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Objective To investigate the clinical efficacy of levothyroxine replacement therapy in children with hypothyroidism.Methods 45 children with hypothyroidism admitted from Apr.2015 to Dec.2016 were selected as observation group,and 45 healthy children in the same period were selected as the control group.Children in the control group received regular diet and were paid attention to nutritional balance.Children in the observation group were given levothyroxine sodium on the basis of dietary guidance.The two groups were treated continuously for 6 months.The levels of thyroid function,insulin-like growth factor,indicators for growth and development and inflammatory factors were measured before and after treatment in both groups.Results After treatment for 3 months and 6 months,the levels of FT3,FT4,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group increased significantly compared with those before treatment,and the levels of TSH in the observation group decreased significantly(P＜0.05).The levels of FT3,lFT4,TSH,IGF-1,IGFBP-3 and IGF-1/IGFBP-3 in the observation group after treatment for 6 months were (7.17±0.06)pmol/L,(2.74±0.07)mU/L,(207.67±9.06)μg/L,(0.46±0.02) mg/L and(34.59±1.97).The difference was not statistically significant (P＞0.05).After 3 months and 6 months of treatment,the height,body weight,osteocalcin and 25-(OH)2D3 levels in the observation group were significantly higher than those in the control group (P＜0.05),and there was no significant difference between the two groups after 6 months (P＞0.05).The difference was statistically significant (P＜0.05).Conclusion Left thyroid hormone replacement therapy can significantly improve the thyroid function of children with hypothyroidism,increase the level of thyroid-associated hormone and insulin-like growth factor,promote the growth and development of children,which is worthy of clinical application.
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Objective To investigate the development of tidal breathing lung function in very low birth weight infants with bronchopulmonary dysplasia(BDP).Methods Two hundred and sixty-two very low birth weight infants hospitalized in Wenzhou Children′s Hospital were enrolled as objects.All infants were given the tidal breathing pulmonary function test within a week before discharge and at the corrected age of 6 to 8 months.According to clinical diagnosis,they were divided into BPD group(n=65) and non-BPD group(n=197),and BPD group were divided into mild group(n=31),moderate group(n=20) and severe group(n=14) according to the severity.The lung function indexes were compared between different groups.Results The results of the test within a week before discharge displayed that the respiratory rates in the BPD groups were higher than those in the non-BPD group(all P＜0.05).The peak expiratory flow(TPEF),tidal expiratory flow at 75%,50%,and 25% tidal volume(TEF75,TEF50,TEF25) in moderate to severe BPD group were higher than those in other groups(all P＜0.05),while in mild BPD group were higher than those in non-BPD group(all P＜0.05).The ratio of time to peak tidal expiratory flow to total expiratory time (TPEF/TE),ratio of volume to peak tidal expiratory flow to total expiratory volume (VPEF/VE) were lower in BPD group than those in non-BPD group,the decline was more obvious as the BPD was more serious(all P＜0.05).No significant differences were found between groups in tidal volume(P＞0.05).The result at the corrected age of 6 to 8 months displayed that TPEF,TEF75,TEF50,TEF25 in severe BPD group were still higher than those in any other group(all P＜0.05),while TPEF/TE,VPEF/VE were lower than those in any other group(all P＜0.05),no significant differences were found between other groups in other indicators(P＞0.05).Conclusion Preterm infants BPD have different degrees of lung injury,but as the age grows some lung function indexes can improve gradually(at the corrected age of 6 to 8 months).However,early severe small airway obstruction is still serious.Therefore,it′s important to prevent and treat BPD for the prevention and regulation of respiratory tract disease in future.
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Objective To study the effect of minimal enteral nutrition on the immune system of newborn infants under mechanical ventilation (MV) with intratracheal intubation.Methods Eighty-one patients under MV with intratracheal intubation were divided into two groups:treatment group and control group.Forty patients in treatmet group accepted early minimal enteral nutrition,while other 41 patients in control group accepted normal feeding,then T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM),occurane of secondary infection,time of beginning fully enteral feeding,occurance of abdominal distension were recorded.Results There were no significant differences of T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM) changes between the two groups in which the time of patients beginning MV under intratracheal intubation was less than five days (P ＞ 0.05) ; while comparing patients in the two groups whose MV time was equal or greater than five days,the changes of T-lymphocytes CD3[(37.3 ± 1.6)％,(42.6 ±2.8)％],CD4[(29.1 ±1.7)％,(34.6 ±2.1)％],CD4/CD8 (17.9 ±1.8,18.9 ± 1.6),immunoglobulins IgA[(55.42 ±3.98) mg/L,(129.00 ±7.76) mg/L],IgM[(130.29 ±10.92) mg/L,(317.33 ± 11.64) mg/L] in treatment group were more significant than those in control group(P ＜0.05) ;furthermore the differences of the secondary infection occurance,the time beginning fully enteral feeding,intravenous nutrition and hospital stays in the treatment group [20％ (8/40),(8.56 ± 1.78) d,(10.56 ± 1.78) d,(12.63 ± 1.73) d] were lower significantly than those in the control group [48.78％ (20/41),(10.20 ± 1.65) d,(12.15 ± 1.69) d,(14.15 ± 1.64) d] (P ＜ 0.05).These were no significant differences on abdominal distension and gastric retention between the treatment group [20％ (8/40),17.5％ (7/40)]and the control group [24.39％ (10/41),19.51％ (8/41)] (P ＞ 0.05).Conclusion Early minimal enteral nutrition in infants under long time MV with intratracheal intubation could improve immune function recovery,reduce the occurance rate of secondary infection,shorten the time beginning fully enteral feeding,intravenous nutrition and hospital stay.
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Objective To investigate the significance of total bilirubin/albumin in predicting bilirubin neurotoxicity.Methods Eighty-three cases with hyperbilirubinemia who treated from May 2007 to August 2010 were selected,the serum total bilirubin and albumin were detected and total bilirubin/albumin was calculated.According to brainstem auditory evoked potential(BAEP)results,the patients were divided into normal BAEP group and abnormal BAEP group and compared.Results There were 27 cases of abnormal BAEP group and 56 cases of normal BAEP group.Total bilirubin and total bilirubin/albumin in abnormal BAEP group were higher than those in normal BAEP group[(356.50±59.23)μmol/L vs.(318.70±55.12)μmol/L,(5.02±0.49)×10-3 vs.(4.56±0.43)×10-3],the differences were significant (P0.05).Conclusion Total bilirubin/albumin can reflect serum unconjugated bilirubin level of neonatus with hyperbilirubinemia better than total bilirubin,and it can can be taken as one index to evaluate the risk factors of bilirubin neurotoxicity.