Risk factors for cow's milk protein allergy in infants: a multicenter survey / 中国当代儿科杂志

OBJECTIVE@#To investigate the risk factors for cow's milk protein allergy (CMPA) among infants through a multicenter clinical study.@*METHODS@#A total of 1 829 infants, aged 1-12 months, who attended the outpatient service of the pediatric department in six hospitals in Shenzhen, China from June 2016 to May 2017 were enrolled as subjects. A questionnaire survey was performed to screen out suspected cases of CMPA. Food avoidance and oral food challenge tests were used to make a confirmed diagnosis of CMPA CMPA. A multivariate logistic regression analysis was used to investigate the risk factors for CMPA.@*RESULTS@#Among the 1 829 infants, 82 (4.48%) were diagnosed with CMPA. The multivariate logistic regression analysis showed that maternal food allergy (OR=4.91, 95%CI: 2.24-10.76, P6 months (OR=0.38, 95%CI: 0.17-0.86, P<0.05) were protective factors.@*CONCLUSIONS@#The introduction of complementary food at an age of <4 months, maternal food allergy, and antibiotic exposure during pregnancy are risk factors for CMPA in infants.

Prognostic analysis of children with Henoch-Schonlein purpura treated by Helicobacter pylori eradication therapy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of Helicobacter pylori (Hp) eradication therapy on prognosis in children with Henoch-Schonlein purpura (HSP).</p><p><b>METHODS</b>A total of 153 children with HSP were divided into Hp infection treatment group (n=22), Hp infection control group (n=21), and Hp infection-negative group (n=110). The Hp infection treatment group received one-week triple therapy for Hp eradication in addition to conventional treatment, while the Hp infection control group and Hp infection-negative group received conventional treatment. All patients were followed up for prognostic evaluation.</p><p><b>RESULTS</b>The response rates of the Hp infection treatment, control, and negative groups were 86% (19/22), 90% (19/21) and 85% (94/110), respectively (P>0.05). The recurrence rates of HSP in the Hp infection treatment, control, and negative groups were 14% (3/22), 24% (5/21) and 31% (34/110), respectively (P>0.05). The incidence of Henoch-Schonlein purpura nephritis (HSPN) in the Hp infection-negative group (36%, 40/110) and control group (33%, 7/21) was significantly higher than that in the Hp infection treatment group (5%, 1/22) (P<0.05 for both), but no significant difference in the incidence of HSPN was found between the control and negative groups (P>0.05).</p><p><b>CONCLUSIONS</b>One-week triple therapy for Hp eradication may be useful to reduce the incidence of HSPN in children with HSP infected with Hp.</p>

Clinical application of cardiac output monitoring in children with severe hand-foot-mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Significant cardiac dysfunction has been found in children with severe hand-foot-mouth disease and heart failure is the major cause of death in these patients. Evaluation of cardiac function is essential for the treatment of severe cases. This study evaluated the clinical value of cardiac output monitoring in children with severe hand-foot-mouth disease.</p><p><b>METHODS</b>A total of 107 children with severe hand-foot-mouth disease admitted to the pediatric intensive care unit from April 2011 to September 2011 were enrolled and divided into three groups by clinical stage: 73 cases in stage 2, 23 cases in stage 3 and 11 cases in stage 4. Cardiac output and stroke volume were measured by ultrasonic cardiac output monitors (USCOM). Ninety-five children received MRI scanning and were grouped according to the results of MRI: 41 cases (medulla oblongata involvements in 9 cases) in abnormal MRI group and 54 cases in normal MRI group. Cardiac output was compared between the children in different clinical stages and between different MRI results.</p><p><b>RESULTS</b>Compared with children in clinical stages 2 and 3, cardiac output in children in clinical stage 4 decreased significantly (P<0.05). There was no differences in cardiac output between the normal and abnormal MRI groups, however cardiac output was significantly lower in children with medulla oblongata involvement than in those with other involvements and normal MRI.</p><p><b>CONCLUSIONS</b>Significant decrease in cardiac output suggests critical conditions and medulla oblongata cardiovascular center involvement in children with severe hand-foot-mouth disease. Dynamic measurement of cardiac output is valuable for treatment of the disease.</p>

A modified management of the transcatheter occlusion of patent ductus arteriosus: using angiography combined with transthoracic echocardiography / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility of angiography combined with transthoracic echocardiography (TEE) as a modified management of the transcatheter occlusion of patent ductus arteriosus (PDA).</p><p><b>METHODS</b>Forty children with PDA were randomly divided into two groups (n=20 each): observed and control. The control group accepted traditional transcatheter occlusion, and the observed group received a modified management (angiography combined with TEE). The children in the observed group were monitored by realtime TTE.</p><p><b>RESULTS</b>A complete occlusion was acquired by one occlusion operation in each child in the observed group. The TTE demonstrated that the occlusion device was in place, and that the blood flow velocities in the left and right pulmonary artery and the descending aorta were in normal ranges. There were shorter X-ray exposure time, shorter recovering time and less ICU stay time in the observed group than in the control group. The complications associated with blood vessel puncturation occurred in four children from the control group, but none of the observed group had the complications. The total hospitalization cost in the observed group was less than in the control group.</p><p><b>CONCLUSIONS</b>Angiography combined with TEE as a modified management of the transcatheter occlusion of PDA is recommended.</p>

Decreased circulating endothelial progenitor cell function: relationship with serum concentrations of high-sensitivity C-reactive protein in children with Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the function of circulating endothelial progenitor cells and its relationship with serum concentrations of high-sensitivity C-reactive protein (Hs-CRP) in children with Kawasaki disease.</p><p><b>METHODS</b>Ten children with Kawasaki disease and ten healthy children as a control group were enrolled. The peripheral mononuclear cells were induced into endothelial progenitor cells using Dulbecco's Modified Eagle Medium containing vascular endothelial growth factor and basic fibroblast growth factor. The proliferative ability, migratory ability and adhesive ability of endothelial progenitor cells were assessed by MTT methods, modified Boyden chamber methods and cell culture plate adhesion method, respectively. The concentrations of serum Hs-CRP were measured by latex enhanced turbidimetric immunoassay.</p><p><b>RESULTS</b>The proliferative ability, migratory ability and adhesive ability of endothelial progenitor cells in the Kawasaki disease group were significantly lower than those in the control group (P<0.01). The serum concentrations of Hs-CRP in the Kawasaki disease group were significantly higher than those in the control group (87.1+/-30.2 mg/L vs 5.3+/-3.4 mg/L; P<0.01). The function of circulating endothelial progenitor cells was negatively correlated with serum concentrations of Hs-CRP in the Kawasaki disease group.</p><p><b>CONCLUSIONS</b>The function of circulating endothelial progenitor cells is decreased in children with Kawasaki disease, which may be associated with the abnormal expression of inflammatory mediators.</p>

Significance of serum CD62p and CD63 levels in patients with head injury / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To determine the serum levels of CD62p (alpha-granular membrane protein) and CD63 (lysosome intact membrane protein) in patients with head injury and to observe its relation to injury severity.</p><p><b>METHODS</b>Fifty-three patients with head injury were divided into 3 groups; Group A patients with mild head injury; Group B with moderate head injury; and Group C with severe head injury. The serum levels of CD62p, CD63 were measured on 12 h, d 1, 3, 5 and 7 after injury.</p><p><b>RESULT</b>The serum levels of CD62p and CD63 in Group B and Group C were higher than those in Group A and control (P<0.05). The serum level of CD62p in Group C was higher than that in Group B (P<0.05). The serum levels of CD62p in Group C on d 1, 3, 5 after injury were higher than those on 12 h (P<0.05). The serum level of CD63 in Group B on d 3 after injury were higher than that on 12 h (P<0.05). The serum levels of CD63 in Group C on d 1, 3, 5 after injury were higher than those on 12 h (P<0.05).</p><p><b>CONCLUSION</b>The serum levels of CD62p and CD63 in patients with head injury may be helpful for identifying the severity of injury, and CD62p seems to be more sensitive.</p>

Study on the correlation of between infection, inflammation and coronary artery disease / 中华流行病学杂志

<p><b>OBJECTIVE</b>Recently studies showed infections of Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp) and cytomegalovirus (CMV) played roles in the development of atherosclerosis. The aim of this study was to study relationship between infection of Cp, Hp and CMV, systemic inflammation and coronary artery disease (CAD).</p><p><b>METHODS</b>Fourty-five patients with at least one coronary artery stenosis > 50% and 33 control subjects with negative coronary angiography were recruited for this case-control study from May 2000 to October 2001. Antibodies against Cp, Hp and CMV were measured and serum C-reactive protein (CRP) levels determined for each case. CRP level > 0.8 mg/dl was defined at elevated CRP level.</p><p><b>RESULTS</b>The prevalence of Cp IgG, Hp IgG or Hp IgA antibody was associated with CAD (P = 0.017, P < 0.001, P = 0.009). After adjustment for age, gender, smoking, hypertension, hyperlipidemia and diabetes, the association was still seen. Mean CRP value was significantly higher in patients with CAD, compared to those without CAD (P < 0.001). Multivariate analysis showed statistical significance (P = 0.03). Elevated levels of CRP were found to be an important parameter for CAD (P = 0.032). The prevalence of Cp IgG antibody, Hp IgG and CMV IgG antibody all showed no association with elevated levels of CRP (P = 0.391, P = 0.253, P = 0.724). The ratio of elevated levels of serum basic CRP in the group with IgG antibodies to 3 pathogens was 32.1% while in the group with IgG antibodies to <or= 2 pathogens it was 14.9%. But with no significance difference between the two (P = 0.078).</p><p><b>CONCLUSIONS</b>Two chronic infections, Cp and Hp, might increase the risk of CAD. There was no association of CMV infection with CAD. C-reactive protein was an independent parameter of CAD, but the increased systemic inflammation in CAD did not seem to be related to aforesaid infection.</p>