Epidemiological Investigation of Child Simple Obesity in Zhengzhou Area and Intervention Research on Massage Along Channel of Traditional Chinese Medicine / 实用儿科临床杂志

Objective To explore incidence of child obesity in Zhengzhou area and intervention measures.Methods In 2001, spot check was conducted on 5688 cases of high and primary school students ,including 2848 boys and 2840 girls at the age of 7-18.Child obesity was diagnosed by meeting reference BMI value published by Cole et al,conducted comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment for 22 cases of simple obesity children (7-15 years old, 18 boys, 4 girls) selected for one month, and follow-up survey 6 months after treatment.Results Five thousands,six hundreds and eighty-eight high and primary school students investigated had an overweight incidence of 15.4%, an obesity incidence of 3.2%,boys' overweight incidence and obesity incidence(19.2%,4.6%) were remarkably higher than those of girls (11.5%,1.7% P<0.001). Overweight incidence of various age groups evidently differed(χ2=42.88 P<0.001) with the group of 8-15 years old children as popular. Incidence of various age groups also differed(χ2=21.28 P<0.05) with 7-10 years old and 14-15 years old children as popular. After one-month treatment, weight of all the 22 cases of fat children decreased from (76.45±19.87) kg upon hospitalized to (69.06±17.98) kg with a decrease of (7.43±2.58)kg, BMI value decreased from (31.05±3.96) before treatment to (27.72±3.54).Weight and BMI value before and after treatment differed evidently (t=13.6,12.88 P<0.01), and weight and BMI value decrease were remarkably related with those upon hospitalized (r=0.77 P<0.01;r=0.49 P<0.05).Conclusions Incidence of child obesity has been increasing in recent years, comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment have good curative effect and are comfortable, well received by children and suitable to promote and apply.

Comprehensive Healing Treatment of 30 Cases with Small and Short Penis in Simple Obesity Children / 实用儿科临床杂志

Objective To investigate the therapy for small and short penis in simple obesity children.Methods Sixty simple obesity children with short and small penis were randomly divided into 2 groups(experiment group 30 cases and control group 30 cases).The experiment group received comprehensive treatment(consisting of massage of traditional Chinese medicine,behavior modification,dietetic and sport adjustment) to lose weight and treated by short and small penis healing apparatus.The control obesity children were given conducted behavior,dietetic and sport adjustment,and treated by short and small penis healing apparatus.Results After treatment,weight of 30 cases in the experiment group decreased,with a decrease of(7.75?3.50) kg.Body mass index(BMI) decreased from(31.10?3.88) before treatment to(27.82?3.49),and BMI before and after treatment changed significantly(t=12.68 P

Late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (glutaric aciduria type II) / 中华儿科杂志

<p><b>OBJECTIVE</b>Glutaric aciduria type II, or multiple acyl-CoA dehydrogenase deficiency is an autosomal recessively inherited defect of mitochondrial energy metabolism. The authors report two cases of late-onset glutaric aciduria type II, and evaluate the procedures for the diagnosis and treatment of this rare disease.</p><p><b>METHODS</b>The clinical and biochemical characteristics of 2 patients with late-onset glutaric aciduria type II were documented. Case 1 presented with lipid storage myopathy for 3 years. Case 2 presented with intermittent episodes of non-ketotic hypoglycemia and muscle weakness for 9 years. The diagnosis of the 2 cases was confirmed with gas chromatography/mass spectrometry analysis of urine samples. Riboflavin supplementation and a low-fat, low-protein, high-carbohydrate diet were initiated as soon as the diagnosis was made.</p><p><b>RESULTS</b>Organic acid analysis on both untreated cases revealed massive glutaric acid with elevated concentrations of isovalerylglycine, isobutyrylglycine, ethylmalonic acid, adipic acid, suberic acid and other dicarboxylic acids. The clinical manifestations were improved remarkably after the administration of riboflavin and diet control. Consistent improvements of sera enzymes and urine organic acids were observed during the course of treatment.</p><p><b>CONCLUSION</b>Patients with unexplained myopathy, metabolic acidosis or hypoglycemia should be carefully screened for inherited metabolic disorders. Riboflavin in conjunction with appropriate diet control is an effective therapeutic regime for patients with late-onset glutaric aciduria type II.</p>

Application of gas chromatography-mass spectrometry analysis on urine filter paper in the high-risk screening and diagnosis of inherited metabolic diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>To establish a specific procedure for the high-risk screening and diagnosis of organic acidurias and other inherited metabolic diseases in China.</p><p><b>METHODS</b>A nation-wide network for the high-risk screening and diagnosis of genetic metabolic diseases was formed to facilitate the collaboration. Urine samples were collected using filter paper from patients with clinical symptoms suspicious of inherited metabolic diseases. The samples were eluted with distilled water and internal standards were added. Samples were treated with hydroxylamine hydrochloride to form oximes to improve the recoveries of 2-ketoacids. Urinary organic acids were extracted with ethyl acetate and diethyl ether under acidic condition. After dehydration, the combined organic phase was evaporated to dryness with nitrogen. The residues were added with BSTFA + 1%TMCS and heat incubated to form the trimethylsilyl derivatives, and then were analyzed on an Agilent 5890/5973N gas chromatography-mass spectrometer (GC-MS), with a 7683 series auto-sampler. The peaks were identified by reference to a mass spectral library.</p><p><b>RESULTS</b>Totally 352 samples were collected from the network collaborating hospitals since 2001. Thirty-four (9.66%) cases of various inherited metabolic diseases were diagnosed with an age range of 2 days to 14 years. The disease profile was consisted of methylmalonic acidemias (6), alpha-keto-glutaric aciduria (5), tyrosinemia type I (4), dicarboxylic aciduria (4), multiple carboxylase deficiency (3), phenylketonuria (3), lactic acidemia (3), propionic acidemia (2), ornithine transcarbamoylase deficiency (1), ethylmalonic-adipic aciduria (1), glutaric aciduria type II (1) and 3-methylcrotyl CoA carboxylase deficiency (1). The most common clinical symptoms and signs included mental and developmental retardation, convulsion, musculotonic abnormality and jaundice. Routine laboratory tests often revealed metabolic acidosis, hypoglycemia and hyperammonemia, etc.</p><p><b>CONCLUSION</b>Urine organic acids analysis by GC-MS remains to be the most important technique for the high-risk screening and diagnosis of inherited metabolic diseases. Use of urine filter paper for sample collection and analysis in advanced genetic metabolic centers is a practical approach to extend the diagnostic capacity and improve the management of such diseases in China. Collaborative network played a critical role in the success of the program.</p>