Clinical features and treatment of acute clenbuterol poisoning in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study clinical features, treatment and curative effects in children with acute clenbuterol poisoning, in order to provide a basis for early diagnosis and treatment.</p><p><b>METHODS</b>Clinical data of 28 hospitalized children with acute clenbuterol poisoning in April 2011 were retrospectively studied.</p><p><b>RESULTS</b>Of the 28 patients, there were 15 males and 13 females, aged 1 to 13 years (mean age 6.5±4.8 years). Vomiting, palpitations and limb shaking were found as main clinical manifestations in the patients. Main changes of blood biochemical included hypokalemia, lactic acidosis, hyperglycemia, hypsocreatinkinase. Snus tachycardia and S-T segment depression were observed on ECG. Patients' symptoms were gradually alleviated after 12-78 hours by use of beta blockers, potassium supplement, protecting the heart and other symptomatic and supportive treatment. Blood biochemical indexes were improved after 48 hours of admission. All of the patients were cured after 5 days. The symptoms of the patients do not longer occur during a follow up of half a month.</p><p><b>CONCLUSIONS</b>Acute clenbuterol poisoning is characterized by vomiting, palpitations, limb shaking, hypokalemia, lactic acidosis and tachycardia in children. An early effective treatment of this disease can improve prognosis in children.</p>

Study advances of nonalcoholic fatty liver disease in children / 中华实用儿科临床杂志

Nonalcoholic fatty liver disease(NAFLD) in obese children has increasingly become the most common cause of chronic liver disease in children and adolescents.NAFLD includes simple steatosis and nonalcoholic steatohepatitis,which will progress to cirrhosis and hepatocellular carcinoma.It is recognized as a hepatic manifestation of metabolic syndrome.With regarding to the pathogenesis of NAFLD,the "multiple-hit" hypothesis is more popular.Although clinical symptoms,laboratory data,and imaging findings are important,liver biopsy is regarded as the gold standard for the diagnosis of NAFLD.In addition,liver biopsy is essential for assessing the degree of necro-inflammatory change and fibrosis in NAFLD.Although pharmacotherapy has been studied in clinical trials,lifestyle modification by diet and exercise remains the mainstay of treatment for NAFLD.

Application of food allergens specific IgG antibody detection in chronic diarrhea in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The causes of chronic diarrhea in children are complex. At present, food allergy is generally viewed as an important cause of this disorder, and IgG-mediated delayed allergy plays a major role in this process. This study aimed to explore the link between food specific IgG and chronic diarrhea in children, as well as the value of food allergens-specific IgG antibody detection in the management of this disorder.</p><p><b>METHODS</b>Eighty-two children with chronic diarrhea and 30 healthy controls were enrolled. Serum levels of specific IgG antibody to 14 kinds of food were detected using ELISA. The results were classified into four grades: Grade 0 (negative), Grade 1 (mild allergy), Grade 2 (moderate allergy) and Grade 3 (severe allergy). The patients received a diet treatment based on the results of food specific IgG antibody detection. Children with negative IgG antibody were allowed to continue their current diet. In children with Grade 1 allergy, the food responsible for the IgG antibody positive test was given only at an interval of four days. In children with Grade 2 or 3, the offending food was eliminated from the diet.</p><p><b>RESULTS</b>Of the 82 children with chronic diarrhea, 79 (96.2%) had increased specific IgG levels for one or more of the 14 foods tested compared to 8 (26.7%) of the controls (P <0.01). The majority of patients showed increased specific IgG levels for milk (68.3%) and egg (62.2%). A low proportion of patients (2.4%) was allergic to chicken, and no patient was allergic to pork. The symptoms were improved in 65 patients (79.3%) after 1 week to 3 months of diet treatment.</p><p><b>CONCLUSIONS</b>Food allergy is one of major causes of chronic childhood diarrhea. Food specific IgG antibody detection may assist in the dietary management of this disorder.</p>