Clinical features of intestinal polyps and risk factors for secondary intussusception in children: an analysis of 2 669 cases / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of intestinal polyps and the risk factors for secondary intussusception in children.@*METHODS@#A retrospective analysis was performed for the medical data of 2 669 children with intestinal polyps. According to the presence or absence of secondary intussusception, they were divided into two groups: intussusception (n=346) and non-intussusception (n=2 323). Related medical data were compared between the two groups. The multivariate logistic regression analysis was used to identify the risk factors for secondary intussusception.@*RESULTS@#Among the children with intestinal polyps, 62.42% were preschool children, and the male/female ratio was 2.08∶1; 92.66% had hematochezia as disease onset, and 94.34% had left colonic polyps and rectal polyps. There were 346 cases of secondary intussusception, with an incidence rate of 12.96% (346/2 669). Large polyps (OR=1.644, P<0.001), multiple polyps (≥2) (OR=6.034, P<0.001), and lobulated polyps (OR=93.801, P<0.001) were the risk factors for secondary intussusception.@*CONCLUSIONS@#Intestinal polyps in children often occur in preschool age, mostly in boys, and most of the children have hematochezia as disease onset, with the predilection sites of the left colon and the rectum. Larger polyps, multiple polyps, and lobulated polyps may increase the risk of secondary intussusception, and endoscopic intervention is needed as early as possible to improve prognosis.

Novel PHEX gene mutations in patients with X-linked hypophosphatemic rickets: an analysis of 2 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate PHEX gene mutations in 2 patients with X-linked hypophosphatemic rickets (XLH) and their families and to clarify the genetic etiology.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of two patients with XLH. High-throughput sequencing was used to detect the PHEX gene, a pathogenic gene of XLH. PCR-Sanger sequencing was used to verify the distribution of mutations in families.</p><p><b>RESULTS</b>Both patients had novel mutations in the PHEX gene; one patient had a frameshift mutation, c.931dupC, which caused early termination of translation and produced the truncated protein p.Gln311Profs*13; the other patient had a splice site mutation, IVS14+1G>A, which caused the skipping of exon 15 and produced an incomplete amino acid chain. Their parents had normal gene phenotypes.</p><p><b>CONCLUSIONS</b>c.931dupC and IVS14+1G>A are two novel mutations of the PHEX gene and might be the new pathogenic mutations of XLH.</p>

Clinical application of single-balloon enteroscopy in children with small intestinal bleeding / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value and safety of single-balloon electronic enteroscopy in children with small intestinal bleeding.</p><p><b>METHODS</b>Seventy children with clinically suspected small intestinal bleeding, including 38 males and 32 females aged 4-13 years, underwent single-balloon enteroscopy under general anesthesia. Twenty-six cases underwent the procedure through the mouth, 32 cases through the anus, and 12 cases through both.</p><p><b>RESULTS</b>Of the 70 children, 58 (83%) had small bowel disease according to the single-balloon enteroscopy results, including 24 cases of non-specific inflammation, 12 cases of allergic purpura, 8 cases of Crohn's disease, 8 cases of Meckel's diverticulum, and 6 cases of Peutz-Jeghers syndrome.</p><p><b>CONCLUSIONS</b>Single-balloon enteroscopy is a safe, effective means for the diagnosis of small intestinal bleeding among children.</p>

Related factors on patients with depression related to Alzheimer's disease based on the improved cumulative logistic regression / 中华流行病学杂志

Objective To explore the determinants of Alzheimer' s disease (AD) patients with depression.Methods The degree of depression on AD patients was assessed by the geriatric depression scale.Improved cumulative logistic regression (ICLR) was used to analyze the determinants of AD patients with depression.Results 196 AD patients were investigated.Among the 196 AD patients,there were 60(30.6％ ) males and 136(69.4％ ) females,at 58-89 years of age (72.3 ± 6.0).Physical activity,diabetes,MoCA,hearing,economic sources and alcohol were related to the degree of depression of AD patients (P＜0.10 ).The difference between “normal” and “mild depression” was smaller than difference between “mild depression” and “severe depression”.Conclusion AD patients with mild depression were the target population for prevention and they were influenced by several factors listed above.

Efficacy observation of electroacupuncture intervention on severe acute pancreatitis at early stage complicated with intestinal paralysis / 中国针灸

<p><b>OBJECTIVE</b>To explore the clinical efficacy of electroacupuncture intervention on severe acute pancreatitis (SAP) at early stage complicated with intestinal paralysis.</p><p><b>METHODS</b>Sixty-eight cases of SAP were randomly divided into observation group (48 cases) and control group (20 cases). In observation group, according to the course of sickness, the early-stage subgroup (30 cases, hospitalized in 3 d) and late-stage subgroup (18 cases, hospitalized in 3-7 d) were subdivided. In control group, the conventional treatment was applied. In observation group, based on the same treatment as control group, electroacupuncture was supplemented at Zhongwan (CV 12), Zusanli (ST 36), Neiguan (PC 6), Hegu (LI 4), etc. Acute physiology and chronic health evaluation (APACHE) II scores, the recovery time of intestinal paralysis and laboratory indices, complications, operation transfer rate, death rate and the admission time were compared among groups after treatment.</p><p><b>RESULTS</b>The total effective rate was 83.3% (25/30) in early-stage subgroup, which was superior to 72.2% (13/18) in late-stage subgroup and 65.0% (13/20) in control group (P < 0.05, P < 0.01). In early-stage subgroup, the remission time of abdominal pain, the remission time of abdominal distention, the recovery time of borborygums, the recovery time of gas discharge, and the recovery time of defecation were all shorter significantly than those in late-stage subgroup and control group (P < 0.05, P < 0.01). In early-stage subgroup, APACHE II scores, the recovery time of WBC and blood/uric amylase, complications, operation transfer rate, death rate and admission time were all lower remarkably than those in late-stage subgroup and control group (P < 0.05, P < 0.01); but, there were no statistical significant differences in comparison between late-stage subgroup and control group (all P > 0.05).</p><p><b>CONCLUSION</b>The clinical efficacy of electroacupuncture intervention on SAP complicated with intestinal paralysis is superior remarkably to that of conventional treatment, and the efficacy of electroacupuncture intervention at early stage is better than that at late stage.</p>

Effect of Chinese herbal medicine for calming Gan (肝) and suppressing hyperactive yang on arterial elasticity function and circadian rhythm of blood pressure in patients with essential hypertension / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of Chinese herbal medicine for calming Gan (肝) and suppressing hyperactive yang (平肝潜阳, CGSHY) on arterial elasticity function and the circadian rhythm of blood pressure in patients with essential hypertension (EH).</p><p><b>METHODS</b>Adopting a parallel, randomized design, sixty-four patients with EH of stages I and II were randomly divided into two groups according to a random number table, with 32 in each group. The patients in the treatment group were treated with CGSHY and those in the control group were treated with Enalapril. All patients were given 24-h ambulatory blood pressure monitoring (ABPM) before and after a 12-week treatment. Trough/peak (T/P) ratios of systolic and diastolic blood pressure (SBP & DBP) of each group were calculated. The circadian rhythm of their blood pressure was observed at the same time. The changes in elasticity of the carotid artery in the patients, including stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC), augmentation index (AI), and pulse wave velocity (PVWβ) were determined by the echo-tracking technique before and after a 12-week treatment. In the meantime, their levels of nitric oxide (NO) and endothelin-1 (ET-1) were measured respectively.</p><p><b>RESULTS</b>After treatment, all parameters in the 24-h ABPM and the elasticity of the carotid artery (β, Ep, AC and PVWβ) were markedly improved, the level of NO was increased, and ET-1 was decreased in both groups as compared with values before treatment (P<0.05 or P<0.01). Further, the improvements in the ratio of T/P of SBP & DBP and in the level of NO and ET-1 in the treatment group were more significant than those in the control group (P<0.05). There were no significant differences in all parameters in the ABPM monitoring and the elasticity of the carotid artery, the recovery of blood pressure circadian rhythm, and the therapeutic effect of antihypertension in EH patients between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>Chinese herbal medicine for CGSHY may lower the blood pressure smoothly and recover the circadian rhythm of blood pressure in EH patients. They may also improve the carotid elasticity of EH patients similar to that of Enalapril. The mechanism of action of Chinese herbs on EH might be related to the regulation of vascular endothelium function.</p>

Application of electronic gastroscopy in 177 infants at ages of 0-3 months / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical application and the safety of electronic gastroscopy in infants at ages of 0-3 months.</p><p><b>METHODS</b>An Olympus electronic gastroscope GIF 260 or GIF 230 was applied in 177 infants at ages of 0-3 months with upper gastrointestinal symptoms. An ECG Monitor II was used for monitoring heart rate, cardiac rhythm and pulse transcutaneous oxygen saturation in 65 infants during the whole process of gastroscopy. Some related treatments were performed under the electronic gastroscope, such as removal of foreign body, topical administration of antihemorrhagic drugs, reduction of volvulus of stomach and bougienage of oesophagus.</p><p><b>RESULTS</b>All 177 infants were examined successfully and they all well tolerated. Forty-two cases demonstrated positive findings in 68 cases of upper gastrointestinal bleeding. Ninety-two cases demonstrated positive findings in 104 cases of recurrent vomiting. Under the electronic gastroscope, removal of foreign body in the upper gastrointestinal tract was performed in 5 cases; topical administration of antihemorrhagic drugs or electrocoagulation for stopping bleeding in 22 cases; reduction of volvulus of stomach in 3 cases.</p><p><b>CONCLUSIONS</b>As a safe and visual means for diagnosis of digestive tract diseases, the electronic gastroscopy may be recommended for wide application in infants at ages of 0-3 months.</p>

Acupuncture at points of the liver and gallbladder meridians for treatment of migraine: a multi-center randomized and controlled study / 中国针灸

<p><b>OBJECTIVE</b>To investigate the therapeutic effect and safety of acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine.</p><p><b>METHODS</b>Multi-central, randomized and controlled trial was used and 253 cases of migraine were divided into an acupuncture group and a western medicine group. The acupuncture group was treated with acupuncture at points of The Liver and Gallbladder Channels with Taichong (LR 3), Yang-lingquan (GB 34), Fengchi (GB 20), Ququan (LR 8) selected as main points, and the western medicine group with oral administration of Flunarizine tablets for 4 therapeutic courses. The total therapeutic effects 3 and 6 months after the treatment, the scores of various symptoms of migraine before and after treatment, and the stability of therapeutic effect in one-year following-up survey were observed in the two groups.</p><p><b>RESULTS</b>After treatment, mean times and duration of the headache attack were significantly improved in the two groups (all P < 0.01) with the acupuncture group better than the western medicine group (P < 0.05). The total effective rates for stopping pain after treatment, 3 months and 6 months after treatment in the acupuncture group were 93.0%, 93.0% and 87.7%, respectively, which were better than 85.6%, 86.5% and 69.2% in the western medication group (all P < 0.01). One year later, the stability of the therapeutic effect in the acupuncture group was better than that in the western medicine group (P < 0.05); the adverse reaction and the compliance in the acupuncture group were significantly superior to those in the western medicine group.</p><p><b>CONCLUSION</b>Acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine is safe, effective, and with stable long-term therapeutic effect.</p>

Effect of calming the liver and suppressing the hyperactive YANG drugs on lymphocyte protein in hypertension patients with hyperactivity of liver-YANG / 中南大学学报(医学版)

OBJECTIVE@#To explore the effect of calming the liver and suppressing the hyperactive YANG drugs on the lymphocyte protein and clinical efficacy in the hypertension patients with hyperactivity of liver-YANG, and to identify the therapy.@*METHODS@#Twenty-six hypertension patients with hyperactivity of liver-YANG were treated by calming the liver and suppressing the hyperactive YANG drugs for 2 courses. Symptoms of Chinese medicine and blood pressure were observed, and the separated lymphocyte total protein of normal and hypertensions before and after the treatment were examined by the solid-state pH gradient 2-dimensional gel electrophoresis. The differences of the protein expression were analyzed by ImageMaster 2DE analysis software with two-way patterns.@*RESULTS@#The total efficiency rate of calming the liver and suppressing the hyperactive YANG drugs was 88.5%, and the drugs could significantly relieve the symptoms, such as headache, dizziness, dry mouth, irritability, etc. Calming the liver and suppressing the hyperactive YANG drugs could also remarkably reduce the blood pressure,with significant different between pre-treatment and post-treatment (P<0.05). The average spots of lymphocyte gel proteins in the normal and the hypertension patients with syndrome of hyperactivity of liver-YANG before and after the treatment were 527+/-41,559+/-62, and 543+/-59, respectively. Compared with normal people, the expression of 15 proteins was down-regulated, and 10 up-regulated in the hypertension patients with syndrome of hyperactivity of liver-YANG. Compared with the pre-treatment, the expression of 12 proteins was increased in the 15 down-regulated proteins, and 6 decreased in the 10 up-regulated proteins after the treatment in the hypertension patients with syndrome of the hyperactivity of liver-YANG.@*CONCLUSION@#Calming the liver and suppressing the hyperactive yang drugs may mildly depress the blood pressure and improve the symptoms of Chinese medicine. The effect of drugs in treating hypertension may probably be associated with regulating the expression of some proteins in lymphocytes.

Dehydroepiandrosterone sulfate and insulin of prepubertal girls born small for gestational age / 中华儿科杂志

<p><b>OBJECTIVES</b>To investigate whether the association between low birth weight and increased risk of developing premature adrenarche, adrenal hyperandrogenism, hyperinsulinism and insulin resistance is apparent in prepubertal girls born small for gestational age (SGA) and analyze when adrenarche occurs in SGA infants and normal birth weight girls.</p><p><b>METHODS</b>The study was performed in 39 prepubertal SGA girls with a mean age of 7.4 +/- 1.7 years and 42 prepubertal appropriate for gestational age (AGA) girls with a mean age of 7.4 +/- 1.7 years served as controls. All children were born at term and were prepubertal. Detailed physical examination was performed for all the children after 12 h of overnight fasting. Blood samples were taken for the measurement of fasting glucose (FPG), insulin (FIns), dehydroepiandrosterone sulfate (DHEAS), cortisol and estradiol concentrations. Insulin sensitivity was assessed by insulin sensitivity index [IAI = log(e) (FPG x FIns)].</p><p><b>RESULT</b>There was no premature adrenarche in SGA and AGA groups. Birth weight was significantly lower in SGA group (P < 0.001). Gestational age was similar in both groups. At the time of the study, the ages, body mass index (BMI), fasting glucose, cortisol and estradiol did not significantly differ between the two groups. But body height and weight were significantly lower in the SGA group (P < 0.05 for both). The fasting plasma insulin in the SGA group was higher than that in AGA group (common logarithmic transformation: 1.076 +/- 0.041 vs. 1.050 +/- 0.051, P < 0.05). The insulin sensitivity index was not significantly different between the two groups (-4.0165 +/- 0.1761 vs. -3.9768 +/- 0.2314). The serum DHEAS was significantly higher in SGA children than in AGA children (common logarithmic transformation: 2.637 +/- 0.271 vs. 2.514 +/- 0.250, P < 0.05). From about age 7 the concentration of DHEAS had a gradual rise in AGA children. The time of DHEAS rise tended to be earlier in SGA children compared with AGA children.</p><p><b>CONCLUSIONS</b>Adrenarche commences at approximately 7 years of age in AGA girls. The time of adrenarche tended to be earlier in SGA girls compared with AGA girls. There were adrenal hyperandrogenism and hyperinsulinism in prepubertal girls born small for gestational age. But there was no insulin resistance as assessed by insulin sensitivity index.</p>

Evaluation of antibacterial activity of amoxycillin sodium and clavulanate potassium and the pharmacoeconomics in the therapy of acute respiratory infection / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the antibacterial activity of amoxycillin sodium and clavulanate potassium (trade name: Anqi) in vitro and the pharmacoeconomics in the therapy of acute respiratory infection.</p><p><b>METHODS</b>Minimal inhibition concentration (MIC), minimal bactericidal concentration (MBC) and bactericidal curve of amoxycillin sodium and clavulanate potassium against common pathogens were determined and compared with some other same kind of antibiotics without beta-Lactamase inhibitor. Eighty cases diagnosed as respiratory infection were randomly divided into 4 groups: group 1 was treated with i.v. Anqi; group 2 was treated with i.v. Anqi and oral consecutive strategy; group 3 was treated with iv ampicillin and sulbactam; group 4 was treated with i.v. cefuroxime. The clinical therapeutic effects were observed and cost-effectiveness analyzed.</p><p><b>RESULTS</b>In terms of MIC, MBC and bactericidal curve of 135 bacterial strains, Anqi was superior to the other same-kind antibiotics without beta-lactamase inhibitor, this effect was especially obvious on Klebsiella pneumoniae and Escherichia coli which can produce extended spectrum beta-lactamases (ESBLs). The cost-effectiveness of the consecutive therapy group was the best.</p><p><b>CONCLUSION</b>Anqi has a wide antimicrobial spectrum and strong effect on the bacteria producing ESBLs, the consecutive therapy strategy should be clinically recommended.</p>