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ISSN 1674-3865  CN 21-1569/R
主管:国家卫生和计划生育委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

Table of Content

    25 December 2021, Volume 13 Issue 6 Previous Issue    Next Issue
    Effects of preterm delivery on early language, sleep and cognitive development of infants
    LIU Fang, ZHANG Wenliu, TAN Lijun, LEI Yanbo, HUANG Lihua, NONG Ruizhen
    2021, 13 (6):  461-464.  doi: 10.3969/j.issn.1674-3865.2021.06.001
    Abstract ( 602 )   PDF (736KB) ( 343 )   Save
    Objective To investigate the effect of preterm delivery on early language, sleep and cognitive development in infants.Methods From September 2019 to September 2020, 34 premature infants aged 12 to 36 months who visited the high-risk infant clinic of Liuzhou Hospital of Traditional Chinese Medicine were selected as the study group, and 124 infants born at term who had no high-risk factors during the routine physical examination of the child care clinic during the same period were selected as the control group.The Early Language Development Process Scale(EIMS) was used to evaluate the language development, the Brief Sleep Questionnaire for Infants and Young children(BISQ) was used to investigate the sleep status, and the neuropsychological scale for children aged 0 to 6 years was used to evaluate the intelligent cognitive development of the two groups.Results There were statistically significant differences in the total developmental quotient and the three subscale developmental quotients of the two groups(P<0.05).There were statistically significant differences between the two groups in the latency to sleep and the duration of nocturnal awakenings, the study group being longer than the control group(P<0.05). There were no statistically significant differences in the duration of daytime sleep, duration of night sleep, total duration of 24-hour sleep, or the number of nocturnal awakenings(P>0.05).In cognitive development, there were statistically significant differences in developmental quotient of the four functional areas of fine movement, adaptability, language and social interaction, the study group was lower than the control group(P<0.05).There was no statistically significant difference in the development quotient of major motor energy regions(P>0.05).Conclusion The development of preterm infants is different from that of full-term infants in terms of early language and latency at night, so early intervention should be given, to promote the neural development and maturity of preterm infants and improve the long-term prognosis.Combined assessment of early language development and sleep function may serve as a warning indicator for early screening of brain development in infants at high risk of premature delivery.
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    Analysis of prevalence and risk factors of language development delay in preschool children in some urban areas of Zhengzhou from 2017 to 2019
    SHAN Dandan, LIU Xiaojuan, BAI Yinyan
    2021, 13 (6):  465-468.  doi: 10.3969/j.issn.1674-3865.2021.06.002
    Abstract ( 540 )   PDF (732KB) ( 413 )   Save
    Objective To analyze the prevalence and risk factors of language development delay in preschool children in some urban areas of Zhengzhou from 2017 to 2019.Methods The kindergartens under the jurisdiction of Zhongyuan District, Erqi District and Guancheng District of Zhengzhou City were involved as the study sites. Random cluster sampling was conducted from 2017 to 2019 and early screening diagnosis was performed, and 7 800 preschool children (aged 3 to 6 years old) form 50 kindergartens were selected as the research subjects. According to the language development quotient, sound, auditory brainstem response(ABR) and S-S method of Gesell Developmental Diagnostic Scale, the prevalence of language developmental delay in children was evaluated comprehensively. A demographic questionnaire developed by our hospital was distributed to learn about the general data of preschool children with language development delay and their family members concerning gender, age, occupation and education level. Univariate and multivariate Logistic regression models were used to analyze the risk factors.Results Among 7 800 preschool children, there were 480 cases suffering from language development delay, accounting for about 6.15%. The incidence rate of language delay in boys was 6.47% (247/3 816), which was higher than that of girls (5.85%,233/3 984), but the difference was not statistically significant(P=0.25). The incidence rate of language delay of children aged 3 to 4 was 6.21%(156/2 512), slightly higher than 6.18%(162/2 623) for 4 to 5 years old and 6.08%(162/2 665) for 5 to 6 years old, but the difference was not statistically significant(P=0.843). Univariate analysis showed that parental childbearing age(low), parental educational level(low), family intimacy(poor), family composition(>3 persons), family monthly income(<8 000 yuan), parenting style(spoiling,leaving children alone and mixing) and neonatal diseases were all risk factors for language development delay. According to multivariate Logistic regression model analysis, father's childbearing age(<22 years old), monthly income level(<8 000 yuan),parenting styles such as spoiling, leaving children alone and mixing and neonatal diseases were independent risk factors for language development delay;the democratic parenting style and excellent family intimacy were the protective factors.Conclusion As for preschool children with language development delay, it is necessary to pay special attention to boys aged 3 to 4 years old. Since many of the independent risk factors are social factors, it is necessary to emphasize the family support during the treatment process to help improve language development delay.
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    Mechanism of p38MAPK signaling pathway mediating miR-21 in renal ischemia-reperfusion injury
    LIU Lianhong, LI Zhihui
    2021, 13 (6):  468-472.  doi: 10.3969/j.issn.1674-3865.2021.06.003
    Abstract ( 304 )   PDF (868KB) ( 64 )   Save
    Objective To study the functioning mechanism of microRNA-21(miR-21) and p38MAPK signaling pathway in renal injury of ischemia reperfusion(IR).Methods Male C57BL/6J mice were divided into four groups based on whether IR was performed: blank control group, IR group, sham operation group and ischemia preconditioning+ischemia reperfusion group (IPC+IR group).Then they were each divided to 8 subgroups according to different time points after IR(0min,5min, 30min, 45min, 2h, 12h, 24h, 48h). Analyze the renal tissue, miR-21 level, expression level of p38MAPK and p-p38MAPK protein, and pathological injury of kidney.Results (1)Pathology of kidney:there was no obvious renal injury in the blank control group;pathology injury of kidney gradually appeared after IR in IR group and sham-operation group, which peaked at 24h and gradually recovered; after ischemic preconditioning, the tendency of pathological injury of kidney in IPC+IR group was parallel to that in IR group, but the injury of each subgroup was milder than IR group, and there was statistical difference in the score of renal tubular pathological injury between IPC+IR group and IR and sham-operation group(P<0.01). (2)p38MAPK expression level: there was no statistical difference in the relative expression level(p-p38MAPK/β-actin) among the groups at the 8 time points(P>0.05). (3)The relative expression level of p-p38MAPK(p-p38MAPK/p38MAPK):there was no obvious expression in blank control group; in IR group, the relative expression level of p-p38MAPK increased rapidly at 15min after IR and peaked at 2h, and remained at a relatively high level afterwards.After ischemic preconditioning, the tendency of the relative expression level of p-p38MAPK in IPC+IR group was parallel to that in IR group,and the level peaked at 2h, but it was lower in each of the 8 subgroups than in the IR group and sham-operation group, the difference being statistical(P<0.01).(4)Expression level of miR-21:in IR group, with time passing, miR-21 expression increased at 5min after IR and peaked at 24h,being 15.2 times that of baseline, and remained at a relatively high level, while there was no obvious change in miR-21 expression level in blank control group. After ischemic preconditioning,in IPC+IR group, the  expression level of miR-21 remained at the peak level of the IR group at each time points within 48h, which was about 14.8 times that of that of the baseline level,and there was statistical difference between IPC+IR group and sham-operation and IR group(P<0.01).Conclusion The possible mechanism of ischemic preconditioning in protecting kidney may be to upregulate miR-21 and inhibit the phosphorylation of p38MAPK in order to reduce the expression of the related downstream inflammatory mediators of p38MAPK signaling pathway.
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    Progress in the external treatment of traditional Chinese medicine for children with pneumonia
    HUANG Mengxue, DU Linlin
    2021, 13 (6):  473-476.  doi: 10.3969/j.issn.1674-3865.2021.06.004
    Abstract ( 598 )   PDF (724KB) ( 1561 )   Save
    Pneumonia is one of the common respiratory system diseases in children. External treatment of traditional Chinese medicine(TCM) has certain advantages. The author reviewed the literatures on the external TCM therapies in recent years and made a brief summary of nine aspects, including acupoint application of traditional Chinese medicine, pediatric massage, cupping, enema with Chinese herbs, Chinese medicine iontophoresis, acupuncture, foot bath with Chinese medicine, microwave irradiation, and auricular point pressing with bean. This article summarizes the progress in order to provide reference for the treatment of pediatric pneumonia.
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    Theoretical mechanism of "Tiaofu Tongluo" combined probiotics in improving brain injury sequelae in neonatal

    WEI Yuhui, LI Ruishi, HE Si, FENG Zhaocai
    2021, 13 (6):  476-479.  doi: 10.3969/j.issn.1674-3865.2021.06.005
    Abstract ( 447 )   PDF (731KB) ( 316 )   Save
    Through combing the recent related literatures, a study is conducted on the theory and feasibility of carrying out the therapy of "Tiaofu Tongluo" combined with probiotics to improve the brain injury sequelae in the neonates with the starting point of the role of pro-inflammatory factors in brain injury and the role of probiotics in improving the central nervous injury by inhibiting the expression of pro-inflammatory factors.
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    Analysis of global registration of clinical trials in children with idiopathic nephrotic syndrome
    WANG Xiaoran, ZHENG Pan, SUN Shijie
    2021, 13 (6):  480-484.  doi: 10.3969/j.issn.1674-3865.2021.06.006
    Abstract ( 322 )   PDF (846KB) ( 258 )   Save
    Objective To analyze the clinical research characteristics of clinical trial registration of idiopathic nephrotic syndrome in children at home and abroad.Methods The clinical trials about idiopathic nephrotic syndrome in children published from September 31, 2020 were collected by ICTRP, an international clinical trial registration platform, and the database was established. The number of clinical trial registration, distribution, trial design, intervention measures and outcome indicators were analyzed.Results A total of 129 related clinical trials were retrieved, which were mainly carried out in India(23.3%), China(13.2%) and Japan(13.2%). The sponsors were mainly universities and medical institutions(68.5%). Most of the studies were intervention clinical studies(76.7%), more than half of which were randomized controlled trials(58.1%). Most of the trial stages were concentrated in stage Ⅲ(28.7%). The main intervention measures were western medicine(97%), and there were 2 items of traditional Chinese medicine intervention and one special diet. The main outcome indicators included the time of first recurrence, clinical remission rate (including partial remission and complete remission) and urinary protein.Conclusion Since 2005, the number of clinical trials registered in children with idiopathic nephrotic syndrome has increased as a whole, but the number of registrations varies greatly in different regions, and the registration information of some trials is incomplete. There is an urgent need to improve the awareness of registration, standardize the registration information of clinical trials, and further strengthen the related researches on clinical standardized management, individualized treatment, genomics and traditional Chinese medicine intervention in children with idiopathic nephritic syndrome.
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    Characteristics of early intestinal flora in neonatal asphyxia
    ZHANG Huating, YIN Di, CHEN Yihuan, GONG Xiaohui, QIU Gang, HU Yong
    2021, 13 (6):  485-488.  doi: 10.3969/j.issn.1674-3865.2021.06.007
    Abstract ( 484 )   PDF (777KB) ( 368 )   Save
    Objective To investigate the characteristics and explore the clinical significance of intestinal flora in asphyxiated neonates.Methods Seven neonates with asphyxia were chosen from Shanghai Children's Hospital as asphyxia group,and 11 healthy neonates were included in the control group. The 16S rRNA sequencing was used to study the difference in intestinal micro-ecology in neonates with asphyxia.Results The diversity index of flora in the neonates with asphyxia was higher, and the dominant bacteria were Clostridium, Veillonella, Lunamonomonas, Anaerobic Sclerotium, and Boschia. Those in the neonates of the control group were Gemini, Streptococcus granulosus, Sarcobacteria, Haemophilus, and Pasteuraceae.Conclusion This study has confirmed that there are significant differences in the intestinal flora between the two groups. Asphyxia may play an important role in the colonization of early intestinal flora in neonatal asphyxia, and may further become a cause of gastrointestinal dysfunction.
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    Expressions of serum sICAM-1 and CD40L in children with Mycoplasma pneumoniae pneumonia and their correlation with prognosis
    YANG Ying, LIU Yakun, DONG Tianjin
    2021, 13 (6):  488-492.  doi: 10.3969/j.issn.1674-3865.2021.06.008
    Abstract ( 521 )   PDF (756KB) ( 212 )   Save
    Objective To detect the levels of serum soluble intercellular adhesion molecule-1(sICAM-1) and CD40 ligand(CD40L) in children with Mycoplasma pneumoniae pneumonia, and to explore the relationship between their expression levels and prognosis.Methods A total of 146 children with Mycoplasma pneumoniae pneumonia treated in our hospital from February 2019 to May 2020 were selected as the research subjects, and they were divided into mild group(74 cases) and severe group(72 cases) according to the severity Mycoplasma pneumoniae pneumonia; meanwhile, 78 healthy children were selected as control group. The levels of serum sICAM-1, CD40L, inflammatory factors C-reactive protein(CRP) and procalcitonin(PCT) were detected by enzyme-linked immunosorbent assay (ELISA); the forced expiratory volume in the first second(FEV1) and forced vital capacity(FVC) were measured by lung function instrument, and FEV1/FVC ratio was calculated; the correlation between serum sICAM-1, CD40L and inflammatory factors and pulmonary function in children with Mycoplasma pneumoniae pneumonia was analyzed; the prognostic factors of Mycoplasma pneumoniae pneumonia in children were analyzed.Results The levels of serum sICAM-1, CD40L, CRP and PCT in severe group were higher than those in mild group and control group, FEV1 and FEV1/FVC were lower than those in mild group and control group; the levels of serum sICAM-1, CD40L, CRP and PCT in mild group were higher than those in control group, and FEV1 and FEV1/FVC were lower than those in control group(P<0.05). Serum sICAM-1 and CD40L were positively correlated with CRP and PCT in children with Mycoplasma pneumoniae pneumonia, and negatively correlated with FEV1 and FEV1/FVC(P<0.05). The levels of serum sICAM-1, CD40L, CRP and PCT in children with Mycoplasma pneumoniae pneumonia in the poor prognosis group were higher than those in the good prognosis group, while the levels of FEV1 and FEV1/FVC in the poor prognosis group were lower than those in the good prognosis group(P<0.05). sICAM-1 and CD40L were independent risk factors of poor prognosis in children with Mycoplasma pneumoniae pneumonia(P<0.05).Conclusion The expression levels of serum sICAM-1 and CD40L in children with Mycoplasma pneumoniae pneumonia are increased significantly with the severity of the disease, and they are closely related to the prognosis of the children. Both of them may be of important value in auxiliary evaluation of pulmonary function and prognosis of children with Mycoplasma pneumoniae pneumonia.
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    Effect of EEG biofeedback therapy combined with learning task training on clinical symptoms of children with ADHD
    WU Mei, ZHONG Yan, ZHAO Sha, WU Zongwen
    2021, 13 (6):  493-496.  doi: 10.3969/j.issn.1674-3865.2021.06.009
    Abstract ( 716 )   PDF (729KB) ( 739 )   Save
    Objective To explore the effect of EEG biofeedback therapy combined with learning task training on the clinical symptoms of children with attention deficit hyperactivity disorder (ADHD).Methods A totally of 157 children with ADHD were selected, who were diagnosed in this hospital from Jan.2018 to Jan. 2020, and they evaluated by continuous attention test, Conners Child Behavior Scale and ADHD screening scale (SNAP-IV)-parent version before and after EEG biofeedback therapy combined with learning task training.Results The number of errors, the number of missing reports and the reaction time in the results of continuous attention test after treatment were lower than those before treatment(P<0.05).Conners Child Behavior Scale showed that hyperactivity indexes decreased, and there was some improvement in behavior and psychosomatic, learning, anxiety, impulsivity/hyperactivity problems after treatment(P<0.05). SNAP-IV scale showed that the symptoms of inattention and hyperactivity/impulsivity were improved after treatment(P<0.05).Conclusion EEG biofeedback therapy combined with learning task training is effective in the treatment of children with ADHD, which can improve the clinical symptoms of children, and is conducive to further control of hyperactivity, impulsivity and inattention.
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    Level and significance of C-reactive protein, platelet parameters and undercarboxylated osteocalcin in children with Kawasaki disease complicated with coronary artery lesions
    LI Shujuan, LIANG Hong, CHEN Xiaoyi
    2021, 13 (6):  496-499.  doi: 10.3969/j.issn.1674-3865.2021.06.010
    Abstract ( 385 )   PDF (760KB) ( 199 )   Save
    Objective To investigate the serum C-reactive protein(CRP) level, platelet count(PLT) and undercarboxylated osteocalcin(ucOC) levels in children with Kawasaki disease complicated with coronary artery lesions(CALs) and its significance.Methods Totally 72 cases(observation group) of children with Kawasaki disease treated in our hospital from September 2017 to September 2019 were selected, and 70 healthy children receiving physical examination during the same period were selected as the control group. The serum CRP, PLT and ucOC levels were detected, and the occurrence of CALs in children with Kawasaki disease was examined by echocardiography.Results The CRP and PLT in the observation group were significantly higher than those in the control group(P<0.05), while ucOC was significantly lower than those in the control group(P<0.05). There were 25 children with CALs by echocardiography. In the observation group, CRP in children with CALs was significantly higher than that in children without CALs(P<0.05), while ucOC was significantly lower(P<0.05). There was no significant difference in PLT between children with and those without CALs in observation group(P>0.05). The area under ROC curve of CRP and ucOC in diagnosing Kawasaki disease with CALs was 0.701 and 0.651(P<0.05).Cut-off values were 74.69 mg/L and 12.36 g/L, the sensitivity was 48.00% and 52.00%, and specificity was 87.23% and 89.36%, respectively.Conclusion CRP, PLT and ucOC levels are increased in children with Kawasaki disease complicated with CALs, among which CRP and ucOC has certain application value in diagnosing Kawasaki disease complicated with CALs.
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    Risk factors for the severity of bronchopulmonary dysplasia in very and extremely preterm infants
    GAO Qi, JIANG Haiyan, HE Haiying , LIU Lijun
    2021, 13 (6):  500-503 .  doi: 10.3969/j.issn.1674-3865.2021.06.011
    Abstract ( 615 )   PDF (733KB) ( 199 )   Save
    Objective To explore the risk factors affecting the severity of bronchopulmonary dysplasia(BPD) in very and extremely preterm infants in neonatal intensive care unit(NICU), and to provide theoretical evidence for the prevention and treatment of different degrees of BPD.Methods The research method of retrospective analysis was applied. The clinical data of 129 very and extremely preterm infants with  gestational age <32 weeks diagnosed with BPD in neonatal intensive care unit of our hospital from December 2013 to December 2018 were collected, and the infants were divided into grade Ⅰ BPD(33 cases),grade Ⅱ BPD(55 cases) and grade Ⅲ BPD(41 cases) according to the clinical diagnostic criteria. Univariate analysis was used to compare the maternal status, birth status, complications and treatment measures. To explore the independent risk factors influencing the severity of bronchopulmonary dysplasia in very and extremely preterm infants, multivariate Logistic regression analysis was used to analyze the significant factors of univariate analysis.Results Univariate analysis showed that there were statistically significant difference in birth weight, pulmonary hemorrhage, extrauterine growth retardation,  oxygen inhalation concentration >40%, blood transfusion ≥3 times, high frequency invasive mechanical ventilation and invasive mechanical ventilation time among the three groups. Multivariate Logistic regression analysis showed that pulmonary hemorrhage(OR=9.207,95%CI:0.151~4.289) and invasive mechanical ventilation time (OR=1.110,95%CI:0.021~0.188) were independent risk factors for BPD severity in very and extremely preterm infants.Conclusion The severity of BPD in very and extremely preterm infants is related to multiple factors. Pulmonary hemorrhage and invasive mechanical ventilation time are independent risk factors for BPD severity in very and extremely preterm infants. Prevention of pulmonary hemorrhage and reduction of invasive mechanical ventilation time are important measures to reduce the severity of BPD.
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    Effect of elbow joint functional exercise based on game mode on pain degree and elbow joint function in school-aged children with supracondylar fracture of humerus
    WU Huiling, YU Qing, LI Jiahui, NIU Xueqiang
    2021, 13 (6):  504-507.  doi: 10.3969/j.issn.1674-3865.2021.06.012
    Abstract ( 367 )   PDF (727KB) ( 180 )   Save
    Objective To explore the effect of elbow joint functional exercise based on game mode on the pain degree and elbow joint function of school-aged children with supracondylar fracture of the humerus.Methods A total of 97 school-age children with supracondylar fracture of the humerus in our department were divided into groups by random number table method. Forty-eight patients in the control group were given elbow flexion and swing rehabilitation training, and 49 patients in the observation group were given elbow joint functional exercise based on game mode; the effects were compared.Results The VAS score of the observation group was lower than that of the control group after 1 week and one month of training. The fracture healing time was lower than that of the control group. The rate of good joint function, score in joint range of motion, and degree of elbow joint pronation and supination were higher than the control group. The differences were statistically significant(P<0.05).Conclusion The elbow joint functional exercise based on game mode can effectively improve the range of motion of the elbow joint, reduce the pain degree, and increase the rate of good elbow joint function in school-age children with supracondylar humeral fractures.
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    Analysis of risk factors of influenza complicated with pneumonia in children
    MA Bingnan, LIN Jing, ZHOU Jiewen
    2021, 13 (6):  507-510.  doi: 10.3969/j.issn.1674-3865.2021.06.013
    Abstract ( 625 )   PDF (736KB) ( 308 )   Save
    Objective To explore the related risk factors of influenza complicated with pneumonia in children, in order to achieve early identification and perform  correct treatment.Methods A total of 446 cases of influenza in children hospitalized in Guangzhou Eighth People′s Hospital from April 2016 to March 2019 were retrospectively analyzed. They were divided into pneumonia group(n=212) and non-pneumonia group(n=234) according to whether they were complicated with pneumonia or not. Through consulting the relevant clinical data of the studied cases the research information was collected, including gender, age, fever, history of wheezing, chest imaging, blood routine, hsCRP, PCT, myocardial enzyme spectrum and medication. The factors which had statistical significance according to single-factor comparison were included in the multivariate Logistic regression analysis.Results The single factor comparison of clinical data between the two groups showed that there were significant differences in age<3 years old, fever>4 days, WBC<3×109/L, hsCRP>20 mg/L, PCT>2 μg/L and application of oseltamivir 48 hours after onset(P<0.05).Further multivariate Logistic regression analysis showed that age<3 years old, hsCRP>20 mg/L and application of oseltamivir 48 hours after onset were independent risk factors of influenza complicated with pneumonia in children.Conclusion For children with influenza with CRP>20 mg/L who have poor response to treatment,chest X-ray should be taken in time to exclude pneumonia. The children under 3 years should be given oseltamivir within 48 hours of onset, which is of great significance in reducing pneumonia and improving prognosis.
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    Changes and clinical significance of mean platelet volume in peripheral blood of children with immunoglobulin A vasculitis
    ZHANG Maoxia, MA Hong
    2021, 13 (6):  511-514.  doi: 10.3969/j.issn.1674-3865.2021.06.014
    Abstract ( 306 )   PDF (795KB) ( 96 )   Save
    Objective To analyze the relationship between MPV, RDW, PLT, NLR, PLR, MPR level and IgA vasculitis(IgAV) in children with IgAV.Methods A total of 179 children with IgAV were included as the research subjects, who were diagnosed and treated in the First Hospital of Shanxi Medical University from Jan. 2015 to Sep. 2020. They were divided into two groups based on whether there was multi-system damage: 89 IgAV children with multi-system damage in the observation group and 90 children with common IgAV in the control group. Pearson bivariate linear correlation analysis was adopted.Multivariate Logistic regression analysis was used to analyze the influencing factors of multi-system damage. ROC curve was drawn to make the analysis.Results The levels of MPV and MPR in the observation group were lower than those in the control group, while the levels of PLT and PLR in the observation group were higher than those in the control group(P<0.05).The level of MPV of the two groups were negatively correlated with PLT and positively correlated with MPR; MPV level was the influencing factor of multi-system damage. The levels of PLT, PLR and MPV of observation group were used to draw the ROC curve. The AUC of MPV, PLT and PLR were 0.128, 0.674 and 0.621, respectively, and the best cut-off values were 8.25, 308.50 and 123.17, respectively.Conclusion MPV, PLT and PLR in peripheral blood may have certain significance in evaluating the multi-system damage of IgAV.
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    Significance of serum uric acid, CysC and NT-proBNP in the detection of children with congenital heart disease and pulmonary arterial hypertension
    GU Bixi
    2021, 13 (6):  515-518.  doi: 10.3969/j.issn.1674-3865.2021.06.015
    Abstract ( 351 )   PDF (755KB) ( 84 )   Save
    Objective To explore the significance of serum uric acid, cystatin(CysC) and N-terminal pro brain natriuretic peptide(NT-proBNP) in the detection of children with congenital heart disease and pulmonary arterial hypertension(PAH-CHD).Methods A total of 126 children with congenital heart disease(CHD) who were treated in our hospital from January 2018 to December 2019 were enrolled, including 74 cases with pulmonary arterial hypertension(PAH, observation group) and 52 cases without PAH(control group). The levels of serum uric acid, CysC and NT-proBNP were determined. The levels of the three indexes were compared among children with different clinic opathological features. The predictive value of serum uric acid, CysC and NT-proBNP for PAH-CHD was evaluated by receiver operating characteristic(ROC) curves.Results The levels of serum uric acid, CysC and NT-proBNP in observation group were significantly higher than those in control group (P<0.05). The levels of serum uric acid, CysC and NT-proBNP were not related to gender, age or CHD types(P>0.05),but they were related to cardiac function grading and PAH severity(P<0.05).The results of ROC curves showed that AUC values of serum uric acid,  CysC, NT-pro BNP and their combination for diagnosis of PAH-CHD were 0.787,0.712, 0.815 and 0.874, respectively. AUC of combination diagnosis was higher than that of single index.Conclusion The diagnostic efficiency of serum uric acid combined with CysC and NT-proBNP is relatively higher for PAH-CHD, which is of certain clinical value.
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    Clinical diagnostic value of prenatal ultrasonographic scoring system in placenta previa with placenta accrete
    FAN Na
    2021, 13 (6):  519-521.  doi: 10.3969/j.issn.1674-3865.2021.06.016
    Abstract ( 299 )   PDF (719KB) ( 63 )   Save
    Objective To explore the clinical diagnostic value of prenatal ultrasonographic scoring system in placenta previa with placenta accreta.Methods Between August 2018 and August 2020, 78 pregnant women were admitted to this hospital, who were enrolled in this study. According to the pathological results, the subjects were divided into group A(34 cases with placenta previa and placenta accreta) and group B(44 cases with placenta previa but without placenta accreta). In group A, there were 11 cases of adhesion type, 14 cases of accrete type and 9 cases of penetrating type. The prenatal ultrasonographic scores of different groups and pregnant women with different types of accreta were compared, and the clinical value of prenatal ultrasonographic score in diagnosing placenta previa with placenta accreta was analyzed.Results The prenatal ultrasonographic scores of group A and group B were (3.85±0.54) and (0.35±0.11). It was found that group A had significantly higher scores than group B(P>0.05). The prenatal ultrasonographic scores of adhesion type, accreta type and penetrating type were (3.69±0.74), (3.88±0.56), and (3.91±0.65), showing no statistically significant differences(P>0.05). The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of prenatal ultrasonographic score in placenta previa with placenta accreta were 94.11%,93.18%, 91.42%, and 95.34%, respectively.Conclusion Pregnant women with placenta previa and placenta accreta have significantly higher prenatal ultrasonographic scores than others, suggesting that the prenatal ultrasonographic score has relatively high value in the diagnosis of placenta previa with placenta accreta.
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    Medication features of Professor Jia Liujin in treating children with chronic cough based on data mining
    WANG Panpan, CHEN Mei, YANG Lili, ZHANG Yan
    2021, 13 (6):  522-525.  doi: 10.3969/j.issn.1674-3865.2021.06.017
    Abstract ( 364 )   PDF (739KB) ( 698 )   Save
    Objective To study the medication features of Prof. Jia Liujin in treating children with chronic cough based on the TCM inheritance Auxiliary System(V2.5).Methods The prescriptions of 152 cases of chronic cough in children were collected, who visited Prof. Jia Liujin's in the Outpatient Department of Affiliated Hospital of Shanxi Medical University from May 2018 to May 2020.The case database was established by the TCM inheritance platform software. The association rules and complex system entropy clustering were employed to analyze the frequency of medication, the rules of prescribing and the novel formulars based on Prof. Jia Liujin's academic experience in treating children with chronic cough.Results A total of 377 prescriptions were screened and collected. Among 111 kinds of Chinese drugs, the frequency was over 30% for 20 drugs, including ginger pinellia, tangerine peel, poria cocos, platycodon grandiflorum, apricot, and herba ephedrae, the frequency of drug combination was over 40% was ginger pinellia-tangerine peel, ginger pinellia-poria cocos, and tangerine peel-poria cocos; the core prescription was San'ao decoction with Liujunzi decoction;meanwhile,8 novel formulars were developed.Conclusion The treatment of chronic cough in children by Prof. Jia Liujin is mainly based on the theory of "sputum and deficiency", and the medication is mainly for moistening tonification assisted by warming and smoothing. It is based on five organs and focuses on tonifying lung and spleen and eliminating evil.The medication is made based on clinical symptoms.
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    Clinical observation of Jianpi Yiqi decoction in the treatment of chronic cough of  lung-qi and spleen-qi deficiency in children
    WANG Hong, MA Yuanyuan, WANG Li, MENG Niuan, CHEN Guangkun
    2021, 13 (6):  526-529.  doi: 10.3969/j.issn.1674-3865.2021.06.018
    Abstract ( 455 )   PDF (726KB) ( 515 )   Save
    Objective To observe the clinical efficacy of Chinese medicine decoction in the treatment of chronic cough of lung-qi and spleen-qi deficiency in children.Methods Totally 93 children with chronic cough of lung-qi and spleen-qi deficiency were selected from the pediatric clinic of Anyang Hospital of Traditional Chinese Medicine who were treated from May 2019 to May 2020,and they were divided into 47 cases in the control group and 46 cases in the observation group.The control group was given routine symptomatic treatment, and the observation group was given oral Chinese medicine decoction on the basis of the treatment for the control group.The curative effect of TCM syndrome and TCM symptom score were compared between the two groups.Results After treatment, the curative effect of TCM syndrome in the observation group was better than that in the control group(P<0.05). The score of TCM symptoms in the two groups after treatment was less than that before treatment, and the score of TCM symptoms in the observation group was less than that in the control group, the difference being statistically significant(P<0.05).Conclusion Chinese medicine decoction in our hospital has good clinical effect on chronic cough of lung-qi and spleen-qi deficiency in children, and can be popularized and applied in clinic.
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    A systematic review of the effectiveness and safety of acupoint application in treating children with cough variant asthma
    LI Panpan, WU Liqun, LU Chen, XU Fangwei, CHENG Yuhang
    2021, 13 (6):  529-536.  doi: 10.3969/j.issn.1674-3865.2021.06.019
    Abstract ( 741 )   PDF (3158KB) ( 1903 )   Save
    Objective To systematically evaluate the effectiveness and safety of acupoint application in the treatment of children with cough variant asthma.Methods Relevant literatures on acupoint applications in treating cough variant asthma(CVA) in children were retrieved from electronic databases, including China National Knowledge Infrastructure(CNKI), WanFang Database , Chongqing VIP information Chinese scientific journals database(VIP), Chinese Biomedical Literature database(CBM), PubMed, Cochrane Library and EMbase database, from their inception till February 2020. Meta-analysis was conducted after extracting related data from the included studies.Results In total, 18 randomized controlled trials(RCTs) involving 1 407 children were selected for the meta-analysis. The analysis indicated that the total effective rate of acupoint applications in the treatment group was better than that in the control group. In terms of the pulmonary function test and ACT scores, the forced expiratory volume in one second(FEV1), forced expiratory volume in one second/forced vital capacity(FEV1/FVC), peak expiratory flow rate(PEF) and ACT scores were better in the treatment group than in the control group. Concerning immune function, IgM, IgG, and IgA values in the treatment group were significantly higher than those in the control group, while IgE values of treatment group were significantly lower. In terms of efficacy in the long run, the treatment group had lower rate of recurrent cough variant asthma and shorter duration spent in eliminating recurrent cough as compared to the control group. The differences in the above research results were statistically significant(P<0.05).Conclusion Acupoint applications can improve the overall efficacy of treatment in children with CVA, improve pulmonary ventilation, boost immunity, and reduce recurrence rate and shorten the duration spent in eliminating recurrent cough.
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    Efficacy of Jiedu Kaiqiao decoction combined with western medicine on purulent meningitis in children
    GUAN Xiaolei
    2021, 13 (6):  537-540.  doi: 10.3969/j.issn.1674-3865.2021.06.020
    Abstract ( 262 )   PDF (727KB) ( 150 )   Save
    Objective To explore the efficacy of Jiedu Kaiqiao decoction combined with western medicine on purulent meningitis in children.Methods A total of 122 children with purulent meningitis admitted to this hospital between August 2018 and September 2020 were selected, and they were randomly divided into the experimental group(61 cases, Jiedu Kaiqiao decoction combined with meropenem dripping) and the control group(61 cases, meropenem dripping).The treatment course was one week. The total effective rate, protein level, white blood cell count, cerebrospinal fluid pressure, procalcitonin(PCT), C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α) were compared between the two groups.Results The total effective rate was 95.08% in the experimental, which was higher than that of the control group(81.97%)(P<0.05). After treatment the level of protein, white blood cell count,cerebrospinal fluid pressure and the levels of PCT, CRP and TNF-α of experiment group were all lower than those of the control group(P<0.05).Conclusion Jiedu Kaiqiao decoction combined with meropenem can help relieve the inflammatory response and cerebrospinal fluid pressure, and reduce the white blood cell count and protein level of children with purulent meningitis, with significant clinical efficacy.
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    Professor Wang Xiafang's experience in the treatment of developmental behavior diseases in children
    CHEN Wen, CHEN Bailu, FENG Yulin
    2021, 13 (6):  540-542.  doi: 10.3969/j.issn.1674-3865.2021.06.021
    Abstract ( 295 )   PDF (709KB) ( 497 )   Save
    Professor Wang Xiafang, a tutor, combines disease differentiation with syndrome differentiation in the treatment of children's developmental behavior diseases, and uses the dialectical reasoning of excess and deficiency and yin and yang of viscera to treat the pathogenic factors such as phlegm, fire, wind and blood stasis. She has developed empirical prescription through long-term clinical practice, combined it with Zhongjing Empirical formula and paid attention to classification and staging treatment,which has achieved good results.
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    Treatment for functional dyspepsia in children based on the theory of "spleen dominating tiredness and spleepiness"
    LI Yaqun, TIAN Yunlong, WANG Jing
    2021, 13 (6):  542-545.  doi: 10.3969/j.issn.1674-3865.2021.06.022
    Abstract ( 437 )   PDF (754KB) ( 438 )   Save
    Functional dyspepsia is a common disease in childhood, which belongs to the category of "anorexia","stagnation","vomitting" and "abdominal pain" in traditional Chinese medicine(TCM) according to the differentiation of main symptoms, and the TCM differential treatment has its unique advantages. Director Wang Jing is good at dealing with spleen and stomach diseases in children and performs clinical diagnosis and treatment of functional dyspepsia based on the theory of "spleen-dominating tiredness and sleepiness" from the syndrome differentiation system of Qian Yi Wu Zang. Considering the changes in the pathogenic factors of the diseases, Director Wang Jing thinks that the pathogenic factors of exogenous evil causing functional dyspepsia in children have been reduced nowadays, while the pathogenic factors such as hand-foot-mouth disease and chicken pox have increased, and such disease causes as having too much greasy and raw food and emotional diet have increased significantly. As a result, the 3 most common clinical syndromes of functional dyspepsia in modern children are dysfunction of spleen in transportation, stagnation of liver invading spleen and comorbidity of lung and spleen. The treatment principle should be to soothing liver and strengthening spleen. Based on the Director's experience, a self-made digestive mixture has been developed in the hospital to strengthen spleen and assisting the transportation. In the digestive mixture, dried tangerine peel is used to strengthen spleen and promote transportation; Poriacocos is used to strengthen spleen and removing dampness; rice sprout, and malt are used to strengthen spleen and stimulate appetite, and promote digestion and regulate stomach. For the children with liver stagnation, Shichangpu and Yujing can be added to soothe liver and relieve stagnation. If there is comorbidity of hand-foot-mouth disease, while the lung qi is being dispersed during acute stage, spleen and stomach should also be dealt with, and the empirical formula of the Director's father for measles is used in combination with the digestive mixture with modification. During the relief period, it is necessary to nourish lung and strengthen spleen, and Huangqi(Astragalus) and Baizhu(Atractylodes) are added to the mixture for treatment.
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    Analysis of experience in differentiation treatment of children with refractory Henoch-Schonlein purpura
    ZHANG Mengmeng, ZHAI Wensheng, ZHANG Yaru, XING Lulu
    2021, 13 (6):  546-549.  doi: 10.3969/j.issn.1674-3865.2021.06.023
    Abstract ( 346 )   PDF (729KB) ( 452 )   Save
    Refractory Henoch-Schonlein purpura refers to a disease in which a large amount of skin purpura appears repeatedly in batches; the course of disease is more than three months, and no kidney, digestive tract or other important organs are involved. In the process of clinical treatment, the conventional method is often not effective and the disease recurs, so the children bear great mental and psychological pressure. By analyzing the clinical symptoms of different children in the long-term clinical practice, the authors summarized the core pathogenesis as imbalance of Ying and Wei, liver depression and spleen deficiency, accumulation of dampness and heat, and deficiency of viscera. Based on the three principles of "harmonizing,clearing,tonifying", the disease was treated by applying methods according to the symptoms, which achieved good clinical efficacy.
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    Investigation and analysis of the application status and quality control of pulmonary function testing in children in Guangdong Province
    LIU Yingfen, DENG Li, JIANG Wenhui, ZHANG Cansheng, FAN Huifeng, WU Peiqiong
    2021, 13 (6):  549-552.  doi: 10.3969/j.issn.1674-3865.2021.06.024
    Abstract ( 302 )   PDF (735KB) ( 133 )   Save
    Objective To investigate the application status and quality control of pulmonary function testing in children in Guangdong Province.Methods A total of 71 hospitals applied for the construction of standardized asthma outpatient service between May 1,2020 and Nov. 30,2020, and they submitted reports on the pulmonary function testing items for children, whose quality control  was analyzed.Results Among the 71 hospitals,31(43.66%) were Grade Ⅲ Level A, and  40(56.33%) were not.There were 50(70.42%) in the Pearl River Delta,10(14.08%) in north Guangdong,7(9.86%) in west Guangdong and 4(5.63%) in east Guangdong. Among the equipment for pulmonary function testing, spirometer(100%) and tidal breathing pulmonary function instrument(63.83%) were the most common; in the non-Grade Ⅲ Level A hospitals there were fewer impulse oscillometers and exhaled nitric oxide equipment(P<0.05). Among the testing items, routine pulmonary ventilation detection and tidal pulmonary function determination were the most common. The rate of performing bronchodilation testing, impulse oscillometer and exhaled nitric oxide detection in the non-Grade Ⅲ Level A hospitals was lower than that in Grade Ⅲ Level A hospitals(P<0.05). Totally 322 reports on routine pulmonary ventilation were received, of which 148 were from the non-Grade Ⅲ Level A hospitals, 174 were not. There were 124(83.78%) first-class quality control reports from Grade Ⅲ Level A hospitals and 108(62.07%) from non-Grade Ⅲ hospitals, 6(4.06%) and 23(13.22%) second-class reports and 18(12.16%) and 41(23.57%) fifth-class reports, respectively.The proportion of first-class reports was higher in Grade Ⅲ hospitals than in non-Grade Ⅲ hospitals, while the proportion of second-class and fifth-class reports was lower(P<0.05).Conclusion  The application status of pulmonary function testing for children in Grade Ⅲ Level A hospitals of Guangdong Province is better than that in non-Grade Ⅲ hospitals: the instruments are better and there are more testing items. There is deference among different regions: the Pearl River Delta is better than the north, west and east Guangdong. As for quality control of reports, the Grade Ⅲ hospitals are better than the non-Grade Ⅲ hospitals. Therefore, the pulmonary function testing needs to be further popularized, and the clinical application and quality control of reports should be strengthened. Systemized and standardized training is required to enable pulmonary function testing to better serve clinical diagnosis and treatment.
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