Early Premature Infant Oral Motor Intervention Improved Oral Feeding and Prognosis by Promoting Neurodevelopment.

OBJECTIVE: This study aimed to explore the clinical significance of early premature infant oral motor intervention (PIOMI) in the prognosis of premature infants. STUDY DESIGN: Infants were randomly divided into an intervention group (n = 78) and a control group (n = 73). PIOMI was given to the intervention group 15 to 30 minutes before feeding once a day for 14 days. The whole procedure lasted 15 minutes, including oral stimulation and nonnutritive sucking. Oral feeding ability and neuromotor development were evaluated using the Preterm Infant Oral Feeding Readiness Assessment (PIOFRA) scale and Infant Neurological International Battery (Infanib) scale. RESULTS: The PIOFRA score was higher in the intervention group and increased with time, showing a group-time interaction effect. The intervention group exhibited a higher feeding efficiency, a shorter transition time from assisted oral feeding to independent oral feeding, and lower body weight at achievement of independent oral feeding. The percentages of infants with a normal score on the Infanib scale were higher in the intervention group at 3 and 6 months of age, and an abnormal ratio was lower in the intervention group at 6 months (p < 0.01). CONCLUSION: PIOMI promoted neuromotor coordination by improving neurodevelopment, thereby improving the oral feeding ability and prognosis of preterm infants.

[Effects of Ligustrazine Injection on Serum Cys C Level in Scierema Neonatorum Children Patients].

Objective To observe the effects of Ligustrazine Injection (LI) on serum cystatin C (Cys C) level in sclerema neonatorum (SN) children patients. Methods Totally 69 SN children patients were recrui- ted as the SN group, 39 with mild SN and 30 with moderate-severe SN. Another 30 neonates were recruited as a control group. Mild SN children patients and moderate-severe SN children patients were respectively assigned to the treatment group and the routine group according to random digit table. Children patients in the routine group received routine supportive treatment and symptomatic treatment, while those in the treatment group were additionally injected with LI (6 mg/kg, adding in 30 mL 5% glucose injection; once per day). All treatment lasted for 7 successive days. Serum level of Cys C, blood urea nitrogen (BUN) , and creatinine (Cr) were detected. The abnormality rate of Cys C, BUN, and Cr was respectively calculated, and their correlations analyzed. Meanwhile, scleroma subsidence time was observed in each group. Results The serum level of Cys C was obviously elevated more in the SN group than in the control group (t =10. 55, P <0. 01). There was no statistical difference in serum level of BUN or Cr between the control group and the SN group (t =1.50, 1. 73; P >0. 05). Serum Cys C level obviously increased in moderate-severe SN children patients than in mild SN children patients (t =2. 11 , P <0. 05); serum levels of BUN and Cr showed increasing tendency in moderate-severe SN children patients and mild SN children patients, but with no statistical difference (t =2. 07, 1. 92; P >0. 05). Linear correlation showed that serum Cys C level was respectively positively correlated with serum BUN level and serum Cr level in the SN group (r =0. 314,0. 287,P <0. 05). The abnormality rate of serum Cys C, BUN, and Cr was 72. 5% (50/69), 27. 5% (19/69), and 36. 2% (25/69), respectively. The abnormality rate of serum Cys C was significantly higher than that of BUN or Cr (x² =41. 04; P <0. 01). Compared with the routine group, serum Cys C level and scleroma subsidence time were obviously lowered in moderate-severe SN chil- dren patients and mild SN children patients of the treatment group (P <0. 05), but with no statistical difference in serum level of BUN or Cr (P >0. 05). Conclusions Serum Cys C level could reflect early renal injury in SN children patients. But LI could obviously reduce serum Cys C level, promote the recovery of renal injury of SN neonates, and shorten scleroma subsidence time.

Clinical features and management outcomes of severe hand, foot and mouth disease.

OBJECTIVE: This study was designed to describe the clinical features and management outcomes of severe hand, foot and mouth disease (HFMD). SUBJECTS AND METHODS: Data on 147 severe HFMD patients during an outbreak in 2009 were analyzed. RESULTS: Most patients were under 3 years of age; 102 (69.4%) were boys. All had skin rashes and fever of ≥38°C. All (n = 147, 100%) showed signs of central nervous system involvement, such as lethargy (n = 124, 84.4%), myoclonic jerks (n = 76, 51.7%), or drowsiness (n = 34, 23.1%). Respiratory symptoms were mainly tachypnea (n = 112, 76.2%) or bradypnea (n = 21, 14.3%). Common cardiovascular symptoms included tachycardia (n = 134, 91.2%) and hypertension (n = 23, 15.5%). Chest X-ray showed increased markings in 76 (51.7%) or consolidation in 44 (29.9%). Hyperglycemia and elevated blood lactic acid levels were found in 127 (86.4%) and 130 (88.4%), respectively. Positive enterovirus EV71-PCR was found in 113 (76.9%). All patients were treated with mechanical ventilation for 61.2 ± 12.8 h (range, 40-96 h), as well as mannitol, dexamethasone, gamma globulin and ribavirin. Dopamine, dobutamine or amrinone was administered in 58.5, 51.0 and 21.8%, respectively. Three patients (2%) died during hospitalization. All others had a full recovery and were discharged after 14.2 ± 1.6 days (range, 12-17 days). CONCLUSION: Central nervous and cardiorespiratory systems were involved in the patients with severe HFMD. Fasting blood glucose and lactic acid levels increased in the majority of patients. Mechanical ventilation and supportive pharmacotherapy were associated with a good clinical outcome in these patients.

Four new species of the genus Eophileurus Arrow, 1908 (Coleoptera: Scarabaeidae: Dynastinae) from Thailand and Vietnam, with notes on some Indochinese species.

Four new species of the genus Eophileurus Arrow, 1908 are described: E. minor Yang Pathomwattananurak, new species (Thailand and Vietnam), E. prelli Yang Pathomwattananurak, new species (Vietnam), E. quadratifovealis Yang Pathomwattananurak, new species and E. sidereus Yang Pathomwattananurak, new species (both Thailand). Two new junior synonyms are proposed: E. confinis Prell, 1913 = E. takakuwai Yamaya Muramoto, 2008, new synonym and E. felschei Prell, 1913 = E. grossepunctatusDupuis, 2014, new synonym. Lectotypes for E. andamanicus Arrow, 1914 and E. siamensis Arrow, 1914 are designated. Taxonomic problems regarding E. confinis and E. malyi Endrdi, 1978 are discussed. Type material of E. andamanicus, E. confinis, E. decipiens Prell, 1913, E. felschei, E. gracilis Prell, 1913, E. grossepunctatus, E. malyi, E. nicobarensis Endrdi, 1978 and E. siamensis is illustrated. A distribution map of the new species and their closest relatives is also provided.

[The preliminary report of investigation: Using mask for cardiopulmonary exercise testing in Chinese children may result misinterpretation and misdiagnosis].

Objective: Observe the increased anatomical dead space of the mask, summarize the law of exercise induced oscillatory breathing (EIOB) in the results of CPET's new 9 figure, and analyze its incidence and age groups that are prone to oscillatory breathing. Methods: After signed the informed consent form by guardian, 501 children from pre-school to middle-school, aged 3~14 year, performed Harbor-UCLA standard protocol CPET with strict quality control in the CPET laboratory of Liaocheng Children's Hospital since 2014. CPET data was interpreted second by second from the breath by breath collection, averaged by 10s and then display by 9 plots. We analyzed the trends, pattern, incidence and age difference for EIOB and gas leakage. Results: The incidence of EIOB was the highest in the 3 to 6-year-old group, which was 42%. The 7 to 10-year-old group was 29.4% and the 11- to 14-year-old group was 29.9%. The three groups were tested by chi-square (x2=7.512), and the difference was statistically significant (P<0.05). 14 out of 508 children had air leakage during CPET, the incidence rate was 2.7%. Conclusion: The phenomenon of oscillatory breathing (OB) in children may be caused by the increased anatomical dead space of the mask, and it is not caused by disease. To improve the quality of CPET and to reduce clinical misdiagnosis, it is recommended to use a mouthpiece to decrease the dead space rather than the musk.

A comparison of sleeping problems in school-age children between rural and urban communities in China.

AIM: To investigate differences in sleeping behaviours in school-age children between urban and rural Chinese communities. METHODS: Children aged between 6 and 12 years old were selected from rural (n= 472) and urban communities (n= 576). Children's sleep habits questionnaire was completed by the parents to assess sleep patterns and sleep problems of the children. RESULTS: In the 6-8 and 9-12 years groups, the average sleep time in urban children was shorter than in the children from rural areas (9.0 +/- 1.1 vs. 11.3 +/- 1.1 h, and 9.2 +/- 1.0 vs. 10.2 +/- 0.9 h, respectively, all P < 0.01). The rate of abnormal sleep behaviour in the urban and rural cohort was 82.8 and 70.1%, respectively (P < 0.05). The prevalence of sleep delays in the 6- to 8-year-old children from urban areas was higher than in the rural areas (60.3 vs. 40.3%, P < 0.01). In the urban 9-12 years group, the rate of day-time sleepiness was higher than in the rural group (52.6 vs. 26.8%, P < 0.01), whereas the night waking rate was lower (43.8 vs. 58.6%, P < 0.01). Multivariate logistic regression analysis showed that the location of the residence, mother's age, parent's sleep habits and education levels predict the sleeping problems in these children. CONCLUSION: Children from urban communities appear to have sleeping problems than children from a rural setting. A parent's sleep habits, education levels and the location of children's residence have significant impact on the children's sleep behaviour and habits.

[Plasma thromboxane A2 and prostaglandin I2 levels and their ratio in children with Henoch-Schonlein purpura nephritis].

OBJECTIVE: To study the changes and roles of plasma thromboxane A2 (TXA2) and prostaglandin I2 (PGT2) levels and their ratio in Henoch-Schonlein purpura nephritis (HSPN) in children. METHODS: Plasma levels of TXA2 and PGI2 were measured using ELISA in 45 children with HSPN and 20 healthy children. RESULTS: Plasma TXA2 level was significantly higher, while plasma PGI2 level was significantly lower in HSPN children in the acute phase than in the control (P<0.01). The ratio of TXA2/PGI2 in HSPN children in the acute phase was statistically higher than in the control (9.55+/-3.56 vs 0.87+/-0.21; P<0.01). In the convalescence phase, plasma TXA2 level remained higher and plasma PGI2 level was elevated and higher than in the control, so the ratio of TXA2/PGI2 was reduced to normal level. CONCLUSIONS: The imbalance of TXA2 and PGI2 may be involved in the development of renal damage in children with HSPN. The balance of TXA2 and PGI2 contributes to renal recovery.

Clinical characteristics and etiology of bacterial meningitis in Chinese children >28 days of age, January 2014-December 2016: A multicenter retrospective study.

OBJECTIVE: To explore the clinical characteristics and etiology of bacterial meningitis (BM) in Chinese children. METHOD: BM cases in children 28days to 18 years old were collected from January 2014-December 2016 and screened according to World Health Organization standards. Clinical features, pathogens, and resistance patterns were analyzed. RESULTS: Overall, 837 cases were classified into five age groups: 28 days-2 months (17.0%), 3-11 months (27.8%), 12-35 months (24.0%), 3-6 years (13.9%), and >6years (17.3%). Major pathogens were Streptococcus pneumoniae (S. pneumoniae, n=136, 46.9%), group B Streptococcus (GBS, n=29, 10.0%), and Escherichia coli (E. coli, n=23, 7.9%). In infants <3 months old, GBS (46.5%) and E. coli (23.3%) were most common; in children >3 months old, S. pneumoniae (54.7%), which had a penicillin non-susceptibility rate of 55.4% (36/65), was most frequent. The resistance rates of S. pneumoniae and E. coli to cefotaxime and ceftriaxone were 14.0%/40.0% and 11.3%/68.4%, respectively. All GBS isolates were sensitive to penicillin. CONCLUSIONS: The occurrence of BM peaked in the first year of life, while S. pneumoniae was the predominant pathogen in children >3months of old. The antibiotic resistance of S. pneumoniae was a concern.

Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition).

BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. METHODS: National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD. RESULTS: Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases. CONCLUSION: The guidelines can provide systematic guidance on the diagnosis and management of HFMD.

Effects of erythropoietin on neonatal hypoxia-ischemia brain injury in rat model.

BACKGROUND: Hypoxic-ischemic (HI) injury to the developing brain remains a major cause of morbidity. To date, few therapeutic strategies could provide complete neuroprotection. Erythropoietin (EPO) has been shown to be beneficial in several models of neonatal HI. This study examines the effect of treatment with erythropoietin on postnatal day 2 (P2) rats introduced with HI injury. METHOD: Rats at P2 were randomized into four groups: sham, bilateral carotid artery occlusion (BCAO), BCAO + early EPO, and BCAO + late EPO groups. Pups in each group were injected with either saline or EPO (5000U/kg) intraperitoneally once at immediately (early) or 48h (late) after HI induction. Body weight was assessed at P2 before and day 7 after HI. Mortality Rate was assessed at 24h, 48h and 72h after HI and brain water content was assessed at 72h. Brain weight and expression of myelin basic protein (MBP) were assessed at day 7 and day 14. At day 31 to 35 following HI insult, neurological behavior function was assessed via Morris water maze (MWM) test. RESULT: HI cause significant higher mortality in male than in female (P=0.0445). Among the surviving animal, HI affect significantly the body growth, brain growth, MBP expression, and neurological behavior. EPO treatments at both early and late time points significantly benefit the rats in injury recovery, in which they promoted weight gains, reduced brain edema, as well as improved spatial learning ability and memory. CONCLUSION: We demonstrated a single dose of EPO at 5000U/kg immediately or 48h after HI injury had significant benefit for the P2 rats in injury recovery, and there was no adverse effect associated with either EPO treatment.

Knockdown of USP39 by lentivirus-mediated RNA interference suppresses the growth of oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a frequently diagnosed life-threatening oral cancer worldwide and has become one of the leading causes of cancer-related mortality. However, the pathogenesis of this disease is very limited. OBJECTIVE: In this study, we aimed to investigate the functional relationship between OSCC and a potential tumor related gene ubiquitin-specific proteases 39 (USP39). METHODS: The lentivirus-based RNA interference was utilized to knock down USP39 expression in human OSCC CAL27 cells. The effect of USP39 on cell proliferation was detected by MTT and colony formation assays. RESULTS: The results uncovered that the proliferation rate was significantly decreased in specific USP39-targeting lentivirus infected cells compared to control lentivirus infected cells. The colony formation capacity was also attenuated in CAL27 cells after USP39 knockdown. Moreover, knockdown of USP39 arrested CAL27 cells in S and G1/M phases of the cell cycle. Furthermore, USP39 silencing induced apoptosis of CAL27 cells via activations of Caspase 3 and PARP. CONCLUSIONS: In conclusion, the inhibition of USP39 in CAL27 cells suppressed cell growth probably via induction cell cycle arrest and apoptosis. USP39 might act as an oncogenic factor in OSCC and could be a potential molecular target for OSCC gene therapy.

Direct, sensitive determination of trace amounts of dissolved ferric iron in natural water by light absorption ratio variation spectrometry.

The chromophore eriochrome cyanine R (ECR) was used to sensitively coordinate Al(II) and Fe(II) in the presence of cetylpyridinium chloride (CPC) at pH 4.8. Trace amounts of Fe(III) can displace Al(III) from the Al(ECR)(CPC) ternary complex to form the Fe(ECR)(CPC) complex. The composition of the complexes was determined by the break point approach. The competitive displacement complexation was sensitive and highly selective, even if no masking reagent was added. An ongoing novel spectrophotometry, named the light-absorption ratio variation approach, was applied to the direct determination of Fe(III) in natural water with recovery between 92.5 and 106%. The detection limit was only 9 ng/mL Fe(III).

[Argon plasma coagulation combined with cryotherapy via bronchoscopy for the treatment of one child with severe post-intubation tracheal stenosis and literature review].

OBJECTIVE: To observe the short term effect of argon plasma coagulation (APC) combined with cryotherapy via bronchoscopy for treatment of severe post-intubation tracheal stenosis in a child. METHOD: A 3-year old boy was admitted for cephalothorax abdominal compound trauma and dyspnea, who had severe post-incubation tracheal stenosis. The agreement about the operation risk was signed by the parents. Endotracheal APC procedure was performed with a bronchoscope under general anesthesia. The APC probe was put into the working channel of the bronchoscope. The stenotic lesion was endoscopically visualized and then coagulated by argon plasma. Such coagulation was carried out several times at the stenotic site until it gradually became dilated. The devitalized tissue was mechanically removed with grasping forceps. Thereafter, bronchoscopic cryosurgery was repeatedly performed at the stenotic site. Clinical symptoms, signs and bronchoscopic manifestations were observed right after operation, after 1 day, 10 days, 1 month and 6 months separately. RESULT: Tracheal tissue hyperplasia and cyanosis disappeared, laryngeal stridor and dyspnea improved obviously right after the operation. General condition of the patient was well, there was no laryngeal stridor and dyspnea 10 days after operation. The mucosa of the surgical site was smooth and no tracheostenosis was seen under bronchoscope at 1 month and 6 months after the operation. CONCLUSION: Argon plasma coagulation combined with cryotherapy via bronchoscope is an effective method to treat tracheal stenosis of children, which needs further exploration for the application.

Non-covalent interaction of 2', 4', 5', 7'-tetrabromo-4, 5, 6, 7-tetrachlorofluorescein with proteins and its application.

The interactions of 2', 4', 5', 7'-tetrabromo-4, 5, 6, 7-tetrachlorofluorescein (TBTCF) with BSA, ovalbumin (OVA) and poly-L-lysine (PLYS) at pH 3.70 have been investigated by combination of the spectral correction technique and the Langmuir isothermal adsorption. The active connection actions such as ion pairs, van der Waals' force, hydrogen bond, hydrophobic bond were proposed to explain the non-covalent interaction between TBTCF and BSA, OVA and PLYS. Effects of the electrolyte and high temperature indicated that union of the active connections between TBTCF and BSA and OVA was too firm to be destroyed. The relationship between the binding number of TBTCF and variety fraction of the amino acid residues was analyzed. The binding number of TBTCF depended on the number of positively charged amino acid residues. The other amino acid residues surrounded and seized TBTCF by hydrogen bonds and hydrophobic bonds when the electrostatic attraction pulled TBTCF to link protein. In addition, a novel method named the absorbance ratio difference was established for determination of protein in trace level and was applied with much higher sensitivity than the ordinary method.