Vitamin D deficiency is a global public health problem.Vitamin D is well known for its classic role in the maintenance of bone mineral density.In addition,vitamin D is also closely related to many infectious diseases.This article describes the physiology of vitamin D and methodology for 25-hydroxyvitamin D or 25(OH) D.The factors that influence vitamin D levels in children and the relationship between vitamin D deficiency in children and infectious diseases are introduced.

10.3969/j.issn.1000-3606.2013.06.009

Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.

BACKGROUND: High-altitude training before competition aims to obtain maximum hypoxia physiological adaptability of athletes through hypoxia environmental irritation at high altitude. Physiological adaptability to high al titude is the substantial foundation for function improvement of athletes,reflecting adjustment of body to environmental changes.OBJECTIVE: In views of self-regulation, practical training and compressed spectral array (CSA) electroencephalogram (EEG), and by observing adaptive change rule of brain before (before competition) and after high-altitude training of swimming athletes, the influence of high-altitude training was analyzed systematically on self-organizing state of athletes before competition so as to probe into the impacts of high-altitude training from brain level.DESIGN: Randomized investigation.SETTING: Guangdong Scientific Institute of Physical Exercise and Physical Exercise College of South China Normal University.PARTICIPANTS: Nine swimming athletes were selected from Guangdong Swimming Team from March to April 2001.METHODS: Time-order observation was applied in the experiment, in which, the results 1 week (3rd March) before high-altitude training, during (22nd March) and on the 5th day (5th April) after the training, the results in competition on the 13th day (12th April) after high-altitude training and corresponding blood lactic acid were tested and SCA EEG was done successively one day before high-altitude training (10th March), on the 1st day after the training (30th March) and on the 11th day after training, that was two days before National Competition (10th April) to observe self- adaptive regulation of brain to sports training load.MAIN OUTCOME MEASURES: ① Training index and lactic acid change before and during high-altitude training and before competition. ②Comparison of results before high-altitude training and in competition. ③Changes in indexes of cerebral evaluation before, during and after high-altitude training and before competition.RESULTS: ① Training results were changeable in high-altitude training.In national competition after high-altitude training, the scores of 6 cases of 10 person-times were reduced. Changes in blood lactic acid after high-altitude training were in conformity with training results. ② After high-altitude training, the average frequency of brain information distribution in athletes was shifted towards high frequency. Before the competition, negative entropy was lessened and information entropy was dispersed and the score in competition was declined.CONCLUSION: ① Cerebral order parameters of athletes constitute multicentralization, form the dispersion of technique control information and result in re-adjustment of brain function at matrix coordinating level, suggesting declining capacity to athletics. ② Effects of high-altitude training and maintaining of its functions are based on coincidence and continuity of arrangement of rise-fall training intensity of individual state and on the recovery and maintaining of the intensity at flatlands.

Objective To observe the clinical efficacy of applying Sweat Reduction Formula (SRF) externally in the treatment of cancer-linked hyperhidrosis. Methods 45 tumor patients, who exhibited excessive perspiration, were selected and recruited randomly into an experimental group (Sweat Reduction Formula group) with 24 patients in it and a control group (Placebo group) with 21 patients in it. The experimental group was treated with SRF and the control group was administrated with placebo. Neuropad diagnostic patches were used to observe the period of time that required for any visual changes in color before and after medication. These observations were then matched with the commonly seen signs and symptoms scoring table, to evaluate the changes of symptoms and KPS. Results The color changing time of the experimental group was 14.45±3.91 min. and 19.51±5.30 min. before and after medications respectively. And the changing time in the control group was 13.49±4.96 min. After medication. The results were highly significant with P<0.05. There were also different levels of significant improvements in terms of spontaneous perspiration, night sweating, dry mouth, feverish sensation over hand-foot centers and body, aversion to cold etc after the treatment in the experimental group. Conclusion It would be more objective to evaluate the clinical efficacy of applying SRF on navel to treat cancer-linked hyperhidrosis with neuropad diagnostic patches.

Objective To study the changes and clinical value of platelet(PLT)parameters and coagulation indicators in children with severe pneumonia.Methods 97 children were divided into severe pneumonia groupⅠand severe pneumonia groupⅡ according to whether children were associated with other diseases besides severe pneumonia,and 30 healthy chil-dren were in control group.The levels of PLT count,mean platelet volume(MPV),prothrombin time(PT),activated par-tial thromboplastin time(APTT),fibrinogen(FIB),antithrombin-Ⅲ(AT-Ⅲ),and D-dimer(DD)among three groups were compared.Results The differences of PLT,MPV,DD and AT-Ⅲ activities were all significant among three groups (all P < 0.05).PLT,MPV and DD levels in group Ⅰ were all significantly higher than those of control group ([454.00±157.00]×109/L vs [300.00±63.00]×109/L ;[9.66±1.24]fL vs [8.90±0.37]fL;[0.47±0.37] mg/L vs [0.27±0.06]mg/L,respectively);AT-Ⅲ activity in groupⅠ was lower than control group([79.91 ± 20.34]% vs[107.03±8.11]%)(both P <0.05).AT-Ⅲ activity and PLT level in group Ⅱwas (66.11±11.12)%and (279.00±185.00)×109/L respectively,which were both significantly lower than group Ⅰ,MPV and DD level was (10.37± 1.51)fL and (0.70±0.46)mg/L respectively,which were both higher than groupⅠ (both P <0.05).Conclusion There is obvious coagulation dysfunction in children with severe pneumonia.The changes in PLT,MPV,AT-Ⅲ and DD levels are associated with the severity of pneumonia.

Objective To study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P <0.01).The differ-ences of the three indexes had no statistical significance between the normal control group and the ordinary infection group(P >0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.

Objectives To study the signiifcance of ifbrin related markers such as ifbrin monome (FM), D-dimer (D-D), fibrinogen and fibrin degradation products (FDP) in diagnosis of pre-disseminated intravascular coagulation (pre-DIC) state in children with severe pneumonia. Methods A total of 213 children with severe pneumonia in pediatric intensive care unit were divided into pre-DIC group and case control group according to the occurrence of pre-DIC. And 40 healthy children were included as normal control group. FM、D-D、FDP、prothrombin time (PT)、activated partial thromboplastin time (APTT)、ifbrinogen (FIB)、platelet count (PLT)、thrombomodulin (TM) levels were analyzed. Receiver operating characteristic curve was used to evaluate the above indexes. Results All the markers but FIB showed signiifcant difference among the three groups (P<0 . 05 ). The differences of FM、D-D、FDP、APTT in paired comparison among the three groups were also signiifcant (P<0.01), Pre-DIC group had the highest level and case control group was the second. Pre-DIC group had higher PT than that of the other two groups (P<0 . 05 ), but PT levels in normal control group and the control group are of no signiifcant difference (P>0 . 05 ). Compared with those in normal control group, TM and PLT levels were signiifcantly higher in the other two groups (P<0 . 01 ), but the differences of TM and PLT in pre-DIC group were not signiifcant in comparison to those in case control group (P>0 . 05 ). FM、D-D、FDP had larger area under curves (AUC) for pre-DIC than other indexes ( 0 . 84、0 . 76、0 . 64 , respectively). The AUC for the joint detection of the three indexes was 0 . 85 . Conclusions Fibrin related markers such as FM、D-D and FDP are valuable indexes in diagnosis of pre-DIC state in children with severe pneumonia, the joint detection of the three indexes would help to improve diagnostic accuracy.

Abstact:Objective To investigate the clinical value of mean platelet mass(MPM)and the procalcitonin(PCT)in diagnosis of Kawasaki disease (KD).Methods A Total of 117 children with KD in the acute stage and 126 children of the control group were detected respectively and compared each other.The indexes contain MPM,PLT,MPV,PDW and PCT.Mean-while,the comparison of each index’s positive rate and the linear correlation analysis of each index were conducted.Results①The level of MPM of the KD group was significant lower than that of the control group,PLT,MPV and PCT significant higher than those (P<0.05,α=0.05).The difference of PDW between the two groups was no statistical significance (P>0.05,α=0.05).②The positive rate of the MPM was significant higher than that of the other indexes (P<0.05,α=0.05). Conclusion The detection of MPM is helpful to the diagnosis of KD and can be used as an indicator of KD clinically.

Objective To investigate the level of 25-hydroxyvitamin D[25(OH)D]and relationship to C-reactive protein(CRP) and procalcitonin(PCT)in children with severe pneumonia.Methods Serum 25 (OH)D levels of 86 cases of children with severe pneumonia,81 cases of children with mild pneumonia and 85 cases of children in healthy control group on admission were deter-mined by ELISA respectively and compared.At the same time,CRP and PCT were tested and the correlation to 25(OH)D in chil-dren with severe pneumonia was analyzed.Results There are statistical differences among three groups(P <0.05,α=0.05 ).The mean values of serum 25 (OH)D were (62.03 ±17.94),(68.90 ±15.22)and (82.21 ±17.89)μmol/L in severe pneumonia pa-tients,mild pneumonia patients and healthy children respectively,furthermore,prevalence of vitamin D deficiency of the sever pneu-monia group was significantly higher than that of the case-control group and normal group (P < 0.05,α= 0.05 ).The level of 25(OH)D was not significantly related to CRP and PCT level in children with severe pneumonia(P <0.05,α=0.05).Conclusion The mean level of vitamin D in children with severe pneumonia was significantly lower,which may be associated with the occurrence and develop-ment of severe pneumonia in children.