Correlation between insulin resistance and myocardial injury in critically ill children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between insulin resistance and myocardial injury in children with critical diseases in light of the fact that such children usually suffer from noticeable insulin resistance and myocardial injury.</p><p><b>METHODS</b>Sixty-three children with critical diseases who were admitted between March 2010 and June 2011 were enrolled to comprise a case group. Fasting blood glucose, serum insulin, myocardial enzyme, and troponin I (CTnI) levels were measured. The insulin resistance index (HOMA-IR) was calculated. The children were classified into two groups: insulin resistance (HOMA-IR>1.0; n=30) and non-insulin resistance (HOMA-IR≤1.0; n=33). Thirty healthy children served as the control group.</p><p><b>RESULTS</b>HOMA-IR, lactate dehydrogenase (LDH), aspartate aminotransferaseaspartate transaminase (AST), creatine kinase (CK), isoenzymes of creating kinase (CK-MB), α-hydroxybuty rate dehydrogenase (α-HBDH) and CTnI in the insulin resistance group were higher than those in the non-insulin resistance and the control groups (all P<0.05). The non-insulin resistance group also showed obviously higher levels in terms of LDH, AST, CK, CK-MB, α-HBDH, and CTnI than the control group (P<0.05). In the insulin resistance group, there exists a positive correlation between HOMA-IR and such indicators as LDH, CK, CK-MB, AST, α-HBDH and CTnI (r=0.697, 0.739, 0.781, 0.642, 0.381, 0.792 respectively; all P<0.05).</p><p><b>CONCLUSIONS</b>Insulin resistance makes myocardial injury more serious; HOMA-IR can serve as a forecast indicator for the degree of myocardial injury.</p>

Efficacy of sublingual immunotherapy in children with dust mite allergic asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the efficacy of sublingual immunotherapy (SLIT) combined with inhaled corticosteroids (ICS) versus ICS alone in children with mild and moderate dust mite allergic asthma.</p><p><b>METHODS</b>Thirty-two children with mild and moderate dust mite allergic asthma were randomly divided into two groups: SLIT+ICS (n=18) and ICS alone (n=14). A total of 30 children completed the one year clinical observation . The amount of ICS administration, the day and night symptom scores, skin-prick test and pulmonary function test results, serum specific immunoglobulin E (sIgE) and G4 (sIgG4) levels and visual analog scale (VAS) scores were compared between the two groups.</p><p><b>RESULTS</b>By the end of one year the SLIT+ICS group had significantly decreased amount of ICS administration than the ICS alone group. Compared with the ICS alone group, the day and night symptom scores decreased, FEF25-75% increased significantly, and serum sIgE levels and VAS scores were significantly reduced in the SLIT+ICS group. There were no statistical differences in the skin-prick test results, and FEV1 and sIgG4 levels between the two groups. No severe adverse events occurred in both groups during the follow-up period.</p><p><b>CONCLUSIONS</b>SLIT combined with ICS may produce a better efficacy than ICS alone in the improvement of day and night symptoms, pulmonary function and VAS scores in children with dust mite-allergic asthma.</p>