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Hypoxia-inducible factor: role in cell survival in superoxide dismutase overexpressing mice after neonatal hypoxia-ischemia. 缺氧诱导因子:在新生儿缺氧缺血后超氧化物歧化酶过表达小鼠细胞存活中的作用。
Pub Date : 2019-12-01 Epub Date: 2019-10-18 DOI: 10.3345/kjp.2019.00850
Ga Won Jeon, R Ann Sheldon, Donna M Ferriero

Background: Sixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies.

Purpose: HIF-1α-deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the role of HIF-2α in HI is not well characterized. Copper-zinc superoxide dismutase (SOD)1 overexpression is not beneficial in neonatal HI. The expression of HIF-1α and HIF-2α was measured in SOD1 overexpressing mice and compared to wild-type littermates to see if alteration in expression explains this lack of benefit.

Methods: On postnatal day 9, C57Bl/6 mice were subjected to HI, and protein expression was measured by western blotting in the ipsilateral cortex of wild-type and SOD1 overexpressing mice to quantify HIF-1α and HIF-2α. Spectrin expression was also measured to characterize the mechanism of cell death.

Results: HIF-1α protein expression did not significantly change after HI injury in the SOD1-overexpressing or wild-type mouse cortex. However, HIF-2α protein expression increased 30 minutes after HI injury in the wild-type and SOD1-overexpressing mouse cortex and decreased to baseline value at 24 hours after HI injury. Spectrin 145/150 expression did not significantly change after HI injury in the SOD1- overexpressing or wild-type mouse cortex. However, spectrin 120 expression increased in both wild-type and SOD1-overexpressing mouse at 4 hours after HI, which decreased by 24 hours, indicating a greater role of apoptotic cell death.

Conclusion: HIF-1α and HIF-2α may promote cell survival in neonatal HI in a cell-specific and regional fashion. Our findings suggest that early HIF-2α upregulation precedes apoptotic cell death and limits necrotic cell death. However, the influence of SOD was not clarified; it remains an intriguing factor in neonatal HI.

背景:60%患有严重新生儿缺氧缺血性脑病的婴儿死亡,而大多数幸存者有永久性残疾。新生儿缺氧缺血性脑病的治疗仅限于治疗性低温,但它不能提供完全的保护。在这里,我们研究了缺氧诱导因子(HIF)是否能促进细胞存活,并提出了神经保护策略。目的:hif -1α-缺陷小鼠在新生儿缺氧缺血(HI)后脑损伤加重,HIF-2α在HI中的作用尚不清楚。铜锌超氧化物歧化酶(SOD)1过表达不利于新生儿HI。在SOD1过表达小鼠中测量了HIF-1α和HIF-2α的表达,并将其与野生型幼崽进行比较,以确定表达的改变是否解释了这种缺乏益处的原因。方法:在出生后第9天给C57Bl/6小鼠注射HI,用western blotting法测定野生型和SOD1过表达小鼠同侧皮质中HIF-1α和HIF-2α的蛋白表达量。此外,还检测了Spectrin的表达,以表征细胞死亡的机制。结果:sod1过表达和野生型小鼠皮层HIF-1α蛋白表达在HI损伤后无明显变化。然而,在HI损伤后30分钟,野生型和过表达sod1的小鼠皮层中HIF-2α蛋白表达增加,并在HI损伤后24小时降至基线值。在SOD1-过表达或野生型小鼠皮层中,HI损伤后Spectrin 145/150的表达无显著变化。然而,在HI后4小时,野生型和sod1过表达小鼠的spectrin 120表达均升高,24小时则下降,表明凋亡细胞死亡的作用更大。结论:HIF-1α和HIF-2α可能以细胞特异性和局部方式促进新生儿HI的细胞存活。我们的研究结果表明,早期HIF-2α上调先于凋亡细胞死亡并限制坏死细胞死亡。然而,SOD的影响尚不清楚;它仍然是新生儿HI的一个有趣的因素。
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引用次数: 7
Food allergy and food-induced anaphylaxis in children: an increasing critical public health issue. 儿童食物过敏和食物诱发的过敏反应:一个日益严重的公共卫生问题。
Pub Date : 2019-12-01 Epub Date: 2019-11-12 DOI: 10.3345/kjp.2019.00493
Sooyoung Lee
This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/ licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Perspective Korean J Pediatr 2019;62(12):431-432 https://doi.org/10.3345/kjp.2019.00493 pISSN 1738-1061•eISSN 2092-7258
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引用次数: 2
Reconsideration of urine culture for the diagnosis of acute pyelonephritis in children: a new challenging method for diagnosing acute pyelonephritis. 重新考虑尿培养诊断儿童急性肾盂肾炎:急性肾盂肾炎诊断的新方法。
Pub Date : 2019-12-01 Epub Date: 2019-10-18 DOI: 10.3345/kjp.2019.00710
Jun Ho Lee, Seonkyeong Rhie

Acute pyelonephritis (APN) should be detected and treated as soon as possible to reduce the risk of the development of acquired renal scarring. However, in the medical field, urine culture results are not available or considered when the prompt discrimination of APN is necessary and empirical treatment is started. Furthermore, urine culture cannot discriminate APN among children with febrile urinary tract infection (UTI) (pyelitis, lower UTI with other fever focus). Therefore, the usefulness of urine culture for diagnostic purposes is small and the sampling procedure is invasive. Congenital hypoplastic kidney is the most common cause of chronic kidney injury in children. Thus, it is desirable that a main target be detected as early as possible when imaging studies are performed in children with APN. However, if APN does not recur, no medical or surgical treatment or imaging studies would be needed because the acquired renal scar would not progress further. Therefore, the long-term prognosis of APN in young children, particularly infants, depends on the number of recurrent APN, not other febrile UTI. New methods that enable prompt, practical, and comfortable APN diagnosis in children are needed as alternatives to urinary catheterization for urine culture sampling.

急性肾盂肾炎(APN)应尽早发现和治疗,以减少发展为获得性肾瘢痕的风险。然而,在医学领域,当需要及时鉴别APN并开始经验性治疗时,尿培养结果是无法获得或考虑的。此外,尿液培养不能区分发热性尿路感染(UTI)(肾盂炎、下尿路感染伴其他发热灶)患儿的APN。因此,尿液培养对诊断目的的有用性很小,采样过程是侵入性的。先天性肾发育不全是儿童慢性肾损伤最常见的原因。因此,在对APN患儿进行影像学检查时,应尽早发现主要靶点。然而,如果APN不复发,则不需要药物或手术治疗或影像学检查,因为获得性肾疤痕不会进一步发展。因此,幼儿,特别是婴儿APN的长期预后取决于APN复发的数量,而不是其他发热性尿路感染。需要新的方法,使快速,实用,舒适的诊断儿童APN作为替代尿培养取样导尿。
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引用次数: 5
Is there a simple and less invasive way to accurately diagnose acute pyelonephritis? 是否有一种简单、微创的方法来准确诊断急性肾盂肾炎?
Pub Date : 2019-12-01 Epub Date: 2019-11-19 DOI: 10.3345/kjp.2019.01186
Seong Heon Kim
This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/ licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Korean J Pediatr 2019;62(12):442-443 https://doi.org/10.3345/kjp.2019.01186 pISSN 1738-1061•eISSN 2092-7258
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引用次数: 0
Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity. 脂质积累产物是儿童肥胖非酒精性脂肪肝疾病的预测因子。
Pub Date : 2019-12-01 Epub Date: 2019-10-28 DOI: 10.3345/kjp.2019.00248
Bahar Özcabı, Salih Demirhan, Mesut Akyol, Hatice Öztürkmen Akay, Ayla Güven

Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults.

Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children.

Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/ L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis.

Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005).

Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

背景:脂质堆积产物(LAP)与成人非酒精性脂肪性肝病(NAFLD)的存在和严重程度相关。目的:本研究评估LAP预测肥胖儿童NAFLD的能力。方法:80例肥胖儿童(女孩38例;年龄6-18岁)。从患者的医疗记录中获得人体测量值和生化值。女生LAP计算为[腰围(WC) (cm) - 58]×triglycerides (mmol/L);[WC (cm) - 65]×triglycerides (mmol/ L)。描述minLAP和adjLAP(分别占WC值的3%和50%),计算总/高密度脂蛋白胆固醇指数(TC/HDL-C)。超声观察NAFLD,按脂肪变性程度分为3组(正常、0级;轻度,一级;中度至重度,2-3级)。通过接收算子特征分析,计算出曲线下面积(AUC)和合适的指标截止点。结果:LAP与青春期分期呈正相关(rho=0.409;P0.005)。adlap正常组与轻度组间差异有统计学意义(P=0.043),其他组间差异无统计学意义(P>0.005)。minLAP组间差异无统计学意义(P>0.005)。结论:LAP是预测儿童NAFLD的一种简便有效的工具。LAP≥42.7,应怀疑为NAFLD。这是第一个评估LAP诊断儿童肥胖准确性的研究。
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引用次数: 11
Monitoring BK virus infection in pediatric kidney transplant recipients 小儿肾移植受者BK病毒感染监测
Pub Date : 2019-10-18 DOI: 10.3345/kjp.2019.01123
M. Cho
This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/ licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Korean J Pediatr 2019;62(11):414-415 https://doi.org/10.3345/kjp.2019.01123 pISSN 1738-1061•eISSN 2092-7258
这是一篇根据知识共享署名非商业许可条款发布的开放获取文章(http://creativecommons.org/许可证/by-nc/4.0/),允许在任何媒介中不受限制地进行非商业性使用、分发和复制,前提是正确引用了原作。编辑韩国儿科杂志2019;62(11):414-415https://doi.org/10.3345/kjp.2019.01123pISSN 1738-1061•eISSN 2092-7258
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引用次数: 2
Evaluation of drug interventions for the treatment of sleep disorders in children with autism spectrum disorders: a systematic review 药物干预治疗自闭症谱系障碍儿童睡眠障碍的评价:一项系统综述
Pub Date : 2019-10-02 DOI: 10.3345/kjp.2019.00668
E. Jenabi, Sara Ataei, S. Bashirian
A structured review study of drug interventions on sleep disorders in patients with autism spectrum disorders (ASD) has not been published to date. This systematic review aimed to investigate drug interventions for the treatment of sleep disorders in children with ASD. The Web of Science, PubMed, and Scopus databases were searched until March 2019. Study quality was assessed using the Delphi checklist. Due to the heterogeneity of the findings, a meta-analysis was not possible. Drug interventions for the treatment of sleep disorders in patients with ASD included melatonin, atomoxetine, and risperidone. Atomoxetine had no effect on sleep disorders in patients with ASD. A total of 10 studies were reviewed. Melatonin appears to be useful for the treatment of sleep problems in patients with ASD, but further studies are needed to determine the effects of other drugs.
迄今为止,一项关于自闭症谱系障碍(ASD)患者睡眠障碍药物干预的结构化综述研究尚未发表。本系统综述旨在研究ASD儿童睡眠障碍的药物干预。搜索Web of Science、PubMed和Scopus数据库直到2019年3月。使用德尔菲检查表评估研究质量。由于研究结果的异质性,不可能进行荟萃分析。治疗ASD患者睡眠障碍的药物干预包括褪黑素、阿托莫西汀和利培酮。阿托莫西汀对ASD患者的睡眠障碍没有影响。共回顾了10项研究。褪黑素似乎有助于治疗ASD患者的睡眠问题,但还需要进一步的研究来确定其他药物的效果。
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引用次数: 9
Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network. 入院时低温对极低出生体重儿的临床影响:来自韩国新生儿网络的结果。
Pub Date : 2019-10-01 Epub Date: 2019-05-22 DOI: 10.3345/kjp.2019.00206
Na Hyun Lee, Soo Kyung Nam, Juyoung Lee, Yong Hoon Jun

Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C-37.5°C.

Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities.

Methods: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed.

Results: The mean admission temperature was 36.1°C±0.6°C, with a range of 31.9°C to 38.4°C. Approximately 74.1% of infants had an admission hypothermia of <36.5°C. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5°C-37.5°C and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04-1.83), 1.44 (95% CI, 1.05-1.97) and 1.86 (95% CI, 1.22-2.82) for infants with admission temperatures of 36.0°C-36.4°C, 35.0°C-35.9°C, and <35.0°C, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy.

Conclusion: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.

背景:早产儿出生后难以维持体温。然而,临床指南主张新生儿体温应保持在36.5℃-37.5℃。目的:我们旨在调查极低出生体重(VLBW)婴儿入院时体温过低的发生率,并确定入院温度与住院死亡率和发病率的关系。方法:一项队列研究,使用前瞻性收集的数据,涉及参加韩国新生儿网络的70个新生儿重症监护病房(NICUs)。从2013年1月至2015年12月出生的登记婴儿中,回顾了5343名妊娠少于33周的VLBW婴儿。结果:平均入院温度为36.1℃±0.6℃,范围为31.9℃~ 38.4℃。结论:韩国很大一部分早产儿在新生儿重症监护病房入院时体温过低,这与高死亡率和一些重要的发病率有关。在这一高危人群中,需要更积极的干预措施来减少体温过低。
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引用次数: 14
Bronchopulmonary dysplasia: how can we improve its outcomes? 支气管肺发育不良:如何改善其预后?
Pub Date : 2019-10-01 Epub Date: 2019-05-17 DOI: 10.3345/kjp.2019.00178
Tae-Jung Sung

Bronchopulmonary dysplasia (BPD) is a chronic lung disease of preterm infants with multiple factors affected from prenatal to postnatal periods. Despite significant advances in neonatal care over almost 50 years, BPD rates have not decreased; in fact, they may have even increased. Since more preterm infants, even at periviable gestational age, survive today, different stages of lung development affect the pathogenesis of BPD. Hence, the definition of BPD has changed from "old" to "new." In this review, we discuss the various definitions of BPD, risk factors from the prenatal to postnatal periods, management strategies by phase, and future directions for research.

支气管肺发育不良(BPD)是一种由产前到产后多种因素影响的早产儿慢性肺部疾病。尽管近50年来新生儿护理取得了重大进展,但BPD发病率并未下降;事实上,他们甚至可能增加了。由于今天更多的早产儿,甚至在围胎龄存活,肺发育的不同阶段影响BPD的发病机制。因此,BPD的定义已经从“旧的”变成了“新的”。在本文中,我们讨论了BPD的各种定义,产前至产后的危险因素,分阶段的管理策略以及未来的研究方向。
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引用次数: 6
The maternal prepregnancy body mass index and the risk of attention deficit hyperactivity disorder among children and adolescents: a systematic review and meta-analysis. 母亲孕前体重指数与儿童和青少年注意缺陷多动障碍的风险:一项系统回顾和荟萃分析。
Pub Date : 2019-10-01 Epub Date: 2019-06-14 DOI: 10.3345/kjp.2019.00185
Ensiyeh Jenabi, Saied Bashirian, Salman Khazaei, Zohreh Basiri

Background: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority.

Purpose: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring.

Methods: The search identified studies published through December 2018 in the PubMed, Web of Science, and Scopus databases. The odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CI) extracted from eligible studies were used as the common measure of association among studies.

Results: A significant association was found between overweight women and the risk of ADHD among children with the pooled HR and OR estimates (HR, 1.27 and 95% CI, 1.17-1.37; OR, 1.28 and 95% CI, 1.15-1.40, respectively). This association was significant between obese women and the risk of ADHD among children and adolescents with the pooled estimates of HR and OR (HR, 1.65 and 95% CI, 1.55-1.76; OR, 1.42 and 95% CI, 1.23-1.61).

Conclusion: The current epidemiological studies present sufficient evidence that prepregnancy overweight and obesity are significantly associated with an increased risk of ADHD among children and adolescents. These findings provide a new approach to preventing ADHD by controlling weight gain in the prenatal period, which should be considered by policymakers.

背景:注意缺陷多动障碍(ADHD)症状对个人、家庭和社会都有重大影响。因此,确定ADHD的危险因素是公共卫生的优先事项。目的:这是一项荟萃分析,评估母亲孕前体重指数与后代患多动症风险之间的关系。方法:搜索确定了截至2018年12月在PubMed、Web of Science和Scopus数据库中发表的研究。从符合条件的研究中提取的比值比(ORs)或95%可信区间(CI)的风险比(hr)作为研究间相关性的常用度量。结果:在合并HR和OR估计值(HR, 1.27, 95% CI, 1.17-1.37;OR为1.28,95% CI为1.15-1.40)。肥胖女性与儿童和青少年ADHD风险之间存在显著关联,HR和OR的合并估计(HR, 1.65, 95% CI, 1.55-1.76;OR, 1.42, 95% CI, 1.23-1.61)。结论:目前的流行病学研究提供了充分的证据,表明孕前超重和肥胖与儿童和青少年患ADHD的风险增加显著相关。这些发现提供了一种通过控制产前体重增加来预防多动症的新方法,这应该被决策者考虑。
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引用次数: 18
期刊
Korean Journal of Pediatrics
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