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OBJECTIVE: To study the expression of WAVE1 and p22phox in peripheral blood mononuclear cells (PBMCs) in children with acute lymphocytic leukemia (ALL) and the relationship of WAVE1 with oxidative stress. METHODS: Real-time PCR was used for detecting WAVE1 and p22phox expression in PBMCs in 41 children with ALL and 10 normal controls. Plasma activity of superoxide dismutase (SOD) was measured by the xanthine oxidase method. Plasma activity of GSH-Px was measured by the DTNB reaction test. RESULTS: The expression of WAVE1 and p22phox was significantly higher in the active ALL groups (newly diagnosed and relapse ALL) than that in the normal control and the complete remission (CR) ALL groups (P<0.01). The CR ALL group showed increased WAVE1 and p22phox expression than those in the normal control group (P<0.05). Plasma activities of SOD (22.62±7.39 U/mL) and GSH-Px (91.73±28.88 μmol/L) in the active ALL group were significantly lower than those in the normal control (166.35±27.93 U/mL and 490.94±39.38 μmol/L, respectively) and the CR ALL groups (107.11±28.57 U/mL and 267.56±82.64 μmol/L, respectively) (P<0.01). WAVE1 expression was positively correlated with p22phox expression (r=0.34, P<0.05) but negatively correlated with plasma activities of SOD and GSH-Px ( r=-0.336 and-0.408, respectively; P<0.05). CONCLUSIONS: WAVE1 and p22phox expression in PBMCs increased and was associated with the disease course in children with ALL. Oxidative stress may be involved in the regulation of WAVE1 expression in ALL children.［Chin J Contemp Pediatr, 2009, 11 (2):88-92］

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OBJECTIVE: To study the clinical features of pediatric acquired immunodeficienecy syndrome(AIDS). METHODS: The epidemiological, clinical and laboratory data of 66 children with AIDS were retrospectively studied. RESULTS: Of the 66 patients, 46 (69.7%) were male and 20 (30.3%) were female, with a mean age of 8.7 years (ranged 2-16 years). The mean age at diagnosis was 7.7 years (ranged 2-15 years). Vertical transmission as the route of infection was documented in 48 cases (72.7%). Fourteen children (21.2%) were infected through blood or blood products. The route of infection could not be identified in 4 cases (6.1%). Body weight loss was noted in 43 cases (65.2%), anemia in 42 cases (63.7%), fever in 40 cases (60.6%), fatigue in 38 cases (57.6%), rash in 31 cases (47.0%), chronic cough in 28 cases (12.1%）, chronic diarrhea in 24 cases (36.4%), CNS involvement in 16 cases (24.2%), oral thrush in 13 cases (19.7%), and hepatosplenomegaly in 12 cases (18.2%). Body height of 30 cases (45.4%) and body weight of 26 cases (39.4%) ranked the lower level. The immune system was severely suppressed in 59 cases (89.4%) and moderately suppressed in 7 cases (10.6%). CONCLUSIONS: Vertical transmission remained the most common route of pediatric HIV infection. There were various clinical manifestations in children with AIDS. The immune systems of the majority of children with this disorder were severely suppressed.［Chin J Contemp Pediatr, 2009, 11 (2):93-95］

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OBJECTIVE: The present study aimed to characterize the clinical presentations and magnetic resonance imaging including conventional MRI and diffusion-weighted imaging (DWI) in newborns with cerebral infarction. METHODS: Clinical records of 16 newborn infants with cerebral infarction were reviewed. All cases underwent DWI examination in addition to conventional MRI examination ［T1-weighted (T1W) and T2-weighted (T2W)］within 5 days after birth. Five patients received the second MRI examination at the age of 11 to 18 days. RESULTS: Eight patients had antenatal risk factors, 9 had intranatal risk factors, and no postnatal risk factors were found. Seizures as the first symptom were noted in 11 neonates, with a short duration and a low frequency. The first imaging examination (within 5 days) showed a slight hypointensity on T1W, a slight hyperintensity on T2W and significantly increased signal intensity with a clear boundary on DWI in the lesions. In the MRI re-examination, more obvious hypointensity on T1W and hyperintensity on T2W were noted, while hypointensity was shown on DWI in the lesions compared with the first imaging results. CONCLUSIONS: Seizures characterized by short duration and low frequency usually may be the first symptom in newborns with cerebral infarction. A hyperintensity on DWI was shown in the lesions at the early stage of neonatal cerebral infarction. A hypointensity on T1W and a hyperintensity on T2W were demonstrated in the lesions with increasing disease duration.［Chin J Contemp Pediatr, 2009, 11 (2):96-99］

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OBJECTIVE: To evaluate the feasibility and safety of the peripherally inserted central catheters (PICC) as a venous access for newborns who need a long-term venous transfusion. METHODS: Sixty-five newborns receiving PICC and 80 newborns receiving peripheral intravenous catheters (PIV) from April 2006 to February 2008 were included in this study. A retrospective cohort study was used to compare the indwelling time of catheters, catheter-related mechanical complications, the incidence of sepsis, and the mortality between the two groups. RESULTS: The indwelling time of catheters in the PICC and the PIV groups was 18.75±7.62 days (range:7-62 days) and 1.49±0.57 days (range: 30 minutes to 4 days) respectively. The indwelling time of catheters in the PICC group was significantly longer than that in the PIV group (P<0.01). The incidence of catheter-related mechanical complications in the PICC group was significantly lower than that in the PIV group (27.7% vs 63.8%; P<0.01). There were no significant differences in the incidence of sepsis and the mortality between the two groups. CONCLUSIONS: The application of PICC can cause a decrease in the number of venous puncture. PICC is a safe and effective venous access in newborns.［Chin J Contemp Pediatr, 2009, 11 (2):100-103］

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OBJECTIVE: To understand the relationship of the grading of periventricular echodensities (PVE) with the morbidity and the occurrence time of periventricular white matter cystic lesions in preterm infants. METHODS: A retrospective, single-centre cohort study of 120 preterm infants with PVE diagnosed by ultrasonography between February 2005 and May 2008 was performed. The infants had a median gestational age of 32 weeks and a median birth weight of 2 230 g. RESULTS: Fifty-two infants (43%) were diagnosed as having PVE I, 42 infants (35%) having PVE II, and 26 infants (22%) having PVE III. The grading of PVE was closely related to birth weight, but not with gestational age. The total morbidity of periventricular white matter cystic lesions was 24% (29/120). The morbidity of the cystic lesions in PVE III patients (65%) was significantly higher than that in PVE II patients (21%) (P<0.01). The PVE III patients developed the cystic lesions earlier than the PVE II patients. CONCLUSIONS: The grading of PVE is closely related to the morbidity and the occurrence time of periventricular white matter cystic lesions in preterm infants.［Chin J Contemp Pediatr, 2009, 11 (2):104-106］

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OBJECTIVE: To study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in Guangzhou. METHODS: The fecal samples of 2 409 children with infectious diarrhea between January 2006 and December 2007 were collected and cultured. Pathogenic bacterium were isolated and identified by biochemical and serological methods. The antibiotic susceptibilities were tested by the Kirby-Bauer method. RESULTS: A total of 448 isolates of pathogenic bacterium (18.6%) were obtained, including Shigella (n=159), enteropathogenic Escherichia coli (n=141), Salmonella (n=76), Vibrion (n=11), fungus (n=41), and C jejuni (n=20). All of isolates of the three major pathogenic bacterium, Shigella, enteropathogenic Escherichia coli and Salmonella, were susceptive to imipenem and less than 10% of the isolates were resistant to the third generation cephalosporins and β-lactamase inhibitors. However, the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim (>75%). CONCLUSIONS: Shigella, enteropathogenic Escherichia coli and Salmonella were major pathogenic bacterium of diarrhea in children from Guangzhou. The major isolates were susceptive to imipenem, the third generation cephalosporins and βlactamase inhibitors, but were resistant to ampicillin and sulfamethoxazole/trimethoprim.［Chin J Contemp Pediatr, 2009, 11 (2):107-109］

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OBJECTIVE: The pathogenesis of electrical status epilepticus during sleep (ESES) in children remains unknown. We undertook a retrospective study of epileptic children who presented with ESES to investigate the correlation factors of ESES. METHODS: Thirty epileptic children with ESES (ESES group) and 30 age-and sex-matched epileptic children without ESES (control group) admitted to Maternal and Child Health Care Hospital of Tangshan between January 2000 and July 2006 were enrolled. The results of questionnaire and laboratory examinations were compared between the two groups. RESULTS: Nine patients had a family history of epilepsy in the ESES group, but only 2 patients in the control group (P<0.05). Language disorder was found in 11 patients in the ESES group, but only 2 patients in the control group (P<0.05). Thirteen patients were confirmed with epileptic syndrome in the ESES group, but only 5 patients in the control group (P<0.05). Twentyfive patients in the ESES group showed mental retardation, but only 5 patients from the control group (P<0.01). CONCLUSIONS: ESES may be correlated with family history of epilepsy, epileptic syndrome, mental retardation and language disorder.［Chin J Contemp Pediatr, 2009, 11 (2):110-112］

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OBJECTIVE: Wolfram syndrome (WFS) is a rare, autosomal recessive inherited disease characterized by various clinical manifestations. The aim of this study was to investigate clinical characteristics of WFS. METHODS: One case of WFS was reported. Combined with the clinical data of 8 cases of WFS which had been reported in China between 1994 and 2007, the clinical characteristics of WFS were reviewed. RESULTS: Insulin-dependent diabetes mellitus as the earliest manifestation was found in all of the 9 patients, with a median onset age of 5.0 years. Optic atrophy occurred in 8 patients (onset age: 8.5 years), diabetes insipidus in 7 patients (onset age: 8.5 years) and deafness in 7 patients (onset age: 9.8 years). Short stature was found in 6 patients and hydroureteronephrosis in 4 patients. CONCLUSIONS: Insulin-dependent diabetes mellitus was the first presentation in children with WFS. Optic atrophy, diabetes insipidus and deafness were common complications, with a various onset age.［Chin J Contemp Pediatr, 2009, 11 (2):113-115］

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OBJECTIVE: To study the etiology of acute upper respiratory tract obstruction in infants. METHODS: The medical data of 12 infants with acute upper respiratory tract obstruction were retrospectively reviewed. The patients received the examinations of laryngoscopy and CT scans for larynx and lungs. RESULTS: All of the 12 infants presented with laryngeal stridor. Eight infants (67%) were diagnosed as congenital simple laryngeal stridor before admission. Based on the clinical features, laboratory examinations, imaging examinations and laryngoscopy, 4 (33%) were definitely diagnosed with thyroglossal ductal cyst, 1(8%) with abscess-emphysema in the posterior wall of pharynx, 1(8%) with cervicallymphangioma, 2 (16%) with subglottic stenosis, and 4 (33%) with acute laryngitis. CONCLUSIONS: Acute upper respiratory tract obstruction is easily misdiagnosed in infants. Thyroglossal duct cyst is a common cause of upper respiratory tract obstruction/laryngeal stridor. It is recommend that laryngoscopy and CT scans for larynx should be performed in infants with laryngeal stridor.［Chin J Contemp Pediatr, 2009, 11 (2):116-119］

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OBJECTIVE: To explore the clinical characteristics, diagnosis and therapy of thyroid carcinoma in children. METHODS: Clinical data of 12 children under the age of 14 years, diagnosed as thyroid carcinoma between August 1998 and August 2008, were reviewed. RESULTS: A hard thyroid mass was observed in 10 out of 12 children with thyroid carcinoma, but only one out of 15 children with benign thyroid tumor (P<0.05). The rate of cervical lymph node metastasis in children with thyroid carcinoma was significantly higher than that in children with benign thyroid tumor (P<0.05). There was no significant difference in the final diagnostic rate of thyroid carcinoma between ultrasonography and CT scans (75% vs 83%; P>0.05). All of 12 cases were pathologically confirmed as differentiated thyroid carcinoma, including papillary carcinoma (7 cases), follicular carcinoma (3 cases) and papillary-follicular carcinoma (2 cases). Nine patients (75%) had cervical lymph node metastasis. All patients received surgical treatment and postoperative thyroxin therapy. No patient was administered with postoperative radioiodine 131I therapy. Unilateral lobectomy plus isthmectomy along with a functional cervical lymph node dissection was a primary operation mode (83%). The follow-up period was 2 months to 10 years. The 5-and 10-year survival rates were 100%. CONCLUSIONS: Childhood thyroid carcinoma is mostly differentiated and characterized by hard thyroid mass and cervical lymph node metastasis. A combination of ultrasonography and CT is helpful to the diagnosis of childhood thyroid carcinoma. The treatment outcome may be satisfactory by optimal therapy in children with thyroid carcinoma.［Chin J Contemp Pediatr, 2009, 11 (2):120-123］

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OBJECTIVE: There are many factors affecting the sensory integration training (SIT) effects in children with autism. This study explored the influential factors for SIT effects in the aspect of the model of sensory processing. METHODS: Ninety-three autistic children aged 1.8-8.3 years were evaluated by the autism behavior checklist (ABC) and the Dunn's model of sensory processing. The SIT effects were evaluated by the sensory integrative schedule. The effects of sex, age, ABC scores and the Dunn's model of sensory processing were investigated by logistic regression analysis. RESULTS: Logistic regression analysis showed that ABC scores (Wald=6.768, P<0.01) and the Dunn's model of sensory processing (Wald=13.549, P<0.01) were influential factors for the SIT effects. The Dunn's model of sensory processing was shown as a more important influential factor. Sex (Wald=1.549, P>0.05) and age (Wald=0.010, P>0.05) were not related to the STT effects. CONCLUSIONS: The Dunn's model of sensory processing is a major influential factor for the SIT effects in children with autism.［Chin J Contemp Pediatr, 2009, 11 (2):124-127］

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OBJECTIVE: The effects of sleep deprivation on the immature brain remain unknown. Based on a computer controlled chronic sleep deprivation animal model, the effects of chronic partial sleep deprivation on growth, learning and memory in young rats were explored. METHODS: Twelve weaned male Spraque-Dawley rats (3-week-old) were randomly divided into sleep deprivation, test control and blank control groups. Sleep deprivation was performed using computer-controlled "disc-over-water" technique at 8-11 am daily, for 14 days. The temperature and weights were measured every 7 days. Morris water maze was used to test spatial learning and memory abilities before and 7 and 14 days after sleep deprivation. After 14 days of sleep deprivation, the rats were sacrificed for weighting their major organs. RESULTS: After 14 days of sleep deprivation, the rats'  temperature increased significantly. During the sleep deprivation, the rate of weight gain in the sleep deprivation group was much slower than that in the test control and blank control groups. The thymus of the rats subjected to sleep deprivation was much lighter than that of the blank control group. After 7 days of sleep deprivation, the rats showed slower acquisition of reference memory, but were capable of successfully performing the task by repeated exposure to the test. Such impairment of reference memory was not seen 14 days after sleep deprivation. CONCLUSIONS: Chronic sleep deprivation can affect growth of immature rats, as well as their abilities to acquire spatial reference memory.［Chin J Contemp Pediatr, 2009, 11 (2):128-132］

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OBJECTIVE: To study the expression of signal transducer and activator of transcription 5b (STAT5b) mRNA and interleukin-4 (IL-4) mRNA in blood mononuclearcells in a rat model of asthma and the effect of montelukast (MK) and BCG-polysaccharide and nucleic acid injection (BCG-PSN) on STAT5b mRNA and IL-4 mRNA expression. METHODS: Fifty-two male Sprague-Dawley rats (weight:140-200 g) were randomly divided into four groups: asthma, MK-treated and BCG-PSN-treated and control groups. Rat model of asthma was prepared by ovalbumin (OVA) sensitization. The rats were sacrificed 24 hrs after the last sensitization. Blood eosinophils (EOS) were counted. Plasma contens of IL-4 and interferon-γ (IFN-γ) were measured using ELISA. Expression of STAT5b mRNA and IL-4 mRNA in blood mononuclearcells was detected with SYBR GREEN I fluorescent quantitation PCR method. RESULTS: Blood contents of STAT5b mRNA and IL-4 mRNA in the untreated asthma group were significantly higher than those in the other three groups (P<0.01). Blood EOS count and plasma IL-4 contents in the untreated asthma group significantly increased, while plasma IFN-γ contents significantly decreased compared with the other three groups (P<0.01). There were no significant differences in the parameters measured among the MK-treated, the BCG-PSN-treated and the control groups. STAT5b mRNA expression was positively correlated to IL-4 mRNA expression, IL-4 content and EOS count (r=0.730, 0.650, 0.664, respectively; P<0.01), but negatively correlated to IFN-γ content (r=-0.798; P<0.01). CONCLUSIONS: STAT5b mRNA and IL-4 mRNA were strongly expressed in blood mononuclearcells in rats with asthma, and there was a positive correlation between them. MK and BCG-PSN had inhibitory effects on the expression of STAT5b mRNA and IL-4 mRNA, which might be contributed to suppression of airway inflammation in asthma.［Chin J Contemp Pediatr, 2009, 11 (2):133-137］

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OBJECTIVE: Some research has shown that there is a dose-dependent relationship between ultraviolet B (UVB) and serum levels of 25-hydroxy vitamin D［25-(OH)D］\. Vitamin D is correlated with bone metabolism. This study aimed to explore the effect of UVB irradiation through glass on serum levels of 25-(OH)D and bone metabolism in rats. METHODS: Wistar rats were fed with vitamin D deficient diet and randomly divided into three groups: no UVB exposure, direct UVB exposure (160 min/d) and indirect UVB exposure (through glass) (160 min/d). By 21 days after exposure, bone mineral density (BMD) and serum levels of 25-(OH)D, parathyroid hormone (PTH), osteocalcin (OC), bone alkaline phosphatase (BALP) and carboxyterminal cross-linked telopeptide of type I collagen (ICTP) were measured. RESULTS: BMD (0.036±0.002 g/cm2) in the indirect UVB exposure group was significantly higher than that in the no UVB exposure group (0.029±0.002 g/cm2) (P<0.01). Serum ICTP level in the indirect UVB exposure group was significantly lower than that in the no UVB exposure group (0.181±0.067 μg/L vs 0.194±0.066 μg/L; P<0.01). Serum levels of PTH, 25-(OH)D, BALP and OC in the indirect UVB exposure group were not significantly different from those in the no UVB exposure group. Compared with the direct UVB exposure group, serum levels of OC (0.559±0.067 ng/mL vs 0.278±0.067 ng/mL; P<0.05) and PTH (0.181±0.067 μg/L vs 0.109±0.067 μg/L; P<0.05) in the indirect UVB exposure group significantly increased, while serum levels of 25-(OH)D significantly decreased (28.67±1.35 nmol/L vs 34.69±4.30 nmol/L; P<0.01). There were no significant differences in BMD and serum levels of BALP and ICTP between the indirect UVB exposure and the direct UVB exposure groups. CONCLUSIONS: UVB irradiation through glass cannot elevate serum levels of 25-(OH)D, but can decrease bone turnover rate and increase BMD. The effect of UVB irradiation through glass on bone metabolism is similar to that of direct UVB irradiation.［Chin J Contemp Pediatr, 2009, 11 (2):138-141］

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OBJECTIVE: To study the role of cell adhesion molecule CD44 in the lung on airway inflammatory response in rats with asthma. METHODS: Thirty-two Sprague-Dawley rats were randomly divided into normal control and asthma groups. Asthma was induced by repeated inhalation of ovalbulium. CD44 expression in the lung was detected by semi-quantitatively reverse transcription-polymerase chain reaction (RT-PCR) and immuno-histochemical staining 1 week and 2 weeks after ovalbulium challenge. Differential leukocytes (mononuclear phagocytes, neutrophils, eosinophils, and lymphocytes) in bronchoalveolar lavage fluid (BALF) were counted. RESULTS: CD44 expression in the lung increased 1 week after ovalbulium challenge (P<0.05) and increased more significantly 2 weeks after ovalbulium challenge (P<0.01) compared with that in the control group. The percentages of lymphocytes and eosinophils in BALF increased, while the percentage of BALF mononuclear phagocytes decreased significantly 1 week and 2 weeks after ovalbulium challenge in the asthma group compared with those in the control group (P<0.05). An increased percentage of neutrophils was found 1 week after ovalbulium challenge in the asthma group compared with the control group (P<0.05). CD44 expression in the lung was positively correlated with the percentages of lymphocytes and eosinophils in BALF in the asthma group 1 week and 2 weeks after ovalbulium challenge, in contrast, lung CD44 expression was negatively correlated with the percentage of mononuclear phagocytes in the asthma group 1 week after ovalbulium challenge. CONCLUSIONS: CD44 was over-expressed in the lung and closely related to inflammatory infiltration in rats with asthma. CD44 may play an important role in the development of airway inflammatory in asthma.［Chin J Contemp Pediatr, 2009, 11 (2):142-145］

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