Table of Content

25 August 2017, Volume 9 Issue 4 Previous Issue    Next Issue

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Determination of serum MMP-9 level and its gene expression in peripheral blood mononuclear cells in children with Mycoplasma pneumoniae pneumonia XU Ying，ZHAO Yue，XIAO Kelin 2017, 9 (4):  277-279.  doi: 10.3969/j.issn.1674-3865.2017.04.001 Abstract ( 678 )   PDF (357KB) ( 105 )   Save Objective To study the serum levels of matrix metalloproteinase-9 (MMP-9) and its gene expression in peripheral blood mononuclear cells in children with Mycoplasma pneumoniae pneumonia(MPP), in order to provide a theoretical basis for the role of MMP in immune pathogenesis of Mycoplasma pneumoniae pneumonia in children. Methods Totally 78 cases of acute MMP patients treated and followed up in Department of Respiration of our hospital from January 2015 to August 2016 were selected as the observation group. Enzyme-linked immunosorbent assay(ELISA) and realtime quantitative PCR method were used to detect the level of serum MMP-9 in acute period and recovery period and the gene expression of MMP-9 in peripheral blood mononuclear cells; at the same time, a total of 78 healthy children in our hospital for health examination were selected as the control group and were given same testing. Results The level of MMP9 in the acute stage of the observation group was significantly higher than that in the recovery stage and that of the control group(P<0.05), but there was no difference between the recovery stage and control group(P>0.05). At the same time, positive expression of MMP-9 mRNA in children at acute rate was higher than that at the recovery period and that of the control group(P<0.05). Conclusion The level of serum MMP-9 and the positive rate of MMP-9 mRNA are of great significance for the diagnosis of the disease. Related Articles | Metrics

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Clinical effect of the treatment with Big Chaiqin lavipeditum prescription for children with pneumonia, cough and fever SONG Guihua，SONG Zhongpeng，ZHANG Bingxue，SUN Mengmeng 2017, 9 (4):  280-283.  doi: 10.3969/j.issn.1674-3865.2017.04.002 Abstract ( 682 )   PDF (510KB) ( 154 )   Save Objective To observe the clinical effect of the treatment with Big Chaiqin lavipeditum prescription for children with pneumonia, cough and fever. Methods From September 2016 to December, 80 children with pneumonia, cough and fever were admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine. The patients were randomly divided into treatment group and control group, with 40 cases in each group. The two groups were treated with conventional antiinfection treatment; when patients' axillary temperature was higher than 37.4 ℃, the treatment group was given Big Chaiqin lavipeditum prescription for foot bathing for 30 min, and the control group was given antipyretic plaster which was put on the forehead of children; if the children's temperature rise again and again, the prescription could be reused. The changes of body temperature before and after treatment at 0.5h, 1h, 2h, 4h, 6h, 8h and 48h were observed and recorded, and the overall efficacy was evaluated after 48h of treatment. Results The total effective rate of the treatment group(92.5%,37/40) was significantly higher than that of the control group(72.5%,29/40), and the difference was statistically significant(P<0.05).The body temperature in the treatment group at 0.5h, 1h, 2h, 4h, 6h, 8h and 48h of treatment was all lower than in the control group, and there was statistical difference(P<0.05). Conclusion Big Chaiqin lavipeditum prescription is significantly effective in the treatment of children with pneumonia, cough and fever. Related Articles | Metrics

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Effect of different dose of astragalus injection on the Caspase-3 activity of mice with viral myocarditis ZHANG Yunjuan，GOU Hongping，NIU Shaomin，DONG Xiangyu 2017, 9 (4):  283-286.  doi: 10.3969/j.issn.1674-3865.2017.04.003 Abstract ( 523 )   PDF (408KB) ( 114 )   Save Objective To observe the effect of astragalus injection on cell apoptosis in mice with viral myocarditis and on the Caspase-3 activity. Methods A total of 60 male Balb/c mice(4 to 6 weeks old) were randomly divided into 5 groups: normal control group(A), model control group(B), low-dose astragalus group(C), middle-dose astragalus group(D) and high-dose astragalus group(E),12 mice in each group. After the mice model of acute viral myocarditis was made, astragalus injection was injected into the abdominal cavity of the mice in group C,D and E［0.1，0.2，0.4 mL/(g·d)］, while normal saline was injected in group A and B［0.1 mL/(g·d)］,once a day for continuously 14 days. On day 3,7,10,and 14,heart and serum samples were taken for pathological testing and the detection of Caspase-3 activity, CK-MB and cTnI. Results (1)Myocardial pathological score, and the value of CK-MB and cTnI of mice in group B were significantly higher than those of group A, the difference being statistical(P<0.05).(2)The Caspase-3 activity, CK-MB, cTnI value and myocardial pathological score in group C,D and E were significantly lower than those in group B, with significant difference(P<0.05).(3)There was no statistical difference on myocardial pathological score, CK-MB or Caspase-3 activity among group C,D and E(P>0.05). Conclusion (1)Cell apoptosis is involved in the myocardial damage of mice with viral myocarditis, and Caspase-3 plays an important role in it.(2)Small-dose astragalus injection can reduce the apoptosis of myocardial cells in mice with viral myocarditis by down-regulating the Caspase-3 activity of myocardial cells, and thus alleviate the damage to myocardial cells. Related Articles | Metrics

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Research progress of TCM treatment for children with cough variant asthma QIAN Meijia,XIE Tianlong,GONG Wen, CUI Shengtao,FENG Xiaochun 2017, 9 (4):  287-289.  doi: 10.3969/j.issn.1674-3865.2017.04.004 Abstract ( 586 )   PDF (479KB) ( 147 )   Save To study the research progress of TCM treatment for children with cough variant asthma. The western treatment with hormones has many side effects and the disease is likely to relapse. The excessive use of antibiotics has reduced the immunity of children. Recently some TCM therapies, such as differentiation treatment, treatment based on stages, individualized treatment and external TCM treatment, have been presented, and are of great significance in the prevention and clinical treatment of this disease. It has long-lasting effect and is clinically superior to other treatments. Related Articles | Metrics

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Study on the etiology and pathogenesis of precocious puberty in children WANG Mengran,WU Yufa, JIANG Li, FENG Qiuzhu, ZHANG Guiju 2017, 9 (4):  290-292.  doi: 10.3969/j.issn.1674-3865.2017.04.005 Abstract ( 587 )   PDF (521KB) ( 169 )   Save By combining the literature reports and reports in the past and at present with the physiological and pathological features of children and taking the modern environment and dieting factors into account, the etiology and pathogenesis of precocious puberty in children are analyzed. The causes mainly include: congenital insufficiency, nutritional imbalance during development and the social environment of living. The main pathogenesis is as follows: this disease originates from liver and kidney; the pathological basis is deficiency of Yin and excess of fire; the liver stagnation is turned into fire; the excess of stomach-fire is the sign; the root and the sign often interact with each other, and some more factors are involved, which promotes the onset, development and change of this disease. Related Articles | Metrics

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Research progress of TCM treatment for functional abdominal pain in children MA Jinmei，CHEN Lu 2017, 9 (4):  293-295.  doi: 10.3969/j.issn.1674-3865.2017.04.006 Abstract ( 684 )   PDF (311KB) ( 295 )   Save A lot of literatures have shown that western medicine has its limitation in the treatment of functional abdominal pain in children, which is mainly anti-infectious, anti-viral, sedative and anti-allergic treatments. In traditional Chinese medical treatment, there are many ways which by combining the internal with the external therapies, has achieved rapid effect, and also, there is no obvious adverse reaction. For external treatment, there are external application, acupunction, moxibustion, cupping, massage and chiropractic therapy. All these treatments are easy to perform and without side effects, and the compliance in children is comparatively high. However, there has been no consensus on TCM treatment due to the recognition difference, so it is necessary to look for more suitable and more accurate ways and to standardize the process of diagnosis and treatment. Related Articles | Metrics

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Analysis of compliance in using wrist rehabilitation training device in wrist dorsiflexion training in children with cerebral palsy TAN Lishuang, HU Xiaoli. Modern Treatment Center 2017, 9 (4):  295-297.  doi: 10.3969/j.issn.1674-3865.2017.04.007 Abstract ( 387 )   PDF (402KB) ( 163 )   Save Objective To study the compliance in using wrist rehabilitation training device in wrist dorsiflexion training in children with cerebral palsy. Methods A total of 98 children with spastic cerebral palsy were treated in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from Aug. 2014 to Feb. 2016, and they were randomly divided into two groups: the control group(52 cases) and the observation group(46 cases). The control group received occupational therapy, while the observation group was asked to wear the device in addition to receiving occupational therapy, one month as a course. The compliance of children and the satisfaction of their parents were investigated by questionnaires. The compliance score was transformed into compliance rate, which was classified into 3 levels: low(<50%),medium(50%～75%) and high(>75%). Results The high compliance rate in observation group was 45.7%(21/46), significantly higher than that in control group(23.1%,12/52);the low compliance rate in observation group was 15.2%(7/46), significantly lower than that in control group(48.1%,25/52); both differences were of statistical significance(P<0.05).The satisfaction rate of parents in observation group was 71.7%(33/46), which was significantly higher than that in control group(42.3%,22/52), and there was statistical difference(P<0.05). Conclusion The self made wrist rehabilitation training device can be used in the occupational therapy, which stimulates the children's interest in rehabilitation training and improves the children's compliance and their parents' satisfaction. Related Articles | Metrics

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Efficacy of Xiyanping injection in assisting the treatment with azithromycin for chlamydia pneumonia in children PAN Fengqi,XU Hao 2017, 9 (4):  298-300.  doi: 10.3969/j.issn.1674-3865.2017.04.008 Abstract ( 616 )   PDF (370KB) ( 163 )   Save Objective To observe the clinical efficacy of Xiyanping injection in assisting the treatment for chlamydia pneumonia in children. Methods A total of 89 children with chlamydia pneumonia were included as the subjects and were randomly assigned to observation group(45 children) and control group(44 children). Children in both groups received intravenous infusion of azithromycin for 3 days, followed by a 4-day stop as a course, for two consecutive courses. Children in the observation group were also given Xiyanping injection 0.2 mL/(kg·d) via intravenous infusion for 10 days. The fever clearance time, effect on cough and side effects were observed between the two groups. Results There were 8 cases whose follow-up was lost because of bad compliance, so finally 81 children completed the treatment plan and follow-up in the two groups, 39 in the control group and 42 in the observation group. In the observation group, fever process was (3.28±1.52)days. The effective rate in treating cough was 59.5%(25/42), 73.8%(31/42) and 90.5%(38/42) at 3, 7 and 14 days of treatment, respectively. The incidence of side effects of azithromycin was 9.5%(4/42). In the control group, fever process was (4.89±1.46) days. The effective rate in treating cough was 20.5%(8/39), 41.0%(16/39) and 66.7%(26/39) at 3, 7 and 14 days of treatment, respectively. The incidence of side effects of azithromycin was 28.2%(11/39). Significant differences were shown between the two groups(P<0.05). Before and after treatment, there was no abnormal change in routine blood and urine test, liver function or myocardial enzymes. Conclusion Xiyanping injection in adjuvant treatment of chlamydia pneumonia in children can rapidly relieve fever and cough, and reduce the incidence of side effects of gastrointestinal irritation caused by azithromycin. Related Articles | Metrics

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Value of serum NT-proBNP and procalcitonin in the diagnosis of Kawasaki disease WANG Xiang, CHEN Zhi, XIAO Yunbin, YANG Zhou, XIANG Jinxing, WANG Yefeng 2017, 9 (4):  301-303.  doi: 10.3969/j.issn.1674-3865.2017.04.009 Abstract ( 774 )   PDF (314KB) ( 129 )   Save Objective To study the value of serum NT-proBNP and procalcitonin in the diagnosis of Kawasaki disease in children and in the prediction of damage to coronary arteries by determining their levels. Methods A total of 65 children with Kawasaki disease were hospitalized in Hunan Children's Hospital from Mar. 2015 to Aug. 2016.They were divided into two groups according to their ultrasonic cardiograms: the group of coronary artery damage(group A,28 children) and the group of no-damage to coronary artery(group B,37 children). A total of 55 children with respiratory infection complicated with fever treated in our hospital during the same period were included as the respiratory infection group(group C). Another 40 healthy children were chosen as the control group. The children with confirmed diagnosis of Kawasaki disease received pulse therapy with venous injection of large dose of immunoglobulin(2 g/kg). After one week, the level of NT-proBNP in each group was detected and the level of procalcitonin in children with Kawasaki disease before and after treatment was also detected. Results The level of NT-proBNP in group A and B was higher than that in group C and the control group(P<0.01). There was no statistical difference on NT-proBNP level between group B and group C(P>0.05), while its level in group A was higher than that in group B, group C and the control group (P<0.05).After treatment with venous injection of immunoglobulin, procalcitonin level was significantly lower than before treatment, and there was statistical difference(P<0.01). Conclusion Serum NT-proBNP level has some value in distinguishing Kawasaki disease from some common infections, and it's a sensitive indicator in predicting the coronary damage in Kawasaki disease. Procalcitonin level is significantly increased in Kawasaki disease, especially at acute stage; however it needs to be proved by more samples whether it is a risk factor of coronary artery damage. Related Articles | Metrics

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Risk factors of severe hand-foot-mouth diseased complicated with heart and lung function failure in children and the observation on the therapeutic effect MA Yongtao, ZHAO Hong, XU Huimin, LI Yuping 2017, 9 (4):  304-307.  doi: 10.3969/j.issn.1674-3865.2017.04.010 Abstract ( 523 )   PDF (529KB) ( 122 )   Save Objective To study the risk factors of severe hand-foot-mouth diseased(HFMD) complicated with heart and lung function failure in children and the therapeutic effect. Methods A total of 108 HFMD children were treated in Kaifeng Children's Hospital from May 2015 to May 2016,and they were randomly divided into two groups: two-drug group and three-drug group, with 54 children in each. There were 45 cases with heart and lung failure and 9 cases without heart and lung failure in each group. The treatment of two-drug or three-drug was performed according to the disease condition. Xiyanping injection and gamma globulin were used in the two-drug treatment group; Xiyanping injection, gamma globulin and mannitol or milrinone or dobutamine were used in the three-drug group. Analyze the risk factors of the HFMD children complicated with heart and lung failure; observe the clinical effect, complications, mortality, average hospital stay, recovery time of myocardial enzyme, and the time to withdraw respirator. Results The total effective rate in three-drug group was 100.0%(54/54),significantly higher than the 83.3%(45/54) of the two-drug group, the difference being statistical(P<0.05).The incidence rate of complications and mortality in three-drug group was significantly lower than that in two-drug group(P<0.05).The average hospital stay, recovery time of myocardial enzyme and the time to withdraw respirator in three-drug group were all shorter than those in two-drug group(P<0.05). The hemodynamic change, EV71 infection, polypnea, disorders of consciousness and increase of troponin were of a higher proportion in children complicated with heart-lung failure than in those without, and the difference was of statistical significance(P<0.05).Multi-factor Logistic regression analysis showed that hemodynamic change, EV71 infection and polypnea were the independent risk factors. Conclusion The heart-lung function failure in Children with severe HFMD is mainly related to hemodynamic change, EV71 infection and polypnea. The three-drug treatment can achieve great effect, which lengthens the survival time of patients, improves the prognosis and meets the treatment demand. Therefore it should be popularized. Related Articles | Metrics

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Treatment for Kawasaki disease with no response to venous injection of gamma globulin and analysis of the risk factors MEI Ling 2017, 9 (4):  308-311.  doi: 10.3969/j.issn.1674-3865.2017.04.011 Abstract ( 764 )   PDF (487KB) ( 140 )   Save Objective To compare and analyze the risk factors of Kawasaki disease with no response to venous injection of gamma globulin and to summarize the treatment experience. Methods A total of 384 cases of Kawasaki disease in children were treated in our hospital from Feb. 2013 to Oct. 2016, including 310 typical cases and 74 incomplete cases. These children were divided into two groups according to their reaction to the treatment of venous injection of gamma globulin: sensitive group (352 cases) and no-response group (32 cases).For these 32 cases, the injection was performed again, or pulse therapy of large dose of hormone was given as an anti-inflammation and expectant treatment. Results The incidence rate of no-response Kawasaki disease was 8.33%(32/384);fever was relieved at (14.1±1.1)d; after 2 weeks of treatment, WBC, PLT, ESR and CRP were decreased significantly, but C-reactive protein was still a little higher than normal［(15.3±3.4)mg/L］. Ultrasound ECG revealed 8 cases of coronary dilation, but there was no such complications as arrhythmia. The fever course, ESR, GPT, the fever time after first injection of gamma globulin and the time of first injection of gamma globulin in the no-response group were higher than those in sensitive group, while Hb level after treatment was lower than sensitive group, the difference being statistically significant(P<0.05).Fever course was an independent risk factor［OR=1.48, 95%CI（2.41～6.17）,P<0.001］. Conclusion Long time of fever may be an important reason for no-response to first-time venous injection of gamma globulin. Therefore, it is necessary to use venous injection of gamma globulin properly, select an appropriate time for injection and give timely anti-inflammation and antipyretic treatment. Related Articles | Metrics

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Effect of montelukast combined with vitamin C in the treatment of children with allergic purpura DING Yunfeng,LI Zhihui,DUAN Cuirong,XUN Mai,WU Tianhui 2017, 9 (4):  312-314.  doi: 10.3969/j.issn.1674-3865.2017.04.012 Abstract ( 900 )   PDF (392KB) ( 116 )   Save Objective To investigate the clinical efficacy of montelukast combined with vitamin C in the treatment of allergic purpura in children. Methods From November 2014 to January 2010, 86 children with Henoch-Schonlein purpura were hospitalized and treated in the Department of Nephrotic Rheumatology, Hunan Children 's Hospital, and they were randomly divided into control group(43 cases) and observation group(43 cases). The control group was treated with montelukast orally taken. The observation group was treated with vitamin C in addition to monteleukast, and the treatment lasted for 7 days. The levels of plasma cytokine(interleukin 6, interleukin 8, tumor necrosis factor α) and adverse effects were compared between the two groups after treatment. Results The total effective rate was 95.35% (41/43) in the observation group, which was significantly higher than that in the control group (81.40%, 35/43), and the difference was statistically significant(P<0.05). After treatment, the level of interleukin 6,interleukin 8 and tumor necrosis factorα was significantly lower in the observation group than in the control group(P<0.05). The incidence of adverse events in the observation group was 2.33%(1/43),which was significantly lower than that of the control group(18.60%,8/43)(P<0.05). Conclusion The combination therapy of montelukast with vitamin C for children with Henoch-Schonlein purpura is effective and safe, with lower adverse reaction incidence. It is worthy of clinical application. Related Articles | Metrics

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Comparison of the effects of nasal intermittent positive pressure ventilation with continuous positive airway pressure for neonatal respiratory distress syndrome in very-low-birth-weight preterm infants ZHAN Qunliang，LING Hua，LIN Lin，CHEN Zhiwei 2017, 9 (4):  315-318.  doi: 10.3969/j.issn.1674-3865.2017.04.013 Abstract ( 486 )   PDF (424KB) ( 112 )   Save Objective To compare respiratory support treatment parameters and complications of nasal intermittent pressure ventilation(NIPPV) with nasal continuous positive airway pressure(NCPAP) in very-low-birth-weight(VLBW) preterm infants. Methods Totally 80 cases of VLBW premature infants were treated in the Second People's Hospital of Shantou from January 2015 to June 2016. They were included as the subjects and were randomly divided into two groups: NIPPV group and group B, each group having 40 cases. Non-invasive respiratory support time, total time with oxygen, 72h domestic replacement use of tracheal intubation and invasive ventilation, pulmonary surfactant use and complications were observed and recorded in detail. Results The rate of 72h domestic replacement use of tracheal intubation and invasive ventilation and the rate of pulmonary surfactant use in NCPAP group were 40% (16/40) and 62.5% (25/40, 17.5%), which were higher than that of NIPPV group［(17.5%,7/40) and (32.5%,13/40)］, the difference being statistically significant (P<0.05). There was no significant difference between the two groups in the time of non-invasive respiratory support and the total oxygen use time with the auxiliary ventilator(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion Compared with NCPAP, NIPPV has no significant difference in non-invasive respiratory support time, total oxygen use time and complications, but it can reduce the use of tracheal intubation and use of pulmonary surfactant. Related Articles | Metrics

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Efficacy of acupuncture combined with drug in the treatment of children with encephalitis sequelae HU Wenjing，LIAO Hongmei，CHEN Mei，FANG Hongjun 2017, 9 (4):  318-320.  doi: 10.3969/j.issn.1674-3865.2017.04.014 Abstract ( 532 )   PDF (367KB) ( 100 )   Save Objective To observe the effect of acupuncture combined with drugs in the treatment of children with encephalitis sequelae. Methods A total of 123 children with encephalitis sequelae, who were hospitalized for treatment in Hunan Children's Hospital from August 2011 to August 2016, were included as the research subjects. They were randomly divided into control group(60 cases) and observation group(63 cases). The control group was given mannitol to reduce the intracranial pressure, and at the same time, the conventional treatment of abatement of fever, sedation, dehydration and dieresis was performed; the children were also given okazepine tablets for orally taking, 150 mg per time, twice a day. The observation group received the same treatment; besides, acupuncture and acupoint injection were performed, 4 to 5 points per time, and aceglutamide(100 mg) was injected. One course lasted for 15d and the children in both groups received two courses of treatment. Compare the treatment effect and the incidence of epilepsy, mental retardation and disability between the two groups. Results In the observation group, the total effective rate was 96.8%(61/63), significantly higher than the control group(81.7%,49/60), the difference being statistically significant(P<0.05). In patients in the observation group the overall complication rate was 3.2%(2/63), significantly lower than the control group(18.3%,11/60), the difference being statistically significant(P<0.05). Conclusion In the treatment of sequelae of encephalitis in children, the combination of acupuncture and drug treatment can improve the treatment effect and reduce complications. Related Articles | Metrics

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Observation on the effect of pulmicort respulas and ventolin combined with methylprednisolone in the treatment of children with bronchiolitis LIU Yatao 2017, 9 (4):  321-323.  doi: 10.3969/j.issn.1674-3865.2017.04.015 Abstract ( 634 )   PDF (368KB) ( 100 )   Save Objective To observe the clinical effect of pulmicort respulas and ventolin combined with methylprednisolone in the treatment of children with bronchiolitis. Methods A total of 118 children with bronchiolitis were included in the study, who were treated in the Pediatric Department of Gongyi People's Hospital from Oct. 2013 to Oct. 2016. They were randomly divided into two groups：59 in observation group and 59 in control group. After admission to the hospital, they were given oxygen inhalation, antitussive and antiviral treatment, and those with viral infection were given antibiotic. In addition, the children in control group received budesonide suspension(plumicort respulas)(1 mg) and salbutamol sulfate inhalation aerosol(ventolin)(0.5 mL), which was mixed with normal saline(2 mL). Then it was inhaled by oxygen-driven method for about 10 minutes, once every eight hours, for continuously one week. The children in the observation group received the same treatment; besides, methylprednisolone injection was given through venous dripping,1～2 mg/kg, twice a day, for 3 day as a course. Observe the effect of the two groups, as well as the time for cough, asthma, wheezing and pulmonary rales to be relieved, determine the concentration of MCP-4 and follow up the incidence of adverse effects. Results The total effective rate in observation group was 98.3%(58/59),significantly higher than that in control group 86.4%(51/59), and the difference was statistically significant(P<0.05). The time for cough, asthma, wheezing and pulmonary rales to be relieved in the observation group was short than that in control group, and there was statistical difference(P<0.05). Concentration of MCP-4 decreased in both groups after treatment, which was even lower in the observation group(P<0.05). There was one case of hoarseness in the control group, while there was no adverse effect in the observation group, there being no statistical difference(P>0.05). Conclusion Pulmicort respulas and ventolin combined with methylprednisolone has significant effect in the treatment of children with bronchiolitis, and can shorten the time of relieving symptoms, which is currently safe and reliable, and worth promotion. Related Articles | Metrics

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Determination of prothrombin time and C-reactive protein in early childhood bacterial sepsis LUO Lan，YAO Zhenya，ZHU Desheng 2017, 9 (4):  324-326.  doi: 10.3969/j.issn.1674-3865.2017.04.016 Abstract ( 415 )   PDF (387KB) ( 125 )   Save Objective To investigate the diagnostic value of determination of prothrombin time(PT) and C-reactive protein(CRP) in early childhood bacterial sepsis. Methods From March 2015 to May 2016, 30 children with bacterial sepsis and 30 children with common fever were treated in Hunan Children's Hospital, and they were assigned to study group and control group respectively. The prothrombin time and C-reactive protein(CRP) concentration in peripheral blood of the two groups were detected and recorded 24 hours after onset, and the accuracy of diagnosis was compared. Results The prothrombin time and C-reactive protein in the study group were significantly higher than those in the control group(P<0.05). The combined determination of prothrombin time and C-reactive protein was more specific than either of the two indexes. The false-positive rate and specificity were decreased. Conclusion The combined detection of prothrombin time and C-reactive protein can improve the diagnosis specificity of early bacterial septicemia in children and reduce the false positive rate of diagnosis. It is helpful in the early diagnosis of the disease. Related Articles | Metrics

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Application of fiberoptic bronchoscopy in children with refractory wheezing MENG Yanni，CHEN Yanping，LI Xiulong 2017, 9 (4):  327-330.  doi: 10.3969/j.issn.1674-3865.2017.04.017 Abstract ( 1217 )   PDF (513KB) ( 137 )   Save Objective To find the cause of refractory wheezing by performing fiberoptic bronchoscopy in 82 children with such disease. Methods Totally 82 children with refractory wheezing in Hunan Children's Hospital from November 2013 to January 2016 were included as the subjects. The results of their fiberoptic bronchoscopy, etiology and complications were analyzed. Results A total of 82 children with refractory wheezing were examined by fiberoptic bronchoscopy，which showed that there were 30 cases of laryngomalacia，3 cases of congenital epiglottis cyst， 2 cases of subglottic scar formation and glottic insufficiency，1 case of congenital laryngeal web and 1 case of subglottic neoplasia. Trachea-bronchial abnormalities included 26 cases of tracheomalacia，1 case of papilloma of trachea，23 cases of trachea-bronchial stenosis，15 cases of trachea-bronchial foreign body，3 cases of tracheal bronchus，2 cases of bridging bronchus and 1 case of tracheoesophageal fistula. Totally 78 children underwent fiberoptic bronchoscopy and bronchoalveolar lavage fluid was obtained and cultured; bacterial culture was positive in 27 cases(34.6%)， and fungal culture was positive in 11 cases(14.1%). The most common complications of fiberoptic bronchoscopy were hypoxia and transient decline of heart rate; 5 cases had fever after operation. Conclusion Fiberoptic bronchoscopy is of great significance to the children with  refractory wheezing. Related Articles | Metrics

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Analysis of the correlation between the diagnosis of rickets and the detection of bone alkaline phosphatase in children TAN Qian 2017, 9 (4):  330-332.  doi: 10.3969/j.issn.1674-3865.2017.04.018 Abstract ( 486 )   PDF (337KB) ( 136 )   Save Objective To investigate the correlation between the diagnosis of rickets and the detection of bone alkaline phosphatase and the detection value. Methods A total of 62 cases of children with infantile rickets were selected in Hunan Children's Hospital who were hospitalized from October 2014 to January 2016 as the observation group，and another 62 cases of children with normal physical examination were selected at the same time in our hospital as the normal control group. The activity of bone alkaline phosphatase was detected by iodonitrotetrazole violet method；blood calcium was detected by azo arsenic method；the correlation between bone alkaline phosphatase and influential factors was analyzed. Results The detection rate of bone alkaline phosphatase abnormality in observation group was 96.77%(60/62)，which was significantly higher than that in normal control group(45.16%，28/62)，the difference being statistically significant(P<0.05); the detection rate of serum calcium abnormality in observation group was 22.58%(14/62)，which was significantly higher than that in normal control group(1.61%，1/62)，and the difference was statistically significant(P<0.05); Spearman correlation analysis showed that there was a positive correlation between seizure，picky eaters，sweating and lack of vitamin D and alkaline phosphatase activity(P<0.05). Conclusion The diagnosis of rickets in children is closely related to the activity of bone alkaline phosphatase，and the diagnosis of rickets can be completed by detection of bone alkaline phosphatase. Related Articles | Metrics

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Analysis of the etiology and clinical characteristics of pleural effusion in 226 children LI Linrui，YANG Min，CHEN Yanping 2017, 9 (4):  333-336.  doi: 10.3969/j.issn.1674-3865.2017.04.019 Abstract ( 464 )   PDF (473KB) ( 141 )   Save Objective To explore the etiology and clinical characteristics of pleural effusion in 226 children and to provide evidence for its clinical treatment. Methods The clinical data of 226 children with pleural effusion who were treated in Hunan Children's Hospital from Jan. 2013 to Jan. 2014 were including symptoms, signs, imaging examinations, and biochemical tests of pleural effusion. Results (1)Infectious factors ranked the first; there were 209 cases(92.5%,209/226) of infectious pleural effusion, and 172 cases were clinically considered as bacterial pleural effusion, of which the first diagnosis was severe pneumonia in 48 cases(22.9%), and measles with pneumonia in 3 cases(1.4%); there were 72 cases of Mycoplasma pneumniae infection(31.8%); 17 cases were irrelevant to infectious factors(7.5%).(2)Thoracentesis was performed in 50 cases, and 48 cases were in accordance with exudative change, 2 cases with leaking change.(3)There were 75 cases(33.2%) of positive phlegm culture.(4)Mycoplasma pneumoniae infection was obviously fewer in children under 3 than in those at or over 3 years old; tuberculous infection was only in the children over 7; the children at or under 3 years old accounted for higher proportion than before in Mycoplasma pneumonia infection.(5)Average hospital stay was 16d. Conclusion Infectious factors ranks the first in the causes of pleural effusion; the number of children with pleural effusion resulting from the same cause is different in different age groups, and the children at or under 3 years old account for higher proportion than before in Mycoplasma pneumoniae infection. The hospital stay of children with pleural effusion is comparatively long. Related Articles | Metrics

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Investigation and study of TCM constitution of healthy children aged 0 to 6 in Wuhan LIU Xiaoying, LAN Ke, WANG Yuanyuan, WANG Yichen, WANG Jun, HU Chenghua, ZHANG Hongyi, WAN Wenyue, CHEN Xingmei 2017, 9 (4):  336-339.  doi: 10.3969/j.issn.1674-3865.2017.04.020 Abstract ( 533 )   PDF (427KB) ( 154 )   Save Objective To work out a classification of TCM constitution at different ages by investigating the children aged 0 to 6 in Wuhan, in order to provide guidance for TCM health care in healthy children. Methods By cross-sectional survey, the healthy children aged 0 to 6 were divided into 4 age groups, and the questionnaire survey on TCM constitution was performed in them. Results A total of 350 valid questionnaires were collected, which showed that the distribution of mild constitution was 65%(228/350), biased constitution 35%(122/350).When the children grew older, the percentage of mild constitution was decreasing(84% to 52%), while that of biased constitution was increasing(16% to 48%), in which the percentage of combined constitution was increasing(0% to 30%). The constitution distribution of different age groups had their own features. In lung-deficiency constitution, the difference on Tebing constitution was of statistical significance(P<0.05),which meant that the lung-deficiency constitution was often combined with Tebing constitution. There was statistical difference on the probability of being biased constitution in the children whose parents only had middle school education or lower(P<0.05). Conclusion The distribution percentage of TCM biased constitution in children aged 0 to 6 in Wuhan increases with the increase of age and also becomes complex, and different age group has different features, which indicates that it is of practical significance to divide the children into 4 age groups. It also shows that attention should be paid to different points in different groups during the constitution intervention. In the treatment it's necessary to pay attention to different features and perform treatment based on constitutions differentiation in order to improve the effect. Related Articles | Metrics

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Nutritional status and influencing factors of 389 preschool children in Dadong District of Shenyang City LI Jinghui， REN Gang， ZHAN Jie， LI Jing， MA Lijie 2017, 9 (4):  340-342.  doi: 10.3969/j.issn.1674-3865.2017.04.021 Abstract ( 459 )   PDF (337KB) ( 377 )   Save Objective To investigate the nutritional status of preschool children in 4 kindergartens in Shenyang City， and to provide reliable for nutritional intervention in preschool children. Methods Height and weight were measured and Kaup index was cakulated in 389 preschool children in Dadong District. The food types and eating habits were surveyed by questionnaires. Analyze the relationship between the related factors and the nutritional status of children. Results In 389 cases of children the average Kaup index was 16.30±2.07， and it was 16.45±1.87 in the boys and 16.12±2.27 in the girls；the index was normal in 346 cases. There were 41 lean cases and 2 cases a little fat. The questionnaires showed that the causes of malnutrition in children were mainly: hating fish， meat， eggs， soybean， etc.，being picky eaters，eating slowly，not having three meals on time，and wrong idea about nutrition in parents. Conclusion Some preschool children in Dadong District of Shenyang city have the phenomenon of malnutrition. Related Articles | Metrics

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Analysis of 251 cases of disabled children in Huoqiu County TU Hongli，SHENG Zhuping，KE Jie，CHENG Qian. Department of Pediatrics 2017, 9 (4):  343-345.  doi: 10.3969/j.issn.1674-3865.2017.04.022 Abstract ( 647 )   PDF (343KB) ( 117 )   Save Objective To understand the main characteristics of disabled children in Huoqiu, and provide scientific basis for eugenics. Methods The relevant data of children who met medical standard for diagnosis of disabled children from August 2009 to August 2013 were collected and analyzed. Results Totally 251 cases of disabled children were enrolled. The proportion of males was 90%(226/251), and the proportion of agricultural household registration was 86.1%(216/251). There were 131 cases of hereditary diseases. The top 5 diseases were mental retardation and deafmutism(contributing equally), congenital heart disease, autism, Down's syndrome and idiopathic epilepsy (contributing equally). There were 120 cases of non-genetic diseases，and the top 5 diseases were cerebral palsy, brain hypoplasia, accidental injury, malignant tumor and secondary epilepsy. Conclusion The number of disabled children in the country is more than that in the city, and the proportion of male is far greater than that of female. Hereditary diseases are mainly mental retardation, deafmutism and congenital heart disease. Non-hereditary diseases are mainly cerebral palsy, brain hypoplasia and accidental injury. Related Articles | Metrics

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Professor Chang Ke's experience in treating children with spleen diseases by “Cleaning away heat and promoting transportation of spleen” HAN Shanshan，CHANG Ke 2017, 9 (4):  345-347.  doi: 10.3969/j.issn.1674-3865.2017.04.023 Abstract ( 559 )   PDF (437KB) ( 166 )   Save There is always deficiency in spleen in children, and because of exterior evil，heat produced by accumulated food, qi depression, sputum coagulation, blood stasis and accumulated heat，spleen was damaged, resulting in such spleen diseases as aptha, anorexia, diarrhea, indigestion and vomiting. Professor Chang Ke was able to treat some common spleen diseases in pediatrics effectively by "Clearing away heat and promoting transportation of spleen", based on the principles of "different disease, the same treatment" and "the same disease, different treatment". Special attention should be paid to three aspects in the treatment process:（1）clearing away heat from spleen and stomach;（2）regulating qi of spleen and stomach to recover function;（3）removing dampness as spleen likes dry environment rather than dampness. Related Articles | Metrics

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Experiences of professor Zhao Kun on treatment of summer fever in children based on the theory of damp-warm syndrome LI Gang，LIU Xiaojing，ZHAO Kun 2017, 9 (4):  348-349.  doi: 10.3969/j.issn.1674-3865.2017.04.024 Abstract ( 404 )   PDF (400KB) ( 99 )   Save Summer fever is a common disease in children, and its pathogeny is related to the improper development of thermotaxic centers in childhood in most cases. The characteristics of summer fever is various, including being obviously seasonal, lingering illness,ineffective treatment with antibiotics and so on. This disease belongs to the damp-warm syndrome in Chinese medicine, according to Professor Zhao Kun, who thinks that the pathogeny contains external cause, internal cause or  both of them. The visceral lesions mainly involve spleen and stomach, and the key of pathogenesis is obstruction of flow of qi and dampness blockage. Regulating the movement of qi of the spleen and stomach should be emphasized throughout the whole treatment. It can achieve good effect in clinics to make clear the location of the lesion and the seriousness of dampness and heat, and to make comparison between healthy qi and pathogenic qi in choosing the proper treatment. Related Articles | Metrics

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Experience in using coptis and lithospermum in the treatment of Henoch-Schonlein purpura related to Helicobacter pylori XU Shanshan，SUN Yang，DI Jiaqi，DING Ying 2017, 9 (4):  350-353.  doi: 10.3969/j.issn.1674-3865.2017.04.025 Abstract ( 477 )   PDF (536KB) ( 132 )   Save Henoch-Schonlein Purura is a common vascular disease，with gastrointestinal symptoms as main manifestations. In recent years a growing number of studies have shown that the relationship between Henoch-Schonlein purura and Helicobacter pylori is close. Thus people pay more and more attention to it. Professor Ding Ying uses coptis and lithospermum properly in the treatment of Henoch-Schonlein purpura related to Helicobacter pylori，achieving the effect of activating blood and removing blood stasis，which is very good. Related Articles | Metrics

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Experiences of Professor Zhao Kun on the treatment of bronchiolitis obliterans at different stage LIU Xiaojing，HAN Yuxia,ZHAO Kun 2017, 9 (4):  353-355.  doi: 10.3969/j.issn.1674-3865.2017.04.026 Abstract ( 376 )   PDF (422KB) ( 102 )   Save Bronchiolitis obliterans is a syndrome of chronic airflow obstruction associated with inflammatory damage to small airway, which is an irreversible chronic obstructive pulmonary disease. Professor Zhao thinks that in this disease, deficiency of Yang is the root cause while stasis of phlegm and blood is the superficial cause. Therefore it is emphasized to perform treatment according to different stages: at the preliminary stage, differential treatment is needed; at the middle stage, reducing phlegm and removing stasis should be done; at the last stage, Yang must be strengthened. This method is proved to be clinically effective. Related Articles | Metrics

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Experience of Professor Yan Yongbin in treating the fever of unknown origin with Ganlu Xiaodu micropills AN Lanhua，LI Xinxin 2017, 9 (4):  356-358.  doi: 10.3969/j.issn.1674-3865.2017.04.027 Abstract ( 607 )   PDF (374KB) ( 115 )   Save The long-term fever of unknown origin(FUO) is a common pediatric disease，whose etiology is complex and clinical diagnosis is difficult. This paper expounds Professor Yan Yongbin′s theory in treating FUO based on damp-warm syndrome，who sticks to the TCM theory and refers to the western medicine, stating clear the etiology and pathogenesis and properly using Ganlu Xiaodu micropills. This medicine results in significant clinical effect through clearing heat and toxin and eliminating dampness. It not only expands the scope of application but also innovates and develops the TCM theory on FUO. Related Articles | Metrics

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"Being dry and crazy，all belong to fire"——Professor Chang Ke's experience in treating heart-fire flaming of attention deficit hyperactivity disorder in children CHEN Jiaojiao， JIANG Wenjie，RAN Xiaoce， CHANG Ke 2017, 9 (4):  358-360.  doi: 10.3969/j.issn.1674-3865.2017.04.028 Abstract ( 676 )   PDF (415KB) ( 181 )   Save Professor Chang Ke's treatment for heart-fire flaming of attention deficit hyperactivity disorder(ADHD) is based on the theory of excess of heart-fire, who believes that heart-fire flaming is also an important cause of ADHD. For these children, the treatment should mainly be clearing heart-fire and cooling blood, and Yunü Xinjing decoction can be used. In the treatment of ADHD, it must be remembered to weaken most of it and then stop. This is an unconventional method, which makes the disease differentiation more detailed and the treatment more targeted. This treatment method is much appreciated in clinics and provides some reference for the clinical treatment for ADHD. Related Articles | Metrics

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Professor Ding Ying's experience in differentiated treatment for children with nephrotic syndrome WANG Long，GAO Min，DING Ying 2017, 9 (4):  361-362.  doi: 10.3969/j.issn.1674-3865.2017.04.029 Abstract ( 437 )   PDF (374KB) ( 125 )   Save Based on years of clinical experience and correct understanding of the etiology and pathogenesis of childhood nephritic syndrome, Prof. Ding Ying has made a prescription for the disease by herself. She puts forward the hormone-Chinese medicine sequence therapy, according to the disease's etiology of being mixed of root causes and symptoms (deficiency in root with actual symptoms), to adjust the Yin-Yang imbalance in children. During the whole process of treatment, attention is paid to promoting blood circulation to remove stasis and tripterygium glycosides is used properly. In treatment it's also necessary to clear the origin and the process in order to reduce the relapse of the disease. This paper summarized Prof. Ding Ying' experience in the treatment of children with nephrotic syndrome, which is of great clinical and theoretical significance. Related Articles | Metrics

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Treatment with Herba agrimoniae for primary immune thrombocytopenia in children ZHAI Wensheng，ZHAI Panpan，LI Le 2017, 9 (4):  363-365.  doi: 10.3969/j.issn.1674-3865.2017.04.030 Abstract ( 644 )   PDF (390KB) ( 112 )   Save Primary immune thrombocytopenia is a common hemorrhagic disease in childhood. It is generally believed that the pathogenesis of this disease is excessive destruction of platelets and decreased production of platelets. In the many years of clinical practice, we have used the convergence and hemostatic effect of Herba agrimoniae in the treatment of this disease in children and achieved satisfactory results. One typical case was presented here for verification. Related Articles | Metrics

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The evolution of five elements in pathogenesis of pediatric pulmonary diseases and its treatment HAN Yuxia，LI Gang 2017, 9 (4):  366-368.  doi: 10.3969/j.issn.1674-3865.2017.04.031 Abstract ( 490 )   PDF (426KB) ( 123 )   Save In the theoretical system of traditional Chinese medicine, the theory of five elements plays a very important role. The physiological connection between the five internal organs is often analyzed through generation and restriction of the five elements, and the interaction of five internal organs is always explained by the invasion-insult of the five elements and the mother-child regulation. An organ is damaged, the other organs will be damaged, too. This article, based on lung diseases, respectively discussed the etiology and pathogenesis of lung diseases infecting the spleen, the liver, the kidney, and the heart by using the theory of five elements. Besides, according to the generation and restriction of five elements used in the analysis of the five organ diseases, the article talked about the treatment ways of supplementing mother and draining child, restricting the mother and draining child, restricting the strong and supporting the weak, in order to provide reference for clinical treatment. Related Articles | Metrics