Comparison among three standards of TW2 to skeletal age determination in children with central precocious puberty / 法医学杂志

OBJECTIVE@#To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds.@*METHODS@#Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0.@*RESULTS@#(1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points.@*CONCLUSION@#TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.

Clinical Analysis of Hashimoto′s Thyroiditis Combined with Hyperthyroidism in 56 Children / 实用儿科临床杂志

Objective To explore the clinical feature,diagnosis,treatment and prognosis of Hashimoto′s thyroiditis(HT) combined with hyperthyroidism in children.Methods The clinical features of 56 children with HT combined with hyperthyroidism,including clinical features,complications,thyroid hormone,thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),the detection of ultrasonic imaging and fine needle aspiration biopsies,diagnosis,treatment and prognosis were analyzed.Results The proportion of men to women was 16 in all 56 children,and the mean age at diagnosis was(9.95?2.09) years.The percentage of positive TGAb and TPOAb were 93% and 98%,respectively in all the 56 children.One child was diagnosed as HT combined with hyperthyroidism coexistent and myasthenia gravis type Ⅰ.The duration of hyperthyroidism ranged from 3 to 24 months.There were 14 children who had hypothyrodism and 8 children were euthyroid in all the 56 children.Conclusions Children with HT hyperthyroidism are more frequent in young females.TGAb and TPOAb are important markers for the diagnosis of HT.Pharmacotherapy is the first choice to treat HT hyperthyroidism.Hyperthyroidism is a clinical process of HT,and the percentage of children with hypothyrodism is increasing along with the development of disease.

Therapeutic Effect of Recombinant Human Growth Hormone on the Stature of Children with Turner Syndrome / 实用儿科临床杂志

Objective To explore the therapeutic effect of recombinant human growth hormone (rhGH) on the stature of children with Turner syndrome(TS) and analyze its influencing factors in treatment.Methods Twelve children with TS were selected in the outpatient department of West China second hospital of sichuan university between Jan.2004 to Jun.2007.They were diagnosed as TS with karyotypically.The average age was 4.9-16.9(11.28?3.64)years old.Every patient must be made sure to have normal liver function,kidney funtion and MRI for hypothalamus and pituitary before enrollment.All cases were never treated with growth hormone or estrin.Not all the patients had the same manifestations:12 cases with short stature,9 cases with cubitus valgue,8 cases with broad chest,4 cases with low posterior hairline,2 cases with webbed neck,11 cases without pubes and armpit hair,none with menarche.Every patient must be made sure to have normal liver function,kidney funtion and MRI for hypothalamus and pituitary before enrollment.rhGH was used subcutaneously 3-5 cm around navel eve-ry night before sleep.Average rhGH dose was 0.16 IU/(kg?d)[0.15-0.18 IU/(kg?d)],and height standard deviation score (HtSDS) was calculated and compared before and after rhGH treatment,and adverse reactions were observed.Results The duration of treatment was different:9 cases for 12 cases months,2 cases for 15 cases months and 1 case for 18 cases months.The average height increase rat was (0.55?0.15) cm / month.Difference of HtSDS existed before and after treatment by t test(t=2.87 P