Clinical value of liver biopsy for infantile hepatitis syndrome / 中华实用儿科临床杂志

Objective To investigate the value of ultrasound-guided liver biopsy for infantile hepatitis syndrome regarding diagnosis,treatment and prognosis.Methods Fifty children with infantile hepatitis syndrome hospitalized in Guiyang Maternal and Child Hospital during Aug.2010 to May 2012 were involved in this study.Ultrasoundguided liver biopsies were performed to evaluate the inflammation grade and fibrosis stage.Immunohistochemical staining was used for pathogen diagnosis.The clinical outcomes were followed-up.Results Thirty-four cases (68％)were CMV infection,6 cases(12％) were vanishing bile duct syndrome,4 cases(8％) were chronic intrauterine infection,4 cases(8％) were congenital anomaly of bilirubin metabolism,and 2 cases (4％) were obstructive cholangitis.All 50 cases showed mild inflammation at portal area(G1-G2 grade).All 50 cases exhibited liver fibrosis.Sixteen cases were S1 stage,20 cases were S2 stage,8 cases were S3 stage and 6 cases were S4 stage.Pathogen analysis:all 50 cases showed intrahepatic cholestasis:38 cases were diffuse cholestasis,and 12 cases were moderate cholestasis.Treatment:all cases were treated using 2-week heteropathy; antivirus was used for CMV infected cases,thus 39 cases were finally cured,9 cases were relieved,and 2 cases were ineffective.Conclusion Liver biopsy is valuable for diagnosis,treatment and prognosis infantile hepatitis syndrome.

Gastric epithelial cell proliferation, apoptosis and P53 protein expression in children with Helicobacter pylori associated chronic gastritis / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate whether Helicobacter pylori infection has any effects on the epithelial cell proliferation, apoptosis and P53 gene expression as well as its role in the pathogenesis of chronic gastritis.</p><p><b>METHODS</b>Sixty children with chronic gastritis were studied. All the children underwent upper digestive tract endoscopy and biopsy specimens were taken. Helicobacter pylori infection was determined with microscopic examination after Gimsa staining and the rapid urease test and 30 of the children were Helicobacter pylori positive and the other 30 were negative. The relation between the findings and cell proliferation was studied by immunostaining; the status of gastric apoptosis was tested by DNA fragmentation in situ using TdT-mediated dUTP biotin nick end labeling (TUNEL). Immunohistochemical method was used to detect the expression of P53 protein; CagA antibody was tested by Western blotting.</p><p><b>RESULTS</b>(1) The proliferative index and apoptosis index in children with Helicobacter pylori infection with CagA positive gastritis were much higher than those of Helicobacter pylori negative gastritis patients [(11.56 +/- 4.21)% vs. (5.85 +/- 2.21)%, (10.58 +/- 5.31)% vs. (2.86 +/- 0.64)%, P < 0.01]. (2) The proliferative index and apoptosis index in 30 cases with Helicobacter pylori infection with CagA positive gastribis were much higher than 21 cases who were cured by effective drugs [(11.50 +/- 4.11)% vs. (3.74 +/- 2.30)%; (10.58 +/- 4.02)% vs. (3.74 +/- 2.30)%, P < 0.01]. (3) The expression of P53 protein in Helicobacter pylori with CagA positive gastritis children was much higher than that of Helicobacter pylori negative cases [(63% vs 16%), P < 0.1].</p><p><b>CONCLUSION</b>CagA positive Helicobacter pylori infection with gastritis improved gastric epithelial cell proliferation and apoptosis. The abnormal expression of P53 protein in gastric epithelium may play an important role in regulation of the processes.</p>

Diagnosis and Treatment of Refractoriness Pneumonia with Fiberoptic Bronchoscopy in 62 Children / 实用儿科临床杂志

Objective To explore the application value of fiberoptic bronchoscopy in the diagnosis and treatment for refractoriness pneumonia in children.Methods Sixty-two cases of refractoriness pneumonia who had not been cured with normal anti-infective therapy for 2 weeks in Guiyang Children′s Hospital from Jun.2005 to Jun.2009 were selected.Fiberopic bronchoscopy Olympus BF-3C30 or BF-P40 examination was applied after routine local infiltration anesthesia to diagnose and local treat refractoriness pneumonia in 62 children.Results There were 27 cases(43%) of simple inflammation,20 cases(32%) of foreign bodies with concurrent infection,7 cases(11%) of dndobronchial tuberculosis,4 cases(6%) of dysplasia with concurrent infection,2 cases(3%) of bronchiectasis,and 2 cases(3%) of pulmonary hemosiderosis,among them,dysplasia were diagnosed on children under 1 year old,foreign bodies with infection on 1-3 years old,and tuberculosis and bronchiectasis on school age.Eleven cases(40%) of simple inflammation were identified various pathogen by bronchoalveolar la-vage fluid culture,mycoplasma PCR test and bronchial brushing and microscopic examination.Forty-seven cases of bronchi obstruction and stenosis caused by inflammation were irrigated and treated by drug and achieved satisfactory,among them,15 cases(79%) of pulmonary atelectasis were recovered with the treatment of fiberoptic bronchoscopy within 2 weeks,14 cases(70%) of foreign bodies were succeed in taking choked thing from bronchus with fiberoptic bronchoscopy.Conclusion The fiberoptic bronchoscopy play an important role in the etiological diagnosis and therapy of refractoriness pneumonia in children.