Relationship between serum erythropoietin levels and brain injury in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between the levels of erythropoietin (EPO) in serum and brain injury in preterm infants.</p><p><b>METHODS</b>Three hundred and four preterm infants (gestational age: 28-34 weeks) born between October 2014 and September 2015 were enrolled in this study. Brain injury was diagnosed using cerebral ultrasound and MRI. The levels of EPO, S100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP) in serum were detected using ELISA. To compare the incidence of brain injury in different serum EPO levels in preterm infants, and the relationship between brain injury and serum EPO levels was analyzed.</p><p><b>RESULTS</b>The incidence rate of brain injury in preterm infants was 41.1% (125/304). The incidence rate of brain injury in the low EPO level group was significantly higher than that in the middle-high EPO level groups (P<0.01). The serum levels of S100 protein, NSE, and MBP in the brain injury groups were significantly higher than in the control group (P<0.01). The serum EPO levels were negatively correlated with serum S100 protein concentration and NSE levels (P<0.05). According to the multiple logistic regression analysis, low gestational age, low birth weight, asphyxia, prolonged mechanical ventilation, anemia and low serum EPO levels were the risk factor for brain injury in preterm infants.</p><p><b>CONCLUSIONS</b>There is a higher incidence rate of brain injury in preterm infants with lower serum EPO levels. The serum EPO levels may be correlated with brain injury in preterm infants.</p>

Analysis of CYP21A2 gene mutation in one case of congenital adrenal hyperplasia / 中国当代儿科杂志

CYP21A2 gene mutations in a child with congenital adrenal hyperplasia (CAH), and the child's parents, were detected in the study. The clinical features, treatment monitoring and molecular genetic mechanism of CAH are reviewed. In the study, DNA was extracted from peripheral blood samples using the QIAGEN Blood DNA Mini Kit; a highly specific PCR primer for CYP21A2 gene was designed according to the sequence difference between CYP2lA2 gene and its pseudogene; the whole CYP2lA2 gene was amplified with PrimeSTAR DNA polymerase (Takara), and the amplification product was directly sequenced to detect and analyze CYP2lA2 gene mutation. The child was clinically diagnosed with CAH (21-hydroxylase deficiency, 21-OHD) at the age of 36 days, and the case was confirmed by genetic diagnosis at the age of 1.5 years. The proband had a homozygous mutation at c.293-13C in the second intron of CYP21 gene, while the parents had heterozygous mutations. Early diagnosis and standard treatment of CAH (21-OHD) should be performed to prevent salt-wasting crisis and reduce mortality; bone aging should be avoided to increase final adult height (FAH), and reproductive dysfunction due to oligospermia in adulthood should be avoided. These factors are helpful for improving prognosis and increasing FAH. Investigating the molecular genetic mechanism of CAH can improve recognition and optimize diagnosis of this disease. In addition, carrier diagnosis and genetic counseling for the proband family are of great significance.

Risk factors and pathogen distribution in premature infants with nosocomial sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the main risk factors and pathogen distribution of nosocomial sepsis among premature infants.</p><p><b>METHODS</b>The clinical data of 3418 hospitalized premature infants from January 2003 to December 2010 were retrospectively analyzed for the risk factors and pathogen distribution of nosocomial sepsis.</p><p><b>RESULTS</b>The incidence of neonatal nosocomial sepsis was 3.10% (106/3418), and the median age at diagnosis of neonatal nosocomial sepsis was 19 (4-48) days. The major pathogens of the infections among these premature infants included gram-positive bacteria (45.2%), especially coagulase-negative Staphylococcus (24.3%), and gram-negative bacteria (41.7%), especially Klebsiella pneumoniae (25.2%), as well as fungus (13.0%). Logistic regression analysis showed that the main risk factors included low birth weight, retention of central venous catheters, and long duration of parenteral nutrition (OR: 3.765, 3.051, and 2.998, respectively; P<0.05).</p><p><b>CONCLUSIONS</b>Low birth weight, retention of central venous catheters, and long duration of parenteral nutrition are the main risk factors for neonatal nosocomial sepsis, whereas the leading pathogen is Klebsiella pneumoniae.</p>

Effect of erythropoietin on apoptosis following hyperoxic lung injury in neonatal rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of recombinant human erythropoietin (rhEPO) on apoptosis following hyperoxic lung injury in neonatal rats.</p><p><b>METHODS</b>Ninety-six neonatal Sprague-Dawley rats were randomly divided into four groups: air-exposed control, air-exposed rhEPO-treated, hyperoxia-exposed placebo (95% oxygen), and hyperoxia-exposed rhEPO-treated. rhEPO (800 U/kg) was administered 2, 4, and 6 days after air or hyperoxia exposure. The rats were sacrificed 3, 7 and 14 days after air or hyperoxia exposure for the assessment of lung histological changes by hematoxylin and eosin staining (n=8 each time point). p-JNK levels were measured by Western blot. Lung cell apoptosis was evaluated by TUNEL assay.</p><p><b>RESULTS</b>Compared with the air-exposed control group, inflammatory cell infiltration was found at 3 days and increased obviously at 7 days, and widening of the alveolar septa was observed, the number of alveoli decreased and normal alveolarization disappeared at 14 days after hyperoxia exposure in the hyperoxia-exposed placebo group. rhEPO treatment alleviated significantly the hyeroxia-induced alterations in lung pathology. P-JNK protein levels and the number of apoptosis cells decreased significantly in the hyperoxia-exposed rhEPO-treated compared with those in the hyperoxia-exposed placebo group.</p><p><b>CONCLUSIONS</b>rhEPO may reduce apoptosis and thus provide a protective effect against hyperoxic lung injury in neonatal rats. JNK signal pathway may be involved in the protective mechanism.</p>

Lung fibrosis induced by mechanical ventilation with different tidal volume in neonatal rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes of collagen synthesis following mechanical ventilation with different tidal volume and the possible mechanism.</p><p><b>METHODS</b>Twenty-four neonatal Sprague-Dawley rats were randomized to hyperventilation (tidal volume 25 mL/kg), conventional ventilation (tidal volume 10 mL/kg) and no mechanical ventilation (control group) (n=8 each group). They were sacrificed 5 hrs after ventilation. Left lung samples were used for histopathologic examinations and the detection of connective tissue growth factor (CTGF) expression by immunohistochemistry. Right lung samples were used for the detection of expression of procollagenIII mRNA(PcolIII mRNA), cysteinyl leukotriene mRNA(CysLT1 mRNA)and CTGF mRNA by PCR.</p><p><b>RESULTS</b>The severity of lung injury and fibrosis increased significantly with the increasing tidal volume compared with the control group. Lung CTGF mRNA expression in the hyperventilation group was significantly higher than that in the control group (P<0.05). Lung PcolIII mRNA and CysLT1 mRNA levels increased with the increasing tidal volume when compared with the control group. The differences in PcolIII mRNA and CysLT1 mRNA levels between groups were significant (P<0.05). There was a positive correlation between lung PcolIII mRNA expression and the severity of lung injury (r=0.78,P<0.01). CTGF and CysLT levels were positively correlated with PcolIII expression (r = 0.59,0.86,P<0.01).</p><p><b>CONCLUSIONS</b>Mechanical ventilation using different tidal volume leads to different severities of lung injury, followed by the occurrence of lung fibrosis. The degree of lung fibrosis is consistent with the severity of lung injury. CysLT and CTGF may be involved in the development of lung fibrosis.</p>

Computerized image processing in esthetic rehabilitation of anterior teeth / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the application of computerized image processing in esthetic rehabilitation of anterior teeth.</p><p><b>METHODS</b>Thirteen patients with esthetic problems in anterior teeth were included in this study. Oral digital images were obtained before and during treatment with a digital camera. All the oral esthetic data of the patients, including tooth shape, tooth shade, tooth characteristic color, incisal transparency, incisal curve, smile line, and gingival curve et al, were collected and analyzed. Diagnostic images of the anticipated esthetic outcome were created by computerized image processing software and transferred to the technician. Restorations were made according to the images by the technician.</p><p><b>RESULTS</b>All anterior teeth of 13 patients were restored with this method and good esthetic results were achieved.</p><p><b>CONCLUSIONS</b>Computerized image processing is a useful method in the esthetic rehabilitation of anterior teeth.</p>

Feature of Ventilation Induced Lung Injury with Different Tidal Volume in Neonatal Rats / 实用儿科临床杂志

Objective To investigate the feature of ventilation induced lung injury(VILI) with different tidal volume in neonatal rats.Methods Thirty-two neonatal rats were assigned to control group(without ventilation),conventional ventilation group(tidal volume 0.010 L?kg-1 for 5 h),hyperventilation 5 h group(tidal volume 0.025 L?kg-1 for 5 h),hyperventilation 3 h group(tidal volume 0.025 L?kg-1 for 3 h) randomly.After ventilation,the lungs were obtained to weigh,score about the degree of lung pathologic injury was count.The levels of IL-6 and IL-10 of lung tissue were detected by enzyme-linked immunosorbent assay.Results The VILI histopathology score in hyperventilation 5 h group,hyperventilation 3 h group,conventional ventilation group and control group were 9.63?1.40,4.40?1.06,6.50?1.85 and 0.00,respectively,the differences were significant among the 4 groups(P=0.000).IL-6 in hyperventilation 5 h group,hyperventilation 3 h group,conventional ventilation group and control group were(785.33?39.06) pg?g-1,(656.78?48.82) pg?g-1,(701.6?33.65) pg?g-1 and(635.02?65.78) pg?g-1,there were significant differences among the 4 groups(P=0.000).The IL-6 level was positively correlated with VILI histopathology score(r=0.78,P