Objective：To investigate the difference effect of biofeedback and DDAVP on PNE children by a randomized control trial (RCT) study. Methods：PNE children who were diagnosed by pediatricians of children's hospital of Fudan University from July 2005 to January 2006 were divided into two groups randomly, one is DDAVP group and the other is biofeedback group. All patients underwent one month's treatment and three month's follow-up. Items of follow-up included enuresis diary，urine flow rate and AQP2 in urine. Results：All 50 PNE children included 26 boys and 24 girls, whose mean age was 8.4±0.9 years. The effective rate of biofeedback was higher than that of DDAVP at the end of treatment and the third month of follow-up. But there was no significantly difference in cure rate and relapse rate in two groups. Compared with the data before treatment, maximum flow rate, voided volume, ratio of normal curves and ratio of Detrusor-sphincter consistentness increased significantly at the end of treatment in biofeedback-group. Two bands of AQP2 were detected in urine. Density of two bands of patients were significantly lower than that of controls. At the end of treatment density of two bands were significantly higher than that of before treatment in DDAVP group. Conclusion：Biofeedback and DDAVP are both effective therapies for PNE. With higher effective rate within four month, biofeedback is worth applying in PNE children. Biofeedback is helpful for correcting voiding dysfunction and DDAVP can increase AQP2 protein in urine.
Objective Henoch-Sch?nlein purpura (HSP), termed as Henoch-Sch?nlein purpura nephritis(HSPN) when a renal involvement was found, is the most common systemic vasculitis affecting children with whose pathogenesy remaining poorly understood as yet. HSPN is one of the most common secondary renal disease as well as the most serious complication of HSP. The attention being paid globally is attributable to the factor that degree of renal involvement may have some effects on the severity and outcome directly. No definite data as yet on choice of time as for corticosteroids administration. Thus we search all studies that have been published worldwide with regards to the effectiveness of the early administration of corticosteroids for reducing risk to renal involvement in patients with HSP by means of Meta-analysis, in order to give some evidences for the choice of corticosteroids dealing with HSP. Methods Evaluate strictly all the studies that have been searched and adopted the studies in high quality that can be analyzed by means of Meta-analysis. Calculate the odds ratio for renal involvement during the time from initial episode to the end of follow-up between treatment with corticosteroids and control. Revman4.2 software was applied to process the data. Results Totally 5 studies including 398 cases were analyzed. The cumulative cases in treatment group were 206, in which 16 developed renal involvement, while in control were 192 and 42 respectively. The pooled OR was 0.29, with a 95% confidence interval (0.16-0.54). Conclusions corticosteroids being used in early stage of HSP can benefit patients for reducing risk to renal involvement compared with control.
Abstract Objective：To determine the current status of pubertal development and prevalence of sexual precocity among Beijing school-aged girls. Methods：As part of the Beijing Child and Adolescent Metabolic Syndrome Study (BCAMS), a cross-sectional study on the presence of secondary sexual characteristics among 9 778 school-aged girls aged 6~18 years was undertaken in Beijing city from April to October 2004. All participants completed a questionnaire on demographic variables. The stages of breast and pubic hair development were assessed through visual inspection using standardized drawings and descriptions based on Tanner criteria. Palpation was required for the assessment of breast stage in order to distinguish adiposity and galactophore. Age at menarche was collected by self-report. Status quo method or probit transformation analysis were used to calculated the median age at menarche and at onset of breast (B2) and pubic hair (P2). Sexual precocity was defined as onset of B2 or P2 before 8 years, or menarche before 10 years. Results： Among 9 778 girls who participated in this study, 5 040 girls (51 .5%) resided in urban. The median menarcheal age was 12.1 (SD=1.1) years in Beijing girls, urban girls experienced menarche, on average, 0.6 years (7.2 months) earlier than did girls in rural (11.9±1.1 vs 12.5±1.1 years). Tanner breast 2 stage (B2) was present at 9.5±1.2 years of age in all girls, 9.4±1.1 years in urban girls, and 9.6±1.2 years in rural girls. Age at onset of pubic hair (P2) was 11.1±1.1 years, 10.8±1.1 years and 11.4±1.1 years in all, urban girls and rural girls, respectively. Comparison with historical data, menarcheal age of Beijing girls has been advanced by 2.1 years since 1962, when the menarche began at 14.16 years, on average of 0.7 years (8.4 months) per decade during 1962~1982, and decreased to 0.43 years (5.2 months) per decade during 1992~2004. The prevalence rates of sexual precocity diagnosed by menarche, breast and pubic hair were 0.79%, 2.91% and 0.22%, respectively. Conclusions：Urban girls in Beijing experienced earlier menarche and onset of secondary sexual characteristics than rural girls. The secular trend towards earlier menarche was observed in Beijing girls over the past 40 years, but the trend appears to decrease in the most recent decade.
Objective：To determine the current status of pubertal development and prevalence of sexual precocity among Beijing school-aged boys. Methods：As part of the Beijing Child and Adolescent Metabolic Syndrome Study (BCAMS), a cross-sectional study on the presence of secondary sexual characteristics among 9 815 school-aged boys aged 6~18 years was undertaken in Beijing city from April to October 2004. All participants completed a questionnaire on demographic variables. The stages of genital and pubic hair development were assessed through visual inspection using standardized drawings and descriptions based on Tanner criteria. The larger-sided testicular size was measured using Prader orchidometer and recorded in milliliters. Age at spermarche was collected by self-report. Status quo method and probit transformation analysis were used to calculate the median age at spermarche and at onset of pubic hair (P2), gentile (G2) and the age at testicular volume34ml. Sexual precocity was defined as onset of P2 or one-sided testicular volume 3 4 ml before 9 years of age. Results：Data were analyzed for 9 815 boys, of whom 50.5% resided in urban and 49.5 % in rural. Spermarche was at age of (14.4±1.2）years in all boys,（14.1±1.1）years in urban boys and (14.8±1.2) years in rural boys. The median age of P2 was (12.2±1.2) years for all, (12.0±1.2) years for urban boys and (12.4±1.2) years for rural boys. Testicular development (34ml) was observed at age of （10.7±1.2) years for all,（10.8±1.2) years for urban boys and (10.7±1.2)years for rural boys. The prevalence rates of sexual precocity according to pubic hair and testicular size were 1.92% and 0.17%, respectively. Conclusions：Difference of pubertal development staging between urban boys and rural boys was observed in this study. More studies on pubertal development in boys are necessary.
Objective To explore the epidemiological characteristics of Norovirus infection in children with diarrhea and to study the Norovirus genotype in Guangzhou. Methods Primers were designed on the basis of the sequence of Hawaii virus after ClustalW alignment of six human norovirus genomic sequences, and amplify the fragment of ORF1-ORF2 junction by nest PCR. The PCR-products were cloned to T vector and sequenced, phylogenetic tree was constructed by the neighbor joining method in Phylip3.65. Results The amplified sequence of orf1/orf2 junction is 1208bp in length, correspond to the regions located between nucleotides 4476 and 5683 in the Hawaii virus genome(GenBank accession number U07611).The sequence contains 3′-RNA polymerase sequence and N-terminus/shell domain in ORF2 gene. The three ORF1-ORF2 fragments are compared with those of Norovirus in GenBank, revealed that the homology with genogroupII ranges between 74%-92%, and genogroupI between 58%-61%.The N/S domains of three samples were analyzed by comparing the sequences of strains representing each genotype of GII, the result revesls that the homology with GII-4 ranges between 92%-96%.phylogenetic trees based on capsid N/S domain and ORF1-ORF2 junction sequence were constructed by the neighbor-joining method with Manchester strain as an outgroup, and find that the three samples are closer to GII-4 stains than to other reference strains. Conclusions Norovirus strains infection in Guangzhou belongs to genogroupII.
Objective To investigate the inhibitory effects of RNA interference (RNAi) expression vector on the expression of aquaporin-4(AQP4) gene in astrocyte primary cultures. Methods RNAi expression vector, which aimed directly at aquaporin-4(AQP4)gene and a control vector served as a non-silencing control were constructed. The expression of AQP4 was detected by Real-Time PCR and Western blotting, cellular volume was determined using [3H] radio-labeled glucose. Results AQP4 RNAi expression vector could reduce the expression of AQP4 mRNA and protein in astrocyte (p 0.05) , and the maximal inhibition of AQP4 mRNA and protein in astrocytes was respectively around 77% and 85% at 48 h after transfection with RNAi expression vector compared to that of controls of control vector-treated and untransfected wild type astrocytes(p 0.05). Also, the cellular water permeability in hypotonic medium were decrease significantly in astrocytes with AQP4 gene silencing (p 0.05). Conclusion The RNAi expression vector can effectively inhibit the expression of AQP4 gene in cultured rat astrocytes, and AQP4 may be the major factor responsible for the water transport of cultured astrocytes.
