Analysis of vitamin D status among children under 7 years of age in some regions of China / 中华儿科杂志

Objective: To explore current vitamin D status and influential factors of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China. Methods: According to the "province-city-hospital" sampling technical route, a total of 1 531 healthy children under 7 years of age were sampled from 11 provinces, autonomous regions or municipalities in China by the cluster random sampling method from November 2020 to November 2021. The demographic information, family conditions, behavior and living habits and feeding behaviors were collected using unified questionnaire. Serum 25-hydroxyvitamin D(25(OH)D) levels were measured by liquid chromatography-tandem mass spectrometry. Serum 25(OH)D<30 nmol/L was considered deficient and 30-50 nmol/L was considered insufficient. With 25(OH)D≤50 nmol/L as the dependent variable, multivariate Logistic regression was applied to analyze the association between vitamin D deficiency and insufficiency and potential influential factors. Results: The prevalence of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China was 14.0% (215/1 531), 3.8% (25/664) and 21.9% (190/867) in 0-<3 and 3-<7 of age years, respectively. Compared to children aged 0-<3 years, children aged 3-<7 years had a 2.6-fold increased risk of vitamin D deficiency and insufficiency (OR=3.60, 95%CI 1.93-6.72, P<0.001). Frequent sunlight exposure (OR=0.46, 95%CI 0.29-0.73, P=0.001), vitamin D supplementation (sometimes, OR=0.33, 95%CI 0.21-0.51, P<0.001; daily, OR=0.20, 95%CI 0.11-0.36, P<0.001) and infant formula intake(4-7 times per weeks, OR=0.43, 95%CI 0.28-0.68, P<0.001) were protective factors for vitamin D deficiency and insufficiency. Conclusion: Vitamin D deficiency and insufficiency are common among children under 7 years of age in 11 provinces, autonomous regions or municipalities of China, which is affected by age, sunlight exposure, vitamin D supplementation and infant formula intake.

Pathogenesis of steroid-resistant asthma and the influence of vitamin D / 中国当代儿科杂志

Glucocorticoid (GC) is currently the most effective drug for controlling persistent asthma; however, there is a significant difference in the response to GC among patients with asthma. Steroid-resistant asthma is one of the subtypes of asthma and has poor response to high-dose GC treatment. It may affect the quality of life of patients and even threaten their lives. Therefore, it is of great significance to explore the pathogenesis of steroid-resistant asthma and related targeted treatment strategy. In recent years, a variety of pathogeneses have been found to participate in the development and progression of steroid-resistant asthma, including the reduction in the binding between GC receptor and GC, the increase in the expression of GC receptor β, over-activation of nuclear transcription factor activating protein 1 and nuclear factor-κB, abnormality in histone acetylation, and immune-mediated cytokine dysregulation. In addition, many studies have shown that vitamin D can improve the sensitivity to GC among patients with steroid-resistant asthma. This article reviews the pathogenesis of steroid-resistant asthma and the influence of vitamin D.

Clinical characteristics of Henoch-Schönlein purpura in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristics of Henoch-Schönlein purpura (HSP) in children.</p><p><b>METHODS</b>The clinical data of 325 hospitalized children who were diagnosed with HSP between June 2012 and June 2014 were analyzed retrospectively.</p><p><b>RESULTS</b>In the 325 children with HSP, the incidence of HSP was higher in winter and spring, with 33.9% and 27.4%, respectively. Infection was the major factor to induce HSP (57.2%). The incidence of renal damage in children with purpura accompanied by abdominal symptoms and children with purpura accompanied by abdominal and joint symptoms was 60.3% and 48.9%, respectively, with statistically significant differences compared with children with purpura alone (P<0.05). In 32 children with purpura nephritis, the pathological grades of IIIa and IIIb were more common, accounting for 28% and 31%, respectively. In 325 children, an increased serum D-dimer level was observed in 260 children (80.0%), an increased peripheral IgA content in 101 children (46.3%), and a decreased CD4+ cell percentage in 62 children (56.4%).</p><p><b>CONCLUSIONS</b>A high incidence of HSP is often seen in spring and winter. HSP is often induced by upper respiratory tract infection. Renal damage is more likely to occur in children with digestive tract symptoms, with IIIa and IIIb as the common pathological grades of renal damage.</p>

Long-term clinical efficacy of mild hypothermia therapy in neonates with hypoxic-ischemic encephalopathy: a Meta analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To systematically evaluate the long-term clinical efficacy and safety of mild hypothermia therapy in neonates with hypoxic-ischemic encephalopathy (HIE).</p><p><b>METHODS</b>All randomized controlled trials (RCTs) of mild hypothermia therapy for neonatal HIE from inception to March 2014 were retrieved from databases including Cochrane Library, PubMed, Embase, CBMdisc, and Wanfang Data. Meta analysis was performed using RevMan 5.1 Software.</p><p><b>RESULTS</b>Eight RCTs met the search criteria. The results of Meta analysis showed that, compared with the control group, systemic hypothermia significantly reduced the mortality rate and the incidence of growth delay (RR=0.73, 95% CI: 0.61-0.89; RR=0.70, 95%CI: 0.54-0.93); selective head or systemic hypothermia therapy significantly reduced the incidence of cerebral palsy (RR=0.65, 95%CI: 0.46-0.94; RR=0.67, 95%CI: 0.52-0.86) up to 12-24 months of age. One study reported that hypothermia reduced the mortality rate and the rate of a composite end point of death or severe disability compared with the control group at 6 to 7 years of age. The incidence of adverse events including sinus bradyarrhythmia, thrombocytopenia and hypoglycemia was significantly higher in the hypothermia group than in the control group, whereas the incidence of cardiac arrhythmia, hypotension, thrombosis or bleeding, hypokalemia, sepsis, and liver dysfunction showed no significant differences between the two groups.</p><p><b>CONCLUSIONS</b>Mild hypothermia therapy demonstrates a significant efficacy in children with HIE up to 12-24 months of age, but there is still a need for further research on childhood outcomes after mild hypothermia for neonatal HIE. This therapy has few adverse effects and a high clinical tolerability.</p>

Etiological study of human bocavirus 1-4 in children with acute diarrhea in Lanzhou, China / 病毒学报

This study aimed to study the epidemiological and clinical characteristics of human bocavirus 1-4 (HBoV1-4) in children with acute diarrhea in Lanzhou and to investigate the association between HBoV and acute gastroenteritis. A total of 331 stool samples were collected from children aged under 5 years with acute diarrhea at the Department of Pediatrics, the First Hospital, Lanzhou University, between July 2012 and June 2013. Nested PCR was used to screen for HBoV and a general PCR was employed to screen other common diarrhea viruses. We found human bocavirus 1, 2, 3 and 4 in 26, 15, 7 and 1 cases, respectively. There was no specific seasonal distribution of HBoV, with infections occurring throughout the year. HBoV was mostly found in children aged between 7 and 12 months, with a mean age of 11.04 months (+/- 6.92 months), and 93.88% of affected children were aged under 2 years. Overall, 71.3% of mixed infections were mixed and the majority of other infections were caused by rotavirus. There was no statistical difference in the incidence of fever and vomiting associated with HBoV infection. A rare virus strain, HBoV4 (LZFB086), was identified, which showed highest levels of nucleotide sequence identity (99.0%) with a single Thai HBoV strain (JQ267789). No case of HBoV2B was found. In conclusion, HBoV1 was a major etiological pathogen of HBoV in pediatric cases in Lanzhou. HBoV4 was detected in feces for the first time in China. The rate of mixed infections was high and rotavirus was dominant. The data presented suggests that HBoV is not a major causative agent of gastroenteritis.

Molecular epideiological and clinical feature of human calicivirus and adenovirus among children with diarrhea less than 5 years old from 2010 to 2011 in Lanzhou, Gansu province / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and molecular epidemiology characteristics of calicivirus and adenovirus in children for viral diarrhea in Lanzhou.</p><p><b>METHODS</b>Stool samples were collected from 295 children with diarrhea at the First Hospital of Lanzhou University, Gansu Province,China, between July 2010 and June 2011. Reverse transcription-polymerase chain reaction (RT-PCR) or PCR were used to detected calicivirus and adenovirus. The adenovirus positive samples were typed by nested PCR and multiple PCR.</p><p><b>RESULTS</b>Of the 295 specimens, 13.2% (39/295) were positive for calicivirus, and 5.1% (15/295) were adenovirus. Typing and Phylogenetic analysis revealed that novirus GII-3 and adenovirus 41 were the dominant strains. Both calicivirus and adenovirus predominately affect children under the age of 2. In seasonal distribution, there was no obvious peak.</p><p><b>CONCLUSION</b>Human calicivirus and adenovirus are important pathogens of viral diarrhea,it is important to develop long-term systematic surveillance.</p>

Reseanh advance in human astrovirus / 病毒学报

Human astroviruses have been recognized as one of the important causes of viral gastroenteritis in infants and young children. In the present work, we reviewed the progress of astrovirus infections in humans, focusing on the serotypes molecular biological, characteristics of disease, pathogenic mechanism, epidemiology and detection methods, and concluded that there were multiple astroviruses circulating in the world, and several novel astroviruses were discovered in recent years. Human astrovirus 1 was the most prevailing serotype. Which caused intestinal and parenteral infections, and the characteristics of infections were similar to other diarrheal viruses. However, the pathogenic mechanism remained unknown. Only limited data was available about the correlation between the novel astroviruses and diseases, and the laboratory detection methods needed to be established.

Molecular and epidemiological study on viral diarrhea among infants in Lanzhou / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the epidemiologic characteristics of viral diarrhea in children under 5 years old in Lanzhou, understand the four major virus in children of distribution.</p><p><b>METHODS</b>In the first hospital of Lanzhou university from Jul 2009 to Jun 2010,we collected 290 stool specimens from children with diarrhea and 114 asymptomatic controls. Rotavirus was detected by ELISA,further strain characterization was carried out by nested PCR. The human calicivirus, astrovirus, adenovirus were detected by RT-multiplex PCR and PCR.</p><p><b>RESULTS</b>At least one of the four viral agents was found in 60% of the specimens. Rotavirus, human calicivirus, adenovirus, and astrovirus were identified in 39.31%, 11.38%, 10.69%, and 4.83% in 290 specimens respectively. Rotavirus G3 was the most prevailing serotype, P [8] was the most common genotype. In the 114 control samples, 7 sample was positived for calicivirus, 5 samples were positived for human adenovirus and 1 sample was positived for astrovirus.</p><p><b>CONCLUSION</b>The results indicated clearly the impact of viral agents causing diarrhea and the importance of long-term systematic surveillance.</p>

Detection and clinical characteristics analysis of human bocavirus 1-3 in children for acute respiratory infection in Lanzhou area / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the clinical and molecular epidemiology characteristics of human Bocavirus 1-3 (HBoV1-3) in children for acute respiratory infection in Lanzhou area.</p><p><b>METHODS</b>Nasopharyngeal aspiration samples and throat swabs were collected from 524 children with ARTI at the First Hospital of Lanzhou University, Gansu Province, China, between December 2009 and November 2010. Nested PCR was employed to screening HBoV1-3, which amplified a 518-bp fragment of the partial NS1 gene. Furthermore, a standard reverse transcription-PCR was used to screen for other common respiratory viruses.</p><p><b>RESULTS</b>The overall frequency of HBoV was 8.2% (43/524), lining up behind human rhinovirus, RSV, parainfluenza virus 3. Thirty of the HBoV-postive children(69.8%) were co-infected with other respiratory viruses. The prevalence of HBoV1 in ALRTI was obviously higher than that in AURI. The 2 HBoV2 NS1 sequences shared 99% and 100% nucleotide sequence identity with HBoV2 strain CU47TH respectively. Two cases of HBoV2 postive children appears gastrointestinal symptoms. The one HBoV3 NS1 sequences shared 99% nucleotide sequence identity with HBoV3 isolate 46-BJ07.</p><p><b>CONCLUSION</b>The HBoV3 was detected at the first time in lanzhou area. HBoV1-3 infection exists in children with acute respiratory tract infections in Lanzhou region, HBoV1 were dominant. The mixed infection rate was higher.</p>

Correlation between vitamin D receptor genetic polymorphism and 25-hydroxyvitamin D3 in vitamin D deficiency rickets / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the correlation between vitamin D receptor genetic polymorphism Fokand vitamin D deficiency rickets in children between 1 to 3 years old, and to explore the significance of hereditary factors in the development of vitamin D deficiency rickets.</p><p><b>METHODS</b>Sixty-two children with vitamin D deficiency rickets and 60 healthy children as a control group were enrolled. Serum levels of 25-hydroxyvitamin D3 were measured using ELISA. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genetic analysis method was used. A restriction fragment length polymorphism in the vitamin D receptor genetic polymorphism Fok I was tested. The frequencies of the vitamin D receptor genotype and allele were compared between the two groups.</p><p><b>RESULTS</b>Serum 25-hydroxyvitamin D3 levels in the rickets group were significantly lower than those in the control group ( 9.1+/-4.1 ng/mL vs 16.1+/-6.9 ng/mL; P<0.05 ). FF genotype in the vitamin D receptor genetic polymorphism Fok I was more common in the rickets group than in the control group (53% vs 25%; P<0.05). F allele frequency in the rickets group was significantly higher than that in the control group (73% vs 57%; P<0.05).</p><p><b>CONCLUSIONS</b>There is a correlation between vitamin D receptor genetic polymorphism Fok I and vitamin D deficiency rickets. This suggests that vitamin D receptor genetic polymorphism might play an important role in determining susceptibility to development of vitamin D deficiency rickets.</p>

Association of the vitamin D receptor gene start codon polymorphism with delayed rickets / 中华儿科杂志

<p><b>OBJECTIVE</b>Delayed rickets is a special type of vitamin D deficiency, the occurrences of delayed rickets mainly relate to vitamin D deficiency, but whether there is hereditary susceptibility of children to development of delayed rickets is unknown. Recently some studies suggest that there is a significant association between vitamin D receptor gene (VDR) polymorphism and the metabolic diseases of bone. The present study aimed to explore the hereditary susceptibility of children to development of delayed rickets through studying the association of the vitamin D receptor gene start codon (VDRSC) polymorphism with delayed rickets.</p><p><b>METHODS</b>The diagnosis was based on clinical, biochemical and radiological data. The subjects were composed of three groups, the patient group had 30 children, the vitamin D deficiency group 35 children, and the control group 60 normal children. The VDRSC genotypes of the three groups were determined by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.</p><p><b>RESULTS</b>There was significant difference in the frequencies distribution of VDRSC genotypes (chi(2) = 13.184, P = 0.010) and VDRSC alleles (chi(2) = 8.975, P = 0.011) among the three groups; the frequency of the FF genotype (56.7%) in the patient group was significantly higher than that in the control group (21.7%, P = 0.006) and that in the vitamin D deficiency group (22.9%, P = 0.002). The frequency of the F alleles in the patient group (70.0%) was significantly higher than that in the control group (48.3%, P = 0.006) and that in the vitamin D deficiency group (47.1%, P = 0.009). Multiple logistic regression analysis showed that FF genotype had a higher risk of delayed rickets (OR = 3.120), indicating that FF genotype may be significantly associated with delayed rickets.</p><p><b>CONCLUSION</b>There is the possibility that the VDRSC polymorphism might be important in determining the hereditary susceptibility of children to development of delayed rickets.</p>

Effect of Glutamine and Epidermal Growth Factor on Neonatal Rats with Necrotizing Enterocolitis / 实用儿科临床杂志

Objective To investigate the effects of glutamine(Gln) and epidermal growth factor(EGF) on small intestinal repair in neonatal rats with necrotizing enterocolitis(NEC).Methods Forty neonatal rats of NEC model were divided into 5 groups:group A(control group),group B(NEC model),group C(NEC+Gln),group D(NEC+EGF+Gln).After NEC model of neonatal rats,all the neonatal rats were returned to their mothers.In the 4~(th) day,all the subjects were put to the death.Intestinal tissue located at the boundary of ileum and cecum was obtained to observe histological changes.Morphological changes were measured under a light microscope,and expression of proliferating cell nuclear antigen(PCNA) as an index of cell proliferation was observed using immunohistochemical staining and image analysis,expression of apoptosis was observed by TUNEL staining and image analysis.Results In group B,the histological lesions ranged was different,and was graded 3 score.In group C,D,the histological lesions ranged was graded 1 score.The number of(PCNA) in group B was lower than that in group A(P

Arsenic trioxide inhibits P-glycoprotein expression in multidrug-resistant human leukemia K562/ADM cell line that overexpresses mdr-1 gene and enhances their chemotherapeutic sensitivity / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of arsenic trioxide (As(2)O(3)) on the apoptosis and P-glyco-protein (P-gp) expression of multidrug-resistant human leukemia K562/ADM cells, and the combined effects of As(2)O(3) with conventional chemotherapeutic agents.</p><p><b>METHODS</b>Multidrug-resistant human leukemia cell line K562/ADM that overexpresses mdr-1 gene was used as the target cells. The cell proliferating activity was assessed with a MTT assay. Cell morphology was examined by light microscopy, confocal microscopy and electron-microscopy. P-gp expression, cell-cycle status were determined by flow cytometry.</p><p><b>RESULTS</b>K562/ADM cells were highly resistant to adriamycin, and cross-resistant to daunorubicin and etoposide. As(2)O(3) at concentrations of 0.5 to 20 micromol/L inhibited the proliferation of K562/ADM cells, and K562/ADM cells were more sensitive to As(2)O(3) than their parent K562 cells did. As(2)O(3) induced marked apoptosis of K562/ADM cells showed by typical apoptotic morphological changes and the appearance of high sub-G(1) cell population. As(2)O(3) significantly inhibited the P-gp expression in K562/ADM cells, and exerted a synergistic effect on the enhancement of the cell sensitivity to adriamycin, daunorubicin and etoposide.</p><p><b>CONCLUSION</b>As(2)O(3) induces growth-inhibition and apoptosis of multidrug-resistant K562/ADM cells, and augments synergistically the sensitivity of the cells to conventional chemotherapeutic agents via down-regulation of P-gp expression.</p>