Objective To perform a follow-up study on psychomotor development in children conceived with assisted reproductive technology. Methods A control-matched study was done including 63 infants born after assisted conception (study group)and 65 natural conception infants(control group). The pregnant women agreed to participate in the study when they were at 28 weeks of gestation and were followed-up in a predefine schedule till delivery. The regular developmental assessment was done with the CDCC Scales of Infant Development for the children of two groups till they were 24 months old. Results The mean birth weight and length were lower in the study group than those of the control group. The incidences of preterm birth,low birth weight,and NICU admission were significantly higher in the study group than those of control group. However,these differences were not significant when only singletons were compared between two groups. No statistical differences were found in the mental development index(MDI)and psychomotor development index(PDI)between two groups. Conclusions Psychomotor development of children born after assisted conception is normal at 24 months of age. Since the incidences of preterm birth,low birth weight,and multifetation are significantly higher in children born after assisted conception,their general health and development should be followed up for a longer time.

To explore the role of cerebro-spinal flu id(CSF)glutamate and nitric oxide (NO) in the pathogenesis of neonatal hypoxic- ischemia encephalopathy (HIE), glutamate and NO in CSF were determined in 24 new born infants with HIE and 8 normal control infants, respectively. The results sh owed that the levels of glutamate and NO in CSF were significantly higher in the neonates with moderate and severe HIE than those in both of the control group an d neonates with mild HIE.There was an obviously positive relationship between le v els of glutamate and NO. It is concluded that glutamate and NO play an important role in the pathogenesis of neonatal HIE.

Objective To explore multiple recurrence of Kawasaki disease (KD).Methods The clinical data of one child with multiple recurrent KD in two years was retrospectively analyzed.Results A four-year boy had his ifrst episode of classic KD without coronary artery abnormality at 2 years old. He had since had four episodes incomplete KD within 2 years, all of which were manifested by fever accompanied with neck lymph node swelling, bilateral conjunctival congestion, red and chap lips and strawberry-like tongue. White blood cell count, C reaction protein, and erythrocyte sedimentation rate were all increased. No purulent changes of cervical lymph nodes were detected by ultrasound. After intravenous infusion with high doses of gamma globulin, the fever was brought down, and the duration of fever was 6~8 d. The fever free intervals between 2 adjacent episode were about 2.5, 1.5, 4.5, and 13.5 months. The clinical manifestations and genetic test results were not consistent with the periodic fever, aphthous stomatitis, pharyngitis, and cervical lymphadenitis syndrome (PFAPA).Conclusion Five episodes of KD within 2 years are rare and a long-term follow-up is warranted.

Objective To explore life quality of infants with eczema and their families before and after treatment. Methods The infants with eczema were divided into food allergic group (FA group,n=46) and non-food allergic group (N-FA group,n=47). The eczema was evaluated by the areas of eczema and severity index (EASI). After 2 months of standardized intervention, the quality of life before and after treatment were assessed by the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) and the Infant’s Dermatitis Quality of Life Index (IDQOL).Results There was no difference between the two groups in age, gender, family history of allergy and feeding patterns (allP?>?0.05). In FA group, there were 34 cases (73.91%) of egg allergy, 20 cases (43.48%) of milk allergy and 2 cases (4.35%) of carrot allergy. After the intervention, the scores of EASI, FAQLQ, and IDQOL were decreased obviously in the two groups, and there were statistical difference before and after treatment (P all< 0.05). Before treatment, the total score and each part of FAQLQ-PF in FA group was similar with N-FA group (P all?>?0.05); After two months of intervention, the total score of FAQLQ in FA group was higher than that in N-FA group (Z =2.83,P=0.005); the subscales of emotional impact, anxiety about food, and social/dietary restrictions were also signiifcantly different between FA group and N-FA group (Z=?2.13-2.89, allP< 0.05). Conclusions Parents of infants with food allergies are more likely to worry about infant's emotional changes and social, dietary restrictions. FAQLQ-PF is more speciifc for assessing the quality of life in food allergies.

Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is an autosomal recessive disease caused by SLC25A13 gene mutations, and is characterized by delayed jaundice clearance, liver dysfunction, and elevated aminoacidemia. The confirmed diagnosis depends on gene analysis. Citrin deficiency is one of the important causes of neonatal intrahepatic cholestasis in China. Recently more and more researches about NICCD were reported. The paper summarized the epidemiology, pathogenesis, clinical characteristics, and progresses in diagnosis and treatment of NICCD.

Objective To explore the clinical and pathological features, diagnosis and treatment of eosinophilic cystitis in children. Method The clinical data of 7 patients with eosinophilic cystitis admitted from 2012 to 2016 were retrospectively analyzed, and the related literature were reviewed. Results The median age of the 7 patients was 9 years, and clinical manifestations were urgent urination, frequent micturition, odynuria, hematuria, abdominal pain and nocturnal enuresis. Ultrasonography and CT examination showed thickened bladder wall and space occupying lesions.All the 7 children received bladder biopsy, and pathology was consistent with eosinophilic cystitis. Six of them were cured after 2 months of drug therapy, and the other one was cured by repeated drug treatment for 1 year.All patients were followed up for 3 months to 4 years until the abnormal symptoms of voiding disappeared and the abnormal changes of bladder disappeared by imaging examination. Conclusion Eosinophilic cystitis in children is a benign lesion, having extremely similar clinical manifestations to bladder tumor. Without biopsy, the diagnosis of eosinophilic cystitis can also be made according to the clinical manifestation, laboratory examination and treatment effect. The treatment for this disease mainly includes hormone, antihistamine and anti-inflammatory drugs.

Objective To investigate the characteristics and essential points of diagnosis and treatment of double trisomy 47,XXX/48,XXX,+8 combined Behcet disease, a rare inherited immunodeficiency disorder. Methods The clinical manifestations, karyotype analysis and gene test results of the patients were analyzed, and relevant literatures were reviewed. Results A 11-year-old girl presented repeated fever for more than 6 years, accompanied with recurrent genital herpes infection and oral apthosis, was clinically diagnosed with Behcet disease. Cytogentic and molecular karyotyping on peripheral lymphocytes demonstrated 47,XXX[12]/48,XXX,+8[18]. Conclusions Conventional karyotype analysis and chromosomal microarray analysis have a complementary role in the diagnosis of the disease. We conclude that patients with constitutional trisomy 8 and those with trisomy 8 confined to the bone marrow are both at increased risk of developing features of Behcet disease. The mechanism may relate to increased gene dosage of candidate genes for Behcet's disease on chromosome 8.

Objective We aimed to study the characteristics and risk factors for blood transfusion in very low birth weight infants (VLBWI). Methods Clinical data of 180 VLBWI, hospitalized from January, 2012 to June, 2016, were studied retrospectively. The infants were divided into two groups according to whether blood transfusion is administered or not. Two groups were compared with general information, diseases in hospital and treatment taken. Results Of the 180 VLBWI, 118 cases (65.6%) were diagnosed with anemia when hospitalized. 57 cases (31.7%) needed blood transfusion with a mean gestational age of 30.3±1.9 weeks and a mean birth weight of 1233.3±123.7 g, The first time to blood transfusion ranged from 2 to 5 weeks after birth, transfusion volume 20ml/Kg once. Fourty-eight (48) cases (84.2%) only took blood transfusion once. Birth weight, gestational age, basal hemoglobin, hematocrit, volume of blood taking before transfusion, duration of hospitalization, duration of continuous positive airway pressure, duration of paraenteral nutrition, duration of vasoactive drugs used, need for intubation、delivery mode, neonatal respiratory distress syndrome, apnea, neonatal hypothyroidism and patent ductus arteriosus showed significant difference between the two groups. Logistic regression analysis revealed that gestational age, birth weight, basal hemoglobin, long duration of hospital stay and blood loss from laboratory testing were risk factors for blood transfusion in VLBWI (P<0.05). Conclusions The rate of blood transfusion in VLBWI was relatively high. Complex complications, critical condition, blood loss from laboratory testing and basal hemoglobin were main risk factors for blood transfusion.

Objectives To investigate the etiology, renal pathology, treatment, and prognosis of children's urinary system injury after hematopoietic stem cell transplantation (HSCT). Methods Clinical data of 81 children with urinary dysfunction after HSCT admitted to the Hematology Department in Children's Hospital of Soochow University were analyzed, and relevant literatures were reviewed. Results In 81 cases (50 males and 31 females), the age ranges from 8 months to 17 years old. Thirty cases (37%) with prerenal injury were recovered after active rehydration and other symptom specific treatment. There were 9 (11.1%) children with renal injury, four cases were given up therapy or transferred to other hospitals, thus lead to an unknown prognosis. Kidney biopsy was performed in the remaining five cases for pathological investigation. After active symptom-speific and etiology-based treatment, serum creatinine and glomerular filtration rate of four cases return to normal. But in the long-term follow-up,one case died of recurrence of primary disease, reinfusion of hematopoietic stem cell combined with renal failure. The remaining 3 patients were with chronic kidney disease (CKD). One case with renal thrombotic microangiopathy was in the chronic dialysis. Postrenal renal injuries were mainly hemorrhagic cystitis (28.4%) and urinary tract infection (16%). After a large dose of rehydration, urine alkalization and anti-infection therapy, they were recovered in the short term with a good prognosis. Conclusions Urinary injury after HSCT is mainly divided into three categories: prerenal, renal and postrenal, in which renal injury is prone to frequent recurrence.

Objective To explore the effect of parvovirus B19 (VB19) infection on pediatric leukemia patients. Methods The pediatric leukemia patients were enrolled in the study in the Children's Hospital of Soochow University. Expression levels of VB19-DNA-PCR were detected using the polymerase chain reaction. Positive patients would be monitored and treated by conventional treatment as well until VB19 gene became negative. The data was compared according to the VB19 clearance time, clinical symptoms and blood counts to evaluate the effect. Results In the 3009 samples from 824 pediatric leukemia patients, there were 36 samples (1.2%) from 12 cases (1.5%) of pediatric leukemia paients with positive VB19 infection. Among the positive patients, 11 cases (1.9%) were from 582 with acute lymphoblastic leukemia (ALL) patients and 1 (0.45%) was from 212 with acute myeloid leukemia (AML). According to the treatment stage, 3 cases were in initially diagnosed period, 2 cases in early stage of consolidation chemotherapy, 4 cases in delayed enhanced chemotherapy period, and 3 cases in maintenance chemotherapy period. According to the treatment response, 4 cases were in continuous treatment, 2 cases were sensitive to treatment, and 3 cases were drug resistant. In the drug resistance group, 2 cases developed into the pure red cell aplastic anemia (PRCA). After treatment, one was recovered from PRCA with VB19 cleared, the other one remained PRCA with continuously positive VB19. Conclusions More VB19 virus infection in pediatric ALL happened in delayed enhanced chemotherapy period. The persistent presence of VB19 infection on pediatric leukemia patients is closely related with PRCA.