＞0.05). 【Conclusion】 The measles antibody level is high among healthy population of JINAN City, so measles outbreak will be little chance in recent years, but vaccinum inoculation can degrade catching measles.

Insulin resistance and metabolic syndrome in children with obesity

HUANG Yong-lan, LIN Wen-chun, HUANG Jun-jing, ZHANG Wen, LIU Li

2011, 19(2):  164-167. 

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【Objective】 To observe the rates of occurrence of insulin resistance (IR) and metabolic syndrome (MS) and the association between IR and MS in a group of Chinese obese children. 【Methods】 Oral glucose tolerance test (OGTT) was done and serum insulin was measured in 76 children (49 males and 27 females) with obesity aged between 3 and 14 years old. Fasting blood sample was also obtained to measure total cholesterol, triglycerides, HDL-C, LDL-C, uric acid, liver function and androgen in serum. 【Results】 In the 76 obese children, 68.4% of them had IR, 27.6% had impaired glucose tolerance or type II diabetes, 61.8% had dyslipidemia, 14.5% had hypertension, 28.9% had hyperuricemia, 26.3% had increased ALT. Hyperandrogenism was found in 6 out of the 27 female children. 32.9% met the criteria of MS. The rates of impaired glucose tolerance, dyslipidemia and MS were 34.6%, 73.1% and 44.2%, respectively, in children with IR, which were significantly higher than those without IR(P< 0.05 or 0.01, respectively). Out of the 20 cases with delayed or absent insulin responsive peak, 13 of them had impaired glucose tolerance and one was diagnosed with Type II diabetes. 【Conclusions】 Insulin resistance and MS are very common in children with obesity. The occurrence of MS is strongly and positively related to IR.

Status of health care among floating children under 7 years old of Changning district and intervention strategies

WANG Fang, LU Qiao-zhen, ZHOU Wen-li, HUANG Bi-kun

2011, 19(2):  167-169. 

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【Objective】 To understand and provide references for health care policy aimed at non-resident children, which may help these children to get equal health care service. 【Methods】 219 non-resident children and 217 local children from Beixinjing community were chosen with random cluster sampling. Their parents were surveyed with structured questionnaire. 【Results】 The rate of systematic management of non-resident children was 19.18%, which was lower than that of local children significantly, and the latter's was 80.65%. The level of physical growth and development of non-resident children was inferior than that of local children. Among non-resident children, the proportion of children whose height values were below the 10th percentile was higher than local ones. So was weight. There was difference between parents of non-resident children and local ones for understanding of necessity about physical examination regularly. The knowledge about nutritional diseases and child health care of non-resident parents was less than local parents, except for vaccination. 【Conclusions】 The status of health care among non-resident children is worse than that of local ones, so we should strengthen propaganda about child health care toward non-resident parents. The model of child health care should be changed to localized management model and all non-resident children should get basic and equal heath care service.

Association of early respiratory infections and children's current asthma

JIANG Ya-li, SHEN Ke, FENG Xue-fang, YE Xu-dan, JIANG Long-ting

2011, 19(2):  169-171. 

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【Objective】 To evaluate the association of a history of respiratory infection in the first few months after neonatal birth with current asthma in locality. 【Methods】 A total of 301 children with average aged 4 years were recruited into study group and 301 children without asthma were categorized into control group. The parents of these children were responded to a questionnaire covering demographic factors, lifestyle, home environment, and health history, including a detailed history of respiratory conditions. Logistic regression was used to model the association of asthma and asthma severity with history of respiratory infections, controlling for gender, family history of asthma, and other factors. 【Results】 Our data indicated the significant association of current asthma with the numbers of respiratory infection and ear infection in the past year and the morbidity of bronchiolitis, pneumonia, bronchitis, NICU treatment in neonate, male, asthmatic family history, allergies and passive smoking, but not with the first age at first respiratory and ear infection. 【Conclusion】 There is association of early respiratory and ear infection with children's current asthma in locality, and more attention about the prevention of asthma must be paid for children with high risk factors of early infection disease.

Relationship between the apoptosis of mononuclear cell and the expression of cytokines and insulin-like growth factor-1 in patients with henoch-schonlein purpura

CHENG Han-rong, WEN Fei-qiu, WU Ben-qing

2011, 19(2):  172-174. 

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【Objective】 To observe the changes of mononuclear cell (MNCs) apoptosis and the level of inflammatory cytokines and IGF-1 in patients with henoch-schonlein purpura (HSP), and to study the relationship between them. 【Methods】 The apoptosis of MNCs in 36 patients with HSP and 22 healthy controls were determined with flow cytometry. The inflammatory cytokines and theIGF-1 were tested with ELISA method. 【Results】 The percentage of MNCs apoptosis in the patients with HSP was significantly higher than that of healthy controls. The levels of IL-8, TNF-α, IL-6, IGF-1 in patients with HSP were significantly higher than those of healthy controls, and the increased levels of inflammatory cytokines and IGF-1 in HSP patients were positively correlated to the percentage of MNCs apoptosis. 【Conclusions】 The data demonstrates that there is a promote apoptotic process of MNCs in active HSP. The high expression of inflammatory cytokines and IGF-1 may play an important role of promoting MNCs apoptosis which reduces the functional life span of MNCs. For this reason, modulating the expression of cytokines, IGF-1 and moderately controlling the apoptosis of MNCs may be a new therapeutic target for HSP treatment.

Risk factors for hypoxic-ischemic encephalopathy in asphyxiated newborn infants

LIN Li, YANG Yu-li, XIE Fei-yan, LU Mei-juan

2011, 19(2):  175-177. 

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【Objective】 To determine the risk factors for hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborn infants. 【Methods】 A retrospective study of 98 asphyxiated newborn infants (gestational age ≥ 37 weeks) in our hospital from January 2008 till the end of June 2009, and 32 newborn infants were complicated by HIE. The clinical data of the HIE group (n=32) were compared with those of the HIE negative group (n=66). 【Results】 The incidences inappropriate antenatal care, prolapsed cord, abruptio placenta, male and post-term gestation in the HIE group were significantly higher than those in HIE negative group (P<0.05), the 1 and 5-minute Apgar scores were significantly lower in the HIE group than those in HIE negative group (P<0.05), a 5-minute Apgar score of 3 or less in infants had a high risk of neonatal death in HIE infants and asphyxiated infants (P<0.05). Inappropriate antenatal care, 1min and 5 min Apgar score had significant relation to HIE occurrence after birth asphyxia (P<0.05). 【Conclusion】 It is very important for the prevention of HIE that these risk factors should be highly concerned to minimize birth asphyxia.

Analysis of the clinical characteristics in 67 neonates with sepsis

SANG Yong-hua , HOU Xin-lin, CHEN Yong-hong

2011, 19(2):  177-179. 

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【Objective】 To analyze the correlation between clinical characteristics, laboratory investigations and perinatal risk factors in neonates with sepsis. 【Method】 Retrospective study was conducted comparing the clinica profile of 67 neonatal sepsis patients and 75 uninfected patients admitted to the hospital 【Results】 Premature rupture of membranes for more than 18 hours, preterm infant low birth weight infant and fetus heart rate late deceleration were risk factors of neonatal sepsis. Theincidence of stagnant temperature or fever, poor response, diarrhea, abdominal distention, relapsing or exacerbating jaundice, neonatal scleredema and arrhythmia were significantly higher in the sepsis group than those in the controll group. The incidence of WBC≥20×10⁹or ≤5×10⁹, the ratio of rhabdocyte/granularcyte I/T cell≥0.2 ,PLT＜100×10⁹,CRP≥8 mg/L in sepsis group were significantly higher than those in the control group. 【Conclusions】 Premature rupture of membranes, preterm infant low birth weight infant and fetus heart rate late deceleration are risk factors of neonatal sepsis. Blood culture combining peripheral WBC, I/T, PLT, CRP may contribute to the early diagnosis of neonatal sepsis.

Epidemiological analysis of hand-foot-mouth disease in Wenzhou in 2009

CHEN Sheng, ZHOU Zu-mu, LIN Dan, SHAN Ruo-qing

2011, 19(2):  179-182. 

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【Objective】 To analyze the current status of hand-foot-mouth disease (HFMD) in Wenzhou City, so as to provide a scientific basis for the government to make the strategy of preventing and controlling HFMD. 【Methods】 The data of HFMD from the National Disease Surveillance Information Reporting System were conducted for statistical analysis and epidemiological description. 【Results】 A total of 20 443 cases of local HFMD were reported in Wenzhou in 2009 with an incidence of 236.87/10⁵. The cases mainly occurred from September to November,which accounted for 51.62%. The ratio of male and female was 1.71∶1. Most of the HFMD patients were the children aged 0 to 5 years old, accounting for 95.84%. The cases who were 0 to 3 years old accounted for 83.07%. There were most cases in the group of scattered inhabiting children, which accounted for 76.38%. Fifty-five of 94 severe cases were laboratory confirmed, with the result of 37 cases tested EV71 positive. 【Conclusions】 The epidemiological characteristics should be considered in the surveillance and prevention of HFMD, especially the local epidemic peaks and the risk populations.

Effect of montelukast on the treatment of IL-5 and eotaxin in serum of children with respiratory syncytial virus bronchiolitis

ZHAO Qian-ye, YU Yan-yan, SUN Qian, DING Tie-mei, WANG Gang, SONG Ji-cheng

2011, 19(2):  182-184. 

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【Objective】 To explore the effect of montelukast on the treatment of airway inflammation in the bronchiolitis after respiratory syncytial virus (RSV) infection by studying the clinical manifestations and change of serum concentration of inflammatory cellular factors including interleukin-5(IL-5) and eotaxin. 【Methods】 88 infants with bronchiolitis caused by primary infection of RSV associated with atopy (1 eczeca,family asthmatic history ) were recruited in the study and they were randomly divided into two groups, forty cases were selected as the control group treated with conventional therapy. 48 cases were treated with montelukast in addition to conventional therapy.Blood samples were collected on the first day on admission before treatment and recovery phase of the disease. Follow-up was done to observe recurrence for 3 months. 【Results】 IL-5 and Eotaxin level in patients during acute phase of the desease were significiantly higher than those during recovery phase, the level of Il-5 and eotaxin were decreased distinctly by montelukast.moreover . The differences in patients with reccurrence of wheeze between trial groups and control groups were significant. 【Conclusion】 Montelukast may decrease the serum concentrations of IL-5, eotaxin and control airway inflammation in the bronchiolitis after RSV, it may play a role in the prevention of recurrence attacks of wheeze after bronchiolitis.

Effect and security of bronchoalveolar lavage on infected atelectasis in children

GUAN Min-chang, TANG Lan-fang, TANG Wei-hong, HANG Jing-guo, YAO Ze-zhong

2011, 19(2):  184-186. 

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【Objective】 To explore the effect and security of bronchoalveolar lavage (BAL) on infected atelectasis in children. 【Methods】 The inpatients who diagnosed with infected atelectasis were retrospectively analyzed in our hospital, the control group(n=40) received only conventional therapy and antibiotic was based on Sputum culture and drug susceptibility, while the treatment group(n=40) received additional bronchoalveolar lavage via fibrobronchoscopy, both the treatment course were 4 weeks,then after 4 weeks the symptoms and signs, X ray or CT changes in the lung were observed, at the same time,the complications were also observed. 【Results】 The effect in the treatment group was better than in the control group, there was significantly difference between the two groups(P<0.01), The symptoms and signs recovered sooner in the treatment group than in the control group (P<0.01), X ray or CT changes in the lung recovered sooner in the treatment than in the control group (P<0.05)after 4 weeks. The incidences of complications in the treatment group were, hemorrhage 2.5%, fever 5%, laryngeal edema 2.5%, bronchospasm 2.5%, cyanosis 2.5%. 【Conclusions】 Bronchoalveolar lavage on infected atelectasis early can improve the transepithelial liquid to be transported, promote to absorbed the inflammation as early as possible and to reexpand the lung. The effect and security of BAL is definite and it deserves promotion.

Study of integrated management of childhood illness training effectiveness evaluation on children's fever and diarrhea component for the township and village health staffs in Lhasa

WANG Ji-hong, Jean Allen, Cath Barker

2011, 19(2):  187-189. 

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【Objective】 To look at the appropriateness and effectiveness of integrated management of childhood illness(IMCI) training course delivered in Lhasa to Village and township doctors, to give suggestions and enrich training approaches on how to continue to improve the paediatric clinica skills of rural health workers in Lhasa. 【Methods】 258 township and village doctors attened the IMCI training course provided by Tibet Health Sector Support Program (THSSP). The trainee's knowledge and practical skills on children's fever and diarrhea were compared before and after training by questionaire, practice evaluation. 【Result】 The trainee's knowledge and practice skills on children's fever and diarrhea had significant difference before and after training(P<0.05). 【Conclusions】 The THSSP supported IMCI training for rural health staffs in Lhasa grass root level are effective. The trainining approaches could be considered as one of the capacity building models for grass root health staffs in Lhasa areas.