ObjectiveTo analyze the clinical features of children with giant coronary artery aneurysms(GCAA) caused by Kawasaki disease(KD)in acute stage and investigate the risk factors of GCAA. MethodsFrom May 2001 to May 2009,inpatients diagnosed as KD in Children′s Hospital,Guangzhou Women and Children Medical Care Centre were enrolled into the study.Inpatients diagnosed as KD with coronary arterial dilation(CAD) or without coronary arterial lesion(CAL) were excluded,but inpatients with delayed diagnosis as KD with CAA were included.Patients with incomplete information were also excluded.Sex,age,clinical manifestations,laboratory examination and treatment of patients were collected.Sex(male,female),fever(≤14 d,>14 d）,delayed diagnosis,WBC［<12，-20，≥20 (×109·L-1)］,PLTmax［<400,-800，≥800 (×109·L-1)］,PLTmin［<100,-400，≥400 (×109·L-1)］,Hb［<90，-110，≥110 (g·L-1)］,ESR［<100，≥100 (mm·h-1)］,CRP［<3，-50，≥50 (mg·L-1)］,ALB［<30，≥30 (mg·L-1)］,days of using IVIG（≤10 d,>10 d） and the use of corticosteroid before diagnosis were chosen as risk factors of GCAA to be analyzed.The risk factors of GCAA caused by KD were estimated by Chi-square test and Logistic regression analysis. ResultsAccording to the inclusion and exclusion criteria,22 patients with GCAA were enrolled into GCAA group.The average age was (2.9±2.8) years(3 months-10 years).65 patients with small or medium coronary artery aneurysms(CAA) were enrolled into control group. The average age was (1.5±1.2) years(3 months to 6 years).There was significant difference in delayed diagnosis(P<0.05),but no difference in clinical manifestations.The results of Chi-square test showed that the age≤6 months or ≥5 years , fever lasting over 14 days,delayed diagnosis,use of corticosteroid before KD was diagnosed , higher ESR, lower Hb and ALB were associated with GCAA significantly(P<0.05). The results of Logistic regression analysis indicated that the odds ratio (OR) of delayed diagnosis was 2.998(95%CI:1.004-8.950,P=0.047), the OR of the usage of corticosteroid before diagnosis was 6.556(95%CI:1.561-28.542,P=0.010), and the OR of ESR≥100 mm·h-1 was 3.591(95%CI:1.164-11.079,P=0.026). All of them were the independent risk factors of GCAA. ConclusionsDelayed diagnosis, the usage of corticosteroid before diagnosis and ESR≥100 mm·h-1 were the independent risk factors for GCAA.
ObjectiveTo investigate the relationship between plasma acylation stimulating protein (ASP) and obesity and metabolic syndrome (MS) among Chinese children and adolescents. MethodsBased on the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study,1 603 children and adolescents (873 boys and 730 girls) aged from 6 to 18 years old were randomly selected from the control group (without any MS component) and the case group (with at least one of the five MS components), and divided into three groups of normal weight (n=603), overweight (n=291) and obese (n=709) according to the sex-age-specific body mass index cutoffs recommended by Chinese Working Group on Obesity (WGOC). The presence of pediatric MS was defined with modified NCEP ATPⅢ criteria by the presence of three or more items of the following five components:①central obesity was defined as waist circumference≥90th percentile for age and gender (established according to the BCAMS study);②elevated systolic and/or diastolic blood pressure ≥90th percentile for age and sex (according to the BCAMS study);③hypertriglyceridemia was defined as TG≥1.24 mmol·L-1;④low serum high-density lipoprotein cholesterol (HDL-C) was defined as ≤1.03 mmol·L-1;⑤impaired fasting glucose (IFG) was defined as 5.60 mmol·L-1. Data including anthropometric measurements (height, weight and waist circumference), systolic and diastolic blood pressure, fat mass percentage by bioimpedance analysis, pubertal development stage were collected. Venous blood samples were obtained by direct vein puncture after an overnight (minimum 12 h) fast. Plasma glucose was detected by the glucose oxidase method. Serum total cholesterol, triglyceride, HDL-C and low-density lipoprotein cholesterol (LDL-C) were measured. Plasma ASP was measured by enzyme-linked immunosorbent assay (ELISA), and plasma complement 3（C3） concentration was determined by turbidimetric assay using a polyclonal anti-human antibody specific against C3 (Lin-Fei Co, P.R. China). For C3 and ASP, the intra- and inter- assay coefficients of variations were <4% and <8%. The percentage of C3 converted to ASP (%ASP/C3) was calculated to evaluate the extent of conversion C3 to ASP. One-way analysis of variance (ANOVA) and general linear model were used to compare the levels of plasma ASP and C3 among various weight status groups. The odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed with multivariable Logistic regression model to investigate the effect of ASP on metabolic abnormalities. ResultsWithin the total groups, 376 subjects were with the presence of MS, and the prevalence rates were 2.2%, 15.5% and 44.9% in normal weight, overweight and obese groups, respectively. Girls had higher plasma ASP than boys (t=2.527, P<0.05). Plasma ASP levels were increased in overweight group and obese group compared with in normal weight group in boys (geometric mean: 57.88 nmol·L-1, 60.63 nmol·L-1 vs 37.58 nmol·L-1, F=34.329, P<0.001) and girls (geometric mean: 60.25 nmol·L-1, 66.68 nmol·L-1 vs 44.16 nmol·L-1, F=22.246, P<0.001).C3 was higher in obese group than that in normal weight group only in girls (P<0.01). The percentage of C3 converted to ASP (%ASP/C3) was also increased in overweight group and obese group versus in normal weight group in both boys (F=17.382, P<0.001) and girls (F=6.317, P=0.002). Plasma ASP increased with the clustering of MS components in boys(F=16.422, P<0.001) and girls(F=9.661, P<0.001). Increased ASP was also associated with the presence of one single metabolic abnormality (especially hypertension, abdominal obesity or hyperglycemia). With age,gender and pubertal development as covariants and the lowest quintile of plasma ASP as reference,the ORs(95%CIs) of the highest quintile of ASP were 3.90(2.38-6.39),6.05(4.06-9.01) and 2.89(1.93-4.33) for predicting overweight,obesity and MS,respectively.But the statistical significance of OR(95%CI) for MS was vanished (P>0.05) after further adjustment for body mass index. ConclusionsElevated plasma ASP levels in obese children and adolescents are associated with the clustering of MS components, and distinct metabolic abnormalities. The level of plasma ASP may be a predictor of overweight, obesity and MS in children and adolescents.
ObjectiveTo explore the serum vitamin B12 levels of children at the age of 2 to 7 years in 4 cities in China and to define the relationship between the levels of serum vitamin B12 and anemia and analyze the effects of several factors related to the level of serum vitamin B12. MethodsFrom May to September 2007 and from May to October 2008，the weight，height and complete blood count(CBC)were measured in 2 116 children at the age of 2 to 7 years in four cities（Chongqing 562，Bejing 513，Zhuhai 560，Wuhan 501） in China．The dietary survey and the concentrations of serum vitamin B12 of 2 002 children were evaluated. The concentrations of serum vitamin B12 were assayed by chemiluminoimmuno assay（CLIA）and the CBC was detected by holo-automatic blood analyser. Results①The average level of children serum vitamin B12（ng·L-1） was 775±312，and the level of children serum vitamin B12 in urbans was higher than that in suburbs（P＜0.001）. The concentrations of serum vitamin B12 of children in Chongqing，Beijing，Zhuhai and Wuhan were 756±220,840±414,772±245 and 736±317，respectively. ②The prevalence of low vitamin B12（vitamin B12 level＜300 ng·L-1）was 4.7%. 1.5% children whose vitamin B12 level was assessed＜200 ng·L-1 were considered as the vitamin B12 deficiency，3.2% children were considered as the vitamin B12 marginal deficiency(vitamin B12 level 200-300 ng·L-1).The prevalence of low vitamin B12 (deficiency and marginal deficiency) in urbans children was lower than that in suburbs.The prevalence of low vitamin B12 of children in Chongqing，Beijing,Zhuhai and Wuhan was 2.1％，3.9％，3.2％ and 9.6%，respectively. There were differences of the prevalence of low vitamin B12 among the cities. ③There were differences of serum vitamin B12 in ages（P＜0.001），and the levels of serum vitamin B12 changed with age from 5 to 7 years.But there were no differences between gender (P＞0.05)．④The results of multivariate stepwise indicated that the concentrations of serum vitamin B12 were mainly related to the contents of vitamin B12 in animal foods (P＜0．05)（b′=0.116，P=0.000）.The contents of vitamin B12 in animal foods for children at the age of 2 to 7 years in urbans were higher than those in suburbs（P＜0.05）.And the contents of vitamin B12 in animal foods for children in the 4 cities were different（P＜0.001）.⑤ There were low correlations between the levels of serum vitamin B12 and hemoglobin（P＜0.001）.The average level of hemoglobin(g·L-1) for the children aged 2 to 7 years in China was 125±11， the levels of hemoglobin in Chongqing，Beijing，Zhuhai and Wuhan were 124±13,129±8,127±13 and 120±9.The level of hemoglobin in urban was higher than that in suburbs. ConclusionsLow serum vitamin B12 of children aged 2 to 7 years was popular in China. But the level of serum vitamin B12 in children aged 2 to 7 years was higher than that in adults. The nutritional condition of vitamin B12 was different by the diets of the children，the contents of vitamin B12 in animal foods determined the levels of serum vitamin B12 for the children and it was beneficial for children to consume foods with vitamin B12 to keep the normal level of serum vitamin B12.The levels of serum vitamin B12 were lowly correlated with the concentrations of hemoglobin.Macrocytic anemia may not occur in children with vitamin B12 deficiency and small or normal cell anemia could be investigated in the early stage of vitamin B12 deficiency. There was no markedly diference in the level of serum vitamin B12 of children between gender，and the level of serum vitamin B12 of children changed with ages．
ObjectiveTo evaluate three different assays，including the phenol-chloroform method, the Chelex-100 method, and the QIAamp DNA Investigator Kit method(kit method) for extracting nuclear DNA (nDNA) from free margins of finger nail and hair samples. Methods30 samples of free nail clipping margins,hair roots and hair stems were obtained from 5 healthy Chinese volunteers.All samples were washed by 100% ethanol and sterile water to remove extraneous DNA from the surface.For nail samples,3 mg clippings were contented in each sample and were further cut into small pieces.For both hair roots and hair stems,3 pieces of 0.3-0.5 cm segments were in each sample.Nuclear DNA was extracted using phenol-chloroform method,Chelex-100 method,and kit method respectively,according to published or commercial protocols.To evaluate the reliability of the three methods for nDNA extraction,polymerase chain reaction (PCR) was conducted by using four pairs of primers located in different chromosomes with product lengths of 188 bp,248 bp,300 bp and 741 bp,respectively.PCR products were detected by 1.8% agarose gel electrophoresis.In order to determine the optimal sample quantity for each kind of material,parallel extractions with altered sample amount of 1 mg,3 mg and 5 mg of nails,or 1 piece,3 pieces and 5 pieces of either hair roots or hair stems were carried out and the results were summarized comparatively.A preliminary study of the eliminating effect on melanin inhibition by increasing Taq polymerase concentration was performed. ResultsPCR results showed that amplification of 248 bp product revealed the highest successful rate among all three kinds of extractions.For nail samples, the successful nDNA extraction rate by kit assay was significantly higher than that in phenol-chloroform and Chelex-100 methods(P<0.05);and successful rate with phenol-chloroform method was significantly higher than that of Chelex-100 assay(P<0.05).For hair stem samples, successful rate of kit assay was significantly higher than phenol-chloroform assay(P<0.05).However,successful rates of nDNA extraction from hair root samples using the three assays were not statistically significant (P>0.05).Among all three kinds of samples,nail sample yielded the highest successful rate (P<0.05),but there was no significant difference between hair root and hair stem samples.With the sample amount increasing, successful rate of kit method increased while successful rates of phenol-chloroform and Chelex-100 methods decreased, suggesting the possibility of PCR inhibition. Conclusions①All three methods could be used to extract nDNA successfully from the given samples, while the kit method was recommended.②All three kinds of samples could be used for nDNA extraction,while free margins of finger nail could be extracted most effectively.
ObjectiveTo set up a more convenient and effective dot-blot hybridization assay for surveillance of HRV circulating in Beijing in recent years. MethodsIn order to show multiplesequence align and analyze the nucleotide sequence of HRV VP7 gene,the software of DNAStar, MegAlign and Primer Premier 5 were used for well-known G serotypes of human rotaviruses from GenBank database.A region which was highly divergent among genes from different serotypes and conserved within genes of VP7s from same serotypes（nt 72-378）was selected as probe. One universal primer pair was designed based on the sequences on both sides of this highly divergent region（nt 51-71 and 379-399）for PCR amplified and digoxigenin labelled probes to be used for five common HRV genotypes (G1-4,G9) in a dot-blot hybridization for VP7 genotyping. Full length VP7 genes of HRV from 200 fecal specimens which were collected from hospitalized children with diarrhea who were detected HRV positive were identified polyacrylamide gel electrophoresis (PAGE) and rotavirus antigen was amplified by RT-PCR.The RT-PCR products were genotyped by the established dot-blot hybridization. VP7 genes of rotavirus from some specimens were genotyped by both dot-blot hybridization and nested PCR for comparison. ResultsThe DNA dot-blot hybridization assay set up in this study was of high sensitivity and specificity by showing no cross reaction among probes from different genotypes. Each of these five probes could detect 10 pg of DNA for corresponding genotype. Out of 200 HRV positive stool specimens, 162 samples could be amplified VP7 gene products. Dot-blot hybridization showed that 41 (25. 3%), 2 (1.2%), 63 (38.9 %) and 35 (21.6%) samples were G1, G2, G3 and G9 genotypes, respectively. Two of 162 cases could not be genotyped and no G4 HRV was detected. Among these genotyped samples, 19 showed that they were co-infected by 2 rotaviruses with different genotypes. The nucleotide sequence analysis of VP7 genes from some of the genotyped samples by DNA dot-blot hybridization demonstrated that the genotypes determined by these two assays were consistent. Of 60 rotavirus positive fecal specimens used for genotyping by nested PCR, 53 were genotyped and 7 were unable to be done, whereas all of these 60 samples were genotyped by this dot-blot hybridization. ConclusionsThe dot-blot hybridization assay established in this study was highly sensitive and specific and could be used for HRV surveys. Data indicated that in addition to the common G1, G2 and G3 genotypes, rotavirus G9 had been infected in Beijing in recent years.
ObjectiveTo develop Chinese static happy, angry, surprised, fearful, sad, disgusted and neutral facial expression photo gallery for future emotion research and to find out a better method for good facial expression picture acquisition. MethodsPeople were grouped by pre-school age, school age ( primary school age, middle school age and academic school age), young people, adult and aged people between 5-year and 80-year-old as the actors showing different facial expressions. Before taking photos, they knew the purpose and agreed to sign the consent. Firstly, all people were standarded to be trained to know the meaning of seven facial emotions,the grades and facial characteristics of seven facial emotions.The facial expression photos were recorded by the same examiner in the same lab. All photos were taken by using Canon IXUS 50 and SAMSUNG S850 under the same mode, and the primary photo gallery was made. Then research team members picked out the well-taken photos to be processed as 10 cm×15 cm facial expression pictures. 60 Chinese university students were asked to identify emotion category in these pictures.Seven pictures of Japanese Female Facial Expression (JAFFE) were used to identify the validity. The pictures were picked out and processed by 28 university students to test their reliability , and to test their validity compared with JAFFE. Results80 pictures were picked out in the first screening. One evaluator was ruled out because of his anxiety and depression, and 59 students (29 boys and 30 girls) screened out 40 pictures, whose discrimination rate was higher than 70%. 21 pictures were picked out to be tested for reliability, validity and emotion grades. The discrimination rates of 21 pictrues were higher than those of JAFFE. Besides pictures angry 1, angry 3, fearful 1-3, sad 3 and disgusted 1-3, the reliability coefficient of the others was higher than 0.7.Compared with JAFFE,the consistency of negative facial expression in 21 pictures was less than the consistency of happy,neutral or surprised facial expression. Conclusions21 facial expression pictures are representative materials for future emotion research.Facial expression and emotion is influenced by different culture.
ObjectiveTo study the relationship between peripheral blood platelet parameters and intracranial hemorrhage(ICH) in prematures and analyze the platelet′s genetic polymorphism.To explain the changes of parameters with genetic knowledge. MethodsPreterm infants(<34 weeks) and extremely low birth weight infants(<1 500 g) who were hospitalized within 24 hours after birth in the NICU of the Yuying Children′s Hospital of Wenzhou Medical College from May 2005 to May 2007 were enrolled in the study,and those infants were excluded who were diagnosed as congenital malformation,congenital metabolism disorder and severe coagulation disturbance. They were divided into ICH and non-ICH groups according to the result of ultrasonic examination assessed by radiologists independently. The polymorphism of the platelet glycoprotein GPIbαHPA-2 alleles was determined in 58 preterm infants with ICH and 65 control infants without ICH. Results①Compared with the non-ICH group, preterm infants with ICH had a significantly lower platelet count ［(172.20±75.81)×109·L-1 vs (230.92±86.50)×109·L-1］, higher mean platelet volume ［(8.39±1.23) fl vs (8.07±1.46) fl］, lower volume ration ［(0.135±0.08)% vs (0.188±0.06)%］, and higher platelet distribution width ［(17.6±1.04)% vs (17.3±1.08)%］.②The prevalence rates of the platelet glycoprotein GPIbαHPA-2 were 77.6% of TT,17.2% of TM, and 5.2% of MM in ICH group;and those were 89.2% of TT, 10.8% of TM, 0 of MM in non-ICH group. Frequency of M was 13.8% in ICH group versus 5.4% in non-ICH group. There were significant differences in frequency of TM, MM and M between these two groups. Conclusions①In preterm infants,the platelet indexes were abnormal.②The relationship between the polymorphism of the alleles of the platelet glycoprotein GPIbαHPA-2 and ICH needs more studies.③The polymorphism of the platelet glycoprotein GPIbαHPA-2 alleles may be not related to the severity of ICH.
ObjectiveEpidemiological research on the anaphylactic disease showed its prevalence rate was very different among regions. Therefore epidemiological survey on the anaphylactic disease would contribute to making appropriate preventive measures for allergic disease in various regions. But except the asthma, rare epidemiological data of the anaphylaxis of 6-12 years old school children have been reported in China until now. So we investigated the allergic symptoms of nose, eyes,airway and skin of 6-12 years old children from the urban areas of Zhongshan to find out the epidemic characteristics of anaphylaxis of the local school children. Methods4 478 children aged 6-12 years from 4 elementary schools in the urban areas of Zhongshan were surveyed by symptom on-the-spot questionnaire about general things, family medical history, allergic symptoms of noses, eyes, lungs and skins, urticaria and prurigo. And further, skin-prick test(SPT) was implemented in 220 cases with positive findings in the questionnaire. Results4 085 efficient questionnaires were taken back with 91.2% of efficiency rate. The data showed at least one member was involved in anaphylactic disease in 25.2% families. The higher prevalence was found in the children whose parents suffered from allergic disease. There was significant difference in the incidence of allergic symptoms of nose between girls and boys, 19.5% and 28.1%,respectively ( t＝31.536,P<0.000 1). 66.9% children with allergic symptoms of nose were troubled in their everyday life to some extent. 51.9% children suffered from allergic symptoms of eyes, mainly emerging in spring with the rate of 77.8％. 140 cases (3.4%) were affected with asthma, 17 of them had an asthma fit last year. In addition, 722 cases had suffered from the skin allergy such as the urticaria, prurigo, and so on. SPT was carried out in 220 children with allergic symptoms to identify the allergen and 196 cases were positive.In succession, common allergens were dermatophagoides pteronyssinus(94.3%), dermatophagoides farinae(92.3%), torrid zone mite(61.2％), mugwort(23.0％), dog hair(13.8％) and cat hair(13.3％). ConclusionsThere existed high prevalence of allergic disease in the school children in the urban areas of Zhongshan.Dust mites were the most common allergene in this region.
ObjectiveTo study the protective effects of early continuing insulin pump infusion on liver injury and its associated mechanism in lipopolysaccharide-induced endotoxemic rats. Methods24 SD rats were randomly divided into 3 groups(every rat was performed an external jugular vein catheterization one day before intraperitoneal injection)：saline control group (n=8),LPS+saline group (n=8) and LPS+insulin group (n=8).Saline control group was given 0.9% saline only.LPS+saline group was intraperitoneally injected lipopolysaccharide (LPS) (Escherichia coli serotype 0111:B4) 10 mg·kg-1, and then was given a pump infusion of 0.9% saline 1 mL·h-1. LPS+insulin group received a pump infusion of insulin solution 1 mL·h-1 after being injected LPS 10 mg·kg-1 intraperitoneally. The dose of insulin was 0.25 U·kg-1·h-1. Blood glucose levels were monitored before intraperitoneal injection and 2 hours, 6 hours, 12 hours, 24 hours after intraperitoneal injection. Blood samples were taken 2 and 6 hours after intraperitoneal injection through external jugular vein catheter and the levels of serum TNF-α and IL-6 were detected by enzyme-linked immunoadsorbent assay (ELISA). Hepatic injury was evaluated by detecting the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) 24 hours after intraperitoneal injection. And the liver pathological changes were also examined 24 hours after intraperitoneal injection. ResultsCompared with saline control group, blood glucose levels elevated significantly in LPS+saline group (P<0.05). In LPS+insulin group, the levels of blood glucose dropped significantly compared with LPS+saline group (P<0.05) and maintained at normal level. In LPS+saline group, the levels of serum TNF-α and IL-6 elevated significantly compared with saline control group (P<0.05). And the levels of serum ALT and AST in LPS+saline group were also significantly higher than that in saline control group (P<0.05). In LPS+insulin group, the levels of serum TNF-α and IL-6 dropped significantly compared with LPS+saline group (P<0.05). And the levels of serum ALT and AST in LPS+insulin group also dropped significantly compared with LPS+saline group (P<0.05). In LPS+saline group, the liver pathological examination showed that LPS could cause hepatocyte edema, liver focal necrosis, inflammatory cell infiltration in portal area and severe congestion of interlobular veins. The pathological examination of LPS+insulin group showed the damage of liver tissue was improved compared with LPS+saline group. ConclusionsEarly continuing insulin pump infusion can protect liver injury induced by LPS. This effect may be related to attenuating inflammatory reaction and reducing the blood glucose level by insulin.
