Pub Date : 2001-12-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.12.104
Zhihui Li
Objective Studies in the last few years suggested that rennin-angiotensin system (RAS) might play an important role in renal progressive damage. RAS blockade could decrease protenuria and alleviate glomerulosclerosis and interstitial fibrosis, but the mechanism of which has been unclear. Therefore, adriamycin (ADR)-induced nephropathy rats were used as the animal model, the chronic progressive renal lesions of the model were studied for clinical manifestations, biochemical analyses of blood and urine, tissue pathologic lesions and molecular pathology in order to clarify the mechanism. Methods The experiments were performed on 72 male rats of 4 weeks old. The rats were randomly divided into three groups (nephropathy, treated and control groups). ADR (2 mg/kg) was intravenously administered twice at a 20-day interval. Treated group received the angiotensin Ⅱ type 1-specific receptor antagonist losartan [10 mg/(kg·d)] daily by gastric perfusion one week after the first injection of ADR until the end of the study. After 7 weeks, four rats in each group were sacrificed every 4 weeks for blood biochemical analyses and histological study. The final study was finished at week 27. Twenty-four hours urinary protein, and serum creatinine were checked with automatic biochemistry analyzer method. A semiquantitative score was used to evaluate the degree of glomerular and tubulointerstitium lesions. The expressions of TGF-β1 and collagen Ⅳ protein in renal tissues were measured with immunohistochemical method. The expressions of TGF-β1 and Ang mRNA in renal cortex were determined with reverse transcription polymerase chain reaction. Results (1)The ratio of kidney to body weight, 24 h urinary protein excretion and concentrations of serum creatinine in nephropathy rats were all higher than those in the treated rats and in the control rats at each time point during the experiment (P<0.01). (2)The glomerular sclerosis score was the highest in nephropathy rats and the lowest in the control rats, but the differences among them became significant only after 19 weeks(P<0.01); by 27 weeks of the experiment, the glomerular sclerosis scores were 29.03±4.64, 261.20±38.72 and 109.11±12.15 in control, nephropathy and treated groups, respectively. The score of tubulointerstitial pathologic lesions was more severe in nephropathy rats than that in the treated and the control rats(P<0.01), and more severe in the treated rats than that in the control rats at every time point after 7 weeks(P<0.01); at the 27 th week of the experiment, scores of tubulointerstitial pathologic lesions were 1.75±0.50, 13.0±1.41, 8.50±1.29 in control, nephropathy and treated groups, respectively. (3) The percentages of TGF-β1 and collagen Ⅳ staining positive-cells both in intraglomerular and tubulointerstitium in nephropathy rats were the highest after 11 weeks (P<0.01). (4)The expression of Ang mRNA in nephropathy rats was much higher than those in the treated and the control rats after 7
{"title":"Losartan slows down chronic progressive renal lesions in adriamycin-induced nephropathy","authors":"Zhihui Li","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.12.104","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.12.104","url":null,"abstract":"Objective \u0000Studies in the last few years suggested that rennin-angiotensin system (RAS) might play an important role in renal progressive damage. RAS blockade could decrease protenuria and alleviate glomerulosclerosis and interstitial fibrosis, but the mechanism of which has been unclear. Therefore, adriamycin (ADR)-induced nephropathy rats were used as the animal model, the chronic progressive renal lesions of the model were studied for clinical manifestations, biochemical analyses of blood and urine, tissue pathologic lesions and molecular pathology in order to clarify the mechanism. \u0000 \u0000 \u0000Methods \u0000The experiments were performed on 72 male rats of 4 weeks old. The rats were randomly divided into three groups (nephropathy, treated and control groups). ADR (2 mg/kg) was intravenously administered twice at a 20-day interval. Treated group received the angiotensin Ⅱ type 1-specific receptor antagonist losartan [10 mg/(kg·d)] daily by gastric perfusion one week after the first injection of ADR until the end of the study. After 7 weeks, four rats in each group were sacrificed every 4 weeks for blood biochemical analyses and histological study. The final study was finished at week 27. Twenty-four hours urinary protein, and serum creatinine were checked with automatic biochemistry analyzer method. A semiquantitative score was used to evaluate the degree of glomerular and tubulointerstitium lesions. The expressions of TGF-β1 and collagen Ⅳ protein in renal tissues were measured with immunohistochemical method. The expressions of TGF-β1 and Ang mRNA in renal cortex were determined with reverse transcription polymerase chain reaction. \u0000 \u0000 \u0000Results \u0000(1)The ratio of kidney to body weight, 24 h urinary protein excretion and concentrations of serum creatinine in nephropathy rats were all higher than those in the treated rats and in the control rats at each time point during the experiment (P<0.01). (2)The glomerular sclerosis score was the highest in nephropathy rats and the lowest in the control rats, but the differences among them became significant only after 19 weeks(P<0.01); by 27 weeks of the experiment, the glomerular sclerosis scores were 29.03±4.64, 261.20±38.72 and 109.11±12.15 in control, nephropathy and treated groups, respectively. The score of tubulointerstitial pathologic lesions was more severe in nephropathy rats than that in the treated and the control rats(P<0.01), and more severe in the treated rats than that in the control rats at every time point after 7 weeks(P<0.01); at the 27 th week of the experiment, scores of tubulointerstitial pathologic lesions were 1.75±0.50, 13.0±1.41, 8.50±1.29 in control, nephropathy and treated groups, respectively. (3) The percentages of TGF-β1 and collagen Ⅳ staining positive-cells both in intraglomerular and tubulointerstitium in nephropathy rats were the highest after 11 weeks (P<0.01). (4)The expression of Ang mRNA in nephropathy rats was much higher than those in the treated and the control rats after 7","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128112969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-12-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.12.113
R. He, Lanqing Uu
Objective Human cytomegalovirus (HCMV) infection is common, about 60%-100% adults are infected with HCMV. Conventional polymerase chain reaction (PCR) assay can detect HCMV easily but its predictive values for detecting those with symptomatic HCMV infection is low. The present study aimed at evaluation of fluorescent quantitative PCR (FQ-PCR) assay in diagnosis of symptomatic HCMV infection by detecting quantitatively HCMV-DNA from urine in infants. Methods 1. Subject and specimens Urine: samples were collected from two groups of infants;group 1 subjects had symptoms or signs such as jaundice, hepatosplenomegaly etc., and were highly suspected to have HCMV infection. Group 2 consisted of healthy infants. Five to ten ml of urine samples were collected from each subject and stored at -70℃until detection. 2. Conventional PCR: Each PCR tube contained 20 μl solution, and the PCR products were 244bp. 3. FQ-PCR: A dual-labeled probe hydrolysis FQ-PCR method was used. Using dual-labeled probes and 5′-exonuclease , the 5′ terminal nucleotides of the probe were cleft by hydrolysis. It was an in vitro monitoring and real-time detection method. 4. Statistics: Comparison of the mean values of the two groups was done by t-test, and comparison of rates was done by χ 2 test. Results 1. HCMV DNA levels: Among 89 patients suspected of HCMV infection clinically, 52 were positive for HCMV DNA by FQ-PCR; these patients were considered to have symptomatic infection. Among 82 healthy subjects, 30 were positive and were considered to have asymptomatic infection. HCMV-DNA copies in 52 symptomatic infection patients ranged from 3.8 to 9.9 log (mean 5.3±1.4) and in 30 asymptomatic patients ranged from 2.7 to 4.6 log (mean 3.5±0.7). Copies in symptomatic patients were significantly higher than those in the asymptomatic ones (P0.01). 2. Defining of a threshold: The optimal threshold was sought by using a receiver operating characteristic curve. The analysis showed that the level of 10 5 copies/ml urine was the best threshold. When this threshold was used , 25 (48.1%) of 52 symptomatic subjects would have been identified, while none of the asymptomatic subject could be identified. The sensitivity for detecting those with symptomatic disease was 48.1%, and specificity was 100%. The positive and negative predictive values were 100% and 52.6% respectively. 3. Comparison of FQ-PCR and conventional PCR assays: We randomly selected 94 subjects from the two groups (including 56 subjects who were suspected to have HCMV infection clinically and 38 healthy infants) and detected HCMV DNA by using both FQ-PCR and conventional PCR methods. Thirty subjects were positive and 36 negative by both assays. The positive rate of FQ-PCR was 60.6% (57/94), and that of conventional PCR was 33.0% (31/94), the consistency rate of the 2 methods was 70.2% (χ 2=25.30, P0.01). FQ-PCR assay was superior to conventional PCR (χ 2=23.3,P0.01). 4. The sensitivity and specificity of FQ-PCR: In this study, the p
{"title":"Quantitative detection of HCMV-DNA from urine in infants by FQ-PCR","authors":"R. He, Lanqing Uu","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.12.113","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.12.113","url":null,"abstract":"Objective Human cytomegalovirus (HCMV) infection is common, about 60%-100% adults are infected with HCMV. Conventional polymerase chain reaction (PCR) assay can detect HCMV easily but its predictive values for detecting those with symptomatic HCMV infection is low. The present study aimed at evaluation of fluorescent quantitative PCR (FQ-PCR) assay in diagnosis of symptomatic HCMV infection by detecting quantitatively HCMV-DNA from urine in infants. Methods 1. Subject and specimens Urine: samples were collected from two groups of infants;group 1 subjects had symptoms or signs such as jaundice, hepatosplenomegaly etc., and were highly suspected to have HCMV infection. Group 2 consisted of healthy infants. Five to ten ml of urine samples were collected from each subject and stored at -70℃until detection. 2. Conventional PCR: Each PCR tube contained 20 μl solution, and the PCR products were 244bp. 3. FQ-PCR: A dual-labeled probe hydrolysis FQ-PCR method was used. Using dual-labeled probes and 5′-exonuclease , the 5′ terminal nucleotides of the probe were cleft by hydrolysis. It was an in vitro monitoring and real-time detection method. 4. Statistics: Comparison of the mean values of the two groups was done by t-test, and comparison of rates was done by χ 2 test. Results 1. HCMV DNA levels: Among 89 patients suspected of HCMV infection clinically, 52 were positive for HCMV DNA by FQ-PCR; these patients were considered to have symptomatic infection. Among 82 healthy subjects, 30 were positive and were considered to have asymptomatic infection. HCMV-DNA copies in 52 symptomatic infection patients ranged from 3.8 to 9.9 log (mean 5.3±1.4) and in 30 asymptomatic patients ranged from 2.7 to 4.6 log (mean 3.5±0.7). Copies in symptomatic patients were significantly higher than those in the asymptomatic ones (P0.01). 2. Defining of a threshold: The optimal threshold was sought by using a receiver operating characteristic curve. The analysis showed that the level of 10 5 copies/ml urine was the best threshold. When this threshold was used , 25 (48.1%) of 52 symptomatic subjects would have been identified, while none of the asymptomatic subject could be identified. The sensitivity for detecting those with symptomatic disease was 48.1%, and specificity was 100%. The positive and negative predictive values were 100% and 52.6% respectively. 3. Comparison of FQ-PCR and conventional PCR assays: We randomly selected 94 subjects from the two groups (including 56 subjects who were suspected to have HCMV infection clinically and 38 healthy infants) and detected HCMV DNA by using both FQ-PCR and conventional PCR methods. Thirty subjects were positive and 36 negative by both assays. The positive rate of FQ-PCR was 60.6% (57/94), and that of conventional PCR was 33.0% (31/94), the consistency rate of the 2 methods was 70.2% (χ 2=25.30, P0.01). FQ-PCR assay was superior to conventional PCR (χ 2=23.3,P0.01). 4. The sensitivity and specificity of FQ-PCR: In this study, the p","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123995787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-12-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.12.107
J. Huang, Qing-shan Ma
Objective The formation of edema in children with nephrotic syndrome (NS) will involve both of the "underfill" and "overfill" mechanisms. It has been recognized that there is a variety of changes in the plasma volume in NS patients. The present study was designed to determine whether the pulmonary capillary wedge pressure (PCWP) could reflect the changes of the plasma volume in NS children. Methods PCWP was measured by using echocardiography techniques, detecting plasma atrial natriuretic factor (ANF, radioimmunoassay method) and hematocrit in 14 NS children, 5 poststreptococcal glomerulonephritis children and 10 normal controls. Results (1) In the edema phase compared with the remission phase, 4 of 14 NS children showed an increased PCWP, which was accompanied by an increased ANF and a decreased HCT; 3 of 14 showed a decreased PCWP, which was accompanied by a decreased ANF and an increased HCT; the rest of 7 NS children showed no change in PCWP along with the other indexes. There were no significant differences in the levels of PCWP, ANF and HCT between the NS children in the remission phase and the normal controls. PCWP was positively correlated with ANF (r=0.76 P<0.001)and negatively correlated with HCT (r=-0.61 , P<0.001). There was a negative correlation between ANF and HCT(r=-0.59 , P<0.001). (2) Fifteen minutes after the infusion of 6% low molecular dextran which would induce the central volume expansion, PCWP was increased [(13.0±2.0) mm Hg] when compared with that [ (10.5±2.8) mm Hg, P<0.01] before the infusion in 9 NS children in the edema phase. Most of them did not present remarkable changes in their heart rates and blood presures except for one who had increased PCWP (from 14.0 mm Hg to 16.9 mm Hg) and manifested with dysphoria, oppressed, hypertention and tachycardia. The symptoms were improved by the active diuretic treatment. Conclusions PCWP measurement with the echocardiography in NS patients could indirectly assess the plasma volume and help to work out the therapeutic strategy for the treatment of edema in NS children. Key words: Nephrotic syndrome; Pulmonary wedge pressure; Atrial natriuretic factor; Hematocrit
目的小儿肾病综合征(NS)水肿的形成有“过充”和“过充”两种机制。人们已经认识到，NS患者的血浆容量有多种变化。本研究旨在探讨肺毛细血管楔压(PCWP)是否能反映NS患儿血浆容量的变化。方法采用超声心动图技术测定14例NS患儿、5例链球菌感染后肾小球肾炎患儿和10例正常人的PCWP、血浆心房钠素因子(ANF，放射线免疫法)和红细胞压积。结果(1)与缓解期相比，14例NS患儿中有4例PCWP升高，同时伴有ANF升高和HCT降低;14例中有3例PCWP下降，并伴有ANF下降和HCT升高;其余7例NS患儿PCWP及其他指标无明显变化。NS患儿缓解期PCWP、ANF和HCT水平与正常对照无显著差异。PCWP与ANF呈正相关(r=0.76 P<0.001)，与HCT呈负相关(r=-0.61, P<0.001)。ANF与HCT呈负相关(r=-0.59, P<0.001)。(2) 9例NS患儿水肿期灌注6%低分子葡聚糖诱导中央体积扩张15 min后，PCWP较灌注前(10.5±2.8)mm Hg升高[(13.0±2.0)mm Hg]， P<0.01。除1例PCWP升高(从14.0 mm Hg增加到16.9 mm Hg)并表现为烦躁、压抑、高血压和心动过速外，大多数患者的心率和血压没有显著变化。经积极利尿剂治疗，症状得到改善。结论超声心动图测量NS患者PCWP可间接评价血浆容量，有助于制定NS患儿水肿的治疗策略。关键词:肾病综合征;肺楔压;房利钠因子;血细胞比容
{"title":"Measurement and significance of the pulmonary capillary wedge pressure in children with nephrotic syndrome","authors":"J. Huang, Qing-shan Ma","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.12.107","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.12.107","url":null,"abstract":"Objective \u0000The formation of edema in children with nephrotic syndrome (NS) will involve both of the \"underfill\" and \"overfill\" mechanisms. It has been recognized that there is a variety of changes in the plasma volume in NS patients. The present study was designed to determine whether the pulmonary capillary wedge pressure (PCWP) could reflect the changes of the plasma volume in NS children. \u0000 \u0000 \u0000Methods \u0000PCWP was measured by using echocardiography techniques, detecting plasma atrial natriuretic factor (ANF, radioimmunoassay method) and hematocrit in 14 NS children, 5 poststreptococcal glomerulonephritis children and 10 normal controls. \u0000 \u0000 \u0000Results \u0000(1) In the edema phase compared with the remission phase, 4 of 14 NS children showed an increased PCWP, which was accompanied by an increased ANF and a decreased HCT; 3 of 14 showed a decreased PCWP, which was accompanied by a decreased ANF and an increased HCT; the rest of 7 NS children showed no change in PCWP along with the other indexes. There were no significant differences in the levels of PCWP, ANF and HCT between the NS children in the remission phase and the normal controls. PCWP was positively correlated with ANF (r=0.76 P<0.001)and negatively correlated with HCT (r=-0.61 , P<0.001). There was a negative correlation between ANF and HCT(r=-0.59 , P<0.001). (2) Fifteen minutes after the infusion of 6% low molecular dextran which would induce the central volume expansion, PCWP was increased [(13.0±2.0) mm Hg] when compared with that [ (10.5±2.8) mm Hg, P<0.01] before the infusion in 9 NS children in the edema phase. Most of them did not present remarkable changes in their heart rates and blood presures except for one who had increased PCWP (from 14.0 mm Hg to 16.9 mm Hg) and manifested with dysphoria, oppressed, hypertention and tachycardia. The symptoms were improved by the active diuretic treatment. \u0000 \u0000 \u0000Conclusions \u0000PCWP measurement with the echocardiography in NS patients could indirectly assess the plasma volume and help to work out the therapeutic strategy for the treatment of edema in NS children. \u0000 \u0000 \u0000Key words: \u0000Nephrotic syndrome; Pulmonary wedge pressure; Atrial natriuretic factor; Hematocrit","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132538833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-01-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.01.111
Z. Dou, Huifeng Zhang
Osteoporosis is one of the major side -effects in the treatment of nephritic syndrome with glucocorticoids, but the exact mechanism of osteopenia is not completely understood. Excess glucocorticoids will induce a reduction of bone formation as well as an increase of bone resorption on the other hand. Objective To analyze the effect of glucocorticoid on the bone resorption activity of childhood nephrotic syndrome (CNS). Methods The bone resorption activities in 68 cases of CNS were evaluated by measuring urinary deoxypyridinoline (DPD) and urinary hydroxyproline (HOP). The patients were divided into three groups. The prednisone-pretreatment group included 25 children (19 boys and 6 girls) aged 4-11 years old without the prednisone treatment. The full dose prednisone group included 25 children (17 boys and 8 girls) aged 4-12 years old with the prednisone treatment [2 mg/(kg·d)] of 4-6 weeks. The reducing dose prednisone group included 18 patients (12 boys and 6 girls) aged 4-12 years old with the reduced dose of prednisone (average 1 mg/kg, q. o.d). The normal control group comprised 16 healthy children (10 boys and 6 girls) of 5-12 years old. The urinary DPD was measured by competitive enzyme-linked immunoassay. The urinary HOP was measured with spectrophotometry. The detecting values of DPD and HOP were corrected by urinary creatinine (Cr). Results The DPD/Cr ratio was obviously increased in full dose prednisone group [(30±17) nmol/mmol] than those in normal control group [(21±5) nmol/mmol, P<0.05], in prednisone-pretreatment group [(20±8) nmol/mmol, P<0.05] and in reducing dose prednisone group [(20±11) nmol/mmol, P<0.05]. The HOP/Cr ratio consisted with the DPD/Cr ratio. The HOP/Cr ratio increased obviously in full dose prednisone group [(5.3±2.7)mg/mmol], which showed significant differences from normal control group [(3.2±1.2) mg/mmol, P<0.05], prednisone-pretreatment group [(3.5±0.9) mg/mmol, P<0.01] and reducing dose prednisone group [(3.7±1.8) mg/mmol, P<0.05]. The DPD/Cr ratio presented a positive correlation with the HOP/Cr ratio in normal control group as well as in other groups of CNS (r =0.64, P<0.01, r =0.65, P<0.001, r =0.79, P<0.001, r = 0.78, P<0.001, respectively). Conclusion Bone resorption activity showed increased in CNS patients after the prednisone treatment. It may be necessary to take bone resorption inhibitor at an early stage in the treatment of CNS for preventing and treating the osteoporosis of glucocorticoid. Key words: Nephrotic syndrome; Child; Bone resorption; Amino acids; Glucocorticoids.
骨质疏松是糖皮质激素治疗肾病综合征的主要副作用之一，但骨质减少的确切机制尚不完全清楚。另一方面，过量的糖皮质激素会导致骨形成的减少以及骨吸收的增加。目的探讨糖皮质激素对儿童肾病综合征(CNS)骨吸收活性的影响。方法采用尿脱氧吡啶啉(DPD)和羟脯氨酸(HOP)测定68例中枢神经系统骨吸收活性。患者被分为三组。强的松预处理组包括25名4-11岁未接受强的松治疗的儿童(男孩19名，女孩6名)。强的松全剂量组25例(男17例，女8例)，年龄4-12岁，给予2 mg/(kg·d)强的松治疗，疗程4-6周。减量泼尼松组患者18例(男12例，女6例)，年龄4-12岁，减量泼尼松(平均每日1 mg/kg, qo.d)。正常对照组为16名5-12岁的健康儿童(男10名，女6名)。采用竞争性酶联免疫分析法测定尿DPD。分光光度法测定尿HOP。用尿肌酐(Cr)校正DPD和HOP的检测值。结果泼尼松全剂量组DPD/Cr比值[(30±17)nmol/mmol]明显高于正常对照组[(21±5)nmol/mmol, P<0.05]、泼尼松预处理组[(20±8)nmol/mmol, P<0.05]和泼尼松减量组[(20±11)nmol/mmol, P<0.05]。HOP/Cr比值与DPD/Cr比值一致。泼尼松全剂量组HOP/Cr比值明显升高[(5.3±2.7)mg/mmol]，与正常对照组[(3.2±1.2)mg/mmol, P<0.05]、泼尼松预处理组[(3.5±0.9)mg/mmol, P<0.01]、泼尼松减量组[(3.7±1.8)mg/mmol, P<0.05]差异均有统计学意义。正常对照组及其他CNS组DPD/Cr与HOP/Cr呈显著正相关(r =0.64, P<0.01, r =0.65, P<0.001, r =0.79, P<0.001, r = 0.78, P<0.001)。结论强的松治疗后中枢神经系统患者骨吸收活性增强。为了预防和治疗糖皮质激素所致的骨质疏松症，在中枢神经系统治疗早期应用骨吸收抑制剂可能是必要的。关键词:肾病综合征;孩子;骨吸收;氨基酸;糖皮质激素。
{"title":"Evaluation bone resorption activity of childhood nephrotic syndrome with urinary deoxypyridinoline and hydroxyproline","authors":"Z. Dou, Huifeng Zhang","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.01.111","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.01.111","url":null,"abstract":"Osteoporosis is one of the major side -effects in the treatment of nephritic syndrome with glucocorticoids, but the exact mechanism of osteopenia is not completely understood. Excess glucocorticoids will induce a reduction of bone formation as well as an increase of bone resorption on the other hand. Objective To analyze the effect of glucocorticoid on the bone resorption activity of childhood nephrotic syndrome (CNS). \u0000 \u0000 \u0000Methods \u0000The bone resorption activities in 68 cases of CNS were evaluated by measuring urinary deoxypyridinoline (DPD) and urinary hydroxyproline (HOP). The patients were divided into three groups. The prednisone-pretreatment group included 25 children (19 boys and 6 girls) aged 4-11 years old without the prednisone treatment. The full dose prednisone group included 25 children (17 boys and 8 girls) aged 4-12 years old with the prednisone treatment [2 mg/(kg·d)] of 4-6 weeks. The reducing dose prednisone group included 18 patients (12 boys and 6 girls) aged 4-12 years old with the reduced dose of prednisone (average 1 mg/kg, q. o.d). The normal control group comprised 16 healthy children (10 boys and 6 girls) of 5-12 years old. The urinary DPD was measured by competitive enzyme-linked immunoassay. The urinary HOP was measured with spectrophotometry. The detecting values of DPD and HOP were corrected by urinary creatinine (Cr). \u0000 \u0000 \u0000Results \u0000The DPD/Cr ratio was obviously increased in full dose prednisone group [(30±17) nmol/mmol] than those in normal control group [(21±5) nmol/mmol, P<0.05], in prednisone-pretreatment group [(20±8) nmol/mmol, P<0.05] and in reducing dose prednisone group [(20±11) nmol/mmol, P<0.05]. The HOP/Cr ratio consisted with the DPD/Cr ratio. The HOP/Cr ratio increased obviously in full dose prednisone group [(5.3±2.7)mg/mmol], which showed significant differences from normal control group [(3.2±1.2) mg/mmol, P<0.05], prednisone-pretreatment group [(3.5±0.9) mg/mmol, P<0.01] and reducing dose prednisone group [(3.7±1.8) mg/mmol, P<0.05]. The DPD/Cr ratio presented a positive correlation with the HOP/Cr ratio in normal control group as well as in other groups of CNS (r =0.64, P<0.01, r =0.65, P<0.001, r =0.79, P<0.001, r = 0.78, P<0.001, respectively). \u0000 \u0000 \u0000Conclusion \u0000Bone resorption activity showed increased in CNS patients after the prednisone treatment. It may be necessary to take bone resorption inhibitor at an early stage in the treatment of CNS for preventing and treating the osteoporosis of glucocorticoid. \u0000 \u0000 \u0000Key words: \u0000Nephrotic syndrome; Child; Bone resorption; Amino acids; Glucocorticoids.","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128382799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-01-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.01.113
Shunying Zhao, Y. Qi
Objective Airway inflammation in asthma is associated with increased expression of inflammatory proteins in epithelial cells. Induction of many of the genes coding for these proteins is regulated by the transcription factor, nuclear factor-κB (NF-κB) in vitro. The authors therefore hypothesized that increased expression of inflammatory proteins in epithelial cells may be related to activation of NF-κB. To test this hypothesis and understand the role of NF-κB in airway inflammation in asthma, the authors examined whether NF-κB was activated in epithelial cells from children with asthma . Methods Airway inflammation was observed by pathological examination; bronchial mucosa specimens were obtained from 9 children with asthma and from 6 control subjects. NF-κB expression was observed by immunohistochemical examination of bronchial mucosa specimens with an antibody to p65, a constituent of NF-κB; NF-κB-DNA binding was measured in nuclear protein extracts of bronchial mucosa specimens by electrophoretic mobility shift assay. Results There was inflammation in the airway of 9 asthmatic children. Immunohistochemical examination showed epithelial cells with nuclear staining in 9 asthmatic children. The electrophoretic mobility shift assay showed that NF-κB-DNA binding bands were present in 4 of 6 asthmatic children in whom the assay was performed. In contrast, there was no inflammation in the airway of the 6 control subjects. Nuclear staining in epithelial cells and NF-κB-DNA binding bands were absent in bronchial mucosa specimens of 6 control subjects. Conclusion These results indicated that activation of NF-κB may be the basis for increased expression of many inflammatory proteins in epithelial cells from children with asthma and a mechanism for formation of airway inflammation in asthma. Key words: Asthma; NF-kappa B; Epithelial cells
{"title":"Activation of nuclear factor-κB in bronchial epithelial cells from asthmatic children","authors":"Shunying Zhao, Y. Qi","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.01.113","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.01.113","url":null,"abstract":"Objective \u0000Airway inflammation in asthma is associated with increased expression of inflammatory proteins in epithelial cells. Induction of many of the genes coding for these proteins is regulated by the transcription factor, nuclear factor-κB (NF-κB) in vitro. The authors therefore hypothesized that increased expression of inflammatory proteins in epithelial cells may be related to activation of NF-κB. To test this hypothesis and understand the role of NF-κB in airway inflammation in asthma, the authors examined whether NF-κB was activated in epithelial cells from children with asthma . \u0000 \u0000 \u0000Methods \u0000Airway inflammation was observed by pathological examination; bronchial mucosa specimens were obtained from 9 children with asthma and from 6 control subjects. NF-κB expression was observed by immunohistochemical examination of bronchial mucosa specimens with an antibody to p65, a constituent of NF-κB; NF-κB-DNA binding was measured in nuclear protein extracts of bronchial mucosa specimens by electrophoretic mobility shift assay. \u0000 \u0000 \u0000Results \u0000There was inflammation in the airway of 9 asthmatic children. Immunohistochemical examination showed epithelial cells with nuclear staining in 9 asthmatic children. The electrophoretic mobility shift assay showed that NF-κB-DNA binding bands were present in 4 of 6 asthmatic children in whom the assay was performed. In contrast, there was no inflammation in the airway of the 6 control subjects. Nuclear staining in epithelial cells and NF-κB-DNA binding bands were absent in bronchial mucosa specimens of 6 control subjects. \u0000 \u0000 \u0000Conclusion \u0000These results indicated that activation of NF-κB may be the basis for increased expression of many inflammatory proteins in epithelial cells from children with asthma and a mechanism for formation of airway inflammation in asthma. \u0000 \u0000 \u0000Key words: \u0000Asthma; NF-kappa B; Epithelial cells","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"647 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122698871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-01-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.01.106
Ze-Zhong Tang, Congle Zhou
Objective To explore the pattern of brain cells apoptosis in newborn rats after hypoxic-ischemia (HI), the relation to Ca2+ overload, and the effect of calcium channel antagonist on apoptosis. Methods The percentage of neuronal apoptosis was measured after 1 hour to 10 days of HI with the flow cytometry. The antagonism of MgSO4 and ligustrazin to the intracellular Ca2+ overload stimulated by the glutamate in the brain slice and neuron was also observed by laser confocal scanning microscopy (LCSM) in vitro. The newborn rats were randomly divided into 4 groups, normal control, HI group, HI with MgSO4 group and HI with ligustrazin group, respectively. Results The apoptosis in neuron was observed in normal newborn rats of 7 days (12±7)%. The increase of apoptosis began after 12 hours of HI (20±7)%. After 5 days of HI, the percentage of apoptosis cells reached a peak level (69±10)%, which showed significantly differences from the percentage of apoptosis 72 hours and 7 days after HI(P<0.01). The percentage of apoptosis decreased to (33±12)% 10 days after HI. Both MgSO4 and ligustrazin showed a positive effect on relieving Ca2+ overload induced by glutamate in vitro. The administration of both drugs after HI could effectively prohibit apoptosis, which decreased to 26.7% and 26.2%, respectively (F=18.86, q=4.34 and 4.25, P<0.01 and <0.05). Conclusion The best time of the treatment of HI might be 5 days after HI, because the peak level of apoptosis showed at the 5th day after HI in the experiment. The calcium channel antagonist MgSO4 and ligustrazin could reduce the neuron Ca2+ overload, and therefore prohibit the apoptosis and protect brains from the HI damage. Key words: Cerebral anoxia; Cerebral ischemia; Apoptosis; Calcium; Intervention studies
{"title":"The pattern of brain cells apoptosis, the relationship to Ca~( 2+) overload and the drug intervention in newborn rats with hypoxic-ischemia","authors":"Ze-Zhong Tang, Congle Zhou","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.01.106","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.01.106","url":null,"abstract":"Objective \u0000To explore the pattern of brain cells apoptosis in newborn rats after hypoxic-ischemia (HI), the relation to Ca2+ overload, and the effect of calcium channel antagonist on apoptosis. \u0000 \u0000 \u0000Methods \u0000The percentage of neuronal apoptosis was measured after 1 hour to 10 days of HI with the flow cytometry. The antagonism of MgSO4 and ligustrazin to the intracellular Ca2+ overload stimulated by the glutamate in the brain slice and neuron was also observed by laser confocal scanning microscopy (LCSM) in vitro. The newborn rats were randomly divided into 4 groups, normal control, HI group, HI with MgSO4 group and HI with ligustrazin group, respectively. \u0000 \u0000 \u0000Results \u0000The apoptosis in neuron was observed in normal newborn rats of 7 days (12±7)%. The increase of apoptosis began after 12 hours of HI (20±7)%. After 5 days of HI, the percentage of apoptosis cells reached a peak level (69±10)%, which showed significantly differences from the percentage of apoptosis 72 hours and 7 days after HI(P<0.01). The percentage of apoptosis decreased to (33±12)% 10 days after HI. Both MgSO4 and ligustrazin showed a positive effect on relieving Ca2+ overload induced by glutamate in vitro. The administration of both drugs after HI could effectively prohibit apoptosis, which decreased to 26.7% and 26.2%, respectively (F=18.86, q=4.34 and 4.25, P<0.01 and <0.05). \u0000 \u0000 \u0000Conclusion \u0000The best time of the treatment of HI might be 5 days after HI, because the peak level of apoptosis showed at the 5th day after HI in the experiment. The calcium channel antagonist MgSO4 and ligustrazin could reduce the neuron Ca2+ overload, and therefore prohibit the apoptosis and protect brains from the HI damage. \u0000 \u0000 \u0000Key words: \u0000Cerebral anoxia; Cerebral ischemia; Apoptosis; Calcium; Intervention studies","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129932856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-01-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.01.114
Xiaodong Zhao, Xi-qiang Yang
Objective To observe the therapeutic and immunosuppressive effects of intravenous immunoglobulin (IVIG) in neonates with pneumonia. Methods Forty-one (etus generation ranged from 36 to 41 weeks) neonates with pneumonia were randomly divided into 3 groups, with 20 neonates in control group, 15 neonates in group of lower dose IVIG in which 500-700 mg/kg IVIG infused and 6 neonates in group of higher dose IVIG in which 1 000-1 200 mg/kg IVIG infused, respectively. IVIG was administered during the 1st to 4th day of the disease onset. Serum IgG, IgM, IgA and IgG subclasses, proliferation of T and B lymphocytes, IL-2, IL-4 and IL-6 produced by PBMC in vitro, IgG subclass levels in PBMC culture supernatants were detected by ELISA and 3 H-TdR incorporation assay respectively before and 2-4 days after IVIG treatment. Results There is no clinical differentiation in all neonates with pneumonia to be observed. Serum IgG and IgG subclass levels in two IVIG groups increased markedly. However, proliferation of T (40 062±13 274) cpm~(24 476±8 241) cpm and B lymphocyte (1 751±677) cpm~(996±423) cpm, IL-2 (472±201) ng/L~(185±83) ng/L, IgG1(602±288) μg/L~(378±126) μg/L, IgG2(304±107) μg/L~(169±68) μg/L and IgG3(71±30) μg/L~(43±19) μg/L productions in higher dose IVIG group decreased significantly after IVIG treatment compared with other groups. Conclusion It′s unlikely that IVIG treatment in favor of neonatal pneumonia. Due to its suppressive effects on functions of T and B lymphocytes at least in short term, the authors advise that its uses in neonatal infections be decided by the functional situation of neonate′s immune system and abusing of IVIG be forbidened. Key words: Infannt, neuborn; Immunoglobulin, intravenous; T-lymophocytes; B-lymophocytes; Immunosuppression
{"title":"Suppressive effects of high dose IVIG on functions of T and B lymphocyte of neonates with pneumonia","authors":"Xiaodong Zhao, Xi-qiang Yang","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.01.114","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.01.114","url":null,"abstract":"Objective \u0000To observe the therapeutic and immunosuppressive effects of intravenous immunoglobulin (IVIG) in neonates with pneumonia. \u0000 \u0000 \u0000Methods \u0000Forty-one (etus generation ranged from 36 to 41 weeks) neonates with pneumonia were randomly divided into 3 groups, with 20 neonates in control group, 15 neonates in group of lower dose IVIG in which 500-700 mg/kg IVIG infused and 6 neonates in group of higher dose IVIG in which 1 000-1 200 mg/kg IVIG infused, respectively. IVIG was administered during the 1st to 4th day of the disease onset. Serum IgG, IgM, IgA and IgG subclasses, proliferation of T and B lymphocytes, IL-2, IL-4 and IL-6 produced by PBMC in vitro, IgG subclass levels in PBMC culture supernatants were detected by ELISA and 3 H-TdR incorporation assay respectively before and 2-4 days after IVIG treatment. \u0000 \u0000 \u0000Results \u0000There is no clinical differentiation in all neonates with pneumonia to be observed. Serum IgG and IgG subclass levels in two IVIG groups increased markedly. However, proliferation of T (40 062±13 274) cpm~(24 476±8 241) cpm and B lymphocyte (1 751±677) cpm~(996±423) cpm, IL-2 (472±201) ng/L~(185±83) ng/L, IgG1(602±288) μg/L~(378±126) μg/L, IgG2(304±107) μg/L~(169±68) μg/L and IgG3(71±30) μg/L~(43±19) μg/L productions in higher dose IVIG group decreased significantly after IVIG treatment compared with other groups. \u0000 \u0000 \u0000Conclusion \u0000It′s unlikely that IVIG treatment in favor of neonatal pneumonia. Due to its suppressive effects on functions of T and B lymphocytes at least in short term, the authors advise that its uses in neonatal infections be decided by the functional situation of neonate′s immune system and abusing of IVIG be forbidened. \u0000 \u0000 \u0000Key words: \u0000Infannt, neuborn; Immunoglobulin, intravenous; T-lymophocytes; B-lymophocytes; Immunosuppression","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127207500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-01-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2001.01.102
Qi-wei Huang, Yu-ming Zhang
Objective To explore the effectiveness of high frequency ventilation in the treatment of neonates with severe respiratory distress syndrome (RDS). Methods Twenty neonates with≥ gradeⅡRDS confirmed by chest X- ray and needed conventional mechanical ventilation (CMV) treatment were enrolled in this study. Patients who failed to maintain SO2 ≥0.90 when FiO2≥0.8 and/or MAP≥11 cmH2O within 2 hours were changed to high freguency ventilation (HFV). Results Twenty cases met the severe RDS criteria, who′s gestational age was (33±4)w and birth weight was (2.1±0.8) kg. Among them 8 cases were assigned to HFV. After 2-hour treatment, SO2 of HFV group increased to>0.90. Arterial to alveoli oxygen ratio (a/A) improved significantly (0.08±0.01 to 0.18±0.05, P<0.01). Oxygenation index (OI) decreased rapidly (33±11 to 14±4, P<0.01). FiO2 decreased rapidly (0.90±0.10 and 0.70±0.20, P<0.01). After 8 hours treatment FiO2 continually decreased to 0.60±0.18. Conclusion The authors concluded that HFV was an effective rescue method for neonates with RDS in whom CMV failed. Key words: High frequency ventilation; Respiration, artificial; Respiratory distress syndrome; Infant, newborn
{"title":"High frequency ventilation in the treatment of severe respiratory distress syndrome","authors":"Qi-wei Huang, Yu-ming Zhang","doi":"10.3760/CMA.J.ISSN.0578-1310.2001.01.102","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2001.01.102","url":null,"abstract":"Objective \u0000To explore the effectiveness of high frequency ventilation in the treatment of neonates with severe respiratory distress syndrome (RDS). \u0000 \u0000 \u0000Methods \u0000Twenty neonates with≥ gradeⅡRDS confirmed by chest X- ray and needed conventional mechanical ventilation (CMV) treatment were enrolled in this study. Patients who failed to maintain SO2 ≥0.90 when FiO2≥0.8 and/or MAP≥11 cmH2O within 2 hours were changed to high freguency ventilation (HFV). \u0000 \u0000 \u0000Results \u0000Twenty cases met the severe RDS criteria, who′s gestational age was (33±4)w and birth weight was (2.1±0.8) kg. Among them 8 cases were assigned to HFV. After 2-hour treatment, SO2 of HFV group increased to>0.90. Arterial to alveoli oxygen ratio (a/A) improved significantly (0.08±0.01 to 0.18±0.05, P<0.01). Oxygenation index (OI) decreased rapidly (33±11 to 14±4, P<0.01). FiO2 decreased rapidly (0.90±0.10 and 0.70±0.20, P<0.01). After 8 hours treatment FiO2 continually decreased to 0.60±0.18. \u0000 \u0000 \u0000Conclusion \u0000The authors concluded that HFV was an effective rescue method for neonates with RDS in whom CMV failed. \u0000 \u0000 \u0000Key words: \u0000High frequency ventilation; Respiration, artificial; Respiratory distress syndrome; Infant, newborn","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121726375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-09-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2000.09.109
Bao-Ping Xu, K. Shen
Objective To investigate the etiology, diagnostic methods and procedures for management of fever of unknown origin (FUO) in children. Methods All 744 children with fever of unknown origin admitted to Beijing Children's Hospital between January 1, 1993 and December 31,1998 were divided into three groups according to age, group 1: younger than 3 years; group 2: between 3 and 7 years; group 3: older than 7 years. Medical records were reviewed retrospectively. Results There were 417 boys and 327 girls with an average of 7.2years (from 14 days to 14 years) . (1) In group 1,50 cases among 96 children (52%) had infectious diseases with 21 cases (22%) of respiratory tract infections; 15 cases and 9 cases of 96 (16% and 9%) had miscellaneons disonders and neoplasm with 14 cases (15%) of congenital diseases and 4 cases (4.2%) of malignant histiocytosis, respectively. Collagen vascular diseases were found in 5 cases (5%) , and in 17 (18%) of 96 cases no diagnosis could be made. (2) In group 2,115 cases among 192 children (59.9%) had infectious diseases with 38 cases (19.8%) of respiratory tract infections; 28 cases and 11 cases of 192 (14.6% and 5.7%) had collagen vascular diseases and neoplasm with 26 cases (13.5%) and 6 cases (3.1%) of juvenile rheumatoid arthritis and leukemia, separately. Miscellaneous disorders were found in 10 cases (5.2%) and in 28 (14.6%) of 192 cases no diagnosis could be made. (3) In group 3,305 of 456 children (66.9%) had evidences of infectious diseases with 102 cases (22.4%) of respiratory tract infections; 69 and 15 of 456 (15.1% and 3.3%) cases had collagen vascular diseases and neoplasm and 37 cases (8.1%) and 8 cases (1.8%) had juvenile rheumatoid arthritis and leukemia, respectively. Miscellaneous disorders were confirmed in 15 of 456 (3.3%) cases with 11 cases (2.4%) of subacute necrotizing lymphadenitis, and no diagnosis could be made in 52 of 456 (11.4%) cases. History, physical examination and routine laboratory studies led to a final diagnosis in 39.9% (297/744) of all cases. Ultrasonography, CT scan, bone marrow examination and biopsy contributed to the diagnosis in 3.4%, 3.7%, 8.5% and 71.1% of the cases, separately. Conclusions Infectious diseases, congenital diseases with disturbances in temperature regulation and neoplasm were the three major causes of FUO in children younger than three years of age. Infectious disease, collagen vascular disease and neoplasm were the three most frequent causes of FUO in children older than 3 years of age. Respiratory tract infection was the leading cause in each group. Juvenile rheumatoid arthritis and leukemia dominated the collagen vascular disease and neoplasm, and subacute necrotizing lymphadenitis was found in a small proportion of the two groups older than 3 years of age. A thorough history of disease, full physical examination of the patient and routine laboratory studies, especially erythrocyte sedimentation rate and C-reactive protein were very importa
{"title":"Retrospective study of 744 children with fever of unknown origin","authors":"Bao-Ping Xu, K. Shen","doi":"10.3760/CMA.J.ISSN.0578-1310.2000.09.109","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2000.09.109","url":null,"abstract":"Objective \u0000To investigate the etiology, diagnostic methods and procedures for management of fever of unknown origin (FUO) in children. \u0000 \u0000 \u0000Methods \u0000All 744 children with fever of unknown origin admitted to Beijing Children's Hospital between January 1, 1993 and December 31,1998 were divided into three groups according to age, group 1: younger than 3 years; group 2: between 3 and 7 years; group 3: older than 7 years. Medical records were reviewed retrospectively. \u0000 \u0000 \u0000Results \u0000There were 417 boys and 327 girls with an average of 7.2years (from 14 days to 14 years) . (1) In group 1,50 cases among 96 children (52%) had infectious diseases with 21 cases (22%) of respiratory tract infections; 15 cases and 9 cases of 96 (16% and 9%) had miscellaneons disonders and neoplasm with 14 cases (15%) of congenital diseases and 4 cases (4.2%) of malignant histiocytosis, respectively. Collagen vascular diseases were found in 5 cases (5%) , and in 17 (18%) of 96 cases no diagnosis could be made. (2) In group 2,115 cases among 192 children (59.9%) had infectious diseases with 38 cases (19.8%) of respiratory tract infections; 28 cases and 11 cases of 192 (14.6% and 5.7%) had collagen vascular diseases and neoplasm with 26 cases (13.5%) and 6 cases (3.1%) of juvenile rheumatoid arthritis and leukemia, separately. Miscellaneous disorders were found in 10 cases (5.2%) and in 28 (14.6%) of 192 cases no diagnosis could be made. (3) In group 3,305 of 456 children (66.9%) had evidences of infectious diseases with 102 cases (22.4%) of respiratory tract infections; 69 and 15 of 456 (15.1% and 3.3%) cases had collagen vascular diseases and neoplasm and 37 cases (8.1%) and 8 cases (1.8%) had juvenile rheumatoid arthritis and leukemia, respectively. Miscellaneous disorders were confirmed in 15 of 456 (3.3%) cases with 11 cases (2.4%) of subacute necrotizing lymphadenitis, and no diagnosis could be made in 52 of 456 (11.4%) cases. History, physical examination and routine laboratory studies led to a final diagnosis in 39.9% (297/744) of all cases. Ultrasonography, CT scan, bone marrow examination and biopsy contributed to the diagnosis in 3.4%, 3.7%, 8.5% and 71.1% of the cases, separately. \u0000 \u0000 \u0000Conclusions \u0000Infectious diseases, congenital diseases with disturbances in temperature regulation and neoplasm were the three major causes of FUO in children younger than three years of age. Infectious disease, collagen vascular disease and neoplasm were the three most frequent causes of FUO in children older than 3 years of age. Respiratory tract infection was the leading cause in each group. Juvenile rheumatoid arthritis and leukemia dominated the collagen vascular disease and neoplasm, and subacute necrotizing lymphadenitis was found in a small proportion of the two groups older than 3 years of age. A thorough history of disease, full physical examination of the patient and routine laboratory studies, especially erythrocyte sedimentation rate and C-reactive protein were very importa","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115694235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-08-16DOI: 10.3760/CMA.J.ISSN.0578-1310.2000.08.102
W. Tu, P. Cheung, Y. Lau
Objective To investigate the effects of insulin-like growth factor 1 (IGF-1) on neonatal immunity. Methods Cord blood mononuclear cells (CBMC) from 10 normal, full-term infants, and 10 adults' peripheral blood mononuclear cells (PBMC, controls) were involved in this study. CBMC and PBMC were cultured in a serum and hormone-free medium. Cytokine activity was measured by ELISA. Results Compared with that of adults, the productions of IL-2, IL-4 and IFN-γ in PHA-stimulated CBMC were significantly decreased, and the productions of IL-10 and IL-12 in LPS-stimulated CBMC were also significantly reduced. IGF-1 alone could not induce IL-2, IL-4, IFN-y and IL-10 productions in CBMC or PBMC. However, it could induce a high level of IL-6 production and a low level of IL-12 production in CBMC or PBMC. IGF-1 significantly increased the productions of both IL-6 and IFN-γ in PHA-stimulated neonatal MNC. Moreover, it increased neonatal IFN-γproduction in PHA-stimulated CBMC to a level similar to that of adults. In LPS-stimulated CBMC, IGF-1significantly enhanced IL-10 production, but it could not increase neonatal IL-10 production to the level comparable to that of adults. However, IGF-1 suppressed IL-12 production in LPS-stimulated CBMC. Conclusion IGF-1could promote maturation of neonatal T cells. Key words: Insulin-like growth factor 1; Fetal blood; Leukocytes, mononuclear; Cytokines
{"title":"Effect of insulin-like growth factor 1 on cytokine productions in neonatal cord blood mononuclear cells","authors":"W. Tu, P. Cheung, Y. Lau","doi":"10.3760/CMA.J.ISSN.0578-1310.2000.08.102","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0578-1310.2000.08.102","url":null,"abstract":"Objective \u0000To investigate the effects of insulin-like growth factor 1 (IGF-1) on neonatal immunity. \u0000 \u0000 \u0000Methods \u0000Cord blood mononuclear cells (CBMC) from 10 normal, full-term infants, and 10 adults' peripheral blood mononuclear cells (PBMC, controls) were involved in this study. CBMC and PBMC were cultured in a serum and hormone-free medium. Cytokine activity was measured by ELISA. \u0000 \u0000 \u0000Results \u0000Compared with that of adults, the productions of IL-2, IL-4 and IFN-γ in PHA-stimulated CBMC were significantly decreased, and the productions of IL-10 and IL-12 in LPS-stimulated CBMC were also significantly reduced. IGF-1 alone could not induce IL-2, IL-4, IFN-y and IL-10 productions in CBMC or PBMC. However, it could induce a high level of IL-6 production and a low level of IL-12 production in CBMC or PBMC. IGF-1 significantly increased the productions of both IL-6 and IFN-γ in PHA-stimulated neonatal MNC. Moreover, it increased neonatal IFN-γproduction in PHA-stimulated CBMC to a level similar to that of adults. In LPS-stimulated CBMC, IGF-1significantly enhanced IL-10 production, but it could not increase neonatal IL-10 production to the level comparable to that of adults. However, IGF-1 suppressed IL-12 production in LPS-stimulated CBMC. \u0000 \u0000 \u0000Conclusion \u0000IGF-1could promote maturation of neonatal T cells. \u0000 \u0000 \u0000Key words: \u0000Insulin-like growth factor 1; Fetal blood; Leukocytes, mononuclear; Cytokines","PeriodicalId":416525,"journal":{"name":"Chinexe Journal of Pediatrics","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131963657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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