Glutamine-Supplemented Parenteral Nutrition and Probiotics in Four Adult Autoimmune Enteropathy Patients

To evaluate the effects of glutamine-supplemented parenteral nutrition (PN) and probiotics in adult autoimmune enteropathy (AIE) patients. Four adult AIE patients were identified from April 2006 to January 2012. Clinical and nutritional data were obtained from the patients' medical records. Glutamine-supplemented PN started immediately when the AIE diagnosis was confirmed. The total PN duration was 351 days. According to the PN prescription, the average caloric intake ranged from 20 to 25 kcal/kg/day, and the protein intake ranged from 1.2 to 1.5 g/kg/day. Alanyl-glutamine (20 g/day) was administered to AIE patients for 4 weeks followed by a 2-week break, and this treatment schedule was repeated when PN lasted for more than 6 weeks. Body weight gain and an increased serum albumin level were achieved after PN, and defecation frequency and quality also improved. Each patient received oral supplements, 250 mL of Ensure and two probiotics capsules (each capsule containing 0.5x10(8) colonies) three times a day when enteral nutrition started. Three AIE patients were successfully weaned off PN, and one patient died of pneumonia. Glutamine-supplemented PN and probiotics show promise in managing patients with AIE and related malnutrition.

Current research on the relationship between vitamin D deficiency and pediatric metabolic syndrome / 中华实用儿科临床杂志

Vitamin D(Vit D) belongs to steroids derivative and is also known as anti-rickets vitamin owing to its effect of anti-rickets.Pediatric metabolic syndrome is a group of complex,interrelated accumulation of risk factors that can lead to cardiovascular disease and type 2 diabetes.Recently,more and more reports demonstrate that Vit D deficiency is associated with the risk for pediatric metabolic syndrome,but the association is disputed among the children which is a special group since they are in the period of growth and the metabolic indicators are in the dynamic changes among all ages.Therefore,research on the relationship between Vit D and the components of pediatric metabolic syndrome will provide some theoretical basis for early intervention and treatment by raising the status of serum Vit D in order to reduce the risk for pediatric metabolic syndrome.

Comparison of different definitions on metabolic syndrome in obese children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To compare the prevalence rates of metabolic syndrome (MS) in obese children, according to three commonly used 'Pediatric MS definitions': (1) the International Diabetes Federation (IDF), (2) Cook, et al, and(3)da Silva, et al, in order to choose an appropriate one for the Chinese obese children. It was also intended to assess the variances of American or Chinese cutoff values on MS prevalence.</p><p><b>METHODS</b>A retrospective study was performed in obese children from Obesity Outpatient Service Program from January 2004 to December 2008. Subjects were eligible if they met the following criteria: (1) aged 7 to 18 years, (2) with no following conditions as hereditary endocrine or metabolic diseases, secondary obesity, hepatic or renal disease, using medication that alters blood pressure or glucose or lipid metabolism etc., (3) data were complete on the variables of interest. Height, weight and waist circumference, systolic and diastolic blood pressure, fasting lipid profiles, blood sugar and insulin were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA). American or Chinese cutoff values were used to identify central obesity and hypertension. The prevalence rates of MS under three definitions were calculated and compared by Kappa test to determine the degree of agreement.</p><p><b>RESULTS</b>136 patients with 103 males and 33 females were enrolled in the study. According to the American cutoff value, 19.2%, 34.6%, 52.9% of the subjects were classified as MS under definitions of IDF, Cook, et al, da Silva, et al respectively, matching well with 19.2%, 43.4%, 58.1% when the Chinese cutoff value was used (Kappa = 1, 0.79, 0.90). The degrees of agreement according to the Kappa statistics between Cook, et al and da Silva, et al (0.52, American cutoff value/0.51, Chinese cutoff value) were better than the others (0.24 - 0.4). Children who were diagnosed as MS under the definitions of Cook, et al. or da Silva, et al. appeared to have had serious insulin resistance when compared to those without MS.</p><p><b>CONCLUSION</b>Prevalence of the metabolic syndrome appeared to be high among the obese pediatric outpatients, which was probably due to the definition being chosen. The use of definitions provided by Cook, et al and da Silva, et al might be more suitable for MS diagnosis in obese children in the outpatient department, if insulin resistance was under consideration. Both American and Chinese cutoff value could be used for MS diagnosis in the Chinese obese children.</p>

The prevalence of non-alcoholic fatty liver disease and its related risk factors in 1180 school children in Shanghai / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the prevalence of non-alcoholic fatty liver disease (NAFLD) and its related risk factors in children in Shanghai.</p><p><b>METHODS</b>A total of 1180 students aged 6 to 14 years (9.0+/-1.9) y from two elementary schools in the Pudong New Area were enrolled in our study, 572 were male and 608 were female. Height, body weight, waist circumference, hip circumference, waist-hip ratio (WHR), blood pressure were measured and liver ultrasound B scans were analyzed for each student. Body mass index (BMI) was calculated as body weight in kilograms divided by the square of height in meters.</p><p><b>RESULTS</b>Liver ultrasonic images were normal in 1155 students (97.9%), 18 students had mild fatty livers (1.5%) and 7 (0.6%) students had moderate fatty livers, while none of the students had severe fatty livers. Of all the NAFLD students, 19 were male and 6 were female. The prevalence of NAFLD in male students was obviously higher compared with that in female students (X2=6.66, P<0.05). The number of students with normal BMI was 934 (79.2%), while 137 (11.6%) and 109 (9.2%) respectively were overweight and obese, according to the age and gender specific BMI chart for Chinese children. The prevalence of NAFLD in students with normal BMI was 0.6% (6/934), while it was 2.9% (4/137) and 13.8% (15/109) in overweight and obese students. The prevalence of NAFLD in overweight and obese students was higher than that in students with normal BMI (X2=85.93, P<0.01). All the students were further divided into two groups based on age: group 1, 714 prepubertal students age 6 to 9 years; group 2, 466 students in puberty stage age 10 to 14 years. The prevalence of NAFLD was 1.7% (12/714) in group 1 and 2.8% (13/466) in group 2. There was no statistical difference between the two groups (X2=2.01), P>0.05. A stepwise multiple regression analysis was performed to evaluate the relationship between NAFLD and its related factors. BMI and WHR were chosen as predictors of NAFLD (x2=69.35), P<0.01.</p><p><b>CONCLUSION</b>Based on liver ultrasound, the prevalence of NAFLD is 2.1% of the 1180 surveyed school students age 6 to 14 years. The prevalence of NAFLD was obvious higher in overweight and obese students compared with that in students with normal BMI. Male students had more NAFLD than female students. BMI and WHR could be used as effective indexes to predict the occurrence of NAFLD.</p>

Transcriptional repression of hDaxx enhanced by adenovirus 12 E1B 55-kDa oncoprotein interacting with hDaxx / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Daxx has been identified as a nuclear protein that involves in apoptosis and transcriptional repression. Daxx co-localizes with the promyelocytic leukemia (PML) protein and regulates transcription. Human Daxx (hDaxx) is a protein that functions as a transcriptional regulation through its interaction with some DNA-associated proteins. The aim of this study was to explore the transcriptional regulatory effect of hDaxx interacting with adenovirus (Ad) 12 E1B (Ad12E1B) 55-kDa oncoprotein.</p><p><b>METHODS</b>The co-localization of hDaxx-Ad12E1B or hDaxx-PML protein in the nucleus was observed under a confocal microscope. Interaction of hDaxx and Ad12E1B was analyzed by yeast two-hybrid assay. Direct binding of hDaxx and Ad12E1B was analyzed using coimmunoprecipitation and Western blot in vivo and in vitro. The activity of a luciferase reporter gene, which was regulated by an hDaxx modulated thymidine kinase (TK) promoter, was detected in an automat luminometer.</p><p><b>RESULTS</b>Ad12E1B, which co-localized with hDaxx in the nuclei of G401-CC3 cells, disrupted the co-localization of hDaxx and PML in the PML oncogenic domains (PODs). hDaxx bound directly to Ad12E1B in vivo and in vitro. hDaxx interacted with Ad12E1B along its full length. Ad12E1B enhanced transcriptional repression activity of hDaxx.</p><p><b>CONCLUSION</b>Ad12E1B disrupts the co-localization of hDaxx with PML in PODs and enhances transcriptional repression activity of hDaxx.</p>