Efficacy and safety of lactase additive in preterm infants with lactose intolerance: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVE@#To study the efficacy and safety of lactase additive in improving lactose intolerance in preterm infants.@*METHODS@#A total of 60 preterm infants with lactose intolerance who were admitted to the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2019 were randomly divided into a lactase treatment group and a control group, with 30 infants in each group. The infants in the lactase treatment group were given 4 drops of lactase additive (180 mg) added into preterm formula or breast milk, and those in the control group were given placebo, oral administration of probiotics (live combined @*RESULTS@#Finally 29 infants in the lactase treatment group and 26 infants in the control group completed the trial. At the end of the first week after intervention, compared with the control group, the lactase treatment group had significantly lower frequency of daily milk vomiting and gastric retention amount (@*CONCLUSIONS@#Lactase additive can safely and effectively improve the clinical symptoms caused by lactose intolerance in preterm infants.

A 5-year retrospective clinical study of perinatal cytomegalovirus infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence, clinical features, and treatment of perinatal cytomegalovirus (CMV) infection, as well as the factors affecting the therapeutic effect of ganciclovir.</p><p><b>METHODS</b>The clinical data of 237 infants who were hospitalized and diagnosed with perinatal CMV infection from 2008 to 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>The clinical features of infants with perinatal CMV infection and the proportion of such infants in all hospitalized infants showed no significant differences across the five years. In most infants, two or more systems were involved, and CMV hepatitis plus CMV pneumonia was most common (43.1%). The results of pathogen detection showed that the percentage of the infants with positive blood CMV-IgM and blood/urine CMV-DNA was 3.8%, while 90.3% of all infants had positive blood CMV-IgM alone and 5.9% had positive blood/urine CMV-DNA alone. A total of 197 infants were treated with ganciclovir, and the cure rate was 88.3%. An abnormal history of pregnancy (OR=6.191, 95% CI: 1.597-24.002) and liver involvement before medication (OR=3.705, 95% CI: 1.537-8.931) were the independent risk factors affecting the therapeutic effect of ganciclovir in infants with perinatal CMV infection.</p><p><b>CONCLUSIONS</b>The epidemiological characteristics of perinatal CMV infection have remained generally stable for the last 5 years. CMV often involves several organs or systems, especially the liver and lung. Ganciclovir has a significant efficacy in the treatment of perinatal CMV infection, and an abnormal history of pregnancy and liver involvement before medication can increase the risk of ganciclovir resistance in infants with perinatal CMV infection.</p>

Effects of extensively hydrolyzed protein formula on feeding and growth in preterm infants: a multicenter controlled clinical study / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of extensively hydrolyzed protein formula (eHF) on the feeding and growth in preterm infants through a multicenter controlled clinical study.</p><p><b>METHODS</b>Preterm infants admitted to eight upper first-class hospitals in China between February 2012 and December 2013 were randomly selected. They were divided into two observation groups and two control groups. The first observation group consisted of preterm infants with a gestational age of <32 weeks, who were fed with eHF for 10-14 days after birth and then with standard preterm formula (SPF) until discharge. The second observation group consisted of preterm infants with a gestational age of 32-34 weeks, who were fed with SPF after birth, but were switched to eHF (7-14 days) if suffering feeding intolerance at 6-8 days after birth. The two control groups with corresponding gestational ages kept to be fed with SPF after birth. Clinical data were recorded to compare feeding condition, physical growth, blood biochemical indices, and major complications between different groups.</p><p><b>RESULTS</b>A total of 328 preterm infants were enrolled. Preterm infants with a gestational age of <32 weeks in the observation group had a significantly shorter meconium evacuation time than in the corresponding control group (P<0.05). They also had significantly lower levels of serum total bilirubin at weeks 1 and 2 after birth compared with the control group (P<0.05). The observation group needed more time in reaching enteral nutrition (EN) basic energy uptake of 50 kcal/(kg·d), partial parenteral nutrition (PPN), hospitalization, and corrected gestational age at discharge compared with the controlled infants (P<0.05). There was no difference in the incidence of extrauterine growth retardation (EUGR) at discharge between the two groups (P>0.05). Preterm infants with a gestational age of 32-34 weeks in the observation group had significantly lower serum total bilirubin levels at 2 weeks after birth compared with the corresponding control group (P<0.05). They required more time in achieving EN basic energy and PPN than in the control group (P<0.05). There was no difference in the incidence of EUGR at discharge between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>For preterm infants, eHF can improve gastrointestinal motility, accelerate bilirubin metabolism and excretion and does not increase the incidence of EUGR.</p>

Efficacy and safety of ribavirin aerosol in children with hand-foot-mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of ribavirin aerosol in children with hand-foot-mouth disease (HFMD).</p><p><b>METHODS</b>A randomized, double-blind, placebo-controlled trial was performed. A total of 119 children with mild HFMD were randomly divided into an observed group (n=59) and a control group (n=60). In the observed group, ribavirin aerosol was given four times within the first hour, followed by once every other hour for the remaining time of the day and day 2; from days 3 to 7, it was given 4 times per day, with 2-3 sprays every time, for 7 days. In the control group, placebo was given in the same way as in the observed group. Additionally, both groups used oral antiviral liquid. The scores of clinical symptoms including oral ulcer, skin rash, nasal congestion, runny nose, sneezing, cough, and fever before and after treatment were recorded to evaluate treatment outcomes. Throat swabs were taken before treatment and 5-7 days after treatment to measure viral load by RT-PCR and to compare the negative conversion rate between the two groups.</p><p><b>RESULTS</b>Fifty-seven patients in the observed group and 56 patients in the control group were tested according to the original research design. After 5-7 days of treatment, the observed group had a significantly higher overall negative conversion rate of enterovirus than the control group (P<0.01). The overall marked response rate and overall response rate of the observed group were 89% and 89%, respectively, significantly higher than those of the control group (29% and 43%). During treatment, there were no adverse reactions such as dizziness, vomiting, and notable decreases in hemoglobin, white blood cells, and platelets in the two groups.</p><p><b>CONCLUSIONS</b>Ribavirin aerosol can be effectively and safely used for treating mild HFMD. With low dosage and few adverse reactions, it holds promise for clinical application.</p>

Clinical features and follow-up of Chinese patients with symptomatic hypogammaglobulinemia in infancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hypogammaglobulinemia is common in infant humoral immunodeficiencies and has complicated causes and outcomes. We aimed to determine the clinical manifestations, immunological changes and outcomes of Shanghai infants with hypogammaglobulinemia.</p><p><b>METHODS</b>Patients under 2 years old, having one or more warning signs of primary immunodeficiency disorders, serum immunoglobulin levels below the lower limit of reference range per age, and with normal numbers for lymphocyte subsets, were analyzed and followed up for 2 to 3 years.</p><p><b>RESULTS</b>A total of 91 children (male-to-female ratio: 2.25: 1) participated in the study. Initial clinical presentation was recurrent upper respiratory tract infection (46%), invasive infection (3%), atopic disease (32%). IgA reduction (77%) was prevalent; 34% patients had more than one isotype reduced. During follow-up, 51 of 62 patients (82.25%) had immunoglobulins normalized at the age between 12 - 48 months; these were diagnosed as transient hypogammaglobulinemia of infancy (THI). Long-term follow-up may reveal a diagnosis for the remaining 11 infants with persistent lower immunoglobulin levels, who did not have antibody titers measured. Earlier onset was correlated with higher rates of normalization. More patients were diagnosed with isolated hypogammaglobulinemia in 2006 compared with the previous 4 years (2002 - 2005).</p><p><b>CONCLUSIONS</b>The awareness of immunodeficiency among pediatricians has been greatly improved. Recurrent otitis media was not a major infection in our patients. THI is a relatively common condition associated with infant hypogammaglobulinemia. In the absence of specific antibody titers, the diagnosis of THI can be confirmed retrospectively with Ig levels normalized in follow-up visits. Therefore, long-term follow-up and frequent re-evaluation of these patients are necessary to distinguish them from true primary immunodeficiency.</p>

Comparison of surface marker of monocyte-derived dendritic cells between cord blood and adult peripheral blood / 上海第二医科大学学报

0.05).The percentage of CD40 positive cells in CBMC-derived DC was lower than that in PBMC-derived DC[(34.80?7.77)% vs(54.37?9.57)%,P

Prospective study on prognosis of infants with neonatal subependymal cysts / 中华儿科杂志

<p><b>OBJECTIVES</b>It is confirmed that most neonatal subependymal cysts (SEC) are closely correlated with intrauterine infection and the short-term prognosis of SEC is not very good. Little information about the long-term prognosis of SEC is available. The purpose of the present study was to explore the short-term and long-term prognosis of neonatal SEC cases via a 6-year follow up.</p><p><b>METHODS</b>Seventy SEC neonates detected by cranial ultrasound between October 1993 and October 1994 were enrolled into SEC group and 70 healthy neonates into control group. Serum antibodies (IgG and IgM) to cytomegalovirus (CMV), toxoplasma and rubella virus and PCR for these pathogens (except for rubella virus) were measured in the two groups. CMV-PCR was also performed for urine specimens. Cranial sonography assessment, physical growth evaluation, Bayley developmental scale or Wyeth developmental scale, brain-stem auditory evoked potential (BAEP) and vision examination were undertaken at 3, 6, 12 months and 6 years in the two groups.</p><p><b>RESULTS</b>The positive rate of CMV-IgM and blood CMV-PCR in SEC group was significantly higher than those of control group (19.1% vs. 5.7%, 12.9% vs. 2.9%). The positive rate of urine CMV-PCR in SEC group was also significantly higher (40% vs 17.1%). No significant difference could be found in the positive rate of PCR for toxoplasma and rubella-IgM between the two groups. The weight and height of infants with SEC were obviously lower than those in control group during the first year after birth. The parameters of the physical development in SEC infants reached the similar level as controls till 6 years old. However, the index of mental development below 80 was more often seen in infants with SEC comparing to that in control group during the whole six years. There were no abnormal findings either in BAEP or vision examination in the two groups.</p><p><b>CONCLUSION</b>Infants with SEC may show a transient retardation of physical growth after birth, while their mental developmental retardation might last for longer time. It is suggested that cranial ultrasound examination should be performed in all neonates for the detection of SEC, and a longer follow-up should be done for infants with SEC.</p>