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    24 October 2005, Volume 26 Issue 5
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    Resistance of Streptococcus Pneumoniae to β-lactams Macrolides and Fluoroquinolone among Children
    Wang Yonghong;Tong Yuejuan;Yu Sangjie;Yang Yonghong
    2005, 26(5):  517-520. 
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    Objective To investigate resistance to β-lactams,macrolides and fluoroquinolone in carriage isolates of Streptococcus pneumoniae in nasopharynx among children under 5 with respiratory infection who attended a general outpatient department at Beijing Children's Hospital from 2002 to 2004.Methods Antimicrobials sensitivity testing of Streptococcus pneumoniae E-test methods and the results were analyzed according to NCCLS(2002).Results Resistance of pneumococci to penicillin was 36%,amoxycillin/clavulanate was 0%, ceftriaxone was 6.1%,cefaclor was 29%,cefuroxime was 30.7%,macrolides were around 90%,and fluoroquinolone were 0%.Conclusion Non-susceptible to penicillin and the second cephalosporin of Streptococcus pneumoniae isolates among children ranged from 29%～36%,and to macrolides were about 90%.

    Effects of Dietary n-3 and n-6 Triglycerides on Long Chain Polyunsaturated Fatty Acid Accretion in Mouse Brain
    Qi Kemin;Jiao Hong;Jiang Zaifang
    2005, 26(5):  521-524. 
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    Objective In this study the effects of dietary n-3 and n-6 fatty acids on brain accretion of docosahexaenoic acid(DHA) and arachidonic acids(AA) were investigated.Methods C57BL/6J female adult mice were fed three different high-fat(18% fat by weight supplying 36% of total energy) diets: soy oil,fish oil and soy:fish oil(5:1) respectively with normal chow diet(6% of fat as soy oil supplying 12% of total energy) as control,for a period of 4 months.Also some mice were mated for breeding new mice with high-fat diets being started 1 month before mating and ended at 2 months following mouse birth.Brain fatty acids were analyzed by gas chromatography and expressed as percent(%) of total fatty acids.Results No differences were found in the effects of dietary fat on DHA and AA levels in brain between young mice and adult mice.Compared to soy oil-fed mice,AA accretion in brain was decreased with no changes in DHA accretion leading to increased DHA/AA ratio in fish oil-fed mice,whereas no changes in both DHA and AA accretion were found but DHA/AA ratio was increased in soy:fish oil-fed mice.Conclusion Increased intake of fish oil n-3 triglycerides does not enhance DHA accretion but increases DHA/AA ratio in mouse brain.

    Mutation Screening of Nkx2.5 Gene and Associated Study in Exon 1 in Chinese with Congenital Heart Disease
    Shi Lin;Shen Adong;Li Xiaofeng;Bai Song;Guan Xiaolei;Li Zhongzhi
    2005, 26(5):  525-528. 
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    Objective To elucidate association and the mutation of Nkx2.5 gene in exon 1 in Chinese patients with congenital heart disease(CHD).Methods We selected 110 CHD patients and 110 normal subjects as control group from Beijing Children's Hospital.After amplifying the exons 1 of the Nkx2.5 gene by polymerase chain reaction(PCR),we purified the PCR products and conducted the sequencing reaction,analyzed the SNPs and mutation screening of the exon 1 of the Nkx2.5 gene,investigate whether or not the Nkx2.5 gene is related with the CHD in Chinese population.Results No mutation was found in the exon 1 of the Nkx2.5 gene;however a new single nucleotide polymorphism(SNPs) was identified,further carried out a case-control study,there were significant differences of the allele between the ventricular septal defect or tetralogy of Fallot patients and normal controls(χ2=34.021,df=2,P<0.01;χ2=15.233,df=2,P<0.01),There were also significant difference of the genotype frequencies of the SNPs between the ventricular septal defect or tetralogy of Fallot patients and normal control(χ2=(24.813),df=1,P<0.01;χ2=7.146,df=1,P<0.01).Conclusion The mutation of Nkx2.5 gene might not be associated with CHD in Chinese population.The allele and genotype distributions of the new SNPs studied were significantly different between the patients with ventricular septal defect or tetralogy of Fallot and control groups.

    Effects of Different Dosages of Hydrocortisone on Homeostasis in Rats at Early Stage of Endotoxic Shock
    Wang Quan;Qian Suyun;Yang Xinli
    2005, 26(5):  528-531. 
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    Objective To investigate the effects of different dosages of hydrocortisone(HC) on the disorder of homeostasis in rats at early stage of endotoxic shock.Methods The rat model of early endotoxic shock was induced by intraveneous injection of lipopolysaccharide(LPS,25 mg/kg) through femoral vein.40 male Wistar rats were randomly divided into the following 5 groups: control group(same volume of normal saline LPS and HC substitutes),LPS group(same volume of normal saline as HC substitute),high-dosage HC group(HD group,HC100 mg/kg),middle-dosage HC group(MD group,HC 50 mg/kg) and low-dosage HC group(LD group,HC 5 mg/kg).Four hours after the hydrocortisone treatment,the specimens were collected for blood gas analyses,as well as electrolytes and blood sugar concentrations detections.Results Metabolic acidosis,hyperkalemia,hypernatremia,hypocalcemia and hyperglycemia were observed in LPS group rats(P<0.05).After HC treatment,the metabolic acidosis and hyperkalemia were attenuated in different degrees,and the most significant improvements were found in LD group.Hypocalcemia and hyperglycemia were corrected significantly only in LD group((P<)(0.05)).High-dosage of HC may even aggravate hyperglycemia.The effects of middle-dosage HC is in-between LD and HD groups,and there was no significant difference between HD and MD groups,P>0.05.Conclusion Different dosages of HC had different effects on homeostasis in early endotoxic shock rats.Low dosage of HC may ameliorate the disorder of homeostasis in early endotoxic shock.High-dosage and middle-dose of HC had no significant improvement in the disorder of homeostasis.

    The Association of HLA-DQA1,DMA,DMB Gene Polymorphism with Type 1 Diabetes
    Sang Yanmei;Yan Chun;Zhu Cheng;Ni Guichen;Hu Yamei
    2005, 26(5):  532-535. 
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    Objective To study the relationship between human leucocyte antigen-DMA,DMB,DQA1 alleles and genetic susceptibility of type 1 diabetes in Chinese.Methods Polymerase chain reaction and dot blot hybridization techniques were used to detect DMA,DMB and DQA1 alleles of experimental subjects.Results DMA* 0103 and DMB* 0103 alleles were significantly increased in the patients of type 1 diabetes,these two alleles were related to genetic susceptibility.DMA* 0102 and DMB* 0101 alleles were significantly increased in the controls.These two alleles were correlated positively to protection of type 1 diabetes.The frequencies of DMA* 0102 and DMB* 0101 alleles were also increased in the controls with DQA1* 0501 alleles.Conclusion Distribution of DMA,DMB alleles in patients and controls show that DM susceptive alleles are somewhat "predominant",while DM protective alleles are somewhat "recessive",and both of their effects can be accumulated.

    Left Ventricular Restrictive Dysfunction and the Clinical Significance in Children with Dilated Cardiomyopathy
    Du Zhongdong;Gu Yanhong;Li Zhongzhi
    2005, 26(5):  536-539. 
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    Objective This study sought to evaluate the left ventricular restrictive diastolic dysfunction(RDD) in children with dilated cardiomyopathy(DCM) and its clinical implications.Methods The diastolic function was assessed in 42 children with DCM(21 male,21 female;aged 1～14 years) and 42 age and gender matched normal children by using 2-dimension and Doppler echocardiography.The mitral peak flow velocities during early filling(E wave) and during atrial contraction(A wave),the ratio of E and A velocity,the deceleration time of the E wave(DT) and isovolumic relaxation time were measured.Pulmonary arterial pressure was assessed by measurement of the tricuspid regurgitant velocity.Results DT was shortened〔(88±27)ms vs(128±40)ms,P<0.01〕,the ratio of E and A velocity increased and isovolumic relaxation time shortened in children with DCM as compared with normal controls,indicating the left ventricular RDD in children with DCM.According to normal criteria, 20(48%) patients had RDD,including 16(38%) with a shortened DT and 14(33%) with an increased ratio of E and A velocity.RDD was related to the dilation of left atrium and ventricle,the elevation of pulmonary arterial pressure and the gradation of cardiac function,but not related to left ventricular ejection fraction.The patients with RDD had higher NY cardiac function scores.During the follow-up period of 1～51 months(mean 26 months),7(35%),3(15%) and 10(50%) of the 20 patients with RDD died,deteriorated or unchanged,respectively;while 1(5%),2(9%),5(23%) and 14(63%) died,deteriorated,unchanged or improved,respectively,in patients without RDD((P<)(0.01)).Conclusion Among children with DCM,48% had RDD,which was associated with the NY cardiac function scores and prognosis.The identification of left ventricular RDD by Doppler echocardiography is helpful for predicting prognosis.

    Antimicrobial Susceptibility and mecA Gene Detection Study of Methicillin-resistant Staphylococcus Aureus
    Fan Jianfeng;Yang Yonghong;Ma Lin;Tong Yuejuan
    2005, 26(5):  540-544. 
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    Objective To investigate the antibiotic resistance of Staphylococcus aureus in communities and hospitals in Beijing.Methods To detect the susceptibility of 11 kinds of antibiotics of 471 strains SA isolated in Beijing with agar dilution method(422 isolates from outpatients in 1993—2000,49 from burnt inpatients),comparing the susceptibility difference of those strains.To the resistance gene of MRSA was detected with polymerase chain reaction(PCR).Results In community-acquired infection isolates,MRSA increased significantly from 12.2% to 29.8% during 1993 to 2000.In nosocomial infection isolates,MRSA was 63.3% in 2000,a little bit lower than that of mid-1990's.All the Staphylococcus aureus strains showed 100% resistance to penicillin.The resistance of SA to some non-β-lactams were: erythromycin 80%,tetracycline 70%,clindamycin 60%,chloramphenical 50%.In community-acquired infection isolates,resistance to ciprofloxin increased significantly from(2.4)% to(21.3)% from 1993 to 2000,no isolates was found to be resistant to gentamycin,rifampin,vancomycin and fusidic acid.In nosocomial infection isolates,the resistance percentage to gentamycin,ciprofloxin and rifampin were 63.3%,63.3% and 57.1% respectively.No strain was found to be resistant to vancomycin and fusidic acid.All the MRSA strains were multi-drug resistant.MRSA strains showed higher resistance percentage to erythromycin,tetracycline,clindamycin,chloramphenical and ciprofloxin than MSSA.Detection of mecA gene by PCR showed that all the high-level methicillin-resistant strains were mecA gene positive,all the low-level methicillinresistant strains were mecA gene negative.Conclusion The results indicate that the resistance rate of SA in Beijing is going up.Detection of mecA gene by PCR is an easy and quick way of screening MRSA strains.

    Diagnostic Value of Procalcitonin in Neonate with Severe Bacterial Infection
    He Jianping;Shen Kunling;Lin Ying;Wu Mingchang;Wang Yonghong;Yang Xuefang;Wang Yajuan;Shao Fang
    2005, 26(5):  545-548. 
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    Objective Procalcitonin(PCT) has been regarded as a marker of bacterial infection.The purpose of this study was to evaluate the diagnostic value of PCT in neonates with severe bacterial infection.Methods The serum PCT concentrations were measured in quantity with immunoluminometric assay and compared with C reactive protein(CRP) and leucocyte count(WBC) in 30 critically ill neonates and 30 non-infected neonates as control.Optimum sensitivity,specificity,predictive values and area under the receiver operating characteristic(ROC) curve were evaluated.Results The serum PCT at admission was much higher in neonates with severe bacterial diseases(media 7.82 μg/L;range 0.97～256.81 μg/L),compared with noninfected neonates as control(0.16 μg/L;(0.10～)1.49 μg/L).Area under the ROC curve was 0.99 for procalcitonin,0.62 for CRP and 0.60 for WBC.The cut off-concentrations for optimum prediction of severe bacterial diseases were:PCT>2 μg/L sensitivity was 87%,both the specificity and positive predictive value were 100%,negative predictive value 88% and CRP>20 mg/L.A sensitivity of 100% and negative predictive value of 100% were yielded and all patients with severe bacterial disease were identified when(PCT>)0.9 μg/L.Conclusion In critically ill neonates the PCT concentration at admission is a better diagnostic marker of infection than CRP and WBC.

    The Renal Local Activation and Regulation of RAS in the Early Stage of IgA Nephropathy
    Zhou Nan;Shen Ying;Jiao Liping;Wang Hui;Meng Qun
    2005, 26(5):  549-554. 
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    Objective This study was carried out to investigate the role of the RAS in the early stage of IgA nephropathy with the aim of providing experimental basis for clinical selection of appropriate drugs.Methods There were 38 biopsy-proven primary IgA nephropathy(IgAN) patients.According to the degree of mesangial proliferation,we divided them into two groups: the groupⅠ of mild mesangial proliferation was to be designated as early IgAN group,the groupⅡ of moderate and severe mesangial proliferation was to be designated as progressive IgAN group.Subjects for normal control group were taken from normal portions of renal cell carcinoma at the time of surgery.Immunohistochemistry methods were used to study the expression of angiotensin Ⅱ(AngⅡ),angiotensin type 1 receptor(AT1R),transforming growth factor-β1(TGF-β1),and the detection of AT1R mRNA by in situ-hybridization on the paraffin-embbedded sections.The percentage of the labeled surface area was evaluated by using a computer Imaging System.Results In normal kidney,AngⅡ AT1RmAT1RmRNA and TGF-β1 are all expressed tracely,in samples from early IgAN patients,a marked increase of the expressions was observed.On the glomerules,AngⅡ expression was significantly higher in progressive group than early IgAN group(P=0.032).There were complex correlations among the factors.Conclusion The renal local AngⅡ had been activated in the early stage of IgA nephropathy. The earlier use of RAS inhibitors may inhibit the progress of IgA nephropathy.

    Clinical Features of Autoimmune Polyglandular Syudrome Type Ⅲ in Children
    Gong Chunxiu;Shen Kunling;Yan Chun;Wu Di
    2005, 26(5):  555-558. 
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    Objective To analyze the clinical features of 16 cases with T1DM and AIDT and to evalute the effect of AITD on T1DM.Methods General data of 16 cases were analyzed including family history,physical signs, hormones and antibodies.T test was used to compare the insulin and HbA1C between 2 groups.Results The onset age of the patients was 7～14 years old,median age was 10.56.3 cases were male and 13 female,The interval between two diseases onset was 0～10 years.T1DM combinded with GD or HT were 4 and 12 cases,respectively.4 patients had family history.The levels of HbA1C of GD were 10%,12% and 14%,respectively before alleviation;GD combinded with hyperparathyroidism were 11.8% and 10.2%,GD combinded with hypoparathyroidism was 6.3%～10%.There were significantly difference between the two groups above metion(P=0.003).Conclusion There are more famales than males,more HT than GD in APS.Most of APS have family history.It is imporfant to check the thyroid function and antibodies early and regularly for T1DM patients,especially for girls.

    Transanal One-stage Pull-through for Long Segment Hirschsprung Disease in Infants
    Wang Dayong;Qiu Xiaohong;Bai Yunsong;Wang Yanxia
    2005, 26(5):  558-560. 
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    Objective A retrospective study was performed to investigate the feasibility,safety and advantages of transanal one-stage pull-through for long segment Hirschsprung disease in infants.Methods The case reports of 39 consecutive children less than 3 years old undergoing Soave pull-through were reviewed.They were diagnosed as long segment Hirschsprung disease with contrast enema and suction rectal biopsy.Age,operating time and bleeding,complications,follow-up,and functional results were analyzed.Results In the transanal Soave pull-through group,one of a longer segment to liver zone led to the selective use of laparoscopy.The mean operation time was 107 min and mean resection colon was 58 cm.There were no complications post operation,such as enterocolitis,stricture or cuff narrowing.The patients tolerated feeding on the third post-operative day.The mean hospital stay after operation was 9.3 d. All patients were followed up in 1,3 and 6 months.After 6 months,all childrenhad 1～3 bowel movements per day.Conclusion The trans-anal one-stage pull-through procedure for most of long segment Hirschsprung disease is an easy adaptation to a well-described technique in infants,without an increased risk of complications.Because there is no intraabdominal dissection,there probably is a lower incidence of adhesive bowel obstruction.Transanal endorectal resection and pull-through technique minimizes blood loss in this study,and as effective as the open standard techniques.The most important is that the surgeons can identify the level of the transition zone histological before they begin the perineal dissection.

    Correlation between Blood Sugar Level and ISS in 163 Children with Traumas
    Liu Tingting;Zhang Jinzhe;Zhou Hong
    2005, 26(5):  561-564. 
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    Objective To investigate the relationship between admission blood sugar level(BSL) and the severity of injury in terms of injury severity score(ISS) in pediatric trauma patients,and try to find an objective index to estimate the prognosis of injured children.Methods A retrospective study was performed.Patients who were admitted to our hospital within 24 h after trauma were enrolled.Those who had been pre-diagnosed diabetic mellitus,been on corticosteroids treatment,or already been given dextrose infusion before BSL investigation would be excluded from the study.Data collected include time to obtain glucose measurement,admission blood sugar level,whether ICU care was required or not,and mortality.ISS was calculated according to Baker ISS.Patients were classified into three groups according admission BSL.Results A total of 163 patients were recruited.A significant direct correlation between admission BSL and ISS was found(r=0.566,P<0.01).ISS of the severe hyperglycemia group(≥11.0 mmol/L) was significantly higher than other two groups(P<0.01).Conclusion The admission blood sugar level had a significant and positive correlation with ISS in pediatric trauma patients,it may be used as a simple index,at least a numerical reference,indicating the severity of injury.Patients with admission BSL ≥11.0 mmol/L should be monitored closely.

    Sequence Analysis of F Protein Gene of Respiratory Syncytial Virus in Beijing Area
    Lu Qi;Shen Kunling;Zhang Yan;Liu Yayi;Zhao Yuhong;Liu Chunyan;Ji Yixin;Xie Zhengde;Xu Wenbo
    2005, 26(5):  565-567. 
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    Objective To study the sequence of F protein gene of 4 respiratory syncytial virus strains in Beijing area of China.Methods P1 and P2 segments of respiratory syncytial viruses were amplified by RT-PCR,then the PCR products were purified for sequencing.Analysis was carried out by Bioedit program.Results The nucleotide sequences of the four RSV strains F mRNA had 94.92%～95.62% overall nucleotide identity with those of RSV isolate A2,the nucleotide sequences of signal peptide of four RSV strains F mRNA had 99.36%～99.73% identity,the F1 chain had 98.93%～99.31%,F2 chain had 96.69%～97.33% identity respectively.The deduced aminoacid sequences of the four strains and A2 F proteins had 97.39%～97.74% overall aminoacid identity,the signal peptide had 99.13%～99.65%,the F1 chain had 98.78%～99.48%,F2 chain had 98.61%～99.30% identity respectively.Conclusion The differences between the A2 and Beijing strains in the F gene are small,so the nucleotide and aminoacid have high identity.The antigenic area Ⅱ could be the potential site of RSV vaccine.

    Virological Features of Epstein-Barr Virus Associated Hemophagocytic Lymphohistiocytosis in Children Cases
    Xie Zhengde;Duan Hongmei;Zhang Hui;Yan Jing;Liu Yayi;Shen Kunling
    2005, 26(5):  568-570. 
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    Objective To analyze virological features of Epstein-Barr virus associated hemophagocytic lymphohistiocytosis in children cases.Methods The patients including 26 children with hemophagocytic lymphohistiocytosis(HLH) and 23 children with infectious mononucleosis(IM).EBV-DNA loads in sera were detected by real-time PCR assay with a commercial kit.Four antibodies,including EBV-IgG/M anti-VCA,EBV-IgG anti-EA,EBV-IgG anti-NA,were detected in sera of HLH cases.Results Seven HLH cases with positive of EBV-DNA in sera were diagnosed as Epstein-Barr virus associated hemophagocytic lymphohistiocytosis(EBV-HLH).The mean EBV-DNA loads in sera of patients with EBV-HLH were(4.586±0.107)×107 copies/mL.Of 7 EBV-HLH, there were 3 primary EBV infections(EBV-IgG anti-NA negative) and 4 reactivated or past EBV infections(EBV-IgG anti-NA positive).All IM cases were positive of EBV-DNA in sera and mean EBV-DNA loads were((6.865±)0.305)×103 copies/mL.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM(P=0.000).Conclusion EBV-HLH may occur in different stages of EBV infection.Detection of EBV-DNA in sera by real-time PCR was more practical in diagnosing EBV-HLH than antibody detection.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM.

    Effects of Houttuynia Herb Injection on RSV Infection in Vitro
    Zhao Yuhong;Shen Kunling;Liu Yayi;Liu Chunyan;Xie Zhengde
    2005, 26(5):  571-573. 
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    Objective To investigate the safety and the efficacy of Houttuynia Herb on RSV infection in vitro.Methods To determine the toxicity of Houttuynia Herb injection on Hep2 monolayer cells with MTT colorimetry.The inhibiting effects of Houttuynia Herb injection on RSV infected Hep2 cells were observed by Plaque forming unit(PFU) assay and the method of CPE in cuvette.The Ribavirin was used as control.Results The maximal concentration(1:10) of Houttuynia was safe to Hep2 cells and did not affect the configuration and development of Hep2 cells.Both Houttuynia(1:10) and Ribavirin 5 mg/L could inhibit 100TCID50 RSV completely and inhibit 1 000TCID50 RSV in half.The effects of two drugs could also make the viral plaques smaller or reduced obviously.Conclusion Houttuynia Herb injection is safe for culture cells and can inhibit RSV which infected Hep2 monolayer cells in vitro.

    Effect of L-asparaginase on Coagulation Abnormatities in Children with Acute Lymphoblastic Leukemia
    Wu Runhui;Duan Yuan;Zhou Xuan;Ma Xiaoli;Wu Minyuan
    2005, 26(5):  573-576. 
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    Objective To analyze the alterations and the causes of coagulation in children with acute lymphoblastic leukemia (ALL) during L-asparaginase(L-asp) treatment and to find out the solutions.Methods 51 ALL patients were analyzedprospectively with 1) changes of APTT,PT,Fib and AT before,during and after treatment of L-asp;comparing the changes different protocols and in different periods of chemotherapy;2) the relationship between coagulation and changes of platelet and(D-dimer) as well as liver function.3) the significance of supplementary therapy in patients with lower AT and/or Fib.Results (1) Fib) and AT were significantly decreased during and at the end of L-asp treatment,but not influenced much by intensity and stages of chemotherapy.2) There were no significant changes of platelets,(D-dimer) and liver function during and at the end of(L-asp).(3) No) thrombosis or hemorrhage occurring after prophylactic supplementary transfusion of AT and/or Fib.Conclusion The negative alterations of Fib and AT were significant in ALL patients during L-asp therapy;These changes were not influenced much by intensity or stages of chemotherapy,neither by liver function;The prophylactic supplementary therapy may reduce the complications of thrombosis and hemorrhage during L-asp treatment.

    Distribution Characteristics of Allergen-specific Serum IgE Antibodies in Asthma Children
    Xiang Li;Xiong Zhenyi;Ren Yixin
    2005, 26(5):  577-581. 
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    Objective To investigate distribution characteristics of allergen-specific serum IgE antibodies in clinical diagnostic asthma children.Methods Inhalant and food allergen-specific serum IgE antibodies were determined in 324 asthma children and 60 non-atopic control children by fluoroenzyme-immunometric assay,UniCAP100,applying the Phadiatop and fx5E testing.We compared the positive ratio of Phadiatop and fx5E between the two groups and computed the positive ratio of Phadiatop among different age groups of asthma children.Eight kinds of inhalant specific IgE antibodies against Dermatophagoids pteronyssinus,Dermatophagoids farinae,house dust,mixed molds,mixed tree pollen,mixed grass pollen,cat and dog dander were selected tested in 94 asthma children with positive phadiatop test,the positive ratio of each inhalant allergen was reported.Results The positive ratio of Phadiatop and fx5E in 324 asthma children were 55.2% and 45.1% respectively,which were significantly higher than that of control group.The mean age of asthma children with mere positive reaction to Phadiatop was significantly older than that of asthma children with mere positive reaction to fx5E((7.47±3.27)year vs(3.80±2.04)year).The highest positive ratio of Phadiatop was 86.4% and 83.3% in 7 and 10 years of age asthma children respectively.The positive ratio of each inhalant allergen specific serum IgE antibody in 94 asthma chidren was that: Dermatophagoids pteronyssinus 62.7%,Dermatophagoids farinae 61.7%, house dust 58.5%,mixed molds 43.6%,mixed tree pollen 27.7%,mixed grass pollen 26.6%,cat dander 47.6%,dog dander 36.0%.Conclusion About 75% clinical diagnostic asthma children presented inhalant and/or food allergen sensitization.Dermatophagoids,house dust and molds were the main inhalatnt allengens in asthma children.Asthma infants mainly manifested food allergen sensitization,but the prevalence of sensitization to inhalant allergen increased in up to 4-year-old asthma children.

    Diagnosis of Fetal Ebstein Anomaly by Echocardiography
    Wu Qingqing;Yao Ling;Chen Yan
    2005, 26(5):  582-584. 
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    Objective To investigate the clinical value of prenatal diagnosis of fetal Ebstein anomaly by echocardiography.Methods Retrospective analyses of 2D-heart views and CDFI(color Doppler flow image) as well as the follow-up findings were made in 5 cases with fetal Ebstein anomaly.Results 5 cases fetal Ebstein anomaly were proved by autopsy;The image features were enlarged right atrium and downward displacement of tricuspid valve in the right ventricle.The deformed tricuspid valve allows a large amount of blood to regurgitate from the right ventricle to the right atrium when the right ventricle contracts.Conclusion echocardiography has very important clinical value in diagnosis of fetal Ebstein anomaly.

    The Assessment of Different Therapies for Endometrial Carcinoma
    Yang Shuli;Wu Yumei;Kong Weimin;Deng Xiaohong
    2005, 26(5):  584-587. 
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    Objective To assess the different therapies for endometrial carcinoma retrospectively.Methods From 1960 to 2001,867 patients with endometrial carcinoma were treated in our hospital.Their clinical and pathological data were analyzed retrospectively.The patients were divided into three groups according to the different therapeutic methods: half dose preoperative radio-brachytherapy and surgery(HR+group S),surgery(group S),radiotherapy(group R).Results The 5 year survival ratesof HR+group S,group S and group R were 93.7%,90.7% and 57.8% respectively in clinical stageⅠ(570 cases),88.3%,64.3% and 25.1% respectively in clinical stageⅡ(134 cases).No significant differences between HR+group S and group S were observed in clinical stageⅠand Ⅱ cases respectively(P>0.05).Meanwhile,The 5 year survival rates of HR+group S,and group S were significantly higher than that of group R in clinical stageⅠand Ⅱ(P<0.01).Conclusion For patients with the endometrial carcinoma in clinical stageⅠand Ⅱ,combined treatment is better than radiotherapy;No significant differences between operation combined with half dose preoperative radio-brachytherapy and surgery.

    Effects of Wild-type p53,GM-CSF and B7-1 Genes Transfer on Proliferation of Ovarian Cancer Cell Line SKOV-3
    Lin Yugeng;Zhang Zhenyu;Wang Lisheng;Wu Bin
    2005, 26(5):  588-592. 
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    Objective To investigate the effects of wild-type p53,GM-CSF and B7-1 genes co-transfer on proliferation ability of ovarian cancer cell line SKOV-3.Methods Transfection SKOV-3 cell with recombinant adenovirus carrying green fluorescence protein gene was used to test the transfection efficiency of adenovirus vector.Transfect SKOV-3 cell with recombinant adenovirus carrying human wild-type p53,GM-CSF and B7-1 genes,then RT-PCR was used to test the gene expression.The appearances of the cells after transfection were compared with the normal cells.Proliferation curve was performed.Results The transfection efficiency can reach 81% when the multiplicity of infection is 400 pfu/cell;the cell transfection with recombinant adenovirus carrying wild-type p53,GM-CSF and B7-1 genes can express the gene products;cell proliferation was reduced after transfection with the recombinant adenovirus carrying wild-type p53,GM-CSF and B7-1 gene.Conclusion The adenovirus vector can transduce wild-type p53,GM-CSF and B7-1 genes into ovarian cancer cell line SKOV-3 effectively;wild-type p53,GM-CSF and B7-1 genes modification can significantly reduce the proliferation of SKOV-3 cells.

    The Experimental Study of the Effects of Radiotherapy Combined with Hyperthermia on the HeLa Cells of Cervical Carcinoma in Laboratory
    Liu Yusheng;Niu Juwei;Zhang Weihua;Kong Weimin;Deng Xiaohong
    2005, 26(5):  593-596. 
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    Objective To seek proper the therapeutic protocol of radiotherapy in combination with hyperthermia,in order to provide the experimental support for clinical treatment of the advanced stage cervical carcinoma.Methods HeLa cells were exposed to radiation,heating and radiation combined with heating respectively in vitro.Counting the cells number and the colony number,drawing the cells survival curve,calculating the growth inhibitory rate,the rate of colony formation and the inhibition of different groups.Results 1) There was no significant difference between exposing at 43 ℃ for 30 min and at 42 ℃ for 2 h(P>0.05).2) The growth inhibition rate of radiation,or hyperthermia alone and radiation combined with hyperthermia were significantly different(P<0.05).3) No differences of the growth inhibition,colony forming and inhibitory rate were found between two seguential managements.4) No differences were found when HeLa cells exposed in the same seguence but in different time intervals(30 min,2 h, 24 h) between two protcols,the rates of growth inhibition,colony forming and inhibition were similar(P>0.05).Conclusion 1) Radiation combined with hyperthermia's effects on the HeLa cells were much better than either radiation or heating.2) Under the same X-ray dose condition, choosing different time intervals between radiation and hyperthermia,there was no difference in the rate of growth inhibition,colony forming and inhibition between radiation followed hyperthermia and hyperthermia followed radiation.

    A Study on the Feasibility and Safety of Laparoscopic Excision of Large Hysteromyoma
    Zhang Zhenyu;Li Shuhong;Guo Shuli;Liu Chongdong;Wang Shuzhen
    2005, 26(5):  597-599. 
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    Objective To study the feasibility and safety of laparoscopic excision of large and multi-hysteromyoma.Methods To evaluate the location,size and the number of myoma by ultrasound preoperation.The amount of hemorrhage was evaluated by volume.Surgical technique: To cut through the envelope of the myoma,resect myoma,and suture the uterus wall.Followed the patients regularly.Results 102 patients were evaluated.There were 33 multi-myoma and 69 mono-myoma.There were 29 cases of intramural myoma,including 13 mono-myoma,with maximum tumor size in diameter 5～12 cm,mean(7.6±2.0)cm;16 multi-myoma,the number of myoma was 2～14,mean(4.9),with maximum tumor size in diameter 3～8.5 cm,mean(5.2±(1.5))cm.There were 61 subserous myoma,44 mono with maximum tumor size in diameter 6～15 cm,mean(8.2±2.5) cm,17 multiple,the number of myoma was 2～14,mean 4.0 with maximum tumor size in diameter 2～10 cm,mean(4.9±2.1)cm;8 intra-broad ligament,with maximum tumor size in diameter 7～12 cm,mean(8.1±0.9)cm.4 submucous,maximum tumor size in diameter 8～10 cm,mean(8.7±0.5)cm.The outcome of operation: 101 cases of laparoscopic myomectomy were performed and 1 cases of mini-abdominal incision myomectomy with assisted laparoscopy no alternative to laparotomy,no case changed to total hysterectomy.Duration of operation: 30～240 min,mean(87.2 ±43.1)min.Blood loss during the operation: 5～400 mL,mean(53.6±56.6)mL.Short term effectiveness: Complete resection 100 cases,nearly complete resection 2 cases,partial resection 0.Complications: pneumoderma 3 cases,hemorrhage post-operation 0 case,subcutaneous hematoma 1 case,infection 1 case.Conclusion Laparoscopic resection of the large and multi-myoma is feasible and safe.The OBGY doctors should pay more attention to the indications of laparoscopic hysteromyomectomy.

    Effects of Tamoxifen on Expression of Oestrogen Receptors,Progesterone Receptors and Ki-67 in Postmenopausal Endometrium
    Gao Wanli;Feng Limin;Zhang Ming;Zhang Hua;Sun Haimei
    2005, 26(5):  600-604. 
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    Objective To investigate the effects of tamoxifen(TAM) on expression of oestrogen receptors(ER),progesterone receptors(PR)and Ki-67 antigen in postmenopausal endometrium.Methods Forty-six postmenopausal breast cancer patients receiving 20 mg/d TAM for at least six months were examined by hysteroscopy and endometrial biopsy,and eighteen age-matched,non-hormonally treated patients with atrophic endometrium post vaginal hysterectomy because of uterine prolapse served as control groups.Immunohistochemical studies for the expression of ER,PR and Ki-67 antigen in endometrium were performed.Results There were significantly increased levels of expression of PR((0.46±)0.05 vs 0.35±0.06,P=0.028) in glandular epithelium in tamoxifen-associated endometrium compared with atrophic endometrium.Also,Ki-67 antigen was expressed more frequently in glandular epithelium in the tamoxifen samples(15.41±4.83 vs 9.05±5.52,P=0.009).The expression of ER in glandular epithelium was higher but did not differ statistically between tamoxifen-associated endometrium and atrophic endometrium(0.47±0.06 vs 0.43±0.06,P=0.063).Conclusion In postmenopausal women tamoxifen exerts a proliferative effect on the endometrium,as measured by Ki-67 antigen.The tamoxifen-associated changes in endometrial PR support an estrogenic effect that is independent of histological diagnosis and duration.This may contribute to the pathogenesis of tamoxifen-associated polyps and carcinomas.

    Clinical Significance of Cervical Cytological Examination in Gestation
    Wang Fengying;Zhang Haizhen;Zhou Yanping;Sun Yanni;Chen Li
    2005, 26(5):  604-606. 
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    Objective To evaluate the clinical implication of cervical cytology in gestation and 2 months postartum.Methods We collected 1 746 cases of the thinprep cytologic test samples from external cervical orifice and cervical cavity.The cytological diagnosis adopted TBS-diagnosis and classification system.Results In 1 746 cases of samples,the inflammatory samples were 143 cases(8.2%).In those cases,the bacterial vaginitis samples were 46 cases(2.6%),trichomonal vaginitis samples were 44 cases(2.5%),candidal vaginitis samples were 53 cases(3.0%).The samples of typical epithelial cells were 94 cases(5.4%).In those cases,the samples of atypical squamous cells(ASCUS) were 63 cases(3.6%),the low-grade squamous intraepithelial lesions(LSIL) were 26 cases(1.5%),the high-grade squamous intraepithelial lesions(HSIL) were 4 cases(0.2%),the carcinoma in situ(CIS) was 1 case(0.1%).The samples of human papilloma virus(HPV) were 28 cases(1.6%),in which,the HPV combined with atypical squamous cells were 20 cases(1.1%),HPV combined with LSIL were 8 cases(0.5%).Conclusion The examinations of cervical cytology has positive effects in prevention and treatment of precancerous changes and carcinoma ingestational women,through the monitoring and management in peripartum,the morbidity and mortality of the preinatal can be reduced.

    The Analyses of Clinical Diagnosis of 766 Cases with Cervical Lesions
    Zhao Guijun;Lin Li
    2005, 26(5):  607-611. 
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    Objective To assess the value of liquid-based thinlayer cytology test(TCT),colposcopy and biopsy in the diagnosis of cervical intraepithelial neoplasia and cervical cancer.Methods 6 201 outpatients in Department of Gynecology,Beijing(Chuiyangliu) Hospital,were given liquid thinlayer cytology examinations from June 2002 to February 2005, the positive cases of TCT were 442,with 324 TCT of negative results but suspected cervical lesions in clinical symptoms,both of 766 cases further underwent colposcopy and biopsy.Pathohistology was golden standard for the diagnoses of different methods.Results 442 cases were positive in 6 201 cases which were screened with TCT.The incidence was 7.13%,with TCT-diagnosed HSIL 21cases,LSIL 82 cases,CC 4 cases,ASCUS/AGUS 335 cases.Colposcopy and pathology diagnosed HSIL 34 cases and 36 cases,LSIL 143 cases and 153 cases,CC both 5 cases,inflammation 584 cases and 572 cases respectively.Compared with pathology,Kappa value of colposcopy checking ≥LSIL and ≥HSIL were 0.887 and 0.868,higher than Kappa value 0.615 and 0.716 of TCT checking ≥LSIL and ≥HSIL.The sensitivity of diagnosis≥LSIL with TCT and colposcopy were 53.1% and 88.7%(P<0.01) respectively,specificity were 99.3% and 98.3%(P>0.05) respectively,total consistent rate were 87.6% and 95.9%(P<(0.01)) respectively,omission diagnostic rate were 46.9% and 11.3%(P<0.01),negative predictive valve were 86.2% and(96.2)%(P<0.01),positive predictive valve were 96.3% and 94.5%(P>(0.05)),misdiagnosis rates were 0.7% and 1.7%((P>)0.05) respectively.Among the 335 cases with ASCUS/AGUS diagnosed with pathohistology,the 282 cases with inflammation,48 cases with CINⅠ,3 cases with CINⅡand 2 cases with CINⅢ.Conclusion Liquid-based thinlayer cytology test used for preliminary screening,can be combined with colposcopic examination and biopsies for clinical diagnosis.In this way,the detection rate and accuracy of cervical diseases can be improved.ASCUS/AGUS cases need more sophisticated examinations.

    The Relationship between Cytokine and Group B Streptococcus Subclinical Infection in Pregnancy
    Chen Yi;Huang Xinghua
    2005, 26(5):  612-615. 
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    Objective To determine whether the Interleukin-6(IL-6),and Interleukin-6 Recep-tor(IL-6R),and Interleukin-8(IL-8) concentrations can be used as index for the diagnosis of GBS subclinical infection in early pregnancy.Methods Culture sepcimens for group B streptococcus were obtained from 208 pregnant women.The maternal serum,amniotic fluid and cord blood were collected seperately in selected 80 pregnants(20 pregnants without infections of other pathogens were GBS carriers;60 pregnants were controls),IL-6 and IL-8 levels were detected by enzymy-linked immunosorbent assay(ELISA) and immunohistochemistry technique.Results There were 20 GBS carriers in 208 pregnants(9.62%).The maternal serum and amniotic fluid IL-6,IL-8 levels in GBS carriers were higher than those in control group.The maternal serum and amniotic fluid IL-6,IL-8 in patients complicated with chorioamnionitis or GBS subclinical infection were all higher than those in control group.Determining cytokine was valuble clinical index for indentification of the chorioamnionitis in patients with GBS subclinical infection,but the relation between cytokine and the incidence of newborn was not found.Conclusion The maternal serum IL-6 is valuable clinical index for indentification of the patients with GBS subclinical infection.

    The Effects of Dietary Patterns and Physical Activities on Gestational Diabetes Mellitus in Rural Districts and Counties of Beijing
    Zhou Li;Wu Lianfang
    2005, 26(5):  616-619. 
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    Objective To investigate the effects of dietary patterns and physical activities on Gestational Diabetes Mellitus.Methods 124 cases with GDM,128 cases with GIGT and 224 cases as control in rural districts of Beijing were inquired with questionnaire.The analyses were focused on such factors as dietary patterns and physical activities.Results The total intake of calories,fat and carbohydrate per day in GDM/GIGT groups were significantly higher compared with that of control group(P<(0.05)).While less physical activities were found in GDM group(P<0.05).Conclusion The results suggested that diets rich in high calories and fat and little activities were the important factors of triggering GDM.

    The Effects of E2,P,E2/P and CRH on Premature Delivery
    Tan Chunying;Lin Li
    2005, 26(5):  620-623. 
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    Objective To study the level and the action of E2,P and CRH in the onset of premature delivery;and investigate the effects of E2,P and CRH on premature delivery and the relationship among E2,P and CRH.Methods 63 pregnant women of threatened prematurity were enrolled as the threatened prematurity group,60 normal pregnant women are selected as normal pregnant group.Three milliliters of venous blood were taken from all of the women. The levels of E2,P were detected by radioimmunoassay,CRH by fluoroimmunoassay.Results 1) In the third trimester,the CRH concentration in maternal plasma increased with advanced gestation.The E2 level had little change.However,the P concentration came to the peak at the 31～32 menstrual weeks,then,it fell down markedly. 2) In the 29～30,(31～)32,33～34,(35～)36 menstrual weeks the CRH,P levels in threatened prematurity groups were significantly different with normal pregnancy(P<0.01).In the 29～30 menstrual weeks,the E2 level was not significant(P=0.648);and so did 31～32 weeks E2 level((P=)0.298);in the 33～34,35～36 menstrual weeks,the E2 levels in threatened prematurity groups were significantly higher than normal pregnancy(P<0.01,(P<)(0.05)).3) The CRH, E2 levels of premature delivery groups were much higher than continuous pregnancy(P<0.01),however,the P level was much lower than continuous pregnant group(P<0.05).Conclusion 1) CRH maybe an important factor in onset of delivery.2) The maternal plasma CRH plays an important role in preterm delivery.Abnormally elevated level of CRH can predict preterm labor.3) In premature delivery P is much more important than E2.

    The Relationship between Obstetrical Causes and Neonatal Asphyxia
    Liu Tong;Wang Fengying;Zhou Qi;Liu Weijing;Yao Hongyan
    2005, 26(5):  624-626. 
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    Objective To investigate obstetrics-related risk factors in terms of neonatal asphyxia and methods of prevention,so as to reduce the incidence of neonatal asphyxia,and improve obstetrical quality.Methods 6 568 neonatal cases delivered in the hospital from 2001.1—2005.5 were analyzed retrospectively to investigate obstetrical causes of neonatal asphyxia, and find out which kind of delivery may induce the neonatal asphyxia.Results Obstetrical complications such as umbilical cord abnormality,oligohydramnios and premature labor were associated with neonatal asphyxia.There was no significant difference in terms of neonatal asphyxia incidence between vaginal delivery and caesarean section,but forceps delivery would induce more neonatal asphyxia.Conclusion Regular prenatal visiting,screening and preventing obstetrical complications can reduce the incidence of neonatal asphyxia.The treatment such as choosing the correct way of delivery,proper management the pregnant complications and curing the depravation newborn can reduce the incidence of neonatal asphyxia and perinatal mortality.

    The Ultrasound Diagnosis and Prognosis of Fetal Pyelectasis
    Zhang Tiejuan;Zhai Guirong
    2005, 26(5):  627-629. 
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    Objective To investigate the ultrasound diagnosis and prognosis of fetal hydronephrosis.Methods Ultrasonography was used to examine fetus aged 20～41 weeks.Thirty fetus were diagnosed as hydronephrosis and followed-up from 3 days to 9 months after birth.According the degree of hydronephrosis,three types were classified of the cases.Type A: the width of pyelectasis was 1.0～1.5 cm,Type B: the width of pyelectasis was 1.5 cm,and renal cotex become thinning.Type C: the width of pyelectasis is bigger than 1.5 cm and renal cotex become thinning.Results 30 cases were followed-up.Prognosis showed that 24 cases were recovered successively,including 19 type A;3 type B;no type C,Two fetus were recovered in last stage of pregnancy.Four neonates were diagnosed as hydronephrosis after birth,then were treated by operation.Two fetus were induced labor.It is suggested that hydronephrosis might be recovered after birth when fetal pyelectasis was about 1.0 to 1.5 cm in diameter.Conclusion Hydronephrosis maybe found in some neonates in long term with simultaneous cortical dilatation after birth.And all neonates must be examined and treated by operation when fetal pyelectasis was bigger than 1.5 cm and renal cortex become thinning.

    The Clinical Study of Endometrial Pathological Changes in Postmenopausal Women with Three-dimensional Transvaginal Sonography and Hysterosonography
    Hou Dongmin;He Wen
    2005, 26(5):  630-633. 
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    Objective To investigate the values of three-dimensional transvaginal sonograpphy and hysterosonography in early diagnosis of the endometrial diseases.Methods 74 patients with postmenopausal bleeding were studied prospectively.Endometrial thickness and volume were measured with 2D and 3D ultrasound respectively,endometrial thickness greater than 5 mm were found in 32 cases with hysterosonography.The changes of the endometrium and compliance of muscularis uteri were observed.The results were compared with histopathologic findings.Results When 10 mL of endometrial volume was set as the criticalor cut off-point of the endometrial abnormalities in postmenopausal women with bleeding,the sensitivity,specificity,positive predictive values and negative predictive value were 95.4%,78.8%,67.7%,97.6% respectively whereas 100%,66.7%,41.2%,100% were obtained respectively when it was used to predict endometrial malignancy and premalignancy.To identify endometrial disorders with 2D-SHG,the values above-mentioned were 100%,96.9%,95.0%,100% respectively whereas 100%,88.2%,86.7%,100% were obtained respectively for predicting endometrial malignancy and premalignancy.The changes of endometrium and compliance of muscularis uteri were significantly different between the groups of benign and malignant pathological changes when contrast medium was injected into uterine cavity(P<(0.05)).Conclusion 3D-TVS and 2D-SHG were reliable methods to diagnose endometrial disorders in postmenopausal women.2D-SHG should be viewed as an important tool in diagnosis and differentiation of endometrial pathological changes especially in the early stages of the malignant diseases.The changes of endometrium and compliance of muscularis uteri may serve as an effective diagnostic method for differentiation of benign endometrial disorders from endometrial cancer.

    The Effects of Intrathecal Morphine Injection on Postoperative Analgesia in Caesarean Sections
    Kang Kai;Xu Mingjun
    2005, 26(5):  634-636. 
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    Objective To investigate the positive and adverse effects of intrathecal morphine injection on postoperative analgesia in caesarean sections.Methods Ninety ASA Ⅰ～Ⅱ patients for elective caesarean section were randomly divided into 3 groups with 30 cases for each.Before operation patients were injected intrathecal with ropivacaine 15 mg,NS 0.5 mL and 10% glucose 1 mL in group A and group C.Ropivacaine 15 mg,morphine 0.2 mg(0.5 mL) and 10% glucose 1 mL in group B.After operation,patients in group A and group B were given 0.16% ropivacaine and(0.002 5)% droperidol in the PCEA bump,total is 100 mL,The group C append 0.005%(5 mg) morphine.PCEA bump was intercalated: No load dosage+basal dosage 2 mL +(0.5) mL/per time+lock time 20 min.VAS and Prince-Henry methods were used postoperatively to evaluate pain feeling in 2,4,6,8,24,36 and 48 h.Results VAS and P-H value at each time in 24 h of group C were lower than group A,but there were no signficant differences(P>(0.05)) between group A and group C,which were higher than that in group B(P<0.01).The dose of PCEA and degrees of TPCA/EPCA in group A and group C were higher than that in group B(P<0.01). 10 and 9 cases needed other additional anaesthetics during postoperative 24 h in group A & C respectively,4 & 1 cases needed neostigmine to accelerate micturition and flatus in group C respectively.Side effects as nausea,vomiting,itching were more in group B than in group A and group C(P<0.05).Conclusion Intrathecal injection of morphine could not only provide satisfactory postoperative analgesia in caesarean sections but also reduce the dose of anesthetics,it had certain side effects yet.

    Isolation and Identification of Mesenchymal Stem Cells From Fetal Heart
    Li Changdong;Zhang Weiyuan;Jiang Xiaoxia
    2005, 26(5):  637-640. 
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    Objective To isolate and identify the phenotype and biological characteristics of mesenchymal stem cell derived from fetal heart.Methods Mononuclear cells from human fetal heart were collected by Percoll gradient centrifugation.The low density cells were cultivated and expanded in MSC media.Phenotype was analyzed by FACS flow cytometer and characteristics of the multipotent were observed.Results Human fetal heart MSCs were successfully cultivated and differentiated into osteoblast and adipose in vitro as the MSCs derived from fetal bone marrow.Conclusion Mesenchymal stem cells existing in human fetal heart and could be isolated by their adherent ability and should be as a novel source for tissue engineering and gene engineering.

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